This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant.

Originally published in German in 1935, this monograph anticipated solutions to problems of scientific progress, the truth of scientific fact and the role of error in science now associated with the work of Thomas Kuhn and others. Arguing that every scientific concept and theory—including his own—is culturally conditioned, Fleck was appreciably ahead of his time. And as Kuhn observes in his foreword, "Though much has occurred since its publication, it remains a brilliant and largely unexploited resource." "To many scientists just as to many historians and philosophers of science facts are things that simply are the case: they are discovered through properly passive observation of natural reality. To such views Fleck replies that facts are invented, not discovered. Moreover, the appearance of scientific facts as discovered things is itself a social construction, a made thing. A work of transparent brilliance, one of the most significant contributions toward a thoroughly sociological account of scientific knowledge."—Steven Shapin, Science

The central purpose of this book is to demonstrate the relevance of social science concepts, and the data derived from empirical research in those sciences, to problems in the clinical practice of medicine. As physicians, we believe that the biomedical sciences have made - and will continue to make - important con tributions to better health. At the same time, we are no less fIrmly persuaded that a comprehensive understanding of health and illness, an understanding which is necessary for effective preventive and therapeutic measures, requires equal attention to the social and cultural determinants of the health status of human populations. The authors who agreed to collaborate with us in the writ ing of this book were chosen on the basis of their experience in designing and executing research on health and health services and in teaching social science concepts and methods which are applicable to medical practice. We have not attempted to solicit contributions to cover the entire range of the social sciences as they apply to medicine. Rather, we have selected key ap proaches to illustrate the more salient areas. These include: social epidemiology, health services research, social network analysis, cultural studies of illness behavior, along with chapters on the social labeling of deviance, patterns of therapeutic communication, and economic and political analyses of macro-social factors which influence health outcomes as well as services.

This book is intended for the practicing surgeon. It is designed to offer practical insights into the essentials of an epidemiological, statistical and outcomes-based approach to surgical practice. Surgeons are invited to begin to develop the requisite skills that will allow them to communicate effectively with their colleagues in epidemiology and

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant.

In the medical treatment of children and teenagers and the accompaniment of their parents, alternative therapies, homoeopathy, anthroposophic medicine, psychology and psychosomatics play an ever greater role alongside conventional, science-based medicine. Before a therapy can be successful, an individual diagnosis must be made, taking somatic sympt