Empiricism has many different faces. As the contributions to this volume demonstrate, in the 17th and 18th century demonstrate medical and philosophical empiricism is less about an "essence" and more a series of specifically modern "acts" or "gestures.".

The Empirical school of medicine, which arose in the third century BCE, defined itself in opposition to rationalist tendencies in medical thought. Causal explanation, which typically appeals to hidden, theoretical entities, is most at home in rationalist physiology and pathology, and much of what the Empiricists had to say about causes belongs to their anti-rationalist polemics. Over the course of the school’s history, however, some members appropriated the language and idea of cause, though always in ways that was consistent (...) with its defining commitment to Empiricism. (shrink)

Vitalism, from its early modern to its Enlightenment forms (from Glisson and Willis to La Caze and Barthez), is notoriously opposed to intervention into the living sphere. Experiment, quantification, measurement are all ‘vivisectionist’, morally suspect and worse, they alter and warp the ‘life’ of the subject. They are good for studying corpses, not living individuals. This much is well known, and it has disqualified vitalist medicine from having a place in standard histories of medicine, until recent, post-Foucauldian maneuvers have sought (...) to change the situation (but for unrelated, contextualist reasons). What is perhaps more suprising is that if we consider the emergence of medical ‘theory’ as a whole, from Harvey through to Locke and Sydenham, is the presence of a sustained anti-experimentalist line of argument, and this from the ‘empiricist’ (not Cartesian or Boerhaavian rationalist) side. It would seem then that ‘empiricks’, medical empiricists and other protagonists of an ‘embodied empiricism’ are not Boylean experimentalists who seek to map out Nature in its transparency, but deliberately archaic, Hippocratic observers of living bodies. (shrink)

Kant introduces empiricism as a deficient position that is unsuitable for the generation of scientific knowledge. The reason for this is that, according to him, empiricism fails to connect with the world by remaining trapped within the realm of appearances. If we follow Galen’s account of the debate ensuing among Hellenistic doctors in the third century B.C., empiricism presents itself in an entirely different light. It emerges as a position that criticises medical practitioners who stray away (...) from the here and now by indulging in theory-driven a priori forms of reasoning. In so doing empiricism remains at all times committed to the world and its agents. In this paper Galen’s account of empiricism will serve me as a means to unravel the dynamics of a discussion that aims to reassess the standards of a dogmatic scientific practice. By looking at Bacon’s and Gassendi’s perception of the ancient medical tradition I will furthermore show that the understanding of what empiricism is crucially depends on the understanding of what scepticism is. (shrink)

Name der Zeitschrift: Apeiron Jahrgang: 47 Heft: 2 Seiten: 141-171.

Getting physical: Empiricism’s medical History Content Type Journal Article DOI 10.1007/s11016-010-9474-4 Authors John Gascoigne, School of History and Philosophy, University of New South Wales, Sydney, NSW 2056, Australia Journal Metascience Online ISSN 1467-9981 Print ISSN 0815-0796.

Amending and Defending Critical Contextual Empiricism: Lessons from Medical Research In Science as Social Knowledge (1990) and The Fate of Knowledge (2002), Helen Longino develops a social epistemological theory known as Critical Contextual Empiricism (CCE). While Longino’s work has been generally well-received, there have been a number of criticisms of CCE raised in the philosophical literature in recent years. In this paper I outline the key elements of Longino’s theory and propose several modifications to the four norms (...) offered by the account. The revisions I propose are shaped by a number of developments in the medical context in recent years. The modified norms, which determined whether a particular community produces objective knowledge, are thus: 1. Avenues for Criticism – there must be recognized avenues for criticism, and these avenues must be publicly accessible and require transparent disclosure of all relevant information (including competing interests) from those who present their ideas. It must also be a community requirement that all members present their ideas for critical scrutiny if they wish them to be recognized as knowledge. 2. Responsiveness to Criticism – the community must be responsive to criticism. 3. Shared Public Standards – there must be some shared standards that determine community membership. Outsiders to a particular community are welcome to engage in critical debates as long as they share at least one of the community standards with the target community. 4. Cultivation of Diverse Perspectives – communities must cultivate diverse perspectives, that is, the perspectives of those who express strong dissent. The version of CCE I defend gives the principle of diversity a more central role than the original and provides greater specification of two of the other norms in light of challenges faced by medical researchers in recent years. The medical context provides us with a number of cautionary tales in which knowledge production that appears to meet the original four norms has been seriously compromised by particular social interests. The proposed modifications attempt to address these ‘loopholes’ in a way that is not ad hoc. I argue that the modifications I suggest are in line with the underlying assumptions and goals of CCE. The modified version of CCE also offers resources for defending CCE against the criticisms leveled against it by Miriam Solomon & Alan Richardson, Alvin Goldman and Philip Kitcher as well as one general concern arising out of a recent work by David Michaels. I provide responses to these criticisms in the final section of the paper. Throughout the paper I connect the theoretical work done in social epistemology to the real practice of knowledge-production as is occurs in the medical context. In light of the variety of social pressures influencing contemporary scientific research, and the role of science in shaping public policy, I argue that a rigorous social epistemology such as CCE is indispensable for understanding and assessing contemporary scientific practice. (shrink)

Thirty years after the rise of the evidence-based medicine (EBM) movement, formal training in philosophy remains poorly represented among medical students and their educators. In this paper, I argue that EBM’s reception in this context has resulted in a privileging of empiricism over rationalism in clinical reasoning with unintended consequences for medical practice. After a limited review of the history of medical epistemology, I argue that a solution to this problem can be found in the method (...) of the 2nd-century Roman physician Galen, who brought empiricism and rationalism together in a synthesis anticipating the scientific method. Next, I review several of the problems that have been identified as resulting from a staunch commitment to empiricism in medical practice. Finally, I conclude that greater epistemological awareness in the medical community would precipitate a Galenic shift toward a more epistemically balanced, scientific approach to clinical research. (shrink)

