Ludwik Fleck and the Art-Of-Fact

168 Evolutionary Anthropology

CROTCHETS & QUIDDITIES

Ludwik Fleck and the Art-of-Fact

KENNETH WEISS

Truth may be beauty, but more in the eye of the beholder than we generally with biological evolution: science acknowledge. Does it matter? works by contingently sorting through available facts or ideas in the context of their own time, but cannot really be In science we routinely assume that bursts of change by which we so often, teleologically heading for truth, be- whatever theory we may have about perhaps so vainly, characterize our cause we have no way to know where them, facts themselves are things that own research or field. Kuhn argued to find it. are—out there in the world to be ob- that a scientific revolution occurs Kuhn was influenced by a little- served. However, it has become rather when a new explanation for the avail- known 1935 book he had stumbled standard for historians and philoso- able data becomes accepted by the across, Genesis and Development of a phers to assert instead that “facts” are body of scientists, a sociocultural phe- Scientific Fact, by a Polish physician human constructs understandable nomenon very different from the pre- named Ludwik Fleck.4 Fleck had antic- only in a particular historical or soci- vailing notion of science as a fact- ipated (or shaped) many of Kuhn’s etal context. They note that scientists driven process. The notion has been ideas. Though rather obscure today, typically argue over very different the- applied, but not without discussion, to Fleck has been called the founder of the ories to interpret the same data. We in all fields of endeavor including an- philosophy of modern medicine. His turn resist this deconstruction by out- thropology.2,3 concern was not so much with revolu- siders who themselves don’t have to A new theory may be more accurate tions but with the way that even the face the struggles of understanding in some ways, or account for more supposed facts of science are driven by Nature. Nonetheless, there may have facts, but Kuhn’s notion of a paradigm context. He stresses that “concepts are been more than idle poetry in Keats’ shift was not about contests between not spontaneously created but are de- assertion that “truth is beauty and different ways to apply an existing termined by their ‘ancestors’.” Fleck’s that is all ye need to know.” Facts may theory, like that of evolution, to the term comparable to Kuhn’s “paradigm” be more determined by the theoretical available facts, such as fights between was thought collective (we might say lenses through which we view the cladists and phenetic systematists, or “school of thought”) and his objective world than we like to think. out-of-Africa versus regional continu- was to understand how an unorches- ity models of evolution. Rather, a par- trated community of scientists estab- lishes what are considered facts around TRUTH AND PROGRESS IN adigm shift is a gestalt change in which a new interpretation of the a theory that necessarily grows out of SCIENCE: “THE BONDS OF body of existing facts replaces, and is historical roots. What counts as fact HISTORY CAN NEVER BE CUT” incommensurable with, an existing varies with time and context. Fleck lik- Thomas Kuhn’s famous book The theory. Evolution contrasts with cre- ens science to troops on the march, a Structure of Scientific Revolutions1 ationism in this respect, for example. small vanguard followed by a main had a transforming effect across both Most scientists strongly assert—be- body. New observations provide some the academic and popular culture lieve—that such changes constitute corrective, but which of the vanguards landscapes. It gave us the satisfying progress in the sense of major steps the main troops follow is unpredictable, term “paradigm shift” for the episodic closer to understanding the truth that and affected—or determined—by so- we assume is out there to be found. ciopolitical and cultural factors. However, it is perhaps not sufficiently This challenges our cherished my- appreciated that scientific theories are thology that we are doing “original” almost always inconsistent even with research. Most of us are not as origi- Kenneth Weiss is Evan Pugh Professor of some of the established facts of their nal nor independent as we may fancy. Anthropology and Genetics at Penn State University. time, and this was true of the victors Without a herdlike ideological coher- in classical Kuhnian “revolutions,” in- ence, science as the public enterprise cluding even the archetypal Coperni- we know today might not be possible, Evolutionary Anthropology 12:168–172 (2003) can one. Whether this is progress to- since any individual can only see or do DOI 10.1002/evan.10118 Published online in Wiley InterScience ward truth is harder to answer than so much. But the herd itself defines (www.interscience.wiley.com). we may think. Kuhn drew an analogy what progress is, and the more who CROTCHETS & QUIDDITIES Evolutionary Anthropology 169

