White Coat Underground

The death and rebirth of vitalism

One of the common themes in biology and medicine is the feeling that somehow there must be more. Creationist cults simply know that life must be more than matter, and mind-body dualists (which includes most alternative medicine advocates) are certain that humans are more than an “ugly bag of mostly water” (sorry for the geek reference). If you can stick with me here, I’ll explain to you a bit of the history surrounding this fallacy.

Most of us intuitively feel that we are both a body and a person. In every day life, it makes a certain operational sense to think of our “mind” as being something distinct. From a biological standpoint, however, this doesn’t work as well.

Biology was one of the last of the “natural philosophies” to become a science. It was clear to those who studied chemistry and physics that certain principles seemed to explain the natural world, but those who studied living things were mostly involved in description. Still, biology has become a science in its own right. According to Ernst Mayr, one of the greatest biologists of the last century, a number of events preceded biology being recognized as a legitimate science. One vital event was the recognition that all biological processes were constrained by the laws of physics and chemistry. Another important step was the rejection of two erroneous principles: vitalism, and teleology.

Teleology is the idea that there is some larger end-point or goal that drives biological processes, such as the idea of the ladder of ascent where the development of life has had, as its goal, the creation of more and more complex forms. Darwin’s synthesis of natural selection and evolution pretty much destroyed this idea. Clearly, if stochastic processes can drive the changes we see in living beings, determinism is out the door. Evolution has elements that are random (changes in environment, mutations, etc.) but other elements that are decidedly non-random (for example, convergent adaptations are difficult to call “random”—sure the processes that underlie them are random, but these processes and pressures lead to a non-random result). But from a “cosmic” standpoint, there is no room left for teleologic explanations.

More offensive to me as a physician is the idea of vitalism. This ancient principle says that the difference between living and non-living things is some sort of non-material vital force. As the natural philosophers of the last few centuries became more sophisticated, they worked with this assumption and tried to define it scientifically. For example, it was felt that organic and inorganic matter differed in that, if melted with heat, only inorganic matter could re-crystalize naturally with the removal of the heat source (since we obviously cannot add that essential vital force). This seemed to give a “scientific” way of testing whether or not something was from a “living” source. If this were found to be true, it might pave the way for more experiments that could help show that there must be some sort of “elan vital” that animates living matter. In 1828, a chemist named Friedrich Wohler synthesized urea, an organic compound, from two inorganic compounds. In other words, he created “life” from “non-life”.

This, and experiments like it, effectively destroyed the best attempt to use knowledge of natural laws to divide living from non-living systems. The implications were probably unimportant to Wohler and many others, but from a modern perspective, this is seen as the beginning of the end for vitalism.

The death of vitalism, and the discovery of genetics, allowed biology to grow into a mature scientific discipline. There are no processes in biology that have not been amenable to scientific investigation or that have required a deus ex machina to fully understand. That doesn’t mean that vitalism is dead. Since we, as human beings, operationally see ourselves and both “mind” and “body”, we will always be tempted to think vitalistically.

This is especially true in the most anthropocentric of sciences, medicine. All alternative medicine is based on the idea that we are more than biology, that there is some force, some elan vital that animates us and elevates us.

  • Chiropractic uses the concept of “vertebral subluxation complexes” that block the flow of vital energy, despite the lack of any evidence for these things.
  • Acupuncture, reiki, and other “energy therapies” claim to affect the role of qi, or vital energy, a non-organic, immeasurable force that animates us. Such a vital force has never been found.
  • Homeopathy makes claims that some sort of magic happens to water when they shake it just right. In this case, it’s actually the water that has some sort of vital force imposed upon it, but then this magic water is supposed to be able to affect human biology via a presumably equally invisible and immeasurable process.

If something is immeasurable and un-observable, either directly or indirectly, then it is not medically relevant. Remember, if you are claiming that an intervention is helping a patient, then you are claiming that it is measurable and observable.

If a measurable, observable phenomenon is better explained by known physical laws than by a vitalistic explanation, then why make up a silly, non-reality-based explanation?

Vitalism, an ancient and discredited philosophy, has become irrelevant in modern thinking with two important exceptions: alternative medicine, and religion. That, right there, should tell you something important.

Comments

  1. #1 D. C. Sessions
    April 13, 2009

    Vitalism, an ancient and discredited philosophy, has become irrelevant in modern thinking with two important exceptions: alternative medicine, and religion.

    You missed several others, but the key difference is that poetry (to name one) is either explicitly or implicitly metaphorical. As you note, vitalism appeals to some pretty basic human tendencies so as long as it’s not taken too seriously as a model of the Universe, we’d best accept it sticking around.

