Abstract:
Cure and cured are not defined medically or scientifically for most diseases. At present, medical tests for cured only exist for some communicable diseases.
This paper discusses the current definitions of cure and proposes a comprehensive definition of cure all illnesses, diseases and medical conditions that can be cured.
Introduction:
Cure is not well defined in current medical theory and practice. Many medical dictionaries do not even contain an entry for the word cure, including: Webster’s New World Medical Dictionary, Third Edition, 2008; The Oxford Concise Medical Dictionary, Ninth Edition, 2015; The Bantam Medical Dictionary, Sixth Edition, 2009; Barron’s Dictionary of Medical Terms, Sixth Edition, 2013; Medical Terminology for Dummies, Second Edition; The Oxford Dictionary of Nursing, Edition 6, 2014, and many more. This is not a new situation. If we look back at The Lexicon Medicum, Seventh Edition, also known as Hooper’s Medical Dictionary, 1838, the word cure is not defined. The London Medical Dictionary, published in 1819, uses the word cure several times, but does not provide a definition of cure. Definitions do exist in non-medical dictionaries, based on historical usage, and some medical dictionaries simply copy these definitions. The word incurable is also poorly defined, if defined at all. It is not possible to prove an illness is incurable – only to give up the search.
The Merck Manual of Diagnosis and Therapy, 11th Edition, Harrison’s Principles of Internal Medicine, and Lange’s Current Medical Diagnosis and Treatment do not contain a definition of cure, rarely use the word cure, and do not use the word cure consistently. The Diagnostic and Statistical Manual of Mental Disorders uses the word cure once, in the phrase “eventual cures for these conditions”, giving the impression that, at present, there are no cures to be found for any mental disorder.
The World Health Organization (WHO) does not define cure nor cured for any type of disease. The alphabetical list of health topics on the WHO website does not contain the word cure, and a search for the word cure on the site’s documents reveals that the word cure is only used with regards to communicable diseases. Other references to cure have little substance and many are “not cure” references. Non-communicable diseases and injuries might be considered incurable by omission, according to the World Health Organization’s website. Cured is not defined. Cure is often used as a publicity reference by WHO and many others. In the WHO article titled “Prevention is better than Cure” the word cure is not defined and does not even appear in the article and “Miracle cure for an old scourge” contains “cure” in the title, but not in the article.
Cured is defined as testable only for communicable diseases, those caused by a parasite or pathogen, where a cure is brought about by removing the parasite with an anti-parasite medicine or through surgical procedure. There are occasional exceptions, as might be expected due to the large number of contributing authors to major references. These exceptions are rarely, if ever, actual cures. Most medical references prefer words like treatment and therapy over cure, as evidenced by their titles, section, and chapter headings.
Most current usage of the word cure is in fundraising and “hope” for future cures, generally published without a definition of cured. News reports of cures are not about cures, instead we have stories of “hope for blindness cure”; cures for non-diseases like “American doctor shortage”, “Japan’s loneliness epidemic”, “urban violence” and “public debt”; and of course “ride for the cure”, “race for the cure”, and “run for the cure”, which are about money, not about cures.
What was the most important new cure discovered in the last 20 years? There are none. Millions, perhaps billions have been donated and invested, without a single disease cure with the exception of new antibiotics and antifungal medicines.
Without a clear, scientific definition of cured for all diseases, we cannot expect a science of medicine to search for cures. Claims of bringing us “closer to a cure” have no scientific foundation, when cured is not defined.
There is a secondary problem in defining cure scientifically. What is to be cured? Dictionary definitions of cure vary widely. Merriam-Webster’s Medical Desk Dictionary offers “1. Recovery from a disease” and “2. Remission of signs or symptoms of a disease, esp. during a prolonged period of observation.” Blakiston’s New Gould Medical Dictionary Illustrated, First Edition, 1949 offers “2. The successful treatment of an illness or a wound” and “3.Special treatment for a disease or an invalid“. Webster’s Dictionary for English Learners – online offers “1. The act of making someone healthy again after an illness.” The Concise Oxford Dictionary of Current English, Fourth Edition avoids disease, illness, and medical condition entirely with “2. Remedy an evil.” as does the Funk and Wagnels Canadian College Dictionary, 1989 with “2. That which restores health or removes an evil“.
