Tatsuno M, Okuda J
Department of Environmental and Preventive Medicine, School of Medicine, Osaka University.
Yakushigaku Zasshi. 1993;28(1):20-7.
The times around the French Revolution, as E. H. Ackerknecht pointed out, were especially epochmaking in that "the clinical medicine" or 'medicine in the hospital' was born and bred through the days by discarding the medicine of court physicians and the metaphysical medicine that had been dominant for centuries until then. This change is, therefore, very important from the viewpoints of sociopolitical, cultural and medical histories. The medicine practised and taught mainly in Paris in those days based politically on the newborn nationalistic centralization; technically on pathologicoanatomy and biostatistics; and conceptually on the modern medical epistemologoy that made it possible to abstract and see a 'disease' from the sick by observation, description and classification of their common signs and symptoms, and then to ignore a suffering specific to each individual patient instead. Thus those who could believe in the être (entity) of a 'disease' the clinical medicine made it 'visible' were trained for medical professionals such as modern physicians, surgeons and clinical pharmacists, which finally realized the professional monopolization of the medicine. The aim of this paper is to report and analyze the historical process how there came out the modern clinical pharmacist who was permitted by the nation as the only occupation to deal in ethical drugs in the hospital, while excluding many other people who had been treating 'traditional medicines' from the modern pharmacies of hospitals.
正如E. H. 阿克克内希特所指出的,法国大革命时期具有特殊的划时代意义,因为“临床医学”或“医院医学”正是在那个时期诞生并发展起来的,它摒弃了宫廷医生的医学以及在此之前统治了几个世纪的形而上学医学。因此,从社会政治、文化和医学史的角度来看,这一变革非常重要。当时主要在巴黎实践和传授的医学,在政治上基于新生的民族主义中央集权;在技术上基于病理解剖学和生物统计学;在概念上基于现代医学认识论,这种认识论使得通过观察、描述和分类患者的共同体征和症状,从病人身上抽象出并看到一种“疾病”成为可能,进而忽视每个患者特有的痛苦。因此,那些能够相信临床医学使其“可见”的“疾病”实体的人,被培养成现代医生、外科医生和临床药剂师等医学专业人员,这最终实现了医学的专业垄断。本文的目的是报告和分析这样一个历史过程:现代临床药剂师是如何出现的,他们被国家允许成为医院中唯一从事处方药业务的职业,同时却将许多其他一直从事“传统药物”治疗的人排除在医院的现代药房之外。