Alchemy, Chemical Medicine, and Chinese Herbal Medicine
Limits to Medicine by Ivan Illich criticizes almost all aspects of modern scientific medicine and discusses issues. In reading it as students of physical therapy and occupational therapy in 1978, students concerned about the term iatrogenesis, iatro – doctor or medicine caused disease, or medical nemesis. The author not only mentions the malpractice but also attacks all the aspects of modern medicine. The marginal utility (effectiveness) of medication at first stages develops, but after getting some extent, over plateau, the effectiveness drops even if people invest medicine more, so we have to limit to medicine – medication to keep health. This may summary of his book as far as a student-then's understanding, and the title of Japanese translation of this book is “De-hospitalizing Society.”
Among many issues he mentions the therapist student is interested in pharmaceutical iatrogenesis, because PTs and OTs work in the field of physical medicine and rehabilitation but nowadays chemical medicine and pharmacy have developed and the gap between the two or the excessive chemical medicine seem to be harmful for our society. He wishes today to question the development of Western chemical medicine and pharmacy, and search for the cause in medieval ages in contrasting Chinese herbal medicine.
Hippocratic Oath reads:
“I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.
“I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.
“But I will preserve the purity of my life and my arts...
Attributed to not only Hippocrates of Cos but also much earlier days of physicians and kept as the ethics of medicine, the Oath swears that health professionals should not do harm. Even using knife on humans being privileged, and herbal medicines might have had strength of poison in case the overdose. Yes, medicine and poison are same, the dose of which is critical weather a herb functions as medicine. Representing many Hippocrates, the Father of Medicine and disciplines must have been well aware of the necessity of humanitarian conduct. Separating from religion and establishing scientific medicine, it may not be analytical. There were no physical or chemical medicines apart in the Father of Physicians, Hippocrates (plural).
Chinese acupuncture or herbal medicine originated since pre-history and dated almost as early as Buddhist history of teachings in India. The Fathers were privileged to use knife, too, well dissected human body to support their practice, and their classic text was entitled Sutras. A huge variety of herbal medicine keeps its tradition based on experience and is now partly supported by health insurance in East Asian countries. It is not side-effective even though not strongly effective when people comply the dose. For example, a cold medicine named “Kakkonto (JP pronunciation)” is effective for the beginning of cold with Vitamin C, and also is offered on prescription base, too. Acupuncture is practiced in Britain and some other countries, and World Confederation for Physical Therapy (WCPT) has sub-group now.
As scientific medicine developed in medieval days, the chemical medicine developed quickly apart from the physical one. Pseudo-scientists rushed doing research and development to change any materials or elements into gold, which is called alchemy, then a lot of people joined to invest to promote such development and the research of medication was facilitated by companies; chemical medicine developed running after gold. In the age of Hippocrates medicine was one and it was not only the medication, but now chemical medicine and pharmacies are still mainstream of the development. Patients may want a panacea, or almighty medicine that cure everything, but we don't have such ilusion. Today patients and families need to be smart enough to know each name and function of medicine, since many are side-effective but the truth may be concealed by pharmacies and doctors; they develop to sell. Medicine is ethics, not mathematics, as old proverb says.
Analytical science allowed us to appreciate immunization and a strong drug of antibiotics that have almost eliminated the danger of infectious diseases; the structure of disease or demography has changed completely. And instead, lifestyle generated disease has prevailed especially in industrialized countries. Here we need to know the prevention and treatment as well as healthy diet. In the U.S. where foods and goods are too much that people have to be careful with satiated culture with obesity, a disease of civilization. A fat person has a bigger heart, so it may cause hypertension, cardio-vascular disease, or stroke. With this change of structure of disease, physical medicine and rehabilitation is running after the chemical one to cope with disabilities after disease or injury, or longevity with disabilities. In Western countries governments tends to control the budget for insurance by suppressing that of medication, shortening the hospitalization, spending more for prevention and rehabilitation. Overall managed care, rather than cure, is a key word now.
To summarize the author's points:
・Western chemical medicine has developed and easily has facilitated investment by big business. It has the nature of Mammon from the beginning of alchemy.
・People have to know at least the name, functions, and side-effects of medicine. It is also our human rights to know the secret of pharmacies if they want to keep.
・Chinese herbal medicine can be an alternative with less side-effects and is prescribed and sold in Asian countries.
・In the change of structure of disease from infective disease to lifestyle-generated one, physical medicine and rehabilitation are needed more to develop running after the chemical medicine. Medication is not only important but also overall managed care is.
・In a more complex society citizens need to learn about the disease itself, cure, care, and prevention.
1. Illich I (late 1970s). Limits to Medicine: Medical Nemesis, the Expropriation of Health. ISBN-10: 0714529931, ISBN-13: 978-0714529936 Marion Boyars Publishers
2. Jones W. H. S. (1923). tran. The Oath. Hippocrates Volume I p. 298. ISBN 0-674-99162-1. Harvard University Press