Main Scientific Leitmotif.

 

Medical Scientific Discovery by means of the Inductive and

 Deductive Scientific Systems as that of Physics.

 

Antecedents of my infancy and young years 1945-1967.

 

I was born ending 1945 at Havana, when there were the post-World War II baby and high technology booms. I remember when I was a little child that I enjoyed very much playing with different instructive toys of the 1950s: "Tinker Toy" of civil engineering and architecture, "Mecano" of mechanic engineering, “Lionel” electric train, etc. I learnt to read reading Walt Disney’s comics translated to Castilian or Modern Spanish, and even some WD’s extraordinary issues in English, and grew my infancy hearing radio and seeing TV. I saw from 1951-1960 many old pictures and episode serials of the US movies and US television. Among them, I stayed very impressed and motivated with the long and very instructive TV serial "Mysteries of Science". Afterwards, I bought personally for the following Christmas Days the Gilbert's toy sets: "Laboratory of Biology" and other year "Laboratory of Chemistry". I was very impressed also with Jules Verne´s books and movies: "20,000 Leagues of Submarine Travel", "The Mysterious Island", and “Around the World in Eighty Days”. I began to read more in English with the pictures and commercial advertising of the monthly collection of the US National Geographic Magazines bought by my German grandfather, Rudolph W. Stusser, from 1934 until his death in 1953.

In my primary school named "Cima College", in Almendares, Marianao, an English session in the morning & a Spanish one in the afternoon, I did not remember to have any special motivation for science, except for natural sciences and arithmetic, although it was a very good private school. I obtained good marks, doing my homework seeing the TV in the evening in the last grades, without studying too much, but never the best ones. In that time, the school made some psychological tests to the children by Prof. Torroella, and my results were different from my brother: I had a graphic or logic intelligence, and he had the other one. The school’s Director, Mrs. Flora Galdós de Cima, former professor of the Phillips School in Kohly neiborhood, always said to my mother that Rodolfo was very intelligent. In those times, I was a very restless, lowbred and undisciplined boy that uses to play in excess with my minor brother Richi, and this occasioned that my parents put me semi-intern in the Cima School. Afterwards, they were look for a new school to put me to pupil (intern all the week) with the support of my Aunt Bubby. The schools that I visited that time with my mother were the great Havana Military Academy and the Candler College, both in the Marianao municipality, but finally I stay in Cima.

It was in the first year of high school in that same Cima School that I first got motivated by the anatomy, physiology and hygiene subject matter by the book of Prof. Castellanos given by a physician Dr. Gustavo Garayburu. I had troubles with arithmetic and algebra' marks in first year, because I used to seat distant from the blackboard and play very much during the Maths’ classes. The school put the low marks’ students extra classes this year. My father talked with a neighbor that knew well high school Maths, who put me to make extra exercises of my own book in his house at night, and then I improved my marks in algebra and geometry the second year, but in the latter not so much as I was hoping. In the third year 1960-61, I was encouraged to change that situation and personally bought in an old second hand book library in the Havana Reina Street the books of Rosell's algebra and of Fiterre's geometry, and with the very good classes of Dr. Jose Tabio, professor of physics & mathematics (later of the School of Physics at Havana University). I studied more by myself without any help, achieving the first best marks of my group of classmates in mathematics in both semesters. In the algebra examination, I solved the last problem correctly without using the standard algebra given in that semester. Later, in seven or eight months of 1962, I made the last fourth and fifth years of high school together, bypassing (without receiving) the Maths (two books of Prof. Mario Gonzalez, later mathematician of the NASA in Cape Cañaveral, Fl), to obtain my high school degree to study the medical sciences career soon. In this time, there were very interesting for me, the classes on human biology and on electricity, specially, on electrodynamics by a student of the electrical engineering school of the Havana University.

An article that I read as teenager in the Journal "Selecciones" (Selections of the US Reader's Digest), where they taught to common people how to resuscitate with intra-thoracic massage a person that in the street has had a heart arrest, influenced very much in my election of the medical career. Other earlier stimulus was that in my third year I survived to a typhoid fever, before the discovery of the cloranfenicol. Afterwards, since my third year of age I began to suffer from a severe allergic bronchial asthma, until today, beginning to get in touch since that moment with many good pediatricians and allergists, and to admire their work.

