Folk medicine

• DEFINITION: Beliefs and practices that include home remedies, herbal therapies, and traditional healing.
• PRINCIPAL PROPOSED USES: Anxiety, arthritis, back pain, cancer, depression, digestive disorders, heart disease, headaches, stress
• OTHER PROPOSED USES: Acquired immunodeficiency syndrome, allergies, human immunodeficiency virus infection, poor circulation, premenstrual syndrome, sexual dysfunction, weight loss

Overview

At the beginning of the twentieth century in the United States, different forms of medical care were widely patronized. In 1910, Abraham Flexner published an influential report that advocated for the use of medical practices based on scientific evidence; he anticipated that folk medicine, which was presumably not evidence-based, would die out in time. A century later, however, alternative medicine is very much alive and thriving. With the advent of the Internet, advanced technology, and the growing scope of immigration and international travel, alternative medical practices from various cultures have been introduced in the United States. Furthermore, the number of rigorous clinical studies comparing the efficacy of alternative medical practices with conventional medicine continues to increase.

Besides treating a specific disease, many types of folk medicine aim to treat and promote well-being in the whole person, including a person’s physical, emotional, mental, and spiritual aspects. Some practices evoke the occult and witchcraft and aim to remove or neutralize evil spirits to cure physical ailments. Other practices take into account a person’s character traits and predispositions before making a diagnosis or creating a treatment plan.

There are many types of folk medicine, but all can be roughly classified into several categories. The first category involves natural products, which are ingested, inhaled, or applied to parts of the body. Over centuries of empirical testing, many cultures have derived combinations of natural substances, such as plant and animal materials for treating disease. Plant material includes leaves, fruits, seeds, bark, stems, and roots.

Another category of folk medicine is mind/body medicine, which involves using the power of the mind to heal the body. Yoga, meditation, and acupuncture can be classified under this category. A popular example of mind/body medicine is acupuncture, in which thin metal needles are inserted through the skin at specific pressure points along “meridians,” or pathways, on the body to clear blockages in the flow of qi (energy). Acupressure stimulates these pressure points manually, using the hands instead of needles.

A third category of folk medicine, manipulative and body-based practices, encompasses therapies that address the bones and joints, soft tissues, and the circulatory and lymphatic systems. One example is spinal manipulation, which involves applying force to a part of the spine, causing it to move beyond its passive range of motion. Another example is massage, which involves rubbing and pressing muscles to stimulate blood and oxygen flow through the muscles.

Finally, other practices, such as movement therapies and energy therapies, can also be considered folk medicines. Energy therapies include those that exploit electromagnetic fields for healing purposes and practices, such as Reiki, which involve the transmission of “universal” energy (believed to be present in every person) from the practitioner to the patient by placing hands on or near the patient or by transmission from a distance.

Mechanism of Action

Natural products that are used as medicines have many different modes of action. For example, fish, seeds, and oils rich in omega-3 fatty acids act by reducing the level of cholesterol in the blood, reducing inflammation, and reducing cardiac arrhythmias (irregular heartbeat). The biological effects of Asian herbal medicines range from promoting circulation and dilating blood vessels to stimulating digestion and increasing skin elasticity. Natural products, such as herbs, are used in both Asian and Hispanic traditional medical practices to restore balance between “hot” and “cold” humors or conditions. In Hispanic folk medicine, for example, hot states are associated with vasodilation and a high metabolic rate, while cold states are associated with vasoconstriction and a low metabolic rate. A hot condition would be treated with herbal therapies that are considered cold treatments; conversely, cold conditions would be treated with hot therapies. Similar principles are used in Asian folk medicine.

Mind/body medicine such as meditation, yoga, and acupuncture uses the power of the mind to improve physical and mental health. The idea is that the mind and body are inextricably connected and influence health as an inseparable whole. Meditation and yoga improve health by reducing stress and increasing calmness and relaxation, which boosts the immune system and promotes physical health. According to Chinese medical concepts, acupuncture releases qi blockages in the body, allowing qi to flow freely, and corrects imbalance between the yin (“cold”) and yang (“hot”) forces. Although the positive effects of acupuncture are becoming accepted among a growing number of laypersons and clinicians, the mechanism of action cannot be readily explained in conventional or Western medical terms. Faith healing can also be thought of as mind/body medicine and is thought to work through the actions of a spiritual power.

Manipulative and body-based practices work by applying force on parts of the body, such as muscles and bones. Massage therapy soothes muscle tension and stimulates blood and oxygen circulation in the muscles. Spinal manipulation increases the flexibility and range of motion of the spinal vertebrae. The mechanisms of action of energy therapies such as Reiki therapy are challenging to characterize in scientific terms.

