Wikipedia - Benutzerbeiträge [de]

Angiologie

2006-11-09T15:14:00Z

136.2.1.103: /* Erkrankungen der Arterien */

[[Bild:Grafik blutkreislauf.jpg|right|thumb|120px|Schema des menschlichen Blutkreislaufs]]
Die '''Angiologie''' ist ein Teilgebiet der [[Innere Medizin|Inneren Medizin]], welches sich mit '''Gefäßerkrankungen''' beschäftigt. Sie befasst sich mit der [[Ätiologie|Entstehung]], [[Epidemiologie]], [[Diagnose]], konservativen und interventionellen [[Therapie]], [[Rehabilitation]] und [[Prävention]] von Erkrankungen der [[Arterie]]n, [[Vene]]n und [[Lymphgefäß]]e.

Die exakte Abgrenzung gegenüber anderen Fachrichtungen oder -teilbereichen ist weder immer möglich noch erwünscht. Erkrankungen der [[Koronargefäß]]e sind allerdings eine Domäne der [[Kardiologe]]n; für Gefäßerkrankungen, die das zentrale Nervensystem betreffen, sind auch Ärzte der [[Neurologie]] und [[Neurochirurgie]] zuständig. Bei Erkrankungen des venösen Gefäßsystems wie [[Krampfadern]] oder [[Postthrombotisches Syndrom|postthrombotischem Syndrom]] und der [[Lymphgefäß]]e gibt es Überschneidungen mit der [[Dermatologie]] und der [[Phlebologie]]. Die [[Gefäßchirurgie]] ist ein Teilbereich der [[Chirurgie]] und gehört nicht zur Angiologie. Bei vielen angiologischen Krankheitsbildern besteht eine enge Kooperation mit anderen medizinischen Fachgebieten.

== Historie ==
Die Angiologie in ihrer heutigen Form als Schwerpunkt der Inneren Medizin existiert in Deutschland erst seit 1995. Sie ist somit der jüngste Zweig der Inneren Medizin, was sich auch in einer Zahl von nur 81 rein angiologisch tätigen Arztpraxen in Deutschland widerspiegelt. ([[Kassenärztliche Bundesvereinigung|Kassenärztlichen Bundesvereinigung]] September 2005).

== Krankheitsbilder ==
Eingeteilt werden die entsprechenden Krankheitsbilder in die Erkrankungen des zuführenden oder arteriellen Anteils des [[Blutkreislauf|Kreislaufsystem]]s, somit der Arterien und der [[Arteriole]]n sowie der [[Kapillare]]n als Bindeglied zum abführenden Anteil des Kreislaufsystems, den Venen und den Lymphgefäßen (bzw. dem [[Lymphsystem]]).

=== Erkrankungen der Arterien ===
Zu ca. 90-95% ist die Ursache der arteriellen Erkrankungen die [[Arteriosklerose]] mit Ausbildung von Engstellen ([[Stenose]]n) oder Verschlüssen. Wegen der Häufigkeit und der Relevanz für die Betroffenen sind besonders zu erwähnen:
*die [[arterielle Verschlusskrankheit]] (AVK) der Becken- und Beinarterien,
*die Engstellen der Halsschlagadern ([[Arteria carotis]]),
*die Engstellen der [[Arteria renalis|Nierenarterie]]n und Eingeweidearterien ([[Mesenterialgefäße]])
Die Arterien des Schultergürtels und der Arme sind eher selten von arteriosklerotisch bedingten Engstellen betroffen.

Außer zur Bildung von Engstellen kann es als Folge der Arteriosklerose durch Schwächung der Gefäßwandstrukturen auch zur Ausweitung der Gefäße kommen, was ab einem bestimmten Ausmaß als [[Aneurysma]] bezeichnet wird.
Von Bedeutung sind dabei wegen der Gefahr des Einreißens der Gefäßwand ([[Ruptur]]) oder der Ablagerung von geronnenem Blut im Aneurysma und anschließender Ablösung ([[Embolie]]) vor allem Erweiterungen der
*Brust- und Bauchschlagader ([[Aorta]]),
*der Beckenarterien und
*der Kniekehlenarterien.

Im Vergleich zur Arteriosklerose ''seltene Ursachen'' von arteriellen Gefäßerkrankungen sind:
*[[Embolie]]n
*Gefäßverletzungen,
*Bestrahlungsfolgen und
*entzündliche Gefäßerkrankungen [[Vaskulitis]].
Eine Sonderform der entzündlichen Gefäßerkrankungen ist die [[Thrombangiitis obliterans]], die im Krankheitsverlauf meist in eine Arteriosklerose übergeht.

"Funktionelle Durchblutungsstörungen" sind nicht Folge eines strukturellen Gefäßschadens (also Stenose oder Verschluss) sondern Folge einer aus verschiedenen Gründen fehlerhaften Steuerung des Gefäßsystems. Typische Krankheitsbilder sind:
*das [[Raynaud-Syndrom]],
*die [[Akrozyanose]] und die
*die [[Erythromelalgie]].
Raynaud-Symptome können aber auch bei systemischen Erkrankungen auftreten im Sinne einer Begleitvaskulitis, wie zum Beispiel bei [[Lupus erythematodes]] oder [[Sklerodermie]].
Die Einnahme von ergotaminhaltigen Medikamenten, die bei manchen Migräneformen eingesetzt werden, können vor allem bei Überdosierung zu einem ausgeprägten Spasmus der arteriellen Gefäße führen, was irreversible Schäden zur Folge haben kann.

Der diabetische Fuß ([[Diabetischer Fuß]]) ist nur zum Teil Folge einer gestörten Durchblutung. Vor allem wird er durch Nervenschäden und Schäden am Fußskelett hervorgerufen. Das [[Mal perforans]] bezeichnet dabei eine Sonderform an der Fußsohle unter den Zehengrundgelenken.

