Logic of medical language

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Logic of medical language

Abstract

"The document 'Logic of Medical Language - Masticationpedia' addresses the complexity of medical language, highlighting how its ambiguity can lead to misinterpretations and diagnostic errors. Through the analysis of a clinical case, it explores the need for formal logic to correctly interpret medical terms, emphasizing the importance of context and intention in term interpretation. Here is a more detailed synopsis, enriched with some key paragraphs from the document:

Medical Language Ambiguity: The text begins by discussing how medical language, a mix of technical terminology and natural language, can generate ambiguity, with specific examples demonstrating how different interpretations of the same medical condition can lead to diverse and sometimes conflicting diagnoses.

The Clinical Case of Mary Poppins: The case of a patient, Mary Poppins (hypothetical name), who has received care from various medical specialties for over a decade is presented. Her clinical history is used as an example to discuss the challenges posed by linguistic ambiguity in the diagnostic process, showing how medical terms such as "orofacial pain" can be interpreted differently by dentists, neurologists, and other specialists.

Encrypted Machine Language and Brain Communication: The document introduces the concept of "encrypted machine language" to describe communication between the human brain (both the patient's and the observer's) and medical professionals, comparing this communication to computer cryptography. This analogy serves to highlight how the incorrect understanding of medical signals can lead to wrong diagnoses.

Meaning and Ambiguity of Medical Terms: The complexity of meaning in medical terms is explored, highlighting how the understanding of a term can vary significantly depending on context and the user's intention. This in-depth look at the semantic aspects of medical terms underscores the need for more accurate interpretation to prevent diagnostic errors.

Final Considerations: The conclusions reaffirm the importance of logical and adaptive thinking in the medical diagnostic process. A paradigm shift is suggested, shifting focus from the symptom to "encrypted machine language" in order to gain a more complete understanding of the disease and improve the diagnostic process by involving more actors.

These key points emphasize how the document questions the effectiveness of current medical language and proposes innovative approaches to overcome its limitations, thereby improving the accuracy of diagnoses and the quality of healthcare."

 

 

Medical language is an extended natural language

Language, essential in the medical field, can sometimes be a source of misunderstandings and errors due to its semantically limited nature and lack of coherence with established scientific paradigms. The discrepancy between the use of language and the scientific context is highlighted in the ambiguity of terms like "orofacial pain," whose meaning can significantly vary if interpreted through classical logic rather than formal logic.

The transition from classical to formal logic is not merely an additional detail but requires meticulous and accurate description. Despite extraordinary advances in medical and dental technology, with the development of advanced instruments such as electromyographs, cone beam computed tomography (CBCT), and digital oral scanning systems, there remains a need for refinement of medical language.

It is crucial to distinguish between natural languages (such as English, German, Italian, etc.) and formal languages, for example, mathematics. The former emerge spontaneously within communities, both social and scientific, while the latter are artificially created for specific applications in fields such as mathematics, logic, and computer programming. Formal languages are characterized by their well-defined syntax and semantics, unlike natural languages, which, despite having a grammar, often lack in terms of explicit semantics.

To ensure that the analysis remains dynamic and engaging, avoiding turning into a dry philosophical dissertation, an exemplary clinical case will be proposed for examination. This will be analyzed through the application of different language logics:

• Classical language,
• Probabilistic language,
• Fuzzy logic and
• Logic of System.

Clinical case and logic of medical language

The patient, Mary Poppins (a fictitious name), has benefited from multidisciplinary medical attention for over a decade, receiving care from dentists, general practitioners, neurologists, and dermatologists. Her medical history is summarized as follows:

At the age of 40, Mrs. Poppins first noticed the appearance of small spots of abnormal pigmentation on the right side of her face. After ten years, a series of significant developments occurred in her condition. During a hospitalization in dermatology, she underwent a skin biopsy, which revealed a diagnosis of localized facial scleroderma, commonly called morphea. Following the diagnosis, she was prescribed corticosteroids. At 44, she began to experience involuntary contractions of the right masseter and temporal muscles, which over time increased in frequency and duration. She described these episodes as blocks, both daytime and nighttime. At her first neurological evaluation, although the discoloration was less marked, her face showed significant asymmetry, with a retraction of the right cheek and a noticeable hypertrophy of the right masseter and temporal muscles. She received various diagnoses, reflecting the challenges posed by the limitations of medical language.