Uses and Applications

The uses of natural products are wide-ranging. They can be used to improve blood circulation throughout the body, treat headaches, and promote weight loss; they are also used to treat arthritis, diabetes, cancer, and heart disease. Mind/body techniques such as yoga and meditation are often used to treat illnesses related to anxiety, stress, and depression. Yoga, meditation, and acupuncture can be helpful in alleviating chronic pain. Acupuncture is also used to treat a wide range of disorders, from headaches to cancer. Manipulative and body-based practices treat back, neck, and shoulder pain, as well as spinal problems. Spinal manipulation is especially useful for treating lower back pain, a common ailment.

Scientific Evidence

Many scientific studies support the use of different types of oils in treating and preventing disease. This includes the use of fish oil in reducing cardiac arrhythmias, sunflower seed oil and olive oil in reducing cholesterol in the blood, and red palm oil in protecting against ischemia-reperfusion injury, which refers to damage to the heart when blood flow is restored (reperfusion) following a period without blood flow (ischemia).

Among mind/body traditional practices, acupuncture is one of the most widely studied. A National Institutes of Health (NIH) consensus panel reviewed the scientific literature about acupuncture to assess its clinical efficacy and biological effects. According to the NIH panel, scientific evidence shows that only dental pain and nausea (related to surgery, chemotherapy, or pregnancy) have been effectively treated by acupuncture. More scientific studies are needed to determine if acupuncture is effective for other conditions. Several studies sponsored by the National Center of Complementary and Alternative Medicine are underway to explore the use of acupuncture therapy in treating high blood pressure and advanced colorectal cancer. However, the National Cancer Institute website provides a summary of studies that show the efficacy of acupuncture in boosting immune function and reducing some of the side effects of chemotherapy, including nausea, weight loss, and depression. Acupuncture also appears to reduce cancer-related fatigue.

Choosing a Practitioner

One should choose a practitioner only after carefully researching their training, qualifications, and experience. In some types of alternative medicine, certification by an accreditation board can help in selecting a practitioner. For example, forty-one states in the United States require acupuncturists to be certified by the National Certification Commission for Acupuncture and Oriental Medicine before they are issued a license to practice. Certification requires passing exams in oriental medicine, acupuncture, and Western biomedicine, usually after completing three to four years of master’s-level coursework and clinical experience. If candidates pass these exams, they are awarded a diploma in acupuncture.

As with conventional healthcare practitioners, certified acupuncturists must earn sufficient continuing education credits to renew this certification every four years. Some physicians and dentists are certified and licensed to practice acupuncture. There are also advanced degree programs in naturopathy and complementary medicine in the United States, focusing on holistic healing using alternative and conventional medical practices. Several schools offer Doctor of Naturopathy (N.D.) degrees, which take four to six years to complete, and fourteen states license N.D.s; licensing requires successful completion of the naturopathic licensing examination.

Safety Issues

The safety of alternative medicine depends on the practitioner, the nature of the therapy, and the context in which the therapy is applied. In addition to choosing a qualified, well-established practitioner, one should take care when initiating new alternative therapies. For example, when starting a new diet regimen or adding dietary supplements, one should be alert to possible interactions with medications or other supplements. Also, because the U.S. Food and Drug Administration does not regulate many supplements and can be purchased without a prescription, one should thoroughly research possible side effects and interactions before adding these substances to one’s diet.

For therapies that involve body manipulation, such as massage and spinal manipulation, possible side effects from poor treatment include sore muscles and muscle and ligament injury. Acupuncture has several side effects; these are mainly associated with the needle puncture site and include the puncture of organs, nerves, or blood vessels; infection (avoidable by using safe-needle techniques); puncture site pain; bleeding; hematoma; and the so-called needle shock reaction, which manifests as excessive sweating and a feeling of faintness after needle puncture.

Bibliography

“Acupuncture (PDQ®)–Health Professional Version.” National Cancer Institute, 25 Jan. 2024, www.cancer.gov/about-cancer/treatment/cam/hp/acupuncture-pdq. Accessed 20 Oct. 2024.

Bester, D., et al. “Cardiovascular Effects of Edible Oils: A Comparison between Four Popular Edible Oils.” Nutrition Research Reviews, vol. 23, no. 2, 2010, pp. 334–48, doi.org/10.1017/S0954422410000223. Accessed 20 Oct. 2024.

Brady, E., editor. Healing Logics: Culture and Medicine in Modern Health Belief Systems. Utah State U, 2001.

Hadady, L. Asian Health Secrets: The Complete Guide to Asian Herbal Medicine. Three Rivers Press, 1996.

Kirkland, H. F., et al., editors. Herbal and Magical Medicine: Traditional Healing Today. Duke UP, 1992.

Motta, Matthew, and Timothy Callaghan. "The Pervasiveness and Policy Consequences of Medical Folk Wisdom in the U.S." Scientific Reports, vol. 10, no. 10722, 1 July 2020, doi.org/10.1038/s41598-020-67744-6. Accessed 20 Oct. 2024.

National Center for Complementary and Alternative Medicine. nccam.nih.gov.