In 1648, J. Marcus Marci of Prague anticipated two chief features of Isaac Newton's celebrated 1672 theory of light and color, namely that colors are inherent to light and that the role of the prism is to separate the rays of color by means of refraction. Furthermore, Marci argued that colors produced by a first refraction are immutable when subjected to refraction by a second prism. This paper argues that the key to Marci's achievement derived from his chymical view (...) of light, which he tested by means of prism trials and geometrical constructions. I also suggest that Marci's unusual coupling of chymical philosophy with mathematics was a move unusual in the history of alchemy; and that his chymical understanding of light belongs to an underexplored tradition in the history of optics, which is distinct from mechanistic and Aristotelian theories of light. (shrink)

There are at least three deep and yet creative tensions in John Locke's writings on the knowledge of the natural world. An exposition of these tensions provides the framework for this chapter. The chapter provides an account of the development of Locke's views from his early medical essays of the late 1660s to his last published writings on natural philosophy. The central locus for Locke's "philosophy of science" will be the Essay. Chymical medicine provided the main field in (...) which Locke was regularly involved in experimentation. Locke believed that geometry and arithmetic presented paradigm examples of the sort of demonstrative reasoning that would be involved in a science of nature, that is, a demonstrative natural philosophy. An important consequence of Locke's ideal of a corpuscular metric is an ongoing concern with metrology. By the early 1690s, Locke modified his views on natural philosophy in the light of the Newtonian achievement. (shrink)

In the late seventeenth century, traditions in anatomy and chymistry came together to ground new theoretical and experimental approaches to understanding the animal body. The researches of Dutch experimenters Reinier de Graaf and his mentor Franciscus Sylvius provide keen insight into the ways experiments were constructed, negotiated, and thought about by leading anatomists and physicians of the time. The objects and approaches de Graaf used in the laboratory—ligature, inflation, injection, tubes, vessels, tasting—were derived from broadly Harveian anatomical and Helmontian (...) class='Hi'>chymical traditions. Experimental traditions and a comprehensive and materialistic chymical theory of acid-alkali interactions unified the artificial and the natural and allowed de Graaf to create and use hybrid animal-apparatus constructions as tools to collect and assay the key ingredients of digestion and disease. (shrink)

Throughout the sixteenth century, learned physicians across Europe performed a diverse array of “trials” of phenomena and published reports about them. This essay traces the phrase “periculum facere” (“to make a trial”) and related terms through natural history investigations, drug testing, chymical analysis, and anatomical discoveries. Physicians used ancient precedents, their learned expertise, and pedagogical authority to anchor the epistemic status of their trials and incorporated the historical narratives of their trial-making within arguments to factual and causal knowledge, even (...) philosophical scientia. Developed from engagement with things, ancient texts, other healers, and students, this lively tradition of contrived, first-person empirical trials flourished in some academic institutions, especially the University of Padua. The frequency and visibility of sixteenth-century medical trials, especially in the education of hundreds of students annually, is essential evidence for understanding how experimentation came to be widespread in early modern Europe. (shrink)

Meteorology is not one of the most discussed topics in Paracelsus studies, although it is closely linked to both Paracelsus’ medicine and cosmology. Furthermore, it appears to be at the very core of Paracelsus’ famous matter theory of three chymical principles, mercury, sulphur and salt, known as the tria prima. By discussing prominent examples of Paracelsus’ explanations on how the tria prima operate within the stars, this article shows how the Swiss physician conceived meteorology within his own body (...) of knowledge, obviously constructed in opposition to the Aristotelian-scholastic tradition, how he based it on a peculiar interpretation of the Biblical creation story, and made it the proper laboratory of his chymical matter theory, applying it first systematically to the field of natural philosophy, especially to celestial phenomena, even before using it for his medical theory in his later writings. (shrink)

Fermentation is a cornerstone phenomenon in Cartesian physiology, accounting for processes such as digestion or blood formation. I argue that the previously unrecognized conceptual tension between the terms ‘fermentation’ and ‘concoction’ reflects Descartes's efforts towards a novel, more thoroughly mechanistic theory of physiology, set up against both Galenism and chymistry. Similarities with chymistry as regards fermentation turn out either epistemologically superficial, or based on shared earlier sources. Descartes tentatively employs ‘fermentation’ as a less teleological alternative to ‘concoction’, later renouncing the (...) explicit use of the term, possibly to avoid chymical overtones. However, his continued use of analogies with fermentative processes in the natural world and in winemaking, coupled with a strong ontological commitment (the stance that the physiological processes are actual fermentations), leads to a reintroduction of natural teleology in his medical system, which I argue may be understood in an Aristotelian sense of ‘simple necessity’. The paper reveals a more nuanced account of Cartesian fermentative medicine, delineating some of its tensions with regard to chymistry as they play out in the dynamics of fermentation and concoction, and linking the analogies to fermentation processes to the difficulties in erasing teleology altogether. (shrink)

Volume 24, Issue 11, November 2024, Page 1-3.

Volume 24, Issue 9, September 2024, Page 48-50.

