Gastroenteritis (Stomach Flu) Glossary of Medical Terms

Abdomen: The belly , that part of the body that contains all of the structures between the chest and the pelvis . The abdomen is separated anatomically from the chest by the diaphragm , the powerful muscle spanning the body cavity below the lungs .
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Abdominal: Relating to the abdomen, the belly , that part of the body that contains all of the structures between the chest and the pelvis . The abdomen is separated anatomically from the chest by the diaphragm , the powerful muscle spanning the body cavity below the lungs .
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Abdominal pain: Pain in the belly (the abdomen). Abdominal pain can come from conditions affecting a variety of organs. The abdomen is an anatomical area that is bounded by the lower margin of the ribs above, the pelvic bone (pubic ramus) below, and the flanks on each side. Although abdominal pain can arise from the tissues of the abdominal wall that surround the abdominal cavity (the skin and abdominal wall muscles), the term abdominal pain generally is used to describe pain originating from organs within the abdominal cavity (from beneath the skin and muscles). These organs include the stomach, small intestine, colon, liver, gallbladder, and pancreas.
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Absorption: Uptake. In the biomedical sciences, absorption has diverse specific meanings.
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Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. Originally, an antibiotic was a substance produced by one microorganism that selectively inhibits the growth of another. Synthetic antibiotics, usually chemically related to natural antibiotics, have since been produced that accomplish comparable tasks.
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Antiemetics : 1. As a noun, a drug taken to prevent or treat nausea and vomiting. As, for example, the antihistamine meclizine hydrochloride (Bonine).
2. As an adjective, pertaining to the prevention or treatment of nausea and vomiting . Opening a window in a car can have an antiemetic effect.
From anti- + emetic .
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Anus: The opening of the rectum to the outside of the body.
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Appendicitis: Inflammation of the appendix , the small worm-like projection from the first part of the colon . Appendicitis usually involves infection of the appendix by bacteria that invade it and infect the wall of the appendix. Appendicitis can progress to produce an abscess (a pocket of pus) and even peritonitis (inflammation of the lining of the abdomen and pelvis).
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Atropine: A drug obtained from belladonna that is administered via injection, eye drops, or in oral form to relax muscles by inhibiting nerve responses. Used to dilate the pupils and as an antispasmodic .
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Bacteria: Single-celled microorganisms which can exist either as independent (free-living) organisms or as parasites (dependent upon another organism for life).
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Bacterial: Of or pertaining to bacteria . For example, a bacterial lung infection .
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Blood count: The calculated number of white or red blood cells (WBCs or RBCs) in a cubic millimeter of blood.
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Bowel: Another name for the intestine . The small bowel and the large bowel are the small intestine and large intestine , respectively.
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Centers for Disease Control and Prevention: The US agency charged with tracking and investigating public health trends. The stated mission of the Centers for Disease Control and Prevention, commonly called the CDC, is "To promote health and quality of life by preventing and controlling disease, injury, and disability."
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Chronic: This important term in medicine comes from the Greek chronos, time and means lasting a long time.
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Clostridium: A group of anaerobic bacteria (bacteria that thrive in the absence of oxygen ). There are 100+ species of Clostridium. They include, for examples, Clostridium difficile , Clostridium perfringens (also called Clostridium welchii), and Clostridium botulinum.
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Clostridium difficile: A bacterium that is one of the most common causes of infection of the large bowel (colon). In technical terms, Clostridium difficile (C. difficile) is an obligate anaerobic or microaerophilic, gram-positive, spore-forming, rod-shaped bacillus.
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Colitis: Inflammation of the large intestine (the colon). There are many forms of colitis , including ulcerative colitis , Crohn's disease , infectious, pseudomembranous, and spastic. For example, intermittent rectal bleeding , crampy abdominal pain and diarrhea can be symptoms of ulcerative colitis. Diagnosis can be made by barium enema, but direct visualization (sigmoidoscopy or colonoscopy ) is the most accurate test. Long-standing ulcerative colitis increases the risk for colon cancer . Ulcerative colitis can also be associated with inflammation in joints, spine, skin, eyes, the liver and its bile ducts. Treatment of ulcerative colitis can involve medications and surgery.
