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© Christelle Durand
Microscopie d'un neurone. Le marquage jaune montre les synapses.
Publication : Annales médico-psychologiques

From clinic to the “foul and exciting field of life”: A psychiatric point of view on clinical physiology

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Annales médico-psychologiques - 01 Jan 2017

Micoulaud-Franchi J-A, Dumas G, Quiles C, Vion-Dury J

Annales Médico-Psychologiques, Revue Psychiatrique. 2017 Jan;175(1)

Abstract
Claude Bernard, and his master François Magendie, by the constitution of physiological science, has brought the establishment of a unifying representation system in the field of medicine. According to these representations, the diseases and the therapeutics would be considered by medical doctors as following the same laws of physiology. Physiology would be the condition of a real scientific medicine. How this positioning may be applied to psychiatry? To answer this question, this article proposes first of all to summarize the principal concepts structuring clinical physiology since Claude Bernard. These concepts are those of the “milieu intérieur”, its stability and its regulation. The principles of this regulation system introduced by Claude Bernard lead us to consider him as the first modern systemic physiologist. Moreover these principles of regulation offer the possibility to understanding in an original way the processes of adaptation and acclimatization of an organism. This article then to analyze how these physiological concepts can be applied to psychiatry, including a discussion on the distinction of normal and pathological (by underlining that the difficulty in defining the disease is not specific to mental disorders), by providing a physiological perspective of the notion of syndrome for linking together in a practical way, the requirements of scientific medicine to that of rigorous clinical medicine.

Résumé
Claude Bernard, et son maître François Magendie, ont permis, par la constitution de la science physiologique, la mise en place d’un système de représentation unificatrice dans le champ de la médecine où la pathologie et la thérapeutique seraient considérées par les médecins comme suivant les mêmes lois de la physiologie. La physiologie serait ainsi la condition d’une véritable médecine scientifique. Comment ce positionnement peut-il s’appliquer à la psychiatrie ? Afin de répondre à cette question, cet article se propose, tout d’abord, de rappeler les concepts essentiels structurant la physiologie clinique depuis Claude Bernard. Ces concepts sont ceux de milieu intérieur, de sa constance et de sa régulation. Les principes de ce système de régulation introduits par Claude Bernard font de lui un précurseur de la physiologie systémique moderne et permettent de comprendre de manière originale les processus d’adaptation et d’acclimatation d’un organisme. Cet article se propose ensuite d’analyser comment ces concepts peuvent s’appliquer à la psychiatrie et notamment à la distinction du normal et du pathologique (et de souligner que la difficulté dans la définition de la maladie n’est pas propre aux troubles mentaux), en offrant une perspective physiologique à la notion de syndrome, concept permettant de lier ensemble, et de manière pratique, les exigences d’une médecine scientifique à celle d’une médecine clinique rigoureuse.

http://www.sciencedirect.com/science/article/pii/S0003448716302013