The clinical context is condensed as follows: the patient, using her natural language, communicates the psychophysical discomfort that has long tormented her. After conducting a series of investigations, such as anamnesis, stratigraphy, and computed tomography of the temporomandibular joint (Figures 1, 2, and 3), the dentist formulates a diagnosis of "Temporomandibular Disorders" (TMD). On the other hand, the neurologist opts for a diagnosis of organic neuromotor pathology, called "Neuropathic Orofacial Pain" (nOP), excluding or minimizing the TMD component as the primary cause. In order to adopt an unbiased approach, we will consider the patient's condition as "TMDs/nOP", thus not favoring either of the two interpretations.

«But who will be right?»

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

Unlike formal languages used in mathematics, logic, and computer programming – characterized by artificial systems of signs governed by strict syntactic and semantic rules – most scientific languages evolve as an extension of natural language, enriching it with a set of technical terms. Medical language falls into this intermediate category: it arises from the expansion of everyday language by incorporating specific terminologies such as "neuropathic pain," "Temporomandibular Disorders," "demyelination," "allodynia," etc. This evolution does not involve the adoption of syntax or semantics distinct from those of the natural language from which it derives. Take, for example, the term "disease" in the context of patient Mary Poppins: a key word in medicine, essential for nosology, research, and clinical practice. Although it represents a fundamental concept in the field, its definition remains remarkably vague and not fully outlined. This ambiguity underscores the intrinsic complexity of medical language, which, despite being enriched with technical terminology, maintains the flexible and sometimes indeterminate characteristics of the natural language from which it originates.

The exact meaning of the term "disease" eludes unanimous understanding, primarily interesting some philosophers of medicine, while most professionals in the field seem unconcerned with its precise definition. The fundamental question is whether the concept of "disease" should be associated with the subject or patient in individual terms, or whether it should refer to the System, that is, the living organism as a whole. This raises a further question: is it possible that a patient, who is not considered sick at time $t_{n}$, might actually coexist with a system that was already in a state of structural damage at an earlier moment, indicated as $t_{i,-1}$?

This reflection leads to deep discussions on the dynamic nature of health and disease, proposing that disease should not be seen simply as an instantaneous state or a static condition, but as an evolutionary process, influenced by temporal factors and the interaction between different biological and pathological systems within the organism. This perspective requires a more sophisticated and probably quantitative interpretation of health, taking into account the temporal variations and dynamics between various biological and pathological systems.

The use of the term "language without semantics," treated as if it were irrelevant or devoid of consequences, and its derivatives share the same lack of semantic clarity. This statement underscores a deep criticism of the assumption that language can exist in a purely structural or formal form, lacking semantic content that defines its meaning. In this way, the essential interdependence between semantics and language for understanding and effective communication is highlighted.

In short,

The question of whether the patient, identified as Mary Poppins, is suffering from a pathology, or if it is her masticatory system exhibiting pathological symptoms, calls for a detailed analysis from a medical standpoint. The distinction between an individual disease and a dysfunction of a complex system like the masticatory system requires a holistic approach that considers the interrelations between the various anatomical and functional components involved.

Medically, the condition could be interpreted as a pathology of the "System," that is, of the masticatory system as a whole. This system is comprised of multiple subsystems, including sensory receptors, both peripheral and central nervous tissue, jaw bones, teeth, tongue, and skin, each playing a critical role in the harmonious functioning of the entire system. A disorder in any of these components can therefore negatively affect the health of the masticatory system as a whole.

Alternatively, the issue could be considered as a specific pathology of the "organ," in this context, the temporomandibular joint (TMJ), which plays a crucial role in mastication and phonation. Dysfunctions or pathologies of the TMJ can lead to complex symptoms that affect not only masticatory functionality but also the patient's quality of life, highlighting the importance of accurate diagnosis and targeted therapeutic approach.

This discussion emphasizes how the ambiguities and limitations of natural language can complicate communication and understanding in the medical field, especially when attempting to describe and diagnose complex conditions. The use of precise medical terminology, along with the analysis of specific clinical cases, thus becomes essential to overcoming these challenges, facilitating clear dialogue and a better understanding of pathologies within the medical community.

Clinical approach

(hover over the images)

• 

  Figure 1: Representation of a patient complaining of "orofacial pain" on the right side of the face.

• 

  Figure 2: Stratigraphy of the patient's TMJ showing condylar flattening and the presence of osteophytes.

• 

  Figure 3: Computed tomography of the TMJ corroborating the stratigraphy findings shown in Figure 2.

