Medical Humanities Series Talks: Lauren Nicole Ross (UCI)

Department: Philosophy

Date and Time: January 24, 2018 | 2:00 PM-4:00 PM

Event Location: HIB 55

Event Details

"The doctrine of specific etiology: The influence of germ theory on modern medicine"
Time: 2:15 - 3:45 p.m.

Modern medicine is often said to have originated with the 19th century germ theory of disease. The success of this theory is typically associated with its commitment to an underlying principle referred to as the "doctrine of speci c etiology." This phrase was coined by Rene Dubos in 1959, in reference to the theory's speci city at the level of disease causation or etiology. This notion of speci city is typically interpreted as a monocausal view where particular diseases have single main causes. It is difficult to overemphasize the perceived importance of this doctrine. The doctrine of speci c etiology is viewed as "the most powerful single force in the development of medicine during the past century" (Dubos 1965, 326), "a singular turning point in the history of medical thought" (Loomis and Wing 1990, 1), "the theoretical core of modern medical ideology" (Downing 2005); the "signature of modern Western medicine" (Mishler 1981, 7); and a "prototype for explaining most diseases," which has"a lasting preeminence" in medicine today (Aronowitz 1998, 8).

There are a number of puzzles associated with the perceived importance of this doctrine. First, it is not always clear exactly what is meant by the doctrine of speci c etiology. The literature lacks a clear account of the types of speci city present in this model and why they matter. Second, while many scholars interpret this doctrine in terms of a monocausal picture they also admit that most diseases have many causes and, thus, do not t this view. If the doctrine of speci c etiology has these issues it is not clear why it is viewed as a signi cant advance in medical theory, which has led to the development of modern medicine. These puzzles raise a number of questions. First, what kinds of speci city are present in this early model of disease? Second, what makes them important and how have they infuenced modern medicine, if they have at all?

In this talk I address these questions by arguing that the 19th century germ theory of disease involves two types of speci city at the level of etiology. One type receives signi cant attention in the literature, but its influence on modern medicine has been misunderstood. A second type is present in this theory, but it has been completely overlooked in this literature. My analysis discusses how these types of speci city led to a novel conception of etiology, which continues to gure in medicine today. I examine how this conception of etiology facilitates disease discovery, classi cation, and explanation, by advocating particular standards that legitimate" disease traits are expected to meet. This project is an effort to clarify what has been viewed as "a profound change in ideas about disease causation that occurred in the late 19th century" and how such ideas have had a lasting influence on modern medicine (Kunitz 1987, 379).

Aronowitz, R. A. (1998). Making Sense of Illness: Science, Society, and Disease. Cambridge University Press.
Downing, R. (2005). As They See it: The Development of the Africian AIDS Discourse. Adonis & Abbey Publishers.
Downing, R. (2011). Biohealth: Beyond Medicalization Imposing Health. Wipf & Stock Pub.
Dubos, R. (1965). Man Adapting. Yale University Pres.
Kunitz, S. J. (1987). Explanations and Ideologies of Mortality Patterns. Population and Development Review 13, 1{31.
Locker, D. (2003). Social determinants of health and disease. In Sociology as applied to medicine. Elsevier.
Loomis, D. and S. Wing (1990). Is Molecular Epidemiology a Germ Theory for the End of the Twentieth Century? International Journal of Epidemiology, 1-3.
Mishler, E. G. (1981). Social Contexts of Health, Illness, and Patient Care. Cambridge University Press.
Tesh, S. N. (1988). Hidden Arguments: Political Ideology and Disease Prevention Policy. Rutgers University Press.