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Holistic Medicine or Reductionism?

This article is divided into the following sections and subsections. Each section can be accessed directly by clicking the title link below, or by scrolling through the article.

Introduction

Section 1

The Holistic Medicine Philosophy
 
The Reductionist Philosophy

Holistic Medicine Sets the Standard for Safety

But What About Efficacy?

But isn't Holistic Medicine just Quackery?

Holistic Medicine: From Alternative to Mainstream?

Links and References

To go to Section 2 of this article, "Why has Orthodox Medicine Failed?", click here.

Holistic Medicine or Reductionism?

Introduction

Although our modern health care system is dominated by drug orientated orthodox medicine, there are an increasing number of people who are seeking  safer and more holistic alternatives. There are many reasons for this upsurge in the popularity of the various forms of alternative or holistic medicine, but most if not all of these are rooted in the failings of orthodox medicine. As has been noted by Williams ( 1a ) for instance, the vacuum created by the abandonment of nutrition by orthodox medicine, is directly responsible for nutrition becoming an alternative therapy. In other words, the so called food faddists and nutrition quacks so often complained about by the medical profession, owe their very existence and continued survival to orthodox medicine! Nature, as they say, abhors a vacuum. 

While holistic medicine is enjoying an increase in popularity, there is still  considerable resistance to this form of medicine in various sections of the medical community. It is therefore necessary, in order to establish the need for change to our current predominantly orthodox medicine based healing system, to examine the weaknesses or failings of orthodox medicine and explore the reasons why these failings occurred. It is important to realise that this fault finding process is made necessary for two reasons. Firstly, those members of our current health care system who are resistant to change should be made more aware of the shortcomings of orthodox medicine and the advantages of holistic medicine. Secondly, there is a perception within the medical community that orthodox medical practitioners may utilise holistic therapies within the context of their current reductionist, interventionist, symptomatic approach to the treatment of disease. In other words, some doctors seek to utilise holistic therapies while rejecting the underlying holistic philosophy. It is vitally important that the reasons why this is not feasible are clearly established. In order to achieve these ends, I will examine in some detail, the weaknesses and failings of orthodox medicine over the past 200 years.

In order to fully understand the reasons for the various strengths and weaknesses of  those forms of healing which comprise our current health care system, namely, orthodox medicine and holistic medicine,  it is necessary to consider the implications and limitations of the philosophies which form the basis of these two systems.

Practitioners of holistic medicine on the one hand, who base their practice on the philosophy of holism, strive to attain a condition of optimum health and believe that the cause of ill health begins with our environment and the fundamental nutritional building blocks of which we are comprised and upon which our every function depends. Practitioners of orthodox medicine on the other hand, who base their practice on the philosophy of reductionism, aim not to attain a condition of optimum health, a concept in which they do not believe, but rather they aim merely to eliminate symptoms of specific diseases. This is achieved predominantly by the use of symptom suppressing drugs and by the surgical removal or replacement of diseased tissues or organs. Whereas holism is fundamentally supportive, cause based, and preventative, reductionism is primarily interventionist and symptomatic, and plays little or no role in prevention.

These alternative philosophies have fundamental limitations which determine their relevance and effectiveness for the treatment or prevention of disease and the maintenance of optimum health. It is the purpose of this discussion to clearly define these limitations and in so doing determine where philosophical changes are likely to be most productive. Such a process is absolutely essential if we are to ensure that any reforms to our health care system are scientifically based, structured and logical.

This web site is about positive change to our health care system. The first step towards positive change is to identify and openly acknowledge the faults and weaknesses in our current system. The second step is to develop and propose corrective changes which are specifically constructed to overcome these faults. The final step of course, is to effectively institute these changes. It cannot be overemphasised that without a comprehensive in depth analysis of current faults in our health care system it is not possible to propose appropriate corrective action and move forward in a logical manner. Our ability to make positive changes is directly proportional to the eagerness and diligence with which we address current faults.

Since the whole orthodox medicine versus holistic medicine debate is frequently rather one sided, I have also included in this discussion references to material with which I fundamentally disagree. I have included this material, which asserts that all forms of alternative medicine are quackery, in the interests of balance and to provide some insight into the basis for this viewpoint.

This discussion is divided into three sections. The first section will consider the two opposing philosophies of holism and reductionism, the relative merits of holistic medicine and orthodox medicine, and the current paradigm shift to alternative medicine. Section 2 will explore the various reasons why orthodox medicine has been unsuccessful in conquering the major diseases which confront modern society. For the final section, the conclusion, which proposes recommendations for positive change, refer to the Integrated Medicine page.

SECTION 1  Holistic Medicine or Reductionism?

The Holistic Medicine Philosophy

The holistic approach to health is fundamentally natural and all perceiving as it embraces all influences upon our being, both internal and external. Unlike reductionism, holism does not seek to fragment, or impose artificial limitations upon, human knowledge and learning. Rather than dissect the body into numerous separate and independent functional areas ( see "Is Illness Holistic" ), it recognises the interdependence of our various bodily systems. Whereas in orthodox medicine the patient becomes a battleground where the doctor conducts open warfare ( 1, 2, 3 ), holistic health care on the other hand, is essentially supportive, caring, and non-invasive. It is fundamentally vitalistic in nature. That is, holistic medicine accepts the importance of vital energy and the inherent healing ability of the body. It strives to restore bodily harmony by supporting the production of vital energy and supporting normal body processes such as elimination, adaptation and nutrition. 

It is the aim of holistic medicine to bring about a condition of optimum health, not just the absence of symptoms of disease, as is the case with orthodox medicine. It is this focus upon health rather than disease which is largely responsible for the cause based nature of holistic medicine and its effectiveness for disease prevention, early diagnosis, and the treatment of subclinical disorders. Whereas orthodox medicine must wait until a predefined disease becomes established before a diagnosis can be made, holistic medicine focuses upon deviations from normality or optimum health, thereby enabling diagnosis at a much earlier stage. The cause based nature of holistic medicine contrasts sharply with the reductionist approach to health care which is the very antithesis of holism. 

One of the fundamental differences between holistic medicine and orthodox medicine is the importance of, and interpretation of, symptoms ( see Orthodox Medicine ). Whereas in orthodox medicine symptoms are viewed as unequivocally bad and must be suppressed at any cost, to the naturopath or holistic practitioner who strives to understand and respect the natural restorative processes of the body, the mechanism of symptom causation is all important, many symptoms being regarded as desirable expressions of the body's attempts to restore normality. The typical example of this is the exacerbation of symptoms which commonly occurs during a recovery process which is termed a "healing crisis" ( 3a, 3b, 3c, 3d, 3e, 3f ).

While the holistic practitioner or naturopath strives to deliberately cause this recovery process and the associated exacerbation of  symptoms which occurs as an inevitable result of the correct treatment of many diseases, to the medical practitioner this would be seen as a deterioration and something which must therefore be prevented. This disagreement is so fundamental in other words, that what is described by holistic medicine as an improvement or resolution of an illness, is regarded by orthodox medicine as a deterioration and something which must be prevented.

Although holistic medicine practitioners have traditionally displayed a considerable degree of openness regarding the underlying philosophy of holism upon which their profession is based, the same cannot be said for practitioners of orthodox medicine. In fact, it is probably true to say that most members of the general public are completely unaware of the opposing philosophy of reductionism which forms the fundamental basis of orthodox medicine. Whatever the reason for this curious anomaly, I will seek to redress this matter in the following paragraphs. The virtues of holism will become even more apparent after considering the disadvantages of reductionism.

For additional info on holistic medicine try the following links ( 2, 3, 4, 5, 6, 7 ).

The Reductionist Philosophy

Reductionism is not just the fundamental philosophy upon which modern medicine is based, but further, it determines the scientific parameters within which this form of medicine is rigidly confined. Reductionism is inherently restrictive and fragmentary. It is the exact opposite of holism.

Reductionism has been defined by Wyngaarden in the classical medical text, the Cecil Textbook of Medicine ( 10 ), as "the exploring of details, and the details of details, until all the smallest parts of the mechanism are exposed to scrutiny." Wyngaarden continues: "instead of reaching for the whole truth, the scientist examines small, defined, and clearly separable phenomena. " It seems from this revealing description, that the successful doctor or scientist will be one who deliberately avoids looking for the "whole truth." This is the fundamental difference between reductionism and holism.

Put another way, reductionism may be defined thus: reductionism is the practice of attempting to understand and simplify an observable phenomena or a biological process by deliberately excluding more and more relevant data until the eventual explanation which is arrived at is so mutually exclusive that it is maximally disconnected from reality. Or, in other words, reductionism is the process of learning more and more about less and less until eventually one knows everything about nothing. 

Opponents of reductionism also point out that this philosophy is based on the false premise that the sum of all the separate parts is equal to the whole. Increasing interest in holism and systems theory however, reveals that various systemic qualities are not revealed by examining the individual components ( 87, 144, 145, 146 ). When it comes to the human body, the whole will always be greater than the sum of all the separate parts. These facts further underline the superiority of holism and the irrelevance of reductionism, something which has been pointed out more than three decades ago ( 10a ).

Reductionism is characterised by a number of important features. Firstly, reductionist orthodox medicine is intrinsically interventionist, that is, the medical practitioner prefers to actively intervene in the patient's illness in an attempt to be seen as having fixed the problem. This is the opposite of holism where the practitioner's role is one of caring and support. The reductionist interventionist nature of orthodox medicine also results in a disease oriented symptomatic approach to patient care.

