Holistic medicine is a very controversial subject. There are passionate opinions on both sides. Opponents claim that if “alternative” treatments really worked, they would be more widely accepted and many illnesses and ailments would have been cured long ago. This side of the debate feels that herbs and medications are often used inappropriately without adequate training and understanding of the potential side effects or dangers and without scientific evidence that they actually work. These treatments have not been thoroughly investigated nor tested for efficacy or safety and in some cases may actually be harmful.
Proponents feel that holistic treatments provide a more “natural” way to heal the body in a world full of chemicals, preservatives and synthetics. Many times, “alternative” treatments are used to augment more traditional treatments and are not commonly used as the only treatment.
In the past few decades, a number of therapies have been growing in popularity. These unproven therapies are quite diverse and go by different names, such as “alternative,” “complementary,” and “integrative.”
At first glance, it seems a little odd that these therapies should grow more popular when scientific medical advances (including veterinary science) are occurring at an amazing pace. But some people are curious about these therapies, and it is helpful to look at them as a whole, to see what they have in common.
First of all, there is the terminology. The words used to describe this group of therapies, which were first proposed in the 1960s and 70s, tend to be misleading. In fact, they obscure what's actually being proposed. There aren't two kinds of medicine - medicine either works or it doesn't work. Consider this: you don't find “alternative” groups in fields such as airplane engineering or bridge building. That's because violating well-established principles in such fields is a sure-fire recipe for disaster. There is no legitimate alternative to effective medicine.
Still, terms such as “alternative,” “integrative” and “complementary” are soothing and sound good. They also tend to put the most positive spin possible on therapeutic claims that are generally either unproven and/or are highly unlikely to be true. If you think about it, such therapies really can't be thought of as genuine “alternatives,” at least if you think of an “alternative” as one that is likely to be equal or superior to a proven therapy.
Such therapies can't really be thought of as genuinely “complementary” unless they can be shown to offer increased effectiveness, improved safety, lessened signs of disease, or fewer deaths when they are added to a proven treatment regimen. Moreover, there is no reason to “integrate” a therapy that doesn't do anything useful. It's a fact that in animals, at least so far, these treatments have not been shown to be a true “alternative” or “complement” to anything.
Most of what is considered “alternative” medicine was pulled out of the dustbin of medical history and dressed up for popular consumption. Bleeding, for instance, was once the most commonly prescribed therapies in human and animal medicine. Its use waned as scientists learned to explore its supposed effects.
Acupuncture may have been around for 2,000 years (at least in people - for a much, much shorter period of time in horses); herbs have been proposed as medications for millennia; homeopathy is a couple of hundred years old.
There are hundreds of herbal recipes and homeopathic approaches to any number of conditions of animals. But if they didn't work then, they aren't going to work now. If a cure or treatment to a condition had been found, everyone would still be doing them.
Practitioners promote alternative therapies as being “natural” somehow. As such, “natural” is being used as a synonym for “good.” They are not the same thing. Such “natural” substances as poison hemlock or locoweed can hardly be considered beneficial; not to mention “natural” disasters, such as hurricanes or floods. In fact, some of the things promoted as “alternative” are anything but natural. For example, the ingredients used to prepare some common homeopathic preparations - crushed honeybees, dog's milk or duck liver, to name a few - can't really be recognized as desirable therapeutic agents, even if they do occur in nature.
Not only are some “natural” traditional medications unnatural, some of them are having a profoundly negative impact on the natural environment. Tigers are facing extinction because their bones are an old Chinese “cure” for rheumatism. Rhinoceros populations are being decimated because a powder made from their horns is a traditional Chinese aphrodisiac. Grizzly bears are in peril because their gall bladders are a cure for who-knows-what. The popularity of unproven and untested herbal supplements threatens the survival of some of the most valuable wild plants, according to scientists and conservationists at a recent United Nations gathering.
And there's more. While the alleged successes of “Traditional Chinese Medicine” are widely celebrated, more sobering messages are often overlooked. In 1998, the Washington Post published an account about public health in rural China, where traditional Chinese medicine would be expected to be the most available.
In spite of the availability of such therapy, various forms of parasitism afflict 70 percent of the population there, resulting in malnutrition, decreased intelligence and general weakening of the workforce. As for acupuncture, the Chinese tried to ban it twice in the past 100 years, and homeopathic schools disappeared around the turn of the 20th century.
Still, it's easy to understand why people find “alternative” therapies so appealing. A yearning for “unity with nature” is something that is common to any number of cultures. Germany has its naturphilosophie. In Asia, this desire exhibits itself as a reverence for tradition and beliefs that try to tie spirituality and cosmology into all phases of life. Many North Americans and Europeans are captivated by “naturopathy,” “holistic” (non-natural) medicine, fairy tales and folk traditions. On the other hand, scientific medicine is complicated and intimidating. People are drawn to that which is comfortable and they tend to resist giving up folk beliefs, traditional healing methods, quaint and familiar ideas and superstitions.
Signs of such superstitions can be seen regularly. Colic in horses is caused by changes in the weather (actually, it isn't). Cold water on hot muscles causes cramps and muscle damage (it doesn't). Feeding garlic keeps the fleas away (it doesn't). Unnamed “toxins” are at the root of all disease and it's important to “detoxify.” (The notion of toxins stems from the musings of Dr. Kellogg at the turn of the 20th century. Though he gave rise to the popular cereal brand, he also made such fad treatments as routine enemas popular.)
