Alternative or Complementary Medicine: Medical History and Its Legacy (2016)

Probably, this article will be published in a scientific miscellany.

Heinz Schott

Alternative or Complementary Medicine: Medical History and Its Legacy

Complementary medicine is an established label for a variety of so-called alternative healing methods implying that they can support and complete academic (i.e. scientific) medicine or biomedicine in a reasonable way. So, especially certain Asian healing concepts like the Traditional Chinese Medicine (TCM) or the Indian Ayurveda medicine are widely appreciated today complementing modern Western medicine. But we should not forget, that there is also a sort of Traditional Western Medicine (let’s call it TWM) regarding historical concepts of European Medicine from antiquity until the 19th century. As a German medical historian considering the history of modern naturopathy (Naturheilkunde), the most important concept of alternative medicine in this part of the world, I focus mainly the situation in the German speaking countries. We should be aware that the origin of the naturopathy movement as the genuine forerunner of the contemporary alternative medicine happened mainly there. Probably, this was generally due to the strong impact of romantic natural philosophy in Germany on medicine and science about 1800, e. g. the influence of Schelling’s natural philosophy (within the context of the German idealism). But I will not deal with this interesting aspect alluding to the history of philosophy. Rather I will outline some historical concepts which are essential to understand the actual panorama of alternative or complementary medicine.

We have many terms describing alternative or complementary medicine. But they are not synonyms, the meaning of them differ more or less slightly: “Outsider Medicine” (German: Außenseitermedizin), “unconventional medical approaches” (unkonventionelle medizinische Richtungen), “unorthodox therapeutic methods”, “holistic medicine” (ganzheitliche Medizin), “soft medicine”, “lay medicine” and last but not least naturopathy (Naturheilkunde). These concepts are opposed to “(natural) scientific” or “academic medicine” (Schulmedizin), high-tech medicine (Apparatemedizin) etc.

We should be aware, that complementary respectively alternative medicine is a term including very heterogeneous healing concepts with sometimes completely contradicting principles (cf. Jütte, 1996). So, phytotherapy and homeopathy have radically different views. Similarly, hydrotherapy and magnetopathy, or the Kneipp cure (Kneippkur) and spiritual healing follow incompatible principles. But there is a common ideological link: the appreciation of the ominous concept of the “healing power of nature” (Naturheilkraft; Greek: physis; Latin: vis medicatrix naturae) implying religious as well as magical moments. When we look not only at the controversy between academic medicine and alternative medicine but also at the diversity of the different alternative methods, we notice how difficult it is to find a common understanding. Who has experienced, how homeopathy is ridiculed by medical authorities to be nothing else than a placebo and how homeopaths fight strictly against this psychological hypothesis will be aware of the deep gap between irreconcilable medical cultures which are really much more “alternative” than “complementary”.

Complementary medicine within the last two or three decades has become an additional branch of medical therapeutics besides biomedicine. The boundaries are always changing, what was included in the past may be more accepted in the presence, like the classical methods of naturopathy, anthroposophical medicine, homeopathy, traditional Indian (Ayurveda) and Chinese medicine, especially acupuncture. It has been always controversial, to which extent alternative medicine should be legally accepted by the official authorities, and how far it is away from miracle healing and charlatanism (cf. Heyll, 2016). It is remarkable, that methods of magic and religious medicine originating from the European history of culture and science are rather excluded from the label “complementary medicine”. This is the case with diverse methods of spiritual healing (German: Geistheilung) or magic healing, e. g. using incantations to charm away warts is still popular in some rural districts in Germany and other European countries.

 Academic medicine versus alternative medicine: The historical schism     

Modern medicine essentially based on natural science was established in the second half of the 19th century. Magical and religious concepts, still very intensively discussed and appreciated by the “Romantic medicine” and its natural philosophy about 1800, became more and more refuted. Finally, at the end of the century, they were identified with “occultism” and excluded from the academic medical world. But at the same time, these suspected concepts flourished outside the scientifically correct medicine represented mainly by bacteriology (Louis Pasteur, Robert Koch) and cellular pathology (Rudolf Virchow) as leading concepts. Now, the conflict between academic and alternative medicine became obvious, particularly between the academic physician scientifically educated and the “natural physician” (Naturarzt, Physiater), very often a lay doctor or healer. But the borderline between the two medical cultures was not always distinct, for practical reasons agents of heterogeneous concepts could also cooperate. So, the university psychiatry at the end of the 19th century had no objections against hydrotherapy for patients suffering from hysteria and the famous French neurologist Jean-Martin Charcot experimented with metals and magnets to demonstrate in public nervous disorders showing e. g. the transfer of anesthesia from one individual to another. Nevertheless, the borderline was drawn more and more clearly between scientific medicine and “occultism” respectively “charlatanism” or “quackery” (German: Kurpfuscherei). Focusing on biomedical research in histology, bacteriology, and biochemistry alternative healing methods appear until today as speculative relics of a past, which are definitely overcome by the scientific and technological progress of medicine.

