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How Chinese Medicine Became GermanHolism, Systems and Free Flow
Chinese medicineHolismSystems
https://holisticsecurity.wordpress.com/2008/06/13/what-is-holism/
“The ancient Chinese had no need of systems theory. They possessed it already, because they cared above all for the commonwealth of creatures and things.”
How did Chinese medicine become holistic?
Dialectics
自然辯證法
Holistic
Medicine
Cybernetics
Systems
Theory
Systems
biology
Integrated
Medicine
Post-
Kantian
Philosophy
Modernity
Germany
Holism
Vitalism
Gestalt
The
Interwar
Years
Traditiona
l
Chinese
Medicine
Cultural/conservativ
e holismKant, Herder, Humbolt
OrganicismJoseph Needham (1900-1995)
The Invention of HolismEcology, systems & empire
Scientific/progressi
ve holismHegel, Engels, Lenin
Friedrich EngelsDialectics of Nature
“The whole of nature accessible to us forms a system, an interconnected totality of bodies, and by bodies we understand here all material existences extending from stars to atoms, indeed right to particles, in so far as one grants the existence of the last named.”
Holism in Nazi Germany
№
How Chinese medicine became holisticPart I: China
整體觀念zhengti guannian
1950sThe Institutionalisation of Chinese Medicine
• 1955: first application of the idea
of holism in the Chinese medical
literature
• 1956: eleven papers on topic of
holism in Chinese medicine
published in Chinese medical
journals
• 1959: Qin Bowei’s Introduction to
Chinese Medicine (中醫入門
Zhongyi rumen) places holism at
the very core of Chinese
medicine
Qian Xuesen 錢學森
writes letter to Lü Bingkui
呂炳奎, Director of the
Chinese Medicine
Bureau at the Ministry of
Health arguing that
traditional western
science “breaks apart the
original wholeness of
things” while Chinese
medicine is part of
Chinese science’s
holistic perspective.
• Systems dialectics 自然辯證法: optimising all aspects of society,
from economics and social coherence to ideology and culture,
war and peace, via a newly powerful understanding of systems
• Systems biology as emergent interface of Chinese medicine and
systems science
№
How Chinese medicine became holisticPart II: The West
• 1951: J Otto - ‘On the holistic perspective in the Chinese healing
art’ (Über Ganzheitsbetrachtung in der chinesischen Heilkunst)
• Chinese medicine as expression of Chinese culture
• Holism as a concern specifically for the integration of body,
mind and spirit.
The San Francisco Renaissance
American Academy of Asian Studies (AAAS)founded 1951 https://soundcloud.com/integraleducation/5-michael-murphy-on-
aaas/recommended
Frederic Spiegelberg1897-1994
Alan Watts1915-1973
Esalenfounded 1961
№
Holistic scienceSystems theory, cybernetics & systems biology
C.G. JungChinese metaphysics and quantum science
“The ancient Chinese mind contemplates the cosmos in a way comparable to that of the modern physicist, who cannot deny that his model of the world is a decidedly psychophysical structure. The microphysical event includes the observer just as much as the reality underlying the I Ching comprises subjective, i.e., psychic conditions in the totality of the momentary situation.”
- C.G. Jung, Forword to the English edition of Wilhem’s Yijing
Ludwig von Bertalanffy (1901-1972)
Cybernetics
‘Stewart Brand once called the Tao Te Ching, written by the Chinese sage
Lao Tzu, the “first systems theory book.” And today,“ Taoism for managers” is
considered a natural part of the ideological furniture of neoliberalism.’
(The Whole Earth: California and the disappearance of the outside, HKW, 2013)
Integrated medicine “maximizes the potential of the physical and social environment, so that healing and better health can thrive.”
Systems biology
But is Chinese medicine really holistic?
Tito Tonietti
• Western science, specifically since the
scientific revolution, predicated on
attempting “to introduce order into that
which changes, by fixing its static, eternal
foundations.”
• Chinese sciences are not holistic because
they do not seek to describe, regulate or
analyse complexity
“Skilful action relies on customary rules [of practice]. Reality, however, is never constrained by such rules.”Fei Boxiong 費伯雄 (1800-1879)
Calculating life orNourishing the vital 養生
Dr Jens Foell Senior Clinical Teaching Fellow School of Public Health Imperial College London
What is in the tin, when holistic is written on the package?
The H wordFreeman J. Towards a definition of holism. British Journal of General Practice. 2005;55(511):154.
The H Word
“Research suggests that interventions that successfully reduce inequalities in health outcomes are generally multi faceted and 'holistic' in approach, and align with local priorities, local ways of working and existing services.”
The H Word
“My diabetes, my care”, CQC Report 2015
…”MDT – a team of healthcare professionals with the full spectrum of clinical skills to
deliver holistic care
to patients with complex problems” (NICE guideline 83 Rehabilitation after critical illness)
“The holism of chinesemedicine did not develop psychology as a separate realm of discourse” (Kirmayer and Young, Psychosomatic Medicine 60:420-430 (1998)
Holistic principle: “The diagnostic task in dysfunction is to determine the pathogeneticchain and to assess the correlation and relevance of its individual links” (Lewit J Orthop Med 1993 16 73-76)
“…clinically appropriate onward referral..as might be applicable to support high quality holisticpatient management” (H&F MSK Tender document 2008)
The Peckham Experiment “They
adopted a holisticapproach to medicine by encouraging a healthy lifestyle long before it became fashionable” (BMJ Vol 338 4/09 pg 790)
“It also gives due consideration to health care providers who should be enabled and supported to provide
effective, holistic and compassionate care.” (People at the centre of health care: harmonizing mind and body, people and systems.Geneva:World Health Organization, 2007)
The H word
Brief overview
Reductionist hermeneutic strategy• Reduction of complexity
• Reduction into compartments or single entities
• Templates and protocols
• Specialisation
• Bureaucratisation
• Standardisation
Goodwin C. Professional Vision. American Anthropologist. 1994;96(3):606-33.
