History of Western Medicine contd: Soul Medicine

There have been glimmers of hope in the development of what I like to call “soul medicine” but sometimes they seem to be lost from view.
In its 1990 definition of palliative care, the World Health Organization said that the
‘control of … psychological, social and spiritual problems is paramount’ in the total care package of those with incurable disease.
At the same time, Michael Kearney, clearly not sharing the optimism of Dossey or the W.H.O., was predicting that the holistic focus in palliative care (let alone in the wider medical field) was in danger of being lost under the weight of the biomedical model of medicine (1) and the narrow mindedness of those who paid attention only to physical symptoms, whom he called ‘symptomologists’. His concerns were justified. Only a few years later in a paper in Progress in Palliative Care a leader in the field, Sam Ahmedzai, wrote in his editorial: The view now, within palliative medicine, is that it is okay to be symptomologists, and proud of it …Ultimately, suffering from losses, lack of love, existential doubts as well as from poverty and cruelty are not medical issues, and the response to them is not necessarily the responsibility of any healthcare discipline (2).

Surely those who have argued for the exclusion of psychological concerns from the field of medicine, let alone spiritual elements, must be mistaken? 

Many have campaigned over the years for a greater understanding of suffering and holistic healing in a medical context. This first assumed some recognition in the UK within the field of cancer and other terminal illness care, where an understanding was developed within the hospice movement, founded in 1967 on the ideas of Dame Cicely Saunders. The spiritual theme of medical care is also picked up by Michael Lerner who has a special interest in mind/body health in the care of cancer patients. In his book, Choices in Healing, (3) he explores the very diverse range of mainstream and complementary treatments available to the cancer patient. These include for example the practice of Yoga and the power of prayer, in addition to shamanism, all clearly understanding the importance of the inner life of the mind and spirit to the overall well being of a patient in the context of a terminal illness. Some of this is inevitably out of date in a fast changing world but Lerner’s book is still available as a valuable overview of the wealth of ideas and treatments available. The book is well illustrated from literary sources that delightfully complement the consideration of the technical aspects of treatments.

Michael Kearney, palliative care consultant and former medical director of palliative care at Our Lady's Hospice in Dublin, Ireland, has also long campaigned for medical practitioners to pay more attention to the interactions of body, mind and spirit in healthcare (4). He writes of the ‘deep’ as well as the ‘surface’ elements of suffering, and the patient’s “soul pain” that must be acknowledged in addition to the physical pain. He suggested that the principles of Asklepian healing should be taught alongside the traditional and well-established Hippocratic style training almost universally taught in medical schools today, so that they can again work together as happened in Hippocrates’ day.
Healing, he says, needs to be given the environment in which the natural human psyche can be given the space to take over and do its own healing work. 

The overriding problem in healthcare today seems to be that too often our doctors are ‘Techno-doctors’ (5) and ‘Super Specialists’ in a system that reduces patients to paper statistics and doctors to slaves of machinery, forgetting the importance of the personal, the subjective and the social aspects of care. ‘By their very nature doctors deal with bits and pieces – microbes, hormone deficiencies or tumors – while patients experience illness as the disorders, disruption and possible disintegration of their ordinary lives…Every healing art sees illness in its own terms. Patients need to remember that the illness is theirs and theirs alone.’(6) And perhaps some physicians need to remember this also?

Apart from the palliative care available for patients at the end of life, it still seems that the different forms of spiritual and religious healthcare (S/RH), complementary and alternative medicine (CAMs) and conventional allopathic clinical practice are not working together as well as they could and should. Many of the CAMs are gaining credibility within mainstream traditional healthcare but the influence of S/RH lags woefully behind.

To be contd...

References:

(1) in Foreword by Balfour Mount p viii to Kearney, Michael, A Place of Healing: Working with Suffering in Living and Dying, Oxford University Press, USA (November 30, 2000), p. 31. Now see Place of Healing: Working With Nature And Soul At The End (Spring Journal paperback, August 27, 2009)

(2) Sam H.Ahmedzai (1997) ‘Five years: five threads’ (editorial, Progress in Palliative Care, 5(6), 235-7

(3) Lerner, Michael, Choices in Healing; Integrating the Best of Conventional and Complementary Approaches to Cancer, Cambridge, Massachusetts: MIT Press paperback edition 1998, p.123.

(4) This is explored in much more detail in Michael Kearney, A Place of Healing, 2000, foreword by Balfour Mount p. iv. Now see Place of Healing: Working With Nature And Soul At The End (Spring Journal paperback, August 27, 2009)

(5) Helman, Cecil, Suburban Shaman: Tales from Medicine’s Frontline, London: Hammersmith Press, 2006, pp. 5.