This historical dichotomy or schism became for the first time clearly obvious in the Renaissance, although during the early modern period religion and magic further flourished within the context of medical alchemy, especially promoted by Paracelsus (i.e. Theophrastus Bombast von Hohenheim; 1493-1541) and his followers like Johan Baptist van Helmont (1579-1644), an ingenious laboratory researcher. The crucial turn happened in the 18th century, the period of enlightenment, when physical and mechanical principles were assigned to the human organism apparently constructed like a machine according to the famous materialistic treatise “L’Homme Machine” (de La Mettrie, 1748). Now, magical practices as they were taught by Paracelsian and other authors were judged to be just a superstitious clinging to “occultism”.  Finally, the progress of (natural) sciences and biology in the 19th century led to the foundation of modern medicine. Besides bacteriology and cellular pathology the impact of Darwinism was of great importance stimulating also the “Social Darwinism” and the idea of eugenics later on. The advancements of immunology, human genetics, and molecular medicine during the last 100 years seemed to make alternative medicine from the scientific viewpoint superfluous and obsolete – whereas the suffering of many patients especially from chronical diseases which could not be relieved by ordinary therapies of academic medicine demanded alternative methods.

The healing power of nature: The common basic idea

All alternative respectively complementary healing concepts have one central idea in common: the healing power of nature (Latin: vis medicatrix naturae, German: Heilkraft der Natur). The medical historian Max Neuburger (1926) analyzed this concept in his classical monograph Die Lehre von der Heilkraft der Natur im Wandel der Zeiten (The doctrine of the healing power of nature in the change of time) very profoundly. This concept emerged for the first time in antiquity within the context of the Hippocratic writings: In the sixth book on “Epidemic Diseases”, the term physis (nature) appears: “Educated is the physis and produces by herself the necessary, without having it learned”. (Hippocrates, Epidem. VI 5,1) In spite of the fundamental importance of this concept for medical history throughout the ages it is not mentioned any longer in encyclopedias and handbooks of medicine today.

The Hippocratic physicians in ancient Greece assumed a self-healing tendency of the human organism demonstrating this paradigmatically with acute febrile diseases. The physis would then transmute the evil mixture of the humors and the crude (pathogenic) substances by its increased vital heat. At best, it would excrete the pathogenic matter through natural pathways: intestine, bladder, skin, or by bleedings like nosebleed, hemorrhoid bleeding (in males), and menstruation (in females). But in severe and incurable diseases the physis would not be sufficient. Then, the physician had to intervene. Hereby, he should skillfully support and complete the natural self-help of the organism. Therefore, he had to differentiate between the symptoms of the self-healing power of the physis and the symptoms of its defeat aggravating the disease in order to know, when his intervention would become necessary. Insofar, the Hippocratic physician had to work as a “servant of nature” (Greek: tes physeos hyperetes).

In this traditional perspective the medical treatment appeared to be per se just an imitation of nature, because it had no other task than accomplishing artificially those natural processes, which cannot work due to the weakness of the healing power of nature – following the very principals of nature. In this understanding, all natural healing methods (German: Naturheilverfahren) strengthened only secondarily the healing power of nature fighting primarily the disease. This way of thinking was especially appreciated by authors who based medicine on natural philosophy. One of the most prominent figures was the above mentioned Paracelsus promoting medical magic and alchemy. But first of all, we have to consider the other side of the coin: the divine power of the healing gods respectively the healing power of God.

Divine power: Religious medicine

The so-called healing power of nature (Heilkraft der Natur) assumes – implicitly or explicitly – a religious dimension. That becomes obvious by the fact that in all periods of the cultural history the healing power of nature is always associated with light, fire, glamour, or beneficial beams. The respective visualization of this power is remarkable in the tradition of the Jewish kabbala, the Christian mysticism of the Middle Ages, the mystic experiences of the theosophists und paracelsians, and finally some esoteric movements being part of alternative medicine. The gloriole (German: Heiligenschein) was a common motif of painting to visualize divine power. It is interesting that the light imagery also emerges where it is not directly connoted religiously. So, the “Eye of God” emanating powerful beams was taken as a symbol for the magnetic “fluidum” by Franz Anton Mesmer, as he showed in a sketch in his late published work (Mesmer, 1814).  The symbol reminds us of certain emblems of alchemists, hermetic natural philosophers, and also freemasons demonstrating their search for divine nature (Gott-Natur, as Johann Wolfgang von Goethe once expressed it).

