Via Erasmo Piaggio 23/8,Riva Trigoso (Genoa) Europe. Founder of Quantum Biophysical Semeiotics Who's Who in the World (and America) since 1996 to 2009.
Ph 0039-0185-42315, Cell. 3338631439 www.semeioticabiofisica.it,email@example.com
At first sight, it could seem paradoxical, absurd, incomprehensible, my former definition of Middle Ages of today’s Medicine, but it contains an important, really distressing, disheartening truth (1-9).
In this brief paper I explain in clear manner what accounts for the reason of the justification of my definition Middle Ages of present Medicine (MAM), or Age of Darkness.
To begin with, I underscore the fundamental bias, scientists all around the world agree with, i.e., according to which, “all men are created equal”, so that Evidence Based Medicine (EBM) is the only theory at the base of every research in western countries. On the contrary, beside this theory, interesting more sponsoring drug producers than single patient, I have demonstrated firstly that individuals are different from biological view-point, and secondly that Single Patient Based Medicine theory really exists (10-13).
In following, I illustrate in a simple, clear way, easy to understand, what accounts for the reason of my term MAM, subdividing the argumentation in specific, distinct, particular paragraphs.
A) All around the world scientists are considering as truth the belief, according to which cancer can involves all individuals, though with diverse incidence. In other words, almost all physicians are overlooking both Oncological Terrain (OT) and OT-dependent Inherited Real Risk, localized in one (or more) biological system (14-24). As a consequence, today’s women are told that it is unavoidable necessary, e.g., to undergo periodically mamma echotmography and mammography, while all men are controlling periodically their PSA blood level, in order to prevent breast cancer and, respectively, prostate cancer.
The truth is that only women involved by both Oncological Terrain and breast cancer Inherited Real Risk in one (rarely in more) mamma quadrant can suffer from breast malignancy (15-23).
This is valid, of course, for carcinogenesis in every biological systems.
Overlooking above-mentioned original scientific concepts, physicians think that all individuals must be enrolled in cancer primary prevention, which will result useless and expensive, generating an avoidable Psychological Terrorism.
Please, reflect on the following message of mine posted recently in Nature.com:
Surely, climate change is real, as states wisely Obama. On the contrary, I believe that NHS Programs are unfortunately stable all around the world, generating the present Middle Ages of Medicine and - as a consequence - Psychological Terrorism. For instance, read
In addition, in every present research, aiming to study drugs usefulness in cancer primary prevention, are enrolled also individuals negative for both Oncological Terrain and OT-dependent Inherited Real Risk, e.g. in the lung. Therefore, research conclusion may be that – for instance – tobacco smoking is a tool of paramount importance in lung cancer primary prevention: a paradigmatic example of MAM.
B) All around the world scientists are considering as truth the belief that all women (and men?) can be involved by osteoporosis. Overlooking osteoporotic constitution, present war against osteoporosis is lost for ever (24-26). In spite of wise, prudent, indifferent advices of drugs companies and machines producers, all women after 40 years must be regularly controlled as far as bone calcium is concerned. In fact, nowadays to prevent osteoporosis, doctors are following precise, but clearly no-updated, WHO Guide Lines, according to which periodical MOC (Bony Computerized Mineralometria), is necessary for all women over 40 years, with and without osteoporosis constitution and ostoporotic inherited real risk; This is another outstanding example of MAM.
C) All around the world scientists are considering as truth the belief that all women and men can be involved in their life by type 2 diabetes, which is a serious today’s growing epidemics. In other words, unfortunately according to present medicine knowledge, all individuals are at different risk of diabetes. Therefore, it is nowadays advisable for everybody controlling fasting and postprandial glucose blood level, aiming to recognize in “early” symptomless patients glucose metabolism impairment. Overlooking Quantum Biophysical Semiotics, a large percentage of men involved by both diabetic “and” dyslipidemic constitutions, conditio sine qua non of diabetes, aren’t controlled, and thus not recognized as diabetics.
At this point, we must remember that so-called diabetic complications are already present when diabetes early diagnosis is made, since they occur years or decades before disorder onset (10, 11, 20, 27, 28) (S. www.semeioticabiofisica.it, Practical Applications, Diabetes).
