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Section 12B... Alternative Medicine

 

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Responding To Alternative Medicine

Peter Saunders

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Also See   Are Yoga & Christianity Compatible?   and Section on   The New Age Movement

 

How should we respond to alternative medicine? Peter Saunders, CMF Student Secretary, gives an overview of the field and suggests some principles to apply in assessing individual modalities.

Alternative medicine is rising rapidly up the healthcare agenda. One in four people in the UK use at least one form of alternative medicine and three out of four people are in favour of alternative therapies being available on the NHS.

One study cited by a recent BMA report suggested that there may be up to 15 million consultations to non-conventional therapists each year in the UK, with about 1.5 million people (2.5% of the population) each year receiving treatment.

The British Register of Complementary Practitioners has 1,000 members and the number is rising by 10% per year. A 1980 UK survey suggested that there were 12.1 non-medically qualified practitioners per 100,000 population - 27% of the number of general practitioners. In addition, 35% of UK GPs have received some training in alternative medicine.

In most member states of the European Union (eg Belgium, France, Spain, Italy and Greece) the practice of medicine by non-recognised health professionals is illegal. In Germany and Scandinavia there is some regulation but in the United Kingdom and Ireland there is virtually no regulation at all.[1]

When one considers the tight controls on the training and practice of orthodox medical practitioners there is clearly a double standard operating. If there are no proper controls for alternative medicine practitioners, then the way is open for charlatans, profiteers and tricksters to operate alongside those who are genuinely providing service of proven value.


What is Alternative Medicine?
Problems of definition

The report of the BMA’s Board of Science and Education’s working party, Complementary Medicine, New Approaches to Good Practice [2] defines non-conventional therapies as ‘those which are not widely used by orthodox medical professionals nor widely taught at undergraduate level in medical and paramedical courses’ - but some therapies regarded as alternative in the UK are taught formally in medical schools elsewhere.

The three terms complementary, alternative and holistic are used almost interchangeably - but convey different messages. ‘Alternative’ implies an either/or relationship with orthodox medicine; ‘complementary’ a both/and relationship while ‘holistic’ implies that non-orthodox therapies treat the ‘whole person’. All these assumptions are controversial.


The Diversity of Therapies
The BMA report says that as many as 160 different forms of non-conventional therapy have been identified. An A to Z of some of the most common includes:

    Acupuncture, Acupressure, Alexander Technique, Aromatherapy, Auricular Therapy, Bach Flower Remedies, Chiropractic, Crystal Therapy, Herbs, Homeopathy, Hypnosis, Iridology, Macrobiotics, Massage, Naturopathy, Osteopathy, Reflexology, Shiatsu, Therapeutic Touch, Transcendental Meditation (TM), Yoga, Zen and Zone Therapy.

On first glance there seems to be very little similarity between one form of alternative medicine and another; but what unifies most of them is the idea of a ‘life force’ or ‘vital energy’ which ensures health, becomes disrupted in disease and can be manipulated by various means.

For example, underlying acupuncture is the belief that there is a vital force or energy called ‘Chi’ which flows freely through the body in twelve meridians or channels. The flow of this energy depends on the balance between two opposite forces; an active, ‘male’ force called ‘yin’ and a passive, ‘female’ force called ‘yang’. When the flow of the Chi energy is free and uninterrupted health is ensured but if the balance between yin and yang is disturbed or if there is any blockage to energy flow then disease results.

These ideas have their roots in the ancient Chinese religion of Taoism which has Chi, yin and yang as fundamental concepts.

Ideologies which underly other forms of medicine use different words for the same general concept of ‘life force’. Shiatsu is based on Shintoism and calls the energy ‘Ki’. Yoga and TM are based on Hinduism and call the force ‘prana’. Homeopathy uses the term ‘vital energy’, chiropractic ‘innate intelligence’ and Maori medicine terms the life force ‘mana’.


The Common Theme of ‘Correcting Imbalance’
In most alternative therapies health is believed to be restored by relieving blockage and restoring flow in the ‘life force’, but the means whereby this is achieved vary widely as listed below:

    Method Modality

    Needling Acupuncture

    Homeopathy Minute doses of diluted medicine

    Reflexology Foot massage

    Aromatherapy Aromatic Oils

    Yoga Adopting Body Postures

    Transcendental Meditation

    Therapeutic Touch Hovering hands

    Macrobiotics Diet


 

Why is Alternative Medicine so Popular?There are seven main factors accounting for the rise in popularity of alternative medicine in the Western World.