The legacy of religious medicine has still a remarkable influence nowadays, even in Europe. So, in spite of the enlightenment and the natural scientific foundation of medicine in the 18th and 19th centuries medical demonology did not disappear. It is still a fascinating topic in public. The concept of demonic possession and exorcism going back to antiquity had a strong impact on the Christian tradition of spiritual healing which is still alive not only in the realm of the Roman Catholic church (the famous exorcist priest Gabriele Amorth died recently in Rome)[1], but also in some Protestant evangelical circles. The scandalous exorcism of Anneliese Michel, a German student, by two Catholic priests ending up with her death in 1976, evoked a crucial discussion in Germany.[2] The general conclusion was: Such cases of “demonic possession” should be treated by psychiatrists and not priests. But exorcism according to clerical rites is still practiced especially in Italy. Apart from this, there are other ways of spiritual healing: healing by prayer, laying on of hands (palm healing), adoration of saints, pilgrimage (e. g. to Lourdes) etc. Religious healing is often practiced independently from a certain clerical framework and merges frequently with magic healing popular in folk traditions like the application of amulets.

Natural Magic: The impact of philosophy   

Magical medicine is generally based on natural philosophy. The most important origin of early modern magical medicine in Europe was the teaching of Paracelsus based on a specific concept of natural philosophy. He assumed the inner nature of man as a “microcosm” (small world) implicating all things of the “macrocosm” (large world) which would impress the former by the influence of the stars (“astral impression”). Invisible “seeds” (German: Samen) would cause diseases originating from the macrocosm and inducing the specific visible disease within the human organism. The medical doctor had to look for remedies as strong as the diseases. This search was motivated by the idea of a healing power of nature. The doctor as a “philosopher” (philosophus according to Paracelsus) had to work “in the light of nature” (im Lichte der Natur). The paracelsian metaphor of Nature as the first or “inward physician” (inwendig Arzt) is still very popular in the discourse of naturopathy. In his book Paragranum (1530) Paracelsus wrote: “A physician should primarily know, where Nature tends to go. Because she (Nature) is the first physician, man is the second one. Where Nature begins, there the physician should help, that she can go out at this location. Nature is a better physician than man […]. Because the disease emanates from Nature, the remedy emanates from Nature and not from the physician […]. Nature teaches the physician and not man“.  (Paracelsus, Ed. Peuckert, vol. 1, p. 503; transl. H. S.)

The practical guideline is clear: The “outward” physician has to be subordinate to the “inward” physician and has to cope with him. So, one can read in the Labyrinthus medicorum errantium – Vom Irrgang der Aerzte (1537/38): “Man is borne to fall over. Now he has got two in the light of nature, which raise him: the inward physician with the inward remedy which is born with him and given to him in the conception […]. But the outward physician begins only, when the inborn one succumbs and is slaved away, tired, then he renders his office to the outward physician.” (Paracelsus, Ed. Sudhoff, vol. 11, p. 198 seq.) Paracelsus wants to strengthen the healing power of nature within man potentiating it in drugs and distilling it from natural things by alchemical procedures. There is a series of terms demonstrating this: archeus, arcanum, vulcanus, virtue, inner balm, mummy (mumia), all of them describe the elusive (spiritual) healing power of nature.

This perspective of natural philosophy coined the magic respective “magnetic” healing art throughout the modern period. So, within the context of mesmerism or animal magnetism at the end of the 18th century the healing power of nature appeared to be a so-called magnetic fluidum pervading the cosmos like ether, which could be transferred to the human nervous system by certain therapeutic techniques. This fluidum, as the Viennese physician doctor Franz Anton Mesmer (1734-1815) named it, was supposed to be a very subtle physical power. It meshed with the idea of enlightenment and in particular with the marvelous light phenomena of the just generated artificial electricity symbolizing with its vital sparks divine Nature. Later on, during the period of Romantic natural philosophy in the early 19th century, mesmerism turned into a spiritual respective psychological concept: The magnetizing (mesmerizing) doctors assumed an unconscious realm within the (autonomous) nervous system, the so-called ganglion system (Gangliensystem) located in the abdomen (hypochondrium), which corresponded directly with the macrocosm. In the “magnetic sleep” also called “artificial somnambulism” (later taken for “hypnotic” sleep) patients could get an insight to their disease and its possible therapy, because they were thought to come in closer contact to the healing power of Nature than in a sober state of consciousness. Paradigmatic for this approach was a famous case history published by the Swabian doctor and poet Justinus Kerner (1786-1862): Die Seherin von Prevorst (1829), which was translated into English (The Seeress of Prevorst, 1846). The “seeress”, her name was Friederike Hauffe, a critically ill young woman, displayed a huge variety of paranormal perceptions and visions. She would have been classified as a great medium by parapsychology some decades later – respectively as a psychotic patient by psychiatry. In her somnambulistic states she imagined remedies, therapeutic devices, and healing procedures not only for herself, but also for other patients visiting her doctor. Even in Sigmund Freuds (1856-1939) theory of the “unconscious” and its creative powers, in particular regarding his term “dream work” (Traumarbeit) in his opus magnum The Interpretation of Dreams (Die Traumdeutung, 1900), we can see the impact of this specific tradition of natural philosophy.

