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Science in medicine: when, how, and what 

Science in medicine: when, how, and what
Chapter:
Science in medicine: when, how, and what
Author(s):

W.F. Bynum

DOI:
10.1093/med/9780199204854.003.020101

February 27, 2014: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

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date: 16 December 2017

Science has always been part of Western medicine, although what counts as scientific has changed over the centuries, as have the content of medical knowledge, the tools of medical investigation, and the details of medical treatments. This brief overview develops a historical typology of medicine since antiquity. It divides the ‘kinds’ of medicine into five: bedside, library, hospital, social, and laboratory. These categories are still principal headings in modern health budgets, but they also have specific historical resonances. (1) Bedside medicine, developed by the Hippocratic doctors in classical times, has its modern counterpart in primary care. (2) Library medicine, associated with the scholastic mentality of the Middle Ages, still surfaces in the problems of information storage and retrieval in the computer age. (3) Hospital medicine, central to French medicine of the early 19th century, placed the diagnostic and therapeutic functions of the modern hospital centre stage in care and teaching. (4) Social medicine is about prevention, both communal and individual, and is especially visible in our notion of ‘lifestyle’ and its impact on health. (5) Laboratory medicine has its natural home in the research establishment and is a critical site for the creation of medical knowledge, setting the standards for both medical science and scientific medicine. François Magendie (1773–1855) was probably the first truly ‘modern’ medical scientist: he had little sense of medical tradition; instead, he sought to establish medicine on new, scientific foundations....

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