Philosophy Of Medicine Research Articles

Core reference ontology for individualized exercise prescription

“Exercise is medicine” emphasizes personalized prescriptions for better efficacy. Current guidelines need more support for personalized prescriptions, posing scientific challenges. Facing those challenges, we gathered data from established guidelines, databases, and articles to develop the Exercise Medicine Ontology (EXMO), intending to offer comprehensive support for personalized exercise prescriptions. EXMO was constructed using the Ontology Development 101 methodology, incorporating Open Biological and Biomedical Ontology Foundry principles. EXMO v1.0 comprises 434 classes and 9,732 axioms, encompassing physical activity terms, health status terms, exercise prescription terms, and other related concepts. It has successfully undergone expert evaluation and consistency validation using the ELK and JFact reasoners. EXMO has the potential to provide a much-needed standard for individualized exercise prescription. Beyond prescription standardization, EXMO can also be an excellent tool for supporting databases and recommendation systems. In the future, it could serve as a valuable reference for developing sub-ontologies and facilitating the formation of an ontology network.

Ontology of doctor and patient relationship and bioethics: from Aristotle's teleology to Pellegrino's philosophy of medicine.

Some philosophical and metaethical theories have tried to provide a fundamental background for bioethics but miss the fundamental question about what medicine is, its nature and its end. We argue that the philosophy of medicine, through the development that Edmund Pellegrino and David Thomasma gave to this field of study, allied with Aristotle's practical and teleological ethics, can provide an ontological background for bioethics beyond the tradition of principles and deontology, with particular emphasis on the uniqueness of the doctor-patient encounter. Some difficulties and criticisms of this ontological model are also examined.

Molecular theranostics: principles, challenges and controversies.

Theranostics is a new term for long-established principles in nuclear medicine. The generalisability of the term means there is a very broad use of the term across the medical literature, not all of which is consistent with the intent in nuclear medicine. The term molecular theranostics better reflects the philosophy and application in nuclear medicine. Even with a clearer definition, there are a number of challenges or controversies whose debate provides a richer understanding of the principles and applications of molecular theranostics. Radioiodine imaging and therapy of hyperthyroidism and thyroid cancer provide the historical context for theranostics. The prototype molecular theranostic is the 68Ga/177Lu DOTATATE pair that targets somatostatin receptor subtype 2 in neuroendocrine tumors. The potential value of precision medicine of radiation dosimetry in molecular theranostics needs a balanced discussion with limitations of reactive dosimetry and the opportunities for predictive or pre-treatment dosimetry. Despite challenges and limitations, molecular theranostics is a powerful tool in the precision medicine landscape. Molecular theranostics is a vehicle for improved outcomes in cancer patients with a future-facing portfolio of opportunities.

Conceptual scaffolding for the philosophy of medicine.

This paper consists of two parts. In the first part, I will introduce a philosophical toolbox that I call 'conceptual scaffolding,' which helps to reflect holistically on phenomena and concepts. I situate this framework within the landscape of conceptual analysis and conceptual engineering, exemplified by the debate about the concept of disease. Within the framework of conceptual scaffolding, I develop the main idea of the paper, which is 'the binocular model of plural medicine', a holistic framework for analyzing medical concepts and phenomena. In the second part, I demonstrate the use and value of the binocular model by analyzing, through the lenses of the model, the phenomenon of health wearable devices and their effects on the concept of diagnosis.

The Life and Legacy of Samuel Hahnemann: Founder of Homoeopathy and His Medical Philosophy.

Dr. Christian Friedrich Samuel Hahnemann (1755) was the visionary founder of homoeopathy, a system of medicine that emerged amidst the orthodox practices of his time. This biography traces Hahnemann's journey from a curious scholar in Meissen to a pivotal figure in global healthcare. His relentless questioning and experimentation led to the development of homoeopathy, grounded in the principles of "like cures like" and potentization. Hahnemann challenged prevailing medical norms, emphasizing individualized treatment and minimal dosing, significantly influencing modern healthcare. Despite considerable opposition, his innovations established a new medical paradigm that inspires practitioners and patients today. This paper explores Hahnemann's early life, education, homoeopathy's rise, key innovations, and enduring legacy. His commitment to original thinking and perseverance birthed homoeopathy and transformed approaches to medicine, highlighting its holistic focus and individualized care. Hahnemann is recognized as a pioneer in compassionate healthcare.

