A Comparative Analysis of Two Historical Approaches to the Formation of the Modern Clinical Medicine

Lee, Jong Chan

Abstract

From the perspective of research methodology, it may be said to exist two kinds of different historical approaches with regards to the formation of modern clinical medicine at the turn of the nineteenth century. One is to explain this in terms of the agency or structure that is associated with research topic. This historical view assumes that the Western scientific rationalism is characterized by the unity of Western tradition and its evolution as continuity. Its main foucs is given either on how French revolution and war affected the growth of clinical medicine and the hospital reform movement or on how Paris Clinical School contributed to the birth of modern clinical medicine. The other is, according to Michel Foucault, to analyze how medical discourses are related to social(institutional) practices. Following Canguilhem's history of concepts, Foucault traces the historical development of the concept of disease. Elizabeth A. Williams, another proponent of this method, conceptualizes the eighteenth-century medicine as three different medical discourses - anthropology, physiology and philosophical medicine, and analyzes how their structural fragmentation were transformed into the modern establishment of clinical medicine in the nineteenth century. In conclusion, first, the historical research may be compatible with epistemological investigation of modern clinical medicine. Second, the modernity of Western medicine can not be fully clarified without understanding the reciprocal relationships between hygienic medicine and clinical medicine.