VIRUSMYTH HOMEPAGE

THE STATE OF ORAL BIOLOGICAL MEDICINE
AFTER THE TIME OF AIDS-PREDICTION AS
THE PANDEMIC CATASTROPHE ON THIS GLOBE

By Heinz Spranger

July 2001

Introduction

HEALTH – neutral varieties between the poles – DISEASE

is a classic organisational schema in both - the theoretical and the practical orientated discussion of life sciences.

In general

the medical information about any findings of normal or abnormal varieties in human behaviour or stage consists according to the elder known diseases of terms without categorical supplements. In the elder nosology names are used like ‘arteriosclerosis’, ‘measles’ and so far; by the use of these names without any prejudicial touch nothing will be said about causality, pathogenesis or symptomatic definition. But this part of nosology already is state of the art for long time and overcame several episodes in the history of medicine.

Other signs of diseases are called by the name of the describer. They are neutral and they open the definition for a lot of more details of the descriptions.

But formally they do not open the possibility for new descriptions too.

A lot of historically new conditions ("new diseases") are bound very tight to their cause or to their genesis or only to their symptoms. This is important when a large number of symptoms has to be described for to allow to point out the similarity of several individual cases. Within those conditions nosologists prefer the arrangement to the values of the symptoms:

If the conditions to be described mainly are causal (e.g. infectious, toxic…) or homologous we use to name the sum of symptoms "First order syndromes".

If the conditions to be described mainly are similar strictly to their sequence of pathogenesis (e.g. malnutrition, malabsorption, fever, pain, diarrhoea – leading to disease or to death with heterologous causality) we use to name the sum of symptoms "Second order syndromes".

If the conditions to be described are neither explained by causality nor explained by cascades of sequences and are so complex that a detailed description nearly is impossible (e.g. systemic lymphadenopathiae, septic bacteriaemia and toxinaemia, sudden multimorbidity) we use to name the sum of symptoms "Third order syndromes".

See: Leiber, B. (Editor): Die klinischen Syndrome. 8th Ed. ISBN 3-541-01708-2.

This is international standard in nosology and semiotics.

Specifying for Oral Biological Medicine

the medical information consists with categorical supplements. The reason is that in contrast to the classical Oral Medicine the "biological view" has more complexity.

This art of holistic view is based on three fundaments:

The oldest fundament is found in the traditional natural medicine and is completed by several parts of modern life sciences.

See: Heine, H.: Biologische Medizin. 2nd Ed. ISBN 3-7773-1230-4.

Another fundament is the Internal and Prenatal Medicine (life in the womb – source of health and disease ?) because of the possible role of interdependence of all morphologic and functional varieties in the living being. Oral Medicine did a lot of research work on this, mainly in the last ten years.

See: www.dr-spranger.net/referenzen.htm

The third fundament is the combination of anamnestic and risk factors that influence the catamnesis including a special statement to the function of outer and inner surfaces of the living beings.

See: www.dr-spranger.net/standpunkt1.htm

Of clinical importance is the role of the four barriers in the oral mucosal membrane:

The film of bacterial flora on the surface of epithelial superficial layer works like a border against other and strange microbial influence e.g. nestle. Therefore this film with its specific adhesions to the superficial layers of the epithelium is called the microbial resistance, the "contamination barrier".

The density of the mucosal membrane, built by the adhesion within the cellular barrier interfere with the enzymatic lead diffusion of toxines. Therefore the thick epithelial barrier is called the "toxin barrier".

Under the epithelium of the oral mucosa just in the middle of the taped connective tissues is the region of large and small phagocytes. This part therefore is named the "cellular barrier".

Down, in the reticular connective tissues, the region of blood vessels, free acting lymphocytes are to be found. This part therefore is called the "humoral barrier" because of the action of B-lymphocytes, plasma cells and their immune response.

The view of biological medicine points out a very fine structured informational system over all barriers, characterised by taxic influences, minimal between the barriers.

The logic of biological therapy as to those barriers must be to diminish all functional related influences and to care for intact surfaces.

The logic of biological therapy as to the interactions within the living being must be to diminish all separated pathologic circumstances, bewaring a strong resistance against the colonisation of strange microbes, the influence of toxic agents through the epithelial barrier and against the reduction of cellular and humoral activities.

Specifying in the discussion of the AID Syndrome

the medical information is severe modified between three identifications:

The first modality of identification is by estimation of symptomatic values. Nosologists name this modality ‘expectant diagnostic trial’. As to the BANGUI-definition well known symptoms out of the sequences of many possible types of pathogenesis are called to be suspected to lead to the state of "Immune Deficiency" of persons. Nosologists use those identifications for denial because they fear too much varieties leading from multiple diseases to only one identified disease without being strictly typical for a cascade-like sequence. Oral Medicine denies the definition as to be a disease because e.g. ‘oral ulcerative aberration’ is no description of any health state at all, only one symptom of some different herpetiforme stomatopathiae .

The second modality of identification is by randomised controls. One of this is a cell-count control. A nosologist denies this control to be specific because it does declare only a stage of mass of cells, not any cause ore any cascades of sequences of their appearance.

