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Stomach and Intestine(Tokyo) Volume 3, Issue 9 （August 1968）

胃と腸 3巻9号（1968年8月発行）

Japanese English

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今月の主題消化管の医原性疾患

綜説

消化管の医原性疾患 IATROGENIC DISEASES OF THE DIGESTIVE ORGANS 池見酉次郎 ¹ , 中川哲也 ¹ , 村瀬政行 ¹ , 松本建一 ¹ , 上野聖満 ¹ , 高山武彦 ¹ , 森崇 ¹ , 青木宏之 ¹ , 伊藤侊 ¹ , 河野友信 ¹ , 中野重行 ¹ , 栗山一八 ¹ , 武谷力 ¹ , 田中正敏 ¹ , 赤木稔 ¹ , 杉田峰康 ¹ , 遠山尚孝 ¹ , 真崎由宜子 ¹ , 山本干 ¹ , 真武弘之 ² , 藤本龍郎 ² Yujiro Ikemi ¹ ¹九州大学医学部心療内科 ²ステーション・クリニック ¹Internal Medicine, School of Medicine, Kyushu University. pp.1061-1068

発行日 1968年8月25日 Published Date 1968/8/25

DOI https://doi.org/10.11477/mf.1403110784

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Abstract 文献概要
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Ⅰ．緒言

　医原性疾患という言葉は，今日ではSirArthur Hurstが最初につくった定義“a term（iatrogenic）applied to disorders induced in the patient by autosuggestion based on the physician's examination，manner or discussion”（医者の検査や言動にもとづく，患者の自己暗示によってひきおこされる病気）からは次第にかけはなれ，iatrogenicを，「医療による」といった意味に，拡大解釈されるのがふつうである．そこで，投薬や手術などの医療行為に伴う副作用が，いわゆる医原性疾患の主要な部分を占めているのが現状である．しかしこの語源からすれば，医師の不注意な言動や診断の誤りによって，そうでなければ避けられるはずだった不利な状態に患者をおとし入れるもの，本来ならば，100％避けられるような種類のものに限られるべきだという考えもなり立つわけである．私どももかねて，「医原性疾患については，Hurstの最初の定義に立ちかえって，薬や手術の副作用だけでなく，医者という薬の副作用についても，反省すべきである」と主張している．

　The definition, “the disorders induced in the patient by auto-suggestion based on physician's examination, manner or discussion,” was made by Arthur Hurst.

　According to this definition, the following investigation and study were made to reexamine iatrogenic diseases. Taking the advantage of the group examinations of the stomach for healthy high school students and middle aged company employees, the frequency of the occurence of the symptoms of the digestive organs by giving the word suggestion “bad stomach” was investigated. Only five to eight per cent of the people showed the symptoms.

　In 60 cases which were thought to have iatrogenic factor, the role of psychological factors concerned with the onset and the course of disease was analyzed. It has become clear that, when a patient showed some symptoms induced by doctor's behaviour, the factors of the patient's charactor and psychological state at this stage, are as important as or rather more important than the factors from doctor's side.

　But it is the doctor's behaviour which lacks the elementary knowledge of the relation between body and soul that causes the iatrogenic diseases. A few cases which were thought to be iatrogenic diseases, were presented. The investigations by inquiries to the internists in the University Hospital and its related institutes and hospitals around the Fukuoka City, were performed. As the results of the investigation, it was found out that the remote cause of the iatrogenic diseases is originated already in medical education and medical system.