Understanding of Medical Terminology

Exploring what "meaning" actually signifies enters us into a complex and multifaceted territory. The Cambridge Dictionary defines it as "what something expresses or represents."However, this explanation, intuitive as it may be, leaves the question open since the understanding of "meaning" remains broad and not universally agreed upon. Various theories, each with their strengths and weaknesses, seek to address this question, leading to heated debates without a definitive answer..

Traditionally, a term is considered a linguistic label representing an object, whether concrete or abstract. In this model, the term acts as an intermediary between language and the object it represents, as in the case of the word "apple," which evokes the image of the fruit known to everyone, regardless of their culture or age. However, terms like "orofacial pain" acquire different meanings depending on the context: for a neurologist, for a dentist, or for Mary Poppins herself, the meaning will vary considerably, reflecting different perspectives and knowledge bases.

These expressions do not derive their meaning merely from representing something "out there" in the world, but rather from how they interact with other terms within their specific world or context. For Mary Poppins, pain takes on a particular meaning in relation to her personal experience and consciousness, independent of any quantifiable external expression such as attempting to assign it a value on a scale from 0 to 10, which may prove to be meaningless without an internal or normalized context.

Similarly, a neurologist will interpret "pain in the right half of the face" based solely on his professional context, involving concepts like synapses, axons, ion channels, and action potentials. Conversely, a dentist will frame the meaning through a lens focused on teeth, the temporomandibular joint, masticatory muscles, and occlusion, demonstrating how meaning is intrinsically linked to the reference context.

---

Considering concepts is crucial in formulating a "differential diagnosis," as their misunderstanding can lead to clinical errors. It is therefore essential to explore the modern philosophy of "Meaning," introduced by Gottlob Frege, which articulates the meaning of a term through the notions of "extension" and "intension."

The "extension" of a concept includes all entities that share a certain characteristic, while "intension" refers to a set of attributes that outline that idea. Taking "pain" as an example, this term is generically applied to a wide range of human experiences, showing high extension but low intension. However, analyzing specific pain in contexts such as dental implants, inflammatory dental pulpitis, and neuropathic pain (atypical odontalgia), we observe that:

• The increase in mechanical and sensory perception threshold follows the activation of C fibers.
• In cases of atypical odontalgia, somatosensory abnormalities such as allodynia, decreased mechanical perception, and reduced pain modulation emerge.
• After the insertion of an implant, no significant somatosensory alterations are noted, although mild pain in the affected area is reported.
• In general, "pain" has a wide extension and limited intension, but focusing on specific types of pain, we notice that greater intension leads to a reduction in extension.

The "intension" of a concept indicates the distinctive aspects that separate it from others, reducing the concept's extension as the specificity of the intension increases. This allows us to distinguish, for example, TMJ pain from neuropathic pain.

In conclusion, the meaning of a term in a given language can be considered as an ordered pair of extension and intension, within a "context."

Specifically, in the dental context, "pain in the right half of the face" embraces a wide extension and an intension delineated by clinical characteristics and radiological or EMG investigations. In the neurological context, however, such pain is associated with an extension and intension defined by specific clinical and diagnostic parameters.

This analysis highlights the vulnerability of medical language to causes of semantic and contextual ambiguity, showing how terms such as "nOP" or "TMD" can assume markedly different meanings depending on the context.

---

Ambiguity and Vagueness

Beyond the specific language used, the meaning of a medical term is strongly influenced by its originating context, which can lead to phenomena of "ambiguity" or "polysemy." A term is considered ambiguous or polysemic when it has more than one meaning. Linguistics and philosophy have paid considerable attention to these phenomena of ambiguity and vagueness;however, despite the negative impact that ambiguity and vagueness can have on adherence to and implementation of Clinical Practice Guidelines (CPGs), these concepts have not yet been fully investigated and distinguished in the medical context.

Doctors' interpretations of vague medical terms can vary significantly,leading to less uniformity and greater variations in clinical practices compared to CPGs. Ambiguity is classified into syntactic, semantic, and pragmatic.

As previously mentioned, a simple linguistic expression like the one referring to Mary Poppins can acquire at least three different meanings depending on the context. The ambiguity and vagueness associated with the term "orofacial pain" can thus become a source of diagnostic errors, highlighting a certain inefficiency of medical linguistic logic in decoding the "machine message" transmitted by the System in real-time.

