That’s No Way To Treat Malady
Using an electronic device which shows which part of a brain is being used, neuroscientist Benjamin Libet’s experiments in 1985 showed that when a person decides to move a finger he experiences that decision 500 milliseconds after there is neural activity in the motor areas – we start to lift a finger before we decide to. We process perhaps 14 million bits of information per second. The bandwidth of consciousness is around eighteen bits. This means we have conscious access to about a millionth of the information we use to survive.
I love drifting off to sleep at night to the sound of the washing machine, tumble-dryer and dishwasher whirring away; it sounds like the heart of the house unconsciously getting on with the job while the family sleeps. It seems an echo of a promise that was the fifties housewife’s dream – when the automation of chores was meant to replace the labour-saving device that was, until then, known as ‘wife’.
I remember being at my grandmother’s and idling through perfectly preserved piles of magazines, decades of back copies for recipes from canned goods and tips to get rid of odd stains.
I was drawn to the adverts, bold statements in red splashed across the drawings of white goods, promising to unshackle women. I imagined my grandmother dreaming of nothing more to think about than getting up half an hour early to put her make-up on. Spitting into her mascara cake to soften it and coating her eyelashes in a magnifying mirror quickly before grandpa saw her without ‘her face’.
When I was allowed to leaf through them, I could almost hear Bill Haley and the Comets rocking around the clock in the background. There were articles about On The Waterfront with Marlon Brando pulling out of the shadow of un-American activities, and pages of models in an era of siren simplicity in women’s fashion. I particularly remember a striking redhead actress from Minnesota, Arlene Dahl, who started a highly successful cosmetics and lingerie company. She launched the first patented bed-cap since 1925, setting the tone for a generation of women. My grandmother loved the layers of overlapping petals of nylon net ruching because they hid the hair-setting pins that held together her newly liberated indulgence in femininity. She even took to the rubber version for the beach.
Of course I wake up to the changes in our lives as women; we live in a time when department stores no longer sell bewitching boudoir ensembles and ‘the cap’ has a new meaning. Magazines have moved on to selling celebrity as an escape, since chores have never been eradicated, no matter how many powerballs scrub our roasting pans and rim blocks freshen up our bowls.
On a dull day, I can suffer from dirt-rage, (mostly because I don’t get out enough to feel road-rage, I think,) and unleash an immeasurable fury at the boys. I know it’s true that in 100 years’ time no one will know how much housework we’ve done, but there is still a certain amount of grease that needs an elbow for a civilised existence. And how much mess can boys leave in their wake? However, most days they are smart enough to keep me too busy to notice till bedtime, when it’s too late to yell. So I end up in a comforting fog of unrelated thoughts as I clear up every day.
I remember thinking that I had lost something I believed in, I had accepted without question the certainty of treatments for what seemed like forever – I was now finding that assertion so terribly flawed, all at once, not in little bite-size, digestible bits. I had not even known I accepted the conviction of modern medicine as conclusive. Just because you believe something doesn’t mean that you know it. It is not enough even for your belief to be true. Philosophers would say that in order for a true belief to count as knowledge, you must also have reason to suppose your belief is true.
Some of what we ‘know’ is just something we believe in. Some of what we believe in, we don’t know we do. Some of what we do know we believe in, we don’t have a whole lot of objective reason to believe is so.
Around seven o’clock one night, the kids were getting into their pyjamas and I was trying to find the pages in the homeopathy book that would explain what kind of treatment homeopathy was.
Instead, the book fell open at a chapter of little potted ancient histories. Distracted by demands for a bedtime story, I left it open there.
Around nine, I heated up do-for-supper soup, and sat down with the past, the pages opened in front of me. I was tired, and I figured history would be easier to get my head around than theory. I have ended up spending a great deal of time with these old guys and found that many of them reassuringly said the same things. I got very fond of them, but that night they were names on a time-line, not friends yet, and it all seemed to have begun a very long time ago. A contemporary of Socrates, circa 460 BC, a Mr Hippocrates (yes, he of the Hippocratic Oath) did some work that is the foundation of our medicine. He was the very first person recorded in our culture to separate medicine from magic and religion. He founded the very radical idea that disease was a result of natural forces and environmental influences, and not divine retribution. For that alone, he deserves his founding title, but he also believed the purpose of medicine was to help our natural healing power to cure ourselves. After closely observing nature, Hippocrates announced that there are two possible ways of curing: by the contraries and the similars. In fact, he is credited with developing The Law of Similars. The Roman medical writer, Aulus Cornelius Celsus, is famous for relying on this approach, in which the principle is to treat illness with something that produces similar symptoms to the problem.
