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Bulletin of Tibetology: aspects of classical Tibetan medicine

Medical History
Cambridge University Press
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Book Reviews diagnosis, was eventually achieved (in Hess's account) by the Natural History School of Johann Lukas Schonlein, which is discussed in the last third of the book, following on from Johanna Bleker's standard work in this field. In the 1830s and 1840s Schonlein and his pupils developed a methodical concept of seeing disease as an ens sui generis, of describing its symptoms, exploring the underlying pathological processes (with chemistry, microscopy, and autopsy), and formulating "nosological units" in view of a future natural system. Under attack from the advocates of a purely physiological medicine (Physiologische Heilkunde), such as Carl August Wunderlich, who rejected circumscribed disease entities and understood the ontological element in Schonlein's concept as an unsubstantiated belief in parasitism, the natural history method was transformed into the clinical method. Schonlein's pupils Conrad Heinrich Fuchs, Carl Canstatt, and August Siebert, who all filled clinical chairs in important German universities, used the ontological conception of disease merely as a clinical operational term and finally gave up the aim of a natural system. What was left was the diagnosis and clinical investigation of disease entities in a modem sense. In following Hess's account one might be tempted to assume a specific German route towards modem diagnosis, that was shaped by ontological ideas stemming from Naturphilosophie and comparative natural history and that thus differed from the path mentioned at the beginning. However, a qualification must be made here. This book is a virtually pure history of ideas. It deliberately abstains from exploring the social context of hospital medicine and its effects on medical practice and experience. The results may therefore reflect to a great extent Hess's historiographical approach and selection of sources. Yet even with this reservation his study should be welcomed for adding a new perspective to the historiography of the clinical method. Andreas-Holger Maehle

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