By X. Oelk. Trevecca Nazarene University.

For instance generic 25 mg lamictal with visa, Hanna said cheap 100mg lamictal with visa, “I didn’t really take [alternative therapies] too seriously until I had an injury 50mg lamictal with mastercard, a car accident,” and Simon told me, “I was quite into athletics. According to Lucy, “I had all the problems of chronic fatigue syndrome plus I had gained fifty pounds, but the medical field, their answer was ‘Well, your liver is damaged, yes, but you can survive quite nicely. For Natalie the significant event was the breakdown of her marriage: “I was in such a rut, my marriage was going downhill and I couldn’t pull out of it. And there were such negative vibes in my home that I decided that the only way that I could pull out of it was to get positive vibes in my mind. By the time the second week of January rolled by I said to somebody: ‘I feel like I’ve lived a whole year already. Scott’s personal crisis involved the break-up of his family and the end of an intimate partnership: “That time that I was getting into [alternative therapies] was also the time of my family really disintegrating, and I was feeling really suicidal, and actually becoming suicidal. This was made plain to me when I found that explanations reported in the literature as to why people seek out alternative forms of healing were not significant factors in motivating those I spoke with to first use these therapies. As I have demonstrated, concept- ualizing people’s initial motivation to use alternative therapies in push/pull terms is problematic. For instance, all but two informants were not pulled towards alternative approaches to health care. They were not shopping for an ideology10 when they first sought out alternative therapies. Holism and control, both aspects of their alternative ideology of health, were beliefs they came to value and espouse after they began participating in alternative health care. They were things they learned through interaction with alternative practitioners and other users of alternative approaches to health and healing, making them a product of, rather than motivator for, their use of these therapies (Deierlein 1994). Thus, ideological factors are better employed in explaining why people continue to use alternative therapies. Furthermore, the argument that people are pushed towards alternative therapies as a result of dissatisfaction with allopathic medicine does not sufficiently explain why people turn to alternative therapies. While those Why People Turn to Alternative Therapies | 51 who participated in this research did associate disillusionment with allopathic medicine with their initial forays into alternative health care, none had wholly rejected allopathic medicine in favour alternative therapies. And as Sharma (1992:77) rightly points out, dissatisfaction with allopathic medicine can not fully explain an individual’s decision to turn to alternative therapies, as discontent with Western medicine is “by no means confined to users of complementary medicine. In this case they found an alternative solution in alternative approaches to health and healing. THE WIDER SOCIO-CULTURAL CONTEXT I have argued that these informants’ initial use of alternative therapies is an instance of problem-solving reflective of generic social processes. But in what social context does this generic process of problem-solving take place? Or more precisely, is the choice of alternative therapy as a solution to problems of ill health reflective of larger socio-cultural change whereby alternative solutions constitute a new option in health-seeking behaviour? In addressing this issue, authors have explained lay participation in alternative therapies by placing it within the context of larger socio-cultural changes in beliefs about health, illness, and the body, which include the following: disillusionment with medical science; lay demands for a larger share of control over health and healing; and a belief in holistic health care, where “health is more than a lack of disease... However, when the frame of analysis is one of the problem-solving actions of individuals, the image which emerges is one of consistency rather than change. To illustrate, the ideological components of the alternative model of health espoused by these people are not new in any objective sense. Culturally speaking, these ideas about health and healing were always there (Archer 1988). For example, elements of these informants’ notion of holism harkens back to Galen and the four humours school (Ziegler 1982). Accordingly, it is not that the elements of the ideology are necessarily new; rather, it is that these beliefs 52 | Using Alternative Therapies: A Qualitative Analysis have now been taken up by these informants in order to articulate a model of health care they perceive as alternative therapy. These ideological components are cultural symbols, ultimately subjective in nature (Cohen 1985:15). Moreover, there has always been a plurality of healing options available to the individual (O’Connor 1995). For instance, in the 1663 volume of the diary of Samuel Pepys, we read of his attempts to solve his health problems by choosing between remedies offered by the apothecaries and those advo- cated by the doctors of physique (Latham and Mathews 1995). Likewise, Connor (1997:59) points out that it was only in the latter part of the nineteenth century that healing options were seen to narrow for Canadians: In addition to those practitioners who would be recognized as physicians by today’s criteria … there existed a smaller group of other medical practitioners... The same phenomenon is evident in the British context, where “the evolving boundaries between orthodox and unorthodox medical knowledge... More to the point, the boundaries that emerged did not eradicate all forms of health care other than allopathic medicine; rather, they remained within the health care system (Bakx 1991), their ideological underpinnings part of the symbolic framework of “ideas which at any given time have holders,” ready to be used by people in their efforts to solve health problems (Archer 1988:xix).