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Colitis: Inflammation of the large intestine (the colon). There are many forms of colitis , including ulcerative colitis , Crohn's disease , infectious, pseudomembranous, and spastic. For example, intermittent rectal bleeding , crampy abdominal pain and diarrhea can be symptoms of ulcerative colitis. Diagnosis can be made by barium enema, but direct visualization (sigmoidoscopy or colonoscopy ) is the most accurate test. Long-standing ulcerative colitis increases the risk for colon cancer . Ulcerative colitis can also be associated with inflammation in joints, spine, skin, eyes, the liver and its bile ducts. Treatment of ulcerative colitis can involve medications and surgery.
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Complete blood count : A set values of the cellular (formed elements) of blood. These measurements are generally determined by specially designed machines that analyze the different components of blood in less than a minute.
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Crohn's disease : A chronic inflammatory disease, primarily involving the small and large intestine, but which can affect other parts of the digestive system as well. It is named for Burrill Crohn, the American gastroenterologist who first described the disease in 1932.
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Cryptosporidium: See: Cryptosporidiosis .
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Dehydration : Excessive loss of body water. Diseases of the gastrointestinal tract that cause vomiting or diarrhea may, for example, lead to dehydration. There are a number of other causes of dehydration including heat exposure, prolonged vigorous exercise (e.g., in a marathon), kidney disease, and medications (diuretics).
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Diabetes: Refers to diabetes mellitus or, less often, to diabetes insipidus . Diabetes mellitus and diabetes insipidus share the name "diabetes" because they are both conditions characterized by excessive urination (polyuria).
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Diarrhea : A familiar phenomenon with unusually frequent or unusually liquid bowel movements, excessive watery evacuations of fecal material. The opposite of constipation . The word "diarrhea" with its odd spelling is a near steal from the Greek "diarrhoia" meaning "a flowing through." Plato and Aristotle may have had diarrhoia while today we have diarrhea. There are myriad infectious and noninfectious causes of diarrhea.
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Diverticulitis: Inflammation of the diverticula (small outpouchings) along the wall of the colon, the large intestine. (One outpouching is a diverticulum; two or more are diverticula).
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Dry mouth: The condition of not having enough saliva to keep the mouth wet. This is due to inadequate function of the salivary glands. Everyone has dry mouth once in a while when they are nervous, upset or under stress. But if someone has a dry mouth most all of the time, it can be uncomfortable and lead to serious health problems.
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Dry skin: Abnormally dry skin . Can be caused by a dry climate, winter weather, deficiency of vitamin A , systemic illness, overexposure to sunlight, or medication . The skin loses moisture. It may crack and peel. Or it may become irritated, inflamed, and itch . Bathing frequently, especially with soaps, can contribute to dry skin.
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Dysentery: Inflammation of the intestine, often with pain, diarrhea , bloody stools, etc. It is usually caused by infestation of the bowel by an ameba. Dysentery can be fatal, usually due to severe dehydration . Treatment includes rapid rehydration, sometimes via IV, and medication. From the Greek "dys-" meaning "abnormal or painful" + "enteron" meaning "intestine" = abnormal or painful intestine.
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Electrolyte: An electrolyte is a substance that will dissociate into ions in solution and acquire the capacity to conduct electricity. The electrolytes include sodium, potassium, chloride, calcium and phosphate. Informally, called lytes. (The clue to the word electrolyte is in the lyte which comes from the Greek lytos meaning that may be dissolved.)
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Enteric: Pertaining to the small intestine . Also called (less often) enteral.
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Escherichia coli: Full term for E. coli, the colon bacillus.
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Essential: 1. Something that cannot be done without.
2. Required in the diet, because the body cannot make it. As in an essential amino acid or an essential fatty acid.
3. Idiopathic. As in essential hypertension. "Essential" is a hallowed term meaning "We don't know the cause."
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Fever : Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.).
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Flu: Short for influenza . The flu is caused by viruses that infect the respiratory tract which are divided into three types, designated A, B, and C. Most people who get the flu recover completely in 1 to 2 weeks, but some people develop serious and potentially life-threatening medical complications, such as pneumonia . Much of the illness and death caused by influenza can be prevented by annual influenza vaccination.
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Food poisoning : A common flu-like illness typically characterized by nausea, vomiting and diarrhea , due to something the victim ate or drank that contained noxious bacteria, viruses, parasites, metals or toxins.
