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ARTICLE |

Clinical Observation:  The Neglected Basic Method of Medicine

George L. Engel, MD
JAMA. 1965;192(10):849-852. doi:10.1001/jama.1965.03080230055014.
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In the current era of medicine, medical students are led to believe that what derives from the laboratory is by definition more basic than what derives from clinical observation. In fact, the preclinical disciplines are generally called "the basic sciences," as if they alone are the approaches truly basic to medicine.

"Basic" means "of or pertaining to the base or essence; fundamental," a relative term, specifying those data or concepts which are necessary before any particular scientific question can be posed or examined. As currently used in medicine, "basic" predominantly reflects the "reductionistic" view of biology, which states that all biological events can be explained by the fundamental laws governing spatial arrangements and interaction of molecules and their component parts.1 Such a perspective demands an a priori faith that living things are nothing but physical-chemical machines. While great scientific advances have accrued from such an assumption, the fact that

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