Helping Nature Do Its Thing
(Rather than trying to ‘control’ nature)
White Rock, February 22nd, 2001
Homeopathy seems like a very strange thing to many people, and particularly to those with the type of scientific background we garner from a ‘western’ education.
My aim in this essay is to give some insight on how homeopathy and the ‘natural’ health therapies (‘naturopathy’) work, in terms of the general principles of natural phenomenology.
The first principle of natural phenomena, that our western education ‘teaches us to forget’ is that systemic harmony or ‘health’ emerges naturally and spontaneously from unconstrained (un-action-managed or ‘non-controlled’) nature. Another way of saying this is as Johannes Kepler said it; that ‘harmony’ or ‘container-constituent-coresonance’ is a natural (divine) property of space that adorns the constituents of space with the aesthetic of harmony.
[[**Note: As Kepler says, harmony is a way of unifying a volumetric region of space , … a characteristic of nature which Newton’s formalism ignored; i.e. Newton described the motion of the planets according to laws oriented to the kinetic (trajectory) motion of the individual constituents of space and ignored the container-constituent-coresonance (volumetric motion) effects. In fact, laws which treat the properties and behaviours of the constituents of space seen as ‘independent causal agents’, as in mainstream science, are innately incapable of addressing the full situation in nature, where the constituent is coresonantly engaging with his volumetrically configured containing constituency (with the ‘shape of space’), a situation which cannot be deduced from the properties and behaviours of the individual constituent. This ‘container-constituent-coresonance’ which is manifest in nature is an example of ‘the participation of space in physical phenomena’ as accounted for in relativity theory. For example, newtonian theory and mainstream science axiomatically asserts that ‘gravity’ is the ‘cause’ of the movement of individual mass-bearing constituents of space and asks us to ‘accept it’ as the cause ‘on faith’. The traditional notions of ‘gravity’ and ‘kinetic motion of inertial masses’ are thus a tautology which stops us from delving further into more complex views of motion manifest in nature, such as ‘container-constituent-coresonance’. ]]
The ‘ignoring’ of manifest ‘container-constituent-coresonance’ situations in unimpeded nature, encouraged by the ‘causal science’ of ‘independent material entities’ leads to dissonance in ‘health management’, … in psychological, physiological and social (community) health management; i.e. we forget that ‘container-constituent-codynamical harmony comes (emerges) when opportunity is opened up for ‘nature to do its thing’.
Our solar system, within which we are both participants and constituents, is an example of how things come together in a ‘nested inner-outer’ harmony. What we know today is that there is a natural ‘coresonance’ amongst the constituents in an open volume of space (i.e. in a volume of space which is unimpeded by human-imposed structures and controls). One can imagine this same type of outer-inner nesting ‘container-constituent-coresonance’ amongst atoms, molecules, cells, organisms and community (and on to the containing environment and solar system container) as being something which tends to emerge naturally.
This point, that ‘harmony’ or ‘health’ is a naturally emergent property of space which permeates all outer-inner nesting levels from the atomic to the celestial is very important to the question of ‘health management’. To underscore this natural ‘coresonance between the containing constituency and the individual constituent in the solar system, here how a modern day scientist interested in the ‘wave interference (harmonic) aspects’ of the solar system, E. E. Richards, describes it;
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"Each cosmic body---a planet, a moon, or a star---utilizes the spherical shape as its
energy containment. The sphere is an ideal shape for a resonant cavity. The very nature
of the sphere means that it resonates over vast spectrums of frequency. For example, if
we start by considering the earth circumference of approximately 7.5 Hz., as a
fundamental, we may calculate and detect many higher harmonically-related frequencies.
In addition, there are radius frequencies with higher harmonics present. Harmonic waves
in a spherical solid set up a periodic distribution within the inner and outer spherical
cavities. The Van Allen energy belts surrounding the earth also present a multitude of
resonant harmonics at lower frequencies than the circumference 7.5 Hz. Figure (9) shows
some of the earth related frequencies. …
… "The Music of the Spheres", an ancient concept of the Universal Song, may be seen as
a reality when considering the motions of the solar system. When the revolutions and
rotations for the planets and their moons are converted to frequencies, there appear many
harmonic relationships. For examples: the Moon's revolution is harmonically attuned to
the three largest moons of Jupiter, which are themselves one octave separated from each
other in their revolutions. Jupiter's rotation is a harmonic of the Earth, and Pasiphae, the
outer moon of Jupiter, is in harmony with the Earth's revolution. There are many other
similar solar system harmonics.
· * * *
Ok, now we have made the point
that ‘health’ is a naturally emergent ‘harmonic’ property of nature.
What does this suggest in terms of ‘health management’? (psychological,
It suggests that ‘health management’ must be based upon ‘opening up opportunity’ for nature to ‘do its thing’, rather than attempting to ‘step in and control nature’.
Here we come to a big philosophical bifurcation in ‘health management’ approach, since our mainstream science does not even recognize the ‘harmonic nature’ of space which induces container-constituent-coresonance in nature, as in the case of the solar system and the psychosomatic system of the human organism. Our mainstream science, which is built into our educational system both in terms of the ‘medium of education’ (protocol for understanding) and the ‘content of education’ (knowledge in its own right), is all about assertive teaching and totally ignores the simultaneous reciprocity between assertive action and transformation of the shape of opportunity.