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Gallbladder: A pear-shaped organ just below the liver that stores the bile secreted by the liver. During a fatty meal, the gallbladder contracts, delivering the bile through the bile ducts into the intestines to help with digestion. Abnormal composition of bile leads to formation of gallstones , a process termed cholelithiasis . The gallstones cause cholecystitis , inflammation of the gallbladder.

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Gastroenteritis: Inflammation of the stomach and the intestines. Can cause nausea and vomiting and/or diarrhea . Gastroenteritis has numerous causes: including infectious organisms (viruses, bacteria, etc.), food poisoning , and stress.
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Gastrointestinal: Adjective referring collectively to the stomach and small and large intestines.
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Gastrointestinal tract: The tube that extends from the mouth to the anus in which the movement of muscles and release of hormones and enzymes digest food. The gastrointestinal tract starts with the mouth and proceeds to the esophagus, stomach, duodenum, small intestine, large intestine (colon), rectum and, finally, the anus. Also called the alimentary canal, digestive tract and, perhaps most often in conversation, the GI tract.
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Giardia: A genus of protozoa that infect the gastrointestinal tract of some animals, including humans. Giardia have a large sucking disk which permits them to adhere to the intestinal lining. The species that infects humans (and causes diarrhea ) is Giardia lamblia .
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Giardia lamblia: A parasite responsible for a contagious form of diarrhea . The parasite is most commonly transmitted through direct contact with infected feces or by eating food or drinking water contaminated by feces. Giardia is one of the most common intestinal parasites in the world. The disease is most prevalent in developing countries, where infections are associated with poor sanitary conditions, poor water quality control, and overcrowding. Giardia is also a major cause of waterborne outbreaks of diarrhea in the US, primarily in mountainous areas where water supplies may be contaminated with feces from humans or animals such as beavers. Campers and backpackers should therefore avoid drinking untreated water from mountain streams. Giardiasis affects three times as many children as adults. It particularly affects diapered children and toddlers being toilet-trained. Families with young children who attend day-care centers are at greater risk of developing giardiasis than is the general population.
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Giardiasis: Infection with Giardia lamblia .
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Immune: Protected against infection. The Latin immunis means free, exempt.
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Indicate: In medicine, to make a treatment or procedure advisable because of a particular condition or circumstance. For example, certain medications are indicated for the treatment of hypertension during pregnancy while others are contraindicated .
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Infant: A child up to 2 years (24 months) of age.
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Infection: The growth of a parasitic organism within the body. (A parasitic organism is one that lives on or in another organism and draws its nourishment therefrom.) A person with an infection has another organism (a "germ") growing within him, drawing its nourishment from the person.
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Inflammation: A basic way in which the body reacts to infection , irritation or other injury, the key feature being redness, warmth, swelling and pain . Inflammation is now recognized as a type of nonspecific immune response .
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Influenza: The flu is caused by viruses that infect the respiratory tract which are divided into three types, designated A, B, and C. Most people who get the flu recover completely in 1 to 2 weeks, but some people develop serious and potentially life-threatening medical complications, such as pneumonia . Much of the illness and death caused by influenza can be prevented by annual influenza vaccination.
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Intestine: The long, tubelike organ in the abdomen that completes the process of digestion. It consists of the small and large intestines.
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Kidney: One of a pair of organs located in the right and left side of the abdomen which clear "poisons" from the blood, regulate acid concentration and maintain water balance in the body by excreting urine. The kidneys are part of the urinary tract. The urine then passes through connecting tubes called "ureters" into the bladder. The bladder stores the urine until it is released during urination.

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Laboratory: A place for doing tests and research procedures and preparing chemicals, etc. Although "laboratory" looks very like the Latin "laboratorium" (a place to labor, a work place), the word "laboratory" came from the Latin "elaborare" (to work out, as a problem, and with great pains), as evidenced by the Old English spelling "elaboratory" designating "a place where learned effort was applied to the solution of scientific problems."
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Lactose: The sugar found in milk. The body uses the enzyme lactase to break down lactose into galactose and glucose .
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Lactose intolerance : Inability to digest lactose, a component of milk and most other dairy products. Lactose is sometimes also used as an ingredient in other foods, so those with a lactase deficiency should check labels carefully.
