"Disease Can Not Exist", October 1899 advertisement in the People's Home Journal for Weltmerism, a form of "magnetic healing"
The history of alternative medicine refers to the history of a group of diverse medical practices that were collectively promoted as "alternative medicine"
beginning in the 1970s, to the collection of individual histories of
members of that group, or to the history of western medical practices
that were labeled "irregular practices" by the western medical
establishment. It includes the histories of complementary medicine and of integrative medicine.
"Alternative medicine" is a loosely defined and very diverse set of
products, practices, and theories that are perceived by its users to
have the healing effects of medicine, but do not originate from evidence gathered using the scientific method, are not part of biomedicine, or are contradicted by scientific evidence or established science. "Biomedicine" is that part of medical science that applies principles of anatomy, physics, chemistry, biology, physiology, and other natural sciences to clinical practice, using scientific methods to establish the effectiveness of that practice.
Much of what is now categorized as alternative medicine was
developed as independent, complete medical systems, was developed long
before biomedicine and use of scientific methods, and was developed in
relatively isolated regions of the world where there was little or no
medical contact with pre-scientific western medicine, or with each
other's systems. Examples are Traditional Chinese medicine and the Ayurvedic medicine of India. Other alternative medicine practices, such as homeopathy,
were developed in western Europe and in opposition to western medicine,
at a time when western medicine was based on unscientific theories that
were dogmatically imposed by western religious authorities. Homeopathy
was developed prior to discovery of the basic principles of chemistry,
which proved homeopathic remedies contained nothing but water. But
homeopathy, with its remedies made of water, was harmless compared to
the unscientific and dangerous orthodox western medicine practiced at
that time, which included use of toxins and draining of blood, often resulting in permanent disfigurement or death. Other alternative practices such as chiropractic and osteopathic manipulative medicine,
were developed in the United States at a time that western medicine was
beginning to incorporate scientific methods and theories, but the
biomedical model was not yet totally dominant. Practices such as
chiropractic and osteopathic, each considered to be irregular by the
medical establishment, also opposed each other, both rhetorically and
politically with licensing legislation. Osteopathic practitioners added
the courses and training of biomedicine to their licensing, and licensed
Doctor of Osteopathic Medicine holders began diminishing use of the
unscientific origins of the field, and without the original practices
and theories, is now considered the same as biomedicine.
Until the 1970s, western practitioners that were not part of the
medical establishment were referred to "irregular practitioners", and
were dismissed by the medical establishment as unscientific or quackery. Irregular practice became increasingly marginalized as quackery
and fraud, as western medicine increasingly incorporated scientific
methods and discoveries, and had a corresponding increase in success of
its treatments. In the 1970s, irregular practices were grouped with
traditional practices of nonwestern cultures and with other unproven or
disproven practices that were not part of biomedicine, with the group
promoted as being "alternative medicine". Following the counterculture movement
of the 1960s, misleading marketing campaigns promoting "alternative
medicine" as being an effective "alternative" to biomedicine, and with
changing social attitudes about not using chemicals, challenging the
establishment and authority of any kind, sensitivity to giving equal
measure to values and beliefs of other cultures and their practices
through cultural relativism, adding postmodernism and deconstructivism
to ways of thinking about science and its deficiencies, and with
growing frustration and desperation by patients about limitations and
side effects of science-based medicine,
use of alternative medicine in the west began to rise, then had
explosive growth beginning in the 1990s, when senior level political
figures began promoting alternative medicine, and began diverting
government medical research funds into research of alternative,
complementary, and integrative medicine.
Alternative medicine
The concept of alternative medicine is problematic as it cannot exist
autonomously as an object of study in its own right but must always be
defined in relation to a non-static and transient medical orthodoxy. It also divides medicine into two realms, a medical mainstream and fringe, which, in privileging orthodoxy,
presents difficulties in constructing an historical analysis
independent of the often biased and polemical views of regular medical
practitioners.
The description of non-conventional medicine as alternative reinforces
both its marginality and the centrality of official medicine. Although more neutral than either pejorative or promotional designations such as “quackery” or “natural medicine”, cognate terms like “unconventional”, “heterodox”, “unofficial”, “irregular”, "folk", "popular", "marginal", “complementary”, “integrative” or “unorthodox” define their object against the standard of conventional biomedicine, entail particular perspectives and judgements, often carry moral overtones, and can be inaccurate.
Conventional medical practitioners in the West have, since the
nineteenth century, used some of these and similar terms as a means of
defining the boundary of "legitimate" medicine, marking the division between that which is scientific and that which is not. The definition of mainstream medicine, generally understood to refer to a system of licensed medicine which enjoys state and legal protection in a jurisdiction, is also highly specific to time and place. In countries such as India and China traditional systems of medicine, in conjunction with Western biomedical science, may be considered conventional and mainstream. The shifting nature of these terms is underlined by recent efforts to demarcate between alternative treatments on the basis of efficacy
and safety and to amalgamate those therapies with scientifically
adjudged value into complementary medicine as a pluralistic adjunct to
conventional practice. This would introduce a new line of division based upon medical validity.
