Alternative Medicine in America.History

Morbidity indicators

2008-01-07T08:00:00.001-08:00

But its rejection leaves a difficult question: if health is something less
that complete physical, mental, and social well-being, how is its scope
to be limited? Health professionals, researchers, and policy makers have
acknowledged the need for such limits, and have introduced the notion
of health-related quality of life (HRQL) as a way to set them. HRQL assessment
tools evolved from older mortality and morbidity indicators,
augmented by measures of functional status, subjective health experience,
and perceived components of “social health.” These instruments
were designed to assess the patient’s performance in, or satisfaction
with, areas of activity affected by her physical and mental functioning.
Since virtually all areas of activity are affected by health, however, these
measures had to limit themselves to the areas most directly or substantially
affected by health. Yet without an understanding of what counts
as “health-related” in this sense, that term does more to label than to
resolve the issue. The proliferation of HRQL instruments has not been
informed by a careful analysis of, or an explicit agreement on, that issue.

Low expected quality of life

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The notion of quality of life, given currency by other developments in
health care, offered a convenient “child-centered” rationale for prenatal
testing and selective abortion: couples should be concerned not only
about whether to have children, or indeed about whether it is moral to
do so (e.g., Brock, 1995; Purdy, 1996), but also about the quality of life
that a particular child could be expected to have. If the chromosomal or
genetic constitution of a fetus appeared to preclude a life of reasonable
quality, it was appropriate to abort. Until recently, selective abortion
escaped the controversy that has accompanied efforts to limit the medical
care given to severely impaired neonates (e.g., Kuhse and Singer,
1985) – a limitation also justified by low expected quality of life – in part
because newborns are generally accorded higher legal and moral status
than fetuses. Despite the continuing controversy over abortion in general,
abortion for disease and impairment was seen, even by many who
were troubled or ambivalent about abortion in general, as a responsible
exercise of reproductive choice (see Asch, 1999).

Midterm abortion

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A concern about quality of life also came to play a central role in
reproductive decision making during the same period. In 1973, the U.S.
Supreme Court recognized early and midterm abortion as a constitutional
right. After Roe v. Wade, a woman could have a legal abortion
through the second trimester anywhere in the United States, for any reason.
Genetic and other reproductive technologies were soon providing
a stock of reasons for aborting that women had never previously
had, through the use of tests that could reveal a variety of diseases,
susceptibilities, and impairments. Because public acceptance of
such tests depended on their being seen as noncoercive, they could
not be presented as public health measures intended to eliminate

Benefits of New Medications

2008-01-07T04:26:00.001-08:00

Patients are not the only group to have become more concerned about
the quality of life that results from medical interventions. The interest of
health researchers, policy makers, and administrators predates the public’s
by at least a decade. Beginning in the 1960s, a variety of medications
were developed to increase patients’ functioning or to lessen their pain,
discomfort, depression, or anxiety without curing their diseases or increasing
their prospects for survival. In order to assess the benefits of
these new medications, the pharmaceutical industry financed the design
and use of some of the earliest quantitative measures of quality of
life. That industry continues to play a major role in developing and utilizing
increasingly sophisticated quality-of-life measures (Walker, 1993;
Spilker, 1996). In the past thirty years, quality-of-life measurement has
been eagerly taken up by researchers, epidemiologists, public and private
health administrators, health economists, and health policy makers.1
Together with estimates of survival and tests of physiological function,
these measures have now become a standard part of the calculus employed
to compare the “cost-effectiveness” of treatments for the same
and different health conditions, a calculus that is used to justify tradeoffs
among limited medical resource

