Two contrasting visions of the body and health in Western and Japanese medical traditions
How we imagine our body profoundly influences the care we receive. Explore the philosophical foundations and practical implications of these two medical paradigms.
What if the way we imagine our body deeply influences the care we receive? In 1620, philosopher Francis Bacon already contrasted two ways of discovering truth: one that jumps directly to generalities and one that rises progressively from particulars to general axioms, which he considered "the right way" although it was not yet in vogue 1 .
This philosophical distinction finds a striking echo in the opposition between two medical approaches: the Western vision of "man-machine" and the traditional Japanese perspective of "man-microcosm". While Western medicine tends to consider the body as a machine composed of separate parts to be repaired, traditional Japanese medicine sees it as an interconnected microcosm, reflecting the universe that surrounds it 1 4 .
This article explores these two paradigms and what they mean for our health and well-being.
The conception of the body as a machine established itself in the West from the 17th century, during the scientific revolution. Charles Dickens would later satirize this in Hard Times (1854) through the character of Mr. Gradgrind who pleads for the "man-machine" and declares: "You will be directed and governed in everything by the real... You have nothing more to do with [imagination]. You must use only the combinations and modifications of mathematical figures that can be proven and demonstrated" 1 .
This approach reduces the human body to an assembly of distinct parts, where illness is perceived as a localized failure that must be eradicated. Health is then simply defined as an absence of disease and functioning within normative parameters . The doctor adopts the position of a general leading a war against disease, with the patient becoming occupied territory where this battle takes place .
In contrast, traditional Japanese medicine, deeply influenced by Chinese thought, considers the human body as a microcosm in constant relation with the universal macrocosm 3 . This vision is rooted in concepts like qi (vital energy), yin-yang (complementary duality) and the theory of Five Agents (wuxing) which establish systematic correspondences between the body, the state and the cosmos 3 .
In this perspective, the body is a garden to cultivate rather than a machine to repair. The doctor and patient work in partnership to improve internal ecological conditions, with the main objective of enhancing the organism's self-regulation capacity . Health is then defined by integrity, adaptability and continuity .
| Aspect | Western Approach (Man-Machine) | Japanese Approach (Man-Microcosm) |
|---|---|---|
| Body Concept | Machine with separate parts | Interconnected garden, microcosm |
| Doctor-Patient Relationship | Doctor as general, patient as occupied territory | Partnership to cultivate health |
| Therapeutic Objective | Eradicate symptoms, maximize performance | Improve self-regulation capacity |
| Health Definition | Absence of disease, normative functioning | Integrity, adaptability, continuity |
| Diagnostic Approach | Focused on affected area | Holistic, considering the entire system |
| Body-Environment Relationship | Relative separation | Deep interconnection |
The mechanistic approach excels in acute care, emergency medicine, and surgical interventions where precise targeting is essential.
The holistic approach shines in preventive care, chronic conditions, and maintaining overall wellbeing through lifestyle harmony.
Research in epidemiology and behavioral sciences has demonstrated that environmental, social and psychological factors play an important role in the incidence of all diseases 4 . This observation has questioned certain postulates of Western biomedical medicine.
A comparative analysis of East Asian medical models and Western biomedical models revealed that these systems are the product of their respective historical and cultural traditions 4 . The attitudes of doctors and patients regarding diagnosis, therapeutic goals, the role of the sick person and the meaning of illness are deeply modified by cultural context 4 .
A crucial epidemiological study examined the rate of heart disease among Japanese-Americans. Researchers discovered that the incidence of heart problems increased significantly among Japanese who emigrated to the United States and adopted the Western lifestyle, gradually approaching rates observed in the general American population 4 .
This study demonstrated the importance of cultural, social and environmental factors in health, partially validating the holistic approach of traditional Japanese medicine that considers the individual in their global context.
In the Western approach, therapy aims to specifically target the pathogen or failing organ. Interventions are often designed to attack the disease directly, with a preference for highly targeted pharmacological or surgical solutions.
Traditional Japanese medicine seeks to restore the overall balance of the system. Treatments like acupuncture, medicinal plants and body practices aim to facilitate the circulation of vital energy (ki) and harmonize relationships between different bodily systems 3 .
Facilitate ki circulation and harmonize energy flows
Rebalance internal systems through systemic approach
Calm the mind and regulate the body
Maintain internal balance through seasonal adaptation
Faced with growing evidence of the importance of psychosocial and environmental factors in health, some researchers have proposed that the biomedical model could be complemented by systemic approaches in which environmental, cultural, social and psychological variables receive as much attention as biological factors 4 .
The challenge consists of integrating the precision and effectiveness of the Western mechanistic approach with the holistic and ecological vision of Japanese tradition. As Margaret Lock notes in her analysis, this integration could respond to current epidemiological trends where chronic diseases, often linked to lifestyle and environment, have become predominant 4 .
The confrontation between the visions of "man-machine" and "man-microcosm" invites us to rethink our relationship to the body and health. While the mechanistic approach has brought undeniable medical advances, its fundamental limitation lies in its tendency to fragment the human being and neglect its ecological and existential dimensions.
Conversely, the microcosmic vision, with its deep understanding of interconnections, reminds us that health is a state of dynamic balance between the individual and their environment. At a time when medicine faces an increase in chronic diseases linked to lifestyle, perhaps we would benefit from cultivating this therapeutic garden where the best of Western science and Eastern wisdom could flourish in harmony.
"Medicine is not only a science, it is also an art" 9 . This art of healing, which recognizes both the mechanical complexity of the body and its nature as a microcosm, might well be the "right way" that Bacon spoke of, the one that had been missing until now.