Before the "fringe"
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"Marriage à la Mode, Plate 3, (The Scene with the Quack)" by William Hogarth, 1745
Prior to the nineteenth century European medical training and
practice was ostensibly self-regulated through a variety of antique
corporations, guilds or colleges. Among regular practitioners, university trained physicians formed a medical elite while provincial surgeons and apothecaries, who learnt their art through apprenticeship, made up the lesser ranks. In Old Regime France, licenses for medical practitioners were granted by the medical faculties
of the major universities, such as the Paris Faculty of Medicine.
Access was restricted and successful candidates, amongst other
requirements, had to pass examinations and pay regular fees. In the Austrian Empire medical licences were granted by the Universities of Prague and Vienna. Amongst the German states the top physicians were academically qualified and typically attached to medical colleges associated with the royal court. The theories and practices included the science of anatomy
and that the blood circulated by a pumping heart, and contained some
empirically gained information on progression of disease and about
surgery, but were otherwise unscientific, and were almost entirely
ineffective and dangerous.
Outside of these formal medical structures there were myriad
other medical practitioners, often termed irregulars, plying a range of
services and goods. The eighteenth-century medical marketplace, a period often referred to as the "Golden Age of quackery",
was a highly pluralistic one that lacked a well-defined and policed
division between "conventional" and "unconventional" medical
practitioners.
In much of continental Europe legal remedies served to control at least
the most egregious forms of "irregular" medical practice but the
medical market in both Britain and American was less restrained through
regulation. Quackery in the period prior to modern medical professionalisation
should not be considered equivalent to alternative medicine as those
commonly deemed quacks were not peripheral figures by default nor did
they necessarily promote oppositional and alternative medical systems.
Indeed, the charge of 'quackery', which might allege medical
incompetence, avarice or fraud, was levelled quite indiscriminately
across the varied classes of medical practitioners be they regular
medics, such as the hierarchical, corporate classes of physicians,
surgeons and apothecaries in England, or irregulars such as nostrum mongers, bonesetters and local wise-women.
Commonly, however, quackery was associated with a growing medical
entrepreneurship amongst both regular and irregular practitioners in the
provision of goods and services along with associated techniques of
advertisement and self-promotion in the medical marketplace. The constituent features of the medical marketplace during the eighteenth century were the development of medical consumerism
and a high degree of patient power and choice in the selection of
treatments, the limited efficacy of available medical therapies, and the absence of both medical professionalisation and enforced regulation of the market.
Medical professionalisation
In
the late eighteenth and nineteenth centuries regular and irregular
medical practitioners became more clearly differentiated throughout much
of Europe. In part, this was achieved through processes of state-sanctioned medical regulation.
The different types of regulatory medical markets created across
nineteenth-century Europe and America reflected differing historical
patterns of state formation.
Where states had traditionally enjoyed strong, centralised power, such
as in the German states, government more easily assumed control of the
medical regulation. In states that had exercised weaker central power and adopted a free-market
model, such as in Britain, government gradually assumed greater control
over medical regulation as part of increasing state focus on issues of public health. This process was significantly complicated in Britain by the enduring existence of the historical medical colleges. A similar process is observable in America from the 1870s but this was facilitated by the absence of medical corporations.
Throughout the nineteenth century, however, most Western states
converged in the creation of legally delimited and semi-protected
medical markets. It is at this point that an "official" medicine, created in cooperation with the state and employing a scientific rhetoric of legitimacy, emerges as a recognisable entity and that the concept of alternative medicine as a historical category becomes tenable.
France provides perhaps one of the earliest examples of the
emergence of a state-sanctioned medical orthodoxy – and hence also of
the conditions for the development of forms of alternative medicine –
the beginnings of which can be traced to the late eighteenth century.
In addition to the traditional French medical faculties and the complex
hierarchies of practitioners over which they presided, the state
increasingly supported new institutions, such as the Société Royale de
Médecine (Royal Society of Medicine) which received its royal charter in 1778, that played a role in policing medical practice and the sale of medical nostrums. This system was radically transformed during the early phases of the French Revolution
when both the traditional faculties and the new institutions under
royal sponsorship were removed and an entirely unregulated medical
market was created.
This anarchic situation was reformed under the exigencies of war when
in 1793 the state established national control over medical education;
under Napoleon in 1803 state-control was extended over the licensing of medical practitioners. This latter reform introduced a new hierarchical division between practitioners in the creation of a medical élite of graduate physicians and surgeons, who were at liberty to practice throughout the state, and the lowly officiers de santé who received less training, could only offer their services to the poor, and were restricted in where they could practice. This national system of medical regulation under state-control, exported to regions of Napoleonic conquest such as Italy, the Rhineland and the Netherlands, became paradigmatic in the West and in countries adopting western medical systems. While offering state protection to licensed doctors and establishing a medical monopoly in principal it did not, however, remove competition from irregular practitioners.
Nineteenth-century non-conventional medicine
From
the late eighteenth century and more robustly from the mid-nineteenth
century a number of non-conventional medical systems developed in the
West which proposed oppositional medical systems, criticised orthodox
medical practitioners, emphasised patient-centredness, and offered
substitutes for the treatments offered by the medical mainstream.
