Can traditional medicine become biomedical science?
How does a traditional healing system transform itself into a scientific one?
It is a worthwhile endeavor, assuming of course, that you don’t believe that the ways of the elders are merely “superstitious nonsense.” (But if you do, how do you square your faith in science with that other bedrock of most Asian societies, filial piety?)
For one, scientization allows the modern world access to bodies of knowledge amassed over centuries. Somewhere, hidden therein, could be the cure to cancer or some other such miracle.
For another, the exercise of shoehorning one set of facts into another forces us to confront the cultural assumptions that underlie so-called objective truths.
(Generally speaking, it’s not a controversial statement to say that different people perceive the same event differently. Curiously, however, this generosity towards other perspectives stops at the boundaries of science.)
The case of Tibetan medicine is instructive. This system of healing came out of the Tibetan monasteries, which meant that it is infused with a religious worldview. At least in the old days, a doctor was also a priest and typically administered to the same community for generations.
In the words of one Tibetan physician,
“But Western medicine… they only believe in the visible things, not the invisible. But we believe in the invisible things… If you are going to become a Tibetan doctor, you have to learn astrology and you have to integrate astrology and Tibetan medicine…We say you have two eyes, a pair of eyes. If you lost one then you cannot see the whole. Religion, of course, is connected to the psychological part. In Tibetan medical theory we believe the body is composed not only of matter but also spirit. We believe that the body is composed of those two things. So even if you diagnose or treat patients, the psychology is very important. This is connected with religion”(as quoted in Adams et. al).
The skepticism of the modern scientific state towards Tibetan medicine took an about turn when it was realized that there were lucrative export markets for holistic medicines (even more so for those with an aura of “Tibetanness”).
Traditional Tibetan medicines are handpicked and combined by the doctors themselves, who are also trained herbalists. Obviously this wouldn’t do for the export market, and so began the process of standardizing the production of Tibetan medicines. The thinking went that through scientization, this medical system would become a more effective and marketable version of itself.
As a first step, the World Health Organization’s (WHO) Good Manufacturing Practices (GMP) protocol for herbal medicine was applied to the manufacture of Tibetan medicines.
The GMP protocol is part of an overall WHO strategy to ensure that member states develop domestic legislation and regulatory models for the production and quality assurance of traditional medicines (and also a recognition of the fact that in developing countries, a majority of the populations still turn to traditional medicines for their primary healthcare needs).
Ironically, while the protocol advocates for the safety, efficacy and quality of traditionally formulated medicines, it does not make any allowance for different cultural understandings of what constitutes “safe,” “efficacious” or “high quality.”
The GMP protocol originated in the specific cultural context of the turn-of-the-twentieth century United States, where medical practitioners were separate from purveyors of biomedicine and the separation between the two became a cornerstone of modern bioethics.
Needless to say, this was the exact opposite of the Tibetan context.
In Tibet, indigenous quality controls require herbal medicines to be harvested by a person of the right spiritual bent in certain areas and at certain times of year to maximize their potency.
By contrast, GMP quality controls require medicines to be processed in sterile environments. There is an obsession with physical cleanliness, with no concessions made to the Tibetan requirement for spiritual cleanliness.
The GMP protocols are but one of many, many areas where Tibetan tradition and science negotiate an uneasy truce.
A dominant ideology neuters threats to itself by incorporating them, thereby reducing their potency.
In The Conquest of Cool: Business Culture, Counterculture, and the Rise of Hip Consumerism, the American writer Thomas Frank wrote of how the protest movements in the sixties were co-opted by corporate America and regurgitated to the public via Madison Avenue as a Volkswagen ad.
Similarly, following scientization, it could be argued that Tibetan medicine is no longer part of a Tibetan system of healing—instead, it has been incorporated into biomedicine. Once uprooted from its original context, however, does the medicine still work as well?
Sources:
Vincanne Adams, Renchen Dhondup and Phuoc V. Le, “A Tibetan Way of Science: Revisioning Biomedicine as Tibetan Practice” in Eds., Vincanne Adamas, Mona Schrempf, Sienna R. Craig, Medicine Between Science and Religion: Explorations on Tibetan Grounds, 2011.
Sienna R. Craig, “’Good’ Manufacturing by Whose Standards? Remaking Concepts of Quality, Safety, and Value in the Production of Tibetan Medicines,” in Anthropological Quarterly, 2011.