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Having engaged himself in an honourable and Improvement in this last Age than Physick purchase 200 mg lamictal amex, so no part useful Calling purchase 200mg lamictal with visa, he faithfully pursued the Designs of it 100 mg lamictal with visa, of that has been more tempting, or more successfully as one who remembered the account he must give to pursued than Anatomy. The Dissections of many pre- the Maker of those Bodies he had undertaken the care ceding Ages turn’d to a small account; so that many of of, and truly Watched for their Lives. He took a great the most admirable Contrivances of Nature and of the deal of Pains to improve himself in that Knowledge greatest Wonders in the lesser World, were inobserv’d; which was necessary to qualify him for a laudable till the Curiosity of some ingenious Men, animated discharge of so great a Trust.... His Countenance with the hopes of some new Discoveries, put them upon was grave and serious, without any lines of Sorrowness farther Enquiries; in which their Industry and Felicity or Affectation; his Speech was soft and obliging, carried them so far, that the Existence of some parts without any Air of conceit or Flattery; his Behaviour before unknown, the Nature, Structure and Use of gentile and courteous, without any Appearance of Art others, began to appear. Observations of our Age about some of the Parts have been very accurate, we have been only coasting about Dr. Luke and said that others; particularly about the internal Fabrick, and “he was not only esteemed by his Patients for his some other things of the Bones our Searchers have been great abilities and care and diligence, but exceed- careless, our Notice slight and transient: not but that ingly beloved too for his amiable Temper, his they deserve our strictest Enquiry and serious Remarks; obliging Tenderness and his most winning and for I do not see but the Almighty Architect has equally excellent Virtues. And how curious the Hand of his ingenious theory that the “porosity” decreased Heaven has been in the Framing and Ordering of this from the cavity towards the outside of the bone Timber-work of our Bodies, may perhaps appear a little because the amount of lubricating medullary oil from this Discourse. It seems very likely that Anthony van The particular concern of the present paper is to Leeuwenhoek, the pioneer microscopist, had give the original description of the “canals,” already observed these “canals” in bone, for in his which is to be found on page 43 of the English letter published in the Philosophical Transactions editions and on page 47 of the Latin edition pub- of the Royal Society on September 21, 1674, he lished in Amsterdam in 1731: makes the following statement: “I have several times endeavoured to observe the parts of a Bone, In the Bones, thro’ and between the Plates, are formed and at first I imagin’d, I saw on the surface of the Pores, besides those which are made for the Passage of Shinbone of a Cow several small veins (which the Blood-Vessels, which are of two sorts; some pene- bone I still keep by me); but I have not found trate the Laminae, and are transverse, looking from the it since in any other bone”... And that I may not be thought to pretend makes no other comment on this observation and to the discovery of what no other mens Eyes can so it must remain doubtful whether the structures discern, because they are generally very difficult to be he saw were actually those that later became observ’d, unless it be the transverse Pores in the inter- nal Lamell, I have the pieces of two Bones, which I known as Haversian canals. Havers was no copyist and he rightly not arranged in any kind of pattern, but have a named his work as Osteologia nova. That his “seeming irregularity,” which tends to preserve canals contained blood vessels and not merely the necessary strength of the bone tissue. The lon- medullary oil as he contended and that they had gitudinal pores are more difficult to see, but are probably been known previously to Leeuwenhoek best observed in the ribs. Havers assumed that the does not detract from the merits or the originality use of these pores was solely for the diffusion of of his observations at a time when the dissemina- the “Medullary Oil” for, he says: “About these tion of scientific knowledge was of necessity passages I was particularly strict in my enquiry, restricted. Nor must we minimize the importance whether they were not formed for Blood-Vessels, of his discovery of the penetrating periosteal tending either to or from the Marrow: and fibers afterwards known as Sharpey’s fibers although some of the Medullary Veins have Pores, (1848). These fibers he describes as “fibrillae or by which they penetrate into the substance of the threads,” and that he appears at times to regard Bone, yet I made my self certain, that these Pores, them as being nervous in function is probably due for the generality of them which I examined, had more to his usage of the term “nerve” in its orig- no Vessels which passed into