I have studied dozens of dictionary definitions of cure, but I have not seen a single definition that suggests we might cure any illness by addressing the cause.
Is the disease cured? Disease is not well defined in medicine – and textbooks use the terms disease, medical condition, mental disorder, and others, without clear definitions and with little consistency. Is the patient to be cured? That makes little sense when many patients suffer from several diseases or medical conditions of varying complexity at the same time.
This paper defines the word cure and cured for “curable illnesses”. A curable illness being a component or group of components of illness which can be cured. If any component of a disease, medical condition, disorder, etc. is incurable, then it is not a curable illness and outside of the scope of this paper. However, remember that incurable is not medically defined either.
Medical References to Cure
There are a few medical references to the word cure, in specific situations, although the usage is not consistent. Current usages of cure can be easily categorized by the ICD/10 three types of disease: communicable diseases, non-communicable diseases, and injuries.
Communicable diseases are cured by addressing the pathogen or parasite. Antibiotics kill bacteria, anti-fungal medicines kill fungus infections, and poisons kill intestinal worms. These cures are clearly defined and cured can be proven by demonstrating that the cause has been addressed. Many medical references refer to this type of cure, but cured in general, is not defined.
The second common usage of cure is with surgery. Historically, a surgeon cures, although in specific cases the word cure is seldom used, and there is generally no test for cured. A dentist cures cavities. A trauma surgeon cures gunshot wounds. Surgical curing generally requires healing to complete the job. Surgical cures often address non-communicable diseases. There is no medical test for cured for surgeries except when the surgery removes a parasite or other cause of a communicable disease.
The third common use of the word cure is healing. It is generally understood that healing cures injuries. Healing occurs irrespective of the illness and regardless of the treatment – although best treatments should aid healing. The usage of the word cure for healing seldom appears in conventional medical references but is common in alternative medical references. However, many so called “healing cures” are actually transformation cures, in the same class as surgical cures – which require healing to complete the cure.
The word cure is commonly used for three types of illness: communicable, non-communicable, and injuries. At present, the only type of illness that can be cured and the cure proven scientifically is a communicable illness, where the cure is brought about by eliminating the cause. Of course, not every illness caused by a pathogen can be cured, thus the familiar phrase “there is no cure for the common cold.”
Incorrect References to Cure
Perhaps a large part of the reluctance to use the word cure is simply that many references to cure are wrong. Everyone “knows” that Vitamin C is the cure for scurvy, but in real cases, Vitamin C does not cure scurvy, it simply addresses the signs and symptoms of a faulty diet. Unless the cause, the faulty diet, is addressed the illness will persist and the patient will need to be continually medicated and advised to “learn to live with” their disease.
The original 1899 version of Merck contained many references to the word cure, but cure was not defined. Most, like “rest cure”, “milk cure” and “grape cure” are simplistic nonsense. However, “Iridectomy: the only cure” (for glaucoma) is still in use today, although the word cure is rarely used for specific surgeries.
Curable Illness Element:
The book A Calculus of Curing introduces the concept of a curable element of illness. A single element of illness has a single cause. A curable illness element is defined there, and for the purposes of this paper, as a single element of illness having a single cause or chain of causes, which is cured by addressing the cause.
Many diseases are very complex. A cancer has a cause, the condition that created the initial cancer cells – which might still be active. It also has the cancer cells, growing out of control. And it might also have injuries and other illnesses caused by that growth and by the body’s attempts to fight the cancer. Curing a disease as complex as cancer requires several cures, several cure elements.
