There is a notion that progress in our knowledge is made gradually with the slow accretion of information, with bricks of information being added slowly to build the edifice of knowledge. Ideas are refined and improved, additional data, whether about the pathogenesis of a disorder or the result of treatment trials, add to the whole. But this is not the only way. Sometimes new ideas arrive and knock down the edifice, something Thomas Kuhn referred to as a ‘paradigm shift’ in his seminal work, ‘The structure of scientific revolutions’.1 The history of science has many well-known examples, perhaps most famously those involving Copernicus, Kepler, Newton and Einstein. Once shifted, the work of building knowledge restarts, but on different foundations. Within neurology, such a shift has occurred in the understanding of encephalitis. Encephalitis has moved from being considered the result of an infective disorder—relating to …

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本期亮点

有一种观点认为，我们的知识进步是随着信息的缓慢增长而逐渐取得的，信息的砖块是缓慢添加以构建知识大厦的。想法得到提炼和改进，额外的数据，无论是关于疾病的发病机制还是治疗试验的结果，都会增加整体。但这不是唯一的方法。有时新的想法会出现并摧毁这座大厦，托马斯·库恩在他的开创性著作《科学革命的结构》1中称之为“范式转变”。 科学史上有许多众所周知的例子，也许最著名的是那些涉及哥白尼、开普勒、牛顿和爱因斯坦。一旦转移，构建知识的工作就会重新开始，但在不同的基础上。在神经病学中，对脑炎的理解发生了这种转变。