Principles and practices of medicine

The medical textbooks in our university library present ‘principles’ as the basis which underlies medical ‘practice’. In this article it is argued that this helps different medical logics to co-exist. The example analyzed is that of anemia in the Netherlands. Currently this is defined pathophysiologically, statistically and clinically. These three definitions are intertwined with different strategies for the creation of normal hemoglobin levels and the detection of patients with anemia. The discrepancies between them, however, do not lead to the controversies that might be expected by those who believe in consistency. Instead, the rhetoric of principles-and-practice helps to bring about peaceful co-existence.