What is folk medicine?

Overview

At the beginning of the twentieth century in the United States, different forms
of medical care were widely patronized. In 1910, Abraham
Flexner published an influential report that advocated for
the use of medical practices based on scientific evidence; he anticipated that
folk medicine, which was presumably not evidence-based, would die out in time. A
century later, however, alternative medicine is very much alive and thriving. With
the advent of the Internet and the Web, and with the growing scope of immigration
and travel, alternative medical practices from a wide range of cultures have been
introduced in the United States. Furthermore, the number of rigorous clinical
studies comparing the efficacy of alternative medical practices with conventional
medicine continues to increase.

Besides treating a specific disease, many types of folk medicine aim to treat and promote well-being in the whole person, including a person’s physical, emotional, mental, and spiritual aspects. Some practices evoke the occult and witchcraft and aim to remove or neutralize evil spirits to cure physical ailments. Other practices take into account a person’s character traits and predispositions before making a diagnosis or creating a treatment plan.

There are many types of folk medicine, but all can be roughly classified into several categories. The first category involves natural products, which are ingested, inhaled, or applied to parts of the body. Over centuries and even millennia of empirical testing, many cultures have derived combinations of natural substances such as plant and animal materials for treating disease. Plant material includes leaves, fruits, seeds, bark, stems, and roots.

Another category of folk medicine is mind/body medicine, which involves
using the power of the mind to heal the body. Yoga,
meditation, and acupuncture can be classified under
this category. A popular example of mind/body medicine is acupuncture, in which
thin metal needles are inserted through the skin at specific pressure points along
“meridians,” or pathways, on the body to clear blockages in the flow of qi
(energy). Acupressure stimulates these pressure points manually, using
the hands instead of needles.

A third category of folk medicine, manipulative and body-based practices,
encompasses therapies that address the bones and joints, soft tissues, and the
circulatory and lymphatic systems. One example is spinal manipulation, which
involves applying force to a part of the spine, causing it to move beyond its
passive range of motion. Another example is massage,
which involves rubbing and pressing muscles to stimulate blood and oxygen flow
through the muscles.

Finally, other practices, such as movement therapies and energy therapies, can
also be considered folk medicines. Energy therapies include those that exploit
electromagnetic fields for healing purposes and practices, such as
Reiki, which involve the transmission of “universal” energy
(believed to be present in every person) from the practitioner to the patient by
placing of hands on or near the patient or by transmission from a distance.

Mechanism of Action

Natural products that are used as medicines have many different modes of action. For example, fish, seeds, and oils rich in omega-3 fatty acids act by reducing the level of cholesterol in the blood, reducing inflammation, and reducing cardiac arrhythmias (irregular heartbeat). The biological effects of Asian herbal medicines range from promoting circulation and dilating blood vessels to stimulating digestion and increasing skin elasticity. Natural products, such as herbs, are used in both Asian and Hispanic traditional medical practices to restore balance between “hot” and “cold” humors or conditions. In Hispanic folk medicine, for example, hot states are associated with vasodilation and a high metabolic rate, while cold states are associated with vasoconstriction and a low metabolic rate. A hot condition would be treated with herbal therapies that are considered cold treatments; conversely, cold conditions would be treated with hot therapies. Similar principles are used in Asian folk medicine.

Mind/body medicine such as meditation, yoga, and acupuncture uses the power of
the mind to improve physical and mental health. The idea is that the mind and body
are inextricably connected and influence health as an inseparable whole.
Meditation and yoga improve health by reducing stress and increasing calmness and
relaxation, which in turn boosts the immune system and promotes physical health.
According to Chinese medical concepts, acupuncture releases qi
blockages in the body, allowing qi to flow freely, and corrects
imbalance between the yin (“cold”) and yang (“hot”) forces. Although the positive
effects of acupuncture are becoming accepted among a growing number of laypersons
and clinicians, the mechanism of action cannot be readily explained in
conventional or Western medical terms. Faith healing can also be thought of as
mind/body medicine and is thought to work through the actions of a spiritual
power.

Manipulative and body-based practices work by applying force on parts of the
body such as muscles and bone. Massage therapy soothes muscle tension
and stimulates blood and oxygen circulation in the muscles. Spinal manipulation
increases flexibility and range of motion of the spinal vertebrae. The mechanisms
of action of energy therapies such as Reiki therapy are challenging to
characterize in scientific terms.

Uses and Applications

The uses of natural products are wide-ranging. They can be used to improve blood circulation throughout the body, treat headaches, and promote weight loss; they are also used to treat arthritis, diabetes, cancer, and heart disease. Mind/body techniques such as yoga and meditation are often used to treat illnesses related to anxiety, stress, and depression. Yoga, meditation, and acupuncture can be helpful in alleviating chronic pain. Acupuncture is also used to treat a wide range of disorders, from headaches to cancer. Manipulative and body-based practices treat back, neck, and shoulder pain, as well as spinal problems. Spinal manipulation is especially useful for treating lower back pain, a common ailment.

