Some philosophers understand natural kinds to be the categories which are constraints on enquiry. In order to elaborate the metaphysics appropriate to such an account, I consider the complicated history of scurvy, citrus, and vitamin C. It may be tempting to understand these categories in a shallow way (as mere property clusters) or in a deep way (as fundamental properties). Neither approach is adequate, and the case instead calls for middle-range ontology: starting from categories which we identify in the (...) world and elaborating their structure, but not pretending to jump ahead to a complete story about fundamental being. (shrink)

The Scottish physician James Lind is the most celebrated name in the history of research into the causes and cures of scurvy. This is due to the famous experiment he conducted in 1747 on H.M.S. Salisbury in order to compare the efficiency of six popular treatments for scurvy. This experiment is generally regarded as the first controlled trial in clinical science (see e.g. Carpenter 1986, p. 52).

In this paper we defend the view that mechanisms are underpinned by networks of difference-making relations. First, we distinguish and criticise two different kinds of arguments in favour of an activity-based understanding of mechanism: Glennan’s metaphysics- first approach and Illari and Williamson’s science-first approach. Second, we present an alternative difference-making view of mechanism and illustrate it by looking at the history of the case of scurvy prevention. We use the case of scurvy to argue that evidence for a (...) mechanism just is evidence for difference-making relations. (shrink)

Modern medicine has produced many successful theories concerning the causes of diseases. For example, we know that tuberculosis is caused by the bacterium Mycobacterium tuberculosis, and that scurvy is caused by a deficiency of vitamin C. This chapter discusses the nature of medical theories from the perspective of the philosophy, history, and psychology of science. I will review prominent philosophical accounts of what constitutes a scientific theory, and develop a new account of medical theories as representations of mechanisms that (...) explain disease. An account of the nature of medical theories should illuminate many aspects of the development and application of medical knowledge. Most importantly, it should contribute to understanding of medical explanation, both at the general level of causes of diseases and at the individual level of diagnosis of particular cases of a disease. Medical researchers seek to explain the causes of diseases such as tuberculosis, while physicians seek to identify diseases that explain symptoms such as fever. A medical theory such as the bacterial theory of tuberculosis provides good explanations at both the general and individual levels. The primary aim of this chapter is to show how these explanations work. A secondary aim is to show how an account of medical theories can shed light on other aspects of medical research and practice, including the nature of medical discovery, the process of evaluation of competing medical theories, and the ways in which effective treatments of disease depend on the development of good mechanistic theories about diseases. (shrink)

In 1747, James Lind carried out an experiment which proved the usefulness of citrus fruit as a cure for scurvy. Nonetheless, he rejected the earlier hypothesis of Bachstrom that the absence of fresh fruit and vegetables was the only cause of the disease. I explain why it was rational for James Lind not to accept Bachstrom’s explanation. I argue that it was the urge for scientific understanding that guided Lind in his rejection and in the development of his alternative (...) theory that humidity was the primary cause of the disease. Central in this process was the search for causal mechanisms which could provide understanding of how the disease developed and which fitted in with the knowledge of the time. Given that the relevant background knowledge and statistical methods were not yet available to Lind, he was right to prefer his own explanation to that of Bachstrom. Although his explanation turned out to be wrong, and Bachstrom’s right, from a historical point of view it offered deeper causal understanding of both the development of the disease and the preventive and curative effects of fresh vegetable food. This case study illustrates how the search for causal mechanisms can not only be enlightening, but also very misleading. (shrink)

This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medicine. The main hypothesis is that grasping a mechanistic explanation of a condition is necessary for a biomedical understanding (...) of that condition. The third part of the paper argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothesis is that clinical understanding combines biomedical understanding of a _disease_ or pathological condition with understanding _illness,_ which involves some degree of personal understanding of the patient. It is argued that, in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources _in addition_ to those involved in biomedical understanding. (shrink)

