Clinical reasoning as midwifery: A Socratic model for shared decision making in person-centred care.

Shared decision making has become the standard of care, yet there remains no consensus about how it should be conducted. Most accounts are concerned with threats to patient autonomy, and they address the dangers of a power imbalance by foregrounding the patient as a person whose complex preferences it is the practitioner's task to support. Other corrective models fear that this level of mutuality risks abdicating the practitioner's responsibilities as an expert, and they address that concern by recovering a nuanced but genuinely directive clinical role. Cribb and Entwistle helpfully categorize models of shared decision making as 'narrower' and 'broader' and praise the latter's 'open-ended and fully dialogical ways of relating'. However, they stop short of providing a philosophical account of how that dialogue works. In this paper, a nurse-midwife and a philosopher collaborate to argue that the Socratic model of dialogue offers a solution to the practitioner-patient dilemma. In the Theaetetus, Socrates compares dialogical reasoning to 'midwifery with all its standard features'. By means of a three-way analogy, elements of midwifery practice are used to illuminate features of Socrates' claim that his dialogue is like midwifery; those features are then translated into an approach to shared decision making as the 'midwifery of good thinking' which both midwives and physicians would do well to adopt. A key concept that emerges is the need for practitioners to make a risk-confidence assessment of the particular content of any decision to appropriately modulate their role in the practice of shared decision making.

The killer of Socrates: Coniine and Related Alkaloids in the Plant Kingdom.

Coniine, a polyketide-derived alkaloid, is poisonous to humans and animals. It is a nicotinic acetylcholine receptor antagonist, which leads to inhibition of the nervous system, eventually causing death by suffocation in mammals. Coniine's most famous victim is Socrates who was sentenced to death by poison chalice containing poison hemlock in 399 BC. In chemistry, coniine holds two historical records: It is the first alkaloid the chemical structure of which was established (in 1881), and that was chemically synthesized (in 1886). In plants, coniine and twelve closely related alkaloids are known from poison hemlock (Conium maculatum L.), and several Sarracenia and Aloe species. Recent work confirmed its biosynthetic polyketide origin. Biosynthesis commences by carbon backbone formation from butyryl-CoA and two malonyl-CoA building blocks catalyzed by polyketide synthase. A transamination reaction incorporates nitrogen from l-alanine and non-enzymatic cyclization leads to γ-coniceine, the first hemlock alkaloid in the pathway. Ultimately, reduction of γ-coniceine to coniine is facilitated by NADPH-dependent γ-coniceine reductase. Although coniine is notorious for its toxicity, there is no consensus on its ecological roles, especially in the carnivorous pitcher plants where it occurs. Lately there has been renewed interest in coniine's medical uses particularly for pain relief without an addictive side effect.

Thinking critically about the occurrence of widespread participation in poor nursing care.

AIM: A discussion of how Arendt's work can be productively re-contextualized to provide a critical analysis of the occurrence of widespread participation in poor nursing care and what the implications of this are for the providers of nursing education. BACKGROUND: While the recent participation of nurses in healthcare failings, such as that detailed in the Francis report, has been universally condemned, there has been an absence of critical analyses in the literature that attempt to understand the occurrence of such widespread participation in poor nursing care. This is a significant omission in so far as such analyses will form an integral part of the strategy to limit the occurrence of such widespread participation of nurses in future healthcare failings. DESIGN: Discussion paper. DATA SOURCES: Arendt's 'Eichmann in Jerusalem: A Report on the Banality of Evil' and 'Thinking and Moral Considerations: A Lecture'. In addition, a literature search was conducted and articles published in English relating to the terms care, compassion, ethics, judgement and thinking between 2004-2014 were included. IMPLICATIONS FOR NURSING: It is anticipated that this discussion will stimulate further critical debate about the role of Arendt's work for an understanding of the occurrence of poor nursing care, and encouraging additional detailed analyses of the widespread participation of nurses in healthcare failings more generally. CONCLUSION: This article provides a challenging analysis of the widespread participation of nurses in poor care and discusses the opportunities confronting the providers of nursing education in limiting future healthcare failings.

Brain activation to cocaine cues and motivation/treatment status.

