The article describes the occurrence, improvement and importance of the clinical case history as the main medical, scientific and judicial health care document and emphasizes the outstanding role of domestic physicians and scientists in its creation. The problem of professional medical culture in the context of the evolution of Russian medical sublanguage and the development of modern means of medical communication is discussed. The clinical case history can reliably serve as an objective evidence of the medical doctor’s culture: neatness, thorough and detailed management, competent written language, legible medical handwriting, the ability to think logically and write epicrises. The role of the functioning of the professional sub language of the health care system as a part of the Russian state language and the urgent need to create normative medical dictionaries are emphasized. [12 figures, bibliography - 63 references].