Alternative Medicine

Loren A. Backhaus

January 21, 1997

RECENT YEARS HAVE WITNESSED AN AMAZING ADVANCEMENT

IN THE POPULARITY OF ALTERNATIVE MEDICINE AS MORE AND MORE PEOPLE SEE THE BENEFITS OF NATURAL WAYS OF HEALING. ALSO PEOPLE ARE TRYING TO TAKE CONTROL OF THEIR OWN HEALTH.

LET'S BEGIN WITH A DEFINITION OF ALTERNATIVE MEDICINE. IN SIMPLEST TERMS, IT IS AN ALTERNATIVE FOR SO CALLED "CONVENTIONAL" OR ALLOPATHIC MEDICINE. ALTERNATIVE THERAPIES DO NOT NECESSARILY REPLACE CONVENTIONAL MEDICINE, BUT COMPLEMENT OR SUPPORT IT. COMMON EXAMPLES OF ALTERNATIVE MEDICINE INCLUDE SPECIAL DIETS, ACUPUNCTURE, MEDITATION, BIOFEEDBACK, CHIROPRACTIC AND YOGA. THESE WILL BE DISCUSSED IN MORE DETAIL LATER.

ABOUT ONE THIRD OF ADULT AMERICANS, MOST OF WHOM CONSULT MEDICAL DOCTORS AS WELL, SPEND AS ESTIMATED 12.7 BILLION DOLLARS A YEAR OUT OF THEIR OWN POCKETS ON A BEWILDERING ARRAY OF ALTERNATIVE TREATMENTS.

THE PHILOSOPHY OF ALTERNATIVE MEDICINE IS THAT IT TREATS NOTHING IN ISOLATION, STRESSING INSTEAD THE IMPORTANCE OF THE HOLISTIC OR WHOLE APPROACH. THIS APPROACH SEES THE

MIND AND BODY AS INSEPARABLE AND CAPABLE OF SELF-REPAIR IF THE INDIVIDUAL IS READY TO TAKE AN ACTIVE PART IN HIS

OR HER OWN HEALING AND GENERAL WELFARE. ON THE OTHER HAND, CONVENTIONAL MEDICINE HAS ALWAYS TENDED TO ISOLATE A PROBLEM AND TREAT IT, OFTEN WITHOUT ANY REFERENCE TO THE ROOT CAUSE OF THE PROBLEM. IT ALSO APPEARS THAT IN THE PAST CONVENTIONAL MEDICINE HAS IGNORED THE MOST IMPORTANT ASPECT

OF HEALING - THE UNTAPPED POWER OF POSITIVE THINKING AND

THE BODY'S INNATE ABILITY TO HEAL ITSELF. THERE ALSO APPEARS TO BE SOME BACKLASH AGAINST CONVENTIONAL MEDICINE BECAUSE

OF ITS TOP DOWN APPROACH IN WHICH THE PATIENT HAS LITTLE

INPUT.

THE OPTIMAL PURPOSE OF ALTERNATIVE MEDICINE IS FOR TREATING PSYCHOLOGICAL DISEASES OR DISEASES CAUSED BY SOCIAL PRESSURES. BY RELIEVING STRESS, ALTERNATIVE MEDICINE CAN PREVENT THE NEED TO TREAT THESE ILLNESSES IN THE FIRST PLACE. ANOTHER USE IS FOR TREATMENT OF CHRONIC PROBLEMS THAT CONVENTIONAL MEDICINE CANNOT CURE. EXAMPLES WOULD BE BACK PAIN, HEADACHE, OR IMMUNE-SYSTEM DEFICIENCIES THAT OFTEN DON'T RESPOND TO CONVENTIONAL THERAPIES. WHIPLASH PATIENTS ARE ALSO CANDIDATES FOR ALTERNATIVE MEDICINE TREATMENT.

