Allopathic Medicine

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The Concise Medical Dictionary defines allopathic medicine as “the orthodox system of medicine, in which the use of drugs is directed to producing effects in the body that will directly oppose and so alleviate the symptoms of a disease.”[1] This definition is defined within and by homeopathy, a medical system of treatment in direct contrast to allopathy (discussed further below in History). An alternate definition of allopathic medicine, not taken from the discipline of homeopathic medicine, but from the Dictionary of Public Health, is “the prevailing form of conventional or orthodox medical practice, based as far as feasible on formally arrived-at diagnostic categories of conditions that are treated on the basis of best available evidence for efficacy of therapeutic measures. Early in the 21st century it is increasingly in transition into evidence based-medicine. “[2]

The allopathic medical system is used by M.Ds. in Western medicine and is a biological approach to healing which uses pharmacological active agents or physical interferences, such as surgery, to treat or subdue symptoms and processes of disease.[3] This approach follows Descartes view of the mind body separation with a mechanistic view of the body divided into parts and a physical cause of a disease. There is less emphasis on the mind as contributing to disease manifestation.[4] For example, psychiatry as a form of allopathic medicine treats mental disorders with pharmacological treatments because of the view that they act precisely upon the neurobiology grounding the disorder.[5]

History


The term ‘allopathy’ was coined in 1842 by C.F.S. Hahnemann to designate its contrast to homeopathy, a system of medicine that he founded upon the precept that disease can be treated with small amounts of drugs that in larger doses would produce that condition or symptoms in healthy individuals as the disease would itself.[6] Because the original term for allopathic medicine was defined in terms of this opposing medical system, its history can also be viewed in the context of homeopathy.
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C.F.S. Hahnemann, The father of homeopathy


In the mid 19th century in Bengali, ideas from print concerning medical traditions and debates between the physicians of the contending medical systems of the time, allopathy and homeopathy, can serve as a case study to help identify and define the characteristics and differences of the systems of the time and how internal debates between the two disciplines created and reinforced their identities.
Following are a summary of some of the central debates between allopathy and homeopathy of the time. While the system of homeopathy was based on a unifying, central ‘law of similars’ or ‘like cures like’ discovered by Hahnemann in 1790, those doctors who called themselves ‘allopaths” collectedly rejected the idea of scientific knowledge of the field needing to be based on one universal law, but rather contended that it is based on several theories at once. The homeopaths of the time argued, that allopathy was based on rationalism and deduction as opposed to their system of empirical and experimental methodology. The issue of dosage was also a point of controversy between the two doctrines, as it was that Hahnemann stressed the effectiveness of using the most minute dose possible of any drug, in contrast to the largely generous doses employed in allopathic medicine.[7]

Aside from the specific differences and characteristics of each system, the context of the mid-19th century paved the path for the professionalization of medicine nation-wide in Britain and the United States and set the groundwork for the establishment of what is known today as orthodox medicine, taken to be allopathic medicine according to the definitions above. This professionalization of medicine was underwritten by the state and also led to a differentiation between orthodox and alternative medical systems. Contributing facets to professionalization were the creation of medical journals such as the Lancet and the Provincial Medical and Surgical Journal in Britain and the Journal of the American Medical Association in the United States, state legislature acts such as Medical Registration Act of 1858 in Britain and increased state-based legislatures in the United States as well as the formation of associations, most markedly the American Medical Association in 1848 followed by the establishment of the American Pharmaceutical Association in 1852, both in the United States. From these creations, the allopathic/orthodox system arose to dominance over practitioners of naturopathy and homeopathy, who were assimilated into the mainstream and to a lesser extent created marginal areas of practice such as osteopathy.[8]

The acceptance of orthodox medicine was aided by the scientific advance in the production of certain vaccines and the procurement of drugs to treat specific disease. Meanwhile during this time period, the discovery of antibiotics contributed to the launching of the pharmaceutical industry, an industry which continues to reinforce and empower allopathic medicine today.[9] Particularly, Louis Pasteur’s discoveries regarding infectious disease gave the theoretical basis for allopathic medicine.[10]



Limitations and Criticisms


Advocates of allopathic medicine correlate recent increases in life expectancy in the last century with the use of drugs, surgery and other medical procedures to improve health and prolong life. This assumption is incorrect, as proven by data collected by the Centers for Disease Control (CDC), which shows that the reduction in death rates improved before the age of modern medicine. The renowned epidemiologist Thomas McKeown, former chairman of the WHO Advisory Group on Health Research and Strategy, concluded that modern medicine had only contributed at most one or two years to the increase of life expectancy by 23 years during the first half of the 19th century. Proponents of allopathic medicine may attribute vaccinations and medical therapy to a decline in infectious diseases and therefore mortality during this time. Instead the major cause for mortality decline was due to better diet and nutrition and a decline in tuberculosis, in which an effective pharmacotherapy for was not developed until 1947. Aside from the smallpox vaccination, medical therapy had only marginal effect before 1935. In addition, the decrease in mortality in the second half of the 19th century was due to improved hygiene and safer food and water, reducing exposure to infection.[11]