Motivation to change is believed to be a key factor in therapeutic success in substance use disorders; however, the neurobiological mechanisms through which motivation to change impacts decreased substance use remain unclear. Existing research is conflicting, with some investigations supporting decreased and others reporting increased frontal activation to drug cues in individuals seeking treatment for substance use disorders. The present study investigated the relationship between motivation to change cocaine use and cue-elicited brain activity in cocaine-dependent individuals using two conceptualizations of 'motivation to change': (1) current treatment status (i.e. currently receiving versus not receiving outpatient treatment for cocaine dependence) and (2) self-reported motivation to change substance use, using the Stages of Change Readiness and Treatment Eagerness Scale. Thirty-eight cocaine-dependent individuals (14 currently in treatment) completed a diagnostic assessment and an fMRI cocaine cue-reactivity task. Whole-brain analyses demonstrated that both treatment-seeking and motivated participants had lower activation to cocaine cues in a wide variety of brain regions in the frontal, occipital, temporal and cingulate cortices relative to non-treatment-seeking and less motivated participants. Future research is needed to explain the mechanism by which treatment and/or motivation impacts neural cue reactivity, as such work could potentially aid in the development of more effective therapeutic techniques for substance-dependent patients.

Treatment readiness and prognosis for problematic smartphone use: Evaluation of the Stages of Change, Readiness, and Treatment Eagerness Scale (SOCRATES) and log data.

Aim: While moderate smartphone use contributes to information gathering and relationship building, excessive smartphone use, also referred to as problematic smartphone use (PSU), has raised concerns because of its addictive nature and associated health consequences. This study aimed to investigate the relationship between treatment readiness and prognosis in individuals with PSU and to assess the predictive ability of smartphone log data in evaluating treatment readiness. Methods: A sample of 47 patients with PSU participated in this study. Treatment readiness was assessed using the Stages of Change, Readiness, and Treatment Eagerness Scale (SOCRATES), and log data were collected using a smartphone log application. Results: The results showed a significant correlation between baseline SOCRATES scores and the difference in Global Assessment of Functioning scores between baseline and 6 months (Spearman's ρ = 0.640, P-value = .001), suggesting that treatment readiness may explain part of the treatment outcomes (Pearson's r 2 = 0.379, P-value = 0.032). In addition, baseline log data, including the log acquisition rate, showed a positive correlation with treatment readiness (Spearman's ρ = 0.328, P-value = 0.045). Conclusion: These findings provide valuable insights into the relationship between treatment readiness and clinical outcomes in patients with PSU, and suggest the potential of log data as objective indicators of treatment motivation.

Death of Socrates: a likely case of poison hemlock (Conium maculatum) poisoning.

INTRODUCTION: The death of Socrates in 399 BCE is described in Plato's dialogue, the Phaedo, written an unknown time afterwards from accounts by others. THE EVIDENCE: Socrates' death has almost always been attributed to his drinking an extract of poison hemlock, Conium maculatum, despite apparent discrepancies between the clinical features described in classical translations of the Phaedo and general clinical experience of poisoning with the toxic alkaloids it contains. EVALUATION: Recent acute philological analysis of the original Greek text has resolved many of the discrepancies by showing that the terms used in the classical translations were misinterpretations of the clinical signs described. It is also likely that the unpleasant clinical effects, such as vomiting, abdominal pain, diarrhoea and muscle fasciculation commonly described in modern reports of poison hemlock poisoning, were not mentioned to present the death of Socrates in a way consistent with his philosophical ideals and those of his pupil Plato. CONCLUSIONS: Seen in this way, the death of Socrates can be accepted as a limited case report of Conium maculatum poisoning. Even after reaching that conclusion, intriguing scientific questions remain about the toxicity of the coniine alkaloids and the mechanisms of their effects.

Two Types of Refutation in Philosophical Argumentation.

In this paper, I highlight the significance of practices of refutation in philosophical inquiry, that is, practices of showing that a claim, person or theory is wrong. I present and contrast two prominent approaches to philosophical refutation: refutation in ancient Greek dialectic (elenchus), in its Socratic variant as described in Plato's dialogues, and as described in Aristotle's logical texts; and the practice of providing counterexamples to putative definitions familiar from twentieth century analytic philosophy, focusing on the so-called Gettier problem. Moreover, I discuss Lakatos' method of proofs and refutations, as it offers insightful observations on the dynamics between arguments, refutations, and counterexamples. Overall, I argue that dialectic, in particular in its Socratic variant, is especially suitable for the philosophical purpose of questioning the obvious, as it invites reflection on one's own doxastic commitments and on the tensions and inconsistencies within one's set of beliefs. By contrast, the counterexample-based approach to philosophical refutation can give rise to philosophical theorizing that is overly focused on hairsplitting disputes, thus becoming alienated from the relevant human experiences. Insofar as philosophical inquiry treads the fine line between questioning the obvious while still seeking to say something significant about human experiences, perhaps a certain amount of what Lakatos describes as 'monster-barring'-a rejection of overly fanciful, artificial putative counterexamples-has its place in philosophical argumentation.

