The Nature of the Whole Holism in Ancient Greek and Indian Medicine

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About the Book It is frequently assumed that the holistic approach is inherent only in non-western medical systems. In this book Vicki Pitman traces holism in the Hippocratic foundations of western medicine. Holism is a concept that has regained currency in contemporary thought, prompted in large part by the resurgence of complementary medicine. The wise aphorisms of Hippocrates are still quoted but few, even western complementary practitioners appreciate holism's Greek origins. Pitman highlights the relationship of ancient medicine with the ideals of Greek Philosophy and demonstrates the commitment of ancient healers to holism in their understanding of the body, in diagnosis and in the treatment of disease. By comparing the ancient Greek model and practice with that of Ayurvedic medicine in India, she shows the practical relevance of ancient thought and methods to modern integrated medicine.

About the Author VICKI PITMAN comes from the United States and first graduated in English.

After attaining M.A. in Teaching she began teaching in secondary education. In the 1980's she trained in herbal medicine and body work and entered clinical practice in England. She belongs to the Unified Register of Herbal Practitioners (UK) and the American Herbalists Guild. She is a tutor and lecturer in herbal medicine, aromatherapy and reflexology and has authored articles in professional journals. In 1986 she began studying Ayurveda. Mrs. Pitman is a member of International Association for the Study of South Asian Traditional Medicine. An interest in the history of herbal medicine led her to research its foundations in the ancient world and to undertake an M. Phil. in. Complementary Health Studies at the University of Exeter from which the present work is the result. Her books include Herbal Remedies (1995), Reflexology: a Practical Approach (1996), Aromatherapy: a Practical Approach (2004).

Foreword It comes as a surprise to learn that the word "holism" was first coined in English in the 20th century by the South African military and political leader, General Jan Christian Smuts (1870- 1950). Smuts' 1926 book, Holism and Evolution used the term to designate the tendency in nature to produce wholes (i.e. bodies or organisms) from the ordered grouping of unit structures. Since then, many authors have adopted the term which, like gestalt, captures the important concept that vital meanings of our world cannot necessarily be understood by an examination of its parts.

To put it differently, certain entities have an essence that is indissoluble, that is a result of their wholeness, not of their constituent elements. Or, as the saying goes, "big is different".

Today, the concept of holism is used widely in the field of Complementary and Alternative Medicine (CAM), where it captures the sense that if medical diagnosis and therapy focus merely on the parts of a patient, or on the parts of a disease entity, then a vital part of the medical situation is occluded. There is wholeness in the situation, in the unity of the patient's whole life and disease state that is worth attending to. And attention to that wholeness leads—CAM practitioners claim—to a positive trans-formation in health care and patient management.

Is this concept of holistic medicine a unique development of the 20th century? In the present book, Vicki Pitman dives deep into the Greek tradition of Hippocrates, the father of Western medicine, to discover whether the roots of holism can be found there. If such roots can be found, then perhaps we can say that Modern Establishment Medicine (MEM) has lost something important that it once had, something worth reclaiming in con-temporary practice.

But Pitman does not stop at that. The classical medicine of India, Ayurveda, is rapidly undergoing the twin processes of globalization and modernization. As such, Pitman recognizes it as a medical force on the world stage. And modern, global Ayurveda also makes the claim to be a holistic medical system. Is that really true? And what exactly does it mean in practice? Pitman returns to the ancient founding documents of Ayurveda, from over two thousand years ago, and searches for the concept and interpretation of holistic medicine in tradition, confronting it comparatively with the evidence from ancient Greece.

Pitman's study is distinguished by several features: originality, scholarly integrity, and accessibility. Perhaps the most important is its historical probity. Pitman grapples with the original texts of Greek and Indian medicine, refusing to simplify, refusing to take anybody else's word for their meaning.

In doing so, Pitman has produced a study which is factually trustworthy, serious, and true to the traditions it explores. The present series, Indian Medical Tradition, is designed to publish exactly this kind of work, which is both scholarly and accessible, both original and topical. Vicki Pitman's reflections and research have much to offer to medical practitioners, medical historians, cultural anthropologists and others. We are delighted and proud to be able to include Vicki Pitman's book in this series.

Preface The name Hippocrates is fundamental to Western medicine. He is often quoted but seldom is references given and few today outside the realms of Classical scholarship appreciate the scope or detail of the works. A chance discovery on the shelves of a provincial library of Ludwig Edelstein's Ancient Medicine prompted me to investigate the Hippocratic Corpus and its authors. Several aspects of the physician's world Edelstein described seemed so like that of a modern complementary herbal practitioner like myself that I simply wanted to find out more: to see if Hippocratic medicine was the source of our holistic practice and how substantial a record of precept and practice remained that a modern practitioner could draw upon. From the lectures of Dr. Vacant Lad I learned of a sister tradition from India, ancient but still practiced, which I felt could help me evaluate and illuminate that of ancient Greece. In the process I found that any notions of boundaries between east and west are actually misleading. Healing arts in many societies draw on universal intimations of holism, human life as part of a greater, spiritual whole.

