![This ebook is for the use of anyone anywhere in the United
States and most other parts of the world at no cost and with
almost no restrictions whatsoever. You may copy it, give it away
or re-use it under the terms of the Project Gutenberg License
included with this ebook or online at www.gutenberg.org. If you
are not located in the United States, you will have to check the
laws of the country where you are located before using this
eBook.
Title: On the Philosophy of Discovery, Chapters Historical and
Critical
Author: William Whewell
Release date: March 25, 2016 [eBook #51555]
Most recently updated: October 23, 2024
Language: English
Credits: Produced by Sonya Schermann, Les Galloway and the
Online
Distributed Proofreading Team at http://www.pgdp.net
(This
file was produced from images generously made
available
by The Internet Archive)
*** START OF THE PROJECT GUTENBERG EBOOK ON THE
PHILOSOPHY OF DISCOVERY, CHAPTERS HISTORICAL AND
CRITICAL ***](https://image.slidesharecdn.com/1150-250328161919-125c9e80/85/Introduction-to-Health-Care-Quality-Theory-Methods-and-Tools-1st-Edition-32-320.jpg)
![Socrates turned his speculations to the moral virtues, and was the
first philosopher who endeavoured to give universal definitions of
such matters. He wished to reason systematically, and therefore he
tried to establish definitions, for definitions are the basis of
systematic reasoning. There are two things which may justly be
looked upon as steps in philosophy due to Socrates; inductive
reasonings, and universal definitions;—both of them steps which
belong to the foundations of science. Socrates, however, did not
make universals, or definitions separable from the objects; but his
followers separated them, and these essences they termed Ideas."
And the same account is given by other writers[2]. "Some existences
are sensible, some intelligible: and according to Plato, if we wish to
understand the principles of things, we must first separate the ideas
from the things, such as the ideas of Similarity, Unity, Number,
Magnitude, Position, Motion: second, that we must assume an
absolute Fair, Good, Just, and the like: third, that we must consider
the ideas of relation, as Knowledge, Power: recollecting that the
Things which we perceive have this or that appellation applied to
them because they partake of this or that Idea; those things being
just which participate in the idea of The Just, those being beautiful,
which contain the idea of The Beautiful." And many of the
arguments by which this doctrine was maintained are to be found in
the Platonic dialogues. Thus the opinion that true knowledge
consists in sensation, which had been asserted by Protagoras and
others, is refuted in the Theætetus: and, we may add, so
victoriously refuted, that the arguments there put forth have ever
since exercised a strong influence upon the speculative world. It may
be remarked that in the minds of Plato and of those who have since
pursued the same paths of speculation, the interest of such
discussions as those we are now referring to, was by no means
limited to their bearing upon mere theory; but was closely connected
with those great questions of morals which have always a practical
import. Those who asserted that the only foundation of knowledge
was sensation, asserted also that the only foundation of virtue was
the desire of pleasure. And in Plato, the metaphysical part of the](https://image.slidesharecdn.com/1150-250328161919-125c9e80/85/Introduction-to-Health-Care-Quality-Theory-Methods-and-Tools-1st-Edition-52-320.jpg)
![disquisitions concerning knowledge in general, though independent
in its principles, always seems to be subordinate in its purpose to the
questions concerning the knowledge of our duty.
Since Plato thus looked upon the Ideas which were involved in each
department of knowledge as forming its only essential part, it was
natural that he should look upon the study of Ideas as the true
mode of pursuing knowledge. This he himself describes in the
Philebus[3]. "The best way of arriving at truth is not very difficult to
point out, but most hard to pursue. All the arts which have ever
been discovered, were revealed in this manner. It is a gift of the
gods to man, which, as I conceive, they sent down by some
Prometheus, as by Prometheus they gave us the light of fire; and
the ancients, more clear-sighted than we, and less removed from the
gods, handed down this traditionary doctrine: that whatever is said
to be, comes of One and of Many, and comprehends in itself the
Finite and the Infinite in coalition (being One Kind, and consisting of
Infinite Individuals). And this being the state of things, we must, in
each case, endeavour to seize the One Idea (the idea of the Kind) as
the chief point; for we shall find that it is there. And when we have
seized this one thing, we may then consider how it comprehends in
itself two, or three, or any other number; and, again, examine each
of these ramifications separately; till at last we perceive, not only
that One is at the same time One and Many, but also how many.
And when we have thus filled up the interval between the Infinite
and the One, we may consider that we have done with each one.
The gods then, as I have said, taught us by tradition thus to
contemplate, and to learn, and to teach one another. But the
philosophers of the present day seize upon the One, at hazard, too
soon or too late, and then immediately snatch at the Infinite; but the
intermediate steps escape them, in which resides the distinction
between a truly logical and a mere disputatious discussion."
It would seem that what the author here describes as the most
perfect form of exposition, is that which refers each object to its
place in a classification containing a complete series of](https://image.slidesharecdn.com/1150-250328161919-125c9e80/85/Introduction-to-Health-Care-Quality-Theory-Methods-and-Tools-1st-Edition-53-320.jpg)
![subordinations, and which gives a definition of each class. We have
repeatedly remarked that, in sciences of classification, each new
definition which gives a tenable and distinct separation of classes is
an important advance in our knowledge; but that such definitions
are rather the last than the first step in each advance. In the
progress of real knowledge, these definitions are always the results
of a laborious study of individual cases, and are never arrived at by a
pure effort of thought, which is what Plato appears to have imagined
as the true mode of philosophizing. And still less do the advances of
other sciences consist in seizing at once upon the highest generality,
and filling in afterwards all the intermediate steps between that and
the special instances. On the contrary, as we have seen, the ascents
from particular to general are all successive; and each step of this
ascent requires time, and labour, and a patient examination of actual
facts and objects.
It would, of course, be absurd to blame Plato for having inadequate
views of the nature of progressive knowledge, at the time when
knowledge could hardly be said to have begun its progress. But we
already find in his speculations, as appears in the passages just
quoted from his writings, several points brought into view which will
require our continued attention as we proceed. In overlooking the
necessity of a gradual and successive advance from the less general
to the more general truths, Plato shared in a dimness of vision[4]
which prevailed among philosophers to the time of Francis Bacon. In
thinking too slightly of the study of actual nature, he manifested a
bias from which the human intellect freed itself in the vigorous
struggles which terminated the dark ages. In pointing out that all
knowledge implies a unity of what we observe as manifold, which
unity is given by the mind, Plato taught a lesson which has of late
been too obscurely acknowledged, the recoil by which men repaired
their long neglect of facts having carried them for a while so far as
to think that facts were the whole of our knowledge. And in
analysing this principle of Unity, by which we thus connect sensible
things, into various Ideas, such as Number, Magnitude, Position,
Motion, he made a highly important step, which it has been the](https://image.slidesharecdn.com/1150-250328161919-125c9e80/85/Introduction-to-Health-Care-Quality-Theory-Methods-and-Tools-1st-Edition-54-320.jpg)
![business of philosophers in succeeding times to complete and to
follow out.
But the efficacy of Plato's speculations in their bearing upon physical
science, and upon theory in general, was much weakened by the
confusion of practical with theoretical knowledge, which arose from
the ethical propensities of the Socratic school. In the Platonic
Dialogues, Art and Science are constantly spoken of indiscriminately.
The skill possessed by the Painter, the Architect, the Shoemaker, is
considered as a just example of human science, no less than the
knowledge which the geometer or the astronomer possesses of the
theoretical truths with which he is conversant. Not only so; but
traditionary and mythological tales, mystical imaginations and
fantastical etymologies, are mixed up, as no less choice ingredients,
with the most acute logical analyses, and the most exact conduct of
metaphysical controversies. There is no distinction made between
the knowledge possessed by the theoretical psychologist and the
physician, the philosophical teacher of morals and the legislator or
the administrator of law. This, indeed, is the less to be wondered at,
since even in our own time the same confusion is very commonly
made by persons not otherwise ignorant or uncultured.
