Make an accurate diagnosis and prescribe. Doctors can not make a diagnosis, where to go

Our body often gives us certain signals about a disease. Absolutely any disease has a number of some signs, which are called. In order to correctly diagnose, you need to identify them. This process called diagnosis.

General concepts of diagnosis

What does the concept of “diagnosis” mean in medicine? This is nothing but the recognition of an ailment. Moreover, this is not only the disease itself, but also the results of the patient's study, which allow the specialist to move from thinking to treatment.

When staging, the specialist is guided by the complaints of the applicant (symptoms), examination of the patient and the results of the tests. This takes into account gender, age, place of residence and other non-medical factors.

It is customary to distinguish several types of diagnoses in medicine: clinical, pathological-anatomical, forensic, epidemiological.

How to diagnose by symptoms?

Previously, only people who had a special medical education could make diagnoses, but after the Internet entered our lives, many of us began to diagnose ourselves and prescribe medications for ourselves. This is not good, because without being a professional in this matter, you can easily make a mistake in making a diagnosis, and because of this, there can be serious consequences.

First of all, you need to carefully monitor. Its rapid decline can signal many ailments, for example, hyperthyroidism (excessive secretion of hormones thyroid gland). This disease women are often exposed young age. As for the elderly, sudden loss weight may indicate malignancy.

If you get sick, then watch how long the cough lasts. If this continues for more than 3 weeks, it may indicate a serious illness. For example, bronchial asthma, about tuberculosis, pneumonia or other oncological diseases.

Read also:

After the massage, the head is spinning: is this considered a norm or a pathology?

Blood in stool ah can talk about polyps in the intestines, hemorrhoids or anal fissure. Black stools can be caused by certain foods, such as beets, prunes, or medical preparations (Activated carbon, some vitamin complexes). If the color has changed without visible reasons, you should contact as soon as possible medical institution, since this is most likely internal bleeding, which was caused by a serious gastrointestinal disease.

Every day you should count the water you drink, not tea and coffee, but water. If you are thirsty and you drink more than 3 liters of water, then this alarm bell. This may indicate pathology of the kidneys, liver, as well as diabetes.

Girls and women are encouraged to keep a schedule of the menstrual cycle. Unscheduled periods can begin due to hormonal imbalance, malnutrition, strict diets, and certain medications. It is recommended that you seek the advice of a specialist as soon as possible.

Self-treatment of a sore throat cannot last more than 3-4 days. After that, it is necessary to consult a specialist, especially in the case of streptococcal infection which can spread throughout the body.

If you have heartburn often enough, you need to see a specialist to rule out diseases of the gastrointestinal tract.

A sharp deterioration in vision, the appearance of "flies" before the eyes are quite dangerous symptoms. Be sure to contact a specialist, because this may indicate detachment of the retina or cerebrovascular accident.

And finally, pay attention to your mood, if it changes too often and you are constantly haunted by depression - this is a reason to consult a psychotherapist, because it is during this state that chronic diseases worsen.

How to make a tongue diagnosis?

AT normal condition our tongue should be pink, have a slight cover and be weak, which can be removed with a toothbrush. If it begins to thicken over time, acquire a yellowish or gray shade, this indicates a reduced immunity.

By the way, if you find a white-yellow coating in the morning and it can be easily removed with a brush, then this is not a reason to panic. And if this could not be done, then this may indicate a fungal infection, various diseases oral cavity or dysbacteriosis.

1. Pale plaque may indicate anemia, while another sign can also be distinguished: fatigue.
2. If you have appeared gray coating, then this may indicate that your body does not have enough iron.
3. When it is slightly enlarged and has a pale coating, and when low acidity, on the contrary, is slightly reduced and drier.
4. A yellowish color may indicate liver pathologies.

The tradition of formulating a medical diagnosis is a legacy of the "interpretation of signs" from the time of Hippocrates and the later "epicrisis". The legislation does not define this term. The most common and widely used definition is: medical diagnosis- these are the doctor's conclusions about the state of health of the subject, about the existing disease (injury) or about the cause of death, expressed in terms provided for by the classifications and nomenclature of diseases.

