Fundamentals of Complementary and Alternative Medicine / Edition 2

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The cornerstone text in the popular series Medical Guides to Complementary and Alternative Medicine, edited by Dr. Micozzi, FUNDAMENTALS OF COMPLEMENTARY & ALTERNATIVE MEDICINE returns fully updated and expanded in its second edition. The unique approach in this book provides the historical background of alternative healing systems, in addition to the most up-to-date information on scientific research, plus basic clinical applications. Rather than attempting to address every conceivable alternative therapy, this text instead explores those that are best supported by clinical trials and hard evidence, making it a particularly valuable reference within traditional medical settings. Intended as an introduction to the topic of alternative medicine, Dr. Micozzi's book has become the standard among medical and health care professionals who wish to learn about incorporating these procedures into an allopathic practice.

The book contains predominantly black-and-white illustrations, with some two-color illustrations.

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Editorial Reviews

From the Publisher

"The book offers detailed descriptions of various tradition-based and speculation-based modalities for healing."

FACT, December 2010

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Product Details

  • ISBN-13: 9780443065767
  • Publisher: Elsevier Health Sciences
  • Publication date: 12/27/2000
  • Edition description: Older Edition
  • Edition number: 2
  • Pages: 432
  • Product dimensions: 8.08 (w) x 10.08 (h) x 0.68 (d)

Read an Excerpt

Chapter 1: Characteristics of Complementary Medicine

The different medical systems subsumed under the category complementary and alternative are large and diverse, but these systems have some common ground in their views of health and healing. I call this overall philosophy a new ecology of health, sustainable medicine, or medicine for a small planet.

Allopathic medicine is considered the "scientific" healing art, whereas the alternatives are considered "nonscientific." However, perhaps what is needed is not less science but more sciences in the study of complementary and alternative medicine. Some of the central ideas of biomedicine are very powerful but are becoming intellectually stale. The study of dead tissue cells, components, and chemicals to understand life processes and the quest for "magic bullets" to combat disease are based on a reductionist, materialist view of health and healing. We have made tremendous advances over the past 100 years by applying these concepts to medicine. However, the resulting biomedical system is not always able to account for and use many observations in the realms of clinical and personal experience, natural law, and human spirituality.

contemporary biomedicine is a scientific paradigm with a particular history, as much influenced by social history as it is by scientific laws. In the laudable effort to make medicine scientific, we have emphasized that knowledge about the worldincluding nature and human nature-must be pursued by the following criteria: (1) objectivism-the observer is separate from the observed, (2) reductionism-complex phenomena are explainable in terms of simpler, component phenomena, (3) positivism-all information can be derived from physically measurable data, and (4) determinismphenomena can be predicted from a knowledge of scientific law and initial conditions. We all know that this is not the only way of "knowing" things but it has become the twentieth century test to determine whether such knowledge is "scientific." In fact, science simply requires empiricismmaking and testing models of reality by what can be observed, guided by certain values, and based on certain metaphysical assumptions. Science itself is not reality but a system of human knowledge. Scientists often detect differences between metaphysical reality and the scientific models constructed through human intellectual activity. These new thoughts about the nature of medicine do not represent a new science so much as they represent a new philosophy.

Therefore the aforementioned criteria are not always applicable. In the science of physics, objectivism is ultimately not possible at the fundamental level because of the Heisenberg uncertainty principle, which states that the act of observing phenomena necessarily influences the behavior of the phenomena being observed. Contemporary biological and ecological science has produced a wealth of observations about interactions between living organisms and their environments in transactional, multidirectional, and synergic ways that are not ultimately subject to reductionist explanations. For positivism and determinism to provide a complete explanation, we must assume that science has all the physical and intellectual tools to ask the right questions. However, the questions we ask are based on the history of science itself as part of the history of human intellectual inquiry.

Contemporary biomedicine conceptually uses Newtonian physics and pre-Darwinian biology. Newtonian physics explains and can reproduce many observations on the mechanics of everyday experience. Contemporary quantum physics (quantum mechanics) recognizes aspects of reality beyond Newtonian mechanics, such as matter-energy duality, "unified fields" of energy and matter, and wave functions (see Chapter 15). Quantum physics and contemporary biology-ecology may be needed to understand alternatives. Nuclear medicine uses the technology of contemporary physics but does not yet incorporate the concepts of quantum physics in its fundamental approach to patient health. Contemporary medicine does measure the body's energy using electrocardiography, electroencephalography, and electromyography for diagnostic purposes, but it does not enlist the body's energy for the purpose of healing.

The biomedical model relies on a projection of Newtonian mechanics into the microscopic and molecular realms.

As a model for everything, Newtonian mechanics has limitations. It works within the narrow limits of everyday experience. It does not always work at a macro (cosmic) level as shown by Einstein's theory of relativity or at a micro (fundamental) level as illustrated by quantum physics. However useful Newton's physics has been in solving mechanical problems, it cannot explain the vast preponderance of nature: the motion of currents; the growth of plants and animals; or the rise, functioning, and fall of civilizations. Per Bak once stated that mechanics could explain why the apple fell but not why the apple existed or why Newton was thinking about it in the first place.

