Abstract

Around 1780 a literary clash concerning the success in the treatment of "fevers" opposed two Scots in London, D. Monro and J. Millar. This reflected the awareness growing among British doctors that therapy, based as it was on authority and tradition needed real evaluation by factual observations in groups of patients and their analysis using simple shop arithmetic. Such "arithmetic observation", applied also to nosography, was seen as the only way of bringing clinical knowledge to the epistemological level of other sciences and on a par with the standards of day-to-day political and economic life. It was fostered by physicians and surgeons particularly in the Army, the Navy, and newly founded hospitals and dispensaries. While it continued unhampered in Britain, its later French version, the "méthode numérique" of P.C.A. Louis, came under severe attack in the Paris Académie des Sciences and the Académie de Médecine around 1836. These debates resulted in the consensus that numbers were indispensable in public hygiene but had no place in "real" clinical medicine