从达尔文医学看肛肠病与上唇系带的相关性

本文复习了应用上唇系带龈交穴诊治痔病的文献,并应用达尔文医学理论讨论其机制。从系统发生的角度看,上唇系带与肛垫的相关性源于摄食与排泄原始口肛结构功能的统一性;从个体发生的角度来看,其相关性源于原始咽与泄殖腔在发生中的系列同源性。从达尔文医学的角度来看,上述相关性是人体原始口肛同一结构设计演化留下的痕迹,痔病在上唇系带产生反应（结节、条索等）基本上是中性的,并不严重,还没有对我们的口腔造成摄食、发音不便,故并没有在自然选择中被淘汰。刺激上唇系带龈交穴治疗痔病利用了演化留下的神经联系的痕迹。     

用达尔文医学的观点看待近视眼的发生和治疗

从近视眼的进化史来看,伴随人类生活方式的改变,眼睛对近距离信息摄取的需求膨胀是近视眼形成的终因.在漫长的人类历史中,近视眼获得的每一种益处,都伴随着相应的代价.而达尔文医学关于生物进化的不完美性决定了近视眼的进化适应和代价将长期共存.因此,从治疗模式来看,应该摒弃达尔文医学固有的消极性而考虑生物的整体性和生态性.近视眼的中医和基因治疗正是避免了达尔文医学治疗模式的理论消极性,而且融入了其有关生物进化、遗传与环境统一的部分理念,可能成为近视眼治疗的候选策略.     

试论医学伦理案例分析的理论基础─—事实判断与价值判断

试论医学伦理案例分析的理论基础—事实判断与价值判断卫生部干部培训中心（北京１０００２４）李传俊近几年来,一些高等医学院校医学伦理学教学中,增加了临床伦理案例分析,旨在提高医学生的分析、判断能力,取得了一定效果。临床伦理案例分析的理论基础是事实判断与价...     

两种医学模式对慢性疼痛的思考与治疗

两种医学模式对慢性疼痛的思考与治疗重庆医科大学（６３００４６）肖丰尽管临床医学非常实际与具体,它总是以一定的理论作为基础的。临床医师的工作实际上受到一定的理论框架制约,不论他们是否意识到这一点。这种理论框架或医学模式与其他每一种理论性概念一样,对相应...     

从达尔文医学看人类抗坏血酸遗传缺陷——纪念维生素概念诞生百年

运用达尔文医学的观点,审视此前在欧文·斯通理论基础上提出的抗坏血酸遗传缺陷假说,分析该遗传缺陷的形成过程,当初的利益与今天的弊端(代价),以及进化对这些弊端做出的补偿.作为结论,值此维生素概念诞生百年之际,提出重新评估维生素特别是维生素C在预防医学和治疗医学中的作用,更新维生素C的概念.     

达尔文之后的进化论

达尔文是一个进化论者，他的自然选择理论对人的思维是一个帮助。这是典型的达尔文式学识。在１８６０年英国科学协会的年会上，牛津大教堂的威尔伯福斯主教（ＳａｍｕｅｌＷｉｌｂｅｒｆｏｒｃｅ）旗帜鲜明地反对亨利·赫胥黎（ＴｈｏｍａｓＨｅｎｒｙＨｕｘｌｅｙ），称之为达尔文的“斗犬”，当时他是伦敦煤矿学校的地质学教授。他们的争议涵盖了许多方面，包括科学，但是对宗教是主要分歧点则很少怀疑。威尔伯福斯当然不是圣经学家，但他对达尔文关于人的起源之暗示感到很不舒服；特别是对我们拥有共同祖先的人可能来自于纯粹的自然起源…     

从辨病与辨证结合中探索中医现代化

从辨病与辨证结合中探索中医现代化中国中医研究院西苑医院博士研究生（北京１０００９１）马国家中医药管理局（北京１０００２６）吴凯一西方医学以原子论自然观为理论基础,追寻的是构成事物的最小单元,把复杂因素分解为简单因子。因此,在原子论自然观指导下,必然...     

分子进化论研究的回顾与思考

分子进化论研究的回顾与思考中国医学科学院博士生（北京１０００２１）柏华一、传统进化论研究的局限性达尔文１８５９年发表的《物种起源》被认为是划时代的杰作,他首次用“自然选择学说”解释物种进化,认为通过变异的产生和生存的选择,使自然界的生物进化普遍存在。...     

自然选择质疑

当代对达尔文进化论的争论几乎是全方位的。尽管当今达尔文主义者的立场和论调与原先的达尔文的进化论已有很大出入，比如说，现代综合进化论对自然选择的创造性作用的突出强调，间断平衡论对达尔文随机渐变理论的重新解释等等，但现代达尔文主义者对作为达尔文进化论核心的自然选择理论一般都是坚持的。本文试图立足于现代自然科学发展的前沿，对这一理论做出再反思。     

精神分析治疗范式与行为治疗范式之分析比较

心理治疗范式是指一种特定的对心理疾患的理论解释和建立在这种解释基础上的治疗技术。我们可以把心理治疗范式发展的历史简要地概括为：精神分析—行为疗法—认知—行为疗法。本文主要侧重于前两种范式的分析和比较,最后将简要提及它们对认知—行为疗法的影响。１　精神分析治疗范式由弗洛伊德（Ｆｒｅｕｄ,Ｓ．）所创立的精神分析是建立在机械主义的决定论*、特别是达尔文（Ｄａｒｗｉｎ,Ｃ．Ａ．）进化论基础之上的。精神分析认为,不论人们的思想如何高深,也不论人的成就多么伟大,它们都与生理需要的满足相关。人不断地追求与肉体…     

