The Revival Of Alternative Medicine.

In recent decades, the improvement of professional standards within alternative medicine has been paralleled by increased public interest and patronage. This improvement constitutes a striking turnaround from the decline experienced by most alternative systems during the middle years of this century. Although as recently as 1969 a federal study concluded “the number of naturopaths ... is rapidly declining”, unconventional practice experienced an extraordinary revitalization in the 1970s. Not only did naturopathy, chiropractic, and other nineteenth-century systems regain popularity, but various newer programs of healing appeared on the scene as well. When the journal Alternative Therapies in Health and Medicine began publication in 1995, its editor was able to identify 39 distinct categories of alternative practice as topics acceptable for articles, everything from anthroposophy to vitamin treatments.

This alternative medicine revival was due in significant measure to rising public disaffection with mainstream medical practice. The reasons for dissatisfaction are a familiar litany: patient alienation from the impersonal and intimidating style of specialized, technological, hospital-based medicine; the dramatic increase during the twentieth century of chronic degenerative diseases, ailments that confound cure but demand caring and cooperative management; awareness of the too-frequent iatrogenic effects of prescription pharmaceuticals; the rise of consumerism and concern for patients' rights and autonomy (much like the 1830s' demands of Thomsonians for medical freedom); and the rising costs of medical care. However, it should be appreciated that those dissatisfactions had been building for a long time. The 1924 survey of Philadelphia patients cited earlier determined that the chief reasons they had sought alternative help were their beliefs that allopaths did not give thorough physical examinations and were “too busy to devote the time and attention that the obscurity of the symptoms ... demanded,” and that “the medicine ordered made the patient feel worse than before taking it”. An Illinois contemporary commented on a similar survey of public discontent with physicians that, “We have rendered wonderful service in the serious ailments. We have not looked properly after the little things,” recognizing that such chronic “little things” were not little matters for patients (74). That same year, 1923, an Indiana physician summed the situation up with the observation that, “irregular healers ... would not exist if they did not fill a kind of need .... This indicates that the people of this country are demanding of the medical profession something more than shaking up test tubes and looking through microscopes”.

To the allopathic profession's credit, that “something more” has been recognized and energetically pursued by physicians in recent years. The 1970s, in particular, were the pivotal decade for a liberalization of mainstream attitudes toward illness and treatment. Family medicine as an area of specialization came into its own in the seventies, dedicated to restoring a more personal and empathic touch to physician-patient interactions. By that time also, the understanding of psychosomatic medicine was undergoing a transformation that would foster a stronger belief in the power of mind to influence body function. The notion that mind and body are fully integrated, and that emotional states affect health, had been part of medical thinking from the time of Hippocrates, and since the 1930s there had in fact been a distinct area of investigation identified as psychosomatic medicine. However, in its initial phase of evolution, psychosomatic medicine had been preoccupied with relating specific physical ailments (e.g., hypertension) to emotional stress.

During the 1960s and 1970s, a more complex interpretation emerged, one that identified psychological forces as one element in the multifactorial etiology of all illnesses. The mind was now being viewed as an ever-present participant in physical functioning. By the end of the 1970s, both the biopsychosocial model of disease and the discipline of psychoneuroimmunology had been developed within allopathic medicine; the former incorporated social pressures into the psychosomatic analysis and the latter clarified neural, endocrine, and immunological pathways by which mind could influence health. During the same period, the introduction of biofeedback practices demonstrated the power of the mind to affect the body therapeutically, and not just pathologically. In short, mind/body medicine was becoming a respectable branch of conventional practice.

Nevertheless, the concept of the mind as healer is more fully associated with alternative medicine, constituting not just an integral part of nineteenth- and early twentieth-century alternative healing philosophy, but also emerging as a distinctive area of practice unto itself in the last third of the twentieth century. One source of this growth has been religion—a significant proportion of Americans have always believed in the power of prayer and have sought spiritual content in their medicine. Scientific medicine's determination to reduce vital phenomena to wholly material, mechanical explanations makes it seem spiritually barren to many and has fueled a revival of healing through prayer. The Human-Potential Movement, which originated in the early 1960s, has been equally important. This movement involves a search for higher and nobler states of consciousness than the base impulses central to Freudian psychology.

