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贝多芬对罗基坦斯基方法论的影响:“面神经相当粗;另一方面,听神经萎缩,没有骨髓”。

Beethoven's influence on Rokitansky's methodology : "The facial nerves were of considerable thickness; the auditory nerves, on the other hand, were shrunk and marrowless".

机构信息

Arbeitsgruppe Geschichte der Medizin und Medical Humanities, Kommission für Geschichte und Philosophie der Wissenschaften an der Österreichischen Akademie der Wissenschaften, Vienna, Austria.

出版信息

Wien Med Wochenschr. 2021 Nov;171(15-16):373-380. doi: 10.1007/s10354-021-00832-y. Epub 2021 Mar 25.

Abstract

Prompted by the autopsy of Ludwig van Beethoven (1770-1827) to seek the origins of disease in a changed anatomy, Carl Freiherr von Rokitansky (1804-1878) initiated a paradigm shift from speculative natural philosophical medicine to systematic scientific medicine. Until then, autopsy reports usually contained clinical observations as well as the diagnosis of the attending physician, which the pathologist merely supplemented with a description of the corpse. Influenced by Rokitansky's search for scientific explanations for disease, pathology evolved from a descriptive to an explanatory science from the early 1830s onwards. The protocols now contained both a clinical and often divergent pathological diagnosis, which, however, explained the origin of the disease and the cause of death. This research led to Rokitansky's three-volume Handbook of Pathological Anatomy, the standard textbook for all medical students of the Habsburg monarchy, which has been translated into Russian, English and Italian. In this work he systematically described the diseases of each individual organ and explained the relationships between clinical symptoms and pathological changes to the organs, i.e., the clinicopathological correlation, which enabled a scientifically based diagnosis. Systematic research into each individual organ led to the development of new specialist clinical disciplines. In his role as medical consultant in the State Ministry, Rokitansky supported the establishment of the world's first clinic for otology. He also influenced the research of such pioneering otorhinolaryngologists as Joseph Toynbee (1815-1866), William Wilde (1815-1876), Prosper Menière (1799-1862), Friedrich Semeleder (1832-1901), Johann Schnitzler (1835-1893), and Adam Politzer (1835-1920).

摘要

受贝多芬(1770-1827 年)尸检的启发,卡尔·罗基坦斯基男爵(1804-1878 年)试图从改变了的解剖结构中寻找疾病的起源,从而引发了从推测性的自然哲学医学向系统科学医学的范式转变。在此之前,尸检报告通常包含临床观察以及主治医生的诊断,而病理学家只是对尸体进行描述。受罗基坦斯基对疾病科学解释的探索的影响,病理学从 19 世纪 30 年代初开始从描述性科学发展为解释性科学。现在的方案既包含临床诊断,也经常包含病理诊断,这些诊断解释了疾病的起源和死亡原因。这项研究导致罗基坦斯基的三卷本《病理学手册》的诞生,该书成为哈布斯堡君主制所有医学生的标准教材,后来被翻译成俄语、英语和意大利语。在这部著作中,他系统地描述了每个器官的疾病,并解释了临床症状与器官病理变化之间的关系,即临床病理相关性,这使得可以进行基于科学的诊断。对每个器官的系统研究导致了新的专科临床学科的发展。作为国家卫生部的医疗顾问,罗基坦斯基支持建立了世界上第一个耳科学诊所。他还影响了约瑟夫·托尼比(Joseph Toynbee,1815-1866 年)、威廉·怀尔德(William Wilde,1815-1876 年)、普罗瑟·梅尼埃(Prosper Menière,1799-1862 年)、弗里德里希·塞梅莱德(Friedrich Semeleder,1832-1901 年)、约翰·施尼茨勒(Johann Schnitzler,1835-1893 年)和亚当·波蒂泽(Adam Politzer,1835-1920 年)等开拓性耳鼻喉科医生的研究。

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