Georg Ivanovas From Autism to Humanism - systems theory in medicine

3. Epistemology

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3.1 Formal logic – syntax and semantics

In experimental science, however, a scientific man is the prisoner of his ideas, if he does not learn to question nature for himself, and if he does not possess suitable and necessary tools

Claude Bernard (148)

Our logic is normally characterized as Greek. But this is only partly true. Sophists like Zenon, who may have become the most often cited philosopher in the current scientific literature, had little impact until recently. So, more precisely: our current logic is Aristotelian (Günther, 1978). Without even realizing our whole way of thinking is influenced by his kind of logic, (Günther, 1976: 250) and “even the most stupid farmer in Flandern would think and feel differently if Plato had not existed” (Maeterlinck cited in Günther, 1976: 353). We all have a precise feeling of what logic is. However, this feeling might be deceiving.

The argument “All men are mortal; all Greeks are men; therefore, all Greeks are mortal” (Mates: 4) seems logical to us, and so it is. Also, the argument “Men are mortal; Socrates is a man; therefore Socrates is mortal” might do at first glance, although it has the same logical value as “Men are numerous, Socrates is a man; therefore Socrates is numerous” (Russell: 164). There is something fishy about these arguments. To understand their hidden problem, let alone to solve them, requires certain logical tools. These tools are not only necessary to solve some ancient riddles. They are also crucial to describe and model living processes.


Logic might be called the ‘science of correct reasoning’ (Webster’s). It comprises two different disciples: syntax and semantics


Syntax, is the theory of uninterpreted signs providing a structure which connects premises with conclusions. It “investigates the relation of consequence that holds between the premises and the conclusion of a sound argument. An argument is said to be sound (correct, valid) if its conclusion follows from or is a consequence of its premises; otherwise it is unsound” (Mates: 4). Syntax is not about truth. It is about proof.. It “guarantees only that if the premises are true, then the conclusion is also true. It does not guarantee that any of the premises are in fact true, nor does it give us any information about the truth-value of the conclusion in case one or more of the premises is false” (Mates: 7).

That is, in order to judge the soundness of a statement, the truth-value of its premises and the soundness of the used deductive logic has to be assessed.

Sound proofs are, however, often problematic: “Mathematics is a deductive science: starting from certain premises, it arrives by a strict process of deduction, at the various theorems, which constitute it. It is true that, in the past, mathematical deductions were often greatly lacking in rigour; it is true also that perfect rigour is a scarcely attainable ideal. Nevertheless, in so far as rigour is lacking in a mathematical proof, the proof is defective; it is no defence to urge that common sense shows the result to be correct, for if we were to rely upon that, it would be better to dispense with argument altogether, rather than bring fallacy to the rescue of common sense. No appeal to common sense, or ‘intuition’, or anything except strict deductive logic, ought to be needed in mathematics after the premises have been laid down” (Russell: 144-145).

This rather strict statement by Russell demonstrates an essential difficulty when it comes to medicine. Russell is absolutely correct refuting intuition as a substitute for logical rigour. The problem is, however, that mathematical rigour is an impossible aim in the science of the living. The main attempt to achieve such rigour is reductionism. But the reductionist approach improves vigour at the cost of the truth-value of its premises, as the conditions of the experiment does not represent anymore the natural conditions.

Furthermore, there is a hidden joke in Russell’s statement. Russell’s attempt was to solve certain problems of logic and to provide more rigour. However, as will be shown below, he induced a development in logic which finally lead to the discovery that rigour is essentially unobtainable, that there is an abyss of incertitude necessarily inherent in all reasoning.


Semantics is the theory of interpreted relations and structures (Günther, 1979: 7). Interpretation is the implementation of meaning. Nothing has a meaning as such, just as seen with the measurements in medicine (chap. 2.1.b). It is attributed by an external observer. But things are not without meaning either. Without meaning things would fall apart. Especially in medicine. All communication (chap. 3.7; 4.2), all therapy (chap. 6.13) is the creation of meaning, of values (chap. 6.1). But meaning is not an item as such, not a simple measurable entity. It reveals itself in a structure, in a relational frame.

Strangely enough, semantics play only a subordinated role in our current science, despite its overriding importance. Except for Peirce in the 19th century (chap. 3.9), only a few biologists and human scientists of the 20th century (Bateson 1972; Watzlawick et al. 1967) applied a semantic logic.

It is this neglect of semantics which leads to the autistic-undisciplined thinking in medicine (chap. 2.1.c). Medicine is undisciplined because there is no structure to formalize complex phenomena. It is autistic (according to current definitions of autism) because the reductionist approach excludes the relational aspects. It might be a coincidence that many important scientists suffered from Asperger syndrome, a kind of autism (Fitzgerald 2004), whereas artists are more inclined to develop psychotic states (Jamison 1993) with an excess of relational thinking. May be the difference between the scientific and the artistic thinking (chap. 1) is somehow also a reflection of the difference between syntax and semantics.

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