The great controversy: cause-and-effect thinking

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The great controversy: cause-and-effect thinking
THE GREAT CONTROVERSY: CAUSE-AND-EFFECT THINKING
In the eighteenth and early nineteenth centuries, doctors tried to explain why they saw certain patterns of diseases. Epidemics broke out in the crowded urban slums created by the Industrial Revolution, due to a lack of sanitation and clean water supplies. Knowing nothing of bacteria and viruses, doctors constructed the theory of 'miasmas' to explain them.
Miasmas were elusive, unidentified atmospheric conditions that could somehow cause disease. To explain the great variety of diseases that appeared in the same crowded areas, the miasmas were assumed to be non-specific -they might cause cholera in some people, yellow fever in others, and so on. As an extension of this idea, other factors in the environment were assumed to cause disease. Cold was an obvious one, and it too was seen as being nonspecific - different people suffered different symptoms when they lived in cold houses or breathed cold air.
In the 1860s and 1870s, a revolution occurred in medical thinking. Dr Robert Koch in Germany and Louis Pasteur in France discovered that microorganisms caused a great many diseases. More importantly, they found that specific bacteria caused specific illnesses. This is a fact that we now take for granted, but in its time it was a remarkable and novel idea. The germ theory, as it was known, quickly replaced the old way of thinking, where a miasma or other environmental factor could cause a great variety of different ills.
The change in medical thinking brought about by the germ theory was a radical one. In a reaction to the vagueness of the old ways of thought, a dogmatic insistence on cause-and-effect thinking took over. From then on, each disease had to have a specific set of symptoms and a specific cause. This way of thinking, with its obvious scientific merits, has dominated medical education for the past century.
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