1. Changes in the Western worldview

Two hundred years ago in Britain most people had a Christian worldview; they believed in a creator God who made us, intervened in our world and to whom we were accountable. But with the publication of Darwin’s Origin of the Species and the rise of biblical criticism, this theistic worldview gave way to an atheistic one.

People began to doubt the existence of God and life after death. Man came to be seen simply as a clever monkey, the product of matter, chance and time in a directionless and purposeless universe. Morality became relative (‘what’s right for me’) rather than absolute.

Now we are seeing another worldview shift from atheism into pantheism. Pantheism is the ideology, which lies behind Eastern religions like Hinduism and also the New Age Movement. God is an impersonal force of which we are all simply a part. Death leads to reincarnation, and morality simply means being in harmony with nature. All is one and all is God. This has meant an increasing openness to all sorts of non-Christian spiritual belief along with a scepticism and suspicion about science.

The change of worldview from theism, to atheism and then pantheism has had profound effects on the way that medicine is practised. While Christian doctors see human beings as a tri-unity of spirit, soul (or mind) and body (1 Thess 5:23), atheistic doctors see them as consisting of just body and mind. By contrast, New Age or alternative medicine practitioners see human beings as an integrated whole; but from a pantheistic rather than a theistic perspective.

Much of alternative medicine has its roots in the New Age Movement, which in turn is rooted in Astrology. Exponents believe that for the last 2,000 years we have been in the age of Pisces (the fishes), but that now we are moving into the age of Aquarius (the water-carrier). The Age of Pisces was characterised by rationality, logic, objectivity and black and white analytical ‘left brain’ thinking. By contrast the Age of Aquarius is characterised by intuitional, subjective, grey ‘right brain’ thinking.

Sociologically the New Age Movement spawned the counterculture of the 1960s with ‘flower-power’, peace protests, drug experimentation and the Hippie movement. Spiritually it paved the way for a wide acceptance of Eastern religious ideology, Astrology and the Occult. Medically the New Age Movement has meant an increasing disillusionment with and scepticism about scientific medicine.

As Christians we reject both the atheistic and pantheistic worldviews. They are quite simply not the way the world is. God does exist. We are made in his image, yet fallen; and death leads to judgement. We embrace the scientific method as a gift of God, but we also see human beings as being more than simply the sum of their parts.


2. Failings of orthodox medicine
There have been great advances in orthodox medicine over the last two centuries which have led to the eradication and alleviation of many diseases which were previously neither preventable nor curable: immunisations for smallpox, antibiotics for infection, anti-psychotics for schizophrenia, chemotherapy for cancer, drugs for heart failure and surgery for a whole host of structural and anatomical problems.

But medicine also has its limits. With many illnesses we have a long way to go. Solid tumours (eg lung, breast and bowel) are in general difficult to treat if surgery fails. There is still much progress to be made in chronic diseases like multiple sclerosis and rheumatoid arthritis, and there is still no orthodox cure for musculoskeletal back pain and the common cold. If we also consider that 75% of people seeing their doctor do not have any defined organic illness, it is easy to see why people may decide to consult alternative practitioners. Patients may also become impatient or disillusioned with the NHS system of referrals and waiting lists.

With some diseases alternative medicine fares no worse than orthodox medicine and it is in these areas that alternative medicine thrives.


3. Medical arrogance
Doctors have not always been ready to admit failure; and on occasions may go on using treatments of doubtful value, or with potential side-effects rather than being honest that nothing else can be done. The inappropriate use of some chemotherapeutic agents or radical surgery for advanced cancer, for instance, may cultivate distrust in patients who then seek other solutions.


4. The side effects of orthodox medicine
Orthodox medicines and surgery can produce side effects and complications, which are sometimes fatal. Examples are often widely publicised by an unforgiving press. By contrast most alternative medicine has little in the way of side-effects.


5. Loss of a whole person perspective
Advances in the science of medicine may be at the expense of the art of medicine. Doctors have less time for the patient, touch patients less often, and are tempted much more now to treat their patients simply as anatomical structures or biochemical machines. There is much less in medicine now of the ritual handshake, pulse-taking, hand on the shoulder etc. Too often the doctor is now ensconced behind his PC and perhaps a formidable desk; while many alternative therapies involve plenty of ‘hands-on’ diagnosis and treatment.

Alternative medical practitioners generally are able to give much more in terms of time and touch, thereby engendering more trust. Homeopaths, for example, may spend up to 90 minutes in a first consultation and 45 minutes on follow up. Patients naturally assume, ‘He must know what he is doing because he spends so much time with me’.


6. Costs of high-tech medicine
High tech medicine is expensive, while often the only cost of alternative medicine is the therapist’s time. This is one feature making alternative therapies increasingly attractive to NHS managers looking to cut costs.