=== Erkrankungen der Venen ===
Häufige und nicht nur für den Einzelnen sondern auch volkswirtschaftlich bedeutsame venöse Erkrankungen sind:
*das primäre Krampfaderleiden (primäre [[Krampfadern|Varikose]]), das zu ca. 70% vererbt wird,
*die chronische venöse Insuffizienz bei angeborener Schwäche des tiefen Leitvenensystems und
*die Venenthrombose ([[Thrombose]]) mit der Folge:
**dauerhafter erworbener Venenschaden, also [[postthrombotisches Syndrom]] und
**chronisches Unterschenkelgeschwür [[Ulcus cruris]].
Als Folge von Krampfadern oder auch als äußeres Zeichen einer anderen zugrundeliegenden Erkrankung kann es zur Entzündung und Gerinnselbildung in oberflächlichen Hautvenen kommen, was als [[Thrombophlebitis]] bezeichnet wird.

=== Erkrankungen der Lymphgefäße ===
Im wesentlichen muss zwischen einem primären und einem sekundären [[Lymphödem]] unterschieden werden. Das primäre Lymphödem ist Folge einer vererbten Schwäche oder Nichtanlage ([[Atresie]]) der Lymphbahnen und manifestiert sich meist im dritten bis vierten Lebensjahrzehnt, während das sekundäre Lymphödem Folge einer anderen Erkrankung ist, die auch den Lymphabfluss schädigt. Ein nicht mehr reversibles und massiv ausgeprägtes Lymphödem wird als [[Elefantiasis]] bezeichnet.
[[Lymphangitis]] und [[Erysipel]] sind relativ häufige entzündliche Erkrankungen der Lymphgefäße.

== Untersuchungsmethoden ==
Die [[körperliche Untersuchung]] konzentriert sich je nach [[Anamnese]] und Beschwerdebild auf die Inspektion von [[Vene]]n, [[Lymphgefäß]]en und Gewebsdurchblutung sowie das Ertasten der [[Puls]]e in den betroffenen Körperregionen.

Bei den meisten Durchblutungsstörungen und Venenerkrankungen erlaubt eine [[Sonografie|Ultraschalluntersuchung]] der Arterien oder Venen, ggf. inklusive Doppler und Farbdoppler, bereits eine zuverlässige Diagnose und Planung der [[Therapie]]. In Zweifelsfällen und vor geplanten Operationen ist in einigen Fällen eine weitere bildgebende Diagnostik sinnvoll. Je nach Fragestellung kommen dafür Röntgenuntersuchungen mit Kontrastmittel ([[Angiografie]], [[Phlebografie]] oder [[Computertomografie]]) und die [[Magnetresonanztomografie]] (''"Angio-MRT"'') in Frage.

Für spezielle angiologische Fragestellungen werden [[Plethysmografie]], Kapillarmikroskopie und Lichtreflexionsrheografie eingesetzt.

== Literatur ==
*Interventionelle Radiologie
**Volume 1 Endovaskuläre Revaskularisation der Beckenstrombahn
**Hermann Berger;Peter Pickel; Wolfgang Weiß ISBN 3-13-105921-4
*Schlaganfall
**100 Fragen und 100 Antworten
**Hans Christoph Diener ISBN 3-13-132961-0
*Arterielle Gefäßerkrankungen
**Standards in Klinik, Diagnostik und Therapie
**Ernst Pilger ISBN 3-13-130631-9
*Atherothrombose
**Ein interdisziplinärer Leitfaden für Grundlagen, Klinik und Management
**Franz Aichner ISBN 3-13-129861-8
*Ultrasonography in Vascular Diseases
**A Practical Approach to Clinical Problems
**Edward I. Bluth;Peter H. Arger; Carol B. Benson;Philip W. Ralls ISBN 3-13-129141-9
*Blutgerinnung und Thrombose
**Bettina Kemkes-Matthes;Gerd Oehler ISBN 3-13-104822-0
*Kursbuch Dopplersonographie und Duplexsonographie
**Nach den Richtlinien der DEGUM und der KBV
**Kurt Huck ISBN 3-13-115371-7
*Ultraschalldiagnostik der hirnversorgenden Arterien
**Manfrted Kaps;Gerhard-Michael von Reutern; Hans J von Büdingen ISBN 3-13-731403-8
*Gefäßkrankheiten in der Praxis
**Hans-Wolfgang Menges;Hubert Mörl ISBN 3-13-114657-5
*Praktische Phlebologie
**Empfehlungen zur differenzierten Diagnostik und Therapie phlebologischer Krankheitsbilder
**Horst-E Gerlach;Eberhard Rabe ISBN 3-13-119231-3
*Gefäßdiagnostik mit Ultraschall Lehrbuch und Atlas
**Doris Neuerburg-Heusler;Michael G. Hennerici ISBN 3-13-707503-3
*Angiologie in Klinik und Praxis
**Malte Ludwig ISBN 3-13-110191-1
*Checkliste Angiologie, Hypertonie, Hypotonie
**Alexander Sturm;Jürgen Chr Reidemeister ISBN 3-13-617803-3
*Vascular Intervention
**Bruce A. Perler;Gary J. Becker ISBN 3-13-108041-8
*Angiographische Diagnostik und Therapie
**Dieter Liermann;Johannes Kirchner ISBN 3-13-108311-5

== Weblinks ==
*http://www.angiologie-online.de
*http://www.dgangiol.de

[[Kategorie:Angiologie|!]]

[[en:Angiology]]
[[es:Angiología]]
[[fr:Angiologie]]
[[it:Angiologia]]
[[pl:Angiologia]]
[[pt:Angiologia]]
[[ru:Ангиология]]
[[tr:Anjiyoloji]]

Wort der Weisheit

2005-10-10T17:18:06Z

136.2.1.103: /* Caffeinated soft drinks */ other reason some LDS do not drink Coke .. appearance of evil

''For the Pentacostal usage of this term, please see [[Word of wisdom]].''

