The germ theory of disease famously brought a new notion of specificity into concepts of disease. At the same time, the work of Pasteur, Koch and their colleagues was developed during the same decades as Charles Darwin's theories of evolutionary biology challenged traditional notions of the essentialism of biological species. This essay examines some of the ways in which Darwin's work was invoked by British doctors seeking to explain clinical or epidemiological anomalies, in which infectious diseases did not (...) appear to breed true. (shrink)

In this paper, I examine the transition from zymotic views of disease to germ views in Britain in the mid-1800s. I argue that neither realist nor anti-realist accounts of theory-change can account for this case, because both rely on a well-defined notion of theory, which, as the paper will show, is inapplicable in this instance. After outlining the zymotic theory of disease, I show that, even though it hardly had anything in common with the germ (...) theory, it was highly successful. However, despite this success, it is not possible to identify stable elements that were carried over to the germ theory; thus, realists cannot account for the shift from one to the other. Anti-realists, however, don’t do much better: their focus tends to be on (radical) discontinuities across theories, yet the zymotic case does not exemplify this, either. Instead, there is a slow and complex evolution from zymotic to germ views, during which various zymotic elements are assimilated into the germ theory, until, eventually, none of the zymotic theory’s original elements are left. (shrink)

By contrasting Hippocratic and nineteenth century theories of disease, this paper describes important conceptual changes that have taken place in the history of medicine. Disease concepts are presented as causal networks that represent the relations among the symptoms, causes, and treatment of a disease. The transition to the germ theory of disease produced dramatic conceptual changes as the result of a radically new view of disease causation. An analogy between disease and fermentation was important for two of the (...) main developers of the germ theory of disease, Pasteur and Lister. Attention to the development of germ concepts shows the need for a referential account of conceptual change to complement a representational account. (shrink)

Evolutionary theory coheres with its neighboring theories, such as the theory of plate tectonics, molecular biology, electromagnetic theory, and the germ theory of disease. These neighboring theories were previously unconceived, but they were later conceived, and then they cohered with evolutionary theory. Since evolutionary theory has been strengthened by its several neighboring theories that were previously unconceived, it will be strengthened by infinitely many hitherto unconceived neighboring theories. This argument for evolutionary theory (...) echoes the problem of unconceived alternatives. Ironically, however, the former recommends that we take the realist attitude toward evolutionary theory, while the latter recommends that we take the antirealist attitude toward it. (shrink)

I argue that neither realist nor anti-realist accounts of theory-change can account for the transition from zymotic views of disease to germ views. The trouble with realism is its focus on stable and continuous elements that get retained in the transition from one theory to the next; the trouble with anti-realism is its focus on the radical discontinuity between theories and their successors. I show that neither of these approaches works for the transition from zymes to germs: (...) there is neither continuity nor discontinuity, but, instead, a gradual evolution from zyme to germ views, during which germ elements are slowly incorporated into zymotic views until, eventually, none of the original zymotic constituents are left. I argue that the problem with both realism and anti-realism is that they rest on the unwarranted assumption that there are clearly delineated zymotic and germ theories as well as arguments for and against these theories, an assumption that does not hold. (shrink)

In this paper, I enquire whether there are Kuhnian paradigms in medicine, by way of analysing a case study from the history of medicine—the discovery of the germ theory of disease in the nineteenth century. I investigate the Kuhnian aspects of this event by comparing the work of the famous school of microbiology founded by Robert Koch with a rival school, powerful in the nineteenth century, but now almost forgotten, founded by Carl Nageli. Through my case study, I (...) show that medical science possesses some Kuhnian features. Within each school, scientists used similar exemplars and shared the same assumptions. Moreover, their research was resistant to novelty, and the results of one party were disregarded by the other. In other words, in a moderate sense, the Koch and Nageli groups worked within distinct paradigms. However, I reject the stronger Kuhnian claim that the terms used within the two paradigms were mutually unintelligible. Focusing on the semantic aspects, I argue that no account of incommensurability of reference can be given in this case, although, for sociological reasons, the two parties talked past each other. I suggest in addition that the rival scientists could have understood each other more easily if their theoretical commitments had not been so deeply ingrained, and I use the example of Pasteur to indicate that the causal account of meaning might have avoided the communication breakdown. (shrink)

The human microbiome is changing the way experts and non-experts think about germs and microorganisms. This essay is a gender analysis of contemporary discourses surrounding the human reproductive microbiome, specifically the vaginal microbiota and the penile microbiota. I first historically situate the human reproductive microbiome within the germ theory of disease. Then, I draw on Heather Paxson’s Foucauldian and Latourian concept of microbiopolitics to argue that microbiopolitics is not only about how humans should live with microorganisms; but it (...) also impacts how humans and microbes live together as gendered beings. I illustrate this gendering through two figures: the microbial mother and the independent organ. (shrink)

What are the effects of our environment on human development and the next generation? Numerous studies have provided ample evidence that a healthy environment and lifestyle of the mother is important for her offspring. Biological mechanisms underlying these environmental influences have been proposed to involve alterations in the epigenome. Is there enough evidence to suggest a similar contribution from the part of the father? Animal models provide proof of a transgenerational epigenetic effect through the paternal germ line, but can (...) this be translated to humans? To date, literature on fathers is scarce. Human studies do not always incorporate appropriate tools to evaluate paternal influences or epigenetic effects. In reviewing the literature, I stress the need to explore and recognize paternal contributions to offspring's health within the Developmental Origins of Health and Disease hypothesis, and coin this new concept the Paternal Origins of Health and Disease paradigm. A better understanding of preconceptional origins of disease through the totality of paternal exposures, or the paternal exposome, will provide evidence-based public health recommendations for future fathers. A father's hereditary contribution exceeds that of his DNA sequence. The environment can regulate systems such as the sperm epigenome, which is inheritable as well and may steer the genome and health status of his offspring. We here suggest a new concept, the Paternal Origins of Health and Disease, as part of the DOHaD theory. (shrink)

At the end of the 19th century, medical research in the United States was descriptive and rudimentary. American physician-investigators were primarily defining and categorizing disease entities. However, seeds of more mechanistic research had been laid in Europe, particularly in Germany, including the germ theory of disease etiology resulting from Pasteur and Koch's discoveries and the detailed descriptive pathology of the human body by Virchow and others. Prior to World War I, a graduate of an American medical school with (...) an interest in research commonly spent time in a laboratory of a productive European investigator. This European influence on American medicine and medical research was greatly respected, and a .. (shrink)