 

7. Consumer demand
Patients are prepared to pay for therapies, which promise what orthodox medicine has failed to deliver; especially for incurable cancer or chronic pain. This demand means that there is plenty of room in the market place for more practitioners.

 

Why Does Alternative Medicine Seem to Work?
Why is it that so many people are seeking alternative medicine therapies when so many of them have been shown not to work in clinical trials? There are at least eight reasons why.


1. Genuine therapeutic effects
Some alternative medicines genuinely work. Over half of prescription and over-the-counter drugs originate as natural compounds or are based on them (e.g. aspirin, digitalis, morphine, adrenaline, curare, all antibiotics except the quinolones etc); and the natural world may hold many more therapeutic treasures. [3]

It is quite conceivable that some alternative medicine practitioners are using useful compounds or techniques which are not yet known to orthodox medicine. But if this is the case then we need to discover what they are so that they can be isolated and given in the correct dose!


2. The placebo effect
If we strongly believe that something (or someone) has the power to help us, then we are much more likely to experience benefit. It is a fact that one third of people given an inert compound to relieve a particular symptom will report relief of that symptom. This is called the placebo effect. In the same way patients who share the therapist’s belief in New Age pantheism or the existence of ‘life force’ will be more likely to benefit from their therapy.


3. Concurrent use of therapies
Belief in an alternative therapy’s effectiveness may develop when it is used concurrently with another more effective orthodox therapy. The effect is then wrongly ascribed to the alternative therapy.


4. Psychosomatic illness
Many illnesses are psychosomatic; in other words a patient’s stress level or mental state can aggravate the symptoms. Asthma, eczema, peptic ulcer and rheumatoid arthritis fall in this category. Alternative therapies, which induce relaxation, may then improve the symptoms.


5. Spontaneous remissions
Many diseases get better by themselves. Viral infections (e.g. warts, common cold) and some tumours (eg malignant melanoma) are examples of conditions, which may spontaneously regress. In such cases people may well then attribute therapeutic effect to the remedy they were trying at the time of recovery, when it fact their improvement at that time may just have been coincidence. This is called the ‘post hoc, propter hoc’ fallacy; in other words ‘because B followed A, then A must have caused B’.


6. Dietary influences
There is a strong link between diet and health, and many alternative therapists recommend that patients drink less coffee or alcohol, eat less fat or more fibre or take vitamins. The resulting improvement may then be due to the change in diet, rather that the alternative therapy being used concurrently.


7. Imagined improvement
Some patients, especially if open to suggestion from others that they ‘look better’, may simply imagine that they ‘feel better’; especially if the symptoms were of a vague nature in the first place. Alternatively they may simply get better at tolerating symptoms, and imagine that the symptoms themselves have diminished.


8. Demonic involvement
There may be real spiritual forces operating to bring healing through demonic power. Such healings may be the bait that Satan then uses to draw a person more deeply into the occult, or into accepting a pantheistic worldview.

 

How Do we Assess Individual Modalities?
It is not possible in this brief review to comment on each and every alternative therapy; but here are some principles, which can be generally applied.

1. Do the claims fit the facts?
Any new orthodox medicine has to undergo extensive pharmacological testing to assess its therapeutic potential, side-effects and interactions with other drugs. Tests are first carried out in animals, then in human volunteers and only then are short and long term studies carried out on real patients.

In the UK if a drug passes these tests it must then be approved by the Licensing Authority. This ensures that drugs reaching the public are both safe and effective.

In the same way medical practitioners must undergo a five year undergraduate training and then work for a further year before they are registered and able to practice independently of a NHS institution.

Similar safeguards for alternative medicines and practitioners are largely absent. There is simply no comparison between the double-blind, randomised, placebo-controlled cross-over trials which many orthodox drugs undergo and the subjective anecdotal ‘evidence’ supporting much alternative medicine. Furthermore, when proper trials are employed the results are often unconvincing.

A Department of Complementary Medicine has recently been set up at the University of Exeter to review trials on alternative and complementary therapies. The contents pages of their quarterly journal FACT (Focus on Alternative and Complementary Therapies) are available on the internet [4] and make interesting reading. Many of the published studies give inconclusive results.

A 1990 French review of 40 controlled trials on homeopathy concluded that the majority were flawed by small sample size and subjective measures of improvement.[5] A 1991 review of 107 trials was similarly inconclusive.[6]

By contrast there is evidence that patients with low back pain treated with chiropractic derive more benefit and long term satisfaction than those treated by hospitals;[7] and that, according to a consensus panel of the US National Institutes of Health, acupuncture is an effective treatment for nausea and vomiting induced by anesthesia, pregnancy or chemotherapy[8] .