In our School of Medicine, I had very good marks without studying too much as well, in spite of that we were doing the first and second year in a one-year intensive course. I was the leader of one of the four best collectives of study (of six students) in about 1000 students that started the career. First, I became interested in cardiovascular physiology, and later in Neurophysiology, both given by Dominican and Chilean professors respectively. I became assistant instructor in 1963 with the scientific guide of Chilean scientist Prof. Bojrn Holmgreen, of German origin. He personally encouraged me to give a seminar only to him, because the rest of the instructor students did not attend it. In my second year, I began to receive classes of propedeutics and semiology of internal diseases from Professor Fidel Ilizastigui, very important since then in my knowledge on clinical sciences. Then, I began to learn at the bedside most of the maneuvers that nurses used to do on the patients apart of the physicians ones. Later I regret not to learn all of them.

It happened in third year some things that influenced my motivational system. I was interested in surgery practice, and studying for a seminar on Cardiovascular Shock, directed by an anesthetist, and then I became interested in the review of all the literature in Spanish and English journals up to 1964 in our Cuban library of medicine guided by the Index Medicus books of the US National Library of Medicine. They were thin books in those years from 1960 to 1965. Thus, I managed in that seminar of Shock apart of the theory of the US surgeon Walter Lillehai and the beginning issues of the becoming theory on "disseminated intravascular coagulation" of the US surgeon Robert Hardaway, later much more developed and accepted. Afterwards, I attended the First International Symposium on Cortical and Subcortical Relations in Cuba organised by our Professor Holmgreen. In it, I did not understand practically anything in the quick English that the foreign scientists of all the countries, including Russian and North American ones, presented their works with slides. Afterwards, Prof. Juan Jimenez of Propedeutics/Semiology, Head of the Medicine Department in the same National Hospital at Aldabó, Havana (later professor in the University of Miami, Fl), joked with me about the high level that would have the case presentation of a “myasthenia gravis” patient that I had in the bed where I was in charge to present to the medical students and staff of our ward. For that presentation, I studied my case at the bedside and with the last books and journals on Clinical Neurology in English of the library. I made the presentation with all the basic (neurophysiologic, biochemical, pharmacological) and clinical and neurological background, and answered all the questions of a third year medical-resident (finishing his thesis about that same disease) for a whole hour in front of a blackboard. When I finished, the old Prof. Juan Jimenez congratulated me, and told the people there that it was the best "case presentation" by a medical student that he had seen in his life. This gave me great confidence in the scientific approach I was using to go in depth at the patient bedside and on the diseases for case presentations. When I began to go in depth in those matters, I began to let the visit of all the patients around the ward, and other diseases with less attention, and my marks went down a little, but I was for the first time motivated in the exhaustive domain of some scientific clinical medicine matters.

Then, I became assistant instructor of clinical propedeutics and semiology, and began to have troubles with the natural generalist approach of my Prof. Taquechel of internal medicine (the resident that asked me about myasthenia). He recommended me now in the Military Hospital Carlos J. Finlay of Marianao "to read less of everything instead of much of few things" to be able to talk more in all the clinical discussions of the staff of instructors and students. I preferred few patients bedside clinical examinations and study in depth their diseases that to know and read less about all the diseases and patients of the ward. From that moment, my favorite type of classes was the seminars and the symposiums, not the current lecture. I began to make overtime in the ward with the patients doing to them different tests that complemented their physical examinations, as the regitine and cold tests for the primary arterial hypertension, and so forth. In the emergency room of the Military Hospital of Marianao, I began as student to learn how to manage the critical patients from an experimented old male nurse. I remembered the first case he showed me: a patient with epileptic convulsions --the “sacred disease”.

