The Art of Diagnosing: Understanding the Difference Between a Symptom and a Sign.

Determining What is Wrong

When coming to making a proper diagnosis Western Medicine depends on a number of variables depending on the condition. Case history, physical exam, laboratory workups, and imaging all have their purposes for coming to the correct conclusion.

Out of the above options the case history should be where your doctor spends most of his time to correctly narrow down the list of possible ailments. If given enough time asking the right questions the patient can often tell their health practitioner what is wrong with them. (Whether they know it or not.)

Western medicine is all about coming up with the right diagnosis for disease. And mostly treats each individual set of symptoms as a unique diagnosis. Without a correct set of diagnosis treatment can't occur. Because most of western medicine's treatments are suppressive in nature, it could be harmful to treat without knowing what you are treating.

By suppressive I mean that most medications are trying to take away the symptom regardless of its cause. If the underlying cause is not changed then the medication is required to avoid the return of the symptom.

Diagnosis are comprised of both objective and subjective findings.

Subjective Findings

These are complaints or abnormalities that can't be observed by the physician and are called symptoms. Pain, dizziness, energy levels, feeling hot are all things that are perceivable to the patient but not the physician.

Objective Findings

These are complaints or abnormalities that can be observed by the doctor and are correctly called signs. Rashes, bleeding, cough, blood pressure, and body temperature are all examples of signs.

The unique combination of signs and symptoms are what make up the definition of a disease. Laboratory work and imaging also fall into the objective sphere but are generally given their own categories and are used to support the diagnosis of a disease.

Why so many diseases?

Part of the reason why there are so many new diseases and syndromes today is that there are new sources of toxicity that are suppressing enzymes which create new chains of symptoms that we are not traditionally used to. These new sets of symptoms don't fall into our previous set boxes and thus require an new classification in order to be able to start treating it.

In Western medicine when you say that you are treating a disease, often all you are treating is the symptoms and signs. If the medication takes away the complaints then the treatment is considered successful. However, if you are constantly required to take a medication you are not actually treating the cause and are just suppressing the unwanted symptom down.

What generally is not taken into account is why is the body producing the symptom in the first place? If it is diarrhea for example, taking something to stop the frequent bowel movements could actually be harmful since that is your bodies way of trying to remove hazardous microorganisms and poisons from your digestive tract. Suppressing the elimination rather then giving supportive treatment (electrolytes and hydration) could actually prolong the time that the person has diarrhea since they aren't allowed to expel the microorganisms on their own.

As a naturopathic doctor I do like having a correct diagnosis. However it is more important to know why the person is having a symptom then to know the diagnosis. Usually the two go hand-in-hand but not always. If you know what organ system is out of balance then you know what you have to do to bring the system back into homeostasis. This approach lets me successfully treat many people who feel unwell but are not yet at the point of having physical degenerations or changes.

The symptoms are indications of improper functioning rather then destruction of the body. However if you are suppressing the symptoms it is only a matter of time before physical changes do start to occur and a formal diagnosis can be made.

Clinical Example of Migraine

A good example in my practice recently is a patient that came to me for chronic daily headaches. After asking her some questions I determined that her headaches were from excess liver toxicity. Putting her on some liver supporting herbs and having her do daily castor oil packs allowed her to reduce the frequency and intensity of her headaches. We are actually in the process of likely determining that it is a toxic exposure from her workplace that is the underlying cause of her liver toxicity.

Putting her on migraine medications were ineffective because they are only trying to deal with the symptoms rather then correct the underlying toxicity. Adding more medications which had to be cleared by the liver would have put her in a repeating cycle of headache after headache.

So whats your approach to health? Are you trying to get to the underlying cause or is suppressing symptoms good enough for you? Please let me know.

References

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