The indigenous traditions, on the other hand, teach an awareness of the ‘sacred space’ in which we are immersed and that it is in a natural primacy since it is the opportunity-giving commons which makes assertive action possible.
For example, if we want our children to develop into their ‘authentic selves’ (natural, healthy selves), we can nurture this by giving them the ‘sacred space’ in terms of corridors of opportunity to ‘do their own thing’, rather than by imposing on them our own ideas of what they should become. This is not to say that we cannot make the wisdom of traditions we have found valuable available to them.
When we act assertively according to our own individual purpose (as if we were truly ‘independent causal agents’ as mainstream science says), we simultaneously, reciprocally transform the shape of opportunity space, the ‘sacred space’ of the commons of nature.
For example, if I use the log I find on the beach to sail over to another island, the log has opened up new corridors of opportunity for me. But since I have taken the log away, I have closed down opportunity corridors for others. Perhaps I should work together with other so that the log can be ferried back and forth to provide ongoing opportunity for others, as it provided for me.
But in our culture, there is this tradition of ‘sovereign ownership’, … ownership even of pieces of the ‘sacred space’, the opportunity-giving commons of nature. If I am rich, I can ‘buy’ a piece of property with ‘waterfront access’ which opens up a corridor of opportunity for me to harvest the fish of the lake. But by fencing off and controlling access to this property, I deprive others of access to the ‘waterfront’ and to the natural opportunity-giving corridors of the commons of nature. The native tradition of keeping the sacred space of the natural commons open and unimpeded is well captured in the speech given by Seattle, Chief of the Suqamish in 1851 (‘How Can You Buy or Sell the Sky’ ), in response to a treaty proposal involving the sale of lands.
Again, in nature, harmony amongst overall constituency and individual constituent (container-constituent-coresonance) tends to emerge naturally, … it is a natural property of unimpeded space. Once we begin to control and manage ‘space’, we are then responsible for creating a man-made version of ‘health’ and ‘harmony’, but it is non-trivial to ‘create harmony’ amongst nested scales of things both above and below our own ‘organismic’ scale level. Clearly, our very cells are imbued with the harmonies of the solar system since they are contained within us and we are contained within the solar system.
Once again we come back to this ‘bifurcation’ in the ‘health management’ approach. The choices are as follows;
The ‘Hygiean’ tradition seeks to ‘open up opportunity space’ for health seen in terms of naturally emerging harmony to come back into dominance. ‘Illness’ is seen in terms of ‘dissonance’ or a ‘falling out of harmonic balance’ of the system. For example, in the condition of ‘gastroparesis’, the natural rhythms of the digestive tract are disturbed by imbalances in the endocrine system (pancreatic system) and this results in gastric ‘dysmotility’. The Hygiean therapy to restore the system to health would be to ‘re-open’ up natural opportunity for the system to return to its natural harmony. This approach would be characterized by the administering of ‘homeopathic’ or ‘naturopathic’ remedies or by techniques such as acupuncture or chiropracty. In the domain of social systems, the therapy to restore the system to health would be, similarly, to re-open natural corridors of opportunity for those sectors of the system which had been deprived of opportunity (e.g. by the ‘exclusion of the less performant’ which accompanies win/lose competition).
2. Health management in the ‘Aesculapian’ tradition.
The ‘Aesculpian’ tradition sees the system in the mechanical terms of ‘cause’ where ‘restoring the system to health’ is visualized in terms of ‘repairing’ the ‘causal agents’ or by eliminating or suppressing those causal agents which are seen as the source of illness. For example, in the condition of ‘gastroparesis’, the Aesculapian therapist would try to identify the ‘most important cause’ such as ‘reducing gastric secretions’. This is achieved by unnatural substances or ‘designer drugs’ such as ‘Omeprazole magnesium’ (‘Losec’ --- “Losec Tablets (omeprazole magnesium) reversibly reduce gastric acid secretion by specifically inhibiting the gastric enzyme H+, K+-ATPas proton pump in the parietal cell.).
While such unnatural drugs may suppress a symptom such as overacidity in a ‘sleeping’ digestive tract, … such interventions disturb the natural harmonies amongst the diverse and multilevel nesting systems, and draw the Aesculapian therapist into the task of dealing with additional disharmonies induced by the first intervention (with additional drugs and interventions). In the domain of social systems, the same therapeutic geometry prevails.; i.e. interventions into ‘cause’, to suppress or eliminate the ‘cause’ of societal illness inevitably induce secondary dissonances which must consequently be addressed by ‘causal interventions’.
