Marginal to Mainstream: Alternative Medicine in America
http://www.100md.com
《新英格兰医药杂志》
The search term "complementary and alternative medicine" (CAM) retrieves more than 40,000 titles from Amazon.com's prodigious Web site. Even the apparently more specific retrieval algorithm at Barnes & Noble's Web site provides 1532 titles. With this plethora of sources, one wonders whether anything has been left unsaid about CAM, a challenge to health care conventions that has entered the popular lexicon only in the past decade or so. A survey of this vast corpus of writings on CAM, however, shows most of it to be made up of how-to books and the unfettered ruminations of popular health gurus. A minority of books are scholarly discussions and disputations of one or more facets of CAM.
Having arrived only recently at the cybersellers' warehouses and at local shopping malls, Mary Ruggie's book, Marginal to Mainstream, manages to provide fresh perspectives from a seasoned sociologist. Currently at Harvard University and formerly the departmental chair at Columbia University, Ruggie is not an entirely detached observer of the CAM scene. She admits in her preface to having been drawn to CAM while a patient herself. However, she avoids aligning herself with or against the dramatis personae of the CAM field or the merits of their claims. Ruggie's goal is more to observe salient currents in the social transformation of American health care with the emergence of CAM than to take sides in the debate surrounding it.
A strength of the book is its trenchant analysis of the nature of CAM and the factors that drove it to the margins of organized medicine throughout most of the 20th century. Ruggie notes that CAM and conventional medicine enjoy different epistemological frameworks. Conventional medicine aspires to practices that are informed through formal scientific inquiry. In CAM, traditional wisdom and our own life experiences suffice to explain the phenomena and guide the choices of daily life. For Ruggie, the "mainstreaming" of CAM is not evidence that it and conventional medicine are relinquishing their philosophical distinctions. Rather, this trend speaks to the recognition within conventional medicine of its own limitations and that personal choices can be agents for health. It also demonstrates the acknowledgment by CAM that it can benefit from a formal appraisal; the vehicle for that appraisal is science.
Ruggie reports on the unwelcome alliance forced by the U.S. Congress on CAM and public agencies such as the National Institutes of Health (NIH) in the early 1990s. Neither the NIH nor the CAM community relished a robust research enterprise that was seen as distracting on one side and sinister on the other. Although too much of Marginal to Mainstream is a catalogue of the research centers and projects that have brought CAM into the hallowed domain of academic health centers, Ruggie is cautiously optimistic that research will not legitimize CAM so much as provide a rational basis for deciding which products and practices are sufficiently safe and effective to be mainstreamed.
Readers of this book could peruse Tovey, Easthope, and Adams's equally recent The Mainstreaming of Complementary and Alternative Medicine: Studies in Social Context (Routledge, 2004) for a more international perspective on many of the issues addressed by Ruggie. Readers could also review Cohen's Beyond Complementary Medicine: Legal and Ethical Perspectives on Health Care and Health Evolution (University of Michigan Press, 2000) for more insights into the government machinery that is abetting or restraining the movement of CAM from marginal to mainstream.
Stephen E. Straus, M.D.
National Center for Complementary and Alternative Medicine
Bethesda, MD 20892(Mary Ruggie. 232 pp. New )
Having arrived only recently at the cybersellers' warehouses and at local shopping malls, Mary Ruggie's book, Marginal to Mainstream, manages to provide fresh perspectives from a seasoned sociologist. Currently at Harvard University and formerly the departmental chair at Columbia University, Ruggie is not an entirely detached observer of the CAM scene. She admits in her preface to having been drawn to CAM while a patient herself. However, she avoids aligning herself with or against the dramatis personae of the CAM field or the merits of their claims. Ruggie's goal is more to observe salient currents in the social transformation of American health care with the emergence of CAM than to take sides in the debate surrounding it.
A strength of the book is its trenchant analysis of the nature of CAM and the factors that drove it to the margins of organized medicine throughout most of the 20th century. Ruggie notes that CAM and conventional medicine enjoy different epistemological frameworks. Conventional medicine aspires to practices that are informed through formal scientific inquiry. In CAM, traditional wisdom and our own life experiences suffice to explain the phenomena and guide the choices of daily life. For Ruggie, the "mainstreaming" of CAM is not evidence that it and conventional medicine are relinquishing their philosophical distinctions. Rather, this trend speaks to the recognition within conventional medicine of its own limitations and that personal choices can be agents for health. It also demonstrates the acknowledgment by CAM that it can benefit from a formal appraisal; the vehicle for that appraisal is science.
Ruggie reports on the unwelcome alliance forced by the U.S. Congress on CAM and public agencies such as the National Institutes of Health (NIH) in the early 1990s. Neither the NIH nor the CAM community relished a robust research enterprise that was seen as distracting on one side and sinister on the other. Although too much of Marginal to Mainstream is a catalogue of the research centers and projects that have brought CAM into the hallowed domain of academic health centers, Ruggie is cautiously optimistic that research will not legitimize CAM so much as provide a rational basis for deciding which products and practices are sufficiently safe and effective to be mainstreamed.
Readers of this book could peruse Tovey, Easthope, and Adams's equally recent The Mainstreaming of Complementary and Alternative Medicine: Studies in Social Context (Routledge, 2004) for a more international perspective on many of the issues addressed by Ruggie. Readers could also review Cohen's Beyond Complementary Medicine: Legal and Ethical Perspectives on Health Care and Health Evolution (University of Michigan Press, 2000) for more insights into the government machinery that is abetting or restraining the movement of CAM from marginal to mainstream.
Stephen E. Straus, M.D.
National Center for Complementary and Alternative Medicine
Bethesda, MD 20892(Mary Ruggie. 232 pp. New )