Friday, 14 September 2012

Eastern and Western Approaches to Medicine

As seen by modern eyes, both the Eastern and Western traditions of medicine were ludicrously wrong. Both were hampered by a prohibition of actually cutting up a body to see its internal structure, so both made guesses that, in the end, proved untrue. However, Eastern physicians seemed satisfied to make mental models of how the body functioned, while Western ones, from time to time, took up a knife on criminals, corpses, or cattle. The difference seems to be a different attitude towards one question: can you heal the sickness by observing a functioning body, or do you need to understand its parts? Can you understand health and sickness through observation and metaphor, or do you need to cut and experiment? The two points of view can be illustrated by considering something a little simpler than a human being, an old-fashioned TV.
A Vacuum-Tube TV with a Rabbit Ears Antenna (from the movie "The Twonky")
These days, a television with a “rabbit ears” antenna is a rare sight. When I was young, however, adjusting the height and angle of the two wires to get the best picture was simply a fact of life. A change of channel or a change of weather might require fiddling with the antenna.

Sometimes, especially when the signal was weak, the person adjusting the antenna would become part of it. The TV picture would remain clear as long as he held onto the antenna in a certain way, or stood near it in a certain place. For whatever reason, some people seemed to have an instinct for finding the right place to hold or stand to get the clearest, healthiest picture.

However, at times, the screen would go black, or fill with a blizzard of white spots called “snow,” or jagged waves, or have its picture race horizontally or vertically across the screen over and over again. At such times, the laying on of hands and supplications to the gods of the airways would not be enough. One would have to understand the cause of the problem to fix it.

Inside the TV was a set of differently-sized and shaped vacuum tubes, like a miniature oriental city with the minarets and domes done in glowing glass. If any of these structures failed, the picture died in some unique way. A technician could see the error on the screen and know what tube had gone bad; he would replace the tube, and the problem would disappear.
An Oriental City in Glowing Glass (
Non-technicians like me could do the same, with a little help in the form of a small cardboard square with a cardboard circle pinned to its centre so that it could rotate. The cardboard circle had two holes in it. As the circle turned, one hole showed pictures of TV screens malfunctioning in specific ways; the other showed what tube caused the malfunction. The back of the cardboard square had a map of the TV’s interior to show where where the replacement tube would go to cure the problem. This little guide let us work like a TV technician without actually becoming one.

The reason for describing this ancient technology and its problems is that the two approaches to fixing a television are, surprise, the two approaches to healing a body. In ancient times, in both East and West, the predominant approach was experimental but noninvasive. Physicians did the equivalent of adjusting the antennae to get a better picture. As they worked from experience and observation, they often obtained results, though any deep understanding of the body was little more than coincidence. Modern medicine, as it developed in the West and spread worldwide, was fundamentally invasive. The back came off the tv, the tubes were identified, and each tube became identified with a specific dysfunction of the picture. In the end, this approach allowed more cures and better theory.

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