Holistic Medicine – A Case of Hypertension and Pain
A common buzzword among so-called non conventional or alternative medicine practitioners, and even among medical doctors, is holistic medicine. Wikipedia (link) defines holistic medicine as:
Holistic health (or holistic medicine) is a diverse field of alternative medicine in which the “whole person” is focused on, not just the malady itself.
Even if, in my opinion, the wikipedia article is biased, I believe that this is a valid definition. Of course, conventional medicine uses the basic definition as well and also tries, at least in our Department of Family and Community Medicine in UP, to live up to it. However, skeptics may wonder, if this phrase is not just some sort of marketing gimmick to pit “evil” big pharma medicine against “holistic”, “natural” or whatever medicine? (Incidentally, shouldn’t it be spelled WHOLISTIC?)
Allow me to relate a story from a patient that illustrates this point. My patient told me that he now sees a “holistic” doctor who took a look at his medications. He was given big pharma pills for hypertension, diabetes and pain. His “holistic” doctor told him to stop taking these meds and instead gave him a new regimen. Garlic was given for hypertension, bittergourd (ampalaya) for the diabetes and turmeric for pain.
Doesn’t anyone see what is weird here?
A medical student with me at the time I was talking to the patient later commented to me, saying, “How is that holistic? All he did was substitute one pill for another each for each symptom.”
Unfortunately, as I am not God and obviously not privy to the conversations had by my patient and his other doctor, I cannot base my opinion on anything more than what I was told. However, based on what I was told, I would have to agree with my student in that this may not be the textbook definition of holistic medicine.
Roots and Branches
Conversely, I would like to share an experience I had with another patient. she had come in a while back with a chief complaint of neck and shoulder pain. She also had a blood pressure reading of *gasp* 170/90. She wasn’t on any medication, and was asking me if I could treat her for that.
I had two choices then – I could treat the hypertension as a mere symptom. I could just use the typical “cookbook” points for hypertension.
Or…I could try to analyze why the patient had elevated blood pressure and treat that. In Traditional Chinese Medicine this is known as distinguishing between the branches and the root. Imagine the disease to be a shrub. In order to fully annihilate the shrub, one cannot just cut off branch after branch as they will just grow back. One must cut off the shrub at the root. However, there are times when the disease is complicated and one cannot easily treat the root because the branches block our view. In that case, we may have to trim some branches off first.
In this case it was easy. The hypertension was a branch. What was the root cause of the hypertension? In my opinion it was the pain. For the purposes of this blog entry I shan’t go into the details of the patient’s pain. Truth to be told, the pain itself is a branch of a different root. However, speaking of the hypertension, we should understand how the body reacts to pain.
What Pain Does to the Body
Pain is the body’s way of telling the mind that the body is in danger. In the early days of human history, the most common cause of pain would be injury from the elements or from animal attack. Hence, the reaction of the body would be to tighten muscles and constrict blood vessels to attempt to lessen bleeding.
Think about it, what happens when blood vessels constrict? It’s simple physics. Imagine a garden hose with water going through it. If one wants to increase the strength of water flow, one can either turn the faucet more to let more water in or use a finger to make the hole smaller. In the latter, the volume of water is the same, but since the area of the hole it must pass through is smaller, it takes greater effort to go through.
Smaller blood vessel = higher blood pressure.
Suffice it to say that after treating the neck and shoulder pain, the patient’s blood pressure was reduced to normal levels without any medical or acupuncture intervention whatsoever.
Holistic Medicine – The Big Picture
I ask then, what really is holistic medicine? Is it not simply looking at the big picture of things? The problem with many conventional physicians and even alternative practitioners is that this concept of the big picture is forgotten. Even in China, my professor lamented to me that a growing number of herbalists seemingly put formulas together by symptom and not looking at the whole formula. He told me to look at today’s prescriptions: plenty of herbs and low doses of each, as if firing a volley of arrows and hoping some hit the target. Compare this to Zhang Zhongjing’s (??- died around 220 AD) formulas – relatively fewer herbs but higher doses. That’s because Zhang Zhongjing would really try to consider the big picture and treat the whole rather than the part.
Admittedly, this is not as easy as it sounds. Any physician with a busy clinic schedule and seemingly endless lines of patients will be tempted to use methods to speed up treatment. However, one really must make the effort to try to understand patients and see the big picture. There will definitely be times when this line of thought is what will differentiate lasting treatment success from band aids on gaping wounds. Ultimately, it will also pay dividends as the patients will learn just how much their physicians care for them.