MEDICINE, ALTERNATIVE

MEDICINE, ALTERNATIVE. Alternative medical practices have arisen in or have easily been transported to the United States, where social values and political infrastructure have encouraged many forms to flourish. The pervading American value placed in persons having autonomy with respect to making decisions over their own bodies; the skepticism toward any professional group having a monopoly on a given field; and Article 10 of the U.S. Constitution, which reserves to each state the exclusive power to set standards, make rules, and license practitioners in their jurisdictions, have enabled the public and small groups of unorthodox practitioners to shape laws that limit the powers of the dominant orthodox medical profession and protect the interests of alternative minority groups. In Europe and most other countries, licensure and medical policy are centralized, and alternative practitioners and their supporters must win one large battle to gain political recognition or face being marginalized. In the United States, alternative medical movements have been able to fight simultaneous battles in several states, winning some and using those successes to institutionalize, build followings, set standards, and continue their struggles in other jurisdictions.

Although alternative medicine has existed throughout the country's history, the greatest growth of alternative medical movements occurred during three eras, when more broad-based social ideologies nurtured the philosophical premises and political aims of such movements. These ideologies were Jacksonian Democracy (roughly the 1820s to the 1840s), populism (1880s–1910s), and New Age thought (1970s–1990s).

The Era of Jacksonian Democracy

President Andrew Jackson and many of his followers trumpeted the virtues of "the common man, " feared large centralized institutions, and had a distrust of professionals, particularly when the latter sought special privileges or exclusive rights based upon expertise to practice in fields traditionally open to those with or without formal training. Consistent with these beliefs, three large alternative medical movements arose during this time.

Samuel Thomson, a self-trained root doctor from New Hampshire, believed that all disorders were caused by obstructed perspiration. He argued that fever was the body's effort to eliminate disease and that orthodox physicians, with their bleedings, blisterings, and use of drugs like mercury, arsenic, and antimony, were jeopardizing the lives of patients and causing many deaths. Thomson believed anyone could treat disease using six classes of remedies consisting of botanical drugs and the steam bath, all designed to produce great internal heat, eliminate the cold, and allow the body to reestablish its natural balance. Thomson wrote a popular book, prepared kits of his medicine, sold individual rights to his practice, and encouraged followers to defeat or repeal medical licensure laws that restricted the practice of medicine to formally trained physicians. Although Thomson was antiprofessional, other alternative groups that employed a wider range of botanical drugs emerged, including Eclectic Medicine, which established schools, journals, and hospitals and won status for its practitioners as physicians.

The second major group of medical reformers, part of the so-called popular health movement, believed that physicians were largely unnecessary because most diseases could be prevented by individuals adopting healthy habits. The most prominent American lecturer and writer in this movement, Sylvester Graham, maintained that disease resulted from excessive stimulation of the tissues. Any food that caused too much stimulation had to be avoided, including tea, coffee, alcohol, pastries, and all fleshy meats. Graham also used the doctrine of overstimulation to warn of the powerful dangers of too much sexual energy. Eating meat, he argued, produced a heightened sex drive, which was health destroying. One of his innovations was a cracker that still bears his name, which was initially designed in part to discourage overstimulation of this type.

The most significant European import during this era was homeopathy, a system of practice originated by the German physician Samuel Hahnemann. Brought to America in the 1820s, homeopathy encompassed two essential principles. The first principle was that the drug best able to cure a given illness would be that which could produce the symptoms of that illness in a healthy person. The second principle was that the smaller the dose, the more powerful the effect. One active part per hundred was shaken in a vial, and one part of that solution was mixed with another ninety-nine inactive parts, and so on, usually thirty times. By the end of the nineteenth century, homeopaths constituted 10 percent and the eclectics 5 percent of the physician and surgeon population in the United States.

