Korean J Med.  2024 Apr;99(2):84-95. 10.3904/kjm.2024.99.2.84.

Human Understanding is Expected of the Physician: Proposing a Model of Disease Development

• Park SH
• Park S
• Kim JY
• Lee HA
• Lee SM
• Lee TH
• Bae SB
• Chang SH
• Jang SH
• Chun SW
• Moon JH

• KMID: 2554308
• DOI: http://doi.org/10.3904/kjm.2024.99.2.84

Abstract

In Harrison’s Principles of Internal Medicine, human understanding is emphasized as one of three necessary characteristics that a physician must have. Inflammation, which is caused by inflammatory inducers (inf-ids), is a fundamental feature of disease at the cellular and molecular levels. Inflammation protects the body, but excessive or prolonged inflammation can be damaging and can cause disease. Humans are repeatedly exposed to external and internal environmental factors that generate inf-ids throughout their lives. External environmental factors include microbial and non-microbial inf-ids, as well as stressors that inevitably arise during social interactions. Internal environmental factors include the adaptive physiological response that is present from birth. Inf-ids may also be produced by the four-step habit loop, which consists of a cue (e.g., stressor), emotions, routine act (adaptive response), and a reward. Immune cells in the circulatory system and in tissues may have positive and negative effects in inflammatory responses. However, low-grade inflammation may be difficult to detect. We propose a model of disease development that integrates external and internal environmental factors from the perspective of human understanding.

Keyword

Human understanding; Disease development; Inflammation; Four-step habit loop; Adaptive response; 인간이해; 질병발생; 염증; 4단계 습관고리; 적응반응