On the other hand, we may remark finally, that Plato's admiration of
Ideas was not a barren imagination, even so far as regarded physical
science. For, as we have seen[5], he had a very important share in
the introduction of the theory of epicycles, having been the first to
propose to astronomers in a distinct form, the problem of which that
theory was the solution; namely, "to explain the celestial phenomena
by the combination of equable circular motions." This demand of an
ideal hypothesis which should exactly express the phenomena (as
well as they could then be observed), and from which, by the
interposition of suitable steps, all special cases might be deduced,
falls in well with those views respecting the proper mode of seeking
knowledge which we have quoted from the Philebus. And the Idea
which could thus represent and replace all the particular Facts, being
not only sought but found, we may readily suppose that the](https://image.slidesharecdn.com/1150-250328161919-125c9e80/85/Introduction-to-Health-Care-Quality-Theory-Methods-and-Tools-1st-Edition-55-320.jpg)
![Relations, as the Relations of Like and Unlike, Greater and Less; and
of mere material objects, as Tables and Chairs. Now to assume Ideas
of such things as these solves no difficulty and is supported by no
argument. In this respect the Ideal theory is of no value in Science.
It is curious that we have a very acute refutation of the Ideal theory
in this sense, not only in Aristotle, the open opponent of Plato on
this subject, but in the Platonic writings themselves: namely, in the
Dialogue entitled Parmenides; which, on this and on other accounts,
I consider to be the work not of Plato, but of an opponent of
Plato[6].
2. I have spoken, in the preceding chapter, of Plato's doctrine that
truth is to be obtained by discerning the One in the Many. This
expression is used, it would seem, in a somewhat large and
fluctuating way, to mean several things; as for instance, finding the
one kind in many individuals (for instance, the one idea of dog in
many dogs); or the one law in many phenomena (for instance, the
eccentrics and epicycles in many planets). In any interpretation, it is
too loose and indefinite a rule to be of much value in the formation
of sciences, though it has been recently again propounded as
important in modern times.
3. I have said, in the preceding chapter, that Plato, though he saw
that scientific truths of great generality might be obtained and were
to be arrived at by philosophers, overlooked the necessity of a
gradual and successive advance from the less general to the more
general; and I have described this as a 'dimness of vision.' I must
now acknowledge that this is not a very appropriate phrase; for not
only no acuteness of vision could have enabled Plato to see that
gradual generalization in science of which, as yet, no example had
appeared; but it was very fortunate for the progress of truth, at that
time, that Plato had imagined to himself the object of science to be
general and sublime truths which prove themselves to be true by the
light of their own generality and symmetry. It is worth while to
illustrate this notice of Plato by some references to his writings.](https://image.slidesharecdn.com/1150-250328161919-125c9e80/85/Introduction-to-Health-Care-Quality-Theory-Methods-and-Tools-1st-Edition-58-320.jpg)
![In the Sixth Book of the Republic, Plato treats of the then existing
sciences as the instruments of a philosophical education. Among the
most conspicuous of these is astronomy. He there ridicules the
notion that astronomy is a sublime science because it makes men
look upward. He asserts that the really sublime science is that which
makes men look at the realities, which are suggested by the
appearances seen in the heavens: namely, the spheres which revolve
and carry the luminaries in their revolutions. Now it was no doubt
the determined search for such "realities" as these which gave birth
to the Greek Astronomy, that first and critical step in the progress of
science. Plato, by his exhortations, if not by his suggestions,
contributed effectually, as I conceive, to this step in science. In the
same manner he requires a science of Harmonics which shall be free
from the defects and inaccuracies which occur in actual instruments.
This belief that the universe was full of mathematical relations, and
that these were the true objects of scientific research, gave a vigour,
largeness of mind, and confidence to the Greek speculators which no
more cautious view of the problem of scientific discovery could have
supplied. It was well that this advanced guard in the army of
discoverers was filled with indomitable courage, boundless hopes,
and creative minds.
But we must not forget that this disposition to what Bacon calls
anticipation was full of danger as well as of hope. It led Plato into
error, as it led Kepler afterwards, and many others in all ages of
scientific activity. It led Plato into error, for instance, when it led him
to assert (in the Timæus) that the four elements, Earth, Air, Fire and
Water, have, for the forms of their particles respectively, the Cube,
the Icosahedron, the Pyramid, and the Octahedron; and again, when
it led him to despise the practical controversies of the musicians of
his time; which controversies were, in fact, the proof of the truth of
the mathematical theory of Harmonics. And in like manner it led
Kepler into error when it led him to believe that he had found the
reason of the number, size and motion of the planetary orbits in the
application of the five regular solids to the frame of the universe[7].](https://image.slidesharecdn.com/1150-250328161919-125c9e80/85/Introduction-to-Health-Care-Quality-Theory-Methods-and-Tools-1st-Edition-59-320.jpg)
Introduction to Health Care Quality: Theory, Methods, and Tools 1st Edition
- 1. Introduction to Health Care Quality: Theory, Methods, and Tools 1st Edition pdf download https://ebookmass.com/product/introduction-to-health-care- quality-theory-methods-and-tools-1st-edition/ Explore and download more ebooks at ebookmass.com
- 2. We have selected some products that you may be interested in Click the link to download now or visit ebookmass.com for more options!. Introduction to Health Care & Careers 1st Edition, (Ebook PDF) https://ebookmass.com/product/introduction-to-health-care-careers-1st- edition-ebook-pdf/ Introduction to Health Care 4th Edition, (Ebook PDF) https://ebookmass.com/product/introduction-to-health-care-4th-edition- ebook-pdf/ Introduction to Health Care 5th Edition Lee Haroun https://ebookmass.com/product/introduction-to-health-care-5th-edition- lee-haroun/ eTextbook 978-1305575073 Introduction to Health Care https://ebookmass.com/product/etextbook-978-1305575073-introduction- to-health-care/
- 3. Introduction to health care Fourth Edition. Edition Dakota Mitchell https://ebookmass.com/product/introduction-to-health-care-fourth- edition-edition-dakota-mitchell/ Patient and Public Involvement in Health and Social Care Research: An Introduction to Theory and Practice 1st ed. Edition Jurgen Grotz https://ebookmass.com/product/patient-and-public-involvement-in- health-and-social-care-research-an-introduction-to-theory-and- practice-1st-ed-edition-jurgen-grotz/ Introduction to Health Behavior Theory 3rd Edition, (Ebook PDF) https://ebookmass.com/product/introduction-to-health-behavior- theory-3rd-edition-ebook-pdf/ Introduction to Network Traffic Flow Theory: Principles, Concepts, Models, and Methods 1st Edition Wen-Long Jin https://ebookmass.com/product/introduction-to-network-traffic-flow- theory-principles-concepts-models-and-methods-1st-edition-wen-long- jin/ McLaughlin & Kaluznyu2019s Continuous Quality Improvement in Health Care 5th Edition, (Ebook PDF) https://ebookmass.com/product/mclaughlin-kaluznys-continuous-quality- improvement-in-health-care-5th-edition-ebook-pdf/
- 7. CONTENTS List of Figures and Tables xvii Preface xxi Acknowledgments xxv About the Author xxvii Introduction xxix PART I: QUALITY MANAGEMENT FUNDAMENTALS 1 1 Foundations of Health Care Quality 3 Defining Quality 4 Contributions of Quality Theorists—Nothing New under the Sun 5 Florence Nightingale • Ernest A. Codman • William Andrew Shewhart • William Edwards Deming • Avedis Donabedian • Joseph M. Juran • Philip Crosby Quality Management Methodologies 14 Total Quality Management • Continuous Quality Improvement vii