Mechanics works in explaining machines. But no matter how popular this metaphor has become (with apologies to National Geographic's "incredible machine" imagery), the body is not a machine and it cannot be entirely explained by mechanics. It is becoming increasingly clear that an understanding of energetics is required. This duality between the mechanical and the energetic has been accepted in physics for most of the past century. This duality is famously illustrated by the fact that J.J. Thomson won the Nobel Prize for demonstrating that the electron is a particle. His son, George P. Thomson, won the Nobel Prize a generation later for demonstrating that the electron is a wave.

"Hard scientists" such as physicists and molecular biologists accept the duality of the electron but have a hard time accepting the duality of the human body. The "soft sciences," which attempt to be inclusive in their study of the phenomena of life and nature, are often looked on with disdain according to the folklore of the self-styled real scientists. However, real science must account for all of what is observed in nature, not just the conveniently reductionistic part.

The biological science of contemporary medicine is essentially pre-Darwinian in that it emphasizes typology rather than individuality and variation. Each patient is defined as a clinical entity by a diagnosis, with treatment prescribed accordingly. The modern understanding of the human genome does not make this approach to biomedical science less preDarwinian. Both the fundamentals of inheritance (Mendel) and natural selection (Darwin and Alfred Russel Wallace) were explained long before the discovery of the structure of the gene itself. Although modern biology-ecology continues to explore the phenomena of how living systems interact at the level of the whole-which cannot be seen under a microscope or in a test tube-molecular genetics continues to dissect the human genome.

It may seem outrageously complex to construct a medical system based on the concepts of modern physics and biology-ecology while maintaining a unique diagnostic and therapeutic approach to each individual. This would indeed be complex if not for the fact that the body is its own entity, a part of nature, and each body has an innate ability to heal itself.

f biomedicine cannot explain scientific obser varions of alternatives, the biomedical para- digm will be revised.

One way of studying and understanding alternative medicine is to view it in light of contemporary physics and biology-ecology and to focus not just on the subtle manipulations of the alternative practitioners but on the physiological response of the body. When homeopathy or acupuncture is observed to result in a physiological or clinical response that cannot be explained by the biomedical model, it is not the role of the scientist to deny this reality but rather to modify our explanatory models to account for it. In this way science itself progresses. In the end there is only one reality. Alternative medical systems, which are relatively old in terms of human intellectual hi tory, always have been trying to describe, understan and work with the same reality of health and healir as biomedicine. Furthermore, whereas contemporary biomedicine uses new technologies in the service relatively old ideas about health and healing, altern tive methods use old technologies whose fundamental tal character may reflect new scientific ideas on phy ical and biological nature (Box 1-1).

Science must account for all of what is observe not just part of it. That is why physics has moved b

A Note About Nomenclature

The word alternative, or the term complementary and alternative medicine, now seems to be culturally encoded in the English language. Workers at Harvard Medical School have provided a basis for a functional definition of the term:

Alternative medicine refers to those practices explicitly used for the purpose of medical intervention, health promotion or disease prevention which are not routinely taught at U.S. medical schools nor routinely underwritten by third-party payers within the existing U.S. health care system.

The Harvard definition seems to be a diagnosis of exclusion, meaning that alternative medicine is everything not being presently promoted in mainstream medicine. This definition may remind us of a popular song from the 1960s called, "The Element Song," which offers a complete listing of all the different elements of the periodic table (set to the tune of "I Am the Very Model of a Modern Major General" from Gilbert and Sullivan's The Pirates of Penzance). It ends with words to this effect: "These are the many elements we've heard about at Harvard. And if we haven't heard of them, they haven't been disco-vard." I have likened the recent "discovery" of alternative medicine to Columbus's discovery of the Americas. Although his voyage was a great feat that expanded the intellectual frontiers of Europe, Columbus could not really discover a world already known to millions of indigenous peoples who used complex systems of social organization and subsistence activities. Likewise, the definitional statement that alternatives are not "within the existing U.S. health care system" is a curious observation for the millions of Americans who routinely use them today...

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Table of Contents

I Basis and Context of Context of Complementary and Alternative Medicine 1
1 Characteristics of Complementary Medicine 3
2 Translational Issues in Conventional and Complementary Medicine 9
3 Social and Cultural Context of Complementary and Alternative Medicine Systems 18
4 History of Vitalism 43
5 The Development of an Integrated Medical Model 57
6 Global Context 72
II Alternative Medical Therapies 85
7 Homeopathy 87
8 Manual Therapies 100
9 Western Herbalism
10 Aromatherapy 146
11 Naturopathic Medicine 159
III Complementary Medical Approaches 193
12 Therapeutic Uses of Neurohumoral Mechanisms 195
13 Psychoneuroimmunology 200
14 Mind-Body Interventions 215
15 Energy Medicine 238
16 Expressive and Creative Arts Therapies 257
17 Humor as Context and Therapy 276
App Health and Humor Resources: Individuals, Organizations, and Publications 298
IV Traditional Medical Systems 301
18 Chinese Medicine 303
19 Traditional Ayurveda 345
App Yoga: Ancient Art and Modern Practice 358
20 Maharishi Ayurveda 366
21 The Islamic Sufi Tradition and Healing 381
22 Native American Healing: A Pan-Indian Perspective 387
App Native American Medicinal Plants 405
23 Curanderismo 411
24 Southern African Healing Traditions and Professional Considerations 429
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