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The author proposes that the only truly natural course of a disease occurs in illnesses that are unsuspected and immediately fatal, challenging the definition of medically managed courses as natural.
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The author proposes a philosophical redefinition of the 'natural history' of a disease, arguing that medically managed courses are not truly natural.
The natural history of a disease has, in recent years, come to mean the nonsurgically treated progress of that illness, But is it proper to consider the medically managed course as natural? Is there really such a total difference between the various forms of intervention? A successful recovery from pneumonia with the aid of penicillin is as complete (and unnatural) as a successful appendectomy, and death from digitalis excess is no less final than after unsuccessful surgery. I propose that the only natural course of a disease occurs in illnesses that are unsuspected and immediately fatal, as with some myocardial . . .
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David Littmann (1971) conducted an editorial in Congestive Heart Failure. The author proposes that the only truly natural course of a disease occurs in illnesses that are unsuspected and immediately fatal, challenging the definition of medically managed courses as natural.
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