Complementary Medicine — An Overview
Orlando G. Florete, Jr., M.D.
Orlando G. Florete Jr., M.D. is Director of the Baptist Institute of Pain
Management.
Introduction
Complementary, Alternative or Integrative Medicine is a technique that uses natural,
non-invasive means to promote health and healing. It emphasizes achieving health,
elimination of disease, treating the underlying cause rather than the symptoms, and
provides an approach addressing the patient as a whole. This holistic approach covers the
role of diet, supplementation, lifestyle, preventive measures, and an active role in the
part of the health practitioner as an empathetic partner in the healing process; someone
who informs, advises, and helps the patient make health care choices. There are multiple
means of alternative medicine. As a rule, regardless of technique, they provide a
comprehensive program for maintaining normal health, prolongs life span, promotes
resistance to diseases, and helps in the recovery process.
Similar to the practice of traditional medicine, integrative medicine uses the four
principles that define the philosophy and foundation of its practice. The first principle
is based on the healing power of nature and the ability of the human body to heal itself.
The health practitioner facilitates and enhances the process with the aid of natural and
non-toxic products. It also emphasizes the healing power of the mind. The second principle
is based on the concept of "primum no nocere"— first do no harm. This is
the basic tenet in the practice of medicine. Thirdly, the identification and treatment of
the cause is of vital importance rather than simply treating the symptoms. Lastly, one of
the roles of the health provider is to be a teacher, educating the patient in achieving
health and avoiding diseases.
The American public has accepted complementary medicine in their daily lives. More than
sixty million Americans have used this techniques, spending billions of dollars annually
on alternative treatment. As a form of treatment, integrative medicine is holistic,
viewing the mind and body as a living integrated system. It's basic premise is that the
mind and body continually interact such that positive thoughts have positive impact in
one's health and negative thoughts have the opposite effect. Conversely,
pathophysiological changes directly affects the mind, leading to emotional and
psychological imbalance. Health is defined not only as the absence of disease but is a
result of all bodily systems working in harmonious balance with each other and with the
environment.
Components Of Integrative Medicine
Integrative or whole body medicine combines the wisdom of Eastern and Western cultures
including India, China, and Greece. The following medical therapies are classified as
alternative or complementary in today's practice of modern medicine: Chinese medicine,
acupuncture and acupressure, biofeedback, herbal medicine, chiropractic medicine,
osteopathy, homeopathy, hypnosis, Ayurvedic medicine, meditation including transcendental
meditation and yoga, nutritional therapy, exercise, massage, visualization, aromatherapy,
hydrotherapy, hyperthermia, music therapy, ozone therapy, and other body therapies.
Chinese Medicine
Chinese medicine is based on the belief that humanity is part of a large creation, the
universe, and subject to the same laws that govern nature. Life and the material universe
come from a single original source, called Tao, which is an integrated whole present in
everything. It consists of two opposing forces, the yin and yang, each of which is
necessary to create all phenomena. The yin represents qualities of cold, rest, passivity,
darkness, inwardness, and decrease while yang is associated with heat, activity,
stimulation, light, outwardness, and increase. Health represents a balance of the yin and
the yang while disease is due to the disharmony between these two opposing forces.
The balance of these two forces within the body is manifest in the flow of energy
called chi. This represents the life force that flows through the body in precise and
orderly patterns called meridians. Chinese medicine identifies fourteen meridians, twelve
of which are associated in maintaining individual organ function while two are responsible
for unifying various systems. Each meridian can either be yin or yang and runs vertically
from the head to the feet, moving the life force (chi) to specific body parts. If the
meridian is blocked or stagnant, an imbalance of the life force is created, resulting in
disease or abnormalities. Treatment is based in bringing harmony between the yin and the
yang. These include the use of certain food, herbs, tai chi exercises, acupuncture,
acupressure, application of heat, or massage.
Acupuncture And Acupressure
Acupuncture is a technique to restore health using a tiny needle as antennae to direct
the life force (chi) to bodily organs and functions, or to drain chi where it is
excessive. It is use to restore balance between the yin and the yang. It is used both as a
diagnostic tool to detect imbalance of the life force and a way to treat diseases. The
needle is inserted just below the epidermis and does not draw blood or cause discomfort.
Heat is sometimes applied to the acupuncture sites, a technique called moxibustion. In
China, acupuncture is commonly used as a method of anesthesia. In the United States,
acupuncture is widely used to treat pain of various etiologies, mental disorder, stop
smoking, treat alcoholism, drug dependence and other forms of addiction. It has also been
used to improve the immune function of AIDS and cancer patients. Acupuncture is discussed
more extensively in a separate article in this issue of Jacksonville Medicine.
