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The New American Medicine III:
Ways to Wellness
 

By Michael Mannion



The current attempt to resolve the conflict between conventional medicine and complementary medicine is not new in American history. In past centuries, the practitioners of "regular" medicine competed quite fiercely with the practitioners of health approaches we now call alternative or complementary. Many of the complementary medical techniques themselves are not new. They are, in fact, far older than Western scientific biomedicine. Even medical therapies created in the 20th century frequently owe their origins to healing traditions that are thousands of years old.

If human beings survive the great turmoil of our era, future historian will look back at this period of development and see it as a crucial turning point for mankind. Individuals and entire societies alike have been struggling to create new ways of living. Often, the "new" ideas that are put forth to get humanity back on the right track are not new at all. They are frequently very old ideas that could not take root in an earlier historical period.

Many of the complementary health therapies, among the oldest on earth, are trying to reassert themselves. In his book, Ether, God and Devil, Wilhelm Reich wrote "We find the accent on life thousands of years ago--in the ancient thought systems of the great Asiatic religions such as Hinduism, certainly in early Christianity, and in the beginnings of the natural sciences in antiquity." The healing traditions that arose from the first religious and scientific attempts to understand reality, and to influence and alter it, also focused on life—the life force, the life energy, the healing power within us all. The earliest known reference to a universal healing energy comes from India in about 5000 BCE.

In our era, a Life and Death struggle is taking place on all levels of existence: within individual human beings; within human society; and on a planetary scale as well. The health of each person; the environmental health of the nations of Earth; and the ecological survival of the planet itself—all are in peril. And humans everywhere are searching for answers. The development of the New American Medicine is one expression of this quest to solve the problems facing humanity today.

Health is now being viewed in a more complete context, one that includes the interaction of many interrelated factors. In the past, healers and patients alike were more aware of the rooting of human beings in Nature. Sickness was considered to be the result of a disharmony between the individual and his or her environment. In most ancient healing traditions, there is no independent "disease" that exists apart from the complex network of relationships between each person and his or her life. Individuals do not exist in isolation.

For the ancient cultures of the mideast, the Australian bush; the African plains; or Native American cultures, the group or the tribe is integral to healing. In the West, this is not the case. Healing and treatment take place on an individual basis. In other cultures, however, the power of the entire community is brought to play in their healing traditions.

Recently, the influence of group support on promoting and maintaining health has become recognized by scientists and physicians in the West. The work of David Spiegel, MD with support groups for women with breast cancer, reported in his book Living Beyond Limits, is an excellent example of this awakening in the medical profession. Dr. Spiegel himself was astonished by the results of his work—the women in his support group lived on average twice as long from the time they entered the study as women who did not.

If these results had been achieved by a drug, they would have been trumpeted worldwide by the mass media and the stocks of the company making the pharmaceutical would have soared. There has been comparatively little response to this heartening news in the medical profession or the press, other than to try to explain it away.

One of the most successful "alternative" methods of healing has used group support since its founding in 1935—Alcoholics Anonymous (AA). This organization embodies many of the principles that guide other complementary healing traditions. In addition to group support, AA members take full responsibility for their own recovery and for maintaining their own health. Self-responsibility for health is a bedrock principle of complementary care. The AA ethos has penetrated into the mainstream culture in America and, in an indirect way, Alcoholics Anonymous may have helped open up the culture to a greater acceptance of complementary medical practices far beyond its own primary purpose for existing.

From Ancient Healing to Modern Treatment

Ancient healing traditions put the concepts of balance at harmony at the center of their conceptions of health and sickness. In Ayurveda, the ancient medical system of India, the balanced functioning of the life force is essential to health. In Traditional Chinese Medicine, harmony and balance of qi energy are evident in the well-known Yin-Yang symbol. In ancient Greece, health was viewed as a balance of the four humors in the body. In fact, the Greeks believed that there was only one disease-humoral imbalance. The healing school of Hippocrates and his followers was devoted to working with the natural force within patients to restore the body to harmony. Galen promoted and expanded the work of Hippocrates during the so-called Golden Age of Rome. During Islam's Golden Age, Avicenna (or Ibn Sina) extended the reach of Hippocratic medicine.

In Europe, from the Medieval period through the Renaissance, healing was not called "medicine." What we call medicine was referred to as "physic." The word Medicine is derived from the Latin word "medico," which means "I drug." The word "physic" was derived from the Greek word "physis," which means nature. To the physician, a student of nature, the preservation of health and prevention of sickness were paramount and were achieved by working with Nature. To the medical practitioner, drug treatment was primary.

Gradually, medicine began to become the dominant practice in the West. Catastrophic diseases devastated Europe. These diseases defied treatment by traditional healing systems. The wisdom of the ancients was powerless in the face of rampant infectious diseases such as the Black Plague or syphilis. In the 16th century, the Italian physician Girolamo Fracastoro studied the spread of smallpox in Europe. He put forth an early germ theory of contagion but few of his contemporaries accepted it.

In the 17th century Thomas Sydenham's studies of quinine in the treatment of malaria changed medicine in the West forever. Malaria is the greatest killer of mankind ever known. In the 17th century, it was a scourge. Sydenham was able to demonstrate that quinine was safe and effective in the treatment of malaria. Sydenham proposed the idea that diseases were distinct entities; they existed separately from the individual and the individual's relation with the environment. His separation of diseases into two categories is still used today: pathgnomic, to describe symptoms shared by most people with a disease and idiosyncratic, to describe symptoms that were unique for individual patients.

In the 18th century, Lannec, the inventor of the stethoscope, divided diseases into two categories: organic and nervous. This was the first time that physical and mental or emotional diseases had been separated in medicine. The rise of pathology with the acceptance of the practice of autopsy also turned medicine toward the study of disease rather than health.

