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2018.04 The Positive Diagnosis of Non-Disease

The meeting on 17 April coincided with members going on a holiday to Gdansk, Adrian Simmons, one of our members, gave an in house talk on “the Positive Diagnosis of Non-Disease”. He explained that he had been a hospital consultant physician – in those days a more general physician than the super specialists of today.  His special interest was in gastro-enterology.

He began by defining disease as something that alters the body’s structure – e.g. inflammation, tumour, infection.  Then he defined illness, and said that most but not all people with a disease feel ill.

He went on to say that some people can feel ill but have no disease.  This is what he meant by non-disease. He had developed an interest in this type of patient.   And he went on to describe to us pointers in the patient which made this diagnosis of non-disease come under consideration.  He talked about a patient’s background, their manner during a consultation, the sort of symptoms they may complain of, how their symptoms progress (in some ways differently from patients with pathological disease), certain findings on clinical examination.  He mentioned some occupations which tend to be associated with non-disease, and some common non-disease clinical syndromes.

He underlined how important it was to enquire at length about the patients’ symptoms, a luxury which doctors in the current NHS may no longer have.

The talk had some amusing moments – especially when he recalled (anonymously of course) the eccentricities of past patients – and their spouses. At times it was quite a salutatory experience to see the doctor’s view – he described the “golden husband” – all consideration in the surgery, but what happened behind closed doors at home? The one that particularly amused me was the spouse who answered for the patient (guilty!).

The talk generated quite a few questions and was brought to a conclusion by the Vote of Thanks, given by Fred Archenhold.


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