In 1968, with very good marks in the career through a selection process to do an Internship in basic and preclinical sciences, as a Master in Science, and a further residence in pharmacology or physiology, equivalent to a Master in Physiology, I made my entrance with two dozens of classmates in the National Center for Scientific Research at Marianao. It was the third course taught in the first elite centre for biomedical research and training in Cuba, and now we are known as part of the founders of that center. It was a very intensive and high level course of a year and a half in exact sciences, molecular biology, philosophy and foreign language, with the “all stars team of professors” from Havana University: Doctor Ernesto Ledon from the Havana University School of Chemistry, a Spanish Doctor Antonio Gonzalez from the School of Physics, and Electronic Engineer Ramon Ventoso of the Technology Faculty. While most of my classmates were reviewing mathematics, I had to study for the first time, the two years high school course of trigonometry, analytic geometry, determinants, matrices, and higher algebra, in two months, because they were absolutely new for me. Finally, I obtained the highest marks in both semesters of mathematics among other classmates. I was disapproved in my grandfather’s German tongue, because I had no time at all to study it.

 

The rest of subject matters that I studied could be seen in my summary and detailed curriculum vitae.

 

The Emergence of My Main Scientific Leitmotif in the Late 1960ies.

 

During a year and a half classes of university physics, the Eng. Ventoso very kindly began to give us out of program, introduction to the theory of science in his subject matter of general physics, when teaching classic and relativist mechanics. He was trained in the Massachusetts Institute of Technology, USA, and dominated Sears´s Manual of Physics very well, but he was delighted giving us theory of science. In the Havana Institute of Technology, those incursions out of program were very bad seen by the students, but not in our research center by some of us. During that year, I began to meditate about, Why in medicine there was not a general manual of physics as Sears & Zemansky or as Resnik & Halliday, or as the ones of Linus Pauling or Sienko & Plane in chemistry? With the presentation of the main scientific principles, theories, methods, and developments, to help medical scientists in training to get quickly the generalities of scientific theory and methods in medicine, to be able to push forward its progress in their general and specific disciplines.

I was then very far to know that a Scottish physician had thought the same thing very impressed with Sir Isaac Newton's Mechanics and "Principia of Mathematics" in Oxford University. Dr. John Brown published his ideas in Latin in 1770. I was also very far to know that in 1873, the Scottish physicist James Clerk Maxwell, integrated the previously independent sciences of electricity, magnetism, and optics, into the unified physics of electromagnetism.

Then, I with two other classmates of that group (Nibaldo Hernandez, who after physiology studied physics, and Francisco Fernandez, who after physiology studied orthopedics -- a kind of medical physics) encouraged by the physics classes, talked with Prof. Segal, a German biologist giving us molecular biology, to study biophysics with him, but this was not well understood by the center authorities and not possible. It was interpreted as pure science not important then. That same little group was going out of those common lectures of physics with Eng. Ventoso, to receive his special seminars in extra time on the Theory of Science, with examples of thermodynamics and electromagnetism too. I began to read out of program, several matters of logicians and philosophers of the Vienna Circle, of Russel and Whitehead, and others logicians of science. I had great troubles in the classes of "soviet" philosophy that I received then, and became very stressed. I was then very far to know that Otto Neurath and other members of the Vienna Circle were between the two World Wars elaborating all a system of thought to develop the unity not only of physics, but of all the sciences, on the basis of physics. The project for the Unity of Science, I much later understood it, as a physical reductionism of all natural and social sciences. Eng. Ventoso were separated of this Center many years after I, due to philosophical and political divergences too. The only one that stayed in contact with Ventoso for the next nine years was I, who continued learning from his talks and studying the books, he suggested me. I do not know where he is now... and if he is alive or death, but I thank him very much for all his great teachings.

In a simultaneous way, my interest in mathematics for medicine woke up with the classes given by Eng. Ventoso, and especially by Dr. Gonzalez. I my view, it was indispensable to develop an inductive-deductive system like physics in medicine, to have previously at least a medium domain of the mathematical theories and methods. In 1969 and 1970, in that scientific center, as methods for the scientific research training of the residents of basic sciences were taught for the biomedical scientists, the first courses of introduction to statistical description and inference, and to computer science. During those three years, Dr. Gonzalez, who was a mathematician pupil of Prof. Rey Pastor in Spain, but a pharmacist too, let in us most of the matters contained in the Defares & Sneddon´s Manual: "The Mathematics for Medicine & Biology" from the Universities of Leyden, Netherlands, and of Glasgow, Scotland, UK. Nevertheless, he let also in a smaller group of us that "when medicine & biology could find their own specific scientific models, then all the mathematics accumulated and even new developments could be in conditions to make progress on medicine & biology like in physics. Here began my first motivation for knowing more mathematics and medical statistics, to be able to improve much more the medical models, and afterwards, to use with them the mathematics as tool to increase and improve medical scientific knowledge based on the example of physics. Dr. Gonzalez also, introduced us in 1970 to a mathematical version of the French Schwarz’s Medical Statistics. In that year, I had a situational reaction due to a high political stress and a divorce stress, and passed psychological examinations with brilliant normal intelligence results that gave me again much more confidence in my possibilities to work in complex problems of medical science. However, I also needed to increase very much my scientific knowledge in clinical medicine and public health.

