APPROACH TO HEALTH
It has been noted recently with respect to the practice of orthodox medical care in Australia: 'The present state of remedial medicine... is one of crisis at a structural level. By this I mean that medicine as a social institution lacks effective means by which its inherent goals can be achieved. The remedial medical services are chaotic and in effective in the extreme.' 1
Not only structurally, but in terms of its own self-definition, its outlook and philosophy of practice, is medicine once again at a turning point. Lord Brain and many others have pointed out the need
for an overall thought-structure to draw the many specialities of medicine together, to give it coherence and greater relevance to people's lives (apart from merely 'saving' them). This does not deny the
many advances that have taken place over the past century, nor does it give way to gloom or pessimism. But it is part of a much wider human movement to re-examine its practices and re-root them
in the total field of human life.
There have, of course, been realisations that medicine is a 'social science' with a 'social goal'. As Sigerist2 states all too plainly, 'there can be no doubt that the target of medicine is to keep individuals adjusted to that environment as useful members of society, or re-adjust them when they have dropped out as a result of illness. It is a social goal.' But this is the very problem. R.D. Laing has pointed this out in a very direct and forceful way: 'No one can (even begin) to think, feel or act now except from the starting point, of his own alienation ... We are all murderers and prostitutes no matter to which culture, society, class, nation one belongs, no matter how normal, moral or mature one takes oneself to be. Humanity is estranged from its authentic possibilities ... Our alienation goes to the roots. The realisation of this is the essential springboard for any serious reflection on any aspect of present interhuman life ... We are bemused and crazed creatures, strangers to our true selves, to one another, and to the spiritual and material world—mad, even, from an ideal standpoint we can glimpse but not adopt. We are born in to a world where alienation awaits us. We are potentially men, but in an alienated state and this state is not simply a natural system. Alienation as our present destiny is achieved only by outrageous violence perpetrated by human beings on human beings.' 3
Laing is particularly referring to the practice of psychiatry today, but it might be equally well extended to the whole of medical practice today. 'The computer can monitor the condition of patients, scan X-rays, study brainwaves, investigate correlations in lists of symptoms and diseases, score psychological tests, and monitor the foetal heart beat in labour. A portable electrocardiograph can enable nurses to record tracings in patients' homes and almost simultaneously have them analysed by a computer in a remote capital city. These are wonderful aids. But the technical instruments remain tools to help us satisfy the real needs of people'.4 Medicine may daily pay more homage to science but it seems to be progressively forgetful of appreciation of man as a total, historical and ecological, earth planetary being.
The National Times (13–18 Sept., 1971) suggested 'the nation's entire health concept appears to be badly in need of resuscitation'. But how? And in what directions? What influences have led to an
ever-increasingly widespread examination of 'alternatives'?
The major factor seems to stem from the 'communications revolution' which has taken place in the last thirty years and with it the realisation of the extent to which man's dominance and exploitation of natural resources has led to the possibility of his own demise within a very short period. This serves to highlight underlying attitudesand concepts which extend all the way from economics to medicine. As G. Evelyn Hutchinson wrote, 'it is evident that the biosphere could remain habitable for a very long time, many times the estimated length of the history of the genus Homo, which might be two million years old. As inhabitants of the biosphere, we should regard ourselves as being in our infancy, particularly when we throw destructive temper tantrums. Many people, however, are concluding on the basis of mounting and reasonably objective evidence that the length of life of the biosphere as an inhabitable region for organisms is to be measured in decades rather than in hundredsof millions of years. This is entirely the fault of our own species. It would seem not unlikely that we are approaching a crisis that is comparable to the one that occurred when free oxygen began to accumulate in the atmosphere.’ 5
Sidney Sax has pointed out some other aspects of this crisis as he sees them directly relevant to medicine today: crowded cities, lack of time continuity (e.g. traffic jams), atmospheric pollution, noise pollution, increasing crime rates, violence, openness to gastro-intestinal infections because of modern food and feeding processes. This interrelationship between 'sickness' and 'society' has led to an overall appraisal of medical theory and practice. 'Health can (now) quite properly be viewed as the outcome of a general system of social interaction, of which medical science forms only a part ... ' 6 The relationship between life style, life events and disease has to be given its proper place. Peter Quince has pointed out how dangerously easy it is for hospital staff (to take a typical example) to become so engrossed in the diagnosis and treatment of disease processes that they lose sight of the sick patient's 'need' for integration and the possibility of 'enhancing human potential' which are basic characteristics of 'alternative' approaches to
medicine or 'healing'.
