ML Dhawale on Susceptibility

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ML Dhawale on Susceptibility

• Susceptibility Definitions
• It is an inherent capacity in all living things
  to react to stimuli in the environment and
  represent a fundamental quality that
  distinguishes the living from the non living.

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ML Dhawale on Susceptibility

• Role of Susceptibility
• Maintains health
• Evolution of constitution
• Development of diathesis
• Development of disease
• Manifestation of disease
• Process of recovery and cure
• Evolution of drug picture
• Manifestation of remedy (remedy relationship)
• Determination of dose and repetition

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ML Dhawale on Susceptibility

• Susceptibility is known to us through the
  reactions that occur between the host and the
  environmental factors. Signs and symptoms
  represent the only perceptible form of evidence
  which signifies to us to reaction that takes
  place within the organism. Susceptibility is
  indirect inference.

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ML Dhawale on Susceptibility

• Susceptibility in Health
• Normal susceptibility evokes a predetermined
  response. In normal susceptibility homoeostasis
  is maintained and hence response is predictable.
  Cell, the unit of life exhibits this
  predetermined response.
• Process of anabolism and catabolism are well
  regulated by homoeostatic controlling system
  which is the neuro-endocrine system.
• Thus susceptibility is reflected through all our
  normal physiological and healing mechanism.

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ML Dhawale on Susceptibility

• Susceptibility and Disease
• Disease is failure of adaptation of the organism
  to the environmental condition. As long as the
  organism is able to maintain its capacity to
  adapt to different environmental condition he
  remains in the state of health even when he is
  facing adverse conditions during which he
  maintains good nutrition, good health, and
  healthy outlook of life (sense of well being).
  Once the adaptation mechanism fails especially
  when the stress mounted is not taken care of it
  reaches the breaking point. This leads to
  disequilibrium and it is made known to the person
  through the feeling of lack of well being. Even
  at this point if warning sign is not hindered and
  the stress continues to be present it leads to
  the further failure of adaptation signs and
  symptoms.

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ML Dhawale on Susceptibility

• Disease travels from spiritual plane to
  functional plane to structural reversible and
  irreversible zone.
• At each phase susceptibility express itself
  through individualizing characteristics, which
  are seen at local tissue level in pace, nature of
  pathology, individual sensitivities of nerves and
  mind during disease phase.
• An intelligent physician takes note of these
  individualizing characteristics to prescribe
  similimum.

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ML Dhawale on Susceptibility

• Disease an expression of susceptibility and
  sensitivity
• The R.E.S. participates in a big way in securing
  the disease response. We have also examined the
  participation of the mind and the nerves in the
  direction given to it and how these regulate the
  fine expressions, especially those reflecting the
  individual in his illness.
• Between the two susceptibility is responsible
  for the major, gross responses the fine ones are
  an expression of the sensitivity. The
  characteristics are often determined by the
  sensitivity the onward march of disease in terms
  of its direction and effects often is a
  reflection of the susceptibility, a low
  susceptibility promoting silent marches while a
  morbid one giving rise to dubious expressions and
  jumps.

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ML Dhawale on Susceptibility

• Disease an expression of susceptibility
  inadequate
• Inadequate response, (excessive, less than what
  is required, early, late or of a type altogether
  different qualitatively and which are way out
  morbid) clearly would not be able to deliver the
  goods. The organism, therefore, would not be
  able to maintain itself in a state of health.

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ML Dhawale on Susceptibility

• Disease And altered State of Equilibrium a
  defensive posture.
• Disease represents a new equilibrium adopted by
  the system in order to assist it to get out of
  trouble. It, therefore, represents not only
  trouble but also the tactics adopted by the body
  to escape or get out of trouble, although
  experience does not get out of trouble, the
  experience does indicate that these have proved
  erroneous in practice.

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ML Dhawale on Susceptibility

• Dr Sarabhai Kapadia on Abnormal susceptibility
  (Kapadia Sarabai 2003)
• Susceptibility or inferior resistance can
  develop in the following ways.
• An organ or system or the organism as a whole,
  can be overused, abused or disused
• Physical trauma
• Mechanical injury can leave its mark.
• Unaccustomed exposure to excessive heat or cold
  or exposure to sudden variations of temperature,
  barometric
• Undernourished condition resulting from
  deficiency of diet increases.
• Over indulgence in rich food etc. over long
  periods resulting in imbalance and exhaustion of
  excretory mechanisms and functions of metabolism.
  
