The origins of modern biomedicine could be traced to the moment in 1838 when Theodor Schwann proclaimed the cell as the fundamental unit of all life. Yet, this true conceptual rupture lay not merely in identifying the cell’s structure but in endowing it with agency: a theoretical and, above all, experimental framework that would come to dominate the biomedical sciences. Over the course of the following century and a half, the search for specificity—locating agency in a single, identifiable unit—became the lodestar of biomedical inquiry. From the late nineteenth-century recognition of bacteria and later viruses as disease agents to the molecular revolution of the mid-twentieth century, and most recently, to the designation of SARS-CoV-2 as the causative agent of COVID-19, this logic of discrete and specific agency has structured the epistemology of biomedicine.
Yet, almost from the outset, this vision of specificity coexisted—sometimes uneasily, sometimes imperceptibly—with an awareness of its limits. The biomedical ideal of a singular, definitive agent has been repeatedly challenged by the sheer complexity of biological processes, which are context-dependent, historically contingent, and locally reactive. Life does not unfold according to a crisp logic of specificity alone; it is responsive, dynamic, and irreducibly situated. The history of biomedicine over the past century might well be told as the oscillation between these two perspectives: the pursuit of specificity on the one hand, and the recognition of biological reactivity on the other.
Recent decades have seen a decisive shift toward the latter. The immune system, once conceived as a fortress enforcing a strict boundary between self and non-self, is now understood as an ecological system—not only defending and attacking but also incorporating and adapting. Similarly, the rise of epigenetics has challenged the notion of genetic specificity, revealing a gradient of gene expression shaped by environmental and developmental factors. Perhaps most strikingly, the very notion of agency in biomedicine has been reconfigured with the advent of the microbiome: a collective entity that regulates immune responses, orchestrates metabolic pathways, and even shapes cognition. In this reconceptualization, agency is no longer specific but distributed, no longer fixed but dynamic and dispersed.
Building upon my previous research into the notion of agency, the history of the cell concept, the conceptual evolution of autoimmunity, and the emergence of epigenetics, this project seeks to historicize and conceptualize these shifting epistemic paradigms. It aims to provide an integrative narrative of modern biomedicine—one in which the fundamental terms of biological explanation are not only revised but, in some cases, entirely inverted.