who wish to maximize their vitality, to create themselves as persons man-
ifesting as much as possible their true human nature in intelligence and
bliss. If health is conceived as inclusive of the exercise of one’s capacities,
then health encompasses creativity. Human beings in general have a high
degree of intelligence and a vast range of potential, so a healthy person
uses these powers in some creative way suited to her nature. The manifes-
tation of creativity can mark a psychophysical state in which require-
ments for basic functioning are met, and a surplus of energy permits the
bringing forth of new connections of meaning, whether in thought, lan-
guage, music, the plastic arts, political participation, or other ways.
Among the ambiguities of human life revealed by consideration of
health and illness is the fact, pointed out by Nietzsche, that pain and suf-
fering can be stimulants to creativity. Walter Kaufmann says of Nietz-
sche’s dialectical conception of health:
It would be absurd to say that the work of healthy artists is eo ipso
beautiful, while that of the ill must be ugly.... Homer was blind and
Beethoven deaf. Even Shakespeare and Goethe—Nietzsche thinks—
must have experienced a profound defect: artistic creation is prompted
by something which the artist lacks, by suffering rather than undis-
turbed good health, by “sicknesses as great stimulants to life” (The Will
to Power, 1003).^79In contrast to Nietzsche’s view, Deutsch describes creativity in terms of
the imparting of vitality:
The creative act is a kind of “letting be,” but at the same time it is a
shaping, a formative act, that involves expressive power. Together with
immanent purposiveness and cooperative control, the creative act is an
infusion of power, an imparting of a felt life or vitality; it is a making of
that which is alive with the very nature of natural-spiritual life.^80Deutsch’s idea of creative beingpertains to creative transformation of the
constraints and conditions of one’s being in the articulation and achieve-
ment of personhood.^81 Personal identity and freedom, he claims, are con-
tingent on creative being. Identity and freedom are determinants of crea-
tive being, and they are determinants of health, in both medical and
religious terms, as will be argued in the following chapter.
Generativity
In biological terms, a determinant of health is the ability to produce off-
spring. The Caraka-samhitÓ a ̄ addresses reproductive generativity in its
meanings of health in ̄ayurveda 73