Acupressure is a variation of acupuncture in which the thumb and fingers are used to
press chi points on the surface of the body. The goal of treatment is to assess the
balance between the yin and the yang and to restore deficiencies or correct excessive chi,
thus restoring health. It is used to relieve muscle tension, improve circulation, relieve
anxiety, increase mental alertness, and aids in healing by removing waste products through
increased blood flow. Acupressure and acupuncture are believed to stimulate the release of
endorphins thus help in relieving pain. Several treatment sessions are needed over the
course of weeks or months to assure success.
Biofeedback
Biofeedback is a technique aimed to control involuntary functions including heart rate,
skin temperature, sweating, and blood pressure through concentration and will power. It
uses electronic devices that amplify body electricity in order to help people monitor
otherwise unconscious physiological processes. The patient is trained to consciously
control previously involuntary functions. Electrodes are attached to the body to provide
readings, giving the patient feedback necessary to determine whether their mental powers
are causing the desired physiological changes. It has been utilized successfully in the
treatment of migraine headaches, sleep disorders, attention deficit disorder in children,
incontinence, postural problems, chronic pain syndromes, and loss of control due to
nervous system damage. It has also been effective in the treatment of cardiac dysfunction,
gastrointestinal disorders, tics, fatigue, cerebral palsy, alcoholism, and various
psychologic disorders including anxiety, posttraumatic stress disorder, and depression.
Herbal And Botanical Medicine
Since the ancient time, the use of plants and plant products in the treatment of
various illnesses was widespread. It is not uncommon that a mixture of herbs, plants,
plant roots, and in some instances, animal parts were mixed together as a concoction.
Through the passage of time, these products were found to work because they contain
chemicals which help cure the disease or suppress its symptoms. Today, approximately
twenty five per cent of the available pharmaceutical products are derived directly from
plants, including some birth control pills (from Mexican yam), digitalis (from foxglove
plant), beta carotene (from certain fruits and vegetables), just to mention a few. As many
as 5,000 plants have been extensively tested for medicinal purpose. Plants such as Aloe
vera, black currant seed, bitter melon, hot chili and sweet bell peppers, green tea,
chamomile, cranberries, dandelion, Echinacea, garlic, ginger, ginkgo biloba, ginseng,
licorice, various mushrooms, St. John's wort and a multitude of the plants and herbs are
used routinely to treat a multitude of medical problems. Natural botanical products are
usually milder in its effect compared to compounded or synthesized products. They are also
released more slowly into the blood stream.
Plant products can be administered several ways including orally in capsule form, as a
poultice whereby the herb or plant is externally applied, as a plaster where the herb is
placed between two pieces of cloth and applied on the affected body surface, or as an
extract which can either be taken orally or applied topically.
Chiropractic Medicine
Chiropractic medicine involves the manipulation of the skeleton.
"Chiropractic" is derived from a Greek word meaning " done by hand".
The ancient Greeks were credited with inventing the technique as early as 1250 B.C. The
modern technique was founded by Daniel David Palmer in 1895 when he first performed spinal
manipulation. The practice is based on the principle that the nervous system ultimately
controls the body and that "subluxation" or misalignment of the spine can impact
one's health. Adjustment of the spine can therefore restore wellness. Present day
chiropractors either manipulate the spine to restore nerve flow and function, as well as
diagnose, treat, and eliminate certain conditions such as low back pain, or treat
"subluxations" in an effort to restore normal nerve flow. Oftentimes, the
chiropractor incorporate other methods of treatment including physical therapy, exercise
massage, nutrition and acupuncture.
Osteopathy
Osteopathic medicine employs manipulation of bones to allow free circulation of blood
and balanced functioning of nerves. The technique was developed by a Civil War physician,
Andrew Taylor Still in an effort to avoid prescribing toxic drugs and find a way to
enhance nature's ability to heal. This practice is based on the assumption that the
structure of various organ systems and tissues affect bodily functions. Correction of
posture problems, mobilization of joints, and spine alignment can therefore improve health
and help in the process of healing. It differs from chiropractic medicine in two ways: 1)
Osteopaths manipulate all joints while chiropractors manipulate only the spine; and 2)
osteopaths also focus on the health of the blood and lymph vessels because they believe
that when blood and lymphatics flow freely, the tissues can optimally function.
Osteopathy has been used successfully in the treatment of certain physiologic motor
disorders in children, and in low back and other chronic pain syndromes. It has provided
help in arthritis, cardiac and pulmonary disease, chronic fatigue syndrome, hypertension,
hiatal hernia, various neuropathies as well as a multitude of spinal and joint disorders.
Osteopaths are involved in comprehensive medical care, including the prevention, diagnosis
and treatment of diseases.