them. That Portal13 course, Havers has since proved to be wrong, for 133 Who’s Who in Orthopedics should rather grudgingly recognize the originality Butler L (1741) The Character of Clopton Havers, of Havers and that he should stress his incomplete M. Memorials and Characters, acquaintance with contemporary literature must Together with Lives of Divers Eminent and Worthy Persons, 279. London not be taken in disparagement of the work of a Dictionnaire des Sciences Mi’dicales (1822) Biogra- man who, while in the active practice of his pro- phie Medicale 5:102. Paris, CLF Panckoucke fession, produced a work that breathed a new Eloy NFJ (1778) Dictionnaire historique de la Medec- spirit of experiment and speculation into the study ine 2:460. London Leewenhoek AVan (1674) Microscopical Observations about Blood, Milk, Bones, the Brain, Spitle, Cutic- ula. Philosophical Transactions 9:121 References Munk W (1878) The Roll of the Royal College of Physicians of London, 2nd edn, 1:477. London, Pub- Anon (1693) An Account of a Book, Osteologia nova, lished by the College or some Observations of the Bones, etc. London, read at their meetings, by the learned and accurate Harleian Society Author, Clopton Havers, M. Philosophical Trans- Payne JF (1885) Dictionary of National Biography actions, No 194:544 25:182 Anon (1898) Archaeologica medica. Edin- Urban & Schwarzenberg burgh, Archibald Constable and Company Butler L (1702) A Sermon Preach’d at the Funeral Young S (1890) Annals of the Barber–Surgeons 373. Furthermore, he was vitally interested and took a very active part in the organization of graduate training at this institution under the auspices of the Graduate School, Uni- versity of Minnesota, and was actively interested in the early development of the American Board of Orthopedic Surgery. Henderson contributed much to the growing specialty of orthopedic surgery. His outstanding efforts were in the treatment of fractures, particularly bone-grafting procedures for ununited fractures and for fractures of the neck of the femur. He also developed an opera- tion for the treatment of recurrent dislocation of the shoulder, which became widely recognized. He wrote many papers on internal derangements of the knee joint and other orthopedic subjects. His work and interest in the development of Melvin Starkey HENDERSON modern orthopedic surgery can be best illustrated by pointing out the various important posts he 1883–1954 held in orthopedic societies. He received his early President of the Clinical Orthopedic Society in schooling in St.

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Furthermore an official government survey of general practice patients in 1998 revealed a high level of satisfaction with the service cheap lamictal 100mg amex, most notably in the sphere of doctor patient communication: 94 per cent of respondents said that their GP was very or fairly easy to understand; 87 per cent said that all generic lamictal 100mg with visa, or almost all buy lamictal 200 mg fast delivery, of the time they were given enough information about their treatment (DoH 1998b). The greatly exaggerated perception (among doctors) of their loss of prestige reflects the underlying force driving this process forward: the crisis of confidence of the medical profession itself. In invoking public demand for tighter regulation, the leaders of the medical profession have projected their own insecurities into society. To the extent that there is popular support for measures such as revalidation, it has largely been fostered by leading medical figures, such as GMC president Donald Irvine, in their responses to scandals such as Bristol and the Shipman case. The danger of the revalidation proposals is that they will exacerbate the medical profession’s loss of confidence rather than alleviating it. The problem is not merely that the drive towards revalidation will lead to the creation of scapegoats and a spate of early retirements, though it undoubtedly will. There is an even more serious danger that it will degrade the profession as a whole and do further damage to the relationship between doctor and patient. This statement followed a series of incidents in which environmental protestors had destroyed experimental GM projects and a media campaign for a ban on further developments. The BMA demanded that ‘the precautionary principle should be applied in developing modified crops or foodstuffs, as we cannot at present know whether there are any serious risks to the environment or to human health involved in producing GM crops or consuming GM food products’. The government, squeezed between a recognition of the substantial economic potential of GM products and mounting public anxieties, tried to hold the line. In May the government’s Chief Scientist (Robert May) and Chief Medical Officer (Liam Donaldson) issued a joint statement reassuring the public that there was ‘no current evidence to suggest that the process of genetic modification is inherently harmful’. In early 2000, however, the government crumbled and announced even tighter