The notion of Vitalism in Medicine

by David J. Schleich, PhD

The work of Bergson, Whitehead, and Deleuze eventually leads one to Georges Canguilhem, a seminal theorist in our era about the notion of "Vitalism". His contention that the life sciences were not reducible, ever, to the physical sciences, now that biopsychosocial medicine is getting some shelf space, is worth a closer look, even in an era of reductionism in health sciences. Canguilhem wrote a pioneering essay in the field of vitalism over seventy years ago called “Machine and Organism” (Canguilhem, 2008a, 1952) in which he declared that technology is really a sub-field of biology. Imagine that point of view back before the information age. It was wonderful to discover that this philosophical position was embedded in the very tenets, literature and practices of naturopathic medicine which had become the core of my professional life.

In addition to Canguilhem’s writing, one will find of strong interest what Osborne (2016) labels as “pathic vitalism” (that we are subject to “sub-normativity”, that is, to disease as well gifted with an unrelenting yearning for life). However, I found other scholars such as Michel Foucault (1989) who shrugged off Canguilhem’s vitalism as being sort of skeptical. Before I even met my first naturopath, I was influenced by Foucault’s sobering commentary, and also to Monica Greco (1998) for her admonition that we had best be ready to face the fact that vitalism will always be challenged and constantly shunted to obscure corners in medical literature. Greco focuses on forms of knowledge in medicine and psychiatry and has a robust presence, however, in that very literature nonetheless. She and others observe that life is more than mechanistic.

About five hundred new naturopathic students who began their four year programs in September reckon that we are more than biology too. They clearly know a lot more about the vital force, qi, ki, prana, and mana than I did at their age. Many have told me over the years that they came to our programs because of that awareness. They got it that mechanism doesn’t explain the whole enchilada about the inherent capacity living beings have to grow, develop and heal.  Symptoms and diseases mean something different to them than to most biomedicine students and so they chose a different path. These days, Osborne (2016) and others encourage us to understand the “normativity of the living organism”, and to see vitalism as “affirmative” and “celebratory” (Osborne, 2016). They are not retreating away from vitalism, slammed irretrievably by the “reductive principles of erstwhile mechanism” (Osborne, 2016). Or, so we hope.

These mostly young millennials are different from the students who were attracted to the country’s single naturopathic program at NCNM almost a half century ago, some say. By and large those students in 1978, those comparing generational differences in philosophy and predispositions go on to comment, eschewed the reductionism/mechanistic mindset more overtly, respecting a non-material vital force instead. One elder of the profession declared at a recent gathering of naturopathic doctors, that if those students from back in the 70s, now elders of the profession, had been worried that Friedrich Wohler’s 1828 synthesized urea experiment as an early distant warning sign of the demise of vitalism was going to shift the profession’s roots, their passion for advancing naturopathy did not falter. He went on to explain that those students from four decades and more ago were significantly grounded in their enthusiasm for the vitalistic hypothesis of the functioning of living cells. Nevertheless, as we close in on the third decade of a new century, the challenge to naturopathic vitalism, chiropractic “vertebral subluxation complexes”, the qi of energy therapies such as acupuncture, reiki, shiatsu and others, and, for a long time now, to homeopathy, are sharper and perhaps more unrelenting.

The TCA cycle and Vitalism

The curricular record shows that those late 1970s naturopathic students also knew about Hans Krebs’ work a century later. Wohler (1828), intrigued by the chemical consequences of isomerism, synthesized an organic compound from two inorganic molecules. Krebs and Henseleit (1932) made sense of the mechanism known to us as the TCA cycle (tricarboxylic acid cycle), by showing how its mechanism included the ornithine cycle, the urea cycle restricted to living cells. Probably Krebs and Henseleit did not have philosophy on their minds. Naturopathic doctors, even those who do not eschew the professional formation impacts and effects of integrative models these days, continue to be strongly rooted in vitalism and understand Krebs’ work in that context, believing passionately often in what Osborne calls “the possibilities for a vitalism of generalized becoming and process across both living organisms and material ‘nature’”. (Osborne, 2016)

On this platform of vitalism, the origins of the medicine embrace frequently described principles and practices which persist into the present, but which remain under siege from without and, alas, increasingly from within, when one considers recent articles attacking homeopathy, for example. The naturopathic professional points at the pernicious toxicity of pharmaceuticals, sugar, certain fats, gluten, intestinal dysbiosis and much more, and that Naturopathic treatments such as detoxification, hydrotherapy and balneotherapy, holistic nutrition, supplementation and body work remain core to professional practice to address this “pathic dimension”. But within this shifting terrain there is a worrying trend. There is a consistent erosion of trust in vitalism which affects ongoing curriculum and influences therapeutic approach. Numerous elders of the profession are alarmed.

