<論文>疾患と名づけの間 : 骨粗鬆症を事例として

Abstract

This article attempts to give a sociological account of the disease 'osteoporosis', using Japanese medical journals from 1995 to 1998 as a source. For the contemporary construction of osteoporosis, there are various different medical disciplines concerned - not just orthopedics, but also gynecology, internal medicine, geriatrics and radiology. As the term 'osteoporosis' is diagnosed by different disciplines employing different diagnostic frames as well as technologies, a number of things are signified by the term. This has caused a loosening of relation between the signifier and the signified of the disease, and therefore, we must ask here whether 'osteoporosis' in this sense possesses one single reality at all. At present, osteoporosis is treated as one disease, and there are disputes across disciplines about the nature of disease. There is a movement to standardize the process of diagnosis, but on another important level, some change can be seen. It could be pointed out that the term osteoporosis tends to function not only as a signifier for a disease but also one for a 'syndrome' (that is to say, more loosely as a collection of signs and symptoms that appears in the onset of the disease and which construct a patient's condition.) In other words, the task of diagnosis that was originally to be carried out both by differentiating and identifying a disease is being done solely according to the principle of identification. This shift has made it possible for some medical disciplines to begin treatment osteoporosis in its own way and at an earlier stage. The double standards for diagnosis (osteoporosis as a disease and osteoporosis as a syndrome) are confusing us.