7_Tyranny of Diagnosis - Charles Rosenberg

7_Tyranny of Diagnosis - Charles Rosenberg - 242 CharlesE...

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Charles E. Rosenberg In traditional medicine, disease concepts were focused on the individ- ual sufferer. They were symptom oriented, fluid, idiosyncratic, labile, and prognosis oriented. Diseases were seen as points in time, transient moments during a process that could follow any one of a variety of possi- ble trajectories. A common cold could become bronchitis, for example, and could then resolve without long-term consequences or could ter- minate, rapidly in a fatal pneumonia or slowly in chronic lung disease. A flux (or looseness of the bowels) could resolve itself without incident or could deteriorate into a fatal or debilitating dysentery. A humoral imbalance might manifest itself in the form of a fever or superficial le- sions as the body tried to relieve itself of noxious matter though the skin. The body was always at risk, but a risk configured in idiosyncratic, physiological, multicausal, and contingent terms (Rosenberg 1977). There were a few
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