From 1971-74, I received a training in internal medicine in Havana University, and work in general internal medicine, general medicine, and public health in the far Oriental rural and sub-urban health areas in my Medical Social Service. In 1973, I decided to study biomathematics, biocybernetics or biostatistics speciality in the National School of Public Health at Havana, to improve the quality of health research and health management too. I passed four months in Oriente reading every night a novel encyclopedia of sciences, about mathematics, cybernetics, information theory, philosophy, etc. I studied the British Bradford Hill’s Introduction to Medical Statistics, and an introduction to set and probability theories.

I began my residency in Biostatistics at Havana University, and studied again mathematics, very much probability and statistics, and research method and logic, by many different books out of program, until the bivariate model from 1974-77 in another one-year intensive course in public health, equivalent to a M.PH, with a two and a half years residency in biostatistics, equivalent to a Master in Biostatistics. I passed a mathematics logic course in the Institute of Economy out of program too. I consulted the work of Russel and Whitehead's "Principia of Mathematics" of the 20-century in the Havana University Library. In an examination of probabilities, I had difficulties with a novel professor and low marks, because I used mathematical logic developments to solve a problem not used by her.

In 1975, I made contact for the first time with the mathematician-physician Prof. Alvan Feinstein's articles from Yale University, defending the clinical and bio-parts of clinical biostatistics through a Mexican physicist Prof. Julio Cesar Margain from the Mexican Public Health Institute. In that year, and in 1979, I had the great opportunity to received from the Emeritus Professor of Biostatistics John Fertig --from Columbia University, NY, USA-- two two-weeks courses in Havana: "experiment design", and "multivariate analysis", without calculators and computers. Prof. Fertig shown us parametric statistical analyses very well, but he was against factorial, cluster, and non-parametric statistical analyses, and he hated Psychometrics, Econometrics, and non biometrical matters and Journals, as well as hated Mervin Susser's "Causal Thinking in the Health Sciences", book from Columbia University too, due to its social orientation. Then, I understood and defined that my aim would be to improve medical and health sciences adjusting the medical part of biostatistics, instead of developing more its mathematical basis, which was the aim of the non-physician biostatisticians and mathematicians.

 

The rest of subject matters that I studied could be seen in my summary and detailed curriculum vitae.

 

In 1974, the Eng. Ventoso, recommended me a very complex and important book on science of the Argentine-Canadian Mario Bunge. " The Philosophy and Strategy of Scientific Research", two volumes translated to Spanish. He also recommended me to observe an opening of the Russian logicians to the western philosophy and logic of science in the book of the Soviet & Cuban Academies of Sciences' "Methodology of the Scientific Knowledge" in 1975, which I read immediately.

In 1974, I began to interchange with Dr. Daniel Joly, Director of the Havana PAHO/WHO office about integral and vertical health programs and statistical registers of diseases, and to read PAHO and WHO documents from 1948 on, and most documentation of our Health Ministry from the 1960s. In 1976, I began to exchange with Prof. Ilizastigui about the defense of medical generalist progress, which was weaken under the impact of the medical specialities development.

I showed Eng. Ventoso in the National Centre for Scientific Research in 1976 a critical methodological paper I wrote: "Biostatistical Problems of Health Research & Management", and Eng. Ventoso helped me to evaluate it. It did not receive any acceptance of my superiors, and less to be published. Then he told me about the classes I was giving of biostatitics in the school of medicine: "To be a good teacher you have to solve all the problems of the book you are teaching, or of the best books, as I have done with the Sears´s books of physics." Then, I had the book of Spiegel about "Theory and Problems of Statistics", a mathematician from the Rensselaer Polytechnic Institute, USA, at my side. I began to think that I preferred to use my scarce time researching and solving the scientific problems still without solution in medicine and public health than to solve the same statistical problems that some mathematicians have solved in the past. I defined there without been aware of it that my main scientific leitmotif would be since then to improve medical & health scientific research methodology & logic, improving at the same time, the research training of medical & health scientists.