Because reductionism is essentially symptom based it is largely irrelevant for prevention or the treatment of sub-clinical or chronic illness. Reductionism has created a medical system which is predominantly suited to the treatment of acute or life threatening illnesses or trauma. It is a system of emergency medicine. Although most chronic illnesses undoubtedly start as mild sub-clinical disorders, the reductionist practitioner is generally disinterested in such disorders until they become more serious ( see "Is Illness Holistic" ). In spite of the reductionist nature of orthodox medicine, even within the medical profession claims are sometimes made that medicine is "holistic" ( 2a, 2b ). Such claims are inaccurate and misleading and merely serve to indicate a lack of understanding of the nature of both holism and reductionism. 

Given the clear reductionist basis of orthodox medicine and the long held rejection of holism as quackery it is startling to see Dr. Capolingua of the Australian Medical Association claiming that the medical training of doctors enables them to best treat patients holistically ( 2b ). According to Dr. Capolingua the fact that other practitioners are not medically trained gives doctors an ability to treat  patients holistically which "is far greater that anyone else's." Precisely how reductionist medical training enables doctors to adopt more holistic treatment strategies than holistic practitioners is not explained by Dr. Capolingua.

The completely irrelevant nature of reductionism when it comes to disease prevention is amply demonstrated by the fact that currently accepted recommendations for disease prevention usually involve the adoption of traditional holistic advice. For instance, suggestions that diseases like heart disease or cancer may be prevented by lifestyle factors such as diet and nutrition merely reflect an acceptance of traditional holistic views, and an admission that the principles of reductionism are totally irrelevant when it comes to disease prevention.

The reductionist model however, is not just fundamental to modern medicine and pharmacology, it increasingly forms the basis of Western herbalism ( 11a, 11b, 11c ). The holistic roots of herbal medicine are frequently displaced by an obsession with a purely symptomatic approach and the use of highly purified "herbs". 

Section 2  Holistic Medicine versus Orthodox Medicine

Holistic Medicine Sets the Standard for Safety

The chances of suffering adverse reactions to alternative medical treatments are "negligible when compared to the risks of being harmed by a traditional physician dispensing powerful drugs and performing risky surgeries" ( 8 ). This is because of the natural and "non-interventionist" ( 8 ) nature of alternative therapies. The various forms of alternative medicine have a safety record which must surely be the envy of orthodox medicine.

Unlike holistic medicine, the risk of being permanently harmed or even killed, by orthodox medicine is very real. In fact, the rise of reductionist medicine has brought with it a brand new group of diseases termed "iatrogenic" or doctor caused diseases ( 9, 11, 12, 13 ) while adverse drug reactions outnumber herb reactions by more than 99 to 1 ( 155 ). According to medical authorities iatrogenic disease is responsible for 180,000 ( 8, 12 ) or as many as 250,000 ( 9 ) deaths annually in the US alone. Even the more conservative estimates suggest that American doctors are responsible for 80,000 - 100,000 deaths every year ( 13, 22b, 132 ). It is claimed that doctors are the third leading cause of death in the US ( 9 ). In addition, more than 2 million Americans may be "seriously injured" by medical treatments every year ( 16 ) and there are 10 million cases of adverse reactions to drugs every year ( 155 ). 

The situation is very similar in Australia where medical authorities claim that orthodox medicine kills from 10,000 - 19,000 people ( 18, 19, 21, 21a, 141 ), and permanently injures 25,000 - 50,000 people, annually ( 20 ). Additionally, more than 80,000 Australians are admitted to hospital each year because of "bad reactions to medication" ( 21 ). Australian medical authorities have also estimated that as many as 40% of medical patients may be victims of iatrogenic diseases ( 22 ). It has been claimed that almost one in five deaths in Australia may be due to medical treatments ( 22c ). In fact, since iatrogenic diseases are responsible for 10,000 - 19000 deaths annually,  Australian statistics reveal that medical mishaps are the third leading cause of death behind cardiovascular disease and cancer ( 139, 140 ). Iatrogenic diseases are responsible for more deaths than strokes ( 139, 140 ). These alarming facts are usually omitted in normal statistics which tend to give iatrogenic diseases an extremely low visibility ( 139, 140 ). In fact the priority given to this matter in the recent report by the Australian Institute of Health and Welfare ( 142 ) suggests that it is officially regarded as being largely irrelevant.

Medical mishaps do not just occur in a hospital environment, they are also exceedingly common in general practice ( 147, 148, 149, 150 ). In spite of the "low volunteer rate" ( 147 ), 30 deaths were reported to occur from 805 incidents involving 324 GP's ( 148 ). Interestingly, GP's reported that the main factor in minimising the chance of long term harm resulting from these medical mishaps was simply "good fortune" ( 148 ). In fact, positive outcomes were due to the combined effects of "good fortune", and the "good physical or psychological condition of the patient" in 43 cases out of 100 ( 148 ). It is also interesting to note that "diagnostic incidents had the most serious outcomes" ( 148 ), a fact which is of vital importance given the inability of GP's to diagnose diseases such as hypothyroidism ( see Thyroid page ).

Interestingly, in Australia, medical authorities have recently reacted to these alarming figures by moves to introduce retraining of doctors, not in the area of their professional skills and competency, but rather in the area of communication skills ( 22a ). It is hoped that this will enable doctors to be more effective in saying "sorry" to patients and thereby avoid litigation for medical mistakes ( 22a ), a confession perhaps that the hazardous nature of interventionist medicine is inevitable. While the fundamental concern of medicine has traditionally been to do no harm, now it seems that medicine assumes that harm will be done and therefore what is required is to avoid the resultant litigation. Instead of accepting responsibility for the hazardous nature of modern medicine and proposing fundamental changes to reduce costs by reducing these hazards, the Australian Medical Association has even claimed that patients should have no right to sue their doctors. According to Dr Kerryn Phelps ( 143 ): "As a community we need to put an end to the notion that patients have the basic right to sue their doctors. That does not appear in any human rights charter." If doctors are concerned about litigation then they should address the cause of the problem and return to a form of medicine that does not kill people.

In the US, 100,000 people die annually because of adverse reactions to prescription drugs ( 9, 16 ) making such drugs the sixth leading cause of death. These deaths are not caused primarily by medical mistakes, but rather, by the inherent toxicity of prescription drugs ( 22 ). Amazingly, one study has apparently found that as many as 51% of new cases of Parkinson's disease are due to prescribed drugs ( 17b ).

Although these figures are cause for grave concern, it seems that this is only the tip of the iceberg since most cases of adverse reactions to prescription drugs go unreported ( 22, 132 ). Medical experts estimate that only 1 - 10% of cases are actually reported ( 22 ). In Australia the reporting of adverse drug reactions is voluntary and most doctors choose not to report adverse reactions to their treatments ( 22 ). An additional problem here is that death certificates are not necessarily required to state that death was caused by an adverse drug reaction ( 22 ). Similarly, in the US, where more than 1 million hospital patients experience "adverse events" every year ( 22b ), "silence" surrounds this issue due to the desire of health authorities not to publicise adverse events or iatrogenic illnesses ( 22b ).

Furthermore, it seems that the person who suffers from an iatrogenic disease may also develop a second iatrogenic disease as a result of medical treatment for the original iatrogenic disease ( 22 ). This has been termed "second level iatrogenesis" ( 22 ). In view of these facts it is not surprising that the incidence of iatrogenic diseases is increasing alarmingly, so much so that it has been described as "epidemic" ( 12, 22 ). Given this background, it is hardly surprising that medical complaints from patients are also increasing alarmingly ( 23a, 23b ).

Adverse reactions to prescription drugs are only one part of the iatrogenic potential of modern medicine ( 20 ). Surgical procedures, including back operations, prostatectomy, and even keyhole surgery, are hazardous procedures which may do more harm than good ( 20 ). Additionally, much of this surgery, like drug therapy, is not even necessary ( 20 ). Even diagnostic tests such as X-rays and CAT scans may pose significant health risks, medical authorities estimating that the use of such procedures may cause as many as 300 annual deaths from radiation in Australia alone ( 20, 54, 80 ). To make matters even worse, the use of sophisticated X-ray technology such as MRI scans, frequently detects problems in normal persons where none exists ( 20, 82 ). For instance, in 30% of normal patients who had back scans ( 82 ), and 100% of normal patients who had scans of the shoulders ( 82 ), definite problems were falsely diagnosed.

Recently the shocking consequences of toxic dyes or contrast mediums used during some X-ray procedures has been increasingly reported ( 14, 15, 17, 17a ). In Australia this dye was used for more than 40 years even though the government and health authorities were well aware that this toxic compound may cause adhesive arachnoiditis even as long as 10 years later ( 14, 15, 17, 17a ), facts which were deliberately concealed from patients ( 14, 15, 17,17a ). The chemical concerned, which contained hydrochloric acid, sulphuric acid and benzene was apparently so caustic that it would even destroy rubber and dissolve polystyrene cups upon contact ( 14, 15, 17,17a ). In view of these facts it is hardly surprising that the dye had "horrendous" ( 17a ) effects including severe back pain, visual problems, paralysis, vertigo and bladder problems ( 14, 15, 17,17a ). Nevertheless, the continuing use of this toxic compound was justified by health authorities on the basis that the benefits outweighed the risks!! It is hardly surprising that the Australian Medical Association wishes to remove the right of patients to sue their doctors.

