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Integrated Medicine: new horizons in holistic medicine and orthodox medicine:
shaping new directions for health care in the 21st century

This page represents the concluding part of the three page article, Holistic Medicine or Reductionism ?, and Why has Orthodox Medicine Failed?. 

Concluding Comments and Recommendations for Positive Change

Integrated medicine is increasingly becoming the way of the future. At the outset of this article ( see Introduction ) I set out to establish the need for change to our current health care system and the nature of any required changes. Using extensive scientific evidence I have succeeded in establishing beyond any doubt that fundamental change is urgently required if we are to safeguard public health. Such changes cannot occur if medicine retains its current form. Integrated medicine, whereby medicine incorporates the many strengths of alternative medicine, is essential.

Evidence cited throughout this discussion has established beyond question both the urgency of, and the depth of, the need for change to our current health care system. While the urgency of this need for change is clearly due to the hazardous ( see Holistic Medicine Sets the Standard for Safety ) and ineffective nature of orthodox medicine ( see But What about Efficacy? and Health Trends ), the depth of the need for change results from the fundamentally flawed reductionist interventionist philosophy of this form of medicine ( see The Reductionist Philosophy ). The limitations of reductionism, and science generally, necessitates that change must be fundamental, not superficial. By combining the best of orthodox medicine with the best of alternative medicine we can form integrated medicine.

Recent enquiries into our health care system have increasingly acknowledged the fact that modern medicine is failing in three major areas ( see Holistic Medicine or Reductionism ). The first of these is safety, because of the increasing incidence of iatrogenic diseases. Secondly, orthodox medicine has completely failed when it comes to effective treatment of chronic illnesses, and thirdly, the high tech interventionist nature of modern medicine has little or no role to play in disease prevention. Since it is generally agreed that these three areas represent the strengths of holistic or alternative medicine it is vitally important that orthodox medicine examine in considerable detail precisely why this is so ( see Orthodox Medicine ). The answers to these problems of orthodox medicine are not mysterious, elusive, and complicated - for they have already been largely solved by alternative medicine. Yet, in spite of these facts, many within orthodox medicine still cling to the belief that fundamental philosophical change is unnecessary, all that is needed is safer drugs and better training etc. Even more amazing is that some practitioners within the realms of alternative medicine seek to adopt a more reductionist approach and move towards orthodox medicine!

Over the past century of high tech scientific advances, morbidity and mortality from cancer and heart disease have increased astonishingly, including an increase in heart disease and cancer death rates of more than 200% and 300% ( see Health Trends ). High tech scientific medicine has resulted in the situation where heart disease now claims the life of an Australian every 10 minutes and the life of an American every 60 seconds ( see Health Trends ). Today, diabetes, obesity, osteoporosis, asthma, depression, ADD, and other diseases are spiralling out of control while iatrogenic diseases have become the third leading cause of death behind cardiovascular disease and cancer. Consumption of prescription drugs and the frequency of medical consultations are increasing alarmingly. In spite of all this medical experts continue to claim we are becoming healthier and living longer and longer. In fact, according to health authorities, particularly those who oppose positive change, medical advances in the past century, in spite of staggering increases in cancer, heart disease, diabetes, and obesity, have enabled us to live 30 years longer!!! Are we really meant to take this seriously?

In fact, although statistics do tend to show that we are managing to keep the sick alive slightly longer, total life span or longevity is virtually the same as it was a century ago ( see Health Trends ). Contrary to what we are often told, heart disease and numerous other chronic illnesses are also becoming more prevalent ( see Health Trends ).

The standard of public debate about health care today is indeed deplorable. Monstrous insults to the collective intelligence of the community are the order of the day. Spin doctoring has reached epidemic proportions as health authorities struggle to conceal the truth about health statistics and convey a false impression about the safety and effectiveness of modern medical science ( see Health Trends page ). Even so called scientific research is coloured by bias and self interest ( see Medical Bias page ). Care and compassion have given way to self interest and insults. Where does science fit into this picture? Is this an abandonment of science? Or is this part of the scientific approach to health care? Science promises so much with its constant promises and breakthroughs and its high tech approach, but in the end we are left with a most determined refusal to accept responsibility for treatment failures.