- 8. viii Contents Organizations Making an Impact on Quality and Safety Standards 16 Institute of Medicine • The Joint Commission Centers for Medicare and Medicaid Services 21 Hospital Compare • Patient Education • Pay for Performance • Never Events Institute for Healthcare Improvement 24 Agency for Health Research and Quality 25 National Quality Forum 27 The Leapfrog Group 27 Data: The Foundation of Quality Management 28 Case Example: Falls • Quality Indicator • Barriers to Using Quality Data to Assess Care • Case Example: Cardiac Surgery Mortality Summary 32 Key Terms 33 Quality Concepts in Action 33 References 33 Suggestions for Further Reading 34 Useful Websites 35 2 Understanding the Impact of Health Care Reform 37 The Affordable Care Act 38 Accountable Care Organizations • Health Insurance Exchanges New Models of Payment 42 Bundled Payment • Pioneer and Advance Payment Accountable Care Organization • Comprehensive Primary Care Improvement • Value-Based Purchasing • Pay for Performance • Case Example: Communicating with Clinicians through P4P Data New Models of Providing Care 47 Patient-Centered Medical Homes • Community Health Centers • Prevention and Wellness • Local Prevention Efforts • Case Example: Influenza Vaccination New Models for Collecting Data 53 Background • Advantages of Electronic Health Records • Challenges to Effective Use of Electronic Health Records • International Classification of Diseases Codes Improving Interpersonal Communication 56 Narrative Medicine • Improving Documentation • Looking Ahead
- 9. Contents ix Summary 60 Key Terms 60 Quality Concepts in Action 61 References 61 Suggestions for Further Reading 62 Useful Websites 63 3 Making the Case for Change 65 What Is Involved in Change? 66 New Models of Care • Case Example: Advanced Illness Screening • Improving Quality Managing and Measuring Quality in the Reform Environment 69 Measuring Quality Performance • Measuring Care in the Community Who Is Involved in Change? 71 Leaders • Managers • Governance • Case Example: Developing a Quality Structure for Change • Administrators and Clinicians • Monitoring Quality • Quality Managers Changing Communication 77 Breaking Down Silos • Educating Patients • Case Example: Confronting Choices • Health Literacy • Communicating across Institutions and Organizations • Organizing Information • Communicating Information The Role of Data in Promoting Change 86 Tables of Measures • Quality Measures • Performance Improvement Summary 89 Key Terms 90 Quality Concepts in Action 90 References 91 Suggestion for Further Reading 92 Useful Websites 92 4 New Challenges for Health Care Professionals 93 Meeting Statistical Expectations for Standards of Care 94 The Evolution of Quality • Measures of Quality • Case Example: Heart Failure Readmission
- 10. x Contents Meeting Patient Expectations 97 HCAHPS • Case Example: Cleveland Clinic Role of Dashboards 100 Leadership Reports Role of Data Analysis 104 Case Example: Assessing High-Risk Pregnancy • Data for Performance Improvement Understanding Different Kinds of Data 105 Challenges with Health Information Technology • Different Data Sources and Clinical Research • Data and Quality Managing Care for Chronic Illness across the Continuum 109 The Medicare Chronic Conditions Dashboard • Quality Measures • Case Example: Readmission Managing Aggregated Patient Care Issues 112 Population-Based Measures • Case Example: Aspirin Administration • Microsystems/Macrosystems • Microsystems and Lean • Case Example: Total Joint Replacement Improving Communication 121 Teamwork • Case Example: Improving Cardiac Mortality Summary 127 Key Terms 127 Quality Concepts in Action 127 References 128 Suggestions for Further Reading 129 Useful Websites 130 5 Improving Patient Safety 133 Understanding Medical Errors and Adverse Events 134 Reporting Patient Safety Issues • Systems Errors • Institutionalizing Error Prevention • The Necessity of Culture Change High-Reliability Organizations 139 Guiding Principles • Becoming a High-Reliability Organization The Role of Quality Management in Promoting a Safety Culture 142 Using Quality Data to Promote Safety • Case Example: Monitoring Falls • Monitoring with Measures • Case Example: APACHE
- 11. Contents xi Prioritizing Improvements 147 Using Data to Define Priorities • Case Example: Understanding Suicide • Defining Priorities Locally • Case Example: Implementing Prioritization Expanding Data Sources: Partnerships to Develop Best Practice 154 Case Example: Collaborations to Promote Patient Safety Leading Organizational Improvements 155 Supporting Quality Data • Business Intelligence The Role of Nursing Leaders in Promoting Safety 158 Communication Strategies • Integrating New Responsibilities • Transformational Leadership • Case Example: Monitoring Patient Safety The Role of the Medical Staff in Promoting Safety 162 Providing Education to New Physicians • Case Example: Resident Education Program Promoting Safety through Effective Communication 165 Breaking Down Silos • Case Example: Reducing Length of Stay for Stroke Patients Summary 169 Key Terms 169 Quality Concepts in Action 169 References 170 Suggestions for Further Reading 170 Useful Websites 171 PART II: APPLYING QUALITY TOOLS AND TECHNIQUES 173 6 Working with Quality Tools and Methods 175 Identifying a Problem 176 Cause-and-Effect Diagram • Flowchart • Checklist • Run Chart • Histogram Describing Information 183 Mean • Median • Mode Variability 185 Range • Standard Deviation • Bell Curve Making Use of Data 188 Significance
- 12. xii Contents Using Quality Tools and Techniques to Improve Safety 189 Root Cause Analysis • Case Example: Sepsis Mortality • Failure Mode and Effects Analysis • Case Example: Blood Transfusion Clinical Pathways or Care Maps 195 Care Map Characteristics • Variance • Improving Efficiency • Case Example: Creating Guidelines Improving Performance: Plan-Do-Study-Act 201 Plan • Do • Study • Act • Case Example: Workplace Violence Summary 206 Key Terms 206 Quality Concepts in Action 206 Suggestions for Further Reading 207 Useful Websites 207 7 Working with Quality Data 209 Working with Measurements 210 Compliance • Case Example: Using Data to Change Practice • Performance Improvement • Case Example: Pressure Injury Performance Improvement Initiative Understanding Issues in Data Collection 214 Case Example: Standardizing Data • Moving from Manual to Electronic Records • Extracting Accurate Data from Electronic Health Records Using Data to Understand Appropriateness of Care 218 Case Example: Analyzing Mortality • Analyzing End-of-Life Care • Case Example: Understanding Mortality The Value of Aggregated Data in Performance Improvement 222 Case Example: Improving Transplant Mortality The Role of Data in Managing Chronic Disease 225 Understanding Readmission • Case Example: Heart Failure Readmissions Using Data to Monitor Variability 230 Control Chart • Variance Analysis Publicly Reported Data 234 Hospital Compare Interpreting and Making Use of Data 237 Administrative Concerns • Data Analytics in the Future Quality Management in the Future 239
- 13. Contents xiii Summary 240 Key Terms 241 Quality Concepts in Action 241 References 241 Suggestions for Further Reading 242 Useful Websites 242 8 Working with Quality and Safety Measures 245 Commitment to Quality 246 The Future of Quality Using Measures to Understand Care 247 For the Consumer • For the Administrator • For the Physician Defining the Measure 250 Define the Numerator and the Denominator • Measuring for Improvement Process Measures 253 Case Example: Medication Measures • Complying with Process Measures • Case Example: Mammography Rate • Understanding Variables • Making Compliance Meaningful • Case Example: Reducing Central Line Infections Pay for Performance 263 P4P Measures Patient Satisfaction Measures 264 Interpreting Patient Satisfaction Scores • Understand the Process • Refine the Process • Define Expectations Monitoring Measures 268 Dashboards in the Past • Dashboards Today • Performance Details Safety and Environment of Care Measures 273 Case Example: Monitoring Safety • Linking Environmental and Clinical Variables Summary 277 Key Terms 277 Quality Concepts in Action 277 References 278 Suggestions for Further Reading 279 Useful Websites 279
- 14. xiv Contents 9 Translating Information into Action 281 Maximizing Efficiency 282 Throughput • Bottlenecks • Theory of Constraints • Queueing Theory • Case Example: Managing Throughput Determining Appropriate Levels of Care 288 End-of-Life Care/Advanced Illness 289 The Reform Mandate Understanding Mortality 291 Financial Implications • Mortality Data Improving ICU Care 295 Case Example: Introducing APACHE Analyzing Readmission 298 Case Example: Readmission Using Data for Improvements 299 Case Example: Joint Replacement Surgery • Case Example: Bariatric Surgery Patient-Centered Care 303 SF-36 • Case Example: Quality of Life Delivering the Message 305 Data and Nursing Staff • Data and Medical Directors • Multidisciplinary Teams • Working with Measures Summary 308 Key Terms 308 Quality Concepts in Action 309 References 309 Suggestions for Further Reading 310 Useful Websites 311 10 Preparing for the Future 313 The New Quality Management 314 The New Role of Administrators The Business of Health Care 315 Improve the Product • Measures of Success • Transparency • Case Example: Improving a Hospital in Trouble
- 15. Visit https://ebookmass.com today to explore a vast collection of ebooks across various genres, available in popular formats like PDF, EPUB, and MOBI, fully compatible with all devices. Enjoy a seamless reading experience and effortlessly download high- quality materials in just a few simple steps. Plus, don’t miss out on exciting offers that let you access a wealth of knowledge at the best prices!