 

Stand-By of My Leitmotif Due to Criticisms of Unconventional Scientific Ideas.

 

In 1976-1977, I made my public health specialist thesis in a less unconventional research, but with an unconventional statistical method for Cuba, Latin America and the Caribbean in those times: Multifactorial analysis --one not give to us in the residency program but taken from the Neurophysiology Department of my first research center. In 1978-79, I began to give in the Oncology & Radiobiology National Institute, the first courses in methodology and logic of research for biomedical laboratory, clinical & health scientists in Cuba.

In those years, I also advised the building of the Clinical Research Section and Department of the Cancer Institute, with all kind of clinical trials and studies in chemotherapy, radiotherapy, surgery, and nuclear medicine. I could study Bunge´s book already mentioned, Susser’s book, requesting the book to the author; Lillienfeld’s "Cancer Epidemiology" and "Foundations of Epidemiology, books borrowed by a foreign scientist visitant; Feinstein´s Clinical Biostatistics and Clinical Judgement, Murphy´s Logic of Medicine and other monographs in science method and logic, medicine, and statistics, I requested to Mercedes Hernandez, MSc, a US Chemist family of my wife, from USA.

In the 1980ies, I made proposals to my superiors attempting to receive support to write an Introductory Manual of Medical & Health Scientific Progress and Research Methodology and Logic, without answer. I began to carry out several studies to obtain a "Unified Science-Prevention-Care-Education-Finance Forecast of Cancer in Cuba from 1985 to 2000"’s research results and its unified methodology, from 1981-87. In those years, I read some position papers from WHO promoting integral programs on non-transmissible diseases. My unconventional forecast studies, with critical results, methodology, and five unified variants --not only the favorite one by the Soviet ortodox oncology school--, were presented to Havana University for the doctoral in science degree (Ph.D) in December 1987. It was not understood, attacked by false learning, and rejected --without the possibility to be defended-- by the health and education authorities since 1988 up-to-date. In spite of that, it sat the methodological bases for three later official Programs of the Public Health Ministry: "Cancer Prevention" & "Oncology Speciality Development" of Cuba 1987-2000, and "Objectives, Aims, and Directives of the Cuban Health System 1992-2000".

Early in the 1990s, I could appreciate the real infirmity of my cancer forecast thesis that was not seen then by any of its scientific critics. The lack of a near to 0 or below it, negative regressive level of development sixth scenario, when we had very much less than the minimum tendency I predicted, due to the sudden collapse of the Eastern European socialist countries, and our unexpected extreme economic dependence from these countries, especially of the former Soviet Union. By the way, to have foreseen the necessity of that scenario 0 or subzero, would have improved the quality of the results, but instead of helpingmy defense would be hindered infinitely much more the defense of my Ph.D thesis.

Then, I was sent to give biostatistical consultations on infantile mortality reduction in Nicaragua from 1988 to 1990. Later, I changed to give scientific consultations to national and regional health research and development, and research training courses in Managua. There, I read many documents from PAHO/WHO of the late 1980ies, some of them encouraging the strengthening of scientific research for the health primary care level. The 100 best original articles of epidemiology and specially the comments of Prof. Milton Terris, from John Hopkins University, et al, in "The Challenge of Epidemiology" of PAHO/WHO in 1988, increased very much my scientific knowledge in medical and health sciences. I have met Terris at Havana in 1986.

 

The rest of my works done could be seen in my summary and detailed curriculum vitae.

 

The Re-Emergence of My Main Scientific Leitmotif in the Early 1990ies.

 

When I returned from Nicaragua, I began to work in the teaching staff (loosing in salary and privileges), organizing the first Plan of Research & Development, and Research Training Courses, in the health area of the Plaza Community Polyclinic from 1990-1994. There, I was very impressed by the social epidemiological books of the Spanish Prof. San Martin as "Medicine, Health, and Society" of 1986, within others. Since 1990, I also made attempts to receive support to write for medical students and doctors an "Introductory Manual on Scientific Research in Community Health & General Medicine", and later other on "Scientific Research in the Laboratory, the Clinics, the Community Office, and the Health Fields", without response either.