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Leukocytes: Cells that help the body fight infections and other diseases. Also called white blood cells (WBCs).
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Lightheadedness: A feeling you are "going to faint." Lightheadedness is medically distinct from dizziness, unsteadiness, and vertigo. See: Dizziness , Unsteadiness, and Vertigo .
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Liter: A metric measure of capacity that, by definition, is equal to the volume of a kilogram of water at 4 degrees centigrade and at standard atmospheric pressure of 760 millimeters of mercury.

• Metric equivalents -- There are 1000 cubic centimeters or 1 cubic decimeter in 1 liter.
• U.S. equivalent -- A liter is a little more than a quart (1.057 U.S. liquid quarts).

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Lumen: A luminous term referring to the channel within a tube such as a blood vessel or to the cavity within a hollow organ such as the intestine . Lumen is a luminous term because it is Latin for light, including the light that comes through a window. When a hollow organ is cut across, you can see light through the space that has been opened. So the word "lumen" came to mean this space.
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Medical history: 1. In clinical medicine, the patient's past and present which may contain clues bearing on their health past, present, and future. The medical history, being an account of all medical events and problems a person has experienced, including psychiatric illness, is especially helpful when a differential diagnosis is needed.
2. The history of medicine.
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Mouth: 1. The upper opening of the digestive tract, beginning with the lips and containing the teeth, gums, and tongue. Foodstuffs are broken down mechanically in the mouth by chewing and saliva is added as a lubricant. Saliva contains amylase, an enzyme that digests starch. 2. Any opening or aperture in the body. The mouth in both senses of the word is also called the os, the Latin word for an opening, or mouth. The o in os is pronounced as in hope. The genitive form of os is oris from which comes the word oral.
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Nausea: Nausea, is the urge to vomit. It can be brought by many causes including, systemic illnesses, such as influenza , medications, pain, and inner ear disease. When nausea and/or vomiting are persistent, or when they are accompanied by other severe symptoms such as abdominal pain , jaundice , fever, or bleeding, a physician should be consulted.
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Norovirus: A group of viruses that are a common cause of food poisoning and acute gastroenteritis ("stomach flu") that can strike quickly with force and make a person feel very sick but which typically resolves within 2-3 days. The characteristic symptoms are nausea, vomiting, diarrhea , and abdominal cramping. The diarrhea is not bloody. Fever, if present, is low-grade. Dehydration is the main complication, especially in infants and the elderly, and may need medical attention.
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Norwalk virus: A family of small round viruses that are an important cause of viral gastroenteritis (viral inflammation of the stomach and intestines). Norwalk disease is a significant contributor to illness in the US. Only the common cold is reported more frequently as a cause of disease. About a third of all cases of viral gastroenteritis after infancy are due to Norwalk viruses.
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Oral rehydration therapy: The administration of special fluids by mouth treat dehydration . Abbreviated ORT. See also: Oral rehydration salts.
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Ounce: A measure of weight equal to 1/16^th of a pound or, metrically, 28.35 grams. The abbreviation for ounce is oz. (An ounce of prevention is reputedly worth a pound of cure.)
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Ova: Plural form of ovum.
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Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse, as in disorders like fibromyalgia . Pain is mediated by specific nerve fibers that carry the pain impulses to the brain where their conscious appreciation may be modified by many factors.
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Pancreatitis : Inflammation of the pancreas. Of the many diverse causes of pancreatitis , the most common are alcohol and gallstones .

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Parasite: An organism that lives in or on and takes its nourishment from another organism. A parasite cannot live independently.
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Pathology: The study of disease. Pathology has been defined as "that branch of medicine which treats of the essential nature of disease." The word "pathology" comes from the Greek words "pathos" meaning "disease" and "logos" meaning "a treatise" = a treatise of disease. The word "pathology" is sometimes misused to mean disease as, for example, "he didn't find any pathology" (meaning he found no evidence of disease). A medical doctor that specializes in pathology is called a pathologist. Pathologists are experts at interpreting microscopic views of body tissues.
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Pediatric: Pertaining to children.