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Aetiological Naturalism in the Philosophy of Medicine: A Shaky Project

Griffiths and Matthewson (2018) employ the selected effects theory to contend that disease involves the impairment of the normal functioning of biological items. Since the selected effects theory focuses on the past effects of those items, I refer to their proposal as “aetiological naturalism”. In this paper, I argue that aetiological naturalism cannot constitute an adequate theory of disease. This is due to the fact that the selected effects theory, which lies at the heart of aetiological naturalism, is flawed. One promise of the selected effects theory is indeed that it is able to account for our normative intuitions about dysfunctional biological items by grounding them on the concept of natural selection incorporated in the selected effects theory itself, where this promise rests upon its claim that appealing to the fitness-enhancing effect of biological items can always explain why they persisted in a population. However, I contend that the naturalisation of normativity cannot be cashed out in terms of biological items’ past effects by discussing two biological phenomena: phenotypic plasticity and negative frequency-dependent selection. I illustrate that in both cases the selected effects theory cannot recognise adaptive items as having a selected effects function, therefore preventing the possibility to assign them any dysfunction. The normative force of the selected effects theory is consequently much diminished, leading in turn to a weakening of aetiological naturalism, given that such project actually relies on the assumed normative force of the selected effects theory itself.

Lorenz Fries on the defense of Avicenna, the prince of physicians: Addressed to the medics of Germany (1530).

During the 14th century CE, a pivotal shift took place in the world of medicine as its epicenter transitioned from the Middle East to Europe. The emergence of the European Renaissance sparked skepticism regarding the significance of Avicenna's contributions to the advancement of medicine. This paper explores how the rise of secularization and the Renaissance in Europe marked significant cultural transformations, fostering the spread of literacy. These societal shifts influenced the trajectory of medical thought, and Avicenna's "Canon of Medicine" received both praise and condemnation amidst the evolving intellectual landscape. In this context, Lorenz Fries composed his "Defense of Avicenna," a testament to his profound admiration for Avicenna's legacy. This paper presents an English translation of Fries' 1530 work, and introduces Fries and Avicenna's "Canon," contextualizing Fries' defense within the broader rejection of Arab-language medical texts in the 16th century. It also explores Avicenna's influence on European medicine and anatomy during the Renaissance and highlights the enduring relevance of his contributions to the annals of science. Fries' defense underscores Avicenna's methodological acumen and emphasizes the importance of a robust theoretical foundation in medical practice. Avicenna's integration of Aristotelianism with Platonism highlighted the necessity of a rigorous method informed by theory in medical analysis. Fries' defense remains relevant today, particularly in advocating for systematic medical analysis against subjective approaches. Avicenna's medical philosophy seems nested within a larger, hopeful attempt to resolve the tensions between science or naturalism and religion or spiritualism. The rejection of Avicenna reflects broader conflicts between Aristotelian and Neoplatonic traditions, suggesting a complex interplay of secularization and theological influences in shaping medical thought during the Renaissance.

Physicians and Iatrogenism from the Philosophy of Medicine to the Sociology of Health

In pre-modern times, health services provided by traditional healers such as clergymen, healers, and herbalists were conducted by professionalss specialized in modern medicine such as physicians and auxiliary health personnel. Although modern Western medicine has developed in many areas, it has been criticized severely. The most important of these criticisms is the unquestionable structure of modern medicine and the methods and techniques used by physicians in the treatment processes in connection with this structure. These criticisms are termed with the concept of iatrogenesis, and criticisms against both modern medicine and physicians are becoming sharper. In this study, the forms of iatrogenesis produced by modern medicine in general and by physicians in particular will be discussed from the perspective of medical philosophy and health sociology. In addition, the relationship between physicians and iatrogenism will be evaluated in the context of recently discussed issues such as patient-physician relations, commercialization of health services, construction of the patient as a customer, pharmaceutical industry and guided scientific studies, excessive use of drugs and medical devices, medicalization of life, gaining popularity of traditional treatment methods.