Sax's book contains many excellent evaluations and suggestions, but it is typical in its neglect. What is health apart from increased life expectancy, lower infant mortality rates and lower maternal mortalty? The concern is death rather than life. It is particularly with respect to the concept and clarity of health and its application in practice (for prevention as well as 'cure') that 'alternative health approaches are strong, particularly as they understand 'the multiple causes of a particular patient's problems' and then motivate and help him to relieve these' 7
Health is not merely the domain of athletes, olympic stars, cranks and general medical practitioners. In fact one hardly goes to a general practitioner if one is well. Health relates to everyone's life, individually and socially. It answers the question of a man's well-being, of his authentic human existence, in terms of economic, social, cultural, historical, interpersonal and transpersonal, physical, emotional, conscious mental and intuitive factors. It seeks to demonstrate a living testimonial to the 'infinity' of man's life, both obvious and subtle. Health is, in fact, the starting point for creative growth and self-directed conscious evolution. It is both the 'stepping stone' and 'power house' of true human culture and growth.
Health is an ecological process, involving the active coordination of every facet of man's life in the biosphere, both within man as an individual and amongst myriads of life expressions in various species and types. Health is 'organic' life based on caring, open creative relationships with one's past (biologically and socially), one's self, the earth and its inhabitants. It is much more than the absence of disease. It is a policy state of 'enjoyment' though it also expresses great anger and distress at the destruction and chaos of human beings. It is a state of positive well-being, a state of 'togetherness' which is like a new ability. It is a condition of being which gives strength to conviction, power to execute ideas into actions and a full-blooded ( ! ) warmth of personality. It is not only felt by oneself but seen and experienced by others. As Dr Pfeiffer wrote, 'Health exists if all functions are properly coordinated and controlled by an organising factor in a harmonious way'. It involves lack of pollution, both internal and environmental, both of the atmosphere and the blood, proper breathing, exercise and rest. As Rabelais said: 'Without health, life is not life; it is only a state of langour and suffering—an image of death'. It involves freedom from fatigue, good appetite, sound sleep, good memory, good humour, clarity in thinking and doing.
Our health depends fundamentally upon nutrition. Yet nutrition is hardly just the process of eating food. What is this food in all its dimensions? Food is not just food. Part of the illusory nature of our consciousness is to detach the object of thought (food) from the total processes which 'produce' it. Nutrition is the proper care of every aspect of our being, as we are related to, intertwined with, our life-matrix or environment. By comprehending the total reality of food, exercise, rest, every aspect of life, by viewing the inter-relatedness of food, air, light, sun, our preparation and eating of it, and the cosmos, we are directly overcoming the illusion of food as 'object' and apart from cosmic processes (i.e . ourselves). Nutrition concerns not only what goes into the mouth, but also the air we breathe, the stimulation of our senses, how we treat our skin, hair, bones (e.g. our posture, flexibility) the empathy we have with others.
Ecological consciousness shows beyond doubt that the individual organism and its environment are a continuous stream or field of energy. Humans are continuous with their natural surroundings. It is as necessary to have fish, air, water, plants, rain, weeds and other humans, as it is to have brains, eyes, hearts, lungs, stomachs and feet. The former are our external organs in the same way as the latter are our internal ones. Since we can no more live without the 'things inside' us as without the 'things outside' us, this living 'I' must include both sides of the skin boundary. 'Erosion of the soil is as much a disease as leprosy and many "growing communities" are as disastrous as cancer'.8
Health is, therefore, hardly a merely personal thing. Surely it is individual, but it is also cultural, social, ecological, planetary, universal and cosmic. Both the maintenance of it and return to it (wholeness of being) depend on the delicate balance of the total factors.
1. G.A. Rennison We Live Among Strangers (Melbourne).
2. HE. Sigerist Civilization and Disease (New York 1970).
3. R.D. Laing The Politics of Experience (Harmondsworth, 1967).
4. S.Sax Medical Care in the Melting Pot; An Australian Review (Sydney, 1972).
5. G.E. Hutchinson Scientific American, September 1970.
6. S.Sax Medical Care in the Melting Pot; An Australian Review (Sydney, 1972), p. 23.
8. Alan W. Watts Does It Matter?