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Pediatrics: "Pediatrics is concerned with the health of infants, children and adolescents, their growth and development, and their opportunity to achieve full potential as adults." (Richard E.Behrman in Nelson's Textbook of Pediatrics)
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Pharmacy: A location where prescription drugs are sold. A pharmacy is, by law, constantly supervised by a licensed pharmacist.
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Poisoning: Taking a substance that is injurious to health or can cause death. Poisoning is still a major hazard to children, despite child-resistant (and sometimes adult-resistant) packaging and dose-limits per container.
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Potassium: The major positive ion (cation) found inside of cells. The chemical notation for potassium is K⁺.
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Primary care: The "medical home" for a patient, ideally providing continuity and integration of health care. All family physicians and most pediatricians and internists are in primary care. The aims of primary care are to provide the patient with a broad spectrum of care, both preventive and curative, over a period of time and to coordinate all of the care the patient receives.
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Primary care provider: In insurance parlance, a physician chosen by or assigned to a patient, who both provides primary care and acts as a gatekeeper to control access to other medical services.
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Pseudomembranous colitis: Severe inflammation of the inner lining of the colon. Pseudomembranous colitis is characterized by pus and blood in the stool and often caused by antibiotics.
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Rectum: The last 6 to 8 inches of the large intestine. The rectum stores solid waste until it leaves the body through the anus. The word rectum comes from the Latin rectus meaning straight (which the human rectum is not).
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Rehydrate: To restore lost water to the body tissues and fluids. Prompt rehydration is imperative whenever dehydration occurs, from diarrhea , exposure, lack of drinking water, or medication use. Rehydration can be by oral or IV administration of fluids.
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Rehydration: The process of restoring lost water to the body tissues and fluids. Prompt rehydration is imperative whenever dehydration occurs, from diarrhea , exposure, lack of drinking water, or medication use. Rehydration can be by the oral route or by the intravenous administration of fluids.
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Respiratory: Having to do with respiration, the exchange of oxygen and carbon dioxide. From the Latin re- (again) + spirare (to breathe) = to breathe again.
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Rotavirus (RV): A leading cause of severe winter diarrhea in young children, RV each year causes an estimated 500,000 doctor visits and 50,000 hospital admissions in the United States. Almost everyone catches RV before entering school but, with rehydration (and good nutrition), nearly all recover fully. However, in poor countries it is estimated that there are at least 600,000 deaths of children under 5 years from RV diarrhea and dehydration .
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Salmonella: A group of bacteria that cause typhoid fever and a number of other illnesses, including food poisoning , gastroenteritis and enteric fever from contaminated food products.
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Shigella: A group of bacteria that normally inhabit the intestinal tract and cause infantile gastroenteritis , summer diarrhea of childhood and various forms of dysentery including epidemic and opportunistic bacillary dysentery. Named for the Japanese bacteriologist Kiyoshi Shiga (1870-1957).
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Sodium: The major positive ion (cation) in fluid outside of cells. The chemical notation for sodium is Na⁺. When combined with chloride, the resulting substance is table salt.
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Staph: Very commonly used shortened form of Staphylococcus , a very common and important group of bacteria. See Staphylococcus .
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Staphylococcus: A group of bacteria that cause a multitude of diseases. Under a microscope, Staphylococcus bacteria are round and bunched together. They can cause illness directly by infection, or indirectly through products they make, such as the toxins responsible for food poisoning and toxic shock syndrome . The best known member of the Staphylococcus family is Staphylococcus aureus . Staphylococcus are the main culprit in hospital-acquired infections, and cause thousands of deaths every year.
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Stomach: 1. The sac-shaped digestive organ that is located in the upper abdomen, under the ribs. The upper part of the stomach connects to the esophagus, and the lower part leads into the small intestine.
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Stomach flu: So-called "stomach flu" actually has nothing to do with the influenza (flu) virus. This term is sometimes used to describe gastrointestinal illnesses caused by other microorganisms.
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Stool: The solid matter discharged in a bowel movement.
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Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the patient's comfort and quality of life.
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Sweat: A colorless transparent acidic fluid with a distinctive odor secreted by the small tubular sudoriferous (sweat) glands situated within the skin and under it in the subcutaneous tissue . The sweat glands discharge their fluid through tiny openings in the surface of the skin.
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Teaspoon: An old-fashioned but convenient household measure. A teaspoon holds about 5 cc of liquid.
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Therapy: The treatment of disease .