These deplorable facts are the result of a medical system which expresses little interest in the whole truth, and they are perpetuated by an attitude of acceptance and dismissiveness. Amazingly, it is not unusual for health authorities to express more concern about one minor adverse reaction to a herbal medicine than about the thousands who die annually from medical treatments. There is it seems, very little concern or compassion for those who suffer needlessly from medical treatments. This contrasts remarkably with the considerable degree of  community concern and compassion which is appropriately shown for the much smaller number of people who die annually as a result of road traffic accidents ( 1,825 in Australia in 2000 ).

In America also, deaths from medical mistakes exceed those from motor vehicle accidents ( 132 ). In fact, according to Kohn et al ( 132 ), "the risk of dying as a result of medical errors far surpasses the risk of dying in an airline accident." Compared to industries like the aviation industry, "health care is a decade or more behind other high risk industries in its attention to ensuring basic safety" ( 132 ).

In view of the prevalence of iatrogenic diseases and the ill effects of prescribed drugs it is interesting to note that medical practitioners commonly suggest that patients will "become accustomed to" the adverse effects of many medications as they continue to take them. In other words, the adverse effects are worse during the initial stages of treatment but frequently lessen or disappear with continued usage. Although doctors commonly acknowledge the occurrence of this phenomena, they are not so forthcoming regarding the precise mechanism behind this lessening of adverse effects. To do so, they first need to explain the mechanism behind the occurrence of adverse reactions in the first place. With the possible exception of allergic or local irritant effects, it would seem that most side effects are merely manifestations of the toxicity of the drug/s concerned.

According to traditional herbal and naturopathic beliefs, elimination of toxins by the body is characterised initially by a stage of acute symptoms as the cells of the body become stimulated and overactive in an attempt to detoxify the body. This acute stage cannot be maintained however, and continued exposure to the toxin causes the cells to become overwhelmed, at which point there is a reduction or cessation of symptoms as the toxaemia becomes suppressed and chronic. From this point of view, the adverse effects of drugs may be merely symptoms of the body's attempts to detoxify or eliminate the toxin from the body. Is this the mechanism behind the body becoming accustomed to drugs? It is indeed interesting to note that doctors often have a rather different attitude when it comes to adverse reactions to herbal treatments. I have never heard a doctor suggest that patients should ignore any side effects of herbal medicines because they will ultimately get used to them. 

If we are at all serious about health we must seek to understand the causative mechanisms behind the appearance of adverse effects. It is unscientific in the extreme to adopt the attitude "out of sight out of mind", although, sadly, such an attitude is probably characteristic of modern science and medicine. We either see the body's warning system as something to be thwarted and overcome, or as something which should be acknowledged and supported.

The facts regarding the dangerous nature of orthodox medicine are quite clear. In the words of Moynihan ( 20 ): "there is a view slowly gaining strength worldwide that the inappropriate use of medical treatments and technologies has become a major threat to public health."  What is not so clear is why this situation is permitted to continue. 

Perhaps this matter has been most appropriately summarised by Chassin ( 20a ):

The determination and energy with which authorities seek to correct this matter is clearly proportional to their level of concern. Interestingly, some medical authorities tend to dismiss any concern on the basis that many patients were seriously ill before they were medically treated and medical hazards are inevitable anyhow! There is also a code of silence within modern medicine about medical mistakes and iatrogenic illness ( 132 ) and even in the media coverage is usually limited to occasional anecdotal reports ( 132 ). It is a matter which is only discussed "behind closed doors" ( 132 ).

Of vital importance here is the fact that doctors apparently regard their professional reputation as being more important than the welfare, or perhaps even the lives, of their patients. According to Leape ( 151 ), doctors are "reluctant to admit and address the problem of errors, both because of feelings of guilt and from the desire to avoid punishment or disapproval by colleagues." This has been confirmed by Makeham and coworkers ( 149 ) and also Kidd and Veale ( 147 ). According to Kidd and Veale ( 147 ), "the current system does not assist individual practitioners to express concerns about errors they witness or make as, in the main, peer support is lacking when adverse events occur in general practice."

It is difficult indeed to understand how qualities such as honesty, integrity, and genuine compassion and concern for the welfare of patients could be regarded by doctors as being undesirable or even punishable. Why would any doctor wish to "punish" a colleague who expresses an allegiance to his/her patient by openly admitting responsibility for a medical error? How could any doctor have more concern about punishment from their colleagues than the welfare of their patients? Such honesty, integrity, and compassion, should surely be much lauded and envied by medical colleagues. Accepting responsibility is commonly the basis of learning.  These are the fundamental qualities which form the foundations for excellence in medical practice. They are certainly not to be despised and punished. The suggestion that medical errors remain unreported because of fear of punishment by colleagues indicates that many doctors have adopted a system of values, priorities and ethics which is fundamentally inconsistent with care of patients and the practice of medicine.  This needs to be addressed urgently at all levels of medicine, particularly medical training. Unless responsibility to patients comes first, our health care system has a very dismal future.

Closed doors must be opened and interests of patients must be paramount if we are to move forward. It is "simply not acceptable for patients to be harmed by the same health care system that is supposed to be offering healing and comfort" ( 132 ).

But What About Efficacy?

In addition to the unsafe nature of orthodox medicine, it is the ineffectiveness of this form of medicine when it comes to preventative medicine and the treatment of chronic illness, which has provided the greatest stimulus for the explosion in the popularity of holistic therapies. The effectiveness of orthodox medicine when it comes to the treatment of serious trauma and acute or life threatening disease, is generally accepted and will not be considered here. 

While the efficacy of orthodox medicine when it comes to the treatment of acute infections is also generally accepted, there are difficulties in determining the totality of the impact of such treatments. Although the effectiveness of anti-microbial treatments when it comes to various specific infections is generally accepted, the overall impact of these treatments can only be viewed by adopting a wider perspective which considers the direction of any changes to the general disease resistance and immunity of the community at large. There is a perception, that although major diseases such as small pox and diphtheria have been all but eliminated, the much more common colds and viral infections are in fact becoming more prevalent. In other words, more people are catching more infections. If this were to be confirmed by scientific studies it may indicate that the antibiotic era correlates with an overall reduction in human immunity.

The other point that should be made here is that the preoccupation with destruction of microbes has displaced any interest in optimising the natural immunity of the patient. Variations in natural immunity, even when it comes to serious diseases like TB ( 1a ), remain unexplained and unexploited.

To clearly assess the impact and effectiveness of orthodox medicine it is necessary to examine health statistics which reflect the incidence of various chronic diseases ( see also the Health Trends page ). Cause of death statistics, which are commonly employed to assess trends in public health, are somewhat more difficult to interpret since they are not a direct measure of the incidence of particular diseases. For instance, if some cancer patients die as a result of aggressive medical treatment before succumbing to the cancer ( 23 ), this could show in the statistics as a reduction in cancer deaths. To avoid this problem I will refrain from using death statistics.

Evidence from around the world shows quite clearly that most, if not all, the major diseases are becoming increasingly prevalent, sometimes alarmingly so ( 23, 24, 25, 26, 27, 28 ). This includes heart disease, cancer, diabetes, asthma, and arthritis. According to Lesso ( 23 ), the incidence of heart disease in Australia has recently shown an increase of 80% in ten years. With asthma the situation is even worse with a 300% increase in twelve years ( 23 ). In Britain also, asthma has doubled in twenty years even though cigarette smoking has been reduced by 50% ( 24a ). Even the use of modern asthma drug treatments has been associated with an increased risk of serious asthma attacks ( 24b ). The alarming increase in the incidence of diabetes has earned this disease the title of the "worlds fastest growing disease" ( 91a ). Of further concern here is the increasing prevalence of diabetes amongst younger people ( 91a ). So serious is the diabetes epidemic that it is estimated that by the year 2050, 29 million Americans, a 165% increase, will suffer from this disorder ( 25a ). Such predictions of course, are based upon a considerable degree of confidence that medicine will continue in its inability to cure diabetes. 

Overall cancer rates have increased 20 - 30% in England ( 27 ) and 12 - 18% in America ( 25 ). American statistics also show an increased incidence of cancer in all age groups ( 25 ). In Australia, medical experts have noted an alarming increase in the rate of childhood cancers over the past few decades ( 23 ). It seems that in some types of cancer, such as kidney cancer, the increased incidence may even be partly due to the use of toxic diuretic drugs ( 25 ).

Although according to Kothari ( 24 ), medical spending has increased in the US from 8 billion dollars annually prior to the 1960's, to 1.25 billion dollars daily now, patients are actually feeling worse. According to Kothari and Mehta ( 28 ), health spending in the US, the UK, and India, is increasing to "the point of bankruptcy" but yet they are getting "less and less of health". Kothari notes that orthodox medicine, even today, knows "next to nothing" ( 24 ) about the cause and cure of the common cold, heart disease and diabetes. Kothari continues ( 24 ): "and medicine must accept it knows next to nothing". Similar sentiments have also been reiterated by Kothari and Mehta ( 28 ) who state that " in all the major illnesses that modern medicine is researching upon and treating, neither the scope of the treatment nor the quantum of money spent makes any difference to the outcome". 

When prominent medical authorities describe current treatment strategies for heart disease as constituting a "cafeteria approach" with "no proven value" ( 29 ) there is clearly need for urgent action. Anti-hypertensive drugs for instance, long considered the front line of attack to reduce deaths from heart disease, are often taken unnecessarily ( 20 ). Although medical practitioners commonly believe that anti-hypertensive drugs must be taken for life, 15% - 75% of patients, were observed to maintain normal blood pressure when these drugs were discontinued ( 20 ). Blood pressure medication of course, should not be discontinued without medical supervision.