- 16. Contents xv Measurements Are the Nuts and Bolts of Quality 319 Know What the Data Mean • Make the Data Useful • Measures Reflect Values Getting Everyone on Board 322 Case Example: Improving Transplant Services • Changing Behavior • Case Example: Understanding Complex Processes Challenges for the Future 324 New Strategies • Break Down the Silos Summary 326 Key Terms 327 Quality Concepts in Action 327 Suggestions for Further Reading 327 Useful Websites 328 Index 329
- 18. LIST OF FIGURES AND TABLES Figures 1.1 Causes of Patient Mortality Pie Chart 6 1.2 Causes of Patient Mortality Histogram 6 1.3 Medication Error Rate Pareto Chart, January 2011–June 2011 12 1.4 Hospital Compare Webpage for Unplanned Readmissions 22 1.5 Hospital Compare for Waiting Times 23 1.6 Quality Indicator 31 2.1 Value-Based Performance at a Community Hospital 46 2.2 Value-Based Performance at a Tertiary Hospital 46 3.1 Screening Tool to Identify Advanced Illness 67 3.2 Dimensions of Care 83 3.3 Lines of Communication 84 3.4 JCPAC Communication 85 4.1 Inpatient Likelihood to Recommend 99 4.2 Quality and Safety Vector of Measures Dashboard 102 4.3 Hospital Comparison Dashboard 103 4.4 Raw Heart Failure Readmission Rate 112 4.5 Tactics and Team Responsibilities 118 4.6 Patient Friendly Care Map for Hip Replacement Surgery 119 4.7 Preoperative Continuum of Care 120 xvii
- 19. xviii List of Figures and Tables 4.8 Postoperative Continuum of Care 120 5.1 Falls with Injury 144 5.2 Analytics and Interpretation 145 5.3 Monthly Emergency Department Data 149 5.4 Raw Sepsis and Severe Sepsis/Septic Shock Mortality Rate, January 2008–September 2014 150 5.5 Discharge Follow-Up Information Heart Failure 152 5.6 Prioritization Matrix 153 5.7 Serum Lactate Order to Result within 90 Minutes for Severe Sepsis/Septic Shock in the Emergency Department 155 5.8 Integrating Data/Generating Reports 158 5.9 Patient Outcome Monitoring Tool 162 5.10 Communication across the Care Continuum 168 6.1 Falls Cause-and-Effect Diagram 178 6.2 Flowchart 179 6.3 Time-Out Checklist 180 6.4 Newborn Deliveries Run Chart 182 6.5 Waiting Time for Emergency Department Triage 182 6.6 Standard Deviation Formula 186 6.7 Blood Pressure Bell Curve 187 6.8 Comparing RCA and FMEA 193 6.9 Transfusion Flowchart 194 6.10 Hip Replacement Care Map 196 6.11 Variance Analysis: CAP Chart 198 6.12 Variance Analysis: CAP Outcome Bar Chart 198 6.13 Quality Improvement through Care Pathways 200 6.14 Improved Efficiency and Throughput 201 6.15 Clinical Guidelines Creation Methodology 202 6.16 PDSA Cycle 203 7.1 Hospital-Acquired Pressure Injury Index 213 7.2 Mortality Surveillance Tool Summary Report 219 7.3 Kidney Transplant Data Input 223 7.4 Wound Infection Rate 224 7.5 30-Day Observed Readmission Rate for Heart Failure Analysis 227 7.6 Heart Failure Readmissions by Age 227 7.7 Heart Failure Readmission Analysis: HF Discharges by Discharge Disposition 228 7.8 Know Your Heart Failure Zones 229 7.9 Control Chart of Clostridium difficile 233 7.10 Hospital Compare Benchmark Report: Inpatient Clinical Measures—Inpatient Surgical Infection Prevention 235 7.11 Timely Heart Attack Care 236 8.1 Hospital Medication Administration Process 254
- 20. List of Figures and Tables xix 8.2 Medication Error Measures 255 8.3 Executive Summary Medication Measures 256 8.4 Medication Safety Alert 257 8.5 Mammography Rate 260 8.6 Independent Variables 261 8.7 Non-ICU Central Line–Associated BSI Control Chart 263 8.8 Public Reporting Scores 269 8.9 Executive Summary 270 8.10 Risk-Adjusted Mortality Index 271 8.11 Non-ICU Central Line–Associated BSI Index 272 8.12 Non-ICU Central Line–Associated BSI Index Pivot View 273 8.13 Safety Services Quarterly Report 275 9.1 Throughput 284 9.2 Ambulatory Surgery Log Tracking 288 9.3 Advanced Illness 291 9.4 APACHE Reports 296 9.5 Bariatric Preoperative Checklist 302 9.6 SF-36 Physical and Mental Health Component Analysis by Time Point 304 10.1 Data Overload 320 Tables 3.1 Inpatient Quality Indicators 87 3.2 Table of Measures for Ambulatory Services 88 7.1 Kidney Transplant Table of Measures 224 9.1 Bariatric Table of Measures 303
- 22. PREFACE When I began to think about revising the outdated Quality Handbook for Health Care Organizations: A Manager’s Guide to Tools and Programs (Jossey-Bass, 2004), my goal was to introduce and explore the many changes that have made an impact on health care in the last decade. I quickly real- ized that I couldn’t simply revise the book for a second edition; too much had changed. An entirely new book introducing quality management was needed if I wanted it to be of value to health care professionals and students. This Introduction to Health Care Quality: Theory, Methods, and Tools seemed necessary. Even the change in titles is revealing. Quality is no longer the sole purview of managers. To the contrary, now everyone—clinicians, administrators, exec- utives, patients—involved in health care services needs to work within a qual- ity framework and be familiar with quality management processes. Students who hope to work in health care, whether in the clinical, administrative, or policy-making roles, need to know the fundamentals of quality management to succeed. Physicians, nurses, pharmacists, and public health policy makers all need to involve themselves in performance improvement activities and under- stand how to transform data into useful information in order to take action. Administrators and executives have to meet the goals of specific quality mea- sures set by government agencies in order to be reimbursed for the delivery of care and medical services. My books are designed to be of practical use to students and professionals and are based on my experience working in the field of quality management xxi
- 23. xxii Preface for decades and teaching fundamentals of quality all over the world. I have the good fortune of being part of a vast health care system that encompasses the entire spectrum of health care services—21 hospitals, the Feinstein Institute for Medical Research, the Krasnoff Quality Management Institute, the Cen- ter for Learning and Innovation, rehabilitation and skilled nursing facilities, a home care network, a hospice network, and progressive care centers—offering a range of outpatient services; ambulatory facilities; psychiatric care; long-term nursing care; and children’s organizations. Thus I have direct and immediate access to the issues that most concern administrators and executives, floor and unit managers, clinicians, policy makers, IT professionals, and others. Writing from personal experience gives me the opportunity to share practical issues of quality in action and relay the direct application of quality management theory, methods, and tools. I have always been a champion of quality and I like to think an advocate for patients’ rights and patient safety. I have worked diligently to ferret out gaps in care and potential gaps in safety to improve performance, and further communication and accountability across the hospital and the continuum of care. I followed this path because I believe in the tenets of quality management; I believe in the objectivity of data to make a case for good or poor care. I believe in numbers, in measurements, in tracking improvements and interventions over time using reliable and valid data. But it was not until I myself became a patient that my theoretical exper- tise quickly became of immediate and practical concern. As a patient, I found myself vulnerable to issues of safety and communication failures that I had writ- ten about and spoken about but had never directly experienced. Although I had always understood the importance of patient identification, for example, until I was receiving chemotherapy and the nurses made absolutely sure that I was getting the correct dose of the correct medications in the correct manner, and asked me multiple times to confirm my name, I didn’t realize how reas- suring it was to know that the procedures developed to ensure proper patient identification were in place and being followed. When I needed my MRI results to be transmitted to my oncologist in a timely fashion, I didn’t want any fail- ures of communication to take place. Ensuring quality care became deeply personal. And although I am probably better educated than most about dealing with health care data, I found that when I was confronted with three very different plans of care from three very highly regarded physicians, I needed to under- stand mortality rates and complications from treatment, numbers, variation, and evidence in a new way. How many patients with my particular very rare cancer had each doctor treated and with what outcome? I realized how valu- able my experience as a quality professional was. I knew what questions to ask. Quality care is, of course, a goal for organizations to strive for, but it is also for everyone. I realized that everyone—health care professionals, patients,
- 24. Preface xxiii and potential patients—should be quality managers. This book, then, is for everyone. New models of health care are so-called patient-centered, making patients central to the care plan and treatment process. Again, to me, this is no longer theory. It is in fact critical that patients understand what is happening to them, why they are having the treatment they are having, what the predicted out- comes will be, and what complications might occur. All these issues, basic to quality management, were now basic to me. All patients should indeed be treated holistically. We are not defined by our disease or our illness; we are people with psychosocial experiences and needs, some of us more capable than others or simply luckier than others in being able to take good care of ourselves. Everyone should be a quality manager. Everyone will have occasion to interact with a health care delivery system of one kind or another, either for themselves or for family and loved ones. Everyone needs to be schooled about quality, how to assess care, what to look for, what is expected, what should not be tolerated. Everyone should be an advocate for quality care. I hope this book will be useful to professionals and nonprofessionals alike.