The ‘if you are tired, the remedy is sleep’ principle.
The cat ever so politely rubbed up against my leg to remind me I hadn’t fed her. Chores stopped the headlong charge towards the goal of completing the chapter, a mental breather. Distracted by the thought that our cat might not like what I had to give her, as it was a new flavour, so who knows, I slipped into thinking about the homeopath we’d visited. It nagged at me that she had said treating like-with-like was how homeopathy worked. It had been the only explanation she offered at the time, but I was too focused on getting the treatment into my grubby hands to do more than nod agreeably, pandering to her wish to be heard.
So why was this so important?
I settled back with the next guy who has been dead a very long time, a well travelled and ambitious Greek physician, circa AD 130–200; Claudius Galenus, or Galen of Pergamum, appointed physician to the gladiators at the age of 28.
His position gave him great opportunities to see inside a working body as he dealt with ‘horrific maulings’, as the texts put it, and so was acquainted with sliced-open, living, pulsing people. This gave him an edge over his contemporaries as, at that time too, vivisection was outlawed in pretty much all the known world. His diagrams of most parts of the body are so vivid you can almost picture him hovering over a freshly wounded gladiator and licking the end of his quill with relish. ‘Hold Spartacus down, I need to see a little more of his iris...!’
His terminology has influenced western medicine, and is still used today. In fact, all the parts of the eye – cornea, pupil, sclera and so on – were named by him; tonsillitis, appendicitis and pneumonia, all his. Galen was prolific, cutting edge, he never wasted an opportunity to see inside a body; alive, cadavers or primates, all were fodder for him. He also devoted much of his energy to rationalising and codifying existing medical knowledge. He quickly rose in the ranks and went on to serve no less than four emperors. As a writer on medicine with a working knowledge of the anatomy, he also brought philosophy back into the debate, to help him win his many arguments.
This one man’s ghostly tendrils of influence have reached through the dark ages and into our practices today. As recently as 1959, a Dr Haynes was summoned before the Royal College of Physicians in London, a body that plays a pivotal role in setting and maintaining standards in medical practice. Apart from its role in examinations, training, education and research, it also advises the government, the public and the profession on health and medical matters.
It summarily dismissed Dr Haynes for considering Galen’s work fallible, and he was only readmitted after he submitted a written withdrawal of his position.21
Between Hippocrates and Galen, you have nearly covered the whole of our medical influences from physiology to philosophy.
Hippocrates devoted a great deal of time to exploring the idea of balance in a human body. Although he wrote extensively on the ‘contrary to suffering’ principle, he established it was to be used in extreme cases. Galen, too, believed in applying contrary remedies to ‘force out diseases’; however, he devoted much of his work to expanding this theory and called it ‘Allopathy’.
I looked up from the book, it was about eleven o’clock and I needed to put the dishwasher on. I was probably going to forget all of this by the morning, and was any of it relevant anyway? As I moved the pans and plates around to squeeze the last cup in, I ran through what I’d read to see if anything stuck in my mind.
There it was, floating in my chore-occupied brain.
THERE was the most essential piece of information.
Forget the old geezers and their dates and achievements; it is about approaches to symptoms, relevant still today.
One approach is to treat symptoms with something to produce the opposite effect in our bodies. Conventional or modern medicine is known as Allopathy, which means ‘contrary to the suffering’.
It treats through suppression or control, ‘applying medicines to obstruct the disease’. Using drugs to suppress symptoms; ‘anti-depressants’, ‘anti-biotics’, ‘anti-inflammatory’, ‘anti-pyretic’ etc. Or produce the opposite of symptoms, using a substance to cause constipation, like aluminium hydroxide to treat diarrhoea.