Vitalism and naturopathy: The modern foundation of alternative medicine   

Modern biology focused the physiological processes of the organism and its relation to the environment. The healing power of nature appeared as the principle of life or life force (or vital force; German: Lebenskraft; Latin: vis vitalis) including all the different tendencies of organic life. Especially influential was the position of Christoph Wilhelm Hufeland (1762-1836) in the early 19th century. He was a famous medical doctor, first in Weimar associated with Goethe and his circle and since 1810 the first dean of the medical faculty of the new founded University in Berlin. His treatise System der praktischen Heilkunde (System of Practical Medicine) included a chapter on the therapeutic of nature (Therapeutik der Natur). He highlighted the concept of the healing power of nature as a keystone of his doctrine. This approach became a model for many concepts of naturopathy (also called “Physiatrie” in its pure form) and was also respected by renowned representatives of clinical medicine. Hufeland’s definition claimed: “That, what we call healing power of nature is not a specific power by its own, but the same vital force (life force; Lebenskraft) of the organic nature, conforming to the whole body and enlightening it and making it alive, related to the object of disease and its healing.” (Hufeland, 1818; translation H. S.) Insofar, all “healing operations of nature” could be deduced from the “basic principles of the organism”, the “principles of natural cures”, like e. g. the laws of excitement or the laws of sympathy, or the principle antagonism, when the affection of an organ produces an opposite affection of other organs.

Regarding these considerations Hufeland questions, “whether it would be therefore not reasonable to leave all diseases to nature and consequently abstain from the (healing) art.” His answer is clear-cut: The abnormal and artificial human lifestyle being related to “the increase in luxury, the refinement, and the immorality” requires the medical art. Hufeland based his medical ethics on his plea to strengthen the vital force by a natural lifestyle. In his influential book Die Kunst, das menschliche Leben zu verlängern (1796), later published under the main title Makrobiotik he demonstrated the practical side of his “natural therapeutics” (Naturtherapeutik). Already the first edition was immediately translated into English (Hufeland, 1797).

In particular, Hufeland promoted the rise of naturopathy in the 19th century including homeopathy which was implemented by Samuel Hahnemann (1755-1843) at the beginning of the 19th century, who published his main work Organon der rationellen Heilkunde in 1810. Hufeland knew Hahnemann personally and published an important article of Hahnemann in his Journal (Journal der practische Arzneykunde …) in 1796 which anticipated the homeopathic law of similars (simila similibus curentur; literally: likes may be cured by likes). Although refuted by academic medicine until today homeopathy could spread and is nowadays a well-stablished healing method in many regions of the world, especially in India and South America (Dinges, 2010). In contrast to the homeopathy the “pure” naturopathy (also called Physiatrie in German literature) as defined by the Bavarian military doctor Lorenz Gleich (1798-1865) in the middle of the 19th century tried to cure without drugs and exclusively with natural resources like coldness and warmness, fresh air and fresh water, natural nutrition etc. These “physiatrists” (Naturärzte) did not only refuse the “allopathic” drugs of academic medicine, but also the homeopathic ones using also chemically modified substances. Besides nutrition (dietetics) hydrotherapy in particular with fresh, cold water, played a central role in the naturopathy movement as diverse healing concepts of hydrotherapy show – from Vinzenz Prießnitz (1790-1851), a peasant farmer from Gräfenberg (Austrian Silesia) in the first half of the 19th century to Sebastian Kneipp (1821-1897), a Catholic priest from Wörishofen (Bavaria), in its second half.