Some cognitive functioning

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The controversy over end-of-life treatment thus continues, now focused
on the morality and legality of physician-assisted suicide and of
decision making for those who appear unable to decide for themselves.
In the former case, the salient issue is typically the right of competent
individuals to enlist physicians’ assistance in committing suicide; in the
latter, the difficulties of ascertaining the prior or hypothetical wishes of
the patient and their relevance to the present decision. In both areas, the
notion of quality of life is firmly entrenched as an important, if often
suspect, consideration. On the one hand, interventions that are technically
feasible, but produce no discernible improvement in quality of
life, are often opposed as pointless and undignified. On the other hand,
the opposition to withdrawing life support from individuals who retain
some cognitive functioning, or the possibility of recovering it, often
emphasizes the quality of life still possible for those individuals.
Patients are not the only group to have become more concerned about

Reproductive practice

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In this Introduction, i will briefly review how quality of life came
to assume such importance in health care and reproductive practice
and policy. We will then discuss some of the conceptual and ethical issues
raised by attempts to measure health-related quality of life and
to use such measures in the evaluation of health care interventions.
Next, we will examine the bearing of these issues on the current rethinking
of disability, a category that has been widely associated with
poor quality of life. We will describe the tension that has arisen between
the emerging understanding of disability as an interaction between
health and nonhealth conditions and environmental factors, and
the effort to systematically measure health-related quality of life. Finally,
wewill preview the discussions of these issues by the contributors to this
volume.

Genetic technology

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Genetic technology has enabled us to test fetuses for an increasing number
of diseases and impairments. On the basis of this genetic information,
prospective parents can predict – and prevent – the birth of children
likely to have those conditions. In developed countries, prenatal genetic
testing has now become a routine part of medical care during pregnancy.
Underlying and driving the spread of this testing are controversial assumptions
about health, impairment, and quality of life. While the early
development of prenatal testing and selective abortion may have been
informed by the questionable view that they were just another form
of disease and disability prevention, these practices are now justified
largely in other terms: prospective parents should be permitted to make
reproductive decisions based on concern for the expected quality of their
children’s lives. These practices, and their prevailing rationale, reinforce
a trend in biomedical ethics that began in the 1970s, one giving a central
role to quality of life in health care decision making

Administering drugs

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appearance (toothlike shape, yellow color) but as a result of experimental
determinations of likeness. Experiment had uncovered the first example of a
drug producing symptoms similar to those it would cure (cinchona), and if
the law of similars was to be generalized so that the full range of human
afflictions could be treated naturally, many more drugs would have to be tested
to learn what symptoms they produced. Hahnemann soon began such tests on
fellow villagers, then advanced to administering drugs to people suffering with
symptoms that tests had shown the drug to produce and, he believed, curing
them. Within a few years he had developed his homeopathic method to the
point that he felt confident announcing it to the world (in a 1796 article) as a
new system of healing derived from a law “dictated to me by nature herself,”
the law that “when homoeopathically selected” a drug “will imperceptibly
create in the patient an artificial condition, bearing a very close resemblance
to that of the natural disease, and will speedily and permanently cure the
sufferer of his original complaints.”5

Yellow mustard

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An approach to healing based on this “law of similars,” Hahnemann
decided, should be called “homeopathy” from the Greek roots homoios (like)
and pathos (suffering). Yet whether spelled “homeopathy” or “homoeopathy”
(a version popular in the nineteenth century and still encountered occasionally),
the notion that like cures like was not an entirely new concept. As a
hunch about nature’s way of healing, it is as old as the human race and has
been applied in every form from the ancient Roman’s faith in the power of
raw dog’s liver to ward off rabies to the seventeenth-century Englishman’s
use of pomegranate seeds to relieve toothache to the eighteenth-century American’s
trust in yellow mustard seed as a preventive of yellow fever. For that
matter, the still popular recommendation of “the hair of the dog that bit you”
as the surest hangover remedy might be thought of as homeopathy

Scottish physician

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Among his literary labors was the translation of foreign medical works
into German, and it was through that activity that Hahnemann arrived at his
interpretation of nature’s way of healing. During his first year of work as a
translator, in 1790, he encountered a passage in a text authored by a celebrated
Scottish physician that addressed the action of the drug cinchona. The dried
bark of a South American tree of the madder family, cinchona contains quinine
and had been used in Europe since the mid-1600s to treat malaria and other
fevers. As one of the handful of drugs with unquestioned therapeutic value,
cinchona was a substance of more than ordinary interest to doctors, and Hahnemann

