Fleck’s “Epistemological Conclusions from the Established History of a Concept”

“Ideas…have a development that proceeds not through abstraction from the particular to the general, but through differentiation or specialization from the general to the particular” (27). Fleck outlines the progression of thought styles and their impact on the understanding of disease concepts. Over time, the concept of syphilis has been explained by the mystical, the empirical, pathogenetical, and etiological (18-19). What are the implications of this?
Fleck’s comparative epistemology means we must treat disease concepts in the same way we do the history of ideas. To ignore this would be to take any modern interpretation of a particular as absolute and independent from the guiding traditions which developed it. It would therefore be incorrect to say, ‘I have isolated what this concept really is. I now know what the concept represents in its totality’. One cannot point to what syphilis is without recognizing its historical development. Fleck outlines how modern explanations of causative agents are developing from the preeminence of bacteriology. The emergence of Spirochaeta pallida represents another contribution to the understanding of Syphilis just as astrology, the therapeutic use of mercury, and pathological experimentation once did. Thus, “…the development of the concept of syphilis as a specific disease is thus incomplete in principle” (19). Our modern understanding of syphilis represents one possibility of many which could be derived from various interpretive traditions so broad they can be considered neither right or wrong (25). It follows that any disease concept must be derived from general abstracts (pre-ideas) into particulars, resulting in a concept that has no truth outside of the traditions which contributed to its development.

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