"Guthrie, Dr Bruce" <[log in to unmask]> said:
Hmmm. I'm not sure that you can jump from that to assuming that
it is antibiotics that have reduced the prevalence of these
complications in the community. Alternative explanations include
the streptococcus changing its relationship with humanity, either
because it's changed or we have (better fed etc). The case of TB
suggests it's a mixture - TB treatment matters a great deal if you
get TB, but the decline in UK TB incidence and death was largely
due to other factors.
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Off hand, I don't know of any evidence that virulence of strep has changed
such that it is less likely to cause suppurative complications, but maybe
someone more knowledgeable can step in.
I don't necessarily think one can give all the credit for declines in
suppurative complications of strep pharyngitis or declines in TB mortality
in the developed countries to evidence-based use of antibiotics, but surely
they deserve some credit.
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Bruce Guthrie said:
The point I was trying to make is that I don't disbelieve in an
"external objective reality in general". Sometimes I act as if I
believe in it, sometimes I don't. When considering walking out of
windows, I do believe in it - it's useful. When considering social
interaction and culture, I sometimes find it helpful to act as if reality
is socially constructed - that's useful too. It isn't necessary to
commit yourself to a single perspective on the world in all
situations.
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Your point is much more nuanced that those made by many post-modernists.
Clearly peoples' internal mental processes (beliefs, values, emotions, etc.)
are socially influenced (but I'm a little leery of the term "constructed"
which seems to suggest "completely determined by") Clearly peoples'
internal mental process, though they have a reality, are extremely hard
to discern by observers. On the other hand, peoples' behavior, and hence
their social interaction, has a physical reality. The question is not
of, e.g., whether I just typed the words above. The question is what they
mean. On the other hand, there is a lot of physical reality that is
completely independent of anything resembling social construction, e.g.,
the metabolic processes of E. Coli, or the rings of Saturn.
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Bruce Guthrie said:
To say that perceptions, beliefs and opinions about reality are
socially influenced is to accept a degree of social construction. It
may be "what most people think is the obvious", but doesn't that
prove my point? A hard belief in an objective external reality full of
"facts" isn't sustainable in all situations. Neither is a hard belief in
multiple shifting realities if it leads to an inability to act in the world.
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OK, see above. My saying this was "obvious" I think was part of another of
my criticisms of postmodernism. I have heard a lot about all the wonderful
insights one can get from postmodernism. But at best the insights I have
seen are like the obvious, ones that were pretty obvious before postmodernism
came along. I am still looking for a single example from those who are more
sympathetic to postmodernism of a really useful insight from it that was not
easily available from other sources.
At this point I too plan to sign off from this discussion. I hope it hasn't
been too far afield. I thank Dr. Guthrie for his thoughtful, well-written
contributions.
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Roy M. Poses MD
Brown University Center for Primary Care and Prevention
Memorial Hospital of RI
111 Brewster St.
Pawtucket, RI 02860
USA
401 729-2383
fax: 401 729-2494
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