Volume 24, Issue 12, December 2024, Page 6-7.

Research into epistemic injustice, the practice of discrediting people as knowers based on their social identity, has gained broad popularity in ethics. Racism in medicine often mani...

The objective of this article is to investigate ethical aspects of technology through the moral term “paternalism”. The field of investigation is medicine. The reason for this is twofold. Firstly, “paternalism” has gained moral relevance through modern medicine, where physicians have been accused of behaving paternalistic and threatening patients’ autonomy. Secondly, medicine is a brilliant area to scrutinise the evaluative aspects of technology. It is argued that paternalism is a morally relevant term for the ethics of technology, (...) but that its traditional conception is not adequate to address the challenges of modern technology. A modification towards a “technological paternalism” is necessary. That is, “technological paternalism” is a fruitful term in the ethics of technology. Moreover, it is suited to point out the deficiencies of the traditional concept of paternalism and to reform and vitalise the conception of paternalism in ethics in order to handle the challenges of technology. (shrink)

The paper first defines palliative treatment and distinguishes it from symptomatic treatment. Then, the palliative situation is delineated as inseparably linked to the finitude of human life. Given the objectives of palliative treatment — responding to symptoms, damage to the patients' self-image, and the proximity of death — a subjective concept of disease is described, that is regarded as the focus of palliative treatment. The essence of the concept of disease is analysed as the patient's experience with a tendency of (...) reduction of her or his vitality. Palliative medicine is shown not to be symptom-oriented, but disease — directed as other domains of medicine. Implications and practical consequences, especially the status of objective findings, of this concept are discussed and therapeutic opportunities in the palliative situation reconsidered. (shrink)

Society has historically not taken a benign view of genetic disease. The laws permitting sterilization of the mentally re tarded~ and those proscribing consanguineous marriages are but two examples. Indeed as far back as the 5th-10th centuries, B.C.E., consanguineous unions were outlawed (Leviticus XVIII, 6). Case law has traditionally tended toward the conservative. It is reactive rather than directive, exerting its influence only after an individual or group has sustained injury and brought suit. In contrast, state legislatures have not been (...) inhibited in enacting statutes. Many of their products can be characterized as hasty, unnecessary, ill-conceived, and based on the heart rather than the head. Moreover the lack of expert consultation sought has also been remarkable. One state legislature, for example, has advocated immunization for sickle cell anemia! Many others have enacted laws for the screening of inborn errors of metabolism, e.g., phenylketon uria, but have poorly defined the lines of responsibility to secure compliance. A spate of specific disease-related bills has emerged in the u.S. Congress, each seeking recognition and appropriations. Sickle cell anemia, hemophilia, Cooley's anemia and Tay-Sachs disease have been among the front-runners for support. Finally, in 1975, Congress has begun to examine an omnibus bill concerning all forms of genetic disease. The bill, termed the National Genetic Diseases Act is, however, still far from being enacted. (shrink)

The article offers an approach to inquiry about, the foundation of medical ethics by addressing three areas of conceptual presupposition basic to medical ethical theory. First, medical ethics must presuppose a view about the nature of medicine. it is argued that the view required by a cogent medical morality entails that medicine be seen both as a healing relationship and as a practical art. Three ways in which medicine inherently involves values and valuation are presented as important, (...) i.e., in being aimed at the good of health, in being a cognitive art evaluating towards that good, and as a manifestation of a virtuous disposition concerning that good. Finally, a value ontology drawn from these considerations is seen as necessarily underlying medical ethics. A set of three such basic values are promoted as crucial: the value of health; the value of the individual patient; and the value of altruism that mediates the class of potential patients. (shrink)

The puzzling case of the broken arm -- Hernias, diets, and drugs -- Why physicians cannot know what will benefit patients -- Sacrificing patient benefit to protect patient rights -- Societal interests and duties to others -- The new, limited, twenty-first-century role for physicians as patient assistants -- Abandoning modern medical concepts: doctor's "orders" and hospital "discharge" -- Medicine can't "indicate": so why do we talk that way? --"Treatments of choice" and "medical necessity": who is fooling whom? -- Abandoning (...) informed consent -- Why physicians get it wrong and the alternatives to consent: patient choice and deep value pairing -- The end of prescribing: why prescription writing is irrational -- The alternatives to prescribing -- Are fat people overweight? -- Beyond prettiness: death, disease, and being fat -- Universal but varied health insurance: only separate is equal -- Health insurance: the case for multiple lists -- Why hospice care should not be a part of ideal health care I: the history of the hospice -- Why hospice care should not be a part of ideal health care II: hospice in a postmodern era -- Randomized human experimentation: the modern dilemma -- Randomized human experimentation: a proposal for the new medicine -- Clinical practice guidelines and why they are wrong -- Outcomes research and how values sneak into finding of fact -- The consensus of medical experts and why it is wrong so often. (shrink)