German Samuel Hahnemann

2008-01-05T13:34:00.003-08:00

The system’s founder, the German Samuel Hahnemann (1755–1843; Fig.
3-1), got his start as a regular MD, obtaining the degree at Erlangen in 1779.
Afterward, he practiced in a succession of small towns in Germany but steadily
lost confidence in the efficacy of the treatments he had been taught to provide.
“I sank into a state of sorrowful indignation,” he related, after coming to
realize “the weakness and errors of my teachers and books.” Medicine, he
decided, was “founded upon perhapses and blind chance,” its professed remedies
nothing but “Pferdecuren [horse cures]

Horrid disgrace of the human MIND

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Silly as they considered Thomson’s steaming-and-puking regimen to be,
nineteenth-century physicians thought of another irregular system as still
more unlikely. Indeed, homeopathy’s practices were so remarkably at
odds with all accepted notions of how nature worked, of how nature conceivably
could work, that they were only to be regarded as utterly impossible. It
was “a stupendous monument of human folly”; it represented “the crowning
exploit of pseudo-scientific audacity”; it constituted a fabric of “astounding
absurdities” and “nonsensical trash.” “This horrid disgrace of the human
mind” was such “a confused mass of rubbish” as to make sense only to
“simpletons” possessed of “imbecile credulity.” All in all, “the fact that men
of sense and character should become its dupes, is one of the most striking
exhibitions of intellectual stupidity and moral obliquity which the history of
fanaticism itself can furnish.”1 Homeopathy was also the most popular of all
alternative systems of practice from the 1850s to the beginning of the twentieth
century.

Use anything that works

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Eclecticism had its origins in the work of Wooster Beach, an 1825 graduate
of a regular medical school who soon grew suspicious of the safety of
orthodox remedies. As early as 1827 he opened a school in New York City
to educate students in the full range of gentle botanical medicines, and as
public dissatisfaction with medical orthodoxy grew over the next two decades,
eclecticism became one of the more widely patronized systems. Its botanic
materia medica was steadily enlarged and refined, its educational system expanded
to more than twenty institutions, and more than sixty journals were
founded. Part of eclecticism’s appeal was its unusually pragmatic approach.
Alone among irregular systems, it made no attempt to rationalize the operation
of its medicines with a theoretical superstructure. “Use anything that works”
was its only principle, a rule that allowed practitioners considerable leeway to
do as they pleased and regular doctors wide scope for derision. “The Eclectics
keep themselves alive by swallowing everything which happens to turn up,”
The Medical and Surgical Reporter commented, “until they have become like
Macbeth’s cauldron.” In the eclectics’ “extraordinary conglomeration” of therapies
were to be found “all the ‘ics,’ ‘lics,’ ‘isms,’ ‘cisms,’ ‘ists,’ and ‘pathies’ ”
of all the other alternative systems.47

Members of another botanical healing

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Far more numerous were the members of another botanicalmembers of another botanical healing
group, one that originated independently of Thomsonianism. Eclecticism was
exactly what its name implied, a system that borrowed freely from all schools
of practice, taking anything that experience showed to be effective and safe.
Thomsonian remedies were quite popular among eclectics, but so were items
taken from Native American and other botanical traditions, as well as nonmineral
drugs from the allopathic armamentarium. Guided by the rule of vires
vitales sustinete, or “sustain the [patient’s] vital forces,” eclectics abjured all
strong depletive treatments, which meant lobelia as well as calomel and
bleeding.46

Troubled by the strifes of society

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Troubled by the strifes of society, depressed by the waste of its
forces and the delays of its columns, he who seeks character for
himself and progress for his kind, oft needs to shelter himself beneath
that divine principle called the time-element for the individual and
the race. Optimists are we; our world is God's; wastes shall yet
become savings and defeats victories; nevertheless, life's woes, wrongs
and delays are such as to stir misgiving. The multitudes hunger for
power and influence, hunger for wealth and wisdom, for happiness and
comfort; satisfaction seems denied them. Watt and Goodyear invent,
other men enter into the fruit of their inventions;