ALTERNATIVE MEDICINE IS ALSO BEING USED MORE IN AREAS WHERE CONVENTIONAL MEDICINE IS SUSPECT. FOR EXAMPLE, THERE IS GROWING FEAR THAT THE OVERUSE OF ANTIBIOTICS WILL LEAD TO MORE DRUG-RESISTANT DISEASES. FOR YEARS DOCTORS HAVE TREATED EAR INFECTIONS IN CHILDREN WITH A REGIMEN OF ANTIBIOTICS. BUT, PEDIATRICIANS ALSO KNOW THAT IF LEFT UNTREATED, MOST EAR INFECTIONS WILL CLEAR UP IN A WEEK OR SO ANYWAY. SO TODAY SOME PHYSICIANS ARE TRYING NATURAL SUBSTANCES RATHER THAN ANTIBIOTICS.

TREATMENT OF DEPRESSION CAN ALSO BE A GOOD USE OF ALTERNATIVE MEDICINE. INSUFFICIENT NATURAL LIGHT CAN LEAD TO DEPRESSION, TIREDNESS OR OVEREATING. IN THE WINTER, ESPECIALLY IN COLDER CLIMATES, THE LEVEL OF INDOOR LIGHT

PRODUCES ONLY ABOUT A TENTH OF THE ILLUMINATION OF A FULL

            DAY OF NATURAL LIGHT. A FORM OF "WINTER BLUES" THAT CAN RESULT FROM THIS IS KNOW AS SEASONAL AFFECTIVE DISORDER. IT AFFECTS AROUND 1 PERCENT OF THE POPULATION, BUT CAN BE

SUCCESSFULLY TREATED WITH SPECIAL FULL SPECTRUM LIGHT UNITS FITTED INTO THE HOME OR OFFICE.

THE NATURAL APPROACH OF ALTERNATIVE MEDICINE GENERALLY

OPERATES UNDER THE FOLLOWING PRINCIPLES:

-  THE BODY HAS A NATURAL ABILITY TO HEAL ITSELF AND REMAIN STABLE. THIS IS KNOW IN MEDICINE AS HOMEOSTASIS.

-  THE HUMAN BEING IS NOT SIMPLY A PHYSICAL MACHINE LIKE A CAR, BUT A SUBTLE AND COMPLEX BLEND OF BODY, MIND AND EMOTIONS AND ALL OR ANY OF THESE FACTORS MAY CAUSE OR

CONTRIBUTE TO PROBLEMS OF HEALTH. THE TERM HOLISTIC MEDICINE HAS BEEN COINED TO DESCRIBE TREATING THE INDIVIDUAL AS A "WHOLE BEING" COMPRISED OF BODY, MIND, AND EMOTIONS, AS OPPOSED TO THE ALLOPATHIC PRINCIPLE WHERE PHYSICAL SYMPTOMS ARE TREATED IN ISOLATION, USING THE SAME TEXTBOOK SOLUTIONS FOR EVERYONE.

-  ENVIRONMENTAL AND SOCIAL CONDITIONS ARE JUST AS IMPORTANT AS AN INDIVIDUALS' PHYSICAL AND PSYCHOLOGICAL MAKEUP AND

MAY HAVE JUST AS BIG AN IMPACT ON HIS OR HER HEALTH.

-  TREATING THE ROOT CAUSE OR CAUSES OF A PROBLEM IS MORE IMPORTANT THAN TREATING THE OBVIOUS IMMEDIATE SYMPTOMS. TREATING SYMPTOMS MAY SIMPLY COVER UP THE REAL UNDERLYING PROBLEM.

       - HEALING IS QUICKER AND MORE EFFECTIVE IF THE PERSON TAKES

CENTRAL RESPONSIBILITY FOR HIS OR HER OWN HEALTH AND HAS

            AN ACTIVE INVOLVEMENT IN THE HEALING PROCESS.

- GOOD HEALTH IS A STATE OF EMOTIONAL, MENTAL, SPIRITUAL AND PHYSICAL BALANCE.

ALTERNATIVE THERAPIES ARE CONSIDERED TO FALL INTO TWO MAIN CATEGORIES. THERE ARE PHYSICAL THERAPIES AND PSYCHOLOGICAL THERAPIES.