als, and other diseases such as leprosy also generated a positive test reactions as well as similar symptoms. Under these conditions, whether it was a “fact” that someone had syphilis or not was not purely objective but de- pended on the assumptions about its particular cause. Many investigators— the “thought collective”—worked, if only in a loosely coordinated way, to find a syphilis blood test. In 1906, Au- gust von Wassermann and colleagues developed the famous reaction that bore his name. On the assumption that the test directly detected bacterial anti- gens, a positive Wassermann reaction Figure 1. A. Thomas Kuhn (http://www.malaspina.com/site/person_733.asp); B. Ludwik Fleck (reprinted with permission, from Polish Philosophy web site: http://www.fmag.unict.it/PolPhil/ was used to define syphilis, separating it Fleck/Fleck.html). by this single criterion from other diseases with similar symptoms. Despite these elements of what seemed like “truth,” the inferences participate the stronger and more re- ON BECOMING FACT: THE from experiments leading to the Was- sistant to displacement (creative or WASSERMANN TEST FOR sermann test were incorrect or purely free thinking) it becomes, and the pre- SYPHILIS empirical in essential ways. The theo- vailing thought collective becomes a retical understanding of the reaction thought constraint. “Whole eras” can The predominant medical problem was in fact wrong. A positive reaction be ruled by a thought constraint. Her- of the time was infectious disease, and was interpreted as proving spirochete etics are not well tolerated; we don’t Fleck exemplified his ideas by show- causation because the theory was that burn them at the stake but the Ly- ing how concepts of syphilis, growing antigen-antibody reactions were spe- senko era showed that we may send from earlier notions of causation, led cific. The method to detect the pres- them to freeze to death in labor to the development of the Wasser- ence of antigen produced by the spi- camps, and today we freeze them out mann test to detect the disease. Syph- rochete is known as complement of research funds. As with any ideol- ilis had long been viewed primarily in fixation (Figure 2). In the first step, ogy, defendants of the thought collec- moral dimensions, a “carnal scourge.” syphilitic tissue used as a source of tive argue that they defend it because In part a legacy of the age-old humeral antigen was mixed with blood from theory, diseases of generalized or it’s true. the person being tested. In an infected vague symptomatology were assumed Ludwik Fleck worked in the pre- person, the antigen binds to antibody, to be due to fouling of the blood. This World War II era in his native Poland. and complement (a component of the notion grew to the point that the early Poland was intimately involved in immune system) is fixed to the anti- 20th Century demanded a “blood test” conflicts in that region, including the gen-antibody complex. A properly to detect the disease. Infectious mi- Communist revolution in neighboring prepared reagent, like red blood cells croorganisms were known by then, Russia. Social, historical, evolution- (rbc’s), is then added. This causes no and Pasteur had recently organized ary, and contextual analysis of human reaction in samples from infected per- (and orchestrated) the scientific and affairs was part of the intellectual life sons that at this state no longer con- bureaucratic machinery in France tain free complement, but the un- of that era in Europe. Fleck’s choice of around the concept of infectious dis- bound complement in the blood of an the term “thought collective” seems to ease causation.5 European nations uninfected person binds to the rbc’s, reflect that context, and he states a scrambled not to be left scientifically producing an easily detected hemo- rather classically Hegelian or Marxist behind in this endeavor. However, lytic reaction. assessment of conflict in science, as symptoms, specificity, and sensitivity Much of Fleck’s book is an account being between opposed theoretical of known reactions and available tests of the many ways this process was a views that resolve into a new consen- made both the disease and its diagno- prisoner of its history and the sus. Fleck says that “after the change sis problematic. Symptoms of syphilis thought-collective’s erroneous choice in thought style, the earlier problem is were not coincident with the visual of assumptions: “It is only after the no longer completely comprehensi- (microscopically detectable) presence choice has been made that the associ- ble.” This contrasts a bit with Kuhn’s of the spirochete bacterium Trepo- ations produced by it are seen as nec- idea, because a problem is not identi- nema pallidum, though people were essary.” I can’t give the details here, cal to an explanatory framework. But convinced that was the cause. The dis- but over time, a legion of investigators to Fleck the two are inextricably re- ease took different, often indefinitely had to tinker with many of the condi- lated. delayed, courses in different individu- tions to make the test even reasonably 170 Evolutionary Anthropology CROTCHETS & QUIDDITIES