Large-scale studies in school

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A series of both small-scale and
large-scale studies in school districts from a variety of countries, including
the United States, Canada, Israel, and Australia, have demonstrated improvements,
sometimes impressive improvements, on such measures as concentration,
organization, productivity, reading skills, spelling skills, math
skills, writing skills, self-awareness, self-expression, and ~onfidenceF.~or instance,
a group of first-year nursing students learned a six-minute daily routine
using techniques similar or identical to the Cross Crawl, K-27 massage,
and the Wayne Cook posture. After several weeks of practice, they showed a
69.5 percent reduction in self-reported anxiety and an 18.7 percent increase
in performance on skill tests, as contrasted with control subject^.^

Your energy field

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Some of the techniques will have greater impact for you than others, but
in combination they will strengthen and balance your energy field. You are
likely to notice gradual improvements in your stamina, vitality, and overall
health. As you make your way through this book, you will be adding additional
techniques. Over time you may also realize, based on how you feel or
how you energy test, that one or more of these techniques isn't as necessary
in your personal routine, but for now, I suggest that you experiment with the
entire routine.

Meridians affect

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Meridians affect every organ and every physiological system, including
the immune, nervous, endocrine, circulatory, respiratory, digestive, skeletal,
muscular, and lymphatic systems. Each system is fed by at least one meridian.
In the way an artery carries blood, a meridian carries energy. As the
body's '(energy bloodstream,'' the meridians bring vitality and balance, remove
blockages, adjust metabolism, even determine the speed and form of
cellular change. Their flow is as critical as the flow of blood; your life and
health depend on both. If a meridian's energy is obstructed or unregulated,
the system it feeds is jeopardized.

Acupuncture points

2007-12-16T11:59:00.001-08:00

T he design of the meridian network is awesome. Rather than thinking of
meridians as an obscure or foreign concept, you can know them as fourteen
tangible pathways that carry energy into, through, and out of your body.
A profound intelligence resides in your meridians. They serve you well without
your even being aware that they exist, but ask in their language for an energy
boost, and they will do as you bid.
Meridians are energy pathways that "connect the dots," hundreds of tiny
reservoirs of heat, electromagnetic, and more subtle energies along the surface
of the skin. Known in Chinese medicine as acupuncture points, these
energy dots or "hot spots" can be stimulated with needles or physical pressure
to release or redistribute energy. Like a river that rises and falls, the flow
of the meridians is ever changing, and its fluctuations can be detected by
sensitive individuals as well as by mechanical instruments. Acupuncture
points are on the surface of the skin, but the meridians they open into travel
deep into the body and through each of the organs and muscle groups. Your
meridians are your body's energy bloodstream.

The demand for drugs

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A persistent problem facing our society is the use of illegal drugs, such as heroin,
cocaine, and crack. Drug use has several adverse effects. One is that drug dependency
can ruin the lives of drug users and their families. Another is that drug
addicts often turn to robbery and other violent crimes to obtain the money needed
to support their habit. To discourage the use of illegal drugs, the U.S. government
devotes billions of dollars each year to reduce the flow of drugs into the
country. Let’s use the tools of supply and demand to examine this policy of drug
interdiction.
Suppose the government increases the number of federal agents devoted to
the war on drugs. What happens in the market for illegal drugs? As is usual, we
answer this question in three steps. First, we consider whether the supply curve or
demand curve shifts. Second, we consider the direction of the shift. Third, we see
how the shift affects the equilibrium price and quantity.
Although the purpose of drug interdiction is to reduce drug use, its direct impact
is on the sellers of drugs rather than the buyers. When the government stops
some drugs from entering the country and arrests more smugglers, it raises the
cost of selling drugs and, therefore, reduces the quantity of drugs supplied at any
given price. The demand for drugs—the amount buyers want at any given price—
is not changed. As panel (a) of Figure 5-10 shows, interdiction shifts the supply
curve to the left from S1 to S2 and leaves the demand curve the same. The equilibrium
price of drugs rises from P1 to P2, and the equilibrium quantity falls from Q1
to Q2. The fall in the equilibrium quantity shows that drug interdiction does reduce
drug use.

