By health we commonly mean a condition of efficiency of one’s body organism that is experienced individually, depending on age, as a state of relative physical and mental well-being characterized by the absence of serious disabling pathologies. This psychophysical health situation, due to medical advances, is today indicated as the achievement of the best quality and duration of life obtainable by preserving and restoring the state of well-being, including spiritual.
The concept of health in history
In Greek antiquity health was conceived as a gift from the gods and disease was considered a magical-religious phenomenon. With Hippocrates (460 BC about 377 BC) he completely changed the perspective according to the principle Νόσων φύσεις ἰητροί, later called by Galen vis medicatrix naturae, or “natural healing force”, which conceived the human body animated by a vital force tending by nature to rebalance the disharmonies caused by pathologies. According to this conception, a person’s illness and health depended on circumstances inherent in the person himself, not on external agents or on transcendent divine interventions; the way to recovery would therefore have consisted in merely stimulating this innate force, not in substituting it: “nature is the doctor of diseases … the doctor must only follow its teachings”. In ancient Rome, according to what Pliny attests, the first Greek “doctor”, coming from the Peloponnese, arrived in Rome in 219 BC: it was a certain Archagatos who was so well received that he was provided with an outpatient clinic at the expense of the state. However, he was very casual in “burning and cutting” the flesh of those who turned to him for healing, so much so that he was soon given the nickname “carnifex” (executioner, butcher).
Pliny’s opinion was shared by the traditionalist Marco Porcio Cato who even suspected that there was a sort of conspiracy by the Greeks who, to avenge the Roman conquest, had sent these butchers to Rome “to kill all the barbarians with their medicine”; on the contrary, in order not to be suspected, Cato added, and to confirm their value as healers, these enemies of the naive Roman people got paid lavishly.
Despite the mistrust of the traditionalists, Greek or foreign doctors established themselves in Rome, so much so that both Caesar and Augustus granted them the right of citizenship and forbade them to be sent back to their places of origin.
The decay of the Roman Empire contributed to the regression of medical practices as in general of all scientific technical activities; it was the religious who handed down the knowledge of the ancient culture thus allowing the awakening of medicine, together with the Arab and Salerno schools (1100). The first medical universities were born and in 1300 the Bolognese school opened the first anatomy school.
Medieval medicine was a set of ancient ideas and spiritual influences: Claude Lévi-Strauss identified this mixture as a “shamanic complex”.
In the Renaissance, medical science gradually came to adopt a methodology no longer linked to the dogmatic observance of the writings of the ancient masters, Hippocrates and Galen in primis, but inspired more and more strongly by the new principles of the scientific method. The relations between medicine and the natural sciences therefore became closer.
In the modern age, medicine takes further steps on the path of a strictly scientific approach, definitively abandoning the empirical-philosophical matrix, also taking advantage of the progress of other disciplines such as physiology, biology and chemistry. We thus move from a phase called by some “heroic medicine” to modern medicine based on evidence of efficacy, thus contributing, together with improvements in nutrition and hygiene, to the decrease in the mortality rate, consequently increasing the expectation. of life.
With the birth of scientific medicine (at the end of the eighteenth century) the bio-medical model was born, coinciding with the birth of the industrial society.
In the twentieth century the first medical specializations develop. According to some authors, this would have led to a gradual abandonment of the holistic approach to the sick person in favor of an exclusively biological study aimed at a specific organ or system.
Health according to the “World Health Organization”
In the twentieth century, health, defined by the World Health Organization (WHO) as a “state of complete physical, mental and social well-being and not simply the absence of disease”, is considered a right and as such is the basis of all other rights fundamentals that belong to people. This principle assigns to the States and to their articulations tasks that go far beyond the simple management of a health system. They should take charge of identifying and seeking, through appropriate alliances, to modify those factors that negatively affect collective health, while promoting favorable ones.
At a meeting of the WHO in 1998 it was proposed to change the original definition of the concept of health in the following terms:
“Health is a dynamic state of complete physical, mental, social and spiritual well-being, not mere absence of disease.”
The discussion, which took place in the WHA52 commissions, which took place from 17 to 25 May 1999, did not reach the General Assembly. Consequently, the original text was maintained despite the favorable vote of most of the WHO representatives. This happened for several reasons, including linguistic, cultural and religious aspects that are not universally shared . In this context, health would have been considered more a means than an end and would have represented a resource of daily life that would allow people to lead productive lives on an individual, social and economic level.
The translation of statements of principle into operational strategies has always been a complex and difficult process, especially when the implications for action require a change in our way of thinking and acting. In this sense, in order to give a significant boost to the pursuit of health by governments, at various levels, the WHO has tried to implement, starting from the 1980s, two strategies that go under the name, respectively, of “promotion of health” and “health strategy for all”. This above all in the awareness that health is the result of a series of social, environmental, economic and genetic determinants and not the simple product of a health organization.
In recent years, attention has been focused more on achieving two strategic objectives: health promotion and disease prevention, in order to reduce national health expenditure, thanks to a decrease in hospital access, and to a lower recourse to healthcare services. treatment and consumption of drugs.