John A. Ryle

Social Medicine: Its Meaning and its Scope

There has been much discussion in the medical journals and the daily press in recent months as to the purport and prospects of social medicine. In the minds of some of the profession there would appear to linger a confusion of thought as to the meaning of the term ; some uncertainty even as to the underlying ideas which have prompted the discussion. The laity and members of the social services and student bodies are eagerly seeking enlightenment; less harassed and preoccupied and, perhaps, more hopeful of the future than the overworked doctor, they have sometimes appeared more receptive and understanding than the profession whose intimate concern these ideas must shortly become. The prevailing uncertainties would seem to be based upon two main misconceptions: (1) that social medicine is just another name for preventive medicine as we now know it, and (2) that social medicine and socialized (or State) medicine are synonymous. It seemed to me that it might be helpful to trace the sources of these misconceptions and to attempt a brief account of what the actual meaning and objectives of social medicine are in the view of those who have, for longer or shorter periods, insisted on the need for an evolutionary change in much of our general teaching, philosophy, tsnd practice.

The Science of Health

For my annual wartime lecture I have chosen on this occasion a subject which, curious though it may seem, finds no special place or mention in the curriculum. Medicine is primarily concerned with the observational study (with a view to its relief) of disease at the bedside, in the consulting-room or clinic, and in the laboratory. Disease also has its own science of Pathology, which is concerned with the more intimate laboratory investigation of its causes, processes, and consequences. But, notwithstanding that the study of health would seem to be the proper preliminary to the study of disease, we find no counterpart to medicine, no parallel observational science devoted to the fireside or field-side or laboratory study of health. Nor is there a science comparable to pathology which deals with the more intimate causes, processes, and consequences of health.