Kaptchuk T J, Eisenberg D M
Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, W/K-400, Boston, MA 02215, USA.
Ann Intern Med. 2001 Aug 7;135(3):196-204. doi: 10.7326/0003-4819-135-3-200108070-00012.
The first of two essays in this issue demonstrated that the United States has had a rich history of medical pluralism. This essay seeks to present an overview of contemporary unconventional medical practices in the United States. No clear definition of "alternative medicine" is offered because it is a residual category composed of heterogeneous healing methods. A descriptive taxonomy of contemporary unconventional healing could be more helpful. Two broad categories of unconventional medicine are described here: a more prominent, "mainstream" complementary and alternative medicine (CAM) and a more culture-bound, "parochial" unconventional medicine. The CAM component can be divided into professional groups, layperson-initiated popular health reform movements, New Age healing, alternative psychological therapies, and non-normative scientific enterprises. The parochial category can be divided into ethno-medicine, religious healing, and folk medicine. A topologic examination of U.S. health care can provide an important conceptual framework through which health care providers can understand the current situation in U.S. medical pluralism.
本期两篇文章中的第一篇表明,美国有着丰富的医学多元主义历史。本文旨在概述美国当代的非常规医疗实践。由于“替代医学”是一个由多种不同治疗方法组成的残余类别,因此未给出其明确的定义。当代非常规治疗的描述性分类法可能更有帮助。这里描述了两类宽泛的非常规医学:一类更突出、属于“主流”的补充与替代医学(CAM),另一类更受文化限制、属于“狭隘”的非常规医学。补充与替代医学部分可分为专业群体、由外行发起的大众健康改革运动、新时代疗法、替代心理疗法以及非规范科学事业。狭隘类别可分为民族医学、宗教治疗和民间医学。对美国医疗保健的拓扑学审视能够提供一个重要的概念框架,通过这个框架,医疗保健提供者可以了解美国医学多元主义的现状。