According to I.V. Davydovsky medical diagnosis has three categories:

• underlying disease
• Complications of the underlying disease
• Concomitant diseases

For many decades of existence, the formula of medical diagnosis has confirmed its logical and practical value.

“The attending physician establishes a diagnosis that is based on a comprehensive examination of the patient and compiled using medical terms a medical report on the disease (condition) of the patient, including the one that caused the death of the patient. Diagnosis typically includes information about the underlying disease or condition, comorbidities or conditions, and complications from the underlying disease and concomitant disease”, - noted in paragraphs 5 and 6 of article 70 federal law November 21, 2011 No. 323-FZ "On the basics of protecting the health of citizens in Russian Federation».

And part 2 of article 14 of the Federal Law of November 21, 2011 No. 323-FZ "On the basics of protecting the health of citizens in the Russian Federation" determines that the powers federal body executive power, carrying out the development of public policy and regulatory legal regulation in the field of healthcare, including: 11) approval of the procedure for organizing a document management system in the field of health protection, unified forms of medical documentation, including in electronic form. Thus, only the specified executive authority determines in which paragraphs of the unified forms of medical documentation (outpatient card, dispensary observation card, sanatorium card, certificates, extracts, etc.) and in what form the diagnosis is formulated. Order of the Ministry of Health of Russia dated December 15, 2014 No. 834n “On approval of unified forms of medical documentation used in outpatient settings and the procedure for filling them out "approved: form No. 025 / y" Medical card patient receiving medical care on an outpatient basis", form No. 043-1 / y "Medical record of an orthodontic patient", form No. 030 / y "Control card for dispensary observation", Form No. 070 / y Spa treatment", form No. 072 / y" Sanatorium-resort card»; form No. 076/u "Sanatorium and resort card for children" according to; form No. 079 / y “Medical certificate for a child leaving for a sanatorium health Camp»; form No. 086 / y "Medical certificate (medical professional advisory opinion)". These documents highlight important role the earliest and most complete formulation of the diagnosis, which is why records of the primary examination of the doctor, examination of other specialists, the head of the department, consultation of the medical commission and generalization of the data by the attending physician clinical examination in without fail ends with a diagnosis. On the first page of the outpatient card, the diagnoses of all diseases for which the patient is being treated are indicated. dispensary observation. On the second page, all first or re-established final (refined) diagnoses are recorded.

In Russia International classification diseases (ICD) is considered the International Statistical Classification of Diseases and Related Health Problems X revision (1995), adopted forty by the third World Health Assembly (Order of the Ministry of Health of the Russian Federation dated May 27, 1997 No. 170 “On the transition of health authorities and institutions of the Russian Federation to the international statistical classification of diseases and health-related problems, X revision”). It is according to this classification that the diagnosis should be established. Do not forget that the ICD is primarily a statistical classification. You can read more about the classification in the article "".

Undoubtedly, a progressive step in 2015 was the publication of the Order of the Ministry of Health of the Russian Federation dated July 7, 2015 No. 422an “On approval of quality assessment criteria medical care"(hereinafter - Order No. 422an). The criteria for the quality of medical care established by this order affect not only the process of providing medical care, but also issues related to the formulation and execution of a diagnosis. The document separates the requirements for the formulation and execution of a diagnosis in an outpatient and inpatient setting. So, paragraph 3 states that a preliminary diagnosis is established by the attending physician during initial appointment patient when providing medical care on an outpatient basis, no later than 2 hours from the moment of treatment, and clinical diagnosis established within 10 days from the date of application. The latter should be made out with an appropriate entry in the outpatient card and be based on anamnesis, examination, data from laboratory, instrumental and other research methods, and the results of consultations of medical specialists. Whole volume diagnostic measures should be provided for by the standards of medical care, as well as clinical guidelines (treatment protocols). If it is difficult to make a diagnosis, a consultation of doctors is held with an appropriate entry in the outpatient card with the signature of the head of the outpatient department medical organization. If it is necessary to provide medical care in a hospital, a referral to the hospital is issued indicating the clinical diagnosis.