The Era of Populism

Midwestern populism encompassed a distrust of large East Coast–controlled businesses and institutions, a belief that elites had gained too much power, and a sense that common people had too little say in shaping government and law in their own interests. As opposed to Jacksonian Democracy, many populists were not against creating laws governing the professions as long as the interests of competing groups were protected. In the 1870s and 1880s, new medical licensure laws were enacted; however, homeopathic and eclectic physicians were given the same rights as orthodox physicians. Challenging this hegemony were two groups—osteopathy and chiropractic.

Osteopathy was founded by Andrew Taylor Still, an apprenticeship-trained Midwestern physician. Still, who had practiced for a time as a bonesetter, believed that disease was the result of an obstruction or imbalance of the fluids caused by misplaced bones, particularly of the spinal column. These misplacements could be corrected through physical manipulation. He established an infirmary and school in Kirksville, Missouri, in 1892. Still's followers relatively quickly gained some measure of legal protection, established other colleges, and gradually expanded osteopathy's scope of practice to incorporate drugs and surgery. Eventually, D.O.s (doctors of osteopathic medicine) won equal rights along with M.D.s as full-fledged physicians and surgeons in every state and equal recognition by the federal government. As homeopathic and eclectic medicine faded after the beginning of the twentieth century, osteopathy became, and remained, the only equivalent professional rival of allopathic medicine, although the differences between the two groups have faded considerably.

Chiropractic appeared within a decade of the emergence of osteopathy and was founded in Davenport, Iowa, by Daniel David Palmer. Like Still, Palmer believed that diseases were due to misplaced bones. Many early chiropractors or D.C.s (doctors of chiropractic) were initially charged with practicing osteopathy without a license, but they demonstrated to courts and eventually legislatures that their diagnostic and treatment techniques were different. Unlike osteopathic physicians, who grew to encompass the full range of medical training and skills, chiropractors, despite the addition of some adjuncts, continued to center their activities on spinal manipulation and quickly became associated in the public mind with that technique, though osteopathy had historical priority.

"New Age" Thought

Fueled by America's continued participation in the Vietnam War and frustration with the perceived failure of government to produce meaningful change consistent with their own beliefs, a growing number of middle-class Americans in the 1970s shifted their attention from reforming society by legislative action to focusing on the potential for personal improvement. Drawing upon the rich traditions of other cultures, and often incorporating metaphysical and spiritual understandings of the basis and meaning of life, millions of Americans turned to a variety of disparate health beliefs and practices, including traditional Chinese and Ayurvedic medicine; crystals and scented candles; rolfing and other body treatments; imaging and other psychological interventions; alternative diets; herbs, vitamins, and other supplements; and a rediscovery of homeopathic and botanical remedies. By the end of the twentieth century, more money was spent by Americans on alternative practitioners and remedies than on visits to the offices of conventional primary care physicians.

This movement also reflected a growing frustration with the way orthodox medicine was practiced. Too little time was spent listening to patients, and while science had contributed to the treatment of acute diseases, many patients with chronic illnesses wanted more relief from their conditions than conventional physicians could provide. The number of alternative treatments that became available provided patients with new choices and new hopes. Experience by physicians with some of these modalities, and later research indicating value in some forms of alternative treatment, encouraged a growing number of conventionally trained physicians to incorporate these methods under the banner of "holistic" or "integrative" medicine. The continued popularity of these most recent forms of alternative medicine will, as in earlier periods, depend not only on the perceived efficacy of the respective practices over time but also on the broader social trends and ideologies that facilitated the emergence and growth of these practices.

BIBLIOGRAPHY

Berman, Alex, and Michael A. Flannery. America's Botanico-Medical Movements: Vox Populi. New York: Pharmaceutical Products Press, 2001.

Gevitz, Norman. The D.O.'s: Osteopathic Medicine in America. Baltimore: Johns Hopkins University Press, 1991.

———, ed. Other Healers: Unorthodox Medicine in America. Baltimore: Johns Hopkins University Press, 1988.

