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Claude Bernard and An Introduction to the Study of Experimental Medicine: "Physical Vitalism," Dialectic, and Epistemology
Abstract
This article explores the profound impact of the thought of Claude Bernard (1813-78) and his philosophy of experimentalism elaborated in his masterwork An Introduction to the Study of Experimental Medicine. I argue that Bernard's far-ranging theoretical impact on medicine and biology marks the end of conventional vitalism and the elusive notion of a "vital force" as a legitimate scientific concept. His understanding of medicine is as epistemologically significant in its time as Newton's contribution was to the physical sciences in the seventeenth century. This essay treats Bernard's philosophical ambitions seriously, exploring his important, even central, role in the mental world of nineteenth-century France. This includes his influence on Henri Bergson (1859-1941) and other late-nineteenth century thinkers. The subtext of Bernard's experimental epistemology is also contrasted with a key idealist philosopher of the period, the German Arthur Schopenhauer (1788-1860), and placed in the context of the larger European philosophical sphere. In contrast to much of mid-nineteenth-century philosophy, Bernard, in creating the framework for experimental medicine, argued for an experimental approach in which a priori assumptions were to be strictly constrained. Bernard's thoughts on the nature of experiment put an end to "systems" in medicine, ironically by replacing all previous medical philosophies with the all-embracing "system" of experiment. And yet, while "vital forces" fade after Bernard, a form of vitalism still flourishes. Even in Bernard's own work, in the struggle with concepts like determinism, complexity, and causality, there is a realization of the unique character of living function in a kind of "physical vitalism."
... O legado do fisiologista francês Claude Bernard (1813-1878) para a teoria da fisiologia em particular, e teoria do conhecimento em geral, assim como para a proposição de "homeostase" pelo fisiologista estadunidense Walter Bradford Cannon (1871Cannon ( -1945, apresenta reiterado interesse para a história e filosofia da biologia no Brasil e no mundo (Sullivan, 1990;Dutra, 2001;Normandin, 2007;Cooper, 2008;Janczur et al., 2013;Arminjon, 2016;Janczur et al., 2017;De Luca Jr., 2022a). ...
... Uma extensa leitura de obras de Bernard e de avaliações históricofilosóficas das mesmas, sugere que a sentença condicional equivalente ao Axioma 1 é apropriada a uma fase de consolidação da fisiologia como ciência experimental (Bernard, 1865(Bernard, , 1878a(Bernard, , 1878bDutra, 2001;Mendelsohn, 1965;Janczur et al., 2013;Normandin, 2007;Cooper, 2008;Wolfe, 2013;Janczur et al., 2017). ...
Uma avaliação crítica recente da “homeostase”, elaborada por Walter Cannon (1871-1945), identifica contradições intrínsecas à associação condicional, feita por Claude Bernard (1813-1878), entre “constância do meio interno” e “vida livre”. Por um lado, a avaliação reitera a importância do “meio interno” - líquido onde vivem as células dos tecidos, estendendo-a à evolução dos compartimentos líquidos corporais. Entretanto, ela também mostra que a associação condicional não tem suporte empírico nem lógico. Portanto, é inválido assumir que “constância do meio interno” seja condição para “vida livre”. À parte de sua contradição intrínseca, outros trabalhos têm criticado o condicional presumindo que Bernard seguido por Cannon estava se referindo a uma rigidez regulatória das variáveis biológicas (da vida) em geral. O objetivo do presente trabalho é mostrar que essa crítica é também inválida, pois a nosso ver Bernard não faz esse tipo de generalização ao se referir a “vida livre”. Concluímos que evitar ambiguidades torna-se necessário para uma efetiva apreciação da contribuição teórica de Bernard para a fisiologia.
... However, the laboratory is the real sanctuary of the medical science." 30 Bernard's work was followed by the young Russian Ivan Mikhaylovich Sechenov (1829-1905, who used frogs to prove the hypothesis of a central control of movement. Such interpretation of reflexes as a physiologic activity related to the brain gave the psyche a physiologic role. ...
... Described the existence of vasomotor, dilator, and constrictor nerves. 29,30 Ivan Mikhailovich Sechenov ...
Although no precise moment or unique event marks its birth, neuroimmunoendocrinology arguably shares a great deal of history with other medical and biologic disciplines. It originated from empirical observations and suppositions that failed to prevail upon the existing axioms. Despite the widespread resistance to embracing novel ideas, the seeming defeats inspired visionary researchers. Those pioneers managed to systematize the emerging knowledge and were able to contribute to science with real foundations. In consequence, new concepts and ideas arose in physiology, anatomy, endocrinology and early immunology. Together, they gave rise to a budding approach on the integration between the nervous, immune and endocrine systems. Then, neuroimmunoendocrinology emerged as a discipline integrating an intricate system with multidirectional functions and interactions that allow for responding to internal and external threats. Such response is mediated by cytokines, hormones and neurotransmitters, involved in different physiologic mechanisms of the organism homeostasis. Neuroimmunoendocrinology is no longer an area of scientific skepticism; on the contrary, it has cemented its position as a biomedical discipline worldwide for the past 70 years. Now, it offers a better understanding of pathologic processes. Neuroimmunoendocrinology is has established its place as a biomedical discipline worldwide in the past 70 years.
... In 1865, Claude Bernard (1) would publish his ground-breaking work 'An Introduction to the Study of Experimental Medicine'. This was not just another chapter in the book of 19 th -century medical inventions and discoveries, but while reflecting on his extensive laboratory life he foregrounded a new epistemology and philosophy of medicine (see, for example, (2)) The notion of scientific revolution (3) may rightly seem obsolete for most historians of science by now (4), yet Bernard's contribution was an indisputable turning point in the medical thinking. Unfairly outshined by the worldwide fame of Pasteur, by revisiting Introduction a new agenda of contemporary medicine becomes clear, one that would redirect the course of the profession and of healthcare altogether. ...
... He was in overt methodological disagreement with Comte, believing that he tended to confuse experimentation with observation, which was the actual advancement Bernard sought to promote. Similarly, his experimentalist approach to science is encompassed by a cautious attitude towards the method and only a partial detachment from metaphysics (2,13). ...
In this article, I critically discuss the contribution of Claude Bernard’s seminal work in medicine, ‘An Introduction to the Study of Experimental Medicine’, published originally in 1865. Although his contribution to physiology and experimental medicine is known to have had worldwide reach in the 19th century, it is now recognised that his work also set an agenda for a renewed epistemology and philosophy of medicine. Without aiming at classifying his scientific frame as a paradigmatic change of medical thought (in the Kuhnian sense of the word), his work is a turning point in the history of contemporary medicine, proposing an alternative explanation of the ‘systems model’ of body functioning by interrogating the pre-existing concept of physical vitalism. To revisit Bernard’s work is, in fact, to explore the basis of a very contemporary discussion on the nature of life, which ranges from ethical to technological concerns.