The dual role of microbial communities as either beneficial/functional or harmful/pathogenic involves two issues concerning causality in physiology and medicine, etiology of disease, and the notion of function in biology. Causal explanation formulated by the germ theory of disease and the Koch postulates connects the existence of a specifically identified microbe to disease by the isolation and identification of a pathogen from an organism with the disease and the successful infection of a healthy individual. Similarly, microbiome research in (...) medicine centers on taxonomic composition in correlation with physiological conditions and germ-free mice experimentations to establish causal connections. However, because the microbiome is an ecological community, it lacks the specificity of identification assumed in the germ theory. Furthermore, the ecological aspects within and between microbiomes such as background conditions, microbial interactions, and interdependence, are treated as confounding. Looking at ecological studies, the causal explanations are less specific regarding complex systems with their processes of interactions. This article makes the following two points: One is that microbiome causality in the host should be understood similarly to the microbiome causality in an ecosystem. The second is that if considering a microbiome’s causality in the host as an ecosystem, its etiological explanation needs to be revisited to include a heterogeneous and mutual notion of interactions. Finally, according to the second point, the notion of function in ecology with its relevant notion of causality should be considered accordingly. (shrink)

Throughout the 19th century and early decades of the 20th century, milk was a dangerous food that required state intervention to make it safe. Throughout this period, the germ theory of contagious disease came to prominence, but could not explicitly determine the causal relationships linking germs, milk, and human illness. Using the notion of an ideational regime, I examine how (1) knowledge claims move from uncertainty to certainty and become privileged claims within ideational regimes that (2) result in (...) an unintended, but necessary deployment of a biopolitical strategy for governance. The argument here is that theoretical uncertainty meant managing populations as a uniform undifferentiated reality using pasteurization technologies. I use two historical moments as evidence of these processes. The first is the 1901 British Congress on Tuberculosis when I argue germ theory came to a theoretical standstill and the second is Ontario’s 1938 amendment to the province’s Public Health Act that permanently institutionalised province-wide compulsory pasteurisation laws organised around the notion of nutritional equivalency. This genealogical exploration should provide some insight into how bacteria became the singular cause of illness and into the conditions that led to targeting milk as the main site of intervention instead of treating individual bodies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:238 HISTORY OF PHILOSOPHY that enigmatic Swiss iatrochemist sympathetically. In any event, Dr. King's sympathetic approach to Paracelsus manages to throw considerable light on the Paracelsian advice to all future physicians: Don't read books! Read the stars, but read them "in Neo-Platonic fashion" (p. 114)! While the author is "judicious" about Galen and Paracelsus in particular, he is far from being so when it comes to Friedrich Hoffmann, a (...) medical materialist and "systematist" from Halle in the eighteenth century. Paradoxically enough, Dr. King has a marked antipathy for the doctor of "sympathy " himself (p. 173). Incidentally, the only other physician in the book who is not liked--apparently for his being polemical (p. 215)--is a famous fellow-pathologist of the last century, Rudolf Virchow. Still, it is only fair to add that the author acknowledges fully Virchow's important contributions to the field of cellular pathology. Finally, Dr. King not only has his likes and dislikes as to the medical men he actually selects from modern medicine to represent changes in theory of disease, but he seems also to have a definite bias in another and more serious sense. With the exception of the Epilogue and Chapter IV, which includes Vesalius and Harvey as well as Hoffmann, all the episodes of modern medicine deemed worthy of study derive from the Germanic world. Curiously enough, although there is no discussion of the germ theory of disease as such in the book, there is mention of Koch, but not of Pasteur. And French physiologist Claude Bernard, the great medical philosopher who tried to do in the nineteenth century for scientific medicine what American pathologist Lester King is attempting in the twentieth, is conspicuous by his absence in The Growth of Medical Thought. PATRICKROMANELL University of Oklahoma Siimtliche Werke von Plato. (Reinbeck b. Hamburg: Rowohlt, 1959-1963. 6 volumes -- Rowohlts Klassiker der Literatur und der Wissenschaft. Griechische Philosophie.) Diese Taschenbiicherausgabe enth~ilt die meisten der von Schleiermacher iibersetzten Dialoge und ffigt die Briefe, den Timaios, den Kritias und die Nomoi in der Obersetzung von H. und F. H. Miiller hinzu. Die Ordnung entspricht offenbar der von den Herausgebern (W. F. Otto, E. Grassi und G. Plamb/Sck) angenommenen chronologischen Reihenfolge. Ausgelassen sind: Minos, Alkibiades H und Theages, Nebenbuhler, Kleitophon und die Epinomis--offenbar weil sie die Herausgeber fiir unecht halten. Die Obersetzung einer Reihe von Dialogen (bes. Parmenides, Politikos, Philebos, Timaios, Kritias) wurde einer Durchsicht unterzogen; leider teilen uns BOOK REVIEWS 239 die Herausgeber nicht mit, von wem. Jedem Dialog geht eine Gliederung voran; jeder Band ist mit einer recht brauchbaren Bibliographie versehen. Es ist erstaunlich zu erfahren, dass der erste Band, erstmalig in 1957 erschienen, in 1963 eine Auflage von 78000 erreicht hat; bleiben auch die Auflageziffern der fibrigen B~inde dahinter zurfick, so sind sie doch genfigend eindrucksvoll. Man wfinscht, der Verlag m6chte doch, durch diesen Erfolg ermutigt, das nach Obgesagtem noch Fehlende--und dazu noch Platons Gedichte--in einem Erg~inzungsband bringen, wie immer man fiber die Echtheit der Stficke denkt. Der stilistische Unterschied zwischen den ~bersetzungen von Schleiermacher (erstmalig: 1804-1810) und von H. und F. H. Mfiller ist ausserordentlich. Dies ist nicht etwa auf die gr6ssere Sprachmeisterschaff Schleiermachers zurfickfiihren. Vielmehr liegt seiner Obersetzungsmethode eine h6chst interessante Theorie zugrunde (die F. A. Wolff, der Schleiermachers ~bersetzung verhShnt und Wilamowitz, der sie als ungeniessbar bezeichnet hatte, offenbar unbekannt war). Dieser Theorie zufolge ist es die Aufgabe des ~2bersetzers, den Leser besffindig daran zu erinnern, dass er nur eine l~bersetzung vor sich hat. Einem ~bersetzer, der sich brfistet, dass sich sein Text so liest, wie ihn der Autor geschrieben h~itte, wenn er in der Sprache des ~bersetzers und seines Publikums gedacht h~itte, sollte erwidert werden "Daffir bin ich dir so dankbar, wie ich es w~ire, wenn du mir das Bild eines Mannes zeigtest und sagtest--So wiirde er ausgesehen haben, wenn ihn mit seiner Mutter ein anderer Vater gezeugt h~tte." In anderen Worten: da sich Inhalt und Ausdruck nicht abtrennen lassen, sollte der f2bersetzer, start das Original seiner Sprache anzueignen, vielmehr--wir gebrauchen hier den bekannten Brechtschen Begriff--im Leser einen Verfremdungseffekt erzeugen. Wie man sieht, ist Schleiermachers ~3bersetzungstheorie jeder "rationalistischen " strikte... (shrink)

