From: sasghm@theseus.unx.sas.com (Gary Merrill)
Subject: Re: Peter Breggin, _Toxic Psychiatry_ (Q)
Originator: sasghm@theseus.unx.sas.com
Date: Fri, 18 Dec 1992 14:40:42 GMT
Organization: SAS Institute Inc.


In article <lj1oafINNsbc@news.bbn.com>, levin@bbn.com (Joel B Levin) writes:
|> In <BzF0M1.1qE@unx.sas.com>  sasghm@theseus.unx.sas.com (Gary Merrill) says:
|> |Ah, Mr. Dyer seems finally to have been prodded into an attempt at
|> |dealing with substantive issues.
|> |In article <1992Dec17.032545.22504@spdcc.com>, dyer@spdcc.com (Steve Dyer) writes:
|> 
|> |Give me a clear explication of "disease" then.  I have, of course,
|> |been focusing on the germ theory.  This is in general a bit too
|> |narrow.  
|> 
|> Yes, just a bit.
|> 
|> |	  So what do *you* suggest?  What *are* the appropriate
|> |criteria for classifying something as a disease?
|> |
|> ||> Nonsense.  You don't even have the faintest idea of what a "disease" is,
|> ||> let alone a "disease model".  How do you expect to argue against it?
|> |
|> |Provide one then.
|> 
|> Yes, Steve, how about a first year med school course (within the space
|> of an eighty line posting if possible)?

Well, at this point I have no way of knowing if Dyer intends to respond
to these requests.  I will be leaving today for a two week vacation
and so will likely miss any responses over the next week or so since
our system tends to purge newsgroups regularly at about that interval.
But, in the words of Arnold, "I'll be back".

If Dyer is capable of coming up with a coherent disease model that
can be evaluated and with respect to which we can evaluate the claims
and research programs of contemporary psychiatry, that would be great.
However, argument by innuendo and the "You don't know what you're talking
about" response in the absence of any evidence or counterexamples pretty
quickly becomes tiresome and ineffective as a debating technique.  So
far I've been told that I'm ignorant (of virtually everything, it would
seem) and that I "don't even have the faintest idea of what a 'disease' is,
let alone a 'disease model'."  The next two weeks will enable me to spend
some time with recent literature, but in departing temporarily I would like
to recommend something along the lines of the following in terms of models,
disease models, and related issues.  I spent about ten minutes prior to
leaving for work this morning looking over our bookshelves at home, and
grabbed some stuff as just a quick sample.  Some of this is a bit old since
neither my wife nor I have been active in these areas for a few years, but
most of this stuff has staying power.

There is quite a bit of literature (in a number of fields) concerning models
in the sciences.  One can start with the older works of Braithewaite and
Hesse and move on to more contemporary things.  A good collection, though
somewhat narrow in its approach to models, is

	_The Concept and Role of the Model in Mathematics and
	Natural and Social Sciences_, ed. by H Freudenthal

Also, consider

	_The Structure of Science_ by E. Nagel
	_The Structure of Scientific Theories_, ed. by F. Suppe
	"Models and Analogues in Biology", in the _Symposium of the
		Society for Experimental Biology_ (1960)

Of course, the classic analysis of the danger of using models is to be
found in the writings of Duehm.

   A discussion of several models (though not a "disease" model per se) in
physiology is to be found in

	_Medical Physiology_, ed. by V. B. Mountcastle
	(see vol II)

   A classic (though of course now quite old) work in the foundations of
medicine and its methodology is

	_An Introduction to the Study of Experimental Medicine_
	by Claude Bernard

   The disease model is discussed (though briefly) in

	_Science and Common Sense_ by James Conant

and several problems with the concept of disease are also analyzed.  More
examples of models and the evolution of the concept of disease can be
found also in

	_Harvard Case Studies in Experimental Science_, ed. by J. Conant

   Issues pertaining to the disease model in psychiatry are treated in
the BBC debate "Psychiatry" which is reprinted in

	_Morality and Medicine_, ed. by A Clow

(One of the participants is, of course, a psychiatrist.)

   More treatments of these areas can be found by looking at issues of 
the _Hastings Center Studies_.  One I unearthed (from 1973) was devoted
to the concept of health and contained papers dealing with the disease
model in general and its use in psychiatry in particular.

   As I say, this list is one I came up with in a few minutes of pulling
stuff off our shelves, and I did not have time even to grub in my files
for reprints of papers.  Not all of the things I have mentioned support
the positions I would take, and sometimes when they do support these
positions they do so for reasons I would reject.  In the coming couple
of weeks I hope to have sufficient time to refresh my memory of the
literature and to explore the more recent literature, thereby decreasing
my total ignorance of these issues.  Meanwhile, perhaps Dyer and others
can come up with more than one-liners as defenses or explications of their
own view.

-- 
Gary H. Merrill  [Principal Systems Developer, C Compiler Development]
SAS Institute Inc. / SAS Campus Dr. / Cary, NC  27513 / (919) 677-8000
sasghm@theseus.unx.sas.com ... !mcnc!sas!sasghm
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