"What Is Holism?" - Dr. John Diamond

“What Is Holism?”

I saw eternity the other night
Like a great ring of pure and endless light,
All calm as it was bright.

HENRY VAUGHN

Photograph by John Diamond, M.D.

Let us start by considering the origin of the word holism. When you consult the Oxford English Dictionary you make a surprising discovery. Holism is a very new word. It has only been in recorded existence since 1926, being coined by a remarkable man, Jan Christian Smuts. Smuts knew his etymology and, in fact checked out the correctness of the word with the great Greek scholar, Gilbert Murray. Here is the Oxford English Dictionary definition of holism:

“A term coined by Gen. J.C. Smuts (1870–1950) to designate the tendency in nature to produce wholes (i.e. bodies or organisms) from the ordered grouping of unit structures. . . . The whole-making holistic tendency, or Holism, operating in and through particular wholes, is seen at all stages of existence.”

The first recorded usage in medicine is not until 1960 – by F. H. Hoffman in Psychosomatics:

“Throughout the United States, concern with teaching about the whole man – ‘holistic’ or comprehensive medicine – is a growing phenomenon in the medical school curriculum.” [If only that were true!]

Smuts wrote it without the w – holistic. Some quibble with this, relating it of course to the word whole. But the w in whole is an affectation which came into English during the fifteenth or sixteenth century. When we consider the etymology, you will see that his spelling is indeed correct.

Smuts was twice Prime Minister of South Africa. He was one of the leading figures in the foundation of the League of Nations and one of the very first statesmen to visit defeated Germany after the war as an act of reconciliation. He wrote his seminal book in 1926 called Holism and Evolution, in a period when he was out of power. Among other things, he understood what was then called the new physics. He is said to have given an explanation of Einstein’s Theory of Relativity which was so easy to understand that people doubted that it could be valid.

One of the seminal writers in Smuts’s life, who helped him with his concept of holism, was Walt Whitman: “every atom belonging to me as good belongs to you.” (Whitman’s influence has been enormous, extending to Gandhi, and including two of his physicians, both concerned with holism: William Osler and Richard Bucke [Cosmic Consciousness].)

The Random House Dictionary defines holism as “the theory that whole entities, as fundamental components of reality, have an existence other than as the mere sum of their parts.”

And the Encyclopedia Britannica describes it as:

The philosophical theory based on the presuppositions of emergent evolution, that entirely new things – ‘wholes’ – are produced by a creative force within the universe; they are consequently more than mere arrangements of particles that already existed.

Thus there are wholes and there is a process of holism to create wholes. This concept was taken up very quickly and widely. The Cambridge Dictionary of Philosophy defines it as: “Any of a wide variety of theses that in one way or another affirm the equal or greater reality, or the explanatory necessity of the whole of some system in relation to its parts.” It then lists metaphysical holism, methodological holism, semantic holism, doxastic holism, epistemic holism, and so forth.

So the concept of holism became very widespread, with little credit being given to Smuts, and with many applications sharing very little understanding of what he was really trying to say: that there is a creative force toward the construction of wholes which are greater than the sum of their parts. And this applies from atomic physics all the way to cosmology. Including, of course, holistic medicine.

Photograph by John Diamond, M.D.

Bertrand Russell writes that there are really two schools of philosophy: the analytic and the synthetic. The analysts break things down into little bits, and the synthetics like Smuts try to create wholes. Breaking into bits, cutting people into pieces, is much easier than seeing them holistically. But you don’t learn holism from dissection.

As Russell says:

“[This] is the question that divides the friends of analysis from its enemies… Suppose I say ‘John is the father of James.’ Hegel, and all who believe in what Marshal Smuts calls ‘holism’ will say: ‘Before you can understand this statement, you must know who John and James are.’ Now to know who John is, is to know all his characteristics, for apart from them he would not be distinguishable from anyone else. But all his characteristics involve other people or things. He is characterized by his relations to his parents, his wife, his children, by whether he is a good or a bad citizen, and by the country to which he belongs. All these things you must know before you can be said to know whom the word ‘John’ refers to.”[1]

This – and more – is what I call the holistic medical conception. If we’re going to examine a sufferer holistically we need to know all of this and more. Who is the patient? Who is John? Russell continues:

Step by step, in your endeavour to say what you mean by the word ‘John,’ you will be led to take account of the whole universe, and your original statement will turn out to be telling you something about the universe, not about two separate people, John, and James.

But it will tell you also of John and James. Russell failed to recognize that John and James were merely parts of the whole. He was a philosopher only of the mind – that was his limitation.

For the end-point of knowledge is heart-Knowledge: All is One, All is Love. All is One is Love.

Pico Della Mirandola (1463–1494), a philosopher not of the brain but of the heart wrote:

“We prefer constantly to seek through knowledge [that is, analysis], never finding what we seek, rather than to possess through love that which without love would be found in vain.”[2]

The path to holism starts with the desire to love and ends with finding it.

John Dewey sought not only brain-knowledge but also heart-knowledge – to really Know:

“To assume that anything can be known in isolation from its connections with other things is to lose the key to the traits that distinguish an object as known. . . . The more connections and interactions we ascertain, the more we know the object in question.”[3]

So again he is concerned with building up a total whole picture of the person in his whole existence. This is the only way to Know. This is what I believe about holistic medicine.

