Application of evolutionary principles to epidemiological problems indicates that cultural characteristics influence the evolution of parasite virulence by influencing the success of disease transmission from immobilized, infected hosts. This hypothesis is supported by positive correlations between virulence and transmission by biological vectors, water, and institutional attendants. The general evolutionary argument is then applied to the causes and consequences of increased virulence for three diseases: cholera, influenza and AIDS.

Modern medicine is often said to have originated with nineteenth century germ theory, which attributed diseases to bacterial contagions. The success of this theory is often associated with an underlying principle referred to as the “doctrine of specific etiology”. This doctrine refers to specificity at the level of disease causation or etiology. While the importance of this doctrine is frequently emphasized in the philosophical, historical, and medical literature, these sources lack a clear account of the types of specificity that it (...) involves and why exactly they matter. This paper argues that nineteenth century germ theory involves two types of specificity at the level of etiology. One type receives significant attention in the literature, but its influence on modern medicine has been misunderstood. A second type is present in this model, but it has been completely overlooked in the extant literature. My analysis clarifies how these types of specificity led to a novel conception of etiology that continues to figure in medicine today. (shrink)

Chomsky's current Biolinguistic methodology is shown to comport with what might be called 'established' aspects of biological method, thereby raising, in the biolinguistic domain, issues concerning biological autonomy from the physical sciences. At least current irreducibility of biology, including biolinguistics, stems in at least some cases from the very nature of what I will claim is physiological, or inter-organ/inter-component, macro-levels of explanation which play a new and central explanatory role in Chomsky's inter-componential explanation of certain properties of the syntactic component (...) of Universal Grammar. Under this new mode of explanation, certain physiological functions of cognitive mental organs are hypothesized, in an attempt to explain aspects of their internal anatomy. Thus, the internal anatomy of the syntactic component exhibits features that enable it to effectively interface with other 'adjacent' organs, such as the Conceptual-Intensional system and the Sensory- Motor system. These two interface systems take as their inputs the assembled outputs of the syntactic component and, as a result of the very syntactic structure imposed by the syntax are then able to assign their sound and meaning interpretations. If this is an accurate characterization, Chomsky's long-standing postulation of mental organs, and I will argue, the advancement of new hypotheses concerning physiological inter-organ functions, has attained in current biolinguistic Minimalist method a significant unification with foundational aspects of physiological explanation in other areas of biology. (shrink)

About 1970, Van Rensselaer Potter coined the term bioethics to bring under one heading broad questions of human survival, environment, and biology. In 1971, Potter outlined a statement of principles that linked the ethics of the biological sciences with the ethics of environmental concern. Regrettably, the field that adopted his rubric bioethics immediately diverged from Potter’s interests. Bioethics has become for the most part identified with medical ethics or health care ethics and in so doing has developed few ethical principles (...) and analyses in relationship to environmental ethics. Similarly, environmental ethics seldom touches on clinical or health care issues, even though the field of environmental health has grown greatly in recent decades. It is the purpose of this article to indicate briefly some of the topics that could be treated effectively as part of a project to reconnect medical ethics and environmental ethics into what may be called sustainable bioethics. (shrink)

Several philosophers have recently argued that phenomenology is well-suited to help understand the concepts of health, disease, and illness. The general claim is that by better analysing how illness appears to or is experienced by ill individuals—incorporating the first-person perspective—some limitations of what is seen as the currently dominant third-person or ‘naturalistic’ approaches to understand health and disease can be overcome. In this article, after discussing some of the main insights and benefits of the phenomenological approach, I develop three general (...) critiques of it. First, I show that what is often referred to as naturalism tends to be misunderstood and/or misrepresented, resulting in straw-man arguments. Second, the concept of normality is often problematically employed such that some aspects of naturalism are actually presupposed by many phenomenologists of medicine. Third, several of the key phenomenological insights and concepts, e.g. having vs. being a body, the alienation of illness, the epistemic role of the first-person perspective, and the idea of health within illness, each bring with them new problems that limit their utility. While acknowledging the possible contributions of phenomenology, these criticisms point to some severe limitations of bringing phenomenological insights to bear on the problems facing philosophy of medicine that should be addressed if phenomenology is to add anything substantially new to its debates. (shrink)

Reflecting on his scientific career toward the end of his life, the French-educated medical researcher René Dubos presented his flowering as an ecological thinker as a story of linear progression—the inevitable product of the intellectual seeds planted in his youth. But how much store should we set by Dubos’s account of his ecological journey? Resisting retrospective biographical readings, this paper seeks to relate the development of Dubos’s ecological ideas to his experimental practices and his career as a laboratory researcher. In (...) particular, I focus on Dubos’s studies of tuberculosis at the Rockefeller Institute in the period 1944–1956—studies which began with an inquiry into the tubercle bacillus and the physiochemical determinants of virulence, but which soon encompassed a wider investigation of the influence of environmental forces and host–parasite interactions on susceptibility and resistance to infection in animal models. At the same time, through a close reading of Dubos’s scientific papers and correspondence, I show how he both drew on and distinguished his ecological ideas from those of other medical researchers such as Theobald Smith, Frank Macfarlane Burnet, and Frank Fenner. However, whereas Burnet and Fenner tended to view ecological interactions at the level of populations, Dubos focused on the interface of hosts and parasites in the physiological environments of individuals. The result was that although Dubos never fully engaged with the science of ecology, he was able to incorporate ecological ideas into his thought and practices, and relate them to his holistic views on health and the natural harmony of man and his environment. (shrink)

Mild hypoferremia represents an aspect of the ability of the body to withhold iron from pathogenic bacteria, fungi, and protozoa, and from neoplastic cells. However, our iron-withholding defense system can be thwarted by practices that enhance iron overload such as indiscriminate iron fortification of foods, medically prescribed iron supplements, alcohol ingestion, and cigarette smoking. Elevated standards for normal levels of iron can be misleading and even dangerous for individuals faced with medical insults such as chronic infection, neoplasia, cardiomyopathy, and arthritis. (...) We are becoming increasingly aware that the wide-spread hypoferremia in human populations is a physiological response to insult rather than a pathological cause of insult, and that attempts to correct the condition by simply raising iron levels may not only be misguided but may actually impair host defense. (shrink)