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Comparing and contrasting alternative medicines to Western medicine (Proceedings)
Alternative therapies have become increasingly popular in recent years, but their use in veterinary medicine is not without controversy.
Alternative therapies have become increasingly popular in recent years, but their use in veterinary medicine is not without controversy. As the use of these therapies has become evermore popular in the general population, and because they have proven to be effective, it has become commonplace to see some of them used in professional practices, both human and veterinary. Other alternative medicines are being used by many people (for themselves and/or their pets), but some of these have not yet received broad-based acceptance.
Examples of the more accepted alternative medicines would be acupuncture and chiropractic. An example of an alternative method that is perhaps less accepted in the veterinary field might be the shamanic approach to soul retrieval. Aromatherapy and Flower Essences (Bach Flowers) are examples of medicines readily available to the general public and to practitioners alike.
Practitioners who use alternative medicines may combine them with Western medicine techniques, or they may use one or more of them almost exclusively. Some holistic practitioners use a variety of alternative methods, and they might use them exclusive to any Western medicine; others stick to one or perhaps two core alternative methods to enhance their Western medicine practice. Practitioners have thus come to use terms such as complementary medicine or integrative medicine to describe the way alternatives are used in their particular practice, and in the case of human medicine CAM (Complementary and Alternative Medicine) has become a popular term.
Comparing and contrasting alternative medicines with Western medicine
While it is impossible to lump all types of alternative medicines into one format, there are some generalities that apply to most alternative medicines.
•As a rule, alternative medicines are "wholistic", and they are applied to the whole animal: body/mind/emotions/spirit. In other words, while a disease may manifest itself in one part of the body, an alternative practitioner would be concerned about how other parts of the whole body were affected by the disease process. And, in addition to attempting to heal the physical aspects of a disease, alternative medicines try to alleviate problems that may be coming from mental, emotional, or "spirited" (i.e. the vital principal or animating force within living beings) sources.
•Alternative practitioners are more likely to assess the whole environment of an animal, believing that an animal's physical and social environment has huge implications on overall health and disease.
•Rather than using Western medicine's paradigm of specifically attacking one "agent" as the only cause of the disease, alternative medicines tend to act by trying to balance the patients overall bodily protective and healing systems. That is, alternative medicines try to balance the animal's whole body defense systems, and they tend to rely on the animal's innate ability to heal itself ... once it has been given the opportunity to do so.
•Alternative medicines often work with the "energetics" of an animal, and their usage is meant to enhance this innate or inner vital force so that it can provide health and healing. An example of this is acupuncture, where needles are used to move the animal's "chi" (the body's inner energetic or animation) so that its forces are balanced throughout the body.
•Some of the ways alternative medicines work are difficult, if not impossible, to measure. Chi, for example, can be felt, and with the proper instrumentation it can be measured, but it is not an easy entity to put a statistical number on. Alternative medicines, and especially the way they work, may therefore be difficult to quantify using Western medicine's methodologies.
•Many alternative medicines use diagnostic and treatment approaches that are totally foreign to the Western practitioner's frame of reference. To an acupuncturist, for example, arthritis may be the result of a blockage of chi through the affected joint, and the treatment will be aimed toward returning a normal flow of chi through that joint (via acupuncture needles and perhaps nutrition, exercise, massage, and/or herbal medicines).
•Alternative medicine practitioners focus on curing the disease in its entirety, claiming that Western medicine often focuses on suppressing symptoms instead of dealing with more hidden, underlying disease causes.
•Alternative medicine's way of evaluating the success of treatments may be different from Western medicine's methodology. For example, an animal may be greatly improved clinically after being treated with one of the alternative medicines, but its blood chemistry values may remain abnormal.
•Since alternative medicines attempt to work by healing the whole body, unexpected beneficial side effects are often noted. An example would be the dog being treated with acupuncture and herbs for a liver condition might become much less angry and difficult to handle.
Side effects from alternative medicines
Anything that has the ability to heal or cure ... also has the ability to cause harm. This holds true for the alternative medicines, although most practitioners report far fewer adverse side effects than they previously observed when using Western medicines. It also holds true – in both Western medicine and the alternative medicines — that the better qualified the practitioner, the better the results will be without untoward adverse side effects.
In addition, there are some alternative therapies, especially some of the herbal remedies – depending on how they are used, that may interfere with the actions of the Western medicines. In this case it behooves the practitioner to know how and when these interferences may occur.
Do the alternative medicines work?
Again, we can only generalize here, but here are some observations:
•Alternative medicines can be effective for treating many diseases, but as a rule they do not work as quickly as some of the Western medicines do. It may take 30 days or more before beneficial results are seen when using herbal medicines, and it typically takes three or four chiropractic or acupuncture treatments before real results are seen. While some diseases may respond rapidly to an appropriate alternative medicine, as a general rule, you won't want to call for an herbalist if you've just been hit by a car.
•Many of the alternative medicines have not been studied with the same statistical scrutiny that Western Medicine uses. In addition, much of the scientific work done on alternative medicines has occurred in Europe or the East, and it can only be found in obscure, foreign language journals. Finally, many of the studies done in this country have been done under Western medicine's paradigms, and alternative medicines oftentimes use very different methods of approach, diagnosis, and assessment.