... The book written by Claude Bernard on experimental medicine revolutionized the way that physicians and surgeons saw and interpreted the medicine of the day, as well as the medicine practiced by future generations of clinicians and clinical researchers [1][2][3][4][5][6][7][8][9][10][11]. In Part I of the Introductionà l'Étude de la Médecine Expérimentale [12], we advanced the genius of Bernard, his life and accomplishments, and his evolution as a scientist, then began evaluating the influence of his book on medicine and surgery. ...
... Bernard saw the experimental method as divided into three stages: observation, hypothesis, and experimentation [1][2][3][4][5][6][7][8][9][10][11]. Experimental reasoning was at the origin of the research enterprise, according to the acclaimed French physiologist [9]. ...
The book that Claude Bernard (1813-1878) published in 1865, the Introduction à l'Etude de la Médecine Expérimentale, fostered a revolution that we believe influenced the practice of surgery when the discipline became a scientific enterprise. In Part I, we set the stage by presenting the life and accomplishments of Bernard, by reviewing his science, and introducing his experimental medicine work. In this issue in Part II, we further analyze his book and determine the "why" of a genuine surgical revolution. What were the factors that generated this revolution, and how a new generation of surgeons learned to become better researchers, and thus better surgeons, were the main objectives of this work. Science, research, and surgery became highly intertwined and the surgeon pursued these fields of knowledge more effectively.
... Unfortunately, this emerging "Bernardian industry" (Jordanova, 1978) substantially lost steam from the late 1980s onwards (Lesch, 1984;Colmean, 1985;Michel, 1991; but see Duchesneau et al., 2013), and since then Claude Bernard has barely existed as a topic of interest within international history and philosophy of science 3 . That is not to say that he has completely disappeared: from time to time, specific aspects of his work are still considered, such as his complex relation to vitalism (Normandin, 2007), or, more recently, the connection between his experimental methodology and nineteenth-century British philosophy of science (Scholl, 2020 4 ). Nonetheless, there are still unexplored avenues to launch a more collective reappraisal of Bernard's underappreciated significance in the history of science. ...
... During the course of the seventeenth and eighteenth centuries, many pieces of the physiological puzzle were collected, but it is another Frenchman, Claude Bernard (1813Bernard ( -1878, who is universally credited with first gathering those pieces into a unified, physiological theory. Readers seeking detailed examinations of the developments leading up to Bernard, and their implications, are directed to our supplementary resources (e.g., Barcroft 1932Barcroft , 1934Adolph 1961;Bligh 1998;Gross 1998;Normandin 2007;Noble 2008;Gomes and Engelhardt 2014;Candas and Libert 2022; also see: Bernard, 1865Bernard, [translated 1949Bernard, ], 1876Bernard, , 1878Bernard, [translated 1974Bernard, ], 1879. The amalgamation of ideas arising from his own research, and the experiments of others, led Bernard to believe that the stability of the internal environment was a condition of life ("la fixité du milieu intérieur est la condition d'une vie libre et indépendante" ;Bernard 1878 [P. ...
This contribution is the first of a four-part, historical series encompassing foundational principles, mechanistic hypotheses and supported facts concerning human thermoregulation during athletic and occupational pursuits, as understood 100 years ago and now. Herein, the emphasis is upon the physical and physiological principles underlying thermoregulation, the goal of which is thermal homeostasis (homeothermy). As one of many homeostatic processes affected by exercise, thermoregulation shares, and competes for, physiological resources. The impact of that sharing is revealed through the physiological measurements that we take (Part 2), in the physiological responses to the thermal stresses to which we are exposed (Part 3) and in the adaptations that increase our tolerance to those stresses (Part 4). Exercising muscles impose our most-powerful heat stress, and the physiological avenues for redistributing heat, and for balancing heat exchange with the environment, must adhere to the laws of physics. The first principles of internal and external heat exchange were established before 1900, yet their full significance is not always recognised. Those physiological processes are governed by a thermoregulatory centre, which employs feedback and feedforward control, and which functions as far more than a thermostat with a set-point, as once was thought. The hypothalamus, today established firmly as the neural seat of thermoregulation, does not regulate deep-body temperature alone, but an integrated temperature to which thermoreceptors from all over the body contribute, including the skin and probably the muscles. No work factor needs to be invoked to explain how body temperature is stabilised during exercise.
... For more on Bernard see [49][50][51][52][53][54][55][56]. ...
The intellectual history of energy homeostasis, focusing on food intake and energy storage, is briefly reviewed. Physiological energetics was founded by Lavoisier, who in the late eighteenth century invented direct and indirect calorimetry and discovered the role of oxygen in combustion and respiration. Energy was understood well enough by the mid-nineteenth century to realize the physiological energy-balance equation, that energy intake – energy expenditure = energy storage, but this did not greatly influence physiological research for another century. Homeostasis, the concept that many vital physiological variables are actively regulated in narrow envelopes, was developed by Bernard and Cannon between approximately 1870–1940 and remains a central principle of physiology. Kennedy coined the term lipostasis in 1953 to refer to the constancy of fat mass, which Mayer argued was the mechanism regulating body weight. A parameterized control-theory model suggests that a proportional negative-feedback control system incompletely compensates weight loss during persistent negative energy balance, suggesting that Cannon's idea of constancy within a narrow envelope may not fit body-weight regulation well. This modelling encourages further application of control theory to issues in energy homeostasis, including to the development of obesity. It also sets the stage for understanding the underlying neuroendocrine mechanisms.
This article is part of a discussion meeting issue ‘Causes of obesity: theories, conjectures and evidence (Part I)’.
... However it is a fact that they can avoid mistakes by reminding steps. Finally one should stress that these DSR are based on various epistemological models, but with a strong Baconian and Popperian direction (Bernard, 1865;Meyerson, 1908;Normandin, 2007;Popper, 1959;Popper, 1972;This, 2009). More precisely, it is assumed (more below) that sciences of nature are advancing through the following steps: (1) identification of a phenomenon; (2) quantitative characterization of this phenomenon; (3) grouping the data into quantitative laws (i.e. ...
Scientific activities appear sometimes difficult for science students or young scientists because a large number of tasks have to be performed according to strict rules that are not always known or remembered. Electronic files guiding scientific activity, with a series of detailed steps and providing explanations about why these steps are needed, can be useful guides for scientists. Such documents, called DSR, are open documents that have been improving for years. They are used for improved traceability and quality, without replacing laboratory notebooks.
... Canguilhem, "Le normal et le pathologique," in Canguilhem 1965, 156. 7 As several authors have noted, Claude Bernard's physiological tradition had little interest in evolutionary or developmental biology, which it did not view as proper sciences (seeNormandin 2007). ...