An element of illness has three parts: the cause, which is present except in the case of an injury; the consequences, the signs and symptoms of the illness; and the intersection of cause and consequences, such that we believe the cause results in the consequences. Injuries are cured by healing – the cause no longer being present. Communicable and non-communicable illnesses persist until the cause is addressed – perhaps intentionally by medicine, or perhaps by health as in the common cold, or perhaps simply by a happy accident.
The key to illness, and the key to cure can only be found in cause. Treatments for signs and symptoms might produce positive results without addressing cause but cannot produce cures. The only illnesses that can be cured, and proven to be cured, are illnesses where the cause can be addressed. Cause is the key to cure, because cause is required for the illness to exist.
Fundamental Causes of Illness
There are two basic or fundamental causes of an active illness. We will leave aside injury illnesses for the moment – injuries are not active, and are caused by excessive stress resulting from the same two fundamental causes.
Non-injury curable illnesses exist and persist because the cause is present.
Illnesses exist because life and health are ongoing processes. Dead things, rocks and sticks, do not get illnesses, but trees and tigers do. Only living things, participating in the ebb and flow of life, fall ill. An illness occurs when the natural healthy flows of life are disrupted or interrupted. There are two basic ways, two types of causes that can create a disruption of a natural healthy life flow:
- A verb cause, a process. A negative process can disrupt the natural flows of life. Life depends on many healthy processes in cooperation and harmony. Any process that goes out of alignment can lead to illness. All illnesses caused by a pathogen or parasite are caused by a negative process, the growth of the parasite. Many other processes can also lead to illness. A faulty dietary process, a faulty exercise or lack of exercise process, a faulty sleep process. Each can lead to an illness that has a process cause, a verb cause.
- A noun cause, a thing or an attribute. Sometimes an illness is caused by a thing or the state of a thing. A dental cavity is a thing. We might view it as an injury – if it can be healed. But if it cannot be healed, it can be a cause of an illness that needs to be addressed. A stroke, a blood clot, even a dislocated shoulder is also an attribute that must be addressed, not healed. A sprained ankle, on the other hand, is an injury that can be healed.
Both types of active illnesses are cured by addressing the cause.
Verb, or process causes are addressed with processes. The faulty process must be addressed to produce a cure. If the diet is faulty, a healthy diet is the cure. If lack of sleep is the cause of illness, the illness can only be cured with healthy sleep processes. Illness elements with process causes are cured by healthy processes. They can occasionally be cured by things – as an infection is cured by a medicine that kills the pathogen. However, most infections are best cured by natural healthiness. Medicines are dangerous – that’s why a doctor’s prescription is required.
Noun causes are addressed by transformation. Often, healing is required. Dental cavities are cured by a dental surgeon, who fills the cavity and repairs the tooth. Cataracts are cured by cataract surgery, transforming the lens to a clear lens, and curing the vision illness. Healing is often necessary when a transformation cure is used, because transformations can cause injuries.
Every cause of illness element can be classified as a verb cause, or a noun cause. The same applies to injuries. Injuries can be caused by unhealthy processes; shin splints are caused by unhealthy exercise, or by unhealthy things; gunshot wounds are caused by bullets. But in the case of an injury, addressing the cause is irrelevant to the cure. Injury causes are only useful for prevention – outside of the scope of this paper.
In some cases of injuries, the cause is still present. However, these illnesses are complex, not elementary illnesses. Complex illnesses are comprised of multiple illness elements and therefore require multiple cure elements.
Causal Illnesses and Attribute Illnesses
The phrases ‘verb illness’ and ‘noun illness’ are unfamiliar and awkward. I will refer to illnesses caused by verbs or processes as causal illnesses, and illnesses caused by nouns or negative attributes as attribute illnesses. Every causal illness has a process cause in the present. Negative attributes generally have causes in the past, with the negative attribute being the cause of an illness in the present.
