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什么叫做症状?

What is called symptom?

作者信息

Eriksen Thor Eirik, Risør Mette Bech

机构信息

Department of Occupational and Environmental Medicine, University Hospital of North Norway, Box 6060, 9038, Tromsø, Norway,

出版信息

Med Health Care Philos. 2014 Feb;17(1):89-102. doi: 10.1007/s11019-013-9501-5.

Abstract

There is one concept in medicine which is prominent, the symptom. The omnipresence of the symptom seems, however, not to be reflected by an equally prominent curiosity aimed at investigating this concept as a phenomenon. In classic, traditional or conventional medical diagnostics and treatment, the lack of distinction with respect to the symptom represents a minor problem. Faced with enigmatic conditions and their accompanying labels such as chronic fatigue syndrome, fibromyalgia, medically unexplained symptoms, and functional somatic syndromes, the contestation of the symptom and its origin is immediate and obvious and calls for further exploration. Based on a description of the diagnostic framework encompassing medically unexplained conditions and a brief introduction to how such symptoms are managed both within and outside of the medical clinic, we argue on one hand how unexplained conditions invite us to reconsider and re-think the concept we call a "symptom" and on the other hand how the concept "symptom" is no longer an adequate and necessary fulcrum and must be enriched by socio-cultural, phenomenological and existential dimensions. Consequently, our main aim is to expand both our interpretative horizon and the linguistic repertoire in the face of those appearances we label medically unexplained symptoms.

摘要

医学中有一个概念十分突出,即症状。然而,症状的普遍存在似乎并未引发人们对这一概念进行深入研究的同等强烈的好奇心,而这一概念本身就是一种现象。在经典、传统或常规的医学诊断与治疗中,对症状缺乏区分并非一个大问题。面对诸如慢性疲劳综合征、纤维肌痛、医学上无法解释的症状以及功能性躯体综合征等难以捉摸的病症及其相应标签时,对症状及其根源的质疑立刻就显现出来,且十分明显,这就需要进一步探究。基于对包含医学上无法解释的病症的诊断框架的描述以及对这类症状在医疗诊所内外如何处理的简要介绍,我们一方面论证医学上无法解释的病症如何促使我们重新思考和审视我们所称的“症状”这一概念,另一方面论证“症状”这一概念已不再是一个充分且必要的支点,必须从社会文化、现象学和存在主义层面加以丰富。因此,我们的主要目标是,面对那些我们标记为医学上无法解释的症状的表象,拓宽我们的解释视野和语言储备。

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