We examine aspects of Canguilhem’s philosophy of biology, concerning the knowledge of life and its consequences on science and vitalism. His concept of life stems from the idea of a living individual endowed with creative subjectivity and norms, a Kantian view which “disconcerts logic.” In contrast, we examine two naturalistic perspectives in the 1970s exploring the logic of life (Jacob) and the logic of the living individual (Maturana and Varela). Canguilhem can be considered to be a precursor of the second view, but there are divergences; for example, unlike them, he does not dismiss vitalism, often referring to it in his work, and even at times describing himself as a vitalist. The reason may lie in their different views of science.
... An additional aspect of relational effects is that when a system is inactive or its normal organization is disturbed (e.g., in cell cultures or tissue slices, routine experimental approaches used because they provide us with greater access and control over a system) the properties that we characterize can differ to those in the intact, active system. Claude Bernard wrote, "the phenomena of a living body are in such reciprocal harmony one with another that it seems impossible to separate any part without at once disturbing the whole organism, " quoting Georges Cuvier, "All parts of a living body are interrelated; they can act only in so far as they act all together; trying to separate one from the whole means transferring it to the realm of dead substances; it means entirely changing its essence" (see Normandin, 2007). An example of a change in essence in dissected or quiescent systems is the absence of functional properties normally established by relationships in the intact, active system. ...
Scientific reductionism, the view that higher level functions can be explained by properties at some lower-level or levels, has been an assumption of nervous system analyses since the acceptance of the neuron doctrine in the late 19th century, and became a dominant experimental approach with the development of intracellular recording techniques in the mid-20th century. Subsequent refinements of electrophysiological approaches and the continual development of molecular and genetic techniques have promoted a focus on molecular and cellular mechanisms in experimental analyses and explanations of sensory, motor, and cognitive functions. Reductionist assumptions have also influenced our views of the etiology and treatment of psychopathologies, and have more recently led to claims that we can, or even should, pharmacologically enhance the normal brain. Reductionism remains an area of active debate in the philosophy of science. In neuroscience and psychology, the debate typically focuses on the mind-brain question and the mechanisms of cognition, and how or if they can be explained in neurobiological terms. However, these debates are affected by the complexity of the phenomena being considered and the difficulty of obtaining the necessary neurobiological detail. We can instead ask whether features identified in neurobiological analyses of simpler aspects in simpler nervous systems support current molecular and cellular approaches to explaining systems or behaviors. While my view is that they do not, this does not invite the opposing view prevalent in dichotomous thinking that molecular and cellular detail is irrelevant and we should focus on computations or representations. We instead need to consider how to address the long-standing dilemma of how a nervous system that ostensibly functions through discrete cell to cell communication can generate population effects across multiple spatial and temporal scales to generate behavior.
... In parallel to mechanical philosophy propositions, there were those aimed at human physiology, such as that of George Stahl in his formulation of the "vital tonic movement" (breaking with some galenic theories). To some extent, he was the precursor of Claude Bernard, who in the 19th century, with his contribution to the study of experimental medicine, marked the end of conventional vitalism (a priori immaterial assumption) and inaugurated physical vitalism, that is, a hybrid model that developed the idea of "organism" as a "vital machine" and not as a "mechanical machine" (48) (49). ...
Context: The theme of health promotion emerges from public health and is based as a space for reflection and health practice, indicating, among other principles, intersectoral initiatives including three recurrent themes in contemporaneity, namely: spiritualities, theologies and religions. Objectives: To point out brief introductory notes on heuristic aspects of theology, spirituality and religion and possible links and approaches to health promotion, in the perspective that it can be given as a contribution to the panorama of interfaces in the aforementioned themes. Material and methods: This was a theoretical essay that, from the scientific and academic space, taking as a strategy the bibliographic narrative, intended a critical and applied reflection in a theoretical-descriptive approach in two thematic axes: a) epistemological heuristic context; and b) approximations and entanglements. Results: Notwithstanding the ontological, heuristic and epistemic peculiarities among the themes addressed, promising interdisciplinary and intersectorial approaches are outlined in the academic, scientific and professional scope. A panorama of complex and potentially positive relationships is drawn up, with even moderate contributions, with initiatives with both theoretical and practical emphasis, opening up an extensive agenda to be undertaken on the horizon. Conclusions: The role of spirituality, theology and religion in health promotion has already been evidenced by initiatives and collaborations that are still discrete, and even potential, with a theoretical-practical agenda open to construction.
... Wiener drew inspiration, as did Bernard, from the extraordinary self-regulatory and self-sustaining capacities of organisms [23,24]. Where Wiener sought to tease out the mechanics of homeostasis, though, Bernard regarded homeostasis more as a fundamental property of life, revealing a surprising vitalist element in Bernard's thinking [25]. The cybernetic conception of homeostasis turns Bernard's conception on its head, and along with that, Bernard's intent in articulating it. ...
‘Brains’ may be considered to be computation engines, with neurons and synapses analogized to electronic components wired into networks that process information, learn and evolve. Alternatively, ‘brains’ are cognitive systems, which contain elements of intentionality, purposefulness and creativity that do not fit comfortably into a brain-as-computer metaphor. I address the question of how we may think most constructively about brains in their various forms—solid, liquid or fluid—and whether there is a coherent theory that unites them all. In this essay, I explore cognitive systems in the context of new understanding of life's distinctive nature, in particular the core concept of homeostasis, and how this new understanding lays a sound conceptual foundation for an expansive theory of brains.
This article is part of the theme issue ‘Liquid brains, solid brains: How distributed cognitive architectures process information'.
... As several authors have noted, Claude Bernard's physiological tradition had little interest in evolutionary or developmental biology, which it did not view as proper sciences. See(Normandin 2007). ...
In this paper we examine aspects of Canguilhem’s philosophy of biology, concerning the knowledge of life and its consequences on science and vitalism. His concept of life stems from the idea of a living individual, endowed with creative subjectivity and norms, a Kantian view which “disconcerts logic”. In contrast, two different approaches ground naturalistic perspectives to explore the logic of life (Jacob) and the logic of the living individual (Maturana and Varela) in the 1970s. Although Canguilhem is closer to the second, there are divergences; for example, unlike them, he does not dismiss vitalism, often referring to it in his work and even at times describing himself as a vitalist. The reason may lie in their different views of science.
... However it is a fact that they can avoid mistakes by reminding steps. Finally one should stress that these DSR are based on various epistemological models, but with a strong Baconian and Popperian direction (Bernard, 1865;Meyerson, 1908;Normandin, 2007;Popper, 1959;Popper, 1972;This, 2009). More precisely, it is assumed (more below) that sciences of nature are advancing through the following steps: (1) identification of a phenomenon; (2) quantitative characterization of this phenomenon; (3) grouping the data into quantitative laws (i.e. ...
... Moreover, their structure is rigidly fixed at the outset, incapable 10 As several authors have noted, Claude Bernard's physiological tradition had little interest in evolutionary or developmental biology, which it did not view as proper sciences. See (Normandin 2007). of change. If, on the contrary, there emerges a system capable of reproduction, even if only badly, slowly, and at great cost, that is a living system without any doubt. ...