On the other hand, many of the alternative medicines have been used for thousands of years or more by millions of people around the world. Whether we choose to admit it or not, the anecdote continues to be an important engine of novel ideas in medicine. There is a long history of anecdotal and case history evidence revolutionizing medical treatment.
As but only one example, it was the anecdotal observation of Dr. Ignaz Semmelweis that led to the discovery that washing hands reduced post-partum mortality, decades before germs were even "discovered." Today's observant doctors recognize that their own experiences, and the experiences of their patients are just as essential to good diagnosis, treatment and patient care as are double-blind, peer-reviewed study results. No matter how wide the perceived rift between the science of doctoring and the art of doctoring, and no matter what the new technologies may deliver unto us in terms of more precise tests and life-prolonging therapies, the work of caring veterinarians will always necessarily take place at the intersection of science and the language and the stories that our clients (and their animals) bring to us.
New paradigms of medicine
Scientists and philosophers from Heraclitus to Einstein have said: "The only constant in the universe is change", and this is true for all sectors of science, for medicine in general, and especially for veterinary medicine.
When we look at potential changes in veterinary medicine, it is our duty to assure that these will be made in a way that honors the constant medical principles of "results-oriented" therapies, cost-benefit implications, and (whenever possible) adhering to the caveat of "do no harm".
Additionally, in the case of veterinary medicine, the human client (animal caretaker) as well as the patient (animal) is a constant factor to consider. Alternative/Natural veterinary medicine will typically include in its scope of relevance and concern: the patient, the patient's caretaker, the nuclear and extended family of animals and human-animals, their surrounding environment, and the long-term and wide-spread affects of the medicines used on the environment – including the patient's "environment" (its inner milieu) and the surrounding environment of the earth.
For a holistic practitioner, the practice of medicine, in all its intricacies, is not an "either-or" proposition; but rather it may often be an "other" decision. One medicine may not fit all, but some medicine will likely help the patient ... if we can only find the correct match, patient to remedy.
From the other side of the mountain
Perhaps the best way to visualize these differences is to imagine the patient and the patient's complex of health and disease as a mountain. Assuming the patient as analogous to a mountain, we can then see each of the practitioner types (allopathic or Western physician, acupuncturist, homeopathic practitioner, herbalist, shaman, etc.) as standing in a different place, viewing the mountain that is the patient from an entirely different perspective.
What evolves with this visualization is the realization that each practitioner sees the same mountain (the patient), but the mountain looks entirely different, depending on where the practitioner stands. Further, if we assume that climbing to the peak of the mountain (health and healing) is the goal of all practitioners, each practitioner will have a different pathway to the top, again depending on the perspective of her or his viewpoint.
Finally, we need to consider the likelihood that, in addition to seeing a different-appearing mountain, each practitioner sees with eyes that have long been embedded within the culture where he/she grew up. Acupuncture may seem strange to us; when it has been the primary medicine of your country for several thousand years (as it has been in Eastern countries), it is accepted as the norm.
Bottom line: Practitioners of different types of medicine are all looking at the same mountain (the same patient); they are simply seeing and approaching the patient from different sides of the mountain when they use the methods they are accustomed to.
Alternative/Natural Medicines are producing only one of the many paradigmatic (and currently ongoing) changes that are likely to occur in science, medicine, and veterinary medicine.
Following are just a few of the other changes in/of medicine that loom on the horizon:
•Further commodification of pets
•Drug company dominance in medical decision making processes
•Quack watch vs quack busters
•Medicine from "ALL sides of the mountain"
•Medicine as a part of the culture
•Context of culture as a constant in all medicines
•"Socialization" of medicine – Clumps of social groups that overlap and interact with each other
•Web-Med and Hook-up-Med as a viable choice
•"What works" medicine – "voting" on what works –vs- being told
•Bottom up vs top down medicine
•Pets AS Medicine
•Further emphasis on mind/body/spirit connection
•A return to more "natural" ways of living and of working with diseases
•Emphasis on "green" and "sustainable" medicines
•Scrutiny of practitioner efficiency
•Wikiscanner vs Wiki
•Divorce of science from medicine
Anthropologists describe early-on changes in a society as the times when early-adopters begin using a method or concept, often without much support from the prevailing thinking or the majority of the population. If early adopters have some success with the new method or way of thinking, their continued use begins to transfer into the general population and at some time a "tipping point" occurs when the critical mass of early adopters integrates the new methodology into the mainstream. At this point, the "mainstream" often co-opts the new methods and claims them as their own, often declaring that they have been using them all along.
Transition times are typically fraught with controversy, and the dialogues/diatribes between early-adopters and traditionalists can be more acrimonious than helpful – it often takes several generations before the tipping point is reached – before new thinking, new methods are adopted by a majority of the population.
According to recent surveys, it is now likely that more than half of all clients in a veterinary practice are using one or more forms of alternative medicine, either for their human or animal family. If this is true, then it behooves the veterinary practitioner to try to understand some of the basic applications of the alternative medicines. In addition, especially since alternative medicine users comprise a majority of the population, it might be time to consider adding one or more of the alternative medicines to the professional practice's toolkit – whether it be through referring to other professionals or training someone within the practice in alternative techniques.