Site Logic


This site is an unusual literary form. It is not a blog site, but a collection of essays which will eventually cover all or most of kidney stone disease. The essays are linked, and in perpetual evolution. Each one is longer and deeper than what I would have written on the specific topic in a standard book or review article.

I have gathered here some articles bearing on science in general, and using kidney stones as a special instance.

They are the philosophical basis for the site, and also a key to how many of the articles are composed.

I know few people read these, and understand why. But for those few I am happy.

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Pieter Brueghel the Elder [Public domain], via Wikimedia Commons

Why Science Matters DRAFT – NOT COMPLETE AT THIS POINT What Am I Writing About? About medicine, all we know of any practical consequence more than what was said in Babylon comes from science as practiced in the West since Harvey and Galileo. And, of all topics in medicine, my rather global and presently unsupported assertion applies remarkably to our common project here, the prevention of kidney stones. To say this more exactly, rational, modern, effective kidney stone prevention arises naturally from knowing what crystals make kidney stones and what forces drive such crystals to form. Prevention arises from cause, cause from science. Why Am I Writing This? Few would doubt that science drives medical progress, so why have I … Continued

I have no illusions this will have mass appeal, but the topic is important and many patients may have an interest in how medicine and science work together in general and in this disease as a particular example. Unlike the rest of this site where I am redacting and elaborating well known themes, here I am forced into originality by the general poverty of writing on the subject. For those who like this kind of writing, the Site Logic Page is its natural home. For those who do not – no doubt a vast majority – pass by.

I have alluded to objectives in my discussion of applied, basic, and empirical science, which was a good place for their first mention but too narrow for a proper exposition. They are in the first case an expression of need, in the second case of desire, and in the third arise from perhaps an altogether different source. Here I am concerned with objectives of applied medical science. CLASSES OF NEEDS What can be the perceived needs of medicine but treatments, prevention, tests – to aid diagnosis or prognosis, methods, techniques and devices? EXAMPLES OF EACH CLASS Consider a patient with calcium oxalate stones not due to systemic disease, ‘idiopathic’ stones. Treatments This refers to stones present; they are there and surgeons need … Continued

WHAT IS THE QUESTION? I understand that some physicians are skilled basic scientists, and that many physicians enjoy reading about basic science. But how does a knowledge of basic science benefit the patients of physicians who have such knowledge? There are two parts to this question. How can being a basic scientist benefit a physician in the practice of medicine, and how can a knowledge of the results of basic science benefit a physician in the practice of medicine. Of these two, I mean to consider only the second: How does a knowledge of basic science results benefit the practice of medicine. Of course, here, I mean practice of medicine concerned with kidney stones – the disease within the province of this site … Continued

Three Sciences of Medicine Certainly we all agree that modern medicine takes its power from science. One kind of science concerns how we can do things. Let me call it ‘applied science’ for want of a name. The other kind concerns how nature does things. This is often called ‘basic science’ or ‘natural science’. Drug development and drug trials are obvious examples of the first. Mechanisms of disease are examples of the second. These statements are so obvious I hesitate to make them, yet in such phrases as ‘evidence based medicine’, ‘basic vs. applied science’, ‘personalized medicine’, and ‘translational research’ the distinction, itself perfectly clear, can blur. If basic science seeks to learn how nature does things, empirical science seeks to … Continued