2024, Number 2
Vitalism: from the philosophy of life to medicine
Full text
10.35366/118284
Language: English/Spanish [Versi?n en espa?ol]
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Page: 131-136
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ABSTRACT
During the "Age of Reason" and part of the "Enlightenment" vitalism was retaken as the most logical explanation for the physical phenomena that occurred in nature and life. From today's perspective, vitalism can be defined as a theory of life, in the life sciences. Much of the preservation and dissemination of vitalism was thanks to the Greek physician Galen of Pergamum (approximately 129-216 BC) who, in addition to his work in health, was an eminent philosopher who took traits from the ideology of Plato (427-347 BC), Aristotle (384-322 BC) and the Hippocratic tradition, to generate their own doctrinal system based on the union of medicine and philosophy. Georg Ernst Stahl (1659-1734) took up the ancient concept of anima (from the Latin soul) with the purpose of giving meaning to the regulation of health and disease. In a contemporary way, François Boissier de Sauvages de Lacroix (1706-1767) introduced animism (the word âme), to the medical school of Montpellier in France (1730's), where the theory of the vital flow arose; Due to Napoleon's campaigns across Europe, as well as the monarch's support for science, vitalism had an international distribution throughout the eighteenth century. It was not until Bichat approached the study of tissue, bringing down the fibrillarist theory and giving rise to the application of an anatomoclinical mentality.INTRODUCTION
During the "Age of Reason" and part of the "Enlightenment", vitalism was considered the most logical explanation for the physical phenomena occurring in nature and life; from today's perspective, vitalism can be defined as a theory of life in life sciences (natural philosophy, natural sciences, and medicine).
Although the origin of vitalism as a doctrine is not known, the term is strongly associated with the medical tradition of the Montpellier school during the 18th century, as well as with the ideas of the physician Paul-Joseph Barthez (1734-1806); however, it should be mentioned that its history goes back to Aristotle and his work.1-3 Likewise, within the conceptualization of vitalism between the 17th and 19th centuries, it is possible to recognize three phases: animism (end of the 17th century), the conception of vital force or energy (1770-1840), and finally the assumption of "organizing power" (beginning of the 19th century).
VITALISM AND ITS EVOLUTION IN THE SCIENCES
Much of the preservation and diffusion of vitalism was thanks to the Greek physician Galen of Pergamon (129-216 BC, who, in addition to his work in health, was an eminent philosopher who took features of the ideology of Plato (427-347 BC), Aristotle (384-322 BC) and the Hippocratic tradition, to generate his own doctrinal system based on the union of medicine and philosophy.2,3 Galen built his biological doctrinal principles on Aristotelian vitalism based on the works "Historia Animalium" (around 343 BC), "De partibus animalium" (around 350 BC), and "De generatione animalium" (4th century BC).4-6
Galen's doctrinal legacy was accepted as an actual science within the medical field so that no other conceptions were developed during the centuries that it was in force. However, in the 17th century Johannes Kepler (1571-1630), Galileo Galilei (1564-1642), Isaac Newton (1642-1727), and René Descartes (1596-1650) gave impetus to the Scientific Revolution, initiated by Francis Bacon (1561-1626) in the second half of the 16th century and, after the publication of the "Discourse on Method" (Discours de la méthode pour bien conduire sa raison, et chercher la vérité dans les sciences, 1637) written by Descartes, for most of the 17th century the Cartesian mechanicism dominated the explanation of life through physics.7-9 However, towards the end of the century, the German physician Georg Ernst Stahl (1659-1734), due to his training as a pietist in the Lutheran movement and his inability to accept the medical-philosophical beliefs based on the framework of Cartesian mechanistic work, took up the ancient concept of anima (from the Latin alma) in order to make sense of the regulation of health and disease, such as the duration and course of human life through a somewhat religious vision; however, he dispensed with the ancient element that took the spirits (animals) as intermediaries between the material and the immaterial.5,8
For Stahl, this soul gives life to matter, although it does not live. Moreover, life cannot be explained by the physical and chemical components that form the body; he did not consider the human body as a mechanism but as "an organism" with a clear distinction between the mind (res cogitans) and the body (res extensa) that manifested the existence of a vital flow (tonicus motor). Thus, animism emerged as an option to the inability of mechanisms to explain certain properties of the human body without including a spiritual element that united reason with the physical aspects of the body.5,10-12
Stahl's ideas were so influential throughout the next century that countless contemporary scholars gave their opinion, such as Gottfried Wilhelm von Leibniz (1646-1716), John Locke (1632-1704), Immanuel Kant (1724-1804), Denis Diderot (1713-1784), Claude-Adrien Helvétius (1715-1771), among others.
