{"id":3224,"date":"2021-12-02T10:00:59","date_gmt":"2021-12-02T09:00:59","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-humanities\/?p=3224"},"modified":"2021-12-10T11:06:12","modified_gmt":"2021-12-10T10:06:12","slug":"the-illness-disease-dichotomy-and-the-biological-clinical-splitting-of-medicine","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-humanities\/2021\/12\/02\/the-illness-disease-dichotomy-and-the-biological-clinical-splitting-of-medicine\/","title":{"rendered":"The Illness-Disease Dichotomy and the Biological-Clinical Splitting of Medicine"},"content":{"rendered":"<p><strong>Article Summary by Luigi Tesio and Marco Buzzoni<\/strong><\/p>\n<p>Suffering from an \u201cillness without a disease\u201d is a common condition. The person is suffering, but no abnormalities can be found in the body. This is the case for chronic fatigue, fibromyalgia, many chronic pain syndromes, and most psychiatric disturbances. The article replies to the debate between defenders and deniers of \u201cpurely\u201d psychological suffering (\u201cit\u2019s all in the mind\u201d), which is important for addressing the stigma of suffering from such conditions as well as discussions about (the need for) biological causes and treatments.<\/p>\n<p>A position reconciling the opposing views is proposed. Neuro-biological phenomena subtend any psychological state, but psychological states can influence biological phenomena. The linear cause-and-effect chain should be replaced by a bidirectional causal vector, varying from case to case, between illness and disease. This would heal many dichotomies affecting medicine, such as those between \u201csymptomatic\u201d and \u201cdisease-modifying\u201d treatments, \u201crehabilitative-palliative\u201d and \u201ccuring\u201d approaches, and, most importantly, the dichotomy between biological science and clinical assistance.<\/p>\n<p>Read the full article on the <a href=\"https:\/\/mh.bmj.com\/content\/47\/4\/507\"><strong>Medical Humanities<\/strong><\/a> journal website.<\/p>\n<p>&nbsp;<\/p>\n<p><em><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-3225\" src=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Tesio-200x300.jpg\" alt=\"Luigi Tesio\" width=\"200\" height=\"300\" srcset=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Tesio-200x300.jpg 200w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Tesio-768x1149.jpg 768w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Tesio-1026x1536.jpg 1026w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Tesio-1368x2048.jpg 1368w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Tesio-640x958.jpg 640w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Tesio-scaled.jpg 1710w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/>Luigi Tesio is an MD, and Full Professor of Physical and Rehabilitation Medicine (PRM) at the University of Milan. He is the Director of the Department of Neurorehabilitation Sciences at the Istituto Auxologico Italiano, a leading research hospital in Milan. His research fields are 1) neuro-mechanical correlations in balance and gait; 2) neuro-mechanical and psycho-mechanical correlations of voluntary movement; 3) psychometrics and outcome measurement in disability studies; and the epistemology of PRM. Representative publications in these fields include: \u201cPhysical and Rehabilitation Medicine targets relational organs,\u201d<\/em> International Journal of Rehabiltiation Research <em>(2020); \u201cThe Motion of Body Center of Mass During Walking: A Review Oriented to Clinical Applications.\u201d\u00a0<\/em>Frontiers in Neurology<em>(2019); \u201cAPAs Constraints to Voluntary Movements: The Case for Limb Movements Coupling.\u201d<\/em>Frontiers in Human Neuroscience-Rehabilitation (<em>2017); \u201cEfficacy and Safety of Extracranial Vein Angioplasty in Multiple Sclerosis: A Randomized Clinical Trial.\u201d<\/em>Journal of The American Medical Association-Neurology <em>(2017); \u201cThe good-hearted and the clever. Why Medicine can be a science (in Italian).\u201d<\/em>Il Pensiero Scientifico Editore <em>(Rome, 2015). \u201cBridging the gap between Biology and Clinical Medicine. Some help from Rasch measurement theory.\u201d<\/em>Journal of Applied measurement <em>(2004).