If we look beyond the spin doctoring and the rhetoric it is clear that most authorities do not dispute the need for change, it is only the nature and degree of change that is disputed. This is evidenced by the fact that even within orthodox medicine there are many who are beginning to embrace alternative therapies, therapies which they regarded as quackery only a decade or two ago. Unfortunately, although the need for change is becoming more urgent and medical researchers are becoming more desperate, there are some who continue to be more motivated by personal gain rather than compassion or concern for the sick and suffering.

For those who seek genuine solutions, three fundamental questions must be answered.

1. Why is alternative medicine so much safer than orthodox medicine? This, it should be noted, is in spite of all the clinical trials and double blind studies utilised by orthodox medicine. Prescription drugs are toxic foreign compounds and regardless of clinical trials they will always be dangerous.
2. Why is alternative medicine so much more effective for the treatment of chronic illnesses? This is in spite of the many medical "breakthroughs" and high tech medical equipment used today. Not surprisingly, suppression of symptoms of chronic illnesses with toxic drugs will not cure anything.
3. Why is alternative medicine much more effective preventatively? This is in spite of the extensive training and specialisation of medical practitioners. How can symptom based surgery and drugs strengthen a patient and enable them to resist disease?

The answers to these questions, which have been clearly demonstrated in the evidence cited throughout this discussion, determines the precise nature and direction of the required changes to our health care system. The continuing failure of orthodox medicine in regard to prevention and treatment of chronic illnesses for instance, emphasises the need for alternative cause based therapies such as nutrition.

In fact, scientific evidence has now documented the effectiveness of nutritional therapies for the treatment or prevention of numerous chronic illnesses including, heart disease, cancer, asthma, diabetes, arthritis, mental disorders, osteoporosis and birth defects ( see But What About Efficacy?, Nutrition is for the Birds, B Vitamins ). What makes nutritional therapies particularly appealing, apart from their safety, is their potential for cure rather than simply suppression of symptoms ( see Symptom Suppression, Nutrition is for the Birds ). Since there seems to be no evidence that nutritional supplements possess significant symptom suppressing potential their effectiveness clearly depends upon their ability to restore and normalise metabolism. In other words, their effectiveness is dependent upon their ability to cure, not conceal. Although symptom suppressing drugs and other medical procedures offer no hope of cure they are generally preferred by medical practitioners to nutritional treatments.

There is absolutely no excuse for this persistent and unscientific bias against potentially curative treatments in favour of toxic and invasive treatments which are generally acknowledged as having no curative potential whatsoever. Are we content to continue blindly suppressing nature's warning signs or do we wish to adopt a more curative cause based approach? Sadly, orthodox medicine remains the single greatest obstacle preventing the general acceptance and implementation of effective nutritional therapies.  Inability to understand the importance of nutrition is a by-product of the restrictive reductionist basis of orthodox medicine.

The failure of reductionist medical science over the past century has placed doctors in a very difficult position. Since the increasing popularity of alternative therapies has threatened to leave doctors behind, many doctors are starting to endorse the alternative therapies which they described only a few years ago as being quackery. While such doctors may now express qualified support for some alternative therapies, they nevertheless continue to adopt a fundamentally reductionist viewpoint and reject the underlying holistic philosophy.

Medicine it seems, is at the crossroads. If at all possible, medicine will continue to persevere with a reductionist approach and support interventionism and genetic engineering. However, if this approach continues to fail the door has been very carefully left slightly ajar so as to make possible a return to alternative therapies. Although the reductionist path towards interventionism and genetic engineering is diametrically opposed to the holistic path towards alternative therapies, medicine is nevertheless enjoying an each way bet.

Clearly, although evidence of the need for change is absolutely overwhelming, there remain some who are unconvinced, some who would prefer to continue on our current path. Let us take a brief look at the future of medicine if we reject fundamental change and continue with current reductionist medical strategies.

Integrate or Disintegrate: modern medicine in the 21st century

The past century of scientific medicine has been characterised by definite trends which, because of their constancy, make future directions in health care easily predictable. 

The reductionist direction of modern medicine for instance ( see The Reductionist Philosophy ), will continue and will increasingly culminate in interventionism and genetic engineering as traditional approaches to treatment of disease continue to fail. Preoccupation with embryonic stem cell research is only the beginning of the story since unless this research rapidly leads to a solution for all mans health problems then the push will be on to proceed further in this direction by utilising therapeutic cloning and other advancements. It would be unthinkable for medical scientists to completely reverse the direction of medical research if the use of embryonic stem cells does not produce the desired results. Medicine will continue to move in a reductionist direction - learning more and more about less and less. Where will it end?

