America Goes Green: An Encyclopedia of Eco

America Goes Green: An Encyclopedia of Eco-Friendly Culture in the United States By: Kim Kennedy White, Editor Leslie A. Duram, Contributing Editor

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COMPLEMENTARY AND ALTERNATIVE MEDICINE Complementary and alternative medicine (CAM) encompasses an array of healing practices and medical systems developed independently of conventional medicine. Americans turn to complementary treatments while continuing to use conventional medicine and use alternative treatments in place of conventional medicine (NCCAM, 2011b). Some of these practices and systems were established over the past two to three centuries, while others come to us from “ancient and indigenous societies” (Micozzi, 2006, xiii). CAM includes healing practices developed in North America, such as polarity therapy and Native American sweat lodges; in Europe, such as homeopathy; and in India and China, such as Ayurveda and traditional Chinese medicine, respectively (Micozzi, 2006). CAM is distinguished from conventional medicine, also called Western or allopathic medicine (Cassidy, 2006; NCCAM, 2011b). CAM has been variously dubbed “unconventional, nontraditional, integral, [and] holistic” (Micozzi, 2006, xiii). Allopathic medicine is practiced by people who hold the degree of doctor of medicine (M.D.) or doctor of osteopathic medicine (D.O.), whereas CAM practitioners receive training and licensing outside mainstream medical schools through dedicated institutes, schools, and associations. Allopathic doctors may also incorporate CAM therapies into their practices, and some U.S. health insurance companies have added coverage for a few CAM treatments, primarily chiropractic and acupuncture.

Jars containing herbs used in traditional Chinese medicine in Chinatown, San Francisco, California. (iStockPhoto.com)

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The usage of CAM has become commonplace in the United States. The 2007 National Health Interview Survey revealed that 38 percent of adult Americans used some form of CAM treatment (NCCAM, 2011b). These treatments may be sorted into a few broad categories: (1) herbal medicine and dietary supplements; (2) mind-body medicine; (3) energy therapies; (4) hands-on therapies; and (5) traditional medical systems (Bauer, 2007; Freeman & Lawlis, 2001; Micozzi, 2006). Many of these therapies require trained health-care professionals for proper application, while others may be done in the privacy of one’s home, sometimes after initial training by a professional. Conventional medicine has a different conception of the human body from the perspectives found among the various CAM practices. While conventional medicine largely treats the physical aspect of the human body, CAM therapies treat the physical and nonphysical aspects of the human

being. In broad terms conventional medicine perceives the site and treatment of disease as the material, physical body, whereas CAM conceives of a unity between mind and body and therefore employs a holistic approach, considering not just material manifestations of disease but also nonmaterial imbalances of energy (Cassidy, 2006). These contrasting perspectives arise from “numerous cogent models of reality” that form the basis for different social and cultural interpretations of the origins of disease and their treatments and cures (Cassidy, 2006, 29). These models of reality “guide the logic of health care delivery” (Cassidy, 2006, 37). Critics of allopathic medicine have accused it of being grounded in materialism and reductionism, concentrating “its attention on the [diseased] organ, ignoring the body as a whole” (Haller, 2009, 45). The allopathic concept of the human body directs medical attention to the “physical body, specifically the structure of its tissues and the movement and transformation of chemicals within cells” (Cassidy, 2006, 37). Most forms of CAM, in contrast, share the belief that the human body has not only a material nature but also an energetic nature (Micozzi, 2006). This energetic nature has been described variously as a vital force by practitioners of homeopathy (Bauer, 2007; Haller, 2009), prana by adherents of Ayurveda (Morrison, 1995), and chi or qi by practitioners of traditional Chinese medicine (Bauer, 2007). Alternative medical practices aim not only to direct this energy to heal a person’s disease state or injury but also to bring this energy into balance to promote well-being and prevent disease. In CAM, the word disease may be rejected in favor of the concept of imbalance, with the therapeutic goal of bringing the person back into balance (Cassidy, 2006). For example, whereas an allopathic doctor might diagnose an individual with hepatitis, a practitioner of traditional Chinese medicine might describe the condition as “rising Liver fire” (Cassidy, 2006, 40). From the perspective of CAM, then, disease may arise from “nonmaterial determinants” (Haller, 2009, 3), such as spiritual and psychological factors or energy imbalances. Holistic health care systems seek to overcome medical practices based on the Cartesian presumption of a split between mind and body that characterizes most conventional medical practices (Bix, 2004, 166) by considering the whole person, including his or her physical, spiritual, psychosocial, and energetic dimensions (Cassidy, 2006). Whereas conventional therapy targets the physical symptom or