When providing medical care in inpatient and day hospital conditions, a preliminary diagnosis is established by the doctor of the admission department or the doctor of the specialized department (day hospital) or the doctor of the department (center) of anesthesiology-reanimation of a medical organization no later than 2 hours from the moment the patient enters the medical organization. Establishment of the Clinical diagnosis should be made within 72 hours from the moment the patient enters the profile department (day hospital) of the medical organization, and when the patient is admitted for emergency indications, no later than 24 hours. Clinical diagnosis in the hospital is based on the same criteria as in the outpatient setting. In case of difficulty, the clinical diagnosis is established by the decision of the council of doctors with the execution of the protocol and making an entry in a special section stationary card, signed by the attending physician and the head of the department. We remind you that these criteria are used for the purposes of examination of the quality of medical care, which is currently carried out only within the framework of compulsory health insurance. You can learn more about this in the articles: "", "".

From July 1, 2017, new criteria for assessing the quality of medical care, approved by the Order of the Ministry of Health of Russia dated July 15, 2016 No. 520n, will come into force(hereinafter - order No. 520n).

Note that, unlike the norm contained in Order No. 422an, Order No. 520n does not contain a time limit for making a preliminary diagnosis by the attending physician during the initial appointment of the patient. Read more about this in the article " » .

We remind you that these criteria are used for the purposes of examination of the quality of medical care, which is currently carried out only within the framework of compulsory health insurance. You can learn more about this in the articles: "", "".

Order of the Federal Compulsory Medical Insurance Fund No. 130 dated July 21, 2015 “On Amendments to the Procedure for Organizing and Carrying out Control over the Volumes, Terms, Quality and Conditions for the Provision of Medical Assistance under Compulsory Medical Insurance, approved by Order No. 230 of the Federal Compulsory Medical Insurance Fund dated December 1, 2010” in the list of grounds for refusing to pay for medical care (reducing the payment for medical care) due to defects in the provision of medical care introduced the presence of a discrepancy between clinical and pathological-anatomical diagnoses of categories 2-3. For the first time, an expert opinion (a protocol for assessing the quality of medical care) includes diagnostic criteria: assessment of the wording, content, time of diagnosis and justification negative consequences errors in diagnosis.

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A unified classification of types of diagnoses has not yet been established. AT clinical practice The customs of business medical circulation include several definitions of the diagnosis: differential diagnosis, laboratory, immunological, preliminary final. Differential Diagnosis is rather part of the rationale and method of medical thinking. Data from laboratory and immunological tests, as objective signs and symptoms, may be under the heading "underlying disease". The preliminary diagnosis and the final diagnosis can be called "preliminary clinical diagnosis" and "final clinical diagnosis", but they should not be distinguished as species.

The most reasonable should be recognized as the judgment that the type of medical diagnosis is determined by the functions that it performs. The following types of diagnosis are distinguished: clinical, pathological-anatomical, forensic, sanitary-epidemiological diagnosis.

Clinical diagnosis- this is a diagnosis established by a patient in a hospital or long-term outpatient observation, which contributes to the treatment and further prevention diseases. A preliminary diagnosis (incomplete) is made during the initial examination, and on its basis a plan of examination and treatment is drawn up, it can be symptomatic, syndromic, nosological. A detailed diagnosis (complete) is formulated in a certain time period on the basis of anamnesis data, examination, laboratory, instrumental and other research methods, the results of consultations of specialist doctors provided for by the standards of medical care, as well as clinical guidelines(treatment protocols), promotes complex treatment and secondary prevention, it can be syndromic or nosological.

Pathological and anatomical diagnosis- the final part of the autopsy protocol, in which the pathologist, based on the analysis of morphological data and clinical materials formulates a synthetic conclusion about the nosological form, the dynamics of the disease (or diseases) and the immediate cause of death. The procedure for its registration is regulated by the Order of the Ministry of Health of Russia dated June 6, 2013 No. 354n "On the procedure for conducting pathological and anatomical autopsies."

Forensic diagnosis- this is a special conclusion on the nature of the damage (disease), the condition of the subject or the causes of death, drawn up on the basis of a forensic medical examination to resolve issues that arise in forensic investigative practice, and expressed in terms accepted in forensic medicine. Order of the Ministry of Health and Social Development of the Russian Federation dated May 12, 2010 No. 346n “On Approval of the Procedure for Organizing and Performing Forensic Medical Examinations in State Forensic Expert Institutions of the Russian Federation” establishes the procedure for conducting examinations and making a forensic medical diagnosis.

