Heuristic Reevaluation of the Bacterial Hypothesis of Peptic Ulcer Disease in the 1950s

Abstract

Throughout the first half of the twentieth century the research on peptic ulcer disease (PUD) focused on two rivaling hypothesis: the "acidity" and the "bacterial" one. According to the received view, the latter was dismissed during the 1950s only to be revived with Warren's and Marshall's discovery of Helicobacter pylori in the 1980s. In this paper we investigate why the bacterial hypothesis was largely abandoned in the 1950s, and whether there were good epistemic reasons for its dismissal. Of special interest for our research question is Palmer's 1954 large-scale study, which challenged the bacterial hypothesis with serious counter-evidence, and which by many scholars is considered as the shifting point in the research on PUD. However, we show that: (1) The perceived refutatory impact of Palmer's study was disproportionate to its methodological rigor. This undermines its perceived status as a crucial experiment against the bacterial hypothesis. (2) In view of this and other considerations we argue that the bacterial hypothesis was worthy of pursuit in the 1950s.

What Is the Epistemic Function of Highly Idealized Agent-Based Models of Scientific Inquiry?

“…Since the distribution of agents at the beginning of the run is random, it could happen that there are no agents on one of the theories. In the case of PUD research, however, we know that there were scientists pursuing both theories from the second half of the nineteenth century onward (Šešelja and Straßer 2014).…”

“… 3 The study, conducted by the famous gastroenterologist Palmer, was based on a methodological error (see Šešelja and Straßer 2014). …”

Rethinking the history of peptic ulcer disease and its relevance for network epistemology

“…After all, warnings about the unsuitability of the method of staining used in Palmer's study had previously been pointed out by Freedberg and Barron (1940), whom Palmer even cited in his paper. This is all the more surprising if we agree with Šešelja and Straßer (2014) that the bacterial research program (in spite of Palmer's findings) had promising lines of inquiry in the 1950s, when it was largely abandoned. What is more, the alleged impact of Palmer's study has never been corroborated by adequate historical evidence.…”

“…The authors of the last two publications are medical practitioners and were included to represent two different interpretations of factors leading to the abandonment of the 'germ theory'. Moreover, we have included a more recent case study on this topic, written in the field of integrated history and philosophy of science (Šešelja and Straßer, 2014).…”

“…The early 20th century research on peptic ulcer disease (PUD) is often mentioned as an example of scientific inquiry 'gone wrong' (e.g. Thagard, 2000;Gilbert, 2000;Solomon, 2001;Zollman, 2010;Wray, 2010;Miller, 2013;Šešelja & Straßer, 2014;O'Connor, 2020). As most accounts of this case report, from the 19th century on there were two major rivaling hypotheses of the disease: the acidity hypothesis, according to which the disease is caused by an excessive acidity of the stomach, and the bacterial hypothesis, which stipulated bacteria as the primary cause of the disease.…”