This is the first of a group of posts about science. They are new in that I attempt to embed science in the larger context of society and commerce, and in the special case of medicine – the only case where I have real expertise.

Examples are important to illustrate this complex area and I mean to draw them from the history of kidney stone research over my lifetime of participating in it.

I made an AI podcast of the article for those who would rather listen.

SCIENCE, COMMERCE, AND SOCIETY: The Case of Medicine

It seems perfectly evident that science, commerce, and medicine all aim at the betterment of life for people in general. And a moment of thought will suggest ways in which they inevitably interact with one another to achieve that final goal. Broadly speaking my aim here is to identify the most crucial of those interactions, whose regulation might, with some effort, bring these three great engines of progress into that alignment which most efficiently extracts from their activities the greatest benefit for society.

On the one hand I need to identify the interactions themselves, but that would not be enough to achieve my aim. I must in addition look into the details of how at least science and medicine function so that the ways in which they affect one another can be understood in terms of the effect of the one on the functioning of the other. At the present time I cannot envision a need to inspect the interior functioning of commerce with the same attentiveness, but, instead, view it from the outside as a gigantic engine that transforms ideas into products, and circulates these products throughout society for common use.

Science, Commerce, and Medicine

Let me position the players upon a simple stage and put some preliminary ideas in place. Imagine society as a circle drawn on a black screen. Within society, disease has always been an unwelcome and destructive presence, and what we now call medicine is just the modern shape of an ancient practice to task certain people with remedying disease. Envision medicine as a white circle around the circle of society. The purposes of the medical profession are prevention, cure, and palliation of disease.

Why, you might say, have I used the color white and the color yellow? Because I need to separate one kind of thing from another if I’m going to have any success in this venture. I have chosen white for facts, for real things in the world, for the names of things. And I have chosen yellow for goals, for things that we acquire through actions. Such things always are nouns.

Commerce is the circulation of society, and I portray it as a circle outside of society and outside of disease. I have chosen blue for actions, and commerce is about action, about the making and selling of things, about distributing them. Those are the main goal of commerce: actions, verbs.

Science is the outermost ring, and it has to do with acquiring new knowledge about nature, about the real world. I use yellow as the ring of science because science is perpetually in quest of new knowledge, and every element of knowledge is a thing -a thing we do not have and wish to somehow acquire.

Of course, it is people who carry out these three important functions within society. I have labeled in white each profession (physician, scientist, businesspersons) because they are noun, names of occupations. And I have used the label ‘professional’ because the people who work within each part have special abilities, experiences, and personal identification with their work. Perhaps a more pragmatic reason for the label is that they are paid for it, it is the way they make their living, it is part of the life they live.

SCIENCE

Kinds Of Scientific Knowledge.

There are three kinds of scientific knowledge. The first of the three is new facts about the world as it is, the world of the senses, unaided or aided by instruments. A name for this kind of science is ‘empiricism’. The second is ‘invention’, making new things that will do what we want to do. The third is more mysterious. It is to discover causes that account for the facts of the world, the processes that have made the world be the way it is. A name for this is ‘theory’, and for it, I use the color red.

Because our senses cannot directly show us these causes at work, we have to imagine what they might be. But then what? How can we tell if the imagining has any truth in it? In fact, the way we proceed is itself indirect, but the best we have so far.

Here is what we do. From what we imagine, we make predictions that can be tested in the real world. Such predictions must be a logical consequence of the imagined cause and susceptible of a test through measurements. Predictions may be about what facts we will discover if we look in a specific place, or what consequences we will find if we make a deliberate change in some part of the real world, a cell, a patient, a volcano, a molecule – in other words if we conduct an ‘experiment’, a contrived experience.

No amount of testing can ever prove a theory true for all time and under all conditions. It may fail a newly contrived test tomorrow. But so long as a particular vision of the world keeps predicting reliably, we can use it and assume it is as true as it needs to be.

Science and Commerce.

Science depends upon the instruments that expand the range of our senses and the reagents that allow us to make measurements. Although scientists may invent them, their main supply is from production and commerce, from businesses that manufacture and distribute them and are paid for their work. The blue arrow between invention and the ring of commerce marks this crucial connection. Likewise the blue arrow between commerce’s ring and the goal of science itself – new knowledge. It connotes a dependence on commerce for science to enlarge its scope and to progress. These two blue arrows are not the same.

It should seem obvious that invention is a most vigorous and immediate linkage between science and commerce. Inventions arise from science. Companies take inventions up and convert them into products they circulate through society. In so doing, they provide the instruments and reagents science needs to create new knowledge and, incidentally, the tests and treatments physicians need to counter disease.

But inventions also directly feed the growth of new companies and the enlargement of existing ones by giving them new items to produce and sell. In this sense, invention and commerce seem to differ from the other linkages and relationships because of their dynamic quality, their seeming ability to bootstrap, to enlarge both commerce and the range of what the scientists themselves can do to further their own ends.

You probably have noticed many of the arrows point in both directions. This is because having more facts or more inventions or more causes expand the ability to obtain more knowledge. It is also true for the instruments and reagents because scientists are forever inventing.

Science And Medicine

The medical profession brings about prevention cure and palliation using knowledge that arises from science, and because science is perpetually adding new knowledge to society there must be a constant flow of information from science to medicine. That flow is in blue, being an activity or action, and moves through the pathways of production and commerce. This is because the journals, books, and professional websites that are the medium of conveyance are themselves businesses that make money by providing this service to society. The arrows are bidirectional because physicians, as they work, produce considerable amounts of information that scientists take up and use, particularly for empirical research.

MEDICINE

The means by which medicine achieves its goals of prevention, cure, and palliation are through diagnosis prognosis and treatment. The first of these is simply to identify a particular disease from among a group of possibilities. Tests are crucial here. The second is to offer a glimpse into the future. As for the treatments themselves, drugs and instruments, they are, like the instruments and reagents of science, manufactured and distributed through the channels of production and commerce.

 SUMMARY.

In the case of medicine, there are numerous interactions between science and commerce and between those two and the profession of medicine itself. A number of them, though worth notice, are obvious. But the peculiar ability of scientific invention to drive the growth of production and commerce, though it should surprise no one who has thought about the matter, is notable. As we look into the interior of science and medicine, this relationship will take on greater detail, and other more subtle but important linkages will emerge.