Weaver Lawrence T
School of Medicine and Centre for the History of Medicine, University of Glasgow, Scotland, UK.
J Hist Med Allied Sci. 2013 Oct;68(4):583-626. doi: 10.1093/jhmas/jrs021. Epub 2012 Apr 3.
The last two hundred years or so have seen the transformation of medical practice from a clinical art to the application of science to the diagnosis and treatment of disease. There has been a historical debate about how the use of technology and discoveries of the laboratory have become integrated within medical practice. In trying to understand the evolution of "scientific medicine," this has generally focused on the tensions between the differing cultures, persons, and professions of the "laboratory" and "clinic" and sought to explain how they were resolved within specific institutions. This paper looks again at the "Glasgow School" (the subject of a number of seminal papers on this subject) and the forces that shaped it, by exploring the career of Leonard Findlay, whose training in Glasgow, and in Berlin (where he worked in a department in which science and medicine were integrated), defined a style of clinical medicine that formed the model for a new sort of university department of medicine in which clinicians and scientists worked side by side, albeit under the leadership of the former. As a clinician exposed in Berlin to the emerging new sciences of nutrition, microbiology, and immunology, which were particularly relevant to the care of sick children, Findlay created in Glasgow a department of medical pediatrics, which owed less to local factors, figures, and forces and more to his experience in Germany.
在过去大约两百年间,医学实践已从一门临床技艺转变为运用科学进行疾病的诊断和治疗。关于技术的应用以及实验室的发现如何融入医学实践,一直存在着历史性的争论。在试图理解“科学医学”的演变过程中,这通常聚焦于“实验室”和“诊所”不同文化、人员及专业之间的矛盾,并试图解释它们在特定机构中是如何得到解决的。本文通过探究伦纳德·芬德利的职业生涯,再次审视“格拉斯哥学派”(关于该主题已有多篇具有开创性的论文)及其形成的影响因素。芬德利在格拉斯哥以及柏林接受培训(他在柏林的一个部门工作,那里科学与医学相互融合),形成了一种临床医学风格,这种风格成为了新型医学大学部门的典范,在这个部门中,临床医生和科学家并肩工作,尽管是以临床医生为主导。作为一名在柏林接触到新兴的营养、微生物学和免疫学等与患病儿童护理特别相关的新科学的临床医生,芬德利在格拉斯哥创建了一个医学儿科学系,该系较少受到当地因素、人物和力量的影响,更多地归功于他在德国的经历。