The following article presents preliminary reflections on a processual theory of health and disease. It does this by steering the discussion more toward an ontology of organisms rather than conceptual analysis of the semantic content of the terms “health” and “disease.” In the first section, four meta-theoretical assumptions of the traditional debate are identified and alternative approaches to the problems are presented. Afterwards, the view that health and disease are constituted by a dynamic relation between demands imposed on an organism (...) and individual presuppositions for adequate response is developed. In the last section, the paper takes stock of three possible objections to and clarifies some implications of this approach to the notions of health and disease. (shrink)

Germund Hesslow has argued that concepts of health and disease serve no important scientific, clinical, or ethical function. However, this conclusion depends upon the particular concept of disease he espouses; namely, on Boorse's functional notion. The fact/value split embodied in the functional notion of disease leads to a sharp split between the science of medicine and bioethics, making the philosophy of medicine irrelevant for both. By placing this disease concept in the broader context of medical history, I shall show that (...) it does capture an essential part of modern medical ideology. However, it is also a self-contradictory notion. By making explicit the value desiderata of medical nosologies, a reconfiguration of the relation between medicine, bioethics, and the philosophy of medicine is initiated. This, in turn, will involve a recovery of the caring dimensions of medicine, and thus a more humane practice. (shrink)

Moshe Tati, a sanitation worker in Jerusalem, was among the first of more than a thousand mortally sick Israelis who signed up for illicit and clandestine ‘transplant tour’ packages that included: travel to an undisclosed foreign and exotic setting; five-star hotel accommodation; surgery in a private hospital unit; a ‘fresh’ kidney purchased from a perfect stranger trafficked from a third country. Although Tati’s holiday turned into a nightmare and he had to be emergency air-lifted from a rented transplant unit in (...) a private hospital in Adana, Turkey back to Israel, Moshe became a poster-boy of transplant tourism for the next decade. João Cavalcanti was among the first of 38 residents of the slums of Recife recruited by retired military Captain Ivan da Silva and his sidekick Captain Gadddy Tauber to travel to Durban, South Africa to provide a spare kidney to an Israeli transplant tourist in Durban. This article examines the logics and practices through which kidney buyers and kidney sellers, organs brokers, surgeons and their accessories convince themselves that they are engaged in an illegal but still mutually beneficial ‘medical-recreational’ adventure, an ‘extreme medical sport’ of sorts. While life, health and survival motivate ‘transplant tourism’, a euphemism for human trafficking in spare body parts, the freedom to roam, mobility, is an essential feature of transplant tours for kidney buyers and kidney sellers. (shrink)

This paper offers a caution that emphasis upon the importance of mathematics in recent historiography is in danger of obscuring the historical fact that, for the most part, mathematics was not seen as important in the pre-modern period. The paper proceeds by following a single case study, and in so doing offers the first account of the mathematical writings of Jean Fernel (1497–1558), better known as a leading medical innovator of the 16th century. After establishing Fernel's early commitment to mathematics, (...) and attempt to forge a career as a cosmographer, it goes on to explain his abandonment of mathematics for a career in medicine. The ‘mathematization of the world picture’ is usually explained in terms of the perceived usefulness of mathematics, but Fernel's case shows that for many pre-modern thinkers mathematics was not regarded as a useful pursuit. The paper should serve as a reminder, therefore, that the take-up of mathematics by natural philosophers was by no means inevitable, but had to be carefully managed by early modern mathematical practitioners. The case of Fernel indicates that perhaps he was not the only would-be mathematical practitioner to abandon mathematics in favour of a calling that was more appreciated by contemporaries. (shrink)

Galen conceives of wounds, fractures, and similar conditions as belonging to one of the highest genera in his taxonomy of disease. This classification is puzzling, as much from an ancient Greco-Roman perspective as from a contemporary one. In what sense are wounds and other injuries diseases? The classification appears more perplexing in light of Galen's method of conceptual analysis, which takes ordinary language use as a starting point. What, then, motivated Galen's departure from common Greek conceptions of disease? This article (...) examines the class of disease that Galen called “dissolutions of continuity” in the broader context of his system of nosological definition and classification. It concludes that Galen's analysis of wounds is driven by his theory of causation, and by his localization of disease and its mechanism inside the body, a conceptualization typical of Greco-Roman medical writing. This conclusion sheds further light on Galen's method of disease classification and the role of dissolutions within it. (shrink)

Despite the upsurge of research on disgust, the implications of this research for the investigation of cultural pollution beliefs has yet to be adequately explored. In particular, the sensitivity of both disgust and pollution to a common set of elicitors suggests a common psychological basis, though several obstacles have prevented an integrative account, including methodological differences between the relevant disciplines. Employing a conciliatory framework that embraces both naturalistic and humanistic levels of explanation, this article examines the dynamic reciprocal process by (...) which contamination/contagion appraisals in individuals serve to shape—and are in turn shaped by—culture-specific pollution beliefs. This complex interrelationship is illustrated by examining ancient Near Eastern and modern ethnographic documentation of pollution beliefs, highlighting the underappreciated function of these pollution beliefs as folk theories for the spread of infectious disease. By evaluating how pollution beliefs shape contamination appraisals in individuals, it will be argued that cultural inheritance has played a much larger role in guiding disease avoidance behavior than has been previously recognized. (shrink)

Autism research is facing profound difficulties. The lack of clinically valuable translations from the biomedical and neurosciences, the variability and heterogeneity of the diagnostic category, and the lack of control over the ‘autism epidemic,’ are among the most urgent problems facing autism today. Instead of encouraging the prevailing tendency to intensify neurobiological research on the nature of autism, I argue for an exploration of alternative disease concepts. One conceivable alternative framework for understanding disease and those we have come to call (...) autistic, can be found in the work of neurologist Kurt Goldstein. His person-centered approach provides radically new ways to investigate and intervene with the behavior we are accustomed to explain by the elusive entity called autism. (shrink)

In this article, I argue that the history and philosophy of autism need to account for two kinds of autism. Contemporary autism research and practice is structured, directed and connected by an ‘ontological understanding of disease’. This implies that autism is understood as a disease like any other medical disease, existing independently of its particular manifestations in individual patients. In contrast, autism in the 1950s and 1960s was structured by a psychoanalytical framework and an ‘individual understanding of disease’. This implied (...) that autism was not a distinct disease but an idiosyncratic and meaningful response of the child to a disturbed development of the ego. These two kinds of autism are embedded in and reveal two very different ‘styles of psychiatric thought’. (shrink)