We delve deeper into this fascinating topic of "encrypted machine language," from which the subsequent chapters will develop.

The term "orofacial pain" does not gain its meaning so much from its purest lexical expression as from the context in which it manifests, evoking a wide range of clinical domains, related symptoms, and interactions with other neuromotor systems, the trigeminal nerve, dental districts, etc. This machine language does not translate directly into verbal language but into an encrypted code based on its own alphabet, which must be deciphered to be converted into natural language. The focus then shifts to the linguistic logic employed to decode this message. To better illustrate this concept, let's consider some practical examples.

Imagine that Mary Poppins complains of "orofacial pain," thus communicating her condition to the referring healthcare providers:

---

«Doc, 10 years ago I started with a widespread discomfort in the jaw, including episodes of bruxism; these worsened so much that I was accusing ‘diffuse facial pain’, in particular in the area of the right ‘TMJ’ with noises in the movements mandibular.
During this period, ‘vesicular lesions’ formed on my skin, which were more evident in the right half of my face.
In this period, however, the pain became more intense and intermittent»

The healthcare provider, whether a dermatologist, dentist, or neurologist, picks up certain verbal messages in Mary Poppins' dialogue, such as "widespread facial pain" or "TMJ" or "vesicular lesion," and establishes a series of hypothetical diagnostic conclusions that have nothing to do with encrypted language.

However, in this context, we should move away from patterns and preconceived opinions to better understand the concept of "encrypted language." Let's assume, then, that the System is generating and sending the following encrypted message, for example: "Ephaptic."

Now, what relation does "Ephaptic" have with nOP or TMD?

Nothing and everything, as we will see better at the end of the chapters on the logic of medical language; we will then devote time to the concepts of cryptography and decryption. Perhaps we've heard about them in spy movies or in information security, but they are also important in medicine, as you will see.

Encryption

Let's take as an example a common encryption and decryption platform. In the following example, we will illustrate the results of an Italian platform, but we could choose any platform, as the conceptual results do not change:

We type our clear message; the machine converts it into something unreadable, but anyone who knows the "code" will be able to understand it.

Let's assume, then, that the same happens when the brain sends a message in its machine language, made of wave trains, ion field packets, and so on; and that this carries a message to be decrypted, such as "Ephaptic."

This message from the Central Nervous System must first be translated into verbal language, to allow the patient to give meaning to the linguistic expression and the doctor to interpret the verbal message. However, in this process, the machine message is polluted by the linguistic expression: both by the patient, who is unable to convert the encrypted message into the exact meaning (epistemic vagueness), and by the doctor, who is conditioned by the specific context of his specialization.

The patient, in fact, by reporting symptoms of orofacial pain in the region of the temporomandibular joint, virtually combines the set of extension and intension into a diagnostic concept that allows the dentist to formulate the diagnosis of orofacial pain from temporomandibular disorders (TMD).

Very often, the message remains encrypted at least until the system is damaged to such an extent that signs and clinical symptoms so obvious emerge to facilitate diagnosis.

Understanding how encryption works is quite simple (go to the decryption platform, choose and try):

1. Choose an encryption key from those selected;
2. Type a word;
3. Obtain a code corresponding to the chosen key and the typed word. For example, if we enter the word 'Ephaptic' into the platform's encryption system, we will get an encrypted code in the three different contexts (patient, dentist, and neurologist) that correspond to the three different algorithmic keys indicated by the program; for instance, key A corresponds to the patient's algorithm, key B to the dental context, and key C to the neurological context.

In the case of the patient, for example, by typing "Ephaptic" and using the A key, the "machine" will return a code like:

$133755457655037A$

The key can be defined as "Real Context."

---

Let us continue with our example:

Let us take a common encryption and decryption platform. In the following example we will report the results of an Italian platform but we can choose any platform because the results conceptually do not change:

«Why do you say that the patient's "key" is defined as the REAL one?»
(difficult answer, but please observe the Gate Control phenomenon and you will understand)

First of all: Only the patient is unconsciously aware of the disease that afflicts his own system, but he does not have the ability to transduce the signal from the machine language to the verbal language. The same procedure occurs in 'Systems Control Theory', in which a dynamic control procedure called ‘State Observer’ is designed to estimate the state of the system from output measurements. Matter of fact, in the control theory, observability is a measure of how much the internal state of a system can be deduced from the knowledge of its external outputs. While in the case of a biological system a ‘Stochastic Observability’ of linear dynamic systemsis preferred, the Gramian matrices are used for the stochastic observability of nonlinear systems.

