Saturday, May 10, 2008

Health Philosophy and Science

In response to this, a reader [aka "Paul" (a dear and good man)], wrote an additional comment, found here, in which he asks me to respond to all his comments. Regarding his request, I have an idea:


No, no. I'm just playing. I couldn't pass that up: hurling virtual taunts is exhilarating.

As for my response to Paul's comments, let me show a bit more of what I believe to be true so we can all see whether Paul and I have more in common than he appears to think. You be the judge whether he and I can agree more than disagree, and whether what I wrote previously (particularly regarding Palmer's goofy claims) can be squared with the below, to wit:
Before the rise of the idea and reality of the physician, of the medicus, and partly alongside with it, we find the idea of the magician or “medicine man”, of the medically knowledgeable person. The physician in the strict sense differs from the premedical, paramedical, or perimedical healer in that he has a higher degree of empirical knowledge.

By paramedical healer I mean those medical services and activities performed by medical professionals of a less than complete medical education, a “paramedic”. By
perimedical healer I mean those methods which lie in, or in proximity to, the properly medical field, but are used by persons of limited medical knowledge and of lower standards of medical professionalism, or by persons who use methods of healing which may be perfectly sound and better than those propogated by school medicine, though statistically less explored and less understood, or simply rejected by members of school medicine because of some prejudices.

What kind of knowledge is gained by medicine as a science? In a word, medicine examines empirical facts, if often unexpected ones. It is a branch of empirical science. With each other empirical science, medicine not only possesses logical and methodological foundations a priori, but also rests on philosophical presuppositions by implying an understanding of the essence of its own subject-matter (the nature of the human person). That said, the empirical side of medicine is that to which I was referring: medicine properly speaking is to a large extent a typical example of an empirical science or of a variety of empirical sciences. It deals with contingent and yet general facts. The empirical data medicine studies concern the human body and man himself, with respect to his health and sickness, and to life and death. While we can to some degree understand the structure and “logic” of these facts, they could still be otherwise. Therefore, medicine and most of the sciences founding it, such as chemistry or anatomy, are empirical sciences, and not a priori sciences (such as logic, philosophy, or mathematics).

It is beyond dispute that medical science has sadly ignored the deeper and philosophical parts of comprehensive medical knowledge, not least of the consequences of which is that wrong philosophical ideas and a lack of deeper wisdom can lead to overlooking many empirical facts about human health and human life: the point of which is that empirical observations as such do not suffice to constitute medical science. They require interpretations which should do justice to the full range of bodily and mental phenomena which, for example, touch the various aspects of health and illness.

Given such a need for a comprehensive interpretation of the phenomena that does full justice to their complex structure, any reductionist approach to problems of health or mental health is bad, however useful it might be in certain areas and respects of empirical inquiry. Undoubtedly - in spite of the overwhelming growth of empirical medical science - the development of scientific knowledge and of its interpretation in modernity was for the most part one-sided and often formed by a materialistic-scientistic outlook which lost contact - by forgetfulness or neglect - with certain valid cognitions or experiences of the perimedical healer. Just consider homeopathic medicine as well as ancient techniques and experiences of Asian medicine, or bear in mind the newly rediscovered Hildegard of Bingen medicine.

Especially in the area of psychiatry and in the treatment of mental disorders as if they and their solutions were mere chemical problems, a materialism as it often underlies modern medicine frequently led to a false conception of the medical reality and the method of medicine; and hence to a regress rather than a progress in coping with problems of health, particularly mental health.

Modern medicine is to a large extent dominated by modern philosophical "models" which underlie our present chemical and technical sciences but are far less adequate to the full reality of health and illness in their relationship to life than previous conceptions had been. These previous conceptions of man and his health problems formed empirical medical ideas and methods which were often far less advanced with respect to empirical details of knowledge but in some respects better able to provide solutions to the fundamental problems of human health, for they were based on more adequate philosophies: a vision of man as a complex machine does not do justice to the human person, and neither does a treatment of diseases as if they were all caused by nothing but chemical and physical factors.

In spite of these limits within the sphere of modern empirical medical knowledge and theory, today's overwhelming body of scientific knowledge clearly and overwhelmingly surpasses anything known to previous generations of physicians. Therefore, the modern physician as scientifically trained healer represents, generally speaking, an immense progress over the medicine man and over past periods of medical science.

The medicine man (humor here Paul) and nature healer differ from the physician in the strict sense also in that they rely more heavily on local traditions and medical beliefs, coupled with their own experience, rather than on the result of carefully conducted observations, experiments, and scientific research undertaken by a world-wide scholarly community. Thus in the medicine man genuine medical knowledge and well-founded theory is often mixed with irrational beliefs. This deficiency of premedical knowledge was partly overcome through modern empirical science.

Yet in the progress of medicine as natural science a sort of immediate and unperturbed contact with physical problems and natural cures was frequently lost. Healers such as Pfarrer Kneipp with his water-cures (hydrotherapy) had to develop their experiences in a paramedical context which was absorbed by medical professionals only at a much later time (these sophisticated cures and treatments of various circulatory problems are popular in Austria and Germany and have been developed further in medical clinics. They show some remarkable results and have been tested and found valuable (e.g., here) by scientific methods). Certain old cognitions by of nature healers were thrown overboard, often for rationalistic philosophical reasons, which demanded concordance with specific scientific methods and techniques. Under the influence of narrowing scientistic idols it frequently occurred that genuine cognitions were rejected or forgotten because their effectiveness could not be explained by the scientific standards of an empiricist conception of natural science (yes, there are other valid conceptions of natural science) and because they lacked a sufficient theoretical basis. This was true, for example, with natural methods of anesthesia and of healing, and remains true for many extremely effective methods of anesthesia and cure which are based on hitherto unexplained facts and sometimes on a speculative theory of the human body foreign to modern science. Consider the largely unexplained effectiveness of homeopathic medicine. Even skeptics of these methods - like myself - will admit that some effects of these methods are undeniable.

But in recent medical research and practice, a new open-mindedness vis-a-vis such cognitions is to be observed. Today generally the monopoly of school medicine is broken and a return to various alternative medical experiences and practices is to be found (e.g., water birthing). All of these should be carefully tested, of course, and the interest in the knowledge they contain should not go at the expense of sound scientific methods.

On the other hand, we must distinguish some things: there is a difference between the careful testing and examining actual results and consequences (side-effects, etc.) of such alternative methods for patients, and understanding why they work. This latter aspect is primarily of a purely scientific interest, it is of little real interest to the patient and physician.

- J. Seifert, What is Human Health?
With the above said, I still assert Palmer was a quack insofar as he held to the belief that 100% of ALL diseases are caused by displaced joints. Call me crazy.

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