Etymology
• Jan Smuts “Holism and Evolution” 1926
• Longstanding dissatisfaction with enlightenment project
• Romanticism
• Vitalism
• Revival in 70s
• New Age Boom
Rosenberg CE. The Therapeutic Revolution: Medicine, Meaning, and Social Change in Nineteenth-Century America. Perspectives in Biology and Medicine. 1977;20(4):485-506.
Ultra brief history of medical models
“The therapeutic paradigm was fundamentally an ancient one: the body was perceived as a complex system connected to the surrounding environment through inputs and outflows and in a state of dynamic equilibrium when healthy.
Illness was a form of imbalance. Therapeutics thus concentrated on re-establishing equilibrium, usually by acting on input and outflow. “
WEISZ, G. 1998. Greater than the parts: holism in biomedicine, 1920-1950, Oxford University Press, USA.
Historical Organismic
Ecological Worldview
Holism
WEISZ, G. 1998. Greater than the parts: holism in biomedicine, 1920-1950, Oxford University Press, USA.
KRIEGER, N. 2005. Embodiment: a conceptual glossary for epidemiology. Journal of Epidemiology and Community Health, 59, 350-355.
The H word
Systemic thinking
• Cybernetics Wiener, O. (1948)Cybernetics: Or the Control and Communication in the Animal and the Machine)
• Systems Theory (von Bertalanffy, Ludwig, (1974) Perspectives on General System Theory)
• Complex adaptive system theory Holland, John H. (1992). Adaptation in natural and artificial systems: an introductory analysis with applications to biology, control, and artificial intelligence
• Emergence (Emergence as a Construct: History and Issues. By: Goldstein, Jeffrey, Emergence, 15213250, 1999, Vol. 1, Issue 1r, Fromm, Jochen (2004),The emergence of complexity, Kassel University Press)
• “The emergent is unlike its components insofar as these are incommensurable, and it cannot be reduced to their sum or their difference." (Lewes 1875 Problems of Life and Mind (First Series), vol. 2, Trübner , p. 412)
• "... the totality is not, as it were, a mere heap, but the whole is something besides the parts ...", i.e., the whole is greater than the sum of the parts. (Aristotle Metaphysics Book 8.6. 1045a Pg 8-10)
Emergence
Narrative turn
• Loss in process of reductionism: Meaning, interactive qualities of caregiver/careseeker relation, sense of coherence
• Opposition against reductionist biomedical paradigm is heterogenous
John Launer, Consultant in family therapy and expert in narrative based primary care
Primary care
Wade/Halligan BMJ 2004
The quest for a contextually sensitive medicine
Wade, D. (2015). "Rehabilitation – a new approach. Part two: the underlying theories." Clinical Rehabilitation 29(12): 1145-1154.
Who is at the centre?
Screenshot QOF target 2014_1_4 SystmOne
NICE (2014). Osteoarthritis - Care and management in adults Clinical guideline CG177 Methods, evidence and recommendations Clinical guidelines, National Clinical Guideline Centre: 505.
The H word
DetachedAttached
Dowrick C, Heath I, Hjörleifsson S, Misselbrook D, May C, Reeve J, et al. Recovering the self: a manifesto for primary care. British Journal of General Practice. 2016;66(652):582.
Do things right Do the right
thing
Dowrick C, Heath I, Hjörleifsson S, Misselbrook D, May C, Reeve J, et al. Recovering the self: a manifesto for primary care. British Journal of General Practice. 2016;66(652):582.
Dowrick C, Heath I, Hjörleifsson S, Misselbrook D, May C, Reeve J, et al. Recovering the self: a manifesto for primary care. British Journal of General Practice. 2016;66(652):582.
Individual self Social self
PhysicalistHumanist
“Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place” SONTAG, S. 1978. Illness as metaphor.
activepassive
Dowrick C, Heath I, Hjörleifsson S, Misselbrook D, May C, Reeve J, et al. Recovering the self: a manifesto for primary care. British Journal of General Practice. 2016;66(652):582.
Virtue signalling
Thank you
Acknowledgements
John Launer
Kath Lovell
References
Dowrick, C., et al. (2016). "Recovering the self: a manifesto for primary care." British Journal of General Practice 66(652): 582.
Checkland, K., et al. (2008). "Biomedicine, holism and general medical practice: responses to the 2004 General Practitioner contract." Sociology of Health & Illness 30(5): 788-803.
Weisz, G. (1998). Greater than the parts: holism in biomedicine, 1920-1950, Oxford University Press, USA.
Freeman, J. (2005). "Towards a definition of holism." British Journal of General Practice 55(511): 154.
Ahluwalia, S. and J. Launer (2014). "Complexity and uncertainty in healthcare." Education for Primary Care 25(4): 181-183.
Wade, D. (2015). "Rehabilitation – a new approach. Part two: the underlying theories." Clinical Rehabilitation 29(12): 1145-1154.•
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