From the above, briefly referred, remarks, it is clear without doubts that whatever diabetes primary prevention, performed overlooking diabetic “and” dyslipidemic constitutions, results unavoidably an expensive lack of success. This is another excellent example justifying the term MAM, i.e., Middle Ages of Medicine.
D) All around the world scientists are considering as truth the belief that all individuals with high blood levels of cholesterol (especially, LDL, No-HDL,TG, a.s.o.), homocysteine, uremia, as well as “every” hypertensive subject, tobacco smokers, obese individuals, stressed humans, and so on, are at risk of cardiovascular disease (CVD), and particularly, Coronary Artery Disease (CAD). In other, few words, in spite of wise, indifferent, neutral advices of lipid lowering drugs producers, the above mentioned pathological conditions are considered risk factors (sometimes, causes!) of CVD, including acute coronary disease.
Frankly speaking, what accounts for the reason of such as great mistake, compromising the primary prevention against an epidemics of present age, is the distressing fact that the large majority of Authors, Editors, Reviewers, University Professors, General Practitioners, National Health Service Authorities, specialized journalist, and also lay-men ignore the existence of Inherited CVD (CAD) Real Risk! (29-33)
At this point, I discuss some current differential diagnosis, since they symbolizing today’s Middle Ages of Medicine.
E) All around the world scientists are considering as truth the belief that ALL individuals with Precordialgia, “could be” affected by CAD, so that they think urgently carry out ECG (electrocardiogram). In fact, laboratory- and image department-dependent physicians advice usually, first of all, an ECG to ALL patient with pain in the central part of their chest, to ascertain possible acute coronary disorder. To ECG follow immediately thorax X-rays, oesophagus-gastro-duodeno-endoscopy, and a long series blood examination, looking for a precise diagnosis, which is really a “bedside” diagnosis, if doctors know Quantum Biophysical Semeiotics. As a matter of fact, when intense digital pressure, applied upon a single heart trigger-point, does not bring about simultaneously gastric aspecific reflex, CAD is excluded in reliable manner (7, 32-35).
Analogously, physicians are able to exclude at te bedside whatever chest disorder, when intense digital pressure, applied upon a single thorax trigger-point, does not bring about simultaneously gastric aspecific reflex. As regards the presence of hiatal hernia, even associated with cholelithiasis and colon diverticulosis (Saint Syndrome), doctors can recognize such as syndrome in 10 seconds (36, 37).
As a consequence, further examinations will follow exclusively when pathological physical semeiotic data are observed. To summarize, current diagnostic procedure in case of precordialgia is a paradigmatic display of MAM.
F) All around the world scientists are considering as truth the belief that ALL individuals with joint pain could be suffering from rheumatic disorders, so that they agree with the necessity, according to Guide Lines, of laboratory research, aiming to recognize possible rheumatism.
As a consequence, patients undergo lab analyzes, joint X-rays, TAC, NMR, a.s.o., in order to make possibly the differential diagnosis and diagnosis.
Unfortunately, overlooking both biophysical semeiotic rheumatic constitution and rheumatic inherited Real Risk doctors cannot recognize individuals who can be involved by such as disorders, separating them from those who surely will never suffer from joint disorder, rheumatic in nature (10, 11). The above remarks, briefly referred, account for the reason of psychological terrorism and today’s Middle Ages of Medicine.
I like conclude the article, illustrating in details a common problem of today’s Medicine, brought about by diffuse utilization of Echographical examination, in every patient presenting abdominal disorders, but more frequently in normal subjects!
G) The patient with a focal liver lesion may present difficult detection and management problems, in particular when upper abdominal symptoms are completely absent. In fact, the wider application of ultrasound and more recently computed tomography and NMR, have identified increasing numbers of patients with no symptoms related to their hepatic lesions.
On the contrary, there are a lot of quantum biophysical semeiotic signs valuable and reliable in bedside finding out and diagnosing focal liver lesions, even clinically silent, as well as in monitoring the course of the diseases (1). Due to clinical phenomenology in the right upper abdominal quadrant, related to retro-ciecal and/or sub-hepatic atypical localization, appendicitis must be considered in differential diagnosis (39,40). Moreover, the usefulness of quantum biophysical semeiotics in both avoiding unnecessary over-investigation and in selecting patients who might benefit from high quality specialist studies has to be emphasized.