  2. #2 Dr Benway
    April 13, 2009

    Vitalism is a sexed up form of dualism. And dualism is a side effect of mentalism, or the brain’s capacity to intuit the presence of other minds.

    Early in my training I entered a patient room and noted tiny pieces of paper crammed into a wall outlet. Third patient that month, fancy that. Makes you wonder, do these people all take the same correspondence course in crazy?

    Later while staring at an outlet in my office, it hit me: it’s a face. And the mouth is contorted by a scream. Does it know how to STFU? No, it does not. Ergo, the paper.

    Better to hallucinate agency where none exists than to miss agency when it’s present and, perhaps, hungry.

  3. #3 ScepticsBane
    April 13, 2009

    Aw…. the ND blog didn’t work out too well so now its back to Homeopathy bashing, eh?

    How about a blog on the following topic:
    Death and Rebirth of Scientism
    cuz just get a load of this classic PalMd comment:

    “If something is immeasurable and un-observable, either directly or indirectly, then it is not medically relevant. Remember, if you are claiming that an intervention is helping a patient, then you are claiming that it is measurable and observable.”

    You’re kidding right? Those bacteria causing pyloric ulcers were not observable nor measureable for quite some time until Barry Marshall came along – you think they were not medically relevant??

    Or else you’re going to be the next Bill Gates if you can “measure” AND “observe” genetic variations, immune system variations, endocrine fluctuations, biochemical messenger cells at the atomic level and any of tens of thousands of other variables many of which medical science does not even know about.

    Next time you want to focus JUST on the observables and measureables, go watch an episode of “Unknown Diagnosis” and go see what happens to people when the old observables and measureables don’t add up.

    You want to criticize alternative medicine you go right ahead but if you plan to blog about how your system of medicine is somehow better based on “science” then you are in for a rude awakening and some very ill (or worse) patients.

    Try explaining away “spontaneous remission”, for example, as a good lesson in how adept the “scientists” are in hiding the unknown from view. But you can’t hide it from the patients, especially the dying ones. People like to live and when knowledge gets out that there’s a better way, then they’re going to try it.

    You like to blog about absurd medical claims dude, well you can try justifying this one – the idea that radiation or chemotherapy which will wreck a person’s immune system while killing some cancer cells is somehow going to cure them of cancer or, how is it put, place them in “remission”. Or that cutting out some tissue is going to somehow fix the problem.

    Make clear in your head the difference between stopgap suppression and cure. If there is a chance that herbs, Homeopathy, Acupuncture, Chiropractic or Reiki does it better, guess which people will choose.

    And here is the final skeleton in your closet – Obama plans a massive reform of the health care industry, has already appointed an outsider to head FDA and includes the creation of unbiased studies on what really does work and what doesn’t. I’d start worrying if I were you, cuz when those studies are in your system may no longer be on top of the heap.

    I won’t mention easily available statistics on what are the main causes of death in hospitals, nor on iatrogenic involvement. Hint… it’s not Homeopathy

  4. #4 PalMD
    April 13, 2009

    Is someone else gonna explain to Bane why his diatribe makes no sense or are you gonna leave it to me?

  5. #5 Pierce R. Butler
    April 13, 2009

    ScepticsBane – which do you find works better for shutting up those damn screaming electrical outlets, Field & Stream or Highlights for Children

  6. #6 Pierce R. Butler
    April 13, 2009

    [pls append to comment # 5:] ?

  7. #7 D. C. Sessions
    April 13, 2009

    Is someone else gonna explain to Bane why his diatribe makes no sense or are you gonna leave it to me?

    Hey, Boss, you want we should fisk him, huh?

  8. #8 Dr Benway
    April 13, 2009

    SkepticsBane,

    The metaphor of the map verses the territory may be helpful.

    Individually we each experience the territory of reality directly or nearly directly. But we can’t see the experiences of others. We’re forced to use symbols to communicate about the territory to each other. Those symbols are the “map.”

    Each person has his or her own map of reality. Groups of people can communicate and create shared maps of reality also. The shared maps may be written or may simply be recalled and repeated aloud.

    Science is a written, rule-based, shared map of reality. No claim about the world gets onto the shared map until it first passes tests of corroboration, falsification, logic, and parsimony. These tests serve to filter out a lot of the error present on individual maps. They likely filter out a bit of truth also. But at least with the rules, science can revise and refine its map over time. Without the rules, there’s no progress.

    When we speak of “medical relevance,” we’re speaking of our shared map of medical understanding and practice. We’re not speaking about the territory, which we cannot share.

    No doubt H. pylori was in the territory causing trouble for a long time before he was added to our collective map. No doubt there are other agents of disease not yet on the map. We don’t claim otherwise.