Yet old concepts struggled on in new form. The ancient understanding of sickness in relation to the interrelationship of the person and environment lived on in the thought of Rudolf Virchow, the so-called "Pope of Pathology." Virchow wrote, "Medicine is a social science...Diseases have no independent or isolated existence." However, the field of bacteriology and the great advances in antisepsis and asepsis made possible by Ignaz Semmelweiss, Louis Pasteur and Joseph Lister altered Western medicine radically, in practice and theory.

By the end of the 19th century, the great plagues were beginning to retreat under the siege of medical treatment. Malaria, tuberculosis, typhoid fever, cholera, dysentery, the plague were conquered—an age of medical miracles seemed at hand. The germ theory, with specific causes for specific diseases, and Dr. Ehrlich's Magic Bullet providing the specific cure, triumphed over the concepts of balance, harmony and healing through influencing the natural life force within.

Alternative Medicine in the United States

In the United States, Dr. Benjamin Rush (one of the signers of the Declaration of Independence) warned physicians against relying on "the healing powers of nature in curing disease." Blood-letting and purgation were standard medical practices in America in the late 1700s and into the 1800s. Physicians prescribed mercury, medicinal alcohol, opium and other powerful tonics and spirits, all of which did great harm to many patients who were little more than guinea pigs.

It was at this time that an "alternative health movement" was born. Many of the alternative health practices from that period are familiar today: chiropractic, homeopathy, nutrition, herbal remedies, and osteopathy. These therapeutic systems arose to challenge the mainstream American medicine of the day.

By 1900, there were about 15,000 homeopathic practitioners in the United States, accounting for about 15 percent of all health providers. For comparison, there were about 8,000 AMA-style practitioners at the time. Most of these American alternative therapies were based on the view that disease was due to disharmony and lack of balance in the body. Disease was not considered to be a distinct entity. This early alternative movement was very influential.

However, by the first decade of the 20th century, organized medicine had begun to move toward establishing itself as the only valid form of health care, separating itself from those who practiced inferior medicine—women physicians (7,000 were in practice), alternative practitioners, and physicians from the lower or working classes of society.

The Impact of the Flexner Report on American Medicine

From 1906 through 1910, the AMA and the Carnegie Foundation reshaped American medicine. A young man named Abraham Flexner produced the eponymous Flexner Report which became the sacred text of this change in medical practice.

Following Flexner's recommendations, the number of medical schools dropped precipitously from 160 to 31; medical education was no longer focused on general practice; medical schools were structured to allow access only to the upper classes; and 20 states were left without any medical schools at all. African-Americans, women, Jews, immigrants and people from the lower classes were all driven out of medicine. A glut of doctors was turned into a shortage. Because they were in demand, physicians' incomes rose considerably.

The Flexner report resulted in little benefit to patients but it did give birth to the medical profession that came to be held in so little regard by so many-a wealthy, white, mostly male, upper class, authoritarian, condescending, medical elite too often more focused on wealth than health. The living patient was forgotten in medicine in the 20th century. Diseases became the center of attention. Health care grew ever more depersonalized as technological and drug-oriented treatment became dominant.

Medicine in 21st Century America

In the 1950s and 1960s, the Civil Rights Movement began to bring about enough change so that African-Americans began to reappear, although in small numbers, in American medical schools. In the 1970s, the women's movement began to shake the medical establishment and women once more were admitted to the great American medical schools, again in small numbers.

In the 1980s, the social changes that began with the counter-culture of the 1960s began to have an impact on medicine. During the conservatism of the 1980s, the alternative medical movement did not disappear, as had the political radical movements of the 1960s. The former radicals, hippies, flower children, health food nuts and adherents of Zen macrobiotics entered medicine, disguised first as students and later as physicians, nurses, professors, mental health professionals and alternative practitioners.

In the early 21st century, these men and women-as practitioners and patients-are now advancing the complementary care movement in the United States. They are not a monolithic group. There are many people involved with varied, sometimes conflicting, visions and agendas. But they are the ones creating the medicine of tomorrow by integrating conventional and complementary care.

It is helpful to review some of the major complementary care approaches that are being incorporated, or that are on the verge of incorporation, into mainstream American medicine. There are many ways to wellness and Americans are exploring them in ever greater numbers. Techniques that are of appeal to American physicians are the main focus here because these will be among the first complementary therapies integrated with conventional medicine.

Scientific Foundations of Conventioanl and Complementary Approaches

Western medicine is based on the concepts of Newton and pre-Darwinian biology. In terms of physics, Western medicine can explain the mechanics of everyday life. It has not yet fully incorporated the advances of quantum physics, which recognizes aspects of reality not considered in the Newtonian worldview. Western medicine does not yet emphasize the findings of modern biological-ecological science, which explores how living systems interact holistically. Patients are still isolated individuals with specific diagnoses and standard recommended treatments.

In contrast, modern quantum physics and biology-ecology are necessary to understand complementary medicine. Homeopathy and acupuncture produce results that biomedicine cannot explain. It seems that it is biomedicine that will have to change its views to incorporate new findings. In a peculiar irony, Western medicine uses advanced technologies to practice a form of medicine based on a number of old, outmoded ideas, whereas complementary techniques use very old health practices whose validity is now being verified by cutting edge physics and biology.

The Influence of Patient Pragmatism

Patients have accepted what the majority of physicians have so far resisted-many alternative treatments have value; they work. Patients are attracted by the focus on wellness and prevention. They are drawn to the concept of self-healing, of mobilizing the body's healing energy. In a way, all healing is self-healing no matter how you look at it. The average American is less put off by the concept of bioenergy today than is the average physician. Physicians, used to studying dead cells and searching chemical structures for answers to life and death questions, balk at the idea that bioenergy imbalances are at the root of illness.

Until the mid-1980s, nutrition and health was a subject too close to quackery for comfort for the medical establishment. Now the American Cancer Society, the American Heart Association, and great medical teaching universities have published their own authoritative guides to nutrition and health. The medical establishment can now accept that foods provide chemical nutrients. But the idea that foods provide energy is another matter (except when the word energy is used as an imprecise, vernacular term).

