Internal illnesses. Subject of internal diseases, history and objectives (lecture notes)

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Internal illnesses. Subject of internal diseases, history and objectives (lecture notes)

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LECTURE No. 1. The subject of internal diseases, history and tasks

Internal diseases is a field of clinical medicine that studies the etiology, pathogenesis, semiotics, treatment, prognosis and prevention of diseases of internal organs.

Internal medicine is the most important section of practical medicine, covering most human diseases. The term "internal diseases" came into practice in the XNUMXth century. and supplanted the more general term "therapy".

From the point of view of a clinician, any disease is a change in the normal functioning of the body, characterized by a violation of the functional activity of a particular system, a limitation of the adaptive, compensatory and reserve capabilities of the body as a whole and a decrease in its ability to work.

Disease is a dynamic process in which dynamism is determined by the coexistence of damage and repair reactions. The ratio between these reactions reflects the direction of the disease towards either recovery or progression. Elucidation of this direction makes it possible to assess the outcome of the disease, to predict the fate of the patient.

Diagnosis of a disease (from the Greek. diagnosis - "recognition") - a brief definition of the essence of the pathological process, reflecting the cause of its occurrence, the main mechanisms that led to the development of changes in the body, and the characteristics of these changes. Every diagnosis that a doctor makes is (ultimately) a differential diagnosis - weighing each individual symptom, evaluating and differentiating it.

In the early stages of development, medicine was not a science and was purely empirical knowledge based only on observations. For the first time, a representative of ancient Greek medicine, Hippocrates, when examining a patient, used palpation, listening, and compiled a description of many symptoms and syndromes of diseases. The doctrine of the pulse was created by the representative of the Alexandrian school Herophilus, the description of some signs of pleurisy, stomach ulcers, meningitis was presented by the Tajik scientist Abu-Ali Ibn-Sina (Avicenna).

In the XVIII-XIX centuries. questions of internal medicine were developed in detail by Auenbrugger, Laennec, G. I. Sokolsky, M. Ya. Mudrov, G. A. Zakharyin.

The scientific clinical school of internal medicine was created by S. P. Botkin, subsequently developed by many brilliant clinicians: I. M. Sechenov, V. P. Obraztsov, N. D. Strazhesko, B. E. Votchal, A. M. Myasnikov, N S. Molchanov, E. M. Tareev, V. Kh. Vasilenko, etc.

At the present stage of development of internal medicine, a great contribution was made by domestic scientists E. I. Chazov, P. E. Lukomsky, F. I. Komarov, G. I. Dorofeev, A. G. Chuchalin, A. I. Vorobyov and others.

The final diagnosis of the disease should include information about the etiology (etiological diagnosis), its pathogenesis (pathogenetic diagnosis), morphological changes (morphological diagnosis) and functional state (functional diagnosis) of the affected organ or system. The final diagnostic formula accumulates all types of diagnoses, and reflects the doctor's view of the pathological process by highlighting the underlying disease, complications and concomitant diseases. In the future, the doctor determines the direction of the development of the pathological process, possible outcomes and consequences of the disease. The assessment of all these changes is carried out as a result of observation of the patient, the use of special additional studies, the treatment used.

Author: Myshkina A.A.

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