In a commendably frank assessment of modern medicine, Kothari and Mehta ( 28 ) note that because of the hazardous nature of  modern treatments, many doctors are reluctant to subject themselves to the same treatments which they give to their patients. According to Kothari and Mehta ( 28 ) in this regard, if doctors had been subjected to their own treatments, "most pills, potions, and procedures would have been abandoned long ago". Interestingly, according to a study cited by Kothari and Mehta ( 28 ), doctors who "faced the prospect of having cancer", would refuse to seek an early diagnosis and would also seek to delay the start of treatment.

In Australia too, "large increases in expenditure have left little noticeable change in the overall health of the populace" ( 92 ) as the predominant diseases become "chronic and degenerative" ( 92 ). This has recently been confirmed also by Walker ( 107 )  in a paper presented to the 7th Annual National Health Outcomes Conference in Canberra, Australia. According to Walker ( 107 ) there has been a significant deterioration, across all economic groups, in the health of Australians below 70 years of age between 1977 and 1995. Walker points out that this deterioration in health, which has also occurred in other developed countries, involves both serious and more minor illnesses. Furthermore, Walker also notes that this deterioration in health has occurred in spite of increased per capita use of medical services and the adoption of healthier diets, reduction in smoking, and more people taking up regular exercise programmes. It is abundantly clear that the cause of this ill health is not being addressed by current health strategies.

Although health authorities often claim that evidence of increasing life expectancy demonstrates an improvement in public health, there are two major reasons why life expectancy figures are an unreliable indicator of changes in public health. Firstly, improvements in life expectancy are very much the result of dramatic reductions in infant mortality which have occurred over the past century. Reductions in infant death rates of course have a dramatic effect upon life expectancy figures. If we remove the influence of reduced infant mortality rates and examine the life expectancy of a 70 year old white American male we find that  his life expectancy has increased from 10.2 years in 1850 to 12.8 years in 1998 ( 107a ), an increase of 2.6 years. Similarly, life expectancy at age 80, across 19 countries, increased by 0.37 years to 2.21 years from the 1950's to the 1980's ( 107b ).

The second problem with life expectancy figures is that they fail to take account of declining quality of life which is commonly associated with ageing. In this respect, according to Dunnell ( 108 ), any extra years of life which have in fact occurred are "extra years with disability, not extra years of healthy life." Because of this fact the usefulness of life expectancy figures have been questioned, modern thought favouring the use of healthy life expectancy figures which are based upon disability adjusted life expectancy or DALE ( 109, 110 ). Given the continuing deterioration in the health of Australians reported by Walker ( 107 ), it is indeed interesting to note that Australia has the second highest healthy life expectancy ranking in the world ( 111 ).

For more information about the use and misuse of life expectancy statistics for assessing health trends in modern society, see the Health Trends page.

When it comes to the public awareness of the effectiveness of modern health strategies it is indeed interesting to note that the increasing incidence of many disorders is not always apparent from media reports. With asthma for instance, during the past few decades I have witnessed various much publicised reports of "breakthroughs" in the treatment of this disorder. These breakthroughs of course, correlate with an increasing incidence of this disorder. The same is true also for other chronic diseases such as diabetes, heart disease, and osteoporosis, where continuing breakthroughs have also correlated with an increasing incidence of these disorders. With depression too, the much publicised breakthroughs in the treatment of this disorder due to the development of so called new generation antidepressants, have also correlated with an increasing incidence of depression. While these breakthroughs may serve to attract funds for medical research, the "benefits" for patients are not so clear.

In contrast to the inability of orthodox medicine to reduce the incidence of chronic diseases, when it comes to acute or life threatening conditions, then this form of medicine has earned an impressive reputation. No one would deny the enormous gains which have been made in trauma management and the treatment of all types of serious injuries. Although similar gains have been made in the treatment of acute diseases such as heart attacks, kidney stones and acute infections, we should not lose sight of the fact that the very occurrence of these acute conditions is often evidence of failure at the sub acute or preventative level. Our aim should surely be to prevent such emergencies rather than perfect the art of patching people up after they have occurred.

Personally, I have experienced considerable benefits from orthodox medicine for the treatment of injuries and acute asthma attacks. Orthodox medicine has also played a vital part in the diagnosis and treatment of my thyroid condition. Although I continue to have considerable difficulties with my thyroid, I nevertheless could not exist without the thyroid hormone supplement which I must take. However, on the downside, orthodox medicine did absolutely nothing to resolve the underlying cause of my asthma or thyroid condition. Although modern antibiotic treatment has been of vital importance to me throughout my life, when it comes to diseases like whooping cough and glandular fever, both of which I have had in the past few years, orthodox medicine had absolutely nothing to offer. 

Perhaps the effectiveness of modern medicine is best summarised by Wyngaarden ( 10 ): "Even if the best of contemporary medicine were universally available without financial barriers, cancer would continue to kill, rheumatoid arthritis would continue to cripple, and schizophrenia would continue to render insane. We have no definitive answers for these diseases and for many more......".

When it comes to holistic medicine, there is abundant and increasing scientific evidence regarding its effectiveness for the treatment or prevention of various chronic diseases. For instance, 14 out of 17 scientific studies have confirmed the effectiveness of chromium supplements in the treatment of insulin resistant diabetes ( 30 ). Although the importance of chromium has been known for 30 years ( 93 ), reductionist practitioners still do not routinely prescribe this mineral for their diabetic patients. Omega-3 fatty acids found in fish oil and flaxseed oil have also been reported to reduce the complications of diabetes as well as the degree of insulin resistance ( 31 ).

Scientific studies have also confirmed the effectiveness of magnesium supplements in reducing the likelihood of kidney stones ( 32 ) and heart disease ( 33 ). It has even been suggested that the addition of magnesium to drinking water ( aren't we getting enough from our diet? ) may reduce heart attack deaths in the US by 150,000 annually ( 34 ). Furthermore, it seems that heart disease may also be reduced by supplements of B vitamins ( 35, 36 ), vitamin E ( 35, 37 ), and also essential fatty acids ( 31a ). Vitamin E and vitamin C (38 ), and also vitamin B6 ( 39, 39a, 39b, 40 ), have also been found useful in the treatment of asthma ( see B Vitamin page for more details ) which is often associated with a deficiency of  B6 ( 39, 39a, 58 ). Evidence indicates that asthmatics may have an increased need for vitamin B6 ( 39a, 39b ), so much so that even doses as high as 50mg may fail to restore B6 levels to normal ( 39a ). In view of the fact that vitamin B5 is a precursor of the adrenal hormone cortisol ( 40a, 40c, 10, 95 ), and has also been found to be effective for the treatment of asthma ( 40c ), it is hardly surprising that later trials of vitamin B6 alone in steroid dependent asthma were unsuccessful ( 40b ). Interestingly, it seems that theophylline, a drug which is used to treat asthma, may actually cause a deficiency of vitamin B6 ( 59 ).

Recently, in an important review of the medical literature, Fairfield and Fletcher ( 137 ) have confirmed that suboptimal vitamin intake is associated with various chronic diseases. In particular, Fairfield and Fletcher ( 137 ) noted the relationship between folate deficiency and heart disease, birth defects and certain cancers; vitamins B6 and B12 and heart disease; and vitamin E and heart disease and prostate cancer. In an accompanying report Fletcher and Fairfield ( 138 ) emphasise that these diseases are associated with what they refer to as "suboptimal" vitamin intake. According to these workers ( 138 ) "suboptimal intake of some vitamins, above levels causing classic vitamin deficiency, is a risk factor for chronic diseases and common in the general population." Fletcher and Fairfield ( 138 ) also draw attention to the fact that current medical tests are not sufficiently reliable to detect this type of deficiency, a fact which further underlines the importance of a holistic approach to health care. They therefore recommend that "all adults take one multivitamin daily." Given the longstanding reluctance of the medical profession to even admit that subclinical vitamin deficiency conditions exist, this is indeed a step forward. 

Another disorder, the increasing prevalence of which seems to correlate with the increased use of prescription drugs, is depression. The development of so called second or third generation antidepressants has been totally unable to prevent the increasing incidence of this disorder ( 96, 97 ), perhaps partly because depression may actually be caused by drugs ( 41, 61, 62, 63 ). In fact, the prescription of antidepressants and other mind altering drugs has reached record levels in Australia, both for adults ( 96 ) and children ( 97 ), so much so that medical experts claim we are going "crazy" ( 96 ). In fact the use of mind altering drugs in Australian children has increased 12 fold in the past decade ( 97 ) and annual prescription rates of the "new antidepressants" in Australia has risen from zero to 2.5 million in a decade ( 20 ). It is claimed that GP's now prescribe more than seven million scripts for antidepressants annually and 1,600,000 are used by teenagers "who cannot get out of bed without them ( 42a ).  Holistically, although B vitamins are commonly used to treat depression ( see B Vitamin page ), the herb hypericum has also been shown to be effective ( 42 ). Commonly used by German doctors, scientific studies have shown this herb to be as effective as many antidepressant drugs ( 42 ).

Another example of the effectiveness of holistic medicine involves the use of glucosamine for the treatment of arthritis ( 60, 60c, 97, 98 ). While conventional medical treatments for arthritis actually accelerate joint destruction ( 60a ), glucosamine assists in rebuilding the joints ( 60, 97, 98 ). Interestingly, although scientific studies have confirmed the effectiveness of glucosamine for 20 years ( 60b, 95, 98 ), this natural therapy is only now beginning to be supported by orthodox medicine.