The rise in use of herbal remedies indicates that Americans are coming to see the value of botanicals. The emerging field of phytomedicine (plant medicine) shows that physicians are moving in that direction as well. But how many are willing to view plants as not only sources of nutrients, or as medicines, but also as elements in vibrational energy healing?

To integrate complementary and conventional medicine successfully, both traditions must be knowledgeable about the other. It is not only conventional physicians who must learn new disciplines; complementary providers need to become well-versed in the basics of biomedicine. This is happening and will continue at an ever-increasing pace. Many MDs are also licensed acupuncturists; many homeopaths also are licensed physicians. Not only is there integration between conventional and complementary health systems. Integration is occurring among diverse complementary practices. For example, Naturopaths use a wide range of healing techniques. Today, chiropractors and Ayurvedic practitioners may work side by side in clinics.

Despite all the differences in approaches, the living human being-a self-healing energy system-is at the center of the efforts to promote health, prevent illness and treat sickness. There is no one "truth" involved. In fact, patient satisfaction entails much more than any objective demonstration of safety and efficacy of one modality. Healing systems are created within a cultural context.

Research shows that all types of health care are experienced as satisfactory if the cultural expectations of the patients are satisfied. For example, in the West, if a patient goes to the doctor and does not receive a prescription, the majority of patients feel as if nothing healing has occurred. "I went to the doctor but he didn't do anyhting" is a common complaint. Without a prescription to take to the pharmacist, the cultural belief in the curative power of synthetic chemicals has not been addressed.

As Americans become more familiar with healing traditions from other countries, and as American culture is transformed in the process, it will become evident that most of what we think that we "know" is actually culturally conditioned. Even highly valued, objective scientific facts are shaped by cultural expectations and preconceptions.

A Patient-Driven Demand for Change

The demand for complementary care is at a peak that has not been seen since the middle of the 1800s. In the early 20th century, technological advances were making it seem as if paradise on earth was at hand. There was almost a worship of the new technology and its miracles, especially the miracle cures it brought to medicine. However, over the course of the century, painful treatments with side effects worse than the disease; hurried, impersonal care; and an over-emphasis on lab tests all left patients feeling uncared for. And they were uncared for in a deep, human way. Complementary medicine offers that one-to-one caring relationship biomedicine no longer provides.

In addition to feeling cared for, educated patients know—much more so than their physicians—that there is a substantial body of scientific evidence indicating that complementary treatments are often as or even more effective than conventional treatments for many conditions. In the United States, it is estimated that 12 percent of the gross national product is spent on health care and that the majority of patients and practitioners are unhappy with the health care delivered.

Popular Complementary Therapies

As a result their dissatisfaction with conventional healthvare, Americans are spending tens of billions of dollars out-of-pocket to get the kind of care they want and need. Let's look at some of the major complementary techniques Americans are turning to to attain and maintain health.

Aromatherapy

This modality involves the therapeutic use of essential oils that are extracted from plants. The term aromatherapy was coined in 1928 by Rene-Maurice Gattefosse, considered to be the pioneer in the scientific use of essential oils. Another French physician, Jean Valnet, described aromatherapy as the medicinal use of plant-derived aromatic essences. Others have depicted this therapy as a combination of science, psychoaromatherapy and perfumery, all in the service of altering the body-mind-spirit. Despite a lack of generally accepted scientific validation, aromatherapy has become increasingly popular.

Essential oils are extracted from different parts of the plant-roots, stalks, leaves, flowers or bark. These oils-volatile, fragrant, organic constituents of plants-can be used in many ways, such as being inhaled, applied by massage, mixed into an ointment or turned into a compress. Aromatherapy is one of the fastest growing alternative treatments in the United States and the United Kingdom. It is even becoming accepted by orthodox medical people. It has been shown to be of value in improving physical and psychological aspects of care.

While there are no definitive double-blind controlled clinical trials of aromatherapy, such research will undoubtedly be undertaken and it seems likely that this technique will be integrated into medical practice in the U.S. Aromatherapy appears to be useful for a wide range of conditions, among them depression, insomnia, hypertension, burns, bacterial infections and heart arrhythmias. The pleasing fragrances of the essential oils contribute to their popularity. But aromatherapy affects the section of the brain known as the limbic system, the structures of which extend through the hypothalamus to the basal forebrain-an area connected with emotional expression. The emotional impact of aromatherapy can be quite useful in chronic conditions such as AIDS, cancer and heart disease.

These substances have been used throughout history. Although modern scientific evidence is lacking, thousands of years of experience by people throughout the world suggest that future studies will prove the medical value of this complementary therapy.

Ayurvedic

Ayurveda, or the Science of Life (or Longevity), is a popular complementary approach for millions of Americans. It is the standard medical approach for nearly one billion Indians. Ayur in Sanskrit means "life" or "life span;" veda means "knowledge." Prana or life energy is at the heart of Ayurveda.

The first phase of this form of medicine dates from about 1200 to 800 BCE. The available information about this period indicates that a form of magical-religious healing was being practiced. The Sanskrit treatises available to us describe the second phase of Ayurveda, the classic phase lasting from 300 or 200 BCE to the first few centuries of the Common Era. The third or syncretic phase began in the 11th century with the Muslim invasions of India and continues to this day. Some writers suggest that the term "New Age Ayurveda" be used to describe the present-day adaptation of classical Ayurveda to the Western medical model.

Indian medicine has always maintained that there is an intimate connection between the microcosm and the macrocosm, between our world and the cosmos, and between human beings and the Universe. Healing can only be understood in this context. The cosmos is composed of five basic elements (earth, air, fire, water, and space.) The interplay of these forces creates all that exists, including human beings. Health is a state of equilibrium of the forces within humans called doshas. There are three doshas and an imbalance of any one of them causes disease.

In Ayurvedic medicine, the eradication of disease is not all that is involved in returning a person to health. The physical, emotional, mental and social aspects of the patient's life must be considered when making a diagnosis and planning treatment. Ayurvedic medicine offers preventive treatment for healthy people, to maintain their state of balance. Purification or alleviation therapy is available for those who become ill.