The theory stating that oxidative stress is at the root of several diseases is extremely popular. However, so far, no antioxidant is recommended or offered by healthcare systems neither approved as therapy by regulatory agencies that base their decisions on evidence-based medicine. This is simply because, so far, despite many preclinical and clinical studies indicating a beneficial effect of antioxidants in many disease conditions, randomised clinical trials have failed to provide the evidence of efficacy required for drug approval. In (...) this review, we discuss the levels of evidence required to claim causality in preclinical research on OS, the weakness of the oversimplification associated with OS theory of disease and the importance of the narrative in its popularity. Finally, from a more translational perspective, we discuss the reasons why antioxidants acting by scavenging reactive oxygen species might not only prevent their detrimental effects but also interfere with essential signalling roles. We propose that ROS have a complex metabolism and are generated by different enzymes at diverse sites and with different timing. Aggregating this plurality of systems in a single theory of disease may not be the best way to develop new drugs, and future research may need to focus on specific oxygen-toxifying pathways rather than on non-specific ROS scavengers. Finally, similarly to what is nowadays required for clinical trials, we recommend making unpublished data available in repositories, as this will allow big data approaches or meta-analyses without the blinders of the publication bias. (shrink)

Not long ago, a colleague chided me for using the term "the biological revolution. " Like many others, I have employed it as an umbrella term to refer to the seemingly vast, rapidly-moving, and fre quently bewildering developments of contemporary biomedicine: psy chosurgery, genetic counseling and engineering, artificial heart-lung machines, organ transplants-and on and on. The real "biological revo lution," he pointed out, began back in the nineteenth century in Europe. For it was then that death rates and infant mortality (...) began to decline, the germ theory of disease was firmly established, Darwin took his famous trip on the Beagle, and Gregor Mendel stumbled on to some fundamental principles of heredity. My friend, I think, was both right and wrong. The biological revolution did have its roots in the nineteenth century; that is when it first began to unfold. Yet, like many intellectual and scientific upheav als, its force was not felt for decades. Indeed, it seems fair to say that it was not until after the Second World War that the full force of the earlier discoveries in biology and medicine began to have a major impact, an impact that was all the more heightened by the rapid bi omedical developments after the war. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Book Reviews The Growth of Medical Thought. By Lester S. King. (Chicago: University of Chicago Press, 1963. Pp. ix + 254. $5.50.) The author of this book is "a pathologist with a background in history and philosophy," to quote from the jacket. This combination of interests is reflected in the Preface itself, where it is stated, "The history of medicine is part of the history of ideas." However, the (...) text itself, unfortunately, is too episodic in treatment and too homiletic in tone to do justice to the explicit goal the author sets for himself at the very outset, which is "to indicate the growth of medical science and the patterns of medical doctrine," by a consideration of a few key figures in the history of Western medicine who represent certain distinct trends in medical theory. In his previous book, The Medical World of the 18th Century (1958), the author likened the historian to the photographer, but he forgot to bring out that a good historian needs (to exploit his own analogy) a movie camera in order to exhibit adequately the growth of things. An ordinary camera will not do for historiography. The volume opens with ancient Greek medicine and ends with the pioneers in molecular pathology. In the present reviewer's opinion, the most effective chapters of the book are the ones dealing with two of the most controversial figures in the whole history of medicine, namely, Galen and Paracelsus. For there more than anywhere else in the book, we learn the sobering lesson that just because, say, Galen's "doctrine of faculties" in Roman medicine is "wrong" (that is, false in fact), from the standpoint of modern science, is no reason for calling it "foolish" (that is, false in theory) --Moli~re to the contrary notwithstanding (p. 77). While Galen's Aristotelian "modes of thought may seem somewhat strange to us," Dr. King insists, "we must preserve a judicious historical attitude" (p. 49) towards them just the same, if our objective is to understand their raison d'etre in the first place. He uses the same criterion with respect to Paracelsus, even though he spoils his case a bit by contradicting himself concerning that bombastic figure of Renaissance medicine, describing him on one page as "essentially a poet and not a scientist or philosopher" (p. 125), and then declaring on another that he "was at heart a philosopher" (p. 137). Now, no matter whether we agree with the author's interpretation of Paracelsus as a "Neo-Platonist" in medicine, he deserves credit for discussing [2s7] 238 HISTORY OF PHILOSOPHY that enigmatic Swiss iatrochemist sympathetically. In any event, Dr. King's sympathetic approach to Paracelsus manages to throw considerable light on the Paracelsian advice to all future physicians: Don't read books! Read the stars, but read them "in Neo-Platonic fashion" (p. 114)! While the author is "judicious" about Galen and Paracelsus in particular, he is far from being so when it comes to Friedrich Hoffmann, a medical materialist and "systematist" from Halle in the eighteenth century. Paradoxically enough, Dr. King has a marked antipathy for the doctor of "sympathy " himself (p. 173). Incidentally, the only other physician in the book who is not liked--apparently for his being polemical (p. 215)--is a famous fellow-pathologist of the last century, Rudolf Virchow. Still, it is only fair to add that the author acknowledges fully Virchow's important contributions to the field of cellular pathology. Finally, Dr. King not only has his likes and dislikes as to the medical men he actually selects from modern medicine to represent changes in theory of disease, but he seems also to have a definite bias in another and more serious sense. With the exception of the Epilogue and Chapter IV, which includes Vesalius and Harvey as well as Hoffmann, all the episodes of modern medicine deemed worthy of study derive from the Germanic world. Curiously enough, although there is no discussion of the germ theory of disease as such in the book, there is mention of Koch, but not of Pasteur. And French physiologist Claude Bernard, the great medical philosopher who tried to do in the nineteenth century for scientific medicine what... (shrink)

