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Wiki 1: Historical Development



Diseases and physical ailments have always been connected with the existence of mankind. This is a social problem that mankind has been facing daily up to now. Since prehistoric or ancient times, people of all cultures and societies have developed different healing methods and technologies to find solutions to these problems. However, there have been different theories and perspectives on why people become sick, so healing practices vary by traditions based on societal beliefs and values.

Wiki 1 is intended to discuss the historical development of traditional and alternative healing (TAH) sciences and technologies, as marked by changes in how people view these medical practices or methods. We aim to study how medical paradigms shift – influenced by interacting social factors that either undermine or advance traditional and alternative medicine – and how these transitions affect society in terms of benefits and costs.


1. The Traditions of Indigenous Healing


What were the traditional medical paradigms? This section aims to identify the historical views on healing by different traditions around the world. We will attempt to briefly discuss major mindsets these “healing traditions” had, who were the practitioners and what methodologies were used.

1.1 Eastern healing traditions

Ayurveda.jpgThe earliest technologies in medicine originated in the Eastern part of the world, especially in China and India, since the earliest civilizations have also risen there. The medical practices in this region were usually passed from generation to generation through oral reception. Ayurveda (literally, the “science of life”) and the Chinese herbology called zhōngyào (or materia medica, meaning, “crude medicine”) both date back to the 1st millennium B.C.[1] These two medical systems are actually ingrained with the Eastern philosophies of Hinduism, Buddhism, Daoism and Confucianism.[2] In their philosophical discussions on the body, mind and nature, these ancient healing traditions emphasize balance and the lack of it as illness.[3] Both stress the use of herbs and vegetable drugs, like that of other ancient healing traditions such as that of the Arabic region, and are still the main component of many natural healing methods.

Sushruta_Samhitá.jpgOne important note that can be made of the Eastern healing traditions is their successes in systemizing and recording their medical practices. For example, the Sanskrit text of Sushruta Samhita (where the earliest surviving medical material Bower Manuscript is directly quoted from, dating 4th cent. A.D) identified human ailments, surgical procedures and vegetable drugs in detail. Meanwhile, the Chinese are even more specific in their medical systematization under the emperors. The first Chinese manual on pharmacology, the Shennong Bencao Jing (Shennong Emperor’s Classic of Materia Medica) lists 365 medicines of which 252 of them are herbs, dates back in the 1st century Han Dynasty. The Shennong herbal classic is by far a very organized classification of medicinal species of roots, grass, woods, furs, mushrooms, animals and stones.[4]

Aside from herbology, Eastern healing traditions also include studies of pressure points (such as in acupuncture, therapeutic massage), “force or energy centers” (such as in yoga, tai chi chuan and meditation) and dietary regulations (such as in vegetarianism) among many other techniques of healing.

More on Eastern Healing Traditions

1.2 Western healing traditions


shamanism.jpgIn these 'primitive' societies shamans and healers were the ones who govern and guide the people to their spiritual needs. Shamans developed techniques for lucid dreaming and what is today called out-of body experience. The Shamans are believed to communicate with “spirit helpers” to heal people and to divine the future.

When Europe plunged into the Dark Ages, the church in rewriting of herbals, removed such information that pertained to diseases of the spirit - possessions, demons and the like - because that was the domain of the Church and had no place in books on medicine. Thus they created a separation of the mind from the body they took the soul out of healing. But the folk medicine was continuously practiced by village healers or sometimes a wandering healer mendicant because some people could not go to a monastery to be healed by priests. This was still influenced by the magical and mystical and there were many irrational beliefs about medicine. After the Dark Ages, European practices flourished and it reached the natives in America.

