The Recurring Popularity of Alternative Medicine

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THE RECURRING POPULARITY OF ALTERNA TIVE MEDICINE ALERED YANKAUER* Of all lhe ills that suffering man endures, The largest fraction liberal nature cures, Of the remaining, 'tis the smallest part Yields to the effort ofjudicious art. —Oliver Wendell Holmes. [1] As Walter Wardwell has pointed out, the term "alternative medicine" is a residual catch-all covering "health practitioners who are other than orthodox" [2]. The medical profession has always faced competition from such practitioners. On the one hand, orthodox medicine has never been able to cure all forms of illness, and it is natural for those who suffer to continue to seek a cure. On the other hand, as Oliver Wendell Holmes pointed out many times, recovery is the rule for many human ills regardless of treatment. Finally, there is the overwhelming importance of faith in the method or the healer as a factor in recovery [3], something known to Holmes, but whose biologic potential we arejust beginning to understand. These factors may account for the persistence of various forms of alternative medicine over time, but not for the high points in its popularity. From all accounts, the popularity of alternative medicine today has reached such a high point. A population survey in the 1990s estimated that a third of those surveyed used at least "one unconventional therapy in the past year," spending an estimated $13.7 billion in the process [4]. The Office of Alternative Medicine in the National Institute of Health, established in 1991, has received a 50 percent increase in its budget [5]. The Harvard Medical Alumni Bulletin devoted its entire summer 1996 issue to "Considering the Alternatives" [6] . An International Congress on Alternative and Complementary Medicine was well attended and provided the occasion for announcing the advent of two new peer-reviewed journals, devoted exclusively to the subject; one of the new journals reported an * University ofMassachusetts Medical Center, 55 Lake Avenue North, Worcester, IvIA 01655.© 1997 bv Lhe University of Chicago. AU rights reserved. 0031-5282/97/4004-1033$01.00 132 Alfred Yankauer ¦ Alternative Medicine impressive print run of 30,000 [7] . A session devoted to ' 'Alternative Medicine in a Scientific World" is included in the program of the 1997 annual meeting of the American Association for the Advancement of Science [8] . And a recent study projected that the supply of alternative medicine practitioners would grow by 88 percent between 1994 and 2010, compared to a 16 percent growth in the supply of physicians [9]. Although there are no comparable surveys to document the popularity of alternative medicine during the first half of the 19th century, aspects of the medical environment at that time bear an uncanny resemblance to those of today. During the first quarter of the present century, there were concerns about the costs of medical care, and a survey documented the popularity of alternative medicine at that time. Both of these periods raised issues similar to those of today. Probing these aspects and similarities may shed some light on the reasons for the current popularity of alternative medicine. (The effectiveness of some of these practices is quite another subject and will not be addressed here.) Lemuel Shattuck's classic survey of Massachusetts, published in 1850, includes the following description of medical practice at that time: We boast of living in an enlightened era of the world, and perhaps, when compared with many others, our boasting may be well founded. Notwithstanding this general characteristic, we have besides physicians, educated according to the rules of some medical organization or some medical school, the homeopathic, the hydropathic, the analytical, the Thomsonian, the botanical, the eclectic, the mesmeric, the pathetistic , the electro-biologic, the chrono-thermal, the Indian, and very many other denominations, each putting forth their own system as the only sure one for the cure of all diseases. Looking superficially at all these classes, it would seem that at no period has medical practice been more unsettled [10]. A 1994 book provides a guide to 27 alternative therapies, many with names or methods similar to those mentioned by Shattuck [H]. There are other similarities between the early 19th and the late 20th centuries. The anti-intellectualism ofJacksonian democracy is paralleled today by the...

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