Haller, John S. Medical Protestants: The Eclectics in American Medicine, 1825–1939. Carbondale: Southern Illinois University Press, 1994.

Kaufman, Martin. Homeopathy in America: The Rise and Fall of a Medical Heresy. Baltimore: Johns Hopkins University Press, 1971.

McGuire, Meredith. Ritual Healing in Suburban America. New Brunswick, N.J.: Rutgers University Press, 1988.

Moore, J. Stuart. Chiropractic in America: The History of a Medical Alternative. Baltimore: Johns Hopkins University Press, 1993.

Whorton, James C. Crusaders for Fitness: The History of American Health Reformers. Princeton, N.J.: Princeton University Press, 1982.

NormanGevitz

See alsoHomeopathy ; Medical Profession ; Medicine and Surgery ; New Age Movement .

Alternative medicine

Alternative medicine is the practice of techniques to treat and prevent disease that are not generally accepted by conservative modern Western medicine. These techniques include homeopathy, acupuncture, herbal medicine, yoga, meditation, chiropractic, massage therapy, biofeedback, naturopathy, and many others. Although some of these forms such as yoga, meditation, and acupuncture have been practiced for centuries in many cultures, the U.S. medical community has been slow to acknowledge their benefits.

With an increased emphasis on disease prevention in recent years, many people have looked to alternative forms of medicine for drug-free approaches to achieving and maintaining good health. Alternative medicine allows people a measure of participation and control in their own well-being, as many of the practices can be taught and self-administered. Some people have turned to alternative medicine in search of treatment or cures for illnesses such as cancer, AIDS (acquired immunodeficiency syndrome), arthritis, and heart disease.

Relaxation techniques

Relaxation techniques help promote sleep, reduce stress, and alleviate pain. Controlled breathing is the simplest form of relaxation and consists of sitting or lying in a quiet place and breathing slowly in through the nose and out through the mouth. An advantage of this technique is that, if needed, it can be performed at any time, in any location, to produce relaxation.

Progressive relaxation therapy is a method of relieving muscle tension. Quietly lying on one's back and focusing on a particular region of the body such as the face, the individual consciously relaxes the muscles in that area. Moving through each part of the body, the individual repeats the process until all the body's muscles are relaxed.

The ancient practice of yoga incorporates relaxation, deep breathing, and postures (placing the body in certain positions) to relieve stress, improve blood circulation, and strengthen the body. Regular practice of yoga has been shown to be helpful in reducing the symptoms of many ailments from depression to heart disease.

Meditation is a method of relaxation in which a person concentrates his mind on a single thing such as an image, a word or phrase repeated silently, or the pattern of his breath. Meditation is usually practiced in a sitting position with the eyes closed and the back held straight. Its immediate benefits are reduced stress and anxiety, lowered blood pressure, and a slower rate of breathing. The daily practice of meditation over a long period of time has been shown to strengthen the body's ability to fight disease.

Biofeedback is a relaxation technique in which an individual learns to consciously control certain body functions—for example, blood pressure. The individual is connected by electrodes to a machine that responds to body signals (blood pressure in this case) by beeping. Increased blood pressure results in a faster series of beeps, which slow as blood pressure decreases. As the beeps slow down, the person realizes that the blood pressure has decreased and tries to remember the relaxed state that created the change. The ultimate goal is to be able to recreate the relaxed state that lowered blood pressure—without the aid of signals. Biofeedback has been used to treat migraines, to improve digestion, to lower heart rate, and to relieve pain. It has also been used to regain some control of muscles in persons who are partially paralyzed.

Hypnotherapy is the use of hypnosis to help a person gain control over stress, pain, and bad habits such as smoking and overeating. It is also sometimes used in medicine to block the sensation of pain during medical procedures and in psychotherapy to assist patients in recalling traumatic events. Under the guidance of a hypnotherapist, the person enters a trancelike state during which his subconscious mind responds to the suggestions of the therapist. The person can be taught to recreate the deeply relaxed state he experienced while under hypnosis and to use it on his own to overcome pain, control eating and smoking habits, and reduce stress.