In summarizing the respective therapies of the ‘Hygiean’ approach (which visualizes health as naturally emergent harmony and restores the opportunity for the system to ‘do its thing’) and ‘Aesculapian’ approach (which visualizes health in terms of the ‘assertive behaviour of independent causal agents’ and intervenes to forcibly restore ‘causal order’), it is clear that the former ‘Hygiean’ approach puts ‘opportunity management’ into the primacy over ‘action management’ (opportunity management is ‘spatial’ and includes action management by allowing actions to proceed according to the opening up of opportunity and thus opening the door to naturally emergent harmony). The latter ‘Aesculapian’ approach puts ‘action management’ into the primacy and this effectively precludes opportunity management, since ‘action management’ deals with the assertive behaviours of the independent causal agents, … and such assertive behaviours simultaneously, reciprocally induce transformation in the shape of opportunity space. The including of action management (kinetic trajectory geometry) by putting opportunity management (volumetric space-time geometry) in the primacy, and the precluding of opportunity management by putting action management in the primacy can be visualized by these two strategies as utilized in the game of pool. The skilled player opts for ‘shape over shots’ since by managing the opening of corridors of opportunity for his community of balls, he can allow them to continually pursue their harmonic purpose. The unskilled player opts for ‘shots over shape’ because his is attracted by the immediate opportunity to ‘fix things’; … unfortunately, his kinetic transaction orientation simultaneously, reciprocally induces transformation in the shape of opportunity space in a dissonant manner and his further actions are often blocked and stymied, necessitating additional ‘corrective shots’.
In our psychological, physiological and societal ‘health’, then, we have the option for two approaches at ‘health management’ or ‘illness therapy’, one is to open up opportunity for natural harmonic health to return (opportunity management) and the other is to ‘intervene’ to correct the workings of the system, an approach which disturbs the natural harmonies in unintended way and leads to further secondary and tertiary interventions to the point that ‘health’ is ‘causally managed’ in a rational-mechanical manner by drugs or by the business or government ‘action managers’ who try to ‘causally’ (rationally-mechanically) restore health to an innately ‘container-constituent-coresonance’ based system.
Given the view of ‘health’ as ‘naturally emergent container-constituent-coresonance’ (natural space-time volumetric harmony), it makes sense to put the Hygiean approach into the primacy and use Aesculapian interventions only in a ‘back-up’ mode. In this way, the dominant thrust can be to keep the corridors of opportunity continually opening up so that the emergence of natural harmony is nurtured.
My aim in this essay was to give some insight on how homeopathy and the ‘natural’ health therapies (‘naturopathy’) work, in terms of the general principles of natural phenomenology. As the above paragraph suggests, the Hygiean or naturopathic approach must be in the primacy, if one accepts ‘health’ as the naturally emergent harmonic property of our volumetric space-time container. This primacy is not only required in the field of medical health management but also in the field of societal health management.
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[[Footnote: This natural geometry of primacy of the Hygiean view of health as an emergent codynamical harmony over the Aesculapian view of health as the ‘correct functioning’ of ‘causal agents’ points to a basic failing in our mainstream (pre-relativistic) scientific models. Deeply imbued in our thinking is the notion that ‘health’ is ‘caused’ by the ‘correct functioning’ of the ‘causal agents’ which participate in the system. This is a notion which ignores the participatory role of space. If we visualize causal agents as skilled automobile drivers whose causal actions must be both precise and correct, this is still too small to describe the ‘health’ of the ‘traffic’ system for a very basic reason; i.e. it splits the drivers apart from their containing environment. If we put these drivers on a crowded freeway with many other drivers ‘the shape of space’ which furnishes the opportunity for them to move will be of primary importance, and this ‘shape’ is ‘co-created’ simultaneously, reciprocally with the codynamics of the ‘driver collective’. This ‘co-creative space-shaping ability (opportunity managing ability) is, at the same time, a skill attributable to a driver and a skill attributable to the driving collective. This co-creative space-shaping, opportunity management skill transcends the skill of driving seen in terms of navigating within a passive environment, … and demands that the driver see himself as his own containing environment at the same time as a being a constituent within the containing environment; i.e. as he moves, he simultaneously, reciprocally transforms the shape of dynamic opportunity space which modulates the ‘flow’ of traffic.
Human physiology is all about ‘flow’, blood flow and lymphatic flow and digestive tract flow and respiratory flow and all of this ‘traffic’ must proceed harmonically, in ‘container-constituent-coresonance’ without ‘jam ups’ or ‘blockages’, for the system to be ‘healthy’. Societal physiology has the same requirement; i.e. the opportunity space cannot be opened up for some drivers and constrained or blocked for others without dissonance and dysfunction erupting, and the shape of opportunity space is not ‘caused’ or constructed by the constituents but is ‘co-created’ by the ‘constituent collective’ or ‘community’. No-one causes dissonance and everyone causes dissonance. No-one causes coresonance and everyone causes coresonances. No-one is the containing environment and everyone is the containing environment.
It is clear that human beings, like other constituents of space, like the planets in the solar system, and like humans in their freeway driving roles, have the ability to be guided by their co-creative participation in the evolving shape of opportunity space. Constituents referencing their actions directly to the ‘shape of space’ is what the general theory of relativity demands. Such theory bypasses the abstract and observer-dependent notions of ‘material kinetics’ and ‘kinetic energy’ and goes directly to the dynamical volumetric distribution or ‘space-time shape’ of energy (i.e. goes directly to the notion of ‘field’). Such direct referencing to the ‘shape of space’ obviates the need for the ‘frightening ghosts’ of inertial reference frame and absolute (globally synchronous) time, since space-and-time are a continuum when one accepts that one is, like the hurricane, one’s own containing space at the same time as one is a participating constituent within one’s containing space.
