Fundamentals of CAM, 6E Micozzi Discussion Questions for Chapters EVOLVE

Note to professor: Some questions are specific to the content of the chapter indicated and others build on progressive knowledge and understanding of all chapters.

SECTION ONE: COMPLEMENTARY/ALTERNATIVE IN HEALTHCARE

Chapters 1, 2 & 3—Introductory Chapters

1. What is meant by having a “scientific” understanding of health and medicine versus other ways of knowing?

2. Compare and contrast the following adjectives as applied to medicine: alternative, complementary, integrative, holistic, natural, regular, unconventional, and traditional. What does each adjective tell us about the origins, applications, and scope of these ? What do they tell us about bias in the dominant medical system?

3. What were the earliest types of books to be printed in the American colonies during the seventeenth and eighteenth centuries? Why do you suppose these books were selected for popular publication?

4. What is the meaning a symptom in physiologic terms? In mainstream, allopathic medicine terms? In complementary and terms?

5. What powers does the U.S. government have over the regulation of dietary supplements, including micronutrients and herbal remedies? Discuss the benefits and challenges of these powers.

6. Discuss the limitations of using clinical research methods designed for testing drugs in the evaluation of the effects of complementary and alternative medicine modalities.

Chapter 4—CAM in Community

1. Give examples of which kinds of therapeutic modalities labeled as complementary/alternative could be offered in mainstream medical settings, and which could not be. 2. Describe some models of new practice settings that could authentically “integrate” CAM modalities into mainstream medical practice. 3. Discuss the pros and cons of “integrating” CAM therapeutic modalities into the mainstream healthcare system vs. accessing them as independent resources in the community. 4. Outline approaches to expanding the role of community and social workers in a broader model of health and healing beyond the parameters of what is defined as the existing healthcare system.

SECTION TWO: FUNDAMENTAL SCIENCES

Chapter 5—Quantum Biology & Biofields in Health and Healing 1. What is a biofield? 2. What kinds of experiments can be done to demonstrate the biofield? 3. What kinds of experiments cannot be done to demonstrate the biofield? 4. What observations have been made that demonstrate the existence of the biofield?

Chapter 6— Medicine

1. True/False: Good correlations have been established between subtle (putative) and electromagnetic (substantive) energy. 2. True/False: Most techniques assume that intentionality interacts with the effects of energy. 3. Describe the paradox of a photon of light behaving as a particle (matter) and behaving as a wave (energy). 4. Describe how the act of observing light effects how it will be seen.

Chapter 7—Quantum Botany, Plant Ecology and Systems Theory

1. Define coherent coupling. What are some examples of coherent coupling? 2. How has adaptation to phytochemicals influenced the physiological processes of organisms that consume plants? 3. What are your thoughts on the chapter author’s proposed three modes of activity based on recently elucidated behaviors of the cell membrane? Do you agree or disagree? Why?

SECTION THREE: MIND BODY MEDICINE

Chapters 8, 9, 10, 11 & 12—Neurohumoral Physiology and PNI; Mind-Body Therapies; Psychometrics; Placebo

1. What are the effects of mental states on the immune system? Give examples. 2. What is the placebo response? Discuss several ways of understanding it in terms of human physiology—in terms of allopathic, mainstream medicine, and in terms of complementary and alternative medicine. 3. What was Transcendentalism? Identify and discuss the leading figures of this movement. 4. What did Carl Jung mean by having the words carved over his doorway, “summoned or unsummoned, G-d will be there”?

5. In the 1970s, why was Zen (Chinese) practice seen as more mature than Hindu psychedelic practice? 6. Emerson and Thoreau were both captivated by Eastern modes of thought and practice, although each had a different intellectual enterprise—Emerson to understand and express universal principles, and Thoreau to deepen his direct experience of the world in moment-by-moment particulars. Discuss the tensions between these complementary orientations and how they have continued to be important in the development of the practice of integrative medicine. Note: Also see Chapter 31 contrasting different orientations for studying : early British social anthropology for finding general rules for organization of medical systems as social institutions, versus early American cultural anthropology for documenting aspects of ethnomedicine unique to beliefs and behaviors of each cultural group. 7. The US occupation of Japan immediately after World War II brought opportunities for many Western medical professionals, as well as non-professionals, to observe a paradigmatically different approach to treatment of medical and psychological disorders. What would it have been like for a from that era to encounter for the first time such basic Eastern insights as (1) the paradox of turning toward rather than away from symptoms for relief and (2) the insistence on the non-dualistic nature of the body and the mind? 8. There are three broad, chronological strokes for the ways that Eastern thought, particularly Buddhist thought, has come into contemporary culture―(a) during the 1950s in an intellectual and aesthetic focus on Zen and sudden enlightenment, (b) during the 1960s and 1970s in an ecstatic and experiential focus on Hindu and Tibetan Buddhist practice and iconography, and (c) in the 1980s and onward in an embodied focus on the psychological insight and gradual awakening of Theravada (Insight) Buddhism. All three are still evident in the culture at large. How does each shape the reception of CAM and integrative medicine? 9. Don Cupitt’s suggestion that one’s own life is now the “privileged religious object” for many people today is suggested from his study of current idiomatic expressions— such as “get a life!” Do you see such a shift taking place? What would you identify as evidence? Is CAM/integrative medicine aligned with this phenomenon? Is CAM/IM taking a leading position? 10. What is the “mechanism of action” of hypnosis? Discuss ways of understanding hypnosis as a clinical treatment. 11. What are the “French paradox” and the “Roseto effect”? Explain your answers. 12. What is stress? (What is it not?) Discuss its health effects, as well as potential benefits. 13. What are the research-demonstrated health effects of meditation? Give examples. 14. Do you think of yourself as having “thin” boundaries or “thick” boundaries? Why? 15. Name three medical disorders that are identified more with thin boundary psychometric type. Three identified more with thick boundary? 16. Discussion the spectrum of Fibromyalgia-Chronic Fatigue Syndrome in terms of thick vs. thin boundary correlations. 17. Name three therapeutic modalities likely to be more effective for people with thin boundary type. For thick boundary type?