Back to the good news

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Back to the good news. There is much you can do to reverse these disturbances.
Throughout history, people have devised exercises and techniques that
bring the body's energies back into balance. Cultures separated by time and
distance, with no communication between them, often used very similar methods.
In my own work, I have several times spontaneously "invented" a technique
or exercise that I later learned was part of the tradition of an indigenous
culture. While we are each as energetically unique as a thumbprint, we all
share a similar physiology. You will be learning techniques that are beneficial
for every body as well as how to adjust the procedures to your particular body.
You can literally weave your energies so they become stabilized, strengthened,
and harmonized as you move through the turbulence of modern life.

Drug-related crime

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But what about the amount of drug-related crime? To answer this question,
consider the total amount that drug users pay for the drugs they buy. Because few
drug addicts are likely to break their destructive habits in response to a higher
price, it is likely that the demand for drugs is inelastic, as it is drawn in the figure.
If demand is inelastic, then an increase in price raises total revenue in the drug
market. That is, because drug interdiction raises the price of drugs proportionately
more than it reduces drug use, it raises the total amount of money that drug users
pay for drugs. Addicts who already had to steal to support their habits would
have an even greater need for quick cash. Thus, drug interdiction could increase
drug-related crime.

Beginning the test

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Be sure the person is ready before beginning the test. Pull
the arm smoothly Apply pressure only long enough to determine if the arm's
resistance holds (generally between one and two seconds). If a muscle is
locked in place or gives a fraction of an inch and then bounces back, the test
has shown that the energy is flowing through the muscle. Do not overwhelm
the muscle oust to be sure." Along with learning the mechanics of energy
testing, I am also interested in helping you cultivate a strong and reliable intuition.
Energy testing is a superb means to that end because it provides tangible
information about subtle energies. With each energy test you perform,
you receive feedback that attunes your intuition to the flow of energies
within you and around you as well as to the subtleties of energy testing itself

Homeopathic treatment

2007-12-06T03:28:00.001-08:00

Homeopathic treatment is individual and specific.
For example, chronic headaches are
conventionally treated with analgesics or antiinflammatory
drugs, but in homeopathy, there
are over 200 symptom patterns of headache with
corresponding remedies for each one. A patient is
profiled according to physical, emotional, and
mental qualities before a remedy is prescribed. If
an incorrect remedy is taken, it will work either
superficially or not at all, so it is recommended
that therapy be conducted under the supervision
of a homeopathic practitioner.

Meridian Functions

2007-12-06T02:41:00.001-08:00

Meridian flows through and serves at least one organ or physiological
system. For example, like the kidneys themselves, the function of the
kidney meridian is purification. The kidney meridian filters toxic energy, allowing
energies that have been obstructed to begin to move. I'll choose to
work with the kidney meridian when I want to "flush" a particular systemfor
example, if the lymph system feels sluggish, the back feels tight, energy is
stuck below the waist, or the body is carrying an illness. The kidney meridian
filters the body's energies, leaving them fresh, clear, and vital, and the kidney's
energies renewed as well. The first points on the kidney meridian, at the
bottom of the feet, are called the Wellspring of Life points The
kidney meridian is said to contain the life force of beginnings and renewal.

