Allopathic medicine

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Allopathic medicine is an expression commonly used by homeopaths and proponents of other forms of alternative medicine to refer to mainstream medical use of pharmacologically active agents or physical interventions to treat or suppress symptoms or pathophysiologic processes of diseases or conditions. The expression was coined in 1810 by the creator of homeopathy, Samuel Hahnemann (1755–1843). In such circles, the expression "allopathic medicine" is still used to refer to "the broad category of medical practice that is sometimes called Western medicine, biomedicine, evidence-based medicine, or modern medicine" (see the article on scientific medicine).

Etymology

Allopathic medicine and allopathy (from the Greek prefix ἄλλος, állos, "other", "different" + the suffix πάϑος, páthos, "suffering") are terms coined in the early 19th century by Samuel Hahnemann, the founder of homeopathy, as a synonym for mainstream medicine.

History

The practice of medicine in both Europe and North America during the early 19th century is sometimes referred to as heroic medicine because of the extreme measures (such as bloodletting) sometimes employed in an effort to treat diseases. The term allopath was used by Hahnemann and other early homeopaths to highlight the difference they perceived between homeopathy and the medicine of that time.
With the term allopathy (meaning "other than the disease"), Hahnemann intended to point out how physicians with conventional training employed therapeutic approaches that, in his view, merely treated symptoms and failed to address the disharmony produced by the underlying disease.^{[clarification needed]} Homeopaths saw such symptomatic treatments as "opposites treating opposites" and believed these conventional methods were harmful to patients.
Practitioners of alternative medicine have used the term "allopathic medicine" to refer to the practice of conventional medicine in both Europe and the United States since the 19th century. The term allopathic was used throughout the 19th century as a derogatory term for the practitioners of heroic medicine, a precursor to modern medicine that did not rely on evidence.
James Whorton discusses this historical pejorative usage:

One form of verbal warfare used in retaliation by irregulars was the word "allopathy." ..."Allopathy" and "allopathic" were liberally employed as pejoratives by all irregular physicians of the nineteenth century, and the terms were considered highly offensive by those at whom they were directed. The generally uncomplaining acceptance of [the term] "allopathic medicine" by today's physicians is an indication of both a lack of awareness of the term's historical use and the recent thawing of relations between irregulars and allopaths.

The controversy surrounding the term can be traced to its original usage during a heated 19th-century debate between practitioners of homeopathy and those they derisively referred to as "allopaths."
Hahnemann used "allopathy" to refer to what he saw as a system of medicine that combats disease by using remedies that produce effects in a healthy subject that are different (hence Greek root allo- "different") from the effects produced by the disease to be treated. The distinction comes from the use in homeopathy of substances that are meant to cause similar effects as the symptoms of a disease to treat patients (homeo - meaning similar).
As used by homeopaths, the term allopathy has always referred to the principle of curing disease by administering substances that produce other symptoms (when given to a healthy human) than the symptoms produced by a disease. For example, part of an allopathic treatment for fever may include the use of a drug which reduces the fever, while also including a drug (such as an antibiotic) that attacks the cause of the fever (such as a bacterial infection). A homeopathic treatment for fever, by contrast, is one that uses a diluted and succussed dosage of a substance, usually containing no actual particles of that substance, that in an undiluted and unsuccussed form would induce fever in a healthy person. Hahnemann used this term to distinguish medicine as practiced in his time from his use of infinitesimally small (or nonexistent) doses of substances to treat the spiritual causes of illness.
The Companion Encyclopedia of the History of Medicine states that "Hahnemann gave an all-embracing name to regular practice, calling it 'allopathy'. This term, however imprecise, was employed by his followers or other unorthodox movements to identify the prevailing methods as constituting nothing more than a competing 'school' of medicine, however dominant in terms of number of practitioner proponents and patients." In the nineteenth century, some pharmacies labeled their products with the terms allopathic or homeopathic.
Contrary to the present usage, Hahnemann reserved the term "allopathic medicine" to the practice of treating diseases by means of drugs inducing symptoms unrelated (i.e., neither similar nor opposite) to those of the disease. He called the practice of treating diseases by means of drugs producing symptoms opposite to those of the patient "enantiopathic" or "antipathic medicine". After Hahnemann's death, the term "enantiopathy" fell into disuse and the two concepts of allopathy and enantiopathy have been more or less unified. Both, however, indicate what Hahnemann thought about contemporary conventional medicine, rather than the current ideas of his colleagues. Conventional physicians had never assumed that the therapeutic effects of drugs were necessarily related to the symptoms they caused in the healthy: e.g., James Lind in 1747 systematically tested several common substances and foods for their effect on scurvy and discovered that lemon juice was specifically active; he clearly did not select lemon juice because it caused symptoms in the healthy man, either similar or opposite to those of scurvy.