The Hygiean model of health equates to the Keplerian view of motion where the constituents of space ‘give way’ (‘nachgeben’ ) for each other so as to co-create the opportunity space necessary for container-constituent-coresonance. A falling from health in this model can be seen in terms of a ‘jam’ or ‘blockage’ in the flow, but since harmonic flow is an ‘emergent property’ of the system, … the result of the co-creative collaboration of the immersed constituents, … one cannot ‘cure’ by means of external intervention to correct those constituents which are not ‘causing’ the correct results, any more than one could cure a traffic jam (dissonant shape of opportunity space) by finding the ‘causal agents’ responsible. One must instead, induce a return of the constituents of the system to the mode of harmonic co-creation of mutual opportunity, and this is the goal of the ‘naturopath’ and homeopath, using natural substances to induce such a return to harmony, … rather than administering specially designed drugs which are intended to ‘suppress incorrect causal behaviours’ or ‘stimulate correct causal behaviours’ as in the Aesculapian approach.
The same ‘geometry’ options for health and healing hold true in the societal domain, and this should come as no surprise since inter-material space-time is an unbounded continuum and the transforming opportunity space which modulates coresonant dynamics at the nesting level of cells in the human body extends without uninterruption out to the level of the transforming opportunity space which envelopes the human organism, the participating constituent of/in the collective of community.
The options of Hygiean and Aesculapian healing are not ‘either/or’ options. The Hygiean option is based on the ‘harmonically evolving shape of space’ and this, as Kepler noted in the case of the solar system, is an over-riding influence because it is (as can be seen in the example of the freeway drivers) ‘simultaneous’ rather than ‘sequential’ (when we move in a codynamic with others, we simultaneously co-create the shape of our containing opportunity space);
"For the former [the harmonies of the parts] cannot exist at the same moment of time, while the latter [overall planetary system harmony] absolutely can." ... "For if the ratios of the journeys [orbital periods] are harmonic, all the other affects which the planets have will be necessitated and bound up with the journeys, so that there is no room elsewhere for establishing harmonies."
Thus, the Hygiean option is a transcendent option which perceives the constituents as the co-creators of their own containing environment (i.e. they are constituent and container at the same time, in the manner of the vortical atmosphere-feature called ‘hurricane’). The Hygiean option ‘includes’ the Aesculapian option as the degenerate Euclidian space and absolute time based view (i.e. ‘Newtonian’ view) wherein container-constituent reciprocity is ignored and one perceives the system behaviour in terms of the assertive actions of the constituents seen as ‘independent causal agents’.
The implication is, the system behaviour must be understood in terms of the Hygiean view to get a complete understanding (e.g. of the co-creation of the shape of opportunity space which modulates the flow patterns of movement) while the Aesculapian view can serve as a valuable support tool. This means that in order to sustain health and to heal, in either a human psychosomatic system or a community psychosomatic system, we must put ‘opportunity management’ (co-creating simultaneous volumetric harmony or ‘container-constituent-coresonance’) in the primacy over ‘action management’ (imposing order on the sequential kinetic trajectory of the constituent) ]].
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der Weltharmonik erklärt Kepler nicht nur die Planetenbewegungen, wie
wir das heute in der Schulphysik mit dem Newtonschen Formalismus tun, sondern er
begründet, warum die Planetenbahnen genau die erkennbare harmonische Ordnung
haben. Das ist eine Frage, die im Rahmen der heutigen Schulphysik überhaupt
nicht mehr sinnvoll gestellt werden kann.
geht nun aber Kepler in der Weltharmonik über das Mysterium
Cosmographicum hinaus? Kepler wußte, daß das Universum in einem
kontinuierlichen Schöpfungsprozeß begriffen ist. Deshalb hatte er im Mysterium
Cosmographicum die Gesetzmäßigkeit dieses Zeugungsprozesses in
harmonischen Verhältnissen gesucht. Doch Kepler hatte diese Verhältnisse
allein zwischen den Planetensphären, den "toten" Dingen (siehe
Schneckenschalen) gesucht, und die lebendige Aktion vernachlässigt. In der Weltharmonik
erkennt er, daß die Harmonie zwischen den Relationen der "lebendigen"
Umlaufgeschwindigkeit der Planeten besteht, und zwar gemessen an den
Winkelgeschwindigkeiten, wie sie einem Beobachter von der Sonne aus erscheinen.
hatte eben an diesem Haus der Welt nichts als Steine gesucht, zwar solche von
gefälliger Form, aber eben doch nur von einer Form, wie sie Steine haben. Ich
wußte nicht, daß der Weltbaumeister die Steine nach dem wohlgegliederten Bild
der belebten Körper gestaltet hatte... Die Harmonie ist gewissermaßen ein Band
der Vereinigung. Es liegt aber eine weitergehende Vereinigung vor, wenn die
Planeten alle miteinander eine Harmonie bilden."
im Kontrast dazu wurde die Harmonie in der politischen und gesellschaftlichen
Welt immer mehr zerstört. Im gleichen Monat Mai geschieht der Fenstersturz zu
Prag, der als offizieller Beginn des Dreißigjährigen Krieges gilt, welcher die
Hälfte der Bevölkerung Zentraleuropas auslöschen wird. Kepler stirbt verarmt
im November 1630 in Regensburg, sein Grab wird später verwüstet und
wissenschaftlich wird er geächtet.