The Native American culture never developed written language, so there was no documentation of Native American medicine until Europeans arrived. Native American medicine historically included many sophisticated interventions that have been lost in whole or in part, such as naturopathy, hydrotherapy, and botanical and nutritional medicine. Ceremonial and ritual medicine is the largest surviving piece of Native American medicine.An undocumented living tradition can only survive through living practitioners. As whole tribes died out, much traditional knowledge was lost. And as the number of indigenous Americans drastically decreased, so did native pride. More Native Americans took up European ways, especially the Christian religion. Fewer people took interest in keeping the traditions alive, but there is evidence that some of this decline may be reversing. Native Americans are increasingly interested in preserving their culture, and healers from other perspectives are keen to learn ancient native wisdom traditions. Elder healers view interest from outside their culture with skepticism. Although some elders feel that sharing native medicine across cultures might help preserve it, most do not trust non-native cultures to honor the integrity of the teachings.

More on Western Healing Traditions

1.3 Philippine healing traditions

For many centuries before the arrival of the Europeans who colonized the Philippines, sickness and diseases of the early inhabitants were treated through their traditional healing practices. A limitation on the study of these healing practices is the absence of documentation on the lives and culture of these people. Despite this limitation, there are researches on the different communities in the Philipines where the descendants of the early Filipinos (even before they are called Filipinos) are still living and these would show the healing practices of the yesteryears.

babaylan.jpgThe Atis of Negros, the Aetas of Zambales, the Dumagats in Rizal and Quezon and the other descendants of the Negritos in various mountainous areas of the country are still very dependent on the forest for their livelihood. They thrive on hunting, fishing, gathering of wild fruits and small-scale farming. Based on this kind of economic activities, the elements of nature dictate their way of life, their culture and their healing practices. Since they are not in control of the natural elements and they are not aware of a scientific explanation of a specific event, they usually believe in various superstitious beliefs. Thus when a person gets sick, a medicine man or a priest/priestess (called as babaylan, baylan or catalunan) is called to exorcise or appease the spirits or the anitos/bathala whom they believed have casted the disease upon a person for a wrongdoing. [5]

But science and technology had also been used by the people even before it is known to be scientific. Medicine men (which are called as herbolarios or albularyos) had been practicing healing through the use of herbs and animal body parts in various ways. The Spaniards, when they colonized the Philippines for 300 years were even amazed of the efficacy of the indigenous remedies against many diseases.

The healing traditions continued to be practiced even though the Spaniards brought medicine men from Europe. The medicine men were only for the colonizers rather than providing service to the colonized natives. Even though the Spaniards assimilated their religious beliefs to the Filipinos, they continued to tolerate the practice of the healing traditions. Maybe a factor of the tolerance is how the Filipinos accepted the tradition. Dr. Jose Rizal, the country's national hero, was even quoted as saying: “…absurd as the practice may seem in the light of reason, if this is widely accepted by the public, we must recognize that there must be some basis for it…”. [6]

Truly acceptance by the people dictates the continuity of the healing tradition in the Philippines. But with the support of the government through further scientific studies and researches, the healing tradition may just become the mainstream instead of being the alternative mode of healing.

More on Philippine Healing Traditions



2. The Advent of Modern Medicine


osler.jpgAccording to Sir William Osler, regarded by many as the Father of Modern Medicine[7] , the rise of the modern medical perspective on diseases and their cures is marked by the story of chinchona[8] :
The rise of modern medicine can be traced back to traditional healing practices as well. In 1638, the wife of the Viceroy of Peru, the Countess of Chinchon, lay sick of an intermittent fever in the Palace of Lima. A friend of her husband's, who had become acquainted with the virtues, in fever, of the bark of a certain tree, sent a parcel of it to the Viceroy, and the remedy administered by her physician, Don Juan del Vego, rapidly effected a cure. In 1640, the Countess returned to Spain, bringing with her a supply of quina bark, which thus became known in Europe as "the Countess's Powder" (pulvis Comitissæ). A little later, her doctor followed, bringing additional quantities. Later in the century, the Jesuit Fathers sent parcels of the bark to Rome, whence it was distributed to the priests of the community and used for the cure of ague; hence the name of "Jesuits' bark." Its value was early recognized by Sydenham and by Locke. At first there was a great deal of opposition, and the Protestants did not like it because of its introduction by the Jesuits. The famous quack, Robert Talbor, sold the secret of preparing quinquina to Louis XIV in 1679 for two thousand louis d'or, a pension and a title. That the profession was divided in opinion on the subject was probably due to sophistication, or to the importation of other and inert barks. It was well into the eighteenth century before its virtues were universally acknowledged. The tree itself was not described until 1738, and Linnæus established the genus "Chinchona" in honor of the Countess.
Although the beginnings of modern medicine cannot be solely attributed to that, we can see that the field of modern medicine has developed from the approval not only of certified physicians but by figures of the royalty and clergy.

