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What does alternative medicine really mean
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What does alternative medicine really mean
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Inizialmente pubblicato nell'European Journal of Herbal Medicine e ripubblicato per gentile concessione.

Marco Valussi

Introduction


In the last two decades practitioners and advocates of Alternative Medicine (AM) have used new and increasingly sophisticated theoretical tools to describe and make sense of alternative practice (nota 1).  This journal has itself published articles that have raised issues concerning the nature and justification of AM and the implications for the practitioners of Herbal Medicine.  In particular Midge Whithelegg, in her article ‘An Alternative Science for Herbal Medicine’ (1995), calls for an alliance between herbalists and AM.
My intention in this paper is to look critically at some of the arguments presented in the literature, and particularly at those that depict AM as free from the power-related dogmas of orthodox medicine and more in tune with Nature and the emerging new ideas in science.  I will suggest that the set of beliefs that AM has promulgated about itself is fallacious, and that a more pragmatic approach might serve us better.  It is also my aim to show how an important perspective of inquiry - that is, the socio-anthropological perspective - has been neglected in favor of others, and how this neglect has conditioned much of the discussion in this field.  Inasmuch as Herbal Medicine shares some features with other therapies or systems commonly termed ‘alternative’, and as the views identified as ‘alternative’ are alive amongst some herbal practitioners, the arguments presented here have some important bearings on the debate about the relationships between Herbal Medicine and biomedicine on one side and AM on the other.


I.
Medicine has been discussed and defined as a human science, or at least as sharing many of the features of human sciences, by many authors (Nota 2) .  However, in examining the various arguments presented as a project of justification for AM (Nota 3) , very little mention is made of the social dimension of illness, or of a socio-anthropological analysis of AM (nota 4).  The most honorable place is undoubtedly reserved for epistemological theories (that is, the theories concerned with the nature of knowledge, rather than, say, those concerned with practice, or ethics).  Emphasis has most notably been placed on the new theories in epistemology and the theory of science developed by Kuhn and the social constructionists, and on the theories of quantum physics, system and complexity theories, and chaos theories.
One inconsistency in the use of these is most revealing: that between some of the historical tenets of AM and the new theoretical tools used.  I assume the following to be some of the most important commonly shared tenets by practitioners of AM: the inherent wholeness of the body and of the soul; the importance of harmony, both as internal harmony and as correspondence to immutable laws or patterns of Nature (‘...certain principles...are shared by acupuncture, herbal medicine, homeopathy, etc...These principles are complementary...Nevertheless, there is an underlying truth towards which every school of thought is working...Surely the universe was created and is sustained on one set of principles, so there can only be one truth.’) (Nota 5); Nature itself; the concept of healing force, vital energy, Life Force, seen as something that integrates, maintains, gives a basis for normal functioning, for maintaining homeostasis; healthiness as purity - purity of foods, purity of thought and emotions; the existence of types - psychological, emotional, elemental, temperamental - and their correspondence to diseases, and so on
Very often the use of ‘new science’ theories and the conclusions drawn from them have been extremely naïve, at times lacking any coherence (e.g. the unconvincing connection made between Teilhard de Chardin’s Darwinian theology and J.E. Lovelock’ Gaia theory by Hoffmann (Nota 6), and also D. St. George’s attempt (Nota 7) in his speech at Middlesex University to string together Kuhnian ‘new paradigms’ and an alleged ‘cosmic force’ or ‘unity’) (Nota 8).  The references offered in support of the claims have been mainly from secondary sources, as in the case of the over-quoted Capra (Nota 9) .
Where primary sources are utilized, they are usually partial readings accepted uncritically, as in the case of quantum mechanics.  The main problem with the way the majority of authors in AM has dealt with the argument is that they have limited themselves to two exponents of the field (namely Capra and Bohm) without acknowledging this partiality of readings (Nota 10) .  They also have taken at face value the ontological implications these authors have believed to see in their theories.  In fact the literature on quantum mechanics is as vast as it is esoteric (Nota 11).  In other instances theories already characterized by vagueness and adaptability have been used (as it is the case for Kuhn’s theory, at least in the 1969 form).
There are two problems with the use of this array of theories as coherent means of justification for AM:

•    1.  Lack of internal coherence.
Not only do the above theories often have very little to do with one another, but they are piled up together in an attempt to unify or reconcile opposite tenets, with no distinctions made between methodological (pertaining to the ways a science structures its methods of research), epistemological (pertaining to the theory of the grounds of knowledge) and ontological (pertaining to the science of being, of the essence of things) (Nota 12).
Of course, whenever this fundamental distinction is lost, any argument can be used to support any other one; ‘anything goes’.
The danger is that a less-than-sympathetic commentator would dismiss, together with these shaky arguments, the more cogent ones which are indeed raised by AM.

•    2.  Lack of external coherence.
Fundamental, and always present in the discussion in AM, is the concept of nature.  
Nature is presented as an unproblematic entity, whose existence and importance is never doubted.  Nature is the reference point towards which therapies have to move, and it is embodied in the sick person as the ‘vital force’, the ‘natural’ tendency of the body to heal, as the ‘vix medicatrix naturae’.  Sometimes Nature is personified by an ancient sage (Hippocrates, Huang Ti), or presented in the name of old traditions that, because of their antiquity, are supposed to have a more direct contact with ‘the natural way’.
“Mankind can look back through thousand of years to herbal medicinals as a safe, readily available, gentler means of healing.  Herbs have been used from the time of recorded history for every facet of life...herbs are all-encompassing and timeless, as nature itself is infinite and eternal.” (Nota 13)
This attitude cannot but engender an idealized picture of Human Being as a naturally balanced being, where mind, body and spirit are happily integrated and where disease is seen as a sign of fragmentation.  Disease, as an internal imbalance, is to be treated through an enhancement of the patient’s own healing force, whether with only the guide of the therapist or with a more direct intervention (as it can be in herbalism) (Nota 14).  These positions can be strongly essentialistic, presupposing the existence of a ‘thing in itself’ that does not depend on contingencies or contexts.



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Marco Valussi
Luciano Posani

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