While neither the medical marketplace nor irregular practitioners
disappeared during the nineteenth century, the proponents of alternative
medical systems largely differed from the entrepreneurial quacks of the
previous century in eschewing showy self-promotion and instead adopting
a more sober and serious self-presentation.
The relationship between medical orthodoxy and heterodoxy was complex,
both categories contained considerably variety, were subject to
substantial change throughout the period, and the divisions between the
two were frequently blurred.
Many alternative notions grew out of the Lebensreform
movement, which emphasized the goodness of nature, the harms to
society, people, and to nature caused by industrialization, the
importance of the whole person, body and mind, the power of the sun, and
the goodness of "the old ways".
The variety of alternative medical systems which developed during
this period can be approximately categorised according to the form of
treatment advocated. These were: those employing spiritual or
psychological therapies, such as hypnosis (mesmerism); nutritional therapies based upon special diets, such as medical botanism; drug and biological therapies such as homeopathy and hydrotherapy; and, manipulative physical therapies such as osteopathy and chiropractic massage. Non-conventional medicine might define health in terms of concepts of balance and harmony or espouse vitalistic doctrines of the body. Illness could be understood as due to the accretion of bodily toxins and impurities, to result from magical, spiritual,
or supernatural causes, or as arising from energy blockages in the body
such that healing actions might constitute energy transfer from
practitioner to patient.
Mesmerism
Franz Anton Mesmer (1734–1815)
Mesmerism is the medical system proposed in the late eighteenth century by the Viennese-trained physician, Franz Anton Mesmer (1734–1815), for whom it is named. The basis of this doctrine was Mesmer's claimed discovery of a new aetherial fluid, animal magnetism,
which, he contended, permeated the universe and the bodies of all
animate beings and whose proper balance was fundamental to health and
disease. Animal magnetism was but one of series of postulated subtle fluids and substances, such as caloric, phlogiston, magnetism, and electricity, which then suffused the scientific literature. It also reflected Mesmer's doctoral thesis, De Planatarum Influxu ("On the Influence of the Planets"), which had investigated the impact of the gravitational effect of planetary movements on fluid-filled bodily tissues. His focus on magnetism and the therapeutic potential of magnets was derived from his reading of Paracelsus, Athanasius Kircher and Johannes Baptista van Helmont.
The immediate impetus for his medical speculation, however, derived
from his treatment of a patient, Franzisca Oesterlin, who suffered from
episodic seizures and convulsions
which induced vomiting, fainting, temporary blindness and paralysis.
His cure consisted of placing magnets upon her body which consistently
produced convulsive episodes and a subsequent diminution of symptoms.
According to Mesmer, the logic of this cure suggested that health was
dependent upon the uninterrupted flow of a putative magnetic fluid and
that ill health was consequent to its blockage. His treatment methods
claimed to resolve this by either directly transferring his own
superabundant and naturally occurring animal magnetism to his patients
by touch or through the transmission of these energies from magnetic
objects.
Caricature of a practitioner of animal magnetism treating a patient, c. 1780
By 1775 Mesmer's Austrian practice was prospering and he published the text Schrieben über die Magnetkur an einen auswärtigen Arzt which first outlined his thesis of animal magnetism.
In 1778, however, he became embroiled in a scandal resulting from his
treatment of a young, blind patient who was connected to the Viennese
court and relocated to Paris where he established a medical salon, "The
Society of Harmony", for the treatment of patients. Recruiting from a client-base drawn predominantly from society women of the middle- and upper-classes, Mesmer held group séances at his salubrious salon-clinic which was physically dominated by a large, lidded, wooden tank, known as the baquet, containing iron, glass and other material that Mesmer had magnetized and which was filled with "magnetized water".
At these sessions patients were enjoined to take hold of the metal rods
emanating from the tub which acted as a reservoir for the animal
magnetism derived from Mesmer and his clients.
Mesmer, through the apparent force of his will – not infrequently
assisted by an intense gaze or the administration of his wand – would
then direct these energies into the afflicted bodies of his patients
seeking to provoke either a "crisis" or a trance-like state; outcomes
which he believed essential for healing to occur.
Patient proclamations of cure ensured that Mesmer enjoyed considerable
and fashionable success in late-eighteenth-century Paris where he
occasioned something of a sensation and a scandal.
Popular caricature of mesmerism emphasised the eroticised nature
of the treatment as spectacle: "Here the physician in a coat of lilac or
purple, on which the most brilliant flowers have been painted in
needlework, speaks most consolingly to his patients: his arms softly
enfolding her sustain her in her spasms, and his tender burning eye
expresses his desire to comfort her". Responding chiefly to the hint of sexual impropriety and political radicalism imbuing these séances,
in 1784 mesmerism was subject to a commission of inquiry by a
royal-appointed scientific panel of the prestigious French Académie de
Médicine. Its findings were that animal magnetism had no basis in fact and that Mesmer's cures had been achieved through the power of suggestion.