This quest for self-actualization supposed the existence of untapped sources of awareness and psychic energy, including the energy to restore the body. During that same decade, the antimaterialist hippy counterculture sparked a fascination with the mystical religious and philosophical traditions of Asian culture, and promoted practices such as transcendental meditation. East and West have since been blended through the New Age healing philosophy that aims at reconciling scientific and spiritual ways of looking at the world and health into a unified intellectual scheme. In this attempt, acupuncture, Ayurveda, and other ancient healing traditions of the Far East—traditions that have always focused on the functional rather than organic disequilibria of the body—have been embraced as particularly powerful ways of comprehending the extraphysical components of health and wholeness. Much like the animal magnetism of the mid-nineteenth-century Mesmerists and the Innate Intelligence of turn-of-the-century chiropractors, the qi, prana, and human energy fields of today's holistic healers are conceptualizations of immaterial agents that sustain harmony both within the body and between the body and the cosmos.

New Age medical mysticism is representative of a final obstacle in alternative medicine's climb toward scientific respectability. Like every other alternative approach, New Age philosophy wraps itself in the banner of holism: in the current climate of healing, one cannot expect to be taken seriously unless one is holistic. The rhetorical use of the term as a label of legitimacy has resulted in a promiscuous crowding of therapies under the broad holistic umbrella. Much of allopathic medicine's remaining reluctance to give complementary medicine a serious hearing is the side-by-side intermingling of methods that are relatively easy to rationalize scientifically (herbs, massage, acupuncture) with therapeutic aromas, personal auras, and mushy empowerment philosophies: “Empathology finds and clears the underlying causes of your ... health issues [and] facilitates your personal truth” (1997 coupon advertisement). But even the most extraterrestrial-seeming of today's holistic therapies can be appreciated historically as striving to do what alternative approaches to care have always attempted: to assist the body in its effort to heal itself.

The value of supporting nature's healing labor has never been stated more eloquently than by the renowned American journalist Finley Peter Dunne, commenting in 1901 on the differences between Christian Science and medicine. “If th' Christyan Scientists had some science,” his Irish protagonist Mr. Dooley proposed, “an' th' doctors more Christianity, it wudden't make anny diff'rence which ye called in—if ye had a good nurse”. The nursing profession has been one of the most active and effective groups in promoting complementary medicine in our own time, and that has been true from its beginnings as a profession. “Nature alone cures,” Florence Nightingale wrote in 1859 as part of her definition of the art and goal of nursing. “What nursing has to do,” she maintained, “is to put the patient in the best condition for nature to act upon him”. This approach has served as the core principle of complementary medical philosophy from the start, since Thomsonian doctors began rescuing patients from the slough of disease by pulling them up the steps of common sense. The best medicine, as Mr. Dooley realized, has always been good nursing.

The history of alternative medicine has, under various names and approaches, been a competitive dance with the dominant orthodox system of treatment. Alternative systems have always risen when the prevailing approaches have become too abstract, too impersonal, too harsh, or too costly for full public support. Alternative systems have usually started by relying on empiricism and outcomes reports, and then often either degenerate into dogma or get absorbed into an orthodoxy-like professionalism; when this happens, they become more distant from the patient, and this makes room for newer alternative systems to arise. Throughout this process, the battle for legitimacy is played out on semantic, regulatory, political, and economic grounds, with each side claiming “nature,” “science,” “holism,” and “healing” on its side. To the degree we can understand and learn from the recurring themes that alternative medicine brings, we will be able to better balance the empirical and rational elements of medicine for the benefit of the ill.