oa South African Medical Journal - The problem of raised blood pressure



Every disease appears as a syndrome of many phenomena; of these, some are aggressive or causative, others defensive, other neutral. Lastly there is a group of phenomena which were originally defensive but which have become exaggerated until they are themselves an offence; this offensive-defensive group may again be subdivided into syndromes where the original defensive character of the phenomenon still transcends its offensive character, and syndromes where the offence of the phenomenon outweighs its defensive value. Various different hypertensive syndromes with known causes are examined and it is shown that the phenomenon of hypertension may play any of these roles. Sometimes it is the cause of the whole disease, sometimes it is defensive against some more malign feature, sometimes it started as defence and gradually became offence, and sometimes it is merely a neutral phenomenon. Before a practitioner decides to attempt the eradication of a disease phenomenon, he should try to decide into which of these groups the feature should be placed. Clearly only offensive features should be eradicated, and then only if their offence outweighs their defensive value. On the whole, medical science has failed to make such a grouping and much unnecessary therapy has resulted.


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