Visualization and guided imagery are additional relaxation techniques that involve focusing the mind on specific images. With eyes closed, the person pictures in his mind a peaceful image or scene and concentrates on the sights, sounds, and smells that make the image soothing. Visualization is sometimes used as a supplemental treatment for patients with cancer or other serious and painful diseases. Guided by a therapist, the patient may visualize his body fighting the disease. This technique has been credited with bringing about physical healing in some cases.

Massage therapy is a method of achieving relaxation by applying pressure to and kneading the muscles of the body. Under the hands of a skilled massage therapist, this relaxation technique can temporarily relieve muscle tension and mental stress.

Chiropractic

Chiropractic is a medical practice founded on the theory that human disease is caused by impaired nerve functioning. This impairment stems from the vertebrae of the spine shifting from their normal place and putting pressure on the spinal nerves. To treat a patient, the chiropractor massages and manipulates the vertebrae back to their proper position.

Holistic medicine

Holistic medicine is an approach to health care that takes into consideration the whole person in the treatment and prevention of disease. According to practitioners of the holistic approach, a person's physical, mental, emotional, and spiritual states must all be in harmony for optimal health. Many licensed doctors practice holistic medicine, and they may include alternative forms of therapy in place of or in addition to traditional forms in treating patients.

Herbal medicine

Herbal medicine uses herbal remedies composed of plant substances to treat illness. Herbs have been used for centuries in most cultures of the world, and many drugs used in modern Western medicine are derived from plants. Herbal remedies can be taken as capsules or as tinctures (plant extracts in alcohol). Fresh or dried herbs can be brewed for teas, applied directly, or mixed with water and used as pastes to treat skin disorders. Herbal remedies are often prescribed by alternative medical practitioners as part of a treatment program that includes proper diet, exercise, and relaxation techniques.

Homeopathy

Homeopathy is a term derived from the Greek words meaning "similar suffering." A system of medicine developed over 200 years ago, homeopathy is based upon the principle that "like cures like." To treat a disease or disorder, the homeopath practitioner prescribes a remedy (an extract of plant, mineral, or animal substances) that produces the same symptoms the patient is experiencing. The remedy would make a healthy person sick, but in a sick person the remedy is thought to stimulate the body's natural defenses and promote healing.

In homeopathy, it is believed that each individual's illness is unique to that person, and both the person's physical and mental states are considered before prescribing a remedy. Like many other alternative medicine practices, homeopathy treats the body and mind as one; what affects one affects the other.

Acupuncture and Acupressure

Acupuncture is a technique developed by the ancient Chinese in which very thin needles are inserted through the skin at specific points of the body to relieve pain, cure disease, or provide anesthesia for surgery. The technique is one element of traditional Chinese medicine, which also includes herbal remedies, massage therapy, and a healthful diet. Acupuncture is practiced in the United States by both medical doctors and licensed practitioners, although its use by physicians is mostly limited to pain relief.

According to Chinese belief, lines or channels of energy cover the body and flow through it. The presence of illness or disease indicates that the flow of energy is blocked. Inserting fine needles at precise points along the channels removes the blockage, restoring the free flow of energy and allowing the internal organs to correct imbalances in their functioning.

Acupressure, also called shiatsu in Japan, is an ancient Chinese method of improving a person's health by applying pressure to specific points on the body. Acupressure uses the same channels of energy flow as acupuncture but does not break the skin. Instead, the acupressure practitioner applies pressure using the fingertips or knuckles to loosen muscles and improve circulation.

Homeopathy is a respected and approved medical practice in parts of Europe, Latin America, India, Greece, South America, and South Africa. In the United States, homeopathy has only begun to be accepted by the mainstream medical community, with some physicians using it along with traditional medicine to treat their patients. The production of homeopathic remedies is regulated by the Food and Drug Administration, and the remedies are available in many natural food stores.

