Médecine, science et technique: recueil d'études rédigées à l'occasion du centenaire de la mort de Claude Bernard (1813–1878)

The five papers collected in this small volume were first presented to the Seminar on the Foundations of the Sciences at the University of Strasbourg in 1978, to mark the centenary of the death of Claude Bernard. The focus of the seminar was not, however, the work of Bernard but the development of medicine, and its relationship with science and technology, in the hundred years since 1878. Thus only the first paper, by Yvette Conry ('Le "point de vue" de la medecine experimentale selon Claude Bernard: une utopie positive?'), is concerned in any detail with Bernard himself. Conry characterizes Bernard's philosophy of science as a positive variant of utopianism, and she argues the shortcomings of this philosophy by setting out Bernard's views on bacteriology, statistics, clinical medicine, and cellular pathology, and then juxtaposing them with the subsequent development of each of these disciplines after his death. The next three papers range very widely indeed. Jean Schwartz ('Pharmacologie, medecine et experimentation clinique') discusses the problems encountered in contemporary pharmacological research and in clinical trials of new drugs. Francois Gremy and Jean-Claude Pages ('Medecine informatique: bilan et perspectives') report on recent developments in the areas of computer-assisted decision-making in medicine and in computer-assisted medical education. (This paper in fact dates from 1983, but an earlier version by Gremy alone was presented to the Strasbourg seminar in 1978.) And Lucien Israel ('Le residu Psy') considers the question of psychosomatic illness and, more broadly, the effects of unconscious mental processes in all therapeutic relations and indeed in all aspects of human life. The final paper, by Georges Canguilhem ('Puissance et limites de la rationalite en medecine'), takes up the theme, championed by Bernard, ofscientific experimentation as the basis ofrationality in medicine. Echoing some of the points raised in the papers of Conry and Israel, Canguilhem discusses the nature ofthe limits within which medical rationality must operate. But he also goes on to develop a strong polemic against the irrationalist elements in Illich's Medical nemesis and the "expropriation of health" thesis generally. Both the breadth of this topic and the thoughtfulness of Canguilhem's approach make his paper easily the most interesting contribution to the volume. Like most published conference proceedings, this one presents the reader with a very heterogeneous collection of papers. The editor attempts, in his introduction, to provide a structure for the whole but succeeds only nominally. If, instead of attempting to cover …