Motivational Stage at Continuous Glucose Monitoring (CGM) Initiation in Pediatric Type 1 Diabetes Is Associated With Current Glycemic Control but Does Not Predict Future CGM Adherence or Glycemic Control.

OBJECTIVES: The Timing of Initiation of Continuous Glucose Monitoring in Established Pediatric Diabetes (CGM TIME) Trial is a multicenter, randomized controlled trial in children with type 1 diabetes, comparing simultaneous pump and CGM with CGM initiation 6 months later (Paradigm, Veo, Enlite Sensor, Medtronic Canada). This study addresses the ability of SOCRATES (Stages Of Change Readiness And Treatment Eagerness Scale) to classify children and parents into distinct motivational stages and identify the stages' association with glycated hemoglobin (A1C) at trial entry and outcomes 6 months after CGM initiation. METHODS: Ninety-eight of 99 eligible children 10 to 18 years of age and 137 of 141 eligible parents completed SOCRATES at trial entry and 6 months later. Parent-child agreement for motivational stage was determined by weighted kappa. Linear regression was used to examine association between motivational stage and i) A1C at trial entry and ii) change in A1C and CGM adherence 6 months after CGM initiation. RESULTS: More than 87% of children and 88% of parents were classified into distinct motivational stages, with weak parent-child agreement. At trial entry, motivational stage was associated with A1C, which was 1.02% higher for children in the Action stage than in the Precontemplation stage (p<0.0001). When compared with children of parents in Precontemplation, A1C for children of parents in the Maintenance and Action stages were 0.83% (p=0.02) and 0.36% (p=0.048) higher, respectively. Precontemplation was associated with shorter diabetes duration. Motivational stage at CGM initiation did not predict change in A1C or CGM adherence 6 months later. CONCLUSIONS: SOCRATES can categorize children with type 1 diabetes and their parents into motivational stages. Although motivational stage was associated with glycemic control at trial entry, it did not predict future diabetes-related behaviour or A1C.

A Socratic Inquiry Into the Nature of Frailty.

In Plato's dialogues, Socrates, the protagonist, attempts to bring out the essential nature of an idea or a concept by engaging in a dialogue with the other characters. He asks probing questions of them to challenge their unquestioned assumptions and to eliminate flaws in their thinking. A hallmark of the dialogues is that Socrates himself never provides a final answer regarding the nature of the idea under discussion. Inspired by the power of the Socratic model to illumine one's thinking on difficult concepts, we have developed a short dialogue examining the nature of geriatric frailty. Our goal is to communicate, in a lively and nontechnical style, some of the fundamental challenges in studying frailty in older adults. Those acquainted with Plato's dialogues will recognize the resemblance to the initial segment of The Republic,1 which takes place in the house of a wealthy merchant named Cephalus. J Am Geriatr Soc 67:2455-2457, 2019.

A New Indobathynella Species from an Indian Cave. The First Cavernicolous Bathynellidae (Syncarida: Bathynellacea) from South-eastern India.

Indobathynella socrates n. sp. is described from Karaiguda Cave in the Visakhapatnam District of Andhra Pradesh state, south-eastern India. This is the first cavernicolous species of Indobathynella, which is incidentally the most reduced genus in the family Bathynellidae as a whole. The type species of this genus, Indobathynella prehensilis, is from a farm bore. The new species fulfils all the principal generic criteria of Indobathynella, but is distinctly different from I. prehensilis in several essential features: absence of subapical seta on antennary exopod; 4 claws on distal maxillulary endite; 6 teeth on mandibular gnathobase, and uropodal exopod without ventro-medial seta. These and all other salient differences between the two species are tabulated. Besides providing brief notes on conservation and biogeography of the new species, a key to all the known Indian taxa of Bathynellidae is given for the first time.

