[Medicine: art or science?]

The question of how science, medicine and medical practice are related also compromises the crucial issue of the character of medicine. At the beginning of the 19th century, medicine tried to overcome the ancient contradiction within the unity of scientific thought and the deduction of guidelines and techniques for medical practice. This aim was partly achieved in medico-theoretical reasoning and practical procedures as well as for nosology, casuistic thinking and diagnostics. But medicine is a discipline directed towards healing. So the intentions of medicine and the reality of clinical healing possibilities, however, showed an increasing divergence since the middle of the 19th century. This divergence triggered considerable reactions not only from "Schulmedizin" and from other disciplines but also from practicing doctors and mainly from (disappointed) patients. Together with the continuous changes in empirical clinical research these internal and especially external reactions to medicine showed fundamental differences between medicine and the sciences. During the decades of this development it has become obvious that medicine will never become a pure science, not even an applied science. As medicine is concerned with patients who need to be considered as individual subjects, medical knowledge and medical practice consequently form a dialectic unity which is directed by the patient as a subject.