The other approach is the opposite of this: to treat symptoms with something to match the effect in our bodies. Homeopathy means ‘similar to the suffering’.
‘Like-for-like’ remedies are intended to support your body’s own defence system. The remedies used to cure are known to be capable of producing the same symptoms, or similar effects to the symptoms, in a well person. If you have a cold with streaming eyes and a runny nose, the remedy may be allium-cepa or red onion, known to produce a runny nose in a healthy person chopping one for the pot.
Galen never understood the circulatory system of the body. He did find that blood vessels carried blood; however, he believed blood flowed from ‘creating organs’ to all parts of the body, where it was consumed, and no blood returned to the heart or liver. When he cauterised a wound and it stopped bleeding, this made sense to him of the idea of contrary treatment. Treatment of a suppressing nature worked and in the context of his time would have produced better results than what they had been doing.
However, this has become a habit over the years to the point where we don’t even know we are doing it and therefore don’t even think to look at it any other way.
I had assumed the two ways of tackling illnesses were modern medical intervention or no intervention; fill out a prescription and get on with it, or let nature take its course. When I began this, I didn’t want to know how it all worked, I just wanted our kids to get over their infections and to breathe properly. I assumed it all worked the same way as conventional medicine, but different; different in a ‘dippyhippy’ way, but nevertheless intended to stop the symptoms. Alternative treatments were nothing more than variations on a theme of intervention; alternative intervention.
At no time, in all the reading I had done, had anyone compared these two opposing theories. Certainly I don’t think this is obvious and it shouldn’t be lost in some dull history section most of us don’t read.
‘Anti-suffering’ is the underlying principle that informs and guides our medical system, our philosophy of treatment and our drugs.
Gimme this straight, I’ve got a boil wash to fit in before midnight.
- The GP treats allopathically – contrary to suffering.
This results in stopping an attack from a pathogen like a virus or bacteria, but is also used to suppress your body’s own defences.
- The alternative is to treat with the symptoms – like-for-like.
This is thought to work with your body’s own defence systems, and is particularly effective for imbalances within the body.
Why isn’t this comparison of principles more widely known, more widely expressed? Why isn’t this the first point brought up when discussing treatments? Why don’t we understand this about our conventional treatment philosophy?
This is the most important distinction we will ever need to know to make a rational, informed consideration of any treatment.
Why don’t we, the great-unwashed public, know this?
Does a treatment work with me or against me, and which approach do I need most for my specific ailment?
We all know if you have a cold that the mucus you produce is your body trying to expel something; it is normal and usually beneficial as it is a mechanism the body has evolved to drive out something that might otherwise spread to the rest of the body and damage vital organs.
Same with a cough; it’s a defence device, a means for your body to exorcise the demon bugs. Fevers are another ‘evolutionarily selected biological defence mechanism’. Although it is a good indicator of illness, it is actually a universal reaction from fishes to mammals that we generate in direct response to infection to overcome it. Like all organisms, bacteria and viruses work best at an optimum temperature, fever is designed to make it so hot the pathogens are boiled alive. Except where a fever is about to cause febrile convulsion, experiments have shown suppressing a fever can actually hinder recovery from infection.
It should be obvious to a four-year-old that handicapping the soldiers on your own team doesn’t give them a fair chance to fight. Medicines designed for that purpose can have drawbacks, and the indiscriminate suppression of symptoms produced in the fight might be misguided.
But it is a fair question to ask, ‘Should you ever suppress the process?’ Yes, is the simple answer. From ancient history to now it is agreed and advocated that it is useful in extreme circumstances: modern medicine is at its best in an emergency. If you are run down, have no chance to put your feet up and your body is in danger of being overwhelmed (which, as a parent, feels like most of the time). If you are under attack from something in the environment (a pathogen), then treatment (a drug) may be appropriate.
It is arguable that if you were about to go into the presentation of your career, or Sunday lunch with the new and unsympathetic in-laws, most people would understand you may not want the humiliation of sweating like a pig and coughing up all over the roast.