Sanitary-epidemic diagnosis is the conclusion formula epidemiologist about the epidemic nature of an infectious disease, the properties of the epidemic focus and the features of the epidemic process, expressed in terms provided for by the nomenclature and classifications adopted in epidemiology. The sanitary-epidemic diagnosis does not directly concern the patient, but is aimed at identifying the features of the emergence, formation and spread of the epidemic focus.

Misdiagnosis can result in both criminal and civil liability.

On the basis of clause 9, part 5, article 19 of the Federal Law of November 21, 2011 No. 323-FZ “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation”, the patient has the right to compensation for harm caused to health during the provision of medical care to him. An incorrect diagnosis is always associated with an incorrect, incomplete, and sometimes simply harmful treatment and can lead to complications of the disease, worsening of the condition, disability and even death, which undoubtedly is a harm to health, which has numerous confirmations in judicial practice. Thus, in the Appellate Ruling of the Moscow Regional Court dated May 18, 2015 in case No. 33-11200/2015, the role of an incorrect diagnosis as a reason for poor-quality medical care was emphasized “due to the fact that the fracture of the acetabulum was not diagnosed and appropriate treatment was not performed , as well as the patient was recommended to become more active, moving on crutches, there was an aggravation of the injury due to the formation of a dislocation of the head femur, which subsequently required an additional operation aimed at eliminating the dislocation of the femoral head ... In the event that a fracture of the acetabulum would have been diagnosed in D.I.Kh. in the Sergiev Posad hospital, the treatment would have been more likely to have been carried out conservatively, that is, without the operation of osteosynthesis of fragments of the acetabulum and reduction of the dislocation of the femoral head .... due to shortcomings in the provision of medical care, he was misdiagnosed , which subsequently led to surgical interventions. On December 1, 2013, he was recognized as a disabled person of the second group. The jurisprudence is clear on this issue. Thus, in the Appellate Ruling dated May 18, 2015 in case No. 33-4519, the Perm Regional Court noted that “In accordance with clause 9, part 5, article 19 of Federal Law No. 323-FZ dated November 21, 2011 “On Health Protection citizens in the Russian Federation” the patient has the right to compensation for harm caused to health during the provision of medical care. In accordance with Article 150 of the Civil Code of the Russian Federation, health is an intangible good. In accordance with Article 151 of the Civil Code of the Russian Federation, if a citizen has suffered moral harm by actions that violate his personal non-property rights, the court may impose on the offender an obligation monetary compensation moral damage. In accordance with 1068 of the Civil Code of the Russian Federation, a legal entity or a citizen compensates for the harm caused by its employee in the performance of labor (official, official) duties ... Late diagnosis did not contribute to the interruption pathological process and could worsen the prognosis of the disease. The panel of judges concludes that poor quality medical service, associated by virtue of its specificity with the need for the plaintiff to use medicines not really aimed at treatment an existing disease for a long time, lack of medical care in the treatment<...>, the presence of physical suffering during the period of treatment due to an incorrect diagnosis undoubtedly caused the plaintiff non-pecuniary damage.”

Criminal liability may arise when:

• official forgery - the introduction by an official into official documents of knowingly false information, as well as the introduction into said documents corrections that distort their actual content, if these acts are committed out of mercenary or other personal interest (in the absence of signs of a crime under Part 1 of Article 292.1 of the Code) (Article 292 of the Criminal Code of the Russian Federation);
• falsification of evidence in a civil case by a person participating in the case, or his representative (Article 303 of the Criminal Code of the Russian Federation).

In case of an incorrect diagnosis, criminal liability may also be imposed under Art. 109; 118 of the Criminal Code of the Russian Federation and not only, depending on the consequences resulting from incorrect setting diagnosis (causing serious bodily harm, death to a patient).

Summing up, we can conclude that the diagnosis (in terms of terms, types, form, grounds) is currently regulated by law, and work in this direction continues. Currently, these criteria are widely used in judicial practice to assess the harm caused.

Which is correct: diagnosis "cancer" or diagnosis: cancer?

Correctly: cancer diagnosis(no punctuation between the word being defined and the application) ; Diagnosis - cancer(a dash is placed between the subject and the predicate).

