What does it mean to know something in medicine? In this episode, we’ll explore this question by developing a historical framework of medical epistemologies in a journey that involves King Nebuchadnezzar, citrus fruit, leeches, water pumps, ICD-10, Socrates, skepticism, and 1970's computer programs designed to replace doctors. This is a version of a Grand Rounds given at BIDMC on October 25, 2019.    Sources:   Bothwell LE et al, “Assessing the Gold Standard -- Lessons from the History of RCTs,” NEJM June 2, 2016. Khushf G, “A Framework for Understanding Medical Epistemologies,” Journal of Medicine and Philosophy, 38: 461-486, 2013. Guyatt G and Tonelli M, Med Roundtable Gen Med Ed.;June 13, 2012 1(1): 75 - 84. Morabia A, A History of Epidemiologic Methods and Concepts, 2004. Tonelli MR, “Integrating evidence into clinical practice: an alternative to evidence-based approaches,” Journal of Evaluation in Clinical Practice, 12(3) 248-256.   Music from https://filmmusic.io "Tango de Manzana" and “Return of the Mummy” by Kevin MacLeod (https://incompetech.com) License: CC BY (http://creativecommons.org/licenses/by/4.0/)