Science

THE PYRAMIDS – WHAT MAKES THEM SO UNIQUE

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THE PYRAMIDS – WHAT MAKES THEM SO UNIQUE

How were they pyramids made?   Why were they created?   What is it that makes them so unique?   This is just a brief glimpse into the world of the pyramids. There is such a plethora of information that I could fill book with.

cairo-051aA pyramid is a structure whose outer surfaces are triangular and converge to a single point at the top, making the shape roughly a pyramid in the geometric sense. The base of a pyramid can be trilateral, quadrilateral, or any polygon shape, meaning that a pyramid has at least three outer triangular surfaces (at least four faces including the base). The square pyramid, with square base and four triangular outer surfaces, is a common version.

A pyramid’s design, with the majority of the weight closer to the ground, and with the pyramidion on top means that less material higher up on the pyramid will be pushing down from above. This distribution of weight allowed early civilizations to create stable monumental structures.

Pyramids have been built by civilizations in many parts of the world. For thousands of years, the largest structures on Earth were pyramids—first the Red Pyramid in the Dashur Necropolis and then the Great Pyramid of Khufu, both of Egypt, the latter the only one of the Seven Pyramid Cultures Built TriptychsWonders of the Ancient World still remaining. Khufu’s Pyramid is built mainly of limestone (with large red granite blocks used in some interior chambers), and is considered an architectural masterpiece. It contains over 2,300,000 blocks ranging in weight from 2.5 tonnes (5,500 lb) to 15 tonnes (33,000 lb) and is built on a square base with sides measuring about 230 m (755 ft), covering 13 acres. Its four sides face the four cardinal points precisely and it has an angle of 52 degrees. The original height of the Pyramid was 146.5 m (488 ft), but today it is only 137 m (455 ft) high, the 9 m (33 ft) that is missing is due to the theft of the fine quality white Tura limestone covering, or casing stones, for construction in Cairo. It is still the tallest pyramid. The largest pyramid by volume is the Great Pyramid of Cholula, in the Mexican state of Puebla.

Ziggurat at Ur in IraqThe Mesopotamians built the earliest pyramidal structures, called ziggurats. In ancient times, these were brightly painted in gold/bronze. Since they were constructed of sun-dried mud-brick, little remains of them. Ziggurats were built by the Sumerians, Babylonians, Elamites, Akkadians, and Assyrians for local religions. Each ziggurat was part of a temple complex which included other buildings. The precursors of the ziggurat were raised platforms that date from the Ubaid period during the fourth millennium BC. The earliest ziggurats began near the end of the Early Dynastic Period. The latest Mesopotamian ziggurats date from the 6th century BC. Built in receding tiers upon a rectangular, oval, or square platform, the ziggurat was a pyramidal structure with a flat top. Sun-baked bricks made up the core of the ziggurat with facings of fired bricks on the outside. The facings were often glazed in different colors and may have had astrological significance. Kings sometimes had their names engraved on these glazed bricks. The number of tiers ranged from two to seven. It is assumed that they had shrines at the top, but there is no archaeological evidence for this and the only textual evidence is from Herodotus. Access to the shrine would have been by a series of ramps on one side of the ziggurat or by a spiral ramp from base to summit. The Mesopotamian ziggurats were not places for public worship or ceremonies. They were believed to be dwelling places for the gods and each city had its own patron god. Only priests were permitted on the ziggurat or in the rooms at its base, and it was their responsibility to care for the gods and attend to their needs. The priests were very powerful members of Sumerian society.

The most famous pyramids are the Egyptian pyramids – huge structures built of brick or stone, some of which are among the962222e7a2d84226d6e19cc8e301c838 world’s largest constructions. They are shaped as a reference to the rays of the sun. Most pyramids had a polished, highly reflective white limestone surface, in order to give them a shining appearance when viewed from a distance. The capstone was usually made of hard stone – granite or basalt – and could be plated with gold, silver, or electrum and would also be highly reflective.

The largest Egyptian pyramids are the pyramids at Giza. The Egyptian sun god Ra, considered the father of all pharaohs, was said to have created himself from a pyramid-shaped mound of earth before creating all other gods. The pyramid’s shape is thought to have symbolized the sun’s rays. The age of the pyramids reached its zenith at Giza in 2575–2150 BC. Ancient Egyptian pyramids were in most cases placed west of the river Nile because the divine pharaoh’s soul was meant to join with the sun during its descent before continuing with the sun in its eternal round.

The Great Pyramid of Giza is one of the Seven Wonders of the Ancient World. It is the only one to survive into modern times. The Ancient Egyptians covered the faces of pyramids with polished white limestone, containing great quantities of fossilized seashells. Many of the facing stones have fallen or have been removed and used for construction in Cairo.

Most pyramids are located near Cairo, with only one royal pyramid being located south of Cairo, at the Abydos temple complex. The last king to build royal pyramids was Ahmose, with later kings hiding their tombs in the hills, like in the Valley of the Kings in Luxor’s West Bank.

There are also at least two surviving pyramid-like structures still available to study, one at Hellenikon and the other at558px-Pyramide_von_Hellinikon Ligourio/Ligurio, a village near the ancient theatre Epidaurus. These buildings were not constructed in the same manner as the pyramids in Egypt. They do have inwardly sloping walls but other than those there is no obvious resemblance to Egyptian pyramids. They had large central rooms (unlike Egyptian pyramids) and the Hellenikon structure is rectangular rather than square, 12.5 by 14 metres (41 by 46 ft) which means that the sides could not have met at a point. The stone used to build these structures was limestone quarried locally and was cut to fit, not into freestanding blocks like the Great Pyramid of Giza.

There are no remains or graves in or near the structures. Instead, the rooms that the walls housed were made to be locked from the inside. This coupled with the platform roof, means that one of the functions these structures could have served was as watchtowers. Another possibility for the buildings is that they are shrines to heroes and soldiers of ancient times, but the lock on the inside makes no sense for such a purpose.

The dating of these structures has been made from the pot shards excavated from the floor and on the grounds. The latest dates available from scientific dating have been estimated around the 5th and 4th centuries. Normally this technique is used for dating pottery, but researchers have used it to try to date stone flakes from the walls of the structures. This has created some debate about whether or not these structures are actually older than Egypt, which is part of the Black Athena controversy. The basis for their use of thermoluminescence in order to date these structures is a new method of collecting samples for testing.

A number of Mesoamerican cultures also built pyramid-shaped structures.  Mesoamerican pyramids were usually stepped, with temples on top, more similar to the Mesopotamian ziggurat than the Egyptian pyramid.

Kathy Kiefer

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HOW IS PARKINSON’S DISEASE TREATED

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HOW IS PARKINSON’S DISEASE TREATED

Are there treatment options for Parkinson’s?

    Are they cost effective?

Or cost prohibitive?

Currently, there is no cure for Parkinson’s disease. Instead, therapy is directed at treating the symptoms that are most bothersome to an individual with Parkinson’s disease.  For this reason, there is no standard or “best” treatment for Parkinson’s disease that applies to every patient. Treatment approaches include medication and surgical therapy.  Other treatment approaches include general lifestyle modifications (rest and exercise), physical therapy, support groups, occupational therapy and speech therapy. In this section, you will become more familiar with the different types of medications commonly prescribed for PD, other alternative therapies, and surgical treatment options. Recent studies have implicated that a treatment is better than no treatment. In other words, medications and therapies may modify the progression of Parkinson’s disease.

Treatment for Parkinson’s Disease (PD), due to its chronic nature, requires broad-based management including patient and family education, support group services, general wellness maintenance, exercise, and nutrition. At present, there is no cure for PD, but medications or surgery can provide relief from the symptoms.   There are so many forms of therapy (or treatment) and medications for Parkinson’s, that I could make a small handbook from all the material available.   This is but a brief look to some treatments/therapies available and not meant to slight some others.

While many medications treat Parkinson’s, none actually reverse the effects of the disease or cure it. Furthermore, the gold standard treatment varies with the disease state. People with Parkinson’s therefore often must take a variety of medications to manage the disease’s symptoms. Several medications currently in development seek to better address motor fluctuations and non-motor symptoms of PD. However, none are yet on the market with specific approval to treat Parkinson’s.

