The state of history and the empire of metaphysics [Review]

One of the curious things about this challenging book is that its ostensible subject— the Saxon medical and political scientist Hermann Conring (1606–1681)— is not mentioned in the title. Constantin Fasolt argues that we cannot know what Conring really thought or meant in his writings, which means that his topic cannot be Conring as such and must instead be that which occludes our knowledge of him, the titular limits of history. Given that we do in fact learn a good deal about Conring from Fasolt’s book, we can only hope that the decapitation of its subject will be rectified in a subsequent edition, or perhaps by the restorative work of librarians putting together subject headings. And yet Fasolt’s decision is understandable, for Conring is indeed a stalking-horse for a much bigger quarry: historiography and the historical consciousness. By “history” Fasolt understands a way of imposing intelligibility on the world, which is founded on the twin assumptions that the past is gone and unchangeable, and that the meaning of texts can be determined by placing them in their historical contexts (ix). In challenging this mode of intelligibility, Fasolt is not attempting to improve professiona history—it’s already as good as it can be—but to displace it. He regards his work as a declaration of “independence from historical consciousness” (32). At the same time, Fasolt insists that he is not simply jumping from historiography to philosophy, or attempting to preempt history with ontology (37-39). That has been tried by Nietzsche and Heidegger, who have been tainted by Nazism (Fasolt thinks unfairly). It has also been attempted by modern philosophers from Gadamer to Foucault and Charles Taylor who, in failing to address the “violence” that its mode of intelligibility does to the world, have not succeeded in outflanking history. Perhaps, Fasolt wonders, it is only the personal experience of those who have been subject to this violence—the experience of those who have been subject to historical examination—that can break the spell of history. Fasolt’s disclaimer notwithstanding, in the course of these remarks I shall argue that he is indeed jumping from history to philosophy, or attempting to outflank history by subjecting it to a particular metaphysical understanding. I shall do so in part by sketching the recent intellectual history of this move—a historical examination that I hope inflicts as little violence as possible on Fasolt’s argument.

Relapse and mortality among HIV-infected and uninfected patients with tuberculosis successfully treated with twice weekly directly observed therapy in rural South Africa

Objective: To determine post-treatment relapse and mortality rates among HIV-infected and uninfected patients with tuberculosis treated with a twice-weekly drug regimen under direct observation (DOT). Setting: Hlabisa, South Africa. Patients: A group of 403 patients with tuberculosis (53% HIV infected) cured following treatment with isoniazid (H), rifampicin (R), pyrazinamide (Z) and ethambutol (E) given in hospital (median 17 days), followed by HRZE twice weekly to 2 months and HR twice weekly to 6 months in the community under DOT. Methods: Relapses were identified through hospital readmission and 6-monthly home visits. Relapse (culture for Mycobacterium tuberculosis) and mortality given as rates per 100 person-years observation (PYO) stratified by HIV status and history of previous tuberculosis treatment. Results: Mean (SD) post-treatment follow-up was 1.2 (0.4) years (total PYO = 499); 78 patients (19%) left the area, 58 (14%) died, 248 (62%) remained well and 19 (5%) relapsed. Relapse rates in HIV-infected and uninfected patients were 3.9 [95% confidence interval (CI) 1.5-6.3] and 3.6 (95% CI 1.1-6.1) per 100 PYO (P = 0.7). Probability of relapse at 18 months was estimated as 5% in each group. Mortality was four-fold higher among HIV-infected patients (17.8 and 4.4 deaths per 100 PYO for HIV-infected and uninfected patients, respectively; P < 0.0001). Probability of survival at 24 months was estimated as 59% and 81%, respectively. We observed no increase in relapse or mortality among previously treated patients compared with new patients. A positive smear at 2 months did not predict relapse or mortality. Conclusion: Relapse rates are acceptably low following successful DOT with a twice weekly rifampifin-containing regimen, irrespective of HIV status and previous treatment history. Mortality is substantially increased among HIV-infected patients even following successful DOT and this requires further attention. (C) 1999 Lippincott Williams & Wilkins.

Beyond ovulation: Oral contraceptives and epithelial ovarian cancer

In a case-control study in three Australian states that included 794 women with epithelial ovarian cancer and 853 community controls for whom we had adequate contraceptive and reproductive histories, Re examined the effects of oral contraceptive use after controlling for estimated number of ovulatory cycles. Other covariates included in the multiple logistic regression analysis were parity, smoking, and history of pelvic surgery. The protective effect of duration of oral contraceptive use appeared to be multiplicative, with a 7% decrease in relative risk per year [95% confidence interval (CI) = 4-9%], persisting beyond 15 years of exposure. Use for up to 1 year may have a greater effect than predicted (odds ratio = 0.57; 95% CI = 0.40-0.82), whereas use before the first pregnancy may be additionally beneficial (odds ratio = 0.95; 95% CI = 0.87-1.03, adjusted for overall duration of use). Better control for ovulatory life might attenuate these estimates somewhat. There was little evidence of waning protection with time since last exposure or of extra benefit with early commencement of oral contraceptive use. We found no convincing evidence of effect modification in any factor examined or differences in effect among the three main histologic cancer types or between borderline and malignant tumors. Oral contraceptives may act by both suppressing ovulation and altering the tumor-promoting milieu.

The policy cycle and vernacular globalization: a case study of the creation of Vietnam National University - Hochiminh City

This article examines the policy cycle and vernacular globalization in the context of higher education reform in Vietnam. Through an analysis of the development of the Vietnam National University - Hochiminh City as part of the post-1986 reconstruction of Vietnamese higher education, the article considers the complex interrelationship between globalized policy discourses, national interests and history in Vietnam, and the specific politics of policy implementation within one institution. Vietnam National University - Hochiminh City was created through an amalgamation of a number of smaller universities, and against the backdrop of social and economic restructuring aimed at promoting industrialization and a market orientation within socialist governance. The article reveals the dynamic tension between these local and global influences on higher education policy and practice, and more specifically, the dilemmas associated with top-down policy implementation when a new organization consists of older organizations with powerful provenance and reputations. In so doing the article demonstrates the necessity to globalize policy theory.

Foucault and Feminism

Online encyclopedia providing detailed, scholarly information on key topics and philosophers in all areas of philosophy. The IEP is free of charge, is available to all internet users world wide, and is continually revised and updated.