At least during a long period of time, focal liver lesions may occur without upper abdominal symptoms. In other words, the majority of focal lesions of the liver are clinically silent, so that an increasing numbers of patients, with no symptoms related to their hepatic disorders, has been identified by wider application of ultrasound and computed tomography (41).
Although there is no widely accepted protocol for assessing these lesions, both sophisticated examinations are definitely included in various suggested algorithms (41, 42). Small haemangiomas and some hydatid cysts, however, have atypical computed tomography and ultrasound appearances (43, 44).
On the other hand, hepatic haemangioma represents the most common benign tumour of the liver and its clinical instrumental diagnosis is often difficult. The lack of diagnostic accuracy of echoscintigraphic detection, furthermore, in assessing a solitary hepatic lesion is well known (38). As a matter of fact, with only the aid of echothomography, for example, is not possible the differential diagnosis between hepatic abscess and solid lesion. On the contrary, ultrasound scanning permits early separation into cystic or solid lesions in almost all cases and also excludes large bile ducts obstruction. It may also identify multiple hepatic lesions.
However, technical difficulties with ultrasound scanning may arise in some patients, due, for instance, to obesity and/or overlying bowel-gas and is then necessary CT, which has an increased overall accuracy compared with ultrasound (38). All patients, observed in the past year, were routinely assessed by means of AP for evidence of hepatic tumor, first by detecting CAEMH, B, II, conditio sine qua non of tumors both benign and malignant, solid or liquid; then the "boxer's test" was carefully examined in order to ascertain the cystic syndrome, in particular starting 4 sec. after test beginning.
As regards the detection of cystic syndrome, we prefer to evaluate the upper third urethral reflex. In all positive cases AP of the liver was then carried out to find one (or more) suspected area. In the patients of the series, finger pressure on cutaneous projection area of focal suspected lesions, induced gastric aspecific reflex and cystic syndrome, thus allowing the clinical evaluation of lesion shape and size. Hepatic neoplasms, primary or secondary, must be taken into account in differential diagnosis, even when primary localization is yet unknown.
AP differential diagnosis between benign and malignant liver tumours is based also on the positivity ofRHSH "complete type" and autoimmune syndrome, both of them present exclusively in the malignancies. Moreover, "simulated defecation test", as well as "simulated micturation test", has proved useful in localizing focal lesions respectively in abdominal organs and urinary tract (unpublished work). When there are abdominal symptoms in the right upper quadrant, among other differential diagnoses, also appendicitis - in atypical retrocecal and/ or subhepatic localization - must be kept in mind, in order to avoid a misdiagnosis full of risk.
On the other hand, a patient with a focal lesion in the liver can be also involved by an appendicitis. From the auscultatory percussion point of view, despite its position, appendicitis is characterized by RESH "complete type" and especially by "tonic gastric contraction sign" (tgc), induced by both simulated defecation test (38, 43) and digital pressure on skin projection of diseased appendix, exactly localized by AP of the cecum. The intensity of the specific sign, furthermore, is directly related to the severity of the illness. On the contrary, the latency time before tgc enhancing is inversely correlated with the seriousness of underlying disease (e.g. from 4 to 8 sec.). As a result of these observations, AP appears to be very useful in diagnosing and differential diagnosing - of course - as well as in monitoring the evolution of appendicitis, apart from any atypical localization.
To return to hepatic focal lesions, it seems easy to separate by mean of AP haemangiomas from both cysts and neoplasms (only in the letter ones there is RESH and autoimmune syndrome). In fact, during the boxer's test, haemangioma size increases, whereas cyst diametre clearly decreases for 3 sec. Obviously, solid focal lesions of the liver do not vary their size during the test.
The above remarks are quite important, because haemangiomas and occasionally hydatid cysts - as a wide literature reports - may have atypical apperarances on initial investigation, and percutaneous biopsy may result in life-threatening hemor-rage, anaphylaxis or hydatic dissemination (24, 38).
In conclusion, although above-remarks represent partial data of my 53-year-long clinical experience, I’ am sure they are sufficient to corroborate the term Psychological Terrorism of today’s Middle Ages of Medicine. My hope is to can go out of both, as soon as possible, with the precious aid of Quantum Biophysical Semeiotics.