Current

Use of the term remains common among homeopaths and has spread to other alternative medicine practices. The meaning implied by the label has never been accepted by conventional medicine and is still considered pejorative by some. More recently, some sources have used the term "allopathic", particularly American sources wishing to distinguish between Doctors of Medicine (MD) and Doctors of Osteopathic Medicine (DO) in the United States. William Jarvis, an expert on alternative medicine and public health, states that "although many modern therapies can be construed to conform to an allopathic rationale (e.g., using a laxative to relieve constipation), standard medicine has never paid allegiance to an allopathic principle" and that the label "allopath" was "considered highly derisive by regular medicine."
Many conventional medical treatments clearly do not fit the nominal definition of allopathy, as they seek to prevent illness, or remove the cause of an illness by acting on the etiology of disease.

History of Anti-vaccination Movements

The Historical Medical Library of The College of Physicians of Philadelphia

This French caricature from around 1800 shows that fear of vaccination quickly produced reactions among artists.

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Health and medicine scholars have described vaccination as one of the top ten achievements of public health in the 20^th century. Yet, opposition to vaccination has existed as long as vaccination itself (indeed, the pre-vaccination practice of variolation came under criticism as well: see this timeline entry for details). Critics of vaccination have taken a variety of positions, including opposition to the smallpox vaccine in England and the United States in the mid to late 1800s, and the resulting anti-vaccination leagues; as well as more recent vaccination controversies such as those surrounding the safety and efficacy of the diphtheria, tetanus, and pertussis (DTP) immunization, the measles, mumps, and rubella (MMR) vaccine, and the use of a mercury-containing preservative called thimerosal.

Smallpox and the Anti-vaccination Leagues in England

Widespread smallpox vaccination began in the early 1800s, following Edward Jenner’s cowpox experiments, in which he showed that he could protect a child from smallpox if he infected him or her with lymph from a cowpox blister. Jenner’s ideas were novel for his time, however, and they were met with immediate public criticism. The rationale for this criticism varied, and included sanitary, religious, scientific, and political objections.
For some parents, the smallpox vaccination itself induced fear and protest. It included scoring the flesh on a child’s arm, and inserting lymph from the blister of a person who had been vaccinated about a week earlier. Some objectors, including the local clergy, believed that the vaccine was “unchristian” because it came from an animal. For other anti-vaccinators, their discontent with the smallpox vaccine reflected their general distrust in medicine and in Jenner’s ideas about disease spread. Suspicious of the vaccine’s efficacy, some skeptics alleged that smallpox resulted from decaying matter in the atmosphere. Lastly, many people objected to vaccination because they believed it violated their personal liberty, a tension that worsened as the government developed mandatory vaccine policies. 
The Vaccination Act of 1853 ordered mandatory vaccination for infants up to 3 months old, and the Act of 1867 extended this age requirement to 14 years, adding penalties for vaccine refusal. The laws were met with immediate resistance from citizens who demanded the right to control their bodies and those of their children. The Anti Vaccination League and the Anti-Compulsory Vaccination League formed in response to the mandatory laws, and numerous anti-vaccination journals sprang up. 
The town of Leicester was a particular hotbed of anti vaccine activity and the site of many anti-vaccine rallies. The local paper described the details of a rally: “An escort was formed, preceded by a banner, to escort a young mother and two men, all of whom had resolved to give themselves up to the police and undergo imprisonment in preference to having their children vaccinated…The three were attended by a numerous crowd…three hearty cheers were given for them, which were renewed with increased vigor as they entered the doors of the police cells.”The Leicester Demonstration March of 1885 was one of the most notorious anti-vaccination demonstrations. There, 80,000-100,000 anti-vaccinators led an elaborate march, complete with banners, a child’s coffin, and an effigy of Jenner.
Such demonstrations and general vaccine opposition lead to the development of a commission designed to study vaccination. In 1896 the commission ruled that vaccination protected against smallpox, but suggested removing penalties for failure to vaccinate. The Vaccination Act of 1898 removed penalties and included a “conscientious objector” clause, so that parents who did not believe in vaccination’s safety or efficacy could obtain an exemption certificate.