Leeuwenhoek.jpgDiscoveries and inventions later developed modern methods of medical diagnosis and treatment. In 1676, bacteria and microorganisms were first observed by a microscope by Antoine van Leeuwenhoek and initiated the scientific field of microbiology. Hundred years later, microbiology aided the development of the germ theory of diseases, which proposes that microorganisms cause many diseases, and which is now a cornerstone of modern medicine. This led to such important innovations such as antibiotics and hygienic practices. [9]

Le_fanu.jpgThe rise of modern medicine is identified by a medical journalist and physician James Le Fanu in his influential book, The Rise and Fall of Modern Medicine, by ten definitive moments: the development of the drugs penicillin, cortisone, streptomycin, and chlorpromazine; surgical techniques such as open-heart surgery, kidney transplants, and in vitro fertilization; the detection of smoking as a cause of lung cancer; the cure of acute lymphoblastic leukemia; and the discovery of the infectious agent helicobacter as a cause of peptic ulcers. [10]

In the history of medicine, he points out that it is now almost impossible to imagine life in 1945, when death in childhood from polio and whooping cough were commonplace, there were no drugs for tuberculosis, schizophrenia or rheumatoid arthritis, or indeed for virtually every disease the doctor encountered. He describes developments that brought immeasurable benefits, including greater freedom from the fear of illness and untimely death, and the amelioration of the chronic disabilities of ageing. The themes are the decline in infectious disease, the widening scope of surgery, key developments in the treatment of cancer, mental illness, heart disease and infertility, and improvements in diagnostic techniques.[11]

2.1 Social factors
In our studies we have realized that with its rise, modern medicine has indeed pushed backed traditional healing practices, due to the massive and ever-growing scientific knowledge that back modern medical practices. Gradually, the paradigm shifted. Modern medicine became the mainstream, and other medicinal practices like herbalism became part of folklore and often seen as ineffective and dangerous.[12] Some traditional healing techniques have been labeled "quackery".

The popularization of, or the accepting public perception towards, modern medicine as conventional approach for healing or treating can be attributed to the structure of the Western educational system and also the growth of capitalism and globalization as the world's major economic mechanism. Universities were forming joint ventures with the [pharmaceutical] industry despite concern that the disinterested search for truth by scientists was being compromised; medical schools in particular were teaming up with pharmaceutical and biomedical companies. [13] With the spread of modern medical technologies, paired with medical education and health care facilities in both developed and developing nations, populations around the world have started to accept modern medicine as the standard. Even the majority of tea-growing tribes (like Oraon and Baraik) in India have started to consult modern medical practitioners first before going to their traditional medicine men. [14]
TCM_Beijing.jpg

On the other hand, we see a different case for China. The Communist rule maintained the role of traditional Chinese medicine in their society because mainly of political reasons (as in the Cultural Revolutio n of Mao Ze Dong) that closed their doors to anything Western. This larg ely contributes to the success of traditional Chinese medicine as to w hy it was not pushed back by modern medicine. Over the years though , as China opens up to the world and has even become open to capitalism, we see a gradual increase in the use of Western medical methods, like cosmetic surgery. However, much of the Chinese population still rely on their healing traditions.

