Wednesday, 18 July 2012

The Diseases of Civilisation

Digging around in the dusty archives, I came across this book review of mine, which was first published around 1983, in "Thinks!", the Magazine of Channel Island Mensa:

"The Diseases of Civilisation" by Brian Inglis: A Review
This is a very comprehensive survey of the entire field of illness; it is beyond my capacity to give a sufficient comment on the whole of its expanse. I shall, therefore, only focus upon one particular case and comment on this; in doing this, I shall try to make plain the strengths and weaknesses of Dr Inglis' method. I choose to look at his method rather than his actual position on the issue chosen, because it seems to me that his method his approach to individual subjects is more or less uniform, but his evidence for a particular case might be poor, and I would not like to pick upon a weaker case, as this would seem unfair.
The general theme running throughout the book is that medical disorders or the likelihood of being afflicted by illness is directly related to states of mind; also, materialistic medicine is not making much headway, if any, in the battle against disease, but a psychological approach often works. It is not orthodox psychiatry that he means, but rather simply altering one's perspective of the illness to look for possible mental problems (i.e. emotional troubles, stress etc.) The practice of this approach is exemplified in various unorthodox treatments.
It should be noted that much of the unorthodox treatment throughout the book is simply anecdotal, by which I mean that we simply hear of successes that have come to light, with no attempt at controls, and no mention of failures. This idiosyncratic reporting, although it often covers numerous individual cases, cannot be taken as a serious "proof" for Dr Inglis' theory of a psychic derivation of illness, and rather diminishes his comprehensive claim that his theory is true most of the time. All that could be securely stated (from reports given) is that his theory may be true for some of the time.
Having said that, I shall now move on to consider one particular topic - that of allergy, and, to  begin with, I shall not criticise his means of choosing "evidence"  but shall assume that the  evidence is indeed conclusive. I thereby give Dr Inglis a stronger case than he has a right to, but I shall show that, even with this concession, his position still has a number of logical loopholes.
Dr Inglis is quite merciless when it comes to exposing the huge deficiencies in our knowledge of allergy; he makes the point that     medical practitioners can quite accurately diagnose the material "trigger" of an allergic reaction, but can provide no concrete answers to the question of why there should, in the first place, have been a reaction. In other words, the external agent involved sets off false alarms in the body's defence mechanism; the agent is easily identified, but the question remains unanswered; what on earth has gone wrong with the "alarm system"?
There then follows a history in which the failure of laboratory work is closely scrutinised, and various unorthodox treatments are considered. On this basis, it is suggested that    "to continue to treat allergies as if they were the product of pathogens is a futile exercise"; instead, we are advised, on experimental grounds, to suppose that allergy is the result of a psychic reaction (using the term in a psychological sense) and is a sort of "fuse wire for stress" or outlet for psychic problems (such as stress, cognitive dissonance, etc.)
It is here that Dr Inglis loses track of logic. After denouncing orthodox medicine for its reduction of illness to organic causes, he seems determined to reduce all illness to psychic roots, with perhaps a token gesture to material causes. In his approach, Dr Inglis seems to provide the mirror image of the medical model. But why should his reductionism be any better than the other? Why, in fact, should illness be reduced to just one effective cause? Dr Inglis happily criticises orthodox medicine for its blinkered approach, then, blissfully ignorant of the irony, sets his own blinkers facing the other way.
Moreover, Dr Inglis' analysis falls far short of his own high standards. He criticises orthodox medicine for not probing deeply enough, or being able to supply full answers. But has he done this? No doubt his metaphors such as "fuse wire for stress" are very vivid, no doubt his jargon phrases such as "cognitive dissonance" are very grand, but do they answer the questions he has posed? Why should a psychic problem be manifest in an allergic reaction to cheese? Why cheese and not, for instance, butter? Why, in other words, should an allergic reaction take one particular form and not another? For all his talk of stress, emotions and the like, his new theory cannot answer these questions any better than the old medical one. And if we are looking as to why the body should produce false alarms - allergic reactions - surely we are entitled to ask of a complete explanation that it tells us why the body should produce certain false alarms on certain occasions, and do nothing at other times?
The trouble is that Dr Inglis' theory does not really help us with these questions; it simply brings inquiry to a dead end, from where it can be taken no further. In part, this is no doubt due to Dr Inglis' stubborn refusal to properly consider the organic aspects of allergy; I suspect that part of the answer may well lie there, in a breakdown of the defence systems decoding procedure. But to return to Dr Inglis, it must be said that he provides a theory which is pretty well impossible to test scientifically; of course, statistical measures are possible,   but such results only indicate the theory may be correct and are a very flimsy kind of evidence. What is needed is a theory that can describe what should occur with specific conditions (such as stress, eating cheese etc) so that what actually happens can be checked out; if it does not agree, then so much for the theory. But Dr Inglis' theory does not seem capable of such a stringent test as befits the logic of science.
The statistical evidence which might serve as second-best is sadly lacking. On allergy - and this is a typical argument used throughout the book, he asks: "why should allergy appear to be so much more prevalent today than it was a century ago?", and answers, "There are no statistics    , admittedly, to confirm this impression." How, then, does he know of the increase? He writes: "If allergic reactions had been common in the nineteenth century, they would surely feature much more frequently in the correspondence, the reminiscences, and the fiction of the era." So the   statistics do not exist, but may be surmised by a very odd sort of special pleading. Note especially the deterministic argument: "if they had been, they would..." I would make two criticisms of this approach. Firstly, this is not historical investigation, unless it is the sort of history gleaned from nineteenth century German scholarship, where this spurious logic was common. Secondly, just because something in the   past is not mentioned in terms familiar to us today, this in itself is insufficient for assuming that it may have been less common then.
Such methodological weaknesses destroy much of Dr Inglis' case. There seems also to be too little awareness of the merits of medical treatment; to believe Dr Inglis, medicine has only scratched the surface in the field of illness. He forgets that while medical science may not have all the answers, it has certainly been effective in keeping great epidemics (such as cholera) at bay, removing such blight as small-pox, and successfully treating such diseases as tuberculosis which were often fatal in the past.
It is as a corrective to a medical reductionism that Dr Inglis has most to contribute; but, in doing this, I regret the overemphasis which he makes for his case. He has points which are worth making about the dangers of a medical reductionism, but it seems that, unknowingly, he argues towards a conclusion that he has already decided to be correct, and he is not prepared to give any contrary evidence a fair hearing. However, it is up to the reader to judge for himself (or herself) whether or not this surmise of mine is correct.

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