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Science and medicine are permeated by metaphors. Generated by every domain of human experience, these metaphors embed scientific and medical thought in historically specific times, places, experiences, issues, attitudes and cultures. We will explore the dynamics of metaphorical thinking and examine such specific examples as “The Great Chain of Being,” Darwin’s “struggle for existence” and “natural selection,” the “reflex” from Descartes to Pavlov to cybernetics, body and mind as clock, factory and computer; illness as imbalance and invasion, and the metaphorical associations of tuberculosis and cancer.