Semeiotics

SEMEIOTICS, semiology (from the Greek sema, semeion—sign, mark), or symptomatology, is the collection, identification, study, and evaluation of the manifestations, signs, and symptoms of various disease states. The content of semeiotics consists primarily of symptoms (see) established through questioning, as well as those recognized through direct observation. However, under a broader interpretation of the concept of semeiotics, it may also include signs revealed by general systemic and special clinical examination, i.e., data from: 1) systematic inspection, palpation, percussion, etc., of the patient themselves; 2) direct examination of their excretions; 3) X-ray, endoscopic, laboratory, and other examinations. However, the methodology and technique of general and special methods of clinical examination do not fall within the scope of semeiotics, as they constitute a separate department of patient study. Semeiotics provides the basic material for diagnosis, while predetermining the direction of the examination. However, for diagnosis, other data not included in the scope of semeiotics are usually needed, such as the history of the present illness, general anamnesis, heredity, verification experiments on animals, etc.; the content of semeiotics is strictly the collection and evaluation of symptoms, which often leads to a diagnosis but does not yet constitute the diagnosis itself. For prognosis, semeiotics also has enormous significance, since individual indicative symptoms determine the probable direction in the course of a given disease process and possible changes in its outcome. The treatment of a given disease is also determined to a very large degree by the present symptoms. The collection of symptoms for each individual disease cannot, in any case, be limited to the patient's complaints; it must be carried out methodically, starting with symptoms of a general nature (such as general well-being, state of strength, febrile state, weight loss, etc.) and subsequently clarifying possible disorders of functions, at least of the most important, and sometimes even of all organs and systems. At the same time, however, it is necessary to identify each symptom through particularly precise questioning with all its smallest characteristic features, determining simultaneously the conditions of its appearance, possible cause, and interrelation with other symptoms and their combinations, which may have a constant character, representing a specific symptom complex or syndrome. Thus, semeiotics has, for the most part, a decisive significance for recognition, prognosis, and treatment, and therefore, in the order of clinical questioning and examination, it must be placed in the first position.