In this paper we suggest a revisionist perspective on two significant figures in early modern life science and philosophy: William Harvey and John Locke. Harvey, the discoverer of the circulation of the blood, is often named as one of the rare representatives of the ‘life sciences’ who was a major figure in the Scientific Revolution. While this status itself is problematic, we would like to call attention to a different kind of problem: Harvey dislikes abstraction and controlled experiments (aside from (...) the ligature experiment in De Motu Cordis), tends to dismiss the value of instruments such as the microscope, and emphasizes instead the privileged status of ‘observed experience’. To use a contemporary term, Harvey appears to rely on, and chiefly value, ‘tacit knowledge’. Secondly, Locke’s project is often explained with reference to the image he uses in the Epistle to the Reader of his Essay, that he was an “underlabourer” of the sciences. In fact, despite the significant medical phase of his career, Locke’s ‘empiricism’ turns out to be above all a practical (i.e. ‘moral’) project, which focuses on the delimitation of our powers in order to achieve happiness, and rejects the possibility of naturalizing knowledge. When combined, these two cases suggest a different view of some canonical moments in early modern natural philosophy. (shrink)

My topic is the materialist appropriation of empiricism – as conveyed in the ‘minimal credo’ nihil est in intellectu quod non fuerit in sensu (which interestingly is not just a phrase repeated from Hobbes and Locke to Diderot, but is also a medical phrase, used by Harvey, Mandeville and others). That is, canonical empiricists like Locke go out of their way to state that their project to investigate and articulate the ‘logic of ideas’ is not a scientific project: (...) “I shall not at present meddle with the Physical consideration of the Mind” (Essay, I.i.2, in Locke 1975; which Kant gets exactly wrong in his reading of Locke, in the Preface to the A edition of the first Critique). Indeed, I have suggested elsewhere, contrary to a prevalent reading of Locke, that the Essay is not the extension to the study of the mind of the methods of natural philosophy; that he is actually not the “underlabourer” of Newton and Boyle he claims politely to be in the Epistle to the Reader (Wolfe and Salter 2009, Wolfe 2010). Rather, Locke says quite directly if we pay heed to such passages, “Our Business here is not to know all things, but those which concern our Conduct” (Essay, I.i.6). There would be more to say here about what this implies for our understanding of empiricism (see Norton 1981 and Gaukroger 2005), but instead I shall focus on a different aspect of this episode: how a non-naturalistic claim which falls under what we now call epistemology (a claim about the senses as the source of knowledge) becomes an ontology – materialism. That is, how an empiricist claim could shift from being about the sources of knowledge to being about the nature of reality (and/or the mind, in which case it needs, as David Hartley saw and Denis Diderot proclaimed more overtly, an account of the relation between mental processes and the brain). (David Armstrong, for one, denied that there could be an identification between empiricism and materialism on this point: eighteenth-century history of science seems to prove him wrong: see Armstrong 1968 and 1978.) Put differently, I want to examine the shift from the logic of ideas in the seventeenth century (Locke) to an eighteenth-century focus on what kind of ‘world’ the senses give us (Condillac), to an assertion that there is only one substance in the universe (Diderot, giving a materialist cast to Spinozism), and that we need an account of the material substrate of mental life. This is neither a ‘scientific empiricism’ nor a linear developmental process from philosophical empiricism to natural science, but something else again: the unpredictable emergence of an ontology on empiricist grounds. (shrink)

In Science as Social Knowledge in 1990 and The Fate of Knowledge in 2002, Helen Longino develops an epistemological theory known as Critical Contextual Empiricism (CCE). Knowledge production, she argues, is an active, value-laden practice, evidence is context dependent and relies on background assumptions, and science is a social inquiry that, under certain conditions, produces social knowledge with contextual objectivity. While Longino’s work has been generally well-received, there have been a number of criticisms of CCE raised in the philosophical (...) literature in recent years. In this paper I outline the key elements of Longino’s theory and propose modifications to the four norms offered by the account. The version of CCE I defend, which draws on lessons learned by medical researchers in recent years, gives principles of epistemic diversity a central role and also provides greater specification of three of the four norms. Further, it offers additional resources for defending CCE against Alvin Goldman’s suggestion that there is a need for a “healthy dogmatism” in science, as well as a concern about “manufactured uncertainty” arising out of recent work by David Michaels. Finally, the modified version proposed here is also well positioned to respond (negatively) to a suggestion from Kristen Intemann that CCE needs to be adapted to incorporate a central insight from feminist standpoint theory. In light of the variety of social pressures influencing contemporary scientific research, and the role of science in shaping public policy, I argue that a rigorous social epistemology such as CCE is indispensable for understanding and assessing contemporary scientific practice. (shrink)

Research into the proper mission of business falls within the context of theoretical and applied ethics. And ethics is fast becoming a part of required business school curricula. However, while business ethics research occasionally appears in high‐profile venues, it does not yet enjoy a regular place within any top management journal. I offer a partial explanation of this paradox and suggestions for resolving it. I begin by discussing the standard conception of human nature given by neoclassical economics as disseminated in (...) business schools; showing it is a significant obstacle to an accurate conception of ethics and how this limits consideration of sustainability and corporate social responsibility. I then examine the scope of the top management journals, showing how their empirical and descriptive focus leaves little room for ethics, which is an essentially conceptual and prescriptive discipline. Finally, I suggest avenues for research into the ethical mission of business, generally—and sustainability and CSR, in particular—by appeal to the precepts of Harvard Business School’s Master’s in Business Administration ethics oath modeled on the medical and legal professions. (shrink)

This paper examines the status of medical experiments using the Leibnizian conception of knowledge. The aim is to consider whether experimentation is a “perceptive foretaste” or a real condition for the advancement of knowledge. To this end I argue, first, that acting on bodies could be a way to understand them and, second, I establish a place for medical experiments in the field of learning. In these ways, I identify a “provisional empiricism” in Leibniz’ medical texts.