This would already be enough to bring now our attention on an extraordinarily explanatory phenomenon called Gate Control. If a child gets hit in the leg while playing soccer, in addition to crying, the first thing he does is to rub extensively the painful area so that the pain decreases. The child does not know the ‘Gate Control’, but unconsciously activates an action that, by stimulating the tactile receptors, closes the gate at the entrance of the nociceptive input of the C fibres, consequently decreasing the pain; the phenomenon was discovered only in 1965 by Ronald Melzack and Patrick Wall.

As much as in computers, encryption-decryption also takes place in biology. In fact, in a recent research the authors examined the influence of molecular mechanisms of the ‘long-term potentiation’ (LTP) phenomenon in the hippocampus on the functional importance of synaptic plasticity for storage of information and the development of neuronal connectivity. It is not yet clear if the activity modifies the strength of the single synapses in a digital (01, all or nothing) or analog (graduated) way. In the study it emerges that individual synapses appear to have an 'all or nothing' enhancement, indicative of highly cooperative processes, but different thresholds for undergoing enhancement. These findings raise the possibility that some forms of synaptic memory may be digitally stored in the brain.

Decryption

Now, assuming that the machine language and the assembler code are well structured, we insert the encrypted message from the Mary Poppins System in the 'Mouth of Truth‘:

$133755457655037A$

Let's pretend that we are Martians in possession of the right key (algorithm or context) the A key that corresponds to the 'Real Context'. We would be able to perfectly decrypt the message, as you can verify by entering the code in the appropriate window:

«Ephaptic»

But, luckily or not, we are not Martians, so we will use, contextually to the information acquired from the social and scientific context, the dental key that correspond to B key, with the consequent decryption of the message into:

«5GoI49E5!»

Using the C key that corresponds to the neurological context, the decryption of the message would be:

«26k81n_g+»

These are extraordinarily interesting elements of language logic, and please note that the encrypted message of the real context ‘meaning’ of the ‘disease’, the A key, is totally different from the one encrypted through the B keys and the C key: they are constructed in conventionally different contexts, while there is only one reality and this indicates a hypothetical diagnostic error.

This means that medical language logics mainly built on an extension of verbal language, are not very efficient in being quick and detailed in diagnostics, especially the differential one. This is because the distortion due to the ambiguity and semantic vagueness of the linguistic expression, called ‘vagueness epistemic’ or ‘epistemic uncertainty’, or better ‘uncertain knowledge’, forcibly directs the diagnosis towards the specialist reference context and not on the exact and real one.

«Why, then, are we relatively successful in diagnostics?»
(An entire separate encyclopedia would be needed to answer to this question, but without going too far, let's try to discuss the reasons.)

Basic diagnostic intuition is a quick, non-analytical and unconscious way of reasoning. A small body of evidence indicates the ubiquity of intuition and its usefulness in generating diagnostic hypotheses and ascertaining the severity of the disease. Little is known about how experienced doctors understand this phenomenon, and about how they work with it in clinical practice. Most reports of the physician’s diagnostic intuition have linked this phenomenon to non-analytical reasoning and have emphasized the importance of experience in developing a reliable sense of intuition that can be used to effectively engage analytical reasoning in order to evaluate the clinical evidence. In a recent study, the authors conclude that clinicians perceive clinical intuition as useful for correcting and advancing diagnoses of both common and rare conditions

It should also be noted that the Biological System sends a uniquely integrated encrypted message to the outside, in the sense that each piece of code will have a precise meaning when individually taken, while if combined with all the others it will generate the complete code corresponding to the real message, that is to "Efapsi".

In short, an instrumental report (or a series of instrumental reports) is not enough to decrypt the machine message in an exact way corresponding to reality. If we expect the message to be decrypted from 2/3 of the code, which perhaps corresponds to a series of laboratory investigations, we would get the following decryption result:

«Ef+£2»

This outcome comes from the deletion of the last two elements of the originating code: $13375545765503$ resulting from $133755457655037A$. So, part of the code is decrypted (Ef) while the rest remains encrypted and the conclusion speaks for itself: it is not enough to identify a series of specific tests, yet it is necessary to know how to tie them together in a specific way in order to complete the real concept and build the diagnosis.

