Soc Sci Med. 1989 ; 29(3): 293-300.

Assumptions governing approaches to diagnosis and treatment.

Aakster CW.

The article analyses two representative medical textbooks, one about regular or 'orthodox' medicine and the other about alternative or complementary medicine. The following dimensions of the disease-concept are discussed: definition, epidemiology, causation, natural history, pathology, clinical features, diagnostic procedures, treatment, effects, complications, rehabilitation, prognosis, prevention, doctor-patient relations, position of the patient, costs and burdens. Although the analysis is not yet complete, some general inferences may be drawn, i.e. the leading model of thinking in regular medicine may be termed 'classical' as opposed to that of complementary medicine, being more 'perspectivistic' in nature. Definitions of disease, as well as diagnostic procedures and therapeutic interventions are organ-specific in regular medicine, and whole-person oriented in complementary medicine. Complementary medicine pays more attention to developmental aspects in disease, the partnership of the patient, the long-term restoration of health, the avoidance of harmful side effects. Also, organisation of the care system is quite different for these types of medicine: being hospital-directed and highly differentiated in regular medicine, while the organisational model of complementary medicine is essentially of a home-centred, integrated type.