[Is disease grounded in the mind, the spirit or communication? Pathology as a leading path in learning about disease].
What is the reason, why pathology could command a dominating position as a central teaching discipline in the last 150 years? Furthermore: can this position be maintained in the future? Pathology takes its definitive stand in the philosophic confrontation of "Mind" versus "Matter". It guards the dogma of Morgagni: every disease is reflected by its typical morphological substrate. As long as this dogma is guarded and defended by the discipline of pathology, we will stay at the helm of teaching in medicine. Recently information as a third reality (besides mind and matter) has come into existence. Information is defined here as genomic information specifically the differentially activated functional genomics. In extension to the old dogma of Morgagni we recognize now an extension to "functional" diseases where we do not (yet) find a pathological anatomical manifestation. In these cases "information" is defined as differences in physical states. They can be converted to information in the sense of meaning and purpose by communication. Pathology provides the bridge between functional genomics and morphological manifestations of diseases (phenomics). The future of pathology is based on the amalgamation of the old and reliable Morgagni-Virchow dogma with the new informational dogma. If pathology provides sense, meaning and significance to phenomics, morphology in relation to functional genomics it will retain and even enlarge its influence as the most important teaching discipline in medicine.
Mittermayer
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C
Institut für Pathologie, Universitätsklinikum Aachen.
D003142:Communication; D004194:Disease / Q000209:etiology* / Q000523:psychology; D006801:Humans; D010336:Pathology / Q000639:trends*