The popularization of modern medicine may be largely attributed to the acceptance and approval of the scientific community over hundreds of years, but in the turn of the current century may have been influenced by health care industries especially those involving pharmaceuticals. Drug companies are said to fund medical schools, and spend a lot of money on advertising. In a nutshell, modern society has become dependent on capitalist systems and media and often find itself in a status quo educational system, therefore the spread of modern medicine has become the convention and even called “traditional” relative to this point in the history of healing.

2.2 Benefits and costs

Modern medical knowledge has made obsolete and in some cases illegal, unethical and dangerous many traditional healing methods.[15] The most obvious benefits are longer life spans, more sanitary and effective practices of cleaning wounds or preventing infections, better diagnosis and treatment, to name a generic few. With the rich database of diseases, their symptoms and their cures, today's society can find quick and easy cures in the form of tablets and pills over the counter.
On the other hand, modern medicine has bred its own dilemma – the easy problems have been solved and those that remain are not finding easy or ethical solutions. [16] This then becomes a major question in terms of societal values toward modern medicine: How do we measure costs and benefits of today’s health care?

prescription_drugs1.jpgHealth care costs have been rising for several years. Expenditures in the United States on health care surpassed $2.2 trillion in 2007, more than three times the $714 billion spent in 1990, and over eight times the $253 billion spent in 1980. Stemming this growth has become a major policy priority, as the government, employers, and consumers increasingly struggle to keep up with health care costs. [17]

In 2007, U.S. health care spending was about $7,421 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries. Total health care expenditures grew at an annual rate of 6.1 percent in 2007, a slower rate than recent years, yet still outpacing inflation and the growth in national income. Absent reform, there is general agreement that health costs are likely to continue to rise in the foreseeable future. [18]

Spending on prescription drugs and new medical technologies has been cited as the primary contributor to the increase in overall health spending. Some analysts state that the availability of more expensive, state-of-the-art drugs and technological services fuels health care spending not only because the development costs of these products must be recouped by industry but also because they generate consumer demand for more intense, costly services even if they are not necessarily cost-effective. [19]
In summary, conventional medicine has become the most convenient approach to health care due to the support of the scientific community and corporate endeavors of pharmaceutical and biomedical companies guided by the principles of capitalist competition. This widened and quickly spread modern healing technologies. Eventually, though, the financial toll of these technologies became more and more apparent because of economic crises. This "tipping point" makes us people look at not only the medical profession and education, but also at the capitalization of science and technology.

3. The Resurgence of Traditional Medicine



The modern conventional medicine quickly gained public acceptance because it is backed up by the so-called scienTCM_in_modern_times.jpgtific method. But because of the overwhelming costs of conventional medicine, people especially in the developing countries have reverted back to the use of traditional medicine. Others have also found modern medicine not working for them, so they also reverted to the traditional way of healing. Thus, most traditional healing methods are now called “alternative” medicine, because they no longer fall under the realm of the modern conventional medicine.

Traditional medicine was also labeled “complementary” especially in the Western world, since people who were using it saw traditional medicine not as an alternative to modern conventional medicine, but as a complement to modern medicine.

3.1 Social factors

Surveys made on different countries indicate the wide use of Traditional and Alternative all over the world. So the wide and increasing acceptance of traditional medicine has pushed governments to respond in this growing need.


external image p059.jpg
-Chart taken from the website of the World Health Organization. [20]

Therefore many government institutions in the developing countries in Africa and Asia found the necessity of traditional medicine. So instead discouraging its use, they have formulated national policies to make the use of traditional medicine legal.

Taken verbatim from an article of the World Health Organization:[21]
More and more governments from countries and areas within the Region [WHO’s Western Pacific Region] have shown a willingness to promote the proper use of traditional medicine and bring it into the formal health service system…There are now 14 countries and areas in the Region that have developed official government documents which recognize traditional medicine and its practice. This is in contrast to a few years ago, when only four countries (China, Japan, the Republic of Korea and Viet Nam) officially recognized the role of traditional medicine in formal health care systems.

tcm_school.jpgSchools and universities, in Australia, China, Japan, and many others, have also begun offering degree courses on traditional and alternative medicine.

