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<translate>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.</translate> <translate>Her brief story is as follows:</translate>
<translate>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.</translate> <translate>Her brief story is as follows:</translate>
*<translate>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).</translate> <br><translate>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</translate> ('''<translate>morphea</translate>''');<br><translate>corticosteroids were prescribed</translate>.
*<translate>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).</translate> <br><translate>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</translate> ('''<translate>morphea</translate>''');<br><translate>corticosteroids were prescribed</translate>.
*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.
*<translate>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.</translate><br><translate>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.</translate> <br><translate>The diagnoses were varied, due to the limitation of the medical language as we will see below.</translate>
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
<translate>The clinical scenario can be reduced to the following</translate>: <translate>the patient expresses in her natural language the psychophysical state that has long afflicted her</translate>; <translate>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'</translate><ref>{{cita libro
| autore = Tanaka E
| autore = Tanaka E
| autore2 = Detamore MS
| autore2 = Detamore MS
| oaf = <!-- qualsiasi valore -->
| oaf = <!-- qualsiasi valore -->
| PMID = 30122441
| PMID = 30122441
}}</ref>; the neurologist remains instead on a diagnosis of organic neuromotor pathology of the 'neuropathic Orofacial Pain' (<sub>n</sub>OP) 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/<sub>n</sub>OP’; so nobody fights.
}}</ref>; <translate>the neurologist remains instead on a diagnosis of organic neuromotor pathology of the 'neuropathic Orofacial Pain' (<sub>n</sub>OP) type, excluding the TMDs component, or does not consider the main cause.</translate> <translate>To not sympathize with either the dentist or the neurologist in this context, we will consider the patient suffering from ‘TMDs/<sub>n</sub>OP’; so nobody fights.</translate>
{{q4|But who will be right?}}
{{q4|<translate>But who will be right?</translate>}}
We are obviously in front of a series of topics that deserve adequate discussion because they concern clinical diagnostics.
<translate>We are obviously in front of a series of topics that deserve adequate discussion because they concern clinical diagnostics.</translate>
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.
<translate>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.</translate> <translate>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. This is why it has no specific and semantic syntax beyond the one it takes from natural language.</translate> <translate>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.</translate>
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>?
<translate>Nobody knows what it means precisely and, apart from some philosophers of medicine, nobody is interested in its exact meaning.</translate> <translate>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>?</translate>
''The term languishes without any semantics as if it were irrelevant or gratuitous and its derivatives share the same semantic obscurity with it.''<ref>{{cita libro
''<translate>The term languishes without any semantics as if it were irrelevant or gratuitous and its derivatives share the same semantic obscurity with it.</translate>''<ref>{{cita libro
|autore=Sadegh-Zadeh Kazem
|autore=Sadegh-Zadeh Kazem
|titolo=Handbook of Analytic Philosophy of Medicine
|titolo=Handbook of Analytic Philosophy of Medicine
}}</ref>
}}</ref>
;In short,
;<translate>In short</translate>,
* is the patient Mary Poppins sick, or is the chewing System damaged?
* <translate>is the patient Mary Poppins sick, or is the chewing System damaged?</translate>
* Is it instead a 'System' disease considering the masticatory System in its entirety consisting of subsets such as receptors, peripheral and central nervous tissue, maxillary bones, teeth, tongue, skin, etc.,?
* <translate>Is it instead a 'System' disease considering the masticatory System in its entirety consisting of subsets such as receptors, peripheral and central nervous tissue, maxillary bones, teeth, tongue, skin, etc.,?</translate>
* Or is it an 'organ' disease involving in this specific case the temporomandibular joint (TMJ)?
* <translate>Or, is it an 'organ' disease involving in this specific case the temporomandibular joint (TMJ)?</translate>
These brief notes demonstrate how the inaccuracies and peculiarities of natural language enter medicine through its syntactic and semantically underdeveloped form. We should deal with some of these peculiarities with concrete clinical examples.
<translate>These brief notes demonstrate how the inaccuracies and peculiarities of natural language enter medicine through its syntactic and semantically underdeveloped form. We should deal with some of these peculiarities with concrete clinical examples.</translate>
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<center>
== Clinical approach==
== <translate>Clinical approach</translate>==
(hover over the images)
(<translate>hover over the images</translate>)
</center>
</center>
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<gallery mode="packed-hover" widths="250" heights="200" perrow="3">