That there was a ‘Bacteriological Revolution’ in medicine in the late nineteenth-century, associated with the development of germ theories of disease, is widely assumed by historians; however, the notion has not been defined, discussed or defended. In this article a characterisation is offered in terms of four linked rapid and radical changes: a series of discoveries of the specific causal agents of infectious diseases and the introduction of Koch’s Postulates; a reductionist and contagionist turn in medical knowledge and practice; (...) greater authority for experimental laboratory methods in medicine; the introduction and success of immunological products. These features are then tested against developments in four important but previously neglected diseases: syphilis, leprosy, gonorrhoea and rabies. From these case-studies I conclude that the case for a Bacteriological Revolution in late nineteenth-century medicine in Britain remains unproven. I suggest that historians have read into the 1880s changes that occurred over a much longer period, and that while there were significant shifts in ideas and practices over the decade, the balance of continuities and changes was quite uneven across medicine. My argument is only for Britain; in other countries the rate and extent of change may have been different. (shrink)

Naturalistic theories of disease appeal to concepts of biological function, and use the notion of dysfunction as the basis of their definitions. Debates in the philosophy of biology demonstrate how attributing functions in organisms and establishing the function-dysfunction distinction is by no means straightforward. This problematization of functional ascription has undermined naturalistic theories and led some authors to abandon the concept of dysfunction, favoring instead definitions based in normative criteria or phenomenological approaches. Although this work has enhanced our understanding of (...) disease and illness, we need not necessarily abandon naturalistic concepts of function and dysfunction in the disease debate. This article attempts to move towards a new naturalistic theory of disease that overcomes the limitations of previous definitions and offers advantages in the clinical setting. Our approach involves a reevaluation of concepts of biological function employed by naturalistic theories. Drawing on recent insights from the philosophy of biology, we develop a contextual and evaluative account of function that is better suited to clinical medicine and remains consistent with contemporary naturalism. We also show how an updated naturalistic view shares important affinities with normativist and phenomenological positions, suggesting a possibility for consilience in the disease debate. (shrink)

There has been much debate about whether the concept of disease articulated in Boorse’s biostatistical theory is value-neutral or value-laden. Here, I want to examine whether this debate matters. I suggest that there are two basic respects in which value-ladenness might be important: it could threaten either scientific legitimacy or moral permissibility. I argue that value-ladenness does not threaten the scientific legitimacy of our disease-concept because the concept makes little difference to the formulation and testing of scientific hypotheses. Likewise, (...) even if our disease-concept is value-laden, this does not show it is morally impermissible. To determine its permissibility, we must regard it as a tool to structure social institutions. Seen in that way, whether our disease-concept is morally permissible is a consequentialist matter and depends exquisitely on unanswered empirical questions. (shrink)

In a previous paper the concept of disease was fuzzy-logically analyzed and a sketch was given of a prototype resemblance theory of disease (Sadegh-Zadeh (2000). J. Med. Philos., 25:605–38). This theory is outlined in the present paper. It demonstrates what it means to say that the concept of disease is a nonclassical one and, therefore, not amenable to traditional methods of inquiry. The theory undertakes a reconstruction of disease as a category that in contradistinction to traditional views (...) is not based on a set of common features of its members, that is individual diseases, but on a few best examples of the category, called its prototypes, and a similarity relationship such that a human condition is considered a disease if it resembles a prototype. It enables new approaches to resolving many of the stubborn problems associated with the concept of disease. (shrink)

Several decades ago, Christopher Boorse formulated an influential statistical theory of normative biological functions but it has often been claimed that his theory suffers from insuperable problems such as an inability to handle cases of epidemic and universal diseases. This paper develops a new statistical theory of normative functions that is capable of dealing with the notorious problem of epidemic and universal diseases. The theory is also more detailed than its predecessors and offers other important advantages (...) over them. It is argued here that statistical theories of biological functions should not be so quickly dismissed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:238 HISTORY OF PHILOSOPHY that enigmatic Swiss iatrochemist sympathetically. In any event, Dr. King's sympathetic approach to Paracelsus manages to throw considerable light on the Paracelsian advice to all future physicians: Don't read books! Read the stars, but read them "in Neo-Platonic fashion" (p. 114)! While the author is "judicious" about Galen and Paracelsus in particular, he is far from being so when it comes to Friedrich Hoffmann, a (...) medical materialist and "systematist" from Halle in the eighteenth century. Paradoxically enough, Dr. King has a marked antipathy for the doctor of "sympathy " himself (p. 173). Incidentally, the only other physician in the book who is not liked--apparently for his being polemical (p. 215)--is a famous fellow-pathologist of the last century, Rudolf Virchow. Still, it is only fair to add that the author acknowledges fully Virchow's important contributions to the field of cellular pathology. Finally, Dr. King not only has his likes and dislikes as to the medical men he actually selects from modern medicine to represent changes in theory of disease, but he seems also to have a definite bias in another and more serious sense. With the exception of the Epilogue and Chapter IV, which includes Vesalius and Harvey as well as Hoffmann, all the episodes of modern medicine deemed worthy of study derive from the Germanic world. Curiously enough, although there is no discussion of the germ theory of disease as such in the book, there is mention of Koch, but not of Pasteur. And French physiologist Claude Bernard, the great medical philosopher who tried to do in the nineteenth century for scientific medicine what American pathologist Lester King is attempting in the twentieth, is conspicuous by his absence in The Growth of Medical Thought. PATRICKROMANELL University of Oklahoma Siimtliche Werke von Plato. (Reinbeck b. Hamburg: Rowohlt, 1959-1963. 6 volumes -- Rowohlts Klassiker der Literatur und der Wissenschaft. Griechische Philosophie.) Diese Taschenbiicherausgabe enth~ilt die meisten der von Schleiermacher iibersetzten Dialoge und ffigt die Briefe, den Timaios, den Kritias und die Nomoi in der Obersetzung von H. und F. H. Miiller hinzu. Die Ordnung entspricht offenbar der von den Herausgebern (W. F. Otto, E. Grassi und G. Plamb/Sck) angenommenen chronologischen Reihenfolge. Ausgelassen sind: Minos, Alkibiades H und Theages, Nebenbuhler, Kleitophon und die Epinomis--offenbar weil sie die Herausgeber fiir unecht halten. Die Obersetzung einer Reihe von Dialogen (bes. Parmenides, Politikos, Philebos, Timaios, Kritias) wurde einer Durchsicht unterzogen; leider teilen uns BOOK REVIEWS 239 die Herausgeber nicht mit, von wem. Jedem Dialog geht eine Gliederung voran; jeder Band ist mit einer recht brauchbaren Bibliographie versehen. Es ist erstaunlich zu erfahren, dass der erste Band, erstmalig in 1957 erschienen, in 1963 eine Auflage von 78000 erreicht hat; bleiben auch die Auflageziffern der fibrigen B~inde dahinter zurfick, so sind sie doch genfigend eindrucksvoll. Man wfinscht, der Verlag m6chte doch, durch diesen Erfolg ermutigt, das nach Obgesagtem noch Fehlende--und dazu noch Platons Gedichte--in einem Erg~inzungsband bringen, wie immer man fiber die Echtheit der Stficke denkt. Der stilistische Unterschied zwischen den ~bersetzungen von Schleiermacher (erstmalig: 1804-1810) und von H. und F. H. Mfiller ist ausserordentlich. Dies ist nicht etwa auf die gr6ssere Sprachmeisterschaff Schleiermachers zurfickfiihren. Vielmehr liegt seiner Obersetzungsmethode eine h6chst interessante Theorie zugrunde (die F. A. Wolff, der Schleiermachers ~bersetzung verhShnt und Wilamowitz, der sie als ungeniessbar bezeichnet hatte, offenbar unbekannt war). Dieser Theorie zufolge ist es die Aufgabe des ~2bersetzers, den Leser besffindig daran zu erinnern, dass er nur eine l~bersetzung vor sich hat. Einem ~bersetzer, der sich brfistet, dass sich sein Text so liest, wie ihn der Autor geschrieben h~itte, wenn er in der Sprache des ~bersetzers und seines Publikums gedacht h~itte, sollte erwidert werden "Daffir bin ich dir so dankbar, wie ich es w~ire, wenn du mir das Bild eines Mannes zeigtest und sagtest--So wiirde er ausgesehen haben, wenn ihn mit seiner Mutter ein anderer Vater gezeugt h~tte." In anderen Worten: da sich Inhalt und Ausdruck nicht abtrennen lassen, sollte der f2bersetzer, start das Original seiner Sprache anzueignen, vielmehr--wir gebrauchen hier den bekannten Brechtschen Begriff--im Leser einen Verfremdungseffekt erzeugen. Wie man sieht, ist Schleiermachers ~3bersetzungstheorie jeder "rationalistischen " strikte... (shrink)