... A lapse into vitalism need not be the disqualifier one might at first imagine, though. Vitalist thought, particularly as it developed in the nineteenth century, has been revealing itself of late as a much richer intellectual tradition than it's typically given credit for (Normandin 2007;Wolfe 2008;Turner 2013b). This ''scientific vitalism'', as it came to be called, did not rely on some vague essence of ''cauliflowerness'' to explain the cauliflower, as today's predominant caricature of vitalism might presume. ...
Niche construction theory (NCT) has been represented as a new and comprehensive theory of evolution, one that breaks the constraints imposed by the dominant and largely gene-selectionist standard evolutionary model that is presently mischaracterized as “Darwinian.” I will argue that NCT is not so much a new theory, as it is a fruitful readmission of a venerable physiological perspective on adaptation, selection and evolution. This perspective is closer in spirit and philosophy to the original (and richer) Darwinian idea developed by Darwin himself, and that animated much of the rich late nineteenth century debate about evolution, heredity, adaptation and development, a debate that was largely eclipsed by the early twentieth century emergence of the Neodarwinian synthesis. I will argue that a full realization of the promise of NCT turns on a full understanding of another intellectual revolution of the nineteenth century, Claude Bernard’s conception of homeostasis, a profound statement of the nature of life that has, through the twentieth century, come to be widely misunderstood and trivialized.
... The analgesic potency of the isolated compound was investigated using rats. Such animal models generate reliable data that gives high predictive value in humans (Normandin, 2007); by identifying target and provide proof of efficacy (Hart et al., 2004). In some instances, these in vivo models have advantages over vitro techniques (Houghton et al., 2007). ...
Diospyros mespiliformis Hochst (Ebenaceae) stem bark is used in traditional medicine for the management of pain related ailments. Several bioactive compounds have previously been isolated from the plant material that includes pentacyclic triterpenes. This study sequentially extracted and carried out a bioassay-guided fractionation of the plant crude material with solvents of varying polarity using analgesic efficacy in rats as bioactivity marker, aimed to isolate the active constituent. Powdered stem bark of the plant was sequentially extracted with hexane, chloroform and methanol; and preliminary tested for analgesic activity. The chloroform extract being the most active amongst the three extracts was subjected to column chromatography, and a fraction was eluted with mixture of hexane and ethyl acetate (50:50%) which yielded a compound. Three dose levels (25, 50 and 100 mg/kg) of the compound were administered orally to rats. Acetylsalicylic acid (100 mg/kg, p.o.) was used as the positive control. Nociception was induced mechanically using analgesy meter, and chemically with formalin. The compound alleviated the pain stimulus induced by the analgesy-meter and formalin in rats. The isolated compound was identified as lupeol using thermo-analysis (DSC), colorimetric, chromatographic and spectrometric techniques that included: UV-visible, IR, and 13 C-and 1 H NMR. It was concluded that lupeol acting alone or synergistically might be responsible for the beneficial effect of the plant in treatment of pain related ailments.
... An Introduction to the Study of Experimental Medicine had an impact not only on science, but on philosophy and the history of ideas as well. 14,19,20 In that volume Bernard confronted the philosophic issues that arose from his approach to truth. Philosophy-the love of wisdom-had embraced the whole field of knowledge for centuries. ...
... In vivo experiments using laboratory animal systems have been used in pharmacological evaluations to generate reliable data and gives high predictive value of efficacy in humans (Normandin, 2007). The in vivo experimental models were chosen in such a way that the existence of both central and peripherally mediated pain relief could be measured (Adzu and Haruna, 2007). ...
... Importantly, the integration of veterinarians in the Académie was deemed valuable for their insight on such experiments [57,78,79]. Amidst many other prominent scientists, two physician-physiologists stood out for their contributions to experimental physiology, François Magendie (1783-1855) and, most notably, Magendie's disciple, Claude Bernard (1813-1878) [67,[80][81][82][83][84]]. Bernard's experimental epistemology, unlike his tutor's more exploratory approach, advocated that only properly controlled and rigorously conducted animal experiments could provide reliable information on physiology and pathology of medical relevance, setting the landmark of experimental medicine [85][86][87][88]. Conciliating Descartes's rationalism with Harvey's empiricism, Bernard acknowledged the importance of ideas and theories for the formulation of hypotheses, safeguarding, however, that these were only useful if testable and only credible if substantiated through experimentation [80,89]. ...
Simple Summary
This article reviews the use of non-human animals in biomedical research from a historical viewpoint, providing an insight into the most relevant social and moral issues on this topic across time, as well as to how the current paradigm for ethically and publically acceptable use of animals in biomedicine has been achieved.
Abstract
The use of non-human animals in biomedical research has given important contributions to the medical progress achieved in our day, but it has also been a cause of heated public, scientific and philosophical discussion for hundreds of years. This review, with a mainly European outlook, addresses the history of animal use in biomedical research, some of its main protagonists and antagonists, and its effect on society from Antiquity to the present day, while providing a historical context with which to understand how we have arrived at the current paradigm regarding the ethical treatment of animals in research.
... Put simply, the scientific description of disease assumes the existence of an objective definition of either qualitatively or quantitatively distinct biological processes in which the normal is defined as either a statistical average (common) or an 'ideal' biological state. Since this seminal work much has been written about the rise and valorization of experimental physiology, and the view that pathology, biology, health and disease could ultimately be reduced to deterministic physico– chemical relationships (Boorse 1977; Coleman 1985; Normandin 2007). In following Bernard's exhortation to rely on experimentation—rather than passive observation—to elucidate the properties of living processes, the determination of an organism's functional ideal has come to have more than a descriptive value. ...
Developments in biomedical science continue to transform our understanding of concepts such as health and disease. The creation
of this expertise has also had a substantive role in changing the veterinary approach to animal diseases. Traditionally, companion
animal veterinarians modelled their practices on developments in the diagnosis and treatment of human patients. As science
and technology have realigned the boundaries between normalcy, intra-species variation and pathology in particular domains
of expertise such as orthopaedic surgery, these patterns of knowledge translation have changed. Not so long ago, treatments
for the rupture of the cruciate ligament in human and canine patients were based on pathoanatomical comparison and designed
to reestablish the stability of the joint by the functional restoration of ligament anatomy. Recently, a radically different
characterization of the canine injury—with a corresponding alternative intervention—has been proposed within the field of
veterinary orthopaedics. It views the normal anatomy of the canine knee as being in some way inherently pathogenic and proposes
the surgical creation of an idealized structure as a remedy to dysfunction and disease. The veterinary focus on an ideal of
patient performance, rather than a specific pathology, is now influencing how orthopaedists choose to approach analogous human
injuries. In this article, I chart the history of canine ‘cruciate disease’ therapies as a means to map some of the epistemic
assumptions, interplays of idealized and analogical reasoning and patterns of knowledge translation central to the biomedicalization
of the science and practice of orthopaedic surgery.