PHYSICAL THERAPIES ARE THOSE THAT WORK OBVIOUSLY AND DIRECTLY ON THE BODY IN A VERY PHYSICAL WAY. EXAMPLES ARE CHIROPRACTIC, OSTEOPATHY, HERBALISM, NUTRITION AND MASSAGE.

CHIROPRACTIC IS A TERM THAT DERIVES FROM TWO ANCIENT GREEK WORDS MEANING MANUALLY EFFECTIVE. IT IS TECHNICALLY DESCRIBED AS THE DIAGNOSIS, TREATMENT AND REHABILITATION

       OF CONDITIONS THAT AFFECT THE NEUROMUSCULOSKELETAL SYSTEM.

CHIROPRACTIC PLACES GREAT EMPHASIS ON THE HEALTH OF THE

NERVOUS SYSTEM.

OSTEOPATHY IS MANIPULATIVE THERAPY THAT WORKS ON THE BODY STRUCTURE (THE SKELETON, MUSCLES AND LIGAMENTS) TO RELIEVE PAIN, IMPROVE MOBILITY, AND RESTORE HEALTH.

HERBALISM IS THE USE OF HERBS AND PLANTS TO PREVENT ILLNESSES AND EVEN TREAT CONDITIONS RANGING FROM COLDS AND FLU TO MIGRAINE HEADACHES AND CANCER.

PSYCHOLOGICAL THERAPIES AIM TO HELP THE BODY THROUGH THE MIND AND EMOTIONS. EXAMPLES ARE COUNSELING, PSYCHOTHERAPY, HYPNOTHERAPY (USE OF HYPNOSIS) RELAXATION THERAPY, MEDITATION (WAY OF CONTACTING THE INNER ENERGY

      THAT POWERS THE NATURAL PROCESS OF HEALING AND

SELF-REALIZATION), YOGA - MOVING MEDITATION BASED ON MOVEMENT AND DEEP BREATHING, AND VISUALIZATION (THE FORMING OF MEANINGFUL IMAGES IN THE MIND WHICH IS USUALLY MORE EFFECTIVE WITH THE EYES CLOSED) LEARNING TO VISUALIZE A PLEASANT RELAXING PLACE AND FIXING IT IN YOUR MIND MAKES IT EASY

TO RECALL IT WHEN YOU NEED TO "TUNE OUT FROM A TENSE SITUATION".

ANOTHER PSYCHOLOGICAL THERAPY IS BIOFEEDBACK THIS IS RELAXATION EXERCISES DONE WHILE WATCHING A COMPUTER READOUT OF HEART RATE, MUSCLE TENSION, SKIN TEMPERATURE AND BRAIN WAVES. THE IDEA IS THAT LEARNING THE PHYSICAL SIGNS OF STRESS HELPS CONTROL THEM.

A THIRD CATEGORY OF ALTERNATIVE MEDICINE IS ENERGY THERAPY.  IT WORKS ON THE IDEA THAT ILLNESS IS THE RESULT OF AN IMBALANCE OR INTERRUPTION IN THE BODY'S NATURAL ENERGY OR LIFE FORCE AT A VERY FINE LEVEL. EXAMPLES ARE HOMEOPATHY (USE OF NATURAL SUBSTANCES IN MINUTE AMOUNTS THAT CAUSES SYMPTOMS SIMILAR TO THOSE YOU ARE TRYING TO TREAT).  THIS IS SUPPOSED TO SPUR THE IMMUNE SYSTEM TO FIGHT THE ACTUAL DISEASE - SORT OF THE WAY A VACCINE HELPS FEND OFF MEASLES.

ACUPUNCTURE IS A 3000 YEAR OLD CHINESE TECHNIQUE BASED ON THE IDEA THAT INSERTING NEEDLES INTO THE BODY CAN RECHANNEL ENERGY THAT HAS GONE ASTRAY AND RESTORE BALANCE AND HEALTHY FUNCTIONING TO THE INTERNAL ORGANS OF THE BODY. ACUPRESSURE INVOLVES THE APPLICATION OF FINGERTIPS OR NAIL PRESSURE TO ACUPUNCTURE POINTS ON THE BODY TO RELIEVE

      TENSION, RESTORE ENERGY AND IMPROVE CIRCULATION.

