[Buddha-l] Re: Medicine, Efficient Cause and Philosophy

[Dan Lusthaus]

Katherine,

With all due respect, you seem to be confusing a few basic categories.

Demanding a material base for identifying a disease and/or its cure is a
matter of material cause, not efficient cause. Medicine's turn to that is
due to Descartes, not Democritus' and Leucippus' atomism -- much less
pythagorean numerology.

The mechanistic outlook is often tied to the invention of the mechanical
clock as a microcosm for how the universe works, and had already worn itself
out by Bergson's day (his major contribution comes with his analysis of time
and duration, especially in facing Zeno's paradoxes, not with any challenge
to mechanistic thinking).

To divide the history of Western medicine into airy and earthy is simplistic
reductionism in the extreme (what about fire and water, not to mention
ether?). For a somewhat surer guide to what the ancients were up to check
out Philip van der Eijk, _Medicine and Philosophy in Classical Antiquity:
Doctors and Philosophers on Nature, Soul, Health and Disease_ Cambridge,
2005.

Western medicine has been resistant to alternate claims precisely because of
a long history of dangerous quacks (mesmerism, electrical therapies, snake
oil, the list is endless). They have insisted that respectability comes with
empirical verification, and have grudgingly embraced chiropractics (spinal
manipulation, not the "elixirs"), acupuncture, and a variety of alternate
therapies precisely because they demonstrate testable results. It's
important, however, to keep in mind that if a specific homeopathic treatment
proves effective, that does not entail that (1) the whole homeopathic
edifice is therefore vindicated, or (2) that the "explanation" for the
efficacy of that specific treatment has anything to do with the homeopathic
theories it may come packaged with -- any more than a tribal healer's
explanation of the various spirits that aid in his diagnosis and treatment
are to be accepted as the effective agents in a treatment -- especially if
one can isolate other elements in the treatment and achieve the same
results.

Acupuncture is an instructive case in point. Obviously the anatomical model
presumed by acupuncture is off the charts for Western medicine, and various
attempts over the years to link the qi circuits to lymphatic or endocrine or
electro-nervous pathways, etc., have failed. Yet -- for SOME things -- it
unmistakably works, especially as an anesthetic (which was, for instance,
demonstrated for Western doctors visiting China in the 1970s after Nixon
thawed relations, by demonstrating its effectiveness on animals -- which
precludes placebo effects -- and dramatic procedures such as performing open
skull brain surgery on conscious individuals who are conversing during the
operation with little or no anesthetic. On the other hand, that did not give
acupuncturists carte blanche to claim a plethora of cures -- each is tested
separately, and mainland TCM (Traditional Chinese Medicine) has been busy
testing its treatments ever since, and scaling back its claims to
demonstrable treatments. One of its champions in the States has been Harvard
Medical School, since some Harvard doctors were among the first to observe
it China back in the 70s. Licensing for acupuncturists in the States is
largely a state by state matter -- some states are very stringent, others
more lax, and there are different sets of standardized tests one has to take
in order to receive a license, depending on which state one wishes to
practice. And contrary to Richard's hyperbolic pronouncement, there are
indeed health plans that permit acupuncture treatments and cover them (some
plans will add provisos as to what sorts of treatments, or under what
circumstances, but bottom line it is a recognized medical procedure). And NO
ONE KNOWS BY WHAT MECHANISM it works.

Railing against the "medical establishment," the FDA, etc., has been a
long-time sport. In the 1960s the two loudest railers were Carleton
Fredricks and Adelle Davis, who put most of their energy into promoting
healthy diets, vitamins, avoiding additives, etc. Davis died at 59 of
stomach cancer, and Fredricks in his early 60s of a heart attack. The
world -- and health -- is just not that simple.

Dan Lusthaus