Thomas McKeown’s work has regularly been related to that of Ivan Illich’s in Medical Nemesis: The Appropriation of Health. He actually credited modern medical science to increasing death rates as a result of incompetent and dangerous medical therapies. llich stated patients “suffered from the side-effects of prescribed drugs, hospital acquired infections, poorly performed surgery and false positives on medical and laboratory tests.”[12] He also accused practitioners of allopathic medicine as being more interested in career, self-oriented and corporate interests than that of concerns for the patient.[13]

Slamak F. Shirazi, PhD., Licensed Acupuncturist and Oriental Medical Doctor claims that allopathic medicine is very effective for addressing most urgent, immediate care situations, citing the situation of an injured person involved in a car accident as an example.[14] The question then arises about the effectiveness of allopathic treatment in long-term or chronic disease and weather medication to relieve symptoms as treatment perhaps only masks them and neglects to address the cause of the underlying condition.



Anthropological Perspective and Examples


From an anthropological perspective, Western allopathic medicine or Biomedicine as a health care system is a product of the culture that cannot be separated from the society that creates and informs it. Every health care system has its own knowledge about the origins and causes of illness, classifications for disease, and treatments and therapies to respond to them alongside standards of administration of appropriate roles and practice within the system. In addition there are power relationships and institutions dedicated to care and rehabilitation of health. Therefore every health system is also socio-cultural, and in analyzing implementations of interventions in clinical practice in relation to patients and practitioners, the use of cultural relativism should be employed, (understanding a culture on its own terms rather than from the morals of the culture of the observer) to avoid ethnocentric attitudes by professionals and theorists.[15]

Using the social context of late-19th century India, British colonialism brought the modern medicine into the sphere and allowed for a collapse of free health care system in favor of modern, money-making hospitals in large cities such as Delhi, Mumbai, Hyderabad and Bangalore, catering to the wealthy and even attracting rich foreigners. This left the poor and marginalized population left to choose between an allopathic and Ayurvedic doctor. In these cases, the Ayurvedic doctor would usually be more accessible, better relate to the family and patient and would charge less for the services.[16]

A second anthropological example is taken from the same time period in Bengal, in which issues of race and class were purported to support the use of homeopathic drugs over allopathic drugs that divided these two medical systems. Colonial discourse on Indians had created the stereotype of a weak and effeminate Indian body, which were internalized and reinforced by literates of the time. Because homeopathic drugs were proclaimed as gentle in contrast to the strong potencies of allopathic drugs, such as quinine use to treat malaria, they were promoted to be better suited for the treatment of Indians, with one scholar even citing the unsuitability of allopathic drugs based on comparison of diet; the rice-eating Indians being unable to consume the same drugs as the cow-eating Europeans. Allopathic doctors vigorously defended quinine as being the only available drug capable of curbing the spread of disease in the inhospitable, disease-ridden environments created by climate, also invoking the colonialist notions of the time.[17] It is clear in both examples that the allopathic and homeopathic health systems were entrenched in the socio-cultural conditions of the time facilitating attitudes on views of health and prescribed treatments.

In the United States and many other Western countries that employ allopathic medicine, the tendency today is to naturalize the medical field as being a universal, absolute truth, when in fact it is relative, contextual and contingent upon our culture that creates it.[18] Proof of this is that the modern medical researcher takes into account the diseases of the few in developed nations, rather than that of the majority in developing countries.[19] Perhaps by beginning to study medicinal practices of cultures that come into contact with Western medicine, we can begin to further advance, develop and inform our knowledge of allopathic medicine to alter implementation and practice towards creating a better health care system for all.

Further Reading


  • Das, S. (2012). Debating scientific medicine: Homeopathy and allopathy in late 19th-century medical print in Bengal. Medical History, 56(4), 463-480.
  • Saks, M. (2003). Orthodox and alternative medicine. (pp. 26-41). New York, New York: Continuum.
  • Stanzak, R. (2006). Bottom line medicine: A layman's guide to evidence-based medicine . (pp. 256-260). New York, New York: Algora Pub.
  • Varma, D. R. (2006). From witchcraft to allopathy uninterrupted journey of medical science. Economic and Political Weekly, 41(33), 3605-3611.