Homeopathy
Homeopathy is derived from the Greek words "homoios" meaning like, and
"pathos" meaning suffering or disease. Homeopathy is a system of therapeutics in
which diseases are treated by drugs which are capable of producing in healthy persons
symptoms like those of the disease being treated. It has been used in the treatment of
migraine headaches, cough, ankle sprain and other conditions such as malaria. At the
present time, the American Medical Association does not recognize this practice of
medicine because it is not based on sound scientific principles.
Hypnosis
Hypnosis employs the principle of suggestion in susceptible individuals. It has been
successfully employed in the treatment of various painful states, ulcers, psychosomatic
disorders, various psychological disorders including obsessive compulsive disorders,
promote weight loss, and to help patients remember traumatic events in their lives. It has
been used in lieu of anesthesia in a variety of surgical procedures. The WHO cautions the
use of hypnosis on patients with organic brain syndromes, psychosis, and antisocial
personality disorder. This subject is extensively reviewed elsewhere in this issue.
Ayurvedic Medicine
Ayurvedic Medicine is a form of holistic practice originating from India employing the
principle of "Ayurveda" which means the science of life and longevity. It is
based on the premise that health is a state of balance among physical, emotional, and
spiritual systems. Disease results from an imbalance among the body's system. This form of
medical therapeutics is highly individualized, and employs meditation, diet revision,
sleep improvement, yoga and other forms of meditation, massage, use of herbs and plant
products, aroma and music therapy. This form of medical practice has been used in India
for more than 6000 years. It believes that optimal health is achieved by cultivating
mental and physical habits that promote physical and spiritual well-being.
Meditation
Meditation is defined as an active process of focusing the mind into a state of relaxed
awareness. A symbolic word or sound (mantra), sound and flow of breathing, or a single
focused image may be utilized to induce a restful trance which strengthens the mind by
freeing it from its accustomed turmoil. It lowers and normalizes blood pressure, heart
rate, and levels of circulating stress hormones and lactate. It increases alpha brain wave
activity indicating a relaxed state. It can lower cholesterol levels, improve
concentration, memory, intelligence, and creativity. Meditation also lowers the immune
system resistance and induces the relaxation response. It has been used to treat disorders
by controlling the involuntary nervous system.
Transcendental meditation is a form of relaxation technique which transcend normal
thought processes to a heightened level of awareness, producing in the body and mind a
sense of profound relaxation and rest. Another form of relaxation technique is yoga, which
in Sanskrit means "union". It focuses on altering the patient's mind, and using
the power of the mind to generate healing within the body.
Nutritional Therapy
Nutrition is one of the most important aspect of holistic medicine. Proper eating and
dietary habits promote health, prevent diseases and helps in the healing and restorative
process. Nutritional supplementation helps in reversing or preventing a variety of
diseases including heart diseases, cancers, strokes, diabetes, and arteriosclerosis. More
than ever, the American public is using vitamins and other natural products to supplement
their diet in the belief that it prevents disease, strengthens their immune system,
modifies the natural course of certain diseases, and prolong their lives.
Exercise
An increasing number of Americans are making exercise part of their daily routine.
Exercise has been found to maintain heart and lung fitness, lowers, hypertension, prevents
loss of muscle mass, reduces body fat, helps maintain the ideal body weight, improves
glucose tolerance, and reduces insulin resistance. Additionally, it helps maintain bone
mass and prevent bone loss, maintains joint flexibility, reduces depression and negative
moods, increases life expectancy, and reduces pain in certain painful states.
Miscellaneous Alternative Techniques
Other alternative techniques to promote help and treat disease include the use of
massage or neuromuscular therapy (this is discussed elsewhere in this issue), hydrotherapy
or use of heated water, hyperthermia or heat therapy, visualization or imagery, the use of
essential oils and aroma, and the use of music as part of the relaxation techniques. These
have been used as an adjunct to traditional medical practice with variable success. These
techniques are non-invasive, have minimal risk, and may provide long lasting benefits in
the whole being of the patient.
Conclusion
The practice of medicine continues to evolve. Alternative medical techniques were once
considered as housewives remedies and quackery but are now becoming part of the
conventional medical approach. With the passage of time, it becomes self evident that
traditional medicine as we know it may not be enough to maintain health, prevent disease
or improve outcome. The time has come for us to step back, take a closer look and examine
the various modalities of complementary medicine with an open mind. Holistic medicine
takes into consideration the mind, body and spirit. We, as physicians have two major
roles: to cure the sick and relieve suffering. In order to achieve these goals, it becomes
imperative that we see the patient as a whole person, emphasizing health maintenance,
disease prevention and self healing.
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Jacksonville Medicine / January, 2000 |