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Editor's Correspondence
February 13, 2006

A Change of Reason: Medicine and the Scientific Revolution

Arch Intern Med. 2006;166(3):369-370. doi:10.1001/archinte.166.3.369

While we admire Dr Wartofsky's work in hypothyroidism, his editorial1 is reminiscent of the criticism that Louis2 received when he first demonstrated that blood-letting lacked benefit in pneumonia. Medicine came late to the scientific revolution, and its thought was still dominated by deductive reasoning. “We have known since Aristotle that fevers are caused by too much red blood . . . ” the argument would begin and then it would be deductively reasoned that since pneumonias were febrile diseases, they would respond to phlebotomy. There was no need to check actual patients to see if that were true. As Spinoza noted, reality was too deceptive to yield the truth. Axioms and general laws had been left by the Ancients, and it was only through philosophy and deductive reasoning that we could discover the truth. Isaac Newton had moved other sciences into inductive reasoning, but medicine somewhat reluctantly dragged itself into modern science. The legal profession, however, remains under deductive reasoning. Consistent with that, Dr Wartofsky1(p1684) concludes,