KeywordsOrthopaedics-Veterinary science-Biomechanics-Epistemic strategies
... He succeeded Magendie at the Collège de France after the latter's death in 1855, and became a professor at the Muséum (National Museum of Natural History) in 1868. He laid the foundations of experimental medicine in L'Introduction à l'étude de la médecine expérimentale (An Introduction to the Study of Experimental Medicine), published in 1865 (Bernard, 1858(Bernard, , 1865a(Bernard, , 1865bNoble, 2008;Normandin, 2007;Tan and Holland, 2005). He then became a member of Académie Française and a person of international reputation. ...
We present a short historical review of the major figures and institutions that contributed to make Paris a renowned centre of physiology and neurology during the xixth and the first half of the xxth century. We purposely chose to focus on the period 1800-1950, as 1800 corresponds to the actual beginning of experimental physiology of the nervous system - what is here referred to as "neuroscience"-and 1950 marks its exponential rise. Our presentation is divided into four chapters, matching the main disciplines which have progressed and contributed the most to the knowledge we have of the brain sciences: anatomy, physiology, neurology, and psychiatry-psychology. The present article is the second of four parts of this review which includes the chapter on neurophysiology with selected biographical sketches of François Magendie, Marie Jean-Pierre Flourens, Claude Bernard, Charles-Édouard Brown-Séquard, Étienne-Jules Marey, Alfred Fessard and Denise Albe-Fessard.
... In 1841, Professor Magendie, the leading physiologist at the time, discovered Bernard's dissecting skills and employed him as an assistant in his laboratory. Claude Bernard published many papers: his masterpiece, "An Introduction to the Study of Experimental Medicine" (1865), and others, no less important, on pancreatic digestion and liver glycogen discovery (15). He died in 1878 from a pyelonephritis and was honored with a state funeral (14). ...
Sir William Harvey (1578–1657), who had many precursors, discovered blood circulation in 1628 after a significant number of anatomic dissection of cadavers; his studies were continued by Sir Christopher Wren and Daniel Johann Major. The first central vein catheterization was performed on a horse by Stephen Hales, an English Vicar. In 1844, a century later, the French biologist Claude Bernard attempted the first carotid artery cannulation and repeated the procedure in the jugular vein, again on a horse. He was first to report the complications now well known to be associated with this maneuver. In 1929 Werner Forssmann tried cardiac catheterization on himself, but could not investigate the procedure further since his findings were rejected and ridiculed by colleagues. His work was continued by André Frédéric Cournand and Dickinson Woodruff Richards Jr in the United States. In 1956 the three physicians shared the Nobel Prize for Medicine for their studies on vascular and cardiac systems. The genius and the perseverance of the three physicians paved the way towards peripheral and central catheter vein placement, one of the most frequently performed maneuvers in hospitals. Its history still remains unknown to most and deserves a short description.
... This is not the place to attempt proper discussion of Bernard, not least since he is not part of our eighteenth-century mandate; suffice it to say that he extends a kind of structural model further, as is best-known in his analysis of physiological determinism. On Bernard and vitalism seeNormandin (2007).18 Stahl (1706b), in Stahl(1859), p. 224. ...
I distinguish between what I call ‘substantival’ and ‘functional’ forms of vitalism in the eighteenth century. Substantival vitalism presupposes the existence of something like a (substantive) vital force which either plays a causal role in the natural world as studied by scientific means, or remains a kind of hovering, extra-causal entity. Functional vitalism tends to operate ‘post facto’, from the existence of living bodies to the desire to find explanatory models that will do justice to their uniquely ‘vital’ properties in a way that fully mechanistic (Cartesian, Boerhaavian etc.) models cannot. I discuss some representative figures of the Montpellier school (Bordeu, Ménuret, Fouquet) as being functional rather than substantival vitalists. Time allowing, I will make an additional point regarding the reprisal of vitalism(s) in ‘late modernity’, as some call it; from Hans Driesch to Georges Canguilhem. I suggest that in addition to the substantival and functional varieties, we then encounter a third species of vitalism, which I term ‘attitudinal’, as it argues for vitalism as a kind of attitude.
... Hermann von Helmholtz, Carl Ludwig and Ernst Brü ce), who aimed to explain all living phenomena exclusively through the laws of physics and chemistry. The ideas of the organic physicists were viewed with considerable skepticism by the physiologist Claude Bernard [7], who considered that physics and chemistry could only inform, but not be the foundation of, the models of physiology. Enquist and Stark [6] cite an organic physicist, D'Arcy Thompson, as a source of inspiration. ...
The metabolic theory of ecology (MTE) claims to derive ecological relationships from the structure of resource distribution networks, which is assumed to determine the scaling of metabolism with body mass, and from the effect of temperature on the rate of biological processes. MTE is controversial. I propose that some of the controversy stems from the implicit adoption of different views of science by the proponents and critics of MTE. The perspective of proponents is consistent with the theory-centric view of science called the received view, whereas many of the critics implicitly adopt an alternative view consistent with a model-centric view of science. I propose that adopting the model-centric view can help to settle some of the differences among proponents and critics of MTE.
In this article, we highlight the contributions of passive experiments that address important exercise‐related questions in integrative physiology and medicine. Passive experiments differ from active experiments in that passive experiments involve limited or no active intervention to generate observations and test hypotheses. Experiments of nature and natural experiments are two types of passive experiments. Experiments of nature include research participants with rare genetic or acquired conditions that facilitate exploration of specific physiological mechanisms. In this way, experiments of nature are parallel to classical “knockout” animal models among human research participants. Natural experiments are gleaned from data sets that allow population‐based questions to be addressed. An advantage of both types of passive experiments is that more extreme and/or prolonged exposures to physiological and behavioral stimuli are possible in humans. In this article, we discuss a number of key passive experiments that have generated foundational medical knowledge or mechanistic physiological insights related to exercise. Both natural experiments and experiments of nature will be essential to generate and test hypotheses about the limits of human adaptability to stressors like exercise. © 2023 American Physiological Society. Compr Physiol 13:4879‐4907, 2023.