In 1993, I began to work also part-time in the Clinical Research Center in the middle of a silenced famine in all Cuba, still open for scientific research. With the opening of my country government, I decided with 25 years of knowledge and experience in scientific research in the fields of medical and health sciences, to also open my eyes and my mind and put my efforts in overtime on the scientific objects, I always thought in the past that were important, but that were seen as luxuries in a medical and health researcher.

One of these objects was healthmetrics in the community polyclinic, and clinimetrics in the clinical center. In 12 months, I understood that less could be made on these matters, if there did not exist yet the special health and clinical models that suggested me the mathematician-pharmacist Dr. Gonzalez 25 years before. I began then by a very delayed snail post mail to obtain hundreds of  scientific reprints and books on medical and health general matters and models that were not in Cuba, which I detected by Medline in CD-Roms.

On January of 1994, I could concrete the first proposal of research project: "Toward a General Theory of Medical Science". Nevertheless, when I began to develop the project, it was easy to see that it was a long work for a very experienced team of international scientists with access to the most complete libraries of science in the world. This proposal was written, in the same way of a design and rationale of a clinical trial or research, and submitted to journals to find partners with different titles from 1994 to 1999. It was sent to 11 editors in chief of noted international medical and non medical journals, and 2 electronic repository and journal, being always rejected. Nevertheless, it was recognised by the Swedish Profs. B.I.B. Lindahl, and Lennart Nodenfelt, from the Advisory Board of Theoretical Medicine Journal, within others. It is important to signal that since 1993, I began to be supported in my survival life with a charity annual family grant, which without the one my wife and I would not have been able to survive doing science. She was studying the marketing research for the supposed opening and transition taking place in those years too.

On the beginnings of 1995, helped also by Current Contents floopy discs, I began to write two other scientific projects. One of research, first titled: "The Creation of Family Medicine New Research Spaces". This with other titles was submitted to three editors of medical journals from 1995-97 without success. Nevertheless, it was recognised by the Scottish Prof. John Howie, of the Editorial Advisory Board of Family Practice Journal, and by the Canadian Prof. Ian McWhinney, father of the Canadian family medicine. The other project of postgraduate research education was first named: Metodology of Laboratory, Clinic and Health Research & Development. A Unified Approach. In July 1997, the French Prof. M. Manciaux, Vice-Chairman, Global ACHR of the French Nantes University, and the Moroccan Dr. Pierre Botrus Mansourian, Secretary ACHR, and Head of the Research Policy Strategy Division of WHO HQs at Geneva, were interested in a further development of an abstract I sent to the Director-General Dr. Nakayima as foundation for the training program. I wrote then: A Unified Approach to Medical (& Health) Scientific Research Methodologies.

In the late 1990s, I read two books of history of medical science that made on my leitmotif a great impact reinforcing it. One, the superb monograph of a novel historian now in the Massachusetts Technological Institute, Prof. Rosser Matthews’ Quantification and the Quest for Medical Certainty, of 1995, from a statistical point of view, confirmed myself its discussions that scientific method and logic in clinical medicine, should be more studied and developed, not substituted completely by Gaussian or “Bayesian” statistical methods. The other one, not less extraordinary monograph, from a medical point of view, of an experienced professor of medical genetics from Oxford University, Sir David Weatherall’s Science and the Quiet Art. The Role of Medical Research in Health Care, of 1995, trying to make the governments and donors aware of the great importance to finance several jumbo basic research projects as the Human Genome (or Brain) Project(s), suggested me the great need to put beside it or them, some Human Clinical Projects, and not only Human Epidemiological and Public Health Projects, as had been suggested before.

