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A Synopsis of Physical Signs in Medicine

The Logic of Medicine By EDMOND A. MURPHY. Pp. xi + 353, illustrated, hard cover. Baltimore and London: The Johns Hopkins University Press, 1976. £1 1.55. This is a most unusual and interesting book and this reviewer believes it is difficult for anyone using measurement of any sort in medical practice to read it without profit. Its theme is the need for clarity of definition of the terms used in ordinary speech, writing (especially in scientific papers) and, further, for the processes of thought which go towards not only making a clinical diagnosis but assessments of treatment and of all the comparisons and judgments made in clinical medicine. It can be read by those without much knowledge of mathematics or statistics but it gains enormously in value if it is read in conjunction with a small text of statistics as applied to medicine: yet it must be emphasized that this is not necessary and it stands alone on its merits. Some idea of the range of this book can be given by quoting first 'The Objective' which states that 'The serious purpose of the book is to explore the ideas behind the evaluation of the sources and interpretation of the data from which the corpus of medical knowledge is to be derived'; and then some of the chapter headings such as 'Words, symbols, and notions'; 'Disease and normality'; 'The diagnostic process'; 'Superstition';'An exercise in qualitativecriticism'. Runningthrough the book is the wide scholarship and humour of the author. The reviewer would particularly like medical students to read it, but practising doctors would need to dispense with their bad or clumsy logical processes which may often be harmful to the patient. The book is well produced and is a credit to the Johns Hopkins University Press.