Answering the call made by Frederic L. Holmes to introduce the concept of the longue durée in the history of science and medicine, this essay sets out to weigh the pros and cons of the concept for the field. It argues that four genres (or traditions) can be distinguished in medical historiography, each with their own ambitions, methods, perspectives and audiences. It concludes by calling for articulated and lively debate between the protagonists of the different genres as the royal way (...) to historical understanding. (shrink)