More than the eye can see

I was thinking about how the discovery of germs has transformed modern medicine so completely. In the same train of thought, I was also thinking about ancient systems of medicine, such as the Greek, Chinese and the Indian systems, and how they were effective (to an extent) even without discovering this key piece of knowledge that unlocks the mysteries of disease.

It is a nice example of an interesting theme: the difference between the ability to cure and the ability to understand. Do we need to understand the fundamentals, the building blocks of disease – in this case, that of germs causing illness – in order to be able to cure it? The answer seems to be, no. Disease is a phenomenon that occurs in a predictably repetitive manner. An unlettered scientist, a  witch-doctor if you will, would, with sufficient experience, be able to identify patterns in the diseases that different people have. For example, he (or she) will be able to identify a combination of symptoms – fever, body pains and rashes – even if it occurs at different times, to different individuals. And then this proto-doctor will be able to give it a name.

Once named, the doctor will be able to administer treatment. True, the first generation of treatment will be completely random – different kinds of food, different environments of rest. But almost by accident, something will end up working, just as some things will end up making the disease worse. By careful cataloging and guided trial and error, the doctor may very well end up being able to not only identify the disease, but also treat it. This process of knowledge accretion is immeasurably improved by the ability to pass on the knowledge from generation to generation, which is why in societies with a strong knowledge culture – such as ancient Greece, or ancient India – where there was a societal approval for teacher-student relationships, the ability to diagnose and cure reached a very high degree of sophistication.

Once a large catalog of diseases and cures has been accumulated, the proto-doctor becomes a proto-scientist. He will now see patterns, not just between disease and cure, but between symptoms, between cure ingredients, between lifestyles. Assisted in some measure by dissection of human remains, or extrapolation from animal innards, this proto-scientist develops a theory of body, a system of anatomy and physiology, and a theory for the manner in which the typical body is affected by disease. The development of the system is, in some sense, an act of compression: taking a huge number of anecdotal facts, the proto-scientist tries to invent abstractions that help in reducing the complexity of the system by reducing the number of variables. In Greek medicine, disease was postulated as a non-equilibrium of the four ‘humours’ (or four liquids) of the body – blood, phlegm, yellow bile and black bile. In Ayurveda also, there is a similar classification, where disease is conjectured to be a dosha (imbalance) of kapha, pita and vata – the three building blocks of physiology. Indeed, Dr A V Balasubramanian of the Center for Indian Knowledge Systems (CIKS) once told me about an Ayurveda doctor who gave him a detailed explanation of the cause, symptoms, effects and treatment of blood cancer using the doshaterminology.

The question is: does the discovery of germs automatically discredit this entire body of work? My staunch answer is: no. This also seems to be the market’s answer, judging by the resurgence in popularity of ayurveda. It is not necessary to understand the fundamentals of a science in order to establish patterns and make intelligent predictions about the future based on past happenings. The more fundamentals we find, the better our ability to predict; however, according to Ayurveda die-hards, there is nothing ‘more fundamental’ about germs compared to doshas, and just because doshas are less tangible, in some sense, than germs (i.e. you cannot see them with a microscope) doesn’t make them any less true. Perhaps, with sufficiently diligent inquiry, the Ayurvedic scientists performing an inquiry into the cause for disease may have, sooner or later, somehow deduced the existence of germs, even if they would never  be able to see them (the microscope not having been invented). The history of science, however, tells us that we find what we look for, and I am quite sure that there are possibly numerous other hypotheses that fit the facts as they were known to the ancients, in addition to the germ theory.

Eventually, then, it comes down to truth. In Gita class, Swami P specifically makes a case against rationalism: the refusal to accept as truth what you cannot perceive for yourself with your sense organs. And yet, this is a rather arbitrary refusal. There is no need for truth in this world to conform to our sense organs. There is no reason to believe that what is true is necessarily what we perceive. Our sense organs have evolved for the purpose of propagation of our genetic matter, not to aid us in self-knowledge or discovery of the truth. The new scientific age we are in has not gone far beyond knowledge that can be gathered by the senses; in a few cases (to pick a random example, magnetic field) we are able to sense a physical quantity, not through a sense organ, but through a ‘transducer’ – which converts the quantity into something that we are able to sense, such as a reading on a dial or a readout on a computer. However, the nature of observed knowledge remains very narrow – facts, observed as singleton sensory stimuli, linked by linear time. It is unlikely that we will ever learn the ‘real truth’ until we have found a way to break out of this straitjacket first.

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