💉 Does Medicine Act Without Disease? What’s Really Behind That Idea
Summary:
We often hear about “preventive medicine” or “treatments without disease.” But even in the absence of diagnosis, medicine remains structured around the concept of disease. In contrast, the patient acts based on concrete symptoms. This asymmetry shapes how medicine works—both in theory and in practice.
đź’ˇ A common misconception: prevention as “disease-free” medicine
At first glance, preventive medicine seems to operate without disease: vaccination, screening, lifestyle advice… But all these actions are motivated by the goal of preventing specific, known diseases. Even when no pathology is present, disease remains the invisible center of medical reasoning.
“Prevention means anticipating the emergence of a pathological state.”
— E.A. Clarke, Preventive Medicine and Public Health, 1974
⚙️ A system organized around risk
Medicine doesn’t just treat what’s present; it also acts before illness occurs. It monitors, models, anticipates. It intervenes in order to prevent potential diseases, often identified through statistics or predictive models. Medicine without disease doesn’t mean absence of disease—it means presence of projected risk.
This logic drives public health policies, medical check-ups, personalized medicine, and early warning algorithms.
👤 The patient: not around disease, but around experience
The patient, by contrast, acts from what is felt. They seek help for pain, discomfort, fatigue… even when no disease is diagnosed. It is the symptom—not a disease entity—that triggers action.
“The patient seeks relief, not definition.”
— G. HermerĂ©n, The patient’s view in clinical decision-making
🧶 Two perspectives in tension
| Perspective | Anchoring Concept | Motivation for Action |
|---|---|---|
| Medicine | Disease (present or potential) | Prevent, diagnose, treat |
| Patient | Symptom (concrete, felt) | Find relief, make sense, act |
🧲 The concept of disease as a self-fulfilling prophecy
One of the paradoxes of modern medicine is that the very announcement of a diagnosis or risk can help bring it about. This is known as the nocebo effect: negative suggestions or expectations can generate real physiological changes.
Even without pharmacological cause, mere mental focus on disease (such as repeated tests, risk alerts, or hyperattention to the body) may lead to:
- changes in body schema (attention-driven neuroplasticity),
- dysregulation of the autonomic nervous system (tension, vigilance),
- and increased vulnerability to functional disorders (chronic pain, fatigue, etc.).
This is not mysticism. It is a well-documented neuropsychological process where the mind becomes a filter—and sometimes a trigger—of actual physiological change.
đź“Ś In summary
- So-called “disease-free” medicine remains oriented around disease as a model to avoid.
- The patient acts based on what is felt, not what is diagnosed.
- This gap may lead to frustration or misunderstanding in care relationships.
- A more symptom-centered medicine could be more embodied, more humane, without sacrificing medical vigilance.