REFLEXOLOGY IS A SPECIALIZED MASSAGE FOR THE HANDS AND FEET AND CAN BE USED FOR DIAGNOSING AND CORRECTING IMBALANCE IN THE BODY.

THERE IS, OF COURSE, SOME CONTROVERSY SURROUNDING ALTERNATIVE MEDICINE.

FOR ONE THING THERE IS A LACK OF QUALITY RESEARCH. MANY OF THE ALTERNATIVE TREATMENTS HAVE NOT UNDERGONE RIGOROUS SCIENTIFIC STUDIES. SOME TREATMENTS CAN BE VERY DANGEROUS IF PATIENTS USE THEM INSTEAD OF STANDARD MEDICAL TREATMENTS. FOR EXAMPLE, CHELATION THERAPY, - THE INTRAVENOUS ADMINISTRATION OF A SYNTHETIC AMINO ACID AND OTHER SUBSTANCES - HAS BEEN USED TO CLEAN DEPOSITS OF CHOLESTEROL-LADEN PLAQUE OUT OF CORONARY ARTERIES. THIS

        PRACTICE CAN BE VERY DANGEROUS AND THE AMERICAN MEDICAL

ASSOCIATION AND THE AMERICAN HEART ASSOCIATION WORN AGAINST UNCLOGGING ARTERIES BY CHELATION.

THERE IS ALSO LIMITED REGULATION OF ALTERNATIVE MEDICINES. THE FEDERAL DRUG ADMINISTRATION'S AUTHORITY BASICALLY APPLIES TO CLAIMS THAT ARE MADE ON LABELS. MANUFACTURERS HAVE BECOME GOOD AT SUGGESTING WITHOUT MAKING CLAIMS.

SOME ALTERNATIVE TREATMENTS CAN BE WASTEFUL AND EVEN HARMFUL. USING COPPER BRACELETS TO TREAT ARTHRITIS OR COFFEE ENEMAS FOR CANCER, FOR EXAMPLE, HAVE NO BASIS IN REALITY,

AND THERE ARE QUACKS WHO SELL CURES FOR INCURABLE DISEASES THAT SIMPLY DO NOT WORK. LAETRIL, A STJBSTANCE DERIVED FROM APRICOT PITS, WAS A VERY POPULAR ALTERNATIVE DRUG THAT WAS

SAID TO CURE CANCER, BUT WAS SHOWN TO BE COMPLETELY INEFFECTIVE AND WAS BANNED IN 1976.

WHAT ABOUT THE FUTURE OF ALTERNATIVE MEDICINE?  THERE

SEEMS TO BE MORE INTEREST FROM THE MEDICAL COMMUNITY THAN IN THE PAST. MANY MEDICAL DOCTORS ARE PRACTICING TECHNIQUES

NOT USUALLY TAUGHT IN MEDICAL SCHOOL. PHYSICIANS ARE TURNING TO ACUPUNCTURE, HERBS, MASSAGE OR MEDITATION TO TREAT COMMON WOES. SOME CALL ALTERNATIVE MEDICINE COMPLIMENTARY MEDICINE BECAUSE THE TECHNIQUES CAN BE USED TO COMPLEMENT STANDARD PRACTICE - AND IN SOME CASES FILL GAPS WHERE CONVENTIONAL TREATMENT IS FOUND LACKING.  FOR PATIENTS DRAWN TO ALTERNATIVE THERAPIES BUT FEARFUL OF ENTRUSTING THEIR CARE TO PRACTICIONERS WITH MEDICAL TRAINING, THE M.D. DEGREE

       PROVIDES A GREATER LEVEL OF COMFORT. AND SINCE THE DOCTOR PRACTICES BOTH CONVENTIONAL AND ALTERNATIVE THERAPIES, YOU INCREASE THE TREATMENT OPTIONS, SO SAYS DR. BRIAN BERMAN, DIRECTOR OF COMPLEMENTARY MEDICINE AT THE UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE.