Other lay doctors propagated crudités (Rohkost) like Gustav Schlickeysen (1843-1893), a vegan and fruitarian, with his “fruit medicine” (Obstheilkunde). He understood raw fruits as “sunlight nutrition” anticipating the vegan movement. Another pioneer was the Swiss Arnold Rikli (1823-1906) preaching light and air bathing as a remedy. At the end of the 19th century the lay medicine was socially very influential and very well organized and created its own “temples of health” in form of special sanatoriums. Those scenarios were embedded in a broad social movement: the life reform (Lebensreform) spreading in the industrialized European countries and in the United States. Nevertheless, the application of the classical naturopathy (hydrotherapy, dietetics) was mostly performed by registered physicians.

There has never been an absolute separation between academic and alternative medicine. At least, they had an ideological overlap in common: The doctrine of the “life force” – the so-called vitalism – preventing the organism from falling ill respectively healing the diseased body. Although academic medicine refused this concept of vitalism more and more, the idea of the healing power of nature remained popular even in high ranks of academic medicine. So, the famous pathologist Rudolf Virchow, a leading figure of scientific medicine at his time, highlighted in his lecture “On the healing powers of the organism”: “Physiocrats [Physiokraten] were called those physicians, who supposed the healing powers within the physiological order of the organism, technocrats (Technokraten) those, who thought to be able to identify the healing powers with means and impacts originating from outside of the patient and have to be applied on him.” (Virchow, 1875; transl. H. S.) He referred to Paracelsus, who had assumed a threefold power play: “the disease, the healthy rest of the body, and the specific force ruling it.” The respective interaction would perform the “struggle for healing” (Heilkampf): On the one hand the essence of the disease, on the other hand the healing intervention. Virchow did not criticize the model, but only speculative personifications of this power play. The presupposed force had to correspond with a real organism. “In this way the human organism seems to be computed one […] the simple parts of it, the cells, can be taken by their own as persons, because they are self-living (selbstlebend) und self-acting (selbstthätig) and their force emerges from their own fabric, their Physis”. Virchow’s view is exemplary for the intensive interest in the traditional concept of the healing power of nature even after the scientific turn of academic medicine in the middle of the 19th century (cf. Pagel, 1931). Insofar, academic and alternative medicine had a leading idea in common – apart from severe controversies about methodological and practical issues.

Medical pluralism: What does it mean?

The contemporary situation in the Western world is paradox: There is a sophisticated and well-organized medical system supervised by state authorities and regulated by respective laws. And at the same time there is a huge more or less unofficial market for alternative healing methods. Some of them cooperate with academic medicine very well and have become more or less a part of it like hydrotherapy, others are strictly opposed like some concepts of spiritual healing. In the case of homeopathy, we encounter a confusing situation. There are representatives of academic medicine who blame it as a pure placebo cure or suggestive therapy and in the last instance as a sort of fraud, whereas many general practitioners (at least in Germany) apply homeopathic drugs. So, this scenery may be characterized by the term “medical pluralism”: Different concepts act at the same time and can be chosen deliberately by the patient or client. This is probably much more evident in some Asian, African, or Latin American countries, where Western biomedicine concurs with other traditional healing concepts. This may be shown e. g. in Tanzania (East Africa). Besides Western High-Tech-Medicine there are at least three other concepts playing an important role: Ayurveda medicine, Yunani medicine (with Greek-Arabic origins), and traditional folk medicine based on demonology and magic. This complex situation is due to historical events during the colonial and post-colonial periods – recently investigated profoundly (Bruchhausen, 2006) –, but cannot be considered here in detail.

What is the present state of the alternative healing art? We have to recognize the social and economic context. The ecological movement with its sensitive feeling for a healthy environment, the traditional folk belief with its rituals (e. g. miraculous healing and pilgrimage), new magical (pagan) healing procedures associated with witchcraft (e. g. Wicca nowadays), a flourishing market for alternative cures – all of them may also indicate a reaction of the people anxious of socioeconomic imbalances and uncomfortable with the impersonal approach of contemporary high-tech bio-medicine. There are (para)medical fairs with a huge diversity of offerings. Often, the respective methods are not explained within their historical context, but praised as singular innovative methods. In certain cases, the methods are declared as thousands of years old and therefore most efficient. This plea can be noticed in certain advertisements of Traditional Chinese and Indian (Ayurveda) medicine. But in fact, these Oriental concepts are probably not older than the Occidental tradition regarding Greek medicine based on much older scientific cultures like Egypt and Mesopotamia. But that, what we might call the Traditional Western Medicine or TWM (humoral pathology, dietetics, magical-sympathetic medicine etc.), was excluded by the Western academic medicine during the 19th century as unscientific speculation and “occultism”. So, the own historical sources and origins were overthrown in the name of scientific progress. (It is not my job to judge, whether this was good or bad.) This happened in other regions of the world only partially: There, heterogeneous healing systems could establish and coexist like in India, where probably more homeopaths practice than in the European countries as a whole.