There are also the Non-Government organizations (NGOs) who are advocates of traditional medicine.

In Germany, practitioners of alternative medicine (e.g.osteopaths, chiropractors, rejuvenators, naturopaths, acupuncturists, herbalists) have their own share of patients are recognized by the state. They have their own societies, meeting places and conventions. These practitioners apply modern technology in their therapies and some are even using plants not mentioned in regular textbooks of pharmacology. [22]

The World Health Organization on the other hand, has also seen the importance of the use and promising potential of traditional medicine especially in the developing countries, therefore it has also formulated policies, which aims to support traditional medicine and ensure its safe and effective use. [23]

With these developments, awareness, particularly in developed or urbanized places, about alternative medicine has been improved thus has become more popular and commercialized. These developments aside from the prevalent factors such as financial difficulties and accounts of success (historical and at present) have now improved confidence in TAH as it has now it's own formal methods of proving efficacy.

Dr_Colbert.jpgThe series of booklets called "The bible Cure" by Don Colbert M.D. is a very good example of how conventional medical doctors now are teaching people how to live, eat properly including taking a good doze of vitamins and minerals alongside with conventional modern medicine. According to Dr. Victoriano Y. Lim,M.D., in his book "Introduction to CAM", biological based treatments, taking supplements and dietary treatments for healing or wellness are categorized as CAM. [24]

Furthermore, the increasing number of health oriented books, television shows, the emphasis in healthy food preparation in cook books including magazines that encourage living and eating properly in order to stay fit are additional factors in the resurgence of TAH/CAM.

3.2 Benefits and costsSC_wo_degrees.jpg

The problem why even though Traditional and Alternative Medicine is gaining popularity, it has not entered mainstream is because of the lack of scientific research to back it up. Some, if not most of Traditional and Alternative medicine are still based on its cultural tradition, so some modern scientists and allopathic doctors still discourage its use.

In an article of the World Health Organization, it states that: [25]
Traditional medicine continues to play an important role in health care. In many parts of the world, it is the preferred form of health care. Elsewhere, use of herbal medicines and so-called complementary and alternative therapies is increasing dramatically. There is no single determinant of popularity. But cultural acceptability of traditional practices, along with perceptions of affordability, safety and efficacy, and questioning of the approaches of allopathic medicine, all play a role. In view of this broad appeal, the general lack of research on the safety and efficacy of traditional medicines is therefore of great concern.
International, national and nongovernmental agencies continue to make great efforts to ensure that safe, effective and affordable treatments for a wide range of diseases are available where they are most needed. WHO estimates, however, that one-third of the world’s population still lacks regular access to essential drugs, with the figure rising to over 50% in the poorest parts of Africa and Asia. Fortunately, in many developing countries, traditional medicine offers a major and accessible source of health care. Use of traditional medicine in primary health care, however, especially in the treatment of deadly diseases, is cause for concern. An evidence-base supporting its safe and efficacious use has yet to be developed

4. Analysis, Conclusions and Recommendations


In our research, we found out that although traditional and alternative medicine is gaining popularity, it will never be able to enter mainstream by itself. It cannot really overpower the medical achievements of conventional medicine. There are still many diseases that can be cured by the use of conventional medicine, with which traditional and alternative healing methods cannot surpass.

Therefore we concluded that if traditional medicine would enter mainstream, it would not be by itself but would go side by side with modern conventional medicine.

4.1 The Future of Traditional and Alternative Healing

Integrative_Med.jpgIs there another paradigm shift coming?