gen can be present without the symptoms, or vice versa, so that defining syphilis as “the disease caused by [Treponema] pallida” reflects a thought- collective’s preconceptions about causation as much as it does the reality. History constrains thought so that at any time most of us can’t think in any other way. Since Fleck’s time we have developed more precise ways including direct detection of treponemal gene sequences to detect the presence of what we have defined as the cause. But the etiological concept is not the only possible, and may not be the best, definition of diseases. They could al- ternatively be classified by the treat- ment they respond to, virulence, the organs they affect, or their symptoms, and there are often multiple causal factors. But that is not how we think in science in our present era.

A MODERN RERUN? There are striking parallels in today’s AIDS epidemic. AIDS, like syphilis, is viewed as a disease of the blood (because of immune deficiency), and Figure 2. Complement fixation test. Left, positive test; right, negative test. Moving top down, has even been seen as another “carnal antigen (diamonds) introduced to blood sample binds to antibody (Y) which captures scourge” of moral dimensions. One complement (dark ovals) in infected (left). Complement remains free in uninfecteds (right). can have symptoms of AIDS without When red cells (rbc’s, grey ovals) are added, they are bound by the free complement in uninfecteds, and lysed. In uninfected, no complement is free to lyse the rbc’s. Schematic. HIV and vice versa. The standard HIV test is an indirect one for antibody to the pathogen, and does not detect per- fectly nor immediately after infection. reliable—at least for clear-cut or late- flected in G.B. Shaw’s introduction to Many host factors like nutrition and stage cases. They had to filter the his 1911 play The Doctor’s Dilemma:6 the burden of other disease affect the “facts” empirically and selectively “The whole art of healing could be course of the disease, which can be through their presumptive lens be- summed up in the formula: Find the indefinitely delayed. As with syphilis, cause, among other things, it was later microbe and kill it.... When there the symptoms are not unique to HIV found that uninfected tissue used as a was no bacillus it was assumed that, as the “cause”; there are many ways to source of antigen could also generate since no disease could exist without a get pneumonia, but pneumonia in a positive reaction. We now know that bacillus, it was simply eluding obser- someone HIV-positive is defined as a constituent of healthy tissue, cardi- vation.” These views were so en- AIDS. There is even a cottage industry olipin, mimics the antigenic proper- trenched that Shaw mused that it was that claims the huge momentum of ties of T. pallidum. Other conditions not clear whether vaccination pro- the AIDS “thought collective” has also induce antibodies to cardiolipin, grams are forced by doctors onto the been misdirected by an unjustified including the other treponemal organ- public or vice versa. proclamation in the 1980s that HIV is isms, and why T. pallidium does so is The causal metaphor of the time a proper etiological entity. Are they still unclear. Nonetheless, the drive was one of combat between an indi- flat-earthers or could the thought col- for a blood test paid off. The reason- vidual against an invasion of microor- lective actually be wrong? Or if truth ing by which a positive reaction was ganisms. However, many microorgan- is not clearly an attainable goal, is related to syphilis was wrong. But the isms live commensally with us, and “wrong” even the wrong concept? test became fact. the highly variable relationship be- We can consider this in light of late tween the spirochete and symptoms PARADIGM OR 19th Century science, with its belief in shows that the metaphor was imper- PROPAGANDA? atomic units of ultimate, universal fect. The parasite and antibodies are causation. Biomedical science found found in the blood, but syphilis is not Fleck describes how a thought col- its causal units in infectious organ- really a disease “of” the blood the way lective maintains itself by various isms. The contemporary view was re- anemia or leukemia are. The patho- ways of inculcation. Academic de- CROTCHETS & QUIDDITIES Evolutionary Anthropology 171