The commission's report, if damaging to the personal status of Mesmer
and to the professional ambitions of those faculty physicians who had
adopted mesmeric practices,[n 5] did little to hinder the diffusion of the doctrine of animal magnetism.
1843 Punch magazine caricature depicting John Elliotson "playing the brain" of a working-class, mesmerised woman
In England mesmerism was championed by John Elliotson, Professor of Practical Medicine at University College London and the founder and president of the London Phrenological Society. A prominent and progressive orthodox physician, he was President of the Medico-Chirugical Society of London and an early adopter of the stethoscope in English medical practice.
He had been introduced to mesmerism in the summer of 1837 by the French
physician and former student of Mesmer, Dupotet, who is credited as the
most significant cross-channel influence on the development of
mesmerism in England.
Elliotson believed that animal magnetism provided the basis for a
consideration of the mind and will in material terms thus allowing for
their study as medical objects. Initially supported by The Lancet, a reformist medical journal,
he contrived to demonstrate the scientific properties of animal
magnetism as a physiological process on the predominantly female charity
patients under his care in the University College Hospital.
Working-class patients were preferred as experimental subjects to
exhibit the physical properties of mesmerism on the nervous system as,
being purportedly more animalistic and machine-like than their social
superiors, their personal characteristics were deemed less likely to
interfere with the experimental process.
He sought to reduce his subjects to the status of mechanical automata
claiming that he could, through the properties of animal magnetism and
the pacifying altered states of consciousness which it induced, "play"
their brains as if they were musical instruments.
Two Irish-born charity patients, the adolescent O'Key sisters,
emerged as particularly important to Elliotson's increasingly popular
and public demonstrations of mesmeric treatment. Initially, his
magnetising practices were used to treat the sisters' shared diagnosis
of hysteria and epilepsy in controlling or curtailing their convulsive
episodes. By the autumn of 1837 Elliotson had ceased to treat the O'Keys
merely as suitable objects for cure and instead sought to mobilise them
as diagnostic instruments.
When in states of mesmeric entrancement the O'Key sisters, due to the
apparent increased sensitization of their nervous system and sensory
apparatus, behaved as if they had the ability to see through solid
objects, including the human body, and thus aid in medical diagnosis. As
their fame rivalled that of Elliotson, however, the O'Keys behaved less
like human diagnostic machines and became increasingly intransigent to
medical authority and appropriated to themselves the power to examine,
diagnose, prescribe treatment and provide a prognosis.
The emergence of this threat to medical mastery in the form of a pair
of working-class, teenage girls without medical training aroused general
disquiet amongst the medical establishment and cost Elliotson one of
his early and influential supporters, the leading proponent of medical
reform, Thomas Wakley. Wakley, the editor of The Lancet,
had initially hoped that Elliotson's scientific experiments with animal
magnetism might further the agenda of medical reform in bolstering the
authority of the profession through the production of scientific truth
and, equally importantly in a period when the power-relations between
doctors and patients were being redefined, quiescent patient bodies.
Perturbed by the O'Key's provocative displays, Wakely convinced
Elliotson to submit his mesmeric practice to a trial in August 1838
before a jury of ten gentlemen during which he accused the sisters of
fraud and his colleague of gullibility.
Following a series of complaints issued to the Medical Committee of
University College Hospital they elected to discharge the O'Keys along
with other mesmeric subjects in the hospital and Elliotson resigned his
post in protest.
This set-back, while excluding Elliotson from the medical
establishment, ended neither his mesmeric career nor the career of
mesmerism in England. From 1842 he became an advocate of
phreno-mesmerism – an approach that amalgamated the tenets of phrenology with animal magnetism and that led to a split in the Phrenological Society. The following year he founded, together with the physician and then President of the Phrenological Society, William Collins Engledue, the principal journal on animal magnetism entitled The Zoist: A Journal of Cerebral Physiology and Mesmerism and their Application to Human Welfare, a quarterly publication which remained in print until its fifty-second issue in January 1856.
Mesmeric societies, frequently patronised by those among the scientific
and social elite were established in many major population centres in
Britain from the 1840s onwards.
Some sufficiently endowed societies, such as those in London, Bristol
and Dublin, Ireland, supported mesmeric infirmaries with permanent
mesmeric practitioners in their employ. Due to the competing rise of spiritualism and psychic research by the mid-1860s these mesmeric infirmaries had closed.
The First Operation under Ether,
painted by Robert Hinckley 1881–1896. This operation on the jaw of a
female patient took place in Boston on 19 October 1846. William Morton
acted as the anaesthetist and John Morrow was the surgeon
The 1840s in Britain also witnessed a deluge of travelling
magnetisers who put on public shows for paying audiences to demonstrate
their craft.
These mesmeric theatres, intended in part as a means of soliciting
profitable private clientele, functioned as public fora for debate
between skeptics and believers as to whether the performances were
genuine or constituted fraud.
In order to establish that the loss of sensation under mesmeric trance
was real, these itinerant mesmerists indulged in often quite violent
methods – including discharging firearms close to the ears of mesmerised
subjects, pricking them with needles, putting acid on their skin and
knives beneath their fingernails.
