Gnosis and Diagnosis

Submitted by Ken Rose on February 21, 2007 - 8:11pm.
Gnosis and Diagnosis

Ancient Greek possessed not less than three distinct terms for knowledge. The first was γνοση (gnosis); the second, σκηνη (skene); and the third, μαθειν (mathein). It is worthwhile to examine the different meanings associated and derived from each of these in order to understand the dynamic relationship that exists between gnosis and diagnosis. For clearly these two terms are linked by a common element, but the character of this linkage has profound implications for the practice of medicine, whatever form practice follows.
What is gnosis? It is possible to reflect on the root in this instance by examining a later branch. The English word “recognize” derives from gnosis. When you look at your own face in the mirror or at the face of a parent or child or long time friend or acquaintance, you do not have to engage in any sort of mental activity, that is to say directed conscious mental maneuvering, in order to know who you are seeing. In contrast, skene and mathein are different approaches to knowledge, differing aspects of knowing. Without going into either at great length, it may suffice to simply say that skene is the kind of knowing that comes from observation and differentiation of perceptions and awareness, which yields the English “science” and all that that word has come to mean; and mathein is the feeling of knowing that arises from figuring things out, calculating as we do when we perform “mathematics.”
Gnosis is something quite different in the way of knowing. Gnosis proceeds from a deeper level of knowledge, i.e., certainty about the world. If you look out the window at the scene you see every day you don’t have to work at all to convince yourself that it is real. In fact, you don’t have to pay much attention to it at all, that is unless something noteworthy has changed. The nervous system is constructed to dampen down repetitive stimulation such as results from seeing the same scene over and over day in and day out or from placing a finger on your forearm and just leaving it there for several moments. Soon we come to neglect the commonplace simply because our bodies are built to do so. It is only another way of expressing this innate aspect of knowledge and ignorance about the body to call it gnosis on the most fundamental level. Becoming aware of this inborn nature is the substance of the kind of direct revelatory experience that those associated with the word gnosis were famous for favoring. The Gnostics preached and practiced the direct pathway to the unknowable that winds its way along the plane that borders the body and the mind.
The Gnostic approach can be traced to the oracle of Delphi, whose temple bore the overarching inscription: γνοση σε αυτον (gnose se auton); know thyself. Pre-Socratic philosophers were filled with this spirit of knowledge and professed its superiority over the other forms and approaches. For the purpose of this essay we will simply take gnosis to mean the fundamental kind of knowledge that seems to be only too obvious. Gnosis is sometimes defined as knowledge of spiritual matters, but we shall take it here to include knowledge of those matters that concern both the spirit and its earthly abode, the body. We shall deal with the innate spirituality of the body in another essay, but for now let it stand as given that in this word gnosis we simply include all knowledge that is known in the same mode or fashion that we know our left hand as our left hand and our right hand as our right. We need not study it or analyze it. We need not calculate or measure or for that matter even compare. We know. That approach to knowledge is gnosis no matter what is known.
The question suggested in the title of this essay concerns the relationship between gnosis and diagnosis. How does the way we know, our characteristic patterns of gnosis, affect (effect?) our methods and more importantly the outcomes of our diagnoses? This question has been on my mind for some time now. Although it didn’t emerge in such simple terms at the time, it was one of the principal questions driving the research and composition of Who Can Ride the Dragon? How does the approach to knowledge and particularly the differences in approaches to knowledge affect (again, effect?) the transmission and reception of Chinese medicine in those situations, such as my own, in which students come from a background that differs extensively from that of the ancient Chinese who coined and used the terms and theories and methods we know as Chinese medicine? Thomas Kuhn wrote that “scientific knowledge, like language, is intrinsically the common property of a group or else nothing at all. To understand it we shall need to know the special characteristics of the groups that create and use it.”
I raise this question in the hopes of sparking a discussion even if not a revolution.

Submitted by Zev Rosenberg on February 23, 2007 - 12:42am.
Ken, While not thinking of these issues in terms of Greek metaphors, I have tried to capture the essence of diagnosis and treatment strategies in Chinese medicine, and distinguish this from the methodologies of diagnosis in Western medicine. In short, Chinese medical diagnosis is more qualitative, biomedical diagnosis more quantitative. This evening, I was reading an interview with Jeff Hawkins ("The Thinking Machine"), creator of the Palm Pilot and Treo phone, in Wired magazine. He is trying to develop software that works in the same way as the brain to absorb knowledge and apply it. Basically, the brain learns from what it senses, beginning at birth, and builds a model of the world and makes decisions and judgments based on this model. Diagnosis in Chinese medicine works in a similar fashion. We gather information, build a reality from this information gather through our senses, and synthesize patterns, i.e. build models from this information. It is a process-oriented approach, that is not limited to specific tissue measurements, and by being process-oriented, it also is less limited by time and space. Another point you raise is the question of culture and transmission of Chinese medicine. Last weekend, the academic dean at PCOM was giving a talk on metacognition, the understanding of one's own thought processes. In Chinese medicine, since the knowledge based comes from a specialized cultural zeitgeist, one must immerse oneself in this milieu and create an environment in which to think and live Chinese medicine. This is precisely what is missing in Chinese medical education in the West, and our greatest disadvantage. Biomedicine is already embedded in the consciousness of most of the world, and its knowledge base, mostly data, is a mouse-click away on Google. It is easy to become immersed in biomedicine. It is much more difficult to immerse oneself in Chinese medicine without a sense of community support (the learning environment), practice in pattern-based thinking, and in connecting the knowledge to its source language. To see our failure in educating students in this way, just look at any typical e-mail user group and view the confusion in understanding even the most basic concepts of Chinese medicine. We need to develop both the proper environment and resources for the study and practice of the medicine we hold dear.