Figure 3. Ideogrammatic schema rather than detail in earlier scientiﬁc anatomical drawings: what is the rib cage? A,B: medieval ideas; B: Vesalius’ Hamlet and the deeper meaning of death; C: a modern (19th Century) mechanical view showing all the “scientiﬁc” details (Sources: A, B, D,4 C7).

grees are required for induction into Fleck goes to some lengths to show requires much advance preparation the guild. Popular science ensures its how scientific illustrations are ideo- and decision-making (e.g., dissecting dominance in the public arena, as can grams of the accepted view. Here he away all material but the skeleton, be seen today on Nova and in the chooses examples of anthropological leaving the cartilage but not intercos- Times, through oversimplified, emo- interest. He compares anatomical tal muscle, membranes or ligaments, tive vividness, personal narrative, and drawings from medieval times to the identifying muscle attachments) that gossipy controversies to lionize fig- present (for a visual tour of this fasci- makes the result a product of our cur- ureheads for the prevailing view (e.g., nating history see www.nlm.nih.gov/ rent view of what the skeleton “is.” Wassermann, Pasteur) and promote exhibition/dreamanatomy/da_intro. enthusiasm for the accepted theory. html). The earlier drawings were func- Isolated facts are fitted gropingly to tionally schematic. For example (Fig- BUT TOASTERS WORK! th the theory in professional journals, ure 3), 12 Century figures show the Fleck and many analysts since and stereotypical digests are then thorax as a figurative rib “cage,” while Kuhn have stressed the ways histori- built into textbooks, handbooks, or in 1543 Vesalius drew a death-meta- cal context leads a view to become laboratory manuals that inculcate phor that obscured anatomic details. accepted, and that the accepted view new students. The latter are often out Today we feel it is “scientific” to know is not the only possible one. The incul- of date even when published.7 those details, but Fleck notes that this cation process converts observations 172 Evolutionary Anthropology CROTCHETS & QUIDDITIES into “facts” that define what is “true” and sometimes indefinitely delayed. on a path to the presumed absolute because the thought collective agrees There are countless examples, but our truth. But the chosen view of the world about them. This leads historians, bi- determination to find genes is un- can have impact beyond the mere intel- ographers, and philosophers to pro- checked.8 Ironically, in having our lectual imprisonment of ideas. For ev- claim the fallibility of science, that sci- collective heads turned the genetic ery path taken there is a path not taken. entists are but arbitrary products of way, we may be overlooking elusive For example, putting our effort errone- their times, or even that the only infectious pathogens responsible for ously into genetics when environment Truth we approach is that of our own many chronic diseases after all.9,10 or infection are the more important vested interest. Evolutionary theory may be espe- cause of disease, or misapplying evolu- There is some merit to these allega- cially vulnerable to these kinds of ideo- tionary theory to justify racial profiling, tions, but scientists do not cling to their logical problems, because inferences would be detrimental to knowledge and belief system only out of ideology or that deal with the unobservable past our own society. caprice. Science has grown to predom- have to be so highly indirect. The way In practice, organized science may inance because, as one of my students we apply genetics to adaptive argu- depend upon thought-collectives— put it, “toasters work.” But does this ments, for example, rests heavily on theory, paradigms, or even ideology. mean that we understand the real na- theory.7 This applies to anthropological But if these are cultural artifacts, and ture of metals (bimetallic thermostats), interests, and in my next installment I’ll the best we humans can actually polymers (plastic knobs), and electrons look at another anatomical example achieve is an approximation with pre- (heating elements)? Or is a toaster sim- raised by Fleck: the structure of the hu- dictive value but unknown relevance ply well within the empirical predictive man brain, in the subtle lights and to truth, then the art-of-fact may be power of our experience? Similarly, the