The main families of drugs useful for treating motor symptoms are Levodopa (L-DOPA), dopamine agonists and MAO-B inhibitors. The most commonly used treatment approach varies depending on the disease stage. Two phases are usually distinguished: an initial phase in which the individual with PD has already developed some disability for which he needs pharmacological treatment, and a second stage in which the patient develops motor complications related to levodopa usage. Treatment in the initial state aims to attain an optimal tradeoff between good management of symptoms and side-effects resulting from enhancement of dopaminergic function. The start of L-DOPA treatment may be delayed by using other medications such as MAO-B inhibitors and dopamine agonists, in the hope of causing the onset of dyskinesia’s to be retarded. In the second stage the aim is to reduce symptoms while controlling fluctuations of the response to medication. Sudden withdrawals from medication, and overuse by some patients, also have to be controlled. When medications are not enough to control symptoms, surgical techniques such as deep brain stimulation can relieve the associated movement disorders.   L-DOPA has been the most widely used treatment for over 30 years. L-DOPA is transformed into dopamine in the dopaminergic neurons by dopa-decarboxylase. Since motor symptoms are produced by a lack of dopamine in the substantia nigra the administration of L-DOPA temporarily diminishes the motor symptomatology.

There are some indications that other drugs may be useful as treatment of motor symptoms in early and late PD, but since quality of evidence on efficacy is reduced they are not first choice treatments. In addition to motor PD is accompanied by an ample range of different symptoms. Different compounds are used to improve some of these problems.   A preliminary study indicates that taking the drug Aricept may help prevent falls in people with Parkinson’s. Donepezil boosts levels of the neurotransmitter acetylcholine, and is currently an approved therapy for the cognitive symptoms of Alzheimer’s disease. In the study, participants taking donepezil experienced falls half as often as those taking a placebo, and those who previously fell the most showed the most improvement.

Treating PD with surgery was once a common practice. But after the discovery of levodopa, surgery was restricted to only a few cases. Studies in the past few decades have led to great improvements in surgical techniques, and surgery is again being used in people with advanced PD for whom drug therapy is no longer sufficient. Less than 10% of PD sufferers qualify as suitable candidates for a surgical response. There are three different mechanisms of surgical response for PD: ablative surgery, (the irreversible burning or freezing of brain tissue), stimulation surgery or deep brain stimulation (DBS), and transplantation or restorative surgery.

Neuroablative Lesion surgery (NAS) locates and destroys, by heat, the parts of the brain that are associated with producing Parkinsonian neurological symptoms. The procedures generally involve a thalamotomy and/or pallidotomy. Because it is difficult to accurately measure the amount of tissue to be destroyed, it is not uncommon for tremors to persist through multiple courses of surgery since tissue is irreversibly damaged and removed and it is safer to test smaller areas of tissue to prevent serious complications, such as a stroke or paralysis. This method has been generally replaced by deep brain surgery.

Deep brain stimulation (DBS) is presently the most used method of surgical treatment because it does not destroy brain tissue, it is reversible, and it can be tailored to each individual at their particular stage of disease. DBS employs three hardware components: a neuro-stimulator, also called an implanted pulse generator (IPG), which generates electrical impulses used to modulate neural activity, a lead wire which directs the impulses to a number of metallic electrodes towards the tip of the lead near the stimulation target, and an extension wire that connects the lead to the IPG. The IPG, which is battery-powered and encased in titanium, is traditionally implanted under the collarbone, and is connected by the subcutaneous extension to the lead, which extends from outside the skull under the scalp down into the brain to the target of stimulation. The entire three component system is sometimes referred to as a brain pacemaker, as the system operates on many of the same principles as medical cardiac pacing.

The pre-operative targeting of proper implantation sites can be accomplished via the indirect and direct methods.

Electrophysial functional mapping (EFM), a tool utilized in both methods in order to verify the target nuclei, has come under scrutiny due to its associated risks of hemorrhages, dysarthria or tetanic contractions.   DBS is recommended to PD patients without important neuropsychiatric contraindications who suffer motor fluctuations and tremor badly controlled by medication, or to those who are intolerant to medication.   DBS is effective in suppressing symptoms of PD, especially tremor. A recent clinical study led to recommendations on identifying which Parkinson’s patients are most likely to benefit from DBS.

Muscles and nerves that control the digestive process may be affected by PD, therefore, it is common to experience constipation and gastroparesis (food remaining in the stomach for a longer period of time than normal). A balanced diet is recommended to help improve digestion. Diet should include high-fiber foods and plenty of water. Levodopa and proteins use the same transportation system in the intestine and the blood–brain barrier, competing between them for access. When taken together the consequences of such competition is a reduced effectiveness of the drug. Therefore when levodopa is introduced excessive proteins are discouraged, while in advanced stages additional intake of low-protein products such as bread or pasta is recommended for similar reasons. To minimize interaction with proteins levodopa is recommended to be taken 30 minutes before meals. At the same time, regimens for PD restrict proteins during breakfast and lunch and are usually taken at dinner.

There is partial evidence that speech or mobility problems can improve with rehabilitation although studies are scarce and of low quality. Regular physical exercise and/or therapy can be beneficial to maintain and improve mobility, flexibility, strength, gait speed, and quality of life. Exercise may also improve constipation. Exercise interventions have been shown to benefit patients with Parkinson’s disease in regards to physical functioning, health-related quality of life, balance and fall risk. In a review of 14 studies examining the effects of exercise on persons with Parkinson’s disease, no adverse events or side-effects occurred following any of the exercise interventions. There are five proposed mechanisms by which exercise enhances neuroplasticity. 1) intensive activity maximizes synaptic plasticity; 2) complex activities promote greater structural adaptation; 3) activities that are rewarding increase dopamine levels and therefore promote learning/relearning; 4) dopaminergic neurons are highly responsive to exercise and inactivity (“use it or lose it”); 5) where exercise is introduced at an early stage of the disease, progression can be slowed. Occupational therapy (OT) aims to promote health and quality of life by helping people with the disease to participate in as many activities of their daily living as possible. There have been few studies on the effectiveness of OT and their quality is poor, although there is some indication that it may improve motor skills and quality of life for the duration of the therapy.

Palliative care is often required in the final stages of the disease, often when dopaminergic treatments have become ineffective. The aim of palliative care is to achieve the maximum quality of life for the person with the disease and those surrounding him or her. Some central issues of palliative are; caring for patients at home while adequate care can be given there; reducing or withdrawing dopaminergic drug intake to reduce drug side effects and complications; preventing pressure ulcers by management of pressure areas of inactive patients; facilitating the patient’s end of life decisions for the patient as well as involved friends and relatives.

Present treatments of Parkinson disease provide satisfactory disease control for most early stages patients. However, present gold standard treatment of Parkinson disease using Levodopa, is associated with motor complications, and does not prevent disease progression. More effective and long term treatment of Parkinson disease are urgently needed to control the progression of the disease. In vivo gene therapy is a new approach for treatment of Parkinson disease. The use of somatic-cell gene transfer to alter gene expression in brain neurochemical systems is a novel alternative conventional treatment.

Gene therapy is currently under investigation. It involves the use of a non-infectious virus to shuttle a gene into a part of the brain. The gene used leads to the production of an enzyme which helps to manage PD symptoms or protects the brain from further damage.

One of the gene therapy based approach involves gene delivery of neurturin and gilial-cell-derived nuerotrophic factor (GDNF) to the putamen in patients with advanced Parkinson’s disease. GDNF protects dopamine neurons in vitro and animal models of parkinsonism; neurturin is a structural and functional analogue of GDNF that protected dopamine neuron in animal model of the disease. Despite the open-label trials have shown benefits of continuous infusion of GDNF, the results were not confirmed in double-blind studies. This may be due to the distribution factor; the trophic factor was not distributed sufficiently throughout the target place.