<\/em><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><em><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-3226\" src=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Buzzoni-210x300.jpg\" alt=\"Marco Buzzoni\" width=\"210\" height=\"300\" srcset=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Buzzoni-210x300.jpg 210w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Buzzoni-768x1095.jpg 768w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Buzzoni-1078x1536.jpg 1078w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Buzzoni-1437x2048.jpg 1437w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Buzzoni-640x912.jpg 640w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Buzzoni-scaled.jpg 1796w\" sizes=\"auto, (max-width: 210px) 100vw, 210px\" \/>Marco Buzzoni is Full Professor of Philosophy of Science in the Department of Humanistic Studies at the University of Macerata, Italy. He was an Alexander von Humboldt-Fellow at the Universities of W\u00fcrzburg, Marburg, Duisburg-Essen and Berlin (TU), Ordinary member and assessor of the Acad\u00e9mie Internationale de Philosophie des Sciences, Ordinary Member of the Institut International de Philosophie, and co-editor of the \u201cEpistemologia\u201d special issue published annually by the journal <strong>Axiomathes<\/strong>. His fields of research are: science and technology, epistemology and methodology of human sciences, philosophy of biology and medicine, and the philosophy of thought experiments. Major publications include: <\/em>Knowledge and Reality in K.R. Popper<em> (Milan, 1982); <\/em>Theory of Meaning, Ontology and Hermeneutics of Scientific Knowledge. Essay on Thomas Kuhn <em>(Milan, 1986); <\/em>Operationalism and Hermeneutics. Essay on the Epistemological and Methodological Status of Psychoanalysis <em>(Milan, 1989); <\/em>Science and Technique. Theory and Experience in Natural Sciences <em>(Rome, 1995); <\/em>Experiment and thought experiment<em> (Milan 2004); <\/em>Thought Experiment in the Natural Sciences<em> (W\u00fcrzburg, 2008).<\/em><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Article Summary by Luigi Tesio and Marco Buzzoni Suffering from an \u201cillness without a disease\u201d is a common condition. The person is suffering, but no abnormalities can be found in the body. This is the case for chronic fatigue, fibromyalgia, many chronic pain syndromes, and most psychiatric disturbances. The article replies to the debate between [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-humanities\/2021\/12\/02\/the-illness-disease-dichotomy-and-the-biological-clinical-splitting-of-medicine\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":345,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15028,15047],"tags":[15044],"class_list":["post-3224","post","type-post","status-publish","format-standard","hentry","category-journal-announcements","category-special-issues","tag-research"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The Illness-Disease Dichotomy and the Biological-Clinical Splitting of Medicine - Medical Humanities<\/title>\n<meta name=\"description\" content=\"&#039;The article replies to the debate between defenders and deniers of \u201cpurely\u201d psychological suffering (\u201cit\u2019s all in the mind\u201d), which is important for addressing the stigma of suffering from such conditions.&#039;\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-humanities\/2021\/12\/02\/the-illness-disease-dichotomy-and-the-biological-clinical-splitting-of-medicine\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Illness-Disease Dichotomy and the Biological-Clinical Splitting of Medicine - Medical Humanities\" \/>\n<meta property=\"og:description\" content=\"&#039;The article replies to the debate between defenders and deniers of \u201cpurely\u201d psychological suffering (\u201cit\u2019s all in the mind\u201d), which is important for addressing the stigma of suffering from such conditions.&#039;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-humanities\/2021\/12\/02\/the-illness-disease-dichotomy-and-the-biological-clinical-splitting-of-medicine\/\" \/>\n<meta property=\"og:site_name\" content=\"Medical Humanities\" \/>\n<meta property=\"article:published_time\" content=\"2021-12-02T09:00:59+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-12-10T10:06:12+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2021\/11\/Tesio-Luigi-and-Buzzoni-Marco-The-Illness-Disease-Dichotomy-and-the-Biological-Clinical-Splitting-of-Medicine-Tesio-200x300.jpg\" \/>\n<meta name=\"author\" content=\"Chris Pak\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Chris Pak\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading 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