Holistic Medicine (Sociology)

There is perhaps no experience so human as that of dealing with illness and/or injury. Our very existence is predicated on being able to function so that we can do all that is expected of us on a daily basis. When we have to cope with a serious injury or illness, there are many choices to be made. Many people are increasingly moving toward the use of treatments and medicine that are covered under the broad term of “holistic medicine.” This is a philosophy that believes in treating the whole person and not just an injured body part or an illness. The notion of the integrated mind-body-spirit is integral to holistic medicine. An important distinction to make is that of the difference between alternative medicine and complementary medicine. The first is used in place of traditional Western medicine, whereas the latter is given in conjunction with traditional medicine and not in place of it.

Keywords Acupuncture; Allopath; Alternative Medicine; Chinese Medicine; Chiropractic Care; Complimentary Medicine; Energy Healing; Herbalism; Holism-Holistic; Homeopathy; Naturopathy; Reiki

Holistic Medicine

Overview

Holistic medicine has become far more popular in Western countries than it ever has before. There may be many reasons why people are choosing to investigate alternative and complementary medicine. One of these may be a sense of dissatisfaction with what modern or conventional medicine can and cannot do. Many people feel that a traditional Western doctor (usually known as an allopath) is limited by the very focused, scientific training he or she receives. While there is respect for the technological innovations and surgical techniques, many feel that Western biomedical science is limited when it comes to a wide range of issues. These often include conditions that are difficult to treat and/or resistant to modern pharmacological medicines such as fibromyalgia, Lyme disease, chronic fatigue syndrome (sometimes called Epstein-Barr Syndrome), chronic pain, cancer, recurring muscular pains and injuries, among others.

There have been some misunderstandings about what holistic medicine is. Some misinterpret it as a group of treatments that are basically “natural remedies” with no science behind them whatsoever. However, homeopathy, herbalism, Chinese medicine, massage therapy, and other treatments are very much rooted in science, albeit in different scientific beliefs than those that serve as the foundation for Western or conventional medicine.

The Philosophy of Holistic Medicine

The terms holistic medicine, alternative medicine, and complementary medicine have often been used interchangeably. In fact, alternative medicine and complementary medicine are different (as explained below), and holistic medicine is a term that tends to embrace the larger definition of a system of treatment and practitioners who do not work within the system of conventional medicine.

A more precise definition of the term is that holism is a philosophy that believes in treating the whole person and in the integration of mind, body, and spirit. Holism promotes the belief that these three elements of a human being must be treated together in order to achieve any notion of “healing,” rather than simply treating a person for a specific illness or injury.

In the holistic belief system, illness and injury are often the result of disharmony in the mind-body-spirit relationship. The disharmony can often come about from a dysfunction in any one of these areas. Holistic medicine believes that a dysfunction in one area affects the whole person and not just that one area of the body.

Research in Australia demonstrated that one of the reasons so many Australians seek out alternative and complementary medicine is because of the holistic philosophy that guides their work. It is also the reason why many Australians are becoming less enthusiastic about Western or conventional medicine, which is seen as nonholistic in nature (Hassed, 2004).

One of the terms that is increasingly popular in Western culture is "wellness." It is not only a term we see in popular magazines advertising day spas and on the shelves of health food stores, wellness is also becoming a philosophy that is permeating Western society. Universities, colleges, and even corporations are beginning to offer wellness programs for their staff. The notion of “holistic” is the foundation for this growing movement of wellness. Many people have become tired of waiting long hours in an emergency room only to be treated by a tired doctor. They want to take their well-being into their own hands, and they feel empowered when they do.

Holistic medicine is as much about a way of life as it is about medical treatment. The holistic philosophy embraces an approach that promotes overall body wellness.

Alternative Medicine

This term refers to alternative medical systems other than allopathic or traditional (conventional) Western medicine. These include traditional Chinese medicine, homeopathy, and herbalism. These all require certification, and the practitioner is referred to as a doctor. He or she might carry the title of naturopathic physician or doctor of chiropractic. Alternative medicine is used in place of traditional or conventional medicine, although some people use them together.