In spite of all this one feels tempted to ask what will be done about the cause of mans illnesses. Why are our hearts, brains, pancreases and bones failing? We are told that Alzheimer's disease may be due to aluminium accumulation or a deficiency of antioxidants. But scientists say they will cure this disease with genetic engineering. If this is true will we no longer need antioxidants? And will we be able to consume unlimited quantities of aluminium? 

In the bold new 21st century of modern medicine the words "cause" and "cure" will become increasingly irrelevant as they continue to become forgotten relics from a distant past. Our original organs will be valued less and less as they become replaced by artificial mechanical hearts, pigs livers and pancreases, and other genetically engineered replacement parts. There will be an increasing obsession with these replacement parts as all attempts to cure our original organs are totally abandoned. As we move further away from the use of supportive or curative healing techniques medicine will be increasingly dependent upon the use of radical interventionist techniques aimed at replacing or repairing our ailing body parts. Perhaps our brains will also be replaced and updated!!

Since the last 50 years of scientific medicine has been characterised by a phenomenally increasing dependence upon drugs, this trend will also continue. As consumption of drugs increases people of all ages will be affected. Increasingly, children too will need more and more drugs. Drugs will be required to enable us to lose weight, to help us to lose fluid, to enable us to breathe, to conceal our aches and pains, to help us sleep, to give us energy, to enable us to cope, to help us to remember to take the correct tablets, and to stop us from becoming depressed. And after taking all these drugs we will require further drugs to settle our stomachs, to relieve nausea, and to prevent reflux. But drugs will also be used increasingly to replace optimum nutrition and a good diet. Symptoms and diseases which result from dietary inadequacies, whether this involves nutritional deficiencies or excessive dietary fat content, will continue to be "treated" by drugs. 

The degree to which we have become dependent upon drugs is underlined by the fact that people today can no longer cope without drugs. It seems even normal people now require antidepressants to enable them to cope and reach an acceptable level of happiness ( 1, 2, 3 ). According to Charlton ( 1 ): 'The evidence is mounting that there are an unknown but significant proportion of people who show no detectable sign of psychopathology, yet whose lives can benefit in a very fundamental way from taking one or another of the 'antidepressant' drugs." But perhaps most people need psychiatric drugs because they are in fact ill ( 2 ). According to Charlton ( 2 ): "The human condition, as we experience it in contemporary life, is one where psychiatric symptoms are endemic, being constantly present in the population - and present at a remarkably high prevalence." Charlton continues: "There is little doubt that, conceived in this way, psychiatric impairment is the norm. Mental health and well being are so rare as to be remarkable. For most people, even a single day of unalloyed well-being is a rare event."

Drug dependence will clearly be an absolutely integral part of 21st century medicine unless there are fundamental changes. New drugs will be actively promoted by both doctors and drug companies until patients develop a dependence upon these drugs and an expectation that they will be prescribed by doctors. When this level of dependence has been created doctors will then blame patients for demanding or expecting drugs. We can see a very clear example of this with the current obsession with cholesterol lowering drugs ( see Health Trends ). Currently, since these drugs are relatively new it is the medical profession and the drug companies who are promoting dependence upon these drugs. In time however, patients will be expecting these drugs to be prescribed, just as has happened previously with tranquillisers and antibiotics etc. Since drug dependence will form such a fundamental part of 21st century medicine, iatrogenic diseases will also increasingly become diseases of the future. Recognition and acceptance of the inevitability of this fact will necessitate that the medical profession examines ways of preventing successful litigation by patients. Otherwise we simply could not afford modern scientific medicine.

Continuing obsession with interventionism and the use of symptom suppressing drugs will also result in further increases in the incidence of chronic diseases. Since the use of these medical strategies has resulted in astonishing increases in heart disease, asthma, cancer, diabetes, mental disorders, and obesity throughout the 20th century ( see Health Trends ), this trend will continue unless medicine adopts a more preventative approach. Additionally, the failure of modern medicine when it comes to chronic diseases will result in a range of new diseases becoming increasingly prominent. For instance, stress related diseases such as chronic fatigue syndrome will increasingly become diseases of the future.