Reconhecimento e política no interior da tradição dialética: Sócrates, o Ateniense, Marx e Lênin / Recognition and politics within the dialectical tradition: Socrates, the Athenian, Marx and Lenin

O objetivo deste artigo é o de chamar atenção para uma série de questionamentos que podem e, a nosso ver, ainda devem ser feitos, acerca de uma suposta, exclusiva e definitiva doutrina política de Platão. Para tanto, inicialmente, é levantada a seguinte pergunta: A República, um dos mais célebres e comentados diálogos escritos por Platão, seria, de fato, o único momento de "sua" obra em que este autor expressaria a "sua" teoria política (comunista)? Amparados na leitura e interpretação imanentista de Hector Benoit a respeito dos diálogos platônicos, partimos da hipótese de que Platão, não sendo Sócrates, expôs ­ através de um personagem denominado Ateniense ­ em seu último diálogo na temporalidade da léxis, As Leis, um projeto de cidade radicalmente distinto daquele d'A República. Tal projeto se baseia na unidade dos contraditórios para a formação educacional dos habitantes de uma cidade composta por amigos que tivessem todas as coisas realmente em comum; cidade que deveria ser realizada na prática, e não apenas na metafísica alma do filósofo, como Sócrates haveria proposto idealisticamente n'A República. Assim, longe de ter abandonado os seus posicionamentos comunistas da juventude, como defendem alguns intérpretes, Platão, ao final da vida, teria, na realidade, os encontrado de modo mais rigorosamente determinado. No final do artigo, Marx e Lênin assumem o protagonismo, o que sugere ser a teoria política um dos fios condutores da milenar tradição dialética

This article aims at drawing attention to a series of inquiries that may and, in our view, still should be asked about a supposed, unique and definitive political doctrine of Plato. Then, initially, the following question is raised: The Re-public, one of the most famous and commented dialogues written by Plato, would be in fact the only moment of "his" work in which this author would express "his" political theory (communist)? Supported by Hector Benoit's immanentist reading and interpretation of the Platonic dialogues, we hypothetize that Plato, not being Socrates, exposed ­ through a character called Athenian ­ in his last dialogue, TheLaws, in the temporality of the lexis, a project of city radically different from that on The Republic. Such a project is based on the unity of contradictories for the educational formation of the inhabitants of a city composed of friends who really had all things in common; city that should be put into practice, and not just in the metaphysical soul of the philosopher, as Socrates idealistically proposed in The Republic. Thus, far from having abandoned, as some interpreters argue, his youthful communist positions, Plato would have in fact found them, at the end of his life, in a more rigorously determined way. At the end of our article, Marx and Lenin take on the leading role, which suggests that political theory is one of the guiding threads of the millennial dialectical tradition

A maravilhosa concepção da mão humana / The wonderful conception from the human hand

Samuel Hahnemann usa seu poder intelectual e de observação para fazer um relato minucioso, e de certa minuciosa, sobre as características da mão humana. Suas analogias e conhecimento das percepções filosóficas impressionam, menos por sua erudição mas pela idade com que ele escreveu o texto. "O que mais eu poderia dizer sobre a carne que está em torno de cada dedo? Ela está disposta de tal modo que aí ainda reconhecemos a Sabedoria divina. Dado que as próprias falanges são muito irregulares ­ pois as articulações e a espécie compreendida entre elas apresentam uma grande diferença de volume ­ esses espaços e essas irregularidades foram recobertas pelo Criador com uma camada carnuda suficiente para pegar tão vigorosamente os objetos e sustentá- -los. Isso para o interior dos dedos, pois exteriormente, por outro lado, não encontramos quase nada de carne e nossos dedos são recobertos apenas por pele, para não se tornarem muito pesados e desajeitados."

Samuel Hahnemann uses his intellectual powers and of observation to give a detailed, and somewhat minute, account of the characteristics of the human hand. His analogies and knowledge of philosophical insights are impressive, less because of his erudition but because of the age at which he wrote the text. "What more could I say about the flesh that is around each finger? It is arranged in such a way that there we still recognize divine Wisdom. Since the phalanges themselves are very irregular ­ because the joints and the species included between them present a great difference in volume ­ these spaces and these irregularities were covered by the Creator with a fleshy layer sufficient to grasp the objects so vigorously and support them. This goes for the inside of the fingers, because externally, on the other hand, we find almost nothing of flesh and our fingers are covered only by skin, so as not to become too heavy and clumsy."

Socrates's Last Words to the Physician God Asklepios: An Ancient Call for a Healing Ethos in Civic Life.

