Systems and Methods
Integrative medicine and complementary medical systems and methods
Integrative medicine is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence and experience, and makes use of all appropriate preventative and therapeutic approaches, including complementary medicine, to achieve optimal health and healing. In Switzerland there is a large number of complementary medical directions and methods, of which the four main systems practiced by physicians are officially recognized and integrated into the health care system: Traditional Chinese Medicine, Anthroposophic Medicine, Homeopathy and Phytotherapy. For physicians, conventional specialist training and the acquisition of a certificate of proficiency in one of the above mentioned complementary medicine approaches are required for reimbursement through the basic health insurance system. Here, we briefly present the complementary medicine approaches that are most frequently practiced or recommended by pediatricians in Switzerland (Huber et al. Swiss paediatrician survey on complementary medicine. Swiss Med Wkly 2019).
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Phytotherapy
Phytotherapy (herbal medicine) is the treatment with plants or plant components, which includes the use of aromatic oils (aromatherapy). It is an empirical medicine that has emerged over centuries and the boundary to home remedies is often fluid. Today, pharmacological and clinical studies increasingly provide a scientific basis for modern phytotherapy. Medical plants represent a composition of multiple components. As a result, herbal medicines often have a broad spectrum of activity with possible synergistic effects of the various components. However, herbal medicinal products can also have side effects and be toxic which must be carefully taken into account. With good to very good tolerability and a large therapeutic range, the spectrum of side effects of herbal medicinal products is however often significantly lower than with conventional medications, allowing for a good risk-benefit ratio. Low dosages are often sufficient. There are a variety of child-friendly formulations (syrup, baths, ointments, etc.), which can be helpful for compliance. In Switzerland, prescription for individual patients can be made, using extemporaneous preparations. A compilation of the child dosages of approved herbal medicinal products can be found on the website of the Swiss Medical Society for Phytotherapy (SMGP).
Swiss Medical Society for Phytotherapy – Schweizerische Medizinische Gesellschaft für Phytotherapie (SMGP) https://www.smgp.ch
Homeopathy
Homeopathy was developed by the German physician Samuel Hahnemann at the beginning of the 19th century. Its most important characteristics are the targeted drug selection with the help of the similarity rule (‘like cures like’), based on individual symptoms and personality traits of the patient, and the treatment with potentised remedies (a process of repeated dilution and shaking), according to the results of their testing in healthy individuals. After a detailed medical history and examination, an individual treatment plan is determined with the participation of the patient.
The certificate of proficiency in homeopathy is administered by the SVHA and is recognized by the Swiss Institute for postgraduate and continuous medical training.
Swiss Association of Homeopathic Doctors – Schweizerischer Verein homöopathischer Ärzte und Ärztinnen (SVHA) https://www.svha.ch/
Traditional Chinese Medicine / Acupuncture
The concepts of „Traditional Chinese Medicine (TCM)“ were developed by different scholars in China over a period of more than 2000 years. Based on its specific concepts, TCM has developed its own system of diagnosis and therapy. Pathological system deviations are understood as disharmony in the organ functional entities and therapy aims to bring them back into a physiological equilibrium. Therapy relies on the following five pillars that are related to one another through the uniform conceptual model.
1. Lifestyle counselling
2. Dietary therapy
3. Pharmacotherapy
4. Acupuncture, moxibustion
5. Qi Gong, Tai Chi, Tuina
In the Western world, acupuncture has established itself as the main method of TCM. Acupuncture is the targeted therapeutic influencing of body functions via specific points on the body surface on the basis of a TCM diagnosis. It is used in a wide variety of medical fields in prevention, therapy and rehabilitation for functional, psychosomatic and organic diseases and for painful conditions.
Pharmacotherapy is the most commonly used TCM therapy method in Asia. It is suitable for the treatment of both acute and chronic diseases. Pharmacotherapy can be combined with acupuncture and dietary therapy.
Dietary therapy of TCM studies the relationship of food to health and uses food to maintain health and treat diseases. On the basis of a TCM diagnosis, foods are used in a synergistic manner either alone or to support other TCM therapies.
Qi Gong and Tai Chi as movement therapies and Tuina, literally translated as “push and pull”, similar to a combination of Western massage and manual therapy, are among the five pillars of Chinese medicine.