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symptoms, holistic therapies target imbalances of energy and expect physical, psychosocial, and spiritual healing responses in the patient. Conventional psychotherapy’s acknowledgment,

however, of “mind and emotions” (Cassidy, 2006, 39) shows that the allopathic paradigm is not wholly materialistic and at least considers the nonmaterial psyche of a human being. Long before the term CAM was coined, alternative health care practices flourished in 1800s America. Homeopathy, a holistic system of medicine founded by Samuel Hahnemann in Germany in 1796 with the publication of the book Organon (Davidovitch, 2004; Kirschmann, 2004), was introduced to America in 1835 by one of Hahnemann’s students who established the first U.S. homeopathic medical school in Allentown, Pennsylvania (Freeman, 2001). Hahnemann coined the word homeopathy from the Greek roots omoios for “similar” and pathos for “feeling” (Carlston, 2006, 96) or “suffering” (Freeman, 2001, 347). He also gave us the word allopathy from the Greek word alloios for “other” to distinguish between homeopathic and orthodox medicine, which aimed to cure disease by counteracting or suppressing physical symptoms (Carlston, 2006, 96). Homeopathy, however, utilizing tiny doses of highly diluted substances called remedies (Bauer, 2007), operates on a set of principles distinct from those of conventional medicine. Homeopathy’s three fundamental principles or laws are the Principle of Similars, the Principle of Infinitesimal Dose, and the Principle of Specificity of the Individual (Freeman, 2001, 349). The Principle of Similars can also be stated as “like cures like” (Bauer, 2007, 128; Freeman, 2001, 349), an idea articulated in the writings of ancient Greek physician Hippocrates and Renaissance physician Paracelsus (Carlston, 2006): Large doses of a plant, animal, or mineral substance will produce disease symptoms in a healthy person; but when administered in small doses to people already sick with those symptoms, they cure the disease (Bauer, 2007; Freeman, 2001). These remedies are considered “vital” because the power of nature interacts with the vital force of the person to whom the remedy is given to produce the desired effect (Haller, 2009). In other words, homeopathy is based on the “natural healing capacity” of the patient (Carlston, 2006, 97). The Principle of Infinitesimal Dose rests on Hahnemann’s observations that the more a substance was diluted the more potent it became (Freeman, 2001). More than 2,000 dilute remedies, derived from plant, mineral, or animal origins, are available today through the homeopathic pharmacopeia and are sold in liquid, pellet, and tablet forms (Bauer, 2007; Carlston, 2006; Freeman, 2001). The Principle of Specificity of the Individual means that remedies are selected to treat the person and his or her unique manifestation of symptoms. For example, not all headaches are alike: Homeopathy has a separate remedy for each of the more than 200 types of headache. Considerations of where in the head the pain resides as well as what types of movements make it worse or better combine with observations of a person’s body and personality type to construct a “profile” of the patient so that the specific remedy may be prescribed (Freeman, 2001).

Other nonmainstream therapeutic practices were developed in the United States and remain popular today. In the 1890s American midwest, Daniel David Palmer established the system of chiropractic treatment and Andrew Taylor Still founded

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osteopathy (Micozzi, 2006). Both of these men deemed themselves “energy” healers and rejected the use of drugs being promoted by conventional medical practitioners (Micozzi, 2006, 13). Homeopathic practitioners were divided on the use of vaccines, which the conventional medical establishment began developing for a whole host of ailments, nearly eight decades after the advent of the first vaccine, which was for smallpox. Conventional medicine, strengthened by the increasingly accepted idea of germ theory in the 1870s and 1880s, was being met with more and more resistance from people who turned to alternative therapies. Women were especially involved in alternative health care practices in the late 1800s and early 1900s and were accepted as members of the American Institute of Homeopathy beginning in 1869, 46 years before they were allowed to join the American Medical Association (Bix, 2004).