Modern medicine, based on enormous progress in science and its applications, has lost dimensions of individualized treatment and compassion which traditionally were an essential part of physician’s service over the millennia in Eastern and Western cultures. Today diseases and symptoms, rather than persons, are treated, based on objective quality norms and inflexible payment schemes rather than the rather than persons. We present a checklist model for personalized health care, which has been successful in teaching and practice to reclaim lost (...) territory in treating patients as persons. (shrink)

This volume reprints in a scholar's edition the first English-language texts on bioethics, John Gregory's (1724-1773) Observations on the Duties and Offices of a Physician and on the Method of Prosecuting Enquiries in Philosophy (London, 1770) and Lectures on the Duties and Qualifications of a Physician (London, 1772). Five previously unpublished manuscripts of Gregory's lectures are also included. An introduction places Gregory's medical ethics and philosophy of medicine in their eighteenth-century contexts of Scottish Enlightenment history and culture, Baconian science (...) and philosophy of medicine, medical practice, the feminine and feminist philosophy of the Bluestocking Circle, and moral sense philosophy, particularly David Hume's concept of sympathy, and provides a bibliography of primary and secondary sources as an aid to teaching and future scholarship. The book's index provides access to Gregory's texts, by using both historical terms and current terminology of bioethics. A volume in the subseries Classics of Medical Ethics. (shrink)

Theories of health and disease which oppose evaluative and descriptive claims or opt for one or the other in defining fundamental concepts err, it is argued, due to an oversimplified conception of both the science of medicine and the art of clinical judgment. The work of Georges Canguilhem on the biological dimensions of value and subjectivity is explored. I conclude that he avoids the falsehoods of (a) neutral, pure fact-based medical science, and (b) cultural, arbitrary notions of value.

This essay focuses on the meaning that the term “experimental” acquires within spiritualism during the second half of the nineteenth century. It builds upon Paul Janet’s notions of “experience” and “experimentation” in psychology, by stressing the role of physiology and pathology in his reflection. Regardless of the role the concept of “experimentalism” took on in Victor Cousin’s psychology, which arguably indicated more an “internal affection” than actual experimentation, in Janet’s spiritualism the term regains its original meaning of empirical verification. Janet (...) highlights the importance of madness to the development of a new psychological paradigm that could reconcile philosophy and medicine, reason and experience, by taking up pathology as a form of natural and indirect experimentation. (shrink)

Lectures delivered at the Johns Hopkins University in 1975. Includes bibliographical references and index.

Introduction -- Entering the world of medicine: contexts -- Why bioethics needs a philosophy (and theology) of medicien -- Perspectives on philosophy of medicine -- Perspectives on theology of medicine -- Finding the target: Messer's theology of health -- A philosophical-theological framework for medicine -- Human vulnerability and the goods of medicine -- Re-engaging the world of medicine: applying philosophy and theology of medicine.

Systems medicine is a promising new paradigm for discovering associations, causal relationships and mechanisms in medicine. But it faces some tough challenges that arise from the use of big data: in particular, the problem of how to integrate evidence and the problem of how to structure the development of models. I argue that objective Bayesian models offer one way of tackling the evidence integration problem. I also offer a general methodology for structuring the development of models, within which (...) the objective Bayesian approach fits rather naturally. (shrink)

Die rasanten technischen Fortschritte in der Genomforschung ermöglichen heute schon die Sequenzierung des einzelnen menschlichen Genoms in wenigen Tagen und zu vertretbaren Kosten. In der Krebsforschung ermöglicht die genetische Sequenzanalyse, zunehmend die Defekte zu identifizieren, die für das Tumorwachstum bei jedem einzelnen Patienten verantwortlich sind. Auf dieser Basis können zielgerichteter Therapien entwickelt werden. Diese Forschung wirft jedoch auch neue, ethische Fragen auf. Diesen normativen Fragen widmet sich in Heidelberg das interdisziplinäre EURAT Projekt mit dem Ziel, ethisch und rechtlich informierte Lösungen (...) zu formulieren und zu etablieren.Dieser Beitrag gibt zum einen einen Überblick über die ethischen und klinischen Fragen, die für den Aufklärungs- und Einwilligungsprozess in die biobankbasierte Genomforschung relevant sind. Zum anderen wird als organisationsethische Antwort auf die Frage, wie eine Forschungsinstitution den verantwortungsvollen Umgang mit genetischen Informationen in Biobanken über die verschiedenen Berufsgruppen und beteiligten Institute hinweg sichern kann, ein Verhaltenskodex vorgestellt. Eine gut begründete, informierte Zustimmung und ein Verhaltenskodex sind beides Elemente einer „Best Practice Leitlinie“ und sollen den verantwortlichen Umgang aller beteiligten Mitarbeiter mit sensiblen genetischen Daten prägen. (shrink)

In the move to critique managed care, the essential principles that first made it a reasonable alternative to fee-for-service medicine can easily be lost. Careful reflection on the history of early grassroots movements that created managed care, and on selected textual narratives of the founders of the managed care organizations at their inception, offers us insight into which of the critical premises and goals of that effort might be reclaimed as we analyze the current managed care environment.