 Seattle, Chief of the Suquamish, … ‘How Can You Buy or Sell the Sky’, transcribed from a speech made in 1851 in response to a treaty proposal under which the Indians would sell two million acres of land for $150,000. Buckminster Fuller calls it "one of the most beautiful and profound environmental statements ever made". From people that have done research, these were not his actual words but the gist of what he said. It make them none the less profound.
How Can You Buy or Sell the Sky?
How can you buy or sell the sky, the warmth of the land? The idea is strange to us. If we do not own the freshness of the air and the sparkle of the water, how can you buy them? Every part of this earth is sacred to my people. Every shining pine needle, every sandy shore, every mist in the dark woods, every clearing and humming insect is holy in the memory and experience of my people. The sap which courses through the trees carries the memories of the red man.
The white man's dead forget the country of their birth when they go to walk among the stars. Our dead never forget this beautiful earth, for it is the mother of the red man. We are part of the earth and it is part of us. The perfumed flowers are our sisters; the deer, the horse, the great eagle, these are our brothers. The rocky crests, the juices in the meadows, the body heat of the pony, and man--all belong to the same family.
So, when the Great Chief in Washington sends word that he wishes to buy our land, he asks much of us. The Great Chief sends word he will reserve us a place so that we can live comfortably to ourselves. He will be our father and we will be his children.
So we will consider your offer to buy our land. But it will not be easy. For this land is sacred to us. This shining water that moves in the streams and rivers is not just water but the blood of our ancestors. If we sell you land, you must remember that it is sacred, and you must teach your children that it is sacred and that each ghostly reflection in the clear water of the lakes tells of events and memories in the life of my people. The water's murmur is the voice of my father's father.
The rivers are our brothers; they quench our thirst. The rivers carry our canoes, and feed our children. If we sell you our land, you must remember, and teach your children, that the rivers are our brothers and yours, and you must henceforth give the rivers the kindness you would give any brother.
We know that the white man does not understand our ways. One portion of land is the same to him as the next, for he is a stranger who comes in the night and takes from the land whatever he needs. The earth is not his brother, but his enemy, and when he has conquered it, he moves on.
He leaves his father's grave behind, and he does not care. His father's grave and his children's birthright are forgotten. He treats his mother, the earth, and his brother, the sky, as things to be bought, plundered, sold like sheep or bright beads. His appetite will devour the earth and leave behind only a desert.
You do not know. Our ways are different from your ways. The sight of your cities pains the eyes of the red man. There is no quiet place in the white man's cities. No place to hear the unfurling of leaves in spring or the rustle of the insect's wings. The clatter only seems to insult the ears. And what is there to life if a man cannot hear the lonely cry of the whippoorwill or the arguments of the frogs around the pond at night? I am a red man and do not understand. The Indian prefers the soft sound of the wind itself, cleansed by a midday rain, or scented with pinon pine.
The air is precious to the red man for all things share the same breath. The white man does not seem to notice the air he breathes. Like a man dying for many days he is numb to the stench. But if we sell you our land, you must remember that the air is precious to us, that the air shares its spirit with all the life it supports.
The wind that gave our grandfather his first breath also receives his last sigh. And if we sell you our land, you must keep it apart and sacred as a place where even the white man can go to taste the wind that is sweetened by the meadow's flowers.
You must teach your children that the ground beneath their feet is the ashes of our grandfathers. So that they will respect the land, tell your children that the earth is rich with the lives of our kin. Teach your children that we have taught our children that the earth is our mother. Whatever befalls the earth befalls the sons of the earth. If men spit upon the ground, they spit upon themselves.
This we know: the earth does not belong to man; man belongs to the earth. All things are connected. We may be brothers after all. We shall see. One thing we know which the white man may one day discover: Our God is the same God.
You may think now that you own Him as you wish to own our land; but you cannot. He is the God of man, and His compassion is equal for the red man and the white. This earth is precious to Him; and to harm the earth is to heap contempt on its creator. The whites too shall pass; perhaps sooner than all other tribes. Contaminate your bed and you will one night suffocate in your own waste.
But in your perishing you will shine brightly fired by the strength of the God who brought you to this land and for some special purpose gave you dominion over this land and over the red man.
That destiny is a mystery to us, for we do not understand when the buffalo are all slaughtered, the wild horses are tame, the secret corners of the forest heavy with scent of many men and the view of the ripe hills blotted by talking wires.
Where is the thicket? Gone. Where is the eagle? Gone.
The end of living and the beginning of survival.
 Herwick, Dr. R., ‘THE LIMITATIONS OF MEDICAL SCIENCE IN THE SOLUTION OF SOCIAL PROBLEMS’
Conference sponsored by The Institute for Theological Encounter with Science and Technology (ITEST) in cooperation with The National Aeronautics and Space Administration (NASA) March 12, 1977 The Ames Research Center, Moffett Field, California The Goddard Space Flight Center, Greenbelt, Maryland The Lewis Research Center, Cleveland, Ohio)
Dr. Robert Herwick, M.D. is presently in private practice in San Francisco. He is also on the clinical faculty at the University of California, Childrens Hospital and St. Joseph's Hospital in San Francisco. Dr. Herwick received his BA in German Literature at Cornell University and was enrolled in Phi Beta Kappa, 1964. He interned at Childrens Hospital in San Francisco in 1969, after receiving his M.D. at the Cornell Medical School in New York City. He completed his Residency in Dermatology at the University of California Medical School in San Francisco in 1972. From 1972 - 74, Dr. Herwick served as Major in the United States Air Force Medical Corps and Chief of Medicine at the Strategic Air Command Headquarters at Omaha, Nebraska.
