WHERE MEDICINE FAILS "hits the bull's-eye."

                                                                                             Martin L. Rossman, M.D.

WHERE MEDICINE FAILS

Contents

                                                            I     Introduction

II   Medicine's Central Problem

 

III  The Cause of our Difficulties

 

IV   The Invisible Whole

 

V     The Lesson of History   

 

VI    The Lesson of Modern Science

 

VII  Conclusion: The Whole Awaits 

Acknowledgment:

Research on this project was supported by grants from the American Philosophical Society and the National Institute of Mental Health.  Research was conducted at the Library of Congress; National Library Of Medicine; Cambridge University, and at London's Wellcome Institute For The History Of Medicine.

From Chapter I  Introduction

"Only he who knows the innermost nature of man can cure him in earnest."

                                                                                                 Paracelsus (1493-1541)  

Medical theory and practice are governed by a philosophy or “metaphysic” which is tacitly assumed, seldom articulated, and never brought into question.  Known to philosophers as “mind-body dualism,” this metaphysic has determined the course of medical history for the past three centuries… 

Body, it is assumed, is governed exclusively by laws pertaining to matter, and matter is uninfluenced by mind...  No whole exists by definition… “Holism” is incompatible with traditional medicine.  The mirror of history reflects our problem with vivid clarity...  

This work has three objectives:

(1)  To demonstrate scientific medicine’s inability to conceptualize or to remedy so-called “stress disorders” (psychosomatic illness).

(2)   To explain how this failure is a product of dualistic thinking.

      (3)   To demonstrate that dualism is iteslf untenable.

… scientific revolution is waiting in the wings.

From Chapter 2: Medicine’s Central Problem

The "Stress" Diseases

Rather than affirming psychological causation (i.e., 'fear caused his arteries to constrict'), science devised a semantic subterfuge... concealing the underlying mystery.  It borrowed a term from physics and applied it to explain causation of psychosomatic disease: "stress."

The medical concept of stress originated in the works of Hans Selye, a distinguished Canadian physiologist, and there was no ambiguity in Selye's original use of the word. He dealt exclusively with physical influences on physical processes...  Animals were given doses of poison insufficient to kill... exposed to extremes of temperature, or spun round in centrifuges at high speeds.  These were physical stresses yet their outcomes resembled the disorders rampant in our modern era where physical stresses are seldom found.  

From this research emerged the modern concept of "stress."  The concept does not diminish, but rather evades the gap between mind and body...

Stress Diseases Historically

Our modern inventory of psychosomatic ills matches closely with the "nervous  disorders" of former centuries. In the seventeen-hundreds, when medicine sought a physical basis for these conditions it chose nerves as the bodily substrate.  Persons with such disorders were said to have "nervous constitutions" and "neuropathic taint."  But since no physical pathology of the nerves could be found, nervousness was an unexplained explainer... 

In 1859 Dr. Robert Macnish wrote: "When a physician pronounces a complaint to be 'nervous' it is a sure proof that he knows nothing about it. The term 'nervous,' as applied to disease is merely a cloak of ignorance."  Not long afterward a medical journal published the quip:

  " A group of symptoms unexplained you label a neurosis,

 and this is rather clever for you've made a diagnosis."

When a physician completed a diagnosis and "nervousness" was the outcome, he would stop further inquiry... he was beyond the realm of "rational medicine."

Summary

All three interpretations: nervous ailments, psychogenic disorders and stress diseases disclose medicine's central problem.  Each fails to bridge the chasm between mind and body.  Nervousness pretends to but is soon found out.  While insisting upon psychological causation, psychogenesis despairs of resolving the enigma, and stress, like the chameleon, never shows its true colors but survives by appearing now physical, now mental, now some combination of both. The more deeply one inquires into the meaning of stress, the wider becomes the divide...

From Chapter 3: The Cause Of  Our Difficulties

     Give the automaton a soul which contemplates its movements,

      which believes itself to be the author of them... and you will on

                                                          this hypothesis construct a man.

                                                                  Charles Bonnet (1720-1793) 

Dualism: Origins in History, Philosophy and Theology

In Descartes' era mechanical technology was startling and new.  Descartes himself was particularly taken by animated statues adorning the gardens at Nurenberg.  These manikins moved about, played musical instruments and executed a variety of human-like functions.  They were powered by water forced through pipes when passers by stepped on concealed levers.

These mechanical clockworks creatures furnished Descartes with a model of bodily movement.  Though their actions had every appearance of intelligent behavior, they were controlled hydraulically.  No intelligent governing principle was requisite for explaining their motions...

Cartesian mechanism readied the way for progress in the biological sciences...  No longer had scientists to seek a governing principle; no longer had they to come to grips with the question 'What is life?'  Life or vitality was no longer a necessary part of the world-picture.  Reductionisn would rule the day, and body tissue would be conceived in exactly the same terms as ordinary, nonvital matter...

Our Concept of Body: The Implications of Mechanism

In the early seventeen hundreds, physiology was defined as "animal mechanics."  The words "body" and "engine" were used interchangeably.  All causes of disease were "cognizable by the senses," and the challenge for the new science of medicine was to identify those physical causes...

Our Concept of Mind: The Implications of Mentalism

Philosophers after Descartes spoke of a "preestablished harmony" which placed mind and body in "artificial union."  The corporeal substance - body, and the incorporeal substance - mind, were said to require two sets of causal principles...  Philosophy accepted a "two-fold genus of beings."  It specified that no productive interchange would be forthcoming between the independent sciences of mind and body...

The following chapter discloses the unhappy fate of those who argued in vain for holism during the historic reign of physical medicine...

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  Subjects:

Medicine, Psychosomatic - Philosophy

Medicine - Philosophy

Mind and Body

Holistic Medicine

Dualism

 See inside the book at: Amazon.com 

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