The Iatriki Biblos (Book of Medicine) by Nikolaos Ieropais. Α 17th-century manuscript examined from a medical viewpoint

The “Iatriki Biblos” (“Book of Medicine”) is part of codex no. 46, hosted at the library of the Olympiotissa Monastery in Elassona, Greece. It is a medical manual that includes many diseases in the form of ailment groups, recording their aetiology, signs and symptoms on which diagnosis and the relevant therapy is based. This treatise constitutes a compendium of many Greek, Arab, Italian or French medical authors’ works. We have examined the “Biblos” from a medical viewpoint to find supporting evidence of: a. The scientific rigor of the text and its correlation with any possible theoretical basis regarding the signs and symptoms described. Although the classification system used today is different, it was possible to identify specific diseases based on the recorded signs and symptoms. Special attention was paid to the Greek terminology, because many terms are used to this day, with the same or different meanings.b. The influence of ancient medical authorities and the prevailing medical knowledge of Ieropais’ time.c. The usefulness or otherwise of the listed iamata (medicaments). We studied the active substances of the proposed plants, animal tissues and minerals, with the aim of ascertaining whether they had any positive or negative effect on the described symptoms.We discuss the problematic nature of such an investigation, as many essential details concerning their action as medicaments are absent.In conclusion, the 17th-century Greek doctor Nikolaos Ieropais adhered to the principles of natural philosophy in medicine of his time. His references to western Renaissance doctors of the 16th century add no new knowledge. The proposed therapies have a slight general and rarely a targeted effect.

Tao Hongjing's Medical Health Preservation Philosophy

In the 21st century, the medical paradigm has transitioned from "disease medicine" to "health medicine," with the developmental trend shifting from "treating diseases" to maintaining a "healthy" state. Tao Hongjing, representing the field of health preservation studies during the Southern and Northern Dynasties in ancient China, contributed distinctive principles and methods to traditional Chinese medicine (TCM) health preservation, constituting a crucial aspect of TCM health preservation academic thought. His concise and cost-effective health preservation theories and methods encapsulate profound health preservation insights and philosophical contemplation, earning commendation from successive generations of medical practitioners and holding remarkable research value. Against the backdrop of implementing the "Healthy China" strategy and advocating "universal health," Tao Hongjing's health preservation philosophy holds significant reference value for enhancing human health awareness and promoting harmonious social development, providing strong practical guidance. This paper focuses on Tao Hongjing's medical health preservation philosophy, utilizing works such as Record of Nurturing Life for Longevity, Zhen Gao, Compendium of Materia Medica Annotations, Records of Renowned Physicians, and Collected Works of Tao's Seclusion ( ) as research materials to thoroughly explore Tao Hongjing's medical health preservation methods and academic characteristics.

Medicine, emotience, and reason

Medicine is faced with a number of intractable modern challenges that can be understood in terms of hyper-intellectualization; a compassion crisis, burnout, dehumanization, and lost meaning. These challenges have roots in medical philosophy and indeed general Western philosophy by way of the historic exclusion of human emotion from human reason. The resolution of these medical challenges first requires a novel philosophic schema of human knowledge and reason that incorporates the balanced interaction of human intellect and human emotion. This schema of necessity requires a novel extension of dual-process theory into epistemology in terms of both intellect and emotion each generating a distinct natural kind of knowledge independent of the other as well as how these two forms of mental process together construct human reason. Such a novel philosophic schema is here proposed. This scheme is then applied to the practice of medicine with examples of practical applications with the goal of reformulating medical practice in a more knowledgable, balanced, and healthy way. This schema’s expanded epistemology becomes the philosophic foundation for more fully incorporating the humanities in medicine.

In Memory of Dr. Taba, the Legendary WHO Regional Director.

The article is a tribute to Dr. Abdul-Hossein Tabatabai-Naini, the former Regional Director of the Eastern Mediterranean Regional Office (EMRO), on the occasion of WHO's 75th anniversary. It reports on his achievements, personality, and philosophy of medicine.

Tianqi pingchan granule promotes recovery of glymphatic system function in a rat model of l-DOPA-induced dyskinesia

