folk medicine

FOLK MEDICINE

Folk medicine refers generally to healing practices traditionally used for alleviating illness and injury, or to aid in childbirth. It is a category of informal knowledge distinct from "scientific medicine", as well as more formal and systematic, but unscientific, medical practices such as Ayurveda. However, it may coexist with these in the same culture or society. Folk medicine as a system includes: home remedies; folk aetiologies of disease; preventative medicine; reproductive techniques; medicinal properties of plants; anatomical knowledge, and healers. Folk medicine may also include elements from the history of medicine. For example the hot-cold concept of health and illness is absent in Spanish folk medicine and did not exist at the folk level in the past (Tan, 1989). However these beliefs are now widespread in Latin America and the Caribbean, and according to Foster (1953) were derived from the élite and scholarly Hippocratic-galenic traditions that were brought to the Spanish colonies by Spanish physicians and clergy. Spanish medical practice at the time of Cristopher Columbus was based on classical Greek and Roman medicine with diffusions from Arab medicine. Other Hippocratic principles are the oppositions of raw / cooked, hot /cold, wet / dry, sweet / sour. In addition, wellbeing is determined by a balance between different elements, bile, phlegm, and blood (Strobel, 1985).

Classical History

Early recognised compilers of existing and current herbal knowledge were the Greeks Hippocrates, Aristotle, Theophrastus (b. 370 BC), Dioscorides and Galen. Roman writers were Pliny and Celsus (Kay, 1996). Dioscorides (Pedianos Dioskurides) included the writings of the herbalist Krateuas, physician to Mithridates VI King of Pontus from 120 to 63 BC in his De Materia Medica (Codex Vindobonensis) (Blunt and Raphael, 1994). De Materia Medica was translated into several languages and Turkish, Arabic and Hebrew names were added to it throughout the centuries (Blunt and Raphael, 1994). Latin manuscripts of De Materia Medica were combined with a Latin herbal by Apuleius Platonicus and were incorporated into the Anglo-Saxon codex Cotton Vitellius C.III. These early Greek and Roman compilations became the backbone of European medical theory and were translated by the Arabs Avicenna (Ibn Sīnā, 980 - 1037), the Persian Rhazes (Rāzi, 865 - 925) and the Jewish Maimonides (Kay, 1996). Translations of Greek medical handbooks and manuscripts into Arabic took place in the eighth and ninth centuries. Arabic folk medicine developed from the conflict between the magic-based medicine of the Bedouins, the Arabic translations of the Hellenic medicine and Ayurvedic medicine (Slikkerveer, 1990). Spanish folk medicine was influenced by the Arabs from 711 to 1492 (Hernández-Bermejo and García Sánchez, 1998). Translations of the early Roman-Greek compilations were made into German by Hieronymus Bock whose herbal published in 1546 was called Kreuter Buch. A Dutch translation Pemptades by Rembert Dodoens (1517-1585) was translated by Charles de L'Écluse (Carolus Clusius, 1526-1609), and was published in English by Henry Lyte in 1578 as A Nievve Herball. This became John Gerard's (1545 - 1612) Herball or General Hiftorie of Plantes (Blunt and Raphael, 1994; Kay, 1996). Each new work was a compilation of existing texts with new additions.

Women's folk knowledge existed in undocumented parallel with these texts (Kay, 1996). Forty-four drugs, diluents, flavouring agents and emollients mentioned by Discorides are still listed in the official pharmacopoeias of Europe (Blunt and Raphael, 1994). The Puritans took Gerard's work to the America where it influenced American folk medicine (Kay, 1996). Francisco Hernandez, physician to King Phillip II of Spain spent the years 1571 - 1577 gathering information in Mexico and then wrote Rerum Medicarum Novae Hispaniae Thesaurus, many versions of which have been published including one by Francisco Ximenez. Both Hernandez and Ximenez fitted Aztec ethnomedicinal information into the European concepts of disease such as "warm", "cold", and "moist", but it is not clear that the Aztecs used these categories (Ortiz de Montellano, 1975). Juan de Esteyneffer's (Johann Steinhöfer) Florilegio medicinal de todas las enfermedas compiled European texts and added 35 Mexican plants. This Florilegio is still used by Mexican healers. Martin de la Cruz wrote an herbal in Nahauatl which was translated into Latin by Juan Badiano as Libellus de medicinalibus indorum herbis or Codex Barberini, Latin 241 and given to King Carlos V of Spain in 1552 (Heinrich et al., 2005). It was apparently written in haste and influenced by the European occupation of the previous 30 years. Fray Bernadino de Sahagún’s used ethnographic methods to compile his codices that then became the Historia General de las Cosas de Nueva Espana, published in 1793 (Heinrich et al., 2005). Castore Durante published his Herbario Nuovo in 1585 describing medicinal plants from Europe and the East and West Indies. It was translated into German in 1609 and Italian editions were published for the next century.

