Vitalism – some philosophers speak.

This is an adapted extract from my PhD thesis: Evans, S. (2009). Challenge, tension and possibility: and exploration into contemporary Western herbal medicine in Australia. Southern Cross University, Lismore. http://works.bepress.com/sue_evans

Vitalism, traditionally a central philosophical concept of herbal medicine, has more recently become an idea surrounded by controversy, not least because it can appear incompatible with a scientific worldview.  Some, like Smuts (1926) who is credited with coining the concept, suggest that the concept of vitalism is outdated and is usefully replaced by holism. However the French philosopher Georges Canguilhem (Delaporte, 1994) argues vitalism should be understood as a moral position rather than a scientific fact: a position  completely in accordance with traditional herbal practice.

In this article, I provide a brief outline of historical approaches to vitalism before discussing the contribution of Canguilhem to this debate. I will restrict the discussion to concepts and approaches to vitalism in European thought, omitting discussion of similar concepts found in indigenous traditions, or in scholarly approaches to herbal medicine such Traditional Chinese Medicine and Ayurveda.

The problem

Vitalism can be linked to a commonsense understanding of the world as being interconnected and alive, an idea which was widespread in Europe prior to the scientific revolution of the 17th century  (Larner, 1992; Sheldrake, 1990; Thomas, 1971). Since the early twentieth century, it has been soundly rejected in scientific circles, with scientists arguing that all biological processes can be explained by the laws of physics and chemistry. Consequently, well-respected chemistry texts suggest that the discrediting of vitalism was necessary to allow for the development of modern organic chemistry (Hart, Craine, Hart, & Hadad, 2007), and Greco (2004, p. 680) states ‘Many biologists today tend to use “vitalism” as a derogatory term associated with lack of intellectual rigor, anti-scientific attitudes, and superstition.’

Within the discipline of herbal medicine, a pre-modern understanding of the world as alive causes discomfort to those who feel it is important for herbalists to adopt the discourse and rhetoric of science. Mills, a leading British herbalist over the last twenty-five years, rejects its religious overtones, stating that ‘the lack of any criterion even to define a vital causal force has meant that vitalism itself has taken retreat into the bunker of modern religion’ (Mills, 1991, p. 120).

Wohlmuth draws attention to the divide between traditional herbalists and those who see herbal medicine as a science.

Many proponents of traditional herbal medicine argue that vitalism and its concept of a ‘vital force’ are fundamental parts of the theoretical and philosophical framework of herbal practice. In contrast, many others, who view herbal medicine as an essentially scientific practice employing medicinal plants as pharmacologically active therapeutic agents, see vitalistic concepts as irrelevant, antiquated and unhelpful to the promotion of herbal medicine as a valuable part of healthcare (Wohlmuth, 2003, pp. 198-199).

However, this emphasis on the science of herbal medicine and rejection of vitalism is not universally accepted. Baer (2004), VanMarie (2002) and Singer and Fisher (2007) draw attention to a developing rift, termed an ‘epistemological bifurcation’ by Singer and Fisher (2007), between those herbal practitioners who consciously support traditional herbal medicine and give centrality to the idea of vitalism, and those, like Mills (1991) and Wohlmuth (2003) above, who reject it.

A short history of vitalism in relation to herbal medicine

Concept Meaning
Vitalism life cannot be understood just through principles of physics and chemistry (Sheldrake, 1990)
Vis mediatrix naturae (healing power of nature) An understanding, originating with Hippocrates, that the body has a natural tendency to recover from disease (Pitman, 2005; Whorton, 2002)
Pneuma spirit – Galen (Holmes, 1989; Nutton, 2004)
Vital force/life force Self-regulating and self-healing, creative, directive intelligence; the Archeus of Paracelsus(Wood, 2000); of early naturopath Lindlahr  (1919) also of Thompson and the Eclectics (Wood, 2000).
Élan vital Philosopher Henri Bergson credited evolution and progress to the élan vital (Bergson, 2001)
Entelechies Biologist Hans Driech used this term to refer to a ‘purposive vital factor’ (Sheldrake, 1990)

Table 1: Concepts related to Vitalism in European herbal medicine

The table above refers to concepts related to vitalism which have been developed by European philosophers over the centuries. These philosophers were not herbalists, but their ideas are relevant to the use of the concept within the philosophy of Western herbal medicine.

Some of the terms listed in this table are used interchangeably within herbal medicine, but they have arisen in different contexts, in different historical periods, and are not identical.  Vitalism refers to a quality which animates all biological entities (McCabe, 2000; Sheldrake, 1990) whereas vis mediatrix naturae is a description originating in the Hippocratic writings, of a principle by which the body recovers from disease (Pitman, 2005). The Roman physician Galen used the term pneuma to refer to a vital spirit  (Holmes, 1989; Nutton, 2004) whereas later writers from the 19th and early 20th century, including the American herbalist Samuel Thompson (Lloyd, 1900), understood ‘vital force’ to be a more concrete, robust force (Wood, 2000), and one which moves the body towards healing. Wood suggests that, as a basis for medical practice, ‘vital force’ has been perceived differently by Paracelsus, Thompson and the Eclectics (among others), and that these differences are evident through the differing styles of therapeutic intervention (Wood, 2000).  The terms élan vital which Bergsen (2001)  used to describe an evolutionary impulse, and entelechy, used originally by Aristotle but reintroduced by Driech to refer to a more individual organising impulse, are not terms often used by herbalists.   The terms listed above indicate a rich tradition of vitalistic thought within Western philosophy, which, with careful re-examination, may contribute to an understanding of its persistence within herbal practice.