The '''Word of Wisdom''' is the common name of [http://scriptures.lds.org/dc/89 Section 89] of the [[Doctrine and Covenants]] of the [[Latter Day Saint movement]] ([[Mormonism]]). It is also the name of a mandatory health code based on that scripture practiced by The [[Church of Jesus Christ of Latter-day Saints]].

According to author [[Joseph Smith, Jr.]], the scripture was received in [[1833]] as a revelation from [[God]]. The introduction and explanation as presented by Smith is "A Word of Wisdom, for the benefit of the council of high priests, assembled in Kirtland, and the church, and also the saints in Zion— To be sent greeting; not by commandment or constraint, but by revelation and the word of wisdom, showing forth the order and will of God in the temporal salvation of all saints in the last days— Given for a principle with a promise, adapted to the capacity of the weak and the weakest of all saints, who are or can be called saints."

The health guidelines are particularly important to [[Church of Jesus Christ of Latter-day Saints|The Church of Jesus Christ of Latter-day Saints]], which relies on the guidelines as the basis for a mandatory health code. The ''Word of Wisdom'' health code is a prerequisite for [[baptism]] or entry into [[Temple (Mormonism)|Mormon temples]].

==The Word of Wisdom revelation==
[[Image:Smokinghand.jpg|right|frame|[[Tobacco smoking]] is one of the activities the Word of Wisdom advised against years before it was recognized as a health threat by the medical community.]]
The revelation, which is found in LDS [[Doctrine and Covenants|D&C]] 89, contains four parts:
#an introduction (verses 1-4)
#a list of substances such as [[wine]], strong drink, and [[tobacco]] that should not be used (verses 5-9)
#a list of foods that should be used, sometimes with certain limitations (verses 10-17)
#a promise to those who follow the guidelines (verses 18-21).

Among the substances which the revelation indicates should not be used, the first is "[[wine]] or strong drink", which the revelation says should not be drunk, except wine may be used as part of the [[Sacrament (Mormonism)|Sacrament]] (like [[Communion]]). The revelation gave the further precaution that if wine is used, it should be pure, and made in Mormon [[winery|wineries]]. The revelation also advised against the use of tobacco and "hot drinks", which was later interpreted as meaning [[coffee]] and [[tea]].

The list of foods and substances which the revelation encourages includes "wholesome [[herb]]s", "[[fruit]]", "in the season thereof", and [[meat]]. Two years earlier, Smith had dictated a revelation against the [[Shaker]] practice of enforcing strict [[vegetarianism]], with the qualification, however, that one who "wasteth flesh and hath no need" would be condemned. ([http://scriptures.lds.org/dc/49/18-21#18 D&C 49:18-19]). In the Word of Wisdom, Smith's dictation similarly stated that meat was to be eaten "sparingly", and ideally only in [[winter]], [[famine]], or "excess hunger".

The revelation also encouraged the use of [[cereal|grain]]s, particularly [[wheat]]. [[Barley]] was also encouraged for use in making "mild drinks" such as [[beer]].

The word of wisdom was a "principle with [a] promise". The promise given to those who followed the advice of the word of wisdom was as follows:
:And all saints who remember to keep and do these sayings, walking in obedience to the commandments, shall receive health in their navel and marrow to their bones; and shall find wisdom and great treasures of knowledge, even hidden treasures; and shall run and not be weary, and shall walk and not faint. And I, the Lord, give unto them a promise, that the destroying angel shall pass by them, as the children of Israel, and not slay them. Amen.[http://scriptures.lds.org/dc/89/18-21#18]

==Interpretation and extension of the Word of Wisdom by the Church of Jesus Christ of Latter-day Saints==

In The [[Church of Jesus Christ of Latter-day Saints]], the original ''Word of Wisdom'' has been extended into a mandatory health code required for baptism or to receive a recommend allowing entry into [[Temple (Mormonism)|Mormon temples]].

=== Adoption by Latter-day Saints as a binding health code ===
Originally, the ''Word of Wisdom'' was given in [[1833]] as a "principle with [a] promise", and was not mandatory. Indeed, observance of the principle was not widespread. After Smith's death, his successor [[Brigham Young]] proposed in [[September 9]], [[1851]] at a General Conference of the Church that the revelation be adopted as a binding commandment for all [[Latter-day Saints]].

=== The Latter-day Saint health code ===
The health code practiced by members of the Church of Jesus Christ of Latter-Day Saints includes the ''Word of Wisdom'' revelation given by [[Joseph Smith, Jr.]], but has evolved gradually through the years. The most significant innovation was the shift in emphasis away from the particular substances listed in the revelation, and toward a more general prohibition against habit-forming substances. In particular, the church has prohibited all alcoholic beverages, including "mild drinks" such as beer, which was allowed in Smith's revelation. In addition, the church came to prohibit the use of wine, even as part of the [[Sacrament (Mormonism)|Sacrament]]. Water is now used in its place. Most recently, the church has prohibited the use of narcotics. However, the church generally regards narcotics, or any other medically-useful substance, as acceptable if used as prescribed by a doctor.

In addition, the part of the code that forbids "hot drinks" has been officially interpreted as prohibiting only coffee and tea, whether or not the drinks are hot. There is no prohibition, however, against herbal tea, or hot chocolate. Most church units also do not emphasize regulations regarding the consumption of meat as prominently as done in Section 89.

===Ambiguous areas within the code===
While there is a general prohibition against habit-forming substances, certain areas within the health code are not clearly defined, and are generally amenable to one's conscience. For example, [[Latter-day Saint]]s are divided concerning the use of caffeinated soft drinks and iced tea. There is also some division concerning the use of coffee, tea, or alcohol as a cooking ingredient. It is also uncertain whether the church allows decaffeinated coffee or tea. A few rare Mormons also take a very strict view concerning caffeine, and refrain from eating chocolate.