- 26. Visit https://ebookmass.com today to explore a vast collection of ebooks across various genres, available in popular formats like PDF, EPUB, and MOBI, fully compatible with all devices. Enjoy a seamless reading experience and effortlessly download high- quality materials in just a few simple steps. Plus, don’t miss out on exciting offers that let you access a wealth of knowledge at the best prices!
- 27. Exploring the Variety of Random Documents with Different Content
- 31. The Project Gutenberg eBook of On the Philosophy of Discovery, Chapters Historical and Critical
- 32. This ebook is for the use of anyone anywhere in the United States and most other parts of the world at no cost and with almost no restrictions whatsoever. You may copy it, give it away or re-use it under the terms of the Project Gutenberg License included with this ebook or online at www.gutenberg.org. If you are not located in the United States, you will have to check the laws of the country where you are located before using this eBook. Title: On the Philosophy of Discovery, Chapters Historical and Critical Author: William Whewell Release date: March 25, 2016 [eBook #51555] Most recently updated: October 23, 2024 Language: English Credits: Produced by Sonya Schermann, Les Galloway and the Online Distributed Proofreading Team at http://www.pgdp.net (This file was produced from images generously made available by The Internet Archive) *** START OF THE PROJECT GUTENBERG EBOOK ON THE PHILOSOPHY OF DISCOVERY, CHAPTERS HISTORICAL AND CRITICAL ***
- 33. ON THE PHILOSOPHY OF DISCOVERY. Cambridge: PRINTED BY C. J. CLAY, M.A. AT THE UNIVERSITY PRESS. ON THE PHILOSOPHY OF DISCOVERY, CHAPTERS HISTORICAL AND CRITICAL; BY WILLIAM WHEWELL, D.D. MASTER OF TRINITY COLLEGE, CAMBRIDGE, AND CORRESPONDING MEMBER OF THE INSTITUTE OF FRANCE.
- 34. INCLUDING THE COMPLETION OF THE THIRD EDITION OF THE PHILOSOPHY OF THE INDUCTIVE SCIENCES. ΛΑΜΠΑΔΙΑ ΕΧΟΝΤΕΣ ΔΙΑΔΩΣΟΥΣΙΝ ΑΛΛΗΛΟΙΣ LONDON: JOHN W. PARKER AND SON, WEST STRAND. 1860. The following are the latest editions of the series of works which has been published connected with the present subject: History of the Inductive Sciences, 3 Vols. 1857. History of Scientific Ideas, 2 Vols. 1858. Novum Organon Renovatum, 1 Vol. 1858. On the Philosophy of Discovery, 1 Vol. 1860. To the History of the Inductive Sciences are appended two Indexes (in Vol. 1.), an Index of Proper Names, and an Index of Technical Terms. These Indexes, and the Tables of Contents of the other works, will enable the reader to refer to any person or event included in this series.
- 35. T PREFACE he two works which I entitled The History of the Inductive Sciences, and The Philosophy of the Inductive Sciences, were intended to present to the reader a view of the steps by which those portions of human knowledge which are held to be most certain and stable have been acquired, and of the philosophical principles which are involved in those steps. Each of these steps was a scientific Discovery, in which a new conception was applied in order to bind together observed facts. And though the conjunction of the observed facts was in each case an example of logical Induction, it was not the inductive process merely, but the novelty of the result in each case which gave its peculiar character to the History; and the Philosophy at which I aimed was not the Philosophy of Induction, but the Philosophy of Discovery. In the present edition I have described this as my object in my Title. A great part of the present volume consists of chapters which composed the twelfth Book of the Philosophy in former editions, which Book was then described as a 'Review of Opinions on the nature of Knowledge and the Method of seeking it.' I have added to this part several new chapters, on Plato, Aristotle, the Arabian Philosophers, Francis Bacon, Mr. Mill, Mr. Mansel, the late Sir William Hamilton, and the German philosophers Kant, Fichte, Schelling and Hegel. I might, if time had allowed, have added a new chapter on Roger Bacon, founded on his Opus Minus and other works, recently published for the first time under the direction of the Master of the Rolls; a valuable contribution to the history of philosophy. But the review of this work would not materially alter the estimate of Roger Bacon which I had derived from the Opus Majus. But besides these historical and critical surveys of the philosophy of others, I have ventured to introduce some new views of my own; namely, views which bear upon the philosophy of religion. I have
- 36. done so under the conviction that no philosophy of the universe can satisfy the minds of thoughtful men which does not deal with such questions as inevitably force themselves on our notice, respecting the Author and the Object of the universe; and also under the conviction that every philosophy of the universe which has any consistency must suggest answers, at least conjectural, to such questions. No Cosmos is complete from which the question of Deity is excluded; and all Cosmology has a side turned towards Theology. Though I am aware therefore how easy it is, on this subject, to give offence and to incur obloquy, I have not thought it right to abstain from following out my philosophical principles to their results in this department of speculation. The results do not differ materially from those at which many pious and thoughtful speculators have arrived in previous ages of the world; though they have here, as seems to me, something of novelty in their connection with the philosophy of science. But this point I willingly leave to the calm decision of competent judges. I have added in an Appendix various Essays, previously published at different times, which may serve perhaps to illustrate some points of the history and philosophy of science. Trinity Lodge, February 8, 1856. ON THE PHILOSOPHY OF DISCOVERY.
- 37. CONTENTS. The chapters marked thus * appear now for the first time. The chapters marked thus † have appeared in other works. Chap. I. Introduction. Chap. II. Plato. Chap. III. *Additional Remarks on Plato. 1.The Doctrine of Ideas. 2.The Doctrine of the One and Many. 3.The notion of the nature and aim of Science. 4.The Survey of existing Sciences. 5.The Constitution of the human Mind. Chap. IV. Aristotle. Chap. V. *Additional Remarks on Aristotle. 1.Induction. 2.Invention. 3.The One in the Many. 4.The "Five Words." 5.Aristotle's contribution to the Physical Sciences. 6.Aristotle's Astronomy. 7.Aristotle on Classification. 8.F. Bacon on Aristotle. 9.Discovery of Causes. 10.Plato and Aristotle. 11.Aristotle against Plato's Ideas. Chap. VI. The Later Greeks. Chap. VII. The Romans. Chap. VIII. *Arabian Philosophers. Chap. IX. The Schoolmen of the Middle Ages.
- 38. Chap. X. The Innovators of the Middle Ages. Raymond Lully. Chap. XI. The Innovators of the Middle Ages—continued. Roger Bacon. Chap. XII. The Revival of Platonism. 1.Causes of Delay in the Advance of Knowledge. 2.Causes of Progress. 3.Hermolaus Barbarus, &c. 4.Nicolaus Cusanus. 5.Manilius Ficinus. 6.Francis Patricius. 7.Picus, Agrippa, &c. 8.Paracelsus, Fludd, &c. Chap. XIII. The Theoretical Reformers of Science. 1.Bernardinus Telesius. 2.Thomas Campanella. 3.Andrew Cæsalpinus. 4.Giordano Bruno. 5.Peter Ramus. 6.The Reformers in General. 7.Melancthon. Chap. XIV. The Practical Reformers of Science. 1.Character of the Practical Reformers. 2.Leonardo da Vinci. 3.Copernicus. 4.Fabricius. 5.Maurolycus. 6.Benedetti. 7.Gilbert. 8.Galileo. 9.Kepler. 10.Tycho. Chap. XV. Francis Bacon.