• Habitual use of drugs such as tea, coffee,
  alcohol, and condiments, which have got temporary
  stimulating and soothing effects affects of
  susceptibility.
• Physiological elements such as Calcium, Iron etc.
  taken in excess and in unnatural form for quick
  gain of energy, if taken in a concentration much
  higher than that found.
• Use of drugs for therapeutic purpose in crude
  form for the purpose of treating infections.
  Contamination by such metals from storing and
  cooking utensils and also from substances used
  for preservations of grains and food is
  important.
• Animal poisoning, including vaccination, serum
• Air pollution.
• Mental stress and persistence of negative
  emotions.
• Sexual dissatisfaction over long periods.
• Partially recovered acute infections especially
  those caused by viruses.

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ML Dhawale on Susceptibility

• CLINICAL OPERATIONAL CONCEPTS (Kapse, 2003)
• Susceptibility Reactivity and Immunity
• These three terms need to be differentiated and
  related to each other in order to derive the
  maximum meaning and implication for our work at
  the bedside.
• Susceptibility is an inherent capacity in all
  living things to react to stimuli in the
  environment at the level of Tissues / Cells. It
  represents a fundamental quality that
  distinguishes the living from the non living.
  Signs and symptoms are the only perceptible form
  of evident that signifies to us the reaction that
  takes place with in the organism. Thus we judge
  susceptibility on
• Availability of characteristic symptoms and signs
  and
• Type of changes occurring at the level of Tissue
  / Cell.
• Susceptibility of the cell is the fundamental
  expression of the genes and its responsible for
  all expressions of the system.

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ML Dhawale on Susceptibility

• Reactivity is an important facet of
  susceptibility. Essentially, reactivity will be
  judged by the effects the evolution as well as
  the content of the forms that are perceptible to
  the clinician. If a form containing a cluster of
  characteristics emerges quite rapidly in a given
  case, it implies that the patient has a high
  state of reactivity while the disease may have
  assumed structural dimensions. In such a
  situation, overall susceptibility would be
  moderate. This analytical treatment of
  susceptibility makes our planning of treatment
  precise and sharp.

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ML Dhawale on Susceptibility

• Susceptibility operates at the general cellular
  level that gets very well reflected in the
  quality of host response at the cellular level
  when the system is under stress. This is
  mediated through the Reticular Endothelial System
  (R.E.S), the protective mechanism available to
  the body the Immunity.

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ML Dhawale on Susceptibility

• Reactivity and immunity will permit us to
  understand the qualitative state of the
  susceptibility

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ML Dhawale on Susceptibility

• Operations
• Take each entity and define the state through
  representation of related data in the 1st column.
  Define corresponding potency and repetition in
  2nd and 3rd column respectively.
• Susceptibility
• A total study on the pattern of the S-F-F-T of
  the chief complaints / associated complaints, in
  conjunction with the examination findings and lab
  investigation and comparing it with the known
  presentation of the clinical state under study
  from standard text books showed allow us to
  define the state of susceptibility.
• A comprehensive definition of Susceptibility has
  already been given above.
• HIGH susceptibility is defined as capacity of the
  individual to throw up a good number of
  characteristics and to limit the extent of
  changes at the level of tissues to a functional
  zone. Such individual require high potency with
  infrequent repetition.
• Moderate susceptibility throws up moderate
  number of characteristics and the changes at the
  tissue level may not be limited to the functional
  zone yet it does show the capacity to prevent
  irreversible structural changes. Such
  individuals require medium potency in infrequent
  repetition.
• Low susceptibility exhibits a poor capacity to
  throw up characteristics and is generally unable
  to prevent structural changes at the tissue
  level. Such individuals require low potency in
  frequent repetition.

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ML Dhawale on Susceptibility

• Sensitivity
• It is an inherent capacity in all living things
  to react to stimuli in the environment at the
  level of Mind and Nerves. It is assessed by the
  intensity and presence of characteristics at both
  these levels. This can also be studied from the
  patients tendency to react (mentally and
  physically) to the distress produced by the
  illness and the data can be obtained through the
  study of intensity of symptoms and the
  understanding of the mental state and symptoms
  and the physical examination findings.