Smallpox and the Anti-vaccination Leagues in the United States

Toward the end of the 19^th century, smallpox outbreaks in the United States led to vaccine campaigns and related anti-vaccine activity. The Anti Vaccination Society of America was founded in 1879, following a visit to America by leading British anti-vaccinationist William Tebb. Two other leagues, the New England Anti Compulsory Vaccination League (1882) and the Anti-vaccination League of New York City (1885) followed. The American anti-vaccinationists waged court battles to repeal vaccination laws in several states including California, Illinois, and Wisconsin.
In 1902, following a smallpox outbreak, the board of health of the city of Cambridge, Massachusetts, mandated all city residents to be vaccinated against smallpox. City resident Henning Jacobson refused vaccination on the grounds that the law violated his right to care for his own body how he knew best. In turn, the city filed criminal charges against him. After losing his court battle locally, Jacobson appealed to the U.S. Supreme Court. In 1905 the Court found in the state’s favor, ruling that the state could enact compulsory laws to protect the public in the event of a communicable disease. This was the first U.S. Supreme Court case concerning the power of states in public health law.

The Diphtheria, Tetanus, and Pertussis (DTP) Vaccine Controversy

Anti-vaccination positions and vaccination controversies are not limited to the past. In the mid 1970s, an international controversy over the safety of the DTP immunization erupted in Europe, Asia, Australia, and North America. In the United Kingdom (UK), opposition resulted in response to a report from the Great Ormond Street Hospital for Sick Children in London, alleging that 36 children suffered neurological conditions following DTP immunization. Television documentaries and newspaper reports drew public attention to the controversy. An advocacy group, The Association of Parents of Vaccine Damaged Children (APVDC), also piqued public interest in the potential risks and consequences of DTP.
In response to decreased vaccination rates and three major epidemics of whooping cough (pertussis), the Joint Commission on Vaccination and Immunization (JCVI), an independent expert advisory committee in the UK, confirmed the safety of the immunization. Nonetheless, public confusion continued, in part because of diverse opinions within the medical profession. For example, surveys of medical providers in the UK in the late 1970s found that they were reluctant to recommend the immunization to all patients. Additionally, an outspoken physician and vaccine opponent, Gordon Stewart, published a series of case reports linking neurological disorders to DTP, sparking additional debate. In response, the JCVI launched the National Childhood Encephalopathy Study (NCES). The study identified every child between 2 and 36 months hospitalized in the UK for neurological illness, and assessed whether or not the immunization was associated with increased risk. NCES results indicated that the risk was very low, and this data lent support to a national pro-immunization campaign. Members of the APVDC continued to argue in court for recognition and compensation, but were denied both due to the lack of evidence linking the DTP immunization with harm.
The U.S. controversy began with media attention on the alleged risks of DTP. A 1982 documentary, DPT: Vaccination Roulette, described alleged adverse reactions to the immunization and minimized the benefits. Similarly, a 1991 book titled A Shot in the Dark outlined potential risks. As in the UK, concerned and angry parents formed victim advocacy groups, but the counter response from medical organizations, like the Academy of Pediatrics and the Centers for Disease Control and Prevention, was stronger in the United States. Although the media storm instigated several lawsuits against vaccine manufacturers, increased vaccine prices, and caused some companies to stop making DTP, the overall controversy affected immunization rates less than in the UK.

The Measles, Mumps, and Rubella (MMR) Vaccine Controversy

Nearly 25 years after the DTP controversy, England was again the site of anti-vaccination activity, this time regarding the MMR vaccine.
In 1998, British doctor Andrew Wakefield recommended further investigation of a possible relationship between bowel disease, autism, and the MMR vaccine. A few years later, Wakefield alleged the vaccine was not properly tested before being put into use. The media seized these stories, igniting public fear and confusion over the safety of the vaccine. The Lancet, the journal that originally published Wakefield’s work, stated in 2004 that it should not have published the paper. The General Medical Council, an independent regulator for doctors in the UK, found that Wakefield had a “fatal conflict of interest.” He had been paid by a law board to find out if there was evidence to support a litigation case by parents who believed that the vaccine had harmed their children. In 2010, the Lancet formally retracted the paper after the British General Medical Council ruled against Wakefield in several areas. Wakefield was struck from the medical register in Great Britain and may no longer practice medicine there. In January 2011, the BMJ published a series of reports by journalist Brian Deer outlining evidence that Wakefield had committed scientific fraud by falsifying data and also that Wakefield hoped to financially profit from his investigations in several ways.
A large number of research studies have been conducted to assess the safety of the MMR vaccine, and none of them has found a link between the vaccine and autism.

