IntroductionDementia diseases, especially Alzheimer’s disease (AD), are of considerable importance in terms of social policy and health economics. Moreover, against the background of the current Karlsruhe judgement on the legalisation of assisted suicide, there are also questions to be asked about medical humanities in AD.MethodologyRelevant literature on complementary forms of therapy and prognosis was included and discussed.ResultsCreative sociotherapeutic approaches (art, music, dance) and validating psychotherapeutic approaches show promise for suitability and efficiency in the treatment of dementia, but in some (...) cases still need to be scientifically tested. Biomarker-based early diagnosis of dementia diseases is increasingly becoming a subject of debate against the background of the Karlsruhe ruling.DiscussionNeeds-oriented and resource-enhancing approaches can make a significant contribution to improving the quality of life of people with dementia. The discussion on the issue of “assisted suicide” should include questions of the dignity and value of a life with dementia.OutlookThe integrative dementia therapy model can be complemented by a religion- and spirituality-based approach. Appropriate forms of psychotherapy should be scientifically evaluated. (shrink)

This paper summarizes Grmek's theoretical contribution to history of disease and explores to what extent the longue durée could still be a useful concept in order to better understand past perceptions of, and reactions to, diseases. The case of the medical responses to epidemic disease in pre-industrial Europe is synthetically expounded in order to illustrate this issue.

This paper examines medical scientists’ accounts of their rediscoveries and reassessments of old materials. It looks at how historical patient files and brain samples of the first cases of Alzheimer’s disease became reused as scientific objects of inquiry in the 1990s, when a genetic neuropathologist from Munich and a psychiatrist from Frankfurt lead searches for left-overs of Alzheimer’s ‘founder cases’ from the 1900s. How and why did these researchers use historical methods, materials and narratives, and why did the biomedical community (...) cherish their findings as valuable scientific facts about Alzheimer’s disease? The paper approaches these questions by analysing how researchers conceptualised ‘history’ while backtracking and reassessing clinical and histological materials from the past. It elucidates six ways of conceptualising history as a biomedical matter: (1) scientific assessments of the past, i.e. natural scientific understandings of ‘historical facts’; (2) history in biomedicine, e.g. uses of old histological collections in present day brain banks; (3) provenance research, e.g. applying historical methods to ensure the authenticity of brain samples; (4) technical biomedical history, e.g. reproducing original staining techniques to identify how old histological slides were made; (5) founding traditions, i.e. references to historical objects and persons within founding stories of scientific communities; and (6) priority debates, e.g. evaluating the role particular persons played in the discovery of a disease such as Alzheimer’s. Against this background, the paper concludes with how the various ways of using and understanding ‘history’ were put forward to re-present historic cases as ‘proto-types’ for studying Alzheimer’s disease in the present. (shrink)

Epidemiological data suggest that previous infections can alter an individual's susceptibility to unrelated diseases. Nevertheless, the underlying mechanisms are not completely understood. Substantial research efforts have expanded the classical concept of immune memory to also include long‐lasting changes in innate immunity and antigen‐independent reactivation of adaptive immunity. Collectively, these processes provide possible explanations on how acute infections might induce long‐term changes that also affect immunity to unrelated diseases. Here, we review lasting changes the immune compartment undergoes upon infection (...) and how infection experience alters the responsiveness of immune cells towards universal signals. This heightened state of alert enhances the ability of the immune system to combat even unrelated infections but may also increase susceptibility to autoimmunity. At the same time, infection‐induced changes in the regulatory compartment may dampen subsequent immune responses and promote pathogen persistence. The concepts presented here outline how infection‐induced changes in the immune system may affect human health. (shrink)