Investigations on neuro-protection are at the forefront of PD research. Currently, there are no proven neuro-protective agents or treatments available for Parkinson Disease. While still theoretical, neuro-protective therapy is based on the idea that certain neurons that produces dopamine and are susceptible to premature degeneration and cell death can be protected by the introduction of neuro-protective pharmaceuticals. This protection can occur before any symptoms manifest based on genetic risk, and also during early or late-stage PD when other treatments have ceased their impact due to the progression of the disease. Accordingly, neuro-protective therapy seeks to delay the introduction of levodopa.

Kathy Kiefer

Major Energy Sources on Earth

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Major Energy Sources on Earth

Since the day that man first made fire, humans have sought out the resources of the earth to power their needs. Whether it’s fuel for cooking, heating or powering, that resource is in high demand. Fortunately, the world provides a vast variety of energy sources for our consumption, though some are better for us and our surroundings than others.

Biomass – Perhaps one of the oldest forms of fuel known to civilization, biomass fuels are any kind of biological matter that people can burn in order to produce heat or energy. In the beginning, biomass consisted of woods, leaves, and grasses, but today, we rely on many more sources. For example, ethanol, an alcohol derived from plants like corn, sugar, hemp, and soy crops, is now blended with gasoline, or used to replace it in some vehicles. While considered more environmentally friendly than some alternatives, biomass still emits particulate pollution when burned.

Production of biomass and biofuels are growing industries as interest in sustainable fuel sources is growing. Utilizing waste products avoids a food vs fuel trade-off, and burning methane gas reduces greenhouse gas emissions, because even though it releases carbon dioxide, carbon dioxide is 23 times less of a greenhouse gas than is methane. Biofuels represent a sustainable partial replacement for fossil fuels, but their net impact on greenhouse gas emissions depends on the agricultural practices used to grow the plants used as feedstock to create the fuels. While it is widely believed that biofuels can be carbon-neutral, there is evidence that biofuels produced by current farming methods are substantial net carbon emitters. Geothermal and biomass are the only two renewable energy sources that require careful management to avoid local depletion.

Fossil Fuels – Fossil fuels are the most commonly used type of fuel in developed nations today. Examples include oil, natural gas, and coal, which are used to power cars, trucks, trains and the majority of power plants around the world. The popularity of fossil fuels initially stemmed from their low prices, but as demand continues to rise, supplies are dwindling and prices have skyrocketed. In addition, fossil fuels are responsible for the majority of particulate emissions today.

Solar Energy – While solar energy does not technically come from the earth, but the sun, it is still considered one of the earth’s most plentiful source of energy. Silicon compounds help to absorb the energy rich rays of the sun and the radiative heat it provides, making possible its use as functional energy for our vehicles, homes, and transportation infrastructure. This is one of the cleanest forms of energy on the planet, but low reserves of silicon, and the price of solar panel production, have rendered it an underused utility.

Hydroelectric Energy – Hydroelectric energy, also known as hydropower, relies on the movement of freshwater bodies of water to move propellers and generate energy. This is typically achieved by building dams at strategic points on rivers. While this provides consistent, clean energy, hydropower is often criticized, as the dams destroy marine habitats and interrupt the mating patterns of key species of fish. A variation of this renewable energy source uses the surface waves of the ocean to generate energy in a similar fashion.

Wind Energy – Wind energy uses giant turbines to harness the natural power of the wind to turn propellers and generate energy for general use. While people can build individual turbines and attach them to homes, this type of energy is more commonly used in flat, plain areas, with the construction of fleets of turbines that are hooked up to a generator that provides for the community. Ruled the cleanest, most environmentally friendly form of energy production, the only complaints against wind energy are that they negatively impact small populations of bats and birds and are accused of causing headaches in humans.

Geothermal Energy – This type of energy is generated by heat from the earth’s core heating water into steam, which turns turbines in order to generate electricity. Typically limited to borders of tectonic plates, new discoveries are, for the first time, allowing scientists to explore the idea of using geothermal power in other areas of the world. The energy is totally clean, although some people have concerns about the safety and reliability of building plants over fault lines. Estimates of exploitable worldwide geothermal energy resources vary considerably, depending on assumed investments in technology and exploration and guesses about geological formations. According to a recent study, it was thought that this might amount to between 65 and 138 GW of electrical generation capacity ‘using enhanced technology’. Other estimates range from 35 to 2000 GW of electrical generation capacity, with a further potential for 140 EJ/year of direct use.

OTEC – Ocean Thermal Energy Conversion (OTEC) relies on the difference in temperature between the different layers of ocean to churn a generator and produce electricity. The result of this pushes warm water to deep levels of the ocean, pushing colder water to the top. Some claim that this results in larger amounts of vegetation and healthy marine environments, whereas others argue that this creates an unnatural setting that throws off the food chain in an area.

COAL – Coal is the most abundant and burned fossil fuel. This was the fuel that launched the industrial revolution and has continued to grow in use; China, which already has many of the world’s most polluted cities, in 2007was building about two coal-fired power plants every week. Coal is the fastest growing fossil fuel and its large reserves would make it a popular candidate to meet the energy demand of the global community, short of global warming concerns and other pollutants. According to the International Energy Agency the proven reserves of coal are around 909 billion tonnes, which could sustain the current production rate for 155 years, although at a 5% growth per annum this would be reduced to 45 years, or until 2051. In the United States, 49% of electricity generation comes from burning coal.

Sustainability – Political considerations over the security of supplies, environmental concerns related to global warming and sustainability are expected to move the world’s energy consumption away from fossil fuels. The concept of peak oil shows that about half of the available petroleum resources have been produced, and predicts a decrease of production.   The antithesis of sustainability is a disregard for limits, commonly referred to as the Easter Island Effect, which is the concept of being unable to develop sustainability, resulting in the depletion of natural resources. Some estimate, assuming current consumption rates, current oil reserves could be completely depleted by the year 2050.

Nuclear fuel – Resources and technology do not constrain the capacity of nuclear power to contribute to meeting the energy demand for the 21st century. However, political and environmental concerns about nuclear safety and radioactive waste started to limit the growth of this energy supply at the end of last century, particularly due to a number of nuclear accidents. Concerns about nuclear proliferation means that the development of nuclear power by countries such as Iran and Syria is being actively discouraged by the international community.

Nuclear fusion – Fusion power is the process driving the sun and other stars. It generates large quantities of heat by fusing the nuclei of hydrogen or helium isotopes, which may be derived from seawater. The heat can theoretically be harnessed to generate electricity. The temperatures and pressures needed to sustain fusion make it a very difficult process to control. Fusion is theoretically able to supply vast quantities of energy, with relatively little pollution. Although both the United States and the European Union, along with other countries, are supporting fusion research, according to one report, inadequate research has stalled progress in fusion research for the past 20 years.

Renewable resources – Renewable resources are available each year, unlike non-renewable resources, which are eventually depleted. A simple comparison is a coal mine and a forest. While the forest could be depleted, if it is managed it represents a continuous supply of energy, vs. the coal mine, which once has been exhausted is gone. Most of earth’s available energy resources are renewable resources. Renewable resources account for more than 93 percent of total U.S. energy reserves. Annual renewable resources were multiplied times thirty years for comparison with non-renewable resources. In other words, if all non-renewable resources were uniformly exhausted in 30 years, they would only account for 7 percent of available resources each year, if all available renewable resources were developed.

Solar energy – Renewable energy sources are even larger than the traditional fossil fuels and in theory can easily supply the world’s energy needs. 89 PW of solar power falls on the planet’s surface. While it is not possible to capture all, or even most, of this energy, capturing less than 0.02% would be enough to meet the current energy needs. Barriers to further solar generation include the high price of making solar cells and reliance on weather patterns to generate electricity. Also, current solar generation does not produce electricity at night, which is a particular problem in high northern and southern latitude countries; energy demand is highest in winter, while availability of solar energy is lowest. This could be overcome by buying power from countries closer to the equator during winter months, and may also be addressed with technological developments such as the development of inexpensive energy storage. Globally, solar generation is the fastest growing source of energy, seeing an annual average growth of 35% over the past few years. Japan, Europe, China, U.S. and India are the major growing investors in solar energy.