==== Caffeinated soft drinks ====
[[Image:Cokecansmall.jpg|thumb|150px|The permissibility of [[Caffeine|caffeinated]] [[soft drink]]s, such as [[Coca-Cola]], are an ambiguous subject in regard to the Word of Wisdom. Some members abstain from caffeinated beverages, while other imbide liberally, while still avoiding hot drinks such as [[tea]] and [[coffee]].]]
The permissibility of consuming caffeinated products such as caffeinated [[soft drink|soda]]s is a longstanding issue among Latter-day Saints. Because of the statements of various Church leaders (which are not official statements nor practices of the Church), some adherents and even non-members believe that caffeine is officially prohibited under the Word of Wisdom. If this were so, it would seem logical that other things which contain caffeine besides soda drinks should be prohibited too. Some members who hold that caffeinated sodas are prohibited distinguish between things with naturally occurring caffeine and those things where caffeine is an additive although any difference in the chemistry and effect of caffeine as an additive or naturally occurring are negligible. In short, members are divided on their stance of consumption of caffeinated beverages, though it is not usually a point of great contention. The Church has no official stance on the consumption of caffeinated beverages and the consumption of such does not constitute breaking the Word of Wisdom (that is, it does not preclude [[baptism]] or entry into a [[Mormon temple]]).

Given the latitude in applying the Word of Wisdom to personal circumstances, many Latter-day Saints feel that the consumption of caffeinated-sodas falls in the category of personal discretion; while some may consider consumption of caffeinated-sodas permissible, others may not. More strict Latter-day Saints hold that while no official prohibition restricts the consumption of caffeinated-sodas, consumption by any member does indeed violate the spirit of the Word of Wisdom, and a member receiving proper inspiration will recognize this as so. Finally, others choose not to drink caffeinated sodas in order to "avoid the appearance of evil" because it may give the wrong impression to those who believe that the church opposes the practice.

==== Health subjects not explicitily addressed====
Section 89 does not specifically address illicit drugs, such as [[cocaine]],
[[methamphetamine]]s or [[cannabis|marijuana]], although the Church has officially denounced their use as a violation of that doctrine. Beyond illicit drugs, there are innumerable subjects related to the Word of Wisdom that have not been addressed in fine detail by the Church: exercise, medical treatment, junk food, etc. This is in keeping with the teachings of the Church that Latter-day Saints, having been given the Gift of the Holy Ghost, are entitled to personal revelation guiding them to make personal choices that are based on individual circumstances and are consistent with the doctrines and practices of the Church. It is not the purpose of the Church to give detailed rules for every aspect of living a [[Christian]] life. The Word of Wisdom is no exception. Thus, Latter-day Saints are expected to make wise choices pertaining to personal health that are not specifically addressed by the Word of Wisdom. This principle allows sufficient latitude for varying circumstances. For example, the specific application of the Word of Wisdom could be potentially more restrictive for a person susceptible to obesity, but that determination is solely in the discretion of the individual.

=== Purpose of the Latter-day Saint health code ===

Adding to the caffeine issue is the broader question of why tobacco, alcohol, coffee, tea and possibly caffeinated-sodas are prohibited at all. The harmful health effects of tobacco are nearly universally recognized. It is presumed in the case of coffee and tea that these drinks are prohibited because of their caffeine content. Thus, the condemnation of caffeine or caffeinated-sodas by some Church leaders. However, some Church leaders have also stated that God has not revealed why some things have been prohibited under the Word of Wisdom. Some suggest that the reasons will not become known for some time as in the case of tobacco. Some have stated further that: the primary purpose of the Word of Wisdom is, like all commandments, for spiritual benefits; and like some other commandments, earthly benefits are merely incidental. For example, there
are a number of promised rewards contingent on obedience to the Word of Wisdom not all of which appear to be direct health consequences of obedience to the dietary code. These rewards stated in section 89 include:

*"shall receive health in their navel and marrow to their bones"
*"shall find wisdom and great treasures of knowledge"
*"shall run and not be weary, and shall walk and not faint"
*"the destroying angel shall pass by them...and not slay them"

===The LDS health code and modern medicine===

==== Health effects of alcohol ====
[[Image:Margarita.jpg|thumb|All [[alcoholic beverage]]s, such as the [[Margarita]], are prohibited by the Word of Wisdom.]]
It has been long established that heavy consumption of alcohol is toxic to the human body, damaging many organs and cells in the body including the brain and liver and giving rise to a higher incidence of [[cancer]] by hindering the immune system.

However, recent scientific research indicates that moderate alcohol consumption of alcohol may provide a mild benefit to help prevent [[coronary heart disease]]. Some of the health effects can be achieved by other means. For example, the beneficial compounds found in red wine, [[polyphenol]]s and [[resveratrol]], are also found, although to a lesser extent, in [[peanut]]s, [[grape|grape juice]] and [[cranberry|cranberry juice]]. However, alcohol itself substantially reduces the risk of [[coronary heart disease]] according to a large number of studies. Whether or not the benefits of moderate drinking outweigh the risks has been a source of controversy. ''See'' [[Alcohol consumption and health]]. This controversy has been an issue of concern for some [[Latter-day Saints]] who see such scientific findings as hostile to the authority of Joseph Smith's revelation. Smith's original revelation allows for the use of beer, and other similar mild alcoholic beverages, though current church practice bans all alcohol consumption.

==== Health effects of coffee ====
''Main article, see [[Coffee#Health]]''
=====Benefits=====
*Coffee can reduce the risk of hepatocellular carcinoma, a variety of liver cancer (Inoue, 2005).
*Increases [[Short-term memory|short term recall]] and increase [[IQ]].
*Reduces the incidence of heart disease.
*Changes the [[metabolism]] of a person so that their body burns a higher proportion of [[lipid]]s to [[carbohydrate]]s, which can help athletes avoid muscle fatigue.
*Reduces the incidence of diabetes in both sexes, but reduces the risk by about 30% in women and over 50% in men.

