Georg Ivanovas From Autism to Humanism - systems theory in medicine

2.1 The medical paradigm

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b ) measurements without semantics


Measure what is measurable.

Make measurable what is not measurable

attributed to Galileo Galilei (1564-1642)

Everything that exists, exists in a quantity

and can therefore be measured

attributed to Lord Kelvin (1824-1907)

Know which abnormality you are going to follow during treatment.

Pick something you can measure

C. Meador (1999)


Precise measurement is a fundamental issue of our current science. It has many advantages. Investigations can be standardized, are comparable and reproducible. This has (or seems to have) a higher validity than philosophical or theological considerations that hardly are called scientific. Philosophy and probably systemic concepts are (or seem to be) too speculative. A solid measurement gives the feeling of security. It might even be called objective if the frame is exactly defined and certain ontological gaps (Bateson/Bateson 1988: 62-63) are silently overlooked

But it’s the little things that always cause the problems. Whereas a measurement seems to be secure, its meaning isn’t. It makes no sense to go to a pharmacy and measure the temperature of all the drugs and conclude on their effectiveness. (However, if temperature is over 80o C probably most drugs are ineffective.) Or the measurement of brain weight (that is less in women than in men) lead (a hundred years ago) to the assumption of a ‘physiological debility of the female’ (Möbius). There was a lot of reasoning when Möbius’ book was published demonstrating a basic epistemological phenomenon: the measurement might be objective, the interpretation is never.

Today only few dare to maintain Möbius’ findings (Shaw et al 2006), because gender differences have to be expressed more cautiously (Witleson et al 2005). But brain research has not changed its objectives. Size is still linked to certain characteristics and often seen as causal: intelligence is connected to the seize of 24 regions known to be related to memory, attention and language (Pichler 2004), sex drive is attributed to the size of the amygdala (Baird et al 2003), depression to the hippocampal volume (Mac Masters/Kusunakar 2004) and ADHD to the size of the corpus callosum (Semrud-Clikeman et al.1994) or the basal ganglia (Qui et al. 2008). Current brain research even found some consolation for the female: although they do not have the brain weight of males, they have more surface due to a greater gyrification in frontal and parietal regions, something said to be important for a good function (Luders et al 2004). Moreover, the enlargement of brain regions through genetical manipulation leads to a worse outcome in mice. That is, there is a kind of optimal size (Leingartner et al 2007) and we could argue that the female is more optimal than the male.

However, all these results make only sense when an underlying causal relation is assumed, the “truism ‘structure defines function’” (Buzsáki 2007). But when seize is an expression of function it would be more a consequence than a cause. And exactly this has been observed, too. Training alters brain’s macroscopic structure and seize (Draganski et al 2004) and brain plasticity remains prominent during the whole life-time (Doidge 2007).

Seize related causations also take for granted that different people have an identical structure and processing. Concerning intelligence, at least, there are indications that the male and the female use different strategies involving different parts of the brain (Haier et al 2005). That is, a measurement as such is meaningless. Its value depends on the underlying theory. The branch of logic dealing with this issue is called the semantics (chap. 3.1).


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