Maria Mies linked the burning of female herbalists as witches in Europe to the rise of capitalism and the development of male-dominated medicine and law in the Middle Ages. This argument has been followed more recently by Silvia Federici who writes that the witch burning was designed to crush the economic independence of women. "The persecution and burning of the midwives as witches was directly connected with the emergence of modern society: the professionalization of medicine, the rise of medicine as a ‘natural science’, the rise of science and of modern economy. The torture chambers of the witch-hunters were the laboratories where the texture, the anatomy, the resistance of the human body — mainly the female body — was studied. One may say that modern medicine and the male hegemony over this vital field were established on the base of millions of crushed, maimed, torn, disfigured and finally burnt, female bodies.

There was a calculated division of labour between Church and State in organizing the massacres and terror against the witches. Whereas the church representatives identified witches, gave theological justification and led the interrogations, the ’secular arm’ of the state was used to carry out the tortures and finally execute the witches on the pyre. Mies, 1986".

Folk medicine is sometimes associated with quackery when practiced as theatrics or otherwise practiced fraudulently, and sometimes with witchcraft and often with shamanism, yet it may also preserve important knowledge and cultural tradition from the past. Practicing scientists sometimes go out of their way to suppress alternative medicine (see Angell and Kassirer, 1998 and BMJ 2007 September 29; 335(7621)). In a fertility survey (Anderson and Cleland, 1984) women who said they used herbs as contraceptives (93.5 % of women in Bangladesh) were placed in the category 'not using'. However unbiased scientific analysis requires that all knowledge claims be subjected to a minimalist standard of rationality that requires that belief be apportioned to evidence and that no assertion about folk medicine or 'theory' be immune from or rejected without critical assessment (see Hawkesworth, 1989). The International Council for Science (ICSU) was asked to carry out a study on the concept of 'traditional knowledge' (Dickson, 1999) in the context of the signing of the Declaration on Science and the Framework for Action at the 1999 World Conference on Science in Budapest, and the 26th General Assembly of the ICSU in Cairo, Egypt (Nakashima and Guchteneire, 1999). Prior to the signing debate took place on whether indigenous knowledge (IK) was scientific or not and scientists expressed surprise at seeing the issue on the agenda. Scientists suggested that including indigenous and traditional knowledge on the agenda might lend ill-deserved credibility to IK or open the door to anti- and pseudoscientific approaches like creationism and astrology. Nakashima and Guchteneire (1999) wondered whether the discomfort of the scientists might be related to their unwillingness to view science as one knowledge system among many. The debate led to a discussion on the nature of scientific knowledge itself; for example what makes the theory of natural evolution 'scientific' and thus distinguishable from astrology when neither can be replicated or reproduced? (Anon, 1999).

Acupuncture Medical Treatment

Acupuncture (from Lat. acus, "needle" (noun), and pungere, "prick" (verb)) or in Standard Mandarin, zhēn jiǔ (lit: needle - moxibustion) is a technique of inserting and manipulating filiform needles into "acupuncture points" on the body with the aim of restoring health and well-being, e.g. treating pain and diseases. Acupuncture is thought to have originated in China and is most commonly associated with Traditional Chinese medicine ([TCM]TCM ARTICLES). Different types of acupuncture (Classical Chinese, Japanese, Tibetan, and Korean acupuncture) are practiced and taught throughout the world.

Scientists are studying the mechanisms and efficacy of acupuncture. Researchers using the protocols of evidence-based medicine have found good evidence that acupuncture is effective in treating nausea and chronic low back pain, and moderate evidence for neck pain and headache. The WHO, the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH), the American Medical Association (AMA) and various government reports have also studied and commented on the efficacy of acupuncture. There is general agreement that acupuncture is at least safe when administered by well-trained practitioners, and that further research is warranted. Though occasionally charged as pseudoscience, Dr. William F. Williams, author of Encyclopedia of Pseudoscience, notes that acupuncture --"once rejected as 'oriental fakery' -- is now (if grudgingly) recognized as engaged in something quite real."

Traditional Chinese medicine's acupuncture theory, although based on empirical observation, predates use of the modern scientific method, and has received various criticisms based on modern scientific thinking. There is no generally-accepted anatomical or histological basis for the existence of acupuncture points or meridians. Acupuncturists tend to perceive TCM concepts in functional rather than structural terms, i.e. as being useful in guiding evaluation and care of patients. As the NIH consensus statement noted: "Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points", the definition and characterization of these points remains controversial. Even more elusive is the basis of some of the key traditional Eastern medical concepts such as the circulation of Qi, the meridian system, and the five phases theory, which are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture." Finally, neuroimaging research suggests that specific acupuncture points have distinct effects on cerebral activity in specific areas that are not otherwise predictable anatomically.