Kathy Kiefer

COSMOLOGY

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COSMOLOGY

Cosmology is the study of the cosmos, as well as the study of the origin, evolution, and eventual fate of the universe.    All cosmologies have in common an attempt to understand the implicit order within the whole of being. In this way, most religions and philosophical systems have a cosmology.

Physical cosmology is the scholarly and scientific study of the origin, evolution, large-scale structures and dynamics, and ultimate fate of the universe, as well as the scientific laws that govern these realities.  Religious cosmology (or mythological cosmology) is a body of beliefs based on the historical, mythological, religious, and literature and traditions of creation and eschatology.

Physical cosmology is studied by scientists, such as astronomers and theoretical physicists; and academic philosophers, such as metaphysicians, philosophers of physics and philosophers of space and time.   Modern cosmology is dominated by the Big Bang theory, which attempts to bring together observational astronomy and particle physics

Although the word cosmology is recent, the study of the universe has a long history involving science, philosophy, esotericism and religion.  Related studies include cosmogony, which focuses on the origin of the Universe, and cosmography, which maps the features of the Universe. Cosmology is also connected to astronomy, but while the former is concerned with the Universe as a whole, the latter deals with individual celestial objects.

Physics and astrophysics have played a central role in shaping the understanding of the universe through scientific observation and experiment. What is known as physical cosmology has been shaped through both mathematics and observation in an analysis of the whole universe. The universe is generally understood to have begun with the Big Bang,  followed almost instantaneously by cosmic inflation; an expansion of space from which the universe is thought to have emerged  13.798 plus or minus 0.037 billion years  ago.

Metaphysical cosmology has also been described as the placing of man in the universe in relationship to all other entities. This is exemplified by the observation made by Marcus Aurelius of a man’s place in that relationship: “He who does not know what the world is does not know where he is, and he who does not know for what purpose the world exists, does not know who he is, nor what the world is.”

Physical cosmology is the branch of physics and astrophysics that deals with the study of the physical origins and evolution of the Universe. It also includes the study of the nature of the Universe on its very largest scales. In its earliest form it was what is now known as celestial mechanics, the study of the heavens.  The Greek philosophers Aristarchus of Samos, Aristotle and Ptolemy proposed different cosmological theories.  In particular, the geocentric Ptolemaic system was the accepted theory to explain the motion of the heavens until Nicolaus Copernicus, and subsequently Johannes Kepler and Galileo Galilei proposed a heliocentric system in the 16th century.   This is known as one of the most famous examples of epistemological rupture in physical cosmology.

With Isaac Newton, and the 1687 publication of Principia Mathematica, the problem of the motion of the heavens was finally solved. Newton provided a physical mechanism for Kepler’s laws and his law of universal gravitation allowed the anomalies in previous systems, caused by gravitational interaction between the planets, to be resolved. A fundamental difference between Newton’s cosmology and those preceding it was the Copernican principle that the bodies on earth obey the same physical laws as all the celestial bodies. This was a crucial philosophical advance in physical cosmology.

Modern scientific cosmology is usually considered to have begun in 1917 with Albert Einstein’s publication of his final modification of general relativity in the paper “Cosmological Considerations of the General Theory of Relativity” (although this paper was not widely available outside of Germany until the end of World War I).   General relativity prompted cosmogonists explored the astronomical consequences of the theory, which enhanced the growing ability of astronomers to study very distant objects.   Prior to this (and for some time afterwards), physicists assumed that the Universe was static and unchanging.

In parallel to this dynamic approach to cosmology, one long-standing debate about the structure of the cosmos was coming to a climax.   A Mount Wilson astronomer had championed the model of a cosmos made up of the Milky Way star system only; while there were arguments for the idea that spiral nebulae were star systems in their own right – island universes. This difference of ideas came to a climax with the organization of the Great Debate at the meeting of the (US) National Academy of Sciences in Washington in April 1920. The resolution of this debate came with the detection of novae in the Andromeda galaxy by Edwin Hubble in 1923 and 1924. Their distance established spiral nebulae well beyond the edge of the Milky Way.

Subsequent modelling of the universe explored the possibility that the cosmological constant, introduced by Einstein in his 1917 paper, may result in an expanding universe, depending on its value. Thus the Big Bang model was proposed by the Belgian priest Georges Lemaitre in 1927 which was subsequently corroborated by Edwin Hubble’s discovery of the red shift in 1929 and later by the discovery of the cosmic microwave background radiation in 1964. These findings were a first step to rule out some of many alternative physical cosmologies.

Recent observations made by the COBE and WMAP satellites observing this background radiation have effectively, in many scientists’ eyes, transformed cosmology from a highly speculative science into a predictive science, as these observations matched predictions made by a theory called Cosmic inflation, which is a modification of the standard Big Bang model. This has led many to refer to modern times as the “Golden age of cosmology”.

In March 2014 astronomers at the Harvard-Smithsonian Center for Astrophysics announced the detection of gravitational waves, providing strong evidence for inflation and the Big Bang.  However, in June 2014, lowered confidence in confirming the cosmic inflation findings was reported.

However, one should not assume that the current scientific conception of cosmology is correct. Although the general picture has remained the same since the 1920s, the specifics are often revised based on new observations and theories. Most notably in the history of cosmology, in 1964 the cosmic microwave background radiation was detected.

Modern cosmology has accumulated massive evidence, such as the cosmic microwave background radiation, that the universe began with a huge explosion known as the Big Bang. This occurred approximately 13.7 billion years ago. Starting from a singularity with zero volume and tremendous mass, the universe was born. Not only was matter ejected into space, but space itself originated with the Big Bang.   Asked on a talk show “what came before the Big Bang”, the legendary physicist Stephen Hawking responded, “What lies north of the North Pole?” indicating that the question was meaningless. However, some physicists consider it likely that our universe is a baby universe of an earlier parent universe.

Our current observable universe is estimated to be about 90 billion light-years in diameter. This is only the observable universe, however, and the entirety of the universe may be much larger, or even infinite. Most physicists working in cosmology also argue that the universe is just one among many, embedded in a larger multiverse.

We find ourselves in a universe capable of sustaining life. Physicists have performed thought experiments where the fundamental physical constants have been modified by tiny increments, and they have concluded that many of these possible sets of physical law would preclude the formation of stable planets or other requirements for life. Rather than suggesting that the universe was fine-tuned by a deity, this indicates that our universe is likely one in a huge ensemble of largely lifeless universes.

Mythological cosmology deals with the world as the totality of space, time and all phenomena. Historically, it has had quite a broad scope, and in many cases was founded in religion. The ancient Greeks did not draw a distinction between this use and their model for the cosmos. However, in modern use it addresses questions about the Universe which are beyond the scope of science. It is distinguished from religious cosmology in that it approaches these questions using philosophical methods.   Modern metaphysical cosmology tries to address questions such as:

  • What is the origin of the Universe? What is its first cause? Is its existence necessary
  • What are the ultimate material components of the Universe?
  • What is the ultimate reason for the existence of the Universe? Does the cosmos have a purpose?
  • Does the existence of consciousness have a purpose? How do we know what we know about the totality of the cosmos? Does cosmological reasoning reveal metaphysical truths?

KATHY KIEFER

 

HOMEOPATHIC REMEDIES

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HOMEOPATHIC REMEDIES

What are some homeopathic rememdies?  What are the origins?

Isopathy is a therapy derived from homeopathy invented by Johann Joseph Wilhelm Lux in the 1830s. Isopathy differs from homeopathy in general in that the remedies, known as “nosodes”, are made up either from things that cause the disease or from products of the disease, such as pus.  Many so-called “homeopathic vaccines” are a form of isopathy.

Flower remedies can be produced by placing flowers in water and exposing them to sunlight. Although the proponents of these remedies share homeopathy’s vitalist world-view and the remedies are claimed to act through the same hypothetical “vital force” as homeopathy, the method of preparation is different. Bach flower remedies are prepared in “gentler” ways such as placing flowers in bowls of sunlit water, and the remedies are not successes.    There is no convincing scientific or clinical evidence for flower remedies being effective.