Background and aimTianqi Pingchan Granule (TPG), as a traditional Chinese medicine, is used in the treatment of Parkinson's disease. l-DOPA-induced dyskinesia (LID) is mentioned as a debilitating motor complication in the course of Parkinson's disease. The purpose of this study is to investigate the effects of TPG on LID via the pathway of the glymphatic system. Experimental procedureA rat model of LID was used in this study. The severity of LID was assessed by behavioural tests. Three doses of TPG were administered once a day for 3 weeks to investigate the role of TPG in behavioural characteristics of LID rats. The glymphatic function was evaluated by utilizing intracisternal infusion of a fluorescenttracer. The amyloid-β levels were measured by Enzyme-linked immunosorbent assay. The expression and distribution of, and GFAP were assessed using immunofluorescence. Results and conclusionDose-dependent effects of TPG in the 1behavioural characteristics were observed. Cortical and striatal influx cerebral spinal fluid tracer were reduced in LID rats with impaired AQP4 polarization. Amyloid-β, AQP4, and reactive astrogliosis was upregulated in LID rats. TPG administration increased cerebral influx of fluorescent tracer, restored polarized localization and expression of AQP4, and attenuated l-DOPA-induced amyloid-β deposits and astrogliosis. This study shows for the first time that glymphatic system function is impaired in LID and TPG attenuates abnormal involuntary movements in rats with LID by protecting the glymphatic system. Section1. Natural Products; 3. Dietary therapy supplements; 4. History, Philosophy and Social-Cultural aspects of Traditional Medicine. Taxonomy (classification by evise)identify the disease condition, the experimental approach.

Manas (Mind) Structure: Exposing the Mysterious Functional Anatomy in the Indian System of Medical Philosophy

The mind is not structured anatomically, as emphasized by modern pathology. Instead, it is expanded as a whole in a subtle form behind the physical body. In the Indian system of medical philosophy, the mind is considered as the astral nerves made third body, which identified as the ‘Manomaya-sharira’ (subconscious mind). The mind is composed of millions of astralnadis, through which Pranic-energies circulate freely into the astral anatomy of mind. Seven-chakras are found parallel to the spine, serving as the major seven innovation centres in the body. These Chakras facilitate the connection of the mind with the seven dimensions of the inner world. From these dimensions the Pranic-energies including Sattva, Raja, Tama are exported to the mind and its Nadi-tantras, influencing both the outer and inner subconscious minds. Subsequently, these elements, viz., Sattva, Raja and Tama are thrown from the mind to the outer world through the seven sense organs, manifesting as either constructive or destructive activities. Thus the mind exists due to ‘Prana’, (energy of Omkara) which increases through deeper meditation, sound sleep, and breathing exercises (O2). The positional behaviour of the mind shifts according to the physical and mental temperament, namely Triguna and Tridosha, or Panchavikara. The negative energy (Tama-guna) of the fourth dimension enters the astral Nadis-system of the mind via the interspace of the solar plexus, which crushes the mind’s structures, and consequently, all the Chakras are corrupted and the Nadis are blocked, so it generates a break in the circulation of ‘Prana’ into the Nadis. As a result, many socio-economic challenges and psychosomatic disorders occur.

Exploring health and disease concepts in healthcare practice: an empirical philosophy of medicine study

In line with recent proposals for experimental philosophy and philosophy of science in practice, we propose that the philosophy of medicine could benefit from incorporating empirical research, just as bioethics has. In this paper, we therefore take first steps towards the development of an empirical philosophy of medicine, that includes investigating practical and moral dimensions. This qualitative study gives insight into the views and experiences of a group of various medical professionals and patient representatives regarding the conceptualization of health and disease concepts in practice and the possible problems that surround them. This includes clinical, epistemological, and ethical issues. We have conducted qualitative interviews with a broad range of participants (n = 17), working in various health-related disciplines, fields and organizations. From the interviews, we highlight several different practical functions of definitions of health and disease. Furthermore, we discuss 5 types of problematic situations that emerged from the interviews and analyze the underlying conceptual issues. By providing theoretical frameworks and conceptual tools, and by suggesting conceptual changes or adaptations, philosophers might be able to help solve some of these problems. This empirical-philosophical study contributes to a more pragmatic way of understanding the relevance of conceptualizing health and disease by connecting the participants’ views and experiences to the theoretical debate. Going back and forth between theory and practice will likely result in a more complex but hopefully also better and more fruitful understanding of health and disease concepts.

Persons and their Brains: Life, Death, and Lessened Humanity

AbstractThe authors of the articles in this issue of The Journal of Medicine and Philosophy address a wide variety of topics, from definitions of disease to bioenhancement. Each author, however, draws out the importance of careful use of language. Over the years, philosophers of medicine and bioethicists have debated questions such as what qualifies something as a disease, whether disease language is evaluative, whether the term “person” encompasses more than just human beings, and what language ought to be used to best convey complex information to patients. Among a great deal of disagreement on these topics, one thing emerges distinctly: that clarity and careful attention to language is paramount in medicine. The articles in this issue contribute to that conversation, presenting complex arguments and illustrative examples of why it is so important to use clear and well-defined terms in medicine, and of the reality-altering power that our language carries.