=====Risks=====
[[Image:A small cup of coffee.JPG|thumb|While only referred to in the Word of Wisdom as "hot drinks," later revelation clarified the statement referred to drinks such as [[coffee]] and [[tea]].]]
*Alleged to cause '[[caffeinism]]', a condition which mimics mental illnesses ranging from anxiety and bipolar disorder to schizophrenia and even psychosis.
*A February [[2003]] [[Denmark|Danish]] study of 18,478 women linked heavy coffee consumption during [[pregnancy]] to significantly increased risk of [[stillbirth]]s (but no significantly increased risk of infant death in the first year).
*Associated with significant elevations in biochemical markers of [[inflammation]]. This is a detrimental effect of coffee on the cardiovascular system which may explain why coffee has so far only been shown to help the heart at levels of 4 or less cups a day (20oz or less). ([http://www.ajcn.org/cgi/content/abstract/80/4/862 abstract])

*Consumption of caffeine can create an illusion of sobriety that could be fatal in some cases. A drunken person by consuming large amounts of caffeine feels as though he or she is sober gain, but in reality his or her judgment and reflexes are still impaired. Death or injury may follow as the impaired person attempts to drive or otherwise operate heavy machinery believing, mistakenly, to be sober.

==== Health studies regarding Latter-day Saints ====
A 14-year study conducted by [[UCLA]] [[epidemiologist]] James E. Enstrom tracked the health of 10,000 moderately active LDS people in [[California]], ending in [[1987]]. Of these non-[[Tobacco smoking|smoking]], [[monogamy|monogamous]] non-[[alcoholic beverage|drinkers]], Enstrom concluded from the study "that LDS Church members who follow religious mandates barring smoking and drinking have one of the lowest death rates from cancer and cardiovascular diseases—about half that of the general population... Moreover, the healthiest LDS Church members enjoy a life expectancy eight to 11 years longer than that of the general white population in the United States." The SMRs (standardized mortality ratios) for whites in the general population is defined as 100. For males in the study, the SMRs "are 47 for all cancers, 52 for cardiovascular diseases, and 47 for all causes; the SMRs for females are 72 for all cancers, 64 for cardiovascular diseases, and 66 for all causes." For high priests who never smoked cigarettes, exercised, and had proper sleep, the mortality rate was less. The results were largely duplicated in a separate study of a Mormon-like subgroup of white non-smoking churchgoers in [[Alameda, California]].{{ref|Enstrom}}

This study and others conclude that Latter-day Saints live significantly longer, healthier lives compared to the general U.S. populace, a consequence that correlates to prohibition of cigarettes in their health code, the Word of Wisdom.

Some Latter-day Saints use these studies to extol the prohibition against even moderate consumption of alcohol, coffee, tea and tobacco as divine guidance whose wisdom will be recognized in time. However, the studies correlate health primarily with the prohibition against tobacco and, perhaps, church attendance. Critics reject these studies in part because other factors may be credited for Latter-day Saints' longevity and health.

=== Views toward modern and alternative medicine ===
The majority of Latter-day Saints acknowledge that generally the treatments of modern [[medicine]] and the advice of their [[physician]]s and the guides issued from the [[Food and Drug Administration|FDA]] is in keeping with the Word of Wisdom. In contrast to this more moderate position, a small minority of Latter-day Saints are wary of modern medicine and have interpreted the Word of Wisdom somewhat less conventionally. This group favors some aspects of [[alternative medicine]]—especially [[herbal therapy|herbal]] or [[homeopathy|homeopathic]] treatments—to modern medicine as a more effective treatment of health problems. (Other alternative lifestyle choices, such as [[home schooling]] or a strong interest in the [[Breastfeeding|La Leche League]], often appeal to this group of Latter-day Saints although interest in a particular, alternative lifestyle is not necessarily inclusive of other popular, alternative lifestyles among the Latter-day Saints.) While alternative treatments might also include [[acupuncture]] for a few, [[magnet therapy]] would be too radical. Still some of the practices, such as the heavy consumption of [[colloidal silver]] for [[common cold]]s, directly contradicts the conventional wisdom of modern medicine and the precautions advised by the FDA. Latter-day Saints generally consider most forms of alternative medicine to be [[quackery]] or based on [[pseudoscience]]. Thus, although Joseph Smith permitted a phrenologist to examine his head in the [[19th century]], nearly all Latter-day Saints now-a-days reject the validity of [[phrenology]], an academically respected field of research in its day.

==References==
*[http://scriptures.lds.org/dc/89 Text of the Word of Wisdom], ''Doctrine and Covenants'' section 89.
*[http://www.jefflindsay.com/WWisdom.shtml The cited Associated Press article and discussion of Word of Wisdom by Jeff Lindsay] (the full article is about halfway down the page)
*[http://www.watchman.org/lds/tmlds.htm ''The Watchman's'' discussion of the UCLA study]
*{{Journal reference url | URL=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=2585528&dopt=Abstract | Author=Enstrom, JE.|Title=Health practices and cancer mortality among active California Mormons | Journal=J Natl Cancer Inst. | Year=1989 Dec|Volume=6;81(23)|Pages=1807-14}}
*{{Journal reference url |Author=Bush, Lester E., Jr. | URL=http://content.lib.utah.edu/cgi-bin/docviewer.exe?CISOROOT=/dialogue&CISOPTR=6654&CISOSHOW=6557 | Title=The Word of Wisdom in Early Nineteenth-Century Perspective | Journal = Dialogue | Year=Autumn, 1981|Volume=14:3|Pages=46-65}}

==Footnotes==
#{{note|Enstrom}} Enstrom, 1989.