(6) Ted Kaptchuk and Michael Croucher, 1986, pp. 26, 37, cited in Mayne, Michael, A Year Lost and Found, London: Darton Longman and Todd, 1987, p. 38.

The History of Western Medicine: Goodbye to holistic medicine!

Just imagine being told that the cure for your “senile decrepitude” was to share your bed with a “vital young person”! 
This was one of the quainter remedies of a certain English physician Thomas Sydenham who, alongside the French philosopher, Rene Descartes, fuelled the massive advances in medical science from the early 17th century, advances which had been stirred by the work of William Harvey. Sydenham lived in the latter half of the seventeenth century. During his career he took it upon himself to revive the Hippocratic School by beginning to catalogue all known diseases of man in extreme and objective detail. Throughout this work he stressed the importance of observation rather than theory in clinical medicine. He was not however always respected for his views – perhaps not surprising really!
By the time that Thomas Sydenham had written his Observationes Medicae, the French Philosopher Rene Descartes, usually regarded as the father of Modern Philosophy, had set out his own philosophical theory on the duality of the mind and the body. In his Meditations Descartes developed the basic philosophy of Plato regarding the dual nature of the mind and body, into what has become known as Cartesian dualism. While Descartes saw the brain as the seat of intelligence, he regarded the body and brain together as simply a machine, quite separate from the soul or mind that Descartes saw as non- physical in nature. He did though believe that the body and soul in some way influence one another, in a way not yet understood.
This was just the excuse which Western medical scientists had waited for, to divorce themselves totally from the mystic element of the life forces.
It enabled them to pursue their medical researches in the context of the body alone, aided immeasurably by Harvey’s legacy.

pilgrims' lodgings at Lluc Monastery Mallorca

The mind and soul could now be left entirely to the cure of the church, which was also losing its grip on the healing nature of its ministry.
The scientific study of medicine was able to advance without having to worry about the possible influences of mind and soul that were intangible and not scientifically measurable. Thus in the excitement of scientific discovery, medicine lost sight of any causal links between mind and body, let alone soul or spirit and any essence of healing, as opposed to caring and curing.
The possible values of holistic medicine were all but lost sight of in the scientific gold rush.

to be contd...

The History of Western Medicine: Hippocrates to Harvey

I am fascinated by the movement to bring the treatment of the mind, soul and spirit back into mainstream Western medicine. I yearn for a wider mainstream recognition that technology and pharmacology cannot provide all the answers where well-being and healthcare are concerned.
Over the next few weeks in this blog I shall be tracing the history of Western medicine, showing where we lost sight of our souls in our treatments and offering signs of hope all around us for those who are looking for healing for our dis-ease as well as cures for our illness. So far in the last two posts I’ve brought us from primitive man to Ancient Greece where Hippocrates was born in the 5th century BC and where the Asklepian healing temples lasted through to the 5th century AD.

Walsingham

There were few changes in the basic practice of Hippocratic medicine until in the second century AD the Greek physician and philosopher Galen came on the scene. Galen developed the theory that the heart generated the heat of the body and that air from the lungs then regulated the body temperature and stopped it overheating. What an amazing thought now, with the benefit of all our scientific techniques for understanding the workings of the human body! Galen’s was a very theoretical physiology, in marked contrast to the objective, factual medicine of Hippocrates. He was however held in very high regard and when he later moved to Rome he was engaged as physician to the Gladiators, a privileged role indeed. His respected theories, born more out of philosophy than from science or theology, served to stifle the further development of medicine as a science for fifteen centuries until the seventeenth century.
We need to bring the early Christian Church into the story here.

The spread of Christianity with its ministry of healing and compassion was influencing the practice of medicine in the first few centuries AD and was also inhibiting the advance of scientific medicine.

Walsingham

Before seeing why this was so, let’s just spend a moment looking at the concept of the Wounded Healer. I love this idea. In our own healing it is possible for us to discover that we are uniquely equipped to understand the healing needs of others, to walk alongside them and assist them in their own healing process. We will feel a profound and healing compassion towards others. The origins of the concept lie in the Greek myth of Chiron the physician and in the earliest indigenous shamans, or medicine men. But for a Christian Jesus Christ is seen as the greatest Wounded Healer of all time. Christ’s healing powers were manifest in many stories throughout His ministry and were carried through into the early healing missions of the Christian apostles. The methods they used included prayer, the anointing of Holy Oils and the laying on of hands, methods that are being reintroduced into healing services in the twenty first century. But the influence of these healing powers in the very early Christian church diminished over time. The apostles were not Jesus and they lacked the confidence or faith to impart His very special healing gifts to the afflicted. There was a gradual reversion to the earliest religious beliefs that illness was in some way caused by man’s sins, that it was mostly in his own power to heal his afflictions.

