Reconsidering Medicine

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This original work explores the philosophy of medicine as a subdiscipline of the philosophy of science, focusing on an epistemological bottom-up perspective rooted in clinical situations, epidemiology, and public health. It does not aim to review existing literature or frame debates but seeks to unveil the implicit conceptual network within medicine. The discussion begins with a linguistic act that identifies health's negative norms, categorizing biological processes into normal, abnormal, and pathologic, none of which are natural kinds. Abnormality is inherently negative and exists in degrees, while pathology is dichotomous. Normality is considered factitious and counterfactual, akin to frictionless planes in physics. Excluding ethical considerations, the book examines the core concepts and connections within clinical and community medicine. It reveals that medicine is filled with dichotomous concepts such as scientific vs. pragmatic discourse, function vs. malfunction, and clinical vs. community-oriented care. Medical thinking embodies a blend of biological and normative dimensions, leading to a hybrid grammar that supports various approaches—naturalistic or normativist, biological or value-laden, and reductionist or holistic. This intricate interplay shapes the understanding and practice of medicine today.