Recently, Australian medical authorities have demonstrated that there is evidence to support the use of traditional Chinese medicine ( 20 ). Medical experts were apparently surprised to witness the effectiveness of Chinese medicine for diseases like hepatitis C ( 20 ). However, researchers also noted that the excessive use of clinical trials may take TCM "down the track of excessive reductionism" ( 20 ) and detract from the ability to apply the "art of medicine" ( 20 ).

Perhaps the most impressive evidence regarding the effectiveness of holistic medicine as compared to orthodox medicine relates to the changing treatment strategies for heart disease and cancer, particularly bowel cancer. With both these disorders high tech medical treatments have been found wanting and preventative treatment now revolves around holistic therapies such as diet and nutrition. Any belief that heart disease and bowel cancer can be prevented or cured by surgery, drugs, or other high tech treatments have been generally abandoned in view of the general acceptance that these treatments are merely symptomatic and have no curative or preventative value. If we are to have any hope of preventing or curing these disorders it is now generally acknowledged that we must use holistic therapies. This is in spite of the fact that not too long ago I can recall orthodox medicine claiming that dietary fibre and wholemeal foods were completely unnecessary for health and certainly played no role in disease prevention. Even at that time however, naturopaths, regarded by doctors as quacks, emphasised the importance of fibre and wholemeal foods, particularly for the prevention of bowel cancer. Doctors it seems, are beginning to catch up to holistic practitioners.

Since the above evidence represent just the tip of the scientific evidence iceberg, it is abundantly clear that holistic medicine and natural therapies are firmly based upon extensive scientific evidence.

Having considered the effectiveness of both holistic medicine and orthodox medicine according to scientific studies, I will now consider my personal experiences regarding the effectiveness of these therapies, particularly the use of B vitamins, in the treatment of asthma ( see Asthma and B vitamins, B Vitamin page ).

During the first twenty years or so of my life I suffered from severe continuous asthma. I did not just experience occasional attacks of asthma, I had asthma 24 hours a day seven days a week unless it was suppressed or controlled by drugs. Everyday I would take a minimum of 3 capsules in the morning and 3 at night, and in spite of this drug regimen, I would still have many days when my asthma was inadequately controlled. On such days my daily dose of drugs could easily increase to more than twenty, even when I was quite young. I should perhaps add at this point, that although asthma inhalants or "puffers" were unavailable when I was young, when they were introduced they were completely useless for controlling my asthma. In addition to this regular regime of anti-asthma drugs I was also prescribed huge numbers of antihistamines, as well as steroids, decongestants, revolting cough mixtures, and a steady stream of antibiotics for the frequent infections.

By the time I reached my late teenage years my asthma began to deteriorate progressively, so much so in fact, that I was prescribed more than 30 tablets to take everyday. When my stomach objected to this cocktail of drugs, doctors, undaunted, prescribed additional tablets to prevent me vomiting up all the others. As a result of all this I then developed severe gastritis and pancreatitis, both of which became chronic. At that point I was extremely ill. I realised that if I was to survive I would have to find some other type of therapy. Orthodox medicine had not only totally failed to address the underlying cause of my asthma, but it had also created new illnesses because of the toxic or violent ( 28 ) nature of medical treatments. In desperation, I turned to alternative medicine.

My first foray into alternative medicine involved the elimination of all dairy products from the diet, and although medical practitioners warned that such an approach was unscientific and useless, it did prove to have quite a dramatic effect upon my asthma. Subsequently I did find out that it had been scientifically proven that heat treated milk was in fact, more allergenic than unheated milk, a fact which medical practitioners and medical nutritionists were generally unaware of. 

In spite of the effectiveness of this elimination diet, this was not the whole answer since it did not address the cause of the problem. My asthma continued, although much improved, and in various other ways I continued to deteriorate. The allergy to milk was clearly just a symptom of a more fundamental problem, a fact which is frequently overlooked in today's obsession with symptomatic treatment. For these reasons I turned to vitamin therapy.

The use of larger than normal doses of vitamins B5 and B6 had a dramatic effect upon my asthma and general condition. I was able to discontinue all asthma medications except for a very occasional puff of an inhaler and I also found I was no longer allergic to milk and was able to tolerate dairy products without any aggravation of my asthma. This situation has continued for the second 20 years of my life.

This creates an interesting comparison. In the 20 years before commencing vitamins I had ingested at least, as an extremely conservative estimate, 40,000 prescribed drugs for asthma, while in the next 20 years I have not taken one!

Amazingly, there are probably still people today who would suggest that the treatment I received for asthma was "scientific". The drugs which were prescribed for me had been proven to be safe and effective by scientifically controlled studies. The whole process of attempting to suppress the symptoms of my asthma while simultaneously turning a blind eye to the cause, was apparently part of this scientific process. Additionally, the suppression of symptoms of drug toxicity by taking additional drugs, a very common practice in modern medicine, was also apparently part of this scientific process. 

On the other hand, the natural therapies which were so effective would probably be considered to be quackery. Reductionists would probably assert that natural remedies could not possibly have helped my asthma, it must have been due to the placebo effect ( 8 ), or perhaps I never had asthma in the first place ( 8 ). Or perhaps the asthma improved simply because I abandoned conventional medical treatment, an apparently common cause of improvement in patients ( 8 ). There are probably still those within mainstream medicine who would suggest that I should abandon the vitamin supplements and return to the drug therapies that have been proven to be so safe and effective by modern medical science!!

I should perhaps emphasise at this point, that it is unscientific to assume that symptomatic treatment of a chronic illness will do anything to resolve the illness if the underlying cause remains untreated. The discovery of new and more powerful means of suppressing symptoms does not change this fundamental fact. Fortunately, the severity of chronic illness in most persons who are so afflicted is such that their symptoms may be readily suppressed by modern treatments and they, and their practitioner, are therefore satisfied with this form of treatment. Ultimately however, when the underlying cause becomes sufficiently severe, which may not occur until later in life, no amount of symptom suppression will be totally effective.

In conclusion I would like to make the following points.

• My drug treatment was not the result of unusual treatments prescribed by one doctor, it was the result of the training of all doctors.
• At the time I commenced natural therapies my asthma was deteriorating progressively.
• My dependence upon vitamins was not satisfied by dietary levels of vitamins nor by low potency supplements. 
• High potency B complex vitamins ( ie. more than 15mg ) made me worse. To prevent these ill effects, the dose of each separate B vitamin had to be individualised and taken in the correct ratio. This could not be achieved with high potency supplements containing equal amounts of all the B vitamins.
• Since medical authorities generally claim that positive response to therapy confirms the accuracy of a diagnosis, it would seem that in my case, drug therapy was used in an attempt to control the symptoms of vitamin deficiency.
• For the sceptics out there, since I am dependent upon vitamin supplements, my symptoms may be easily reproduced by ceasing to take them.

But isn't Holistic Medicine just Quackery?

Although various people, especially certain sections of the medical community, seem to continually seek to divert the alternative medicine debate into a question of quackery or medical orthodoxy, this should be seen as merely an attempt to lower the debate to non scientific or emotive terms. Claims by orthodox medicine as recently as 20 years ago that alternative medicine "ought to be as extinct as divination by examination of bird's entrails" ( 86 ), are clearly not helpful.

The choice is not between quackery and orthodox medicine, rather it is between holism and reductionism. It is a choice between the proven dangers of interventionism and the gentle supportive nature of holistic medicine. It is a choice between the symptom suppression of orthodox medicine, and the cause based preventative nature of holism. In reality of course, if progress was not obstructed by professional self interest and the power of the drug companies, there is no reason why there could not be a sensible blending of both systems.

Since I have undertaken to consider both sides of this debate, I will briefly consider some of the arguments of those who describe all forms of alternative medicine as quackery. It should be borne in mind that these views probably do not reflect the feelings of the majority of medical practitioners.

Quackery it seems, has a very broad definition. Anything which is not orthodox medicine may perhaps be considered to be quackery ( 43, 44, 45, 46, 47, 48). Quacks it appears, usually oppose compulsory fluoridation of the water supply and perhaps even advocate the use of water filters ( 43 ). Quacks also believe that organic foods or health foods are superior to other foods ( 43 ) and they also believe that natural vitamins are superior to synthetic ones ( 43 ). Quacks also believe nutritional deficiencies are common and the Recommended Dietary Allowance (RDA) for vitamins has been set too low to allow for optimum nutrition for everyone ( 43, 49 ). Food faddists are a type of quack who have "exaggerated beliefs in the role of diet and nutrition in health and disease" ( 46 ).

The practice of naturopathy, according to Barrett ( 48 ), is "riddled with quackery". Barrett claims ( 48 ) that naturopathic concepts such as "optimum health" and "vital force" are unscientific and "cannot be measured by scientific methods". Barrett concludes ( 48 ): " I believe that the average naturopath is a muddlehead who combines commonsense health and nutrition measures and rational use of a few herbs with a huge variety of unscientific practices and anti-medical double talk".

While much of these criticisms are emotive rather than scientific, some are based upon misinformation or selective quoting of scientific literature. Organically grown produce for instance, has been shown to have considerably higher nutrient levels than conventional produce ( 156 ), including up to 200 times more zinc ( 101 ). 