达尔文医学的哲学启示

达尔文医学从本源上阐明队类疾病产生的偶然性与必然性的对立统一。其对进化论的重新反思和认识,具有重要的人文价值和现实意义。     

Research traditions and evolutionary explanations in medicine

In this article, I argue that distinguishing ‘evolutionary’ from ‘Darwinian’ medicine will help us assess the variety of roles that evolutionary explanations can play in a number of medical contexts. Because the boundaries of evolutionary and Darwinian medicine overlap to some extent, however, they are best described as distinct ‘research traditions’ rather than as competing paradigms. But while evolutionary medicine does not stand out as a new scientific field of its own, Darwinian medicine is united by a number of distinctive theoretical and methodological claims. For example, evolutionary medicine and Darwinian medicine can be distinguished with respect to the styles of evolutionary explanations they employ. While the former primarily involves ‘forward looking’ explanations, the latter depends mostly on ‘backward looking’ explanations. A forward looking explanation tries to predict the effects of ongoing evolutionary processes on human health and disease in contemporary environments (e.g., hospitals). In contrast, a backward looking explanation typically applies evolutionary principles from the vantage point of humans’ distant biological past in order to assess present states of health and disease. Both approaches, however, are concerned with the prevention and control of human diseases. In conclusion, I raise some concerns about the claim that ‘nothing in medicine makes sense except in the light of evolution’.     

EFFECTS OF ACADEMIC DEGREE AND DISCIPLINE ON RELIGIOUS AND EVOLUTIONARY VIEWS IN CHILE AND COLOMBIA

Relationships between degree/area of academic formation and religious and Darwinian views are controversial. This study aimed to compare the religious beliefs and acceptance of Darwinian evolution between two contrasting South American scientific communities (Chile and Colombia), accounting for different degrees and areas of academic formation. In 2018, 115 last year bachelor students (surveyed as freshmen in 2014 for a previous study) from Chile, and 283 first/last year bachelor students, graduate students, and professors from Colombia, all belonging to biology, chemistry, or physics, were surveyed. Chilean students/faculty were significantly more agnostic/atheist, more accepting of Darwinian evolution, and less creationist than their Colombian counterparts. Academic degree and area differently affected these views in both countries, as only in Chile there was a clear tendency among biologists and physicists with higher degrees to hold less religious and creationist views. Marked differences between the history, socioeconomic contexts, and especially in high school and university curricula of both countries might explain these results.     

Medicine as business and profession

This paper analyzes one dimension of the frequently alleged contradiction between treating medicine as a business and as a profession, namely the incompatibility between viewing the physician patient relationship in economic and moral terms. The paper explores the utilitarian foundations of economics and the deontological foundations of professional medical ethics as one source for the business/medicine conflict that influences beliefs about the proper understanding of the therapeutic relationship. It, then, focuses on the contrast and distinction between medicine as business and profession by critically analyzing the classic economic view of the moral status of medicine articulated by Kenneth Arrow. The paper concludes with a discussion of some advantages associated with regarding medicine as a business.     

Medicine and the Cartesian image of man

The contemporary philosophy of medicine may be characterized as a continuous struggle with the Cartesian heritage, in order to reach a more satisfying image of man. This paper outlines the influence of Cartesian dualism on the foundations of medicine. The notion of a real distinction between the mental and physical, particularly the mechanistic conception of the human body, made possible the development of the natural sciences as well as scientific medicine, not hampered any longer by the risk of colliding with religion or Church. The Cartesian machine model of man immediately appealed to seventeenth century physicians: Dutch Cartesians (Regius, Craanen) and followers of the iatrophysical school (Santorio, Borelli). Dichotomizing between mind and body, subject and object, self and world, self and other, knower and knowledge is constitutive for modern medicine conceiving itself as a natural science.     

患者的药物颜色偏好

本研究比较了患者的一般颜色与药物颜色偏好的不同,探究患者对药物颜色的态度及服药时间对二者的影响。通过对699名患者的调查发现,其一般颜色偏好仍是蓝、红、绿、紫、黄,但药物颜色偏好紫色。与深色相比,患者更偏好浅色药物。患者认为药物颜色的作用主要是区分药物种类,而且服药时间越久,对这种功能的需求越强。这些结果支持了生态效价理论,并有很重要的实用价值。药物颜色偏好的其它影响因素和心理效应是未来研究的方向。     

人文医学与医学人文学几个问题之我见

结合医疗实际工作人文医学和医学人文学的关系应包括：(1)从人文医学的产生背景看,人文精神的内涵孕育于中国古典医学,并非现代之专有;(2)人文医学和医学人文学并非同一层次上的概念,不能交叉理解和使用;(3)从医学发展阶段的划分,提出不能将人文医学与现代医学割裂开,前者是后者的组成部分;现代医学并非生物医学;(4)人文医学的分类应增加军事医学等内容。     

用循证医学证据丰富经验医学内涵——谈临床医生如何面对医学实践模式改变

从具体病例分析入手谈临床医生实践循证医学既需要思维模式转变、又要求掌握实际应用方法,即要敢于分析循证医学证据的实用性、又要善于用循证医学证据丰富经验医学内涵。新医学模式的普及将是临床医生群体认识史上一次具有深度和广度的飞跃。     

Evolution and medicine: the long reach of "Dr. Darwin"

In this review we consider the new science of Darwinian medicine. While it has often been said that evolutionary theory is the glue that holds the disparate branches of biological inquiry together and gives them direction and purpose, the links to biomedical inquiry have only recently been articulated in a coherent manner. Our aim in this review is to make clear first of all, how evolutionary theory is relevant to medicine; and secondly, how the biomedical sciences have enriched our understanding of evolutionary processes. We will conclude our review with some observations of the philosophical significance of this interplay between evolutionary theory and the biomedical sciences.