1

• The great difficulty is in trying to imagine
  something that you have never seen,
• that is consistent in every detail with what you
  have seen,
• and that is different from what has been thought
  of
• furthermore it must be definite and not a vague
  proposition. Feynman page 23

2
Thinking About Health Disease The Power of
Epidemiology

• Example causes of disease
• Florence Nightingale a pushy rich dame who could
  count and knew the power of metaphor and men
• John Snow an anesthesiologist who could imagine
  what he could not see and who could put pins in a
  map

3
Florence Nightingale

• Used a powerful metaphor to inspire people to do
  the right thing for the wrong reason
• Metaphor disease as response to lack of harmony,
  organization, and cleanliness
• Common terms of early 19th century miasma,
  contagion, fermentation
• Lack of doubt -- would have meant no role for the
  nurse

4
Definition of Disease

• ... the thing which strikes the experienced
  observer most forcibly... the symptoms or the
  sufferings generally considered to be inevitable
  and incident to the disease are not symptoms of
  the disease at all, ...
• of the want of fresh air, or of light, or of
  warmth, or of quiet, or of cleanliness, or of
  punctuality and care...

5
What is Infection

• I was brought up, both by scientific men and
  ignorant women... to believe that small-pox was a
  thing of which there was once a first specimen in
  the world which when on propagating itself...just
  as there was a first dog (or a first pair of
  dogs)
• With a little overcrowding, continued fever grow
  up, a little more typhoid fever.. typhus

6
19th Century Reasoning Revolution

• Formalistic philosophical assumptions
• Abstract reasoning
• Belief in miasma, damp, filth, lack of moral
  purity, or harmony as general causes of all
  disease

• Statistics
• Disciplined observations
• Belief in specific environmental causes for
  specific diseases
• Cause could reproduce indefinitely -- has to be
  living thing

7
John Snow Broad Street Pump (1864)

• Observed both changes in human body with
  Cholera and changes across person, place, and
  time in cases of Cholera
• Epidemiological reasoning clusters of cases
  around one pump, but also most cases got water
  from Southwark Vauxhall
• Imagined an explanation

8
Signs of Cholera

• diarrhea, vomiting, and muscle cramps possible
  coma and death
• 19th century scientists found increased amount of
  serum to solids and more acidity (gave unsterile
  saline injections)
• Snow observed intestine and saw changes that
  convinced him gut was source, not blood

9
Geographical Variation of Cases

• Map of London to show where two major water
  companies were located
• Snow walked around London and marked where cases
  occurred on a map
• Asked each household where they got their water
• Predecessor of the Odds Ratio

10
Odds of Getting Cholera

• Lambeth served 26,000 houses 14 died
• Southwark Vauxhall served 40,000 houses 286
  died
• 14/26000.000538
• 286/40000.00715
• Odds ratio .00715/.00053813.3

11
Scientific Progress

• Koch discovered the Cholera Vibrio in 1883
• We have antibiotics and a vaccine
• We also have epidemics of Cholera that have swept
  accross most of Latin America infecting over
  1,000,000 and killing 10,000
• Does the Cholera Vibrio kill?
• How can we interrupt transmission?

12
Transmission Mechanisms

• Waterborne
• municipal water
• putting hand in water vessel
• Food borne
• street vendors foods beverages ices
• leftover rice
• fruits/vegetables
• Seafood -- uncooked and cooked

13
another quote

• You have to permit the possibility that you do
  not have it exactly right.
• If you have made up your mind already, you might
  not solve it. Feynman page 27

14
Feynman ch2
15
Religion the way people believe about their
religious beliefs
16
Most (natural) scientists do not believe in God

• they were taught?
• No
• they know it all?
• No
• they do not understand science correctly?

17
Belief in science and religion is consistent, but
difficult

• It is valuable and necessary to doubt in science
• Conflict between partial facts of science and
  beliefs
• Science does not impact on moral conduct and
  ethical views

18
Religion is

• Metaphysical
• what things are
• where they came from
• what man is
• what God is
• properties of God

• Ethical how to behave
• Inspirational motivates to act well, and
  inspire arts
• science sometimes conflicts with 1 and 2 (should
  not 2?)

19
Moral values (ethics) lie outside the realm of
science

• conflicts (earth as center of universe) led to
  change in metaphysics, but no change in ethics
• Some practice Christian ethics without being
  Christian
• No external scientific evidence that the Golden
  Rule is good
• "Should I" has two parts
• scientific what will happen? (positive)
• ethical do I want that outcome? (normative)

20
illustrations the importance of individuals vs
the importance of the group(s)

• the Golden rule individuals suffer voluntarily
• uberimae fideii
• public education
• First, do no harm
• innovation in pharmaceuticals
• genetic research

21
illustrations continued

• Star Trek The needs of the many vs, the needs
  of the few.
• welfare/redistribution
• salary caps
• life insurance premia
• smoking
• sex
• race
• religion
• discriminate on basis of things under your control

22
illustrations continued

• Pareto improvement Everyone at least as well
  off, and one party better
• the notion of externalities safety, pollution
• theory of comparative advantage

• Max production if all resources allocated to one
  good
• in Elverum, 1C .5T
• in Mordor, 1C 2 T
• these ratios are from a production frontier, not
  shown

23

• Let Elverum produce more computers
• 4 computers, 3 trucks
• Let Mordor produce trucks
• 4 trucks, 0 computer
• Let Morder send 1 truck for 1 computer
• M has 3 trucks, 1 C
• E has 4 trucks, 3 Cs

24
What happened?

• Because the relative costs of production were
  different, total (world) production rose through
  specialization and trade
• more computers, and more trucks
• Called the theory of comparative advantage.

25
illustrations continued

• Jesus improvement Everyone better off, but one
  incredibly worse off
• break up IBM
• break up ATT
• Microsoft???
• deregulation?

26
Virtue as a basis for ethics

• Honor
• honesty
• integrity
• temperance
• fidelity
• humility
• patience

• Persistence
• modesty
• reliability
• Loyalty
• Recall Smith
• Prudence
• Benevolence
• Justice
• Self-command

27
Value The role of government

• Laissez Faire
• Smith and the invisible hand
• Fiscal policy
• John Maynard Keynes
• Monetary Policy
• Milton Friedman

28
Western Civilization is built on two heritages

• humility of the intellect "scientific spirit of
  adventure
• humility of the spirit Christian ethics

29
Russia v. US

• Suppression of ideas v. free ideas,