Also destined to increase in the 21st century are nutritional deficiencies or nutritional dependencies. Although many will probably remain undiagnosed, diseases caused by an inability to efficiently utilise vitamins will become much more prevalent. Today we are just scratching the surface as we find that mental disorders and diseases like heart disease and asthma may simply be nutritional deficiencies resulting from an increased need for specific nutrients.

The current trend to corporatise medicine will also see medicine becoming increasingly profit orientated ( see Health Trends ). Medical resources will be increasingly allocated and prioritised on the basis of cost rather than compassion or the needs of patients. Patients with complex problems which may prove too costly to treat will be placed well down the priority list. As profit becomes more important the private health industry will continue to expand at the expense of the public sector. In fact, there will be a deliberate winding down of the public health system. This will produce a two tiered health system where those who cannot afford the private system will receive an inferior level of health care.

The direction in which orthodox medicine is progressing is abundantly clear. We are becoming increasingly drug dependent as medicine becomes increasingly profit motivated and increasingly reluctant to accept responsibility for medical mishaps.

Past Problems and Future Solutions

Evidence cited throughout this discussion has repeatedly revealed that most of the shortcomings of modern medicine are due to its piecemeal or tunnel vision approach to health care. When medical experts themselves admit that modern medicine is not interested in the "whole truth" ( see The Reductionist Philosophy ) then medical "errors" will inevitably abound. Holistic health discoveries continue to be rejected even if backed by extensive scientific evidence ( see But What About Efficacy? and B Vitamins ).

If we are to deliberately design an effective health care system then we must identify and learn from, the reasons why orthodox medicine has failed to conquer the major Western diseases ( see Orthodox Medicine ). To be effective a health care system must be structured and logical and must avoid past mistakes. Reforms must have a firm corrective and logical basis. We should not seek to make the art of successfully diagnosing and treating human illness more difficult by confining ourselves to a restrictive reductionist interventionist approach which seeks to exclude any serious interest in the nutritional building blocks from which every cell in our body is made. We should seek to maintain optimum health through nutrition rather than seek to perfect the art of intervening after a disease has become established. Our health care system should be fundamentally supportive and cause based rather than interventionist and symptom based ( see Interventionism or Vitalism ).

The overuse of symptom suppressing prescription drugs is cause for major concern. The proliferation of drugs is itself proof of their failure to arrest human diseases, the more drugs we have, the more we need more. Paradoxically the drug companies thrive on the sheer toxicity and ineffectiveness of the drugs they produce. New wonder drugs are constantly produced to replace previous wonder drugs the toxicity of which only became apparent through clinical usage and human suffering. The failure of these new drugs ensures still more will be produced in the future.

The overuse of such drugs is dangerous for three reasons. Firstly of course, the sheer toxicity of drugs ensures the development of iatrogenic diseases. Secondly, the symptomatic nature of drug treatment merely conceals the disease and aggravates the patient's condition over the longer term ( see Symptom Suppression ). The science of concealing illness by the suppression of  symptoms is one of the most pernicious aspects of orthodox medicine. As I have indicated elsewhere, the definition of what constitutes scientific evidence should be changed to emphasise the distinction between curative caused based therapies and symptomatic therapies. Finally, by leading patients to believe that they are becoming well by taking prescription drugs, doctors are dissuading patients from improving their nutrition and making positive lifestyle changes. The widespread use of prescription drugs can never be a fundamental part of a safe cause based health care system because of the dependence which drugs create and the negative effect of this dependence upon positive life style changes.

Underlining the degree to which modern society has become dependent upon drugs is the fact that many people, in their apparent eagerness to justify drug use, now describe certain drugs as being "recreational", a description which is now even acknowledged and accepted by medical practitioners. If the past 100 years of scientific medicine had created a dependence upon nutrition rather than drugs, then public health would not be confronted with the enormous problems which it now is. With the current increased interest in lifestyle factors, doctors should be promoting "recreational vitamins".

Medical practitioners should also communicate much more effectively with patients. Before prescribing symptomatic treatments for chronic illnesses patients should be clearly advised that such treatments may merely serve to conceal the illness and permit it to deteriorate over the longer term, perhaps until it becomes uncontrollable. The hazards of masking symptoms should be fully explained ( see Symptom Suppression ). Patients certainly should not be misled into thinking that suppression of symptoms will do anything to resolve the underlying cause. Patients should be encouraged to pursue a more cause based therapy if they find symptomatic treatment unacceptable.

