David Ingram

Published On


Page Range

pp. 69–192


  • English

Print Length

124 pages

2. Knowledge, Language and Reason

From Ancient Times to the Information Age

  • David Ingram (author)
The story starts long ago, with the gradual conceptualization of knowledge as an encyclopaedia—a circle of learning. This chapter traces a path from the invention of medicine in classical times, through philosophy, language and logic, and through mathematics, natural science and computer science into the modern era of information technology and health care. It follows the librarian’s dilemma over the ages—discovering how best to position books and documents within collections and search them in pursuit of learning.

The chapter proceeds to consider languages as expressions of knowledge, and the different forms they take—spoken, written, artistic, mathematical, logical and computational. This sets the scene for introducing computational discipline that grew from endeavours to formulate rigorous logical foundations of mathematics, in earlier times, and the development of formal logic in support of rigorous reasoning. From there, the computer has become integral to how we express and reason with knowledge, and to problem solving and the discovery of new knowledge. These are twenty-first-century frontiers of machine learning and artificial intelligence.

Moving to the complex world of medical language and terminology, used in representing knowledge about medicine and health care, the chapter discusses difficulties faced in evolving their corpora of terms and classifications, from pragmatic organizations into reliably computable forms. Notable pioneering initiatives and their leaders are profiled, highlighting some ideas that have acquired staying power and others that have not, looking for patterns of success and failure.

Finally, the chapter moves to a discussion of some pioneering computer-based systems for capturing, storing and reasoning with medical knowledge, such as for guiding the prescription of antimicrobial drugs. It closes with a light-hearted take on how we use the terms knowledge, information and data, and a reflection on the traction that is needed in the unfolding of new knowledge and its application in practical contexts.


David Ingram


David Ingram’s career from 1967 spanned posts in industry, the NHS and University Medical Schools. After undergraduate physics at Oxford and several years in the medical engineering industry, he studied computer science and completed doctoral research on the mathematical modelling of biological systems, at University College London. His first academic post was at The Medical College of St Bartholomew’s Hospital, London, from 1975, where he was appointed Professor of Medical Informatics in 1990. From 1995-2011, he was the founding Director of the UCL Centre for Health Informatics and Multiprofessional Education (CHIME). David participated as partner and reviewer in UK Research Council, NHS, national e-Science and EU Health Informatics programmes and projects, including leading the EU GEHR Project (1991-94). This laid the foundations for the ISO-adopted openEHR specifications for a novel, vendor and technology neutral method for standardising the design of electronic health records, now being taken forward internationally by the openEHR.Foundation, of which he is the Founding President and Chairman of the Board of Governors. He is a founding Trustee of the OpenEyes Foundation, which is developing and marketing opensource software for ophthalmology, now providing the care record for 40% of UK patients. In retirement since 2010, he is focused on keeping well – eg by learning and using a new language, tracking lively grandchildren, following new physics, and learning to dance properly! Recently, he has become active in promoting a novel new technology to provide prescription glasses at very low cost for the developing world, where their lack causes extreme hardship.