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Hickam's Dictum

Hickam's dictum is a counterargument to using Occam's razor in the practice of medicine.

Hickam's Dictum Essential facts:
  • "Patients can have as many diseases as they well please".
  • The principle is attributed to John Hickam, MD. (faculty member at Duke University in the 1950s).
  • The actual process undertaken when diagnosing a patient is a continuous generation of hypothesis and then testing of that hypothesis, followed by then modifying the hypothesis, and so on.
  • The principle of Hickam's dictum considers that a particular diagnosis should not be excluded solely because it doesn't appear to fit the principle of Occam's razor.
  • It is frequently statistically more likely that a patient has several common diseases, rather than a single rarer unifying disease.
  • Thus Hickam's dictum is useful in providing physicians with a counterbalancing principle to the uncritical use of Occam's razor in diagnosis.
Saint's triad (example in clinical practice):
  • Saint's triad is the common combination of hiatus hernia, gallbladder disease, and diverticulosis (ascribed to C. F. M. Saint, British surgeon).
  • The triad components have no known pathophysiological interrelationship - and thus the triad is counter to the usefulness Occam's razor.

Posted by ALCHEssMIST.
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William of Ockham (Medieval Philosopher, Franciscan Monk)


William of Ockham Demographics:
  • Name - William of Ockham
  • Other Names - Doctor Invincibilis
  • Birth - ca. 1285
  • Death - ca. 1349 (Bubonic Plague; Black Death) in Germany.
  • Location - came from Ockham (small village in Surrey, England).
  • Occupation - English philosopher, logician, theologian & Franciscan monk.
William of Ockham, The Man:
  • Franciscan monk - hence his belief in a minimalist in lifestyle.
  • Idealised the life of poverty.
  • Battled with the Pope over this issue as did St. Francis.
  • Excommunicated by Pope John XXII.
  • Wrote a treatise demonstrating that Pope John XXII was a heretic.
  • Some consider him the father of epistemology.
  • Wrote a great deal about natural philosophy.
  • Ockham wrote a long commentary on Aristotle's physics.
  • Better known these days for his principle of parsimony - Occam's Razor.
  • This razor became a foundation for what would later become known as the scientific method.
  • The principle of parsimony is one of the pilars of reductionism in science.
  • Both Jean Buridan & Nicole Oresme were followers of William of Ockham.
William of Ockham Education:
  • Studied theology at the University of Oxford (1309-1321).
  • Never completed his Master's Degree.
  • Mentor was John Duns Scotus (he had already writen about the principle of parsimony, and may have influenced William of Ockham regarding this).
Related Links:
Bubonic Plague Famous Deaths
Occam's Razor (Ockham's Razor)


Image Credit - Moscarlop Wikipedia

Posted by ALCHEssMIST.
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Occam's Razor (Ockham's Razor)

"Pluralitas non est ponenda sine neccesitate." or

"Plurality should not be posited without necessity."


The words of medieval English philosopher & Franciscan monk William of Ockham (ca. 1285-1349) who was born in Ockham, Surrey.

Basically this advises that given a choice between two explanations, then you should choose the simplest - ie explanation which requires the fewest assumptions.

The term 'razor' derives from the verb to raze, the 'cutting away of extraneous material'.

The concept is also often expressed in Latin as the lex parsimoniae ('law of parsimony').

The counterargument to Occam's razor in the medical profession is Hickam's dictum, attributed to John Hickam, MD from Duke University in 1950s.



Posted by ALCHEssMIST.
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