Association of Swiss Medical Societies for Acupuncture and Chinese Medicine – Assoziation Schweizer Ärztegesellschaften für Akupunktur und chinesische Medizin (ASA) https://akupunktur-tcm.ch/
Swiss Medical Society for Acupuncture, Chinese Medicine and Auricular Medicine (ear acupuncture) – Schweizerische Ärztegesellschaft für Akupunktur, Chinesische Medizin und Aurikulomedizin (Ohrakupunktur) (SACAM) www.sacam.ch
Anthroposophic medicine
Anthroposophic Medicine was developed by the scientist Dr Rudolf Steiner together with the Dutch physician Dr Ita Wegman at the beginning of the 20th century. It is based on the scientific principles of conventional medicine and extends this through the holistic anthroposophic understanding of the human being. In addition to the natural science perspective, live forces, the soul and the individual spirit are also considered as formative forces. The anthroposophically expanded range of therapies includes, among other, anthroposophic medicinal products, external nursing applications and art and movement therapies. Therapies focus on self-regulation of the organism and strengthening the self-healing capacity of the individual patient, following a salutogenetic approach, i.e. targeting health-maintaining or health-restoring processes.
Association of anthroposophically orientated doctors in Switzerland – Vereinigung anthroposophisch orientierter Ärzte in der Schweiz (VAOAS) https://vaoas.ch/
Medical Section at the Goetheanum https://medsektion-goetheanum.org
Medical Hypnosis
Clinical (or medical) hypnosis is used in many cultures for therapeutic purposes and was expanded mainly through the work of the American psychiatrist Milton H. Erickson. It goes far beyond relaxation techniques and suggestion procedures. Different levels of information processing are used, whereby the patient’s own resources are involuntarily activated. Because the patient creates his or her own solutions, the effects can be profound and sustainable.
Swiss Medical Society for Hypnosis – Schweizerische Ärztegesellschaft für Hypnose (SMSH) https://www.smsh.ch/
Society for Clinical Hypnosis Switzerland – Gesellschaft für klinische Hypnose Schweiz https://www.hypnose.ch
Osteopathy
Osteopathy deals with the structures of the body and the movements that depend on them. It focuses on the interdependence between this relationship and the body’s ability to heal itself. Osteopathy includes all diagnostic and therapeutic measures aimed at improving physiological functions and restoring homeostasis in the various parts of the body that can be affected by somatic complaints. Osteopathy uses a manual approach to treat functional or somatic disorders, whereby the study of the symptoms and the clinical picture as well as the own assessment of the therapist are linked in a holistic way.
Swiss Association of Osteopaths – Schweizerischer Verband der Osteopathen https://www.fso-svo.ch/de_CH/
Craniosacral therapy
At the beginning of the 20th century, craniosacral therapy was developed by Dr William Garner Sutherland, who further developed osteopathy into “cranial osteopathy”. The name craniosacral therapy was first introduced in the 1970s by the American researcher and osteopath Dr John E Upledger. In the understanding of this therapy, the two poles of the skull and the sacrum form a unit with the membranes of the brain and the spinal cord, in which the cerebral fluid pulsates rhythmically. This rhythm (called “breath of life” by Dr Sutherland and further developed by Franklyn Sills) is transferred to the entire body and influences the development and functionality of the whole person. Changes in this system provide the necessary information for a holistic therapeutic approach of the affected anatomical and energetic structures.
Swiss Society of Craniosacral Therapy – Schweizerische Gesellschaft für Craniosacral https://www.craniosuisse.ch/
Ayurveda
Ayurvedic medicine describes three fundamental principles in nature and in humans – vata, pitta and kapha – and assigns all functions of the human body and mind to one of these areas. Balance between these principles is considered fundamental to health. Priority is given to prevention. In the Ayurvedic consultation, the physician first determines the current balance of functions as well as its disturbances in the patient, whereby the traditional pulse diagnosis plays an important role, in addition to medical history and physical examination. The patient’s life style is also recorded. The following methods are available for treatment:
- Counselling on nutrition and daily routine. This forms the basis for every Ayurvedic treatment, since according to Ayurvedic view, errors in these areas are responsible for most disturbances in the metabolic balance.
- Use of medicinal preparations of vegetable, mineral and animal origin. In Ayurveda, both single substances and complex remedies are used.
- Yoga and meditation.
- Panchakarma. This is a sophisticated system of external manual applications and internal cleaning processes that are considered an essential treatment system for normalizing disturbed metabolic processes.
Swiss Medical Society for Ayurveda – Schweizerische Ärztegesellschaft für Ayurveda (SAA) http://www.ayurveda-aerztegesellschaft.ch/