Short term, in an emergency, once in a while, as a last resort, when my body is losing the battle with an invasion by a pathogen, stopping the system in its tracks is an option we have available in this present world. Hippocrates himself put it perfectly: ‘Extreme remedies are very appropriate for extreme diseases.’
I vote for working with my body whenever the problem doesn’t fall into any of those more extreme or immediate criteria. Long term I figure I want me and my family to be vigorous, healthy creatures, ready to take on the complex world we live in, our defence systems in tip-top working order. So fit we don’t get sick. Generally or too casually, I personally cannot understand why we would want our lovingly evolved, built-in defence system – which has taken aeons to create – to be suppressed. If we discount our ‘biological defence mechanisms’ as ‘symptoms of disease’ and treat to suppress them, we misunderstand their very nature, their purpose, their benefits and what they mean about us as humans.
It is the difference between using a dishwasher to clean your plates and smashing them on the ground to solve the washing-up problem.
It has to be understood that the allopathic route is not without consequence. By treating with a substance or procedure intended to halt the symptoms of disease, it can work; but if the body is prevented from dealing with the problem it can have unwanted consequences.
Then a drug is just an umbrella; it keeps the rain off but it doesn’t change the weather.
The ‘contrary to suffering’ principle is aimed at the symptoms. At the level of an invading bacterium (when it would do more harm not to) it may be appropriate to treat with an antibiotic targeted at the bad guys. However, we spend a fortune every year on an ever-growing and probably unnecessary assortment of suppressants, all of which are designed to interfere with our intricate immune systems.
They are not aimed at the pathogen but against our bodies.
Just as an ordinary everyday example, take a common, and seemingly inoffensive, product such as a cough mixture. There are three types. Demulcents, from the Latin to caress soothingly, basically contain syrup, glycerol or honey, and are claimed to reduce irritation by coating the inflamed lining of the airways. Which, as they cannot enter the airways, do no more than coat the back of the throat. Drinking hot lemon and honey will be just as effective.
Then there are opioid derivatives (codeine, dextromorphan and pholcodine) that act directly on the cough centre in the brain, inhibiting the cough reflex. They can stop you coughing in high enough doses by switching off a bit of your brain, but are also likely to cause constipation. And then there are sedative anti-histamines like diphenhyramine; these are popular in cold and flu remedies and work by inhibiting the cough reflex through generally sedating the whole of your brain. They probably work by making you too sleepy to cough. The view of the British National Formulary, the independent drug bible, is that ‘the drawback of prescribing cough suppressants is rarely outweighed by the benefits of treatment’.
Judicious use would certainly appear to be wise advice; it seems sensible to be very cautious about whether we use some things at all.
Many other suppressants are designed to stop or inhibit our own natural immune system. They work on our responses; they are not aimed at the bad guys. They work against our ‘functions’, the bits of us that are essential for us to get through every day. Our functional side is the difference that makes the difference. I accept the ‘contrary to suffering’ treatment seemed to have done its emergency rescue work on the ‘pathology’ of Ben’s symptoms. His body behaved like it had taken on too much work, with too little or conflicting information and not enough tea breaks. Considering his immune system was so – ‘muddled’ would be a good word – antibiotic treatment of Ben’s infection was probably appropriate.
However, I still have a niggling question: ‘What contribution to the problems did we all make with such heavy-handed management of him?’ Nineteen hundred years ago, Celsus wrote, ‘It makes a great difference, whether a person has been properly or wrongly treated from the beginning, because a method of cure is less successful where it has been applied unsuccessfully.’
Without a doubt, the ‘contrary to suffering’ principle has had its place in our history, health and survival as a species. It may have brought us – along with good sanitation and improved nutrition – to a time where we now have the luxury to explore beyond emergency treatment. However, ‘contrary to suffering’ has limitations; it is not good for casual use or when it has to be used for any length of time. It is not great when it is used, not against an invading pathogen, but against how we ‘function’. Celsus pointed out that: ‘Medicine can do nothing in opposition to nature’.
As we now enjoy a time when we do more than survive, perhaps we can consider what it takes to thrive.
Not everything is an alternative intervention.
Some things do not intervene at all.