This piece, included in the drift special issue of continent. , was created as one step in a thread of inquiry. While each of the contributions to drift stand on their own, the project was an attempt to follow a line of theoretical inquiry as it passed through time and the postal service(s) from October 2012 until May 2013. This issue hosts two threads: between space & place and between intention & attention . The editors recommend that to experience the (...) drifiting thought that attention be paid to the contributions as they entered into conversation one after another. This particular piece is from the BETWEEN INTENTION & ATTENTION thread: Jeremy Fernando, Sitting in the Dock of the bay, watching... * R.H. Jackson, Reading Eyes * Gina Rae Foster, Nyctoleptic Nomadism: The Drift/Swerve of Knowing * Bronwyn Lay, Driftwood * Patricia Reed, Sentences on Drifitng * David Prater, drift: a way * * * * * Australia, Summer, 2012. …. essential humanity exists, and runs its course, within a system whose first principle is the preservation of balance. And arching over it all, is the logos of The Dreaming. How shall we state this when we fully understand it I do not know, but I should think we are more likely to ennoble it than not. Equilibrium ennobled is abidingness.” 1 On return to birthplace I write. Caught between jetlag and surprise, a relentless sun cracks my skin. Upright words fall under cockatoo roars. The attempt to settle, to be attentive, is shaken. Some kind of Dreaming surrounds and elements intrude without consent. Homeless at home. Exhausted, I fight sleep’s hard currents. Their victory would confuse the body clock, so the in-between wins. Half-there — half-awake — here in this place — I am driftwood. Driftwood: wood floating in or washed ashore by a body of water. A severed limb set adrift from the birthing body. Tossed from home it’s cast into processes of wind, water, sand, bacteria, decay and movement. Driftwood is orphaned members at the mercy and agency of weather, currents, submersion, and being thrown into dry world. Driftwood — singular plural. White man got no dreaming. Him go ‘nother way. White man, him go different Him got road belong himself. 2 photo: Bronwyn Lay The old man comes from the northern rivers. A while ago, he could no longer pay attention to wage slavery, so retreated north to be with dead redgum that lay abandoned in dry riverbeds. Derived from driftwood peoples tossed here by the sea, he followed the fragile river veins of his birth. He walked along water bodies and through country’s lungs. Some kind of displaced ancestral song compelled his leathered hands to pick up centuries old driftwood from flood plains. It emerged from under muddy creeks, was flung up by salt soaked coves, pushed underground by cracks in the claypan and lay embedded in mud and salinized soil. Smoothed and grooved in equal measure, the branches were marked by an organic alphabet that preceded him. As he held the wood, he touched decomposing circles that started with a blast and never ceased writing into abandoned flesh. When the ute was full the old man returned home having been away with the stuff that ‘growed him up’. His shed filled with red sawdust and the sound of tools at labour. His hands sculptured driftwood. History carved into itinerant skin. I sit opposite the old man. His body no longer holds the repetition of carpentry. He can no longer gift driftwood its detail. Outside redgum bits lie scattered around the fence line and beside the dam. He crouches over an unreliable computer researching the massacres of indigenous peoples that occurred along the same river veins that ‘growed him up’ long ago. Staring into the remnants of frontier resistance that he and I inherit, his eyes nurture fire. He discovers severed limbs and the slicing of tribes. In the ashes of sentences he sifts the lies that smoulder into our histories. In the 30’s the anthropologist Stanner said that due to certain factors — lack of change and isolation — the ideal and real come very close together in indigenous Dreaming. They are a people who were able to defeat history. 3 “If the Ideal and the Real drift too far away from one another (as they did at the end of the middle ages and seem increasingly to do this century) men face some difficult options. They have to change their way of life, or their philosophy, or both, or live unhappily somewhere in-between.” 4 Stanner says Indigenous Dreaming is blackfella thinking. 5 Dreamtime is not ethereal, not utopic, or otherworldly. It’s fused with the real and it’s not mine. I might never understand, but it’s the substance of my home. This here place ‘growed me up’. Is driftwood the unhappy in-between? Is it a radical itinerant written upon by currents? Where are we? The settler restless? photo: Alison Pouliot I return to the bush late one night, tired from high talk in city cafes, to find the old man at his computer. He’s either researching his white farming ancestors, or tracing unrecorded massacres of blackfellas. I laugh, “You know Dad, if you were indigenous you might go out by the dam and sing up your ancestors rather than try find them on a screen.” He peers over his glasses. His stare delivers an ancestral scold. He’s white man. Of course he archives. This is our way. One may see that, like all men, he is a metaphysician in being able to transcend himself. With the metaphysician goes a mood and spirit, which I can only call a mood or spirit of assent, neither despair nor resignation, optimism not pessimism, quietism nor indifference. The mood, and the outlook beneath it, make him hopelessly out of place in a world in which the renaissance has triumphed only to be perverted, and in which the products of secular humanism, rationalism and science challenge their own hopes, indeed their beginnings.” 