    Maps are not territories.

    It occurs to me that conflation of map and territory may be the root of all evil.

  9. #9 Les Lane
    April 13, 2009

    The concept of vitalism survives today as intelligent design. Stories with purposes appear easier to grasp than physical realities.

  10. #10 Harry
    April 13, 2009

    @ ScepticsBane

    Next time you want to focus JUST on the observables and measureables, go watch an episode of “Unknown Diagnosis” and go see what happens to people when the old observables and measureables don’t add up.

    OMG! I friggen love that show! Wanna know my favorite part? It’s when the patients finally get their diagnosis! You know who makes the final diagnosis? Good Physicians who focus on JUST the observables and measurables and then use their gigantic brain to figure it out. I have yet to see the show end with someone reading tea leaves or checking auras to make the diagnosis. Therefore, isn’t that show just another propaganda machine for the industrial medical complex of science-based medicine?

    Your turn.

    -Harry

    I have yet to see a

  11. #11 william meller
    April 13, 2009

    Keep at it Dr Pal. As you must know from your practice, the defeat of ignorance is hand to hand, brain to mind, one on one combat which we are obliged to fight daily in our lives and practices.
    Just to take on the spontaneous remission mission: there are as many good scientific explanations of these occurances as there are instances. Misdiagnosis in the first place accounts for a lot of them. The natural but poorly understood course of many diseases,the waxing and waning of symptoms adds to the lot. Exaggeration, misunderstanding and plain old lying round out the usual suspects.
    Keep up the vital argument.

  12. #12 Egaeus
    April 13, 2009

    This post, especially the geek reference, reminded me of something that has bothered me for a while. Unfortunately, it’s hypothetical and untestable, but it still bothers me.

    Suppose that Star Trek-type transporters were developed. So you have a device that can tear you apart at the atomic level, and put you back together. If you were disassembled and reassembled in such a way, would it still be you? I mean, there would be a person who, from all outward appearances, is you, but what about from the inside? Would your consciousness still exist, or would a “duplicate” consciousness be created, and yours be eliminated?

    You could, with such a technology, presumably make a copy of yourself with different atoms. That duplicate consciousness, while identical, would not be you, so why would a reassembly of your atoms. Seeing as how our consciousness is independent of the particular atoms that create it, at least, I hope I’m not pissing away my consciousness, why would reassembling your body bring back your consciousness?

    What bothers me is that you could never tell. There would be no way to test it. The reassembled human would insist that everything is just fine, and from their perspective it would be, no matter what. It would be a consciousness that believed it was the same consciousness as what was disassembled. But would it be?

  13. #13 daijiyobu
    April 13, 2009

    Dr. L. wrote: “according to Ernst Mayr [...modern scientific knowledge evolved!!! to construe that] all biological processes were constrained by the laws of physics and chemistry [...and includes] the rejection of two erroneous principles: vitalism, and teleology.”

    Excellent post.

    For background on Mayr, see http://en.wikipedia.org/wiki/Ernst_Mayr .

    See also the New York Academy of Sciences 2004 at

    http://www.nyas.org/publications/readersReport.asp?articleID=17

    for an excellent article on the foundations of science as regards ‘the living’ — not vitalistic, not teleological.

    2004, coincidentally, is the year I left ND school and sued them only to have the case kicked out of court.

    Great system we have:

    totally rip people off in terms of education fraud [ND school], take away their future, and leave them no recourse – lesson learned:

    when your own home State is implicated [as well as the USDE], don’t even think that you’ll get a legal venue.

    -r.c.

  14. #14 D. C. Sessions
    April 13, 2009

    What bothers me is that you could never tell. There would be no way to test it. The reassembled human would insist that everything is just fine, and from their perspective it would be, no matter what. It would be a consciousness that believed it was the same consciousness as what was disassembled. But would it be?

    In what way would it make any discernable difference?

  15. #15 daijiyobu
    April 13, 2009

    Also, concerning this biology topic,

    WWPZS?

    [what would PZ say

    {a play on WWJD, in the land of biology!}]

    -r.c.

  16. #16 Nigel
    April 13, 2009
    #9
    The concept of vitalism survives today as intelligent design.

    This is nonsense. Vitalism and intelligent design are two quite different sorts of intellectual dead end. I dare say it is true that a lot of know-nothing religionists tend to believe both, but there would be no (additional) inconsistency in believing in one but not the other. There is nothing in vitalism that is inconsistent with biological diversity being entirely the product of evolution by natural selection, and nothing in ID that rules out the possibility that living things are entirely physical.

    Let’s not sink to the intellectual level of the fundies and woo merchants here. Their arguments largely work by asserting that things that are different are the same (natural selection = eugenics = Naziism, and similar crap). We don’t need to descend to that level.

