Beaney Thomas
Med Humanit. 2013 Dec 1;39(2):126-30. doi: 10.1136/medhum-2012-010297. Epub 2013 Feb 28.
The term, idiopathic, emerged as a key concept in the classification of disease in the 18th century and has become ingrained in our terminology in defining diseases and their aetiologies throughout all fields of medicine. Despite, or perhaps because of this, little has been written about the meaning or meanings of the word itself. Although most medical professionals will be able to offer a definition of idiopathic, different definitions of the word are in use and are often confused or used without an appreciation of the range of meanings. This article aims to clarify these different meanings with reference to historic and current uses. The change from the earlier nosological definition of 'primary' to the most widely accepted current definition, 'of unknown cause', occurred in the late 19th century, reflecting changing perspectives of disease causation. Far from being an innocent translation of 'unknown', idiopathic creates problems for future terminology and adds little to medical understanding. In masking the unknown, the term idiopathic maintains a paternalistic patient-practitioner relationship, and so should be avoided in modern medical terminology.
“特发性”一词在18世纪成为疾病分类中的一个关键概念，并在我们定义医学各个领域疾病及其病因的术语中根深蒂固。尽管如此，或者也许正因为如此，关于这个词本身的含义却鲜有著述。虽然大多数医学专业人员都能给出“特发性”的定义，但该词有不同的定义，且经常被混淆使用，或者在使用时并未意识到其含义范围。本文旨在参照历史和当前的用法来阐明这些不同的含义。从早期“原发性”的疾病分类学定义到目前最广泛接受的“病因不明”的定义的转变发生在19世纪后期，反映了对疾病病因看法的变化。“特发性”远非“不明原因”的简单翻译，它给未来的术语带来了问题，对医学理解也没有多大帮助。在掩盖未知方面，“特发性”一词维持了家长式的医患关系，因此在现代医学术语中应避免使用。