Homeopathy in America In the 1800s homeopathy thrived in the United States and took on a distinctly American character. It incorporated into its pharmacopeia herbs that had been traditionally used in Native American medicine as well as herbs employed by locally based healers such as midwives and herbalists (Carlston, 2006, 102). When life-threatening epidemics hit the American public in the 19th century, homeopathic treatments were reported to be more effective than the toxic treatments prescribed by conventional medicine (Carlston, 2006, 102). An entire academic and medical infrastructure was built up to develop and support the application of homeopathy to public health issues. In 1911, at the height of this first phase of American homeopathy, this alternative medical system boasted numerous local, state, regional, and national societies, clubs, and associations; between 60 and 100 hospitals; 1,000 pharmacies; 13 colleges; and 20 journals (Freeman, 2001; Haller, 2009). In addition, 38 hospitals practiced both homeopathy and orthodox medicine. Opposition from the American Medical Association in the mid-20th century, as well as divisions and conflicts among different groups of homeopaths, caused the homeopathic movement to decline after the 1920s, resulting in the closing of many of its schools and the

shuttering of many of its journals. In the latter third of the 20th century, however, homeopathy experienced a resurgence. Professional associations that organize and advocate for standards of homeopathic care include the American Institute of Homeopathy, established in 1844, and the North American Society of Homeopaths, established in 1990. For Americans who complement conventional medicine with alternative treatments, homeopathy is popular in the 21st century. According to the 2007 National Health Interview Survey, an estimated 3.9 million adults and 900,000 children had used homeopathy in the previous year (NCCAM, 2011a). Although controversy remains in scientific circles as to whether the effectiveness of homeopathic treatments can be proved or not according to the scientific method, some “individual observational studies” have shown some positive effects of homeopathy (NCCAM, 2011a), and orthodox science has recorded homeopathic benefits for the treatment of acute childhood diarrhea, allergies, influenza, pain, and vertigo (Bauer, 2007, 128). As conventional medicine surged at the dawn of the 20th century, many Americans turned to alternative therapies while also opposing orthodox medical practices promoted by the medical establishment. “Radical criticism of regular medicine and public health measures at the turn of the twentieth century was quite often embedded in a network of dissent against the hegemonic Establishment, whether in politics or medicine” (Davidovitch, 2004, 26). Dissenting voices called for medical freedom not only for health care

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practitioners but also for citizens so that they could take health care matters into their own hands without state interference. Among homeopaths in the early 1900s, a minority vigorously opposed compulsory vaccinations for children, while others accepted their application, considering “vaccination as proof of the homeopathic law of similars” (Davidovitch, 2004, 13). Vaccinations, however, were controversial and seen by some political groups as an intrusion of the state into citizens’ private lives (Davidovitch, 2004, 20). Anti-vaccinationism, then, has threaded through American culture for more than 100 years. The link between ill health in the U.S. population and health of the environment was beginning to register among physicians and dentists in the 1930s (Ackerman, 2004). In that decade the U.S. government laid the foundation for a new agriculture paradigm that resulted in wide-scale environmental damage and sweeping dietary changes for the U.S. population (Goodman & Redclift, 1991). State agricultural subsidies that supported processes of intensification, mechanization, and specialization (Woods, 2005) led to farmland consolidation, and multinational agribusiness firms replaced small-scale production of fruits, vegetables, and animals with large-

scale production of globally traded commodities, in particular corn, soybeans, and wheat (Goodman & Redclift, 1991). The Agricultural Adjustment Acts of 1933 and 1938 launched a policy of state market intervention that primarily benefited large commercial growers (Goodman & Redclift, 1991). The resulting production of surpluses in the major commodity crops led to dietary changes for the U.S. population. Agribusinesses gained control of all aspects of food production, including cultivation, processing, packaging, marketing, and distribution, and, partially to absorb the now massive stream of commodity crops, invented highly processed, lownutrient “foods,” such as breakfast cereals. Corporations created a demand for these massproduced foods through advertising (Goodman & Redclift, 1991; Pollan, 2006). U.S. physicians and dentists, however, began to notice the poor nutritional quality of processed foods and blamed much of Americans’ ill health on poor diets (Ackerman, 2004). The American Academy of Applied Nutrition was founded in 1936 by a group of California dentists. In the early 1950s, a group of physicians and laypeople organized to create Natural Foods Associates (now Wisconsin Natural Foods Associates) to sound the alarm about rising rates of chronic health problems in the U.S. population, such as heart disease and cancer, and the relationship between nutritionally deficient foods and nutrient-poor soil (Ackerman, 2004; Hoeting, 2005). Sellers of dietary supplements urged consumption of their products to compensate for nutritionally inadequate diets (Ackerman, 2004, 55). J. I. Rodale, an organic farmer in Pennsylvania, founded the Soil and Health Institute in 1947, the precursor to the Rodale Institute (Rodale Institute, 2011). Rodale published widely on organic farming practices and the connection between healthy soil, healthy food, and healthy people. His publishing company, Rodale Inc., continues to publish many titles on organic farming and human health. The health foods movement that was born in the 1930s grew and matured in the next three decades (Ackerman, 2004). Health foodists believed that educating the public about nutritionally deficient food would persuade people to demand alternatives. They also called attention to the presence of dangerous chemicals in