During the “Age of Reason” and part of the“Enlightenment” vitalism was retaken as the most logicalexplanation for the physical phenomena that occurredin nature and life. From today’s perspective, vitalismcan be defined as a theory of life, in the life sciences.Much of the preservation and dissemination of vitalismwas thanks to the Greek physician Galen of Pergamum(approximately 129-216 BC) who, in addition to hiswork in health, was an eminent philosopher who tooktraits from the ideology of Plato (427-347 BC), Aristotle(384-322 BC) and the Hippocratic tradition, to generatetheir own doctrinal system based on the union of medicineand philosophy. Georg Ernst Stahl (1659-1734) took upthe ancient concept of anima (from the Latin soul) withthe purpose of giving meaning to the regulation of healthand disease. In a contemporary way, François Boissierde Sauvages de Lacroix (1706-1767) introduced animism(the word âme), to the medical school of Montpellierin France (1730’s), where the theory of the vital flowarose; Due to Napoleon’s campaigns across Europe, aswell as the monarch’s support for science, vitalism hadan international distribution throughout the eighteenthcentury. It was not until Bichat approached the study oftissue, bringing down the fibrillarist theory and givingrise to the application of an anatomoclinical mentality
This extensive introductory chapter is divided into two parts. The first part revisits current scholarship on vitalism and poses three key questions: the historical question, the logical question, and the riddle of life. Regarding the historical question, I argue that additional forms of vitalism remain to be identified within the history of science. Concerning the logical question, I contend that a more penetrating analysis, grounded in extensive historical knowledge, should be conducted. Additionally, I assert that proper responses to both the historical and logical questions can illuminate the so-called central question in biology—the riddle of life. The second part of the chapter reviews several significant methodological issues from both historical and logical perspectives. I clarify that this book aims to address the aforementioned three questions through a comprehensive historico-logical study of vitalism, spanning from Aristotle’s natural philosophy to early-twentieth-century physical, biological, and social sciences. This historico-logical method, or the logical analysis of both historical and contemporary scientific knowledge, has been variously endorsed by figures such as Immanuel Kant, post-Kantian philosopher-scientists like Ernest Mach, and several early-twentieth-century philosophical schools including logical empiricism, British analysis, pragmatism, Husserlian phenomenology, and neo-Kantianism, as well as by historicists like French historical epistemologists and Kuhnians. In the second part, I also provide an exposition on the general logic of science and discuss the relationship between science and philosophy following the pivotal nineteenth-century separation of the sciences from philosophy.
Until the mid-seventeenth century, there were only a handful of active drugs in the entire medical pharmacopoia: opium, belladonna, foxglove, willow bark, some cathartics, and antiparasitics. All others were either placebos or nocebos; therefore, most of those who were cured did so believing in the therapeutic effect of the concoctions they consumed, but above all trusting in the experience and word of the doctor or healer who supplied them.
Even today, in the most developed population centers of the world, there is a high percentage of cancer patients who use alternative treatments, based on their belief in the testimonies of those who apply them.
The placebo effect is one of the most extensively studied and most consistently demonstrated medical phenomena throughout the history of medicine.
The doctor and his word are the first placebo that the patient encounters, but unfortunately sometimes it turns out to be a nocebo.
Thomas Hun (1808-1896)-along with his sons Edward (1842-1880) and Henry (1854-1924)-were prime movers in establishing the clinical practice and academic discipline of neurology in the Hudson River Valley of New York in the ninteenth and early-twentieth centuries. This article outlines the life of the family's semi-aristocratic patriarch, beginning with Thomas's unusual educational background and his six-year post-graduate hiatus in Paris of the 1830s, where he came under the influence of P. C. A. Louis (1787-1872). It lays out his subsequent career as professor of the Institutes of Medicine and ultimately as dean of an American medical school that was not situated in a major metropolis. It also will demonstrate how Thomas Hun's career as a medical practitioner, academician, neurophilosopher, and "proto-neurologist" recapitulates the evolution of clinical and academic neurology in nineteenth-century America.
The respiratory barrier, a thin epithelial barrier that separates the interior of the human body from the environment, is easily damaged by toxicants, and chronic respiratory diseases are common. It also allows the permeation of drugs for topical treatment. Animal experimentation is used to train medical technicians, evaluate toxicants, and develop inhaled formulations. Species differences in the architecture of the respiratory tract explain why some species are better at predicting human toxicity than others. Some species are useful as disease models. This review describes the anatomical differences between the human and mammalian lungs and lists the characteristics of currently used mammalian models for the most relevant chronic respiratory diseases (asthma, chronic obstructive pulmonary disease, cystic fibrosis, pulmonary hypertension, pulmonary fibrosis, and tuberculosis). The generation of animal models is not easy because they do not develop these diseases spontaneously. Mouse models are common, but other species are more appropriate for some diseases. Zebrafish and fruit flies can help study immunological aspects. It is expected that combinations of in silico, in vitro, and in vivo (mammalian and invertebrate) models will be used in the future for drug development.
In this third installment of our four-part historical series, we evaluate contributions that shaped our understanding of heat and cold stress during occupational and athletic pursuits. Our first topic concerns how we tolerate, and sometimes fail to tolerate, exercise-heat stress. By 1900, physical activity with clothing- and climate-induced evaporative impediments led to an extraordinarily high incidence of heat stroke within the military. Fortunately, deep-body temperatures > 40 °C were not always fatal. Thirty years later, water immersion and patient treatments mimicking sweat evaporation were found to be effective, with the adage of cool first, transport later being adopted. We gradually acquired an understanding of thermoeffector function during heat storage, and learned about challenges to other regulatory mechanisms. In our second topic, we explore cold tolerance and intolerance. By the 1930s, hypothermia was known to reduce cutaneous circulation, particularly at the extremities, conserving body heat. Cold-induced vasodilatation hindered heat conservation, but it was protective. Increased metabolic heat production followed, driven by shivering and non-shivering thermogenesis, even during exercise and work. Physical endurance and shivering could both be compromised by hypoglycaemia. Later, treatments for hypothermia and cold injuries were refined, and the thermal after-drop was explained. In our final topic, we critique the numerous indices developed in attempts to numerically rate hot and cold stresses. The criteria for an effective thermal stress index were established by the 1930s. However, few indices satisfied those requirements, either then or now, and the surviving indices, including the unvalidated Wet-Bulb Globe-Thermometer index, do not fully predict thermal strain.
In this article, we highlight the contributions of passive experiments that address important exercise-related questions in integrative physiology and medicine. Passive experiments differ from active experiments in that passive experiments involve limited or no active intervention to generate observations and test hypotheses. Experiments of nature and natural experiments are two types of passive experiments. Experiments of nature include research participants with rare genetic or acquired conditions that facilitate exploration of specific physiological mechanisms. In this way, experiments of nature are parallel to classical "knockout" animal models among human research participants. Natural experiments are gleaned from data sets that allow population-based questions to be addressed. An advantage of both types of passive experiments is that more extreme and/or prolonged exposures to physiological and behavioral stimuli are possible in humans. In this article, we discuss a number of key passive experiments that have generated foundational medical knowledge or mechanistic physiological insights related to exercise. Both natural experiments and experiments of nature will be essential to generate and test hypotheses about the limits of human adaptability to stressors like exercise. © 2023 American Physiological Society. Compr Physiol 13:4879-4907, 2023.
