From Big Medical Encyclopedia

SEMIOTICS (Greek semeiotikon a sign, a sign) — the doctrine about symptoms of a disease revealing them maintenance and manifestation. Page — an important component diagnoses (see). At the same time independent value as the discipline stated in training programs on has S. to propaedeutics (see) and in introduction courses various a wedge, disciplines. Except diagnosis, these S. use for forecasting, the choice of tactics of treatment and secondary prevention of diseases. At all stages of development diseases (see) the doctor repeatedly is returned to a semiotics picture of a disease, deepening and specifying it according to specific requirements of diagnostic process and with the advent of new or disappearance of originally expressed symptoms.

Distinguish the general and private S. Predmet of the general S. are the signs relating to a general characteristic of the patient (a sex, age, a profession, heredity, the postponed diseases, usual intoxications, a constitution, sexual development) and its general state (change of consciousness, position of a body, a look, coloring of integuments etc.). Each sign matters in diagnosis. Naira., women have no hemophilia And yes In, but is much more often than men and at young age are ill a lupus erythematosus; measles — a disease of preferential children's age, and atherosclerosis — advanced age; the group of occupational diseases (a silicosis of lungs, a vibration disease) is known, professional conditions can act as risk factors in development of diseases, napr, the work connected with a neuroemotional overstrain contributes to development of an idiopathic hypertensia; smoking — risk factor in developing of coronary heart disease, cancer of a lung; the role of hereditary transfer of such diseases as a diabetes mellitus, schizophrenia, etc. is big; uniform bronze coloring of integuments and pigmentation are characteristic of chronic insufficiency of adrenal glands; the pyknic constitution has independent value in development of a pulmonary heart etc. The general S. studies also reflection in symptoms of changes of function and morphology of bodies (e.g., change of such characteristics of lymph nodes as systemacity of defeat, extent of increase and consolidation, cohesion among themselves, etc. are caused by distinction of morphological changes in them at a lymphoid leukosis, a lymphosarcoma, tuberculosis, a tularemia etc.), including on the basis of researches of laboratory materials (feature of morphological composition of blood at diseases of blood and the hemopoietic bodies, feature of the analysis of urine at diseases of kidneys etc.). All elements of a general characteristic of the patient are considered by the doctor at diagnosis of any disease.

Private S.'s subject of bodies and systems of an organism are symptoms of specific diseases, mechanisms of their emergence and development, diagnostic value, assessment of degree of manifestation (see. Symptom ), features of their combination (see. Syndrome ), reasons of possible absence.

The simplest form of the scientific description and respectively initial level of a research of diseases is the empirical observation numbering the millennia of existence in medicine. It includes first of all specific sensory perception by the doctor of morphological and functional changes of an organism in comparison with norm. At big reliability of the symptoms of a disease revealed at the same time their shortcoming is subjectivity of perception by the doctor, identity of manifestation at each patient and complexity of the object of a research — the sick person, to-ry, acting as the subject, influences process of knowledge of a disease.

Scientific and technical progress considerably added and objektivizirovat sensory perception of structure and function of various systems of an organism. Tool and laboratory methods of a research gave the whole areas of special knowledge, led to their differentiation. At the same time each specialty (e.g., radiology, radiology, immunology, etc.) has the semiotics features as in definition of the allowing opportunities of methods and the importance of the obtained data, and in questions of ways of their expression.

From three main aspects of studying of signs and sign systems — sintaktik, semantics and pragmatics, by medical S. at the present stage it is most connected with two last: with semantic information and especially with pragmatics — studying of usefulness, value, clearness of a sign. In the course of the semiotics research the sign system both natural, and artificial formal languages is used. The natural language of medical terms, concepts includes also their systematization, classification, the graphic representation. In medical classification there are numerous names that sometimes causes difficulties in the correct designation of a symptom, syndrome, nosology. At the same time there are terminological difficulties. On the one hand, some symptoms or syndromes have several names — synonyms, with another — identical names receive the differing symptoms — homonyms. Congestion of the medical dictionary, lack of uniform classifications of nozologiya creates a number of difficulties, in particular in statistical processing of medical documentation. From here need of streamlining and standardization of medical terminology (see. Terminology medical ), aspiration to simplifications of schemes, classifications etc. Besides, there are objective difficulties in disclosure of maintenance of such concepts as a disease, health, norm, etc. The modern medicine uses artificial formal languages (logical-mathematical, information retrieval, programming languages, etc.) first of all with need of storing, storage and reproduction of huge medical information, its streamlining. Performance of these tasks is promoted by use of the COMPUTER. Use in medicine of cybernetics, in particular with the diagnostic purposes, met a number of difficulties, from to-rykh the main there were a difficulty of formalization of medical concepts and impossibility to reduce process of research search to creation of unambiguously operating algorithm. According to the cognitive contents this search is richer and more difficult corresponding algorithms (see). So far it was not succeeded to formalize focal points of profession of a physician and on this base to construct algorithms of inspection of the patient, processing of the received data and decision-making. Some symptoms of diseases, many morphological and functional changes, reaction of the personality to a disease and some other elements considered by medical thinking do not give in to the description in mathematical language.

Bibliography: Subbotin Yu. K. Methodological questions of medical semiotics, Vestn. USSR Academy of Medical Sciences, No. 5, page 76, 1979; it, Semiotics providing the machine diagnosis, in the same place, No. 4, page 84, 1980.

E. I. Sokolov; T. A. Polosova.