Good afternoon! Question on the word "nosology". Often in the educational and methodological literature on pedagogy there are phrases "children with various nosologies", " training program compiled according to nosologies, etc. Under the nosologies in this case refers to hearing, speech, vision, etc. Physicians say that their professional slang uses the word "nosology" in the meaning of "diagnosis" or "several diagnoses". However, in dictionaries, I did not find a different meaning of this word, except for "The section of medicine that studies the types of diseases and their classification." Tell me, please, is it correct to use this word in the meaning of "diagnosis / diagnosis"? Or should one use, for example, the phrase "form of the disease"? Thank you!

The answer of the reference service of the Russian language

We believe that such use is limited to the professional sphere (does not correspond to the literary norm).

Pay attention to question #294554. The phrase "hydrocephalus of the brain" is not pleonasm, because. there is hydrocephalus of the spinal cord. In this case, the definitions of "head" and "spinal" are very important, because they are responsible for the correctness of the diagnosis a. The medics would have killed you guys.

The answer of the reference service of the Russian language

The question was whether the combination is pleonasm. Yes, it is pleonasm. However, it does not follow from this that such a combination is forbidden to be used by physicians (apparently, in this understanding of the answer, the reason for the possible threat). Not every pleonasm is a mistake. There are pleonasms that have become fixed as terms. The turnovers you cited are an example of this.

If it is not possible to improve the adaptive capabilities of the body, operate on patients with a diagnosis of postoperative ventral hernia only according to vital indications. Do I need a comma after the word "if"?

The answer of the reference service of the Russian language

A comma is not required.

Put the numeral in the correct case: We met with 1574 similar cases. In 478 cases out of 866, the diagnosis was confirmed. Add 11 to 284. The weight of the whale's heart reaches 1200 kilograms. About 679 people called the editorial office.

The answer of the reference service of the Russian language

We don't do homework. The Writer will help you to do the task on your own.

good afternoon! tell me if quotes are needed in this case: they made a diagnosis ("infantile cerebral palsy (") how are medical diagnoses written in a letter?

The answer of the reference service of the Russian language

The name of the diagnosis is written with lower case and enclosed in quotation marks.

Diagnosed with diabetes mellitus./Diagnosed with diabetes mellitus.

The answer of the reference service of the Russian language

Quotes are needed.

The question is the following. How to correctly punctuate?
1. Diagnosis: "Obesity of the first degree."
2. The diagnosis of "obesity of the first degree" is not a problem.
Which option is correct 1 or 2? Thanks in advance.

The answer of the reference service of the Russian language

Correct spelling: diagnosis "obesity of the first degree" is not a problem.

Hello. Raises the question of writing a diagnosis with capital letter and in quotation marks in this sentence: "The percentage of children diagnosed with Autism Spectrum Disorder continues to rise." Prompt, please, what spelling of the name of the diagnosis and in this case will be correct. Thanks in advance.

The answer of the reference service of the Russian language

There is no reason to capitalize the diagnosis.

What punctuation should be used in a sentence like "The patient has been diagnosed with amnesia"?
Is the word "Amnesia" in quotation marks and capitalized, or is it preceded by a dash or a colon? How right?

The answer of the reference service of the Russian language

Right: A diagnosis of amnesia was made.

Hello! Can you please tell me whether it is necessary to enclose the name of the diagnosis in quotation marks and write it with capital letters, for example, ... diagnosed with epilepsy or ... diagnosed with "Epilepsy"?

Thank you in advance.

The answer of the reference service of the Russian language

If the name of the diagnosis a does not agree with the generic word, quotation marks are usually used. But there is no reason to write in capital letters. Correctly: diagnosed with epilepsy.

hello!
please tell me, and if possible, explain how to write the correct "name" of the doctors in the following sentence:
"Wide application general x-ray examination clinicians manual therapists due to a greater extent the need to form a nosopathological diagnosis a ... "
i.e. I wonder if a dash will be put here by analogy with a hyphen in a single attachment "doctor-therapist"?
thank you in advance. help a lot)

The answer of the reference service of the Russian language

Yes, a dash is appropriate here.

