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[[File:Atm1 sclerodermia.jpg|left|300px]]

[[File:Atm1 sclerodermia.jpg|left|300px]]

In this chapter, we will discuss current medical language. Specifically, we will discuss the study of the relationships between linguistic expressions and the world to which they refer, or which they should describe. The conclusion is that once the vagueness and ambiguity of this form of language (and therefore the negative consequences that all this entails) have been revealed, there is a need to make it more precise and complete. We want to focus on more mathematical and rigorous reasoning because it can be much more effective if we can manipulate it the right way as we will discuss in this chapter.

In this chapter, we will discuss current medical language. Specifically, we will discuss the study of the relationships between linguistic expressions and the world to which they refer, or which they should describe.  

 

The conclusion is that once the vagueness and ambiguity of this form of language (and therefore the negative consequences that all this entails) have been revealed, there is a need to make it more precise and complete. We want to focus on more mathematical and rigorous reasoning because it can be much more effective if we can manipulate it the right way as we will discuss in this chapter.

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{{ArtBy|

First of all, we must distinguish between natural languages (English, German, Italian, etc.) and formal languages, such as mathematics. The natural ones emerge naturally in social communities as much as in scientific communities. Simultaneously, the formal languages are artificially built for use in disciplines such as mathematics, logic and computer programming. Formal languages are characterized by ''syntax'' and ''semantics'' with precise rules, while a natural language has a fairly vague syntax known as ''grammar'' and lacks any explicit semantics.  

First of all, we must distinguish between natural languages (English, German, Italian, etc.) and formal languages, such as mathematics. The natural ones emerge naturally in social communities as much as in scientific communities. Simultaneously, the formal languages are artificially built for use in disciplines such as mathematics, logic and computer programming. Formal languages are characterized by ''syntax'' and ''semantics'' with precise rules, while a natural language has a fairly vague syntax known as ''grammar'' and lacks any explicit semantics.  

To keep this study active and engaging, and to avoid it degenerating into a boring treatise on the philosophy of science, let’s consider a very explanatory clinical case. We will deal with it using different languages: [[Logic of classical language|Classical language]], [[Logic of Probabilistic language|Probabilistic language]], [[Logic of Fuzzy language|Fuzzy logic]] and [[Logic of System language|Logic of System]].  

To keep this study active and engaging, and to avoid it degenerating into a boring treatise on the philosophy of science, let’s consider a very explanatory clinical case. We will deal with it using different languages:  

*[[Logic of classical language|Classical language]],  

*[[Logic of Probabilistic language|Probabilistic language]],  

*[[Logic of Fuzzy language|Fuzzy logic]] and  

*[[Logic of System language|Logic of System]].  

===Clinical case and logic of medical language===

===Clinical case and logic of medical language===

Patient Mary Poppins (obviously a fictitious name) was followed and treated for over 10 years by multiple colleagues, including dentists, family doctors, neurologists and dermatologists. The brief history is as follows: the 50-year-old woman first noticed small patches of abnormal pigmentation on the right side of her face at the age of 40. On her admission to a dermatological division, a skin biopsy was performed, and it was consistent with the diagnosis of localized scleroderma of the face, or '''morphea'''; corticosteroids were prescribed. At the age of 44, she began to have involuntary contractions of the right masseter and temporal muscles; the contractions increased in duration and frequency over the years. The spasmodic contractions were referred to by the patient as both day and night lock. At her first neurological evaluation, dyschromia was less evident. Still, her face was asymmetrical due to a slight indentation of the right cheek and marked hypertrophy of the masseter and right temporal muscles. The diagnoses were varied, due to the limitation of the medical language as we will see below.       

Patient Mary Poppins (obviously a fictitious name) was followed and treated for over 10 years by multiple colleagues, including dentists, family doctors, neurologists and dermatologists. Her brief story is as follows:  

*the woman first noticed small patches of abnormal pigmentation on the right side of her face at the age of 40 (she was now 50). <br>On her admission to a dermatological division, a skin biopsy was performed, and it was consistent with the diagnosis of localized scleroderma of the face ('''morphea''');<br>corticosteroids were prescribed.  