The Ayurvedic physician has access to a wide range of medicinals that have been used since ancient times. Botanically-based Ayurvedic pharmaceutics are derived from the Ayurvedic medical tradition. Mineral and inorganic drugs come from Indian alchemical traditions. In India, medicines and foods are inextricably connected, so much so that the first Ayurvedic pharmacies were probably kitchens.

Food as medicine is extremely popular in the U.S. today, with physicians such as Stephen L. DeFelice, MD promoting what he calls a "Nutraceutical Revolution." Georges Halpern, MD is another physician who has made the connection between food and health. He is working on developing a program in which pleasure-including the pleasure of healthy eating-is the basis of good health.

Ayurvedic medicine focuses on the whole person in the context of the external world. Maintaining and re-establishing the body's inner balance and harmony is the focus of its healing efforts. The Ayurvedic emphasis on the role of diet and emotions in health is becoming part of Western medicine today. It will clearly become an important part of the New American Medicine.

Traditional Chinese Medicine


The role of culture is evident in all medical practice. For example, American gynecologists put their patients in an uncomfortable position with their feet in stirrups, while British physicians allow their patients to lie on their side in a relaxed position. These choices are culturally determined. A patient in China may refuse surgery for painful kidney stones, opting for herbal medicine instead. However, the choice may be made, not for medical reasosn, but because of a social fear of the consequences of having surgery noted on his working papers; surgery can sometimes bar individuals from promotion on the job. Cultural considerations are especially important in understanding Chinese medicine.

Americans may think of Chinese herbs as gentle and safe. They are not aware of the powerful purgative therapies in this tradition. Tibetan medicine is in vogue, but few Americans would opt for Tibetan cautery with a red hot iron. Chinese medicine has evolved over the millennia and has incorporated ideas and practices from around the world. It is not static. Even such a fundamental practice of Chinese medicine as pulse diagnosis has undergone great changes over thousands of years. In Chinese medicine, nothing is thrown away. Discarded ideas and practices are put to the side, but they often return again centuries later. Or they make their way to other Asian nations, such as Japan, and flourish there.

Shen Nong (2698-2598 BCE), the Fire Emperor, is considered the father of Chinese herbal medicine. He is also thought to have taught the Chinese to cultivate plants and raise livestock. Huang Di (2697), the Yellow Emperor, is the creator of Traditional Chinese Medicine and is thought of as the father of the Chinese Nation. Legend has it that the Yellow Emperor gained his medical knowledge from "visiting Immortals." (Visiting from where?) His classic work The Yellow Emperor's Inner Classic describes Chinese medicine in a form that we find familiar today, almost 4700 years later.

Yin and Yang are fundamental concepts in Chinese medicine. They express the idea of complementary but opposing forces that exist in a dynamic state of equilibrium. Yin and yang are present simultaneously as paired functions of nature. The Yellow Emperor's Inner Classic and the I Ching or Book of Changes both seek to explain the relationship of Yin and Yang to health and happiness.

The language of Chinese medicine focuses on dynamic balance, interrelationships, interdependence and the interaction of the inner and external environments. In many ways, Chinese medicine is in accord with modern ecological thought. But no concept may be more important to Chinese medicine than qi-the life energy that pervades the human body and maintains health. Qi flows through the meridians (non-neural energy pathways) and is influenced by acupuncture. It supports, nourishes and protects the body. Qi is responsible for circulation and respiration.

Disease is seen as a disturbance of qi, the life energy, within the body. Acupuncture is used to regulate the qi. An intimately related technique, moxibustion, is also used to regulate qi. Moxibustion involves burning dried and powdered leaves of artemesia vulgaris on or near the skin to stimulate the flow of qi. Cupping and bleeding are also techniques used in Chinese medicine, separately or together.

Chinese massage involves the manual stimulation of acupuncture points to affect the qi. And Qigong uses exercise, breathing and the mind to influence the body's qi. Chinese herbal medicine has been part of health care in that country since the very beginnings of its medical tradition. The Chinese materia medica lists 5,767 herbs, minerals and animal parts as therapeutically active agents. It is the qi in the herbs, not the chemicals, that are thought to bring healing.

Today, Traditional Chinese Medicine is practiced all over the world: in Korea and Japan; throughout Europe; and in the United States and Canada. This medical tradition has been the focus of a great deal of research in recent years. The National Center for Complementary and Alternative Medicine has funded studies of acupuncture, Chinese herbal therapy, Traditional Chinese Medicine, moxibustion and Qigong. Other medical societies and universities are also conducting research in this area.

Improved design of clinical trials is expected to yield more accurate evaluation of the effectiveness of Chinese medicine in treating a wide range of illnesses. However, it seems certain that this approach to health will play a major role in the New American Medicine.

Chiropractic

The concept of a vital force or energy is central to chiropractic, which calls it "innate or universal intelligence." Humans are believed to possess an innate healing power, an expression of the inner wisdom of the body. The goal of chiropractic is to use this healing power to promote health and reverse illness. In chiropractic, it is believed that it is essential to find the cause of a disease before suppressing its symptoms. Drugs can hinder a return to health by suppressing the body's natural healing energy. Natural approaches should be the first treatments. Diet and regular exercise are considered essential to good health.

Chiropractic has faced great difficulties in the United States. Although Hippocrates was a practitioner of spinal manipulation, for decades, the AMA tried to destroy chiropractic. But in 1990, the United States Supreme Court found the AMA guilty of antitrust violations for having engaged in a conspiracy to contain and eliminate the chiropractic profession. Today, increasing numbers of AMA physicians refer patients to chiropractors.

In 1994, the Agency for Health Care Policy and Research of the U.S. Department of Health and Human Services issued its Guidelines for Acute Lower Back Pain, which included a strong endorsement of the value of spinal manipulation. Significantly, the panel stated that spinal manipulation produced both relief from painful symptoms and functional improvement. No other nonsurgical treatment produced these results, making chiropractic the treatment of choice for acute low back pain.