In the rising popularity of traditional and alternative healing methods, some researchers have concluded that traditional medicine might become part of mainstream medicine and will co-exist side by side with conventional medicine. Experts call this “integrative” medicine.
In an online article of the National Center for Biotechnology Information:[26]

The use of alternative/complementary medicine has been increasing considerably. Conventional medicine must begin to address issues related to the use, safety, regulation, research and education of alternative/complementary medicine. Integrative medicine combines conventional medicine and alternative complementary practices. Integrative medicine is an innovative approach to medicine and medical education. It involves the understanding of the interaction of the mind, body and spirit and how to interpret this relationship in the dynamics of health and disease. Integrative medicine shifts the orientation of the medical practice from disease based approach to a healing based approach. It does not reject conventional medicine nor uncritically accepts unconventional practices. Integrative medicine is an effective, more fulfilling human approach to medicine based on the benefit of the patient by following good medicine practices in a scientific manner.
dean_ornish.jpgIn a recent interview by Dr. Dean Ornish with Dr. Ralph Snyderman of the National Academy of Sciences, Dr. Snyderman further explains the meaning of integrative medicine and why it is beneficial to the health care systems we have on today. It is very surprising for Dr. Snyderman to speak of integrative medicine, since the National Academy of Sciences, which is one of the foremost and prestigious of organizations in the U.S. and around the world, is known to be skeptical of anything that cannot be explained by standard scientific reasoning.
Here's an excerpt from the said interview: [27]
What is the difference between integrative medicine and complementary or alternative medicine? How would you respond to people like Arnold Relman, the former editor-in-chief of the New England Journal of Medicine, who said, “There’s no such thing as alternative medicine; there’s medicine that works and medicine that doesn’t work.”
Yes, but where I have difficulties in my own mind is the difference between something being scientifically proven and being intuitively obvious. For example, the issue of caring and compassion–does that need to be scientifically proven? When an individual is dealing with a very difficult problem and if we’re thinking about their health approach during that problem–the importance of maintaining will, motivation, empowerment–and the encouragement one could get from support groups or from mindfulness meditation, or from participating in yoga or from receiving acupuncture if the belief is that acupuncture may be helping with the particular problem–is that CAM or is that conventional, or is it common sense? Is it necessary to prove everything if the therapy itself causes no harm but allows the individual to feel empowered and motivated? Integrative medicine uses the entire armamentarium, both traditional and nontraditional, to give an individual a full array of what they need to maintain and improve their health. If an individual has a chronic disease such as cancer, integrative medicine may include everything that works and alleviates suffering. It recognizes that in addition to chemotherapy, the tumor is growing within a human being that is facing new fears, anxieties, and complexities in their life. What do they need to do to be able to navigate this very difficult path in which the therapies themselves might be very onerous; how do we enhance the individual’s will to be able to survive a difficult ordeal?
For more information regarding the interview, you could check on the link: Dean Ornish Interviews Dr. Ralph Snyderman.

4.2 Recommendations

Traditional healing methods have helped a lot of people in there search for alternative cures to their physical ailments. However be cautioned that although there are many traditional and healing methods that are approved by the WHO and in the Philippines, the DOH, there are as many (or even more) bogus traditional medical practitioners as there are bona fide ones. There are also a lot of "miracle" drugs that have entered the market without really having any scientific and legal basis.

Therefore WHO advises us not to approach traditional and alternative medicine with uninformed skepticism, at the same time not embrace it with uncritical enthusiasm. We should still be discriminating and not be naive when it comes to choosing the right medicine.

4.3 Reflections

Our collaboration for Wiki 1 has been a valuable learning process. As we are UP Open University students, we are well exposed to modern technologies and advancements in everyday life so being assigned to study traditional and alternative healing practices allow us to look at science, technology and society from a fresh, new perspective. The discussions we had over TAH are useful not just for our academic study but for realizing TAH's role in our own daily living, health, and belief system. This is why we wanted to share our reflections and express how this project enriched our own knowledge on TAH. Please click here for Team Maramba's Wiki 1 Reflections.