Socrates's last words have remained enigmatic despite over two millennia of philosophical, literary, and historical interpretations. This paper suggests that Socrates was executed for questioning the imperialistic actions of Athens in the Peloponnesian War by elevating the emerging cult of Asklepios and advocating for Asklepian ideals. Plato's dialogues show that Socrates saw Asklepios as more worthy of emulation than the warlike gods of the state-supported Greek pantheon. While dying from the executioner's hemlock, Socrates asks his friend Crito to pay the traditional thank offering given to the physician-god: a cock symbolizing rebirth. He looks to the only god then known to revive the dead to help his ideas and spirit live on. Socrates's last words thwart Athenian authorities' attempts to silence him, issue a call for Asklepian ideals to prevail in the city of Athens, and identify the selfless caring for others exemplified by Asklepios as the highest duty for all humans. Socrates calls us from the past to remember timeless Asklepian physician duties to self, patients, and community. Socrates reminds modern physicians of their personal duty to make their own spiritual health their first priority, their professional duty to comfort the sick and alleviate suffering, and their societal duty to advocate for the vulnerable, sick, and suffering and the health of the public.

El problema de la muerte propia: reflexiones entre filosofía y psicoanálisis / The problem of one's own death: reflections between philosophy and psychoanalysis

Resumen Este artículo se propone retomar el problema de la muerte propia, aquella que Freud consideró como imposible de representar. Este trabajo apunta a mostrar que, aunque sea irrepresentable, el análisis puede y debe producir un cierto saber sobre la muerte. Se toma como base la idea lacaniana de que una ética del deseo obliga al sujeto a entrar en ese lugar que el autor llamó "entre dos muertes" y que hace de la muerte simbólica un dato previo a la muerte real. Se revisan los aportes de Sócrates y Heidegger sobre la posición ética frente a la muerte propia, con el propósito de mostrar las convergencias y divergencias entre estos autores y Lacan. Finalmente, con el objetivo de mostrar que existen observables clínicos de que el análisis produce un cambio de posición a este respecto, se examinan los sueños de varios psicoanalistas que han publicado el relato de su experiencia de análisis. Se concluye que los indicadores de este cambio de posición son principalmente el planteo del tema de los asuntos pendientes y la necesidad de los actos resolutivos.

Abstract This article approaches the issue of one's own death, the one considered by Freud as something impossible to represent. This paper has as a purpose to show that, although unrepresentable, analysis can and should generate certain knowledge about death. The Lacanian idea is taken as a basis that an ethic of desire forces the subject to enter that place called by the author "between two deaths" that turns symbolic death a prior data to real death. The contributions of Socrates and Heidegger on the ethical position towards one's own death are reviewed, in order to show the convergences and divergences between these authors and Lacan. Finally, aiming at showing there are clinical facts that indicate that the analysis produces a change of position in this regard, the dreams of several psychoanalysts who have published their experience of analysis are examined. It is concluded that the indicators for this change of position are mainly the issue statement of unresolved matters and the need for resolutive acts.

Synthetic wisdom.

Wisdom is a special kind of virtue. It is not to be identified with any outstanding cognitive ability-like having a prodigious memory or knowing a lot. Rather it consists in seeing what is most important and most valuable, either within a particular domain or in life as a whole. In the life of a wise person, that insight should be accompanied by traits of character, enabling the person to pursue what is seen as valuable. Viewing wisdom as a capacity for synthetic understanding, I argue for the need for philosophy, even at a time when all of us have much to learn from the sciences.

A short-term follow-up study of a surgeon-customised fully-coated hydroxyapatite femoral stem using a nation-wide joint registry.

OBJECTIVE: To compare revision rates between otherwise-identical fully-coated and proximally-coated hydroxyapatite (HA) femoral stems using a nation-wide registry. METHODS: 249 proximally-coated stems (50 µm HA) and 225 fully-coated stems (100 µm HA and 50 µm titanium) were followed over a mean of 34.9 and 23.2 months respectively. RESULTS: Four proximally-coated (rate: 1.61%) and five fully-coated stem revisions (rate: 2.20%) were reported, with no statistical difference between groups (p = 1.0, OR 0.90, 95% CI 0.20-3.97). Registry data showed no difference in performance between fully-coated and proximally-coated stems nationwide (rate: 2.22%, p = 0.82). CONCLUSION: There is no statistical difference in survival between fully-coated and proximally-coated HA prostheses in the short-term.

Gods behaving badly.

This paper addresses the myths surrounding the birth and death of Asclepios, the popular healing God of the Greeks and his place among other deities of the Greek Pantheon. The enigmatic invocation of Asclepios by Socrates, the Athenian philosopher condemned to take the hemlock, in his final moments is also discussed.

