de Micheli-Serra A
Instituto Nacional de Cardiología Dr. Ignacio Chavez, Departamento de Farmacología, México, D. F.
Gac Med Mex. 1999 Jan-Feb;135(1):67-72.
A historic outline of the evolution of medical thought toward scientific medicine is presented. Galen from Pergamon, one of science's first philosophers, wrote an Institutio logica, which can be considered as an introduction to the scientific method. Later, the Nominalists of the XIV century, precursors of modern science, thought that science's object was not the general, vague and indeterminate, but the particular, which is real and can be known directly. About the middle of the XVII Century the bases of the modern science became established thanks to a revolution formented essentially by Galileo, Bacon and Descartes. During the XVIII Century, parallel to the development of the great current of English Empiricism, a movement of scientific renewal also arose in continental Europe following the discipline of the Dutch Physicians and of Boerhaave. In the last century, Claude Bernard dominated scientific medicine, but his rigorous determinism impeded him from taking into account the immense and unforeseeable field of the random. Nowadays, we approach natural science and medicine from particular groups of facts, that is, from the responses of Nature to specific questions, but not from general laws. Furthermore, in recent epistemology, the concept that experimental data are not pure facts, but rather, facts interpreted within a hermeneutical context has been established. Finally, a general tendency to retrieve philosophical questions concerning the understanding of essence and existence can frequently be seen in scientific inquiry. In the light of the evolution of medical thought, it is possible to establish the position of scientific medicine within the movement of ideas dominating in our time.
本文呈现了医学思想向科学医学演变的历史概述。来自佩加蒙的盖伦是科学的首批哲学家之一,他撰写了《逻辑原理》,可被视为科学方法的入门书籍。后来,14世纪的唯名论者作为现代科学的先驱,认为科学的对象不是普遍、模糊和不确定的东西,而是具体的、真实且可直接认识的东西。大约在17世纪中叶,现代科学的基础得以确立,这主要归功于由伽利略、培根和笛卡尔引发的一场革命。在18世纪,与英国经验主义主流发展并行的是,在荷兰医生和布尔哈夫的学科影响下,欧洲大陆也兴起了一场科学复兴运动。在上个世纪,克劳德·贝尔纳主导了科学医学,但他严格的决定论使他无法考虑到随机这一广阔且不可预见的领域。如今,我们从特定的事实群体,即从自然对特定问题的反应来研究自然科学和医学,而非从一般规律入手。此外,在最近的认识论中,实验数据并非纯粹事实,而是在诠释学背景下被诠释的事实这一概念已经确立。最后,在科学探究中经常可以看到一种重拾关于本质和存在理解的哲学问题的总体趋势。鉴于医学思想的演变,有可能确定科学医学在我们这个时代占主导地位的思想运动中的地位。