The Lady Tasting Tea: How Statistics Revolutionized Science in the Twentieth Century
The Lady Tasting Tea: How Statistics Revolutionized Science in the Twentieth Century
复制标题
品茶女士：统计学如何彻底改变了二十世纪的科学
DOI：
10.1038/90908
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发表时间：
2001
期刊：
影响因子：
82.9
通讯作者：
J. Potter
中科院分区：
文献类型：
--
作者：
J. Potter
读一本关于历史上最著名的医疗纠纷的书会教会你两件事：第一，当时间旅行时，不要回到16世纪去修复动脉伤口。其次，尽管常识层出不穷，但外星人已经登陆地球。在赫尔曼的书中，外星人这个词并没有写在任何地方，但如果过去是任何迹象的话，那么现在的科学界回避的一些看似奇怪的理论将在未来得到确凿的证明。这似乎肯定是《医学界大争执》反复出现的主题。“纷争”主要围绕着先驱科学家为争取他们的革命理论获得认可而进行的斗争。在十个组织类似的章节中，赫尔曼巧妙地带领读者完成了每个章节的案例研究。信息很明确：如果你打算挑战科学惯例的规范，准备好为获得认可而进行一场诽谤、彻底的战斗。但赫尔曼从不说教或谴责--就像任何优秀的历史学家一样，他只是陈述事实，将猜测和道听途说保持在最低限度。这些章节足够集中，足以保持这本书的势头，但又足够成熟，足以对冲突进行足够复杂的描述。赫尔曼熟练地交流这些复杂的科学问题，这是他流畅、清晰的风格的功劳。在《医学大仇杀》一书中，许多科学家不得不与贯穿整个思想史的对变革的教条、近乎本能的抵制作斗争。拉蒙·卡哈尔于1905年发现了大脑中神经冲动的机制，他提出这一理论的时候，“许多，也许是大多数教授……鄙视显微镜，认为它甚至有损于生物学的进步。这就像试图用他们放在新钱包里的纸板美国运通卡之一购买机票一样。公平地说，医学界在变革方面与世界其他地区没有什么不同。而每一次发现都需要摧毁一个已经确立的想法。之前持有的理论越根深蒂固，对变革的反对就越激烈。当伊格纳兹·塞梅尔韦斯在1849年辩称，降低分娩期间极高的妇女死亡率的最有效方法是让产科医生洗手时，医疗机构有理由感到不安，因为这么多患者的死亡本来是可以轻松避免的。在这种情况下，塞梅尔韦斯被医院解雇似乎是不幸的，但却是不可避免的。通常情况下，没有具体的证据来证实这些理论，因为这些想法往往比技术确认早了几年。在威廉·哈维的案例中，他在1628年提出了血液在全身持续循环的理论，直到他死后四年，马塞洛·马尔皮吉使用改进后的显微镜证明，全身微小的毛细血管促进了静脉和动脉之间的血液循环，他的想法才得到证实。最近，争执的症结似乎是媒体的聚光灯让细菌理论的缔造者路易斯·巴斯德和发现艾滋病的罗伯特·加洛等科学家的瞳孔扩大。巴斯德在动物身上成功地演示了狂犬病和炭疽疫苗后，成为法国反活体解剖运动(19世纪的善待动物组织)的更大目标。反对活体切除的人会更喜欢他用孤儿作为对照吗？在发现艾滋病病毒后，加洛受到了美国媒体的如此折磨，以至于他曾愤怒地表示，他的生产生活被剥夺了“六年的美好时光”。随着对每一项历史性发现的反对声音不断涌现，这些科学家需要全神贯注地揭开真相，以至于他们可以屏蔽对性格和声誉的歪曲和恶毒的诽谤。也许从这个角度来看，他们的任何想法都被接受了，这是这些人坚持不懈的功劳。但并不是所有赫尔曼的水深火热都损害了主人公的生活。在几个案例中，对发现的竞争最终丰富了结果，导致了更快、更安全和更有效的治疗。在阿尔伯特·萨宾和乔纳斯·索尔克之间争夺脊髓灰质炎疫苗的精彩精彩一章中，这一点尤其真实。尽管索尔克是第一个发明疫苗的人，但萨宾的版本(第二年就准备好了)制造成本更低，而且可以口服，在帮助消灭全球流行病方面，它比索尔克拥有巨大的优势。可以说，如果没有这两种疫苗，根除脊髓灰质炎的任务将具有无限的挑战性。所以，下次你拿着相机坐在自家后院，绿色的光芒吞没了你的草坪椅，把你抬上一艘奇怪的漂浮的宇宙飞船时，想想索尔克的挣扎和哈维的艰辛。但别忘了路易吉·加尔瓦尼。为了证明“动物电”的存在，他上演了一些离奇的公共场面，其中他用电击死了一些动物的头，甚至是一个最近被处决的杀人犯的头。这导致眼睛开始痉挛地抽搐，就像S一样。在那之后，他的作品成了马戏团娱乐的代名词，他的科学声誉受到了损害。如果你是一位向《国家询问报》提交不明飞行物照片的科学家，这是一个恰当的警示故事。拿起一本《医学界的大冤家》，别说你从未被警告过。
Reading a book about the most famous medical disputes in history teaches you two things: first, when time traveling, don’t go back to the 16th century to get that arterial wound fixed up. Second, despite mountains of common sense to the contrary, aliens have already landed on earth. The word aliens isn’t written anywhere in Hellman’s book, but if the past is any indication, and it usually is, some seemingly outlandish theory shunned by the present scientific community will be proven conclusively in the future. That certainly seems to be the recurring theme of Great Feuds in Medicine. The ’feuds‘ revolve mainly around the struggles of pioneering scientists to garner acceptance for their revolutionary theories. In ten similarly organized chapters, Hellman competently takes the reader through a case study of each. The message is clear: if you intend to challenge the norms of scientific convention, be prepared for a defaming, exhaustive fight for recognition. But Hellman is never preachy or condemnatory—like any good historian he simply presents the facts and keeps the conjecture and hearsay to a minimum. The chapters are focused enough to maintain the book’s momentum, yet well developed enough to allow a sufficiently complex description of the conflict. The adeptness with which Hellman communicates these complex scientific problems is a credit to his smooth, lucid style. Many scientists in Great Feuds in Medicine had to struggle against the dogmatic, almost instinctual resistance to change that has prevailed throughout intellectual history. Ramón y Cajal, who discovered the mechanism for nerve impulses in the brain in 1905, put forward his theory at a time in which “many, perhaps the majority of professors... despised the microscope, considering it even prejudicial to the progress of Biology.” Which