Scientific Evidence

Many scientific studies support the use of different types of oils in treating and preventing disease. This includes the use of fish oil in reducing cardiac arrhythmias, sunflower seed oil and olive oil in reducing cholesterol in the blood, and red palm oil in protecting against ischemia-reperfusion injury, which refers to damage to the heart when blood flow is restored (reperfusion) following a period without blood flow (ischemia).

Among mind/body traditional practices, acupuncture is one of the most widely
studied. A National Institutes of Health (NIH) consensus panel reviewed
the scientific literature about acupuncture to assess its clinical efficacy and
biological effects. According to the NIH panel, scientific evidence shows that
only dental pain and nausea (related to surgery, chemotherapy, or pregnancy) have
been effectively treated by acupuncture. More scientific studies are needed to
determine if acupuncture is effective for other conditions. Several studies
sponsored by the National Center of Complementary and Alternative Medicine are
underway to explore the use of acupuncture therapy in treating high blood pressure
and advanced colorectal cancer. However, the National Cancer Institute Web site
provides a summary of studies that show the efficacy of acupuncture in boosting
immune function and in reducing some of the side effects of chemotherapy,
including nausea, weight loss, and depression. Acupuncture also appears to reduce
cancer-related fatigue.

Choosing a Practitioner

One should choose a practitioner only after carefully researching his or her training, qualifications, and experience. In some types of alternative medicine, certification by an accreditation board can help in selecting a practitioner. For example, forty-one states in the United States require acupuncturists to be certified by the National Certification Commission for Acupuncture and Oriental Medicine before they are issued a license to practice. Certification requires passing of exams in oriental medicine, acupuncture, and Western biomedicine, usually after completion of master’s-level educational programs that involve three to four years of course work and clinical experience. If candidates pass these exams, they are awarded a diplomate in acupuncture.

As with conventional health-care practitioners, certified acupuncturists must
earn sufficient continuing education credits to renew this certification every
four years. Some physicians and dentists are certified and licensed to practice
acupuncture. There are also advanced degree programs in naturopathy
and complementary medicine in the United States, focusing on holistic healing
using alternative and conventional medical practices. Several schools offer the
doctor of naturopathy (N.D.) degree, which takes four to six years to complete,
and fourteen states license N.D.’s; licensing requires successful completion of
the naturopathic licensing examination.

Safety Issues

The safety of alternative medicine depends on the practitioner and on the
nature of the therapy and the context in which the therapy is applied. In addition
to choosing a qualified, well-established practitioner, one should take care when
initiating new alternative therapies. For example, when starting a new diet
regimen or adding dietary supplements, one should be alert to possible
interactions with medications or other supplements. Also, because many supplements
are not regulated by the U.S. Food and Drug Administration and
can be purchased without a prescription, one should research possible side effects
and interactions thoroughly before adding these substances to one’s diet.

For therapies that involve body manipulation, such as massage and spinal manipulation, possible side effects from poor treatment include sore muscles and muscle and ligament injury. Acupuncture has several side effects; these are mainly associated with the needle puncture site and include the puncture of organs, nerves, or blood vessels; infection (avoidable by using safe-needle techniques); puncture site pain; bleeding; hematoma; and the so-called needle shock reaction, which manifests as excessive sweating and a feeling of faintness after needle puncture.

Bibliography

Bester, D., et al. “Cardiovascular Effects of Edible Oils: A Comparison Between Four Popular Oils.” Nutrition Research Reviews (2010): 1-15. Review article of the efficacy of fish, sunflower seed, olive, and red palm oils in treating and preventing heart disease.

Brady, E., ed. Healing Logics: Culture and Medicine in Modern Health Belief Systems. Logan: Utah State University, 2001. Overview of the traditional medical practices of various cultures.

Hadady, L. Asian Health Secrets: The Complete Guide to Asian Herbal Medicine. New York: Three Rivers Press, 1996. Comprehensive and user-friendly guide to the use of Asian herbal medicine in the diagnosis and treatment of a range of diseases.

Kirkland, H. F., et al., eds. Herbal and Magical Medicine: Traditional Healing Today. Durham, N.C.: Duke University Press, 1992. Discusses the use of traditional herbal medicines in disease treatment.

National Cancer Institute. “Acupuncture.” Available at http://www.cancer.gov/cancertopics/pdq/cam/acupuncture/healthprofessional. A summary of clinical studies examining the efficacy of acupuncture for cancer symptoms and chemotherapy-related side effects.

National Center for Complementary and Alternative Medicine. http://nccam.nih.gov. A comprehensive U.S. government resource for news articles, scientific studies, and general consumer information about complementary and alternative medicine.