Therapeutic Evolution and the Challenge of Rational Medicine

Abstract

As generations of physicians have sought more rational bases for medical practice, they have swung between the poles of enthusiasm and skepticism. They have sought therapeutic power and confidence by reducing their scope of vision toward more precise targets of intervention and measures of success, sometimes losing sight in the process of the broader significance of therapy within the lives of patients and populations. A historical approach to therapeutics, as examined through the pages of the Journal, can help to redirect our attention toward the practical context in which medicine has evolved.