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Toxin: One of a number of poisons produced by certain plants, animals, and bacteria.
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Traveler's diarrhea: Diarrhea that results from infections acquired while traveling to another country. Among the causes of traveler's diarrhea are enterotoxigenic E. coli and a variety of viruses.
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Typhoid: See: Typhoid fever .
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Typhoid fever : An acute illness with fever caused by infection with the Salmonella typhi bacteria contracted from contaminated water and food. The disease has an insidious onset characterized by fever, headache, constipation , malaise , chills, and myalgia (muscle pain). Diarrhea is uncommon, and vomiting is not usually severe. Confusion, delirium, intestinal perforation, and death may occur in severe cases. Without therapy , the illness may last for 3 to 4 weeks and death rates range between 12% and 30%. The disease is transmitted through contaminated drinking water or food. Large epidemics are most often related to fecal contamination of water supplies or street vended foods. A chronic carrier state -- excretion of the organism for more than 1 year -- occurs in approximately 5% of cases. Typhoid Mary was a chronic carrier.
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Ulcerative colitis : A relatively common disease that causes inflammation of the large intestine (the colon). The cause is unknown.
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Vaccination: Injection of a killed microbe in order to stimulate the immune system against the microbe, thereby preventing disease. Vaccinations, or immunizations , work by stimulating the immune system, the natural disease-fighting system of the body. The healthy immune system is able to recognize invading bacteria and viruses and produce substances (antibodies) to destroy or disable them. Immunizations prepare the immune system to ward off a disease. To immunize against viral diseases, the virus used in the vaccine has been weakened or killed. To only immunize against bacterial diseases, it is generally possible to use a small portion of the dead bacteria to stimulate the formation of antibodies against the whole bacteria. In addition to the initial immunization process, it has been found that the effectiveness of immunizations can be improved by periodic repeat injections or "boosters." Also see Vaccines (in the plural) and Vaccine of a specific type (such Vaccine, Polio).
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Vaccines: Microbial preparations of killed or modified microorganisms that can stimulate an immune response in the body to prevent future infection with similar microorganisms. These preparations are usually delivered by injection.
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Vibrio: A group of bacteria that includes Vibrio cholerae, the agent of cholera , (a devastating and sometimes lethal disease with profuse watery diarrhea ) and Vibrio comma (which is shaped like a comma). Vibrio move about actively . The word "vibrio" in Latin means "to quiver."
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Vibrio cholerae: One of the Vibrio bacteria, V. cholerae (as the name implies) is the agent of cholera , a devastating and sometimes lethal disease with profuse watery diarrhea .
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Viral: Of or pertaining to a virus. For example, "My daughter has a viral rash ."
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Viral infection: Infection caused by the presence of a virus in the body. Depending on the virus and the person's state of health, various viruses can infect almost any type of body tissue, from the brain to the skin. Viral infections cannot be treated with antibiotics; in fact, in some cases the use of antibiotics makes the infection worse. The vast majority of human viral infections can be effectively fought by the body's own immune system , with a little help in the form of proper diet, hydration, and rest. As for the rest, treatment depends on the type and location of the virus, and may include anti-viral or other drugs.
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Virus: A microorganism smaller than a bacteria, which cannot grow or reproduce apart from a living cell. A virus invades living cells and uses their chemical machinery to keep itself alive and to replicate itself. It may reproduce with fidelity or with errors (mutations)-this ability to mutate is responsible for the ability of some viruses to change slightly in each infected person, making treatment more difficult.
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Viruses: Small living particles that can infect cells and change how the cells function. Infection with a virus can cause a person to develop symptoms. The disease and symptoms that are caused depend on the type of virus and the type of cells that are infected.
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Vomit: Matter from the stomach that has come up into and may be ejected beyond the mouth, due to the act of vomiting.
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World Health Organization: An agency of the United Nations established in 1948 to further international cooperation in improving health conditions. Although the World Health Organization inherited specific tasks relating to epidemic control, quarantine measures, and drug standardization from the Health Organization of the League of Nations (that was set up in 1923) and from the International Office of Public Health at Paris (established in 1909), the World Health Organization was given a broad mandate under its constitution to promote the attainment of "the highest possible level of health" by all people. WHO defines health positively as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity."
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