This complementary therapy has made great strides since its tumultuous early days. There is now a solid base of scientific evidence supporting its claims; many insurance companies offer coverage to its practitioners; and approximately 20 million Americans see chiropractors each year. Chiropractic is the third largest health practice in the world, surpassed only by mainstream medicine and dentistry. Chiropractors are licensed to practice in the U.S and must follow a rigorous course of study. Accreditation comes from such groups as the Council on Chiropractic Education. Chiropractors cannot perform surgery or dispense drugs. Their practice consists of manual adjustment or manipulation of the spine.

About 9 of 10 patients who visit the chiropractor do so because of back pain, neck pain or headaches. Spinal manual therapy can be extremely effective for these conditions. Randomized clinical trials have shown spinal manipulation to be a superior means of managing low back pain. No studies have shown spinal manipulation to be less effective than other forms of treatment for low back pain. A number of trials have demonstrated that chiropractic is more effective than drugs in treating headaches resulting from muscle tension. Studies in Ontario, Canada have found chiropractic to be safer and more effective than conventional medical care for low back pain.

As it completes its first 100 years of existence, and flourishes in the 21st century, chiropractic is being integrated into the conventional medical system in America. Most chiropractors do not want to become allopathic physicians. Neither do they want to be second-line practitioners, existing only on referrals from mainstream physicians. They are, and want to be seen as, equal partners on the health care team. Many patients see them that way. It is only a matter of time before most allopathic physicians do as well.

Healing Touch

In 1998, when the Journal of the American Medical Association featured an article on therapeutic touch based on the work of a grammar school child (a girl whose mother was violently opposed to therapeutic touch) a farcical nadir seemed to have been reached in organized medicine's opposition to complementary care. However, The New York Times and the major television news shows lowered the level of serious medical discourse even further by absurdly touting the young girl's school project on page one and as the lead story on the evening TV news.

Would the media reaction have been the same if the school girl had discovered that therapeutic touch was even more effective than previously thought?

Healing touch is a term used to describe a number of complementary modalities that have a long tradition in healing. All are founded on an understanding that there is a universal energy at the heart of healing. Energy healing through ancient and modern techniques involving touch shows great value for many emotional and physical disorders. The hand-mediated healing techniques that are used today include acupressure and shiatsu massage; therapeutic touch; Barbara Brennan's Hands of Light; reflexology; Reiki; Qigong; and Polarity therapy. There are many others as well.

One healing energy is at work, though it is called by many names in different systems of medicine. The Krieger-Kunz model of Therapeutic Touch (TT) and Healing Touch (HT) are widely used by nurses in the United States. The American Holistic Nurses' Association offers a Certificate Program in Healing Touch for Health Care Professionals. It is not really accurate to use the word "touch" in describing these techniques. In actuality, practitioners do not touch the patients; their hands are held above the body, inches or even feet away. Practitioners and patients say they feel energy during the sessions. Since there is no physical contact, bioenergy is postulated as the cause of the reported positive physiological responses to treatment.

There is a wide range of practices. Polarity therapy, for example, combines chiropractic, osteopathy, naturopathy, acupuncture, reflexology and other techniques. Reiki and acupressure were brought to the United States intact from other societies. It is quite interesting that nurses have become aware of these healing touch techniques, applied them in practice, and defended them against fierce criticism, whereas physicians have avoided these health approaches.

Because of their training in biomedicine, physicians may be more apt to accept the prevailing scientific "wisdom" that healing bioenergy is non-existent, and that healing touch is a placebo or a hoax. Victoria Slater, RN puts forward an interesting hypothesis about why, in general, nurses embrace, and physicians eschew, healing touch.

She notes that in the beginning of their training, nursing students give bed baths to one another and then work with living, energetic people, with whom they share intimate, emotional interactions. Medical school students are introduced to the human body through cadavers. Later, as modern practitioners, most physicians have little emotional contact with their patients. Is it possible that because physicians do not experience energetic, emotional contact with their patients, they do not feel or appreciate the energy of healing touch?

As with other complementary modalities, it is quantum physics and not Newtonian physics that may help explain the therapeutic effects of the various healing touch methods. However, until the results of objective quantum experiments verify subjective experience, physics provides only interesting speculation about the mechanisms of action for healing touch.

Touch has been used to treat swelling, reduce pain, relieve anxiety, and fight depression. It has been shown to be useful for premenstrual syndrome, diarrhea, fever, hives and symptoms of AIDS. It has also been helpful with patients receiving chemotherapy or radiation therapy. Nurses have used touch in hospitals, hospices, nursing homes and in home health care settings. Healing touch has been used in pediatric, surgical and psychiatric wards. It has proved beneficial for pregnant women in birthing classes, in nurseries and neonatal intensive care units.

Very few studies of healing touch have been published, or received much mainstream attention, save for the highly-touted grammar school child's landmark piece in the august Journal of the American Medical Association. However, clinically, healing touch has demonstrated effectiveness in managing a number of different conditions. As more and more people experience the benefits of healing touch, interest in performing good clinical trials will grow. It remains to be how soon it will be before the medical establishment warms up to healing touch.

Herbal Medicine

The human use of plants predates recorded history. Every known human culture has used plants for food, medicine, clothing and as part of healing and religious rituals. Herbal medicine uses plants to maintain health, prevent illness and treat disease. Herbal medicine involves both self-care and guidance from an expert educated in this approach to health. Egyptian, Chinese, Tibetan, European and American herbal traditions are all of value to today's practitioners. In addition, it is the healing power of the vital energy of the plants that is central in herbal medicine.

Almost all the herbal traditions place an emphasis on the whole person, body, mind and spirit. In addition, they focus on health and wellness and on the unique individual patient. For example, if a Chinese herbologist saw five patients with high blood pressure, each would most likely receive a different herbal remedy or combination of remedies. Most herbalists are not seeking to alleviate symptoms; they are looking to treat and eliminate the underlying cause of the illness. Herbalists are generally open to learning about new remedies from their own or other healing traditions.

