The use and abuse of history

medical men. The editors are, however, commendably cautious as to the possible existence and viability of a philosophy ofmedicine as an independent enterprise akin to the philosophy of science, which is an established discipline like the philosophy of biology. They do believe, nevertheless, that common ground exists between physicians and philosophers, and that, as Temkin has suggested, there is room for a consideration of medical logic, medical ethics, and medical metaphysics. But as well as a philosophy of medicine there is need for a philosophy in medicine: a critical analysis of basic concepts and presuppositions in medicine, and of its significance and limitations. This book deals with some of these and discusses models of explanation and systems of value in the biomedical sciences. Although most of the papers should be read by historians of medicine, those of greatest interest to them will be Lester King's, 'Some basic explanations of disease: an historian's viewpoint', Chester Bums', 'Diseases versus healths: some legacies in the philosophies of modem medical science', and Engelhardt's, 'The concepts of health and disease', all ofwhich are excellent contributions. Toulmin on 'Concepts offunction and mechanism in medicine and medical science', given as a tribute to Claude Bernard, is also outstanding. The Round-Table Discussion is likewise profitable to historians. In fact they should all possess a copy of this book, although the price will probably be the usual deterrent. The symposiasts concur that the philosophy ofand in medicine are legitimate topics ofstudy, for as Dr. E. D. Pellegrino concludes: ". . . Indeed without the engagement and the conjunction of medicine and philosophy, no viable or understandable image of man can be synthesized for our times. And, the absence of such a synthesis is a major deficit in contemporary culture." (p.234). We can look forward to further volumes in this series, which are planned to encompass the analysis of philosophical problems pertinent to medicine, and we can congratulate the editors, the contributors and the publishers for what they have achieved so far.