“Green Our Vaccines”

Thimerosal, a mercury containing compound used as a preservative in vaccines,has also been the center of a vaccination and autism controversy.  Although there is no clear scientific evidence that small amounts of thimerosal in vaccines cause harm, in July 1999, leading U.S. public health and medical organizations and vaccine manufacturers agreed that thimerosal should be reduced or eliminated from vaccines as a precautionary measure. In 2001, The Institute of Medicine’s Immunization Safety Review Committee issued a report concluding that there was not enough evidence to prove or disprove claims that thimerosal in childhood vaccines causes autism, attention deficit hypersensitivity disorder, or speech or language delay.A more recent report by the committee “favors rejection of a causal relationship between thimerosal-containing vaccines and autism.”Even with this finding, some researchers continue to study the possible links between thimerosal and autism.
Despite scientific evidence, concerns over thimerosal have led to a public “Green Our Vaccines” campaign, a movement to remove “toxins” from vaccines, for fear that these substances lead to autism. Celebrity Jenny McCarthy, her advocacy group Generation Rescue, and the organization Talk about Curing Autism (TACA) have spearheaded these efforts.

In Conclusion

Although the time periods have changed, the emotions and deep-rooted beliefs—whether philosophical, political, or spiritual—that underlie vaccine opposition have remained relatively consistent since Edward Jenner introduced vaccination.
Last update 16 Jan 2014

Vaccine Side Effects and Adverse Events

Copyright Dennis Kunkel Microscopy, Inc.

Corynebacterium diphtheriae, SEM x3750, artificially colored

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A vaccine is a medical product. Vaccines, though they are designed to protect from disease, can cause side effects, just as any medication can.

Most side effects from vaccination are mild, such as soreness, swelling, or redness at the injection site. Some vaccines are associated with fever, rash, and achiness. Serious side effects are rare, but may include seizure or life-threatening allergic reaction.
A possible side effect resulting from a vaccination is known as an adverse event.
Each year, American babies (1 year old and younger) receive more than 10 million vaccinations. During the first year of life, a significant number of babies suffer serious, life-threatening illnesses and medical events, such as Sudden Infant Death Syndrome (SIDS). Additionally, it is during the first year that congenital conditions may become evident. Therefore, due to chance alone, many babies will experience a medical event in close proximity to a vaccination. This does not mean, though, that the event is in fact related to the immunization. The challenge is to determine when a medical event is directly related to a vaccination.
The Food and Drug and Administration (FDA) and the Centers for Disease Control and Prevention (CDC) have set up systems to monitor and analyze reported adverse events and to determine whether they are likely related to vaccination.

Types of Side Effects

To understand the range of possible vaccination side effects events, it is useful to compare a vaccine with relatively few associated side effects, such as the vaccine for Haemophilus influenza type B, with a vaccine known to have many potential side effects, such as the infrequently used smallpox vaccine (given to military personnel and others who might be first responders in the event of a bioterror attack).
Haemophilus influenza type B is a bacterium that can cause serious infections, including meningitis, pneumonia, epiglottitis, and sepsis. The CDC recommends that children receive a series of Hib vaccinations starting when they are two months old.
Smallpox is a serious infection, fatal In 30% to 40% of cases, and caused by the Variola major or Variola minor virus. No wild smallpox cases have been reported since the 1970s. The World Health Organization has declared it eradicated.
The information below about side effects of Hib and smallpox vaccination is from the Centers for Disease Control and Prevention.

Hib Vaccine Side Effects

• Redness, warmth, or swelling where the shot was given (up to 1 out of 4 children)
• Fever over 101°F (up to 1 out of 20 children)

No serious side effects have been related to the Hib vaccine.

Smallpox (Vaccinia) Vaccine Side Effects

Mild to Moderate Problems 

• Mild rash, lasting 2-4 days.
• Swelling and tenderness of lymph nodes, lasting 2-4 weeks after the blister has healed.
• Fever of over 100°F (about 70% of children, 17% of adults) or over 102°F (about 15%-20% of children, under 2% of adults).
• Secondary blister elsewhere on the body (about 1 per 1,900).