Such displays of the anaesthetic qualities of mesmerism inspired
some medical practitioners to attempt surgery on subjects under the
spell of magnetism.
In France, the first major operation of this kind had been trialled,
apparently successfully, as early as 1828 during a mastectomy procedure.
In Britain the first significant surgical procedure undertaken on a
patient while mesmerised occurred in 1842 when James Wombell, a labourer
from Nottingham, had his leg amputated.
Having been mesmerised for several days prior to the operation by a
barrister named William Topham, Wombell exhibited no signs of pain
during the operation and reported afterwards that the surgery had been
painless.
This account was disputed by many in the medical establishment who held
that Wombell had fraudulently concealed the pain of the amputation both
during and after the procedure. Undeterred, in 1843 Elliotson continued to advocate for the use of animal magnetism in surgery publishing Numerous Cases of Surgical Operation without Pain in the Mesmeric State.
This marked the beginning of a campaign by London mesmerists to gain a
foothold for the practice within British hospitals by convincing both
doctors and the general public of the value of surgical mesmerism.
Mesmeric surgery enjoyed considerable success in the years from 1842 to
1846 and colonial India emerged as a particular stronghold of the
practice; word of its success was propagated in Britain through the Zoist and the publication in 1846 of Mesmerism in India and its Practical Application in Surgery and Medicine
by James Esdaile, a Scottish surgeon with the East India Company and
the chief proponent of animal magnetism in the subcontinent.
Although a few surgeons and dentists had undertaken fitful
experiments with anaesthetic substances in the preceding years, it was
only in 1846 that use of ether in surgery was popularised amongst
orthodox medical practitioners.
This was despite the fact that the desensitising effects of widely
available chemicals like ether and nitrous oxide were commonly known and
had formed part of public and scientific displays over the previous
half-century.
A feature of the dissemination of magnetism in the New World was its increasing association with spiritualism. By the 1830s mesmerism was making headway in the United States amongst figures like the intellectual progenitor of the New Thought movement, Phineas Parkhurst Quimby, whose treatment combined verbal suggestion with touch. Quimby's most celebrated "disciple", Mary Baker Eddy, would go on to found the "medico-religious hybrid", Christian Science, in the latter half of the nineteenth century. In the 1840s the American spiritualist Andrew Jackson Davis
sought to combine animal magnetism with spiritual beliefs and
postulated that bodily health was dependent upon the unobstructed
movement of the "spirit", conceived as a fluid substance, throughout the
body. As with Quimby, Davis's healing practice involved the use of
touch.
Osteopathy and chiropractic manipulation
Deriving from the tradition of ‘bone-setting’ and a belief in the flow of supernatural energies in the body (vitalism), both osteopathy and chiropractic developed in the USA in the late 19th century. The British School of Osteopathy was established in 1917 but it was the 1960s before the first chiropractic college was established in the UK.
Chiropractic theories and methods (which are concerned with
subluxations or small displacements of the spine and other joints) do
not accord with orthodox medicine’s current knowledge of the
biomechanics of the spine. in addition to teaching osteopathic manipulative medicine
(OMM) and theory, osteopathic colleges in the US gradually came to have
the same courses and requirements as biomedical schools, whereby
osteopathic doctors (ODs) who did practice OMM were considered to be
practicing conventional biomedicine in the US. The passing of the
Osteopaths Act (1993) and the Chiropractors Act (1994), however, created
for the first time autonomous statutory regulation for two CAM
therapies in the UK.
History of chiropractic
Chiropractic began in the United States in 1895. when Daniel David Palmer
performed the first chiropractic adjustment on a partially deaf
janitor, who then claimed he could hear better as a result of the
manipulation. Palmer opened a school of chiropractic two years later. Chiropractic's early philosophy was rooted in vitalism, naturalism, magnetism, spiritualism and other unscientific constructs. Palmer claimed to merge science and metaphysics.
Palmer's first descriptions and underlying philosophy of chiropractic
described the body as a "machine" whose parts could be manipulated to
produce a drugless cure, that spinal manipulation could improve health,
and that the effects of chiropractic spinal manipulation as being
mediated primarily by the nervous system.
Despite their similarities, osteopathic practitioners sought to differentiate themselves by seeking regulation of the practices. In a 1907 test of the new law, a Wisconsin based chiropractor was charged with practicing osteopathic medicine without a license. Practicing medicine without a license led to many chiropractors, including D.D. Palmer, being jailed.
Chiropractors won their first test case, but prosecutions instigated
by state medical boards became increasingly common and successful.
Chiropractors responded with political campaigns for separate licensing
statutes, from osteopaths, eventually succeeding in all fifty states,
from Kansas in 1913 through Louisiana in 1974.
Divisions developed within the chiropractic profession, with "mixers" combining spinal adjustments with other treatments, and "straights" relying solely on spinal adjustments. A conference sponsored by the National Institutes of Health in 1975 spurred the development of chiropractic research. In 1987, the American Medical Association called chiropractic an "unscientific cult" and boycotted it until losing a 1987 antitrust case.