Therefore, there is a need for:

«A System Logic that integrates the sequence of the machine language code»
(true! we'll get there with a little patience)

Final Considerations

The logic of language is by no means a topic for philosophers and pedagogues; but it substantially concerns a fundamental aspect of medicine that is Diagnosis. Note that the International Classification of Diseases, 9th Revision (ICD-9), has 6,969 disease codes, while there are 12,420 in ICD-10 (OMS 2013). Based on the results of large series of autopsies, Leape, Berwick and Bates (2002a) estimated that diagnostic errors caused 40,000 to 80,000 deaths annually. Additionally, in a recent survey of over 6,000 doctors, 96% believed that diagnostic errors were preventable.

Charles Sanders Peirce (1839–1914) was a logician and practicing scientist; he gradually developed a triadic account of the logic of inquiry. He also distinguishes between three forms of argumentation, types of inference and research methods that are involved in scientific inquiry, namely:

1. Abduction or the generation of hypotheses
2. Deduction or drawing of consequences from hypotheses; and
3. Induction or hypothesis testing.

In the final part of the study conducted by Donald E Stanley and Daniel G Campos, the Peircean logic is considered as an aid to guaranteeing the effectiveness of the diagnostic passage from populations to individuals. A diagnosis focuses on the individual signs and symptoms of a disease. This manifestation cannot be extrapolated from the general population, except for a very broad experiential sense, and it is this sense of experience that provides clinical insight, strengthens the instinct to interpret perceptions, and grounds the competence that allows us to act. We acquire basic knowledge and validate experience in order to transfer our observations into the diagnosis.

In another recent study, author Pat Croskerry proposes the so-called "Adaptive Expertise in Medical Decision Making", in which a more effective clinical decision could be achieved through adaptive reasoning, leading to advanced levels of competence and mastery.

Adaptive competencies can be obtained by emphasizing the additional features of the reasoning process:

1. Be aware of the inhibitors and facilitators of rationality (Specialists are unwittingly projected towards their own scientific and clinical context).
2. Pursue the standards of critical thinking. (In the specialist, self-referentiality is supported and criticisms from other scientific disciplines or from other medical specialists are hardly accepted).
3. Develop a global awareness of cognitive and affective biases and learn how to mitigate them. Use argument that reinforces point 1.
4. Develop a similar depth and understanding of logic and its errors by involving metacognitive processes such as reflection and awareness. Topic is already mentioned in the first chapter ‘Introduction’.

In this context, extraordinarily interesting factors emerge that lead us to a synthesis of all what has been presented in this chapter. It is true that the arguments of abduction, deduction and induction streamline the diagnostic process but we still speak of arguments based on a clinical semeiotics, that is on the symptom and/or clinical sign. Even the adaptive experience mentioned by Pat Croskerry is refined and implemented on the diagnosis and on the errors generated by a clinical semeiotics.

Therefore, it is necessary to specify that semeiotics and/or the specific value of clinical analysis are not being criticized because these procedures have been extraordinarily innovative in the diagnostics of all time. In the age in which we live, however, it will be due to the change in human life expectancy or the social acceleration that we are experiencing, ‘time’ has become a conditioning factor, not intended as the passing of minutes but essentially as bearer of information.

In this sense, the type of medical language described above, based on the symptom and on the clinical sign, is unable to anticipate the disease, not because there is no know-how, technology, innovation, etc., but because the right value is not given to the information carried over time

This is not the responsibility of the health worker, nor of the Health Service and nor of the political-industrial class because each of these actors does what it can do with the resources and preparation of the socio-epochal context in which it lives.

The problem, on the other hand, lies in the mindset of mankind that prefers a deterministic reality to a stochastic one. We will discuss these topics in detail.

In the following chapters, all dealing with logic, we will try to shift the attention from the symptom and clinical sign to the encrypted machine language: for the latter, the arguments of the Donald E Stanley-Daniel G Campos duo and Pat Croskerry are welcome, but are to be translated into topic ‘time’ (anticipation of the symptom) and into the message (assembler and non-verbal machine language). Obviously, this does not preclude the validity of the clinical history (semeiotics), essentially built on a verbal language rooted in medical reality.

We are aware that our Linux Sapiens is perplexed and wondering:

«... could the logic of Classical language help us to solve the poor Mary Poppins' dilemma?»
(You will see that much of medical thinking is based on the logic of Classical language but there are limits)

Bibliography & references

Masticationpedia is a charity, a not-for-profit organization operating in dentistry medical research,
particularly focusing on the field of the neurophysiology of the masticatory system
 

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