Alternative Health Care

3. The Core of Alternative Medicine: Age-Old Wisdom Made New

3 The Core of Alternative Medicine Age-Old Wisdom Made New Attending an alternative medicine conference, scanning the titles shelved under the heading of alternative medicine in a "megastore," or "surfing the net" for sites related to alternative medicine can be both an overwhelming and a puzzling experience . The sheer volume ofwhat is readily available, no less its vague boundaries and overlapping categories, are, at best, confusing. Beyond the rhetorical titles of some of the most popillar works (Total Health; Everyday Miracles; Ageless Body) Timeless Mind), the wide range ofapproaches, techniques, and philosophies encompassed is striking. There are specific healing techniques such as aromatherapy, flower remedies, massage , guided imagery, and acupuncture. Then there are entire systems of medicine: Traditional Chinese Medicine (TCM), Ayurvedic medicine, naturopathy, homeopathy, and mindbody medicine, among others. And there are other things that woilld seem to be more than a specific technique but less than a fully developed system of medicine, such as qigong, yoga, and herbal medicine. Finally, there are the so-called "NewAge" phenomena like crystal healing and psychic healing, which defy simple classification. What, if anything, do these have in common? One thing they have in common is that they have typically not been taught about in American medical schools, not been utilized by most physicians and hospitals, and not reimbursed for by most in40 Copyrighted Material The Core ofAlternative Medicine 41 surance plans. A definition of alternative medicine based upon what it is notis therefore both accurate and convenient. It avoids the need to become embroiled in conceptual questions about the assumptions that underlie words like "health," "illness," and "healing." Not surprisingly, it is this straightforward empirical approach to defining alternative medicine that is used by the federal government and mainstream medicine. The Office of Alternative Medicine at the National Institutes of Health defines alternative medicine as "an unrelated group of nonorthodox therapeutic practices, often with explanatory systems that do not follow conventional biomedical explanations." In the study conducted by Daniel Eisenberg and his colleagues that appeared in the prestigious New EnglandJournal ofMedicine and is the most frequently cited academic report on the subject, alternative medicine was defined as "medical interventions not taught widely at u.s. medical schools or generally available at U.S. hospitals." Historically, there has been no alternative medicine, but rather many alternative medicines, each separate in its own mind. Practitioners of these alternative modes of care have often viewed each other competitively and acted accordingly, practicing in isolation from one another. Until recently, the various forms of alternative medicine had only been linked negatively by more conventional groups as health fraud or quackery. Organizations like the American Medical Association have been quite willing to describe the approaches now called "alternative medicine" as united by their ignorance, foolishness, and irrationality. But to define alternative medicine only by what it is not avoids important questions about its fundamental nature as well as that of mainstream medicine. The power, prestige, and authority, not to mention financial rewards, accrued by mainstream medicine have typically been justified by its practitioners as emerging from the application of scientific rationality to medical practice. Whatever is taught in medical school, or pracCopyrighted Material 42 Chapter Three ticed on patients, is assumed by the general public to have some scientific basis. Ifa specific technique can become "mainstream " simply by its inclusion in a mainstream institution such as a medical school, what role does that leave for scientific rationality as an arbiter? Accepting an exclusively residual definition of alternative medicine may be pragmatically useful, but it is not very helpful in understanding the larger questions about the differences between mainstream and alternative medicine. More importantly, for our purposes, accepting a residual definition alone makes it difficult to understand the growing power and popularity of those techniques and approaches that comprise alternative medicine. Ifthere are underlying themes within this cacophony of concepts, approaches, and techniques, then starting with the assumption that they do not exist will make them harder to find. There is no shortage of alternative medical practitioners who emphatically state that there are underlying commonalities to the wide range of alternative techniques. A number of earlier academic observers have been able to extract a coherent set of common themes from their studies of the topic. However , to specifY a conceptually cohesive set ofcommon elements does not necessarily indicate that they are apparent in the everyday practice of alternative medicine. Thus, in laying out the...