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The Cancer Journal - Volume 5, Number 6 (November-December 1992)
Ludwik Fleck was born in Lwow on July 11, 1896. In 1922, at the age of twenty-six,
he received his medical degree from the Lwow University. He served as assistant
to Rudolf Weigl, a well known typhus specialist at Lwow medical school. He then
specialized in bacteriology in Vienna, and headed the bacteriological and chemical
laboratories of the State Hospital in Lwow. From 1928-1935 he was head of the
bacteriological laboratory of the Social Sick Fund in Lwow. He was an expert
in microbiology and immunology, that was then known as serology.
During his medical studies Fleck was also interested in philosophy and after
graduating he continued devoting his time to philosophy, sociology and history
of science. Most of his publications on philosophy were written in Polish. In
1935/36 Fleck published his major philosophical monograph, "Genesis and Development
of a Scientific Fact" (1), written in German and translated into English,
forty years later.
During the Nazi occupation Fleck served as a physician in the Lwow ghetto where
he discovered that urine of typhus patients was a good source of rickettsial
antigen and could be utilized for the development of a vaccine. In 1942 he was
arrested by the Germans and forced to develop the vaccine for the German forces,
after which he was deported to Auschwitz. He survived and emigrated to Israel
where he headed the Department of Experimental Pathology at the Israel Institute
for Biological Research in Ness-Ziona. Fleck was actively involved in medical
research and discovered the leukergy phenomenon. Ludwik Fleck died in Ness-Ziona
on July 5, 1961 at the age of 64.
Before 1977, Fleck's philosophical work was completely unknown, when Trenn and
Merton translated his monograph, "Genesis and Development of a Scientific Fact"
into English (1). At the same time W. Baldamus assigned his student T. Schnelle
to study Fleck's publications systematicaIly. Schnelle's study Has recently
been translated into English and serves as main source on Fleck (2).
Fleck is interested in the philosophical theory of reality
rejecting any absolute and objective criteria of knowledge. There is no
objective and absolute truth. Truth in science is a function of a particular
thinking style by a group of scientists, or thought-collective. A thought-collective
is "a community of persons exchanging ideas or maintaining intellectual interaction".
The individuals of a thought-collective share the same thought-style.
Truth and falsehood in science are meaningful only within a specific thought-collective
and with respect to a given thought-style and depend on the purpose of investigation.
Different views can be equally true (3).
For Fleck, facts depend on particular thought-styles varying in a non progressive
way with time and culture. A scientific fact does not exist, rather it develops:
"Sciences do not grow as crystals, by apposition, but rather as living organisms,
by developing every, or almost every, detail in harmony with the whole". "The
process of cognition is not a two-term one...It does not occur solely between
an abstract subject and an equally absolute object. The collective is incorporated
into this process as a third member"."Between the
subject and the object there exists a third thing, the community. It is creative
like the subject, refractory like the object, and dogmatic like an elemental
power".
Fleck's notion of the relativity of truth originates in medicine. According
to Fleck diseases do not exist in nature but are constructed by physicians
for didactic reasons. "It is easier to find one's way in a forest than in
botany. It is easier to cure a patient than really to know what his disease
is". Yet this very nature of medicine is regarded by the exact sciences as non
scientific. It appears as if medicine is more an art than a science. Not to
Fleck, who claims that even in the exact sciences facts are not absolute and
they develop. There is no absolute truth even in physics, and the physical
scientific fact evolves and develops exactly as in medicine. Even in physics
it is impossible to separate the object from the subject, and both are influenced
by the sociology of thought. "We approach the ideal 'absolute' reality not even
asymptotically since it changes incessantly, renews itself and moves away from
us at the same pace as we are advancing ".
In the era of the "Big Bang theory" that describes the evolution of the universe
(4), such a philosophy seems untenable. According to Hawking the universe is
governed by universal and absolute mathematical laws. This view underlies modern
physics. Yet the existence of this idealistic view of the universe is threatened
by a new scientific revolution known as theory of Chaos, that claims that nothing
in nature is absolute. Statements, facts and truths are relative (5,6). This
sense of the absolute, so typical of physics, and deeply embedded into its thought-style
will from the view-point of other thought-styles always remain relative.
No wonder that Fleck's revolutionary ideas were rejected. His philosophy was
resurrected only after Thomas Kuhn prepared the scientific community
for accepting it with his "Structure of Scientific Revolutions" (1962). Philosophically
Fleck was also a forerunner of Chaos theory. Now that the number of his followers
is growing, his philosophy will be updated in light of modern technological
innovations and the Chaos revolution.
Fleck applied medical reasoning for demonstrating the relativity of truth in
science. In spite of being an epistemologist, Fleck is first of all a philosopher
of modern medicine who introduced the notion of the relativity of diseases.
The definition of a disease is arbitrary and depends solely on the thought-style
within which it is studied. Each discipline involved in medicine defines the
disease in a different way; e.g., "sore throat" that has different meanings
to a clinician, bacteriologist, or an epidemiologist. Superficially it appears
as if all are dealing with the same phenomenon, which may be extremely misleading
particularly when the disease is treated.
Similar difficulties exist in oncology and may explain its current conceptual
confusion. Each discipline involved in cancer research defines the disease from
a different view angle and the main difficulty of oncology is to decide which
cancer concept to apply. Is it a parasite, or a mutated gene: or could it result
from the breakdown of immunological surveillance? Cancer should first of
all be defined within the clinical thought-style, a disease with three ingredients:
neoplasia, para-neoplasia and cachexia. Any thought-style disregarding one of
them is inacceptable (8,9)!
G. Zajicek
References
1. Fleck L. Genesis and development of a scientific fact. The University of
Chicago Press, Chicago USA, 1977.
2. Cognition and fact. Materials on Ludwik Fleck. Cohen R.S. and Schnelle T.
Eds. D. Reidel Publishing Company, Boston USA, 1986.
3. Lowi I. The immunological construction of the self. In: "Organism and the
Origins of the Self". Tauber A.I. Ed. Kluwer Academic Publishers Norwell USA.
p 43-71, 1991.
4. Hawking S.W. A Brief History of Time. Bantam Books New York, 1988.
5. Zajicek G. Chaos and Biology. Meth. Inform. Med. 30: 1-3, 1991.
6. Zajicek G. Meta-Analysis and Chaos. Cancer, J. 4:152-153,1991.
7. Kuhn T.S., Structure of scientific revolutions. The University of Chicago
Press, Chicago USA 1962.
8. Zajicek G. Hypothesis: Cancer is a metabolic deficiency. Cancer J. 4:356,1992.
9. Zajicek G. Cancer and metaphysics. Cancer J. 5,1,1992.