    #14 – Why the hell should anyone care what PZ Myers would say about it (though it is hardly difficult to guess)? Is he the atheist Jesus now?

  17. #17 daijiyobu
    April 13, 2009

    Nigel, you’re a little touchy, and very funny:

    vitalism and teleology are linked, and opposed to science,

    wherein vitalism speaks of a purposeful /

    teleological / INTELLIGENT life spirit figment — when you boil it down — instead of an actual empirical explanation.

    It’s a superstitious place-filler that stops thought.

    I think there’s quite an inconsistency regarding science, vitalism, and ID though you state there isn’t.

    Re: “Atheist Jesus” [hilarious!],

    kind of like ‘jumbo shrimp’, or ‘science-based naturopathy’ [even funnier].

    Are you being ironic when you criticize someone for drawing unfair similarities, and then do so yourself?

    Cheers.

    -r.c.

  18. #18 Chris Noble
    April 13, 2009

    The concept of vitalism survives today as intelligent design.

    Rupert Sheldrake’s “Morphic Resonance” is a better example.

  19. #19 PalMD
    April 13, 2009

    I’d have to agree that vitalism and ID are linked. IDiots cannot believe that life is simply matter. They do invoke a vital principle (in this case God) that MUST animate life in some way.

  20. #20 Kim
    April 14, 2009

    Anyone who’s experienced a brain injury or side effect of medication changing their personality should be pretty clear on mind being a phenomenon of the physical brain.

  21. #21 ScepticsBane
    April 14, 2009

    To Harry:

    Well said Harry – I “friggin” love that show too!

    You want to know my favorite part? It’s at the end where the patient has suffered for weeks and months and almost died with wrong “scientific” diagnosis after wrong “scientific” diagnosis and then I think of the millions of patients who are not covered by the few hundred “success” stories in the program – those who got worse, suffered and died because they were convinced not to seek alternative treatments in some other system of medicine, died not realizing that there are alternatives to be explored which people like PalMd and his diatribes are designed to deny.

    What killed these many unfortunates? Things “immeasurable and unobservable either directly or indirectly”, the very things that PalMD tells us are not medically relevant.

  22. #22 Dunc
    April 14, 2009

    Suppose that Star Trek-type transporters were developed. So you have a device that can tear you apart at the atomic level, and put you back together. If you were disassembled and reassembled in such a way, would it still be you? [...] It would be a consciousness that believed it was the same consciousness as what was disassembled. But would it be?

    When you wake up in the morning, how do you know you’re actually the same person who went to sleep the night before? Perhaps “you” “die” every night, only to be re-created every morning with the same memories?

    Sleep well. :)

  23. #23 rob
    April 14, 2009

    Egaeus and Dunc.

    i was going to mention the sleep thing too. when you go to sleep and wake up you have a discontinuity of your consciousness. you are awake, then suddenly awake again with time passing without your awareness. if you were disassembled and reassembled in some kind of star trek teleporter you would also have a disconinuity. i suspect it would be kinda like going to sleep and waking up.

    there are a couple books by Richard Morgan. the first one is “Altered Carbon.” most people have an implant that records memory and experience. if your meat body is killed, the implant can be put in a new body or artificial body and you are “alive” again. or are you? the book is mostly a detective cyberpunk type book with these ideas in the periphery.

  24. #24 Prolix
    April 14, 2009

    Just as we can distinguish between a computer and the program executed upon it, it we can distinguish between the physical and chemical basis of life and life itself. Life acts to preserve the narrow set of conditions that make it possible. It’s this activity to conserve and propagate itself which is the vital force. And just as problems with a computer usually aren’t hardware malfunctions, illness is most often not a problem with the chemical and physical basis of life, but a disorder of the vital force.

  25. #25 Egaeus
    April 14, 2009

    D.C. Sessions: It wouldn’t, except as a…well…metaphysical…exercise. If you were separated into your constituent atoms, you would die. If those atoms were then reassembled, would it still be you?

    It would make me hesitate to step into the transporter if I didn’t think that the consciousness that I know as “me” would emerge on the other side, but rather a copy of “me.” While the copy would b3e indistinguishable both from outside, and to itself, it would still mean that “I” will cease to exist, and a copy will take my place. I think it’s a valid, but unanswerable question, even if such a device existed.

    Dunc, I don’t, but at least I know to a reasonable amount of certainty that I haven’t been completely disassembled and reassembled while I slept.

  26. #26 Dr Benway
    April 14, 2009

    Prolix,

    Natural selection. Worth looking up. Saves you from the rather non-parsimonious teleological entity you call “life.”

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