What is knowledge? How do we acquire it? How do we verify it? An invisible pendulum has swung between two opposing sets of answers to those questions in Western Civilization for over 2500 years. One side says we can’t know reality; our senses only perceive appearances. The other side says we can know reality; our senses perceive what exists. Which claim is true?

First, I’d like to say that I respect the thousands of people who have struggled with this issue throughout history. Here I would only like to examine how the swinging pendulum affects our everyday lives. I choose the context of medicine because I’m most familiar with it. Second, for the sake of brevity I’m going to call one side NO, meaning we can’t know reality, and the other side YES, meaning we can know reality.

Ignaz Semmelweis guessed there was a connection between the spread of disease and standard hospital procedures during the 1840s. He surmised that something unseen was being passed from patient to patient, so he devised new practices of hygiene, including hand washing by the staff, to test the idea. His methods worked. He kept meticulous records and published them. For this his peers hounded him out of Vienna. Louis Pasteur discovered micro-organisms, bacteria, about twenty years later. Joseph Lister invented antiseptic surgery based on the work of Semmelweis and Pasteur. So modern medicine was born. Why did it happen so quickly? And why didn’t it happen earlier?

The latter question reminds me of the quip: Why didn’t Caesar drive a Lincoln? All of the necessary foundations for an automobile existed in the first century B.C., like metallurgy, engineering, steam-engines, and that black, stinky stuff that oozed out of the ground — and burned — but the automobile didn’t happen. Neither did antiseptic medicine. I would argue that the pendulum swung from Plato’s NO to Aristotle’s YES and back to the middle, so that by the time Augustus made himself emperor of Rome, and hired the writer Virgil to justify it, people were satisfied with political power and life as it was.

The pendulum swung further toward NO as the generations passed for the next thousand years in Europe. The Black Death was a total mystery, and its recurrence was explained in terms of fantasy and magic. Meanwhile, a third of the population died. (I should add that bubonic plague is still around, and a few people die from it every year, but it’s easily treated and cured these days.)

The discovery of ancient Greek documents via Arabic translations during the Italian Renaissance pushed the pendulum back toward YES. By 1600 we find Bacon, Bruno, Copernicus, Kepler, and Galileo engaged in YES activities, which culminated in Newton’s grand synthesis. This gave rise to a multitude of new thoughts, like John Locke’s notion of liberty, and Semmelweis’ notion of an invisible carrier of disease.

What came to be called the germ theory gained acceptance largely due to the success of trial and error experiments that produced an observable improvement in results, that is fewer deaths and fewer epidemics. It wasn’t until the compound microscope was refined and widely used that microorganisms could actually be identified.

One might imagine that the obvious benefits produced by science and technology during the 18th and 19th centuries pushed the pendulum permanently to YES, but it did not. A significant number of intellectuals in Europe denied the benefits and despised those grubby people who got dirty doing experiments and inventing things. True knowledge was to be found in contemplating the hidden reality beyond the observable world, and only a select few could do it. They alone understood the perfect society, and they would force people to behave accordingly. The pendulum swung back and forth, and it hasn’t stopped yet.

Responses to my essay on infection control were varied and revealing. One nurse said MRSA was a hoax and the procedures were unnecessary. Another nurse said their whole staff had MRSA and they didn’t have time to follow procedures. One citizen said these sick people should die at home. Another citizen said that germ theory is nonsense. Sounds like confusion to me. A valuable input on how seriously they take this problem outside the US was sent by another reader; this article also blames the CDC for letting things get out of hand.

I think we are seeing the all-powerful State trying to make the pendulum stand still at NO. They have usurped the authority and tell us, only we know the truth. The State controls medicine from top to bottom. The State decrees what is disease, how it may be studied and by whom, how it must be treated and by whom, how it will be funded and how much they will pay. Hospitals and doctors are confined by State regulations to a narrowly defined range of choices. If a given issue, like HIV, SARS, or Bird Flu, hits the media and gains popular attention, it immediately becomes a political football and the State decrees new policies, procedures, and money, while the real problems go begging.

Who are these mighty rulers of American medicine? They’re bureaucrats. And what do bureaucrats do when they make a mistake? Deny-and-cover-up. It’s standard policy in the White House, in Congress, at the DOJ, the Pentagon, and all of the alphabet agencies, including the CDC. So if the CDC declares that MRSA is not a problem, but Bird Flu is, that’s the way it goes. It confuses people who actually work with the sick and infected day in and day out, and it confuses the public who only see the façade and don’t know what’s going on inside the building. And when the bad news hits the media, they’ll deny-and-cover-up, as usual.

I think this pendulum is going to swing hard in the other direction one of these days.

Thanks to David Calderwood for the idea.