Naturalistic theories of disease appeal to concepts of biological function, and use the notion of dysfunction as the basis of their definitions. Debates in the philosophy of biology demonstrate how attributing functions in organisms and establishing the function-dysfunction distinction is by no means straightforward. This problematization of functional ascription has undermined naturalistic theories and led some authors to abandon the concept of dysfunction, favoring instead definitions based in normative criteria or phenomenological approaches. Although this work has enhanced our understanding of (...) disease and illness, we need not necessarily abandon naturalistic concepts of function and dysfunction in the disease debate. This article attempts to move towards a new naturalistic theory of disease that overcomes the limitations of previous definitions and offers advantages in the clinical setting. Our approach involves a re-evaluation of concepts of biological function employed by naturalistic theories. Drawing on recent insights from the philosophy of biology, we develop a contextual and evaluative account of function that is better suited to clinical medicine and remains consistent with contemporary naturalism. We also show how an updated naturalistic view shares important affinities with normativist and phenomenological positions, suggesting a possibility for consilience in the disease debate. (shrink)

Historians of modern medicine often divide their subject into two parts, separated by the bacteriological revolution of the late nineteenth century, when medicine supposedly became 'scientific' for the first time. The history of medical geography - to say nothing of other subjects - calls this common view into question. At least in the United States, students of medical geography, arguably the pre-eminent medical science in an age dominated by miasmatic theories of disease, readily adapted to the discovery of germs. And (...) although bacteriology quickly eclipsed medical geography in the world of medicine, place remained an important consideration in treating asthma (and allergies generally) throughout the post-bacteriological period. (shrink)

Whipple disease is a rare, infectious, disease first described from a single case by Whipple in 1907. As well as characterising the clinical and pathological features of the condition, Whipple made two suggestions regarding its aetiology. These were either than the disease was caused by an infectious agent, or that it was of metabolic origin. As the disease is now thought to be caused by infection with the bacterium Tropheryma whipplei, historical reviews of the history of the disease typically mention (...) only the first of these suggestions. In this paper, we therefore revisit Whipple’s other theory. We argue that a diverse and often successful research programme was developed around this mechanism of disease causation which gave rise to many useful findings on the condition. In the later parts of this article, we then turn to discuss the surprising neglect of this period of Whipple disease research in the current literature, and conclude by offering a brief reconstruction of this early history suitable for use in a technical context. (shrink)

Religious healing specialists such as shamans often use magic. Evolutionary theories that seek to explain why laypersons find these specialists convincing focus on the origins of magical cognition and belief in the supernatural. In two studies, we reframe the problem by investigating relationships among ethnomedical specialists, who possess extensive theories of disease that can often appear “supernatural,” and religious healing specialists. In study 1, we coded and analyzed cross-cultural descriptions of ethnomedical specialists in 47 cultures, finding 24% were also religious (...) leaders and 74% used supernatural theories of disease. We identified correlates of the use of supernatural concepts among ethnomedical specialists; incentives and disincentives to patronize ethnomedical specialists; and distinct clusters of ethnomedical specialists that we label prestigious teachers, feared diviners, and efficacious healers. In study 2, we interviewed 84 Maasai pastoralists and their traditional religious and non-religious healing specialists. We found that laypersons relied on medicinal services based on combinations of efficacy, religious identity, and interpersonal trust. Further, laypersons and specialists largely used abstract concepts that were not conspicuously supernatural to describe how local medicines work. We conclude that religious healers in traditional societies often fulfill a practical and specialized service to local clients, and argue that supernatural theories of disease often reflect abstract cognition about rare phenomena whose causes are unobservable (e.g., infection, mental illness) instead of a separate “religious” style of thinking. (shrink)

In this paper, I utilise the tools of analytic philosophy to amalgamate mono-causal and multi-causal theories of disease. My aim is to better integrate viral and socio-economic explanations of AIDS in particular, and to consider how the perceived divide between mono-causal and multi-causal theories played a role in the tragedy of AIDS denialism in South Africa in the early 2000s. Currently, there is conceptual ambiguity surrounding the relationship between mono-causal and multi-causal theories in biomedicine and epidemiology. Mono-causal theories focus on (...) single, typically microbial, sources of illness and are most concerned with infectious diseases. By contrast, multi-causal theories allow for multiple factors to underpin a disease’s aetiology, including socio-economic and behavioural factors, and they usually focus on chronic non-communicable diseases. However, if these theories are taken to be strictly distinct, this prevents the inclusion of both microbial and socio-economic factors in a single explanation of any particular disease. This strict distinction became a problem when trying to explain the disproportionate prevalence of AIDS in southern Africa and ultimately contributed to the tragedy of AIDS denialism in South Africa. In tandem with viewing how the perceived divide between multi-causal and mono-causal theories underpinned AIDS denialism, I examine Thabo Mbeki’s specific role, while acknowledging that AIDS is being deprioritised on a broader international level. Overall, I will demonstrate that any long-term plan to eliminate AIDS will require viral and socio-economic factors to be considered simultaneously and that such a theoretical approach requires a clearer understanding of the underlying concepts of disease aetiology. (shrink)