The eighteenth century was characterized by the continuous dispute between both philosophical currents, where each one was reinforced according to concepts implemented by each of the new emerging thinkers. Thus, the mechanistic ideology was strongly hit after being criticized by the French scholar Pierre Daniel Huet (1630-1721), who affirmed that the Cartesian doctrine was a plagiarism of the philosophy exposed in the work "Antoniana Margarita: opus nempe physicis, medicis ac theologis non minus vtile quam necessarium"13 by the Spanish physician Antonio Gomez Pereira (1500- 1558) published during the 16th century which represented the first modern approach to brain function to the exclusion of the Galenic concepts of soul and spirit, and established a topographical brain model for the functioning of the prefrontal cortex.8,9,14 The dispute was further fueled sometime later by Herman Boerhaave (1668-1738) when he spoke of "iatro-mechanics," expressing the existence of a clear division between soul and body with a connection that could not be explained.15,16 All this would form the basis of the philosophy of mind and the conceptualization of mind-body dualism, denoting the non-physical view of mental phenomena.
Contemporaneously, François Boissier de Sauvages de Lacroix (1706-1767) introduced animism (the word âme) to the medical school of Montpellier in France (1730), where the theory of the vital flux (formerly defined by Stahl as tonicus motor) regulating health, disease, duration, and course of human life emerged.3,17 However, with time, Boissier's ideas moved away from the original Stahlian animism by affirming that the main role of the soul is in the emotions, having nothing to do with other physiological phenomena (such as movements or secretions). We can say that vitalism emerged as a conservative and more measured response to mechanistic and atomistic physicochemical reductionism.3
Montpellier's vitalist ideas continued to change due to the thinking of Paul Joseph Barthez (1734-1806), a pupil of Boissier, who preferred to call it "le Principe Vitale" or "vital principle", as well as Jean Guillaume Grimaud (1750-1789) who subdivided the Principe Vitale into external and internal motor forces (forces motrices) and an internal "inferior" vital sense (sens vital intérieur).3,16-18
In the mid-18th century, many physicians and naturalists described vital activity as originating in the body parts. Among the most important proponents of this theory were the ophthalmologist Albrecht von Haller (1708-1777) and Théophile de Bordeu (1722-1776); von Haller established, based on microscopic observations and experimental investigations, the basic concept of "fiber", as well as its inherent properties: irritability (contractility), sensitivity and immanent force (vis insita).16-19 He also clarified that these properties are exclusive to animate objects and nonexistent in inert matter. In addition, von Haller distinguished between the irritability of the muscular fiber, which he called contractility, and the excitability of the nervous fiber, which he called sensibility. He called sensitive fiber in man that, by being touched, transmitted to the soul the impression of this contact.16 He took the skin's sensitivity as a reference to compare with the rest of the organism. These ideas formed the pillar of the vitalism of the Montpelier school, whose major exponents were Louis de La Caze (1705-1765) and Gabriel F. Venel (1723-1775) together with Bordeu. However, we must emphasize that both Bordeu and Haller described the inherent properties of living beings; Bordeu's vitalistic theory was based on the irritability of the fibers, while Haller emphasized sensibility and immanent force; this is why Marie-François-Xavier Bichat (1771-1802) creator of the experimental method and modern histology, explicitly compared Barthez's vital principle with Stahl's anima, and therefore considered these vital properties similar to gravity and other physical forces.3,16-19
Having said this, due to the Napoleonic campaigns throughout Europe, as well as the support of the monarch towards science, vitalism had an international distribution during the 18th century, giving rise to different variants throughout the continent. Thus, in Germany, the "vital force" (Lebenskraft) developed as a rather abstract concept (Medicus, 1774), as a universal "formative impulse" (Bildungstrieb) (Blumenbach, 1787) or as an "organizing principle" operating according to a "rational plan" (Müller, 1833-1834). Meanwhile, in Italy, Luigi Galvani defended the idea of the existence of two types of electrical energy: animal energy and "common" energy. Galvani read his lecture "De Animali Electricitate" for the first time at the Academy of Sciences of Bologna on October 30, 1786. In addition to presenting his results in the 1971 paper "De viribus electricitatis in motu musculari. Commentarius", which changed the medicine of the time after giving rise to a scientific debacle with the Italian physicist Alessandro Giuseppe Antonio Anastasio Volta (1745-1827).20,21
On the other hand, "mesmerism" was born in Vienna and introduced by the physician Franz Anton Mesmer (1734-1815), who affirmed the existence of "animal magnetism", a universal fluid. However, it did not have the support of the scientific community. Mesmerism moved away from the scientific method and medicine. During the following years, it was adopted as an unconventional therapy and was associated with mystical traditions giving rise to the genesis of associated sciences and diverse therapies such as spiritualism, phrenology, clairvoyance, and telepathy; however, vitalism remained in force as an indoctrinated theory for the medical sciences.22
VITALISM AND THE SCIENTIFIC METHOD