The low concentration of homeopathic remedies, which often lack even a single molecule of the diluted substance, has been the basis of questions about the effects of the remedies since the 19th century. Modern advocates of homeopathy have proposed a concept of “water memory”, according to which water “remembers” the substances mixed in it, and transmits the effect of those substances when consumed. This concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to have any detectable effect, biological or otherwise.  Pharmacological research has found instead that stronger effects of an active ingredient come from higher, not lower doses.

Outside of the CAM community, scientists have long regarded homeopathy as a sham or as “supernatural quackery”.  There is an overall absence of sound statistical evidence of therapeutic efficacy, which is consistent with the lack of any biologically plausible pharmacological agent or mechanism. Abstract concepts within theoretical physics have been invoked to suggest explanations of how or why remedies might work, including quantum entanglement, the theory of relativity and chaos theory.  However, the explanations are offered by non-specialists within the field, and often include speculations that are incorrect in their application of the concepts and not supported by actual experiments.   Several of the key concepts of homeopathy conflict with fundamental concepts of physics and chemistry.   For instance, quantum entanglement is not possible as humans and other animals are far too large to be affected by quantum effects, and entanglement is a delicate state which rarely lasts longer than a fraction of a second. In addition, while entanglement may result in certain aspects of individual subatomic particles acquiring each other’s quantum states, this does not mean the particles will mirror or duplicate each other, or cause health-improving transformations.

The proposed mechanisms for homeopathy are precluded from having any effect by the laws of physics and physical chemistry.     The extreme dilutions used in homeopathic preparations often leave none of the original substance in the final product. The modern mechanism proposed by homeopaths, water memory, is considered erroneous since short-range order in water only persists for about 1 picosecond.  Existence of a pharmacological effect in the absence of any true active ingredient is inconsistent with the observed dose-response relationships characteristic of therapeutic drugs (whereas placebo effects are non-specific and unrelated to pharmacological activity). The proposed rationale for these extreme dilutions – that the water contains the “memory” or “vibration” from the diluted ingredient – is counter to the laws of chemistry and physics, such as the law of mass action. 

The extremely high dilutions in homeopathy preclude a biologically plausible mechanism of action. Homeopathic remedies are often diluted to the point where there are no molecules from the original solution left in a dose of the final remedy. Homeopaths contend that the methodical dilution of a substance, beginning with a 10% or lower solution and working downwards, with shaking after each dilution, produces a therapeutically active remedy, in contrast to therapeutically inert water. Since even the longest-lived non-covalent structures in liquid water at room temperature are stable for only a few picoseconds, critics have concluded that any effect that might have been present from the original substance can no longer exist. No evidence of stable clusters of water molecules was found when homeopathic remedies were studied using nuclear magnetic resonance.

Furthermore, since water will have been in contact with millions of different substances throughout its history, critics point out that water is therefore an extreme dilution of almost any conceivable substance. By drinking water one would, according to this interpretation, receive treatment for every imaginable condition.   For comparison, ISO 3696: 1987 defines a standard for water used in laboratory analysis; this allows for a contaminant level of ten parts per billion, 4C in homeopathic notation. This water may not be kept in glass as contaminants will leach out into the water.

Practitioners of homeopathy hold that higher dilutions — described as being of higher potency — produce stronger medicinal effects. This idea is inconsistent with the observed dose-response relationships of conventional drugs, where the effects are dependent on the concentration of the active ingredient in the body. This dose-response relationship has been confirmed in myriad experiments on organisms as diverse as nematodes, rats, and humans.

No individual preparation has been unambiguously shown by research to be different from placebo. The methodological quality of the primary research was generally low, with such problems as weaknesses in study design and reporting, small sample size, and selection bias.  Since better quality trials have become available, the evidence for efficacy of homeopathy preparations has diminished; the highest-quality trials indicate that the remedies themselves exert no intrinsic effect.

The fact that individual randomized controlled trials have given positive results is not in contradiction with an overall lack of statistical evidence of efficacy. A small proportion of randomized controlled trials inevitably provide false-positive outcomes due to the play of chance: a statistically significant positive outcome is commonly adjudicated when the probability of it being due to chance rather than a real effect is no more than 5%—a level at which about 1 in 20 tests can be expected to show a positive result in the absence of any therapeutic effect. Furthermore, trials of low methodological quality (i.e. ones which have been inappropriately designed, conducted or reported) are prone to give misleading results.

 Science offers a variety of explanations for how homeopathy may appear to cure diseases or alleviate symptoms even though the remedies themselves are inert:   The placebo effect — the intensive consultation process and expectations for the homeopathic preparations may cause the effect;  Therapeutic effect of the consultation — the care, concern, and reassurance a patient experiences when opening up to a compassionate caregiver can have a positive effect on the patient’s well-being;  Unassisted natural healing — time and the body’s ability to heal without assistance can eliminate many diseases of their own accord; Unrecognized treatments — an unrelated food, exercise, environmental agent, or treatment for a different ailment, may have occurred;  Regression toward the mean — since many diseases or conditions are cyclical, symptoms vary over time and patients tend to seek care when discomfort is greatest; they may feel better anyway but because of the timing of the visit to the homeopath they attribute improvement to the remedy taken;  Non-homeopathic treatment — patients may also receive standard medical care at the same time as homeopathic treatment, and the former is responsible for improvement;  and Cessation of unpleasant treatment — often homeopaths recommend patients stop getting medical treatment such as surgery or drugs, which can cause unpleasant side-effects; improvements are attributed to homeopathy when the actual cause is the cessation of the treatment causing side-effects in the first place, but the underlying disease remains untreated and still dangerous to the patient.

While some articles have suggested that homeopathic solutions of high dilution can have statistically significant effects on organic processes including the growth of grain, histamine release by leukocytes, and enzyme reactions such evidence is disputed since attempts to replicate them have failed.  Supposedly it was discovered that basophils, a type of white blood cells, released histamine when exposed to a homeopathic dilution of anti-immunoglobulin E antibody. The journal editors, skeptical of the results, requested that the study be replicated in a separate laboratory. Upon replication in four separate laboratories the study was published. Still skeptical of the findings, Nature assembled an independent investigative team to determine the accuracy of the research, consisting of Nature editor and physicist Sir John Maddox, American scientific fraud investigator and chemist Walter Stewart, and sceptic James Randi.  After investigating the findings and methodology of the experiment, the team found that the experiments were “statistically ill-controlled”, “interpretation has been clouded by the exclusion of measurements in conflict with the claim”, and concluded, “We believe that experimental data have been uncritically assessed and their imperfections inadequately reported.”   James Randi stated that he doubted that there had been any conscious fraud, but that the researchers had allowed “wishful thinking” to influence their interpretation of the data.  The provisions of homeopathic remedies have been described as unethical.

Patients who choose to use homeopathy rather than evidence-based medicine risk missing timely diagnosis and effective treatment of serious conditions such as cancer.

Some homeopathic remedies involve poisons such as Belladonna, arsenic, and poison ivy which are highly diluted in the homeopathic remedy, only in rare cases are the original ingredients present at detectable levels. This may be due to improper preparation or intentional low dilution. Serious adverse effects such as seizures and death have been reported or associated with some homeopathic remedies.   Instances of arsenic poisoning have occurred after use of arsenic-containing homeopathic preparations. Zicam Cold remedy Nasal Gel, which contains 2X (1:100) zinc gluconate, reportedly caused a small percentage of users to lose their sense of smell; 340 cases were settled out of court in 2006 for 12 million U.S. dollars. 

Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.

Homeopathy is a controversial topic in complementary medicine research. A number of the key concepts of homeopathy are not consistent with fundamental concepts of chemistry and physics. For example, it is not possible to explain in scientific terms how a remedy containing little or no active ingredient can have any effect. This, in turn, creates major challenges to rigorous clinical investigation of homeopathic remedies. For example, one cannot confirm that an extremely dilute remedy contains what is listed on the label, or develop objective measures that show effects of extremely dilute remedies in the human body.

