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Who should define disease?

BMJ 2011; 342 doi: (Published 11 May 2011) Cite this as: BMJ 2011;342:d2974

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Medicine has passed from Anatomy to an Analytical Era.

Contemporary knowledge in medicine is very complex, and no human mind
can absorb it all as was possible in ancient times. Accordingly with the radical scientific, technological changes and the coming of new
paradigms, we can call the last century by several names, one of them being the century of medicine. Never before, in human history were there so many
discoveries related to medicine as there were in the 20th century.

Biophysics, Biochemistry, Immunology, Genetics, Pharmacology are
responsible for the appearance of new paradigms in the health sector.
Pathogenesis, independently from its causes, has several development
levels, from the molecular to the microscopic. Long before the
appearances observed by the naked eye, classic signs and symptoms of
disease, there are troubles at subatomic, atomic, molecular,
supramolecular, cellular, tissue levels. In each of them the body has its
own compensation mechanisms. When one of these procedures fails or is
deficient, pathological signs appear.

Disease must be defined taking into account the characteristics that it
has when the possibility of working against them exists to bring
the organism to a normal state. The majority of definitions, in health,
characterize disease in a state when is not possible to cure the patient.
Using those definitions physicians find changes in their patients when it
is only possible to do one or both of these two things: treat pharmacologically to
reduce the violence of disease and so ameliorate the clinical frame of it,
or surgically remove damaged parts of the body for solving the problem. In both cases they cannot heal or cure their patients.

Disease must be defined by its classic characteristics at tissue and
subcellular level. They can be detected by laboratory methods. At this
level, disease is at a reversible state. In this phase, a highly qualified
physician must be capable of taking correct actions for diagnosing and
reversing the problem.

Competing interests: No competing interests

31 May 2011
Emilio Polo Ledezma
Teacher of Clinical Biochemistry.
Carlos Polo Rivera - Ninth Semester Medical Student.
Health's Faculty of the Surcolombiana University, Paca Research Group, Neiva -Huila -Colombia.