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论文作者:留学生论文论文属性:讲稿 Lecture Notes登出时间:2011-01-17编辑:anterran点击率:5122
论文字数:1354论文编号:org201101170955259326语种:英语 English地区:英国价格:免费论文
关键词:THE NEW LABORATORY SCIENCEBLOODLETTINGTHEORY AND PRACTICEALTERNATIVE WAYS OF KNOWINGTHE RISE OF PUBLIC HEALTH英语论文写作笔记
THE NEW LABORATORY SCIENCE
-- German physiology institutes establish new model of medical science
-- similar institutes established in medical schools throughout Europe and North America during the later C19
-- increasingly, medical students are expected to study the laboratory sciences
-- however, the laboratory sciences are institutionally separate from medical practice itself
-- conducted not by medical practitioners, but by a new profession of academic medical scientists
-- based in laboratories, not at the bedside
-- research aimed at producing basic biological knowledge, not applied medical knowledge – and findings published in separate journals
-- taught as part of the pre-clinical curriculum, not as part of clinical training
BLOODLETTING: THEORY AND PRACTICE
-- 留学生用英语from the 1830s, bloodletting declines in practice
-- Edinburgh doctors debate why this should be so
-- most argue that it is due to a change in the type of disease, from sthenic to asthenic
-- John Hughes Bennet, Prof of Institutes of Medicine, argues that previous theories of disease were wrong
-- Virchow’s new theory of cellular pathology has led to recognition that feeding, not bleeding, is best
-- dispute over decline in bloodletting is actually about the site of intellectual authority in medicine
-- Bennet is saying doctors should look to the laboratory sciences for leadership in therapeutics
-- other doctors are saying that observation of disease at the bedside is the best basis for treatment
ALTERNATIVE WAYS OF KNOWING
-- laboratory way of knowing tailored to professional advancement in the academic community
-- knowledge of universal laws of the natural world inc. the animal machine
-- based in shared disciplinary skills and knowledge
-- standardised and reproducible techniques and procedures
-- individual judgement excluded from observations
-- clinicians’ way of knowing tailored to advance their relationships with private patients
-- knowledge of the individual patient and his/her unique circumstances and personality
-- based in individualised and incommunicable skill and knowledge
-- trained senses and intuitions
-- extensive experience of medicine and of life
-- e.g. Sherlock Holmes based on Joseph Bell, a clinical teacher at Edinburgh
THE RELATION OF LABORATORY SCIENCES TO CLINICAL MEDICINE IN THE LATE C19
-- separation of laboratory sciences from clinical training enables medicine to claim the prestige of the new sciences
-- e.g. Edinburgh professorship in Institutes of Medicine becomes full-time professorship of Physiology in 1874
-- justified as part of a general scientific preparation for clinical training – unified basis for surgery and medicine
-- but enables clinicians maintain their authority over the practice of diagnosis and treatment
-- e.g. new laboratory techniques of tissue pathology and histological diagnosis remain secondary to clinical judgement
-- new diagnostic technologies e.g. sphygmograph are dismissed as inferior to human senses
-- so how does the relationship between science and practice develop subsequently?
THE RISE OF PUBLIC HEALTH
-- urbanisation and population growth
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