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

[Dan Lusthaus]

Katherine,

I'm not sure how far we can go on a buddhism discussion list delving into
Bergson, Descartes, ancient Greek theorists, etc.

To perhaps simplify this, perhaps a few key issues:

1. As Dante mentioned, one the strengths (and weaknesses) of some alternate
medical approaches is that they are more prone to customize treatment to
individuals, each of these approaches offering its own grid of categories
and focal points by which to orient that customized treatment. And this
often entails a trial and error approach to each new patient (in fact,
conventional medicine also takes this trial and error approach to each
patient, only with a different set of grids, tests, etc.). Depending on the
skill, sensitivity and artistry of the practitioner, the resources that the
approach makes available are best tailored to the needs of the person. The
less skillful, etc., the practitioner, the more he will expect the patient
and his symptoms to conform to the approach's theory. Given that
practitioners of any approach will be prone to that spectrum of attitudes,
the question then shifts, when comparing different approaches, which
provides the most resources and which most sensitizes the practioner to take
advantage of that full range. One should, I suspect, be most suspicious of
those approaches that claim to have the solution for everything. One of the
aspects of modern medicine is that it doesn't make that claim -- it claims
and puts lots of money and research into *finding* and *seeking* cures and
improved treatments. Stated another way -- which is more likely to actually
happen: a homeopath adopting a conventional medical treatment, or a
conventional doctor adopting a proven homeopathic treatment? You may
disagree, but I would say the latter.

A corollary is that different approaches may be better suited for certain
types of illness.

2. I'm not sure what you think efficient causality means, but to say
something is NOT causally efficient is basically to say it doesn't work. If
homeopathy lacks efficient causality, then that is an admission that it
doesn't work. I don't thnk that is what you want to claim. Efficient
causality does not require mechanistic models.

3. Mechanistic thinking is not an evil, especially when applied to medicine.
When my car doesn't work, I take it to a mechanic who accepts that
mechanistic thinking works. The computers and internet by which we are
currently communicating was designed and built by mechanistic thinking. Were
it not for mechanistic thinking, therefore, we would never have heard of
each other and wouldn't be communicating now. Knowing how organs work, how
the body functions, what effects certain agents have on bodily functions,
etc. are all useful types of knowledge.

Let me give, as an example, the SARS epidemic of a few years back. Not a
single person died of SARS in the US, and there was no outbreak. Only people
who had contracted it while abroad (mostly Asia) and brought it back with
them, fell ill, and they were all cured. In China, Taiwan, etc. where a
combination of conventional and traditional Chinese therapies were employed,
many people died, and the disease did spread. Toronto also had fatalities
and some spreading of the disease. Why was the US spared? Two factors:

(1) A very observant nurse, who received an old Chinese grandmother in her
emergency room, remembered reading about similar symptoms in a recent
medical journal -- this was before SARS had made headlines; she found the
article, re-read it, and

(2) immediately put the woman, and very soon afterward, the granddaughter
who had also traveled to China with the grandmother but had taken a little
longer to display the symptoms, into *isolation.*

Isolation is a technique by which a patient is placed in a room where
anything that comes in or out of the room, is kept from making contact with
other people. Objects are discarded in special "contaminated" trash that is
disposed of in a special way. People who enter the room put on special gowns
and gloves, masks, etc., and remove them in a special way when they exit the
room, so as not to inadvertently touch the outside, exposed surfaces of
those gowns, etc. (all medical personel learn those techniques). It is based
on a notion of unseen, mechanistic organisms (germs, viruses, etc.) that can
spread by contact.

Subsequently, US medical staff were put on alert for SARS (especially after
the Toronto outbreak), and every case that appeared was put in isolation. It
never spread, as a result.

By way of contrast, in Taiwan, a hospital that had taken in numerous SARS
cases was quarantined, the workers forbidden to leave. Not understanding the
principle of isolation (which could have spared them such draconian
measures), after a couple of days the workers protested and literally
climbed out windows, etc., to escape the hospital and go home. Guess what?
SARS did spread.

No alternative medicine system had come up with the notion of or techniques
of isolation. Nor would they have the means to recognize which diseases
require isolation and which don't. This is only a tiny example, but how many
cases of SARS were prevented from ever happening just by knowing when and
how to employ this simple technique is incalculable. In addition, whoever
came to a US medical facility with the SARS they had contracted abroad was
cured -- no one died.

Dan Lusthaus