Histories of individual traditional medical systems
Ayurvedic medicine
Ayurveda or ayurvedic medicine
has more than 5,000 years of history, now re-emerging as texts become
increasingly accessible in modern English translations. These texts
attempt to translate the Sanskrit versions that have remained hidden in
India since British occupation from 1755–1947.
As modern archaeological evidence from Harappa and Mohenja-daro is
distributed, Ayurveda has now been accepted as the world's oldest
concept of health and disease discovered by man and the oldest
continuously practiced system of medicine. Ayurveda is a world view that
advocates man’s allegiance and surrender to the forces of Nature that
are increasingly revealed in modern physics, chemistry and biology. It
is based on an interpretation of disease and health that parallels the
forces of nature, observing the sun's fire and making analogies to the
fires of the body; observing the flows in Nature and describing flows in
the body, terming the principle as Vata; observing the transformations
in Nature and describing transformations in the body, terming the
principle as Pitta; and observing the stability in Nature and describing
stability in the body, terming the principle as Kapha.
Ayurveda can be defined as the system of medicine described in
the great medical encyclopedias associated with the names Caraka,
Suśruta, and Bheḷa, compiled and re-edited over several centuries from
about 200 BCE to about 500 CE and written in Sanskrit. These discursive writings were gathered and systematized in about 600 CE by Vāgbhaṭa, to produce the Aṣṭāṅgahṛdayasaṃhitā ('Heart of Medicine Compendium') that became the most popular and widely used textbook of ayurvedic medicine in history. Vāgbhaṭa's work was translated into many other languages and became influential throughout Asia.
Its prehistory goes back to Vedic culture and its proliferation in written form flourished in Buddhist times. Although the hymns of the Atharvaveda and the Ṛgveda
mention some herbal medicines, protective amulets, and healing prayers
that recur in the ciphered slokas of later ayurvedic treatises, the
earliest historical mention of the main structural and theoretical
categories of ayurvedic medicine occurs in the Buddhist Pāli Tripiṭaka, or Canon.
Ayurveda originally derived from the Vedas, as the name suggests,
and was first organized and captured in Sanskrit in ciphered form by
physicians teaching their students judicious practice of healing. These
ciphers are termed slokas and are purposefully designed to include
several meanings, to be interpreted appropriately, known as 'tantra
yukti' by the knowledgeable practitioner. Ayu means longevity or healthy
life, and veda means human-interpreted and observable truths and
provable science. The principles of Ayurveda include systematic means
for allowing evidence, including truth by observation and
experimentation, pratyaksha; attention to teachers with sufficient
experience, aptoupadesha; analogy to things seen in Nature, anumana; and
logical argument, yukti.
It was founded on several principles, including yama (time) and
niyama (self-regulation) and placed emphasis on routines and adherence
to cycles, as seen in Nature. For example, it directs that habits should
be regulated to coincide with the demands of the body rather than the
whimsical mind or evolving and changing nature of human intelligence.
Thus, for the follower of ayurvedic medicine, food should only be taken
when they are instinctively hungry rather than at an arbitrarily set
meal-time. Ayurveda also teaches that when a person is tired, it is not
wise to eat food or drink, but to rest, as the body's fire is low and
must gather energy in order to alight the enzymes that are required to
digest food. The same principles of regulated living, called Dinacharya,
direct that work is the justification for rest and in order to get
sufficient sleep, one should subject the body to rigorous exercise.
Periodic fasting, or abstaining from all food and drink for short
durations of one or two days helps regulate the elimination process and
prevents illness. It is only in later years that practitioners of this
system saw that people were not paying for their services, and in order
to get their clients to pay, they introduced herbal remedies to begin
with and later even started using metals and inorganic chemical
compositions in the form of pills or potions to deal with symptoms.
Emigration from the Indian sub-continent in the 1850s brought practitioners of Ayurveda (‘Science of Life’). a medical system dating back over 2,500 years,
its adoption outside the Asian communities was limited by its lack of
specific exportable skills and English-language reference books until
adapted and modernised forms, New Age Ayurveda and Maharishi Ayurveda,
came under the umbrella of CAM in the 1970s to Europe.
In Britain, Unani practitioners are known as hakims and Ayurvedic
practitioners are known as vaidyas. Having its origins in the Ayurveda, Indian Naturopathy
incorporates a variety of holistic practices and natural remedies and
became increasingly popular after the arrival of the post-Second World
War wave of Indian immigrants.[citation needed] The Persian work for Greek,Unani
medicines uses some similar materials as Ayurveda but are based on
philosophy closer to Greek and Arab sources than to Ayurveda.
Exiles fleeing the war between Yemen and Aden in the 1960s settled
nearby the ports of Cardiff and Liverpool and today practitioners of
this Middle Eastern medicine are known as vaids..