1) Stagnaro S. www.nature.com. The Great Beyond, July 11, 2008
2) Stagnaro Sergio. Semeiotica Biofisica Quantistica: Precisazione sulla Vaccinazione anti HVP nella Prevenzione del Cancro Cervicale. www.fcenews.it , 24 ottobre 2008, http://www.fcenews.it/index.php?option=com_content&task=view&id=1899&Itemid=45
3) Stagnaro Sergio. Role of NON-LOCAL Realm in Primary Prevention with Quantum Biophysical Semeiotics. www.nature.com, 01 Feb, 2008-05-17 http://www.nature.com/news/2008/080130/full/451511a.html
4) Stagnaro Sergio. The Lancet, January 28, 2008. Bedside Biophysical-Semeiotic Osteocalcin Test in Diagnosing and Monitoring Diabetes.
5) Stagnaro Sergio e Paolo Manzelli. Semeiotica Biofisica Endocrinologica: Meccanica Quantistica e Meccanismi d’Azione Ormonali. Dicembre 2007, www.fce.it, http://www.fcenews.it/index.php?option=com_content&task=view&id=816&Itemid=45
6) Stagnaro Sergio e Paolo Manzelli. Semeiotica Biofisica: Realtà non-locale in Biologia. Dicembre 2007, www.ilpungolo.com, http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5217
7) Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. Lecture, V Virtual International Congress of Cardiology. http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php
8) Stagnaro Sergio e Paolo Manzelli. 03 Gennaio 2008, Limiti della Medicina Ufficiale. L’Esperimento di Lory.
9) Stagnaro Sergio e Paolo Manzelli. L’Esperimento di Lory. Scienza e Conoscenza, N° 23, 13 Marzo 2008. http://www.scienzaeconoscenza.it//articolo.php?id=17775
10) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004. http://www.travelfactory.it/
11) Stagnaro S., Stagnaro-Neri M., Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Travel Factory, Roma, 2005. http://www.travelfactory.it/
12) Stagnaro Sergio. Single Patient Based Medicine: its paramount role in Future Medicine. Public Library of Science.
13) Stagnaro Sergio. Single Patient Based Medicine, Therapeutic Monitoring and proper Drugs Prescription. Nature Medicine.com. April, 4, 2008.
14) Stagnaro S., Stagnaro-Neri M. Una patologia mitocondriale ignorata: la Istangiopatia Congenita Acidosica Enzimo-Metabolica. Gazz. Med. It. - Arch. Sci. Med. 149, 67 1990. 2) Stagnaro S. New bedside way in reducing mortality in diabetic men and women. Ann. Int. Med. http://www.annals.org/cgi/eletters/0000605- 200708070-00167v1
15) Stagnaro-Neri M., Stagnaro S., Cancro della mammella: prevenzione primaria e diagnosi precoce con la percussione ascoltata. Gazz. Med. It. - Arch. Sc. Med. 152, 447 1993
16) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Ed. Travel Factory, Roma, 2004.
17) Stagnaro S., Stagnaro-Neri M., Oncological Terrain, conditio sine qua non of Oncogenesis, 2004: http://www.gutjnl.com/cgi/eletters?lookup=by_date&days=60
18) Stagnaro Sergio. "Genes, Oncological Terrain, and Breast Cancer" World Journal of Surgical Oncology., 2005, http://www.wjso.com/content/3/1/45/comments#205475
19) Stagnaro S. Reale Rischio Semeiotico-Biofisico. Ruolo diagnostico e patogenetico dei Dispositivi Endoarteriolari di Blocco neoformati patologici tipo I, sottotipo a) oncologici e b). Ed Travel Factory, Roma, www.travelfactory.it, in press
20) Stagnaro S. Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention. The Lancet. March 06 2007. http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1
21) Stagnaro Sergio. Bedside diagnosing Pancreas Cancer , even in its inherited real Risk.
