There are two preferred ways of sharing medical information. One is data centered and for very good reasons has dominated our epistemology for almost a century. The other is empirical, based on a motley collection of hunch and experience. Both ways complement each other, both are important for our growth as physicians and surgeons dedicated to walk with our patients to their recovery.

For some reason that I am not able to explain the wonderful and experienced colleagues from Latin America and Africa are shy about telling their experience and opinion. Perhaps it is because in Latin America academic and professional promotions do not depend on the number of peer reviewed publications. In any case we at Surgical Neurology International feel that those voices need to be heard. Thus, we have launched this series that has been called “How I do it”.

We asked four Pediatric Neurosurgeons from Latin America and asked them to tell us about their approach to a prevalent condition neglected by the designers of public health strategies, neural tube defects.

The original text is in Spanish accompanied by an English translation that while short in nuances manages to be loyal to the intentions of the authors.

The papers are short, it could not be otherwise, and the authors have almost never published before. But the papers are dense in technical insight. In all the papers the reader will hear the undercurrent of devotion to the most forgotten of the patients, the malformed born in a low and middle-income country.

I praise James Ausman, M.D. the editor for accepting, supporting and encouraging this initiative. As I ready the papers for submission I recognize my shortcomings in polishing the message of my colleagues. And while coming contributions on “How I do it” will better the previous, this first series has the charm and innocence of a great dream.

How I Do It

Sex, gender and social change in Britain since 1880

Emics and Etics: The Insider-Outsider Debate. Edited by Thomas Headlund, Kenneth Pike, and Marvin Harris. Beverly Hills, Calif.: Sage Press, 1990. 226 pp.

Birth Control, Sex and Marriage in Britain, 1918 to 1960

The roles of the Edinburgh, Kelso, and Newcastle dispensaries in charitable relief, 1776-1810

This paper examines the rise of an epistemic genre, the Observationes, a new form of medical writing that emerged in Renaissance humanistic medicine. The Observationes (collections of case-histories) originated in the second half of the sixteenth century, grew rapidly over the course of the seventeenth, and had become a primary form of medical writing by the eighteenth century. The genre developed initially as a form of self-advertisement by court and town physicians, who stressed success in practice, over and above academic learning, as a core element of their professional identity. This unprecedented emphasis on practice as a source of knowledge remained a key feature of the Observationes in its subsequent development. As the genre evolved, the original emphasis on therapeutic success gave way to a new focus on the descriptive knowledge of disease through detailed observation. The authorial identity projected by the writers of Observationes was increasingly that of the learned and experienced observer, bent on comparing notes and sharing his cases with the fellow members of the res publica medica. This paper charts the development of the genre, examining how its growth contributed to the new epistemological value of observation in the age of the Scientific Revolution.

Sharing cases: the Observationes in early modern medicine.

The early modern genre of historia connected the study of nature and the study of culture from the early Renaissance to the eighteenth century. The ubiquity of historia as a descriptive method across a variety of disciplines -- including natural history, medicine, antiquarianism, and philology -- indicates how closely intertwined these scholarly pursuits were in the early modern period. The essays collected in this volume demonstrate that historia can be considered a key epistemic tool of early modern intellectual practices.Focusing on the actual use of historia across disciplines, the essays highlight a distinctive feature of early modern descriptive sciences: the coupling of observational skills with philological learning, empiricism with erudition. Thus the essays bring to light previously unexamined links between the culture of humanism and the scientific revolution.The contributors, from a range of disciplines that echoes the broad scope of early modern historia, examine such topics as the development of a new interest in historical method from the Renaissance artes historicae to the eighteenth-century tension between "history" and "system"; shifts in Aristotelian thought paving the way for revaluation of historia as descriptive knowledge; the rise of the new discipline of natural history; the uses of historia in anatomical and medical investigation and the writing of history by physicians; parallels between the practices of collecting and presenting information in both natural history and antiquarianism; and significant examples of the ease with which early seventeenth-century antiquarian scholars moved from studies of nature to studies of culture.

https://jps.library.utoronto.ca/index.php/aestimatio/article/download/25768/18912

Historia: Empiricism and Erudition in Early Modern Europe

In this article, I argue that we should consider the medical case narrative as an “epistemic genre.” I suggest that historians of knowledge (including medical knowledge) should draw a distinction between “epistemic” and “literary” genres, and that the medical case narrative belongs to the first group, that is, those kinds of texts that develop in tandem with scientific practices. I also argue that the history of the medical case narrative should be studied in a long-term perspective. In general, the focal point of the historiography on the medical case narrative has tended to gravitate around the late eighteenth and nineteenth centuries, with only cursory attention to earlier periods and no attempt to reconstruct the long-term lineaments of the story. I believe that this modernist focus has a very serious flaw, as it ignores the presence of a vast literature of case collections in pre-modern medicine. I believe that we need to trace the history of the medical case narrative as a genre that evolved over a very long period of time, from antiquity to modern medicine. For this purpose, I adopt the approach that literary scholar Franco Moretti has called “distant reading,” that is, a focused attention to the long duration of a genre within a culture as well as its variations across cultures.
	 What do we see when we look at the long-term development of the medical case narrative? Distant reading suggests, at first sight, that the genre appeared in embryonic form in antiquity, with the Hippocratic Epidemics, but also that it disappeared for long periods of time, to emerge again, in new form and with new vitality, in the late Renaissance. Most interestingly, distant reading also suggests that the evolutionary dynamic of the case narrative was closely intertwined with that of two other fundamental epistemic genres, the recipe and the commentary. Here, I examine in particular the association between case and commentary.

The Medical Case Narrative: Distant Reading of an Epistemic Genre

Observation rising : birth of an epistemic genre, 1500-1650

The genealogy of observation as a philosophical term goes back to the ancient Greek astronomical and medical traditions, and the revival of the concept in the Renaissance also happened in the astronomical and medical context. This essay focuses primarily on the medical genealogy of the concept of observation. In ancient Greek culture, an elaboration of the concept of observation (tērēsis) first emerged in the Hellenistic age with the medical sect of the Empirics, to be further developed by the ancient Sceptics. Basically unknown in the Middle Ages, the Empirics' conceptualisation of tērēsis trickled back into Western medicine in the fourteenth century, but its meaning seems to have been fully recovered by European scholars only in the 1560s, concomitantly with the first Latin translation of the works of Sextus Empiricus. As a category originally associated with medical Scepticism, observatio was a new entry in early modern philosophy. Although the term gained wide currency in general scholarly usage in the seventeenth century, its assimilation into standard philosophical language was very slow. In fact, observatio does not even appear as an entry in the philosophical dictionaries until the eighteenth century--with one significant exception, the medical lexica, which featured the lemma, reporting its ancient Empiric definition, as early as 1564.

Gianna Pomata

Papers

Sharing cases: the Observationes in early modern medicine.

Historia: Empiricism and Erudition in Early Modern Europe

The Medical Case Narrative: Distant Reading of an Epistemic Genre

Observation rising : birth of an epistemic genre, 1500-1650

A word of the Empirics: the ancient concept of observation and its recovery in early modern medicine.