The claim that natural vitamins are better than synthetic ones is also of interest. According to Wardlaw and Insel in their authoritative nutrition textbook ( 99 ): "whether isolated from foods or synthesized in the laboratory, vitamins are the same chemical compounds and work equally well in the body. Claims by health food literature that 'natural' vitamins isolated from foods are more healthful than those synthesized in a laboratory are nonsense." As we shall see however, it seems scientific evidence contradicts this claim by Wardlaw and Insel.

Although Barrett describes claims of the superiority of natural vitamins as a "flat lie" ( 43 ), he then proceeds to state that there may be what he terms a "minor exception" (43 ). It is indeed interesting to note at this point that another prominent antiquackery activist and colleague of Stephen Barrett, namely Victor Herbert, seems to take the opposite view and actually emphasises the difference between natural and synthetic vitamins ( 158 ): "chemical synthesis produces racemic ( D, L) product (ie. two mirror-image molecules, facing each other), one of which is natural ( ie. the form found in bacteria and plants, and nutrient in humans), and the other of which is synthetic, not found in nature, and may have harmful properties." If indeed a quack may be identified by a belief in the superiority of natural vitamins, then it would seem that the views expressed by Herbert could be described as quackery. It would seem to me however, in this respect at least, Herbert's view is consistent with the available scientific evidence.

Perhaps the best known example of the difference between natural and synthetic vitamins is vitamin E, scientific evidence having clearly demonstrated the superiority of the natural form of this vitamin (  51, 95, 158 ). From a quackery perspective, the recent history of vitamin E is indeed interesting. In 1972 nutrition students were taught that the only form of vitamin E with significant vitamin activity was alpha- tocopherol, all the other tocopherols and tocotrienols existing for no reason since they had no significant vitamin activity ( 93 ). In 1996 however it was reported that heart disease patients were deficient in gamma- tocopherol and not alpha- tocopherol which is the form that is in virtually all supplements ( 95, 159, 160 ). Subsequently it has also been shown that gamma- tocopherol, the predominant form of vitamin E in foods, and mixed tocopherols, are more effective forms of vitamin E than the universally used alpha-tocopherol ( 76 , 95, 158, 160, 161, 162, 164, 165, 168, 169, 170 ). In fact, supplements of alpha-tocopherol actually may prevent uptake of gamma- tocopherol by cells and lower cellular vitamin E levels ( 158,160, 161, 168 ). Additionally, food forms of vitamin E (mainly gamma- tocopherol ) have been shown to reduce heart disease deaths while alpha-tocopherol was ineffective ( 162 ). According to Chen and colleagues ( 76  ) the ineffectiveness of vitamin E in some clinical trials may be due to the use of alpha- tocopherol alone. Evidence increasingly indicates that the entire family of eight vitamin E compounds ( alpha, beta, delta and gamma tocopherol and alpha, beta, delta and gamma tocotrienol ) may have significant health benefits (see Dispelling the Vitamin E Myths).

I should add here that the suggestion of Wardlaw and Insel ( 99 ) that alpha and gamma tocopherol "exist both in nature and in synthesized vitamin supplements" is extremely misleading since most supplements contain alpha-tocopherol alone. Inclusion of gamma-tocopherol in some supplements is a result of the health food industry's interest in superior products, not because of a push by mainstream medicine and nutrition. 

After the past half century of labelling those who believed in the superiority of natural vitamins as "quacks", scientific evidence has now vindicated the accuracy of these quackery beliefs. Science and mainstream medicine were wrong and have been misinforming and misleading the public. The "quacks" have been correct all along. The beliefs promoted by scientists over the past 50 years regarding natural and synthetic vitamin E are now known to be sheer quackery. Scientists all over the world have been conducting clinical trials of a form of vitamin E which represents just one small part of the vitamin E compounds in foods and a form which may actually aggravate cellular vitamin E status (see Dispelling the Vitamin E Myths). Once again the scientific rejection of the importance of "natural" vitamins and cellular nutrition has been the cause of needless human suffering. It is amazing how many supposedly scientific beliefs are based upon rumour and old wives tales such as "synthetic is equal to natural" and "vitamin status can be determined by blood levels". Science has at last learned the lesson that "natural is best" and cellular nutrition is of vital importance. The reductionist approach of medicine has been found wanting yet again.

The inappropriate use of the term "quackery" and the persistent failure of the scientific community to inform the public of the possible adverse effects of alpha-tocopherol or unnatural forms of vitamin E and the superiority of natural forms, according to the definition of Herbert ( 158 ), may in retrospect relegate mainstream medicine and scientists to the status of "snake oil salesman": "deception by omission of adverse facts, and the use of deceptive and misleading 'buzz words' has remained the hallmark of snake oil salesman down through the ages."

The normally marketed form of vitamin B12, cyanocobalamin, is also inferior to the natural forms of this vitamin. The natural, biologically active forms of vitamin B12 are, hyroxocobalamin, methylcobalamin, and adenosylcobalamin ( 52, 100 ). During the manufacture of vitamin B12 cyanide is added (as a contaminant) to form the biologically inactive commercial form of B12, cyanocobalamin ( 100, 166 )  . When injected or ingested, the cyanide must be removed from this form of the vitamin before it becomes active ( 166 ). Such was the concern about the toxicity of the cyanide radical in cyanocobalamin, which may cause atrophy of the optic nerve ( 157 ), that even three decades ago serious suggestions were made that cyanocobalamin should be banned and replaced with hydroxocobalamin ( 157 ). Hydroxocobalamin, which is commercially available, has a superior effect to cyanocobalamin in that it is better retained by the body and produces higher levels of B12 ( 53 ). Furthermore, because of the affinity of hydroxocobalamin for cyanide, this form of the vitamin, unlike cyanocobalamin, can be used to treat cyanide poisoning ( 52, 57 ). Conditions such as tobacco amblyopia also respond to hydroxocobalamin but not to cyanocobalamin ( 52, 53, 57 ). Recent evidence also suggests that methylcobalamin is even more effective than the other forms of B12 ( 55, 56, 166, 167 ). For a commercial source of methylcobalamin refer to the links page.

It is abundantly clear that scientific evidence has repeatedly confirmed the superiority of natural or food forms of vitamins as compared to their synthetic counterparts. To suggest otherwise is inconsistent with the scientific facts and can only be regarded as quackery or deliberate deception.

Barrett also claims, during his critical assessment of naturopathy, that the concept of a vital force or vital energy, which is fundamental to many holistic healing systems, "cannot be measured by scientific methods" ( 48 ). I notice with some interest that Barrett has neglected to mention the fact that the existence of vital energy or "innate vitality", has been acknowledged by one of the greatest medical scientists of the 20th century, namely, Hans Selye ( 102 ). Selye, who laid the foundations for the "holistic conceptualisation of disease" ( 104 ), is one of only eight elite scientists to have authored more than 1000 research publications ( 105 ). I would certainly not seek to question the credentials of Hans Selye.

The common belief, also promoted by those who are opposed to natural therapies, that consumption of a normal balanced diet guarantees optimum nutrition and freedom from nutritional deficiencies ( 43, 49 ), is now known to be a fallacy. In fact, it has now been proven by various scientific studies that many people are deficient in vitamins in spite of the fact that their diet allegedly contains adequate amounts of these nutrients ( see B vitamins, or Nutrition and Megavitamins ). Furthermore, these studies also reveal that it may be impossible to correct these deficiencies unless there is widespread use of megavitamin supplements. In fact it is now increasingly being realised that many people have a genetically increased need for specific vitamins which makes the use of megavitamin supplements essential if  diseases caused by nutritional deficiencies are to be avoided ( see B vitamins, Nutrition and Megavitamins, Nutrition Breakthroughs, for a detailed consideration of the evidence ).

Once again we find the earlier pioneers of orthomolecular nutrition or megavitamin therapy have been vindicated by science. Those who have traditionally supported the use of drugs and opposed the use of megavitamins have adopted a view which, according to modern scientific knowledge, can only be regarded as quackery.

In spite of all these scientific facts however, there are still those who claim the intake of vitamins in excess of RDA's is harmful ( 158, 163 ) and the diet contains "adequate" amounts of all nutrients ( 158, 163 ). Such sweeping generalisations, which completely ignore such vital facts as quality and quantity of food in the diet and genetic individuality, are of course completely meaningless from a scientific point of view. Such views are more closely aligned with quackery.

Unscientific allegations that mainstream holistic therapies are quackery should clearly not be taken too seriously. In this age of unprecedented community acceptance of holistic therapies it is interesting to note the paucity of complaints which originate from those who have had first hand experience with such therapies. In stark contrast, complaints about medical practitioners are spiralling. In spite of this, doctors who warn of the allegedly "dangerous" nature of holistic medicine usually do not display the same level of concern about the current epidemic of iatrogenic diseases.

In view of the fact that holistic medicine is generally much safer and more effective preventatively than is orthodox medicine, it would seem to me that allegations of quackery say much more about the accuser than they do about the accused. In this respect it is interesting to note that according to Willis ( 103 ) "the hostility of conventional practitioners to alternative practitioners" is usually based on "ignorance" of their methods.

I will consider various other aspects of quackery in Section 2 under the subtitle, "Science Today.....Quackery Tomorrow".

Holistic Medicine: From Alternative to Mainstream?