- 39. 1.(I.) General Remarks. 2.Common estimate of him. 3.We consider only Physical Science. 4.He is placed at the head of the change: 5.(II.) He proclaims a New Era; 6.(III.) By a Change of Method; 7.Including successive Steps; 8.Gradually ascending. 9.(IV.) He contrasts the Old and the New Method. 10.(V.) Has he neglected Ideas? 11.No. 12.Examples of Ideas treated by him. 13.He has failed in applying his Method; 14.(VI.) To the Cause of Heat. 15.He seeks Causes before Laws. 16.(VII.) His Technical Form worthless. 17.He is confused by words. 18.His "Instances." 19.Contain some good Suggestions. 20.(VIII.) His "Idols." 21.(IX.) His view of Utility. 22.(X.) His Hopefulness. 23.(XI.) His Piety. Chap. XVI. *Additional Remarks on Francis Bacon. 1.Mr. Ellis's views. 2.Mr. Spedding's views. Chap. XVII. From Bacon to Newton. 1.Harvey. 2.Descartes. 3.Gassendi. 4.Actual Progress in Science. 5.Otto Guericke, &c. 6.Hooke.
- 40. 7.Royal Society. 8.Bacon's New Atalantis. 9.Cowley. 10.Barrow. Chap. XVIII. Newton. 1.Animating effect of his Discoveries. 2.They confirm Bacon's views. 3.Newton shuns Hypotheses. 4.His views of Inductive Philosophy. 5.His "Rules of Philosophizing." 6.The First Rule. 7.What is a "True Cause"? 8.Such as are real? 9.Or those which are proved? 10.Use of the Rule. 11.Rule otherwise expressed. 12.The Second Rule. 13.What are Events "of the same kind"? 14.The Third Rule: 15.Not safe. 16.The Fourth Rule. 17.Occult Qualities. 18.Ridiculed. 19.Distinction of Laws and Causes. Chap. XIX. Locke and his French Followers. 1.Cause of Locke's popularity. 2.Sensational School. 3.His inconsistencies. 4.Condillac, &c. 5.Importance of Language. 6.Ground of this. 7.The Encyclopedists. 8.Helvetius.
- 41. 9.Value of Arts. 10.Tendency to Reaction. Chap. XX. The Reaction against the Sensational School. 1."Nisi intellectus ipse." 2.Price's "Review." 3.Stewart defends Price. 4.Archbishop Whately. 5.Laromiguière. 6.M. Cousin. 7.M. Ampère. 8.His Classification of Sciences. 9.Kant's Reform of Philosophy. 10.Its Effect in Germany. Chap. XXI. Further Advance of the Sensational School. M. Auguste Comte. 1.M. Comte on three States of Science. 2.M. Comte rejects the Search of Causes. 3.Causes in Physics. 4.Causes in other Sciences. 5.M. Comte's Practical Philosophy. 6.M. Comte on Hypotheses. 7.M. Comte's Classification of Sciences. Chap. XXII. †Mr. Mill's Logic. (I.)What is Induction? §§ 1-14. (II.)Induction or Description, §§ 15-23. (III.)In Discovery a new Conception is introduced, §§ 24-37. (IV.)Mr. Mill's Four Methods of Inquiry, §§ 38-40. (V.)His Examples, §§ 41-48. (VI.)Mr. Mill against Hypotheses, §§ 49, 50. (VII.)Against prediction of Facts, §§ 51-53. (VIII.)Newton's Vera Causa, §§ 54, 55. (IX.)Successive Generalizations, §§ 56-62. (X.)Mr. Mill's Hope from Deductions, §§ 63-67.
- 42. (XI.)Fundamental opposition of our Doctrines, §§ 68-71. (XII.)Absurdities in Mr. Mill's Logic, §§ 72-74. Chap. XXIII. *Political Economy as an Inductive Science. 1.Moral Sciences. 2.Political Economy. 3.Wages, Profits, and Rents. 4.Premature Generalizations. 5.Correction of these by Induction—Rent. 6. " Wages. 7. " Population. Chap. XXIV. †Modern German Philosophy. (I.)Science is the Idealization of Facts, §§ 1-8. (II.)Successive German Philosophies. Kant, Fichte, Schelling, Hegel, §§ 9-16. Chap. XXV. †The Fundamental Antithesis as it exists in the Moral World. Moral Progress is the Realization of Ideas. Chap. XXVI. *Of the "Philosophy of the Infinite." God is Eternal. Chap. XXVII. *Sir William Hamilton on Inertia and Weight. 1.Primary and Secondary Qualities. 2.Meaning of the Distinction. 3.Sir W. Hamilton adds "Secundo-Primary." 4.Inertia. 5.Sir W. Hamilton's arguments and reply. 6.Gravity. Sir W. Hamilton's arguments and reply. Chap. XXVIII. †Influence of German Systems of Philosophy in Britain. 1.Stewart on Kant. 2.Mr. G. H. Lewes on Kant. 4—6.Mr. Mansel on Kant. His objection to our Fundamental Ideas, and Reply. 7—10.New Axioms are possible. 11—13.Mr. Mansel's Kantianism.
- 43. 14—16.Axioms are not from experience. Chap. XXIX. *Necessary Truth is Progressive. Objections considered. Chap. XXX. *The Theological Bearing of the Philosophy of Discovery. 1—4.How can necessary truths be actual? 5, 6.Small extent of necessary truth. 7.How did things come to be as they are? 8.View of the Theist. 9—12.Is this Platonism? 13.Idea of Time. 14, 15.Ideas of Force and Matter. 16.Creation of Matter. 17.Platonic Ideas. 18—21.Idea of Kind. 22.Idea of Substance. 23.Idea of Final Cause. 24, 25.Human immeasurably inferior to Divine. 26.Science advances towards the Divine Ideas. 27.Recapitulation. Chap. XXXI. *Man's Knowledge of God. 1, 2.Opinions. 3.From Nature we learn something of God. 4—6.Though but little. 7, 8.From ourselves we learn something concerning God. 9—11.Objections answered. 12.Creation. 13.End of the World. 14.Moral and Theological views enter. Chap. XXXII. *Analogies of Physical and Religious Philosophy. 1, 2.Idealization of Facts and Realization of Ideas; 3, 4.Both imperfect. 5, 6.Divine Ideas perfect. 7—9.Realization of Divine Love.
- 44. 10—13.Realization of Divine Justice. 14.Analogy of Physical and Moral Philosophy. 15, 16.Supernatural Beginning, Middle, and End indicated. 17.Suggestion of a Future State. 18—20.Confirmation from the Intellect of Man. 21.From the Moral Nature of Man. APPENDIX. PAGE Append. A.Of the Platonic Theory of Ideas 403 B.On Plato's Survey of the Sciences 417 BB.On Plato's Notion of Dialectic 429 C.Of the Intellectual Powers according to Plato 440 D.Criticism of Aristotle's Account of Induction 449 E.On the Fundamental Antithesis of Philosophy 462 F.Remarks on a Review of the Philosophy of the Inductive Sciences 482 G.On the Transformation of Hypotheses in the History of Science 492 H.On Hegel's Criticism of Newton's Principia 504 Appendix to the Memoir on Hegel's Criticism of Newton's Principia 513 K.Demonstration that all Matter is Heavy 522 ON THE PHILOSOPHY OF DISCOVERY.
- 45. Wär' nicht das Auge sonnenhaft Wie könnten wir das Licht erblicken? Lebt' nicht in uns des Gottes eigne Kraft Wie könnte uns das Göttliche entzücken? Goethe. Were nothing sunlike in the Eye How could we Light itself descry? Were nothing godlike in the Mind How could we God in Nature find?
