• C Hamonet and T Magalhaes.
• Service de Réadaptation médicale, CHU Henri Mondor, 51, avenue du Maréchal de Lattre-de-Tassigny, F 94010 Créteil. hamonet@club-internet.fr
• Presse Med. 2001 Mar 31; 30 (12): 587590587-90.

AbstractThere has been a good deal of discussion and though on the notion of health. The most widely employed definitions can be termed "physiological", focusing on organs and normality. These definitions result from the development of medicine around the concept of disease, leading Boissier de Sauvages, author of a disease classification that continued to be used until the current classification proposed by the WHO, to state that "health, considered in its historical context, is the concourse of phenomena designating life and perfect structures". The current WHO classification goes beyond the notion of disease and introduces the very positive concept of theoretically total "well-being". In light of the evolution in the reasons why people call upon the health care system, we propose considering health as an equilibrium describing an individual's capacity to cope with the environment and taking into account the available health care resources. Thus, as proposed by René Dubos, health is a "relatively trouble-free state devoid of suffering". We integrate the notions of handicap that we have developed in a four-dimensional approach where subjectivity plays a very important role. Our proposal totally changes the notion of cure: one can be diabetic and cured, paraplegic and cured.

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