Singularities and Universals: The Historical Roots of Case Reports and Clinical Trials in Biomedical Literature

This manuscript examines the historical underpinnings of two prominent genres in biomedical literature: the individualized case report and the systematically averaged clinical trial. Although both are fundamental to clinical science, their intellectual origins reflect divergent approaches to the study of nature. Tracing these approaches back to classical antiquity, we find Hippocratic medicine valuing detailed observations of individual patients, a focus later enriched by the Renaissance fascination with wonders and anomalies, known as paradoxography. In contrast, medieval Aristotelian science, with its emphasis on the regularities and universal laws of nature, provided a philosophical foundation for the development of population-based methodologies. We argue that these two traditions—one celebrating the exceptional case, the other seeking aggregate evidence—continued to shape scientific inquiry through the Middle Ages and into the Scientific Revolution. The dialectic between them can still be observed in modern biomedical writing: case reports give voice to rarities and novel phenomena, while clinical trials aim for reproducible, generalized knowledge. By exploring the historical, philosophical, and methodological roots of these genres, we gain insight into how scientific culture has balanced the importance of singular marvels with the necessity of robust statistical evidence. This balance remains central to contemporary medical research and practice.