restrictions on the development of GM foodstuffs. In his classic text, The Mirage of Health, published forty years before the GM controversy, Rene Dubos noted the widespread conviction that maintaining the scientific status quo would safeguard humanity against new threats: ‘It is often suggested that a moratorium on science would give mankind the opportunity to search its soul and discover a solution to the problems that threaten its very survival’ (Dubos 1960:214). He commented that ‘this static formula of survival’ was ‘not new’: ‘indeed it has been used with much biological success by social insects’. Through a highly stratified and efficient mode of organisation, colonies of ants and termites had solved many of 155 CONCLUSION the problems which were the subject of endless discussions and conflicts in human societies. In a similar way, the ‘arrested societies’ of isolated aboriginal groups, which ‘resembled in some respects the societies of bees and ants’, confirmed the possibility of achieving a stable equilibrium with their environment—and ‘an acceptable degree of physical health and happiness’. However, though this stability may have allowed these societies to avoid the problems of adapting to change, it was also ‘incompatible with the growth of their civilisations, indeed, with the very growth of man’ (Dubos 1960:215). The approval of a moratorium on the development of GM food because of possible dangers to health, by prestigious bodies of the medical profession and the scientfic community as well as by the government, is a reflection of the fatalistic outlook of contemporary society. In the current climate, every scientific advance, from test-tube babies to key-hole surgery, provokes more anxiety at the possible adverse consequences than celebration of the potential benefits. Fears about the dangers of science are part of a wider pessimism about the prospects for the advance of humanity through active intervention in nature or in society (Gillott, Kumar 1995). Though the rising influence of environmentalism has not yet led to the promotion of insect colonies as a model for human society, the popular cult of the primitive (as reflected, for example, in the affinity of contemporary environmentalists for the tribal peoples of the rainforests) indicates the scale of disillusionment with achievements of civilisation (Bookchin 1995). Given the impracti-cability of a return to an idealised aboriginal state, this outlook is expressed in demands to call a halt to further attempts at human advance, whether through scientific or social initiatives. In a society of lowered horizons and diminished expectations, security and safety have become the highest values and the goal of preserving health has become the zenith of human aspirations. The idea that to safeguard health it is necessary to restrain, if not stop, scientific advance appears to be in stark contrast to the widely quoted utopian concept of health adopted by the World Health Organisation at its founding conference in 1946: ‘Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity’ (MacKenzie 1946) Yet, as Dubos observed, dreams of an imaginary past and utopian visions of the future share a common theme: ‘different as they appear to be, both imply a static view of the world which is 156 CONCLUSION incompatible with reality, for the human condition has always been to move on’ (Dubos 1960:208). It is striking that, after its adoption in that brief period of hope for the future between the end of the Second World War in 1945 and the onset of the Cold War in 1947, the WHO’s definition of health disappeared from public view until it was rediscovered in the 1970s. If, as Dubos noted, myths of a golden age provide mankind with ‘solace in times of despair and with elan during the expansive periods of history’, then we can readily identify the heady days of post-war reconstruction with the latter, and the period of increasing gloom that began with the recession of the 1970s with the former. The defect of utopian visions and static formulas is that they are out of tune with that restless quest for change which distinguishes humanity from the rest of the natural world: Life is an adventure in a world where nothing is static; where unpredictable and ill-understood events constitute dangers that must be overcome, often blindly and at great cost; where man, like the sorcerer’s apprentice, has set in motion forces that are potentially dangerous and may some day escape his control. Far from being an end in itself, health was ‘the condition best suited to reach goals that each individual formulates for himself, in a process guided by social rather than biological urges (Dubos 1960:219). Writing in more optimistic times, he recognised that the pursuit of certain human ideals and goals may have unfavourable consequences for the human species, but accepted that this was a price that must be paid for progress. As he emphasised, ‘it is man’s dignity to value certain ideals above comfort, and even above life’.

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