Modern medicine seeks to determine the disease process (pathology) accounting for a patient's symptoms. Once the disease process has been identified, treatment can focus on counter measures, which have proven benefit (evidence based -Q33.22).Table 3. 1 indicates the main groups of disease causation. This has been applied to the potential causes of recurrent miscarriage(recurrent miscarriage).
Table 3. 1 (Click on the appropriate Question Number)|
DISEASE PROCESS |
General Example |
Gynaecological Example |
|
CONGENITAL |
Hole in the heart
|
Absent uterus |
|
TRAUMA |
Road traffic accident
|
Pelvic floor injury during childbirth |
|
INFLAMMATION |
Influenza |
Pelvic infection |
|
metaBOLIC |
Malnutrition |
Absent periods due to malnutrition |
|
HORMONAL |
Diabetes
|
Menopause |
|
AUTOIMMUNE |
Rheumatic Disease
|
Recurrent miscarriage |
|
TUMOUR |
Lung cancer
|
Fibroid / Cancer of cervix |
|
AGEING |
Osteoarthritis
|
Menopausal vaginal symptoms |
|
PSYCHOLOGICAL |
Depression |
Premenstrual tension |
Frequently, a patient has two or more unrelated problems. You could, for example, have heavy periods and an abnormal cervical smear result. Sometimes there may be a combination of related processes: a lady may feel tired and lethargic due to anaemia(Q 24.10) resulting from heavy periods associated with fibroids (14) and, as a result of these problems, she may feel depressed.
The medical profession recognises that there may be a collection of inter-related problems. The concept that a patient should be treated as a whole person rather than as a disease process is part of the basic training of doctors although the term holistic approach seems to have been adopted by those who advocate alternative medicine to suggest that they invented the idea.