This article explores Galen's analysis of and response to the Rationalist and Empiricist medical sects. It argues that his interest in their debate concerning the epistemology of medicine and anatomy was key to his advancement of an experimental methodology.

In this chapter, Hankinson discusses the major Hellenistic Medical theories and figures, from the Alexandrian doctors Herophilus and Erasistratus in the third century bc to the Empiricist, Rationalist, and Methodist schools of the early Imperial period. Hankinson argues that the practical basis of medical science broadened and deepened the debate about the nature of causal explanation. The Empiricists were sceptics in their attitude to causes, thinking that observation and report of evident conditions and their cures was sufficient for (...) medical science, and thus eschewing causal theory. Rationalist doctors attacked the inadequate methodology of the Empiricists, and they try to explain why the antecedent cause should bring on such and such an effect, while emphasizing the need to decide rationally the proper use of induction, and the relevancy of similarities. The Methodists treat as irrelevant antecedent causes or factors, and they recognized just two pathological conditions—relaxation and constriction; the doctor's concern is to determine by direct observation in which state is the body. (shrink)

The clinical empiricism of Thomas Sydenham (1624–1689) and his definition of especie morbosae represented a substantial turn in the medicine of his time. This turn supposed the shift towards an ontological conception of diseases, from a qualitative to quantitative interpretation. Sydenham’s clinical proposal had a great influence on empiricism philosophical thinking, particularly in John Locke and his delimitation of knowledge. The dialogue between medicine and philosophy, set out by Sydenham-Locke, reactivates the problem of the clinical and theoretical foundations (...) of medical thought, as well as the limits of scientific knowledge. Similar to problem exposed in the Hippocratic treatise On ancient medicine, seventeenth-century medicine seeks its epistemological foundations and the solution to its difficulties in clinical experience, probability and analogy. The aim of this work is to show the Sydenham’s contribution to one of the great controversies between medicine and philosophy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 545 Haroutunian, would have balked at the notion that their " empiricism " could be abstracted from the christological and trinitarian confession 0£ the church. In general, it would seem that a genuinely " empirical" approach would seek to engage the actual truth claims of religious com· munities on their own terms-even when those claims conflict with historicist suppositions. Second, in so far as Dean thinks (...) there is a uniquely American reli· gious experience or style of thought, privileging that style seems a dangerous move indeed. Dean is not unaware of the dangers. He specifically denies that he is engaging in any form of " American exceptionalism " (p. 25) ; it is simply that an " appropriately American historicism, centering on American culture, would have a greater chance of suggesting practices that work for and are true for America " (p. 24). But I am skeptical that such disclaimers address the real problem. Near the very end of the book, Dean suggests that a modi· fied naturalism might lead to " a notion of God that was more genuinely American than anything earlier," culminating in the recognition that " American thought about God is really the thought of a national com· munity" (p. 144). Descriptively that may well be the case; but then the Christian theologian must seek norms elsewhere. History Making History does not show us how historicist insigh~ might be incorporated into ecumenical, trinitarian theology, but that does not mean the attempt will prove unfruitful. Meanwhile, this bit of philosophical tale-telling will hold the interest of readers theological and otherwise. JOSEPH L. MANCINA Yale University New Haven, Connecticut Medical Ethics: Sources of Catholic Teaching. By KEVIN D. O'ROURKE, O.P. and PHILIP BOYLE, O.P. St. Louis: Catholic Health Associa· tion, 1989. Medical Ethics: Common Ground for Understanding. By KEVIN D. O'RouRKE, O.P. and DENNIS BRODEUR. St. Louis: Catholic Health Association, 1989. Healthcare Ethics: A Theological Analysis. By KEVIN D. O'RouRKE, O.P. and BENEDICT ASHLEY, O.P. 3rd ed. St. Louis: Catholic Health Association, 1989. Sources of Catholic Teaching is a compendium of recent "official" statements by Roman Catholic ecclesiastical bodies on issues concern· ing medical ethics. Arranged alphabetically according to topics, this col- 546 BOOK REVIEWS lection of statements from the papacy, the Roman Congregations, and the conferences of Catholic bishops could prove to he a very helpful reference tool. It contains a brief introduction which seeks to explain the role of these statements in the Catholic moral theology and Catholic medical ethics, a table of contents of the statements included, and then the statements themselves. In most instances it does not contain the entire document or statement hut only excerpts therefrom. There are some weaknesses in this work. First, these statements are not self-explanatory; they are in need of interpretation and explanation in many instances. But the authors present only the bald text and do not offer any explanatory comments. They apparently presume that these statements are pellucid to the reader, hut this is an unwarranted pre· sumption. For example, clarifying comments should have been added to the statement from the Declaration on Euthanasia because the allocution of Pius XII about giving lethal doses of analgesia is not entirely clear. A second difficulty with this work is the brief and somewhat insubstantial introduction on conscience and the role these statements should play in the formation of conscience. This sort of work invites a substantial and extended commentary on the nature of moral judgments, the relationship of conscience to the natural law, and the authority of these statements. The authors note that not all of the official statements issued by various organs of the Church are of equal authority, hut they do not try to identify the specific authoritative status of the various statements they include in their work. The reader is thus left to his or her own devices to determine, for example, the relative weight of statements of the administrative hoard of the NCCB versus statements of state episcopal conferences. A still further problem is that some of the statements are of virtually no significant authority for Catholics. For example, the statement of the administrative hoard of the NCCB on AIDS is of questionable... (shrink)