6 The clinamen sometimes comes abstract — the rarefied swerve of possibility. But in the place we gather &mdash where this text has landed — in the heart of settler colony denial — the clinamen reminds of familiar violence and goes maximum. The earth’s swerve. Topography’s tip. Physics gone violent. Here, drift is initiated by the tear of flesh, scurvy voyages, frontier blood and the deracination from belonging. Here, war precedes drift. We all got tossed. Here. Pay attention. The country has its own gaze. ‘Lest we forget’. The seasonal turn on aborescent substances starts with a fall, an upwards rupture, a drop, a cut, a storm, a violence, a loss, forced migration, refugees, agricultural imperialism, settler wheat and poisoned rations. Pay attention to aftermath debris. Don’t drift too far from the real. History hasn’t settled into the water. It still tosses limbs back and forth. Surrounded by the backdrop of Dreaming country the old man archives and dreams. Both ways of settling into the real. But lest we forget, time, in this place, has no textual tick — tock. Our bodies know this, even though we persist with shipwreck illusions. It’s difficult being here. Here. Pay inattention. I walk through eucalyptus, over dried out clay pans and under kookaburras. It’s been two years in-between. This time country speaks strong underfoot. Forget books, forget texts, forget other lands and times, beginning and end. Be here. All falls raw. Leaves drop and refuse to compost. Bark untethers quick. Light denudes worlds. The heated horizon melts monoliths. It’s enough to make Cartesians shiver. Awake. Refuse the temptation to run. Have enough courage to drift into here. Love with a gum tree. Stand with her whole and dissolving. She moves light between our limbs, tossing them to wind. She — the original romance — is the dream that dares touch flesh and reaches over nightmares with elemental desire. I gaze and lose me. There’s no distance. The land that ‘growed me up’ speaks with symbiotic breath. There’s no division, no separation, no other. The gum is plastic arborescence. You be my body for me, always were. …..but I wake to driftwood histories and recall slaughters. Drifted, wicked fellow citizen — the other is someone else’s blind sleep. Betrayal maintains the other as mine. Archives reveal this place doesn’t belong to me. Body articulates that it became here. Gumtree cares not………her arms take me in anyway. “Like all men he is a philosopher in being able to use his power of abstract reason. His genius, his metier, and in some sense — his fate is that because of endowment and circumstance this power has channelled itself mainly into one activity, making sense out of social relations among men living together.” 7 The old man excavates seven generations of settler ancestors. They’re an ordinary lot with written-upon skin. He records genocides that occurred alongside his peoples fertility. Bodies rise from riverbeds like sovereign sacrifices. It hurts. It disrupts. He labours at the past with gestures that might go unnoticed in a country suffocated by rich amnesia. Inside walls, he seems attentive to historical details. Outside he seems inattentive to time, lost to us and embedded in a family of active matter — the bush. His driftwood skin appears around my eyes - grooves of experience, the rush of cruel sun, the push of blind winds, and the love of everything. The sovereign’s reluctant children are thrown here by, with and through blood, but country gets in and sculpts us here. photo: Chris Corrigan “But his abstractions do not put him at war with himself.” 8 The kangaroo family appears at dusk. When the sun is soft I follow the old man into the back paddock. Children skip behind us. In-between generations, I step into the old man’s driftwood leanings. My feet find traces of his understanding – the archivist that reads trees. Here, on home dirt, inattention and attention collapse as we wander into where we are. The roo family gaze at us. Through the grass the old man’s wooden finger articulates kin’s details. He points to the head male, the mother holding a joey in pouch and the young warriors side by side. My children, quieter than ever, meet the laser - eyed silence of another family. In half-light Dad, me, and the kids mirror the kangaroo constellation and stand gentle together. At the bushblock’s limit we encounter ancestral desires. White peoples are subject to driftwood histories. We’re severed limbs attempting to fuse here now, with what was, only to discover our skin becomes racked and embedded with the weather. Into the shelter and fissures of this difficult and ambiguous inheritance, I fall into dream light until balance saturates. Light breaks when the kangaroos move. They bounce someplace else without effort or impact. We turn and tread through the dark towards home. It’s time to sleep. Driftwood skin covers the country. Dreaming is still. photo: Bronwyn Lay NOTES W.E.H. Stanner, The Dreaming and Other Essays , (Melbourne: Black Inc. Agenda, 2009), 72. Ibid., 56. Stanner is recalling one intelligent old man who said to him, “with a cadence almost as though he had been speaking in verse.” Ibid., 60. Ibid., 69. Ibid., 58. Ibid., 67. Ibid., 68. Ibid., 59.  . 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Motivated by a recent trend that advocates a reassessment of the aim of medical science and clinical practice, this paper investigates the epistemic aims of biomedical research. Drawing on contemporary discussions in epistemology and the philosophy of science, along with a recent study on scurvy, this paper (1) explores the concept of understanding as the aim of scientific inquiry and (2) establishes a framework that will guide the examination of its forms in biomedical research. Using the case of Tuberculosis (...) (TB), (3) it is argued that grasping a mechanistic explanation is crucial for reaching a threshold of understanding at which we may speak of an objectual, biomedical understanding of TB. (shrink)