To make the following quote from Hegel more apposite here, we can replace what he calls the “Idea” with “the whole” or “holism”:

“Each of the parts of philosophy is a philosophical whole, a circle rounded and complete in itself. In each of these parts, however, the philosophical Idea is found in a particular specificality or medium. The individual circle, since it is internally a totality, bursts through the limits imposed by its special medium, and gives rise to a wider circle. The whole thus resembles a circle of circles. The Idea appears in each single circle, but, at the same time, the whole Idea is constituted by the system of these peculiar phases, and each is a necessary member of the organization.”[4]

So, you have wholes and then wholes and then wholes, bigger and bigger wholes. Circles of wholes and then bigger and bigger wholes. For as Mirandola states:

“To divide a thing is the same as destroying it, nor can we take away from any thing its natural unity without at the same time robbing it of its integrity of being. For a whole is not its parts, but that unity which springs out of the sum of its parts, as Aristotle demonstrates in the eighth book of his Metaphysics.”[5]

And now here, from a completely different field, is T. S. Eliot:

“No poet, no artist of any art, has his complete meaning alone. His significance, his appreciation is the appreciation of his relation to the dead poets and artists. You cannot value him alone; you must set him, for contrast and comparison, among the dead. I mean this as a principle of aesthetic, not merely historical, criticism. The necessity that he shall conform, that he shall cohere, is not one-sided; what happens when a new work of art is created is something that happens simultaneously to all the works of art which preceded it. The existing monuments form an ideal order among themselves, which is modified by the introduction of the new (the really new) work of art among them.”[6]

So you can see the whole history of art, the whole history of the universe, as being a whole which is constantly being refashioned into a new whole as new wholes are created within it.

Photograph by John Diamond, M.D.

In his biography of Smuts, Keith Hancock states that his concept of holism started on his father’s farm when as a small boy he discovered his kinship with the stones, plants and animals of that small universe of the farm.[7]

“In his uncle’s church . . . he had learnt that the farm and its creatures and its people and he himself all belonged to a great universe, created and governed by God. In his student years . . . he learnt that science had a different story to tell. Or was it the same story, told in a different way? Eenheid, unity, became his philosophical quest. His craving for eenheid, was now finding its nourishment not in science and its philosophies, but in poetry – in the poetry of Goethe, in the poetry of Whitman.”

In fact, he went on to write a book about Whitman which I have not been able to locate. In the middle of his study of Whitman, Hancock says Smuts made an exhilarating discovery. “Wholeness was the stamp not only of persons, but of matter, life, mind – of the universe and everything that it contained.”

And to quote from the South African Dictionary of Biography:

“[Smuts] maintained that matter, life and mind are not disparate phenomena but manifestations of the cardinal principle of Wholeness in a successive order extending from inorganic beginnings to the highest levels of spiritual activity, that is, ‘holistically’ bound to give rise to each other in a definite series in the stages of Evolution. The gist of the treatise is the presupposition of Wholeness (Holism) as a fundamental factor in the universe.”

Permit me now to give three more highly relevant quotes from Smuts:

“One cannot help being struck by the way in which the cells in an organism not only co-operate, but co-operate in a specific direction towards the fulfillment and maintenance of the type of the particular organism which they constitute. The impression is irresistible that cell activities are co-operative, that they are inherently or through selective development co-ordinated in a specific direction, and that the impress of the whole, which forms the organism is clearly stamped on all of the details.”

And:

“In some indefinable way this whole is not an artificial result of its parts; it is itself an active factor like its parts, and it appears to be in definite relation with them, influenced by them and again influencing them, and through this continuous interaction of parts and whole maintaining the moving equilibrium which is the organism.”

And further:

“Both matter and life consist of unit structures whose ordered grouping produces natural wholes which we call bodies or organisms. This characteristic of ‘wholeness’ meets us everywhere and points to something fundamental in the world. Holism is the term here coined for this fundamental feature of wholeness in the world [my emphasis]. Its character is both general and specific or concrete, and it satisfies our double requirement for a natural evolutionary starting point.

“Wholes are not mere artificial constructions of thought; they actually exist; they point to something real in the universe, and Holism is a real operative feature, a vera causa. There is thus behind Evolution no mere vague creative impulse or Elan vital, but something quite definite and specific in its operation, and thus productive of the real concrete character of cosmic Evolution.”

This is what I try to feel about a sufferer. This is what I mean by seeing him holistically. This is not just doing acupuncture on him or any other particular technique as a part of the rubric nowadays called holistic medicine. It is seeing every aspect of him as a whole. He is a whole, and all his functions within him are little wholes summating to this whole which is him within the wholeness of his existence within the wholeness of Existence. And in order to be able to help him, you have to help him to see himself within the wholeness of his existence in the wholeness of Existence.

If you want to call this philosophy, then the ultimate easing of the suffering of mankind is to help them in their hearts to know this philosophy of holism. Once they know their wholeness in the wholeness of Existence, they are at last at peace. They have gratefully accepted themselves in their existence.

Many years ago someone called me a clinical philosopher and I think that now I would agree with this. Clinical in the sense of helping and caring, and philosopher in the sense that central to my practice are the philosophers – Smuts, Hegel, Spinoza, Plato, Parmenides, Plotinus, Eckhart, Lao Tzu, Chuang Tzu, Mencius, Pelagius, Shankara, Ramakrishna, Vivekenanda, Dogen, Shinran and Zeno come immediately to mind. And there are many others – some old friends, some new. And the poets, the philosophers of the unconscious – especially Blake.

I believe the ultimate questions of philosophy are: Who am I in Existence? And Where? And Why? And to know this and to teach it is the only way to overcome the sufferer’s anguish. So I am more and more drawn to philosophy and less and less attracted to medicine (which breaks wholes down into even smaller bits). And the philosophy I am drawn to more and more is the one, of course, which views things, people, in the whole. I hope that some time in the future the holistic practitioner will be well-grounded in philosophy – infinitely more so than I am with my smattering of readings here and there. It is what it has to be. It is philosophy – but not in the head – in the heart.

Excerpt from Holism and Beyond: The Essence of Holistic Healing