A physician and spokesman for the French Ideologues, Pierre-JeanGeorges Cabanis (1757-1808) stands at the crossroads of several influential developments in modern culture--Enlightenment optimism about human perfectibility, the clinical method in medicine, and the formation and adaptation of liberal social ideals in the French Revolution. This first major study of Cabanis in English traces the influences of these developments on his thought and career. Originally published in 1980. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously (...) out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

How are we to connect the mechanist methodology used by Baglivi in his physiological treatises with the apparently strict empiricism that he promotes in his therapeutic work entitled Practice of Physick, reduc’d to the Ancient Way of Observations? In order to answer this question, we examine the methodological implications of the “history of diseases” that Baglivi promotes by using Bacon’s recommendations in the Novum organum. Then, we compare this result with the place that historians generally gave to Baglivi in (...) the medical context of that time: the place of a dogmatic and “iatromechanist” physician who was far from practical and therapeutic concerns. This confrontation allows us first to apprehend the polemical origin of the so-called “iatromechanism” as a historiographical label, and second, to question the preeminence of the role of observations in the shaping of the classical distinction between “rational” physicians and “empirical” ones. When Early Modern physicians use the dichotomy between “empirical” and “rationalist” in order to discredit what they perceive as oversimplification or dogmatism, there is most often a third group at stake: a group which is depicted as the providential and intelligent solution to sectarianism. For Baglivi, this third group would be an “Empirick rational sect.” The distinction between a medicina prima and a medicina secunda allows us to understand such an apparently paradoxical category. (shrink)

This book provides a post-positivist theory of deterministic and probabilistic causality that supports both quantitative and qualitative explanations. Features of particular interest include the ability to provide true explanations in contexts where our knowledge is incomplete, a systematic interpretation of causal modeling techniques in the social sciences, and a direct realist view of causal relations that is compatible with a liberal empiricism. The book should be of wide interest to both philosophers and scientists. Originally published in 1989. The Princeton (...) Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

In this sweeping volume of comparative philosophy and intellectual history, Barry Allen reassesses the values of experience and experiment in European and world traditions. His work traces the history of empirical philosophy from its birth in Greek medicine to its emergence as a philosophy of modern science. He surveys medical empiricism, Aristotlean and Epicurean empiricism, the empiricism of Gassendi and Locke, logical empiricism, radical empiricism, transcendental empiricism, and varieties of anti-empiricism from Parmenides (...) to Wilfrid Sellars. Throughout this extensive intellectual history, Allen builds an argument in three parts. A richly detailed account of history's empiricisms in Part One establishes a context in Part Two for reconsidering the work of the radical empiricists--William James, Henri Bergson, John Dewey, and Gilles Deleuze, each treated in a dedicated chapter. What is "radical" about them is their effort to return empiricism from epistemology to the ontology and natural philosophy where it began. In Part Three, Allen sets empirical philosophy in conversation with Chinese tradition, considering technological, scientific, medical, and alchemical sources, as well as selected Confucian, Daoist, and Mohist classics. The work shows how philosophical reflection on experience and a profound experimental practice coexist in traditional China with no interaction or even awareness of each other, slipping over each other instead of intertwining as they did in European history, a difference Allen attributes to a different understanding of the value of knowledge. Allen's book recovers empiricism's neglected, multi-textured contexts, and elucidates the enduring value of experience, to arrive at an idea of what is living and dead in philosophical empiricism. (shrink)

The author argues that ancient Skepticism may be most suited to deal with two crises in the Age of COVID-19: both the physical or epidemiological aspects of the pandemic, and the epistemological and ethical crisis of increasing disbelief in the sciences. Following Michel Bitbol, I suggest one way to mitigate this crisis of faith may be for science to become more epistemically modest, renouncing some of its claims to describe reality as it objectively is, and adopting an “intransitive” rather than (...) a “transitive” approach to Nature. This was the attitude adopted by the Greco-Roman medical school of the Empirics, which may also be of assistance in combatting the urgent problem of Fake News. The epistemology of Skepticism and the scientific methodology of the closely related Medical Empiricism shows that an epistemically modest, non-interventionist approach to science is quite compatible with a robust and sophisticated proto-experimental scientific methodology. (shrink)

The author argues that ancient Skepticism may be most suited to deal with two crises in the Age of COVID-19: both the physical or epidemiological aspects of the pandemic, and the epistemological and ethical crisis of increasing disbelief in the sciences. Following Michel Bitbol, I suggest one way to mitigate this crisis of faith may be for science to become more epistemically modest, renouncing some of its claims to describe reality as it objectively is, and adopting an “intransitive” rather than (...) a “transitive” approach to Nature. This was the attitude adopted by the Greco-Roman medical school of the Empirics, which may also be of assistance in combatting the urgent problem of Fake News. The epistemology of Skepticism and the scientific methodology of the closely related Medical Empiricism shows that an epistemically modest, non-interventionist approach to science is quite compatible with a robust and sophisticated proto-experimental scientific methodology. (shrink)

The purpose of this paper is twofold: to discuss some challenging issues concerning Sextus’ works and outlook, and to offer an overview of the influence exerted by Sextan Pyrrhonism on both early modern and contemporary philosophy.

The articles examines how failure, especially in so-called 'stochastic' arts or sciences like medicine and navigation stimulated reflections about the nature of the knowledge required of a genuine art (techne) or science.

