The Growth of Medical Thought By Lester S. King (review)

The Growth ofMedical Thought. By Lester S. King. Chicago and London: University ol Chicago Press, 1963. Pp. ix+254. $5.50. Medicine is concerned ultimately with the normal and abnormal reactions to a variety ofstimuli that affect the human organism. These reactions are studied to learn how they come about, what they mean for the proper functioning of the organism, and how to recognize those that are or may become serious and consequently require attention, so that measures can be taken to prevent, remove or alleviate their causes and consequences. To do this effectively, the physician must have a body ofknowledge and an acceptable frame ofreference, that is, some concept ofthe nature and cause ofsickness in terms of which he can define the specific cases that he encounters. Throughout known history, and probably even before, men have accumulated knowledge about health and disease, have conceptualized and systematized this information, and have developed means for implementing such knowledge. The occurrence and changes ofthese facets in the course oftime, the persons involved in them, the circumstances and influences that have affected them—these are the substance ofmedical history. Dr. King has chosen to deal with the history ofmedical ideas from the point ofview that medical thought is an aspect ofintellectual history. The ideas and concepts that have influenced medicine, the theories that underlie medical research and practice—these are the primary concern ofhis book. From the large body ofavailable material on medical men and ideas, a small number ofphysicians have been selected who are representative of certain historical periods and ofcertain problems and patterns of thought. The first three chapters are each devoted to an individual (Hippocrates, Galen, Paracelsus) while the last two cover a group ofseven (Vesalius, Harvey, Hoffmann, Boerhaave, Schwann, Rokitansky, Virchow). More than halfthe book is taken up by the first three physicians. The approach to these thinkers is best stated, perhaps, in Dr. King's own words: "Choosing a few individuals who represent trends in intellectual history, I have tried by episodic treatment to indicate the growth ofmedical science and the patterns ofmedical doctrine. I have tried to place inperspective the critical spirit and sound method that goodphysicians have displayed throughout history, and alsoto show thepitfallsthat beseteventhe wisest." Thus, the limits ofthisstudy andthe frame ofreferencewithinwhich it must be evaluated are quite clear. First ofall, it is not a history ofmedical thought, and the title given to it is misleading. Growth indicates change and process; these aspects are considered only very tangentially or not at all. Secondly, the substance ofthe book is a series ofanalyses of the thought of selected physicians, focused on their use of observational, empirical, and experimental data; the manner in which they advanced from such data to the construction ofhypotheses, theories, and speculative systems; and finally the degree to which critical evaluation was applied to these elements and structures. Essentially, Dr. King is concernedwiththeexplanatoryprocess; thatis, themodes orpatterns ofthought bywhich medical thinkers have selected facts, fitted them into a pattern or relationship, and thus developed an explanatory concept or principle. At bottom, this is a study ofthe logic of medical explanation in selected cases, and might more accurately have been entitled "patterns of medical explanation in selected historical periods." The mediod employed is basically an explication des textes, not unlike that ofthe "New Criticism" in literature. 390 Book Reviews Perspectives in Biology and Medicine · Spring 1963 Within the limits that he has set for himself, Dr. King has produced a very creditable result. This b an interesting, well written volume, and a highly personal one. It is clearly directed at physicians, biologists, and any other educated persons who may have an interest in the history and philosophy ofscientific thought. Philosophers ofscience who not infrequently base themselves largely on the physical sciences may find useful comparative materials here. Teachers of medical history will clearly find it useful for their students. I have no doubt that the book can serve well for a wide audience with some interest in medicine and science, and today such an audience should be wide indeed. Particularly good are the chapters on Galen and Paracelsus. This is especially commendable because historical understanding of these physicians and their work has been plagued by prejudice...