What is really new regarding alternative medicine? One could claim: All healing methods practiced in the field of alternative medicine were once directly or in a modified form “scientifically” acknowledged by medical schools. They belonged themselves to the respective contemporary academic medicine. This is e. g. the case with early modern astrological and herbal medicine (phytotherapy). Even in 19th century universities chairs for animal magnetism and homeopathy were established. What was lege artis in former times becomes odd in the present time. So, the application of a magnetic stone for the cure of a dislocated uterus pulling it to the right place prescribed by Paracelsus would hardly accepted be academic physicians today.

Nevertheless, the academic medicine includes elements of traditional healing rites. It is not as “rational” as it pretends. There are moments in the doctor-patient-relation which remind us of phenomena – one could also speak of “magical moment” – common in all healing methods: “transference love” (Übertragungsliebe, S. Freud), placebo effect, confidence, or faith. Brain, heart, stomach, liver, and kidneys as organs are connected with emotions coined by the cultural history of mankind, which cannot be overcome just by the verdict of a “scientific”, “rational” explanation (e. g. the heart is just a pump). So, the controversial debate on the concept of brain death shows the contrast between scientific definition and emotionally experienced reality.

Also the popular statement “the doctor is the drug” (or: the drug “doctor”) coined by the psychoanalyst Michael Balint (1836-1970) can hardly be exclusively defined and measured by means of natural science. Nevertheless, the modern business of medicine and its technical procedures implicate magic and religious moments, which – quasi in the form of a secularized science – are difficult to figure out. So, one may conclude with Sigmund Freud (before he founded psychoanalysis) regarding the popular attitude of patients to use naturopathy and ask naturopaths: “If we have any reason to blame the pious expectation of the sick person we must not be so ungrateful to forget, that the same power also supports continuously our own medical work.” (Freud, 1890, p.300; transl. H. S.) Indeed, the miraculous “placebo effect” introduced into the medical terminology not until 1950ies is a mighty healing factor beyond the traditional separation of the two realms: academic versus alternative medicine. One can also speak of the “healing factor of suggestion” as Hippolyte Bernheim, the great French pioneer of psychotherapy titled one of his books (Bernheim, 1888; translated into German by Sigmund Freud). Medical pluralism does not mean necessarily the clash of medical cultures and the obstruction of Western bio-medicine. It can also be the base of an effective help for sick persons in distress. So, many patients all over the world enjoy a polypragmatic treatment.

Appendix

Concepts and practical methods of alternative medicine – more or less popular in Europe, especially Germany: An overview

Based on Die Bilanz des 20. Jahrhunderts [The balance of the 20th century], ed. by Bodo Harenberg, Dortmund 1991, p. 189; with essential modifications.

Alternative respectively complementary medicine is not a well-defined discipline or field of disciplines. There are many overlapping doctrines and therapeutic methods. So, one is confronted with a complex situation, which cannot be pressed in an unambiguous historical and systematical frame. The following scheme delivers just a preliminary overview and is far from being complete and systematically elaborate.

 

Healing method Principle Application

 

Naturopathy (Naturheilkunde); biological medicine Regulation of disturbed physiological functions and biological rhythms regarding respiration, heat regulation, secretion etc.; recovery of biological imbalances Functional, psychosomatic disorders; stress conditions; methods of preventive medicine; not used in emergency medical aid
Naturopathy in the narrow sense: treatment by natural means (light, air, heat, soil, water) Healing stimulation by natural means empowering weakened physiological functions (hardening against softness); treatment of symptoms by opposed agents (traditional principle: contraria contrariis, e. g. fever is cooled by a cold compress) Chronic diseases, neurasthenia, psychosomatic disorders; hydrotherapy (Kneipp Cure, steam baths, sauna, drinking cure with healing waters); sun and light therapy; cataplasms: mud, moor, fango
Therapy via nervous system including regulation of the disease herd, neural therapy, chirotherapy, acupuncture, reflexology therapy Reflex arcs between organs, muscles, connective tissue, and skin areas supplied by the same nerve roots; the stimulation of the body surface is supposed to affect the corresponding organs and tissues of the same segment Pain syndromes: headache, strain traumas, renal colic; exploration of “interference fields” in chronic diseases
Dietetics, nutrition teaching, fasting cures (e. g. Bircher-Benner, M. O. Bruker, Waerland), food combining, macrobiotic food Care of the organs of digestion and excretion; regulation of diverting pathogenic substances out of the body Rheumatism; muscle bracing and muscle pain; circulation disorders; obesity; digestive disorders
Chirotherapy (manual medicine) – counted among academic medicine Disorders of the motion apparatus are supposed to affect general health via the nervous system Therapy of disorders of the musculoskeletal system, in particular the spine (back pain)
Osteopathy;

