WHAT IS MEDICAL SEMIOLOGY AND WHAT DOES IT STUDY? - MEDICINE - 2024

The medical semiotics or clinic is the branch of medicine that is responsible for studying and evaluating the signs that may indicate an injury or disorder of a function. Semiology can guide the doctor to a clinical examination that includes physical signs, both functional and general.

The information is complemented by other exams such as imaging and biology. The procedures developed to obtain the information, basically the interrogation and the physical examination, are known as the clinical method.

Semiology is the mainstay of clinical medicine. It is an art and a science. It presents a method to classify knowledge and its objective is the diagnosis. When well developed, this discipline allows health professionals not only to make the proper diagnosis, but also to have a prognostic evaluation and define the general lines of treatment.

The methodology of medical semiology is language and thought. Semiological science in medicine is applied in different clinical and surgical modalities.

History

The diagnosis of symptoms and signs has come a long way since Hippocrates needed to test a patient's urine.

Semiology is the study of signs, and it had its origin not in medicine but in philosophy. The medical use of the study of signs began in the 17th century and since then it has been the key to diagnosis in medicine.

Identifying signs has become increasingly dependent on the physician as time and technology have progressed.

Antony van Leeuwenhoek invented the microscope and used it to discover cells and microbes in 1674, thus opening up the possibility of identifying signs of diseases completely invisible to the naked eye, such as foreign organisms in the blood and urine, changes in the composition of the blood and waste material.

Signs and symptoms

Although many people use the words "sign" and "symptom" interchangeably, there are important differences that affect their use in the medical field.

A symptom is understood to be any subjective evidence of disease. A sign is any objective evidence of a pathology. Consequently, a symptom is a phenomenon experienced by the patient, while a sign is a phenomenon that can be detected by someone other than him.

Clinical signs are those that are obtained through clinical examination and are classified into two:

First dichotomy

• General signs: temperature, pulse, fatigue.

  Focal signs: delimited to a zone.

Second dichotomy

• Functional signs: signs detected on questioning, not verifiable by another clinical sign, such as pain or dysphagia.
• Physical signs: those obtained in the respective examination, such as redness, abnormal sound of the heartbeat.

The paraclinical signs come from complementary tests such as X-rays, computed tomography, blood tests, among others.

General signs

The general signs are not very specific, since they do not have any characteristic of the organ and are common to many conditions. The general signs allow the doctor to evaluate the general condition of the patient and the repercussions of the pathology

The basic difference between signs and symptoms is who sees the effect. A rash could be a sign, a symptom, or both. If the patient notices the rash, it is a symptom. If the doctor, nurse, or anyone other than the patient notices the rash, it is a sign.

If both the patient and the doctor notice the rash, it can be classified as a sign and a symptom.

Regardless of who realizes that a system or part of the body is not working normally, signs and symptoms are the ways in which the body lets the patient know that something is wrong.

Some signs and symptoms need a doctor's follow-up, while others can resolve without any treatment.

A symptom is a deviation from a normal function or feeling, which is evident to a patient, and reflects the presence of an unusual condition or disease. Examples of symptoms are:

• Dizziness.
• Nausea.
• Pain.

Symptom types

There are three types of symptoms:

Remitting symptoms

If symptoms improve or resolve completely, they are known as remitting symptoms. Symptoms of the common cold, for example, can occur for several days and then disappear without treatment.

Chronic symptoms

These are long-lasting or recurring. Chronic symptoms are often seen in ongoing conditions, such as diabetes, asthma, or cancer.

Recurring symptoms

They are symptoms that have occurred in the past, were resolved, and then returned. For example, symptoms of depression may not occur for years, although they may return later.

Quantitative semiology

Quantitative semiology is a branch of medical semiology, whose fundamental role consists in quantifying the relevance of a clinical sign. Studies the presence or absence of the disease, the presence or absence of a sign, in order to establish the most accurate diagnosis possible.

Doctors regularly face dilemmas when ordering and interpreting diagnostic tests. Quantitative semiology is of great help in gauging the relevance of clinical signs.

Semiology and its influence on the doctor-patient relationship

The doctor-patient relationship is a complex concept in medical sociology in which patients voluntarily approach a doctor and, therefore, become part of a contract in which they tend to comply with his guidance.

Globally, this relationship has evolved with advances in semiology and due to the commercialization and privatization of the health sector.

With the development of medical semiology, the diagnosis of diseases was significantly improved. At the same time, it has required communicational conditions that medical professionals must cultivate.

A good doctor-patient relationship and an adequate use and practice of semiology make clinical diagnosis more accurate and reliable.

The correct interpretation of the signs and symptoms, supported by rigorous clinical tests, give high reliability to the diagnoses. Medical semiology plays a fundamental role in clinical diagnosis and in the doctor-patient relationship.

References

1. Nordqvist, Christian. Reviewed by Deborah Weatherspoon. Thu 22 February 2018. Why do signs and symptoms matter? Recovered from: medicalnewstoday.com
2. Clinical semiology. (2018). Human pathology. humpath.com.
3. Chatellier G, Ménard J, Degoulet P. La Revue du Praticien.

   Introduction to quantitative semiology. Recovered from: europepmc.org.

4. Exploring the dimensions of doctor-patient relationship in clinical practice in hospital settings. (2014). Recovered from: ncbi.nlm.nih.gov.
5. Bassel Abou-Khalil and Karl E Misulis DOI (1993). Seizure Semiology. Oxfor Medicine On Line. Recovered oxfordmedicine.com.