In the US, Ayurveda has increased popularity since the 1990s, as
Indian-Americans move into the mainstream media, and celebrities visit
India more frequently. In addition, many Americans go to India for
medical tourism to avail of reputed Ayurvedic medical centers that are
licensed and credentialed by the Indian government and widely legitimate
as a medical option for chronic medical conditions. AAPNA, the
Association of Ayurvedic Professionals of North America, www.aapna.org,
has over 600 medical professional members, including trained vaidyas
from accredited schools in India credentialed by the Indian government,
who are now working as health counselors and holistic practitioners in
the US. There are over 40 schools of Ayurveda throughout the US,
providing registered post-secondary education and operating mostly as
private ventures outside the legitimized medical system, as there is no
approval system yet in the US Dept of Education. Practitioners
graduating from these schools and arriving with credentials from India
practice legally through the Health Freedom Act, legalized in 13 states.
Credentialing and a uniform standard of education is being developed by
the international CAC, Council of Ayurvedic Credentialing,
www.cayurvedac.com,
in consideration of the licensed programs in Ayurveda operated under
the Government of India's Ministry of Health and Family Welfare, Dept of
AYUSH. In India, there are over 600,000 practicing physicians of
Ayurveda. Ayurveda is a legal and legitimate medical system in many
countries of South Asia.
Chinese culture
Traditional Chinese medicine has more than 4,000 years of history as a system of medicine that is based on a philosophical concept of balance ( yin and yang, Qi, Blood, Jing, Bodily fluids, the Five Elements, the emotions, and the spirit) approach to health that is rooted in Taoist philosophy and Chinese culture. As such, the concept of it as an alternative form of therapeutic practise is only found in the Western world.
The arrival into Britain of thousands of Chinese in the 1970s introduced Traditional Chinese Medicine – a system dating back to the Bronze Age or earlier that used acupuncture, herbs, diet and exercise. Today there are more than 2,000 registered practitioners in the UK.
Since the 1970s
Until
the 1970s, western practitioners that were not part of the medical
establishment were referred to "irregular practitioners", and were
dismissed by the medical establishment as unscientific or quackery.[1] Irregular practice became increasingly marginalized as quackery
and fraud, as western medicine increasingly incorporated scientific
methods and discoveries, and had a corresponding increase in success of
its treatments. In the 1970s, irregular practices were grouped with
traditional practices of nonwestern cultures, and with other unproven or
disproven practices that were not part of biomedicine, and the entire
group began to be marketed and promoted as "alternative medicine". Following the counterculture movement
of the 1960s, misleading marketing campaigns promoting "alternative
medicine" as an effective "alternative" to biomedicine, and with
changing social attitudes about not using chemicals, challenging the
establishment and authority of any kind, sensitivity to giving equal
measure to values and beliefs of other cultures and their practices
through cultural relativism, adding postmodernism and deconstructivism
to ways of thinking about science and its deficiencies, and with
growing frustration and desperation by patients about limitations and
side effects of science-based medicine,
use of alternative medicine in the west began to rise, then had
explosive growth beginning in the 1990s, when senior level political
figures began promoting alternative medicine, and began diverting
government medical research funds into research of alternative,
complementary, and integrative medicine.
1970s through 1980s
1990s to present
Sen. Tom Harkin at a press conference.
In 1991, after United States Senator Thomas Harkin became convinced his allergies were cured by taking bee pollen
pills, he used $2 million of his discretionary funds to create the
Office of Alternative Medicine (OAM), to test the efficacy of
alternative medicine and alert the public as the results of testing its
efficacy.
The OAM mission statement was that it was “dedicated to exploring
complementary and alternative healing practices in the context of
rigorous science; training complementary and alternative medicine
researchers; and disseminating authoritative information to the public
and professionals.” Joseph M. Jacobs
was appointed the first director of the OAM in 1992. Jacobs' insistence
on rigorous scientific methodology caused friction with Senator Harkin.
Harkin criticized the "unbendable rules of randomized clinical trials"
and, citing his use of bee pollen to treat his allergies, stated: "It is
not necessary for the scientific community to understand the process
before the American public can benefit from these therapies."
Increasing political resistance to the use of scientific methodology
was publicly criticized by Dr. Jacobs and another OAM board member
complained that “nonsense has trickled down to every aspect of this
office”. In 1994, Senator Harkin responded by appearing on television
with cancer patients who blamed Dr. Jacobs for blocking their access to
untested cancer treatment, leading Jacobs to resign in frustration. The
OAM drew increasing criticism from eminent members of the scientific
community, from a Nobel laureate criticizing the degrading parts of the
NIH to the level a cover for quackery, and the president of the American Physical Society
criticizing spending on testing practices that “violate basic laws of
physics and more clearly resemble witchcraft”. In 1998, the President of
the North Carolina Medical Association publicly called for shutting down the OAM. The NIH Director placed the OAM under more strict scientific NIH control.