It's a sort of moebus strip argument. Rather than circularly assuming what it should prove, it assumes one of the things Fodor says he has disproved. It assumes that the extensions of those concepts thought by some to be recognitional are in fact controlled by stereotypes. Why do I say that? Because Fodor assumes that what makes an instance of a concept a "good instance" is that it is an average instance, that it sports the properties statistically most commonly found (...) among instances of that concept. But that the "good instances" are always the common instances is remotely plausible only if we take concepts to be organized by stereotypes. True, a goldfish is not an average or stereotypical fish (SSis that true?) and the nursing profession is not average for a male and maleness is not average for a nurse. But there is surely is nothing borderline about the fishiness of a goldfish nor, typically, about the maleness of a male nurse or the petness of a pet fish. Notice also that good examples of some kinds of things are very hard to find, for example, good examples of the fallacy of accent, and good examples of wild children, and (nowadays) good examples of scurvy are hard to find. If good instances had to be instances that were average, including in respects having nothing to do with the point of the category being defined, and if recognitional concepts had to recognize by attending to average properties, then I suppose the recognitional ability defining the concept "sphere" would have to include the ability to tell whether a thing bounces! (shrink)

Despite the practical knowledge throughout the nineteenth century that citrus fruit cured scurvy, and that rickets and beriberi were diseases caused by poor diet, it was not until 1901 that animal feeding experiments led one investigator to propose the existence of 'accessory food factors,' a lack of which was determined to be the cause of some illnesses (Hopkins, 1949. In Joseph Needham and E. Baldwin (eds.), Hopkins and Biochemistry, 1861-1947: Papers Concerning Sir Frederick Gowland Hopkins, O.M., P.R.S., with a (...) Selection of His Addresses and a Bibliography of His Publications. Cambridge: W. Heifer and Sons Ltd). The discovery of vitamins has long been considered as a delayed discovery. This delay has been attributed to the power of the germ theory in physiology at the time. While the germ theory and theories of autointoxication certainly played a role in delaying the discovery of vitamins, I argue further that it is important to consider the difference made to physiology by understanding the vitamins’ catalytic function. The profound difference made to physiology by the vitamins’ catalytic function suggests that a vitamin concept had previously been systematically inaccessible to researchers working within the conceptual framework of Bernardian physiology. (shrink)