Homeopathy

The growing popularity of alternative medicine is due in large part to the growth of homeopathy. This science was developed in the late eighteenth century by the German doctor and biologist Dr. Samuel Hahnemann. One of the primary principles in homeopathy is the law of similars. The premise states that “like cures like.” In other words, "a substance produces symptoms of illness in a well person when administered in large doses. If we administer the same substance in minute quantities, it will cure the disease in a sick person" (Novella et al., 2008, p. 9). Hahnemann had very different ideas about the body from his colleagues who practiced conventional medicine. He believed in the concept of the “constitution,” the notion that the body must be treated as a whole and that the right remedy would literally “kick start” the system into healing itself at the most basic level. In this way, homeopathy would not treat disease; it would heal the body. The second principle is the law of infinitesimals, which states that "substances become more potent when diluted" (Novella et al., 2008, p. 9).

Of course, Hahnemann did not have the technological advantage that modern doctors and scientists enjoy. Over the years since its inception, homeopathy has always been somewhat controversial. Some scientists have suggested that the remedies are so highly diluted that there is actually nothing of the original substance left. There are doctors who have criticized homeopathy and suggested that people get well only because they have convinced themselves they are better (the placebo effect). An interesting roundtable discussion of scientists took place at Penn University in 2008. After much initial skepticism, their conclusion was that homeopathy is indeed a valuable form of medical science. Novella (2008) states:

… homeopathy is very plausible and there is both ample clinical and epidemiological evidence that it works. Homeopathy will become an integral part of medicine despite the paradoxical nature of its remedies and all other prejudices against it, simply because homeopathy is safe, efficacious, and cost effective (p.13).

The concept of the constitution is an important one in homeopathy. In many ways, this is the vital life force that Hahnemann believed exists in all of us. As a result of this belief, the classical homeopath engages in a highly detailed discussion with every patient especially during the initial visit. The homeopath is concerned with everything, not just the physical symptoms occurring at the time. They want to know about the person's emotions, their personal interactions, work life, stressors, dreams, and anything else of importance in the person's life. They also take into account the person's appearance, demeanor, and body language. "Homeopaths use the vital force assessment to guide dose (potency) selection and treatment pace and to judge the likely clinical course and prognosis" (Bell et al., 2004, p. 124).

This notion of a vital force or constitution indicates that Hahnemann may have already known or understood (at least to a degree) what happens to the body on the atomic or molecular level. This is something that not even our present-day scientists can measure. The inability to measure this notion of the “life force” or “constitution” has been one of the criticisms leveled at homeopathy. The other has been its use of substances that are toxic in their natural state, such as arsenic, but are medicinal and safe in their diluted form, such as Arsenicum Albun, a well-known homeopathic remedy.

Jobst (2005) states her conclusions thusly:

In the meantime, if patients are recovering through the use of nontoxic homeopathic medicines and using the homeopathic method, let us, as physicians, get on and heal in the truest sense of that word, while as scientists we search to understand the mechanisms by which our activities might be working, and let us strive to always remain open (p. 274).

Traditional Chinese Medicine

Traditional Chinese medicine (TCM) may be one of the world's oldest medical systems. It was developed over 2,000 years ago and has only become popular in Western cultures in the late twentieth and early twenty-first century. One of the key concepts in TCM is the notion of the qi, or life-force. In some ways, this notion of a life-force is somewhat similar to the notion of the vital force in homeopathy, but they are understood and treated differently. There is no doubt that TCM is fundamentally different from Western medicine in many essential ways. Even with a small similarity to homeopathy, it is also distinctly different from any other form of medical treatment. It is important to take into account that TCM is a reflection of a specific culture, like Ayurvedic medicine developed in India. Some of the components that are essential to TCM include:

• Personal observations of the physician,

• A subjective basis for diagnosis,

• Healing as a way to balance the body's processes,

• Measuring the outcomes of treatment qualitatively (versus quantitatively), and

• Gearing the treatment to the individual and not the condition (Shea, 2006).

One of the criticisms of TCM is that it is based on a physician's subjective observations rather than an in-depth examination of the person (Shea, 2006). This observation has even been made in China, where many are beginning to question its efficacy. A second criticism has been regarding the herbs used to treat. A typical Chinese pharmacy has thousands of remedies made from a wide array of herbs, animal parts, and other pharmacopeias.