Especially when it comes to the treatment of non-terminal chronic illnesses, patients should be encouraged to pursue less toxic non-drug therapies as a first treatment option. Attempts to justify the use of toxic drug therapy or invasive medical treatments on the basis of their alleged "risk/benefit" should be discouraged since this presumes that their are only two treatment options, namely, medical treatment or no treatment. Respect for the patient's right not to be harmed by treatment should automatically ensure that the practitioner will give first preference to the safest and least toxic treatment options. Determination to do no harm should be uppermost in the minds of all practitioners, not just holistic practitioners. The poor track record of modern medicine when it comes to iatrogenic diseases and patient safety will not change if first preference continues to be given to the use of toxic or invasive therapies.

Since iatrogenic disease has now become the third leading cause of death in Australia there should be major penalties for anyone who causes this type of illness. While personal litigation remains a necessary deterrent it does have the disadvantage that the temptation of personal gain may encourage trivial or fraudulent claims. In the current interventionist medical environment it is absolutely imperative that every doctor ( and hospital ) is required to keep a publicly available detailed statistical record of his/her treatment successes or failures, including possible drug side effects. While such reforms will require legislative backing, increasing awareness of the problems currently confronting our health care system should maximise the incentives for voluntary participation.  For those who are concerned about either the welfare of their patients or the costs of medical insurance and litigation, such a scheme should be embraced with considerable enthusiasm. Initial costs of implementation will be rapidly repaid by reductions in litigation and insurance costs. The urgent need for such a scheme is a result of the hazardous nature of 21st century medicine combined with the persistent refusal of the medical profession to institute their own corrective action. It is part of the process of accepting responsibility. Avoidance of responsibility will result in disintegration, certainly not integration.

There should also be more consideration of the contribution of the patient to disease resistance. In fact, it is the abandonment of nature and vitalism by orthodox medicine and the resultant disinterest in the patient's own ability to heal, which has resulted in the violent interventionist nature of orthodox medicine ( see Interventionism or Vitalism ). There is a fundamental arrogance about a healing system which seeks not to support nature, but rather to subvert it ( iatrogenic diseases of course, are the result of subverting nature ). It is this arrogance which tends to produce an inherent rigidity in orthodox medicine.

Although the role of the patient in resistance to disease should be taken more seriously, this certainly does not mean patients should be blamed for their illnesses. Creating a condition of optimum health and vitality and maximum resistance to disease remains the responsibility of those who are specially trained to treat illness and restore health. In spite of this fact there is a disturbing trend today to blame people for their various afflictions. Blame it seems, is frequently a substitute for effective medical treatment - if the disease cannot be treated effectively it must be the fault of the patient. Patients must accept responsibility for deliberate lifestyle choices and practitioners must accept responsibility for correct diagnosis and treatment of their patients, especially when treatment is ineffective.

Unfortunately, the current trend to cast the burden of responsibility totally upon patients is being increasingly adopted by bureaucrats and politicians who are desperately searching for an answer to the exploding costs of health care. This is a very disturbing trend which reveals a glaring desire to give priority to economic considerations rather than health and compassion. In fact, increasing demands upon both the health care system and the welfare system are not accepted as being genuine even in spite of the fact that statistics reveal that chronic illnesses and disabilities are becoming increasingly prevalent ( see Health Trends page ). Just as blame is a substitute for effective medical treatment at an individual level, so it is also at a national level. Even the increasing consumption of prescription drugs is said to be the fault of patients, not the fault of deteriorating public health and an ineffective medical system. Apparently doctors have no choice but to prescribe excessive or unnecessary drugs because of the forceful and intimidatory demands of patients. Even excessive  use of antibiotics, tranquillisers and sleeping tablets is said to be caused by the persistent and irresistible demands of patients. Doctors it seems, have absolutely no choice and are forced to cooperate.

Let us be quite clear and quite honest about this. The suggestion that doctors are incapable of controlling their prescribing habits when confronted with "demanding" patients is not only highly insulting, it also implies widespread medical incompetence. This predicament is the fault of an ineffective medical system and NOT the fault of aggressive overbearing irresistible patients. It is a medical problem, not an economic or political problem. It is a manifestation of a medical system in complete disarray. If we are going to continue to blame patients every time that they present with a problem for which there is no effective medical treatment we will never get anywhere. Similarly, if we continue to blame patients for the increasing prevalence of chronic illnesses and disabilities there will be no positive progress. If we are to move forward we must be honest and cease this cancerous epidemic of denial.

