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Perspectives in Biology and Medicine 43.4 (2000) 502-518

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Why Not Call Modern Medicine "Alternative"?

Don G. Bates *

We call it "modern" medicine, "scientific" medicine, and "biomedicine," but if the term weren't already in use, we could just as reasonably call it "alternative" medicine. That only becomes obvious, though, if we look at the orthodox medicine of the 20th century in a broader historical and cultural context. That is what I am going to do in this article, as a way of thinking about where modern medicine is going, and whether it has anything to learn from alternative medicine. To do this, however, I am not going to compare alternative medicine with modern medicine directly. Instead, I will contrast what I call the "classical" with the "20th-century" paradigm [1, 2]. But first I need to explain what I mean by classical, 20th-century, and paradigm, and how each of these relate to the practices we conventionally call "alternative."

As is well known, the history of medicine in the West has its roots in fifth-century BCE classical Greece, a tradition which was still responsible for the dominant orthodoxy in Europe and North America just two centuries ago [3]. Although it varied over the centuries, it is still reasonable to call all of it Hippocratic or Galenic medicine, based as it was on the texts and traditions surrounding the Hippocratic corpus of writings from around 400 BCE, and those of his devoted follower, Galen, 600 years later. Admittedly, the so-called scientific revolution of the 17th century had a big impact on the understanding of how the healthy body works, but it had very little effect on the way that medicine was practiced [4].

In fact, a distant descendent of that Hippo-Galenic tradition--sometimes called "heroic" medicine 1 --was the orthodoxy of the day, when, in [End Page 502] the late 18th, but particularly early 19th centuries, some other forms of medicine began to appear: homeopathy, Thomsonianism, magnetic therapy, hydropathy, and later osteopathy, naturopathy, chiropractic, Christian Science, and the like--all in conscious opposition to that orthodoxy [5]. And it was this that gave rise to the label alternative, but alternative not so much to the new scientific medicine, which was only just developing, as to that earlier, heroic medicine, itself a version of the classical tradition. Moreover, that classical tradition became known as allopathy, initially to contrast it with homeopathy, but later, to distinguish heroic medicine from these various alternatives, in general.

So, first of all, it is this ancient Hippo-Galenic tradition, represented in the early 19th century by heroic medicine or allopathy that I am calling the classical paradigm. Nevertheless, I am going to argue that, despite their label, the alternative medicines maintained many similarities to the classical paradigm from which they were claiming to be different, while both alternatives and heroic medicine were radically different from the new medicine of the 20th century. Thus, I wish to claim, what we today call alternative medicines are really remnants of that classical paradigm, even though they started out claiming to be alternatives to it (and even if, since then, some of those so-called alternatives have evolved a bit from their 19th-century roots).

As for the 20th-century paradigm, what I mean is the medical model that began to evolve over the course of the 19th century, and that came to dominate all medical practice to an extraordinary degree in the first two-thirds to three-quarters of the century just finished. Thus, on the one hand, I am using 20th-century to cover modern, scientific, and bio-, but, on the other hand, I do not want the label to obscure the fact that public perceptions of that model have begun to change over the last two or three decades. For while the 20th-century model still overwhelmingly applies in practice, the public's attitude towards it does seem to be changing. More and more, the focus seems to be at least as much on the ways in which it falls short...


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