This book is based on the dissertation for the M. Phil. in Complementary Health Studies at Exeter University (1999). I am very grateful to so many people for their generous aid and guidance. The excellent Centre for Complementary Health Studies, and especially my supervisor Roger Hill gave me the supportive base I needed. John Wilkins and Anne Glazier were my academic tutors for Greek and Ayurvedic medicine; I benefited much and enjoyed much from my discussions with them. Drs. Vacant Lad and Robert Svoboda brought a high standard of Ayurvedic training to western students. Vivian Nutton and Rebecca Fleming generously made time to answer my questions and guide my thoughts about the Hippocratic Corpus. My dear friend Dr. Keller Freeman kindly helped with the revision of the dissertation. Sue Williams of Yeovil College Library helped me obtain many needed books without my having to travel, by using the facilities of the marvelous British Library loan service. The Library of the Welcome Centre for the History of Medicine and its staff were also most valuable and helpful. Lois Reynolds gave generously of her time in the final stages.

Several Ayurvedic physicians kindly allowed me to observe their clinical work and made themselves available for interview: Dr. Deepak Gunawant of London, whom I met through the good offices of Gopi Warder; Dr. O.P. Arora of Ludhiana and Dr. Gopal Sharma of Jullundur, Punjab; Dr. J.V.K. Taneja and Dr. Narish Jaiswar of the Ayurvedic and Unani Tibbia College, Karol Bagh, Delhi. Dr. Ram Manohar and his students at ARMARC (Karnataka, India) were good enough to proof the typescript for errors and provide the correct diacritical marks for the Ayurvedic portions of the work. John Wilkins generously did the same for the Greek. I am perhaps most indebted to Dominik Wujastyk. Having read the dissertation, he encouraged me to offer it for publication and facilitated in many ways its preparation. Also, as a person and a scholar he has been an inspiration to me. Finally, I thank Mary Burgess for her support and particularly my husband Tony Pitman, a Classics scholar. His enthusiasm for Greek culture is highly infectious! As I delved into the texts and commentaries, and grappled with Greek words and concepts, he helped in in-numerable ways.

Introduction ANCIENT GREEK MEDICINE AND CONTEMPORARY HOLISTIC MEDICINE

Perhaps you too have heard what good doctors say when a patient comes to them with sore eyes. They say, I think, that they cannot attempt to heal his eyes alone, but that they must treat his, head too at the same time, if his sight is to recover. They say too that to think that one could ever treat the head by itself without the whole body is quite foolish. On that principle then, they apply their regimens to the entire body and attempt to treat and heal the part in conjunction with the whole. Plato: Charmides, 156 b-c.1

This fifth century B.C. report of the approach of physicians in ancient Athens towards disease and healing is striking in its similarity to the approach of twentieth century practitioners of complementary, or 'holistic' medicine. Indeed so striking is it that it prompts the questions: Is it possible that the origins for the contemporary holistic approach are to be found in 'that principle' on which these ancient Greek physicians based their work? What else is there in their work which is still either germane to, or reflected in, the practice of present day holistic medicine?

Answers to such questions are important for several reasons. Many contemporary holistic practitioners are attracted to study the traditional and ancient medical systems of, for example China, India, Tibet, or Native Americans precisely because they offer an integrated approach to health care (both cure and prevention) grounded in a comprehensive understanding of living beings.

Such systems are perceived from the outset to be 'holistic' and it is this quality that their Western practitioners perhaps feel is lacking within a Western context. It is the aim of this thesis to establish whether or not there is a tradition for holism native to Europe and comparable to these systems in its comprehensiveness.

Of course many practitioners and even many laypersons may be vaguely aware that they are working within a tradition traceable back 'to ancient times. For example, they may quote snippets of Hippocrates, or perhaps more rarely Galen, but the totality of the tradition such figures represent is not as immediate or well-known to them as the tradition of ancient Ayurvedic writers is for contemporary maydays (physicians).2 Among practitioners, there seems a far larger proportion of concepts congenial to holistic medicine which are borrowed or incorporated from non-European medical traditions.3 Teaching introductory classes of herbal medicine to the general public, this author has found that the concept of yin and yang, of five phases, is much more widely known than that of the elements, temperaments and humors of the Greco—Roman, preenlightenment world. Ayurveda is similarly enjoying at present a wide exposure in the popular media.

The appeal of these systems seems to lie in the fact that they are at one time both ancient and modem. Their origin is in the ancient world and they have continued to exist, one way or another, throughout the centuries, to grow and develop, to have withstood the onslaught of colonialism and to continue to be practiced efficaciously down to the present day. Though certainly not unchanged throughout their history, the integrity of their grounding in tradition remains intact.

By contrast, the concepts and practices of what might be termed traditional European medicine are less well known and connected to the day-to-day practice of contemporary holistic medicine practitioners. We are less aware of being part of a tradition going back some two thousand years than is an Indian Ayurvedic vaidya.

PURPOSE AND METHODOLOGY

The questions which are prompted therefore are: Is this lack of connection to a Western tradition of holistic medicine due to the absence in the ancient science of medicine of anything which is valid today for today's practitioners? Or perhaps is it due to the absence of a 'western' holistic model of sufficient substance to understand health and treat disease? In attempting to answer these questions, this book examines the Hippocratic Corpus from the point of view of contemporary holistic criteria to ascertain if there is a corresponding model for understanding and treating health and disease holistically, of comparable substance to that of holistic models from other traditions. The Hippocratic Corpus is chosen because it is the most extensive written record of the ancient European ideas about medicine and health, forming the major starting point of Galen's system, which itself became the dominant model for health and care until the scientific revolution.

Extensive quotations from the Corpus are given in order that the writers may speak for themselves as often as possible. Even with this, the effort is not without its dangers. As Wesley Smith has remarked in his introduction to his translations of the Epidemics(Books 2, 4-7) each subsequent commentator or scholar of, the Corpus beginning with Galen himself has tended to read into the works the prevailing themes and concerns of himself and his times.

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