||Health, in medical terms, is the harmonious and efficient working of the entire person. The definition does not sit comfortably in post-Cartesian science and needs to acknowledge the description of person as body-mind or body-mind-spirit.
The Western scientific description of the structure and function of the body has achieved great elegance. Since the invention of the microscope the constituent parts have been revealed in increasingly great detail. Microscopists have been worthy companions of painters and textile-makers in the skilful use of dyes and pigments to reveal the parts of tissues and cells. Biochemical studies have complemented the observations of structure, and have explained how the parts are constructed and maintained, how biological information is stored and transmitted, and how the energy to maintain life is derived and stored. The full picture explains the roles of the parts of our diet the contribution of the Earth to our health.
The construction of this picture has been, at least aesthetically, one of the great triumphs of human thought. All this notwithstanding, Western medical science has no means of measuring or defining health other than as the absence of signs or symptoms of disease. The large and elegant mass of information has also proved difficult to translate into means of providing a health-promoting regimen, or, with a few notable exceptions, of explaining the basis of illnesses. The science of nutrition is particularly disappointing in providing information which can survive critical evaluation.
Medical advice about health seems to be derived from a consideration of risk factors which enable the prediction of likelihood of, for instance, heart attackâ€”that is to say, sedentary lifestyle, smoking, high cholesterol levels, diabetes melitus and high blood pressure are the factors which make a heart attack more likely in proportion to the number you have. Of these factors, giving up smoking and doing some strenuous exercise seem to have the most clearly proven benefit. If you have high blood pressure it must be reduced by â€˜lifestyleâ€™ changes, or by drugs. If you have diabetes the illness must be controlled, and you must also eat a diet high in grains and pulses. What to do about high cholesterol levels remains unclear. Reducing cholesterol by drugs does not alter the heart attack rate, and increases the chance of other life-threatening illnesses. Altering the kind of fats eaten has not been shown to be of proven benefit. The most extensively exploited and most well-known advice is doubtful. Advice about health has had to be advice of doubtful scientific value about illness. In apparently comparable countries in the â€˜developedâ€™ world the heart-attack rate is rising in some and falling in others, for unexplained reasons.
By contrast classical Chinese medicine was based firmly upon the maintenance of health: it is said that the physician was paid only when the person was well. If the person had complaints or symptoms, the thrust of the treatments was to enable the reemergence of health-regulatory mechanisms. Health was maintained by harmonizing with Nature, tempering activity according to the seasons, basing diet upon the grains, not being dominated by an excess of emotions and being moderate about all things. If the physician was required to intervene the intent was the ennabling of harmonious flow and distribution of chi or qiâ€”a substance not unlike the structure and function of blood which transports and manifests everything to do with person. The calligraphic character for chi consists of â€˜breathsâ€™ and â€˜the steaming grain of riceâ€™. Health could also be encouraged by meditative exercises like Chi Kong (or Qi Gong) and Tai Chi Chuan (or Tai Ji Chuan).
In the years preceding and following World War II, there developed in Western medical practice a remarkable and innovative idea, that a doctor should know the members of the community as healthy people, and that illness should be regarded as an intercurrent event and not as the sole reason for doctor-patient encounter. The idea was that doctors, with a team of helpers nurses, home visitors, social workers, industrial hygenists, etc. should provide day-to-day health care services to everyone, also utililizing â€˜well-personâ€™ clinics. As the people got to know each other there would be an emerging database about the state of health of the community, and over time, medical interventions could be evaluated, compared and reported upon. The advantages of the system are that doctors and their helpers are all members of a team acknowledging the value of all contributors, and that people in the community deal with people they come to know, each respecting the other. Not least, the database accumulates information of increasing quality enabling critical evaluation of medical interventions.
Health Centres were first set up and successfully operated in Peckham, London, England in the 1930s and in Polela, Natal, South Africa in the 1940s. The idea was to have been the model for the British National Health Service, but too many medical planners seem to have found it threatening. The term Health Centre is now sometimes used to describe the building in which General Practitioners work, but this has no link with the original concept. TG
See also Daoism; disease; medicine.