On clinical grounds, patients who choose to use homeopathy in preference to normal medicine risk missing timely diagnosis and effective treatment, thereby worsening the outcomes of serious conditions.   Critics of homeopathy have cited individual cases of patients of homeopathy failing to receive proper treatment for diseases that could have been easily diagnosed and managed with conventional medicine and who have died as a result and the “marketing practice” of criticizing and downplaying the effectiveness of mainstream medicine.   Homeopaths claim that use of conventional medicines will “push the disease deeper” and cause more serious conditions, a process referred to as “suppression”.  Some homeopaths (particularly those who are non-physicians) advise their patients against immunization.  Some homeopaths suggest that vaccines be replaced with homeopathic “nosodes”, created from biological materials such as pus, diseased tissue, bacilli from sputum or (in the case of “bowel nosodes”) feces.

Homeopathy is fairly common in some countries while being uncommon in others; is highly regulated in some countries and mostly unregulated in others. It is practiced worldwide and professional qualifications and licenses are needed in most countries.   Regulations vary in Europe depending on the country. In some countries, there are no specific legal regulations concerning the use of homeopathy, while in others, licenses or degrees in conventional medicine from accredited universities are required. In Germany, to become a homeopathic physician, one must attend a three-year training program, while France, Austria and Denmark mandate licenses to diagnose any illness or dispense of any product whose purpose is to treat any illness.   Some homeopathic treatment is covered by the public health service of several European countries, including France, the United Kingdom, Denmark, and Luxembourg.   In other countries, such as Belgium, homeopathy is not covered. In Austria, the public health service requires scientific proof of effectiveness in order to reimburse medical treatments and homeopathy is listed as not reimbursable, but exceptions can be made; private health insurance policies sometimes include homeopathic treatment.   The Swiss government, after a 5-year trial, withdrew homeopathy and four other complementary treatments in 2005, stating that they did not meet efficacy and cost-effectiveness criteria, but following a referendum in 2009 the five therapies are to be reinstated for a further 6-year trial period from 2012.

The Indian Government recognizes homeopathy as one of its national systems of medicine, it has established AYUSH or the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy under the Ministry of Health and Health and Family Welfare The Central Council of Homeopathy was established in 1973 to monitor higher education in Homeopathy, and National Institute of Homeopathy in 1975.   A minimum of a recognized diploma in homeopathy and registration on a state register or the Central Register of Homoeopathy is required to practice homeopathy in India.

 In the United Kingdom, MPs inquired into homeopathy to assess the Government’s policy on the issue, including funding of homeopathy under the National Health Service and government policy for licensing homeopathic products. The decision by the House of Commons Science and Technology Committee follows a written explanation from the Government in which it told the select committee that the licensing regime was not formulated on the basis of scientific evidence. “The three elements of the licensing regime (for homeopathic products) probably lie outside the scope of the … select committee inquiry, because government consideration of scientific evidence was not the basis for their establishment,” the Committee said. The inquiry sought written evidence and submissions from concerned parties.

Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.

Kathy Kiefer

HERBALS

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HERBALS

The exact composition of an herbal product is influenced by the method of extraction. A tea will be rich in polar components because water is a polar solvent. Oil on the other hand is a non-polar solvent and it will absorb non-polar compounds. Alcohol lies somewhere in between.

Many herbs are applied topically to the skin in a variety of forms.  Essential oil extracts can be applied to the skin, usually diluted in a carrier oil (many essential oils can burn the skin or are simply too high dose used straight – diluting in olive oil or another food grade oil such as almond oil can allow these to be used safely as a topical).  Salves, oils, balms, creams and lotions are other forms of topical delivery mechanisms. Most topical applications are oil extractions of herbs. Taking a food grade oil and soaking herbs in it for anywhere from weeks to months allows certain phytochemicals to be extracted into the oil. This oil can then be made into salves, creams, lotions, or simply used as oil for topical application. Many massage oils, antibacterial salves and wound healing compounds are made this way. One can also make a poultice or compress using whole herb (or the appropriate part of the plant) usually crushed or dried and re-hydrated with a small amount of water and then applied directly in a bandage, cloth or just as is.

A number of herbs are thought to be likely to cause adverse effects.  Furthermore, “adulteration, inappropriate formulation, or lack of understanding of plant and drug interactions have led to adverse reactions that are sometimes life threatening or lethal. “ Proper double-blind clinical trials are needed to determine the safety and efficacy of each plant before they can be recommended for medical use.  Although many consumers believe that herbal medicines are safe because they are “natural”, herbal medicines and synthetic drugs may interact, causing toxicity to the patient. Herbal remedies can also be dangerously contaminated, and herbal medicines without established efficacy, may unknowingly be used to replace medicines that do have corroborated efficacy.

 Standardization of purity and dosage is not mandated in the United States, but even products made to the same specification may differ as a result of biochemical variations within a species of plant.  Plants have chemical defense mechanisms against predators that can have adverse or lethal effects on humans. Examples of highly toxic herbs include poison hemlock and nightshade.  They are not marketed to the public as herbs, because the risks are well known, partly due to a long and colorful history in Europe, associated with “sorcery”, “magic” and intrigue. Although not frequent, adverse reactions have been reported for herbs in widespread use.  On occasion serious untoward outcomes have been linked to herb consumption. A case of major potassium depletion has been attributed to chronic licorice ingestion, and consequently professional herbalists avoid the use of licorice where they recognize that this may be a risk. Black cohosh has been implicated in a case of liver failure. Few studies are available on the safety of herbs for pregnant women, and one study found that use of complementary and alternative medicines are associated with a 30% lower ongoing pregnancy and live birth rate during fertility treatment. Examples of herbal treatments with likely cause-effect relationships with adverse events include aconite, which is often a legally restricted herb, ayurvedic remedies, broom, chaparral, Chinese herb mixtures, comfrey, and herbs containing certain flavonoids, germander, guar gum, liquorice root, and pennyroyal.  Examples of herbs where a high degree of confidence of a risk long term adverse effects can be asserted include ginseng, which is unpopular among herbalists for this reason, the endangered herb goldenseal, milk thistle, senna, against which herbalists generally advise and rarely use, aloe vera juice, buckthorn bark and berry, cascara sagrada bark, saw palmetto, valerian, kava, which is banned in the European Union, St. John’s wort, Khat, Betel nut, the restricted herb Ephedra, and Guarana.

 There is also concern with respect to the numerous well-established interactions of herbs and drugs.  In consultation with a physician, usage of herbal remedies should be clarified, as some herbal remedies have the potential to cause adverse drug interactions when used in combination with various prescription and over-the-counter pharmaceuticals, just as a patient should inform an herbalist of their consumption of orthodox prescription and other medication.

For example, dangerously low blood pressure may result from the combination of an herbal remedy that lowers blood pressure together with prescription medicine that has the same effect. Some herbs may amplify the effects of anticoagulants. Certain herbs as well as common fruit interfere with cytochrome P450, an enzyme critical to much drug metabolism.

A herbalist is: (a) A person whose life is dedicated to the economic or medicinal uses of plants. (b) One skilled in the harvesting and collection of medicinal plants. (c)  Traditional Chinese herbalist: one who is trained or skilled in the dispensing of herbal prescriptions; traditional Chinese herb doctor. Similarly, Traditional Ayurvedic herbalist: one who is trained or skilled in the dispensing of herbal prescriptions in the Ayurvedic tradition.  (d)  One trained or skilled in the therapeutic use of medicinal plants.

Herbalists must learn many skills, including the wild-crafting or cultivation of herbs, diagnosis and treatment of conditions or dispensing herbal medication, and preparations of herbal medications. Education of herbalists varies considerably in different areas of the world. Lay herbalists and traditional indigenous medicine people generally rely upon apprenticeship and recognition from their communities in lieu of formal schooling.

In some countries formalized training and minimum education standards exist, although these are not necessarily uniform within or between countries. For example, in Australia the currently self-regulated status of the profession results in different associations setting different educational standards, and subsequently recognizing an educational institution or course of training. The National Herbalists Association of Australia is generally recognized as having the most rigorous professional standard within Australia. In the United Kingdom, the training of medical herbalists is done by state funded Universities.

In the European Union (EU), herbal medicines are now regulated under the European Directive on Traditional Herbal Medicinal Products.