This paper examines medical scientists’ accounts of their rediscoveries and reassessments of old materials. It looks at how historical patient files and brain samples of the first cases of Alzheimer’s disease became reused as scientific objects of inquiry in the 1990s, when a genetic neuropathologist from Munich and a psychiatrist from Frankfurt lead searches for left-overs of Alzheimer’s ‘founder cases’ from the 1900s. How and why did these researchers use historical methods, materials and narratives, and why did the biomedical community (...) cherish their findings as valuable scientific facts about Alzheimer’s disease? The paper approaches these questions by analysing how researchers conceptualised ‘history’ while backtracking and reassessing clinical and histological materials from the past. It elucidates six ways of conceptualising history as a biomedical matter: scientific assessments of the past, i.e. natural scientific understandings of ‘historical facts’; history in biomedicine, e.g. uses of old histological collections in present day brain banks; provenance research, e.g. applying historical methods to ensure the authenticity of brain samples; technical biomedical history, e.g. reproducing original staining techniques to identify how old histological slides were made; founding traditions, i.e. references to historical objects and persons within founding stories of scientific communities; and priority debates, e.g. evaluating the role particular persons played in the discovery of a disease such as Alzheimer’s. Against this background, the paper concludes with how the various ways of using and understanding ‘history’ were put forward to re-present historic cases as ‘proto-types’ for studying Alzheimer’s disease in the present. (shrink)

The history of the research on peptic ulcer disease is characterized by a premature abandonment of the bacterial hypothesis, which subsequently had its comeback, leading to the discovery of Helicobacter pylori—the major cause of the disease. In this paper we examine the received view on this case, according to which the primary reason for the abandonment of the bacterial hypothesis in the mid-twentieth century was a large-scale study by a prominent gastroenterologist Palmer, which suggested no bacteria could be found in (...) the human stomach. To this end, we employ the method of digital textual analysis and study the literature on the etiology of PUD published in the decade prior to Palmer’s article. Our findings suggest that the bacterial hypothesis had already been abandoned before the publication of Palmer’s paper, which challenges the widely held view that his study played a crucial role in the development of this episode. In view of this result, we argue that the PUD case does not illustrate harmful effects of a high degree of information flow, as it has frequently been claimed in the literature on network epistemology. Moreover, we argue that alternative examples of harmful effects of a high degree of information flow may be hard to find in the history of science. (shrink)

On the basis of experiences in pastoral hospital care, the relationship between disease, sin, and guilt in the life of patients is explored. Against the disregard of this subject in medicine, and even in most of pastoral care, it is argued that patients' interest requires that their hidden or manifest questions be addressed, rather than their being exposed to efforts at “helping” through mere attempts at “debt clearance.” Only by openly confronting sin and guilt can the patient be taken seriously (...) in his role as subject of his disease. Theological and anthropological background considerations revealing the essence of sin as a disruption or even destruction of the Divine gift of life in its realization through a lived relationship to God and other humans are offered as evidence for this claim. (shrink)

Even though medics in the present day may think that clinical pathology is derived from normal physiology, I argue here that this is not necessarily the case. Historically, physiology may have been derived from clinical pathology. After deriving physiological knowledge like this, medics can reverse the conceptual priority, to make believe that physiological knowledge is at the foundation of medical practice. This implies that supposedly objective physiological knowledge can be influenced by the evaluative judgements made to define practical concepts of (...) clinical pathology. I argue for this view using the history of the disease heart failure, drawing on an argument made by Georges Canguilhem. (shrink)

The history of the research on peptic ulcer disease is characterized by a premature abandonment of the bacterial hypothesis, which subsequently had its comeback, leading to the discovery of Helicobacter pylori – the major cause of the disease. In this paper we examine the received view on this case, according to which the primary reason for the abandonment of the bacterial hypothesis in the mid-twentieth century was a large-scale study by a prominent gastroenterologist Palmer, which suggested no bacteria could be (...) found in the human stomach. To this end, we employ the methodof digital textual analysis and study the literature on the etiology of PUD published in the decade prior to Palmer’s article. Our findings suggest that the bacterial hypothesis had already been abandoned before the publication of Palmer’s paper, which challenges the widely held view that his study played a crucial role in the development of this episode. In view of this result, we argue that the PUD case does not illustrate harmful effects of a high degree of information flow, as it has frequently been claimed in the literature on network epistemology. Moreover, we argue that alternative examples of harmful effects of a high degree of information flow may be hard to find in the history of science. (shrink)