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food and advocated for organic farming years before the environmental movement took off in the 1960s. Promoting environmental protection, health foodists exhorted “farmers to preserve and restore the fertility of their soil by…following the conservation practices recommended by the U.S. Soil Conservation Service” (Ackerman, 2004, 63). Their beliefs were validated by Rachel Carson’s 1962 book, Silent Spring, in which the harmful effects of agricultural chemicals in the environment were highlighted. Citizens seeking alternatives to conventional medicine also sought

alternative, healthier sources of food, a trend still apparent today. The organic foods sector, for example, has grown at a rate of 20 percent per year over the past several years, with 4.1 million acres of U.S. farmland in organic production (Laux, 2011). During the social foment of the 1960s and early 1970s, feminists began to protest conventional medicine, which had given them “the twin disasters of diethylstilbestrol (DES) treatment and the Dalkon Shield” (Bix, 2004, 153). DES had resulted in birth defects in newborns, while the Dalkon Shield had caused serious gynecological injuries (Kolata, 1987). Women claimed that the medical establishment had an inadequate understanding of women’s health concerns, needs, and experiences. “Women’s health activists explicitly defined holism as superior to allopathic medicine, not only medically, but also politically and socially, in its sensitivity to gender, race, class, and environmental concerns” (Bix, 2004, 153). American women in the countercultural movements increasingly turned to alternative therapies for medical treatment, appreciating “shamanism for its exotic mystery, Chinese medicine for its non-Western emphasis on balance, and herbalism for its harmony with nature” (Bix, 2004, 156). Herbalism, in particular, surged in popularity in the 1990s, and herbalist teachers reminded students that for thousands of years women had been gathering herbs, learning their therapeutic benefits, and administering them to self and loved ones. Herbalists made an explicit connection “between environmentalism and holistic medicine,” sometimes calling their therapeutic practices “ecological healing” (Bix, 2004, 169). Out of a 1969 feminist conference near Boston grew the Boston Women’s Health Book Collective, which politicized women’s health issues (Bix, 2004) and resulted in the 1973 publication of the trend-setting book Our Bodies, Ourselves. The book presented women-centered medical information that women could not find elsewhere and sparked self-education programs. Its subsequent editions featured expanded coverage of holistic medicine. Support for alternative medicine represented an indictment of modernity, whose capitalist, industrialist, and political systems had sickened the Earth and its life forms. Environmentalists and ecofeminists drew parallels between the “gentleness and balance” of holistic medicine and feminine qualities, and they rejected the pathologizing of natural cycles in women’s lives, such as menstruation and menopause (Bix, 2004, 164). Critics of the male-dominated medical community called for more funding for breast-cancer research and focused attention on toxins in the environment and the toxic effects of cancer treatments. Women also demanded more mainstream medical research be conducted on women, since much medical knowledge was based on male-only research samples that ignored the important physiological differences between the sexes