In the United States, most herbal remedies are loosely regulated dietary supplements by the Food and Drug Administration.  Manufacturers of products falling into this category are not required to prove the safety or efficacy of their product; though the FDA may withdraw a product from sale should it prove harmful.

Some herbs, such as cannabis and coca, are outright banned in most countries though coca is legal in most of the South American countries where it is grown. The cannabis plant is used as a herbal medicine, and as such is legal in some parts of the world. Since 2004, the sales of ephedra as a dietary supplement are prohibited in the United States by the FDA, and subject to Schedule III restrictions in the United Kingdom.

Native Americans medicinally used about 2,500 of the approximately 20,000 plant species that are native to North America. With great accuracy, the plants they chose to use for medicine were in those families of plants that modern phytochemical studies show contains the most bioactive compounds.

 Some researchers trained in both western and traditional Chinese medicine have attempted to deconstruct ancient medical texts in the light of modern science. One idea is that the yin-yang balance, at least with regard to herbs, corresponds to the pro-oxidant and anti-oxidant balance. This interpretation is supported by several investigations of the ORAC ratings of various yin and yang herbs.

In India, Ayuruedic medicine has quite complex formulas with 30 or more ingredients, including a sizable number of ingredients that have undergone alchemical processing, chosen to balance Vata, Pitta or Kapha.

In Tamil Nadu, Tamils have their own medicinal system now popularly called Siddha medicine.  The Siddha system is entirely in the Tamil language.  It contains roughly 300,000 verses covering diverse aspects of medicine. This work includes herbal, mineral and metallic compositions used as medicine. Ayurveda is in Sanskrit, but Sanskrit was not generally used as a mother tongue and hence its medicines are mostly taken from Siddha and other local traditions.   In the book, Encounters with QI:  “The Chinese and Western medical models are like two frames of reference in which identical phenomena are studied. Neither frame of reference provides an unobstructed view of health and illness. Each is incomplete and in need of refinement.” Specifically, the traditional Chinese medical model could effect change on the recognized, and expected, phenomena of detachment to patients as people and estrangement unique to the clinical and impersonal relationships between patient and physician of the Western school of medicine.

Four approaches to the use of plants as medicine include:

 1. The magical/shamanic—almost all societies, with the exception of cultures influenced by Western-style industrialization, recognize this kind of use. The practitioner is regarded as endowed with gifts or powers that allow him/her to use herbs in a way that is hidden from the average person, and the herbs are said to affect the spirit or soul of the person.

2. The energetic—this approach includes the major systems of Traditional Chinese Medicine, Ayurveda, and Ugani.   The practitioner may have extensive training, and ideally be sensitive to energy, but need not have supernatural powers.  .

3. The functional dynamic—this approach was used by early physiomedical practitioners, whose doctrine forms the basis of contemporary practice in the UK. Herbs have a functional action, which is not necessarily linked to a physical compound, although often to a physiological function, but there is no explicit recourse to concepts involving energy.

4. The chemical—Modern practitioners – called Phytotherapists an attempt to explain herb actions in terms of their chemical constituents. It is generally assumed that the specific combinations of secondary metabolites in the plant are responsible for the activity claimed or demonstrated a concept called synergy.

Herbalists tend to use extracts from parts of plants, such as the roots or leaves but not isolate particular phytochemicals. Pharmaceutical medicine prefers single ingredients on the grounds that dosage can be more easily quantified. It is also possible to patent single compounds, and therefore generate income. Herbalists often reject the notion of a single active ingredient, arguing that the different phytochemicals present in many herbs will interact to enhance the therapeutic effects of the herb and dilute toxicity.  Furthermore, they argue that a single ingredient may contribute to multiple effects. Herbalists deny that herbal synergism can be duplicated with synthetic chemicals. They argue that phytochemical interactions and trace components may alter the drug response in ways that cannot currently be replicated with a combination of a few putative active ingredients. Pharmaceutical researchers recognize the concept of drug synergism but note that clinical trials may be used to investigate the efficacy of a particular herbal preparation, provided the formulation of that herb is consistent.

 In specific cases the claims of synergy and multi-functionality have been supported by science. The open question is how widely both can be generalized. Herbalists would argue that cases of synergy can be widely generalized, on the basis of their interpretation of evolutionary history, not necessarily shared by the pharmaceutical community. Plants are subject to similar selection pressures as humans and therefore they must develop resistance to threats such as radiation, reactive oxygen species and microbial attack in order to survive. Optimal chemical defenses have been selected for and have thus developed over millions of years.   Human diseases are multifactorial and may be treated by consuming the chemical defenses that they believe to be present in herbs. Bacteria, inflammation, nutrition and ROS (reactive oxygen species) may all play a role in arterial disease.  Herbalists claim a single herb may simultaneously address several of these factors. Likewise a factor such as ROS may underlie more than one condition.  In short herbalists view their field as the study of a web of relationships rather than a quest for single cause and a single cure for a single condition.

In selecting herbal treatments herbalists may use forms of information that are not applicable to pharmacists. Because herbs can moonlight as vegetables, teas or spices they have a huge consumer base and large-scale epidemiological studies become feasible. Ethno-botanical studies are another source of information. For example, when indigenous peoples from geographically dispersed areas use closely related herbs for the same purpose that is taken as supporting evidence for its efficacy.   Herbalists contend that historical medical records and herbals are underutilized resources. They favor the use of convergent information in assessing the medical value of plants. An example would be when in-vitro activity is consistent with traditional use.

 Kathy Kiefer

ALTERNATIVE MEDICINES

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ALTERNATIVE MEDICINES

Alternative medicine is any practice that is put forward as having the healing effects of medicine but is not based on evidence gathered using scientific methods.  It consists of a wide range of health care practices, products and therapies, using alternative medical diagnoses and treatments which typically have not been included in the degree courses of established medical schools or used in conventional medicine.  Examples of alternative medicine include homeopathy, naturopathy, chiropractic, energy medicine and acupuncture.

Complementary medicine is alternative medicine used together with conventional medical treatment in a belief, not proven by using scientific methods, that it “complements” the treatment.  CAM is the abbreviation for Complementary and alternative medicine.  Integrative medicine (or integrative health) is the combination of the practices and methods of alternative medicine with conventional medicine.

The term alternative medicine is used in information issued by public bodies in the Commonwealth of Australia, the United Kingdom and the United States of America.  Regulation and licensing of alternative medicine and health care providers varies from country to country, and state to state.

The expression “complementary and alternative medicine” (CAM) resists easy definition because the health systems and practices to which it refers are diffuse and its boundaries are poorly defined.  Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique, therapeutic practice and in their relationship to the medical mainstream. Some alternative therapies, including Traditional Chinese Medicine and Ayurveda, have antique, non-Western origins and are entirely alternative medical systems; others, such as homeopathy and chiropractic, are native to the West and emerged in the eighteenth and nineteenth centuries. Some, such as osteopathy and chiropractic, employ manipulative physical methods of treatment; others, such as meditation and prayer, are based on mind-body interventions.  Treatments considered alternative in one location may be considered conventional in another.  Thus, chiropractic is not considered alternative in Denmark and likewise osteopathic medicine is no longer thought of as an alternative therapy in the United States.

One common feature of all definitions of alternative medicine is its designation as “other than” conventional medicine. For example, the widely referenced descriptive definition of complementary and alternative medicine states that it is “a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine.” This definition has been criticized as, if an alternative therapy, both effective and safe, is adopted by conventional medical practitioners, it does not necessarily follow that either it or its practitioners would no longer be considered alternative.   Complementary and alternative medicine is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes all such practices and ideas self-defined by their users as preventing or treating illness or promoting health or well-being. Boundaries within CAM and between the CAM domain and that of the dominant system are not always sharp or fixed.