Naturopathy

Founded in the early part of the twentieth century, naturopathy is a system of healing disease using natural means. This drug-free method of treating patients relies on natural means such as manual manipulation, homeopathy, herbal medicine, hydrotherapy (water therapy), massage, exercise, and nutrition. The body's power to heal is acknowledged to be a powerful process that the practitioner, or naturopath, seeks to enhance using all-natural remedies that appear to help the patient.

Naturopaths are trained practitioners who diagnose and treat disease and are licensed in a number of states. They are specialists in preventive medicine who teach patients how to live in ways that maintain good health. Naturopaths sometimes work with physicians to help patients recover from major surgery. Although naturopathy is not widely accepted in the medical community, some physicians are also naturopaths.

Alternative Medicine

EAT AND GET THIN

In the late 1990s it seemed everyone in the United States was trying to lose weight, and the preferred diet of the era was a high-protein, low-carbohydrate regime. Popularized by "the diet doctor," Dr. Robert C. Atkins, and his best-selling books, the diet did not limit the amount a person could eat. He maintained that by changing what people ate they could change their metabolism so that fat stores were mobilized and consumed, and weight loss would occur in the absence of limited portions or hunger.

The fundamental concept is that carbohydrates disrupt the balance of sugars and the natural hormone, insulin, which regulates them, thus promoting fat storage and weight gain. By eliminating carbohydrates the body goes into ketosis with resulting weight loss. Nutritionists and physicians questioned the safety of the low-carbohydrate plans. The absence of fiber found in cereals or vegetables, for example, caused bowel disturbances in some dieters. Cardiologists voiced concern with a diet that is high in meat, cheese, eggs, and cream. Atkins maintained that those who followed his regime would experience a lowering of their serum lipids and an improvement in high-to-low density ratios. He also argued that much of the criticism came from economic interests, because many of the foods used in his diet meant minimal profits to the food industry.

The benefits of Atkins's diet were inconclusive. There was no research to indicate that the diet kept weight off. Even Atkins admitted that there were no long-term weight loss studies of his diet—and losing weight and keeping it off are really two different problems.

Source:

Carole Sugarman, "Eat Fat, Get Thin?" Washington Post Health Magazine (23 November 1999): 11-14.

No Doctors

Various alternative medicines and remedies became popular during the 1990s, some of which faded from view as rapidly as they entered the popular consciousness. Because they were classified by the Food and Drug Administration (FDA) as tood supplements rather than medications, they received no federal approval and could be purchased without a prescription. Melatonin, a naturally occurring inexpensive sleep medicine, took the nation by storm in 1995 as a remedy for jet lag. Herbal medicines such as St. John's Wort (for depression), ginkgo biloba (for Alzheimer's disease), milk thistle (for liver disease), saw palmetto (for prostate problems), or Garcinia cambogia (for weight loss) flooded the market, The manufacturers of Metabolife, a weight-loss product, saw sales zoom to close to $1 billion in 1999 in spite of concerns by physicians that some of its components might be dangerous without proper monitoring. Though Americans spent as much as $27 billion a year on herbal remedies, the major drug companies showed little interest since the naturally occurring ingredients could not be patented. As a result, research lagged far behind the enthusiasm for natural, but often potent and sometimes dangerous, remedies.

Muscle Drugs

Herbal formulas such as creatine also gained popularity among some athletes. When Mark McGuire hit his record-breaking seventieth home run in 1998, he was taking a supplement, androstenedione, to build his muscles. He stopped taking the medication after the 1998 season, however, and had almost as good a year in 1999 without it. He ceased using the supplement in order not to encourage its use by young athletes. Phoenix Suns forward Tom Gugliotta's seizure and respiratory arrest was attributed to the use of an over-the-counter herbal supplement containing gamma butyrolactone, which supposedly hastens muscle recovery and serves as a sleep aid.