The medical specialty of psychiatry should possess a basic science in which pathologies are considered deviations from normal brain physiology. Historically, psychoanalytic pathogenesis was considered separately from brain physiology. It was not scientific because observations could not be refuted. Countering this, Eli Robins's legacy stemmed partly from his having been damaged by a psychoanalyst. It eschewed pathogenesis. Attempting to integrate psychiatry with medicine more generally, Robins and colleagues refocused on empiricism, although they acknowledged the brain's centrality. Here I (...) hold that the term biology used in the context of psychiatry should broadly encompass social facets of organismal function. The term “sociophysiology” may best describe the central basic science of psychiatry because it alludes to brain functions used for the person's social realm. Disruptions of such functions result in deviant behaviors and unpleasant feelings which psychiatrists diagnose and treat. Future study encompassing top-down and bottom-up research should include genome-neural-behavioral analyses. (shrink)

The Pneumatist school of medicine has the distinction of being the only medical school in antiquity named for a belief in a part of a human being. Unlike the Herophileans or the Asclepiadeans, their name does not pick out the founder of the school. Unlike the Dogmatists, Empiricists, or Methodists, their name does not pick out a specific approach to medicine. Instead, the name picks out a belief: the fact that pneuma is of paramount importance, both for explaining health (...) and disease, and for determining treatments for the healthy and sick. In this paper, we re-examine what our sources say about the pneuma of the Pneumatists in order to understand what these physicians thought it was and how it shaped their views on physiology, diagnosis and treatment. (shrink)

Following a recent trend in the field of the history of philosophy and medicine, this paper stresses the necessity of recognizing empiricism’s patent indebtedness to the sciences of the body. While the tribute paid to the Hippocratic method of observation in the work of Thomas Sydenham is well known, it seems necessary to take into account a trend more critical of ancient medicine developed by followers of chemical medicine who considered the doctrine of elements and humours to be a (...) typical example of the idols that hinder the improvement of medical knowledge and defend the necessity of experimentation. In light of the fact that modern discoveries resulted in a “new frame of human nature,” they developed a critical reading of ancient empiricism. As a consequence, we can distinguish between two distinct anti-speculative traditions in the genesis of philosophical empiricism. The first recommends an active investigation into nature and refers to the figure of Democritus, the ancient philosopher who devoted himself to the dissection of beasts. Defenders of this first tradition refuse point-blank to be called ‘empiricists’, a label which had a very negative meaning during the seventeenth century, when it was used to dismiss charlatans and quacks. The other tradition, stressing as it does the role of description and observation, is more sceptical of the ability of dissection or anatomy to give us access to causes of diseases. This later tradition comes closer to the definition of ancient empiricism and to the figure of Hippocrates. (shrink)

This article presents and transcribes a newly identified John Locke manuscript – an index Locke made of Anton Deusing’s De motu cordis et sanguinis itemque de lacte ac nutrimento foetus in utero, dissertationes (Groningen, 1655). Deusing (1612–1666) was a polymath and medical eclectic with a scholastic predisposition who wrote numerous medical texts in the 1650s and 1660s. Locke owned and read several of these works, taking notes from them, and indexing at least two of them during his (...) class='Hi'>medical research at Oxford in the mid-1660s. The recovery of this manuscript further underlines Locke’s own medical eclecticism at this time, highlighting the contrast between his views in this part of his career and the empiricism he later came to evince. (shrink)

The five books of Artemidorus of Ephesus’ Oneirocritica (c. second century CE) constitute the largest collection of divinatory dream-interpretations to survive from Graeco-Roman antiquity. This article examines Artemidorus’ contribution to longstanding medico-philosophical debates over the ontological and epistemic character of such dreams. As with wider Mediterranean traditions concerning premonitory dreams, Greeks and Romans popularly understood them as phenomena with origins exterior to the dreamer (e.g. a visitation of a god). Presocratic and Hippocratic thinkers, however, initiated an effort to bring at (...) least some dream events within the body as interior processes of a physical soul, a bodily turn which ultimately engendered a split in thinking about the possibility and scope of prophetic and diagnostic dreams (e.g. Hippocrates Regimen 4, Aristotle On Prophecy in Dreams, Rufus of Ephesus, and Galen). Here, I examine the way that Artemidorus meant the Oneirocritica to address seriously questions about the origins of dreams and the powers of empirical science in two, related ways. We will see that his defense of oneirocriticism as a techne unfolds along two main axes. First, Artemidorus constructs a necessary veneer of scientific credibility by mobilizing the tropes and organizational strategies characteristic of contemporary technical literature. Secondly, he anchors that authority upon a materialist account of prophetic dreams as “semiotic movements of the soul.” As Price, S. 1986. “The Future of Dreams: From Freud to Artemidorus.” Past & Present 113: 3–36 and Harris-McCoy, D. 2012. Artemidorus’ Oneirocritica: Text, Translation, and Commentary. Oxford: Oxford University Press observed, this explicit commitment to an empirical method of dream-interpretation resembles that of the Hellenistic medical ‘sect’ known as ‘Empiricists,’ who eschewed interest in theoretical etiology in favor of observation, comparison, and compilation of symptoms and outcomes. Pushing beyond similarity, I argue that Artemidorus not only deployed this method to defend empirically grounded accounts of dream-divination (cf. Cicero De div. 1), but endeavored to show that such a scientific method can be used to stabilize and corral productively the potentially infinite number of interpretations any dream-sign might bear without recourse to an underlying, causal theory. (shrink)

The philosophical thought of John Locke, a physician by profession, was colored by Locke's medical outlook to a much greater degree than had ever been suspected. Patrick Romanell, in John Locke and Medicine, examines Locke's relatively unknown medical writings and asks how Locke's own distinctive conception of human knowledge, traditionally classified under British empiricism, developed. He finds that, of all of Locke's interests, it is medicine that accounts most directly and effectively for his practical ideal of life (...) and for his constant appeal to "profitable knowledge." In his masterpiece An Essay Concerning Human Understanding (1690), Locke attempted, as he stated it, "to describe to others, more particularly than had been done before, what it is their minds do, when they perform that action, which they call knowing." Locke was intent on describing "the natural history of knowledge" and he required an appropriate method of inquiry. Romanell shows that it was Locke's medical thought and his background as a physician that provided the paradigm for his famed "historical, plain method" of inquiry that he applied to his philosophical analysis of human understanding. In addition to the light this sheds on Locke's philosophy, this new information causes us to reconsider several other significant issues: the nature of the debate between the competing schools of Continental Rationalism and British Empiricism; the position of Sydenham the physician in Locke's intellectual development; and the subtle differences of temper within the long tradtition of British Empiricism itself. John Locke and Medicine is the first book to discuss the hitherto neglected relationship between Locke the phycisian and Locke the philosopher. A major contribution to the study of John Locke, it is also a fascinating account of one of the many instances of the meeting of medicine and philosophy in the history of ideas. (shrink)