Instead of blame, let us begin to accept responsibility, not only for treatment successes, but also for treatment failures. Health care should not be based upon a desire to blame patients for being sick or failing to respond to orthodox treatments. Let us accept, as a matter of absolute urgency, the need for fundamental change to our health care system.

Sadly, notwithstanding my above comments, some medical authorities will undoubtedly respond to the ongoing ineffectiveness of modern medicine by continuing to cast the burden of responsibility onto patients. In this respect it is interesting to observe the current medical obsession with "lifestyle diseases" ( see Health Trends ). While the part played by lifestyle in disease causation has long been acknowledged by holistic medicine, orthodox medicine on the other hand, has traditionally regarded such claims as quackery. Over the past century suggestions by holistic practitioners that lifestyle factors such as diet and nutrition could prevent serious diseases have been persistently ridiculed by orthodox medicine, the clear implication being that orthodox medicine will ultimately cure these conditions by its scientific interventionist approach. Increasing awareness of the shortcomings of interventionism however, has resulted in increased acceptance of the importance of  lifestyle factors in disease causation. There are two aspects of modern medicine's new attitude to lifestyle diseases which are of particular importance.

Firstly, if orthodox medicine is to begin to accept responsibility for treatment of lifestyle diseases then it must cease its interventionist approach and utilise the traditional caring and supportive approach of holistic medicine. Doctors must be much more concerned about positively eliminating the possibility of nutritional deficiencies occurring throughout the community. This clearly involves considerably more understanding of lifestyle factors such as diet and the use of nutritional supplements, use of which must be encouraged and supported by medical practitioners ( see B Vitamins, Nutrition is for the Birds ). Instead of encouraging drug dependence such positive lifestyle factors must be preferred to toxic drug therapies as a first treatment option for non-life threatening chronic diseases. This also includes the use of diet and nutritional supplements to treat excessive cholesterol levels, a problem which, in spite of the current emphasis upon lifestyle factors, is increasingly being treated by even more drugs, making cholesterol lowering drugs one of the greatest moneyspinners for drug companies ( see Health Trends ). To encourage even more dependence upon drugs in this way is inconsistent with responsible health care. When confronted with a choice between dietary or nutritional intervention and drug intervention, in spite of the rhetoric about lifestyle factors, modern medicine always seems to opt for the most profitable ( drug ) alternative ( see Health Trends ).

In keeping with this concern about lifestyle factors medical practitioners and medical organisations must also accept much more responsibility for safeguarding the quality of our food supply. They must play an active role in ensuring primary producers, manufacturers and retailers supply only quality unadulterated health promoting foods. The health food industry should be supported by the medical profession. Medicine should be supportive of positive lifestyle changes. Although this is an absolutely vital part of our health care system and a very significant lifestyle factor, it is also one that modern medicine has traditionally ignored.

Secondly, the acceptance by orthodox medicine that lifestyle factors have more to offer for the treatment or prevention of various diseases than does modern science raises serious questions about the relevance of science for health care. Acknowledgement of the importance of lifestyle factors is a clear acknowledgement also that the role of mother nature in restoring and maintaining health is much more important than the role of scientific interventionism. Since lifestyle factors such as diet and nutrition exert their effects by optimising vital energy and the body's own restorative mechanisms these facts must clearly be given much greater priority in medical training. The most important lesson to be learned here is not simply that lifestyle factors are effective, but what is much more important are the underlying reasons and mechanisms that are responsible for this effectiveness ( see Orthodox Medicine,  Nutrition is for the Birds ). Appropriate emphasis must be given to the use of holistic cause based therapies. The fact that it has been found necessary to abandon interventionism on the other hand, necessitates that the role of interventionism in modern health care must also be re-evaluated and clarified.

In many ways, the health care standard to aspire to today is set by the various mainstream forms of alternative medicine. In terms of safety for instance, alternative medicine could never accept the level of iatrogenesis which is accepted as being part and parcel of of orthodox medicine. The frequency of fatal or non fatal reactions to treatments which occur in orthodox medicine ( see Holistic Medicine Sets the Standard for Safety ) could never be tolerated in alternative medicine, either by patients or practitioners. The ultimate goal of alternative medicine, namely the attainment and maintenance of optimum health, is also a much higher ideal than the suppression of symptoms of clinical disease ( see Symptom Suppression ), which is the aim of orthodox medicine. The preventative aspects of holistic medicine, now increasingly acknowledged by orthodox medicine through the endorsement of traditional holistic therapies such as the use of diet and nutrition to prevent diseases like cancer and heart disease, is also one of the unique strengths of holistic medicine. These aspects of alternative medicine are responsible for the increasingly high level of esteem with which this form of medicine is regarded in the community. 