Energies correlate with ill health

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isturbances in meridian energies correlate with ill health. The amount
of light emitted by the meridians of laboratory animals decreased when
the animals were ill and increased as treatments such as acupuncture began
to improve their physical condition.4 Because disrupted meridian energies
often precede illness, meridian readings are sometimes used to predict
health vulnerabilities and prevent disease. Some government employees in
Japan, for instance, are routinely screened during their annual medical examination
by a machine that has twenty-eight electrodes attached to the
meridian endpoints. Only people with abnormal meridian readouts are required
to go through further diagnostic testing

Meridians energy

2007-11-26T09:02:00.001-08:00

If you think of the meridians as an energy transportation system, a complex
traffic network, you have a concrete model of how meridian energies interact.
When a freeway becomes congested, it may be necessary to divert
some of the traffic onto another highway. An off-ramp may need to be cleared
or widened. If a highway or meridian becomes backed up with too much ennergy
, as occurs in the hubbub of daily life, a bottleneck forms. And the resources
needed to support the community or the body are also blocked. It becomes
difficult to provide food and remove waste products. Likewise, if a
highway is damaged in an earthquake, even the critical support services that
form the community's "immune systemo-like police, fire, and ambulance
units-cannot function properly. Because your body is in use twenty-four
hours every day, day in and day out, and because it is under continual stress
and has periodic "earthquakes," its pathways need regular maintenance and
repair as well as an occasional major renovation.

Meridians affect

2007-11-26T08:55:00.001-08:00

OPPORTUNITY COST AND COMPARATIVE ADVANTAGE

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OPPORTUNITY COST AND COMPARATIVE ADVANTAGE
There is another way to look at the cost of producing potatoes. Rather than comparing
inputs required, we can compare the opportunity costs. Recall from Chapter
1 that the opportunity cost of some item is what we give up to get that item. In
our example, we assumed that the farmer and the rancher each spend 40 hours a
week working. Time spent producing potatoes, therefore, takes away from time
available for producing meat. As the rancher and farmer change their allocations
of time between producing the two goods, they move along their production possibility
frontiers; in a sense, they are using one good to produce the other. The opportunity
cost measures the tradeoff that each of them faces.
Let’s first consider the rancher’s opportunity cost. Producing 1 pound of potatoes
takes her 8 hours of work. When the rancher spends that 8 hours producing
potatoes, she spends 8 hours less producing meat. Because the rancher needs only
1 hour to produce 1 pound of meat, 8 hours of work would yield 8 pounds of meat.
Hence, the rancher’s opportunity cost of 1 pound of potatoes is 8 pounds of meat.
Now consider the farmer’s opportunity cost. Producing 1 pound of potatoes
takes him 10 hours. Because he needs 20 hours to produce 1 pound of meat, 10
hours would yield 1/2 pound of meat. Hence, the farmer’s opportunity cost of 1
pound of potatoes is 1/2 pound of meat.

Final

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Áyurveda (pronounced Aa-yer-vay-da), said to
be a world medicine, is the most holistic or comprehensive
medical system available. Before the
arrival of writing, the ancient wisdom of healing,
prevention, and longevity was a part of the spiritual
tradition of a universal religion. Healers gathered
from the world over, bringing their medical
knowledge to India. Veda Vyasa, the famous sage,
preserved the complete knowledge of Áyurveda
in writing, along with the more spiritual insights
of ethics, virtue, and Self-Realization. Others say
Áyurveda was passed down from God to his angels,
and finally to humans.

Apparent dilemma

2007-11-18T11:05:00.001-08:00

Bickenbach identifies an apparent dilemma for the
construction of health measures: they must either locate the burden of
health conditions entirely in the individual, which is unfair or misleading,
or they must take account of social and environmental contributions
to that burden, thereby ceasing to be measures of health performance
or attainment. He concludes that if policy makers are to take equality
in health care seriously, they should explore alternatives to health measures
and to the kind of cost-effectiveness analysis that employs them,
alternatives such as the “benchmarks of fairness” scheme proposed by
Norman Daniels and his colleagues.Despite their differing emphases and conflicting judgments, our contributors
develop common themes.Several of them scrutinize alleged
conceptual and empirical links between impairment and well-being,
and between health and well-being. Most claim that those links are
more tenuous or complex than is often supposed. Asch, Wasserman,
and Shakespeare, for example, argue that reproductive decision making
in its present social context is shaped by unjustified or overbroad
generalizations about the impact of impairments on well-being, ignoring
the highly variable effects of different impairments in different settings.