The purpose of this study is to determine empirically the state of the art of the medical care, when healthcare personal is confronted with ethical dilemmas related with the care they give to the geriatric population. An observational, longitudinal, prospective and qualitative study was conducted by analyzing the correlation between healthcare personnel–patient relationship, and ethical judgments regarding dilemmas that arise in daily clinical practice with geriatric patients. Mexican healthcare personnel with current active practices were asked to write up an (...) ethical dilemma that arose frequently or that had impacted their medical practice. From the narrative input, we were able to draw up a database with 421 dilemmas, and those corresponding to patients 60 years and older were selected (n = 54, 12.8 %). The axiological analysis of the narrative dilemmas of geriatric patients was made using dialectical empiricism. The axiological analysis values found most frequently were classified into three groups: the impact of healthcare, the roles of the physician, and refusal of therapy; the healthcare role of educator, caring for the patients’ life and the risk of imminent death where the values found more often. The persistence and universality of certain dilemmas in geriatrics calls for awareness and requires a good training in the ethical discernment of these dilemmas. This would help to improve substantially the care and the life quality of this population. (shrink)

The medical specialty of psychiatry should possess a basic science in which pathologies are considered deviations from normal brain physiology. Historically, psychoanalytic pathogenesis was considered separately from brain physiology. It was not scientific because observations could not be refuted. Countering this, Eli Robins's legacy stemmed partly from his having been damaged by a psychoanalyst. It eschewed pathogenesis. Attempting to integrate psychiatry with medicine more generally, Robins and colleagues refocused on empiricism, although they acknowledged the brain's centrality. Here I (...) hold that the term biology used in the context of psychiatry should broadly encompass social facets of organismal function. The term sociophysiology may best describe the central basic science of psychiatry because it alludes to brain functions used for the person's social realm. Disruptions of such functions result in deviant behaviors and unpleasant feelings which psychiatrists diagnose and treat. Future study encompassing top-down and bottom-up research should include genome-neural-behavioral analyses. (shrink)

This chapter contains sections titled: Epicurean Empiricism Critiques of Cartesianism Conclusion.

We argue why interpretability should have primacy alongside empiricism for several reasons: first, if machine learning models are beginning to render some of the high-risk healthcare decisions instead of clinicians, these models pose a novel medicolegal and ethical frontier that is incompletely addressed by current methods of appraising medical interventions like pharmacological therapies; second, a number of judicial precedents underpinning medical liability and negligence are compromised when ‘autonomous’ ML recommendations are considered to be en par with human (...) instruction in specific contexts; third, explainable algorithms may be more amenable to the ascertainment and minimisation of biases, with repercussions for racial equity as well as scientific reproducibility and generalisability. We conclude with some reasons for the ineludible importance of interpretability, such as the establishment of trust, in overcoming perhaps the most difficult challenge ML will face in a high-stakes environment like healthcare: professional and public acceptance. (shrink)

The Renaissance sceptic and medical doctor Francisco Sanchez has been rather unduly neglected in scholarly work on Renaissance scepticism. In this paper I discuss his scepticism against the background of the ancient distinction between Academic and Pyrrhonian scepticism. I argue that Sanchez was a Pyrrhonist rather than, as has been claimed in recent years, a mitigated Academic sceptic. In keeping with this I shall also try to show that Sanchez was crucially influenced by the ancient medical school of (...) empiricism, a school closely allied with Pyrrhonism. (shrink)

Contents: Introduction, Bibliography On the Sects for Beginners An Outline of Empiricism On Medical Experience Index of the Persons Mentioned in the Texts Index of the Subjects Mentioned in the Texts.

Newton’s impact on Enlightenment natural philosophy has been studied at great length, in its experimental, methodological and ideological ramifications. One aspect that has received fairly little attention is the role Newtonian “analogies” played in the formulation of new conceptual schemes in physiology, medicine, and life science as a whole. So-called ‘medical Newtonians’ like Pitcairne and Keill have been studied; but they were engaged in a more literal project of directly transposing, or seeking to transpose, Newtonian laws into quantitative models (...) of the body. I am interested here in something different: neither the metaphysical reading of Newton, nor direct empirical transpositions, but rather, a more heuristic, empiricist construction of Newtonian analogies. Figures such as Haller, Barthez, and Blumenbach constructed analogies between the method of celestial mechanics and the method of physiology. In celestial mechanics, they held, an unknown entity such as gravity is posited and used to mathematically link sets of determinate physical phenomena (e.g., the phases of the moon and tides). This process allows one to remain agnostic about the ontological status of the unknown entity, as long as the two linked sets of phenomena are represented adequately. Haller et. al. held that the Newtonian physician and physiologist can similarly posit an unknown called ‘life’ and use it to link various other phenomena, from digestion to sensation and the functioning of the glands. These phenomena consequently appear as interconnected, goal-oriented processes which do not exist either in an inanimate mechanism or in a corpse. In keeping with the empiricist roots of the analogy, however, no ontological claims are made about the nature of this vital principle, and no attempts are made to directly causally connect such a principle and observable phenomena. The role of the “Newtonian analogy” thus brings together diverse schools of thought, and cuts across a surprising variety of programs, models and practices in natural philosophy. (shrink)

