Interface: Holistic Health and Traditio~nal Medicine MALCOLM C. TODD, MD IT IS PARADOXICAL that at a time when contemporary medicine is providing the best quality of health care ever known, we see alternative approaches gaining greater prominence. Why do some of these apparently unorthodox alternatives become so successful? Is it patient dissatisfaction and disappointment with the doctor, or what he said, or that he does not seem to care, or that he admits "I have done all I can for Mother." Or, is there something special in these alternative approaches that our profession has overlooked? Hardly a day passes that the postman fails to deliver two or three announcements of seminars, programs or cassettes on holistic (or wholistic) health. In September 1977 the University of Illinois held a National Symposium on Wholistic Health Care sponsored by the Kellogg Foundation and the Wholistic Health Center.1 In December of the same year, the American Medical Association sponsored a symposium in Las Vegas on holistic medicine and health care. And in May 1978 the first American Holistic Medical Association annual session was held in Denver with Category I Continuing Medical Education credit being offered to the participants. Thus, there seems to be a real need for the medical profession to learn what is meant by holistic health, and then to assist in estabiishing credibility for those procedures that have merit, while informing the public of the subjects that are products of quackery. Finally, as we accept alternatives to health care, we should not be afraid to reject those that are not founded on a scientific basis. Holistic comes from the Greek word holos which means entirety or whole. Holistic health has been defined as a state in which a person is integrated in all levels of being-that is, in body, Refer to: Todd MC: Interface: Holistic health and traditional medicine, In Orthodox medicine, humanistic medicine and holistic health care-A forum. West J Med 131: 464-465, Dec 1979 Dr. Todd is Past President, International College of Surgeons, 1976; Past President, American Medical Association, 1974-1975, and Clinical Professor of Surgery, University of California, Irvine. Reprint requests to: Malcolm C. Todd, MD, 2840 Long Beach Blvd., Long Beach, CA 90806.

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mind and spirit. One might ask several questions: What is holistic health and what does it entail? What is involved scientifically in the holistic view of health care? Is it just a curious or exotic term, or are there real values in this approach to health care? My own concerns involve both curiosity and caution. I am curious as to its accurately applied meaning and cautious as to whether all its elements are scientifically sound, as well as how they will fit into our traditional pattern of health care. Further, I am concerned about the ethics of recommending therapies for which there is no scientifically proved effectiveness as yet. It has been suggested that many modalities of treatment may be used in holistic healing. To achieve this, it will be necessary to tap the resources of our most learned scholars, sophisticated researchers and expert clinicians and practitioners to teach each person to assume responsibility for himself and to heal himself through modification of unhealthy attitudes, values or lifestyle. If we physicians admit there should be alternative approaches to the traditional management of disease, of life, and of. death and dying, then might this be the place for holistic care? Certainly, there is need for modifications in life-style in dealing with stress and tension; so too, new perspectives may be needed in the treatment of organic disease. Therefore, we need to learn and evaluate life-long modification skills that have been derived from ancient cultural traditions, and how we might integrate them with new technologic discoveries. The responsibilities of a doctor to his patient were clearly outlined by Hippocrates more than 2,300 years ago when he emphasized that physicians must consider the whole man to diagnose and treat properly health care problems. He pointed out that the well-being of a person is influenced by social and environmental as well as physiological changes, and that the art and science of medicine include consideration of all these factors.

The original Hippocratic oath bids each physician to swear by "Apollo the Physician, by Aesculapius, and Hygieia and Panacea. Hygieia, of course, is synonymous with the prevention of disease . . . and calls on the physician to be concerned with preventive as well as therapeutic medicine. This thesis was reinforced in the Hippocratic doctrines which stated "The well-being of man is influenced by all environmental factors . . . the quality of air, water and food, the winds and topography of the land .. . and the general living habits." Therefore, understanding the effects of environmental and social forces on human beings is important if the physician is to practice the art, as well as the science of medicine. But Hippocrates lived in much simpler times . long before the revolution in science and technology which has transformed our lives, bringing with it problems as well as progress. Menninger2 implies in his writing that there is a striking inability on the part of doctors and psychiatrists to practice a form of holistic medicine that integrates knowledge of the body, mind and environment. Resistance by the medical profession to these new approaches may be due to conceptual polarities in medicine, such as bodymind dualism or the separation of health from illness. Dr. Daniel Feldman,3 of the University of California, Irvine, states "The holistic view of illness postulates that it is a composite phenomenon, contributed to and shaped by a number of influences, which may or may not bear a direct causal relationship to each other." He maintains that management of illness requires an understanding of as many of these influences as possible. Such an attitude is important, particularly to patients with chronic disabling disease, because their illnesses involve not only organic medical problems, but social, economic, environmental and behavioral problems, as well. Chronic disabling conditions should be examined within the context of a total human environment and involvement. For example, holistic medicine should serve as an interface between those patients who have psychiatric and behavioral problems and those

methods of treatment needed to control or cure these conditions. Our contemporary system of medical care in the United States is one of detection and cure; it is not geared toward prevention of disease or promotion for good health. It has been said that the goal of holistic health is promotion of vigorous well-being both as an individual and societal commitment. Therefore, it is up to each of us to make changes in our own life-styles and environment that will bring about good health. But society should be aware of the charlatans who advertise themselves as holistic healers, yet who are without any special qualifications. We can see a full complement of colorful characters . . . Chinese herbalists, psychiatric healers, Indian shamans and some medical doctors all vying for "a piece of the action," which leads one to ask, "Is it really good, or is it not?" Medical care alone cannot bring about substantial improvement in the health of all people; it may need the accompaniment of better behavioral, social and environmental concepts. Dr. Richard Chilgren, Associate Professor of Pediatrics, University of Minnesota (personal communication, February 1978) has said The term holistic health may in some ways be a catchall of alternative approaches to health care. But more than that, the phrase implies-if not a specific directionat least a trend already evident in many places, that perhaps may be reflected in the integration of mind, body and spirit, or by a redefinition of health to include a sense of consciousness-raising or growth. On the other hand, in perhaps a more ethical sense, holistic health addresses the human energy crisis; the energy-sapping life-style problems which are less amenable to the technologic approach to medicine. It redirects us to the importance of exploring our inner space, or consciousness, through emphasis on health education and responsibility for self.

So it seems proper and timely that the medical profession and its related organizations become informed about and involved in some of the acceptable alternative programs to health care as we work to improve the traditional approach to care. REFERENCES 1. National Symposium, September 15-16, 1977, Granger Westberg Wholistic Health Center, Inc., Hinsdale, Ill. 2. Menninger RW: Psychiatry 1976: Time for a holistic medicine (Editorial). Ann Int Med 84:603-604, May 1976 3. Feldman DJ: Chronic disabling illness: A holistic view. J of Chronic Dis 27:287-291, Aug 1974

THE WESTERN JOURNAL OF MEDICINE

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Interface: holistic health and traditional medicine.

Interface: Holistic Health and Traditio~nal Medicine MALCOLM C. TODD, MD IT IS PARADOXICAL that at a time when contemporary medicine is providing the...
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