While it is indeed encouraging to see orthodox medicine slowly beginning to accept the importance of some traditional holistic concepts, especially the importance of diet, it is the rejection of the underlying holistic philosophy which continues to retard the acceptance of these facts amongst the medical community. The predominance of reductionism guarantees that holistic discoveries will be accepted begrudgingly and without the full potential of holistic medicine being realised or understood. The point must be made most emphatically that it is not possible to effectively utilise natural holistic treatments in a reductionist symptomatic setting. Herbs used in this way will inevitably become highly purified symptom suppressing drugs. In this connection the lessons of history are of vital importance.

The beginning of orthodox medicine 200 - 300 years ago was characterised by the introduction of reductionism and the abandonment of holism. In fact, the manufacture of potent drugs from purified herbs was only made possible by the abandonment of holism. In practice such changes are usually made gradually until the underlying philosophical change is complete. It is ironic that current health authorities have responded to the recent upsurge in the popularity of holistic medicine by pro-reductionist suggestions that herbs should be purified and more rigidly controlled. Can history possibly repeat itself when the consequences of reductionism over the past 300 years are now well known? The limited advantages of reductionism should be maintained, but not at the expense of the survival of holism.

One of the most significant and confusing problems facing health care consumers today is the fragmentation of health care into opposing and rigidly introverted disciplines. There is little recognition, either at the level of the practitioner or the patient, of the limitations of the various forms of health care and their efficacy for specific types of illness.  This is a tragedy for public health in the 21st century. Restrictive paradigms which impose artificial boundaries upon health related studies are a deterrent to learning and improvements in public health.

While orthodox medicine is clearly superior to holistic medicine for the treatment of serious trauma and acute or life threatening diseases, holistic medicine, with its fundamentally supportive nature and its ability to embrace the importance of nutrition, is much more effective when it comes to promoting healing and preventing further illness in the future. The powerful interventionist and symptomatic nature of orthodox medicine has little relevancy when it comes to prevention or the treatment of most chronic illnesses ( see Symptom Suppression ).

One area perhaps, which causes some confusion, is the treatment of diseases which have caused a degree of irreversible damage to a certain tissue or organ. Since holistic medicine is based upon the ability of the body to heal itself, this type of medicine may be totally irrelevant if irreversible damage has occurred to a particular tissue or organ, or there is an inability to properly digest food and absorb, metabolise or transport nutrients ( see Interventionism or Vitalism? ). Although for instance, my own autoimmune thyroid disease may lead to destruction of thyroid tissue, this fact is not always accepted by alternative practitioners. The difficulty here of course, is to be absolutely sure that irreversible changes have occurred.

While proponents of holistic medicine tend to adopt the attitude that nearly any level of tissue damage is reversible, orthodox medicine on the other hand, since healing is not their forte, tend to take the opposite view and resort to dramatic interventionist techniques even when the tissue damage is completely reversible. It is in this area particularly where accurate diagnosis and a high level of co-operation between alternative medicine and orthodox medicine is highly desirable. The use of toxic drugs and risky surgical procedures should not be considered as a first treatment option in the absence of acute or life threatening disease or the presence of irreversible tissue damage.

Even amongst alternative therapies there exists this same introversion and rigidity Although nutritional therapies for instance, probably represent the ideal starting point for responsible health care management, such therapy is not normally part of herbal medicine. For all the strengths of traditional Chinese herbal medicine, especially regarding constitutional balancing, it is not the ideal discipline for the diagnosis and treatment of vitamin deficiencies. On the other hand, the constitutional benefits of Chinese medicine are generally not a feature of Western herbal medicine ( see Traditional Medicine page ).

Health care can only benefit from an integration of the various healing systems. An integration which is patient oriented and based upon genuine respect for the strengths of each particular system.