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(Bix, 2004, 160). Such activism resulted in the 15-year federal Women’s Health Initiative (WHI), which enrolled more than 160,000 postmenopausal women in a series of clinical trials and observational study (Bix, 2004). Together with its follow-up Extension Study, the WHI has provided much valuable knowledge on heart disease, breast and colorectal cancer, and osteoporotic fractures in postmenopausal women (WHI, n.d.). The pursuit of alternatives to conventional medicine has led the mainstream medical establishment to take notice of CAM and to include the concerns of marginalized groups, such as women and people of color. Web sites of such conventional medical establishments as the National Institutes of Health, Mayo Clinic, and Centers for Disease Control and Prevention have large sections dedicated to various CAM therapies. While conventional medicine continues to be largely based on the Cartesian split between “matter and spirit,” CAM promotes an integration of mind, body, and spirit (Bix, 2004, 166). Wholeness within the person and unity between people and the environment will promote health for both society and nature. GINA K. THORNBURG See also: Eco-Therapy (Health). References Ackerman, Michael. 2004. “Science and the Shadow of Ideology in the American Health Foods Movement, 1930s–1960s.” In Robert D. Johnston, ed., The Politics of Healing: Histories of Alternative Medicine in Twentieth-Century North America. New York and London: Routledge, 56– 67. Bauer, Brent, ed. 2007. Mayo Clinic Book of Alternative Medicine. New York: Time. Bix, Amy Sue. 2004. “Engendering Alternatives: Women’s Health Care Choices and Feminist Medical Rebellions.” In Robert D. Johnston, ed., The Politics of Healing: Histories of Alternative Medicine in Twentieth-Century North America. New York and London: Routledge, 153–180. Carlston, Michael. 2006. “Homeopathy.” In Fundamentals of Complementary and Integrative Medicine, 3rd ed. St. Louis, MO: Saunders Elsevier. Cassidy, Claire M. 2006. “Social and Cultural Factors.” In Fundamentals of Complementary and Integrative Medicine, 3rd ed. St. Louis, MO: Saunders Elsevier. Davidovitch, Nadav. 2004. “Negotiating Dissent: Homeopathy and Anti-vaccinationism at the Turn of the Twentieth Century.” In Robert D. Johnston, ed., The Politics of Healing: Histories of Alternative Medicine in Twentieth-Century North America. New York and London: Routledge, 11– 28. Freeman, Lyn W. 2001. “Homeopathy: Like Cures Like.” In Mosby’s Complementary and Alternative Medicine: A Research-Based Approach. St. Louis, MO: Mosby.

Freeman, Lyn W., and G. Frank Lawlis. 2001. Mosby’s Complementary and Alternative Medicine: A Research-Based Approach. St. Louis, MO: Mosby. Goodman, David, and Michael Redclift. 1991. Refashioning Nature: Food, Ecology and Culture. London: Routledge. Haller, John S. 2009. The History of American Homeopathy: From Rational Medicine to Holistic Health Care. New Brunswick, NJ: Rutgers University Press.

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Hoeting, John. 2005. “The 45-Year Saga of WNFA.” Quarterly Magazine. Available at: http://www.wisconsinnaturalfoods.org/05w45yearsaga.html. Kirschmann, Anne T. 2004. “Making Friends for ‘Pure’ Homeopathy: Hahnemannians and the Twentieth-Century Preservation and Transformation of Homeopathy.” In Robert D. Johnston, ed., The Politics of Healing: Histories of Alternative Medicine in Twentieth-Century North America. New York and London: Routledge, 29–42. Kolata, Gina. 1987. “The Sad Legacy of the Dalkon Shield.” New York Times, December 6. Available at: http://www.nytimes.com/1987/12/06/magazine/the-sad-legacy-of-the-dalkonshield.html?src=pm. Laux, Marsha. 2011. “Organic Foods Trends Profile.” Agricultural Marketing Resource Center. Available at: http://www.agmrc.org/markets_industries/food/organic_food_trends_profile.cfm. Micozzi, Marc S., ed. 2006. Fundamentals of Complementary and Integrative Medicine, 3rd ed. St. Louis, MO: Saunders Elsevier. Morrison, Judith H. 1995. The Book of Ayurveda: A Holistic Approach to Health and Longevity. New York: Fireside. National Center for Complementary and Alternative Medicine (NCCAM). 2011a. “Homeopathy: An Introduction.” Available at: http://nccam.nih.gov/health/homeopathy/. National Center for Complementary and Alternative Medicine (NCCAM). 2011b. “What Is Complementary and Alternative Medicine?” Available at: http://nccam.nih.gov/health/whatiscam/. Pollan, Michael. 2006. The Omnivore’s Dilemma: A Natural History of Four Meals. New York: Penguin. Rodale Institute. 2011. “The History of Rodale Institute.” Available at: http://rodaleinstitute.org/about_us. Women’s Health Initiative (WHI). n.d. Available at: http://www.whiscience.org/. Woods, Michael. 2005. Rural Geography. London: Sage.