From Library Journal
Thagard (philosophy, Univ. of Waterloo, Ontario; Mind: Introduction to Cognitive Science, MIT, 1996) presents a detailed structure for the scientific understanding of disease built on social, philosophical, and logical constructs. After an overview of the scientific process, he provides a detailed case study of how the theory that the bacterium Helicobacter pylori causes peptic ulcers gained acceptance. He then looks at the social aspects of scientific understanding and reviews the collaborative process of current scientific research, consensus building, and even the validity of information on the Internet. This valuable work is directed at students, scholars, and educated lay readers. Recommended for university and large college libraries.AEric D. Albright, Duke Medical Ctr. Lib., Durham, NC Copyright 1999 Reed Business Information, Inc.


From The New England Journal of Medicine, October 21, 1999
How do scientists explain disease? In trying to find an example from the recent past to answer this question, one could hardly do better than the fascinating history of how scientists have explained peptic ulcers. As readers of the Journal are surely aware, most ulcers were once thought to be caused by excess production of acid. But over the past two decades, scientists and physicians have come to believe instead that most ulcers are caused by infection with Helicobacter pylori. It would be something of an understatement to say that the theory of bacterial causation of peptic ulcer was poorly received at first. Perhaps the best evidence for this is the fate of an abstract submitted to a gastroenterology meeting in 1983. The authors of that abstract suggested that a newly discovered bacterium, one that has come to be called H. pylori, might cause ulcers. Of the 67 abstracts submitted to that meeting, 59 (88 percent) were accepted for presentation; the one on the new bacterium was not. Such lack of enthusiasm notwithstanding, today the idea that bacteria cause ulcers is part of standard textbook science, taught to students across the land as well-established fact. How did this transition take place? The story of how H. pylori came to be accepted as a cause of ulcers lies at the heart of this book. Thagard is a philosopher who has explored changes in scientific theories in a number of articles, published primarily in philosophy journals. In this book, he brings together many of his arguments and concludes, in brief, that to describe transitions in ideas about what causes a disease, one cannot rely on simple, unidimensional models of change. Only a synthesis of cognitive, social, and physical explanations can fully explain transitions from one set of theories to another. This book shows how one can combine several levels of explanation of changes in a scientific theory. The first section considers general models of how scientists change their ideas about diseases and argues for an organized group of "explanation schemas" that takes into account many different causes. The second part of the book examines how this model works in the case of peptic ulcers. Thagard examines both the discovery of the role of H. pylori in ulcer formation and the process by which that discovery came to be accepted. He correctly emphasizes the key (and often overlooked) role of technology in changing a theory; endoscopes, microscopes, and special stains were all necessary for making apparent the role of H. pylori. Collaboration was also key. The research was possible only because researchers with expertise in complementary areas worked together. In the last part of the book, Thagard explores his theories in detail. He discusses how cognitive processes change a theory and how analogies and conceptual changes create new ideas. Another section deals with the social processes involved in changing scientific ideas. Thagard considers why those in the sciences (and not in the humanities) in the late 20th century are so fond of collaboration and what advantages such collaboration may hold for scientific research. He also discusses consensus conferences and the use of the Internet. A concluding chapter provides a theory of how distributed computing can be used to model the complex cognitive and social processes involved in doing science. Thagard quotes Einstein to the effect that "everything should be as simple as possible but not simpler." Unfortunately, he does not always heed this advice in his book. The topic is inherently fascinating, but the ideas are presented in a style that makes for arduous reading at times, a problem ameliorated somewhat by an explicit organization that will usually help the reader work through the thickly articulated prose and return to the main thrust of the argument. This book is not the best place for readers to turn for a clear introduction to the history of ideas about H. pylori. How Scientists Explain Disease is primarily about ideas and theories that may or may not have anything to do with how scientists and physicians do their work. For example, Thagard suggests that the thinking of Hippocrates, Pasteur, and late-20th-century investigators can all be understood with the same sort of explanatory schemas. But this notion is hard to reconcile with increasing evidence that science and scientists are inextricably embedded in a specific social, political, and economic context -- a context that has clearly changed over the centuries and is missing from most of this book. Because the models presented here lack sufficient evidence about the ways that investigators actually reasoned about disease, they may or may not reflect how theories changed in the past. Although Thagard attempts to integrate social elements into his explanations, he clearly has little use for the social construction of knowledge. This stance is consistent with his desire to make the book normative as well as descriptive. He writes, "Philosophy of science is concerned not only with how science is done but also with how it should be done." The norms are presented as though they were transhistorical and transcultural. But how can this be? How we explain disease has changed throughout the course of history. It is certainly possible that soon it will no longer change -- that both the science and the philosophy of the late 20th century will forever persist as accepted truth. I cannot help but wonder, however, what new philosophical models of how scientists explain disease will exist a century or two hence. Reviewed by Joel D. Howell, M.D., Ph.D.
Copyright © 1999 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.


