Literature Annotations


Nuland, Sherwin B.
The Mysteries Within


Genre Treatise (286 pp.)
KeywordsAlternative Medicine, Anatomy, Art of Medicine, Heart Disease, History of Medicine, History of Science, Hysteria, Medical Advances, Medical Mistakes, Medical Research, Physician Experience, Surgery, Survival, Trauma
Summary

In The Mysteries Within, Sherwin Nuland takes the reader on a guided tour of selected organs inside the human body. Beginning with the stomach, he progresses along to visit the liver, spleen, heart, uterus, and ovaries. At each point he addresses various historical and contemporary beliefs, as promised in the book's subtitle, "A Surgeon Reflects on Medical Myths." Nuland brings to this endeavor the patented mixture of personal story, elucidation of medical history, and plain old good writing that characterizes all of his books.

For example, he devotes the first three chapters to the stomach. The first consists mostly of a brilliant clinical tale in which a six-week-old baby is found to have a wax bezoar in his stomach. The second and third provide a cogent survey of beliefs about the stomach's function, beginning with Greek humoral theory, continuing through van Helmont and the iatrochemists, and ending with Ivan Petrovich Pavlov and his seminal monograph, The Work of the Digestive Glands.

Van Helmont and his mentor, Paracelsus, appear again and again in later chapters as the earliest champions of the idea that the body runs by means of chemical processes (iatrochemistry). However, as Nuland points out, Paracelsus has left us two different legacies. One is his devotion to chemistry and experimentation, which eventually led to modern biological science. The other is his devotion to alchemy and mysticism, which makes him as well a forerunner of contemporary irrational systems of healing.

Commentary

Sherwin Nuland's best-selling How We Die: Reflections on Life's Final Chapter was grounded in the physiological and pathological facts of dying. The author then built an interesting edifice of clinical stories and social and cultural observations on his biological foundation. He followed the same pattern in his next book, The Wisdom of the Body (How We Live). (See annotations in this database.) With some variation, he uses the same successful formula to make The Mysteries Within.

For health professionals and students, Nuland's clinical tales are perhaps the most fascinating part of the book. But the book's theme (as summarized in the Epilogue) is medicine's painstaking journey over hundreds of years from magic and mysticism toward scientific understanding. Thus far at least, a major prerequisite for this journey has been the gradual abandonment of comprehensive schemes and unified theories. Nuland writes that the biggest obstacle to the advance of medical knowledge has been "the continuing search for a single unifying explanation of the behavior of all life and matter." (p. 259) This means, for example, humoral theory, iatrochemistry, and all religiously-based explanations of biology. It also includes unitary theories of healing like homeopathy and chiropractic.

Nuland's attitude toward religion seems similar to that of the essayist and paleontologist Stephen Jay Gould; i.e. religion and science are two mutually exclusive realms of human experience. Because they do not overlap, there is no reason for the antagonism that has occurred in the past and in many cases still occurs. (Consider, for example, the still-controversial issue of teaching evolution by natural selection in American schools.)

PublisherSimon & Schuster
Edition2000
Place PublishedNew York
Annotated by Coulehan, Jack
Date of Entry 12/27/01
Last Revised 02/19/02