Until the 1930s, American physicians relied on plant-based drugs as primary forms of medicine. Medical schools taught students about plant medicine. In 1870, the United States Pharmacopeia listed 636 herbal remedies. In 1990, there were only 58 herbs listed. Herbal medicines had been replaced by synthetic drugs, which could be patented and earn their manufacturers enormous sums of money. Today, with organized medicine so closely connected with the drug industry financially and philosophically, physicians are ignorant of botanical medicine. Some refer to herbs as the people's medicine.

Modern life has contributed to the alienation of the majority of people from nature and natural processes. Few Americans have direct contact with nature, save for TV nature shows and special eco-vacations. And fewer still have any contact with the cultivation of herbs and foods that have healing properties. Self-care with herbal medicine through growing one's own herbs is rare indeed. Yet such renewed contact with medicinal plants would be healing in itself on many levels.

Most of the extensive and valuable research of the safety and efficacy of botanicals has been performed outside the United States. Funding for such research is unlikely in America because, unlike synthetic drugs, botanicals cannot be patented. Without patents, vast profits are not possible. Therefore, the drug industry will not invest in research in herbal remedies. Other organizations in society must perform this critical research. However, it is difficult to see where the money to do this will come from in a nation where health care is a business and profit comes first and foremost. Botanicals for wellness and prevention cannot ever compete with billion-dollar blockbuster drugs for chronic diseases in a health care industry guided by corrupt, crony capitalist "market forces."

It may not be the physician who eventually replaces the herbalist of old. Instead, it may be the pharmacist. Americans are beginning to develop ongoing relationships with their pharmacists. Now that the personal or family physician relationship has almost entirely vanished, pharmacists are filling a vacuum in the health care profession. In fact, a recent survey of Americans indicated that the pharmacist is now the most trusted health care provider in the country. Pharmacists are learning about herbal medicines just as stores are lining their shelves with herbal remedies of widely varying quality.

Echinacea was the most used remedy in the United States until the advent of antibiotics and other "wonder drugs." Ironically, in a stunning turnabout, sales of echinacea are beginning to surpass competing over-the-counter products. However, just as botanicals are about to give synthetic drugs a run for their money, their popularity may be their undoing. The very existence of medicinal plants needed to create the remedies is now threatened. The preservation of seeds, of germ plasm, of the biodiversity of plant life, and of the natural habitats of the plants, are among the most critical challenges facing our world. If the natural world is destroyed, their will be no natural remedies.

Homeopathy

This healing method was developed by a German physician and chemist named Samuel Hahnemann, MD (1755-1843). Hahnemann was the author of a book on medicines that was quite well known in his day. Homeopathy is a system of self-healing. As with many other complementary methods, homeopathy has at is center a concept of the life force or life energy, the vis mediatrix naturae, or natural healing force. Homeopathy involves the use of small doses of remedies that resonate with the illness instead of fight it; that actually produce signs and symptoms of the illness in healthy people. Hahnemann's therapy was guided by what he called the Law of Similars, "Let likes be cured by likes."

The name homeopathy was created by Hahnemann from the Greek roots "omoios," meaning similar, and "pathos," meaning feeling. It was Hahnemann who also coined the term "allopathy," which is used frequently today to describe conventional physicians. Allopathic medicine, unlike homeopathy, did not let like cure like. Instead, it used medicines that sought to counteract the disease symptoms or medical techniques that were not directly related to the symptoms, such as bloodletting or purging. Today's allopaths use powerful synthetic drugs.

Homeopathy was and remains a unique healing system. Most American physicians consider it absurd, although it is increasingly popular with patients. Homeopathic remedies have moved from the health food store to the drug store all across the United States. This complementary therapy does not offer hypotheses about the true nature of disease and health. Rather, it is a way of treating illness whose only confirmation is in its results.

Homeopathic remedies were tested by a method Hahnemann called "provings," in which substances are administered to healthy people in doses strong enough to cause symptoms of disease without doing any harm. In this manner, information was assembled about the relationship of each remedy to specific health conditions. Provings are believed to be an experimental technique useful in investigating the medicinal value of practically any substance.

In this medical system, all healing is self-healing that involves the entire organism and applies only to individuals. Isolated parts of the organism cannot be treated and healed. For the homeopath, healing cannot be reduced to one formulaic approach that is valid for everyone. Hahnemann believed it was the life energy itself, the vital force, that was the ultimate source of health and disease. Although conventional medicine disdains the concept of a life force, it is now being forced by new information to confront evidence of a physical life energy.

To a practicing homeopath, illness is a disturbance of the vital force. These practitioners look at the totality of symptoms, which includes looking at the full life experience of the patient, including emotional life.

Homeopaths do not reject or ignore the appropriate advice of physicians and will use conventional medical techniques, such as drugs or surgery, when needed. This technique, however, allows the patient to remain in control throughout the healing process. Homeopathy is a difficult art for many to practice because each case truly is individual. It may take years of experience before a practitioner becomes proficient.

Homeopaths use the smallest doses of a remedy possible. This makes adverse side effects almost impossible. Homeopathic remedies are thought to be effective even in doses in which the active ingredient cannot be detected chemically. By diluting remedies through a process called "succussion," homeopaths theorize that the vital energy is freed from its chemical bonds and is released into the solution. This may be the most controversial aspect of homeopathy. Although many of those who practice conventional synthetic drug therapy simply cannot accept the claims of homeopathy regarding its remedies, others believe that new technologies such as laser spectroscopy and bioassay are detecting activity in homeopathic remedies. It is thought by some that a new bioenergetic science may be just at its beginning.

It is difficult to test homeopathic remedies using standard Western technology. Most scientists reject the homeopathic theory because they believe extreme dilution produces a useless solution, not a remedy. In 1980, the results of a double-blind study using homeopathy to treat rheumatoid arthritis was published in a peer-reviewed journal and showed statistically significant results. A later study of homeopathic remedies for arthritis showed no beneficial results. However, in this study, all of the patients were given the same medicine. This is standard conventional practice; it is not true homeopathic practice. The individualization of homeopathic treatments makes investigation by clinical trials extremely difficult.