Bursitis

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Bursitis
Bursitis is the inflammation of the bursae, which
are fluid-filled sacs that act as cushions in reducing
the friction where muscle and tendon meet
bone. Excess fluid collects in the sacs resulting in
pain, swelling, heat, and restricted movement.
Bursitis is most often caused by overuse; other
causes include infection, injury, arthritis, or gout.
Areas most affected are the shoulder, elbow,
knees, hips, and heels. Tendonitis is a similar condition
affecting the tendons, which are the
fibrous tissues that connect muscle and bone, also
caused by overuse and responds to the same
treatments as bursitis.
Immobilize and rest the affected area, although
once the swelling has diminished, exercise is advisable
to prevent a permanent situation from developing.
Applying a cold compress (such as a bag of
frozen peas or ice pack after rubbing skin with oil
to prevent frostbite) is helpful and then alternate
or use just hot compresses when pain and swelling
subside. TENS, an electrical nerve-stimulation
unit, is beneficial in alleviating the pain.

Native American remedies

2007-11-16T02:13:00.001-08:00

Claiming to side with nature instead was the distinguishing therapeutic philosophy
of those first alternative systems of practice that appeared in America
in the early 1800s. Systems of practice is specified because while there had
been a variety of methods available as alternatives to conventional medicine
before the nineteenth century, the practitioners of folk medicine, the so-called
root-and-herb doctors, the purveyors of Native American remedies, and other
informally trained medicos had not been professionalized to any significant
degree. They were often paid for their ministrations, to be sure, but they
generally practiced alone, using what knowledge they had acquired in their
individual ways. They did not band together with people of like mind to
prescribe the same drugs and to swear allegiance to the same theory. They
did not establish schools to train the next generation of practitioners, organize
professional societies, or publish journals. The alternative healers who came
onto the scene in the early nineteenth century did all those things, and that
is what made their practices stand out as systems.

Regular physicians

2007-11-16T02:03:00.001-08:00

Regular physicians of the first half of the nineteenth century maintained
allegiance to their traditional drugs for other reasons as well. Doing something
active in place of waiting for nature instilled confidence in patients that the
doctor had power, and confidence stimulated recovery. Indeed, if the doctor
did not take action, more often than not the patient or his family demanded
it. “How often,” one physician complained, was he “forced by patients and
their friends to give medicine when it is not plainly indicated. . . . He must
cure quickly, or give place to a rival.” Finally, calomel, bleeding, and other
heroic treatments were the very things that gave the profession its distinctiveness
vis a` vis unconventional healers. As these enemies became ever more
strident in their attacks on traditional medicine, it was only natural for MDs
to close ranks and cling more tightly to that tradition as a badge of professional
identity, making depletive therapy the core of their self-image as medical
orthodoxy. In brief, a fair amount of lip service was paid to nature by physicians
of the mid-1800s, but when it came down to practice instead of philosophy,
they sided with art.

nature versus art

2007-11-14T08:36:00.001-08:00

The resultant debate of “nature versus art” (“art” denoting the doctor’s
pharmaceutical armamentarium) was a hotly contested issue among America’s
regular physicians from the 1830s into the 1860s. But the fact that Oliver
Wendell Holmes, the profession’s most articulate spokesman for therapeutic
humility, described “nature-trusting” as a “heresy” indicates that the majority
of doctors denied nature’s power to heal unassisted, and stayed on the side of
active intervention. Some of the orthodox actually denied there was any such
thing as the vis medicatrix naturae. (“Obscure and incomprehensible,” one
doctor called it; “only an inference—a theory,” stated another.) Most acknowledged
that when the body was attacked by disease it did make efforts
to reverse the injury and reclaim health but believed that generally the aid of
the physician was required nonetheless. To have concluded otherwise would
have been a form of professional suicide, an admission that the doctor was
redundant. Even Holmes and other nature-trusters hardly abandoned drugs
altogether. They simply called for a more moderate and discriminating use of
those that seemed to have some clinical evidence in their favor, rationalizing
their use as agents that removed obstacles to nature’s reparative activity.
Judged that way, even calomel could be identified as a friend of nature; used
judiciously, the purgative eliminated constipation, which might otherwise cause
discomfort, weakness, and sleeplessness.