[[Category:Latter Day Saint texts]]
[[Category:Latter Day Saint doctrines, beliefs, and practices]]

Wort der Weisheit

2005-10-10T17:11:37Z

136.2.1.103: /* The Latter-day Saint health code */ chgd Utah church to COJCOLDS

''For the Pentacostal usage of this term, please see [[Word of wisdom]].''

The '''Word of Wisdom''' is the common name of [http://scriptures.lds.org/dc/89 Section 89] of the [[Doctrine and Covenants]] of the [[Latter Day Saint movement]] ([[Mormonism]]). It is also the name of a mandatory health code based on that scripture practiced by The [[Church of Jesus Christ of Latter-day Saints]].

According to author [[Joseph Smith, Jr.]], the scripture was received in [[1833]] as a revelation from [[God]]. The introduction and explanation as presented by Smith is "A Word of Wisdom, for the benefit of the council of high priests, assembled in Kirtland, and the church, and also the saints in Zion— To be sent greeting; not by commandment or constraint, but by revelation and the word of wisdom, showing forth the order and will of God in the temporal salvation of all saints in the last days— Given for a principle with a promise, adapted to the capacity of the weak and the weakest of all saints, who are or can be called saints."

The health guidelines are particularly important to [[Church of Jesus Christ of Latter-day Saints|The Church of Jesus Christ of Latter-day Saints]], which relies on the guidelines as the basis for a mandatory health code. The ''Word of Wisdom'' health code is a prerequisite for [[baptism]] or entry into [[Temple (Mormonism)|Mormon temples]].

==The Word of Wisdom revelation==
[[Image:Smokinghand.jpg|right|frame|[[Tobacco smoking]] is one of the activities the Word of Wisdom advised against years before it was recognized as a health threat by the medical community.]]
The revelation, which is found in LDS [[Doctrine and Covenants|D&C]] 89, contains four parts:
#an introduction (verses 1-4)
#a list of substances such as [[wine]], strong drink, and [[tobacco]] that should not be used (verses 5-9)
#a list of foods that should be used, sometimes with certain limitations (verses 10-17)
#a promise to those who follow the guidelines (verses 18-21).

Among the substances which the revelation indicates should not be used, the first is "[[wine]] or strong drink", which the revelation says should not be drunk, except wine may be used as part of the [[Sacrament (Mormonism)|Sacrament]] (like [[Communion]]). The revelation gave the further precaution that if wine is used, it should be pure, and made in Mormon [[winery|wineries]]. The revelation also advised against the use of tobacco and "hot drinks", which was later interpreted as meaning [[coffee]] and [[tea]].

The list of foods and substances which the revelation encourages includes "wholesome [[herb]]s", "[[fruit]]", "in the season thereof", and [[meat]]. Two years earlier, Smith had dictated a revelation against the [[Shaker]] practice of enforcing strict [[vegetarianism]], with the qualification, however, that one who "wasteth flesh and hath no need" would be condemned. ([http://scriptures.lds.org/dc/49/18-21#18 D&C 49:18-19]). In the Word of Wisdom, Smith's dictation similarly stated that meat was to be eaten "sparingly", and ideally only in [[winter]], [[famine]], or "excess hunger".

The revelation also encouraged the use of [[cereal|grain]]s, particularly [[wheat]]. [[Barley]] was also encouraged for use in making "mild drinks" such as [[beer]].

The word of wisdom was a "principle with [a] promise". The promise given to those who followed the advice of the word of wisdom was as follows:
:And all saints who remember to keep and do these sayings, walking in obedience to the commandments, shall receive health in their navel and marrow to their bones; and shall find wisdom and great treasures of knowledge, even hidden treasures; and shall run and not be weary, and shall walk and not faint. And I, the Lord, give unto them a promise, that the destroying angel shall pass by them, as the children of Israel, and not slay them. Amen.[http://scriptures.lds.org/dc/89/18-21#18]

==Interpretation and extension of the Word of Wisdom by the Church of Jesus Christ of Latter-day Saints==

In The [[Church of Jesus Christ of Latter-day Saints]], the original ''Word of Wisdom'' has been extended into a mandatory health code required for baptism or to receive a recommend allowing entry into [[Temple (Mormonism)|Mormon temples]].

=== Adoption by Latter-day Saints as a binding health code ===
Originally, the ''Word of Wisdom'' was given in [[1833]] as a "principle with [a] promise", and was not mandatory. Indeed, observance of the principle was not widespread. After Smith's death, his successor [[Brigham Young]] proposed in [[September 9]], [[1851]] at a General Conference of the Church that the revelation be adopted as a binding commandment for all [[Latter-day Saints]].

=== The Latter-day Saint health code ===
The health code practiced by members of the Church of Jesus Christ of Latter-Day Saints includes the ''Word of Wisdom'' revelation given by [[Joseph Smith, Jr.]], but has evolved gradually through the years. The most significant innovation was the shift in emphasis away from the particular substances listed in the revelation, and toward a more general prohibition against habit-forming substances. In particular, the church has prohibited all alcoholic beverages, including "mild drinks" such as beer, which was allowed in Smith's revelation. In addition, the church came to prohibit the use of wine, even as part of the [[Sacrament (Mormonism)|Sacrament]]. Water is now used in its place. Most recently, the church has prohibited the use of narcotics. However, the church generally regards narcotics, or any other medically-useful substance, as acceptable if used as prescribed by a doctor.

In addition, the part of the code that forbids "hot drinks" has been officially interpreted as prohibiting only coffee and tea, whether or not the drinks are hot. There is no prohibition, however, against herbal tea, or hot chocolate. Most church units also do not emphasize regulations regarding the consumption of meat as prominently as done in Section 89.

===Ambiguous areas within the code===
While there is a general prohibition against habit-forming substances, certain areas within the health code are not clearly defined, and are generally amenable to one's conscience. For example, [[Latter-day Saint]]s are divided concerning the use of caffeinated soft drinks and iced tea. There is also some division concerning the use of coffee, tea, or alcohol as a cooking ingredient. It is also uncertain whether the church allows decaffeinated coffee or tea. A few rare Mormons also take a very strict view concerning caffeine, and refrain from eating chocolate.