Herbalism

Herbal medicine may have been humanity's first attempt at a synthesis of conditions and corresponding treatments. The very first treatments may have been the herbs and flowers that people found in their immediate surroundings. However, herbal medicine has come a long way since those early days of human civilization. In fact, the words “herbal” and “natural” seem to be everywhere. People in Western countries are flocking to the stores to buy lotions with lavender, tea with chamomile, and even cleaning products are being infused with natural and herbal elements. Modern-day herbalists engage in training, and they must be certified to practice. Although many advancements have been made in our understanding of what herbs can do and our preparations of herbal remedies, there are still concerns about the safety of these remedies.

Ernst (2004) explains, "Safety issues related to herbal medicine are complex: possible toxicity of herbal constituents, presence of contaminants or adulterants, and potential interactions between herbs and prescription drugs" (p. 985). Given these concerns, why is it that herbal remedies have become so popular, and what is it that people and practitioners can do to ensure the remedies are safe and appropriate? One of the reasons for the increasing popularity of herbal remedies is the same reason for the boom in homeopathy and TCM. People are looking for natural answers to their problems. In fact, there is a larger irony here. On the conventional side of medicine, there are concerns over the safety of herbs and other alternative remedies. Yet, many people carry the same concern regarding pharmaceutical medicines and conventional treatments. People worry about radiation from CT scans and MRIs. They wonder whether the medicines they are taking will cause serious side effects, as has been the case with many medicines that have had to be taken off the shelf permanently.

Ginkgo biloba, echinacea, garlic, ginseng, and saw palmetto were among the most commonly used herbal or dietary supplements in 2007 (Nahin, Barnes, Stussman & Bloom, 2009), and the herbs most researched on the National Center for Complementary and Alternative Medicine (NCCAM) website in 2012 were evening primrose oil, St. John’s wort, fenugreek, echinacea, and aloe vera. One important concern is that unlike homeopathic remedies, herbs have the potential to interact with pharmaceutical drugs.

Complementary Medicine

These are treatments that are given in conjunction with and not in place of allopathic treatment.

Complementary medicine prides itself on being noninvasive and nonpharmaceutical. It should be noted that some (but not all) practitioners in this field of medicine are also highly regulated, undergo rigorous training, and must be certified in order to practice.

Chiropractic

While many people might think of chiropractic care as a relatively recent treatment, it was actually developed back in the late nineteenth century (Cooper & McKee, 2003). For decades, chiropractors fought to be accepted as a legitimate form of medical treatment by mainstream conventional medicine. In the twenty-first century, conventional medicine is becoming more supportive of chiropractors, and many doctors and some surgeons refer their patients to chiropractors before considering more invasive procedures such as surgery. Still, there are medical practitioners and patients who are skeptical (and some even fearful) of chiropractic manipulations. The technique used is called spinal manipulative therapy (SMT).

The primary reason people go to chiropractors is for musculoskeletal pain. Most often, this is back or neck pain. They rely on the chiropractor's use of SMT to alleviate their pain and hopefully avoid more invasive treatments. SMT is based on the principle that the spine experiences “subluxations” of the joints. This literally means that joints go out of place and must be manipulated back into place. When they are out of alignment, these joints can cause muscular, joint, and nerve pain (Cooper & McKee, 2003). Unfortunately, some studies have suggested that SMT is not always reliable and has sometimes demonstrated adverse side effects, and there is a problem with consistency of treatments among chiropractors, which makes the treatments questionable (Cooper & McKee, 2003). Many insurance companies in the U.S. will not pay for chiropractic treatment, and there are still concerns among conventional doctors about the efficacy of chiropractic care.

Massage Therapy

The growing popularity of massage therapy is not surprising. To lie on a firm, supportive table, while soft music plays and someone kneads out the knots in your body has a soothing ring to it. The question is whether or not massage therapy has any medical purpose. There are many different forms of massage, including deep tissue, Swedish, and shiatsu. Some doctors and researchers suggest that while having a massage is a nice experience and provides short-term pain relief, it does not have any long-term medical advantage. Others would disagree. Massage therapy is neither new nor unusual in Western culture. Unlike other complementary and alternative forms of medicine that have only emerged relatively recently, massage therapy seems to be an almost universal form of treatment. According to Kaye et al. (2006), "Massage therapy, especially deep tissue massage (DTM), has been used for centuries to relieve myofascial syndromes including muscle spasm, muscle strain, and pain associated with numerous neuromuscular pathological processes" (p. 128).