Every causal or attribute illness is cured by addressing the cause.
How do we know if we have addressed the right cause? The illness is cured. A cure proves the cause. As we get better at guessing causes that cure, we get better at curing.
Causal Illness: Chains of Cause
Every causal illness has a causal chain. Every process cause has a cause. Every cause of a cause has a cause. Whenever we find a verb cause, we can always find a cause of the cause, and a cause of the cause of the cause. We might also find direct consequences of the cause – that are not yet an illness.
A causal illness element has not a single cause, but a single chain or train of causes. Each link in the chain is essential to cause the illness.
Which cause is important? Which cause leads to a cure? Any action that successfully breaks the chain, by successfully addressing any cause in the chain, can lead to a cure. If addressing a cause does not cure an illness element, then either:
- the cause was not successfully addressed, or
- the cause addressed was not in the causal chain of the illness being addressed.
When we recognize the existence of chains of cause, we can see that any causal illness might have many possible cures. Every link in a causal chain might also have multiple cure alternatives.
However, we need to be cautious and aware that the cure for a causal illness is usually a healthy process – not a single action. We cure scurvy, malnutrition, and obesity with a healthy diet process, not with a supplement, a big meal, or a short diet.
Attribute Illness: Cure Alternatives
An attribute illness is caused by a thing, a negative attribute. The illness is cured when the negative attribute is transformed to a neutral or healthy state. Without transformation, the illness persists. Any attribute illness might also have many possible cures. A dental cavity is transformed with a filling, a crown, a cap, or perhaps even an implant or an extraction – depending on which is the best cure. There are different surgical techniques used to transform the eyes of patients with cataracts – to cure the faulty vision. Some transformations can be very minor, like a physical manipulation that reseats a dislocated shoulder, while others are very severe, like open heart surgery.
Elementary Cures
An elementary cure addresses a single illness element. We might believe most illnesses are complex, but every complex illness started with an elementary illness that was not cured and became complex as more causes were added. Complex illnesses consist of a set of elementary illnesses, each requiring an elementary cure to address each cause.
Cured
We can summarize the meaning of cure and define cured with a few simple rules.
An illness is cured when:
- the cause has been successfully addressed (or is gone). Of course, it is always difficult to know if the cause has been addressed, but if we believe the cause has been addressed, we can move to the next test. If the cause was a process, we must believe the process cause has been addressed. If the cause was an attribute, we need to believe the attribute cause has been transformed.
- the signs and symptoms have faded or are gone. With complex diseases, consisting of several illness elements, possibly with similar or overlapping signs and symptoms, it can be difficult to be certain that the signs and symptoms of a specific illness element are gone.
- no more medicines are required for the signs and symptoms. If a medicine is still required, the illness has not been cured. Of course, if one element has been cured – and other elements still exist, there may be a need to medicate those signs and symptoms until those causes are addressed.
- damage caused by the illness has been healed. An injury illness is cured when we believe that healing has completed or reached a stage where no further healing is possible or likely.
Every test of an element of cured requires a judgement. We cannot declare a cure without making a judgement. At present, our medical systems have little experience making judgements about cured. We need to practice judging cured, to become better at recognizing cured, so that we can find more cures.
Conclusion
At present, cure and cured are very poorly defined in conventional medicine. If we wish to cure, we need to develop definitions of cure for every disease, and work to refine those definitions as we search for cures. This paper presents a starting point to define cures through the concept of elements of cure, where each cure element addresses a single cause.
As we explore elements of illness, and elements of cures, we will learn more about general and specific cures. We will learn that the best cures come from health, from improvements in process or attribute healthiness. Unhealthy life processes result in causal illnesses, which are cured with healthy life processes. Unhealthy attributes cause attribute illnesses, which are cured by healthy transformations. Healthy healing cures injuries.
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First published on Academica.edu: A Definition and Exploration of Cure
