Lebenskraft, Radical Reality, and Occidental Medicine: How Science Is Leading Us Back to a Holistic View

Lebenskraft, Radical Reality, and Occidental Medicine: How Science is Leading us back to a Holistic View Monica Ledoux Abstract: Analyzing a human being through her/his constituent parts, physiology has led to significant breakthroughs in research. However, this approach is reaching its limits as one becomes ever more aware that essential holistic factors such as multicausal illnesses, the importance of the microbiome, and psychological factors are not addressed. A holistic approach to medicine reemerged in the nineteenth century under different guises, such as homeopathy, and with varying degrees of scientific grounding. More recent initia- tives, such as translational microbiome research, multidisciplinary consultations and a new focus on patient/doctor communication, are now gaining momentum, boosted by new scientific discoveries. It is likely that a more holistic approach to studies of human well being in twenty-first century medicine will offer opportunities for better understanding how the body responds to its environment.1 The Focus on Anatomy In Renaissance Europe Andreas Vesalius (1514-1564), a professor at the University of Padua, became convinced that autopsy was a necessary exer- cise for the genuine understanding of human anatomy. He considered em- pirical, direct observation to be the only reliable method of investigation, which represented a dramatic break with previous medical practice. His dis- secting of cadavers introduced a period of rapid advances in knowledge of the anatomy and development of surgical procedures. The introduction of the microscope in laboratory techniques in 1674 by Anton van Leeuwen- hoek (1632-1723) allowed for enhanced knowledge of ever-smaller struc- tures such as blood corpuscles, lymph cells, nerve cells, and bacteria. These advances eventually led to such subspecialties as hematology, immunology, neurology, and microbiology. Moreover, scientific progress led to classifying diseases in medical textbooks. Diseases were listed as oncologic, inflammatory, infectious, and genetic and were assigned specific causes. Since then, medical science has progressed in all domains by assessing a medical prob- lem according to the affected areas. This approach allowed for significant knowledge gains about human anatomy and physiology, until the amount of knowledge grew so large that medicine itself had to be compartmentalized into more manageable specialties: cardiology, hepatology, dermatology, 1 Please note that this chapter retains the medical science practice of listing source cita- tions as references to the numbered items in the works cited included at the end of this chapter. 306 Monica Ledoux urology, ophthalmology, etc. with doctors taking care of a single organ: heart, liver, skin, kidneys, or eyes. Despite all the stunning advantages of scientific advances for patient treatment, one downside became visible: while doctors concentrated on facts concerning the particular organ they were treating, they ran the risk of loosing sight of the patient as a person with his/her individual way of func- tioning and feeling. In the past, this led to such absurdities as caretakers in hospitals referring to a hospitalized patient as “the liver in room 5” because they could not remember his name or professors discussing a patient’s chart in a hospital room with interns without realizing that the concerned person was not in his bed. Renewed Holism In the last third of the twentieth century, signs of a movement toward a holistic understanding of the multifarious causes of an illness began to reap- pear in papers presented at scientific meetings. One new approach, for ex- ample, was to view an illness as being simultaneously oncologic and genetic, inflammatory and psychosomatic. Researchers theorized, moreover, that in certain diseases more than two causal factors or triggers might be involved, as in the case of eczema which is inflammatory and often has a genetic pre- disposition (e.g., filaggrin gene) that flares up with stress and thus has psychosomatic symptoms too. Moreover many patients can react to environ- mental factors as well. Clearly, human organisms are complex and not reducible to their constituent parts. In medical textbooks, disease continued to be classified as infectious, oncologic, and autoimmune, along with a notation of their reductionist cause. In more and more chapters a second or third causal factor was men- tioned. What if we were to move away from a single organ/single factor disease toward a view of human beings existing in a somewhat fragile equilibri- um determined by a multitude of internal and external factors? Increasingly, medical science is beginning to move away from a focus on a single organ as well as the simplified search for a single factor that leads to a specific disease and is returning to a more holistic view of the human body as an assemblage of interconnected systems. The reductionist search for a specific cause of a disease potentially blinds the researcher to the nature of the interactive factors involved in the appearance of a “malfunction.” As noted, seventeenth-century Dutchman Anton van Leeuwenhoek perfected the microscope that allowed the discovery of microorganisms. Since then, science has gained insight into a multitude of microorganisms along a broad scale, the best-known ones being bacteria, fungi, and viruses. They are largely considered infectious and are studied with the goal of find-.

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