Prior to the nineteenth century, the practice of medicine in the Western world was as much art as science. But, argues W. F. Bynum, 'modern' medicine as practiced today is built upon foundations that were firmly established between 1800 and the beginning of World War I. He demonstrates this in terms of concepts, institutions, and professional structures that evolved during this crucial period, applying both a more traditional intellectual approach to the subject and the newer social perspectives developed by recent historians of science and medicine. In a wide-ranging survey, Bynum examines the parallel development of biomedical sciences such as physiology, pathology, bacteriology, and immunology, and of clinical practice and preventive medicine in nineteenth-century Europe and North America. Focusing on medicine in the hospitals, the community, and the laboratory, Bynum contends that the impact of science was more striking on the public face of medicine and the diagnostic skills of doctors than it was on their actual therapeutic capacities.

The book - which includes essays by physicians, philosophers, and a nurse - is divided into three parts: one deals with how empathy is weakened or lost during the course of medical education and suggests how to remedy this; another describes the historical and philosophical origins of empathy and provides arguments for and against it; and a third section offers compelling accounts of how physicians' empathy for their patients has affected their own lives and the lives of those in their care. We hear, for example, from a physician working in a hospice who relates the ways that the staff try to listen and respond to the needs of the dying; a scientist who interviews candidates for medical school and tells how qualities of empathy are undervalued by selection committees; a nurse who considers what nursing can teach physicians about empathy; another physician who ponders whether the desire to be empathic can hinder the detachment necessary for objective care; and several contributors who show how literature and art can help physicians to develop empathy.

Completely rewritten by the internal medicine faculty as Johns Hopkins, this is a brand-new version of Harvey's classic book.

"Although physicians make use of science, this book argues that medicine is not itself a science, but rather an interpretive practice that relies heavily on clinical reasoning." "In How Doctors Think, Kathryn Montgomery contends that assuming medicine is strictly a science can have adverse effects. She suggests these can be significantly reduced by recognizing the vital role of clinical judgment."--BOOK JACKET.

A risk factor is anything that increases the risk of disease in an individual.