Although there is increased recognition of the inevitable--and perhaps sometimes beneficial-- role of values in scientific inquiry, there are also growing concerns about the potential for commercial values to lead to bias. This is particularly evident in biomedical research. There is a concern that conflicts of interest created by commercialization may lead to biased reasoning or methodological choices in testing drugs and medical interventions. In addition, such interests may lead research in directions that are unresponsive to pressing social needs, (...) when it is profitable to do so. Feminist philosophy of science seems particularly well situated to provide resources to help address such concerns because this literature has both 1) theorized about how to minimize biases in science, e.g., sexist or androcentric biases, and 2) generated accounts of objectivity that do not require individual scientists to be value-neutral or disinterested. Two such accounts are assessed in relation to concerns about commercial bias: those offered by feminist empiricism and standpoint feminism. We argue that standpoint feminism is more promising because it has resources to address, not just the epistemological, but also the inescapably ethical dimensions of commercial bias. (shrink)

From Galileo and Newton to Thomas Hobbes and Martin Luther King, Jr., thinkers throughout history have consciously employed scientific techniques to better understand the non-physical world. The Age of Reason and the Enlightenment led theorists to apply scientific reasoning to the non-scientific disciplines of politics, economics, and moral philosophy. Instead of relying on the woodcuts of dissected bodies in old medical texts, physicians opened bodies themselves to see what was there; instead of divining truth through the authority of an (...) ancient holy book or philosophical treatise, people began to explore the book of nature for themselves through travel and exploration; instead of the supernatural belief in the divine right of kings, people employed a natural belief in the right of democracy. In this provocative and compelling book, Shermer will explain how abstract reasoning, rationality, empiricism, skepticism--scientific ways of thinking--have profoundly changed the way we perceive morality and, indeed, move us ever closer to a more just world. (shrink)

Philosophers are drawn to the Atomic Theory like a dog to an old shoe, but my results about realism and anti-realism in Tracking Truth, and the distinctive position I have carved out on their basis, are independent of the fate of my comments about that historical case. I will defend those comments against Stanford’s objections below, but first I will explain the argument of my chapter, because its results undermine not only historically important antirealist positions, but also the approach via (...) unconceived conceivables that Stanford’s criticisms (and his pessimistic induction) depend on. The issue is claims about equal evidential support that empiricist defenses of epistemological anti-realism, including Stanford’s, must and do appeal to. In Chapter 6 of Tracking Truth, I show that the best known probabilistic definitions of evidential support imply the anti-realist’s key equalsupport claims are either false or inconsistent with the view he wants to base on them. There are reasons to think that it is not even possible to define a probabilistic notion of support that will do the job the anti-realist needs. It follows from this, as I explain below, that the anti-realist has not defended the claim that we are in principle, or even probably, unable to confirm high-level theories – for this, I say, we must wait and see, and make our best estimates. This, and my claim that we have actually gotten beyond observables – a point made with pregnancy tests and tests for medical conditions – make room for realism. I do not endorse the kind of realist claim that says we generally have a right to believe our successful hypotheses that go beyond observables. Some successful hypotheses are better confirmed than others, and some are not at all. However, since the anti-realist’s general skeptical arguments fail, I also do not think we need such general claims in order to have a right to confidence in those particular hypotheses for which we do have good evidence. I call my approach to the epistemological realism-anti-realism debate “evidential.” The nub of the issue between the two camps has always been whether we have a right to believe our scientific theories – in some sense that includes at least some of their claims about unobservable matters – on the basis of our evidence.1 Answers to this question depend on what our evidence actually is, and on the definition or criteria for evidential support.. (shrink)

Aristotle's voluminous writings on animals have often been marginalised in the history of philosophy. Providing the first full-length comprehensive account of Aristotle's biology, its background, content and influence, this Companion situates his study of living nature within his broader philosophy and theology and differentiates it from other medical and philosophical theories. An overview of empiricism in Aristotle's Historia Animalium is followed by an account of the general methodology recommended in the Parts of Animals. An account of the importance (...) of Aristotle's teleological perspective and the fundamental metaphysics of biological entities provides a basis for understanding living capacities, such as nutrition, reproduction, perception and self-motion, in his philosophy. The importance of Aristotle's zoology to both his ethics and political philosophy is highlighted. The volume explores in detail the changing interpretations and influences of Aristotle's biological works from antiquity to modern philosophy of science. It is essential for both students and scholars. (shrink)

The article offers a brief set of definitions of metaphysical and epistemological principles underlying three distinct theories of consciousness and then relates these paradigms to a triad of contemporary therapeutic modalities. Accordingly, it connects materialism, empiricism, determinism and a passive interpretation of the “mind”=brain to medication interventions and behavioral and cognitive treatments. In this context, the paper proceeds to argue that these treatment approaches are theoretically incapable of addressing the dominant issue of man’s loneliness, and his struggle to escape (...) from it, as the most basic universal drivein human beings. Next, it discusses the dualist, idealist, and rationalist assumptions of an active reflexive, self-consciousness, which has dominated insight-oriented treatment methodologies since Freud. And, finally, it treats the Hesperian and Sartre an phenomenological andexistential descriptions of awareness as grounded in the transcen­dent principle of intentionality emphasizing the aspects of the freedom of consciousness. Lastly, it claims that the first view stresses the temporal present; the second the past; and the third the future. (shrink)