Christopher Boorse’s bio-statistical theory of health and disease argues that the central discipline on which theoretical medicine relies is physiology. His theory has been much discussed but little has been said about its focus on physiology or, conversely, about the role that other biomedical disciplines may play in establishing a theoretical concept of health. Since at least the 1950s, epidemiology has gained in strength and legitimacy as an independent medical science that contributes to our knowledge of health and (...) disease. Indeed, it not only provides important information about disease distribution and aetiology, but the risk-factor approach it employs seems to challenge BST’s binary conception of health and disease. The objective of the article is to show, firstly, how important information deriving from descriptive and analytical epidemiology forms part of our contemporary medical concepts of health and disease, and secondly, that these elements are not taken into account by BST in a satisfactory way. The article’s central contention, therefore, is that if the project of defining the theoretical concept of health is to be maintained, more importance should be accorded to the contribution made by epidemiology—alongside physiology—in defining health. (shrink)

Behavioral immune system describes psychological mechanisms that detect cues to infectious pathogens in the immediate environment, trigger disease-relevant responses and facilitate behavioral avoidance/escape. BIS activation elicits a perceived vulnerability to disease which can result in conformity with social norms. However, a response to superficial cues can result in aversive responses to people that pose no actual threat, leading to an aversion to unfamiliar others, and likelihood of prejudice. Pathogen-neutralizing behaviors, therefore, have implications for social interaction as well as illness behaviors (...) and responses to health communications. In this study, we investigate how PVD influences conformity, attitudes to other people and to lockdown regulations through the lens of the Reinforcement Sensitivity Theory. RST describes personality in terms of biologically-driven approach and avoidance motivations which support personal goals. Participants from the United Kingdom public completed an RST personality questionnaire and then read either coronavirus morbidity-mortality statistics and current United Kingdom government lifestyle regulations, just the regulations, or no information at all. They all completed the Perceived Vulnerability to Disease scale to assess BIS-relevant Germ Aversion and Perceived Infectability, followed by questions measuring social conformity, warmth toward others and attitudes toward lockdown measures. Significantly lower PVD scores were observed in the no-information condition, with the other conditions showing no difference. In terms of RST, approach behaviors related to goal-drive persistence work alongside fear in explaining conformity to social norms. Reward related approach behaviors partially explained warmth toward others, indicating that social rewards gained through interaction continue to be strong drivers of behavior. We found no role for RST traits in attitudes toward lockdown. Overall, coronavirus-related behavior is not driven purely by fear, but also by social and/or protection goals regulated by approach motivation. This study presents new insights into public perceptions of coronavirus and government regulated lifestyle restrictions, helping to explain social behaviors in terms of biologically driven mechanisms. Such understanding is vital if we are to successfully motivate public behavior to constrain spread of the virus. (shrink)

Here are some of the most important discoveries in the history of medicine: blood circulation (1620s), vaccination, (1790s), anesthesia (1840s), germ theory (1860s), X- rays (1895), vitamins (early 1900s), antibiotics (1920s-1930s), insulin (1920s), and oncogenes (1970s). This list is highly varied, as it includes basic medical knowledge such has Harvey’s account of how the heart pumps blood, hypotheses about the causes of disease such as the germ theory, ideas about the treatments of diseases such as antibiotics, (...) and medical instruments such as X-ray machines. The philosophy of medicine should be able to contribute to understanding of the nature of discoveries such as these. The great originators of the field of philosophy of science were all concerned with the nature of scientific discovery, including Francis Bacon (1960), William Whewell (1967), John Stuart Mill (1974), and Charles Peirce (1931-1958). The rise of logical positivism in the 1930s pushed discovery off the philosophical agenda, but the topic was revived through the work of philosophers such as Norwood Russell Hanson (1958), Thomas Nickles (1980), Lindley Darden (1991, 2006), and Nancy Nersessian (1984). Scientific discovery has also become an object of investigations for researchers in the fields of cognitive psychology and artificial intelligence, as seen in the work of Herbert Simon, Pat Langley, and others (Langley et al., 1987; Klahr, 2000). Today, scientific September 14, 2009 discovery is an interdisciplinary topic at the intersection of the philosophy, history, and psychology of science. The aim of this chapter is to identify patterns of discovery that illuminate some of the most important developments in the history of medicine. I have used a variety of sources to identify forty great medical discoveries (Adler, 2004; Friedman and Friedland, 1998; Science Channel, 2006; Strauss and Strauss, 2006).. (shrink)

Modern medicine is often said to have originated with nineteenth century germ theory, which attributed diseases to bacterial contagions. The success of this theory is often associated with an underlying principle referred to as the “doctrine of specific etiology”. This doctrine refers to specificity at the level of disease causation or etiology. While the importance of this doctrine is frequently emphasized in the philosophical, historical, and medical literature, these sources lack a clear account of the types of (...) specificity that it involves and why exactly they matter. This paper argues that nineteenth century germ theory involves two types of specificity at the level of etiology. One type receives significant attention in the literature, but its influence on modern medicine has been misunderstood. A second type is present in this model, but it has been completely overlooked in the extant literature. My analysis clarifies how these types of specificity led to a novel conception of etiology that continues to figure in medicine today. (shrink)

In this article, we defend a normative theory of prenatal equality of opportunity, based on a critical revision of Rawls's principle of fair equality of opportunity . We argue that if natural endowments are defined as biological properties possessed at birth and the distribution of natural endowments is seen as beyond the scope of justice, Rawls's FEO allows for inequalities that undermine the social conditions of a property-owning democracy. We show this by considering the foetal programming of disease and (...) the possibility of germ-line modifications. If children of lower socioeconomic background are more likely to develop in a poor foetal environment and germ-line enhancements are available only to the rich, initial inequalities between the rich and the poor would grow, and yet FEO would be satisfied. In order to avoid the problem, we propose a revised FEO principle omitting any reference to the comparison of natural endowments. Our revised FEO requires that institutions mitigate social class effect from reproduction and gestation to the greatest extent compatible with parental freedoms and the value of the family. (shrink)

