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Chemical control of respiration in chronic respiratory failure

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FlenleyDC_1967redux.pdf (28.89Mb)
Date
1967
Author
Flenley, David. C.
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Abstract
 
 
As with most prefaces, this is written after the main work, but it is still intended to be read first. It should serve two purposes, which I hope can be combined without conflict, the first to act in the manner of a Shakespearean chorus, setting the scene for the main play, and the second to allow the author to present a purely personal view of the motives underlying this work.
 
Science has a multiplicity of definitions but the conventional Concise Oxford Dictionary one of "systematic and formulated knowledge's will suffice as a start. Karl Pearson, in his book "The Grammar of Science" extends his definition to embrace the scientific method. He states "the classification of facts, the recognition of their sequence and relative significance is the function of science ". He deprecates the idea that science is merely a compendium of useful knowledge, and elevates the scientific frame of mind (by which he means the forming of judgments based upon facts, unbiased by personal feeling) as being sufficiently justified in itself. This seems to me to be an essentially moral argument, for the practice of logical thinking, which is my interpretation of Pearson's "scientific frame of mind ", appears to invoke no necessity for justification by results. This would not imply that all such results of logical thought are necessarily good, in a moral sense, but I would submit that intellectual freedom, both to reason and to dream, is in itself morally desirable.
 
For most people, however, dreams and reasons must start from a present reality, and in this case the reality has been a complex problem in a disturbance of a physiological control mechanism. How does carbon dioxide fail to stimulate the breathing in patients with severe chronic bronchitis?
 
For the application of Pearson's definition it is apparent that the facts which are to be classified must first be ascertained. What are facts ? I have no full answer, for any definition must involve truth, and real knowledge of truth eludes me. However, I can substitute for this unattainable objective of truth, by using what I believe is an honest assessment of scientific method. I may never really know anything, but if I make an honest observation, and consider to the best of my ability the possibilities of error in my observation, in my submission, I have made a contribution whose value will depend upon my abilities. My interpretation of this observation, or in Pearson's terms, my classification of my "fact" and its placement in sequence and recognition of its significance, will always be open to question, but the care with which the observation was made must indicate its proximity to infallibility. In this sense, therefore, I can merely state my complete agreement with Gray "to those physiologists whose imperishable observations provoke my perishable interpretations".
 
It would follow, therefore, that in my view the accuracy of the observation or the "fact ", is of paramount importance. Nonetheless, observations without thought for their use, or interpretation, are unlikely to provoke a spirit of enquiry to seek new observations. A science which seeks to establish facts alone would, in my view, be sterile.
 
In the present study the difficulties of the problem impose their own discipline. To investigate a control system, it is desirable to study the responses of the system to known variations in a stimulus. To know about something properly, there is no substitute for measurement, to paraphrase Lord Kelvin. In this problem, therefore, measurements of both response and stimulus, and then attempts to relate these in some mathematical form are made. However, the basic problem lies in the possibility of error in these primary physical measurements of both stimulus and response. Furthermore, the accuracy with which we can measure these values, at least in the case of the stimulus, is of the same order as that which provokes a response in the stimulated system.
 
The manner in which I have attempted to face these problems will be shown in the following pages. I am conscious of many defects in the methods I have used, and my conclusions are drawn with a full knowledge that they are only justifiable in so far as they take account of their foundations in these possibly perishable observations.
 
URI
http://hdl.handle.net/1842/32184
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