Reflection in the font at Salisbury Cathedral

Any possible link between the healing methods of the early church and the clinical methodology of Hippocrates were short lived.

In 1215 Pope Innocent the Third condemned surgery and all priests who practiced it. Then in 1248 the dissection of the human body was declared sacrilegious and anatomy was condemned as a subject of study. 

A split of medicine away from the healing ministries of the church was inevitable.
Little then changed in the development of Western medicine until 400 years later when in 1628 the English physician William Harvey, after nine years of painstaking research, was able to present his theories on the circulation of the blood. This proved to be the most significant medical event since Galen. It opened the way for massive advances in medical science…but at the expense of healing therapy, as we shall see...

Hippocrates: the Father of Western Medicine

Considering that Hippocrates has profoundly influenced the development of Western medicine we rather surprisingly know very little about him!

In my last post I introduced the idea that in the context of medicine I believe we need to de-mechanize our bodies, to consider the healing needs of soul and spirit alongside the modern and often wonderful scientific advances, to develop a truly holistic healing opportunity for the patient.

the Lotus flower - divine symbol in Asian traditions

Over the next few weeks I shall trace the history of Western Medicine, showing how we lost sight of this important truth and how we are beginning to pick up the traces again.

We continue the story in Ancient Greece with Hippocrates, widely and popularly regarded as the father of Western medicine as we now know it. Hippocrates was a Greek physician born in the fifth century BC on the island of Cos. The Hippocratic Oath or a modified version of it is still taken by physicians on first qualification at some Universities. Hippocrates developed and worked with a physical model of the human being, looking for cures to physical conditions and following a rational, evidence based medicine with recourse to external agents to effect the cures, much as science is applied to medicine today.

His medicine was based on observation and objectivity, placing more emphasis on the body that could be measured and described, rather than on the subjectivity of feelings and senses. The Hippocratic physicians were not very interested in the opinion of the patient and distanced themselves from any of the charms and incantations of the many traditional and ‘unconventional’ healing methods of the time based on magic and religion. This is why Virgil described the medicine of the day as the silent art. Indeed Hippocrates is still sometimes blamed when people today say that doctors do not communicate well with their patients!

Hippocrates was however said to be good at diagnosis and prognosis. Perhaps, who knows, he used his intuitive skills, that we now see in the modern day medical intuitives. The Hippocratic School believed that all disease had its origin in the yellow and black biles, blood and phlegm, which were the four fluids of the body. These fluids were believed to parallel the natural elements of air, earth, fire and water and their varying proportions in the body influenced the emotional or physical attributes of the patient, or their ‘humors’. At that time medicine was by no means the respectable profession that we recognize today.

  

A Buddhist shrine in Bangkok

Medicine had no status and anyone was able to practice in whatever form they wished.

Hippocrates gained respect in this environment with his more detailed methodology. That is not to say that he lost sight of the holistic approach to medicine, which he is said to have still regarded as important in the overall treatment of the person.

It seems though that he believed in a natural and unknown healing power of the mind rather than a divine or spiritual healing force. 

Hippocrates insisted that the body could heal itself naturally and that no treatment should interfere with that healing process. The predominant philosophy in Hippocrates’ time regarding the relationship of the mind and body was that of Plato, who broadly speaking believed that humans had an external soul, linked to the physical body but existing before and after the life of the material body. Certainly the influences of the mind and emotions on physical health were recognized.

One of the less conventional methods of healing that was already well established in Greece at that time was to be found in the Asklepian Temples, named after Asklepios, the Greek God of Healing. Hippocrates was said to respect this hugely popular treatment of the day.

Asklepios was the son of a union between the nymph Coronis and the great Apollo. Because Coronis had been unfaithful to Apollo Apollo’s twin sister Artemis killed her during her pregnancy. The baby Asklepios was removed from his mother’s dead body on the funeral pyre, probably by his father or Hermes, and handed over to Chiron the Wounded Healer to raise him in the art of healing. Asklepios looked towards psychological and spiritual healing, of the mind and soul, for what were otherwise regarded as incurable and chronic conditions. The Greek view of the day was that such conditions were caused by the gods and needed divine healing and that this had to come from within. The Island of Cos had an important Asklepian healing temple and would be visited by such invalids. The patients would be fasted, rested and cleansed in sacred springs under the supervision of the priests. They would then be left to sleep in special resting places, where they would dream. The essence of the healing was that this process of dreaming worked within the psyche of the patient rather than at his conscious level. In the morning the dreams would be discussed with the temple priests and the patient would then leave an offering before he went on his way. Snakes played an important role in this healing process in the temples. It is possible that their healing power was attributed to their ability to slough their skins regularly. This would have been seen as rejuvenation, although of course we know now that this is a natural stage of the growth process.