The objective of this critique is to demonstrate that the theory of “internal environment” (TIE) does not support the theory of “homeostasis” (TOH). We review and conclude that remains valid the concept of “internal environment”, which corresponds anatomically to the extracellular fluid (ECF) that bathes tissue cells. The Claude Bernard's classification of “life”, a corollary of the TIE under a strict “reactive” paradigm, we then interpret as a classification of how animals behave in response to environmental changes. According to such interpretation, the two theories agree that, when facing changes in the external environment, animals with “free” behavior regulate essential metabolism factors present in the ECF. These are “internalized environmental factors” or IEF (temperature, O2, water, and basic organic and inorganic “nutrients”), a marine legacy of the evolution of the body fluid compartments. However, we show that have empirical and logical shortcomings key inferences derived from the TIE. Such inferences representing traditional premises of TOH we summarize here in two axioms: “if free behavior then regulated IEF” and “all behavioral mechanisms regulate the IEF”. In addition, whereas “stability” means “free behavior versus dormancy” in TIE, it means “tissue cells that resist destruction” in TOH. This leads to inevitable contradictions, here discussed at length, that reduce the scope of TOH. We might be in need of a theory that considers not only where TIE and TOH are superficially valid, but also where they crucially diverge, in order to explain “stability” as applied to physiology and behavior.
Objective
The purposes of this article are to describe the development of vitalism from its earliest Hellenistic form to that of a contemporary vitalism ethos and to propose the importance of vitalism in the philosophy of chiropractic and the chiropractic health care paradigm.
Discussion
A review of the history of vitalism is offered to clarify the use of the term within the chiropractic literature and to provide a defensible position for vitalism as a foundation for future research in the philosophy of chiropractic. The founder of chiropractic, Daniel David Palmer, drew heavily from spiritualism and vitalism in his construction of early chiropractic philosophy. As chiropractic practice and philosophy have evolved, that vitalistic foundation has become a polemic used by factions within the profession, resulting in political challenges. The controversy within chiropractic mirrors similar debates within academic philosophy regarding vitalism. The philosophy of vitalism has developed beyond its classical constructs, emerging as an ethos amenable to informing research within clinical applications and a perspective capable of informing the identity of chiropractic.
Conclusion
Exploring the broad historical context of vitalism may allow for an understanding of the plurality of vitalist ideas and a clarification of the concept within chiropractic literature. Adopting vitalism within the philosophy of chiropractic as an ethos based on the work of Georges Canguilhem provides a view of life as fundamentally original, adaptable, and unpredictable, and therefore not sufficiently understood in purely reductionist terms.
Resumen Este artículo analiza cómo el discurso médico incorpora una serie de reflexiones sobre las conductas morales en Buenos Aires en la primera parte del siglo XIX. A través del estudio de tres textos, cuyos autores son los médicos Diego Alcorta, Guillermo Rawson y Francisco Javier Muñiz se identifican una serie de registros argumentales que resaltan el funcionamiento de los órganos, la cuestión de la herencia y la gravitación del clima en función de reflexionar sobre la moralidad de los individuos y las poblaciones. Este fenómeno de transferencia de saberes se debe a la presencia de la tradición médica francesa sumándose a factores locales derivados del intenso proceso de politización de la sociedad bajo el segundo gobierno de Juan Manuel de Rosas.
In order to understand the work of the radical psychiatrist Wilhelm Reich in wider context, I ask whether or not he can be considered a vitalist. Beginning with some brief discussion of the idea of vitalism, this chapter moves to look at Reich’s seminal writings and the details of his life in an effort to properly situate him in the context of the vitalist tradition. I argue that Reich encountered deep resistance to, and criticism of, his ideas, and his role as an outsider in relationship to mainstream psychological paradigms was coveted but also unavoidable. Not only does Reich clearly fit into the vitalist paradigm – understanding him in these terms actually helps explain why he struggled for legitimacy and recognition in the psychiatric field throughout his career. Regardless of this peripheral role, or perhaps because of it, much interest remains in Reich’s thought, and his insights can still give us a more nuanced sense of sexuality and its relationship to life, spirituality, society and politics.
To undertake a history of vitalism at this stage in the development of the ‘biosciences’, theoretical and other, is a stimulating prospect. We have entered the age of ‘synthetic’ life, and our newfound capacities prompt us to consider new levels of analysis and understanding. At the same time, it is possible to detect a growing level of interest in vitalistic and organismic themes, understood in a broadly naturalistic context and approached, not so much from broader cultural perspectives as in the early twentieth century, as from a scientific perspective – or at least a view lying at the boundaries or liminal spaces of what counts as ‘science’.
Through most of the twentieth century, biology’s image as a valid science has been gauged by how closely it adheres to the norms of “objective” sciences like physics, chemistry and mathematics. Strains of biological thought that depart from this norm are deemed non-scientific. This presumes that life is fundamentally a physical, chemical and thermodynamic phenomenon. While this approach has been very fruitful, it is questionable that it can lead to a coherent theory of biology. This is particularly the case for certain obvious (self-evident?) properties of living systems, including purposefulness, design, and intentionality. The tendency has been to treat these phenomena as illusions, as in numerous invocations of “apparent” design, “apparent” purposefulness and “apparent” intentionality. I argue in this essay that these phenomena are far from illusory, but are in fact quite real. I further argue that a coherent theory of biology must account for purpose, design and intentionality, and I offer one possible way to do so through the fundamental phenomenon of homeostasis.
Resumen Objetivo: analizar la disputa intelectual entre el médico Cosme Mariano Argerich y el profesor de Filosofía Juan Crisóstomo Lafinur. El debate, situado en el espacio porteño y registrado en el diario El Americano, se originó por la introducción de nuevas enseñanzas ligadas al sensualismo y a la Fisiología francesa en el Colegio de la Unión del Sud en 1819. Desarrollo: se desea demostrar la existencia de un proceso de apropiación de saberes de estos actores locales según sus intereses y posicionamientos. Conclusiones: el propósito de Argerich y Lafinur era construir argumenta-ciones con el fin de convencer a una incipiente opinión pública de las propuestas del sensualismo y de la Fisiología de Magendie, respectivamente. En su afán por vencer en la discusión, ambos personajes perfeccionaron tanto sus demostraciones, que se puede observar un registro discursivo distinto respecto a las nociones originales de los autores europeos.
In this chapter we focus on the relationship at the turn of the twentieth century between vitalistic theories and a special case of a holistic approach to biology, Kurt Goldstein’s organicism. We consider Goldstein’s biographical and historical background and present the research cases that lead him to formulate his ‘holistic-organismic’ approach to the study of the brain and the mind, which developed into an ambitious theory on the nature of biological knowledge. Goldstein’s organicism emerges as an antagonist to the aseptic and unsatisfactory framework of mechanistic biology. However, Goldstein’s organicism strives to keep apart from some members of its own ‘family’ of anti-mechanistic approaches. It is especially wary of the metaphysical commitments of vitalistic hypotheses, and seeks alternative conceptual routes to traditional problems in the biological sciences, like teleology and the organization of the living. Goldstein’s organicism will result in a rigorously materialist but non-reductionist epistemology of biology, which represents in his view the only feasible route to effective therapy. Goldstein’s efforts to solve the problem of teleology, while incomplete, ultimately reveals the richest dimension of his intellectual legacy, that of an ethical stance towards science and medical practice.
