A Critique of Criticism in Medicine and the Biological Sciences in 1958

A CRITIQUE OF CRITICISM IN MEDICINE AND THE BIOLOGICAL SCIENCES IN 1958 WILLIAM B. BEAN, M.D.* In reading Mr. Godwin's ingenious work on politicaljustice, it is impossible not to be struck with the spirit and energy ofhis style, die force and precision of some ofhis reasonings, the ardent tone of his thoughts, and particularly with that impressive earnestness ofmanner which gives an air oftruth to the whole. At the same time it must be confessed that he has not proceeded in his inquiries with the caution that sound philosophy requires; his conclusions are often unwarranted by his premises; he fails sometimes in removing objections which he himself brings forward; he relies too much on general and abstract propositions , which will not admit of application; and his conjectures certainly far outstrip the modesty ofnature.—T. R. Malthus The critic has played a central role in the development ofliterature. It is said that Samuel Johnson, single-handed, held back the rising tides of romanticism for a lifetime. Many splendid critics in belles-lettres have themselves produced works of excellence, sometimes even masterpieces. Coleridge, Ruskin, and Arnold excelled in criticism and creative writing. The critic in the plastic arts, perhaps because ofthe variety ofthe media and the complete subjectivity of aesthetic percepts, has been less effective in curbing excesses or providing guidance. Few critics have been artists, and few artists have been critics. Germinal developments have come more from practicing artists than from critics. Narcissus becomes the patron saint who guides the bemused sophistries ofcomplete subjectivity so that ultimately the artist alone enjoys or understands his own creations. This might explain what some sense as a deterioration of modern painting. However this may be, criticism in medicine and in science has been so neglected that it has been unfruitful as a guide and stabilizing influence, * Head of Department of Internal Medicine, State University of Iowa, College of Medicine, Iowa City, Iowa. 224 William B. Bean · Criticism in Medicine Perspectives in Biology and Medicine · Winter 1958 save in the hands ofa few brilliant, though neglected, exponents, such as Whitehead, Russell, Trotter, RyIe, Dingle, and Walshe. My purpose is to inquire how much this neglect ofcriticism stems from the nature ofthe biological sciences and how much results from the dogmatic hostility to philosophy which too often hovers about the laboratory. I have no special qualifications for such an essay. I have neither the consecutive leisure to let my thoughts mellow in scholarship nor the wisdom to see all the problems clearly. I come rather as a gadfly to stir up those more able to clarify the issues and propose solutions for the problems. It would be naïve to suppose that I have consistently applied in practice some ofthe thoughts set forth. A sanguine hope is that ajournai ofideas such as Perspectives will provide a forum for free and honest criticism, not carping but searching, and be not beholden to the renowned figure or figurehead or fearful ofuncovering error or flabby thinking. A theme for thisjournal might well beJefferson's motto for the University ofVirginia: "For here we are not afraid to follow truth, wherever it may lead, nor to tolerate any error so long as reason is left free to combat it." The best way to construct a really self-satisfying scientific paper is to be completely ignorant ofwhat has been done in the field before. To investigate , one must gather facts, arrange facts, and then manipulate circumstances in experiments before posing deeper questions. It is not the increasing bulk offacts but largely the casual indifference ofso many scientists which accounts for their profound ignorance ofscience. This is even more harmful than the wide discrepancy between what is believed about "science " by laymen and what it actually is. To cultivate the critical faculty, one must have facts and know how to identify data. The true and the false must be separated. Facts must be set in order before the stage is ready for the slow advance of knowledge. Knowledge comes when it is realized that data do not comprise science but are the stuff from which science arises, as form and order develop with selection, the use ofinductive reason, and the synthesis...