Doctors are becoming less skeptical about the long term benefits of massage therapy. People are being referred to massage therapists for a wide range of physical and psychological conditions. There have been clinical studies to suggest that massage therapy has both physical and emotional benefits. The use of massage therapy has broadened from being a luxury for an occasional ache or pain to being used for people with multiple sclerosis, cancer, HIV/AIDS, neurological trauma, sciatica, depression, anxiety disorders, and many others. While some people do experience bruising, soreness, fatigue, and increased discomfort (Cambron, Dexheimer, Coe, & Swenson, 2007), most people feel better after massage therapy.

Acupuncture

The most famous treatment in traditional Chinese medicine is probably acupuncture. This treatment has gained increasing popularity in Western countries. Acupuncture is thought to be primarily helpful for aches and pains or to alleviate the problems from an injury; however, it has a much broader medical application. Acupuncture has been used in clinical trials for a wide range of moderate ailments to life-threatening conditions. These include arthritis, chronic back pain, sciatica, HIV/AIDS, and many others. The technique involves using various sized needles that the acupuncturist inserts into points along meridians in the body. These meridians are energy points and designed to stimulate the qi, or the person's life-force, and the healing process. The “needling” can be done dry or using electricity. "Acupuncture has established a reputation among the public for being a safe and effective treatment for a range of conditions. It relies greatly on its reputation for its widespread acceptance and growth as a valuable treatment technique" (White, 2007, p. 9).

Additional treatments in complementary and alternative medicine include aromatherapy, ear candling, energy healing, crystal healing, reflexology, lymph drainage, and cranial sacral therapy.

Further Insights

Integrating Holistic Medicine into Conventional Medical Training

One of the most promising applications is that of integrating these alternative and complementary medical treatments and philosophies into conventional medical training. By 2004, a majority of allopathic and some osteopathic medical schools provided some kind of complementary and alternative medicine curriculum to their students (Saxon, Tunnicliff, Brokaw, & Raess, 2004). Although this represents an intriguing and perhaps promising concept, skepticism remains strong among students and practitioners of conventional medicine concerning alternative forms of medicine such as herbalism and TCM. Critics question the efficacy and reliability of complementary and alternative medicine practices, and researchers at NCCAM and other organizations seek to legitimize them by subjecting them to the scientific scrutiny and proof of efficacy required of conventional Western techniques.

Despite this ongoing skepticism, given the increasing popularity of alternative medicine, and the fact that many people are turning to alternative practitioners, it is to the advantage of conventional doctors that they have at least some level of knowledge regarding these medical systems. At the very least, they are enabled to communicate with their patients in an informed and understanding way and assist them as they pursue a more holistic approach to their health care.

Conclusion

Holistic medicine is a growing field all over the world. Many people are turning to holistic medicine out of frustration with some of the failures of conventional medicine. Some people feel that conventional medicine is impersonal, while holistic medicine is personal and more attentive. The reasons for turning to holistic medicine may be due, in part, to the fact that some people are becoming skeptical of pharmaceuticals and do not like taking pharmaceutical medications. The growth of the “natural” industry is very much a part of the holistic approach that many people find comforting. While there are still conventional practitioners who maintain a skeptical attitude toward natural products that they feel are insufficiently tested or regulated, many are beginning to accept the benefits of the holistic approach. The notion of attending to the mind-body-spirit is one that gives people a sense that the practitioner cares.

Terms & Concepts

Acupuncture: A practice in traditional Chinese medicine that uses needles of various sizes to stimulate points along the body's energy streams, called meridians.

Allopath: Refers to a doctor of medicine who practices conventional or traditional Western medicine.

Alternative Medicine: A branch of medicine that embraces a wide range of various medical systems from different cultures that are not based in biomedicine. Some of these include Chinese medicine, homeopathy, and herbalism.

Aromatherapy: A treatment that uses essential oils to help restore balance to body, mind, and spirit. Essential oils come from plants, and the premise is that they stimulate the sense of smell, which can impact how we feel.

Chinese Medicine: Also referred to as traditional Chinese medicine, this is a system of medical treatment developed over 2,000 years ago in China and embraces the use of Chinese herbs, acupuncture, and a unique system of diagnosis. Over the centuries, there have been several forms of Chinese medicine, and the unified system known as TCM only emerged in modern times.

Chiropractic Care: A nonpharmaceutical, hands-on approach that uses spinal manipulations as the core of its treatments. The chiropractor trains for the same number of years as a medical doctor and is accorded the title doctor of chiropractic medicine.