Christopher Boorse’s Health care ethics: an introduction, Temple University Press, Philadelphia, pp 359–393, 1987; in Humber, Almeder, Totowa What is disease?, Humana Press, New York City, pp 1–134, 1997; J Med Philos, 39:683–724, 2014) Bio-Statistical Theory comprehends diseases in terms of departures from natural norms, which involve an objectively describable deviation from the proper physiological or psychological functioning of parts of the human organism. I argue that while recent revisions and additional considerations shield the BST from a number of (...) issues raised by critics, they give rise to significant new challenges. These are related to the attribution of epistemic authority, the possibility of multiple concepts in the authoritative literature, and the framing of BST as “philosophical explication.” The conclusion is that, in its current form, the BST is unable to provide a robust framework for a naturalist classification. (shrink)

I have argued elsewhere that scientific realism is most significantly challenged neither by traditional arguments from underdetermination of theories by the evidence, nor by the traditional pessimistic induction, but by a rather different historical pattern: our repeated failure to conceive of alternatives to extant scientific theories, even when those alternatives were both (1) well-confirmed by the evidence available at the time and (2) sufficiently scientifically serious as to be later embraced by actual scientific communities. Here I use August Weismann's defense (...) of his influential germ-plasm theory of inheritance to support my claim that this pattern characterizes the history of theoretical scientific investigation generally. Weismann believed that the germ-plasm must become disintegrated into its constituent elements over the course of development, I argue, only because he failed to conceive of any possible alternative mechanism of ontogenetic differentiation. This and other features of the germ-plasm theory, I suggest, reflect a still more fundamental failure to imagine that the germ-plasm might be a productive rather than expendable resource for the cell. Weismann's case provides impressive support for the problem of unconceived alternatives while rendering its challenge to scientific realism deeper and sharper in a number of important ways. (shrink)

Competing contemporary theories of health, the reductionist and the relativist of an objective goal, can be classified as objectivist theories. The ultimate goal of all living things is life, the standard by which states or functions can be measured, and thereby defined as healthy or disease states. While disease can be classified in a taxonomy of biological dysfunctions without remainder, health is a richer concept that includes not only biological values, but also moral values, both leading to the ultimate goal (...) of human flourishing. (shrink)

Normativism holds that there is a close conceptual link between disease and disvalue. We challenge normativism by advancing an argument against a popular normativist theory, Jerome Wakefield’s harmful dysfunction account. Wakefield maintains that medical disorders are breakdowns in evolved mechanisms that cause significant harm to the organism. We argue that Wakefield’s account is not a promising way to distinguish between disease and health because being harmful is neither necessary nor sufficient for a dysfunction to be a disorder. Counterexamples to (...) the harmful dysfunction account are considered, such as mild infections, perceptual deficits, and beneficial illnesses. Then we consider two ways of amending the harmful dysfunction account to address these cases and argue that the proposed amendments raise even more serious problems for this account. These problems apply generally to any normativist theory and raise doubts about the entire normative approach to the philosophy of health and disease. (shrink)

The following article presents preliminary reflections on a processual theory of health and disease. It does this by steering the discussion more toward an ontology of organisms rather than conceptual analysis of the semantic content of the terms “health” and “disease.” In the first section, four meta-theoretical assumptions of the traditional debate are identified and alternative approaches to the problems are presented. Afterwards, the view that health and disease are constituted by a dynamic relation between demands imposed on an (...) organism and individual presuppositions for adequate response is developed. In the last section, the paper takes stock of three possible objections to and clarifies some implications of this approach to the notions of health and disease. (shrink)

Protection motivation theory is a theoretical framework informative for understanding behavioral intentions and choices during exceptional and uncommon circumstances, such as a pandemic of respiratory infectious disease. PMT postulates both the threat appraisal and the coping appraisal as predictors of health behaviors. Recent advances in the field of behavioral immune system research suggest that humans are equipped with a set of psychological adaptations enabling them to detect the disease-threat and activate behavioral avoidance of pathogens. The present study, set within (...) PMT framework and informed by the BIS research, aimed to explain and predict voluntary adherence to COVID-19 guidelines by perceived personal risk and vulnerability to disease as threat appraisal variables, and trust in science as the response efficacy element of coping appraisal. Gender, age, belief in the second wave, perceived personal risk, germ aversion, and trust in science were all found to be significant positive predictors of the intent to adhere to non-pharmacological COVID-19 recommendations, with the belief in the second wave, germ aversion, and trust in science being the most important ones. On the other hand, only the belief in the second wave and trust in science were significant positive predictors of the intent to adhere to pharmacological COVID-19 recommendations. Interventions aimed at enhancing preventative measures adherence should take into account that the psychological mechanisms underlying adherence to these two types of recommendations are not identical. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Response to Elvira Panaiotidi, “The Nature of Paradigms and Paradigm Shifts in Music Education”Wenyi W. KurkulAt the beginning, I would like to congratulate Elvira Panaiotidi on her interesting paper and on her proposal to move beyond the long-running debates that began in the mid-1990s between Bennett Reimer and David Elliott and their respective supporters. I also applaud her affirmation that, beyond the numerous debates within the music-education philosophy community, (...) the ultimate goal is to put the theories to work in schools or, in other words, to convert theories into operative paradigms.Echoing her affirmation, I shared her article with a class of my graduate students after I received the invitation to respond to this paper. All of my graduate students are current schoolteachers in the greater Washington, DC metropolitan area in the United States. Some of them are young teachers; others have decades [End Page 114] of teaching experience. As a university professor, I have always been thrilled by how much my thoughts are inspired by my students—by their stories, writing, discussions, dialogues, and sometimes very challenging questions in class. Their concern for their daily jobs and their students constantly remind me of our responsibilities to the children in the schools. However, with our schools and students in mind, I have to ask the music education philosophy community a question: Is "producing a unified concept of music," or "searching for a unified approach," or even aiming to "develop a unified approach in music education" as proposed by Panaiotidi what we truly need?In her paper, Panaiotidi discusses the debate over the approaches in music education by Reimer and Elliott in the context of paradigm shifts. The term, "paradigm shift," was introduced by Thomas Kuhn in 1962 in his highly influential book, The Structure of Scientific Revolutions. Kuhn proposes that almost every significant break-through in the field of scientific endeavor is first a break with tradition, with old ways of thinking, with old paradigms. For example, until the germ theory was developed, there was a high percentage of deaths during childbirth and scientists were not sure why. Likewise, in military settings, more people were dying from small wounds and diseases than from the major traumas experienced on the frontlines. But as soon as the germ theory was developed, a whole new paradigm—a better, improved way of understanding what was happening—made dramatic and significant improvements in the practice of medicine possible.The United States today is the setting for another fruitful and powerful example of a dramatic paradigm shift. The traditional concept of government had been monarchical, based on the divine right of kings. It was not until centuries later that a significant break-through paradigm was developed: government of the people, by the people, and for the people. A constitutional democracy was born that unleashed tremendous human energy and ingenuity. This new paradigm, over time, generated personal empowerment, free enterprise, a higher standard of living, freedom and liberty, and influence and hope unequaled in the history of the world.Stephen R. Covey, the author of a popular book in the late 1980s, The Seven Habits of Highly Effective People, cites Kuhn's conception of paradigm shift to illustrate his own ideas. He describes an experiment at the Harvard Business School in which an instructor passed out a picture of a young woman to half of the class and a picture of an old woman to the other half. The students were asked to look briefly at the picture and pass it back. The professor then asked the class to describe the woman as he projected on a screen a picture of a woman that was a combined image of the "old" and "young" women. Needless to say, the students debated the age of the woman. If they had seen the "young" version, [End Page 115] they could see only a young woman now, and vice-versa. Each student was adamant about his or her position. They did not see the image in another way until the lines were pointed out to demonstrate the features of the old and young woman. Covey cites this exercise to prove the powerful conditioning effects of one... (shrink)