Thus, the work of Canguilhem can be relevant these days and needs a seminar or two of attention, especially in year one, and most especially in year two when the necessary, but frequently (without context and continuing support for the principles of naturopathy) pernicious effects of biomedicine content as they bump headlong into naturopathic curriculum.  What makes Canguilhem unique is that his starting point was predicated on biological facts, a kind of “disciplinary organicism” (Magnus, 2008). What makes Canguilhem’s work so useful for the naturopathic student is its optimism about how the “fending off” of the second law of thermodynamics is the whole point, given that all medical theories and practices cannot defeat its consequences. Yes, the “vital organization” of living systems atrophy and fail, Canguilhem says; however, pathic or not, the work of the Naturopathic doctor is powerful in the affirmation and celebration of life, and in healing and perpetuation. Canguilhem calls this phenomenon of human life, “latitude of meaning” or “lability” (Le Blanc, 2002).

Pressures on contemporary medical curriculum

Contemporary naturopathic students understand scientific medicine as helpful in contending with the welter of hypotheses surrounding them every day in disciplines such as anatomy, pathology, biology and physiology, to name a few, and the myriad of other disciplines in contemporary academic medicine. Important to remember, of course, is that the naturopathic student of 2020, unlike his or her counterpart from 1970, now have access to information and clinical detail about quantum field dynamics (e.g. nuclear medicine, radiology, imaging diagnostics).  The rapidly advancing curriculum (in integrative medicine) calls on our students, as well as biomedicine students, to pay attention to what is new in the merging of physics with biochemistry. Thus, the motion-creating resonance of energy and matter is not anathema to the contemporary naturopathic student.  Rather, a more substantial grounding in the theory and literature of “vitalism” can enhance and ensure the modern ND that the human biofield is very much about vitalism after all.  

We have new lingo for all of this: ion flux, modulated cell function and psychoneuroimmunology. The graduates of NCNM from the 1970s knew full well that the so-called weak electrical fields (EMF therapies) were paying attention to the vitalist dimensions of the life force, whether it was an ionic charge between two acupuncture points, or the subtle energy flows and transfers in Reiki, homeopathy, Qi Gong or, a bit later on, Polarity Therapy.  As Ross points out (2019), students of medicine will pick up quickly on the overlapping nature of the chakra system with the endocrine system (root – adrenals; sacral – generatives; solar plexus – pancreas; heart – thymus and so on), if only we show them.  Canguilhem would have said, I think, that an emphasis on biochemical treatment over quantum/energy-based treatments has not benefitted from what Vitalism has taught us for millennia about the mental, emotional and spiritual elements of living beings. Let’s tell our students more about Georges Canguilhem and the astonishing relevance of Vitalism in 2020.

References

Canguilhem, G. (2008a) [1952]. Knowledge of life. In S. Geroulanos, D. Ginsburg (Eds.), New York: Fordham University Press

Foucault M. Georges Canguilhem: philosopher of error. In: Canguilhem G, editor. The normal and the pathological. New York: Zone; 1989.

Greco, M. Illness as a Work of Thought. 

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Kenne-Saffran E., Kinner, R.K.H. Origins of Renal Physiology: Vitalism and Synthesis of Urea. American Journal of Nephrology. 1999; 19: 290-294. https//doi.org/10.1159/000013463. April 23, 1999. Accessed September 23, 2019.

W?hler F: über künstliche Bildung des Harnstoffs. Ann Phys Chem 1828;12:253–256

Krebs HA, Henseleit K: Untersuchungen über die Harnstoffbildung im Tierk?rper. Z Physiol Chem 1932; 210:33–66.

Magnus R. Biosemiotics within and without biological holism: a semio-historical analysis. Biosemiotics. 2008;2008(1):379–396. doi: 10.1007/s12304-008-9021-5.

Le Blanc G. Georges Canguilhem et la vie humaine. Paris: Presses Universitaires de France; 2002

Ross, C.L. (2019). Energy Medicine: Current Status and Future Perspectives. Global Advances in Health and Medicine. 2019; 8: 2164956119831221. Published online 2019 Feb 27. doi: 10.1177/2164956119831221