Of Medicine and Dialectics

a review article by William Ging Wee Dere*

DR. DAYA VARMA’S book, The Art and Science of Healing Since Antiquity, is fascinating, rich, and full of insights into the history, science, political economy, cultural and social aspects of medicine. It is a people’s history of medicine and a refreshingly non-Eurocentric view of medical science. It goes a long way to de-mystify medical practice with a dialectical materialist approach. It should be recommended reading for all health workers to obtain a broader outlook on their profession, as well as for anyone who is concerned with today’s health care.

Dr. Varma poses and answers two important and profound questions. “Why are there many schools of medicine when this is not true for other sciences such as physics and chemistry?” And the (Joseph) Needham question: “why modern science had not developed in Chinese civilisation (or Indian or Islamic) but only in that of Europe?”

DayabookTo answer the first question, Varma through extensive scholarship, documents the development of the art and science of medicine since antiquity. The author writes, “The modern medicine, like all schools of medicine, is a child of spiritual medicine commonly known as witchcraft. It has made gigantic advances, but not enough to remain unchallenged by other streams of the witchcraft. This book is an attempt to analyze how witchcraft unfolded into its different variants and why modern medicine is its most rational expression.” He postulates that the first healers were women, mothers taking care of their sick babies using whatever spiritual or material tools they had at hand.

Varma masterfully dissects and skilfully navigates through the various schools of medicine from the ancient empirical medicine of Egypt; transitioning to the materialist Indian Ayurveda and Chinese medicine systems; the Greek school of medicine upon which Western medicine inherited the Hippocratic oath; to the Islamic Unani-Tibb medicine. Along the way, he deals with other branches such as Allopathy and Homeopathy. The author delves in depth into the social, political and material conditions that gave rise to each of the ancient schools of medicine. All of these schools paved the way to the emergence of modern scientific medicine as cultivated in the West the past 200 years.

The author, a lifelong Marxist, shows that the reason for the uneven development of medical sciences around the world is mainly due to the state of the productive forces in the various societies. The three great rivers of the world, Yangtze, Ganges and Nile allowed China, India and Egypt to be self-sustaining and insular and “did not allow for despondency.” Whereas, Europe overthrew the yoke of feudalism. Through its exploitation of labour, and especially through its plunder of the overseas colonies, it accumulated the capital to push forward the Industrial Revolution with the required scientific and technical breakthroughs (Needham question). In the aftermath of feudalism, America inherited all the innovative characteristics of the Industrial Revolution to make its own advances in medical sciences, especially medical technology.

During the Industrial Revolution, Western medicine made progress to try to keep its work force healthy and alive. Cholera and malaria are examples of diseases in which causes and cures were discovered. Varma explains the class nature in the treatment of these diseases. Varma exposes the gender bias in almost all aspects of medicine. “This relative silence on the role of women in medicine reflects many things. It is very likely that women gave birth to the science of medicine during the era, which got characterized as witchcraft. But the progress of medicine, like that of all other sciences, goes hand in hand with development of institutions to sideline women under various pretexts, …” There have been only 10 women awarded the Nobel Prize for physiology or medicine since 1901. The author also points out women’s health care has been industrialized, “a market was created for stilbestrol against miscarriage and for hormone replacement therapy to prevent physiological changes for menopause. Women’s body is subjected to other uncalled-for interventions due to the creation of a market for such intervention.”

Varma states that health care in advanced capitalist societies like the US is as much political as scientific. In the richest country in the world, health care delivery for the majority of the population falls behind that of Cuba, just 150 km away. He also asserts that traditional or alternative medicine continues to thrive in areas where there is a poor health care system. Being a medical scientist, Varma is naturally biased in favour of the scientific method. However in the People’s Republic of China, where the health care system is relatively decent, certainly a lot better than pre-Liberation, western medicine and Traditional Chinese Medicine (TCM) are both practiced side by side. TCM usually looks after the common everyday ailments of people like colds/flu, skin, insomnia, stress, etc., whereas western medicine doctors are consulted for more complex diseases and for surgical intervention.

Varma has a very interesting take in concluding the book on aspects of “democracy, secularism and science.” He contends the break from feudalism and religious obscurantism gave rise to capitalism and western democracy as the highest form of economic and political development which permits materialist medical science and science in general to develop. Naturally the forces of productions would propel scientific and technological development in order to advance the needs of capital. The accumulation of capital mainly through its exploitation of the colonies provided the funds for scientific research and development.

The main criticism this reviewer finds with the book is technical, its repetitiveness. One hopes the next edition will employ a good editor to tighten the text. Nevertheless, the book is fairly easy reading for medical scientists and laymen alike.

At the end of the book, Dr. Varma reproduces the 1978 Declaration of Alma-Alta on Primary Health Care. The Conference promised universal primary health care in the world by 2000. A decade has past and primary health care in most parts of the world is still quite dismal. Quoting from the Declaration:

“The Conference strongly affirms that health, which is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector.”

The Art and Science of Healing Since Antiquity
by Daya Ram Varma MD, PhD
Publisher: http://bookstore.xlibris.com/Products/SKU-0090516050/default.aspx
Trade Paperback; $23.99; 413 pages; 978-1-4568-4210-9
Trade Hardback; $34.99; 413 pages; 978-1-4568-4211-6
eBook; $9.99; 978-1-4568-4212-3

* William Ging Wee Dere is a Montréal-based engineer, community activist and filmmaker. He is presently co-directing, with Malcolm Guy, a film due out in the Spring of 2012 looking at the reality of young Québécois of Chinese origin. It’s tentatively entitled: Être chinois-e au Québec. Check out the production blog here:  http://etrechinoisauquebec.net/

The first film by Dere and Guy, Moving the Mountain (1993), looked at the history of the Chinese community in Canada and the impact of the infamous Head Tax and Exclusion Act. The first film to look in depth at Canada’s racist treatment of the early Chinese migrants, Moving the Mountain has been screened around the globe.

Author Daya Varma has been a long-time Montréal resident and McGill professor. The authors of this blog have the greatest respect for Daya, who taught us much about South Asia and the global anti-imperialist struggle.

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