Chapter 1 advent (pages 1–2): Sir Douglas Black
Chapter 2 Delineation of medical stipulations: Conceptual versions of ‘Physical’ and ‘Mental’ issues (pages 3–23): Leon Eisenberg
Chapter three Structural Determinants of ailment and their Contribuition to scientific and medical growth (pages 25–40): Alexander G. Bearn
Chapter four medical technology (pages 41–52): E.J.M. Campbell
Chapter five the worth to scientific perform of uncomplicated and utilized scientific learn performed 20 years in the past (pages 53–71): C.J. Dickinson
Chapter 6 The overview of Efficacy, Toxicity and caliber of Care in Long?Term Drug remedy (pages 73–95): C.T. Dollery
Chapter 7 Problem?Solving in technological know-how (pages 97–114): Michael Woodruff
Chapter eight primary study in Molecular Biology: Its Relevance to drugs (pages 115–135): M.F. Perutz
Chapter nine French clinical learn: the danger of ‘Demedicalization’ (pages 137–149): Philippe Meyer
Chapter 10 overall healthiness companies study: Why and the way? (pages 151–167): Peter F. Hjort
Chapter eleven Client?Oriented drugs (pages 169–183): Douglas Black
Chapter 12 executive wishes and Public expectancies (pages 185–195): Sir Philip Rogers
Chapter thirteen foreign Coordination of Biomedical study (pages 197–213): S.G. Owen

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A veritable lepidopterists’ paradise was erected by Boissier de Sauvages, who in 1768, in his Nosologia Methodica, grouped diseases into ten classes, 295 genera, and 2400 species. Although a mere recitation of the advances in medical knowledge that have flowed from Morgagni’s initial observations would be both self-evident and repetitious, I would be remiss if I did not refer to Bichht, who in 1800 was the first to point out that pathological changes occurred not so much in organs as in tissues.

The benefits of clinical research are both direct-through improved practice-and indirect-through improved teaching and contributions to biological science. I t is suggested that the clinical scientist, experienced in both clinical and research work, has a potential not to be expected from collaboration between nonscientific clinicians and non-clinical scientists, Problems which particularly affect clinical research include: ethics: difficulty in being experimentally rigorous; the need to be opportunistic; dependence on transient workers; excessive concern with the end stages of irreversible disease; triviality; uncritical and premature imitation of research in practice.

We are of course considering this from the standpoint of medical practice, but nobody here would hold that medical practice is the only thing relevant to health and disease. Environment, political action and social factors are in many cases more important. In the past the general improvement in health has been due to these factors more than to what doctors have done. But now we have to consider what we can d o about our part of the problem. In that sense I think Dr Bearn hit the nail very much on the head.

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