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ML Dhawale on Susceptibility

• Suppression
• A case may present with paucity of symptoms, or
  absence of expected indication or involvement of
  deeper organs after disappearance of external
  manifestations,. This occurs as a result of
  procedures which do not aim at curing the disease
  from within. As a result, the susceptibility
  gets undermined and the dynamic disturbance is
  pushed inwards involving more vital organs. This
  state generally leaves behind a poor state of
  susceptibility and requires low or medium potency
  in frequent repetitions.

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ML Dhawale on Susceptibility

• Correspondence (Degree And Level) Constitutional
  Remedy
• Here the levels of similarity of the selected
  constitutional remedy that is mind (symptoms /
  state / attribute) and body (symptoms / state /
  attribute) and the extent and depth of disease
  process needs to be stated.
• If the remedy of the case has complete / total
  similarity at both mind and body it should be
  used to high potency with infrequent repetition.
  Partial or superficial similarity of the remedy
  at both mind and body will lead to use to low r
  medium potency in infrequent repetition.
• Correspondence (Degree And Level) Sector Remedy
• This aspect is seen while handling an acute
  episode or a one-sided chronic disease. If the
  sector totality is covered completely by the
  remedy, then we use high potency in infrequent
  repetition. Partial or superficial similarity
  will require low or medium potency.
• Correspondence (Degree And Level) Intercurrent
  Remedy
• Intercurrent totality takes into account
  specific characteristic general features as well
  as miasmatic features from the case. Similarity
  at both miasmatic and characteristic general
  features will call for high potency. Similarity
  only at the level of miasmatic features may
  demand medium potency.

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ML Dhawale on Susceptibility

• Functional Changes
• The quality and quantity of functional V/s
  structural components in the changes in the
  disease process must be studied. Diseases with
  predominant functional changes would favor high
  or medium potency in infrequent repetition.
• Structural Changes
• Disease with predominantly reversible structural
  changes will require medium or low potency with
  frequent repetition. Diseases with irreversible
  structural changes would favor low potency in
  frequent repetition. Here a remedy, which is
  being used as a palliative remedy, should be
  given in infrequent repetition.

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ML Dhawale on Susceptibility

• General Vitality
• This is determined by the state of vital signs
  and the functioning of vital organs. If the
  vitality is good, use high potency in infrequent
  doses. If it is poor low potency in frequent
  repetition should be used. In acute illnesses
  with low vitality or reaction poor we may require
  high potency in frequent repetition.

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ML Dhawale on Susceptibility

• Presentations
• Fundamental Miasm This is determined by the
  family history and past illnesses of the patient.
  It gives an idea of the soil of the patient and
  indicates the direction in which illness of the
  patient would proceed. .
• Dominant Miasm This is determined by the
  miasmatic expressions dominant in the presenting
  complaints. It defines the role of the
  intercurrent remedy in the planning of treatment.

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Sarabhai Kapadia

• Dr Sarabhai Kapadia on Abnormal susceptibility
  (Kapadia Sarabai 2003)
• Susceptibility or inferior resistance can
  develop in the following ways.
• An organ or system or the organism as a whole,
  can be overused, abused or disused
• Physical trauma
• Mechanical injury can leave its mark.
• Unaccustomed exposure to excessive heat or cold
  or exposure to sudden variations of temperature,
  barometric
• Undernourished condition resulting from
  deficiency of diet increases.
• Over indulgence in rich food etc. over long
  periods resulting in imbalance and exhaustion of
  excretory mechanisms and functions of metabolism.
  
• Habitual use of drugs such as tea, coffee,
  alcohol, and condiments, which have got temporary
  stimulating and soothing effects affects of
  susceptibility.
• Physiological elements such as Calcium, Iron etc.
  taken in excess and in unnatural form for quick
  gain of energy, if taken in a concentration much
  higher than that found.
• Use of drugs for therapeutic purpose in crude
  form for the purpose of treating infections.
  Contamination by such metals from storing and
  cooking utensils and also from substances used
  for preservations of grains and food is
  important.
• Animal poisoning, including vaccination, serum
• Air pollution.
• Mental stress and persistence of negative
  emotions.
• Sexual dissatisfaction over long periods.
• Partially recovered acute infections especially
  those caused by viruses.