Therapy ( ancient Greek θεραπεία therapeia "service, care, healing") or treatment describes all measures that aim to positively influence disabilities , illnesses and injuries . The prerequisite for therapy is a previously obtained diagnosis . The aim of a therapist is to enable or accelerate healing , or at least to alleviate or eliminate the symptoms and to restore physical or psychological functions. Different ways to treat a disease are often referred to as therapy options .
In order to be able to recommend an appropriate therapy, a diagnosis must first be carried out. A diagnosis is made by assessing and classifying the symptoms and various examination findings. The actual therapy then consists of measures to remedy the symptoms or preferably the cause of the disease. If a therapy is appropriate for the treatment of a clinical picture, one speaks of an indication (the “ indication ” of a certain treatment).
The Therapeutics (old Greek θεραπευτική (τέχνη) therapeutikē (Techne) "healing art") had originally (in the understanding of humoral pathology ) the harmonization of a derailed juices equilibrium in the organism to the target. In a modern view, it is the doctrine of healing methods, which deals with forms of therapy and therapy methods, their mode of action and their range of applications.
An important part of most therapies is communication between therapist and patient . It helps to ensure that the treatment meets the subjective needs of the patient and improves the patient's ability to work towards a favorable course of the disease. The psychiatric therapy relies even primarily on methods of systematic communication.
Therapy is based on a direct or indirect action by the therapist on the patient. The possibilities of influence are diverse:
- In surgery , the patient's body is manipulated with tools ( surgery ).
- The internal medicine is mainly based on the administration of drugs ( drug therapy , chemotherapy ) or the removal of pathological liquids ( puncture of ascites or pleural effusion ). There are also radiation therapies (radiotherapies) with ionizing radiation (especially against malignant tumors ) or with or. introduced, radiating substances ( radioiodine therapy against some tumors of the thyroid gland , contact irradiation of inoperable tumors using implanted capsules). However, light therapy for skin diseases or depression or electroconvulsive therapy under anesthesia are also used to break through severe depression.
- The physical therapy uses physical means such as electricity, heat or cold therapy treatments in the water, therapeutic exercise and manual therapy. It is mainly used to heal the musculoskeletal system.
- Psychotherapy is used to treat mentally, emotionally and psychosomatic diseases, states of suffering or behavioral disorders with the help of various forms of verbal and non-verbal communication. These include depth psychological and behavioral approaches as well as artistic therapies ( art therapy , theater therapy , music therapy , dance therapy ) and, more recently, forms of virtual rehabilitation .
Usually, the effectiveness of a therapeutic procedure must be able to withstand a review using a scientific method in order to be recognized by scientific medicine (see also: evidence-based medicine ). Nevertheless, especially outside of hospitals and medical practices, methods are often used that do not meet this requirement (such as alternative medicine and naturopathy ).
Forms of therapy
In therapy, one can differentiate between:
- the "general" therapy, which is based on the overall condition of the patient.
- the "special" therapy that deals with specific details of the symptoms.
Depending on the goal and purpose, additional adjectives are added to the word therapy:
- causal , if it eliminates the pathogenic cause or at least strives to do so (e.g. combating the responsible bacteria of bacterial pneumonia directly with antibiotics)
- symptomatic if only to alleviate the existing symptoms and not the underlying cause (eg. as directed expectorant cough medicine for acute bronchitis , asthma spray the asthma attack, non-drug therapy for dementia ).
- curative if it aims at the patient's recovery (from at least one defined illness)
- palliative , if it onlyalleviates symptoms orprevents complications without counteracting the underlying disease itself (e.g. surgical re-widening of the malignant overgrown airways in bronchial carcinoma for better breathing).
- conservative whendonewith the help of medication and / or physical measures .
- operative , if it is aimed at the surgical treatment by operation of a disease condition.
- supportive (or vaguely adjuvant ) if the undesirable side effects of a (mostly anti-tumor) treatment are treated (e.g. nausea- relieving medication for nausea with cytostatic chemotherapy )
- Calculated if, from experience (e.g. disproportionate effort in general medicine or in acute danger to life), it is not practical to wait for a confirmed diagnosis and treatment is already started on suspicion (e.g. immediate administration of antibiotics if a bacterial meningitis )
- elective , if the time of the intervention can be determined relatively freely (as in many outpatient operations)
- frustrated when it is in vain (e.g. frustrated resuscitation )
- preventively when the precautionary treatment of a not yet broken out, but probably is occurring disease in the future (such as a special. diet already before symptoms occur in certain, established in routine testing congenital metabolic diseases: see screening ).
- Prophylaxis (dentistry) in the sense of the therapy of factors potentially triggering dental diseases.
The vaccinations are a strengthening of the body against the susceptibility to possible infectious diseases (protective vaccinations) and therefore not a therapy in the strict sense. It is different if there is a high probability that an infection has already occurred. In this case the incubation period of the pathogen has not yet expired completely (the pathogen has not yet "attacked"). In this case, it is a therapeutic vaccination (e.g. if rabies is suspected ) with which one can "overtake" the pathogen so that it encounters a prepared immune system .
Over-therapy and incorrect therapy
Resistance to therapy is used when a sick person does not ( or no longer) responds to treatments that, according to the current state of knowledge, have been carried out correctly and, as a rule, should at least have led to an improvement in the symptoms or, in the best case, to a cure of the disease. If this is not the case, the condition is called therapy-resistant (or therapy-refractory ). Then alternative therapy methods must be considered. However, it is also possible that the patient has to be classified as exhausted and that further treatment no longer has any curative claims.
- Elderly therapy
- Treatment abroad
- Treatment request
- Occupational therapy
- Body therapy
- Speech therapy
- Peloid therapy
- Thérapie (magazine)
- Animal Assisted Therapy
- Heat therapy
- Therapeutic religious education
- on legal issues: patient law , sociotherapy , therapeutic treatment (German law)
- Heinrich Schipperges †: Health. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 486.
- Arnd Krüger : History of movement therapy, in: Preventive medicine . Heidelberg: Springer Loseblatt Collection 1999, 07.06, 1 - 22.