Throughout human history illness has been socially interpreted before its range of meanings could be understood and disseminated. Writers of diverse types have been as active in constructing these meanings as doctors, yet it is only recently that literary traditions have been recognized as a rich archive for these interpretations. These essays focus on the methodological hurdles encountered in retrieving these interpretations, called 'framing' by the authors. Framing and Imagining Disease in Cultural History aims to explain what has been said (...) about these interpretations and to compare their value. (shrink)

ABSTRACT The history of Latin America, the history of disease, medicine, and public health, and global history are deeply intertwined, but the intersection of these three fields has not yet attracted sustained attention from historians. Recent developments in the historiography of disease, medicine, and public health in Latin America suggest, however, that a distinctive, global approach to the topic is beginning to emerge. This essay identifies the distinguishing characteristic of this approach as an attentiveness to transfers of contagions, cures, and (...) medical knowledge from Latin America to the rest of the world and then summarizes a few episodes that demonstrate its promise. While national as well as colonial and neocolonial histories of Latin America have made important contributions to our understanding, works taking the global approach have the potential to contribute more directly to the decentering of the global history of disease, medicine, and public health. (shrink)

Biology is the study of life, psychology is the study of mind, and medicine is the investigation of the causes and treatments of disease. This chapter describes how the central concepts of life, mind, and disease have undergone fundamental changes in the past 150 years or so. There has been a progression from theological, to qualitative, to mechanistic explanations of the nature of life, mind and disease. This progression has involved both theoretical change, as new theories with greater explanatory power (...) replaced older ones, and emotional change as the new theories brought reorientation of attitudes toward the nature of life, mind, and disease. After a brief comparison of theological, qualitative, and mechanistic explanations, I will describe how shifts from one kind of explanation to another have carried with them dramatic kinds of conceptual change in the key concepts in the life sciences. Three generalizations follow about the nature of conceptual change in the history of science: there has been a shift from conceptualizations in terms of simple properties to ones in terms of complex relations; conceptual change is theory change; and conceptual change is often emotional as well as cognitive. The contention that historical development proceeds in three stages originated with the nineteenth-century French philosophers, Auguste Comte, who claimed that November 9, 2006 human intellectual development progresses from a theological to a “metaphysical” stage to a “positive” (scientific) stage (Comte, 1988). The stages I have in mind are different from Comte’s, so let me say what they involve. By the theological stage I mean systems of thought in which the primary explanatory entities are supernatural ones beyond the reach of science, such as gods, devils, angels, spirits, and souls. For example, the concept of fire was initially theological, as in the Greek myth of Prometheus receiving fire from the gods.. (shrink)

Publisher: Philosophical Library Publication date: 1953 Subjects: Medicine Medical / Diseases Medical / General Medical / Diseases Medical / Microbiology Science / Life Sciences / Biology / Microbiology Notes: This is an OCR reprint. There may be typos or missing text. There are no illustrations or indexes. When you buy the General Books edition of this book you get free trial access to Million-Books.com where you can select from more than a million books for free. You can also (...) preview the book there. (shrink)

Historians looking to make history a professional discipline of study in Victorian Britain believed they had to establish firm boundaries demarcating history from other literary disciplines. James Anthony Froude ignored such boundaries. The popularity of his historical narratives was a constant reminder of the continued existence of a supposedly overturned phase of historiography in which the historian was also a man of letters, transcending the boundary separating fact from fiction and literature from history. Just as professionalizing historians were constructing a (...) methodology that called on historians to be inductive empirical workers, Froude refused to accept the new science of history, and suggested instead that history was an individual enterprise, one more concerned with drama and art than with science. E. A. Freeman warned the historical community that they “cannot welcome [Froude] as a partner in their labors, as a fellow-worker in the cause of historic truth.”This article examines the boundary work of a professionalizing history by considering the attempt to exclude Froude from the historian’s discourse, an attempt that involved a communal campaign that sought to represent Froude as “constitutionally inaccurate.” Froude suffered from “an inborn and incurable twist,” argued Freeman, thereby diagnosing “Froude’s disease” as the inability to “make an accurate statement about any matter.” By unpacking the construction of “Froude’s disease,” the article exposes the disciplinary techniques at work in the professionalization of history, techniques that sought to exclude non-scientific modes of thought such as that offered by Froude. (shrink)