From Kirkus Reviews
A laborious examination of the evolution of the bacterial theory of peptic ulcers, pointing more generally to how scientific theories evolve. Thagard (Philosophy/Univ. Of Waterloo, Canada) begins by arguing against a traditional view of scientists as individuals conducting objective experiments with no presupposed outcome. The ``postmodern view'' of scientists trying to prove a hypothesis that will be most beneficial to them (``largely a matter of politics'') is similarly too simplistic. Thagard interlaces general arguments about the nature of scientists and scientific research with specific details of several scientific theories, such as headline-provoking conditions like ``mad cow'' disease and chronic fatigue syndrome. In the meat of the book, the author discusses diseases such as scurvy and his benchmark case, the bacterial theory of ulcers. The history of this theory is elaborated in some detailwe learn, among other things, that one of the reseachers swallowed a live culture of the bacteria to prove his point. Thagard's general discussions of scientific research schemas include many flow-chart-like diagrams that demonstrate possible cause-and-effect relationships, such as how social and psychological explanations of science relate to the science itself. The book tries too hard to explain itself, plodding through each theory step by step, even giving some arguments in outline form. This poor writing tends to obfuscate matters rather than simplify them. Thagard's treatment of complex equations showing causal probabilities, for example, concludes with the obtuse statement that ``causal reasoning requires the abductive inference that a factor has the power to produce an effect.'' Once deciphered, this is hardly a profound point. At its best, an engaging description of mysterious diseases past and present, but the book gets bogged down in flow charts, outlines, and equations that will leave the casual reader more frustrated than enlightened. (33 illustrations, not seen) -- Copyright ©1999, Kirkus Associates, LP. All rights reserved.


Book News, Inc.
Using the recent discovery of as a case study, Thagard (philosophy and cognitive science, U. of Waterloo, Canada) analyzes how disease mechanisms are discovered, explained, and accepted. He focuses on mind, society, and experiment as equally important factors in the development of new theories. -- Copyright © 1999 Book News, Inc., Portland, OR All rights reserved


William C. Summers, Yale University
"Thagard's model of the growth of scientific knowledge complements and extends current work while skillfully advancing a new account of knowledge growth. His literary style makes the arguments clear and accessible."


Charles Bangham, The Times Higher Education Supplement
Remarkable for its clarity. If this is what philosophers can do for medicine, we need more help from them.


Lindley Darden, Philosophy of Science
Clear and easy to read . . . [S]uitable for the general public and students . . . [and] professional[s].


Review
This clear and easy to read book is suitable for the general public and students, as well as professional philosophers of science. . . . The general reader will appreciate introductions to the logical, cognitive, and sociological approaches to the study of science. . . . Useful summaries at the end of each chapter allow a quick read of main points.


Book Description
"This is a wonderful book! In How Scientists Explain Disease, Paul Thagard offers us a delightful essay combining science, its history, philosophy, and sociology. Choosing as a case study the discovery that ulcers can be caused by bacteria and not simply by stress, Thagard takes us right into the heart of science and medicine, showing in a fascinating and illuminating way how scientists think, why they like ideas and (even more) why they might set up really strong objections to something which posterity judges a major advance.... It has been a long time since I read a book as important as this, and more importantly, it has been a long time since I read a scholarly book which gave me such simple pleasure."--Michael Ruse, University of Guelph, author of Monad to Man How do scientists develop new explanations of disease? How do those explanations become accepted as true? And how does medical diagnosis change when physicians are confronted with new scientific evidence? These are some of the questions that Paul Thagard pursues in this pathbreaking book that develops a new, integrative approach to the study of science. Ranging through the history of medicine, from the Hippocratic theory of humors to modern explanations of Mad Cow Disease and chronic fatigue syndrome, Thagard analyzes the development and acceptance of scientific ideas. At the heart of the book is a case study of the recent dramatic shift in medical understanding of peptic ulcers, most of which are now believed to be caused by infection by the bacterium Helicobacter pylori. When this explanation was first proposed in 1983, it was greeted with intense skepticism by most medical experts, but it became widely accepted over the next decade. Thagard discusses the psychological processes of discovery and acceptance, the physical processes involving instruments and experiments, and the social processes of collaboration, communication, and consensus that brought about this transformation in medical knowledge. How Scientists Explain Disease challenges both traditional philosophy of science, which has viewed science as largely a matter of logic, and contemporary science studies that view science as largely a matter of power. Drawing on theories of distributed computing and artificial intelligence, Paul Thagard develops new models that make sense of scientific change as a complex system of cognitive, social, and physical interactions. This is a book that will appeal to all readers with an interest in the development of science and medicine. It combines an engaging style, significant research, and a powerfully original argument.


