THE WEST VIEW: IT IS JUST A BODY JULIAN BAGGINI

In Britain, where I live, I’m always coming across places that offer traditional Chinese medicine. However, I have yet to see a single premises with ‘traditional Western medicine’ above the shop window.

If we ask why traditional medicine thrives outside the West but not in it, one obvious answer is that older forms of medicine only thrive in the absence of well-funded, widely available ‘proper’ medicine, when people seek help from whichever source they can, effective or not.

There may be more to this than advocates of traditional medicines would care to admit, but filling a gap left by an underfunded health service cannot be the whole story. Plenty of people seek help from ‘alternative medicine’ and many claim to find it. But most of that medicine is either old and foreign, like acupuncture and Ayurveda, or a relatively recent Western invention.

Homoeopathy, for example, was created in 1796, with one of its most popular schools, Bach flower remedies, founded in the 1930s. Chiropractic has its origins in the 1890s, while osteopathy was born in the United States in 1874. The only traditional Western medicine still practised to any degree is herbalism, and even that now draws on non-Western sources.

A fuller explanation requires an understanding of how the Western mind has shaped its medicine. One root is a dualism of mind and body that has characterised philosophy in the West since the time of Plato. For him, our souls ‘are simply fastened and glued to their bodies…only able to view existence through the bars of a prison’. Our bodies are merely temporary vessels to carry our true selves, our souls.

Not every philosopher has been as sharply dualistic as Plato; but he set the tone of thinking to come. One result is that medicine has been seen merely as an engineering problem. It does not require a holistic system of thought that brings together body and mind. All you need to know is which part to fix and you can be sent on your way, cured.

Only recently has mainstream medicine embraced the idea that to treat the whole patient you need to address emotional as well as physical needs; and that the body heals quicker when the mind is treated at the same time.

The mechanistic way of thinking is accentuated by another characteristic of Western philosophy: its reductionism. This is the method of understanding things

我住在英，國 走在街上，不時會見到提供傳統中醫服務的招牌，但掛著「傳統西」牌醫招的診至所， 今還未見過。為何傳統醫藥只能在西方以外的地區興起？最明顯的答案，莫過於這些地方缺乏資源充裕、應供 充足的「」正當 醫療，人們只能退而求，其次 也顧得不 這些方法是否真有療效，令這些古老療法得以繼續存在。

提倡傳統醫藥的人士，大概不會承認這種講法，不過這種講法亦未能提供一個完整的答案。不少人尋求「類另 療法」，並且聲稱找；到了 但是他們找到的治病良，方若不是老古 的外來療法（如針灸育和阿 吠陀醫療法）是近，就 較 期的西發方 明。順例如勢，療法 就是年1796 的產物，當中的巴哈花卉精華療法是為廣 人採用的流派，更要待1930年代才出現。脊醫源自1890年代；而接骨則術 誕生於1874年的美。國 現時仍然通行的傳統西方療法，就只剩下草藥學，但現在使用的草藥很多已並非源自西方。

by breaking them down to their smallest constituent parts. This is described clearly in the EncyclopŽdie, the French Enlightenment’s distillation of all secular knowledge. In its introduction, D’Alembert points out that ‘bodies have a large number of properties’ and that ‘in order to study each of them more thoroughly, we are obliged to consider them separately’.

This is an advantage, not an inconvenience. ‘ This reduction,’ he wrote, ‘makes them easier to understand.’

Once again, the implications for medicine are clear. The body has a number of parts and properties and the way to understand them is to examine each one in isolation. Everyone knows that the body is a complete system but it is analysed and treated in terms of its parts.

A third, vital feature of Western philosophy is its strong idea of progress. Many attribute this to the Christian worldview that sees human history as moving in discrete phases, from the election of the Jews as the chosen people, through the times of prophets, to the coming of Christ, culminating in his return and the final judgement.

In many other times and places, however, time has been seen as more cyclical and history has no final destination, humanity no ultimate goal.

Stripped of its religious roots, belief in progress has become one of the defining features of Western thought since the Enlightenment. This leads to the wholesale shedding of old ideas as soon as newer, apparently better ones come along. Hence scientific medicine had no philosophical interest in preserving what worked from its folksy predecessors. Like so many beautiful buildings that were torn down to make way for forward-looking modern constructions, old medical practices simply had to go.