Complementary Medicine: Various health care techniques and strategies such as physical therapy, massage therapy, and many others that are used as a complement to either traditional or alternative medicine.

Energy Healing: Is based on the belief that the practitioner uses his or her intuition and intent to create a flow of energy through his or her hands and to the client. The premise is to stimulate energy flow and a sense of well-being.

Herbalism: A system of treatment that uses herbs in specific formulations to produce natural medicines. The practitioner of this form is generally known as an herbalist or certified herbalist.

Holism-Holistic: The term that refers to the philosophy underlying all complementary and alternative medicines. In the holistic belief system, illness and injury are often the result of disharmony in the mind-body-spirit, which practitioners see as one.

Homeopathy: A form of alternative medicine that uses minute dosages of substances that produce the symptoms of the illness. They are given to the person in the belief that doing so will stimulate the body's own healing power. The primary purpose of homeopathy is to stimulate the body's own healing responses or the “constitution.”

Bibliography

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Cambron, J. A., Dexheimer, J., Coe, P., & Swenson, R. (2007). Side-effects of massage therapy: A cross-sectional study of 100 clients. Journal of Alternative & Complementary Medicine, 13 , 93–796. Retrieved July 1, 2008, from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=27391535&site=ehost-live

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Hassed, C. S. (2004). Bringing holism into mainstream biomedical education. Journal of Alternative & Complementary Medicine, 10 , 405–407. Retrieved July 1, 2008, from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=13189153&site=ehost-live

Jobst, K. A. (2005). Homeopathy, Hahnemann, and the Lancet 250 years on: A case of the emperor's new clothes? Journal of Alternative & Complementary Medicine, 11 , 751–754. Retrieved July 1, 2008, from EBSCO online database, SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=18977622&site=ehost-live

Kaye, A. D., et al. (2008). The effect of deep-tissue massage therapy on blood pressure and heart rate. Journal of Alternative & Complementary Medicine, 14 , 125–128. Retrieved July 1, 2008, from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=31218830&site=ehost-live

Nahin, R. L., Barnes, P. M., Stussman, B. J., & Bloom, B. (2009). Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007. National Health Statistics, 18, 1–6. Retrieved November 12, 2013, from http://www.cdc.gov/NCHS/data/nhsr/nhsr018.pdf

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Saxon, D. W., Tunnicliff, G., Brokaw, J. J., & Raess, B. U. (2004). Status of complementary and alternative medicine in the osteopathic medical school curriculum. Journal of the American Osteopathic Association, 104, 121–126. Retrieved November 12, 2013, from http://www.jaoa.org/content/104/3/121.full#ref-7

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White, A. (2007). The safety of acupuncture techniques. Journal of Alternative & Complementary Medicine, 13 , 9–10. Retrieved July 1, 2008, from EBSCO online database, SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=24088185&site=ehost-live

Wu, E. S. (2013). Traditional Chinese medicine in the United States: In search of spiritual meaning and ultimate health. Lanham, MD: Lexington Books. Retrieved November 12, 2013 from EBSCO online database eBook Collection (EBSCOhost). http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=588513

Suggested Reading

Cloninger, R. C. (2004). Feeling good: The science of well-being. New York, NY: Oxford University Press.

Coulter, I. D. (1999). Chiropractic: A philosophy for alternative health care. Oxford, England: Butterworth-Heinemann.

Cummings, S., & Ullman, D. (1984). Everybody's guide to homeopathic medicines. Los Angeles, CA: Jeremy T. Archer.

Heller, T., et al. (Eds.). (2005). Perspectives on complementary and alternative medicine: A reader. London, England: Routledge.

Juvva, S., & Newhill, C. E. (2011). Rehabilitation contexts: A holistic approach. Journal of Human Behavior in the Social Environment, 21, 179–195. Retrieved November 12, 2013 from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=59131920

Kendall, D. E. (2002). Dao of Chinese medicine: Understanding an ancient healing art. New York, NY: Oxford University Press.

Merrick, J. (2013). Textbook on evidence-based holistic mind-body medicine: Holistic practice of traditional Hippocratic medicine. New York, NY: Nova Science Publishers, Inc. Retrieved November 12, 2013 from EBSCO online database eBook Collection (EBSCOhost). http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=608842

Ziment, I., & Rotblatt, M. (2002). Evidence-based herbal medicine. Philadelphia, PA: Elsevier Health Sciences.