Acupuncture treats the human body as a whole that involves several "systems of function" that are in some cases loosely associated with (but not identified on a one-to-one basis with) physical organs. Some systems of function, such as the "triple heater" (San Jiao, also called the "triple burner") have no corresponding physical organ, rather, represents the various jiaos or levels of the ventral body cavity (upper, middle and lower). Disease is understood as a loss of balance between the yin and yang energies, which bears some resemblance to homeostasis among the several systems of function, and treatment of disease is attempted by modifying the activity of one or more systems of function through the activity of needles, pressure, heat, etc. on sensitive parts of the body of small volume traditionally called "acupuncture points" in English, or "xue" (穴, cavities) in Chinese. This is referred to in TCM as treating "patterns of disharmony".

Needles are being inserted into patient skin.

Treatment of acupuncture points may be performed along several layers of pathways, most commonly the twelve primary pathways meridians, located throughout the body. Other pathways include the Eight Extraordinary Pathways Qi Jing Ba Mai, the Luo Vessels, the Divergents and the Sinew Channels. Unaffiliated, or tender points, called "ah shi" (signifying "that's it", "ouch", or "oh yes") are generally used for treatment of local pain. Of the eight extraordinary pathways, only two have acupuncture points of their own. The other six meridians are "activated" by using a master and couple point technique which involves needling the acupuncture points located on the twelve main meridians that correspond to the particular extraordinary pathway. Ten of the primary pathways are named after organs of the body (Heart, Liver, etc.), one is named for the serous membrane that wraps the heart (Heart Protector or Pericardium), the last is the 'three spaces' (San Jiao). The pathways are capitalized to avoid confusion with a physical organ (for example, we write the "Heart meridian" as opposed to the "heart meridian"). The two independent extraordinary pathways Ren Mai and Du Mai are situated on the midline of the anterior and posterior aspects of the trunk and head respectively. The twelve primary pathways run vertically, bilaterally, and symmetrically and every channel corresponds to and connects internally with one of the twelve Zang Fu ("organs"). This means that there are six yin and six yang channels. There are three yin and three yang channels on each arm, and three yin and three yang on each leg.

The three yin channels of the hand (Lung, Pericardium, and Heart) begin on the chest and travel along the inner surface (mostly the anterior portion) of the arm to the hand.

The three yang channels of the hand (Large intestine, San Jiao, and Small intestine) begin on the hand and travel along the outer surface (mostly the posterior portion) of the arm to the head.

The three yin channels of the foot (Spleen, Liver, and Kidney) begin on the foot and travel along the inner surface (mostly posterior and medial portion) of the leg to the chest or flank.

The three yang channels of the foot (Stomach, Gallbladder, and Bladder) begin on the face, in the region of the eye, and travel down the body and along the outer surface (mostly the anterior and lateral portion) of the leg to the foot.

The movement of qi through each of the twelve channels is comprised of an internal and an external pathway. The external pathway is what is normally shown on an acupuncture chart and it is relatively superficial. All the acupuncture points of a channel lie on its external pathway. The internal pathways are the deep course of the channel where it enters the body cavities and related Zang-Fu organs. The superficial pathways of the twelve channels describe three complete circuits of the body, chest to hands, hands to head, head to feet, feet to chest, etc.

The distribution of qi through the pathways is said to be as follows (the based on the demarcations in TCM's Chinese Clock): Lung channel of hand taiyin to Large Intestine channel of hand yangming to Stomach channel of foot yangming to Spleen channel of foot taiyin to Heart channel of hand shaoyin to Small Intestine channel of hand taiyang to Bladder channel of foot taiyang to Kidney channel of foot shaoyin to Pericardium channel of hand jueyin to San Jiao channel of hand shaoyang to Gallbladder channel of foot shaoyang to Liver channel of foot jueyin then back to the Lung channel of hand taiyin. Each channel occupies two hours, beginning with the Lung, 3AM-5AM, and coming full circle with the Liver 1AM-3AM.

info :wikipedia

CHINA : Traditional Medicine

Traditional Chinese medicine (also known as TCM, simplified Chinese: 中医; traditional Chinese: 中醫; pinyin: zhōngyī) is a range of traditional medical practices originating in China that developed over several thousand years. The English phrase "TCM" was created in the 1950s by the PRC in order to export Chinese medicine; there is no equivalent phrase in Chinese (zhōngyī xué translates literally as simply "Chinese medicine studies"). In fact, TCM is a modern compilation of traditional Chinese medicine. TCM practices include theories, diagnosis and treatments such as herbal medicine, acupuncture and massage; often Qigong is also strongly affiliated with TCM. TCM is a form of so-called Oriental medicine, which includes other traditional East Asian medical systems such as traditional Japanese, and Korean medicine.

