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Roberta Bivins sets herself an ambitious aim with this book: to "examine medical systems from several global cultures ... and consider their interactions over four centuries", from the seventieth to the twentieth. These centuries "were in many ways transformative both of western medicine and of the western ad non-western worlds". The book wants to guide us through the changes that gave medicine -- both orthodox and alternative -- the shape it has today.
The histories of orthodox and alternative medicines are deeply connected. Bivins in fact explains that "to have medical systems, theories, and practices that can properly be regarded as alternative, one must have a recognized, definable, and at least relatively stable orthodoxy to which they oppose themselves"; accordingly, the book is widely concerned with orthodox medicine, its development and the way it faced the appearance of different medical systems. The book is a history of alternative medicine in so far as it is a history of western orthodox medicine.
A long introduction --following a short preface -- gives a wide overview of the landscape Bivins is going to describe. She sets here "the stage by describing and comparing classical and modern western medicine, Ayurveda, and Chinese medicine".
We discover the importance of starting her historical journey from the seventieth century: this allows us to appreciate that for a long time medicine has been very different from the medicine we now know and, in some respects, similar to alternative medicines. It was in fact characterized by a holistic approach: connections among body, mind, society and environment were at the hearth of medical culture and health was seen as a complex balance of humors. The body of patients was seldom touched and surgery was extremely rare: it was a "desperate last resort", painful and dangerous.
Although there were many important differences -- "material, theoretical, and institutional" -- among medical systems, Bivins argues that "medicine in pre-modern world" ignores the distinction between western and non western, orthodox and non-orthodox medicines. This situation "endured into the eighteenth century".
In this century, however, important changes occurred. With the rise of European imperialism, medicine became "a representative aspect of culture" and "European models of natural knowledge and medicine" consolidate. Just as in the previous century, there has been a careful observation of other medical systems, but this time with a hostile attitude. European medicine, Bivins claims, becomes a "metric for assessing the relative standing and progress of civilizations". These changes don't go hand in hand with relevant changes in medical practice. It is only in the course of the nineteenth century, in fact, that the idea of a 'scientific' medicine appears: experiments get more and more important, just as body observation. The idea of an orthodoxy is strengthening.
During the twentieth century, we assist the industrialization of medicine, that is to the "increase in the complexity of medical organization and technologies, and in the number of specializations". It is now that we can start to talk properly of alternative, complementary and orthodox medicine.
After the depiction of this scenario, the following four chapters follow closely the interplay between western and alternative medical systems.
In the first chapter, Bivins analyzes western attitude toward acupuncture and moxabustion between the late seventeenth century ant the eighteenth one. She focuses on the reports of some European practitioners. There is a quite complete ignorance of the theories supporting alternative medical systems and, accordingly, the attempt to explain them in terms of western medical knowledge.
In the second chapter, we see the originating orthodox medicine facing mesmerism and homeopathy between the eighteenth and the twentieth century. Born as innovations inside European orthodox medicine, they soon gain the hostility of traditional medicine.
In the third chapter, we are led back to acupuncture and homeopathy, but this time Bivins is concerned with what happens in the nineteenth century to inquire whether the different responses to them can be accounted for in terms of their different origins. The first was in fact born in China and the second in Europe. She moreover argues that this is an extremely important period for medicine, since the divide between orthodoxy and heterodoxy gets deeper. Ironically, the strengthening of homeopathy contributed to it: it had the effect to unify all the regulars against it.
In the fourth chapter Bivins focuses on the responses to cross-cultural exchange in non-western world, reporting the responses both of indigenous and western people. She goes back to mesmerism and homeopathy but she also analyzes the origins of a new western theory, germ theory.
It is not very easy to follow Bivins in these chapters and to reconcile them with the wider picture depicted in the introduction. They give good snapshots, but the reader can easily lose of sight the overall view.
On the other side, nonetheless, her analysis is always very detailed. This aspect, together with a rich bibliography -- in which she adds some comments about the books she recommends -- makes the book a good starting point for everyone interested in this topic.
This path leads us, in the conclusion, to the analysis of the medical scenery of our days. Bivins underlines the differences in comparison to what has been shown in the previous chapters. Many changes have occurred in practitioners' and lays' attitudes toward different medical systems, in the possibility to get to alternative remedies and to know their origins and their stories, in communication of new discoveries and their effectiveness, in the relationship between practitioners and patients, in the power of orthodox medicine and its spread all over the world, in the factors influencing medicine.
At the very end of the book, Bivins suggests that maybe the most important change is "that more people have the chance to see medicine from other cultures in practice, on the ground, with their own eyes -to judge for themselves if qi or prana are more or less credible, comprehensible, and intellectually attractive than neurotransmitters or the Krebs cycle".
© 2011 Silvia Di Paolo
Silvia Di Paolo is a Ph.D. student from the University of Rome La Sapienza. Her main fields of interests are logic, philosophy of logic, and history of logic. In the past few years, she has been focusing on the work of Frege. She is now concerned with Brandom's reading of Frege as an inferentialist.