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Medical traditions

Bag of `Omohukyi' plant, lantana salvifolia, Uganda, collected 1919

Bag of `Omohukyi' plant, lantana salvifolia, Uganda, collected 1919

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Traditional medicine in the UK today

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Medical knowledge is developed and passed on in many ways. Every community has ideas about the causes of and cures for suffering, illness and disease. These are often spiritual beliefs as well as practical therapies and techniques. Some traditions, or systems of medical knowledge, are tied to a part of the world. Others spread widely, particularly once they become formalised in books and schools.

Prominent medical traditions include biomedicine, Traditional Chinese Medicine (TCM), Unani Tibb in the Arabic-speaking world, and Ayurveda from India. Local medical traditions are also found worldwide. Some, such as African medical traditions, share features with neighbouring systems.

In Europe and other parts of the world, medical systems operate in a medical marketplace - that is, where individuals can choose between practitioners and traditions with competing ideas about curing illness and maintaining health. In the mid 1800s biomedicine became the dominant tradition in Europe. Established European traditions, such as herbalism and homeopathy, did not die out. However, they are now seen as complementary or alternative medical systems.

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How is biomedicine different?

Since the 1800s biomedicine has used sophisticated technology and become closer to science. It relies on germ theory, which looks for illness in the form of causal agents such as bacteria and viruses. It uses physical changes in the body’s structures to define disease. It also relies on quantitative and statistical methods such as clinical trials. Biomedicine is now practised worldwide. It was introduced in some countries through European colonisation. Other countries, such as Japan and China, supported biomedicine from the late 1800s.

This emphasis on science has made biomedicine extremely powerful. However, the patient’s own understanding and experience of suffering and illness has become less central. Other traditions are seen as more holistic. They treat patients as unique individuals, and look at the whole range of factors that might influence health.

What is ‘alternative’ medicine?

Some practices, such as mesmerism, gained acceptance and then faded. Hydrotherapy and homeopathy have gone in and out of fashion. The medical marketplace partly makes one medicine considered as an alternative tradition.Medical traditions that receive government support dominate because they are more available and cheaper. Decisions that insurance companies and health providers make about which medical treatments they will pay for can significantly affect the success of an alternative tradition. This is the case with acupuncture, chiropractic, and psychoanalysis.

Traditions exchanging knowledge

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Traditions have influenced each other, competed, and shared techniques, knowledge and practice. By the early 1700s smallpox inoculation was practised across parts of Africa, India and the Ottoman Empire. It spread from the Ottoman Empire to Europe, and from Africa to the Americas with enslaved Africans. The works of Hippocrates, composed in ancient Greece, were translated into Arabic by authors such as Ibn Sina, and became the foundation of Unani Tibb. They were rediscovered in Europe in their Arabic translations during the Renaissance and became central to biomedicine.

Expanding empires affect local traditions in different ways. Many brought new medical systems with them; some competed with existing practices. The Muslim occupation of India from the 1100s brought Unani Tibb to south Asia. Since then, Unani Tibb and Ayurveda have exchanged many ideas. Once established in a new culture, traditions are often influenced by local ideas and practices. Materia medica, the materials used to make up medicines, have been shared between traditions in India.

Traditional Chinese medicine has spread worldwide and influenced other traditions. Traditional Japanese medicine, called kampo, originated in Chinese medicine and developed its own techniques and drugs. It still uses acupuncture and moxibustion, but modern Kampo uses pre-packaged and prepared herbal remedies. Since the 1960s they have been integrated into Japanese biomedicine.

Colonialism and nationalism

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The most striking meetings between medical systems were during the 1800s at the height of European imperialism. Western powers expanding through Africa and Asia brought biomedicine with them, and local traditions were disregarded as superstition or quackery. European rulers assumed their hygiene, public health and medical treatment systems were superior. Theories about racial difference were also used to classify different peoples as inferior or deficient.

Under colonial regimes, traditional medicine practitioners were often banned or had to be registered by the government. European governments decided what knowledge and training was appropriate to a doctor or surgeon. In response to epidemic diseases such as cholera and smallpox, new ideas about hygiene and public health were imposed on local populations, often using the military. Even when lives were saved, this aggression alienated local people. Many medical traditions became linked to nationalist movements. In 20th-century India and China local knowledge was defended against imposed ideas.

Some people trained in European medicine used medical arguments to criticise colonialism. Mauritanian psychiatrist Frantz Fanon argued that colonialism and racism harmed the physical and psychological health of colonised people.

Moving across traditions

Some techniques and drugs have moved across traditions and changed meanings. Chinese medicine was introduced to Europe in the late 1700s. Acupuncture was the main technique adopted, but it was used with European models of anatomy rather than Chinese ideas. Both use similar technology and techniques, but are based on different models of the body. In most African medical traditions illness is understood in terms of individual and community relationships with the spirit world. However, new drugs and herbs are incorporated into these systems. They are seen as vessels for spiritual powers, not as chemically active ingredients.

Bioprospecting is where researchers look for chemically active ingredients in plants and traditional remedies. Artemisia is a good example of a plant which has been used in TCM, and has now been adapted in biomedicine as an antimalarial drug.

Contemporary traditions

In many countries multiple traditions are available to those who choose or can afford them. One system is often supported by the state as the official medicine. Other traditions are available privately, and may be regulated.

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Bibliography

R C Keller, Colonial madness: psychiatry in French North Africa (Chicago; London: University of Chicago Press, 2007)

D Arnold (ed.), Imperial medicine and indigenous societies: disease, medicine, and empire in the nineteenth and twentieth centuries (New York: Manchester University Press, 1998)

R E Bivins, Acupuncture, expertise, and cross-cultural medicine (Houndmills, Basingstoke; New York: Palgrave, 2000)

R E Bivins, Alternative medicine?: a history (Oxford: Oxford University Press, 2007)

N Gevitz  (ed.), Other Healers: Unorthodox Medicine in America (Baltimore: Johns Hopkins UP, 1988)

M Gijswijt-Hofstra, H Marland and H de Waardt (eds), Illness and healing alternatives in Western Europe (London: Routledge, 1997)

J C Whorton, Nature cures: the history of alternative medicine in America (Oxford; New York: Oxford University Press, c2002)

R Cooter (ed.), Studies in the history of alternative medicine (Basingstoke: Macmillan in association with St Antony's College Oxford, 1988)

M Chamberlain, Old wives' tales: their history, remedies, and spells (London: Virago, 1981)

W F Bynum and R Porter (eds), Companion Encyclopedia of the History of Medicine (London: Routledge, 1993)

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