「心身医学は，全人的医療に展開しなくてならない」は，米国のシカゴ大学教授で，心身医学の先人フランツ・アレキサンダーや我が国の池見酉次郎(九州大学教授)に共通の展望である．全人的医療や患者中心医療は，耳あたりのよいことばであるがゆえ，多くの大学や病院がミッションとして掲げているが，実践している医療施設は少ない．我が国には，橋田邦彦が戦前から全機的医療を唱えたように，多くの蓄積がある．一方，総合診療医の育成が叫ばれている．総合診療医は，まず全人的医療が実践できなくてはならない．以下の要件が必須になる．教育・研究・実践のための大学院大学の設置が望まれる．

1. パソジェネシス，サルトジェネシスの相互主体的鼎立

2. 患者の生活者としての理解(intrapersonal communication)

3. 誕生から死までの連続性の中での患者理解

4. 機能的病態(機能性身体症候群：FSS)の積極的診断・治療

5. 器質的病態の早期診断，専門医療への紹介，副作用低減のための補法の適応

6. 致死的病態へのケア

7. チーム医療のリーダーシップ

8. 医師―患者関係の構築(interpersonal communication)

9. 患者の行動変容のための患者教育

10. 臨床研究

11. 自己研鑽：健康哲学・医療哲学・死生学・医療倫理学

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In the United States, where the federal government is only moderately committed to cultural development, private sector entities function as support groups for cultural affairs. Corporations and foundations are major funding sources for museums. Although private sector money has a direct and sometimes enormous effect on collections, the participation of corporations and foundations in shaping history museum exhibitions and educational programs has been overlooked in museum studies. This article examines this critical and complementary history museum - private sector connection by focusing on the 2000 acquisition process for the George Washington Lansdowne portrait at the National Portrait Gallery. The NPG exhibits the history of the United States through portraits of extraordinary people. As part of the Smithsonian Institute, 60 to 70% of the NPG’s budget comes from the US government and the rest is raised through its own efforts. In other words the NPG is a quasi-governmental entity.

NPG acquired the Lansdowne portrait with the support of a private foundation. This full-length portrait painted by Gilbert Stuart in 1797 was a gift from a Philadelphian merchant to the Marquis of Lansdowne. It had been on loan to the NPG since the gallery’s opening in 1968. In the fall of 2000, the British owner of the work suddenly announced to the NPG that he would auction the painting unless the gallery purchased it. The NPG made a public appeal, describing the situation to potential donors as a national crisis. As a result, the Nevada-based Donald W. Reynolds Foundation saved the Lansdowne portrait from what they considered to be a patriotic crisis. Through the course of the purchase process, a painting that had been in a foreign collection for two centuries was transformed into a “national icon” and eventually a “national treasure,” revered as an equal to the Declaration of Independence and the Stars and Stripes. This private funding process not only saved the painting, it also altered its status.

It must also be noted that 9/11 changed the meaning of this portrait. George Washington has been endowed with various qualities through the centuries: he has been seen as everything from demi-god to ordinary father. Then, as symbolized by the fire fighters’ self-sacrificing behavior at Ground Zero, post 9/11 society came to view the Lansdowne Washington portrait as an image of a great self-sacrificing figure who led and saved a young nation.

As part of the process of receiving the considerable funds needed for the acquisition, the Lansdowne portrait went from being a loaned work displayed among other portraits to a national treasure and representation of patriot self-sacrifice. These changes result from the integrated and complementary collaboration between the NPG and a private foundation, a situation completely unlike the general perception of a hostile relationship between public and private interests. The Lansdowne acquisition case reveals how the private sector is not a mere funding source, but rather is a vital participant in the shaping and interpretation of history at museums.

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When Thomas Paine wrote a pamphlet in Philadelphia to justify and encourage the revolutionary war, it was entitled Common Sense by Benjamin Rush, a Continental Congressman who had studied medicine in Edinburgh under Willam Cullen. Since Cullen was quite familier with the literati of the Scottish Enlightenment including such pioneers of the common sense school of philosophy as Lord Kames, Thomas Reid, and Dugald Stewart, their vocabulary might have been popular among medical students. Thus it is almost certain that Rush took the words common sense from the Scottish Enlightenment to give it to Paine's pamphlet. However, by this trans-Atlantic transfer the word changed its meaning from conservative to radical. Needless to say Paine's common sense was that of the American common peope longing for independence whereas in the Scottish origin it was the common sense of those men of taste who were vehemently attacking the revolting colonies.
Although it is an open question how clearly Rush was conscious of the total change of the meaning of the words, it might have been that he had at least a vague idea of the change before he met Paine. He wrote that he introduced Paine to the revolutionary cause to which he had joined earlier. He had been a regular member of Catharine Macaulay's salon in London. In any case, he later clearly denied the universal validity of common sense. He critisized Cullen's Greco-worship in medicine and even the personal worship towards Cullen himself. Thus Rush changed his attitude towards common sense twice, that is say, first as a revolutionary and secondly as an empirical scientist in medicine. He was a surgeon in the revolutionary war, and a medical practitioner and professor after the war. True he was a empirical scientist he has never doubted Christianity.

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