Book Review:

Weil, Andrew. Health and Healing. Houghton Mifflin Company, Boston. 1988.

As a biocultural science, anthropology recognizes that whatever the biological traits held in common by all humanity are, such traits will be interpreted through the cultural context of a society and reacted to in a manner appropriate to that society. Yet another level of interpretation is added as individual members of a society choose among various options (within a society) to deal with individul circumstances. This principle holds true for countless aspects of the human condition.

Health and Healing, although neither written by nor targeted towards anthropologists, is a thorough exploration of this principle as applied to illness and medicine in the United States. Intended as a layperson's guide to this astounding variety of medical practices and practicioners, Health and Healing discusses and compares the theory and practice of the predominant american medical system (allopathy) with its multitude of competetitors.

The author, a practicing M.D. who has spent virtually his entire medical career researching and comparing medical systems in the U.S. and other countries, makes an early declaration of determined objectivity, pointing out that "no system of treatment works all the time" (pp. 19-20) and that every system he examined has some apparent flaw that can prevent patients from attaining maximum possible health. In many cases, that flaw is simply a system's dogmatic assertion that it is the only correct system; in other instances, it many be a more fundamental flaw in theory. Nevertheless, Weil asserts that all such flaws are problematic in that they interfere with the expressed purposes of such systems: to heal the sick.

Weil's book is divided into six main sections. In the first section, "Treatment and Cure: The Strange Case of Homeopathy", Weil begins the book with an autobiographical account of a homeopathic practicioner curing his chest pains. He then dives headlong into an explanation of the history and theory of homepathy, with specific intent. First he shows the reader a theory of treatment that violates american "common sense" on how to correct illness. Weil's historical discussion then proceeds to show that the allopathic medical system the reader regards as traditional and normal is relatively new, and hardly the ancient art it aspires to be with its Hippocratic Oath.

Hopefully having smashed some of the readers cherished preconceptions, Weil proceeds into the second section, entitled "What is Health?" explains some quirks in the traditional american definition of health. Foremost among those quirks is that health is traditionally defined only by absence of illness, an interesting cultural insight suggesting that illness is a natural state and doctors are doing patients a favor by "improving" them, rather than simply restoring them to normal as in many other societies.

Weil then attempts to redefine health in the context of a dyamic equillibrium, which is (at best) a tricky thing to do for american reading audiences. Americans (as westerners) are accustomed to seeing dualities as opposed rather than complementary. Weil obviously had difficulty finding an citable western discussion of such dynamic equillibriums (many such discussions in western literature are either highly technical or hopelessly New Age) and quotes Black Elk and Lao-Tzu in his defense. While both are respectable philosophers, their unfamiliarity to most americans may hamper their effectiveness in this context.

Finally, Weil uses this section of the book to lay down some principles to judge health regardless of what system is being used, in order to facilitate comparison of the various systems. Together with the third section of the book, "Healing" (which explains the biological principles of unassisted healing), it is here that Weil comes closest to creating (effectively cross-cultural) models that can be used to judge any healing system. With these models described as clearly as possible, Weil can settle into analyzing the various healing systems that have established themselves in the United States. Such is the purpose of Health and Healing's fourth section and largest section "A Bewildering Array of Therpeutic Sources". It's quite an array.

The first three chapters of Section 4 are devoted to a detailed study of allopathy, in a determined effort to make the reader see that allopathy is as incomplete and falable as any other system of medicine. One chapter, "Materia Medica" provides a detailed history of medical drug use in western society and traces the current tendency to overprescribe by allopaths too confident that drugs can cure anything. The third chapter "Sins of Omission" systematically attacks flaws in the philosphy of allopathy, presumably in an effort to encourage some skepticism (on the part of readers) towards allopaths who stress extreme invasive procedures as the primary means of health care.

The remainder of the section examines various other healing systems, ranging from well-examined ones like osteopathy and chiropractic to the almost impossible to study faith healing. Weil can afford to be a little less vitriolic in these chapters, as he is not working against culturally-ingrained worship of the systems, rather trying to present them in comprehensible light to those unfamiliar with them. Yet he does not fall into senseless praise of any alternative system, and rightly points out fundamental flaws in osteopathy and naturpathy, discusses the almost infuriating subjectivity of faith healing (not to mention the lack of study done on psychic healing) and the dangers of wishy-washy holism or unrepentant quackery.

Weil wraps up this long section with a comparison of the various systems examined, reiterating the key point thst no single system can cure everything, and pointing out that every system works best when the patient believes it its effacy. In doing so, Weil neatly segues into the fifth section of the book, "Mind and Body".

It is in this fifth section that Weil discusses a subject that has darted in and out of the previous four sections' discussions, namely the connection between mental states and healing, including an long discussion of the much maligned placebo effect. Weil points out that any treatment that the patient believes in (whether biologically effective or not) contains some placebo value, and that the traditional allopathic distinction between "actual" effect and "placebo" effect is (and probably never will be) clear-cut. Weil further argues that allopathic physicians are underutilizing placebo treatments, reserving them for control groups in drug tests or for patients they denigrate as purely psychosomatic (using a bad definition of psychosomatic, yet).

Weil further believes that allopaths have created a need for placebo treatments within american society (i.e. people expect prescriptions when they visit the doctor), but refuse to take this need seriously, or worse yet misuse it by prescribing unneccesary drugs to satsify the patient, or "just to be sure". Allopaths, according to Weil, may themselves be caught up in a strange varient of placebo use, where any drug is better than no drug at all.

Weil then discusses more intentional applications of mental abilities for healing, such as hypnosis and biofeedback, which he feels are unrespected and underutilized by most medical practioners when they are in fact fairly practical (and nonintrusive) means of utilizing such "mental cures". The sixth and final section of Health and Healing is "Health and Healing in the Year 2000", which suggests one way to correct the imprecise philosophy of allopathic medicine would be for it to catch up with the other sciences in its basic conception of reality (in other words, medicine needs some new metaphysics). While most of the modern sciences have recognized a certain "interdependence of observer and observed" (p. 264) (which is a fundamental aspect of quantum physics, the first western natural science to start discussing dynamic equillibrium, albeit it in the esoteric and highly technical realm of particle transitions), medicine has stuck with an essentially mechanistic view of the universe that for the most part ignores the effects of human concsciousness on human beings. This section (and the book) end with a plea for all practioners of medicine (especially allopaths) to end their sectarian bickering and start working on testing the untested in order to compile a useful body of "multi-system" healing.

Health and Healing is very good portrait of the various systems of healing utilized in the United State, serving both as a definitive guide for the layperson trying to decide which form of treatment is suited for what ailments (a decision laypeople will have to make until and if healers start becoming more well-rounded) and as an introduction for social scientists in the subject. The even coverage of history, philosophy, methods, and performance of the various systems is a remarkable achievment considering the emotionalism the healers and patient have for the subject. Weil is an admirable example of someone who resisted conversion to any one system in order to find the best of all them and provide suggestions for an ultimate reconciliation of what should be allied professions. His approach makes Health and Healing both a practical guidebook and the first step towards a blueprint for revising the clinical aspects of american medicine.

Filed at 03:06:20 PM EST on 04 December 1992 from Toledo, OH