References


  1. ^ Martin, E. (2010). Concise medical dictionary. (8th ed.). Oxford, New York: Oxford University Press. Retrieved from http://www.oxfordreference.com.ezproxy.lib.usf.edu/view/10.1093/acref/9780199557141.001.0001/acref-9780199557141-e-301?rskey=AQ8FvV&result=1
  2. ^ Last, John M. (2007). A dictionary of public health. Oxford, New York: Oxford University Press. Retrieved from http://www.oxfordreference.com.ezproxy.lib.usf.edu/view/10.1093/acref/9780195160901.001.0001/acref-9780195160901-e-147?rskey=4Xa8cA&result=1
  3. ^ Shirazi, S. F. (2012). Allopathic vs. holistic medicine.Acupuncture Today, 13(9), Retrieved from http://www.acupuncturetoday.com/mpacms/at/article.php?id=32630
  4. ^ Twin Cities Public Television. (2005). Allopathic medicine emerges as the primary western medical model. Retrieved from http://www.thenewmedicine.org/timeline/allopathy
  5. ^ Rose , N., & Abi-Rached, J. (2012). Neuro: The new brain sciences and the management of the mind. (pp. 20-20). Princeton, New Jersey: Princeton University Press.
  6. ^ John Hopkins University (n.d.). Allopathic medicine. Retrieved from http://web.jhu.edu/prepro/health/allopathic.html
  7. ^ Das, S. (2012). Debating scientific medicine: Homeopathy and allopathy in late 19th-century medical print in Bengal. Medical History, 56(4), 463-480. doi: 10.1017/mdh.2012.28
  8. ^ Saks, M. (2003). Orthodox and alternative medicine. (pp. 26-41). New York, New York: Continuum.
  9. ^ Twin Cities Public Television. (2005). Allopathic medicine emerges as the primary western medical model. Retrieved from http://www.thenewmedicine.org/timeline/allopathy
  10. ^ Macintosh, A. (1999). Understanding the differences between conventional, alternative, complementary, integrative and natural medicine. Townsend Letter, July(1999), Retrieved from http://tldp.com/medicine.htm
  11. ^ Stanzak, R. (2006). Bottom line medicine: A layman's guide to evidence-based medicine . (pp. 256-260). New York, New York: Algora Pub. Retrieved from http://eds.a.ebscohost.com.ezproxy.lib.usf.edu/eds/ebookviewer/ebook/bmxlYmtfXzE0ODMzNV9fQU41?sid=2f6e477f-4e7f-4450-a099-b875905bcc7c@sessionmgr4003&vid=1&format=EB&lpid=lp_3&rid=0
  12. ^ Stanzak, R. (2006). Bottom line medicine: A layman's guide to evidence-based medicine . (pp. 261-261). New York, New York: Algora Pub. Retrieved from http://eds.a.ebscohost.com.ezproxy.lib.usf.edu/eds/ebookviewer/ebook/bmxlYmtfXzE0ODMzNV9fQU41?sid=2f6e477f-4e7f-4450-a099-b875905bcc7c@sessionmgr4003&vid=1&format=EB&lpid=lp_3&rid=0
  13. ^ Stanzak, R. (2006). Bottom line medicine: A layman's guide to evidence-based medicine . (pp. 261-262). New York, New York: Algora Pub. Retrieved from http://eds.a.ebscohost.com.ezproxy.lib.usf.edu/eds/ebookviewer/ebook/bmxlYmtfXzE0ODMzNV9fQU41?sid=2f6e477f-4e7f-4450-a099-b875905bcc7c@sessionmgr4003&vid=1&format=EB&lpid=lp_3&rid=0
  14. ^ Shirazi, S. F. (2012). Allopathic vs. holistic medicine.Acupuncture Today, 13(9), Retrieved from http://www.acupuncturetoday.com/mpacms/at/article.php?id=32630
  15. ^ Langdon, E. J., & Wiik, F. B. (2010). Anthropology, health and illness:an introduction to the concept of culture applied to the health sciences. Rev. Latino-Am. Enfermagem, 18(3), 459-466
  16. ^ Varma, D. R. (2006). From witchcraft to allopathy uninterrupted journey of medical science. Economic and Political Weekly, 41(33), 3605-3611. Retrieved from www.jstor.org/stable/4418591
  17. ^ Das, S. (2012). Debating scientific medicine: Homeopathy and allopathy in late 19th-century medical print in Bengal. Medical History, 56(4), 463-480. doi: 10.1017/mdh.2012.28
  18. ^ Langdon, E. J., & Wiik, F. B. (2010). Anthropology, health and illness:an introduction to the concept of culture applied to the health sciences. Rev. Latino-Am. Enfermagem, 18(3), 459-466
  19. ^ Varma, D. R. (2006). From witchcraft to allopathy uninterrupted journey of medical science. Economic and Political Weekly, 41(33), 3605-3611. Retrieved from www.jstor.org/stable/4418591