Mnoge biološke funkcije dopuštaju stupnjevanje. Na primjer, lučenje određenog hormona u organizmu može biti na višoj ili nižoj razini, u usporedbi s istim organizmom drugom prilikom ili u usporedbi s drugim organizmima. Koje razine funkcioniranja predstavljaju slučajeve disfunkcije; gdje da povučemo crtu? To je kvantitativni problem za teorije disfunkcije i bolesti. Cilj mi je braniti verziju bioloških teorija disfunkcije kako bih se uhvatio u koštac s ovim problemom. Međutim, također ću dopustiti da evaluativna razmatranja uđu u teoriju bolesti. Moj argument (...) se temelji na razlikovanju između biološke i kliničke perspektive. Prema mom mišljenju, bolest je ograničena na slučajeve koji spadaju u granice bioloških disfunkcija. Odgovor na kvantitativni problem ne zahtijeva proizvoljne odluke ili društveno vrijednosne sudove. Stoga se zalažem za nearbitrarnu metodu koja se temelji na činjenicama kako bi se riješio kvantitativni problem. Ipak, nisu sve biološke disfunkcije instance bolesti. Dodavanje kliničke perspektive omogućuje nam da spriječimo potencijalnu preveliku uključenost biološke perspektive, zato što postavlja dodatna ograničenja za određivanje granica bolesti. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Response to Elvira Panaiotidi, “The Nature of Paradigms and Paradigm Shifts in Music Education”Wenyi W. KurkulAt the beginning, I would like to congratulate Elvira Panaiotidi on her interesting paper and on her proposal to move beyond the long-running debates that began in the mid-1990s between Bennett Reimer and David Elliott and their respective supporters. I also applaud her affirmation that, beyond the numerous debates within the music-education philosophy community, (...) the ultimate goal is to put the theories to work in schools or, in other words, to convert theories into operative paradigms.Echoing her affirmation, I shared her article with a class of my graduate students after I received the invitation to respond to this paper. All of my graduate students are current schoolteachers in the greater Washington, DC metropolitan area in the United States. Some of them are young teachers; others have decades [End Page 114] of teaching experience. As a university professor, I have always been thrilled by how much my thoughts are inspired by my students—by their stories, writing, discussions, dialogues, and sometimes very challenging questions in class. Their concern for their daily jobs and their students constantly remind me of our responsibilities to the children in the schools. However, with our schools and students in mind, I have to ask the music education philosophy community a question: Is "producing a unified concept of music," or "searching for a unified approach," or even aiming to "develop a unified approach in music education" as proposed by Panaiotidi what we truly need?In her paper, Panaiotidi discusses the debate over the approaches in music education by Reimer and Elliott in the context of paradigm shifts. The term, "paradigm shift," was introduced by Thomas Kuhn in 1962 in his highly influential book, The Structure of Scientific Revolutions. Kuhn proposes that almost every significant break-through in the field of scientific endeavor is first a break with tradition, with old ways of thinking, with old paradigms. For example, until the germ theory was developed, there was a high percentage of deaths during childbirth and scientists were not sure why. Likewise, in military settings, more people were dying from small wounds and diseases than from the major traumas experienced on the frontlines. But as soon as the germ theory was developed, a whole new paradigm—a better, improved way of understanding what was happening—made dramatic and significant improvements in the practice of medicine possible.The United States today is the setting for another fruitful and powerful example of a dramatic paradigm shift. The traditional concept of government had been monarchical, based on the divine right of kings. It was not until centuries later that a significant break-through paradigm was developed: government of the people, by the people, and for the people. A constitutional democracy was born that unleashed tremendous human energy and ingenuity. This new paradigm, over time, generated personal empowerment, free enterprise, a higher standard of living, freedom and liberty, and influence and hope unequaled in the history of the world.Stephen R. Covey, the author of a popular book in the late 1980s, The Seven Habits of Highly Effective People, cites Kuhn's conception of paradigm shift to illustrate his own ideas. He describes an experiment at the Harvard Business School in which an instructor passed out a picture of a young woman to half of the class and a picture of an old woman to the other half. The students were asked to look briefly at the picture and pass it back. The professor then asked the class to describe the woman as he projected on a screen a picture of a woman that was a combined image of the "old" and "young" women. Needless to say, the students debated the age of the woman. If they had seen the "young" version, [End Page 115] they could see only a young woman now, and vice-versa. Each student was adamant about his or her position. They did not see the image in another way until the lines were pointed out to demonstrate the features of the old and young woman. Covey cites this exercise to prove the powerful conditioning effects of one... (shrink)

In the contemporary biomedical literature, every disease is considered genetic. This extension of the concept of genetic disease is usually interpreted either in a trivial or genocentrist sense, but it is never taken seriously as the expression of a genetic theory of disease. However, a group of French researchers defend the idea of a genetic theory of infectious diseases. By identifying four common genetic mechanisms (Mendelian predisposition to multiple infections, Mendelian predisposition to one infection, and major gene and (...) polygenic predispositions), they attempt to unify infectious diseases from a genetic point of view. In this article, I analyze this explicit example of a genetic theory, which relies on mechanisms and is applied only to a specific category of diseases, what we call “a regional genetic theory.” I have three aims: to prove that a genetic theory of disease can be devoid of genocentrism, to consider the possibility of a genetic theory applied to every disease, and to introduce two hypotheses about the form that such a genetic theory could take by distinguishing between a genetic theory of diseases and a genetic theory of Disease. Finally, I suggest that network medicine could be an interesting framework for a genetic theory of Disease. (shrink)