This paper explores alternative approaches to the conception of scientific literacy, drawing on cultural studies and emerging practices in language arts as its framework. The paper reviews historic tensions in the understanding of scientific literacy and then draws on the multiliteracies movement in language arts to suggest a scientific multiliteracy. This is explored through analyzing the writing practices of groups other than scientists who for a variety of reasons must engage science. Specifically the paper examines zine writers who are ‘professional’ (...) human research subjects, i.e. derive a part of their annual income by signing up for psychological and medical experiments, and science fiction fans, who produce their own texts in response to the narratives they love. The paper argues that these literacy practices add to traditional notions of scientific literacy possibilities of history, fiction, critique, as well as more traditional empiricism embraced by national standards. The paper concludes by considering the ambivalence towards science in both of these popular scientific literacy communities’ writings, arguing that what multiliteracies offers is a possibility of a more nuanced, more appropriately ambivalent, and more politically and ethically engaged subject of science than offered by the current version of literacy dominating science educational discourse. (shrink)

As a result of this case study, additional questions arise. These can be cast into at least three groups. The first concerns the development of critical empiricism in the ancient world: a topic of much interest in our own century, expecially with regard to the work of the logical empiricists. Many of the same arguments are present in the ancient world and were hotly debated from the Hippocratic writers through and beyond Galen. Some of the ways in which Galen (...) reacts to Hippocratic and Aristotelian influences may, in part, be explained by Galen's own posture as a so-called Dogmatist. Both the Empirics and the Methodists offered alternative viewpoints on the place, role, and limits of observation in biomedical research. Though I have written on this relationship in the Hippocratic writers and Aristotle,44 it remains to be discussed in detailed fashion just how critical empiricism acted in Galen's evaluation of biomedical problems (aporiai). Contrasts between Galen and his predecessors might further clarify this issue both as a historical question and as it affects the construction of biological theory.The second area explores the question of how one develops comprehensive theories. In this respect Galen follows Aristotle's methodology rather closely. Both look at what theories are available to them and then systematically review the problems raised, at the same time refuting what they find inadequate. This is an effective strategy, for it permits utilizing the best features of earlier work to fashion a new whole. Indeed, Galen himself seems to attribute his use of such a methodology to his “ecletic” medical and philosophical training. Both Aristotle and Galen endeavor to employ techniques of theory integration. That is, they use aspects of theories they have already espoused to deal with new problems. This suggests the emergence of formal, logical coherence as an element in theory evaluation. The obvious drawback is that it can cause mistakes in one area to be repeated and ingrained in other areas. Such errors, because they are at the very core of an explanatory framework, may take centuries to correct. Future studies may shed light on how theory integration acts both in a positive and in a negative way.Finally, this case study offers a glimpse of how science progresses. Even though the advances in medical technology were comparatively minor, there is a great deal more sophistication in the conception theoreis of Aristotle and Galen than was present in the Hippocratic writers. Some of this (in Galen's case) had to do with increased anatomic and physiological knowledge, but most, I believe, is due to the evolution of scientific knowledge. If further work were done specifically on this question, it might document more completely how scientific knowledge on a specific topic evolves. The mode of advancement is primarily through gradual refinement of the types of questions being asked by these ancient authors, and the ramifications of their answers.Ancient theories of conception offer a fine case study in the history and philosophy of how a theory begins the develops. I have tried to suggest some interrelationships among the more important theories, as they focused upon Aristotle's own conception theory. There has been renewed interest in such cases in recent years. It is my hope that future specialized studies will increase our knowledge of method and practice in these important case studies and thereby augment our understanding of the genesis and application of biological theories. (shrink)

This paper examines the conclusions that one must draw from the finding that there are values in science. The value-ladenness of scientific claims puts the nature and role of empirical evidence into question, as seen in recent discussions in the philosophy of medicine regarding evidence-based medicine and feminist science studies, which maintains the normativity of its feminist claims. Within the critical literature and debates surrounding evidence-based medicine (EBM), one finds a championing of the lessons learned from post-positivist science studies: the (...) evidence-based effort to ground medical decision-making in the most rigorous sources of scientific evidence obscures the social values that necessarily enter into all decision-making contexts, the complex social context of clinical practice being no exception. The critics of EBM claim that to try to derive a formal methodology governed by pre-established rules, guidelines, and hierarchies of information misplaces the contextual and social features of biomedical knowledge and practice, thereby obscuring the power interests that so problematically dictate large factions of biomedical research and practice. Yet possible relativist implications follow from this finding, and we find that the EBM critics amply criticize EBM’s tacit theory of evidence, but then fail to formulate a constructive alternative theory of evidence within this fact-value interplay. After overviewing some such criticisms of evidence-based medicine, I turn to contemporary critical science studies, especially the feminist empiricism of Lynn Hankinson Nelson and Helen Longino, for workable alternative theories of evidence within a framework of normative scientific claims. I will suggest these theories fail to guide medical decision-making because of some undesirable consequences of Quinean fact-value holism: the denial that our values have logical content and are therefore not empirically examinable relativises even these nuanced conceptions of evidence. A naturalized look at how facts and values actually interact in medical decision-making suggests that this fact/value holism is not realistic. I provide an illustrative example of a physician devising a treatment recommendation for a patient to demonstrate that in practice, facts and values intermingle in the decision-making process without indeterminacy and subsequent appeals to moral and political frameworks, as feminist empiricism suggests. In the end, value-laden evidence can retain its adjudicative force and normativity. (shrink)

The fundamental standard of health care is health. Theories of health affect how we conceive of good health, ill health, Good patients, and Good providers. They also profoundly affect how we go about attempting to solve health problems once we’ve identified them. In this chapter, I argue that the way health care providers, bioethicists, and public health experts approach health relies on ideal theory despite the heavy knowledge that this world will never be ideal. We need a conception of health (...) that accounts for this. I outline the weakness of ideal theory in general and with respect to theories of health, and argue in favor of a nonideal approach to health that is rooted in intersubjectivity, empiricism, inclusivity, contextual specificity, and reflexivity which are not entrusted to any one set of knowers. Throughout, I use the example of how we approach fatness, and medicalize obesity, to illustrate where we’ve gone wrong and to chart a path toward how we can go right. (shrink)