Unschuld P U
Institute of the History of Medicine, University of Münich.
Sci Context. 1995 Spring;8(1):9-30. doi: 10.1017/s0269889700001873.
This paper introduces the notion of plausibility as a decisive condition for the acceptance by groups in society of fundamental ideas concerning the nature of illness. Plausibility, it is argued, helps to explain both transition from one system of fundamental ideas to another in history, and coexistence of different such systems in a single civilization. Hence this paper challenges an interpretation of medicine prevalent, especially in medical anthropology, since the 1940s, when Erwin Ackerknecht introduced the idea of medicine as an integrated aspect of a society's or community's culture. Because early research focused on small-scale communities where a majority, if not all, of the members adhered to one world view and experienced one and the same existential environment, medicine came to be identified as a cultural system representative of entire communities and, later, societies. Hence we speak of Chinese medicine as if there were one system of therapeutic ideas and practices representative of China as a whole. The fact is that even though medicine is indeed a cultural system, it is representative only of the culture developed by people sharing identical environments and experiences. That is, if within one civilization different groups coexist in different existential realities entailing different notions of what causes crisis and how to maintain harmony, then these groups will believe in different systems of ideas concerning the generation, treatment, and prevention of illness. Such systems of ideas are therefore always metaphorical reflections of a real social environment or of one aspired to. It is not truth (Wahrheit) that leads to an acceptance of basic therapeutic ideas but plausibility (Wahrschein).
本文介绍了似真性这一概念，它是社会群体接受有关疾病本质的基本观念的决定性条件。有人认为，似真性有助于解释历史上从一种基本观念体系向另一种基本观念体系的转变，以及不同的此类体系在单一文明中的共存。因此，本文对自20世纪40年代以来尤其是在医学人类学中盛行的一种医学解释提出了挑战，当时欧文·阿克克内希特提出医学是社会或社区文化的一个综合方面的观点。由于早期研究集中在小规模社区，其中大多数（如果不是全部）成员坚持一种世界观并经历相同的生存环境，医学开始被视为整个社区乃至社会的文化体系代表。因此，我们谈论中医时，就好像存在一个代表整个中国的治疗思想和实践体系。事实上，尽管医学确实是一种文化体系，但它只代表由共享相同环境和经历的人所发展的文化。也就是说，如果在一种文明中，不同群体共存于不同的生存现实中，这些现实带来了关于什么导致危机以及如何维持和谐的不同观念，那么这些群体就会相信关于疾病的产生、治疗和预防的不同观念体系。因此，这些观念体系始终是对真实社会环境或所向往的社会环境的隐喻性反映。导致人们接受基本治疗观念的不是真理（Wahrheit），而是似真性（Wahrschein）。
