Nosography

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Nosography (derived from ancient Greek: νόσος [nosos], = "disease", "damage" and γραφειν [graphein] = "write"), also (clinical) description of the disease means the description of disease states as possible without evaluation in contrast to nosology , in which it is about the systematic evaluation of the "pure descriptions". Nosography and nosology thus represent two mutually contradicting borderline concepts. Description cannot do without evaluation and nosography therefore cannot do without nosology. Nosography, however, runs the risk of indirectly and unnoticed using preconceived nosological concepts, leaving the “purely descriptive” point of view. A purely descriptive point of view is unfortunately hardly possible, but from a phenomenological point of view it is fundamentally aimed at.

Practical approach

For the above reasons, nosography is the deepest level of medical diagnostics. It is based on the specific individual case of a sick person, which must be recorded and dealt with as comprehensively and clearly as possible. This is a prerequisite for a diagnostic concept formation. When diagnosing, a doctor makes use of the experience gained in other cases of illness , whereby syndromes can also be described as intermediate stages . A collection of experiences goes beyond the description of syndromes to the abstract formulation of certain disease units and diseases . The descriptive presentation of the nosography includes all nosological criteria of the classification as viewpoints, i.e. clinical picture, pathology , disease course etc.

Dangers of extreme positions

Clinical pathology, which represents the theoretical background of medical practice, moves between two different emphases. One focus is the collection of empirical material gained from individual cases. The other emphasis is the classification of this material in a system of diagnostically different and well differentiated categories . If one of these two accents predominates, there are diagnostic and therapeutic dangers, since the treatment of diseases requires the most accurate diagnosis possible. The procedure follows the main principle of Kant's criticism : views without concepts are blind, concepts without views are empty.

  • Predominate nosographic accentuation
A predominance of nosographic emphasis consists in equating symptoms with illnesses and culminates in the “registration ad infinitum” of symptoms , cf. also the descriptive situation of psychological symptomatology today . This excess weight is colloquially contemptuously referred to as "diagnostic bean counting". Overly subjective judgments or judgments related to certain individual cases without sufficient methodologically differentiated investigation options can also flow into the description. This is e.g. B. the case of Charcot's triad, intention tremor , nystagmus , and chanting language . This complex of symptoms was considered typical of multiple sclerosis by Jean-Martin Charcot (1825–1893) . It is therefore called Charcot's disease. However, the triad is no longer considered appropriate to the common manifestations of the disease, as the disease has been studied in more detail over the course of over a hundred years. Although Charcot already examined the cases of illness known to him anatomically and pathologically and believed in this way to have found predilection for the infestation in the brain, the localizability of disturbed brain functions on which the triad is based is viewed more as a chance finding, since the foci of the disease are spread too irregularly over the nervous system.
  • Predominate nosological emphasis
The premature diagnosis and the use of preconceived nosological concepts without sufficient investigation must be seen as the predominance of nosological emphasis. This excess weight is colloquially referred to as diagnostic labeling.

Individual evidence

  1. ↑ a b Rudolf Degkwitz et al. (Ed.): Mentally ill. Introduction to Psychiatry for Clinical Study . Urban & Schwarzenberg, Munich 1982, ISBN 3-541-09911-9 ; Part II. Description and structure of mental illness; Cape. 5.1 Terms from general pathology, column indicated below with ~: - (a) p. 47 ~ 1, 48 ~ 1-2, 52 ~ 2 on stw. "Nosography"; (b) p. 48 ~ 2 on the “individual case” section.
  2. ↑ Nosography . In: Norbert Boss (Ed.): Roche Lexicon Medicine . 2nd Edition. Hoffmann-La Roche AG and Urban & Schwarzenberg, Munich 1987, ISBN 3-541-13191-8 , p. 1250, Gesundheit.de/roche
  3. ^ Criticism . In: Heinrich Schmidt : Philosophical dictionary (= Kröner's pocket edition. 13). 21st edition, revised by Georgi Schischkoff . Alfred Kröner, Stuttgart 1982, ISBN 3-520-01321-5 , p. 381.
  4. ^ Registration ad infinitum . In: Karl Jaspers : General Psychopathology . 9th edition. Springer, Berlin 1973, ISBN 3-540-03340-8 ; 4th part: The conception of the totality of mental life . Cape. 1 The synthesis of the clinical pictures. P. 472.
  5. ^ Charcot triad of symptoms . In: Gustav Bodechtel: Differential Diagnosis of Neurological Diseases . 3. Edition. Georg Thieme, Stuttgart 1974, ISBN 3-13-309103-4 , p. 342.
  6. ↑ Désiré-Magloire Bourneville , Léon Guérard: De la sclérose en plaques disséminées. Nouvelle étude sur quelques points de la sclérose en plaques disséminées par Bourneville . Adrien Delahaye, Paris 1869 ( Text Archive - Internet Archive ).