In the 1990s, a number of trials in Europe have demonstrated that homeopathy may be beneficial in the treatment of allergic rhinitis; fibrositis; influenza; and asthma. In 1992, the British Medical Journal published a meta-analysis of homeopathic clinical trials which revealed that 15 of 22 trials showed positive results. The journal called for more well-designed studies of homeopathy. In the U.S., asthma, headaches, depression, allergies skin problems and psychological problems were common reasons patients consulted physicians who use homeopthy in their practices.

In Europe, this therapy is growing in popularity. Homeopathy is used by 25 percent of German physicians and 32 percent of French general practitioners; 42 percent of British physicians refer patients to homeopaths. In India, homeopathy is part of the national health service. In addition, India has hundreds of homeopathic medical schools and an estimated 100,000 practitioners. Many thousands of homeopaths practice in Argentina, Brazil and Mexico, which has five medical colleges that offer homeopathic training. South Africa also has a number of major homeopathic colleges.

In the United States, there has been a large increase in the use of homeopathy treatments in the last 20 years. During the 1980s, sales of homeopathic remedies rose by 1000 percent. Some estimate that sales of these remedies are rising at an annual rate of 25 percent. In a study of conventional physicians, it was discovered that those who use homeopathy in their practice spend more than twice as much time with their patients as do other conventional doctors. They also saw fewer patients each day. Physicians who used homeopathy ordered 50 percent fewer diagnostic procedures and tests, and prescribed drugs at a much lower rate.

Although the jury is still out, it seems likely that homeopathy will play a significant role in the emerging New American Medicine. It may be particularly useful for chronic health problems that conventional medicine is unable to handle adequately. Functional problems in which there is no tissue damage (e.g., insomnia, fatigue); conditions for which there is no effective treatment (e.g., viral illness, AIDS); illnesses that require the chronic use of drugs (e.g., allergies, arthritis); and health problems for which elective surgery is a choice (e.g., hemorrhoids, fibroid tumors) may all be appropriate for homeopathic treatment.

Naturopathic Medicine

The term Naturopathy was coined in New York City by Dr. John Scheel to describe his approach to health. The teachings of Benedict Lust actually form the foundation of naturopathy. However, its roots go back to the ancient healing traditions of many cultures around the world. Naturopathy is not characterized by any particular form of treatment. In a way, it is more a philosophy that a specific therapy. A fundamental belief of this system is that the body has the ability to heal itself through the power of the life energy or life force. In naturopathic medicine, it is essential for health to live within the laws of nature.

In the naturopathic system, life is more than biochemistry. It is believed that the body has an innate intelligence. As in other health systems, disease is believed to be caused by a disturbance in energy functioning. The bacteria, viruses or other specific disease-related factors are able to do harm because of the underlying imbalance or disharmony in the body.

To the naturopath, health is a dynamic state in which a person can survive life's struggles and stresses and thrive. The naturopathic physician sees his or her role as that of assisting nature, using the least invasive methods possible. Naturopaths refer patients to other health care professionals when indicated.

Practitioners who earn their Doctor of Naturopathic Medicine degree study a wide range of therapies. Naturopaths are able to prescribe drugs and perform outpatient surgical procedures. They have styles of practice that vary as much as the eclectic mix of therapies they use. Some stay with a strict natural approach, primarily using lifestyle modification, diet, detoxification and hydrotherapy. Other naturopaths may practice medicine in a way that does not seem to be much different from conventional physicians, save for the use of botanical remedies instead of synthetic drugs.

Today, most naturopaths consider themselves to be a fully integrated part of the health care system. However, not all state governments agree and naturopaths are not licensed to practice in all 50 states.

The basic principles of naturopathy include a belief in the healing power of nature; a view of the doctor as teacher; a preference for noninvasive treatments; in an underlying cause for every illness, often found in lifestyle or diet; treatment of the whole person; an emphasis on preventive medicine; and a focus on wellness, maintaining health and increasing vitality. As with conventional physicians, naturopaths accept the Hippocratic dictum, "First do no harm."

One of the most fascinating schools of medicine in the United States was the Eclectic School of Medicine. This group viewed the "heroic" efforts of allopathic physicians as dangerous to health. They proposed a form of medicine based on the European, Native American, and American healing methods. The Eclectic herbal textbook, King's American Dispensary, written by Harvey Wickes Felter and John Uri Lloyd and published in 1898, describes the history, preparation and use of over 1,000 botanical medicines. The Eclectic herbal approach had a profound impact on naturopathy.

In 1922, Morris Fishbein, editor of the Journal of the American Medical Association, began a personal campaign against medical therapies he considered "quackery." With the growing political power of the AMA behind it, Fishbein's campaign proved successful in suppressing naturopathy and many other complementary approaches to health. AMA-style medicine came to be viewed, legally as well as socially, as the only legitimate medicine.

In the 1960s, with the emergence of the counter-culture, there was renewed interest in naturopathy. Disenchantment with depersonalized, expensive AMA-style medicine combined with a new appreciation of environmental and ecological concerns. The principles of naturopathy appealed to many people at that time. In 1978, the John Bastyr College of Naturopathic Medicine (now called Bastyr University) was founded to teach science-based naturopathic medicine. It became the first accredited naturopathic college in America. In 1993, the Southwest College of Naturopathic Medicine and Health Science was founded in Scottsdale, Arizona. The National College of Naturopathic Medicine in Portland, Oregon and the College of Naturopathic Medicine at the University of Bridgeport in Connecticut are also advancing the cause.

Naturopathic practitioners are basically primary care providers. They make conventional Western diagnoses, often use biomedical approaches to treatment, but may also use acupuncture, herbs, chiropractic, homeopathy, healing touch, psychological counseling or any number of other helpful medical interventions.