The biblical injunction to ‘enquire, probe and investigate thoroughly’ (Dt 13:14ff) must surely be relevant here. We should always ask, ‘What is the evidence that this therapy really works?’


2. Is there a rational scientific basis?
We know how most orthodox drugs work. They may stimulate receptors (eg b agonists in asthma), modify cell transport (eg probenecid), block enzymes (eg allopurinol), replace missing compounds (eg vitamin B12) or chelate toxins (eg penicillamine). The action of any given drug is determined by its concentration at the site of action; and the actions are understandable in view of their known biochemical and physiological effects. By contrast the majority of alternative medicines have no rational scientific basis.

    Homeopathy involves diluting an active compound to such a degree that the resulting ‘potency’ contains not even a molecule of the original active ingredient.

    Iridology claims to link each area of the iris with a separate part of the body when it is known that no such anatomical links exist. Reflexology is based on the belief that there are connections between the sole of the foot and internal organs; again in the absence of any scientific evidence.

    There is similarly no evidence for the existence of the ‘meridians’ (energy channels) of acupuncture or the ‘chakras’ (psychic spinal centres) of yoga.

In some cases an alternative therapy may be working because of some scientific reason unknown to the therapist. It has been suggested, for instance that the therapeutic effects of acupuncture could be explained by the release of endogenous (naturally produced) pain-killers called endorphins. If this is indeed confirmed, then acupuncture will be shown to have a scientific basis, but this will not, by any means prove that Taoist ideology is true or that Chi energy exists.


3. Is it the improvement due to the therapy or some other factor?
Transcendental Meditation lowers blood pressure, but why? Is it because it enables the Goddess Kundalini to migrate up the spine and unite with Brahman in the head (as Hindus believe); or is it simply that meditation induces relaxation and reduces the sympathetic output that raises blood pressure?

Similarly, chiropractic has been shown to help low back pain, but is this because manipulation of the spine alters the flow of ‘innate intelligence’ or because it helps to alleviate musculoskeletal trigger points?

In each of these cases it seems to be the methodology rather than the principle of prana or innate intelligence that brings the therapeutic effect.

There is thus a world of difference between the GP who makes a diagnosis by taking a history and doing an examination and the alternative medicine practitioner who does it by examining an iris or swinging a pendulum. There is also a huge gulf between the GP who uses acupuncture on the basis of its proven effectiveness in clinical trials and the practitioner who uses it because he believes it alters the balance of yin and yang.


4. What is the worldview behind it?
What is the worldview behind the therapy? As mentioned acupuncture has its roots in Taoism, yoga in
Hinduism and therapeutic touch in New Age ideology. This alone should make us suspicious.

What was the motivation of the therapist who developed the treatment? Hahnemann, the German physician who developed homeopathy, was a freemason. Kreger, the New York Nursing Professor who invented therapeutic touch, is a Buddhist; and her collaborator Kunz was Vice President of the Theosophical Society and an occultist and psychic. Edward Bach (of ‘flower remedy’ fame) was a doctor who trusted his ‘spirit self’ for knowledge and guidance.

It might be objected here that much orthodox medicine has been developed by atheists with an atheistic worldview and yet that does not stop us benefiting from their insights. This is true. We are not saying that pantheists are unable to discover beneficial treatments which are God-given; but simply that their worldview should make us wary in assessing their therapies.


5. Does it involve the occult?
Are occult means of divination used in deciding on diagnosis or treatment? We should heed
the biblical warnings about Mediums and Spiritists (Lv 9:31, 20:6; Acts 16:16-21), Astrology (Is 47:13-15), Magic Charms (Ezek 13:20-23), Diviner’s Wands (Ho 4:12),Sorcery (Acts 19:19), Witchcraft (Gal 5:20), Magic Arts (Rev 9:21, 21:8, 22:15) and the Occult (Dt 18:10-12) generally.


6. Is it medically safe?
Most alternative therapies have little in the way of side effects, but there are exceptions. Acupuncture, for example, may cause pneumothaorax or transmit infection. Chiropractic neck manipulation has been associated with vertebral artery obstruction and some herbal therapies result in toxicity or even death. But perhaps the greatest danger is that alternative therapies can create a false sense of security, which leads to delay in diagnosis or in implementation of effective orthodox medicine.


7. Has it stood the test of time?
This is not a guarantee, as clearly many occult devices stand the test of time, but we can be equally sure that something, which genuinely works or is of God will stand the test of time.

