Paradigm lost or paradise declining? American physicians and the 'dead end' of the Paris clinical school.
Paradigm lost or paradise declining? American physicians and the 'dead end' of the Paris clinical school.
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范式丢失还是天堂衰落？
DOI：
10.1163/9789004333284_009
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Warner,JH
中科院分区：
文献类型：
--
作者：
Warner,JH
到了世纪中期，埃尔温·阿克克内希特在《巴黎医院的医学，1794-1848》（1967）一书中断言：“法国医学已经走入了死胡同，就像医学史上迄今为止所有的医学主义所做的那样”。[1]在起草文本的过程中，阿克克内希特将事件发生的日期从1850年调整到1848年，使他的医学故事与政治叙事相一致。[2]“到了1848年，巴黎的“医院医学”已经走到了死胡同，它的势头已经消失了“;巴黎学派，防尘套上写得更可怕，”被1848年革命扫走了“。[3]近年来，他对巴黎画派的描述及其被认为是死路所暗示的不连续性都受到了质疑。我们对19世纪上半叶巴黎医学界的新形象比阿克克内希特的大胆描绘更为复杂--例如，它对激进的临床医学的奉献和对基础科学的排斥远没有那么铁板一块--而医学计划的枯竭使整个事情走向死胡同的概念开始显得言过其实和简单化。因此，令人惊讶的是，阿克克内希特援引的最有力的证据--曾经流入巴黎的外国医学生流向德国城市的大规模转移--几乎没有受到质疑。根据阿克克内希特的解释，1815年和平后，德国、英国和美国的医生涌入巴黎，这为巴黎临床学校的智力活力提供了明确的证据。同样，19世纪中叶后，学生从法国转向德国，也就是说，转向后来形成统一的德国和其他国家。
By the middle of the nineteenth century, Erwin Ackerknecht asserted in Medicine at the Paris Hospital, 1794–1848 (1967),‘French medicine had maneuvered itself into a dead end, as all empiricisms had done so far in medical history’. 1 Somewhere in the course of drafting his text Ackerknecht adjusted the date of that event from 1850 to 1848, bringing his medical story into line with a political narrative. 2 ‘By 1848, Paris “hospital medicine” had come to a dead end, its momentum spent’; the Paris School, the dust jacket put it more luridly, was ‘swept away by the Revolution of 1848’. 3 In more recent years, both his depiction of the Paris School and the discontinuity implied by its putative dead end have been drawn into question. Our emerging image of the Parisian medical world of the first half of the nineteenth century is more complex than Ackerknecht’s bold portrait–far less monolithic in its consecration to radical clinical empiricism and exclusion of the basic sciences, for example–while the notion that exhaustion of the empiricist programme brought the whole thing to a dead end has begun to appear overstated and simplistic. It is surprising, therefore, that what Ackerknecht invoked as the most powerful testimony to a dead end–the massive shift in the stream of foreign medical students that once flowed into Paris toward German cities instead–has remained little questioned. The imposing influx of German, British, and American medical practitioners into Paris after the peace of 1815, according to Ackerknecht’s interpretation, offers unambiguous evidence of the intellectual vibrancy of the Paris Clinical School. Equally, the redirection of students after mid-century from France to Germany–that is, to both the states that later would form a unified Germany and other