Trends in Alternative Medicine

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Trends in Alternative Medicine

Overview

"Alternative medicine" may be defined as medicine that is different from "conventional" treatment. These treatments are not based on "modern" concepts of disease. The Office of Alternative Medicine (OAM) at the National Institutes of Health (NIH) defines alternative, or "complementary," medicine as "those treatments not taught widely in medical schools, not generally used in hospitals, and not usually reimbursed by insurance." With developments in the last years of the 1900s, this definition will probably change.

In the latter part of the twentieth century, the number of various practitioners of alternative medicine had increased in Western Europe and the United States. It is estimated that half of the U.S. population may go to an alternative practitioner. This figure does not reflect the number of individuals who venture into self-help practices.

One factor in the development of the alternative medicine movement was the emerging idea of self-help, which perhaps came about as a reaction to the image of practitioners of Western medicine as doctors who dehumanize patients and who are concerned only with disease and not about the prevention of pain or illness. In the West in the 1960s the movement dubbed "counterculture" questioned all kinds of traditions, including medicine. In fact, in 1976 Ivan Illich, a guru of the counterculture, argued that Western medicine had reached a watershed and had become a major threat to health.

In the early 1970s President Richard Nixon began "Ping-Pong diplomacy," which helped draw attention to Eastern philosophies. Publicity regarding the failures of Western medicine, with its drugs and technology, added to the public's cynicism. (The thalidomide scare of the early 1960s exemplified this situation.) At the time, a number of countries in Europe joined in a project called the European Council of Science and Technology to examine the potential of alternative medicine. The United States also opened the Office of Alternative Medicine for funding purposes.

Many therapies in alternative medicine are holistic, emphasizing the physical, mental, emotional, and spiritual aspects of the whole person. Some of the treatments are preventive, stressing good health practices.

Background

To understand alternative medicine, one must look at traditional Chinese medicine and the Indian system of Ayurvedic medicine. In these philosophies, the body is treated as a whole. It is a unity, but one also affected by outside forces. In Indian medicine, the body interacts not just with the physical environment, but also the social structure, changing mental needs, and the accumulated karma of the soul that inhabits it. All these factors have vital energy, which strengthens or weakens the body and affects consciousness.

Indian medicine is called Ayurvedic, a system that teaches life-enhancing practices. Yoga, a series of meditative exercises, comes from the Siddha tradition, which believes in balancing the body's innate vital energies.

Chinese medicine combines physical movement and thought, called Dao Yin, as both preventive and healing arts. Central to Chinese medicine is ch'i, which Taoist philosophies describe as the vital force in the body; control of ch'i promotes power and longevity. Philosophers of the Sung dynasty (960-1279 A.D.) describe ch'i as composed of a balance between yin and yang. Yin, the female principle, is dark and passive and represented by the earth. Yang, the male part, is active and light and represented by the heavens. According to their beliefs, the forces of yin and yang act in an individual's body just as in nature. Disease is caused by a disharmony between the two and bringing balance back will restore health. The five elements of wood, metal, earth, water, and fire are balanced to ward off disease.

Both Chinese and Indian medicine draw upon animals, plants, and minerals to provide treatment for disease. Eastern medicine is contrasted to Western science, whose history reflects years of fighting to destroy "vitalism" and has reduced life to molecules and atoms. The Western reliance on technology and its concentration on disease also contrasts with the principles of holistic medicine, or the treatment of the whole person.

Impact

While many forms of alternative medicine have roots in the Eastern tradition, the West has changed or adapted many ideas. Growth in the West, is after all, is consumer driven. Popular forms of alternative, or complementary, medicine include acupuncture, chiropractic therapy, osteopathy, homeopathy, herbalism, hydrotherapy, and meditation.

Acupuncture, the insertion of one or more small metal needles into the body for therapeutic purposes, is of Chinese origin. Devised before 2500 B.C., the practice grew out of the cosmic theory of yin and yang. A yin-yang imbalance causes a disruption of the life force, or ch'i, which flows through twelve meridians, or pathways, in the body. Practitioners of acupuncture insert arrowhead-shaped needles over the twelve bases or other specialized points. When inserted, the practitioner may twist or twirl the needle or apply an electrical current.

Used in China as an anesthesia during surgery, Western visitors have witnessed how normally painful operations have been carried on with fully conscious patients. Western explanations include such speculations as that the needle insertions activate certain natural painkillers (endorphins or enkephalins, for example) or that the stimulation of acupuncture closes pain impulses to the brain. Other Western observers have rationalized that there is a placebo effect.

Applications of acupuncture, however, have supplemented Western medical practice. For example, preliminary studies from the University of Maryland indicate that acupuncture reduced pain and improved joint function in osteoarthritis patients, although it did not cure the underlying cause of inflammation.