 

Applying the Tests
As an example of applying the tests above let us consider homeopathy. First, there is no clear evidence that it actually works. Second, it has no rational scientific basis; there is no reason known to science why a solution containing not a single molecule of a given active substance should have any therapeutic effect. Third, it is based on a pantheistic worldview with the concept of ‘vital energy’ playing a prominent role. Fourth, practitioners will often use occult means (such as pendulums) in diagnosis. While it does appear to be safe and to have stood the test of time, these other considerations should make us very wary indeed.

 

Difficult Questions

Finally let us finish by considering some of the objections, which Christians might raise to the kind of critique I have just given.

1. Weren’t many medical treatments initially ‘natural’ anyway?
This is correct (e.g. aspirin (willow bark), digitalis (foxglove), Morphine (poppies)) but the natural ingredient needs to be clearly identified and given in the right dose. Many useful natural drugs are toxic if given in too high a dose (eg digitalis, opium).

Decisions about which compound to give must also not be based on

    occult practices (e.g. rituals, spells, charms, astrology, clairvoyance,

    pendulums, spirit guides etc) as previously mentioned.


2. How can something be wrong if it actually works?
First, we need to be sure that the given therapy does actually work. Have there been properly controlled clinical trials carried out showing that it is better than placebo, or is it supported simply by anecdotal testimony?

Second we need to ask why it works. Is it working as a result of occult power? (Deut 13:1-6; Ex 7:11,22, 8:7, 18,19; Mt 24:24). If so it may be leading to the bondage, rather than to the liberation, of the patient. We must be ready to test everything (1 Thess 5:21).


3. Isn’t there some good in it?
It’s often objected that we should not throw out the baby with the bath water; and there is some truth in this... but is the baby and bath water really a good analogy? It is very easy to see the difference between baby and bath water but often extremely difficult to separate out the good and bad in alternative medicine.

A better analogy is the poison mushroom.[9] While poison mushrooms contain plenty of good fat, carbohydrate and protein we recommend that people don’t eat them because it is impossible to separate out the good and the bad.

Everything that does not proceed from faith is sin; so if we have doubts it may well be better to abstain (Rom 14:23).


4. How can it be wrong if good Christians I know use it?
Good Christians may be ignorant or deceived or simply have their consciences blunted from
habitual sin. There is no-one with perfect discernment who is right in all their words, let alone all their beliefs (Jas 3:1). Good Christians may also have a lot personally invested in a therapy if a friend or relative is practising in it or has benefited from it and their objectivity may be accordingly clouded.

 

Summary
We have reviewed the rapid rise in popularity in alternative medicine, and seen that while therapies are diverse, there is a pantheistic ideology behind many of them.

Alternative medicine is popular because of changes in the Western worldview, the perceived failings, arrogance, costs and side effects of orthodox medicine, and because it appears to bring a ‘whole person’ perspective.

While some therapies may genuinely work, apparent improvements are often due to other reasons such as spontaneous remissions, the use of concurrent orthodox medicine or the placebo effect.

Each branch of alternative medicine needs to be assessed individually to determine its effectiveness, scientific basis, mode of action, safety, underlying worldview and links with the occult.

We should be wary, but we must be careful also that we do not miss genuine gifts, which God has given. The biblical injunction to ‘test everything... hold on to the good... avoid every kind of evil’ (1 Thess 5:21,22) is surely as relevant here as in any other area of the Christian life.

Peter Saunders

 

Recommended Reading

I am indebted in particular in compiling this overview to the following sources:

Coker R. Alternative Medicine - Helpful or Harmful? Great Britain: Monarch and CMF, 1995.

Fergusson A. Alternative Medicine - A Review. Journal of the CMF 1988;26-29 (April)

Pfeiffer S. Healing at any Price. Word Books, 1988.

Smith G. A Christian Perspective on Alternative Medicine. Christians in Caring Professions, 1997.

References

  1. Two exceptions to this state of affairs are osteopathy and homeopathy.
  2. Complementary Medicine - Controls needed, says BMA. BMJ 1993; 306: 1713 (26 June)
  3. BMJ 1998;316:1266 (25 April)
  4. http://www.exeter.ac.uk/FACT/
  5. Hill C and Doyon F. Review of randomised trials of homeopathy. Rev Epidemiol Sante Publique 1990 38:139-147
  6. Kleijnen J et al. Clinical Trials of Homeopathy. BMJ 1991;302:316-323
  7. Meade TW et al. Randomised Comparison of chiropractic and hospital outpatient management for low back pain. BMJ 1995;311:349-351 (5 August)
  8. BMJ 1997;315:1252 (15 November)
  9. I am indebted to Jock McGregor of L’Abri Christian Fellowship for this analogy
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