Osteopathic Medicine practiced by physicians only in the US, elsewhere belonging to alternative medicine

The bone as the starting point of disorders of certain organs, holistic anthropological model, diversity of different concepts and doctrines Relaxation of muscle bracing, alleviation of pain, bone setting, cure of vertical subluxation causing irritation of respective nerve roots
Chiropractic; no strict demarcation from chirotherapy and osteopathy Vertebral subluxation causes a variety of disorders, overlapping with principles of manual and osteopathic medicine Manipulation of the spine to cure especially (low) back and neck pain, bone setting, special methods of manipulations (different schools)
Phytotherapy (herbal medicine);

Established by ancient (Greek) medicine, fundamental for the history of Occidental medicine;

also basic for traditional Chinese, Japanese (Kampo) and Indian (Ayurvedic) medicine

Medicinal plants as drugs for interior and exterior application (e. g. plant fluids, tea blends); complex ingredients, no mono preparations; therefor very difficult for standardization All sorts of functional disorders of specific organ systems (cardiovascular, respiratory, dermal etc.), chronic diseases; also acute illnesses (e. g. common cold) and stress symptoms (e. g. sleeplessness)
Homeopathy (high and low potencies);

one of the most controversial concepts of alternative medicine; academic medicine blames the lack of evidence; mostly discredited as pure placebo therapy

Based on the principle of Samuel Hahnemann (1755-1843): Similia similibus curentur (like cures like) — a substance causing symptoms of a disease in healthy persons could cure similar symptoms in sick ones; substances (herbal, animal, mineral) are prepared by dilution and succession (“potentization”) Mainly applied in chronic diseases which cannot be effectively treated by academic medicine (e. g. neuro-dermatitis, asthma, vegetative dystonia); pain therapy (eventually additionally); veterinary homeopathy also widely used (its effectiveness would prove that homeopathy is not just a placebo, homeopaths argue)
Anthroposophical medicine;

A concept of complementary medicine relatively acknowledged in Germany and Switzerland

 

Based on anthroposophy, the philosophical doctrine of Rudolf Steiner (1861-1925) focusing a holistic, spiritual, and esoteric anthropology; diseases originate from disharmony of the “essential members” of an individual Harmonizing therapeutic methods enabling the patient to recover from his/her imbalances, such as herbal medicine and homeopathic substances, curative eurythmy [sic], chromotherapy (color therapy), art and painting therapy, music therapy
Folk or popular medicine;

Worldwide spreading corresponding to regional traditions of healing; historically important in Europe

Basically coined by ideas of natural magic, demonology, healing rites, religious practices Amulets against evil (demonic) influences; regional traditions of healing (e. g. charming away warts); household remedies
Traditional Chinese Medicine (TCM); influenced i.a. traditional Japanese (Kampo) and Korean medicine; established in Europe in the late 20th century, today worldwide spreading Central is the conception of “Qi”, the subtle life energy flowing within the organism via the “meridians”; imbalance between Yin (dark, cold female) and Yang (light, hot, male) produces disorders All cases of non-surgical treatment; therapeutic objective is to correct the imbalances directing the Qi by certain techniques: acupuncture, moxibustion, specific drug therapy, movement therapy (Qigong), massage (Shiatsu in Japan)
Ayurveda (Traditional Indian Medicine)

Worldwide spreading since some decades

 

 

The Sanskrit term means “life knowledge”; the imbalance between the three doshas (elemental substances) Vata, Pitta, and Kapha) results in disease; holistic approach of harmonizing In Europe, Ayurveda practices are integrated in general wellness applications; medical use focuses on good digestion and excretion applying yoga, meditation, herbal medicine, special (Sattvic) diet
Kundalini yoga;

deriving from Indian Sanskrit scriptures and corresponding to different yoga schools

Kundalini, a primal energy located at the base of the spine, can be awakened by meditation ascending to and enlightening the other six superior chakras (energy nodes of the subtle body) Yoga exercises have become a part of the Western life style and a sort of “ersatz religion” at the end of the 20th century; yoga techniques are supposed to be helpful in all psychological or physical disorders
Spiritual healing;

“Healing through the Spirit”;

Faith healing (e. g. Christian Science)

Assumption of a divine healing power which can be mobilized by prayers, religious rites, pilgrimage (e. g. Lourdes), (clerical) exorcism All possible disorders may be treated; “miraculous healing” of severe diseases as a provocation of academic medicine
Esoteric healing methods;

unclear boundaries, heterogeneous concepts

 

