Biomedicine (Western medicine)—Brief History and Basic Principles

The most dominant and widespread healing system in the present world of the twenty-first century is the biomedical system. It is also known as “scientific, conventional, or allopathic medicine to distinguish it from alternative medicine, and Western medicine to distinguish it from traditional non-Western medicine” (Levinson and Gaccione 1997, 47). Biomedicine has become prevailing, as Porter (1999, 6) explains, not only because of its powerful scientific and technological development, but also of its being perceived to be effective by people and societies, as well as of the factors relating to Western political and economic ascendancy.

Drugs and cases of illnesses with their treatments in the Chapter on Medicine, as said in Chapter One, will be interpreted and discussed by means of Āyurveda and biomedicine. In the last section a brief account of the history and basic principles of Āyurveda has been covered. Background knowledge of biomedicine is deemed necessary for those readers who are unfamiliar with this healing system. In this section, a brief history of biomedicine with its Western roots will be outlined first. Then the important principles and features of biomedicine will be furnished.

[1. Brief History of Biomedicine]

[2. Basic Principles of Biomedicine]

In this section, modern medicine’s history and its basic principles have been briefly depicted. Modern medicine, in fact, had its onset during the scientific revolution in the seventeenth to eighteenth centuries, when natural sciences started to flourish and they provided the strong momentum for biomedicine to arise. The empirical and rational approach of modern biomedicine, however, may be traced back to ancient Graeco-Roman medicine, which was based on the humoral physiology and primitive anatomical knowledge obtained from animal dissection. Many famous physicians made contributions to Graeco-Roman medicine, with Hippocrates and Galen being particularly renowned in Western medicine.

After the fall of the Roman Empire, this medical tradition became stagnant during the Middle Ages, where the Church became dominant and discouraged research in science and medicine. This resulted in virtually no progress in medicine during this period, except that the healthcare service was mainly supplied by the Church and the clerical orders. But in the Islamic countries during this time, where the Graeco-Roman medicine had spread to, medicine blossomed there. Famous physicians, like Rhazes and Avicenna, preserved the medical knowledge and composed influential texts, which were translated into Latin and brought to Europe. At that time, Arabic medicine also contributed a lot to chemistry through its alchemist research.

The Renaissance set a good background for the advance of modern medicine, when there was a strong urge for change from tradition, as well as an interest in the human form. Anatomy and physiology were thoroughly studied since then, providing a strong base for the development of biomedicine. Moreover, since the scientific revolution in the Enlightenment period of the seventeenth to eighteenth centuries and up to the present day, by the effort of numerous scientists and physicians, there have been countless discoveries and inventions in various areas of medical sciences and clinical practice, forming the highly scientific biomedical system which is the dominant form of medicine in the world today.

Modern biomedicine is based on natural sciences, especially the biological sciences. It is characterised by its reliance on science and scientific principles (such as objectivity, rationality, validity, reliability, repeatability, verifiability, etc.), utilisation of technology (e.g. low-tech and high-tech equipment, bioengineering, biotechnology, etc.), and a high degree of specialisation (various divisions in the medical sciences and clinical specialties).

This medical system regards disease as being caused by natural or biological factors, which can be endogenous or exogenous. Factors can be predisposing ones (making a person more susceptible to disease, such as age, gender, heredity, lifestyle, and environment), or direct causes of disease (such as genetic abnormalities, infectious agents, trauma, tumours, and so on).

Making a diagnosis is an important medical activity, comprising taking a detailed medical history from the patient, performing a physical examination, determining a differential diagnosis, and conducting investigative tests. Diagnosis of disease is made on the basis of the collected clinical data.

Then, the physician has to inform the patient of the clinical findings, discuss the treatment plan with the patient, and decide the best suitable treatment for the patient with his/her agreement. Treatment can be curative, supportive, or palliative. It can be in form of medications, surgical interventions, and/or radiotherapy. Other measures such as diet control, physical exercise, psychotherapy, social support, and so on may be prescribed if needed. These various therapeutic measures may be provided in different clinical settings such as a clinic, health centre, hospital, or at home. They are under constant monitoring by the clinicians and are changed when needed.

Prevention of disease is another important aspect of medicine. There are three levels of prevention in the modern medical system. They are: primary prevention (to avoid the arising of disease by removing any possible causes), secondary prevention (to stop the occurrence of symptom by early detection of disease), and tertiary prevention (to limit the progress of disease and the degree of disability).

Modern medicine nowadays follows the principle of evidence-based practice, which is the provision of the most appropriate clinical care based on the best evidence found in updated medical literature, the physician’s expertise, and the patient’s needs. In addition, in the twenty-first century, biomedicine is, on the one hand, heading into the molecular era, with molecular biology and genetics becoming dominant in medical research and practice; and on the other hand, it also pays more attention to the holistic concept, by taking care of the other dimensions of an individual, such as the psychological, spiritual, social, and environmental. Holistic healthcare is thus being emphasised, and many disciplines such as social medicine, environmental medicine, and so on are being developed.

In this chapter, four sections have been covered, with the purpose of assisting readers to understand more thoroughly the discussions and interpretations of the medical data in the Chapter on Medicine in the coming chapters. These four are: the history of ancient Indian medicine (up to the time of the Buddha); the source of the present study, i.e. the Vinaya Piṭaka, the Skandhaka, and the Chapter on Medicine; a brief history and basic principles of the Āyurvedic tradition; and a brief history and basic principles of modern biomedicine.

In the next chapter, a succinct discussion of Buddhist ideology on health, disease, and other relating issues will be supplied. Readers can thus understand the Buddhist stance on these topics before appreciating the discussions and interpretations of the medical data in the Chapter on Medicine, which will be found in the subsequent chapters.