Canghilhem’s contribution

A potentially fruitful approach to the ‘problem’ of reconciling vitalism with science  is provided by Georges Canguilhem (1904-1995). Canguilhem gets around the problem of needing to establish the existence of vitalism by defining it as an ethical position. For him, it is a perspective from which to develop attitudes concerning health and disease. He does not claim that vitalism is true, and rejects calls to provide ‘proof’ of vitalism. Rather, he understands it as an ethical system.  (Canguilhem in Delaporte, 1994, p. 288).

He claims that vitalists are people who see themselves ‘in a filial relationship with nature’, that is, as part of nature, in which they find ‘life, soul and meaning’ (Cangiulhem in Delaporte, 1994, p. 288). Canguilhem differentiates these individuals from those who stand separate and apart from nature, observing it from a distance (Delaporte, 1994).  If vitalism is understood as an ethical position, questions of ‘veracity’ as understood by natural science do not need to be addressed. From this perspective, vitalism does not need to be a clearly articulated doctrine, and not consistent with the principles of rational thought as required by contemporary science (Canguilhem in Delaporte, 1994, p. 288).

Canguilhem is concerned with what vitalism does and what its adoption leads to in terms of medical practice, more than in what it is.  He is a philosopher and a medical practitioner, not a herbalist or naturopath, but his approach is consistent with the philosophy of natural medicine when he describes a concern with vitalism in medicine as:

a biology for physicians sceptical of the healing powers of medication… Because nature is the first physician, therapy is as much a matter of prudence as of boldness. Vitalism and naturalism were thus inextricably associated. Medical vitalism reflected an almost instinctive wariness of the healing art’s power over life (Canguilhem in Delaporte, 1994, pp. 287-288) (my emphasis).

Canguilhem’s focus on consequences rather than ‘truth’ may not endear him to scientists, but is likely to be sympathetically received by those who are concerned with the limitations of science’s demonstrated ability to lead to social progress (Jagtenberg, 1987; Sheldrake, 1990; Wright, 2004). His emphases on utilising nature as healer, and on minimum intervention rather than dramatic, heroic attempts by the practitioner to ‘heal’, are characteristic of natural medicine (Coulter, 2004). These principles are consistent with the emphasis in contemporary Western herbal medicine on the body’s ability to heal itself (vis mediatrix naturae), on the role of practitioner as facilitator in this process, and the individuality of treatment. Patients are understood as unique individuals rather than as carriers of specific pathologies.

Canguilhem further asserts that health is defined by adaptability. This is consistent with the idea of a ‘vital response’, so important to some herbalists. For Canguilhem, health is far from a steady state. He claims that for a person’s health to be maintained in narrow boundaries is the opposite of health, as ‘what characterises health is the possibility of transcending the norm’ (Canguilhem, 1991, pp. 196-197). This association of health and activity with health is consistent with the association of acute symptoms with vitality and chronic symptoms with a lack of vitality which is a fundamental principle in both herbal medicine and naturopathy (Bradley, 2006; Griggs, 1997). Canguilhem understands that

To be in good health means being able to fall sick and recover, it is a biological luxury. Inversely, disease is characterised by the fact that a reduction in the margin of tolerance for the environment’s inconstancies (Canguilhem, 1991, p. 199).

Canguilhem avoids the need to prove the existence of vitalism by removing it from the phenomena appropriate for scientific inquiry, re-interpreting it as a ‘morality’ rather than a ‘fact’, and concentrating on its implications for medical practice. He demonstrates how vitalism leads to tenets of natural medicine including naturalism and therapeutic conservatism. His perspective on the relationship between humans and nature is reminiscent of rural and pre-Enlightenment life where humans are responsive to nature and see themselves as part of the natural world, rather than the rulers of it, and is consistent with contemporary herbal philosophy.

Conclusion

The concept of vitalism in European thought has a rich history, and has been interpreted from a range of perspectives. While the idea of the ‘genie in the machine’ may be problematic for many herbalists, particularly those of a more scientific perspective, it is worth considering the consequences of the concept before dismissing it. Just as thinking of the earth as a living organism, as Gaia, can change our behaviour towards her, imagining treating our patients’ vital force as well as their discomfort or pathology, as Canguilhem suggests, can change our treatment protocols. The benefit of this is that it can encourage us to be more conservative in our utilisation of our precious plant resources, and to be more alert to our reliance on natural processes within clinical practice.

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