- 46. B CHAPTER I. INTRODUCTION. y the examination of the elements of human thought in which I have been engaged, and by a consideration of the history of the most clear and certain parts of our knowledge, I have been led to doctrines respecting the progress of that exact and systematic knowledge which we call Science; and these doctrines I have endeavoured to lay before the reader in the History of the Sciences and of Scientific Ideas. The questions on which I have thus ventured to pronounce have had a strong interest for man from the earliest period of his intellectual progress, and have been the subjects of lively discussion and bold speculation in every age. I conceive that in the doctrines to which these researches have conducted us, we have a far better hope that we possess a body of permanent truths than the earlier essays on the same subjects could furnish. For we have not taken our examples of knowledge at hazard, as earlier speculators did, and were almost compelled to do; but have drawn our materials from the vast store of unquestioned truths which modern science offers to us: and we have formed our judgment concerning the nature and progress of knowledge by considering what such science is, and how it has reached its present condition. But though we have thus pursued our speculations concerning knowledge with advantages which earlier writers did not possess, it is still both interesting and instructive for us to regard the opinions upon this subject which have been delivered by the philosophers of past times. It is especially interesting to see some of the truths which we have endeavoured to expound, gradually dawning in men's minds, and assuming the clear and permanent form in which we can now contemplate them. I shall therefore, in the ensuing chapters, pass in review many of the opinions of the writers of various ages concerning the mode by which man best acquires the truest knowledge; and I shall endeavour, as we proceed, to appreciate the
- 47. real value of such judgments, and their place in the progress of sound philosophy. In this estimate of the opinions of others, I shall be guided by those general doctrines which I have, as I trust, established in the histories already published. And without attempting here to give any summary of these doctrines, I may remark that there are two main principles by which speculations on such subjects in all ages are connected and related to each other; namely, the opposition of Ideas and Sensations, and the distinction of practical and speculative knowledge. The opposition of Ideas and Sensations is exhibited to us in the antithesis of Theory and Fact, which are necessarily considered as distinct and of opposite natures, and yet necessarily identical, and constituting Science by their identity. In like manner, although practical knowledge is in substance identical with speculative, (for all knowledge is speculation,) there is a distinction between the two in their history, and in the subjects by which they are exemplified, which distinction is quite essential in judging of the philosophical views of the ancients. The alternatives of identity and diversity, in these two antitheses,—the successive separation, opposition, and reunion of principles which thus arise,—have produced, (as they may easily be imagined capable of doing,) a long and varied series of systems concerning the nature of knowledge; among which we shall have to guide our course by the aid of the views already presented. I am far from undertaking, or wishing, to review the whole series of opinions which thus come under our notice; and I do not even attempt to examine all the principal authors who have written on such subjects. I merely wish to select some of the most considerable forms which, such opinions have assumed, and to point out in some measure the progress of truth from age to age. In doing this, I can only endeavour to seize some of the most prominent features of each time and of each step, and I must pass rapidly from classical antiquity to those which we have called the dark ages, and from them to modern times. At each of these periods the modifications of
- 48. opinion, and the speculations with which they were connected, formed a vast and tangled maze, the byways of which our plan does not allow us to enter. We shall esteem ourselves but too fortunate, if we can discover the single track by which ancient led to modern philosophy. I must also repeat that my survey of philosophical writers is here confined to this one point,—their opinions on the nature of knowledge and the method of science. I with some effort avoid entering upon other parts of the philosophy of those authors of whom I speak; I knowingly pass by those portions of their speculations which are in many cases the most interesting and celebrated;—their opinions concerning the human soul, the Divine Governor of the world, the foundations or leading doctrines of politics, religion, and general philosophy. I am desirous that my reader should bear this in mind, since he must otherwise be offended with the scanty and partial view which I give in this place of the philosophers whom I enumerate.
- 51. T CHAPTER II. Plato. here would be small advantage in beginning our examination earlier than the period of the Socratic School at Athens; for although the spirit of inquiry on such subjects had awakened in Greece at an earlier period, and although the peculiar aptitude of the Grecian mind for such researches had shown itself repeatedly in subtle distinctions and acute reasonings, all the positive results of these early efforts were contained in a more definite form in the reasonings of the Platonic age. Before that time, the Greeks did not possess plain and familiar examples of exact knowledge, such as the truths of Arithmetic, Geometry, Astronomy and Optics became in the school of Plato; nor were the antitheses of which we spoke above, so distinctly and fully unfolded as we find them in Plato's works. The question which hinges upon one of these antitheses, occupies a prominent place in several of the Platonic dialogues; namely, whether our knowledge be obtained by means of Sensation or of Ideas. One of the doctrines which Plato most earnestly inculcated upon his countrymen was, that we do not know concerning sensible objects, but concerning ideas. The first attempts of the Greeks at metaphysical analysis had given rise to a school which maintained that material objects are the only realities. In opposition to this, arose another school, which taught that material objects have no permanent reality, but are ever waxing and waning, constantly changing their substance. "And hence," as Aristotle says1, "arose the doctrine of ideas which the Platonists held. For they assented to the opinion of Heraclitus, that all sensible objects are in a constant state of flux. So that if there is to be any knowledge and science, it must be concerning some permanent natures, different from the sensible natures of objects; for there can be no permanent science respecting that which is perpetually changing. It happened that
- 52. Socrates turned his speculations to the moral virtues, and was the first philosopher who endeavoured to give universal definitions of such matters. He wished to reason systematically, and therefore he tried to establish definitions, for definitions are the basis of systematic reasoning. There are two things which may justly be looked upon as steps in philosophy due to Socrates; inductive reasonings, and universal definitions;—both of them steps which belong to the foundations of science. Socrates, however, did not make universals, or definitions separable from the objects; but his followers separated them, and these essences they termed Ideas." And the same account is given by other writers[2]. "Some existences are sensible, some intelligible: and according to Plato, if we wish to understand the principles of things, we must first separate the ideas from the things, such as the ideas of Similarity, Unity, Number, Magnitude, Position, Motion: second, that we must assume an absolute Fair, Good, Just, and the like: third, that we must consider the ideas of relation, as Knowledge, Power: recollecting that the Things which we perceive have this or that appellation applied to them because they partake of this or that Idea; those things being just which participate in the idea of The Just, those being beautiful, which contain the idea of The Beautiful." And many of the arguments by which this doctrine was maintained are to be found in the Platonic dialogues. Thus the opinion that true knowledge consists in sensation, which had been asserted by Protagoras and others, is refuted in the Theætetus: and, we may add, so victoriously refuted, that the arguments there put forth have ever since exercised a strong influence upon the speculative world. It may be remarked that in the minds of Plato and of those who have since pursued the same paths of speculation, the interest of such discussions as those we are now referring to, was by no means limited to their bearing upon mere theory; but was closely connected with those great questions of morals which have always a practical import. Those who asserted that the only foundation of knowledge was sensation, asserted also that the only foundation of virtue was the desire of pleasure. And in Plato, the metaphysical part of the
- 53. disquisitions concerning knowledge in general, though independent in its principles, always seems to be subordinate in its purpose to the questions concerning the knowledge of our duty. Since Plato thus looked upon the Ideas which were involved in each department of knowledge as forming its only essential part, it was natural that he should look upon the study of Ideas as the true mode of pursuing knowledge. This he himself describes in the Philebus[3]. "The best way of arriving at truth is not very difficult to point out, but most hard to pursue. All the arts which have ever been discovered, were revealed in this manner. It is a gift of the gods to man, which, as I conceive, they sent down by some Prometheus, as by Prometheus they gave us the light of fire; and the ancients, more clear-sighted than we, and less removed from the gods, handed down this traditionary doctrine: that whatever is said to be, comes of One and of Many, and comprehends in itself the Finite and the Infinite in coalition (being One Kind, and consisting of Infinite Individuals). And this being the state of things, we must, in each case, endeavour to seize the One Idea (the idea of the Kind) as the chief point; for we shall find that it is there. And when we have seized this one thing, we may then consider how it comprehends in itself two, or three, or any other number; and, again, examine each of these ramifications separately; till at last we perceive, not only that One is at the same time One and Many, but also how many. And when we have thus filled up the interval between the Infinite and the One, we may consider that we have done with each one. The gods then, as I have said, taught us by tradition thus to contemplate, and to learn, and to teach one another. But the philosophers of the present day seize upon the One, at hazard, too soon or too late, and then immediately snatch at the Infinite; but the intermediate steps escape them, in which resides the distinction between a truly logical and a mere disputatious discussion." It would seem that what the author here describes as the most perfect form of exposition, is that which refers each object to its place in a classification containing a complete series of
