Scientific Medicine and Historical Research

SCIENTIFIC MEDICINE AND HISTORICAL RESEARCH OWSEI TEMKIN, M.D.* Such recognition as the history of medicine is gaining in medical schools is largely based on the educational value of historical teaching. Whereas in most disciplines the teacher is expected to engage in research, this cannot be said generally of medical history. Indifference toward couecting inconsequential data is understandable, but I believe I discern antagonism here and there to serious and critical historical study insofar as it is not ancillary to the other medical disciplines. I attempt here a theoretical discussion of the intrinsic reasons that underHe the antagonism between scientific research and historical research and a consideration of the possibility of overcoming this antagonism. A considerable amount ofHterature touches on similar problems (i, 2, 3). Without laying claim to novelty, I wish to bring into reHefthose features which seem to me to promise an organic fusion between these two kinds of research. My discussion disregards the non-scientific part of medicine because I beHeve that much of the antagonism is associated with the growth of scientific medicine since the nineteenth century. The following analysis, being strictly limited to research, should not be mistaken for an appraisal ofthe general interrelationship betweenmedicine and history, which comprise much more. On the other hand, I speak of science and the history of science rather than ofmedical sciences and their history. Excursions into the history of physics and, above all, the need for brevity may excuse this terminology, which I trust will not confuse the reader. Physiology, the basis of experimental medicine, has been in the forefront ofmy mind. In his Introduction to the Study ofExperimental Medicine, Claude Bernard (4) describes the "true scientist": * Director, Institute ofthe History ofMedicine,Johns Hopkins University, 1900 East Monument Street, Baltimore ¡, Maryland. 70 Owsei Temkin · Scientific Medicine and Historical Research Perspectives in Biology and Medicine · Autumn 1959 Thetruescientistis onewhose workincludesbothexperimenta 1theory andexperimental practice, (i) He notes afact; (2) apropos ofthis fact, an idea is born in his mind; (3) in the light ofthis idea, he reasons, devises an experiment, imagines and brings to pass its material conditions; (4) from this experiment, new phenomena result which must be observed , and so on and so forth. The mind ofa scientist is always placed, as it were, between two observations: one which serves as starting point for reasoning, and the other which serves as conclusion. In this description, research—the quest for something new—appears as the tool of scientific progress. It may be good to compare Claude Bernard's statement with one by Galen (5), some eighteen hundred years ago: Now I, for my part, as I have already said, did not set before myselfthe task ofstating what has been so well demonstrated by the Ancients, since I cannot surpass these men either in my views or in my method of giving them expression. Doctrines, however which they either stated widiout demonstration, as being self-evident (since they never suspected that there could be sophists so degraded as to contemn the truth in these matters ), or else which they actually omitted to mention at all—these I propose to discover and prove. Galen's "Ancients" are, above aU, Hippocrates and Plato, then Aristotle and a few others who lived shortly after him. Is it likely that any modern scientist would narrowly limit the task of research to adding proofs to views expressed by Harvey, Pasteur, and Virchow and discovering what they had omitted? The modern scientist will not necessarily lack respect for his "ancients"—he may favor going to the sources ofour knowledge, reading Hippocrates, Harvey, Pasteur, and Ehrlich—but the idea of truths estabHshed once and for aU and needing only elucidation and supplementation hardly appeals to him. It follows that a scientist who accepts a concept ofresearch such as defined above impHcitly accepts a theory of the history of science. It does not matter whether he knows anything at all about that history. What matters is the conviction that "true science" corrects the old, discovers the new, and thus cannot fail to advance over the old. Claude Bernard's Introduction to Experimental Medicine formulates a method of scientific research that embodies this assurance of scientific progress. Apart from logical...