shadows of evolutionary theory. what counts most in science. Wassermann test has successfully diag- In regard to progress, scientists nosed exposure in many thousands of when pressed often claim that all NOTES instances, and nobody questions a rela- we’re trying to do is to develop better tionship between the pathogen and predictive approximations. But deep I welcome comments on this column: symptoms. So are we really being mis- down, we act as if we believe, and [email protected]. I have a feedback led in any important way by our collec- many assert that we’re approaching page at www.anthro.psu.edu/rsrch/ tive ideologies? Is it of more than mild the real truth. Whether or not that’s weiss_lab/index.html. I thank Anne historical interest why or that we view an illusion, it is a powerful motivator. Buchanan, Malia Fullerton, Nancy the pathogen as “the cause” of AIDS or But there are often alternative expla- Tuana, and John Fleagle for critically syphilis? nations. Wassermann and his contem- reading this manuscript, and Dom Eg- We still seek point causes today, but poraries “tuned” their work to melo- gart on toasters. they are a different kind of scourge: dies to which they could resonate. bad behavior or bad genes. The mid- Exceptions were overlooked, ignored, REFERENCES dle 20th Century proclaimed the con- or rationalized, and experiments de- Many things discussed here can be quest of infectious disease, and our signed that left little room for alterna- profitably explored by web searching. biomedical fixation moved dramati- tive interpretation. The same kind of cally, first to environmental, and then phenomenon as been observed in eth- 1 Kuhn T. 1962. The structure of scientific revo- to genetic causation, the idol of to- nology and archeology, such as what lutions. Chicago: University of Chicago Press. 2 Chamberlain JG, Hartwig WC. 1999. Thomas day’s biological thought collective. To the “facts” are regarding sophisticated Kuhn and paleoanthropology. Evol Anthropol 8: paraphrase Shaw, when there is no pre-Columbian Amazonian culture 42–44. gene we assume that since no disease and technology,11 or whether behav- 3 Cartmill M. 1999. Revolution, evolution, and Kuhn: a response to Chamberlain and Hartwig. can exist without such a gene, it must ioral evolution explains why (or that?) Evol Anthropol 8:45–47. simply be eluding observation. In the the Yanomami are “the fierce people.” 4 Fleck L. 1935. Genesis and development of a sense that theory and fact are insepa- Kuhn notes that scientists struggle to scientific fact (1976 reprint, with editorial com- rable, the assumed gene is considered accommodate “anomalies” that are ment by Kuhn and others). Chicago: University of Chicago Press. fact—we even name the gene for the “reinterpreted to make them con- 5 Latour B. 2000. The pasteurization of France. trait—when it has not yet been iden- form.” Almost all theories “contain Cambridge, Mass: Harvard Press. tified (genes “for” dyslexia, homosex- some element of wishful thinking by 6 Shaw GB. 1911. The doctor’s dilemma (1980 uality, and diabetes are examples). their scientific proponents.” That’s not reprint). New York: Penguin. 7 Weiss KM. 2002. Come to me my melancholic Every issue described here in regard what engineers do: they build in em- baby! Evol Anthropol 12:3–6. to infectious causation also applies to pirical safety factors so they need not 8 Weiss KM, Buchanan AV. 2003. Evolution by current genetic view of disease causa- worry about the ultimate theory, be- phenotype. Perspectives in Biology and Medicine tion. We develop DNA (blood) tests to cause they really are just trying to in press. 9 Ewald P. 1994. Evolution of infectious disease. detect mutations in clear-cut cases, make toasters that work. New York: Oxford Press. but genetic causation is far less clear The point is not that a given view of 10 Ewald P. 2000. Plague time: how stealth in- in most cases, because a person can the world is superficial or wrong, but fections cause cancers, heart disease, and other have the symptoms without the allele that it is somewhat arbitrary and con- deadly ailments. New York: Free Press. 11 Raffles H. 2002. In Amazonia: a natural his- or the allele without the symptoms, textual and neither necessarily more tory. Princeton: Princeton University Press. and the symptoms are highly variable true than alternative views, nor a step © 2003 Wiley-Liss, Inc.