Dear "Literacy", I repeat my question. Answer, please (very interesting and important for work).
Why are there no quotation marks in combinations of luxury class, swing style, profession welder, but in combinations the color "metallic", the stamp "top secret", the diagnosis "pneumonia", the specialty "mathematics" have quotation marks?
Why in the combination "director Petrov" the application is the director, and in the combination "swing style" the application is swing? And in the combination "my son Borka" is the application my son or Borka? The rule is inconsistent. It says: if the application is in front of the word being defined, then the comma is not put, and if it is still put, then the word being defined and the application will change places - that's all. In "my son Borka" the application is my son, and in "my son, Borka" the application is Borka. This rule explains the already placed comma, but does not explain when to put it.
What determines the clarifying intonation (and the setting of a comma) in applications expressed by a proper name?
He looks like my son Borka.
He looks like my son, Borka. Here, according to Rosenthal, the criterion is singularity or plurality. What other criteria are there? The Complete Academic Guide to Punctuation hints that, in a single application, the comma is affected by the prevalence of the combination being defined, but there are no examples or clarifications.

The answer of the reference service of the Russian language

Thanks for the questions!

You are pointing to one of the most difficult and controversial passages in Russian spelling. First, about quotes. The fundamental difference between combinations profession "welder" and specialty "mathematics" no, it is desirable to write such combinations uniformly. (However, there is still one difference: you can make a grammatically correct coordinated combination welder profession and cannot be combined specialty of mathematics; this is already a difficulty in the field of grammar, and not in the field of text design, although the latter stems from the former).

And how uniform - let's proceed from the emerging practice of writing. If the application is a changeable, inflected word, then in the case of a case mismatch, quotation marks appear, which act precisely as a graphic sign of mismatch. Therefore, in practice, combinations such as by profession "mathematics", by profession "welder" etc. Combinations style + luxury, retro, pop, empire, baroque and others are combinations with immutable applications, in order to additionally mark this immutability, quotes are not needed.

These are polar cases. The examples you named are intermediate between the two poles, which is why there is a design inconsistency in them.

Now about commas. The root of the problem is what is considered the main and what is the dependent word in the phrase, because the phrase implies a subordinate relationship between its parts, between the words included in it. Thus, the problem again leaves the purely punctuation framework and moves into the sphere of grammar, that is, the structure of the text, its structure, and the logical relationships between words. And these logical relationships are built by the author of the text, the author of the thought, the message. And therefore, the final decision - when choosing one of the possible (we emphasize: possible, that is, logically consistent) options - is up to the author of the text.

Would the phrase "diagnosing a" be correct? What about "diagnosing a"?

The answer of the reference service of the Russian language

Combination making a diagnosis wrong, establishing diagnosis - correct.

Hello!!!
How to spell the diagnosis "diabetes mellitus" or the diagnosis of diabetes mellitus or the diagnosis " Diabetes"?

The answer of the reference service of the Russian language

Correctly: diagnosis of diabetes mellitus.

In ancient times, when there were no methods and hardware diagnostics, doctors, in order to determine the patient's condition, relied only on external signs of trouble. After carefully looking at the person for some time, the doctor confidently diagnosed him.

Today, the conclusion about the disease, as a rule, is made only after the patient has undergone necessary analyzes. But at the same time, experienced doctors, just like their ancient predecessors, widely use diagnostics based on external signs. Actually, why shouldn't the patients themselves adopt some of the observations of doctors? After all, this will help a person to quickly navigate his condition and not puzzle over which specialist he should sign up for, but an appointment, and in the office, immediately clearly identify his symptoms. This will greatly help the doctor in your treatment.

Here is a list of some signs of disease, proposed by American doctors.

Legs. Feet hurt a lot of people, and in old age they bother almost everyone. After all, they carry a huge load every day. Noting in which places this load manifests itself most of all, you can understand what changes are taking place in your body.

So, if a hard callus "horseshoe" stretches along the edges of the heels, especially with cracks, this indicates possible problems with the joints or the musculoskeletal system as a whole. For example, if the skin hardens along the outer edges of both heels, then you need to pay attention to the condition of the spine, if on the inside, closer to the instep of the foot, then you should check the intestines. Rough skin on inner edges thumbs legs should prompt you to visit an endocrinologist and ask him to examine your thyroid gland.