Cases Journal BMC. 31 October 2008. http://www.casesjournal.com/content/1/1/280/comments#313610
22) Stagnaro Sergio. Bedside Detecting Lung Cancer Inherited Real Risk. Variant Baserga’s Sign. Medical News Today’s, 23 Oct 2008. http://www.medicalnewstoday.com/youropinions.php?opinionid=33875
23) Stagnaro Sergio. Bedside Diagnosing Pheochromocytoma, since its initial stage of Inherited Real Risk. Cases Journal 2008, http://www.casesjournal.com/content/1/1/30/comments#304598
24) Stagnaro Sergio. Bedside diagnosis of osteoporotic constitution, real risk of inheriting ostoporosis, and finally osteoporosis. Theoretical Biology and Medical Modelling 21 June 2007. http://www.tbiomed.com/content/4/1/23/comments#285569
25) Stagnaro-Neri M., Stagnaro S., Diagnosi Clinica Precoce dell’Osteoporosi con la Percussione Ascoltata. Clin.Ter. 137, 21 -27 1991 [Medline].
26) Stagnaro S. Co Q10 in the prevention and treatment of primary osteoporosis. Preliminary data. Clin Ter.;146(3):215-9 [MEDLINE]
27) Stagnaro S., Stagnaro-Neri M. Valutazione percusso-ascoltatoria del Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131, 1986.
28) Stagnaro S., West PJ., Hu FB., Manson JE., Willett WC. Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. [Medline]
29) Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. Lecture, V Virtual International Congress of Cardiology. http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php
30) Stagnaro Sergio. Biophysical-Semeiotic Inherited Coronary Real Risk, conditio sine qua non of CAD.17 August 2007.
31) Stagnaro Sergio. Reale Rischio Congenito di CAD: Nosografia e Terapia. www.fce.it 22 maggio 2008 http://www.fcenews.it/index.php?option=com_content&task=view&id=1390&Itemid=47
32) Stagnaro Sergio. Bedside recognizing Inherited CAD Real Risk. www.natura.com 21 May, 2008. http://network.nature.com/forums/pmgs/1587?page=1#reply-4262
33) Stagnaro Sergio. Bedside Recognizing CAD Inherited Real Risk and silent CAD with Biophysical Semeiotics. Lipid in Health and Disease. (29 May 2008) http://www.lipidworld.com/content/7/1/19/comments#299588
34) Stagnaro Sergio. Bedside Evaluation of CAD biophysical-semeiotic inherited real risk under NIR-LED treatment. EMLA Congress, Laser Helsinki August 23-24, 2008. "Photodiagnosis and photodynamic therapy", Elsevier, Vol. 5 suppl 1 august 2008 issn 1572-1000.
35) Stagnaro Sergio. Diagnosi clinica di cuore sano in un secondo! 7 Aprile 2008. www.fce.it http://www.fcenews.it/index.php?option=com_content&task=view&id=1218&Itemid=47
36) Stagnaro Sergio. Saint’s Syndrome. Bed-side Diagnosis by means of Biophysical-Semeiotics. www.semeioticabiofisica.it
37) Stagnaro Sergio. Hiatal Hernia, Oesofageal Peristalsis Modificazions And Gastro-Oesofageal Reflux Disease (Gerd): Clinical Diagnosis By Means Of Biophysical Semeiotics.
38) Stagnaro S., Stagnaro-Neri M. Auscultatory Percussion in Detection Focal Liver Leions even Clinically Silent. Acta Med. Medit. 8, 89-94, 1992.
39) Stagnaro S. Bed-side diagnosing acute appendicitis and gastrointestinal diseases. Gut.j.on line, 2003: http://gut.bmjjournals.com/cgi/eletters/52/5/770-a#100
40) Stagnaro-Neri M., Stagnaro S., Appendicite. Min. Med. 87, 183, 1996 [Medline]
41) Thompson J.N., Gibson R., Czerniack A., Blumgart L.H., Focal liver lesions: a plan for management,
Brit. Med. L, 1985, 290, 1643.
42) Scheible W., A diagnostic algorhitm for liver masses, Semin. Roemtgenol., 1983, 18, 84.
43) Johnson C.M., Sheedy P.P., Stanson A.W., Stephens D.H., Hattery R.R., Adson M.A., Computed
tomography and angiography of cavernous hemangiomas of the liver, Radiology, 1981, 138, 115.
44) Snow J.H., Goldstein H.M., Wallace S., Comparison of scintigraphy, sonography and computed
tomography in the evolution of hepatic neoplasm, A.T.R., 1979, 132, 915.
Sergio Stagnaro MD
Via Erasmo Piaggio 23/8
Riva Trigoso (Genoa) Europe
Founder of Quantum Biophysical Semeiotics
Who's Who in the World (and America)
since 1996 to 2009