Wednesday, January 21, 2015

Alternative Medicine

I have what to say about this and don't agree with everything written here but maybe another time. In the meantime you should also listen to this.

Rabbi Shabtai Rappaport

F.'s vision was deteriorating. A checkup by his ophthalmologist revealed cataracts on both eyes, one being at a more advanced stage than the other. The doctor recommended an immediate surgery for the former, and a subsequent one for the latter, to be performed after a few months. F. who had never undergone surgery before asked, rather peevishly, whether the operation was absolutely necessary, and perhaps there was a different treatment that could improve his eyesight. The physician who in his opinion have encountered this attitude much too frequently to be tolerant about it, stated curtly that surgery was indeed unavoidable.

 F. found himself detesting the doctor's attitude, which was lacking an understanding of his anxieties and concerns. When he read that academic medicine has changed from a medical art into a technological science, he agreed, and considered his case an ample illustration. When friends told him about a healer, who treated cataracts using non-conventional methods, without surgery, with many people testifying that the treatment actually helped them and improved their vision, he decided to pay this healer a call. F. liked the healer a lot. He appeared to be a human being rather than a mere technical expert, and promised him a possible cure, or at least an improvement, through his healing methods. F. decided to start upon the healer's course of treatment, reasoning that he had much to gain by it, and almost nothing to lose. In the unlikely event of a failure there will always be time for a conventional surgery.


 The use of non-conventional healing, known also as alternative medicine, is probably as old as humanity itself. It existed in every generation side by side with what was then considered scientific or conventional medicine. Talmud discusses this healing, regarding the usual license to transgress almost any law in order to save human life. It quotes (Yoma 8/4) two opinions as to whether it is permitted for a person bitten by a rabid dog to eat a piece of that dog's diaphragm, in order to prevent him from contracting rabies. Dogs are considered unclean animals in Jewish dietary laws, whose flesh should not be eaten. The majority opinion held that even in this case of obvious danger to human life, the prohibition on eating dog's meat cannot be violated.  Rambam in his commentary to mishna explains that eating the rabid dog's diaphragm helps the patient by ways of mysticism only. Infraction of law is only permitted while employing medical procedures which are clearly understood, and are the conclusions of research based on logic and proper experiments. On the other hand, healing procedures based upon non-scientific assumptions do not merit such infraction, because the logic basis upon which these are founded is flimsy and assailable, and proper experimental trial of these methods is almost impossible. The verity of these methods is based only on the claims of the practitioners. Rambam concludes: "I taught you a very important concept, one which you should fully understand and remember".  The commentary to mishna was authored in Rambam's youth. In his Guide to The Perplexed (Vol III ch. 37) which was his last great work, he elaborated on this idea in more detail. There is an entire section of Jewish law whose object is to clear out wrong ideas which humanity accepted together with idolatry. These ideas were mainly prevalent, in biblical times, among the Egyptians and the Knaanites. These convictions were associated with all types of magic, attributing wonderful qualities to things or actions. Such qualities were never explained logically, and common sense cannot accept them. Because people were always afraid of famine, they gladly accepted magical methods to increase rainfall, like rain dancing. Because they dreaded disease, and medicine could never alleviate all maladies, they adopted non-scientific healing which did promise cure. Rambam concludes that Torah absolutely prohibited the use of any means which are not founded on scientific logic. Still, there are agents - Rambam cites laxatives as an example - that we know empirically of their medical qualities even though we lack the theoretical knowledge to understand them. These agents may be used because proper experimental trials prove their value.  Rambam opinion that any medical method, not based either on scientific theory and logic or on proper empirical knowledge, is prohibited, was not a consensus view. One of the most prominent medieval scholars, Rabbi Shlomo ben Aderet (known as Rashba) argued strongly against it. In a detailed responsum (vol. I res 413) he claims that following Rambam's argument an absurd conclusion is reached, that the usage of any new medicine is prohibited, because a novel idea does not have a proper theoretical basis, and certainly not an empirical one.   This disagreement extends itself into another area. There is an explicit bibilical law forbidding all kinds of magic and witchcraft. After listing the prohibited practices (Dt. 18/9-12) the bible decrees that one should maintain total faith in G-d. Rambam elucidates the various practices to which the bible was alluding Mishne Tora (Idolatry 11/4-15), and explains that one of these is astrology, which is no different than other witchcraft. His interpretation of the decree to have total faith in G-d is [ibid. 11/16] that all magic and wizardry are based on falsehoods, and were used by the early pagan priests to attract common people. It is improper for Jews, who inherited real wisdom, to be attracted by this nonsense, and to suppose that there might be some real benefit in it. A person who has faith in these practices and others similar to them, and considers them to embody verity and wisdom, but that for some reason were prohibited by G-d, is truly foolish and uneducated. The truly intelligent scholar should clearly realize that all these methods and practices that were forbidden in Torah, are not items of wisdom but of worthlessness and stupidity, which attracted the mindless and caused them to abandon reason and verity. This is why Torah decreed following the prohibition of all these falsehoods that a person should maintain total faith in G-d. 


Rashba argues that everyday experience demonstrates the practical truth of specific attributes of herbs, gems and metals, that can assist in the healing process. He maintains (Vol IIX - Responsa Attributed to Nachmanides - res 283) that astrology is a real science. Humanity developed this science of looking into the future because of its inborn anxiety of forthcoming events. However, a person should follow G-d unquestioningly, and believe that G-d always watches over him.  The latter disagreement whether there is any truth in magical and mystic methods, is inseparable from the first argument whether practicing non-scientific medicine is permitted. Because according to Rambam in the same manner that one must be certain that there is only one G-d, one must realize that there is only one logic. It is obvious that present day science does not represent ultimate truth. Empirical knowledge keeps changing, and consequently does theoretical science. Rambam explains (Guide to The Perplexed ibid.) that medical procedures described in the talmud, which seem to be derived from magic, actually depict what was then considered proper experimental methods. Once these methods improved, and it was shown that these procedures are of no value, it became forbidden to use them. Hence, traditional, non-changing medicine, is by definition non- scientific, and therefore represent an alternative logic to that that was granted to us by G-d, and may lead to seeking an alternative G-d as well. It is therefore forbidden to practice it, as part of the general prohibition against idolatery. 


To sum it up - anything that works is G-d's own and therefore permitted and encouraged, the rest does not work. The exact same arguement covers astrology too. Had it possess real ability of looking into the future, it could not have been prohibited.   According to Rashba science does not cover all reality, non-scientific medicine may indeed heal, and is not prohibited. Even practices that are prohibited in order to maintain a pure faith in G-d may have practical value.  It seems that nowadays this disagreement might be settled. The science of statistics, which is continually developing, enables us to judge whether many methods and theories have any practical value and give better results than random chance. There is an ever improving, universally accepted, method of controlled trials for medicine. Not a single trial showed "real" alternative healing of being more beneficial than "fake" healing. Namely that because people have faith in this healing, this faith by itself helps them, regardless of the method which is used. The only significant benefit alternative medicine has so far shown to possess is the pain-relief power of acupuncture. It is true that patients suffering from cataracts reported an improvement following a non-scientific healing process, but when their vision was checked, it was demonstrated that it was not improved. What was improved was only their subjective feeling about their eyesight. 

According to that the ruling of Rambam should be accepted as final. F. should not take the healer's treatment for his cataracts, because being a folly, it is also a transgression of biblical law.