WHILE MANY DOCTORS BELIEVE ALTERNATIVE MEDICINE SHOWS PROMISE, OTHERS ARE TROUBLED BY THE LACK OF GOOD STUDIES TO MEASURE THE OUTCOME AND COST-EFFECTIVENESS OF THESE PRACTICES. THEY ALSO WORRY ABOUT PRACTICIONERS USING ALTERNATIVE TECHNIQUES FOR SERIOUS DISEASES THAT COULD PROGRESS IF NOT TREATED WITH CONVENTIONAL DRUGS OR THERAPY.

THERE ARE NO FIGURES ON HOW MANY DOCTORS PRACTICE ALTERNATIVE MEDICINE BUT ONE SURVEY OF DOCTORS IN THE CHESAPEAKE BAY AREA FOUND THAT 70% OF FAMILY PHYSICIANS

EXPRESSED INTEREST IN RECEIVING TRAINING IN MULTIPLE AREAS OF ALTERNATIVE MEDICINE. AT LEAST 26 MEDICAL SCHOOLS IN

13 STATES, INCLUDING HARVARD, COLUMBIA AND STANFORD ARE OFFERING COURSES IN ALTERNATIVE MEDICINE.

THE DOCTORS MOST LIKELY TO PRACTICE COMPLEMENTARY MEDICINE ARE THOSE WHO TREAT CHRONIC PROBLEMS SUCH AS BACK PAIN, HEADACHE OR IMMUNE-SYSTEM DEFICIENCIES THAT OFTEN DON'T RESPOND TO CONVENTIONAL THERAPIES.

IT IS ESTIMATED THAT ABOUT 3000 AMERICAN PHYSICIANS HAVE BEGUN TO INCORPORATE ACUPUNCTURE INTO THEIR PRACTICES, AND HUNDREDS MORE ARE TAKING COURSES IN ITS USE. IN EUROPE, THE TREND IS OVERWHELMING AS OUT OF 88,000 PRACTICING ACUPUNCTURIST, 62,000 ARE MEDICAL DOCTORS.

INSURERS HAVE ALSO STARTED TO TAKE NOTICE OF ALTERNATIVE MEDICINE. SEVERAL PAY FOR ACUPUNCTURE, BIOFEEDBACK AND MASSAGE, IF PRESCRIBED BY A PHYSICIAN. ONE COMPANY, AMERICAN WESTERN LIFE OF FOSTER CITY, CALIFORNIA, COVERS A WIDE RANGE OF TREATMENTS. OXFORD HEALTH PLAN, A MAJOR INSURER IN THE NORTHEAST LAST FALL BEGAN OFFERING ITS 1.4 MILLION MEMBERS

AN OPPORTUNITY TO CONSULT A NETWORK OF ALTERNATIVE MEDICAL PRACTITIONERS, INCLUDING ACUPUNCTURE, CHIROPRACTORS, NATURO PATHS, MASSAGE THERAPIST, YOGA INSTRUCTORS, CLINICAL NUTRITIONIST AND REGISTERED DIETITIANS. ONE REASON IS THAT OXFORD EXPECTS THAT GIVING PATIENTS ACCESS TO ALTERNATIVE PRACTITIONERS WILL COST LESS THAN IF THEY MUST ALWAYS RELY ON CONVENTIONAL MEDICINE. MUTUAL OF OMAHA, A MAJOR INSURER, NOW REIMBURSES PATIENTS FOR PROGRAMS THAT INVOLVE DIET,

MEDITATION, EXERCISE AND SUPPORT GROUPS TO TRY AND REVERSE CORONARY ARTERY DISEASE. OTHER INSURERS COVER A YOGA, MEDITATION AND DIET PROGRAM AT THE MEDICINE RESEARCH INSTITUTE IN SAUSALITO CALIFORNIA FOR REVERSING CORONARY ARTERY DISEASE. WHEN YOU COMPARE THE COST OF AN ANGIOPLASTY TO THE COST OF THE PROGRAM, THE INSURERS ARE SAVING $5.55 FOR EVERY DOLLAR THEY SPEND. MOREOVER 90% OF THE PEOPLE RECOMMENDED FOR BYPASS HAVE BEEN ABLE TO AVOID IT.  DR. DEAN ORNISH OF THE MEDICAL RESEARCH INSTITUTE DEMONSTRATED THAT HEART DISEASE CAN BE REVERSED BY CHANGING ONE'S DIET AND LIFESTYLE. THE FINDINGS WERE PUBLISHED IN THE SEPTEMBER 1996 ISSUE OF THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. THE INSTITUTE'S HEART DISEASE PATIENTS WERE

