Endocrinology as Paradigm, Endocrinology as Authority

What I would like to talk about with you tonight is endocrinology as paradigm, and endocrinology as authority. What is the process by which the ideas in a science such as endocrinology change with time, and how best can new ideas develop? How do ideas in science influence society, aside from the obvious effect of technology? Two things inspired me to speak to you on this subject. The first is the influence which Thomas Kuhn's extraordinary book on "Structure of Scientific Revolutions" had on me when I first read it 20 years ago. I believe it provides a framework within which we may view our own field with profit. The second is that in casting about for a subject to talk on tonight, I uncovered my programs of previous Endocrine Society meetings I have attended and apparently, for some reason, not discarded. I came up with the very first meeting I attended, just after graduate school; the 37th meeting of the Society. In going back over the program of that meeting, it was clear that it was simply not possible to predict, in 1955, what would be the state of our science today, although, of course, in retrospect one can see how we came from 1955 to now. The book by Kuhn, which first appeared in 1962, was a very influential interpretation of the nature of science. A scientific paradigm, according to Kuhn, is a coherent, universally recognized scientific explanation, or theory, of a hitherto unresolved set of data. Once a paradigm becomes compelling enough to achieve acceptance, because it appears to explain so much, Kuhn says that a scientific revolution has taken place. He calls "normal Science" that process of science which investigates the world, fleshing out the paradigm with new questions, theories and methodologies, all adding to belief in the paradigm. The phase of normal science may take place for many years. Then, as more observations are made, dissonances begin to occur between observations and paradigm. If these dissonances become large enough they may lead to the next revolution. The uniqueness of science lies in the fact that its practitioners work daily within a well defined discipline, hoping some day to make an observation in which the expected does not occur, and something goes so wrong that there is an indication that the paradigm itself is at fault. Jonathan Schell, in his 1982 book, "The Fate of the Earth" (2), captured better than anything else I have ever read the specific and idiosyncratic nature of scientific knowledge. "Revolutions born in the laboratory are to be sharply distinguished from revolutions born in society . . . scientific revolutions (show) universality . . . and permanence once they have occurred . . . The human experiences that art deals with are, once over, lost forever, like the people who undergo them, whereas matter, energy, space and time alike everywhere and in all ages, are always open for fresh inspection . . . The rigorous exactitude of scientific methods does not mean that creativity is any less individual, intuitive or mysterious in great scientists than in great artists, but it does mean that scientific findings, once arrived at, can be tested and confirmed by shared canons of logic and experimentation. The agreement among scientists thus achieved permits science to be a collective enterprise, in which each generation, building on the accepted findings of the generation before, makes amendments and additions, which in their turn become the starting point for the next generation." These two viewpoints, one by Kuhn and one by Schell, explain the powerfulness of science, which results from the collectivity and continuity of a universal process. We are here together tonight because of an extraordinarily successful paradigm—the concept of an endocrine gland and hormones was put forward more than a hundred years ago. What were the problems addressed by endocrinologists in 1955, when I first attended the meetings? Are our paradigms the same—or are we in the middle of a scientific revolution, which we have not, perhaps, recognized because we are in the midst of it? First for some numbers. The 1955 program (3) consisted of only 62 papers, presented in consecutive sessions. The greatest proportion of the papers, 35%, were on adrenal endocrinology. The proportion of papers at