==== Caffeinated soft drinks ====
[[Image:Cokecansmall.jpg|thumb|150px|The permissibility of [[Caffeine|caffeinated]] [[soft drink]]s, such as [[Coca-Cola]], are an ambiguous subject in regard to the Word of Wisdom. Some members abstain from caffeinated beverages, while other imbide liberally, while still avoiding hot drinks such as [[tea]] and [[coffee]].]]
The permissibility of consuming caffeinated products such as caffeinated [[soft drink|soda]]s is a longstanding issue among Latter-day Saints. Because of the statements of various Church leaders (which are not official statements nor practices of the Church), some adherents and even non-members believe that caffeine is officially prohibited under the Word of Wisdom. If this were so, other things which contain caffeine besides soda drinks would be prohibited too. Some members who hold that caffeinated sodas are prohibited distinguish between things with naturally occurring caffeine and those things where caffeine is an additive although any difference in the chemistry and effect of caffeine as an additive or naturally occurring are negligible. In short, members are divided on their stance of consumption of caffeinated beverages, though it is not usually a point of great contention. The Church has no official stance on the consumption of caffeinated beverages and the consumption of such does not constitute breaking the Word of Wisdom (that is, you can obtain a [[temple recommend]] if you regularly consume caffeinated beverages).

Given the latitude in applying the Word of Wisdom to personal circumstances, many Latter-day Saints feel that the consumption of caffeinated-sodas falls in the category of personal discretion; while some may consider consumption of caffeinated-sodas permissible, others may not. More strict Latter-day Saints hold that while no official prohibition restricts the consumption of caffeinated-sodas, consumption by any member does indeed violate the spirit of the Word of Wisdom, and a member receiving proper inspiration will recognize this as so.

==== Health subjects not explicitily addressed====
Section 89 does not specifically address illicit drugs, such as [[cocaine]],
[[methamphetamine]]s or [[cannabis|marijuana]], although the Church has officially denounced their use as a violation of that doctrine. Beyond illicit drugs, there are innumerable subjects related to the Word of Wisdom that have not been addressed in fine detail by the Church: exercise, medical treatment, junk food, etc. This is in keeping with the teachings of the Church that Latter-day Saints, having been given the Gift of the Holy Ghost, are entitled to personal revelation guiding them to make personal choices that are based on individual circumstances and are consistent with the doctrines and practices of the Church. It is not the purpose of the Church to give detailed rules for every aspect of living a [[Christian]] life. The Word of Wisdom is no exception. Thus, Latter-day Saints are expected to make wise choices pertaining to personal health that are not specifically addressed by the Word of Wisdom. This principle allows sufficient latitude for varying circumstances. For example, the specific application of the Word of Wisdom could be potentially more restrictive for a person susceptible to obesity, but that determination is solely in the discretion of the individual.

=== Purpose of the Latter-day Saint health code ===

Adding to the caffeine issue is the broader question of why tobacco, alcohol, coffee, tea and possibly caffeinated-sodas are prohibited at all. The harmful health effects of tobacco are nearly universally recognized. It is presumed in the case of coffee and tea that these drinks are prohibited because of their caffeine content. Thus, the condemnation of caffeine or caffeinated-sodas by some Church leaders. However, some Church leaders have also stated that God has not revealed why some things have been prohibited under the Word of Wisdom. Some suggest that the reasons will not become known for some time as in the case of tobacco. Some have stated further that: the primary purpose of the Word of Wisdom is, like all commandments, for spiritual benefits; and like some other commandments, earthly benefits are merely incidental. For example, there
are a number of promised rewards contingent on obedience to the Word of Wisdom not all of which appear to be direct health consequences of obedience to the dietary code. These rewards stated in section 89 include:

*"shall receive health in their navel and marrow to their bones"
*"shall find wisdom and great treasures of knowledge"
*"shall run and not be weary, and shall walk and not faint"
*"the destroying angel shall pass by them...and not slay them"

===The LDS health code and modern medicine===

==== Health effects of alcohol ====
[[Image:Margarita.jpg|thumb|All [[alcoholic beverage]]s, such as the [[Margarita]], are prohibited by the Word of Wisdom.]]
It has been long established that heavy consumption of alcohol is toxic to the human body, damaging many organs and cells in the body including the brain and liver and giving rise to a higher incidence of [[cancer]] by hindering the immune system.

However, recent scientific research indicates that moderate alcohol consumption of alcohol may provide a mild benefit to help prevent [[coronary heart disease]]. Some of the health effects can be achieved by other means. For example, the beneficial compounds found in red wine, [[polyphenol]]s and [[resveratrol]], are also found, although to a lesser extent, in [[peanut]]s, [[grape|grape juice]] and [[cranberry|cranberry juice]]. However, alcohol itself substantially reduces the risk of [[coronary heart disease]] according to a large number of studies. Whether or not the benefits of moderate drinking outweigh the risks has been a source of controversy. ''See'' [[Alcohol consumption and health]]. This controversy has been an issue of concern for some [[Latter-day Saints]] who see such scientific findings as hostile to the authority of Joseph Smith's revelation. Smith's original revelation allows for the use of beer, and other similar mild alcoholic beverages, though current church practice bans all alcohol consumption.

==== Health effects of coffee ====
''Main article, see [[Coffee#Health]]''
=====Benefits=====
*Coffee can reduce the risk of hepatocellular carcinoma, a variety of liver cancer (Inoue, 2005).
*Increases [[Short-term memory|short term recall]] and increase [[IQ]].
*Reduces the incidence of heart disease.
*Changes the [[metabolism]] of a person so that their body burns a higher proportion of [[lipid]]s to [[carbohydrate]]s, which can help athletes avoid muscle fatigue.
*Reduces the incidence of diabetes in both sexes, but reduces the risk by about 30% in women and over 50% in men.