TCM theory asserts that processes of the human body are interrelated and in constant interaction with the environment. Signs of disharmony help the TCM practitioner to understand, treat and prevent illness and disease.

In the West, traditional Chinese medicine is considered alternative medicine. In mainland China and Taiwan, TCM is considered an integral part of the health care system. For example, TCM treatments may be prescribed to counter the side effects of chemotherapy, cravings and withdrawal symptoms of drug addicts, and a variety of chronic conditions.

TCM theory is based on a number of philosophical frameworks including the theory of Yin-yang, the Five Elements, the human body Meridian system, Zang Fu organ theory, and others. Diagnosis and treatment are conducted with reference to these concepts. TCM does not operate within the contemporary scientific paradigm but some practitioners make efforts to bring practices into a biomedical and evidence-based medicine framework.

Much of the philosophy of traditional Chinese medicine derived from the same philosophical bases that contributed to the development of Taoist philosophy, and reflects the classical Chinese belief that individual human experiences express causative principles effective in the environment at all scales.

During the golden age of his reign from 2698 to 2596 B.C, as a result of a dialogue with his minister Ch'i Pai (岐伯), the Yellow Emperor is supposed by Chinese tradition to have composed his Neijing Suwen (內經 素問) or Basic Questions of Internal Medicine, also known as the Huangdi Neijing. Modern scholarly opinion holds that the extant text of this title was compiled by an anonymous scholar no earlier than the Han dynasty just over two-thousand years ago.

During the Han Dynasty, Zhang Zhongjing (張仲景), the Hippocrates of China, who was mayor of Chang-sha toward the end of the 2nd century AD, wrote a Treatise on Cold Damage, which contains the earliest known reference to Neijing Suwen. The Jin dynasty practitioner and advocate of acupuncture and moxibustion, Huang-fu Mi (215 - 282 AD), also quoted the Yellow Emperor in his Jia Yi Jing (甲乙經), ca. 265 AD. During the Tang dynasty, Wang Ping claimed to have located a copy of the originals of the Neijing Suwen, which he expanded and edited substantially. This work was revisited by an imperial commission during the 11th century AD.

Classical Chinese Medicine (CCM) is notably different from Traditional Chinese Medicine (TCM). The Nationalist government elected to abandon and outlaw the practice of CCM as it did not want China to be left behind by scientific progress. For 30 years, CCM was forbidden in China and several people were prosecuted by the government for engaging in CCM. In the 1960's, Mao Zedong finally decided that the government could not continue to outlaw the use of CCM. He commissioned the top 10 doctors (M.D.'s) to take a survey of CCM and create a standardized format for its application. This standardized form is now known as TCM.

Today, TCM is what is taught in nearly all those medical schools in China, most of Asia and Northern America, that teach traditional medical practices at all. To learn CCM typically one must be part of a family lineage of medicine. Recently, there has been a resurgence in interest in CCM in China, Europe and United States, as a specialty.

Contact with Western culture and medicine has not displaced TCM. While there may be traditional factors involved in the persistent practice, two reasons are most obvious in the westward spread of TCM in recent decades. Firstly, TCM practices are believed by many to be very effective, sometimes offering palliative efficacy where the best practices of Western medicine fail, especially for routine ailments such as flu and allergies, and managing to avoid the toxicity of some chemically composed medicines. Secondly, TCM provides the only care available to ill people, when they cannot afford to try the western option. On the other hand, there is, for example, no longer a distinct branch of Chinese physics or Chinese biology.

TCM formed part of the barefoot doctor program in the People's Republic of China, which extended public health into rural areas. It is also cheaper to the PRC government, because the cost of training a TCM practitioner and staffing a TCM hospital is considerably less than that of a practitioner of Western medicine; hence TCM has been seen as an integral part of extending health services in China.

There is some notion that TCM requires supernatural forces or even cosmology to explain itself. However most historical accounts of the system will acknowledge it was invented by a culture of people that were already tired of listening to shamans trying to explain illnesses on evil spirits; any reference to supernatural forces is usually the result of romantic translations or poor understanding and will not be found in the Taoist-inspired classics of acupuncture such as the Nèi Jīng or Zhēnjiǔ Dàchéng. The system's development has over its history been skeptically analysed extensively, and practice and development of it has waxed and waned over the centuries and cultures which it has travelled - yet the system has still survived this far. It is true that the focus from the beginning has been on pragmatism, not necessarily understanding of the mechanisms of the actions - and that this has hindered its modern acceptance in the West. This, despite that there were times such as the early 18th Century when "acupuncture and moxa were a matter of course in polite European society".

info : wikipedia