*At the age of 44, she began to have involuntary contractions of the right masseter and temporal muscles; the contractions increased in duration and frequency over the years. The spasmodic contractions were referred to by the patient as both day and night lock.<br>At her first neurological evaluation, dyschromia was less evident. Still, her face was asymmetrical due to a slight indentation of the right cheek and marked hypertrophy of the masseter and right temporal muscles. <br>The diagnoses were varied, due to the limitation of the medical language as we will see below.       

The clinical scenario can be reduced to the following: the patient expresses in her natural language the psychophysical state that has long afflicted her; the dentist, after having performed a series of tests such as anamnesis, a stratigraphy and a CT scan of the TMJ (Figures 1, 2 and 3), concludes with a diagnosis of 'Temporomandibular Disorders', which we call 'TMDs'<ref>{{cita libro  

The clinical scenario can be reduced to the following: the patient expresses in her natural language the psychophysical state that has long afflicted her; the dentist, after having performed a series of tests such as anamnesis, a stratigraphy and a CT scan of the TMJ (Figures 1, 2 and 3), concludes with a diagnosis of 'Temporomandibular Disorders', which we call 'TMDs'<ref>{{cita libro  

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  }} - Epub 2018 Jun 12.</ref>; the neurologist remains instead on a diagnosis of organic neuromotor pathology of the 'neuropathic Orofacial Pain' (_nOP) type, excluding the TMDs component, or does not consider the main cause. To not sympathize with either the dentist or the neurologist in this context, we will consider the patient suffering from ‘TMDs/_nOP’; so nobody fights.

  }}</ref>; the neurologist remains instead on a diagnosis of organic neuromotor pathology of the 'neuropathic Orofacial Pain' (_nOP) type, excluding the TMDs component, or does not consider the main cause. To not sympathize with either the dentist or the neurologist in this context, we will consider the patient suffering from ‘TMDs/_nOP’; so nobody fights.

 

{{q4|But who will be right?|good question}}

{{q4|But who will be right?}}

We are obviously in front of a series of topics that deserve adequate discussion because they concern clinical diagnostics.       

We are obviously in front of a series of topics that deserve adequate discussion because they concern clinical diagnostics.       

Unlike the formal languages ​​of mathematics, logic and computer programming (which are artificial systems of signs with precise rules of syntax and semantics), most scientific languages ​​develop as a simple expansion of natural language with a mix of some technical terms. The medical language belongs to this intermediate category. It emerges from natural and everyday language by adding terms such as 'neuropathic pain', 'Temporomandibular Disorders', 'demyelination', 'allodynia', etc. It is why it has no specific and semantic syntax beyond the one it takes from natural language. For example, let's consider the term 'disease' referring to the patient Mary Poppins: this is a term that indicates the fundamental concept of medicine, disease at the base of nosology and clinical research and practice. It is expected to be a well-defined technical term, yet it is still an indefinite term.   

Unlike the formal languages of mathematics, logic and computer programming (which are artificial systems of signs with precise rules of syntax and semantics), most scientific languages ​​develop as a simple expansion of natural language with a mix of some technical terms. The medical language belongs to this intermediate category. It emerges from natural and everyday language by adding terms such as 'neuropathic pain', 'Temporomandibular Disorders', 'demyelination', 'allodynia', etc. It is why it has no specific and semantic syntax beyond the one it takes from natural language. For example, let's consider the term 'disease' referring to the patient Mary Poppins: this is a term that indicates the fundamental concept of medicine, disease at the base of nosology and clinical research and practice. It is expected to be a well-defined technical term, yet it is still an indefinite term.   

Nobody knows what it means precisely and, apart from some philosophers of medicine, nobody is interested in its exact meaning. For example, does 'disease' concern the subject/patient or the System (as a living organism)? And consequently: can a patient who is not sick in time <math>t_n</math>  live together with a system already in a state of structural damage in time <math>t_{i,-1}</math>?

Nobody knows what it means precisely and, apart from some philosophers of medicine, nobody is interested in its exact meaning. For example, does 'disease' concern the subject/patient or the System (as a living organism)? And consequently: can a patient who is not sick in time <math>t_n</math>  live together with a system already in a state of structural damage in time <math>t_{i,-1}</math>?