The 21st Century and Beyond

Change is inevitable if we are to safeguard public health. Change however, should be deliberate and structured and should proceed logically by first addressing shortcomings in our current health care system. The first part of this process is to define in some detail the nature of these shortcomings and it is to this end which this article has been dedicated. Although there may be some who would suggest that medicine should be allowed to evolve in a haphazard ad hoc manner, such an approach is not only unscientific, it also poses an unacceptable cost in terms of human suffering and lives. The changes proposed in this article are entirely logical and are based upon extensive scientific evidence.

Although there are many today who seem content to permit medicine, and our health care system generally, to stumble along from catastrophe to catastrophe and from contradiction to contradiction, it is my belief, based upon the evidence I have considered, that our health care system should be positively and holistically structured upon a firm basis of science, logic and common sense.

Orthodox medical practitioners do an invaluable job within their area of expertise, as do holistic practitioners. Why however, do we continue to pretend that orthodox medical treatments are the most appropriate types of treatment for disease prevention or treatment of subclinical or chronic illnesses? Why is it that we cannot produce an effective, safe, patient orientated integrated system of health care where both types of medicine are used primarily within their particular areas of expertise? Toxic symptom concealing drugs and hazardous invasive procedures should be reserved for trauma or acute or life threatening diseases and should not be a first treatment option for chronic illnesses. Drug dependence should be actively discouraged wherever possible. The possibility that drugs are being used to conceal symptoms of nutritional deficiencies must also be positively eliminated.

If we are at all serious about health care we must identify, as a matter of absolute urgency, those practitioners and hospitals which have the better records of treatment successes. We must learn from the reasons for these successes or failures by examining in detail these real life clinical trials. It is tragic that this most comprehensive source of real life medical experience remains disorganised and unused. Can we afford to continue to ignore the results of these most extensive clinical trials?

Although integrated medicine is the way of the future we must ensure however, that those qualities of alternative medicine which are responsible for its longstanding safety and effectiveness are fully retained. While there must be a degree of integration between alternative medicine and orthodox medicine we must also accept that there is a fundamental incompatibility between the underlying holistic and reductionist philosophies. The holistic philosophy involves a mind set or world view that is totally foreign to modern reductionist thought ( see Overcoming Medical Bias ) and this separation must be respected and taught to succeeding generations. 

Integrative medicine is not simply "combination medicine" where alternative medicine is added to orthodox medicine, but rather, integrative medicine involves a genuine holistic philosophical approach embracing optimum health of the whole person ( 4 ). Whereas the piecemeal approach of conventional medicine examines "parts of health care and parts of the individual, but not the complete system", integrative medicine adopts an all inclusive holistic approach ( 4 ).

While reductionist medical science should continue it must do so with an increasing awareness of the "whole truth". It must increasingly acknowledge and support the survival of holism. In accord with its awareness of the "big picture" or total truth, its more supportive, preventative and cause based nature, and its greater safety, holism must not just survive, it must become more predominant.

The choice is simple. Do we require a fundamentally safe cause based, preventative approach to health care, or on the other hand, a hazardous symptomatic interventionist approach characterised by an ever increasing dependence upon drugs? Our health care system should be constructed accordingly.

The future success of integrated medicine will be determined by the respect accorded the underlying philosophies of holism and reductionism and the degree to which the separation and independence of these philosophies is respected and preserved. While alternative medicine and orthodox medicine must become integrated, the underlying philosophies must remain totally separate if future generations are to experience the benefits of holism. Integrated medicine is cooperative medicine. Integrated medicine is patient oriented medicine. While the philosophies are incompatible, where there is good will, people are not.

With compassion, concern, and understanding providing our motivation, and with a direction determined by truth, logic and common sense, let us look beyond the square and move towards a safer and more effective health care system.

References

1.http://www.hedweb.com/bgcharlton/psychopharm.html  See: Bruce G Charlton, Psychopharmacology and the human condition, J. Roy. Soc. Med., , 1998; 91: 599-601.
2.http://www.hedweb.com/bgcharlton/psychhuman.html  See: Bruce Charlton, Psychiatry and the Human Condition, Radcliffe Medical Press: Oxford, UK, 2000.
3.http://www.socialaudit.org.uk/5016-RSM.htm  See: Bruce G Charlton, Psychopharmacology and the human condition, J. Roy. Soc. Med., , 1998; 91: 599-601.
4.http://archinte.ama-assn.org/issues/v162n2/abs/isa00023.html  See: Iris R. Bell, et al, Arch Intern Med. 2002;162:133-140.

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