When it acts as a signifier in relation to itself', it is therefore doubly signified: by itself and by the disease, which, by characterizing it, opposes it to non pathological phenomena; but, when taken as a signified (by itself or by the disease), it can receive its meaning only from an earlier act that does not belong to its sphere: from an act that totalizes and isolates it, that is, from an act that has transformed it into a sign in advance.