Attention

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At first, attention was motivated primarily by the recognition that practitioners
needed to know more about unconventional systems of care in order to engage
their alternatively inclined patients in open discussion of their habit (in contrast
to shaming them in the manner of the cartoon physician). Eisenberg had found

New Yorker medicine

2007-11-13T07:19:00.001-08:00

Yet in just the few years since the publication of that New Yorker cartoon,
mainstream medicine’s historic disdain for alternative medicine has softened
remarkably. The decision by the U.S. Congress in 1991 to establish an Office
of Alternative Medicine at the National Institutes of Health was, to be sure,
a political act, and one that enraged many MDs.

Systems of healthy treatment

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Systems of treatment as a grab-bag of inert (when not dangerous) therapies
foisted upon gullible hypochondriacs by scientifically uncritical quacks. Alternative
doctors, Spalding Gray has joked on behalf of physicians, believe that
“everything gives you cancer,” but there’s no need to worry, because they also
believe that “everything else heals you of it.” (The emphasis is Gray’s; italicized
words in quoted passages throughout this book were italicized in the
original.)

Another alternative methods

2007-11-13T03:12:00.001-08:00

That alternative methods were so widespread in the presumably enlightened
1990s was a startling realization for the medical profession. It shouldn’t
have been, for there’s nothing at all new in the current enthusiasm for unconventional
therapies. Comparable levels of support have been the norm for
most of the last two centuries: Americans, in short, have been fooling around
with alternative medicine for a long time.
That such activity has been mere foolishness has been the opinion, of
course, of orthodox practitioners. From the start, MDs have scorned alternative

Eighteenth-century medicine

2007-11-13T02:47:00.001-08:00

Eighteenth-century medicine had gone overboard in its reliance on highly
speculative theoretical constructs as the basis for therapeutic decisions, suffering
an imbalance that encouraged a search for more empirical approaches. The
increasingly heroic therapeutic interventions that the theories encouraged likewise
created a backlash, and the resultant desire to place more trust in the
body’s natural restorative powers was reinforced by the appeals of Romantic
philosophers and poets to return to nature as the source of all truth and beauty.
Further, the quickening pace of professionalization of American medicine that
was evident by 1800 generated opposition. Eighteenth-century medical practice
had been only loosely organized and regulated, an activity in which just about
anyone was free to participate.

Interesting facts about alternative medicine in America

2007-11-09T07:24:00.001-08:00

In the autumn of 1994, a New Yorker cartoonist imagined a clinical scene
in which a patient who is literally radiant with health, his body throwing
off a nearly blinding aura of wellness, is nevertheless being sternly admonished
by his physician because he has achieved his health the wrong way:
“You’ve been fooling around with alternative medicines, haven’t you?” the
doctor scolds.1
New Yorker cartoons constitute the most sensitive of barometers to shifting
currents in America’s cultural atmosphere. And in truth, whatever one
chooses to call it—alternative medicine, unconventional medicine, holistic
medicine, complementary medicine, integrative medicine (some even like the
term vernacular medicine)—a lot of people have been fooling around with
unorthodox forms of therapy in recent years. In a now legendary survey
published in 1993, Harvard’s David Eisenberg reported that one in three
Americans had used one or more forms of alternative medicine in 1990, and
expressed surprise at the “enormous presence” of healing alternatives in American
society. When Eisenberg and colleagues repeated the survey in 1997,
furthermore, they found that “alternative medicine use and expenditures have
increased dramatically” since the first study: now 40 percent of the population
employed such procedures