Dr Caleb Parry, eminent 18th century physician of fashionable Bath
Spa, and one of the first doctors to describe thyrotoxicosis, once wrote
that 'it is more important to know what sort of patient has the disease
that what kind of disease the patient has'. Unfortunately, the patient
has rather slipped out of focus in the enthusiasm of modern orthodox
medicine for technological solutions and scientific evidence. Patients
with biological disease are frequently objectified as ill stomachs, sick
lungs or damaged kidneys, while the ever increasing multitude of people
with 'functional' illnesses that cannot be explained by a well defined
pathology and cause, often complain that doctors do not listen to them.
It is the latter who make up such a large proportion of people seeking
help from complementary medicine. CAM therapists do what doctors have so
little time to do. They try to understand the sick person and they use
techniques that relax the emotional tension that often keeps the illness
going .
We all know from experience in childhood that getting better is not
just a matter of taking the medicine, it requires time, rest, compassion,
understanding and care. Ill patients need to have faith in their carers
and treatments if they are going to get well. Despite amazing
achievements and dedicated practitioners, faith in orthodox medicine is
at an all time low. This is no doubt exacerbated by an unsustainable
caseload and a cynical media that seems intent on undermining our
institutions .
Integrated Medicine attempts to combine the best of both systems, but
it is not just about adding a bit of acupuncture to the aspirin, it is
about restoring an understanding of the patient, his or her attitudes,
beliefs, personal history and life situation, to health care. Research in
integrated medicine should not just investigate the efficacy of a
'complementary' set of instruments in the medical bag'. We need to
understand more clearly how the disharmony caused by life situations can
make people ill through, for example, long term destabilisation of the
autonomic nervous system and hypothalamo-pituitary adrenal axis , and how
relaxation, contemplation, confidence, and trust might work though
neuroendocrine and neuroimmune mechanisms to facilitate self healing.
Time is ripe for integrating the science and the humanity of health care
around an understanding of the ill person. Let's hope we can find the
time to seize the opportunity.
Nick Read, Professor.
Jack Czauderna, Family Doctor.
Centre for Integrated Medicine, Institute of General Practice and
Primary Care,
Northern General Hospital. Sheffield S5 7AU.
Rapid Response:
Integrated medicine: Finding the Time
Integrated medicine: Finding the time.
Dr Caleb Parry, eminent 18th century physician of fashionable Bath
Spa, and one of the first doctors to describe thyrotoxicosis, once wrote
that 'it is more important to know what sort of patient has the disease
that what kind of disease the patient has'. Unfortunately, the patient
has rather slipped out of focus in the enthusiasm of modern orthodox
medicine for technological solutions and scientific evidence. Patients
with biological disease are frequently objectified as ill stomachs, sick
lungs or damaged kidneys, while the ever increasing multitude of people
with 'functional' illnesses that cannot be explained by a well defined
pathology and cause, often complain that doctors do not listen to them.
It is the latter who make up such a large proportion of people seeking
help from complementary medicine. CAM therapists do what doctors have so
little time to do. They try to understand the sick person and they use
techniques that relax the emotional tension that often keeps the illness
going .
We all know from experience in childhood that getting better is not
just a matter of taking the medicine, it requires time, rest, compassion,
understanding and care. Ill patients need to have faith in their carers
and treatments if they are going to get well. Despite amazing
achievements and dedicated practitioners, faith in orthodox medicine is
at an all time low. This is no doubt exacerbated by an unsustainable
caseload and a cynical media that seems intent on undermining our
institutions .
Integrated Medicine attempts to combine the best of both systems, but
it is not just about adding a bit of acupuncture to the aspirin, it is
about restoring an understanding of the patient, his or her attitudes,
beliefs, personal history and life situation, to health care. Research in
integrated medicine should not just investigate the efficacy of a
'complementary' set of instruments in the medical bag'. We need to
understand more clearly how the disharmony caused by life situations can
make people ill through, for example, long term destabilisation of the
autonomic nervous system and hypothalamo-pituitary adrenal axis , and how
relaxation, contemplation, confidence, and trust might work though
neuroendocrine and neuroimmune mechanisms to facilitate self healing.
Time is ripe for integrating the science and the humanity of health care
around an understanding of the ill person. Let's hope we can find the
time to seize the opportunity.
Nick Read, Professor.
Jack Czauderna, Family Doctor.
Centre for Integrated Medicine, Institute of General Practice and
Primary Care,
Northern General Hospital. Sheffield S5 7AU.
E-mail: N.W.Read@sheffield.ac.uk
Competing interests: No competing interests