Zhumian Granules improves PCPA-induced insomnia by regulating the expression level of neurotransmitters and reducing neuronal apoptosis

Ethnopharmacological relevanceSleep problems, according to Traditional Chinese medicine (TCM) philosophy, are attributed to the imbalance between yin and yang. Zhumian Granules, also known as Sleep-aid Granules or ZG, are a traditional Chinese herbal remedy specifically designed to alleviate insomnia. This formula consists of many components, including Wu Wei Zi (Schisandrae Chinensis Fructus), Suan Zao Ren (Ziziphi Spinosae Semen), and other medicinal plants. According to the pharmacology of Traditional Chinese Medicine (TCM), Wu Wei Zi and Suan Zao Ren have the ability to relax the mind and promote sleep. When taken together, they may balance the opposing forces of yin and yang. Therefore, ZG may potentially be used as a therapeutic treatment for insomnia. Aim of the studyThis research was specifically developed to establish a strong empirical basis for the subsequent advancement and utilization of ZG in the management of insomnia. This research aimed to gather empirical data to support the effectiveness of ZG, thereby providing useful insights into its potential therapeutic advantages for persons with insomnia. Materials and methodsThis study utilized Zhumian Granules (ZG), a traditional Chinese herbal decoction, to examine its sedative and hypnotic effects on mice with PCPA-induced insomnia. The effects were assessed using the pentobarbital-induced sleep test (PIST), Morris water maze test (MWM), and autonomic activity test. The levels of neurotransmitters in each group of mice were evaluated using UPLC-QQQ-MS. The impact of ZG on the quantity and structure of hippocampal neurons was seen in brain tissue slices using immunofluorescence labeling. ResultsZG was shown to possess active sedative properties, effectively lowering the distance of movement and lengthening the duration of sleep. ZG mitigated the sleeplessness effects of PCPA by elevating the levels of 5-hydroxytryptamine (5-HT), 4-aminobutyric acid (GABA), and 5-hydroxyindoleacetic acid (5-HIAA), while reducing the levels of dopamine (DA) and norepinephrine (NE), as well as decreasing neuronal death. ConclusionsThis research confirmed the sedative and hypnotic properties of ZG and elucidated its probable mechanism involving neurotransmitters.

Individuals and their Environments in Georges Canguilhem’s Philosophy of Medicine

Georges Canguilhem s’est opposé à la médecine positiviste qui cherche à établir la normalité une fois pour toutes. Il a en revanche mis au centre de la médecine les individus, avec leurs variations et leurs subjectivités. D’un côté, il s’est concentré sur l’individu dans sa globalité, par opposition à ses organes et tissus ; d’un autre côté, il a soutenu qu’un individu n’est normal que par rapport à un milieu donné. Dans cet article, je soutiens que la conception de Canguilhem du normal comme relatif à un individu et à son milieu est toujours d’une grande actualité. En même temps, je soutiens qu’il a négligé de développer certaines questions soulevées par sa propre philosophie. Notamment, il n’a pas pleinement analysé comment les individus en viennent à juger de leur propre normalité ni les conséquences sociales de leurs jugements. De même, il n’a pas considéré que tous les individus et groupes n’ont pas le même pouvoir de façonner leur milieu et le milieu des autres. L’approche holistique de Canguilhem à l’égard des êtres humains et de leur milieu fait que la question des jugements des individus sur leur propre normalité est plus complexe qu’il ne l’a reconnu.

Reference-Class Problems Are Real: Health-Adjusted Reference Classes and Low Bone Mineral Density.

Elselijn Kingma argues that Christopher Boorse's biostatistical theory (the BST) does not show how the reference classes it uses are objective and naturalistic. Recently, philosophers of medicine have attempted to rebut Kingma's concerns. I argue that these rebuttals are theoretically unconvincing, and that there are clear examples of physicians adjusting their reference classes according to their prior knowledge of health and disease. I focus on the use of age-adjusted reference classes to diagnose low bone mineral density in children. In addition to using the BST's age, sex, and species, physicians also choose to use other factors to define reference classes, such as pubertal status, bone age, body size, and muscle mass. I show that physicians calibrate the reference classes they use according to their prior knowledge of health and disease. Reference classes are also chosen for pragmatic reasons, such as to predict fragility fractures.