Catatonia is a psychomotor disorder that has gone through numerous descriptions since 1874, reflecting the many changes in psychiatric disease conceptualization that have occurred within that time frame. Catatonia has been variously described as a distinct disease entity, as a part of schizophrenia, and as a nonspecific manifestation of many disorders. Because of its association with schizophrenia, the description of catatonia was particularly affected by the psychopharmacological era, beginning in the 1950s, and by the development of the Diagnostic and Statistical (...) Manual of Mental Disorders (DSM). Changing trends in psychiatric research—especially the brain-based disease model, research methods favoured by the evidence-based medicine movement, and the codes and categories of the DSM—also profoundly influenced the evolving concept of catatonia. This paper discusses these important factors that affected recognition, treatment, and study of catatonia in order to reveal the biases and assumptions made when constructing a disease concept. (shrink)

This paper examines what it is for a condition to be a disease. It falls into two sections. In the first I examine the best existing account of disease (as proposed by Christopher Boorse) and argue that it must be rejected. In the second I outline a more acceptable account of disease. According to this account, by disease we mean a condition that it is a bad thing to have, that is such that we consider the afflicted person to have (...) been unlucky, and that can potentially be medically treated. All three criteria must be fulfilled for a condition to be a disease. The criterion that for a condition to be a disease it must be a bad thing is required to distinguish the biologically different from the diseased. The claim that the sufferer must be unlucky is needed to distinguish diseases from conditions that are unpleasant but normal, for example teething. Finally, the claim that for a condition to be a disease it must be potentially medically treatable is needed to distinguish diseases from other types of misfortune, for example economic problems and legal problems. (shrink)

This book has been defined around three important issues: the first sheds light on how people, in various philosophical, religious, and political contexts, understand the natural environment, and how the relationship between the environment and the body is perceived; the second focuses on the perceptions that a particular natural environment is good or bad for human health and examines the reasons behind such characterizations ; the third examines the promotion, in history, of specific practices to take advantage of the health (...) benefits, or avoid the harm, caused by certain environments and also efforts made to change environments supposed to be harmful to human health. The feeling and/or the observation that the natural environment can have effects on human health have been, and are still commonly shared throughout the world. This led us to raise the issue of the links observed and believed to exist between human beings and the natural environment in a broad chronological and geographical framework. In this investigation, we bring the reader from ancient and late imperial China to the medieval Arab world up to medieval, modern, and contemporary Europe. This book does not examine these relationships through the prism of the knowledge of our modern contemporary European experience, which, still too often, leads to the feeling of totally different worlds. Rather, it questions protagonists who, in different times and in different places, have reflected, on their own terms, on the links between environment and health and tries to obtain a better understanding of why these links took the form they did in these precise contexts. This book targets an academic readership as well as an “informed audience”, for whom present issues of environment and health can be nourished by the reflections of the past. (shrink)

"This is a wonderful book! In "How Scientists Explain Disease," Paul Thagard offers us a delightful essay combining science, its history, philosophy, and sociology.

Philosophical debates about the concept of disease, particularly of mental disease, might benefit from reconsideration and a closer look at the established terminology and conceptual structure of contemporary medical pathology and clinical nosology. The concepts and principles of medicine differ, to a considerable extent, from the ideas and notions of philosophical theories of disease. In medical theory, the concepts of disease entity and pathologicity are, besides the concept of disease itself, of fundamental importance, and they are essentially connected to the (...) concepts cause of disease or etiological factor, natural course or natural history of disease, and pathological disposition. It is the concept of disease entity that is of key importance for understanding medical pathology and theory of disease. Its central role is shown by a short reconstruction of its main features and its intrinsic connection to the concept of pathologicity. The meaning of pathologicity is elucidated by explicating the underlying criteria. (shrink)

Health, Disease, and Illness brings together a sterling list of classic and contemporary thinkers to examine the history, state, and future of ever-changing "concepts" in medicine.