On the other hand, when compared to that which is old and comfortable, technical, professional and scientific medicine is relatively new, only having been in existence for about a hundred years. Plus, it keeps changing - the volume of medical information is estimated to double every four to eight years. The language seems strange and it's not easily understood; indeed, special schools are set up so as to help make that language more understandable. However, even if you don't completely understand the language, revolutions in modern medicine has dramatically changed the quality of life.
So, why is it that “alternative” and “complementary” therapies seem to be getting so much press? In fact, why do they exist at all? There are probably several reasons. In general, “alternative” and “complementary” therapies tend to find a niche in one of three areas:
- The first is where no cure currently exists. Where there is a cure, such as giving intravenous fluids in the treatment of dehydration, there is simply no “alternative” needed because the proven therapy is effective. Unfortunately, however, most conditions do not have a cure. No one has yet solved the difficult problems posed by laminitis in horses or arthritis in any species. Thus, it's a sad fact that the use of any currently available treatment for an incurable condition will most likely ultimately fail. This leaves room for any number of treatment possibilities. Still, it seems unlikely that cures and effective treatments for difficult-to-treat conditions have been somehow forgotten; the advances in medicine have come from looking forward, not backward.
- The second playground for “alternative” therapies is in the treatment of things that are likely to turn out all right anyway. A good number of things that cause people to worry about their animals, such as minor scrapes or sprains or self-limiting viral infections, can most likely be treated successfully, using any number of approaches. Indeed, such conditions tend to get better on their own (unless the therapy gets in the way). So when treatments are given for diseases that are going to improve anyway, the treatment is usually credited for the therapeutic “success.” Whether you use homeopathic arnica, an herbal poultice or a dose of pain reliever, your horse's sole bruise or your dog's limp may get better on its own if you give simply it some time.
- The third situation where “alternatives” are popular is in the treatment of animals that are not sick and have no signs of disease or in animals where it's not possible to demonstrate or diagnose a real medical problem. “Alternatives” appeal to a group of people that have been termed the “worried well”; a group that worries something might go wrong soon, even if nothing is wrong at the moment. With such an attitude, it's easy to be persuaded that a regular dose of herbs is “good for your animal's metabolism” or that “adjustments” help keep your animal's spine in good working order.
Some people assert that acupuncture is a good treatment for back pain in horses, but the fact is that a reliable way to diagnose back pain in the horse has yet to be determined. Under such circumstances, it's easy to imagine that there's been some benefit to treatment when none has actually been provided, especially when the intentions of both the provider and the consumer of the therapy are so good. The bottom line is that overeager concern about “wellness” care, or a tendency to attribute vague and undefined perceptions of an animal feeling “unwell” to some poorly defined health condition, simply opens the door to almost unlimited opportunities for any number of devices and treatments to get incorporated into your pet's care (and your pocketbook).
There is a large and ever-increasing body of work that shows that most “alternatives” are not effective.
- Acupuncture has failed to demonstrate its usefulness in virtually every condition in human medicine in which it has been examined.
- Chiropractic-type treatments appear to have some mild effect when applied to humans with acute low back pain, but they haven't been shown to be superior to other types of manual therapies (such as massage) and the certainly haven't been shown to cure any disease condition.
- Homeopathy has never been shown to be effective for anything.
- And herbs, some of which may occasionally contain active pharmacologic ingredients, still pose tremendous problems in terms of purity, safety, content and effectiveness.
One quick test for the usefulness of an alternative therapy is to ask what would happen if tomorrow it were no longer available? How much would acupuncture or homeopathy or Bach's flower remedies be missed? If you had never heard of them, would your pet's health suffer one bit? Are there any real medical conditions for which a therapeutic “alternative” would be a good first choice? Could you say the same thing about antibiotics, colic surgery or a tetanus vaccination?
- Another way of looking at the questions posed by alternative therapies is to turn a question around. People talk about how long acupuncture has been in existence, as if it's longevity somehow equals effectiveness (astrology has been around a long time, too). But if you can conclude that acupuncture is effective because it's been around for so long, why, if it's truly effective, are there still so many questions about its real usefulness after all this time?
Still, if you're treating a self-limiting or chronic condition with a therapy that's unlikely to do much harm, there's likely to be little danger of direct harm to your animal. That being said, side effects from “alternative” therapies are real - animals have been injured by “adjustments,” poisoned by “natural” plants and have reacted aggressively to the placement of acupuncture needles. Real danger also comes when “alternative” treatments are proposed for conditions that can be cured. Under such circumstances, things can go rapidly downhill.
Your pet's wound may get better whether you use an herbal dressing or an antibiotic dressing. However, if the wound becomes infected and the infection goes unrecognized or the herbal dressing isn't effective, the result could be devastating. Even when there's no danger of direct harm, adding an unproven “complementary” therapy to one that is already effective is not necessarily a good thing. Indeed, if you add as many therapies as possible to the treatment plan for a single condition, the only thing that you will do for sure is drive up the cost of care.
There has always been a fringe of “healers” willing to supply unproven and/or untested methods that are rejected by scientific biomedicine. Today, mostly as a result of vigorous promotion by proponents of such methods and their uncritical acceptance, a minority of the public now has firm belief in the “power” of supplements, antioxidants, magnets and in the idea that medicine is somehow harmful. Fortunately, in most cases, such beliefs cause little harm, but the potential for harm is there. The current times are really no different from any other time in history. Products with debatable or no effects have always been made, given and sold by earnest and eager “healers.” Sometimes those products compete with effective products - sometimes they're merely “complementary.” Still, without good evidence of effectiveness, there's really no reason to use any of them. However, there has always been good grazing along the fringes of the pastures of medicine.