Friday, July 03, 2009

When does realism prevail?

Reading Owsei Temkin's book Galenism, I came upon an interesting paragraph on Vesalius the great 16th century anatomist. In a 1538 publication Vesalius attempted to represent traditional Galenic physiological concepts in visual form. In a drawing of the liver and portal system of veins carrying the caption: "The liver, workshop of sanguification…," the liver is represented with its traditional five lobes. On the other hand, in an illustration of the "organs of generation," where the liver does not play a central role, the liver is sketched incompletely, yet correctly, with two lobes. It was Temkin's conclusion to this observation that caught my attention. It seemed to resonate so well with my experience of practicing psychiatry in a world of distorting theories. "Where realism was of little consequence," he writes, "it could be allowed to prevail." And how are we to know, I thought, when, in our experience, realism does prevail?