Moderate to Severe Problems 

• Serious eye infection, or loss of vision, due to spread of vaccine virus to the eye.
• Rash on entire body (as many as 1 per 4,000).
• Severe rash on people with eczema (as many as 1 per 26,000).
• Encephalitis (severe brain reaction), which can lead to permanent brain damage (as many as 1 per 83,000).
• Severe infection beginning at the vaccination site (as many as 1 per 667,000, mostly in people with weakened immune systems).
• Death (1-2 per million, mostly in people with weakened immune systems).

For every million people vaccinated for smallpox, between 14 and 52 could have a life-threatening reaction to smallpox vaccine.

How Do I Find Out the Side Effects for Different Vaccines?

When you or a child gets a vaccine, the health care provider gives you a handout known as the Vaccine Information Statement (VIS). The VIS describes common and rare side effects, if any are known, of the vaccine. Your health care provider will probably discuss possible side effects with you. VIS downloads are also available through the CDC’s website.
Package inserts produced by the vaccine manufacturer also provide information about adverse events. Additionally, these inserts usually show rates of adverse events in experimental and control groups during pre-market testing of the vaccine.

How Are Adverse Events Monitored?

VAERS

The CDC and FDA established The Vaccine Adverse Event Reporting System in 1990. The goal of VAERS, according to the CDC, is “to detect possible signals of adverse events associated with vaccines.” (A signal in this case is evidence of a possible adverse event that emerges in the data collected.) About 30,000 events are reported each year to VAERS. Between 10% and 15% of these reports describe serious medical events that result in hospitalization, life-threatening illness, disability, or death.
VAERS is a voluntary reporting system. Anyone, such as a parent, a health care provider, or friend of the patient, who suspects an association between a vaccination and an adverse event may report that event and information about it to VAERS. The CDC then investigates the event and tries to find out whether the adverse event was in fact caused by the vaccination.
The CDC states that they monitor VAERS data to

• Detect new, unusual, or rare vaccine adverse events
• Monitor increases in known adverse events
• Identify potential patient risk factors for particular types of adverse events
• Identify vaccine lots with increased numbers or types of reported adverse events
• Assess the safety of newly licensed vaccines

Not all adverse events reported to VAERS are in fact caused by a vaccination. The two occurrences may be related in time only. And, it is probable that not all adverse events resulting from vaccination are reported to VAERS. The CDC states that many adverse events such as swelling at the injection site are underreported. Serious adverse events, according to the CDC, “are probably more likely to be reported than minor ones, especially when they occur soon after vaccination, even if they may be coincidental and related to other causes.”
VAERS has successfully identified several rare adverse events related to vaccination. Among them are

• An intestinal problem after the first vaccine for rotavirus was introduced (the vaccine was withdrawn in 1999)
• Neurologic and gastrointestinal diseases related to yellow fever vaccine

Additionally, according to Plotkin et al., VAERS identified a need for further investigation of MMR association with a blood clotting disorder, encephalopathy after MMR, and syncope after immunization (Plotkin SA et al. Vaccines, 5^th ed. Philadelphia: Saunders, 2008).

Vaccine Safety Datalink

The CDC established this system in 1990. The VSD is a collection of linked databases containing information from large medical groups. The linked databases allow officials to gather data about vaccination among the populations served by the medical groups. Researchers can access the data by proposing studies to the CDC and having them approved.
The VSD has some drawbacks. For example, few completely unvaccinated children are listed in the database. The medical groups providing information to VSD may have patient populations that are not representative of large populations in general. Additionally, the data come not from randomized, controlled, blinded trials but from actual medical practice. Therefore, it may be difficult to control and evaluate the data.
Rapid Cycle Analysis is a program of the VSD, launched in 2005. It monitors real-time data to compare rates of adverse events in recently vaccinated people with rates among unvaccinated people. The system is used mainly to monitor new vaccines. Among the new vaccines being monitored in Rapid Cycle Analysis are the conjugated meningococcal vaccine, rotavirus vaccine, MMRV vaccine, Tdap vaccine, and the HPV vaccine. Possible associations between adverse events and vaccination are then studied further.

Vaccine Injury Compensation

For information on systems for compensating individuals who have been harmed by vaccines, see our article on Vaccine Injury Compensation Programs.

Last update 27 Jan 2014