Despite its wide distribution, vitalism's main difficulty was to distance itself from the scientific method and the various philosophical currents that derived from it; there was opposition and reluctance towards the practice of experimentation, including experimentation on life and a 'vitalist' reaction to this perspective; it was not until Bichat approached the study of tissue that the fibrillarist theory in force since the sixteenth century was demerited and gave rise to the application of an anatomoclinical mentality.23 Histopathological studies and the conceptualization of the term "tissue" centered on French physiology eventually consecrated a new mechanistic antithesis with the need to resort to the vitalist hypothesis. Bichat defined and enshrined the properties of living systems down to their components through their 21 tissues (Table 1); this made the vital properties assigned to these components opposed to their physical properties, again overthrowing mechanicism. For the above, the French physician François Magendie (1783-1855) provided useful insight through his experiments. Magendie founded the first physiology laboratory in France in 1830, and many of his experiments were aimed at abolishing the vital properties known as sensibility and contractility and "considering them as functions"; however, he recognized that many physiological phenomena remained beyond experimental reach, so it was not possible to explain them in physical terms for the time. While Magendie was not entirely a vitalist, his experiments gave rise to a "rational" view of vitalism and physiological empiricism.23,24
On the other hand, the German Theodor Schwann (1810-1882) proposed two views on organized bodies: the teleological view, which stated that "every organism originates with an inherent power which molds it in conformity with an overriding idea, arranging the molecules in the necessary relation to achieve certain purposes established by this idea". And second, the physical view: "...the fundamental powers of organized bodies agree essentially with those of inorganic nature, which work together blindly by the laws of necessity and independently of any purpose". Schwann's theory was perhaps the precedent or preamble to the coming changes for the vital force theory.25,26
Sooner rather than later, Claude Bernard (1813-1878), a pupil of Magendie, had to re-establish the methodological hypothesis as a fundamental part of the experimental method; this gave rise to the axiom of determinism. Claude Bernard believed it was necessary to abandon the idea of antagonism between the general external forces and the vital internal forces of organisms, which meant repealing the dogma imposed by the vitalist and mechanistic doctrine.27-30
The 19th century gave way to a new way of thinking; the empiricism of Magendie and Claude Bernard evolved towards doctrines in which reason is the fundamental pillar of science: rationalism and positivism.28-30
Nowadays, philosophy and medicine are still working hand in hand, although they no longer explain life and the organism's functioning. Currently, the question lies in the origin of our thinking and the ability to see ourselves as thinking beings; the medical-philosophical conceptualization allows us to explain some characteristics of human beings of a social nature such as free will, empathy, and emotional states, among others.31 In addition, it allows us to rationalize our own consciousness, which, in recent years, has led to the genesis of cognitive neuroscience that allows the explanation and interpretation of emotions around a situational link and the conditions associated with different neurological diseases. Figure 1 briefly summarizes the philosophical currents related to vitalism and their important exponents.
REFERENCES
Villarino H. La Antoniana Margarita de Gómez Pereira y el origen de la controversia sobre el mecanicismo animal entre realismo, idealismo y materialismo (ejercicio de exploración de una vía indirecta de retorno a la escolástica. Rev Chil Neuro-Psiquiatr. 2001; 39: 316-328. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-92272001000400007&lng=es. Disponible en: http://dx.doi.org/10.4067/S0717-92272001000400007
Gómez-Pereira A, Antoniana Margarita: opus nempe physicis, medicis ac theologis non minus vtile quam necessarium". Methymnae Campi...: in officina chalcographica Guillielmi de Millis, 1554. Reproducción digital del original conservado en la Biblioteca Histórica de la Universidad Complutense de Madrid. [Ültima visita 04-04-2023] Disponible en: http://alfama.sim.ucm.es/dioscorides/consulta_libro.asp?ref=X533768690&idioma=0
Lennon TM. 'Pierre-Daniel Huet, Skeptic Critic of Cartesianism and Defender of Religion', in Steven Nadler, Tad M. Schmaltz, and Delphine Antoine-Mahut (eds), The Oxford Handbook of Descartes and Cartesianism, Oxford Handbooks (2019; online edn, Oxford Academic, 9 May 2019), [Ultima visita 04-04-2023] Available in: https://doi.org/10.1093/oxfordhb/9780198796909.013.48
AFFILIATIONS
1 Hospital Central Sur de Alta Especialidad (HCSAE), PEMEX. Department of Neurosurgery. Tlalpan, Mexico City.
2 National Autonomous University of Mexico (UNAM), Graduate Studies Division. University City, Mexico City; Mexico. Autonomous University of Tamaulipas (UAT). Tampico School of Medicine "Dr. Alberto Romo Caballero". Research Department. Tampico, Tamaulipas; Mexico.
3 Department of Anatomic Pathology. The American British Cowdray Medical Center, Cuajimalpa, Mexico City, Mexico.
4 Hospital General de México "Dr. Eduardo Liceaga". Department of Neurosurgery. Cuauhtémoc, Mexico City, Mexico.
Disclosure: the authors declare no conflict of interest and declare that the manuscript submitted here has not been previously or simultaneously submitted to any other journal for consideration and/or publication.
Financing: there was no source of external funding.
CORRESPONDENCE
Julio César López Valdés, M.D. E-mail: jc.lopz@live.comReceived: 11/07/2023. Accepted: 08/21/2024