In historical perspective the book presents some logical concepts underlying medical thinking--definition, diagnosis, classification, semeiology, the ontology of disease, causation, scientific method, so-called "scientific medicine" and kindred topics. Histories of concrete diseases especially tuberculosis, illustrate these concepts "in action" over several centuries, within their contemporary intellectual environment. The thought modes of the earlier physicians, absurd as they may seem today, often showed excellent logic. Historically, medical thinking remains surprisingly constant, despite spectacular scientific "progress".

In this remarkable book Michel Foucault, one of the most influential thinkers of recent times, calls us to look critically at specific historical events in order to uncover new layers of significance.

Her careful building of positions, her unique approaches to analyzing problems, and her excellent insights make this an important work for feminists, those ...

Beginning with a case vignette, this paper uses a semiotic approach to analyze several different kinds of understanding used in clinical medicine. By outlining semiotic structures, four distinct modes of understanding can be defined: (1) the representational mode, corresponding to scientific medicine; (2) the pragmatic mode, constituting the basic standpoint of medicine; (3) the hermeneutic mode, underlying the empathic, humanistic spirit of medicine; and (4) the ontologic mode, associated with both the ethical and ritual aspects of medicine. Clarifying the relationship (...) between these modes avoids common confusions in clinical situations. Although experienced clinicians intuitively use these different modes, they do not necessarily reflect upon them. They are instead mindful of them, and this unique multi-modal consciousness, I suggest, provides a model for integrating theory and practice. (shrink)