Treatment readiness, attitudes toward, and experiences with methadone and buprenorphine maintenance therapy among people who inject drugs in Malaysia.

BACKGROUND: Little is known about attitudes toward and experiences with opioid maintenance therapy (OMT) among people who inject drugs in Malaysia, a country where people who inject drugs comprise 1.3% of the adult population. METHODS: In 2010, 460 people who inject drugs in Greater Kuala Lumpur, Malaysia were surveyed to evaluate attitudes toward and experiences with OMT and treatment readiness. Attitudes towards OMT with both methadone and buprenorphine were assessed using an opinions scale. Multivariable linear regression was used to assess correlates of treatment readiness, measured with the 19-item Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). RESULTS: All 460 participants used opioids and nearly all (99.1%) met criteria for opioid dependence. Few had had previous experience with methadone (9.3%) or buprenorphine (12.6%) maintenance therapy, yet many had used methadone (55.2%) or buprenorphine (51.7%) outside of treatment settings. Fifteen percent had injected buprenorphine in the past month, and of the few that were currently receiving buprenorphine maintenance therapy, almost all were injecting it. The majority of subjects exhibited a moderate level of treatment readiness and a preference for methadone over buprenorphine. Those with low treatment readiness scores were more likely to have previous experience with compulsory drug detention centers (p<0.01), needle/syringe exchange programs (p<0.005), or be of Indian ethnicity (p<0.001). Past use of methadone (p<0.01), older age (p<0.001), higher stress symptom severity (p<0.001), and sharing of needles or syringes (p<0.05) were associated with higher treatment readiness scores. CONCLUSION: There are suboptimal levels of OMT experience among people who inject drugs that may be improved by addressing factors that influence patient attitudes. Those individuals with moderate treatment readiness may be targeted by brief motivational and cognitive interventions in primary care, prisons or OMT clinics aimed at improving entry into and retention in treatment.

A retrospective diagnosis of epilepsy in three historical figures: St Paul, Joan of Arc and Socrates.

It has been suggested that undiagnosed epilepsy profoundly influenced the lives of several key figures in history. Historical sources recounting strange voices and visions may in fact have been describing manifestations of epileptic seizures rather than more supernatural phenomena. Well-documented accounts of such experiences exist for three individuals in particular: Socrates, St Paul and Joan of Arc. The great philosopher Socrates described a 'daimonion' that would visit him throughout his life. This daimonion may have represented recurrent simple partial seizures, while the peculiar periods of motionlessness for which Socrates was well known may have been the result of co-existing complex partial seizures. St Paul's religious conversion on the Road to Damascus may have followed a temporal lobe seizure which would account for the lights, voices, blindness and even the religious ecstasy he described. Finally, Joan of Arc gave a detailed narrative on the voices she heard from childhood during her Trial of Condemnation. Her auditory hallucinations appear to follow sudden acoustic stimuli in a way reminiscent of idiopathic partial epilepsy with auditory features. By analysing passages from historical texts, it is possible to argue that Socrates, St Paul and Joan of Arc each had epilepsy.

Greek underpinnings to his methodology in unraveling De Motu Cordis and what Harvey has to teach us still today.

William Harvey's writings betray amazing insights born out of countless hours of thoughtful experimentation. Throughout his life, Harvey worked as a tireless and thoughtful researcher and a transmitter and intermediary between the ancient Greek natural philosophers and physicians and the "moderns," for whom he founded two forward-looking, interlinked sciences: modern physiology and nascent cardiology. Harvey's methodology and demonstrations were of such fundamental and standardizing nature as to secure the sure progress of these two sciences. Thus, he rendered to them such a service as Descartes's cogito ergo sum furnished to Philosophy in giving it a rational standard of certainty, for want of which the more speculative minds of that era were inundated with extraordinary conjectures. If Harvey disproved Galen, he absorbed and continued in his physiologic research many a principle from Aristotle, whose supreme disciple he remains. The guidance and authority of Aristotle were strong with him to the end. Harvey's account of the motions of the heart and blood in the circulation demonstrated that complex physiological systems can be represented in straightforward mechanical terms, a concept which has remained fundamental to the present day. The philosophical implication of William Harvey's discovery of the circulation of the blood was the resolute application of the experimental method to cardiology. In my judgment, he established today's forward-looking discipline of translational cardiovascular research. In due course, he should be widely acknowledged to have done so.