I needed seven years and sometimes more, to have access to the majority (not to all) of the literature I wanted to read in 1993 and 1994. In May 1998, I could have personal access to Internet restricted to PubMed and few other medical pages, and in August 1999 to full Internet two hours weekly. Still I have two books, within many other books and articles, which I have not been able to read even having gone to The University of Edinburgh Library. It was there in Edinburgh in September 1998, when I was invited by Prof. John Howie, of the School of Medicine's General Practice Department. There, I searched and read the first article against Dr. John Brown's medical deductive system, the earliest precursor of my first and main scientific project. He created in the 18-century a speculative system of principles for medicine, trying to have a model similar to that of Newton in physics, but without its scientific foundations. This was due to the still not developed enough medical scientific empirical knowledge in those times. Brown's system was rejected completely within other facts and arguments by French physicians, on the basis, in my opinion, not only of the speculations, but on a not exact scientific data that existed on the properties of opium (the main drug of his theoretical system) in the beginnings of the 19-century.

By this and other articles (of the last 30 years) I received from the US Ruth Hargis cousin of my wife in California, I have thought that Brown's medical system had the extremely ambitious objective for those times, not only to organize the still scarce and primitive medical sciences empirical results to influence in their progress, but also to establish the practice patterns for the medical care, including therapeutics, on the main basis of a extremely powerful drug, but only that, one drug. Nevertheless, the premises of Brown's model to organize and develop the scientific ideas of medicine, are still there waiting for the medical and health scientists of the 21-century, as well as the huge amount of accumulated scientific knowledge in medicine and public health, since Dr. Brown lived, to be developed much more, with an inductive-deductive system as the one of Newtonian Physics.

Two very important books for my philosophical and ethical understanding of clinical medicine and public health, have been two of Hugo Tristram Engelhardt, of Baylor College, Houston, Texas: “Philosophy of Medicine. A Guide to the Culture of Science, Technology, and Medicine”, and “The Foundations of Bioethics”, 2nd edition. From the latter one, I made a book review in Spanish suggested by the own Engelhardt.

The two books that still I have not been able to read completely are as follows. One is from the Dutch Prof. Henk ten Have, G Kimsma and SF Spicker, eds. Medicine and the Growth of Knowledge. 1st ed. Dordrecht: Kluwer, 1990. This was written apparently in the frame of an older and general book of science that I have consulted from the Hungarian I. Lakatos and A. Musgrove.eds. Criticism and the Growth of Knowledge, of 1974 of Cambridge University. The other one is the analysed, from the British John Brown. Elements of Medicine, of 1770 in English edition. In: William Cullen Brown. The Works of Dr. John Brown. London: Ballantyne, 1804. This second book is essential for me to examine it, to be able to write an essay about the validity of some of the scientific ideas and attempts of Dr. Brown, and its possibilities for the progress of scientific medicine and public health in the 21-century. (I have kindly received these two books by two friends of US PtPAP Cuban Program Cindy Tryniszewski, RN, and Jim van Eyck, MD)

 

The scientific research and research training projects mentioned here and others developed after in 1998-2001, are posted in the unconventional Integration Science Program on General Medicine, Nursing, Technology & Public Health.

 

From 2005 to 2007, I had the great opportunity to read two books. The first one, the Gross, Levitt and Lewis et al. The Flight from Science and Reason. of 1997, which I looked for, when I went to Edinburgh School of Medicine library and could not photocopy. This set of essays defends our concrete and formal sciences from the reanimation of old irrational tendencies emerged when they were less mature in empirical data and theoretical precepts. I read it first articles on quantum physics and on traditional medicine problems by photos of the articles that sent me my friend in Austin, Texas, Dr. John Marshall. Early in 2006, I received the whole book and other book: Le Fanu's The Rise and Fall of Modern Medicine, of 1999 with a great description of the medical advances between the 1940s and 1970s, and the fall in the subsequent decades and its hypothetical causes. These two books were bought to me by my friend Leslie Cooper of the Mayo Clinics in Rochester. With these two books I have been again encouraged to write some papers enhancing the scientific method in medicine and the clinical discovery of new facts, theories, methods and technologies empowering clinicians and surgeons scientific research.

Now, I am studying the book of David Bohm “Science, Order and Creativity”, and the Roland Omnes book “Quantum Philosophy: Understanding and Interpreting Contemporary Science”, among many online articles on these matters to analyze medicine and public health from different methodological and logical perspectives. These books were send to me by my friends Erick Beck, Donald Asp, Robert Kriel and Linda Krach, all physicians from Minneapolis-Saint Paul

 

The papers on the matter can be read in two web sites: e-essay of 2006 and e-letter of 2008.

 

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