There are proponents that hold alternative medications seek to avoid differing forms of medical knowledge and, while it is an essentially political definition, this should not imply that the dominance of mainstream biomedicine is solely due to political forces. According to this definition, alternative and mainstream medicine can only be differentiated with reference to what is “intrinsic to the politically dominant health system of a particular society of culture”.  However, there is neither a reliable method to distinguish between cultures and subcultures, nor to attribute them as dominant or subordinate, nor any accepted criteria to determine the dominance of a cultural entity.  If the culture of a politically dominant healthcare system is held to be equivalent to the perspectives of those charged with the medical management of leading healthcare institutions and programs, the definition fails to recognize the potential for division either within such an elite or between a healthcare elite and the wider population.   Some say there is no alternative medicine, there is only scientifically proven, evidence based medicine supported by sold data of unproven medicine, for which scientific data is severely lacking.

Normative definitions distinguish alternative medicine from the biomedical mainstream in its provision of therapies that are unproven, unvalidated or ineffective and support of theories which have no recognized scientific basis. These definitions characterize practices as constituting alternative medicine when, used independently or in place of evidence-based medicine, they are put forward as having the healing effects of medicine, but which are not based on evidence gathered with the scientific method.  “It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine – conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted. But assertions, speculation, and testimonials do not substitute for evidence. Alternative treatments should be subjected to scientific testing no less rigorous than that required for conventional treatments.

Complementary medicine” refers to use of alternative medicine alongside conventional science based medicine, in the belief that it increases the effectiveness.  In Australia even alternative medicine includes:   acupuncture; aromatherapy; chiropractic; homeopathy; massage; meditation and relaxation therapies; naturopathy; osteopathy; reflexology, traditional Chinese medicine; and the use of vitamin supplements.

Some herbal therapies are mainstream in Europe but are alternative in the US.

Dating from the 1970s, medical professionals, sociologists, anthropologists and other commentators noted the increasing visibility of a wide variety of health practices that had neither derived directly from nor been verified by biomedical science. Since that time, those who have analyzed this trend have deliberated over the most apt language with which to describe this emergent health field.   A variety of terms have been used, including heterodox, irregular, fringe and alternative medicine while others, particularly medical commentators, have been satisfied to label them as instances of quackery. The most persistent term has been alternative medicine but its use is problematic as it assumes a value-laden dichotomy between medical fringes, implicitly of borderline acceptability at best, and a privileged medical orthodoxy, associated with validated medico-scientific norms.   The use of the category of alternative medicine has also been criticized as it cannot be studied as an independent entity but must be understood in terms of a regionally and temporally specific medical orthodoxy.  Its use can also be misleading as it may erroneously imply that a real medical alternative exists.   As with near-synonymous expressions, such as unorthodox, complementary, marginal, or quackery, these linguistic devices have served, in the context of processes of professionalization and market competition, to establish the authority of official medicine and police the boundary between it and its unconventional rivals.

 During the late eighteenth and nineteenth centuries regular and irregular medical practitioners became more clearly differentiated throughout much of Europe and, as the nineteenth century progressed, most Western states converged in the creation of legally delimited and semi-protected medical markets.   It is at this point that an “official” medicine, created in cooperation with the state and employing a scientific rhetoric of legitimacy, emerges as a recognizable entity and that the concept of alternative medicine as a historical category becomes tenable.  As part of this process, professional adherents of mainstream medicine in countries such as Germany, France, and Britain increasingly invoked the scientific basis of their discipline as a means of engendering internal professional unity and of external differentiation in the face of sustained market competition from homeopaths, naturopaths, mesmerists and other nonconventional medical practitioners, finally achieving a degree of imperfect dominance through alliance with the state and the passage of regulatory legislation.

 Critics in the US say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because the word implies that the treatment increases the effectiveness of science-based medicine, while alternative medicines which have been tested nearly always have no measurable positive effect compared to a placebo.    Grounds for opposing alternative medicine which have been stated in the US and elsewhere are:   that it is usually based on religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, or fraud;  that alternative therapies typically lack any scientific validation, and their effectiveness is either unproved or disproved; that the treatments are those that are not part of the conventional, science-based healthcare system; that research on alternative medicine is frequently of low quality and methodologically flawed;  that where alternative treatments are used in place of conventional science-based medicine, even with the very safest alternative medicines, failure to use or delay in using conventional science-based medicine has resulted in deaths; that methods may incorporate or base themselves on traditional medicine, folk knowledge, spiritual beliefs, ignorance or misunderstanding of scientific principles, errors in reasoning, or newly conceived approaches claiming to heal;  Alternative medicine practices and beliefs are diverse in their foundations and methodologies, and typically make use of preparations and dosages other than such as are included in the Pharmacopeia recognized by established medical schools. The wide range of treatments and practices referred to as alternative medicine includes some stemming from nineteenth century North America, such as chiropractic and naturopathy, others that originated in eighteenth- and nineteenth-century Germany, such as homeopathy and hydropathy, and some that have originated in China or India, while African, Caribbean, Pacific Island, Native American, and other regional cultures have traditional medical systems as diverse as their diversity of cultures.

Examples of CAM as a broader term for unorthodox treatment and diagnosis of illnesses, disease, infections, etc., include yoga, acupuncture, aromatherapy, chiropractic, herbalism, homeopathy, hypnotherapy, massage, osteopathy, reflexology, relaxation therapies, spiritual healing and tai chi.  CAM differs from conventional medicine. It is normally private medicine and not covered by health insurance.  It is paid out of pocket by the patient and is an expensive treatment.   CAM tends to be a treatment for upper class or more educated people.

Alternative therapies based on electricity or magnetism use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in an unconventional manner rather than claiming the existence of imponderable or supernatural energies.

Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, and minerals, and includes traditional herbal remedies with herbs specific to regions in which the cultural practices arose. Non-vitamin supplements include fish oil, Omega-3 fatty acid, glucosamine, Echinacea, flaxseed oil or pills, and ginseng, when used under a claim to have healing effects.

Mind-body interventions, working under the premise that the mind can affect “bodily functions and symptoms”, include healing claims made in hypnotherapy, and in guided imagery, meditation, progressive relaxation, qigong, tai chi and yoga. Meditation practices including mantra meditation, mindfulness meditation, yoga, tai chi, and qi gong have many uncertainties. Naturopathy is based on a belief in vitalism, which posits that a special energy called vital energy or vital force guides bodily processes such as metabolism, reproduction, growth, and adaptation. The term was coined in 1895  by the “father of U.S. naturopathy”.  Today, naturopathy is primarily practiced in the United States and Canada.  Naturopaths in unregulated jurisdictions may use the Naturopathic Doctor designation or other titles regardless of level of education.

Traditional Chinese medicine is based on a concept of vital energy, or Qi, flowing in the body along specific pathways. These purported pathways consist of 12 primary meridians. TCM has many branches including, acupuncture, massage, Feng shui, herbs, as well as Chinese astrology.  TCM diagnosis is primarily based on looking at the tongue, which is claimed to show the condition of the organs, as well as feeling the pulse of the radial artery, which is also claimed to show the condition of the organs.

Proponents of alternative medicine often used terminology which was loose or ambiguous to create the appearance that a choice between “alternative” effective treatments existed when it did not, or that there was effectiveness or scientific validity when it did not exist, or to suggest that a dichotomy existed when it did not, or to suggest that consistency with science existed when it might not; that the term “alternative” was to suggest that a patient had a choice between effective treatments when there was not; that use of the word “conventional” or “mainstream” was to suggest that the difference between alternative medicine and science based medicine was the prevalence of use, rather than lack of a scientific basis of alternative medicine as compared to “conventional” or “mainstream” science based medicine; that use of the term “complementary” or “integrative” was to suggest that purported supernatural energies of alternative medicine could complement or be integrated into science based medicine. “Integrative medicine” or “integrated medicine” is used to refer to the belief that medicine based on science would be improved by “integration” with alternative medical treatments practices that are not, and is substantially similar in use to the term “complementary and alternative medicine”.

Use of placebos in order to achieve a placebo effect in integrative medicine has been criticized as “diverting research time, money, and other resources from more fruitful lines of investigation in order to pursue a theory that has no basis in biology”.

Integrative medicine may mislead patients by pretending placebos are not.  “Quackademic medicine” is a pejorative term used for “integrative medicine,” which is considered to be an infiltration of quackery into academic science-based medicine.

 Kathy Kiefer