The third modality of identification is that by tests. Useful are test with high sensibility together with tests with high specification. Only corresponding results lead to the definition of a syndrome or a disease. A nosologist denies this to lead to an identification of disease if the source of sensibility and the source of specification are coming from separate question-answer-programs. On the other side a nosologist would accept the identification of a syndrome if in all cases one of the three orders of syndromes could be characterised.

But in all cases of so-called AIDS the nosologic characterisation follows the combination between the result of a searching and this from an operational test if there is an additional medical diagnosis from indicator diseases.

Indicator diseases are those that solely lead to the characterisation of immune deficiency. The list of those diseases is long; they are or they must not be equal to "opportunistic diseases" that occur during the period of pathogenesis of any disease that is similar to immune deficiency and its way to superinfections and complications!

Clinical debates on Oral biological medicine

found the origin of health and disease in three sources:

One of them is prejudicial genetic. It must be explained by biology that there is a disposition to suffer from infectious relations depending on a lack of immune deficiency (deficiency diseases are known, deficient amounts of substrates are responsible for diseases and syndromes).

The second is followed-up by sequences of disorders of events in human ecology (e.g. malnutrition, poor sanitation, results of poverty, results of multimorbidity).

The third is acquisition. This may be by toxic or inflammatory influence or by break-down of biological barriers and the disorder of cellular and humoral defence (lifestyle habits by the use of drugs – breakdown of surface-barriers and the breakdown of defence barriers too).

Clinical debates on nosology and semiotics in Oral Medicine

found the semantic of definitions as to ‘syndromes’:

Symptoms, leading to the state of oral and/or systemic disease, are marked by both: oral signs of a disease and their origin.

Summations of symptoms then lead to the characterisation of a ‘syndrome’ if they will be found in typical combinations with another. The more combinations are to be found, the more vapid is the result of the description.

In these cases with unknown or heterologous etiology it must be possible to characterise the sequence of disease stages or to characterise the complexity.

In all the cases of AIDS not one of the describers was able to classify syndromes with symptoms in the oral cavity or in the systemic health into the three upper named syndrome orders.

It is to be accepted and known from a lot of syndromes that during the first time of their clinical incidence that they could only be classified by typical combination of irregular symptoms or by the name of the describer. As to be seen, this opens the definition to add more details. In these cases practice and science are asked to combine the clinical appearance with the varieties of pathologic stages informing about human ecological influences too.

This is similar to the description of ‘tuberculosis’, first described as "consumption", later as "Robert Koch’s disease", later disentangled as causal, cascadic and complex varieties of stages, to to-days definition of over 36 types of diseases.

In the cases of AIDS amateurish helplessness lead to the theory of mono-causality, namely the HIV/AIDS-theory, in most of the countries without the acceptance of human ecological factors, only based on the numbers of HIV-positive called persons or on definitions without searching and operational tests.

The reason may be political, economical or the fact, that instead in the field of microbiology with microscope findings only some viruses are really represented as figures. No HIV ever has been represented. In other cases of virology biochemical reactions have to be preferred. They are expensive as the searching and operational tests are. And therefore they are not delighted as rough estimations for discussions.

Clinical debates on pathogenesis and therapy in Oral Medicine

lead to the fact that a lot of clinical and pathologic findings summarised by declaring "AIDS" for long time are well known. This is not at all typical for an epidemic. Specific and unspecific therapy is well known too:

Out of the number of the so-called ‘indicator-diseases’ (they are bound to the definition of AIDS together with the upper named tests) in relation to Oral Medicine are to be found:

• etiologic first order syndromes:
  Herpes simplex with
  chronic (>1 month) oral ulcerative aberrations,
  Candidiasis,
  Mycobacteriosis
  
• cascadic second order syndromes:
  wasting syndrome
• complex syndromes:
  erosive leukoplacia,
  Histoplasmosis,
  Lymphoplasmosis,
  Lymphadenopathia.

Only as to a multimorbide patient it seems to be clear that the reason of definite morbidity and mortality creeps from one pathology to another.

The number of ‘opportunistic diseases’ is larger than this of indicator diseases because the most them lead to pre-mortal diseases . They reach from oro-pharyngeal candidiasis to systemic conditions being very complicate and conduct as to their complexity to multimorbidity.

Oral medicine accepts as to be of therapeutic influence:

• Combination of oral and systemic diagnosis
• Influences of medical anamnesis and catamnesis
• Patients clarification about ecological factors of diseases
• Patients solution about lifestyle habits
• Therapeutic care of opportunistic diseases
• Therapeutic care of indicator diseases
• Measurable results of medical catamnesis
• Reference of searching and operational tests

Oral medicine never accepts mono-causality in the human biological system

Oral medicine never accepts toxic agents as state of the art of therapy

For bearing the consequences out of this point of view of nosology Oral Medicine wishes to renew the discussion about the characterisation of the AID’Syndrome’, to dispense with definitions as to lead to disease-identifications, to dispense with screening-tests without catamnestic operational tests of high sensibility and specification

and to renew the discussion about individual medical therapy, including human ecology.

Prof. Heinz Spranger is a Nosologist and Semiotist in Oral Medicine, and a Practitioner in Periodontology and Oral Medicine, living in Dersum, Germany. E-mail: info@dr-spranger.net, website: www.dr-spranger.net

VIRUSMYTH HOMEPAGE