In ancient times, both Western medicine and traditional Chinese medicine, the way of thinking belongs to the category of holism. The basic feature of holistic way of thinking is to emphasize the wholeness of human being, to put the center of attention on the level of human being as a whole, to examine and regulate the process of health and disease presented at the level of human being as a whole, and to summarize and master the law of wholeness.
Holism is a fundamental characteristic of human beings, and the holistic way of thinking is in line with this characteristic of human beings, thus it is reasonable in nature and its clinical significance has been fully proved. Traditional Chinese medicine has been using this holistic thinking until now, and it has become one of the major characteristics of traditional Chinese medicine.
The holistic view is also the core idea of modern system theory. Modern system theory believes that a system is composed of elements or subsystems, but the overall performance of the system can be greater than the sum of the performance of each element. Therefore, when studying such systems, one must start from the whole, analyze its parts and the relationship between the parts based on the whole, and then achieve a deep understanding of the whole through the analysis of the parts.
My holistic view is a holistic view based on modern systems theory.
The body as a whole
The human body is an organic whole that develops and differentiates from a fertilized egg, unlike machinery that is made up of different parts. Therefore, some scholars believe that the human body as a whole is a meta-whole, not a combined whole. The meta-whole principle reveals the uniqueness of the human being, different from the wholeness of the machine, and that the parts within the whole cannot exist independently of the whole.
The human body as a meta-whole is an open dynamic system that exchanges matter and energy with the outside world. The eight subsystems of the system are all interconnected through nerves and endocrines and are inseparable from each other. When the subsystems function normally, they can maintain a normal relationship with each other and the whole can function normally, and vice versa. Abnormal function of one subsystem will affect other subsystems through neurology and endocrinology, which in turn will affect the function of the whole.
What is often seen clinically is that a lesion in one system can be followed by a series of signs and symptoms in other systems, sometimes even before any signs and symptoms appear in the system where the disease is located.
Any disease is basically an overall disease, while the pathological changes in tissues, organs and sites of action of pathogenic factors are local manifestations of the systemic disease. Local lesions can affect the whole body through neurological and humoral pathways, and the systemic functional state of the organism can also affect the development and progression of local lesions through these pathways.
Plato, the great philosopher of ancient Greece, once said that one cannot treat a local area without treating the whole.
Mind and body as a whole
The human body is not only an organic whole, but also a mind-body unity. Within the body as a whole, the mind and body are interconnected and inseparable. Somatic diseases can cause psychological changes, and psychological diseases can show a series of symptoms in the body, and even cause pathological changes in the body.
Psychosomatic medicine is a science that studies the role of biological, psychological and social factors on health and disease and their interrelationship, and is an interdisciplinary and marginal science, which is a sub-discipline in the field of medicine that studies the mind and body. Modern medicine views the phenomena of health and disease from a holistic point of view, treating physiological and psychological phenomena as two opposing and unified aspects of the life process, and no longer separating them completely. Such an advancement in medical epistemology has practical significance for clinical work.
According to the report of the global collaborative study “Psychological Disorders in General Medical Institutions”, which was organized by the World Health Organization with the participation of 14 countries and centered on 15 cities, 99.1% of patients with psychological disorders presented to various departments of general hospitals with physical symptoms as their main complaint. The results of this study provide a glimpse of the mind-body relationship.
Clinical manifestations and laboratory test results should be viewed as a whole
Clinical manifestations refer to the patient’s subjective symptoms and the objective physical findings of the physician’s examination. Laboratory findings are the results of biochemical, biologic and pathologic examinations of the patient with modern advanced instruments. The excessive admiration for science and technology has led people to overly believe and rely on the results of instrumentation, neglecting the basic symptoms and signs of the patient. In fact, not only are the symptoms and signs the external manifestations of the essence of the disease, but the laboratory test results are also the results of examining the external manifestations of the disease DD biochemical, pathogenic and pathological.
In other words, all three are manifestations of the disease and should be considered as a whole. In terms of the diagnostic value of diseases, there is no difference between the three, and one should not lose sight of the other. When analyzing and judging laboratory test results, it is necessary to do so on the basis of the patient’s symptoms and signs. Without careful analysis of patient-specific symptoms and signs, over-reliance on laboratory test results often leads to conclusions that are far from the true picture.
In addition, symptoms, signs and laboratory test results reflect a specific time cross-section in the process of disease occurrence and development, reflecting a “point” in the entire course of the disease. The medical history reflects the dynamic evolution of the patient’s disease occurrence, development and recovery, and reflects the “line” and “surface” composed of many “points” of the disease. It can be seen that medical history contains more information for diagnosis.
Therefore, we hope that you will pay attention to the questioning and collection of medical history. British scholars have reported that about 82.5% of patients in general hospitals can be diagnosed by taking a detailed medical history, while 8.75% each require physical examination or laboratory tests to help make the diagnosis.
Theoretical thinking, empirical thinking and philosophical thinking are one and the same
Clinical thinking includes theoretical thinking, empirical thinking and philosophical thinking. Theoretical thinking is a kind of advanced thinking, which does not stay in the knowledge of the external characteristics and surface connection of the object, but is guided by scientific theories, with the help of scientific abstraction and theoretical insight to deeply analyze the contradictions and problems, and form a rational understanding of the nature of the object and the law of development.
Empirical thinking is the form of thinking that determines the problem on the basis of experience, and is the most basic and general form of thinking, which is characterized by the importance of content, intuitive perception, superficiality of perception, limitations of observation, and non-quantitative analysis. Philosophical thinking is the ability to reflect and synthesize as a whole on the basis of empirical and theoretical thinking, and is a more advanced and mature theoretical thinking ability.
Unfortunately, many physicians work all their lives, accumulate a wealth of experience, have a high level of medical theory, but do not give a damn about philosophical thinking. In fact, philosophical thinking is very important. Hippocrates, the father of Western medicine, believed that “the medical man must at the same time be a philosopher.” Aristotle, the great philosopher of ancient Greece, believed that “philosophy should begin with medicine, and medicine should ultimately come down to philosophy.” Galen, a medical master of the ancient Roman period, famously said, “The best doctors should also be philosophers.”
Theoretical thinking and empirical thinking are the basis of philosophical thinking. Leaving theoretical thinking and empirical thinking, philosophical thinking becomes the source of no water, the end of no foundation. At the same time, philosophical thinking permeates inside theoretical thinking and philosophical thinking. Therefore, philosophical thinking should be viewed as a whole, together with theoretical and empirical thinking.
Although, we take theoretical thinking, empirical thinking and philosophical thinking as a whole. However, within this whole, philosophical thinking has strategic and directional significance, and its correctness or incorrectness often has the effect of “missing the mark by a thousand miles”. Just as strategic mistakes cannot be compensated tactically, deviations in philosophical thinking are difficult to compensate with specific theoretical and empirical thinking.
Therefore, a physician with philosophical thinking can stand on the peak of the philosophy of scientific thinking, to build a high level, far-sighted.