The physician’s highest calling, his only calling, is to make sick people healthy -- to heal, as it is termed.
- Aphorism 1, Organon of Medicine [Kunzli, trans.]
In the footnote to this first paragraph of his Organon of Medicine, Dr. Samuel Hahnemann goes on to say: We don’t need speculations as to the inner workings of the body, we will never understand every subtlety of the human organism, we don’t need endowed chairs of theoretical medicine. We need doctors to get busy helping people. Implied: Because we already know all we need to heal the sick.
This may sound bold coming from a 19th century physician. How could we have possibly known back then all we needed to heal the sick? Don't we know so much more now?
Indeed, we do. But Hahnemann wasn't objecting to medical knowledge or the search for better medical knowledge. He was objecting to the way that knowledge was being applied, without mastery and without a principle of cure. He was objecting to medical speculation.
It may be helpful to know that Hahnemann was at the forefront of medicine during his time. He is a still a hero in standard medicine because of his understanding of communicable disease and his writings on hygiene. I personally believe Hahnemann would be thrilled with modern advances in microbiology and medical technology.
So, what did Hahnemann mean when he said in this footnote that the physician's calling did not "consist of trying endlessly to explain disease phenomena and their proximate cause, which will always elude him"?
One of the most common misconceptions Americans have about modern medicine has to do with how much we actually know about the human body. The practices of medicine seem to be predicated on the idea that more depth of knowledge yields better health care. So, with all the vast increases in medical knowledge over the last 80 years, with the whole human genome mapped, we must have all the processes of the body mastered, right?
Well, not exactly. It seems the deeper we dig the more complicated everything becomes.
To understand the complexity of something like our genetic code, think of genes as individual characters in a 20,000-letter alphabet. These characters can be put together to produce millions of words, some with hundreds or thousands of letters each. So, having mapped the genome (found out the shapes of the characters), we still don't know what most of those letters sound like, much less how those sounds combine to make words or how those words interact. We're not even sure if there are discrete words or whether they might overlap each others' spelling like some enormous poem written without a space bar.
What many people may not know is that, while we have already started fiddling with the master code to life -- re-forming characters and inserting foreign ones to see what happens -- we still don't have a basic understanding of some of the anatomical structures in the human body.
For example: There is an entire nervous system in the gut that consists of about a hundred million neurons. It has the ability to operate independently of the central nervous system, and we're not sure exactly what it does. Traditional Chinese Medicine probably has a very clear idea of what it does, but because western medicine tends to discount anything that can be observed but not explained, standard medicine does not.
Another important example: We don't understand exactly how muscles contract. We have a good idea, but if we had the mechanism mastered, we probably wouldn't be learning recently, after 30 years of heavy calcium supplementation, that excess calcium in the body may cause heart muscle malfunction!
It turns out that chasing after every minute chemical interaction in the body is not so easy, because every one interaction is linked to other interactions, and these relationships ramify beyond the ability of the human intellect to grasp or control.
I don't want to suggest that modern medicine hasn't done its best to understand these things. Quite the contrary. Nor do I want to suggest that there's a problem with learning more about the human body. Our knowledge of physiology helps us to understand the links between various symptoms we see in a person and to come to a more effective way of dealing with that person's illness and understanding what happens to that person under treatment.
But if we base our entire system of medicine on biochemistry, we had better then understand how the body works biochemically! In the meantime, we should not be basing our therapies on the idea that we can control that chemistry.
As to Hahnemann's assertion that we will NEVER have a complete understanding of the body's complexity, he may be wrong about that. I don't know. But we have many decades now of laboratory-based medicine that might well back him up: think of Thalidomide, Vioxx and the dozens of less notorious drug recalls issued by the FDA every year.
These drugs were theoretically supposed to accomplish this or that change in a person's physiology, but their effects were deeply regrettable once those chemicals actually got into a lot of human bodies for a few years.
I think Hahnemann would say that until we do have all that knowledge and have crafted coherent, unified principles of biochemical health and healing, we should not base our treatments on such knowledge and the theories it engenders.
But, if we don't base our medicine on biochemistry, if we don't use all this knowledge we've amassed, where are we left? Aren't we lost without all this information?
No. It turns out there are simpler and more reliable ways to understand people than by trying to chart the nuances of their individual chemistry. For starters, you can listen to what people say about themselves, physically, emotionally and intellectually.
In homeopathy we call such statements, "symptoms," and we understand disease by the "totality of symptoms."
[Quotes from Hahnemann, Dr. Samuel, Organon of Medicine, 6th ed.; J. Kunzli M.D., Alain Naude, and P. Pendleton, translators; United States (1982).]
The endless cycle of idea and action,
Endless invention, endless experiment,
Brings knowledge of motion, but not of stillness;
Knowledge of speech, but not of silence;
All our knowledge brings us nearer to our ignorance,
All our ignorance brings us nearer to death,
But nearness to death, no nearer to GOD.
Where is the Life we have lost in living?
Where is the wisdom we have lost in knowledge?
Where is the knowledge we have lost in information?
- T.S. Eliot