Looking at swollen calves and ankles, usually talk about an excess of water in the body and, accordingly, about shortcomings in the work of the kidneys and heart. But the reason for this can be the most banal - swelling often occurs if a person sits at a desk for a long time or, conversely, stands for many hours on his feet (as, for example, hairdressers). In such cases, it is easy to get rid of edema, and at the same time an extra static load on musculoskeletal system, changing the position of the body every half hour and doing a little warm-up. It is also useful to redistribute the load of the foot: for example, walk on tiptoe, on the outer and inner edges of the foot, massage the sole. The fact is that there are dozens of biological points connected with all internal organs kneading which will activate these organs. If the state of the cardiovascular system allows you, give your legs a feasible load: walk more, climb top floor not on the elevator, but on their own.

Leather. This one big organ human body can tell a lot about him. In particular, dry and flaky skin indicates a lack of vitamins, A or B, white spots on the skin may indicate a lack of a number of other vitamins, including C. They are also a sign of thyroid disease or developing diabetes.

It happens that "bruises" remain on the body from the slightest pressure. In this case, it is necessary to consult a specialist in blood diseases, because the appearance of hematomas is a symptom of anemia and a number of other diseases of the circulatory system.

Nose. When red streaks appear on the tip of the nose, it is usually thought that the person is prone to alcohol. But to the same extent it indicates problems with the heart muscle. If the entire tip of the nose turns red, one can think of a decrease in the function of the stomach and duodenum. The white tip of the nose indicates problems with blood circulation.

Nails reddish brown color indicates kidney disease. thick neck often accompanied by the appearance of goiter - a disease of the thyroid gland associated with a deficiency in the body of iodine.

Much capable tell your eyes, which is not accidentally called the mirror of the soul and body. Diagnosis of the iris of the eye has long been included in the arsenal of doctors. But you can not even know about the nuances reflected through the iridology device, but judge the state of health by appearance eye. If they are clean, clear, with a clear pattern of the iris, then everything is fine in the body. Redness, "blurring" of the iris may indicate problems with the liver. But the swelling of the lower and upper eyelids can indicate both a violation of the heart, kidneys, and problems with gynecology.

If you have bad hearing, this may indicate many problems, not counting directly "ear". Hearing loss often occurs with hypertension, osteochondrosis cervical, diseases of the kidneys, brain and a number of other ailments.

YOUR CORRECT DIAGNOSIS

The most important in medical business is to identify the cause that destroys human health. The doctor, together with the patient, needs to establish, identify, find the "criminal". If it is clear which disease causes suffering, then there is clarity in the treatment. Once the diagnosis is made, it is easier to proceed further. But making the correct diagnosis is not only the most important thing in clinical medicine, but also the most difficult. Despite the achievements modern medicine, the appearance of expensive diagnostic complexes despite all efforts medical workers Unfortunately, it often happens that we fail to convict the "criminal". When there is no exact, correct diagnosis, the doctor has to act blindly, and the treatment prescribed in such situations is often ineffective.

A person sometimes gets sick so hard that sometimes even a pathologist in a section after lethal outcome, having the opportunity to look into any corner of the body, cannot say what a person was sick with. Sometimes the pathologist, who is the last resort, cannot establish the correct final diagnosis. The cause of death in such situations is established as the most probable.

An experienced clinician differs from a less experienced one in that the less experienced one gets the most job satisfaction when he cures the patient. More experienced doctor he also rejoices at the recovery of the big one, but he experiences the greatest satisfaction when he puts correct diagnosis in a difficult patient, when he catches a "criminal" and "puts him behind bars."

The vast majority of patients are convinced that making the correct diagnosis is the business of doctors only. They are sure that absolutely nothing depends on them here. it typical mistake, an embarrassing misconception.

If the doctor and the patient work together on the diagnosis, then the diagnosis is more accurate, more correct.

What can a patient without medical education, to make sure that the diagnosis was made correctly?

First of all, he must include himself in the team of medical professionals who care for him. He must become a full-fledged, full-fledged partner, a member of the team, he must play an active role in the diagnostic and treatment process, and not be a passive observer. The quality of information depends on the patient, the accuracy of the data on the basis of which the doctor makes a diagnosis. How correctly the patient will be able to broadcast to the doctor what is happening in his body, so correct will be his diagnosis. If these data are crooked, so will the diagnosis. It has already been noted that uncertainty is part of medicine. The patient can reduce this uncertainty.