Yoga and Touch

Traditional forms of nonmedical treatment also gained in popularity, Massage, or touch therapy, was reputed to help not only muscle aches and pains, but also to reduce blood pressure, improve the immune system, and raise levels of the mood-elevating brain chemical serotonin. Though less risky than some supplements, not all of the claims of its enthusiasts could be supported. Emily Rosa, a fourth-grade student in Colorado, did an experiment that was reported in The Journal of the American Medical Association, debunking the idea that an energy field is generated by therapeutic touch. Acupuncture, on the other hand, was found to be effective by a National Institute of Health (NIH) panel in treating painful disorders of the muscles and skeletal system.

Insurance

Dr. Dean Ornish of Sausalito, California, believed that even blocked arteries could be opened without surgery, using a regime of meditation, yoga, group support, and a low-fat vegetarian diet. His documented results are so good that forty major insurance companies decided to cover the program as an alternative to surgery. His program cost $5,500 rather than the $15,000 for an angioplasty or $40,000 for bypass surgery. Insurance companies that had been reluctant to pay for alternative therapies became more enthusiastic when they discovered that they usually cost far less than traditional medicine and surgery. The Health Care Financing Administration (HCFA) in the Department of Health and Human Services (HHS) began funding a demonstration study in late 1999 to determine if Medicare coverage of the program would save that program money. Chiropractic care, long despised by physicians and insurance companies, also came to be covered by many insurance companies, though often under state mandate. A few insurance companies also covered acupuncture.

Sources:

Geoffrev Cowley, "Healers," Newsweek, 131 (16 March 1998): 50-54.

Cowley, "Melatonin," Newsweek, 126 (7 August 1995): 46-49.

Cowley and Patricia King, "Going Mainstream," Newsweek, 125 (26 June 1995): 56-57.

Cowley and Jamie Reno, "Mad About Metabolife," Newsweek, 134 (4 October 1999): 52.

John Greenwald, "Herbal Healing," Time, 152 (23 November 1998): 60-67.

"Herbal Supplement Might be Factor in Gugliotta's Seizure," USA Today, 28 December 1999.

Michael D. Lemonick, "Emily's Little Experiment," Time, 151 (13 April 1998): 67.

Karen Springen and Marc Peyser, "The New Muscle Candy," Newsweek, 131(12 January l998):68.

Ann Underwood, "The Magic of Touch," Newsweek, 131 (6 April 1998): 71-72.

alternative medicine the treatment and prevention of disease by techniques that are regarded by modern Western medicine as scientifically unproven or unorthodox. The term alternative medicine can encompass a wide range of therapies, including chiropractic , homeopathy , naturopathy , acupuncture , herbal medicine , meditation, biofeedback , massage therapy, and various "new age" therapies such as guided imagery and naturopathy. Although many alternative therapies have long been widely employed in the treatment of disease, the scientifically oriented modern medical establishment has typically been skeptical about, and sometimes strongly opposed to, their use. Despite this, Americans spend billions of dollars on alternative treatments each year. In 1993 the U.S. National Institutes of Health established the Office of Alternative Medicine to examine the merits of such techniques. See also holistic medicine .

complementary medicine (kom-pli-ment-ări) n. various forms of therapy that are viewed as complementary to conventional medicine. Previously, complementary therapies were regarded as an alternative to conventional therapies, and the two types were considered to be mutually exclusive (hence the former names alternative medicine and fringe medicine). However, many practitioners now have dual training in conventional and complementary therapies. There is very limited provision for complementary medicine within the confines of the National Health Service. See acupuncture, aromatherapy, chiropractic, homeopathy, naturopathy, osteopathy, reflexology, reiki.

com·ple·men·ta·ry med·i·cine • n. any of a range of medical therapies that fall beyond the scope of scientific medicine but may be used alongside it in the treatment of disease and ill health. Examples include acupuncture and osteopathy. See also alternative medicine.

alternative medicine (awl-ter-nă-tiv) n. see complementary medicine.