Naturopathic physicians may actually be the vanguard of the New American Medicine. In naturopathic practice, the integration of conventional and complementary practice is a reality. Conventional medicine itself now embraces many naturopathic practices such as lifestyle modification, stress reduction, diet and exercise and dietary supplementation. Naturopathy is a rapidly growing profession. As it becomes more widely known by the public, it is attracting more patients as well.



Money and Medicine in America

It now appears increasingly obvious that conventional and complementary therapies are not mutually exclusive, either philosophically or practically. Rrather, they are mutually beneficial to practitioners and patients alike. Practitioners from differing schools of thought have a great deal to teach one another. In this manner, health care for their patients may improve dramatically. A new integrative medicine is taking shape.

Money is the measure in America, determining much of what occurs in medicine today. And, as Bob Dylan said, "money doesn't talk, it swears." It is useful, then, to see how the business community views current developments in complementary medicine.

Chiropractic is the largest market in alternative medicine. A recent Gallup poll showed that 30 percent of U.S. adults had seen a chiropractor and an astounding 90 percent felt the treatment was effective. Insurers are covering 85 percent of chiropractic care; 50 percent of HMOs offer chiropractic; 72 percent of self-insuring companies offer chiropractic benefits to employees. Businesses are interested in the potentially lucrative opportunities of supplying chiropractors with supplements and homeopathic remedies.

The growing consumer demand for homeopathic remedies is attracting the interest of some American business as well. In the United States, only three percent of the public uses homeopathic remedies, compared to 36 percent in France. About 70 companies now sell homeopathic remedies in the U.S. but two companies, Boiron and Standard, dominate the market. Business executive agree that, in order for homeopathic manufacturers to flourish in the U.S., educational institutions must begin to teach homeopathy. Consumer demand—which is low but still outstrips supply—is not enough to make the market attractive to big business. Physicians and pharmacists need to be educated about homeopathic remedies if these useful remedies are to become more widely available.

Insurance companies are discovering the benefits of complementary care: low cost for care compared with conventional treatments and a huge and growing market of people seeking coverage for alternative therapies. The 1993 Eisenberg study woke up the insurance industry, which was stunned to learn that Americans were spending nearly $14 billion out-of-pocket for complementary care. In 1999, an estimated $20 billion was being spent, money that could go to the insurance companies themselves. By 2005, it appears over $50 billion annually on alternative health care.

In addition, 46 states now mandate coverage of chiropractic; seven of acupuncture; 17 of osteopathy; and 2 of nutritional counseling. And these numbers are growing. Recently, Washington State mandated that all health plans cover regulated providers of alternative medicine, including acupuncture, chiropractic, naturopathy, massage, and midwifery.

Massage therapy is booming in America. Over the past 20 years, the number of massage schools has exploded, from 15 to over 800. The International Massage Association now has 16,000 members and expects rolls to surge to 100,000 in the next five years. There are one million massage therapists in the U.S. Many prestigious American hospitals are now performing research into the beneficial health effects of massage. American business is not that interested in massage because, generally, massage therapists do not sell products to their customers. Insurance companies typically limit coverage to massage required for rehabilitative purposes.

Acupuncturists are of interest to business because about 25-33 percent of their revenues are generated by the sale of supplements, herbs and other products to their patients. Acupuncturists are now licensed in 37 states and insurers are increasingly including them in coverage. The IRS even accepts acupuncture treatment as a legitimate deduction.

Businesses are intrigued by the possibilities naturopaths present. They are the most likely practitioners, in addition to chiropractors, to sell nutritional supplements, vitamins, minerals and herbal remedies out of their offices. Insurance companies are also strong supporters of naturopathy. Naturopaths may find the bureaucratic world of third-party payment difficult to manage, however, since most cannot afford the staff to handle the volume of paperwork, whereas conventional physicians usually can.

Economics has prodded pharmacists to dip their toes into the waters of complementary medicine. The rise of interest in natural remedies has made it possible for pharmacists to reclaim their traditional role as educators and advisors to their customers. Many pharmacists are turning to natural remedies exclusively, leaving the synthetic drug business behind. Pharmacists can play an especially valuable role since patients seem to trust them more than their physicians when it comes to complementary medicine. A pharmacist can answer such important questions as whether a patient who is taking an anticoagulant may also take Vitamin E safely.

American business sees the complementary care field as a great potential opportunity for sales of a wide range of products. Natural remedies are increasingly alluring in a time when four of the top five leading causes of poisoning fatalities are FDA-approved drugs-antidepressants, pain-killers, sedatives and heart drugs. Poisoning from herbal remedies is quite rare. In fact, though tens of thousands of Americans are poisoned by ornamental plants each year, natural products seem harmless. The relative safety of herbal remedies is attractive to business in America's litigious society.

Patients and consumers; those in medical-related businesses; and physicians in the business of medicine are all aware of the potential benefits of the integration of conventional and complementary care—and of the inevitability of this merger of medical approaches. But how this will be done, and what type of medical care will emerge, remains to be seen.


Conclusion: Is All Medicine Energy Medicine?


Hippocrates, the father of Western medicine, taught that the physician does not heal but only assists the true healer: the life force or life energy. Western biomedicine has lost this truth. But it is the life energy that is at the core of Ayurveda, Traditional Chinese Medicine, Chiropractic, Healing or Therapeutic Touch, Herbal Medicine, Homeopathy, Naturopathic Medicine and other forms of "energy medicine" to which Americans are turning in ever larger numbers.

The effectiveness of these healing traditions, as described by their founders, is based on the healing function of the natural life energy. The practioner only assists nature in restoring balance and harmony to the living organism. It is the life energy in healer's hands, the plant, the remedy, the homeopathic solution that is the effective healing force.

It is the Life Energy, functioning in all living things, that needs to be investigated and understood functionally, not mechanistically or metaphysically. A practical comprehension of Life Energy is essential if we are to make progress in medicine and science. For it is the Life Energy that is the basis for what will become the New American Medicine.




 

© 2004 Journal of The Mindshift Institute

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