In seeking to examine the capabilities and the limitations of medical science in solving problems of social significance, one must begin by tracing the history of medicine as it recedes from its enlightened present into the darkness of ancient times. As with other historical inquiries, it is not surprising to find that perhaps fundamentally little is new ... that recurrent themes and patterns are discerned which may at the same time provide a basis for optimism or disillusionment, depending upon one's interpretation.
One of the most ancient concepts of health was that personified by Hygiea, the Greek goddess of health who watched over the corporeal welfare of the residents of Athens. Health was then based upon a unity with nature, a temperate lifestyle and the belief that good health was a natural attribute. Rather than treating the sick, Hygiea embodied the ideal of the preservation of natural health through living in harmony with nature. Slowly this ancient concept was replaced after the fifth century B.C. by the cult of Aesculapius, the son of Apollo and the god of medicine. Aesculapian temples were erected to which the sick were brought for mysterious healing rituals as well as for mineral baths, exercises (an early precursor of today's physical therapy) and various unctions. The therapeutic ceremony, performed by the temple priest during a nocturnal trance in which a healing dream was interpreted, was not entirely dissimilar to "modern" Freudian or Jungian psychoanalytic practices. The salient point about the cult of Aesculapius is that it was a therapy of intervention, of combating a disease and seeking its expulsion from the body. The restoration of health was based to a large extent upon superstition: and at times almost charlatan mysticism which effected a magical cure together with an increase in the temple coffers. It is parenthetically somewhat disturbing that the staff of Aesculapius with its single snake has become the symbol of today's medical profession. This becomes less objectionable, however, when one considers the often inappropriately used caduceus (that winged staff with two entwined snakes). This of course was the symbol of Mercury, the god of commerce and of thieves!
Throughout history this dichotomy of Hygienic health through natural harmony and Aesculapian healing by intervention eternally recurs. Hippocrates, the great Greek father of medicine, returned to the former tradition and stressed the treatment of the person as a whole, reflecting and participating in a natural order of natural health. The good physician assisted nature after the manner of "similia similibus," treating like with like. An example of this would be applying hot compresses to augment the inflammation of a local infection. Hippocrates taught that the body was endowed with the ability to cure itself and that the outward signs of disease were laudable manifestations of this process. He brought the practice of medicine to the bedside where the physician carefully observed the clinical condition of his patient and sought to assist the natural process which he carefully observed and for the first time quantitated. The inner balance of the four bodily humors was first evaluated. Then a diagnosis and prognosis were offered and finally a homeopathic treatment was instituted to assist the body in reestablishing an inner harmony with the natural order. The very word "physician" based on the Greek root for "nature" reflected this understanding of the doctor's role. This philosophy of non-intervention was carried forth into the Roman Empire and there are numerous examples of its influence. Tiberius advised that anyone who consulted a physician after the age of 30 was a fool, as he thereby demonstrated that he had not yet learned to account for his own life or body.(1)
The counter current of allopathic medicine, often based on the opposite principle of "contraria contrariis" (that is, attempting to counteract external symptoms by producing an opposite effect) was not buried with the ruins of the Aesculapian temples. It has reappeared throughout history and at times has coexisted to a remarkable extent with the natural harmony concept of Hygiea. The Gnostics of early Christian times developed rather elaborate rituals for the expulsion of disease. Disease by their understanding represented the adversary forces of evil over which a mystical salvation could be effected by the initiates. Their invocation with the word "abrucadabra" survives in the vocabulary of prestidigitators of modern times. To my knowledge this incantation is not in frequent use today by many members of the modern medical profession, no matter how heretical their personal philosophy.
During the middle ages phlebotomy, or blood letting, enjoyed a great popularity: the penultimate example of "contraria contrariis." The rationale for this was to divert toxic materials from one organ to another and thence out of the body: a rather primitive concept until one considers the present day therapy for Porphyria Cutanea Tarda, a dermatologic abnormality of hemoglobin metabolism. This therapy consists in fact of repeated phlebotomies to divert excessive heme precursors from the liver and bone marrow. In the past decade this has been recognized as unquestionably the treatment of choice in this disorder and is used in every major university and teaching hospital in the western world. Phlebotomy also survives today as standard therapy for Polycythemia Vera and Idiopathic Hemochromatosis. These provide rather striking examples of the aphorism taught to medical students studying pharmacology: "Be not the first by whom the new is tried, nor yet the last to lay the old aside." Medical practices in the middle ages such as blood letting were based to a great extent upon ill-founded dogma perpetuated by the rigid scholasticism into which medicine had fallen and numerous unsubstantiated and even harmful remedies were carried forward unchallenged. There survived, nonetheless, a viable kernel of effective treatment based largely upon practical results rather than pathophysiologic theory.
The physician of the fourteenth century, by contrast, used very little such rational empiricism, but become more and more preoccupied with the grandeur of such external trappings as prescribing drugs by ceremoniously pointing them out at the pharmacy with his baton. His excellence by our "scientific" standards and his proximity to the patient's bedside waned in inverse proportion to the majesty of his flowing robes and elaborate costumes.