Snakes are still symbolized in the Caduceus, the international medical symbol that shows a serpent entwined around Asklepios’ staff. 

The Caduceus has also become the popular symbol of the Wounded Healer. It is known that Hippocrates worked in co-operation with the Asklepians and may have referred some of his patients to the temples. There was clearly some integration of these different schools of healing. The Asklepian Temples and their healing methods had disappeared by 500 AD although of all the pagan cults of the time these treatments lasted longer than any of the others into the Christian era. This was because they were enormously popular with the ordinary citizens. With the demise of these healing temples the Greek recognition of the influence of mind and spirit in the healing process was lost to Hippocratic medicine. Although aspects of the Asklepian healing method are seen again in some of the complementary and alternative therapies of today, there is widespread resistance to these ‘soft’ therapies among many ‘mainstream’ medical clinicians. Meanwhile into that ancient Greek culture a new genre of healing literature was appearing. It was being recognized that writing about one’s own afflictions could be a source of comfort for others with similar suffering. This ‘consolatory ministering’ flourished from around the mid fourth century BC to the Renaissance of the fifteenth century.

There were few changes in the basic practice of Hippocratic medicine until in the second century AD the Greek physician and philosopher Galen came on the scene. I shall pick up the story with Galen in my next post... 

Where are we going wrong in Western Medicine? Has it lost its soul?

I can always rely on the local branches of the Scientific and Medical Network to organize stimulating and refreshingly different meetings which push the boundaries of our understanding of the nature of reality – within their overall mission objective of exploring and expanding the frontiers of science, medicine and spirituality.

(why not go across to their website to see their mission, aims and values for yourself – it is a very worthy organization for all who think that there must be something beyond the totally materialistic and reductionist world which we have created for ourselves in the West.)

Sea of Galilee

Last night certainly didn’t disappoint our expectations, as many members and non members gathered to hear the medical anthropologist Dr Natalie Tobert speak to us about Alternative Psychiatry, based on her fieldwork in India on bio-medical, religious and spiritual strategies for mental health. Natalie Tobert is course director of the educational programme, Medicine Beyond Materialism, education director of Aethos and has run workshops worldwide as well as publishing many articles and two books.

She showed us how in India there is no dominant medical paradigm for ill health, and the practitioner draws on social factors, cultural and religious beliefs which are all critical determinants of health and well being. The discussion which followed concentrated on how we can bring these ideas into the Western medical health system, not only for the benefit of the ethnic minorities who are quite clearly not well served by our allopathic medicine but also for the benefit of us all.

Bangkok

Now this is something I have been really interested in promoting for several years. I believe firmly that in the context of medicine we need to de-mechanize our bodies, to consider the healing needs of soul and spirit alongside the modern and often wonderful scientific advances, to develop a truly holistic healing opportunity for the patient, so I am very much on the same wave length as Natalie here.

Very early on in its history Western medicine lost its soul to scientific advances and we can learn so much from the Eastern traditions of which Natalie spoke so eloquently. There are glimmers of hope. Slowly but surely we are beginning to realize the importance of the whole person again in our healthcare systems, but progress is slow, although as with many things the USA are ahead of the UK and the rest of Europe in this regard.

For earliest man physical illness was inextricably linked with the mind, with spirituality and with religion. The original belief was that disease came from the gods as punishment for invoking their displeasure in some way. Amulets found alongside the remains of Paleolithic man were almost certainly used as charms for healing purposes, a recognition at that time of the importance of the mind to the cause of illness, a precursor of modern psychology long before it was known as such! Later, but still long before the birth of medical science, man called on his religion to heal his pain and suffering. He sought wholeness of the body, a holistic approach to healing.

Now I'm not saying that all of these beliefs stand the test of time and education, but I am saying that we ignore the lessons we can learn from indigenous wisdom at our peril.  

Western medicine largely lost this holistic wisdom with the advancement of medical science, and it was not to be rediscovered until the second half of the last century. In this new millennium I believe that in time we will come to marvel at how we could have ignored this sense of the soul’s healing significance for so long. Over the next few weeks I am going to trace the history of Western medicine and see how and why the importance of the soul, spirit and mind was lost sight of in the enthusiasm of technological and pharmacological advance and how we are now beginning to rediscover this vital element in our health and well being. And I will be discussing why I think that this has enormous social consequences for us all.

Tomorrow I’ll start with Hippocrates, Asklepios and Galen…

Thank you Natalie for helping us spread the debate...