=====Risks=====
[[Image:A small cup of coffee.JPG|thumb|While only referred to in the Word of Wisdom as "hot drinks," later revelation clarified the statement referred to drinks such as [[coffee]] and [[tea]].]]
*Alleged to cause '[[caffeinism]]', a condition which mimics mental illnesses ranging from anxiety and bipolar disorder to schizophrenia and even psychosis.
*A February [[2003]] [[Denmark|Danish]] study of 18,478 women linked heavy coffee consumption during [[pregnancy]] to significantly increased risk of [[stillbirth]]s (but no significantly increased risk of infant death in the first year).
*Associated with significant elevations in biochemical markers of [[inflammation]]. This is a detrimental effect of coffee on the cardiovascular system which may explain why coffee has so far only been shown to help the heart at levels of 4 or less cups a day (20oz or less). ([http://www.ajcn.org/cgi/content/abstract/80/4/862 abstract])

*Consumption of caffeine can create an illusion of sobriety that could be fatal in some cases. A drunken person by consuming large amounts of caffeine feels as though he or she is sober gain, but in reality his or her judgment and reflexes are still impaired. Death or injury may follow as the impaired person attempts to drive or otherwise operate heavy machinery believing, mistakenly, to be sober.

==== Health studies regarding Latter-day Saints ====
A 14-year study conducted by [[UCLA]] [[epidemiologist]] James E. Enstrom tracked the health of 10,000 moderately active LDS people in [[California]], ending in [[1987]]. Of these non-[[Tobacco smoking|smoking]], [[monogamy|monogamous]] non-[[alcoholic beverage|drinkers]], Enstrom concluded from the study "that LDS Church members who follow religious mandates barring smoking and drinking have one of the lowest death rates from cancer and cardiovascular diseases—about half that of the general population... Moreover, the healthiest LDS Church members enjoy a life expectancy eight to 11 years longer than that of the general white population in the United States." The SMRs (standardized mortality ratios) for whites in the general population is defined as 100. For males in the study, the SMRs "are 47 for all cancers, 52 for cardiovascular diseases, and 47 for all causes; the SMRs for females are 72 for all cancers, 64 for cardiovascular diseases, and 66 for all causes." For high priests who never smoked cigarettes, exercised, and had proper sleep, the mortality rate was less. The results were largely duplicated in a separate study of a Mormon-like subgroup of white non-smoking churchgoers in [[Alameda, California]].{{ref|Enstrom}}

This study and others conclude that Latter-day Saints live significantly longer, healthier lives compared to the general U.S. populace, a consequence that correlates to prohibition of cigarettes in their health code, the Word of Wisdom.

Some Latter-day Saints use these studies to extol the prohibition against even moderate consumption of alcohol, coffee, tea and tobacco as divine guidance whose wisdom will be recognized in time. However, the studies correlate health primarily with the prohibition against tobacco and, perhaps, church attendance. Critics reject these studies in part because other factors may be credited for Latter-day Saints' longevity and health.

=== Views toward modern and alternative medicine ===
The majority of Latter-day Saints acknowledge that generally the treatments of modern [[medicine]] and the advice of their [[physician]]s and the guides issued from the [[Food and Drug Administration|FDA]] is in keeping with the Word of Wisdom. In contrast to this more moderate position, a small minority of Latter-day Saints are wary of modern medicine and have interpreted the Word of Wisdom somewhat less conventionally. This group favors some aspects of [[alternative medicine]]—especially [[herbal therapy|herbal]] or [[homeopathy|homeopathic]] treatments—to modern medicine as a more effective treatment of health problems. (Other alternative lifestyle choices, such as [[home schooling]] or a strong interest in the [[Breastfeeding|La Leche League]], often appeal to this group of Latter-day Saints although interest in a particular, alternative lifestyle is not necessarily inclusive of other popular, alternative lifestyles among the Latter-day Saints.) While alternative treatments might also include [[acupuncture]] for a few, [[magnet therapy]] would be too radical. Still some of the practices, such as the heavy consumption of [[colloidal silver]] for [[common cold]]s, directly contradicts the conventional wisdom of modern medicine and the precautions advised by the FDA. Latter-day Saints generally consider most forms of alternative medicine to be [[quackery]] or based on [[pseudoscience]]. Thus, although Joseph Smith permitted a phrenologist to examine his head in the [[19th century]], nearly all Latter-day Saints now-a-days reject the validity of [[phrenology]], an academically respected field of research in its day.

==References==
*[http://scriptures.lds.org/dc/89 Text of the Word of Wisdom], ''Doctrine and Covenants'' section 89.
*[http://www.jefflindsay.com/WWisdom.shtml The cited Associated Press article and discussion of Word of Wisdom by Jeff Lindsay] (the full article is about halfway down the page)
*[http://www.watchman.org/lds/tmlds.htm ''The Watchman's'' discussion of the UCLA study]
*{{Journal reference url | URL=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=2585528&dopt=Abstract | Author=Enstrom, JE.|Title=Health practices and cancer mortality among active California Mormons | Journal=J Natl Cancer Inst. | Year=1989 Dec|Volume=6;81(23)|Pages=1807-14}}
*{{Journal reference url |Author=Bush, Lester E., Jr. | URL=http://content.lib.utah.edu/cgi-bin/docviewer.exe?CISOROOT=/dialogue&CISOPTR=6654&CISOSHOW=6557 | Title=The Word of Wisdom in Early Nineteenth-Century Perspective | Journal = Dialogue | Year=Autumn, 1981|Volume=14:3|Pages=46-65}}

==Footnotes==
#{{note|Enstrom}} Enstrom, 1989.

[[Category:Latter Day Saint texts]]
[[Category:Latter Day Saint doctrines, beliefs, and practices]]