I have to say a few things about the present state of medical science, and some possible implications for the future of the practice of medicine. This is risky ground. We do not have a very good record for the fulfilling of promises in medicine: over the past 25 years we have made too many promises, predicted too much too soon, and bragged much too much. As a result the public has mixed feelings about medicine as a scientific enterprise. On the one hand we are widely admired for having presumably converted medicine from an art to a science within a generation, but on the other we are confronted by uncomfortable questions about the human diseases which remain unsolved. How is it that such a high science, possessed (as it is generally believed) of a correspondingly high technology, can have left us still with such a list of things undone? More than half of human cancers remain beyond curing (although our methods for destroying cancer tissue have greatly improved); schizophrenia can be palliated by today’s drugs, but it cannot be turned round or prevented; heart disease and stroke are still the major causes of premature death in our society; cirrhosis, rheumatoid arthritis, multiple sclerosis, the vascular lesions of diabetes, the senile psychoses, mental retardation, and the majority of congenital disorders all remain untouchable. With all that science, why such a list?
KeywordsMultiple Sclerosis Pernicious Anemia Liver Extract Scientific Enterprise Closing Remark
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