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Book Review |
Department of Animal and Veterinary Science
California State Polytechnic University
Pomona, California
Lawrence Tyler. New York: The Haworth Herbal Press, 2000.
Professor Tyler, a sociologist interested in the study of Indian and Chinese medicine, has produced a useful book examining alternative health care in the United States. An important aspect is the book’s discussion of the different philosophies on which today’s alternative medical treatments are based. The general bibliography lists many high-quality references.
The growth in acceptance of traditional Chinese medicine results in part from the rapid increase of the Asian population in the United States, but other population groups with non-traditional therapies have made their mark as well. Alternative approaches are due also to an increased interest in health and fitness and the desire for miracle cures, which Western science cannot offer. Further, Western medicine has become impersonal and expensive. Natural medicines have thus taken on health-benefit connotations in the American health culture prompting increased use of herbal medicines and alternative therapies. The book provides a source of discourse on these health alternatives.
Philosophically, alternative therapies do not meet the standards of therapy sanctioned by the AMA. On the other hand, alternative therapeutic regimens incorporate nutrition, and Western medicine has done so in recent years as well. The major difference currently is the former’s treatment of the whole person, rather than the latter’s tendency to focus on a single disease or ailment.
Several different philosophies that alternative treatments are based on, such as shamanism, Indian Ayurvedic medicine and traditional Chinese medicine, are discussed with comparisons of each to the others, as well as to traditional American medicine. Traditional Chinese medicine and Indian Ayurvedic medicine emphasize creating harmony in the body, while shamanism relies on healing of spirits; none are specifically targeted in curing an illness.
There are negative consequences to these practices in their extensive animal and plant harvesting practices, for example of bears for their organs and other parts and ginseng for tea, thereby endangering them as species.
The AMA has made a critical review of existing alternative therapies based on proven efficacy. The organization has cautioned health professionals to remain skeptical, but not to be critical of patients’ decisions until complete determination has been made of the health problem and the needed treatment. Economic growth and social acceptance of alternative/herbal medicine is growing rapidly. Many health insurance plans now include coverage for alternative therapies.
Eighty percent of the world’s population uses herbal medicines as natural remedies, while in the US herbal remedies are sold as dietary supplements. Safety and efficacy remain a primary concern. The FDA is apprehensive of undeclared drug substances, inadequate labeling for content and use, undeclared metals, potentially toxic ingredients and specifically regulated ingredients (e.g., narcotics), and the making of unproven treatment claims for serious medical conditions. Currently imported products are of primary concern; however, the growth of the herbal market is huge, and many major pharmaceutical and food companies are becoming involved in the marketing and distribution of natural remedies.
Although there is a growing need for regulation, the USFDA has no financial support to expand its investigative powers into the safety and efficacy of phytomedicines. By classifying them as supplements, rather than as drugs, regardless of potency or possible side effects, the labeling laws would produce some regulation. Unfortunately, needed oversight is not present, even though potential health problems exist. The critical requirement for drug evaluations is the comparison of the therapeutic agent to a placebo. These tests are expensive and not always conclusive. The results are confounded by spontaneous remissions and non-specific factors in healing. To minimize side effects, single, purified agents are normally evaluated at different doses, while herbal remedies may work best as complex formulations.
This guide encourages an increased awareness of philosophies related to alternative therapies. It provides an educational experience for all health professionals, as well as a means to understand patients’ need to use alternative therapies in the self-treatment of their ailments.
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