In this original and compelling book, Jeffrey P. Bishop, a philosopher, ethicist, and physician, argues that something has gone sadly amiss in the care of the dying by contemporary medicine and in our social and political views of death, as shaped by our scientific successes and ongoing debates about euthanasia and the "right to die"-or to live. The Anticipatory Corpse: Medicine, Power, and the Care of the Dying, informed by Foucault's genealogy of medicine and power as well as by a thorough grasp of current medical practices and medical ethics, argues that a view of people as machines in motion-people as, in effect, temporarily animated corpses with interchangeable parts-has become epistemologically normative for medicine. The dead body is subtly anticipated in our practices of exercising control over the suffering person, whether through technological mastery in the intensive care unit or through the impersonal, quasi-scientific assessments of psychological and spiritual "medicine."
I distinguish between 'substantival' and 'functional' forms of vitalism in the eighteenth century. Substantival vitalism presupposes the existence of a (substantive) vital force which either plays a causal role in the natural world as studied scientifically, or remains an immaterial, extra-causal entity. Functional vitalism tends to operate 'post facto', from the existence of living bodies to the search for explanatory models that will account for their uniquely 'vital' properties better than fully mechanistic models can. I discuss representative figures of the Montpellier school (Bordeu, Ménuret, Fouquet) as functional rather than substantival vitalists, and suggest an additional point regarding the reprisal of vitalism(s) in the 20th century, from Driesch to Canguilhem: that in addition to the substantival and functional varieties, we encounter a third species of vitalism, which I term 'attitudinal', as it argues for vitalism as a kind of attitude.
In the latter decades of the 19th century, European physicians debated a controversial practice that mixed placebos with suggestion therapy to treat children diagnosed with neurotic disorders and behavioral problems. Designed to optimize suggestibility in juvenile patients, this “moral orthopedics” offered parents and therapists the message that children could be saved from becoming victims of their own personalities, of familial neuroses, or even of public health problems. Case studies, published in medical journals and books, circulated accounts of innovative strategies to treat childhood hysteria and to change habits that were considered destructive. Moral orthopedics actualized the insight that suggestibility could be therapeutically productive for juvenile subjects. However, because its adherents sought to manipulate patients' behavior and health by influencing unconscious thought, moral orthopedics provoked questions of expertise and disciplinary propriety among domains of medicine, law, and philosophy. This article reconstructs the controversy surrounding moral orthopedics by examining case studies. I argue that adherents of moral orthopedics did overcome philosophical objections raised against the method, and that they did so through what physician Edgar Bérillon referred to as “education of the will.”
A comparison is made between Biologos, the "language of language" that predominates in current infocentric biology, and Logos, the classic bringer of form to chaos. The immaterial information on which Biologos is based is seen to bear intriguing similarities to just the sort of disembodied formative powers that an aggressively materialist biology has long derided. I address these issues by meeting a (perhaps only hypothetical) charge that my own work is in some sense vitalist, first with the usual flat denial, then with a countercharge. My third move is a nontraditional one, meant not as capitulation or acquiescence, but as an acknowledgement that the terms of this debate, never clear, continue to be remarkably ill-defined. The question of how best to think about development, or epigenesis--the process whereby organisms come into being--remains a legitimately contested and difficult one.
Claude Bernard (1813-1878), the most distinguished French physiologist of the 19th century, made incomparable contributions to the world of medicine of his times and even to ours. Bernard believed in scientific determinism and created the term milieu interieur as a manner to better understand experimental medicine and to present a new way of explaining the function of the living organism. Bernard dealt with innovative developments in the glycogenetic function of the liver, extrahepatic glycogenesis, the role of pancreatic juice in the digestion of fats, vasomotor nervous system discoveries, and other important physiological advances. In 1865, Bernard's most extraordinary book on the philosophy and understanding of experimental medicine appeared. This book represented Bernard's unique contribution to the progress of medical and surgical research. Because of the enormous implications of this work on the advancement of surgical research, which were subsequently applied to clinical surgical practice, we propose that this book created a surgical revolution.
Claude Bernard's concept of the internal environment (milieu intérieur) played a crucial role in the development of experimental physiology and the specific medical therapeutics derived from it. This concept allowed the experimentalist to approach the organism as fully determined yet relatively autonomous with respect to its external environment. However, Bernard's theory of knowledge required that he find organismic functioning as the result of an external necessity. He is therefore unable to explain adequately the origin or operation of organismic autonomy. A more complete conception of biological autonomy must include a theory of knowledge that can accommodate the organism as a source of discrimination and determination. Only in this way will it be possible to see organisms as active as well as reactive, as ordering as well as ordered. This shift in perspective is crucial if medicine is to be able to characterize, for example, susceptibility to disease. A cognitive sense of the organic interior is proposed as an alternative to Bernard's internal environment.
Although American philosophers and physicians are generally familiar with the writings of Claude Bernard (1813–1878), especially
his Introduction to the Study of Experimental Medicine (1865), the medicial epistemology of Georges Canguilhem, born in 1904, is virtually unknown in English speaking nations.
Although indebted to Bernard for his conception of the methods to be employed in the acquisition of medical knowledge, Canguilhem
radically reformulates Bernard's concepts of ‘disease’, ‘health’, ‘illness’, and ‘pathology’. Contemporary exhortations to
medical professionals and medical students that they “pay more attention to the whole patient” take on significance in working
through the writings of Canguilhem; of crucial importance is the relation that obtains between a patient's unique symptomatology
and the proper drug regiment that is required.
L'A. demontre que le concept de l'individualite a joue un role important dans le developpement de la pensee de Canguilhem (G.) et represente l'enigme de sa reflexion sur la relation entre la vie et la connaissance
For the original text see Henri Bergson
- Ibid
Ibid., 13. For the original text see Henri Bergson, " La philosophie de Claude Bernard, " in La pensé et le mouvant, 12th ed. (Paris: Presses Universitaires de France, 1941), 229.
Journal of the51. Holmes
- Bernard
Bernard, Experimental Medicine, 67. Journal of the51. Holmes, " Claude Bernard, the Milieu Inté, " 3–25.
Ideology and Rationality in the History of the Life Sciences
- Georges Canguilhem
Georges Canguilhem, Ideology and Rationality in the History of the Life Sciences (Cambridge, MA: M.I.T. Press, 1988), 62.
Claude Bernard, the Milieu Inté
- Holmes
Holmes, " Claude Bernard, the Milieu Inté, " 3–25.