Since the nineteenth century the theory and practice of mainstream Western medicine has been grounded in the biomedical model. In the later years of the twentieth century, however, it has faced a range of serious problems, which when viewed collectively, remain unresolved despite a variety of responses. The question we now face is whether these problems can be dealt with by modifying and extending the principles underlying the biomedical model, or whether a more radical solution is required. Recent critiques of (...) Western medicine have focused mainly on the biopsychosocial model in relation to the former approach, but it will be contended that this cannot deal adequately with the challenges that medicine currently faces, because although it addresses both the scientific and humanistic aspects of medicine it fails to harmonise them. I shall therefore argue for the necessity of a more radical approach, and suggest that what is required to accomplish this is the development of a new medical cosmology, rooted in an older and more global framework. Such a fundamental change would inevitably involve a long term process which it is not yet possible to fully comprehend let alone specify in detail. Some of the necessary features of such a new medical cosmology can, however, already be distinguished and the outline of these is described. (shrink)

I thank Brassington for his reply, especially for stating “that there is rather a lot going for Szasz's argument, and I agree broadly with the conclusion”. In further support of my thesis regarding the fictitious nature of mental illness as a disease similar to diseases of bodily organs, I add the reminder that, prior to the sixteenth century, the word “mind” meant only minding. The birth of the concept of mind as an entity and of the term “mind” as a (...) noun is the symptom of the metamorphosis of the mediaeval, religious view of the world into the modern, scientific view of it. (shrink)