Holism, Reductionism, Balance

Integrating Natural and Conventional Medicine:
reductionism, holism, and a balanced view

When I first heard the word holistic at the veterinary college it sounded esoteric, an idea that was received with skepticism by some and with contempt by most – including myself. Today, I incorporate holism into my practice, and the word holistic pops out of the mouths of scientists, politicians, businessmen and even soldiers.

Yet now we see the opposite extreme, in which companies brand their products as holistic to increase their appeal and make more money. We see absurdities such as a dog kibble presented as 'holistic' – as absurd as the idea of presenting a 'reductionistic' banana. Holistic has become a brand; or to follow the logic of Naomi Klein [author of the book No Logo], holistic has become a logo.

Rather, holism is a philosophy, a way of seeing the world, and a method of inquiry and action.

Reductionism and modern scientific medicine
Modern life in general and medicine in particular are influenced by scientific discoveries. Through science we have been able to develop technologies that have improved our quality of life. In medicine, science has resulted in the treatment of diseases such as diabetes – where the discovery of insulin injections has saved the lives of many. Animals afflicted with diabetes drink excessive amounts of water, urinate large amounts, may lose weight and have erratic behaviour. Scientific studies have led us to discover that these dogs have an excess of glucose (sugar) in their blood and a deficiency of insulin. Insulin is a hormone, produced by the pancreas, that helps cells to take up glucose from the blood stream. The solution to diabetes became clear: inject insulin.

But scientific experiments are conducted by humans. The way in which experimentation is conducted, the type of experiments carried out, and the interpretation of the data collected are influenced by the philosophy of the scientist involved. Still to date, the method used to resolve a problem consists of breaking the problem into parts until we find the faulty part. Therefore, the solution is replacing or fixing the faulty part. This is called reductionism, which forms the basis of modern conventional medicine. This method has had spectacular successes. The discovery of insulin is one; antibiotic treatment of infectious diseases is another; and there are many more. Grateful for the gifts, we place reductionistic science on a pedestal and ask it to be the solution to all of our problems.

Reductionistic science became the religion of our secular civilization. However, so many problems defy solution by reduction. We kept asking: how do we cure cancer? How do we treat degenerative diseases? How do we avoid the side effects of drugs? The answers did not come. The scientist kept asking for patience, understanding and more funding to keep breaking the problem into smaller and smaller pieces. I gave up, rejected the whole thing and swung the other way. I reached the point where I considered anything that came from reductionistic, conventional science, or anything said to be scientific, to be un-natural and bad. I declared that science had it wrong. "The whole is more than the sum of its parts" was my mantra.

Holism

In the holistic view, a living system must be studied as a whole. If we take a living system and break it into components, we lose a great deal of information that results from the interaction between the parts. Therefore, the isolated part gives us a hopelessly incomplete picture of the properties of the whole. In other words, what a part (an organ, a cell or a molecule) can do greatly depends on its interaction with other parts.

Scientific holism has discovered that living systems are complex structures, organized in hierarchical levels from the micro (molecular) to the macro (organ/system) levels. Unique properties emerge at each level of complexity. Emergent properties are solely due to the interaction between the parts. In medicine, this philosophy is at the basis of Traditional Chinese Medical (TCM) physiology. In TCM and TCVM all of the organs are seen to participate in a complex dance of interactions, summarized in the generation cycles of the five elements. For treatment, one must account for all of the interactions.

Classical homeopathy takes holism in medicine even further: the diagnosis and treatment is weighted on the behaviour of the whole system, with less concern for the individual dysfunctional parts. Scientific holistic medicine is having great successes and it is gradually becoming part of the mainstream. However, some are adopting holistic medicine as if it were a religion where there is not room for fault; where any faults are just a result of our impatience and incompetence in following the doctrine. We are reaching the point where it is considered that if something is holistic, or said to be holistic, it must be natural and good.

Yin, Yang and the balanced approach

Oriental philosophy assigns everything to one of two qualities: yin and yang. Black and white; dark and light, down and up; et cetera. These qualities are complementary because they need each other in order to exist and each contains the other. There is light in darkness; you may be down in relation to one person but up in relation to someone else; sometimes you need to apply a weak force, sometimes a strong one. Western philosophy tends to divide things into opposing poles and the dynamics are of conflict between opposing views.

While sometimes the best method is to see things in the Western way, the Eastern way needs to be considered as well. We see reductionism (conventional science) in opposition to holism. Holism is seen as an alternative. However, like yin and yang reductionism and holism are complementary. It is very unlikely that a diabetic dog will be alright with acupuncture or homeopathic treatment alone. Likewise, far too often it is difficult to regulate blood sugar levels with insulin alone, and if other organs are affected, adding other drugs is problematic. Most cats die within two years of diagnosis, even if insulin therapy is instituted. However, if in addition to insulin therapy we add a holistic approach, the patient may live a long and happy life even if the blood sugar is not tightly regulated. Bacterial infections are common in medicine and antibiotics are effective to kill bacteria. However, not all infections at all times should be treated with antibiotics, nor should we refrain from using an antibiotic when a life-threatening infection, or the potential of one, is before us.

We need to have the fluidity of mind to move within the spectrum of philosophies and therapeutic techniques without being framed by a doctrine. Scientific inquiry is the best way of making an unbiased assessment of the value of therapies. However, we need to incorporate more holistic philosophy into experimentation. In medical practice, sometimes we need to use reductionism, sometimes holism, but we always have to see that one contains the other and that they are complementary.

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