- 54. subordinations, and which gives a definition of each class. We have repeatedly remarked that, in sciences of classification, each new definition which gives a tenable and distinct separation of classes is an important advance in our knowledge; but that such definitions are rather the last than the first step in each advance. In the progress of real knowledge, these definitions are always the results of a laborious study of individual cases, and are never arrived at by a pure effort of thought, which is what Plato appears to have imagined as the true mode of philosophizing. And still less do the advances of other sciences consist in seizing at once upon the highest generality, and filling in afterwards all the intermediate steps between that and the special instances. On the contrary, as we have seen, the ascents from particular to general are all successive; and each step of this ascent requires time, and labour, and a patient examination of actual facts and objects. It would, of course, be absurd to blame Plato for having inadequate views of the nature of progressive knowledge, at the time when knowledge could hardly be said to have begun its progress. But we already find in his speculations, as appears in the passages just quoted from his writings, several points brought into view which will require our continued attention as we proceed. In overlooking the necessity of a gradual and successive advance from the less general to the more general truths, Plato shared in a dimness of vision[4] which prevailed among philosophers to the time of Francis Bacon. In thinking too slightly of the study of actual nature, he manifested a bias from which the human intellect freed itself in the vigorous struggles which terminated the dark ages. In pointing out that all knowledge implies a unity of what we observe as manifold, which unity is given by the mind, Plato taught a lesson which has of late been too obscurely acknowledged, the recoil by which men repaired their long neglect of facts having carried them for a while so far as to think that facts were the whole of our knowledge. And in analysing this principle of Unity, by which we thus connect sensible things, into various Ideas, such as Number, Magnitude, Position, Motion, he made a highly important step, which it has been the
- 55. business of philosophers in succeeding times to complete and to follow out. But the efficacy of Plato's speculations in their bearing upon physical science, and upon theory in general, was much weakened by the confusion of practical with theoretical knowledge, which arose from the ethical propensities of the Socratic school. In the Platonic Dialogues, Art and Science are constantly spoken of indiscriminately. The skill possessed by the Painter, the Architect, the Shoemaker, is considered as a just example of human science, no less than the knowledge which the geometer or the astronomer possesses of the theoretical truths with which he is conversant. Not only so; but traditionary and mythological tales, mystical imaginations and fantastical etymologies, are mixed up, as no less choice ingredients, with the most acute logical analyses, and the most exact conduct of metaphysical controversies. There is no distinction made between the knowledge possessed by the theoretical psychologist and the physician, the philosophical teacher of morals and the legislator or the administrator of law. This, indeed, is the less to be wondered at, since even in our own time the same confusion is very commonly made by persons not otherwise ignorant or uncultured. On the other hand, we may remark finally, that Plato's admiration of Ideas was not a barren imagination, even so far as regarded physical science. For, as we have seen[5], he had a very important share in the introduction of the theory of epicycles, having been the first to propose to astronomers in a distinct form, the problem of which that theory was the solution; namely, "to explain the celestial phenomena by the combination of equable circular motions." This demand of an ideal hypothesis which should exactly express the phenomena (as well as they could then be observed), and from which, by the interposition of suitable steps, all special cases might be deduced, falls in well with those views respecting the proper mode of seeking knowledge which we have quoted from the Philebus. And the Idea which could thus represent and replace all the particular Facts, being not only sought but found, we may readily suppose that the
- 56. philosopher was, by this event, strongly confirmed in his persuasion that such an Idea was indeed what the inquirer ought to seek. In this conviction all his genuine followers up to modern times have participated; and thus, though they have avoided the error of those who hold that facts alone are valuable as the elements of our knowledge, they have frequently run into the opposite error of too much despising and neglecting facts, and of thinking that the business of the inquirer after truth was only a profound and constant contemplation of the conceptions of his own mind. But of this hereafter.
- 57. T CHAPTER III. Additional Remarks on Plato. he leading points in Plato's writings which bear upon the philosophy of discovery are these: 1. The Doctrine of Ideas. 2. The Doctrine of the One and the Many. 3. The notion of the nature and aim of Science. 4. The survey of existing Sciences. 1. The Doctrine of Ideas is an attempt to solve a problem which in all ages forces itself upon the notice of thoughtful men; namely, How can certain and permanent knowledge be possible for man, since all his knowledge must be derived from transient and fluctuating sensations? And the answer given by this doctrine is, that certain and permanent knowledge is not derived from Sensations, but from Ideas. There are in the mind certain elements of knowledge which are not derived from sensation, and are only imperfectly exemplified in sensible objects; and when we reason concerning sensible things so as to obtain real knowledge, we do so by considering such things as partaking of the qualities of the Ideas concerning which there can be truth. The sciences of Geometry and Arithmetic show that there are truths which man can know; and the Doctrine of Ideas explains how this is possible. So far the Doctrine of Ideas answers its primary purpose, and is a reply (by no means the least intelligible and satisfactory reply) to a question still agitated among philosophers: What is the ground of geometrical (and other necessary) truth? But Plato seems, in many of his writings, to extend this doctrine much further; and to assume, not only Ideas of Space and its properties, from which geometrical truths are derived; but of
- 58. Relations, as the Relations of Like and Unlike, Greater and Less; and of mere material objects, as Tables and Chairs. Now to assume Ideas of such things as these solves no difficulty and is supported by no argument. In this respect the Ideal theory is of no value in Science. It is curious that we have a very acute refutation of the Ideal theory in this sense, not only in Aristotle, the open opponent of Plato on this subject, but in the Platonic writings themselves: namely, in the Dialogue entitled Parmenides; which, on this and on other accounts, I consider to be the work not of Plato, but of an opponent of Plato[6]. 2. I have spoken, in the preceding chapter, of Plato's doctrine that truth is to be obtained by discerning the One in the Many. This expression is used, it would seem, in a somewhat large and fluctuating way, to mean several things; as for instance, finding the one kind in many individuals (for instance, the one idea of dog in many dogs); or the one law in many phenomena (for instance, the eccentrics and epicycles in many planets). In any interpretation, it is too loose and indefinite a rule to be of much value in the formation of sciences, though it has been recently again propounded as important in modern times. 3. I have said, in the preceding chapter, that Plato, though he saw that scientific truths of great generality might be obtained and were to be arrived at by philosophers, overlooked the necessity of a gradual and successive advance from the less general to the more general; and I have described this as a 'dimness of vision.' I must now acknowledge that this is not a very appropriate phrase; for not only no acuteness of vision could have enabled Plato to see that gradual generalization in science of which, as yet, no example had appeared; but it was very fortunate for the progress of truth, at that time, that Plato had imagined to himself the object of science to be general and sublime truths which prove themselves to be true by the light of their own generality and symmetry. It is worth while to illustrate this notice of Plato by some references to his writings.
- 59. In the Sixth Book of the Republic, Plato treats of the then existing sciences as the instruments of a philosophical education. Among the most conspicuous of these is astronomy. He there ridicules the notion that astronomy is a sublime science because it makes men look upward. He asserts that the really sublime science is that which makes men look at the realities, which are suggested by the appearances seen in the heavens: namely, the spheres which revolve and carry the luminaries in their revolutions. Now it was no doubt the determined search for such "realities" as these which gave birth to the Greek Astronomy, that first and critical step in the progress of science. Plato, by his exhortations, if not by his suggestions, contributed effectually, as I conceive, to this step in science. In the same manner he requires a science of Harmonics which shall be free from the defects and inaccuracies which occur in actual instruments. This belief that the universe was full of mathematical relations, and that these were the true objects of scientific research, gave a vigour, largeness of mind, and confidence to the Greek speculators which no more cautious view of the problem of scientific discovery could have supplied. It was well that this advanced guard in the army of discoverers was filled with indomitable courage, boundless hopes, and creative minds. But we must not forget that this disposition to what Bacon calls anticipation was full of danger as well as of hope. It led Plato into error, as it led Kepler afterwards, and many others in all ages of scientific activity. It led Plato into error, for instance, when it led him to assert (in the Timæus) that the four elements, Earth, Air, Fire and Water, have, for the forms of their particles respectively, the Cube, the Icosahedron, the Pyramid, and the Octahedron; and again, when it led him to despise the practical controversies of the musicians of his time; which controversies were, in fact, the proof of the truth of the mathematical theory of Harmonics. And in like manner it led Kepler into error when it led him to believe that he had found the reason of the number, size and motion of the planetary orbits in the application of the five regular solids to the frame of the universe[7].
- 60. Welcome to our website – the perfect destination for book lovers and knowledge seekers. We believe that every book holds a new world, offering opportunities for learning, discovery, and personal growth. That’s why we are dedicated to bringing you a diverse collection of books, ranging from classic literature and specialized publications to self-development guides and children's books. More than just a book-buying platform, we strive to be a bridge connecting you with timeless cultural and intellectual values. With an elegant, user-friendly interface and a smart search system, you can quickly find the books that best suit your interests. Additionally, our special promotions and home delivery services help you save time and fully enjoy the joy of reading. Join us on a journey of knowledge exploration, passion nurturing, and personal growth every day! ebookmasss.com