From the Inside Flap
"This is a wonderful book! In How Scientists Explain Disease, Paul Thagard offers us a delightful essay combining science, its history, philosophy, and sociology. Choosing as a case study the discovery that ulcers can be caused by bacteria and not simply by stress, Thagard takes us right into the heart of science and medicine, showing in a fascinating and illuminating way how scientists think, why they like ideas and (even more) why they might set up really strong objections to something which posterity judges a major advance. . . . It has been a long time since I read a book as important as this, and more importantly, it has been a long time since I read a scholarly book which gave me such simple pleasure." (Michael Ruse, University of Guelph, author of Monad to Man) "Thagard's model of the growth of scientific knowledge complements and extends current work while skillfully advancing a new account of knowledge growth. His literary style makes the arguments clear and accessible." (William C. Summers, Yale University)

FROM THE PUBLISHER

How do scientists develop new explanations of disease? How do those explanations become accepted as true? And how does medical diagnosis change when physicians are confronted with new scientific evidence? These are some of the questions that Paul Thagard pursues in this book that develops a new, integrative approach to the study of science. How Scientists Explain Disease challenges both traditional philosophy of science, which has viewed science as largely a matter of logic, and contemporary science studies that view science as largely a matter of power. Drawing on theories of distributed computing and artificial intelligence, Paul Thagard develops new models that make sense of scientific change as a complex system of cognitive, social, and physical interactions.

FROM THE CRITICS

Library Journal

Thagard (philosophy, Univ. of Waterloo, Ontario; Mind: Introduction to Cognitive Science, MIT, 1996) presents a detailed structure for the scientific understanding of disease built on social, philosophical, and logical constructs. After an overview of the scientific process, he provides a detailed case study of how the theory that the bacterium Helicobacter pylori causes peptic ulcers gained acceptance. He then looks at the social aspects of scientific understanding and reviews the collaborative process of current scientific research, consensus building, and even the validity of information on the Internet. This valuable work is directed at students, scholars, and educated lay readers. Recommended for university and large college libraries.--Eric D. Albright, Duke Medical Ctr. Lib., Durham, NC Copyright 1999 Cahners Business Information.

Booknews

Using the recent discovery of as a case study, Thagard (philosophy and cognitive science, U. of Waterloo, Canada) analyzes how disease mechanisms are discovered, explained, and accepted. He focuses on mind, society, and experiment as equally important factors in the development of new theories. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Kirkus Reviews

A laborious examination of the evolution of the bacterial theory of peptic ulcers, pointing more generally to how scientific theories evolve. Thagard (Philosophy/Univ. Of Waterloo, Canada) begins by arguing against a traditional view of scientists as individuals conducting objective experiments with no presupposed outcome. The "postmodern view" of scientists trying to prove a hypothesis that will be most beneficial to them ("largely a matter of politics") is similarly too simplistic. Thagard interlaces general arguments about the nature of scientists and scientific research with specific details of several scientific theories, such as headline-provoking conditions like "mad cow" disease and chronic fatigue syndrome. In the meat of the book, the author discusses diseases such as scurvy and his benchmark case, the bacterial theory of ulcers. The history of this theory is elaborated in some detail—we learn, among other things, that one of the reseachers swallowed a live culture of the bacteria to prove his point. Thagard's general discussions of scientific research schemas include many flow-chart-like diagrams that demonstrate possible cause-and-effect relationships, such as how social and psychological explanations of science relate to the science itself. The book tries too hard to explain itself, plodding through each theory step by step, even giving some arguments in outline form. This poor writing tends to obfuscate matters rather than simplify them. Thagard's treatment of complex equations showing causal probabilities, for example, concludes with the obtuse statement that "causal reasoning requires the abductive inference that a factor has the power to produce an effect." Oncedeciphered, this is hardly a profound point. At its best, an engaging description of mysterious diseases past and present, but the book gets bogged down in flow charts, outlines, and equations that will leave the casual reader more frustrated than enlightened. (33 illustrations, not seen)

WHAT PEOPLE ARE SAYING

This is a wonderful book! In How Scientists Explain Disease,Paul Thagard offers us a delightful essay combining science,its history,philosophy,and sociology. Choosing as a case study the discovery that ulcers can be caused by bacteria and not simply by stress,Thagard takes us right into the heart of science and medicine,showing in a fascinating and illuminating way how scientists think,why they like ideas and (even more) why they might set up really strong objections to something which posterity judges a major advance. . . . It has been a long time since I read a book as important as this,and more importantly,it has been a long time since I read a scholarly book which gave me such simple pleasure.  — Princeton University Press