In the previous chapters, I have already dwelled in detail on what and how the patient should give the doctor so that the doctor makes a complete, correct diagnosis. Here I deliberately used the verb "give", realizing that the phrase can be interpreted in two ways. Provide accurate, objective, full information about your illness and about yourself. No one knows your body better than you, the features of its reactions. Only you know what matters most to you. As noted, the doctor cannot feel the disease for you. The doctor only helps to convey the manifestations of the disease to the patient. Being clear about what is happening to you is very important. Sometimes this is not easy for the patient. Most often, patients give either too little information or overload their speech with details that are absolutely irrelevant.

It is necessary for the patient to strive for clarity of presentation, since the correctness of the diagnosis depends on it.

After the doctor, having analyzed the data obtained, informed you of your diagnosis, ask on the basis of what, on what data, he came to such a conclusion. Let him convince you that you are suffering from exactly the disease that he speaks of. In the vast majority of cases, this can be done with two or three simple sentences. If the doctor speaks firmly and in words that you understand, the “criminal” is caught. If you see doubts, hesitations, dissatisfaction, sometimes verbosity of a conscientious, competent, experienced doctor, then diagnostic search may need to continue. Here, without even delving into the meaning of what has been said, but by the way the doctor answers your question about the reliability of your diagnosis, one can judge with big share probability of its validity.

Peace of mind is what a smart patient should look to their doctor for when they ask to be convinced of the correctness of their diagnosis.

If you are a "difficult case" and are given the most likely diagnosis, do not hesitate to ask your doctor what other conditions may be causing these symptoms. This will help the doctor to take a broader look at the problem, to “spread the net” more widely, to extra work on differential diagnosis, be more creative. Let his thought process, his "torment" in making a diagnosis be in front of you. This will allow you to join the search process. Ask your doctor what else can be done to clarify the diagnosis. What should be your next steps to catch the "criminal".

An important and well-established technique for difficult diagnoses is the second opinion. If you are exposed to the most likely (approximate) diagnosis and there is no complete clarity of what exactly is happening to you, it is advisable to consult another doctor. This does not mean that the first doctor is bad. Clinical medicine is made up of uncertainties. Different doctors have different experiences, different schools, they think differently. It may well be that the second doctor already had a patient with similar problems that he managed to solve. The second doctor may be more "corrosive" or more interested in this branch of medicine. AT difficult situations both the third and the fourth opinion are not excluded. According to American doctors, the second opinion changes the treatment and diagnostic tactics in 1/3 of cases! A good clinician will never be offended if you tell him about your desire to consult another doctor.

With particularly difficult diagnoses, it is advisable to consult narrow specialists with extensive experience. As a rule, in such cases, the patient should contact large medical research centers that specialize in certain areas of medicine. It is best for the patient to look for such centers together with his attending physician. Sometimes the problem can be solved only in our capitals, and sometimes - only abroad.

Watch your body's reactions. Be proactive if your prescribed treatment is not working or you are getting worse. Let your doctor know about this. There must be a strong relationship between you and your doctor Feedback . In such a situation, do not strive to go through the entire prescribed course of treatment, to bring it to the end. The reason for this may be that you are being treated for another illness. It happens. Find out with your doctor why the treatment is not working. Perhaps it is too early to wait for improvement, and the deterioration is due to the work of the drug. Or perhaps your diagnosis is wrong and you should continue the diagnostic search.

In our country, there are few organizations that really protect the rights of the patient, and there are no structures that help patients to be included in the diagnostic and treatment process. In this regard, our patients should be much more active than, say, in developed countries where such structures exist. For now, it's the other way around.

Medical workers in Western countries better prepared, more motivated, better equipped, but their patients, who seemed to be able to relax, are much more active than ours. Therefore, in the West they live longer.

Understanding that much depends on the patient in identifying the disease gives him the opportunity to live longer.

Your right diet Under the general designation "cancer" refers to malignant neoplasms. It must be taken into account that the manifestations of each of them are different. In this regard, one cannot speak of general diet for all cancer patients, consideration should be given to