references.jpg
References

  1. ^ Girish Dwivedi, Shridhar Dwivedi (2007). History of Medicine: Sushruta – the Clinician – Teacher par Excellence. National Informatics Centre. http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf Retrieved 2008-10-08.
  2. ^ Unschuld, Paul Ulrich (1985). Medicine in China: A History of Ideas. University of California Press.
  3. ^ Wujastyk, D. (2003). The Roots of Ayurveda: Selections from Sanskrit Medical Writings. Penguin Classics.
  4. ^ Underwood, E. Ashworth & Rhodes, P. (2008) in medicine, history of. Encyclopedia Britannica 2008
  5. ^ Reed W. (1904). Negritos of Zambales. Retrieved December 25, 2009 from http://www.bohol.ph/books/nz/nz.htm#d0e2304Type your reference here.
  6. ^ Dayrit, Ocampo and Dela Cruz. History of Philippine Medicine 1899-1999
  7. ^ American College of Physicians, Osler's Bedside Library: An Introduction to the world's greatest literature for physicians. Public release OCt. 12, 2009. http://www.eurekalert.org/pub_releases/2009-10/acop-obl101209.php
  8. ^ Osler, Sir William. The Evolution of Modern Medicine, 1921.
  9. ^ Madigan, M. and Martinko, J. Brock Biology of Microorganisms. 2005.
  10. ^ Le Fanu, J. The Rise and Fall of Modern Medicine. 2000.
  11. ^ Bottomley, V. MT Bookshop. Management Today. June 2001.
  12. ^ Davis, A. B. A few words about folk medicine. http://missourifolkloresociety.truman.edu/remedy.html
  13. ^ Krimsky, S. Science in the Private Interest - Has the Lure of Profits Corrupted Biomedical Research? 2003.
  14. ^ Pfeffer, G. and Behera, D. K. Contemporary Society: Tribal Studies Vol. 2: Development issues and change. 1997.
  15. ^ Davis, A. B. A few words about folk medicine. http://missourifolkloresociety.truman.edu/remedy.html
  16. ^ Kane, R. L. Journal of Community Health. Vol. 4 No. 2. Winter 1978.
  17. ^ Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group, 2007 National Health Care Expenditures Data. March 2009.
  18. ^ Kaiser Family Foundation and Health Research and Educational Trust. Employer Health Benefits 2008 Annual Survey. September 2008.
  19. ^ Congress of the United States, Congressional Budget Office. Technological Change and the Growth of Health Care Spending. January 2008.
  20. ^ Sources: Eisenberg DM et al, 1998; Fisher P and Ward A, 1994; Health Canada, 2001; BMJ, 2002, 325.990; WHO, 1998; and government reports submitted to WHO.http://apps.who.int/medicinedocs/en/d/Js5416e/5.2.html
  21. ^ World Health Organization. The Work of WHO in the Western Pacific Region. Report of the Regional Director, 1 July 2001 – 31 June 2001. Manila, WHO Regional Office for the Western
    Pacific, 2001.
  22. ^ Dayrit, Ocampo and Dela Cruz. History of Philippine Medicine 1899-1999
  23. ^ World Health Organization (2002) WHO Traditional Medicine Strategy 2002–2005. Article retrieved January 4, 2010 from the online website of the World Health Organization. http://whqlibdoc.who.int/hq/2002/WHO_EDM_TRM_2002.1.pdf
  24. ^ Dr. Victoriano Y Lim - "Introduction to CAM"
  25. ^ World Health Organization (2002) WHO Traditional Medicine Strategy 2002–2005. Article retrieved January 7, 2010 from the online website of the World Health Organization. http://whqlibdoc.who.int/hq/2002/WHO_EDM_TRM_2002.1.pdf
  26. ^ National Center for Biotechnology Information (2010) Integrative Medicine: A paradigm Shift in medical Education and practice. Retrieved January 7, 2010 from the online website of National Center for Biotechnology Information, http://www.ncbi.nlm.nih.gov/pubmed/11293891
  27. ^ Michael Wayne. (March 3, 2009) The Coming Paradigm Shift in Health Care - Part 2. Article retrieved January 7, 2010 from lowdensitylifestyle.com, http://www.lowdensitylifestyle.com/the-coming-paradigm-shift-in-health-care-part-2/