It is claimed that a paradigm shift is occurring in our health care system as alternative medicine begins to compete with orthodox medicine to become the dominant paradigm ( 2, 65, 67, 69 ). Although it has been suggested that nutritional therapy and environmental medicine is now part of orthodox medicine ( 84 ), and in spite of the increasing grass roots support for alternative medicine, there is an enormous chasm to bridge before orthodox medicine would be in fear of losing its dominance. Since the upper echelons of orthodox medicine do not appear to be any closer to abandoning their reductionist interventionist approach than they were 2 or 3 decades ago, it would appear that there is more likely to be an integration or takeover rather than a paradigm shift ( 66, 69, 86 ). In fact, the newly emerging medicine has already been termed "integrative medicine" ( 86, 86a, 86b ). Integrative medicine could only be regarded as a desirable and positive change insofar as it establishes and consolidates a genuine respect for the principles of holism and an appreciation of the whole truth. As has been acknowledged by Bell and co-workers ( 87 ), integrative medicine ideally involves a completely new holistic approach and is not simply "combination medicine" where alternative medicine is added to orthodox medicine.

While this upsurge in the popularity of alternative medicine is consumer driven, largely as a result of the hazardous and ineffective nature of orthodox medicine ( 65, 66, 70, 71, 72, 83, 86a, 86b ), there are those who claim that the alternative health movement is an ideological movement which is part of post modernism and globalisation ( 65, 66, 67, 73, 74, 75 ). In fact, the adoption of natural alternative treatments by orthodox medicine is claimed by many to be due to the shift from modernism to post modernism. Interestingly, according to Chan and Chan ( 74 ) however, although society generally is becoming "more post modernist", orthodox medicine, with the introduction of so called "evidence based medicine", is going in the opposite direction and becoming "increasingly modernist". Due to the fact that evidence based medicine would normally be considered to be firmly based upon modern scientific concepts, the view expressed by Chan and Chan would appear to be quite valid. However it seems there is little scientific basis for many practices which are utilised by orthodox medicine, while conversely, the practice of alternative medicine is not without some scientific support ( see Medical Evidence or Medical Ignorance? ). If orthodox medicine is not based upon science, clearly, the move towards alternative medicine can hardly represent an abandonment of modern scientific methods ( see Medical Evidence or Medical Ignorance? ).

Since my views may be construed by some to support a post modernist political world view, notwithstanding the fact that this discussion concerns health and not politics, it is important that I make my opinion about this matter quite clear.

Although there are those who regard holistic medicine as part of post modernism ( 67, 74, 75 ), this is a view which I totally reject. In my own case, my interest in holistic medicine predated the invention of post modernism. Furthermore, holistic medicine, being a grass roots movement which has long struggled to survive against continuing condemnation from academics and orthodox medicine ( 2a, 85, 86 ), is exactly the opposite of post modernism which was born in the halls of academia ( 77, 78 ). In fact, the determination with which mainstream medicine and science has sought to persecute and discredit alternative medicine is such that resort has been given to the use of fraudulent studies ( 86 ) and violent gun toting "SWAT" type raids of the premises of a qualified medical doctor who utilised nutritional therapy ( 22 ). This type of persecution and deregistration of nutritionally oriented doctors is still continuing in the United States, Canada, and the UK ( 89, 90, 91 ). 

Additionally, although globalism and interdependence are fundamental aspects of post modernism ( 65, 67 ), this is exactly the opposite of holistic medicine which is rooted in self empowerment and self sufficiency ( 66, 69, 72 ). For those who are interested, I will consider post modernism in more detail elsewhere ( click here ).

Post modernism aside, current evidence suggests that the terms of any integration of alternative medicine and orthodox medicine will be decided by medical authorities ( 66 ), who of course, have been trained to evaluate concepts from a narrow reductionist viewpoint ( 10 ). In my view it is absolutely essential that medical authorities fully understand and accept the underlying holistic philosophy if they are to be capable of understanding its mechanisms and fully appreciating its capabilities. This has been confirmed by Whitelegg ( 69 ) who notes that alternative medicine "will be ineffective if it is applied in an authoritarian, hierarchical and elitist setting". According to Whitelegg ( 69 ), the desire of orthodox medicine to "move into the alternative world with the existing paradigm intact", means that "it assesses the alternative by orthodox criteria, subjects remedies and therapies to objective scientific scrutiny, absorbs what will fit, redefines what cannot be readily explained, and rejects the remainder as unscientific". At the very least this type of integration may result in a reduction of free choice or the range of available treatment options ( 66 ), the banning of some herbal therapies ( 66 ), the loss of "patient friendliness" and gentleness ( 66 ), and an abandonment of the importance of "self healing" ( 2a, 66 ). Another possible consequence of the move towards holistic medicine is the tendency of some authorities to blame people for their illnesses ( 11 ). 

The importance of understanding these underlying philosophical concepts is highlighted by the inability of modern medicine to explain the effectiveness of therapies such as acupuncture from a restrictive scientific viewpoint, a fact which is still a source of concern for orthodox medicine ( 64, 74 ). Interestingly, when science does uncover evidence of the existence of the mysterious meridians upon which acupuncture is based, publication of this research in medical journals is likely to be suppressed ( 86b ). Orthodox medicine nevertheless remains determined not to accept the philosophy upon which acupuncture is based ( 11 ). The determination with which modern medicine seeks to preserve its current reductionist paradigm is undoubtedly the single greatest impediment to positive change and any genuine integration with alternative medicine.

Not surprisingly perhaps, many medical authorities still refuse to openly admit the shortcomings of modern medicine ( 64, 65, 79 ), perhaps even claiming that orthodox medicine has proved "to be so apparently effective" ( 66 ) that "most Americans are healthier than ever before" ( 64 ). Any suggestion however, that the effectiveness of modern medicine is such that fundamental change is unnecessary is simply inconsistent with the facts, a point which is made abundantly clear by reference to the safety, effectiveness, and health trends section of this web site.

Denial of the shortcomings of medicine is a very significant problem which permeates through all levels of our modern health care system. As is noted by Chan and Chan ( 74 ) for instance, publishers of medical journals are very selective about the research articles which they select for publishing, negative trial results frequently being refused publication ( 74, 83, 117, 121, 122, 123, 124, 125, 126, 127,128 ). In one recent instance, the refusal to publish negative results has caused up to 80,000 deaths in the US alone ( 86 ). Since "most research money comes from the chemical and drug companies" ( 84 ), it is hardly surprising that medical literature is characterised by a "paucity of articles which report negative findings" ( 74 ). In a disturbing editorial in the British Medical Journal entitled "The Scandal of Poor Medical Research" ( 128 ), Altman points out that "the leaders of the medical profession seem only minimally concerned" about this problem and " make no apparent efforts to find a solution." The reader who is interested in medical bias should refer to the Medical Bias page while the quality of medical research is dealt with more fully in the Medical Evidence or Medical Ignorance? section.

Although we are plagued with iatrogenic diseases and all the major Western diseases are becoming more prevalent, many medical practitioners remain puzzled by the popularity of alternative medicine and seek to blame post modernism or even religion ( 65, 72, 73, 79, 81 ). In any other field of human endeavour this would be described as denial, certainly not the way to move forward. With so much evidence available regarding the shortcomings of medicine, the first step, which should simply be a matter of collective medical conscience, is undoubtedly an in depth soul searching enquiry into the reasons for this failure of modern medicine. Instead of this we have a situation where medical journals refuse to publish reports which may illuminate the shortcomings of medicine and many in the profession still pretend that change is unnecessary.

Having said this however, it should be acknowledged that the movement towards alternative medicine within the medical profession has been initiated, not by the medical hierarchy, but rather by general practitioners ( 65 ). General practitioners have responded to their patients awareness of the advantages of alternative medicine and have therefore begun to incorporate such treatments into their practices on the basis of their safety and clinical effectiveness ( 65, 66, 68, 72 ). Medical authorities have generally resisted these changes, claiming that treatments should only be used when they have been scientifically proven to be effective, and not merely because they are clinically effective.

This situation creates a considerable dilemma for orthodox medicine. The continuing failure of orthodox medicine necessitates that eventually there must be a general acknowledgement of this failure ( as distinct from acknowledgement on a disease by disease basis ) and a search for more effective treatments which could be incorporated into the practice of medicine. Given the desperate plight of medicine, and, on the other hand, the safety and effectiveness of alternative therapies, there is undoubtedly increasing pressure for medicine to adopt such therapies, even in spite of objections from medical reductionists.

Furthermore, the corporatisation of medicine throughout the world ( 112, 113, 114, 115, 116, 117, 118, 119, 120 ) is also inconsistent with any meaningful integration with holistic medicine. Since mainstream medicine, the instigators of corporatised medicine, have long sought to persecute or outlaw alternative medicine ( 112 ), it is hardly surprising that corporatised medicine refuses to acknowledge or accept the validity of alternative therapies ( 119 ). Moves to corporatise medicine therefore, particularly when it comes to preventative medicine, the traditional strength of alternative medicine, could be seen as another attempt to abandon alternative therapies. There is absolutely no doubt that research into preventative holistic techniques are inconsistent with the requirements of profit oriented corporatised medicine, a fact which will see such research undoubtedly give way to the emergence of one stop medical supermarkets which specialise in symptom suppressing interventionist techniques. Unfortunately, when medical research becomes corporatised and hence dictated by profit, it becomes increasingly unscientific and unreliable ( 117 ).