Two popular therapies, chiropractic medicine and osteopathy, do not have a clear connection with either the East or West but have a holistic and preventive component. Chiropractic, a form of manipulation of spinal vertebrae and other joints to stimulate the nervous system, was developed in 1895 by Iowa merchant David D. Palmer (1845-1913). Doctors of chiropractic are trained in accredited chiropractic colleges, which teach an interrelation between the musculoskeletal structure and nervous system. Chiropractic techniques include heat therapy, traction, and nutritional counseling.

Osteopathy, which also manipulates the spine and other joints, was founded by Andrew Taylor Still (1828-1917). One difference between chiropractic and osteopathy is that osteopathic doctors can prescribe medication. Major insurance companies in the United States are beginning to cover payments for these types of therapies.

Homeopathy is based on the idea that "like cures like,"—the more dilute a homeopathic substance is the greater the medicinal effect. This system was introduced in 1796 by the German physician Samuel Hahnemann (1755-1843), who noted that large doses of quinine, a treatment for malaria, produced effects similar to the symptoms of malaria. He theorized that if large doses aggravate the illness, then minute doses will treat it. When one thinks of the treatments of the day, such as bleeding, purging, and using strong doses of drugs (polypharmacy), patients welcomed homeopathy. In the twentieth century, homeopathy has been criticized because it focuses on disease and not health. Nevertheless, homeopathy does have adherents, including the International Homeopathic Medical League in Bloemendaal, Netherlands.

Herbalism, the use of plants to prevent or treat illness, draws heavily on Eastern tradition. Many herbs, such as ginkgo biloba and ginseng, are popular and greatly advertised. The Chinese medical tradition has an extensive folklore regarding herbals. Herbal remedies, however, have not met the test of scientific studies. The alleged benefits of herbs come from anecdotal testimonies given by people who have taken the herbs and declared that they have been helped. The FDA therefore has not approved herbal remedies, noting a lack of standardization and proven effectiveness. Some of the herbal remedies are beginning to be investigated using scientific methods. For example, ginkgo biloba, used for memory improvement, was found somewhat effective in relieving symptoms of Alzheimer's disease but caused major side effects, such as gastrointestinal disturbances, in some people. Also, an herbal mixture called Maharishi Amrit Kalish, from the Indian tradition, is a potent antioxidant and decreases atherosclerosis.

Hydrotherapy, a therapy involving health-giving baths and the drinking of spa water, came into vogue in the nineteenth century through the efforts of Vinzenz Priessnitz (1799-1851), a farmer who believed the water on his land could make one well. This belief in the healing power of water has also been connected to religious shrines. Many Western practitioners agree that disease and injuries may directly improve from the relaxing effect of being immersed in water but do not given credence to water's healing powers.

The main tenet of mind/body medicine is that thoughts and emotions are central to health. The mind and body are considered to be united and practices include prayer and meditation. Boston's Deaconess Hospital, for example, has a large Mind/Body Institute for research. Spiritual healing, or the laying on of hands, supposedly transmits energy to the client and marshals the subject's energy for physical healing. This technique is an old one that links Eastern practices to traditional Western beliefs.

Other alternative, or complementary, therapies include: aromatherapy, the use of essential oils from plants for massage or inhalation; hypnosis, the use of an artificially induced state of semi-consciousness for therapy; massage, the manipulating of the body to improve health; naturopathy, an approach to prevention and treatment based on enhancing lifestyle, diet, and exercise; radisthesis, the use of dowsing with a pendulum to diagnose and treat illness; reflexology, the therapeutic massage of the feet; shiatsu, a Japanese technique bringing together finger pressure and massage; and biofeedback, self-monitoring using an electronic apparatus designed to give information so one may gain control one's over body or mind. Some Western practitioners use a form of biofeedback to assist patients. For example, after prostate surgery, biofeedback is used to teach patients how to regain bladder control.

Books based on Eastern therapies are bestsellers. Writers such as Deepak Chopra (1946- ), who blends Ayurvedic medicine with Western science, has sold millions of copies of his books.

The debate over alternative medicine is alive and well. Hard-liners of the scientific method demand proof rather than philosophy—a major difference between the East and West. Driven by medical consumers, however, their position is softening. In 1992 Congress mandated establishment of the OAM and awarded grants to six U.S. universities for various studies. In 1996 Congress allotted 7.4 million dollars to the OAM and 12 million in 1997. Moreover, in 1997, 30% of American medical schools were offering courses in complementary medicine. In 1998 Congress gave the NIH 10 million dollars a year for five years for mind/body research.

EVELYN B. KELLY