Very different principles: “white magic”, Wicca (contemporary neopagan witchcraft), natural religion doctrines, reincarnation therapy No specific indication, all possible disorders may be treated; healing rites are embedded in a specific religious environment (e. g. pagan mythology of the Celts)
Magnetopathy, mesmerism, radionics, medical dowsing Assumption of occult cosmic rays (“fluidum”, “magnetism” etc.) which can be perceived by sensitive people used for diagnostics and healing Chronical diseases and inabilities; specific techniques: magnetopathic cures (e. g. laying on of hands),

devices for detection of (pathogenic) “earth rays”

Lay medicine, support or self-help groups Idea of self-treatment: patients should become their own doctors, often in cooperation with academic medicine and health institutions Chronical diseases and disabilities: e. g Alcoholics anonymous; diabetes support groups; encounter groups for cancer patients

 

References

Bernheim, Hippolyte: Die Suggestion und ihre Heilwirkung. Autorisirte deutsche Ausgabe von Sigmund Freud. Leipzig; Wien 1888.

Bruchhausen, Walter: Medizin zwischen den Welten. Geschichte und Gegenwart des medizinischen Pluralismus im südöstlichen Tansania. Göttingen 2006.

Dinges, Martin: Die Homöopathie erobert die Welt, in: Europäische Geschichte Online (EGO), hg. vom Institut für Europäische Geschichte (IEG), Mainz 2010-12-03. URL: http://www.ieg-ego.eu/dingesm-2010-de  URN: urn:nbn:de:0159-20101011100 [2016-09-20].

Freud, Sigmund: Psychische Behandlung (Seelenbehandlung). In: S. Freud: Gesammelte Werke, Vol. 5, Frankfurt 1961, S. 300.

Freud, Sigmund: Die Traumdeutung. Leipzig; Wien 1900.

Hahnemann, Samuel: Organon der rationellen Heilkunde. Leipzig 1810.

Hufeland, Christoph Wilhelm: Die Kunst, das menschliche Leben zu verlängern. Jena 1796.

Hufeland, Christoph Wilhelm: The Art of Prolonging Life. 2 vols. London 1797.

Hufeland, Christoph Wilhelm: System der practischen Heilkunde. Ein Handbuch für academische Vorlesungen und für den practischen Gebrauch. Vol. 1, 1st ed. Jena 1818.

Heyll, Uwe: Was ist Alternativmedizin? In: Versicherungsmedizin 68 (2016), pp. 131-135.

Jütte, Robert: Geschichte der alternativen Medizin. Von der Volksmedizin zu den unkonventionellen Therapien von heute. München 1996.

Kerner, Justinus: Die Seherin von Prevorst. Erster Teil: Eröffnungen über das innere Leben des Menschen. Zweiter Teil: Ueber das Hereinragen einer Geisterwelt in die unsere. Stuttgart: Cotta, 1829. – Engl. Edition: The seeress of Prevorst, being revelations concerning the inner-life of man, and the inter-diffusion of a world of spirits in the one we inhabit. London 1845.

La Mettrie, Julien Offray de: L’Homme Machine. Leiden 1748.

Mesmer, Franz Anton: Mesmerismus oder System der Wechselwirkungen. Theorie und Anwendung des thierischen Magnetismus als die allgemeine Heilkunde zur Erhaltung des Menschen. Hg. von Karl Christian Wolfart. Berlin 1814.

Neuburger, Max: Die Lehre von der Heilkraft der Natur im Wandel der Zeiten. Stuttgart 1926.

Pagel, Walter: Virchow und die Grundlagen der Medizin des XIX. Jahrhunderts. Jena 1931 (Jenauer medizin-historische Beiträge; H. 14).

Paracelsus, Ed. Sudhoff = Theophrast von Hohenheim gen. Paracelsus: Sämtliche Werke. 1. Abteilung: Medizinische, naturwissenschaftliche und philosophische Schriften. 14 vols. Ed. by Karl Sudhoff. München; Berlin 1922-1933.

Paracelsus, Ed. Peuckert = Theophrast Paracelsus: Werke. Ed. by Will-Erich Peukert. Vols. 1-5, Darmstadt 1965.

Virchow, Rudolf: Über die Heilkräfte des Organismus. Vortrag. Berlin 1850.

[1] http://www.nytimes.com/aponline/2016/09/17/world/europe/ap-eu-rel-italy-obit-amorth.html (9/20, 2016)

[2] https://en.wikipedia.org/wiki/Anneliese_Michel/ (8/31/2016)

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