by clicking the arrows at the side of the page, or by using the toolbar.
by clicking anywhere on the page.
by dragging the page around when zoomed in.
by clicking anywhere on the page when zoomed in.
web sites or send emails by clicking on hyperlinks.
Email this page to a friend
Search this issue
Index - jump to page or section
Archive - view past issues
Chiropractic Journal of Australia : CJA June 2012
46 Chiropractic Journal of Australia Volume 42 Number 2 June 2012 Local Biologies Local biologies illustrated how the notions of life, health and hazard evolved over time and according to cultures. For instance, the defnition of death was modifed in 1981 in order to facilitate organ harvesting and transplants. Yet the new defnition was not readily accepted in all countries, for instance in Japan where organ transplants have been authorized only in recent years. More generally, cultural backgrounds, societal circum- stances, and representations fashioned the understanding of physiological processes and the subjective experience of physical sensations. Variable tolerance thresholds excluded certain manifestations from the medical feld, or turned into problematic signs and symptoms what was previously ignored or elsewhere regarded as non-pathological. Natural processes and commonplace situations were medicalised and new pathologies emerged. There were examples on all continents, such as Brazilian susto, French crise de foie (indigestion), depression in Western societies, etc.; but female mid-life transition of menopause, and the sometimes associated syndrome, was a key example of interactions between societal circumstances and physiological processes. Traditionally, some African cultures gave ageing women an increased role in society, on par with men, and symptoms were ignored. Since mid-19th century, European and North American physicians have considered menopause as a disorder that needed medical attention. Hormonal treatments have been increasingly prescribed since the 1970s in spite of controversies and changing protocols. Anthropologist Margaret Lock, who used the terms “local biologies”, studied the ways this transition was apprehended in Japan and in North America.12 In Japan occasional manifestations associated with kônenki were felt as minor disturbances, the usual complaint being upper back soreness that only deserved limited attention. Japanese women were recommended to have a healthy lifestyle and, whenever needed, to use traditional remedies. This was signifcantly different from symptoms reported by American women and related medical instructions. It should now be observed whether Japanese women will be convinced of the necessity of heavy medical treatments; and whether symptoms will change following evolution of lifestyles. In Europe, as in North America, women were convinced that hormonal treatments were necessary to ease symptoms and to maintain adequate bone mass. They learned in recent years, amidst anxiety-producing controversies, that these treatments were not safe. While many physicians cautiously hesitated as to the opportunity of such treatments, women felt at a loss and frequently resorted to natural remedies. Some Contemporary Interpretations Our contemporaries are convinced of their autonomy and of their capacity of controlling nature, including their own body. In his critique of industrial societies, essayist Ivan Illich stressed that “the pursuit of a healthy body” is obsessional: “A new model has sprung that engenders people who objectify themselves: those who conceive of themselves as ‘producers’ of their bodies.” 13 It used to be important to stay healthy, it is now imperative to prevent any physical or existential hazard, to improve health and well-being, practically endlessly. Individuals should be adaptable and adequately ftted for the high demands of modern societies. This trend encouraged promising claims from many health care methods and patients were turned into consumers. In this context, the notion of holism developed by Smuts was hastily interpreted and equated with the vague idea of globality, something like “The whole is in the whole,” thus discarding the author’s ambition to lay the foundations of an epistemology that would encompass dynamic and creative processes. Thus muzzled, holism became in the 1970s a pervasive motto of the New Age nebula, a repetitious terminology in discourses of many health professionals and of the large public. Current holism supported an entanglement of speculations with a view to maintaining a global understanding of human beings: from emphasis on interactions of body functions to rapports with the environment, and to a metaphysical understanding of reality. Associated with naturism it encouraged self care and observance of a healthy lifestyle. Holism was considered as inseparable from traditional health care, at least in idealized descriptions. A wide range of methods adopted notions from these traditions, tempered by modern scientifc terminology and suited to ambitions of ftness and competition. 14 Holism heralded quality of care. Most complementary and alternative medicines claimed to be holistic, thus loosely combining science and ideology, sound practice and marketing strategies. Although they ambitioned to compensate for the reductionism of biomedicine and its shortcomings, they frequently referred to monistic principles and merely featured one symbolic representation of the human body, one method or one remedy. Methods that were based on the principle “One cause, one disease, one cure,” or “All diseases are psychosomatic,” were termed holistic whereas they were obviously reductionist. Media coverage of holistic health care was extensive. Works of authors such as Bernard Siegel, Norman Cousins, Matthews Simonton, Deepak Chopra, etc. became publishing hits. An appealing discourse, although not fully innovative, encouraged many individuals to become responsible for their own health. It was usually astutely wrapped around common sense, popular remedies, approximate adaptation of traditions, and romanticisation of the body’s self-regenerative power; it skilfully included cursory references to quantum physics, neurosciences, and psychoanalysis; it also evidenced looting from chiropractic. Quality of Life and Public Health In the 1970s the idea was elaborated to appreciate the impact of pathological processes and therapies on patients’ daily lives, routines, and well-being. Standardised questionnaires based on psychometric methods were devised for the collection of empirical observations and measures likely to render such a practical and intimate experience. This methodology seemed to be compatible with respect of patients’ autonomy while refning medical procedures and generating new knowledge for social and medical sciences (epidemiological studies; evaluation of therapeutic protocols HOLISM IN HEALTH CARE JOLLIOT
CJA March 2012
CJA September 2012