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SCIENTIFIC METHOD IN SCIENCE AND MEDICINE* SIR PETER MEDAWAR, F.R.SA I should like to spend the first few minutes of my lecture explaining the meaning of its title a little more exactly. By such a title as this I could be taken to mean that I intended to expatiate upon the variety, uses, and value of scientific technology and instrumentation in medicine. I abjure this ambition, however, partly because I cannot easily think of a more tedious subject, or a subject more inappropriate to the present occasion—having regard to the fact that, what with Memorial-Sloan-Kettering, New York Hospital-Cornell Medical School, and the great Rockefeller University itself, I am lecturing near the midst of what must surely be the highest concentration of scientific and medical talent in the whole of midtown New York—which is just my figurative way of saying "in the whole world," for I really do not know where else in the whole world we could find its equal. Yet when we appraise the contributions of science and technology to medicine, we must not forget that there are older medical cultures in which a recourse to instrumentation and to the laboratory generally entails some element of loss of face—some still further depreciation of the arts of clinical judgment. In such cultures as these the bright-eyed young man's enthusiastic enquiry about the potentialities of nuclear magnetic resonance spectroscopy for medicine is quietly but firmly rebuked by a reminder of those older clinicians who were able to diagnose diabetes mellitus by watching flies buzzing around a drop of evaporated urine—a test which presumably works only in the summer owing to the widespread uncertainty about where flies go in the winter. I need hardly tell an audience such as this that to prefer unaided clinical judgment to the use of laboratory aids where they are appropriate is to prefer lip reading to the use ofthe hearing aids which science provides in abundance: every modern clinician knows that scientific processes enormously enrich and potentiate clinical judgment, but as I regard this statement as self-evidently true I shall say no more about it. *Second William S. Paley Lecture on Science and Society, Department of Medicine, New York Hospital-Cornell Medical Center, March 29, 1974.> tClinical Research Centre, Watford Road, Harrow, HAl 3UJ Middlesex, England. Perspectives in Biology and Medicine · Spring 1975 | 345 My purpose instead is to outline my conception, founded essentially on Karl Popper's, of the process of intellectual enquiry as it occurs in both science and medicine and to try to convince you that scientists and clinicians use essentially the same method of enquiry. Towards the end of my talk I shall devote some little time to discussing, with examples, good and bad scientific theories. II Before I embark upon this program let me make the point that not one of those whom we recognize as authorities on scientific method was himself a scientist. Francis Bacon was a lawyer and a man of affairs and the author, many still contend, of the plays of Shakespeare; John Stuart Mill was what we should now call a sociologist. Your own C. S. Peirce was, as Karl Popper now is, a great philosopher. One cannot but wonder at the fact that scientists themselves are so seldom deeply interested in scientific methodology. I myself believe that their performance as scientists would be greatly improved by a clearer understanding of the intellectual structure of creative thought in science. Ill The traditional view of scientific method is that scientists use a special process of thought known as "induction." Inductivism is a complex of beliefs of which the salient points are: the Truth lies all around us out there in Nature, so that the scientists's main task is to discern and record matters of fact and then to classify and appraise them according to certain more or less well defined rules—whereupon the truth will certainly reveal itself. Thus the scientist collects facts much as entomologists collect beetles. The process of observation can be relied upon implicitly to reveal the Truth as it lies about him in nature. The scientist, therefore , is a shrewd spectator...

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