In 1998, Sen. Harkin responded to the criticism and stricter
scientific controls by the NIH, by raising the OAM to the level of an
independent center, increasing its budget to $90 million annually, and
renaming it to be the National Center for Complementary and Alternative Medicine
(NCCAM). The United States Congress approved the appropriations without
dissent. NCCAM had a mandate to promote a more rigorous and scientific
approach to the study of alternative medicine, research training and
career development, outreach, and integration. In 2014 the agency was
renamed to the National Center for Complementary and Integrative Health
(NCCIH). The NCCIH charter requires that 12 of the 18 council members
shall be selected with a preference to selecting leading representatives
of complementary and alternative medicine, 9 of the members must be
licensed practitioners of alternative medicine, 6 members must be
general public leaders in the fields of public policy, law, health
policy, economics, and management, and 3 members must represent the
interests of individual consumers of complementary and alternative
medicine.
By 2009, the NCCIH budget had grown from annual spending of about
$2 million at its inception, to $123 million annually. In 2009, after a
history of 17 years of government testing produced almost no clearly
proven efficacy of alternative therapies, Senator Harkin complained,
“One of the purposes of this center was to investigate and validate
alternative approaches. Quite frankly, I must say publicly that it has
fallen short. It think quite frankly that in this center and in the
office previously before it, most of its focus has been on disproving
things rather than seeking out and approving.”
Members of the scientific and biomedical communities complained that
after a history of 17 years of being tested, at a cost of over $2.5
Billion on testing scientifically and biologically implausible
practices, almost no alternative therapy showed clear efficacy.
From 1990 to 1997, use of alternative medicine in the US increased by 25%, with a corresponding 50% increase in expenditures. By 2013, 50% of Americans were using alternative medicine, and annual spending on CAM in the US was $34 Billion.
Other periods
The
terms ‘alternative’ and ‘complementary’ tend to be used interchangeably
to describe a wide diversity of therapies that attempt to use the
self-healing powers of the body by amplifying natural recuperative
processes to restore health. In ancient Greece the Hippocratic
movement, commonly regarded as the fathers of medicine, actually gave
rise to modern naturopathy and indeed much of today’s CAM.
They placed great emphasis on a good diet and healthy lifestyle to
restore equilibrium; drugs were used more to support healing than to
cure disease.
Complementary medicines have evolved through history and become
formalised from primitive practices; although many were developed during
the 19th century as alternatives to the sometimes harmful practices of
the time, such as blood-lettings and purgation. In the UK, the medical
divide between CAM and conventional medicine has been characterised by
conflict, intolerance and prejudice on both sides and during the early
20th century CAM was virtually outlawed in Britain: healers were seen as
freaks and hypnotherapists were subject to repeated attempts at legal
restriction.
The alternative health movement is now accepted as part of modern
life, having progressed from a grass-roots revival in the 1960s reacting
against environmental degradation, unhealthy diets and rampant
consumerism.
Until the arrival of the Romans in AD43, medical practices were
limited to a basic use of plant materials, prayers and incantations.
Having assimilated the corpus of Hippocrates, the Romans brought with
them a vast reparatory of herbal treatments and introduced the concept of the hospital as a centralised treatment centre. In Britain, hydrotherapy (the use of water either internally or externally to maintain health and prevent disease) can be traced back to Roman spas. This was augmented by practices from the Far East and China introduced by traders using the Silk Road.
During the Catholic and Protestant witch-hunts from the 14th to
the 17th centuries, the activities of traditional folk-healers were
severely curtailed and knowledge was often lost as it existed only as an
oral tradition. The widespread emigration from Europe to North America
in the 18th and 19th centuries included both the knowledge of herbalism
and some of the plants themselves. This was combined with Native
American medicine and then re-imported to the UK where it re-integrated
with the surviving herbal traditions to evolve as today’s medical herbalism movement.
The natural law of similia similibus curantur, or ‘like is cured
by like’, was recognised by Hippocrates but was only developed as a
practical healing system in the early 19th century by a German, Dr
Samuel Hahnemann. Homeopathy
was brought to the UK in the 1830s by a Dr Quinn who introduced it to
the British aristocracy, whose patronage continues to this day. Despite
arousing controversy in conventional medical circles, homeopathy is
available under the National Health Service, and in Scotland
approximately 25% of GPs hold qualifications in homeopathy or have
undergone some homeopathic training.
The impact on CAM of mass immigration into the UK is continuing into the 21st century. Originating in Japan, cryotherapy
has been developed by Polish researchers into a system that claims to
produce lasting relief from a variety of conditions such as rheumatism,
psoriasis and muscle pain. Patients spend a few minutes in a chamber cooled to −110 °C, during which skin temperature drops some 12 °C.
The use of CAM is widespread and increasing across the developed
world. The British are presented with a wide choice of treatments from
the traditional to the innovative and technological. Section 60 of the
Health Act 1999 allows for new health professions to be created by Order
rather than primary legislation.
This raises issues of public health policy which balance regulation,
training, research, evidence-base and funding against freedom of choice
in a culturally diverse society
Relativist perspective
The term alternative medicine refers to systems of medical thought and practice which function[citation needed] as alternatives to or subsist outside of conventional, mainstream medicine.
Alternative medicine cannot exist absent an established, authoritative
and stable medical orthodoxy to which it can function as an alternative.
Such orthodoxy was only established in the West during the nineteenth century through processes of regulation, association, institution building and systematised medical education.
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