This book is... a survey history of medicine from the earliest times, centered thematically on how changing concepts of disease have affected its management.... One finds a gratifying mastery of recent as well as classic scholarship in medical history and a careful sidestepping of positivistic excesses.... Disease and Its Control is a fresh and welcome synthesis of historical scholarship that will be accessible to interested laymen. (Annals of Internal Medicine).

Paul Griffiths and John Matthewson argue that selected effects play the key role in determining whether a state is pathological. In response, it is argued that a selected effects account faces a number of difficulties in light of modern genomic research. Firstly, a modern history approach to selection is problematic as a basis for assigning function to human traits in light of the small population sizes in the hominin lineage, which imply that selection has played a limited role in shaping (...) these genomes in the evolutionarily recent past. Secondly, determining both the genetic basis of disease and selective histories of the various alleles involved may be experimentally intractable. Thirdly, the existence of “selected disorders” is well supported, and yet on the other hand many other common diseases may not reduce evolutionary fitness. In summary, the biological ends promoted by natural selection, as best modeled in recent research, do not adequately ground a concept of dysfunction that aligns well with the interests of human health. (shrink)

Some ‘naturalist’ accounts of disease employ a biostatistical account of dysfunction, whilst others use a ‘selected effect’ account. Several recent authors have argued that the biostatistical account offers the best hope for a naturalist account of disease. We show that the selected effect account survives the criticisms levelled by these authors relatively unscathed, and has significant advantages over the BST. Moreover, unlike the BST, it has a strong theoretical rationale and can provide substantive reasons to decide difficult cases. This is (...) illustrated by showing how life-history theory clarifies the status of so-called diseases of old age. The selected effect account of function deserves a more prominent place in the philosophy of medicine than it currently occupies. _1_ Introduction _2_ Biostatistical and Selected Effect Accounts of Function _3_ Objections to the Selected Effect Account _3.1_ Boorse _3.2_ Kingma _3.3_ Hausman _3.4_ Murphy and Woolfolk _4_ Problems for the Biostatistical Account _4.1_ Schwartz _5_ Analysis versus Explication _6_ Explicating Dysfunction: Life History Theory and Senescence _7_ Conclusion. (shrink)

Alzheimer disease is a huge and growing societal problem with upwards of 35% of the population over the age of 80 developing the disease. AD results in a loss of memory, the ability to make reasoned and sound decisions, and ultimately the inability to take care of oneself. AD has an impact not only on the sufferer, but their caretakers and loved ones, who must take on a costly and time-consuming burden of care. AD is found in virtually all racial (...) and ethnic groups. Genetic influences on AD are substantial, and there has been a 30 year history of both success and failure. Mutations for rare early onset forms of the disease have been identified, but this information has not yet led to an effective treatment. Multiple common genetic variations have also been identified, and have led to new insights into the potential role of microglia cells in addition to neuronal cells in the brain. Despite intensive efforts, a significant portion of the genetic etiology of AD remains unknown and must be identified. (shrink)

A great number of constructive suggestions for the analysis of the concepts and models treated are presented in this book, which mirrors a current debate within the theory of medicine by covering three central topics: the concepts of health and disease; definition and classification in medicine; and causal explanation in medicine. Among the issues dealt with are: How should the concepts of health and disease be characterized in order to be of relevance to clinical practice? Should we try to define (...) particular diseases in explicit terms? What should be the criteria for selecting causes when explaining disease or death? These problems are treated from various points of view, the contributors being drawn from the fields of clinical medicine, epidemiology, psychiatry, social medicine, philosophy, and history of medicine. (shrink)

This anthology of essays presents a sample of studies from recent philosophy of medicine addressing issues which attempt to answer very general (interdependent) questions: (a) what is a disease and what is health? (b) How do we (causally) explain diseases? (c) And how do we distinguish diseases, i.e. define classes of diseases and recognize that an instance X of disease belongs to a given class B? (d) How do we assess and choose cure/ therapy?