Introduction
The changes in medicine, and particularly epidemiology, that took place during the 19th century, concentrated in the latter half of the century, are often referred to as a revolution by medical historians. Here I consider whether these changes exemplify a Kuhnian revolution. To do this I first outline the characteristics of a Kuhnian revolution, I will then outline the changes in medical practice over the 19th century. I will then consider the change in epidemiology in light of Kuhn’s ideas and then an altered Kuhnian view put across by Gillies. Concluding that the proposed bacteriological revolution does not fit that of a characteristic Kuhnian revolution.
Scientific …show more content…
If it is the case that a disease has multiple mutually sufficient causal mechanisms it again seems as if the Kuhnian idea of paradigms breaks down here, as it did for the case of epidemiology in a macro sense. Consider lung cancer, there is no one necessary and sufficient cause for lung cancer instead there are multiple causes which interact with each other such as smoking, work environment, processed meat consumption etc. (Rotham and Greenland, 2005) In this circumstance if a new cause of cancer is discovered, as it seems to in some newspaper every week, it would be difficult to characterise the miniscule local oncological paradigm changes as anything other than normal science. Hence even the idea of Kuhnian revolution when applied to a local disease paradigm is not always applicable. Applying this to the case of the suggested bacteriological revolution, before bacteria was a known pathogen diseases were not thought of as having singular necessary and sufficient causes; multiple factors were acknowledged to be the cause of a certain disease. For example accepted causes of cholera included rotting food, anger and “cold fruits” such as melons or cucumbers (Marsh). Hence the epidemiological landscape even for specific diseases of the time doesn’t seem to fit with Kuhnian paradigms. The most that can be said is that each disease went from a pre-paradigmic stage to a paradigm as the causal agent was identified as being a particular bacterium, if these bacteria were seen as a single necessary and sufficient cause. This was the case in many but not all of the reclassifications of disease that took place in the latter half of the nineteenth century (Worboys,