[Organic versus non-organic diseases. A distinction necessary for rational practice]

A great many, perhaps the majority, of those who see a doctor present subjective suffering and behaviour disorders that are problematic to classify as illness. This is because no pathobiological foundation for such classification is demonstrated--no matter how thoroughly the patients are examined, or how long they are followed up. Symptomatologically too, organic and non-organic conditions are distinctive. While organic illnesses are characterized by physical and biochemical signs, non-organic disorders manifest only distressing experiences (as pains or anxiety) or undesirable behaviour (as abuse of alcohol)--phenomena that are inseparable from normal sensation, emotion, intentions and actions. As for treatment, the main methods applied in organic illnesses are of a physical and biochemical nature. In cases of subjective suffering or behavioural deviances therapy consists of general relief, correction and sedation--all of the kind we make use of in our everyday lives. If the majority of those who consult a doctor are not really ill, what then, is the alternative? Individual and collective misery? The sole alternative to illness is normal psycho-physiological and behavioural variations. A widely held opinion, however, is that non-organic disorders fulfill the criteria for illness. This means that some kind of pathological substrate is postulated even when we fail to demonstrate its existence. The crucial point, however, is not to solve the problem of whether a person is ill or not, but to underline that we are dealing with two separate categories of phenomena - bio-pathologically and psycho-physiologically founded suffering and dysfunctioning.