While, as far as the medical hierarchy is concerned, the evidence supporting the mainstreaming of alternative medicine is far from convincing and there continues to be very little evidence that orthodox medicine is attempting to change at a fundamental philosophical level by the abandonment of reductionism, there is at least some recognition of the need for fundamental change. According to the Institute of Medicine of the National Academy of Sciences in their recent medical enquiry entitled "Crossing the Quality Chasm" ( 129 ), "the American health care delivery system is in need of fundamental change." The Institute continues: "the frustration levels of both patients and clinicians have probably never been higher. Yet the problems remain. Health care today harms too frequently and routinely fails to deliver its potential benefits"................." between the health care we have and the care we could have lies not just a gap, but a chasm."

In line with their claim that change to our current health care system needs to be fundamental rather than superficial, the Institute states ( 129 ): "we are also confident that this higher level of quality cannot be achieved by further stressing current systems of care. The current care systems cannot do the job. Trying harder will not work. Changing systems of care will."

In spite of the recent enquiries in America in 2000 ( 132 ) and 2001 ( 131 ), and also the White House Commission on Complementary and Alternative Medicine in 2002 ( 130 ), which further underlined the need for change and recognition of alternative therapies, it is most disturbing to witness the resistance to change which still exists in large sections of the medical community ( 133, 134, 135  ). In fact, the recent WHCCAMP report ( 130 ), has even been described as "outlining the agenda for establishing quackery" ( 135 ). There are enormous problems in modern medicine when a health care system which kills around 100,000 people annually is defended in such a manner against the infinitely safer alternative forms of health care which are described as quackery.

The truth is of course that the above enquiries do not go anywhere near far enough ( 136 ). This will continue to be the case until there is a genuine reappraisal of the relevance of the fundamental reductionist philosophy upon which medicine is based. Any genuine attempt to address the shortcomings of medicine inevitably involves a detailed examination of the fundamental underlying philosophy. All these enquiries are based upon the clear assumption that current medical practices, if applied consistently and without error, will provide a safe and effective level of care. This assumption is entirely invalid however, since a reductionist, symptomatic, interventionist approach to health care is always going to be fraught with problems, no matter how perfectly it is applied. After all, medical authorities themselves admit they are not interested in the "whole truth" ( 10 ).

The safety record of alternative medicine speaks for itself. If this record has been achieved because of efficient organisation and application, then orthodox medicine should take note and follow its example.

Notwithstanding my above comments, there is some light beginning to emerge at the end of the tunnel. It is slowly becoming apparent, at least in some quarters of biology and medical science, that the fragmented reductionist view of biology and medicine is outdated and irrelevant since, as I have previously indicated, it is increasingly being recognised that the sum of the parts is not equal to the whole ( 87, 144, 145, 146 ; see also Nutrition and Megavitamins ). This restrictive reductionist approach is slowly giving way to the increasing application of systems theory which acknowledges qualities of whole systems, such as robustness ( 146 ), which may not be apparent from examining isolated system components ( 87, 144, 145, 146 ).

While it is difficult to assess with certainty the direction in which orthodox medicine is progressing, this is not so with herbal medicine ( 88, 11a, 11b, 11c ) and perhaps alternative medicine generally ( 69 ), which is moving in the direction of orthodox medicine style reductionism and "science". Herbal medicine is under increasing pressure to abandon the fundamentally holistic origins upon which it is traditionally based and adopt a more reductionist approach such as that utilised by orthodox medicine.  Proponents of this move support reductionist changes such as the standardisation of herbs, the abandonment of holistic or constitutional forms of herbal medicine, and the preference for a more symptomatic non-individualised approach.  Such changes, which individually and collectively reflect a philosophical directional change towards orthodox medicine style reductionism, are at odds with the very fundamental holistic roots of herbal medicine.  It is interesting to note for instance, that although natural unpurified herbs have been used successfully for thousands of years, we are now suddenly being told that these herbs must be standardised or purified.  Such suggestions are based upon the same reductionist philosophy which resulted in the "need" for the purification of foods ( ie. manufacture of white flour, sugar, etc.) and the manufacture of powerful drugs from purified herbs. Evidence shows that standardised herbs, which resemble drugs, are more toxic than whole herbs ( see Nutrition and Megavitamins ). 

Various herbal authorities have expressed concern about the current trend to "standardise" herbs or reduce them to their so called "active" constituents. According to Chevallier for instance (152 ), "the whole herb is worth more than the sum of its parts and scientific research is increasingly showing that the active constituents of many herbs, for example those in Ginkgo (Ginkgo biloba), interact in complex ways to produce the therapeutic effect of the remedy as a whole.......the value of a medicinal herb cannot be reduced to a list of active constituents." Similarly, according to Ody ( 153 ), "in extracting these chemicals and seeking to turn herbal remedies designed to help the body heal itself into powerful drugs to obliterate symptoms, we forget one of the basic tenets of traditional healing: a belief that one tries to treat the cause of disharmonies and 'dis-ease' rather than the effects."

According to Landis ( 155 ): "In pharmacognosy, the scientific principles of the West are applied to herbal medicine. All substances are analyzed and broken down by their components, which are studied for their individual effects. This is usually done in the absence of the context that gives herbal medicine its rich dimensions. The herbs are plucked out of the healing system of origin, leaving behind all of the accompanying wisdom, observation, and intuition that made them most useful, understandable, and safe in their native culture. Orthodox scientists like this approach to herbs, and even insist upon it, saying that is the only "scientific" way to approach any kind of medicine. Thus herbs are treated like drugs in an attempt to wedge them into more familiar concepts and filter them through the current scientific paradigm, so that they can be understood in terms of modern scientific thought."

This matter has been addressed in some detail by Holmes ( 154 ):

Standardised herbs, which have had their synergistic and balancing compounds removed, are more like drugs and may lack the safety of whole herbs, perhaps being more liver toxic ( 155; see also Nutrition and Megavitamins ). As science advances supposedly "inactive" constituents of herbs are also increasingly recognised as being "active" constituents ( 155 ). For these reasons it has even been suggested that standardised herbs should not be described as "herbs" ( 155 ).

In considering the merits of whole herbs we must recognise that the "assumption that isolation and standardisation automatically make for more effective medicine is straight out of reductionist Cartesian thought, which gave rise to conventional medicine" ( 155 ). The "synergies, safeguards, and enhancements" ( 155 ) contained in whole herbs are "considered by herbalists to be a key strength of herbal medicine" ( 155 ). The need for standardising of herbs is a result of the mind set that seeks to isolate and conceal specific symptoms rather than restore the health of the patient ( 155 ). Although standardised herbs may be more toxic and less effective in a holistic or cause based sense, such herbs may nevertheless offer increased "opportunities for patents and commercial monopolies" ( 155 ).

In spite of the various arguments which may be used to support or justify these types of changes, we must be quite clear that such changes reflect an unmistakable philosophical directional change towards orthodox medicine style reductionism. Already, injectable herbal products are in use ( 86 ), and consideration has been given to the possibility of producing a potent antidepressant drug from St John's Wort ( 85 ). Such developments are of course, only possible with the medicalisation of herbal medicine.

According to Whitelegg ( 69 ), alternative medicine is moving towards orthodox medicine because of "increasing pressure to professionalise". Whitelegg continues ( 69 ): "As a result, many therapies have been at pains to distance themselves from their folk traditions and shrink from citing their often long history of successful use. Proof is sought by clinical trial to establish practice on a scientific basis with little thought as to appropriateness of method".  From past experience it should be noted, the professionalisation of alternative medicine has been shown to be merely a means by which orthodox medicine can extend its control over such therapies ( 103, 106 ).

While the use of clinical trials may be very useful, when it comes to holistic medicine we must be sure not to sacrifice established holistic concepts in an an effort to integrate with orthodox medicine ( 20 ). Naturopaths and holistic practitioners should not abandon traditional fundamental aspects of their training. This is a very real problem, especially in regard to the naturopathic interpretation of symptoms and the use of clinical trials ( see discussion about clinical trials ).  To the holistic practitioner, an exacerbation of symptoms termed a "healing crisis" is considered a positive sign and therefore something which represents a goal, and not something which should be prevented ( strangely, although orthodox medicine accepts this type of deterioration or healing crisis during withdrawal from various drugs or alcohol, the general principle or mechanism underlying this manifestation is not accepted. ). In spite of these facts there is a disturbing tendency today for some alternative practitioners to adopt the orthodox medical viewpoint and assume that symptom suppression is desirable and indicates a recovery process.

I should emphasise at this point, that the claim that orthodox medicine is "scientific" while alternative therapies are "unscientific" is without any factual basis. Mainstream medicine readily acknowledges that it embraces both "scientific" and "unscientific" therapies ( 86a ). Unlike alternative medicine however, the "unscientific" practices used in mainstream medicine have been developed by those within the medical profession and it is this fact apparently, which makes the use of unscientific practices acceptable to the medical community ( 86a ). For more details about the alleged scientific basis of orthodox medicine, refer to the Medical Evidence or Medical Ignorance section.

Especially since the scientific basis of orthodox medicine is not sustainable, concerns that alternative medicine may serve to "drive a wedge between medicine and science" ( 86b ) are totally misplaced. The yardstick for assessing medicine is its safety and clinical effectiveness and this is clearly where our concerns should lie.

Whatever the final result of this interaction between orthodox medicine and alternative medicine, the long term survival of alternative medicine can only be assured if the traditional holistic philosophy upon which it is based is preserved intact. Failure to do this will result in a gradual swallowing up of alternative medicine by orthodox medicine.

Click here to go to Section 2 of this article, "Why has Orthodox Medicine Failed?"

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