DIVIDED INTO TWO GROUPS, EXPERIMENTAL AND CONTROL.  THE

EXPERIMENTAL PATIENTS WENT ON A DAILY DIET IN WHICH ONLY

10% OF CALORIES CAME FROM FAT (COMPARED WITH THE AMERICAN HEART ASSOCIATION RECOMMENDED MAXIMUM OF 30%) THEY DID CONSIDERABLE EXERCISE (MOSTLY WALKING) YOGA, AND MEDITATION, AND THEY PARTICIPATED IN A TWICE-WEEKLY PROFESSIONALLY GUIDED SUPPORT GROUP. TEST RESULTS SHOWED IMPROVEMENTS IN THEIR CARDIOVASCULAR FUNCTION, WHILE PATIENTS IN THE CONTROL GROUP WHO HAD MADE NO CHANGES IN THEIR DIETS OR LIFESTYLES, DID

NOT SHOW ANY IMPROVEMENT.

PARTICIPATION IN SUPPORT GROUPS NOT ONLY SEEMS TO IMPROVE QUALITY OF LIFE BUT LENGTH OF LIFE. IN A 10 YEAR STUDY CONDUCTED BY DR. DAVID SPIEGEL, A STANFORD MEDICAL SCHOOL PROFESSOR OF PSYCHIATRY, WOMEN WITH METASTATIC BREAST CANCER

WHO PARTICIPATED IN SUPPORT GROUP THERAPY HAD TWICE THE SURVIVAL TIME OF WOMEN IN THE NON-PARTICIPATING GROUP.

IN SUMMARY, THERE ARE STILL MANY UNANSWERED QUESTIONS ABOUT ALTERNATIVE MEDICINE.  HOWEVER, THERE IS SOME EVIDENCE THAT WE MAY BE HEADED FOR A NEW ERA OF MEDICINE THAT COMBINES THE BEST OF WORLDS, THE SOPHISTICATED DIAGNOSTICS AND HEROIC CURES

OF TRADITIONAL WESTERN MEDICINE AIDED BY ALTERNATIVE TECHNIQUES THAT TAP INTO THE BODY'S NATURAL HEALING POWERS.

UNTIL THEN, THE BEST ADVICE IS TO PROBABLY HEED CAUTION. WHILE MANY ALTERNATIVE THERAPIES POSE LITTLE RISK EXCEPT TO THE WALLET, A FEW CAN BE DANGEROUS.  THE GREATEST POTENTIAL FOR HARM IS IF THEY CAUSE YOU TO ABANDON OR DELAY PROVEN MEDICAL TREATMENT. PEOPLE SHOULDN'T SUBSTITUTE AN ALTERNATIVE

TREATMENT FOR A CURRENTLY ACCEPTED PRACTICE. AN URGENT PROBLEM LIKE A POSSIBLE FRACTURE, SERIOUS INFECTION OR WORRISOME CHANGE OF HEALTH SHOULD BE EVALUATED BY A DOCTOR.

FOR NOW, IT'S UP TO CONSUMERS TO MAKE EDUCATED CHOICES ABOUT ALTERNATIVE CARE.  IF IT SOUNDS TOO GOOD TO BE TRUE, IT PROBABLY IS. BUT IF A PHYSICIAN CAN SUCCESSFULLY USE A TECHNIQUE WHERE CONVENTIONAL MEDICINES FAIL, THEN THE PATIENT CLEARLY HAS SOMETHING TO GAIN BY TRYING SOME ALTERNATIVE TECHNIQUES.