With the coming of the Renaissance, man was again elevated to a position deserving of the center of human thought and with this came a regeneration of the classic espousal of the harmony of nature and of disease as a temporary disequilibrium in this harmony. Great advances were made in anatomy by Leonardo in his quest for accurate representation of the human body in his sculpture. As physicians returned to the Hippocratic teachings lost in the scholasticism of the middle ages they regained their position of social esteem and shedding their magisterial robes again became educated and cultured members of society. In the seventeenth century Galileo pioneered the scientific method which become the cornerstone for all modern science. The discovery of new methods and tools proliferated during the next hundred years as the microscope, blood transfusions, obstetrical forceps and new surgical instruments took their place in the physician's armamentarium.
The doctors of this enlivened period again began to drift away from the patient's bedside to such enterprises as Anton Mesmer's tub of sulphuric acid with its iron bars to conduct healing magnetic forces into his diseased and gullible patients. Despite temporary dalliances such as this, the Romantic era of the late eighteenth century lured physicians back again from the laboratory and its paraphernalia to a de-scienced and perhaps overstated concern for the natural state of man. Rousseau taught that all sickness was the result of deviation from the natural state; that a return to this basic harmony was the goal of all medicine. The scientific era had now gone full circle. It had worshiped in the temples of science and dabbled in external contrivances in seeking the key to health. Now such events as the discovery of Tahiti in 1767 fueled a new quest for an idyllic happiness almost to the exclusion of all "extraneous" aids. Hygiea returned triumphant and Aesculapian intervention had again fallen from power, this time, however, only temporarily. The romantic fervor could not be indefinitely sustained, nor could scientific discoveries be repressed by the noble savage, and the Age of Reason supervened.
With the Industrial Revolution came unsanitary crowding and frightening increases of communicable diseases such as typhoid and smallpox, and with these there came a demand for social reform. This reform, it must be carefully noted, was based upon the Hygienic ideals of the Romantic era rather than occuring as a direct consequence of the intervention of scientific theories. It is the thesis of biologist and Nobel laureat Rene Dubos in his book "The Mirage of Health" that the dramatic decline in European death rates that began in the nineteenth century was the result of these social reforms and preceded the introduction of the germ theory(2) and other medical advances. It is a universally uncontested fact that the increase in life span documented during the past 200 years is almost entirely a function of the decrease in infant mortality which is in turn almost entirely the result of increased hygiene. It has been demonstrated that 90% of the total decline in combined mortality from scarlet fever, diphtheria, whooping cough and measles between 1860 and the present occured before the introduction of antibiotics.(3) One of the leading opponents of the germ theory, chemist Max von Pettenkofer, was almost singly responsible or a fivefold drop in typhoid mortality in Munich in the late nineteenth century. This he did by convincing the town authorities that on an aesthetic basis it would be more desirable to divert the cities sewage from upstream to downstream.(4)
A brief look at the incidence of modern epidemics will perhaps dispel any illusion that the gates to Elysium have been thrown open before us by vaccines, antibiotics and modem medical techniques. Taking measles as an example, one sees this viral infection of negligible importance in 1785. By 1804 it had increased to such an extent as to equal the death rate from smallpox. By 1840 measles had declined and was replaced by scarlet fever as the primary infectious disease. By 1915 the death rate from measles had climbed again, this time to outstrip the death rate from smallpox, scarlet fever and diphtheria combined. Since that year its incidence has steadily declined.(5) In Europe leprosy and plague reigned in the fourteenth and fifteenth centuries, syphilis in the sixteenth, smallpox in the seventeenth and eighteenth, scarlet fever, tuberculosis and measles in the nineteenth. The great influenza pandemic of 1918 killed 20,000,000 people world wide. That specter was raised again only this year. Paradoxically as the incidence of a disease decreases, its virulence may increase because of less natural immunity. This was the case with poliomyelitis during this century: better sanitation meant less exposure to the virus during early childhood and a fall in the overall pool of antibodies with a marked worsening in the severity of the disease for those unfortunate few who did encounter the pathogen during later childhood. The Salk and Sabin vaccines are now therapeutically adding to this antibody pool, but as one disease is "conquered" one asks of history whether another will not inexorably rise up to take its place. Such is Dubos' "mirage of health." At this very moment in history, helicopters are flying smallpox vaccine into Ethiopian villages and public health experts fully expect to have seen the last case of smallpox on the face of the earth this spring. This is no small accomplishment as smallpox has literally raged epidemically for all recorded time. Records of it go back to 1122 B.C. in the Tcheou dynasty. With such statistics it is tempting to believe that twentieth century man has finally wrested fire from the gods and has begun to immolate all diseases, one at a time, upon the alter of the temple of Aesculapius. Tempting, that is, if considered without the benefit of historical perspective.