Belatedly, there is recognition that at least some forms of traditional medicine might have their merits after all. Most remarkable is the revival of interest in medical leeches. These little blood-sucking creatures have become a comic shorthand for all that was crude and ineffective in premodern medicine. But they did have some genuine benefits and now they are making a comeback. For example, they have been very effective in preventing tissue death after limb transplantation.

Belief in progress and scientific reductionism helped the West outpace the rest of the world for several centuries. But it also blinded it to resources in its own past. Traditional Western medicine looks unlikely to make a wholesale comeback but medicine is now adding older and holistic tools to its impressive modern technological kit.

若更想全面地解釋這種情況首，要先 了解方想西 思 如何塑造醫學。其中一個根源，是自柏拉圖以來一直主宰西方哲學的心物二元論。柏拉圖認為，我們的靈魂「是只 被牢牢地綑綁和黏在肉體上……只能夠透過樊籠柵欄的縫隙 窺探存在的本義。」換言之，我們的身體只是個暫時的載體，盛載著我們真實而不朽的靈魂。

並非有學所 哲 家都像柏拉圖般執著於二元論，但卻他 左右了後世的思發想 展。其中一個結果，就是學醫 僅被人視為一個工程學的問題，不必以一套整全的思想體系將身心結合在一起。西方醫學認為，要只 針對有問題的身體部位對， 症下藥後之 ，病人自能痊癒。主流學醫 要晚到 近接同才納時照顧身體和情緒的治療理念，認同兼身顧心的療法才能令身體更快康復。

這種機械式的思想亦深受西學方哲 中的簡化論影響。簡化論主張，若要了解一少事物，最好將之逐一分拆，直至最細小的部分，由此得徹獲 透 的了解。啟法國蒙運動時期編撰的《百科全書》，網羅所世有 俗知可識， 說是清楚解釋簡化論的好例子。這本鉅著副輯的 編 D’Alembert在序言中指 出「身體擁有多種特性」，而為了「將這些特性逐一仔細研究，我們必須先將之個別分開。」此舉非但並未構成不便，反而帶來了優勢。他寫道：「種這 簡化方式我，令 們更易掌握身體的特性。」

這種思想對醫學的影響再清楚不過。身體有同不 的部位和特性，了解它們的方法，就是逐一予以獨立的研究。人人都知道身體是個完整的系，統 但人們卻就個別的部位作出診斷和治療。

西方哲學第三個重要的特點，是強調時間不斷前進。此說普遍被視為來督自基教的世界基觀。教督 將人類歷史總結為幾個獨立的階段，從猶太人被選為上帝的子民始開 ，然後經歷先知時代，再進入降耶穌生的年代，最後祂重臨人間對， 世人展開大審判。但在基督教信仰以外的世界，人們有截然不同的觀念；時間被視為周而復始的循環，沒歷史 有結終 之時，而類人 亦沒有什麼終極目標。

撇開宗教根源不論，西思自蒙方 想 啟時期以來的另一個重要，特點 就是對進步這一觀念深信不移；當一些更新穎而且似乎更好的想思 與學說出現時，舊有的一套就會被人全盤捨棄。因此，經科研發展立而建的一套醫學從，哲學角度來看，不會有興趣保前流留人 傳下來的民間療法。這種情況就像漂亮的舊建築，因發展之名被粗暴拆卸一樣，古老的療法不會見容於現代醫學。

近年，坊間終於意識某到 些傳統醫學亦可能有其作用，當中以水蛭療法的復興最受注目。這種細小的吸血蟲曾被人用來嘲古醫諷 老 學既原始又無效，現在卻因擁有實際療效而捲土重來。其中的一個例子，是已水證實 蛭能有效防止植後肢 出現的組織壞死情況。

進說步 和簡化論令西發方 展的步方加速數， 百年來遠遠超越其他文明，但同時亦令西對有方 舊 的知識視若。無睹 今時今日傳統西方醫學似乎難以全盤回歸，但現代醫學大可在越卓 的科技成就中，納入有效而整全的古老醫學元素。

ONLY RECENTLY HAS WESTERN MEDICINE EMBRACED THE IDEA THAT THE BODY HEALS QUICKER WHEN THE MIND IS TREATED AS WELL西方醫學要到晚近才認同兼顧身心的療法才能令身體更快康復