is like trying to buy a plane ticket with one of those cardboard American Express cards they put in new wallets. In fairness, the medical community is no different from the rest of the world when it comes to change. And each discovery required the destruction of an already established idea. The more entrenched the previously held theory, the fiercer the opposition to change. When Ignaz Semmelweis argued in 1849 that the most effective way to lower the extremely high mortality rate of women during childbirth was for obstetricians to wash their hands, the medical establishment was justifiably unsettled knowing the death of so many patients could have been easily prevented. In such a light, Semmelweis’ dismissal from his hospital job seems unfortunate but inevasible. Oftentimes, concrete proof was not available to substantiate these theories because the ideas were often years ahead of technological confirmation. In the case of William Harvey, who theorized in 1628 that blood circulated continuously throughout the body, his ideas were not vindicated until four years after his death, when Marcello Malpighi used an improved microscope to prove that tiny capillaries throughout the body facilitated the circulation of blood between veins and arteries. More recently, the crux of the feuds seems to be the glaring media spotlight dilating the pupils of scientists like Louis Pasteur, the architect of germ theory, and Robert Gallo, who discovered AIDS. Pasteur became a bigger target for the French antivivisection movement (the PETA of the 19th century) after his successful demonstration of both a rabies and anthrax vaccine on animals. Would the antivivisectionists have preferred he use orphans as controls? And Gallo was so tormented by the American press following his discovery of the AIDS virus that he once stated in exasperation that “six good years” had been robbed from his productive life. With such opposition constantly swirling against each historic discovery, these scientists needed to be so consumed with uncovering the truth that they could block out the upturned noses and vicious slander of character and reputation. Perhaps in this light, it’s a credit to the perseverance of these individuals that any of their ideas ever came to be accepted. But not all of Hellman’s watermarked feuds damaged the life of the protagonist. In several instances, the competition for discovery wound up enriching the result, leading to quicker, safer and more effective treatments. This is especially true in the wonderfully well-written chapter about the competition for a polio vaccine between Albert Sabin and Jonas Salk. Though Salk was the first to create a vaccine, Sabin’s version (which was ready the following year) was cheaper to make and could be administered orally, giving it a huge edge over Salk’s in helping to stamp out the worldwide epidemic. Arguably, without both vaccines, the task of eradicating polio would have been infinitely more challenging. So the next time you’re sitting in your backyard with a camera and a greenish glow engulfs your lawnchair and lifts you up into a strange, floating spaceship, think about the struggles of Salk, and the hardship of Harvey. But don’t forget about Luigi Galvani. In trying to prove the existence of “animal electricity”, he staged some bizarre public spectacles in which he electrocuted severed animal heads, and even the head of a recently executed murderer. This caused the eyes to begin twitching about spastically like at a séance. After that, his work became synonymous with circus entertainment, and his scientific reputation suffered. A fitting cautionary tale, if you’re a scientist submitting UFO photos to the National Enquirer. Pick up a copy of Great Feuds in Medicine and don’t say you were never warned.