The greatest danger of our present scientific medical Weltanschauung is not, however, simply a mistaken optimism about the eradication of a finite number of disease entities one at a time. It is rather that it constitutes one of many bases upon which the subtle erosion of man's personal responsibility for his own life is precariously founded. Disease has come once again to be looked upon as something extraneous which has fallen upon man and must be expelled, rather than as a necessary manifestation of an inherent disharmony in a fallen universe. The responsibility for being sick is shifted from the individual to the doctor and worse, to the medical establishment. A cure is demanded, if not of the physician then of the goddess of Science whom he vicariously represents. If the World Health Organization can successfully eradicate smallpox in a ten year campaign, one demands the some for cancer, diabetes and heart disease. Understanding illness as a complex disharmony affecting an even more complex individual, read "human being," has in many cases been temporarily set aside in the frenzied search for specific etiology and then for its curative antithesis. The pendulum has again swung back to healing by "contraria contrariis."
Ivan Illich speaks of the "medicalization of life" in his book "The Medical Nemesis." For rich and poor, life is turned into a pilgrimage through checkups and clinics back to the ward where it started... this lifespan is brought into existence with the prenatal checkup, when the doctor decides if and how the fetus shall be born, and it will end with a mark on a chart ordering resuscitation be suspended."(6) He observes that "unsick people have come to depend on professional care for the sake of their future health."(7) Carrying this a step further, Paul Ramsey sees present day concern with various genetic techniques including cloning to eliminate diseases from future generations as treating "non patients," i.e., the species or the gene pool rather than individuals.(8) Individual rights may be violated in the name of a higher eugenic goal of "a healthier mankind" rather than healthier men. The object of the healing art drifts further and further from the suffering individual and threatens to become lost in a misty realm of generalities and lofty causes. Clearly these questions must be answered, for in perfecting techniques to prolong an individual's life, the process of natural selection ceases to operate and the overall incidence of heritable diseases, once limited by death before the age of reproduction, increases exponentially. A case in point is the incredible increase in the incidence of diabetes mellitus in the general population -- an increase made possible by the use of insulin in literally saving the lives of juvenile diabetics, allowing them to reproduce and perpetuate their genetic abnormality. The exciting possibilities of DNA-recombinant engineering radically to correct the cause of diabetes on a chromosomal level releases the specter of mutant genes and their possible effect upon those now living.
Medical scientists today have been lead from one discovery, one triumph to another, inexorably further away from the patient's bedside and from the Hippocratic ideal. Embued with the fervor of this new religion, the patient himself has in his faith in science literally chased his physician thither. The healer has often retreated to the inappropriate security of prophylactic laboratory tests ("prophylactic" in the sense of offering protection for him against the threat of malpractice litigation for failure to diagnose). In other cases he may have hidden himself behind a barrage of computerized fluoroscopes, radioisotope assays and electron microscopic analyses to avoid confronting his ultimate inability radically to cure. The profound anxiety stirred up by the realization of this limitation has become as untenable for the worshippers at the temple, the patients, as it has for its high priests. The flight from such a frightening realization further and further into the technologic strata betrays the society's growing existential dilemma. The individual has increasingly abdicated responsibility for his own life in the great illusion that he has enhanced his ability to enjoy that life. He seeks no longer only the apple, but the entire tree. He has climbed a bit too far and too fast out upon a limb of that tree and he is frightened. To retrace his ascent is impossible and so he clings more tightly, more stubbornly to these branches and looks higher still for a resting place. Like Faust he has ventured so for and so high that in his bedazzlement he has risked losing his very self. Dubos expresses this quite well: "To discover, to describe, to classify, to invent, has been the traditional task of the scientist until this century; on the whole a pleasant occupation amounting to a sophisticated hobby. This happy phase of social irresponsibility is now over and the scientist will be called to account for the long-term consequences of his acts. His dilemma is and will remain that he cannot predict these consequences because they depend on many factors outside his knowledge or at least beyond his control -- in particular on the exercise of free will by men."(9) Obviously I cannot end on such a pessimistic note of what I see as a strong trend on the stage of modern medicine's reenactment of the Aesculapian scenario. As with other oscillations of history, there endures a spirit of the healing art which is transcendent, the spirit of comforting a patient who suffers, a spirit which is nonetheless immanently present in the technology adopted by the healer. Technology cannot be dismissed with a nostalgic sentimentality, the Samaritan today would have rejected the pouring of oil into his patient's wounds. We know today that oil impedes wound healing. One would not relish the prospect of treating bacterial endocarditis without penicillin or leprosy with sulfones, no matter how Hippocratic his concern for the whole patient. Given this spirit of healing, the awesome complexities of technology can be forged into remedies of inestimable value to be utilized by the good physician. Absent this spirit and Science, that foreboding temple priestess, usurps the physician's role, transforms means into ends, and in the end displaces individuals as the rightful recipients of the healing art. Free man is thereby lead further out that limb at whose end is found the loss of yet another facet of his existential freedom: the ultimate responsibility for his own body.
1. Arturo Castiglioni, "A History of Medicine," Jason Aronson,
Inc., New York, 1975, p. 143.
2. Rene Dubos, "Mirage of Health," Harper & Row, New York,
1959, p. 23.
3. Ivan Illich, "Medical Nemesis," Pantheon Books, 1976, New
York, p. 16.
4. Dubos, op. cit., p. 149.
5. Ibid., p. 177.
6. Illich, op. cit., p. 79.
7. Ibid., p. 122.
8. Paul Ramsey, "Fabricated Man," Yale University Press, 1970, p. 101.
9. Dubos, op. cit., p. 271.
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