Chapter 13—Prayer, Religion, Intentionality, and Spirituality 1. Discuss prayer in terms of the concept of “healing at a distance” and intentionality. [Note: see also Chapter 6 Energy Medicine] 2. Compare spirituality and religious practice. 3. Name three health benefits associated with regular religious participation. 4. Until the 20th century, were seen as having a “sacerdotal” or priestly role in society and for the patient in addition to whatever knowledge and skills they brought for the practice of medicine. Do you think healers should or should not be involved in with the spiritual dimensions of the patient? Of the community; of the larger society?

Chapter 14—Humor, Laughter, and Wellness 1. Is humor part of health and medicine? Why? Why not? 2. Has research been performed on humor and medical outcomes? Give examples. 3. If you have one, share an experience in which you have either participated or witnessed humor in a medical or clinical setting. 4. Tell a joke to the class that you find funny. Not everyone will laugh, because humor is subjective. But at least you will!

Chapter 15—Integrative Mental Healthcare 1. Compare and contrast a neurochemical model of mood disorders, with a physiologic model, and with a psycho-social-spiritual model. 2. Discuss the relationship of psychiatric drugs to suicides and mass homicides. 3. Compare and contrast therapeutic approaches to mental health: drug-based, talk- based, and community-based therapies.

SECTION FOUR: BODYWORK AND MANUAL THERAPIES

Chapters 16 and 17—Massage, Bodywork and Touch Therapies 1. How is the human body both physical and energetic? 2. How does fascia have an impact on the function of the organs it surrounds and infiltrates? How is the fascial system important in the balance of health in the human body? 3. Define the proprioceptive, vestibular, and visual systems. What is the effect of gravity? 4. Discuss how the parietal lobe of the brain processes and organizes physical reality. 5. Because some manual and touch therapies have little documentation on record, the therapies discussed in this chapter are not inclusive of all that exist. After reading the chapter, identify and discuss any therapies that you encountered that are not mentioned here. 6. List the research-demonstrated health and wellness benefits of massage in the setting.

7. Discuss the recently “discovered” anatomic-physiologic model that connective tissues and cells comprise a distinct “new” organ of the body.

Chapter 18— and Spinal 1. What are the three conditions most commonly treated by chiropractors? 2. The traditional “bone-out-of place” model used to explain the mechanism for chiropractic’s beneficial effects has been replaced by what contemporary model? 3. What term has been used historically by chiropractors as a synonym for spinal joint dysfunction? 4. More studies have been done on the treatment of lower back pain, the most common cause of pain and disability in working Americans, than perhaps any other contemporary medical condition. Why is the human body so susceptible to back pain and injury? Describe what the preponderance of research studies shows about the most effective, and cost-effective approaches, for both relieving pain and restoring function for acute, and for chronic low back pain.

Chapter 19— 1. Describe the premise on which the practice of reflexology is based? 2. What are four main benefits of reflexology? 3. In what ways can the profession of reflexology be regulated and standardized?

Chapter 20—Yoga 1. Define yoga. 2. What are the three primary elements of a yoga practice? How do they relate to the eight limbs of yoga as set forth by Patanjali in the Yoga Sutra? 3. Define ida and pingala and describe their role in pranayama. 4. Yoga as practiced in the West in modern times often has less emphasis on spiritual union and more emphasis on performing yoga postures for physical and emotional well-being. Do you believe a comprehensive system of yoga practice is likely to have more benefits than a practice, which is focused mainly on performing asanas? Why or why not? 5. Describe the role of meditation on the pineal gland and how this role may affect various body systems. 6. What are some possible mechanisms by which yoga may provide benefits to health? 7. Have you personally noticed the diurnal alternations in nasal airway passages that are described in connection with yoga practice? What do you think is the influence on neuro-physiology as related to yoga/meditation? On health in general? 7. List the research-demonstrated health and wellness benefits of yoga. 8. What are some of the hazards of yoga as currently practiced in the US?

SECTION FIVE: WESTERN ELECTROMAGNETIC, NATURAL, NUTRITIONAL, AND PLANT-BASED THERAPIES

Chapter 21—Western Origins of Natural Medicines, Nature Cure, and 1. Describe how the frontier circumstances of the North American continent from 1492 to 1942 influenced the availability of medical care, and the development of natural alternatives. 2. What were some of the first “herbals” compiled describing botanical remedies and their uses in North America? 3. How did discovery and acceptance of the “germ theory” of disease in the second half of the 19th century influence medical science, education and practice? 4. What developments in the early 20th century contributed to the decline of alternative medical education and practice?

Chapter 22—Contemporary Naturopathic Medicine 1. Given the diversity of therapeutic modalities taught today, as well as the many disciplines that form their roots, what principles/guidelines do you see yourself using as a foundation for your clinical judgment? 2. What influence does the vis medicatrix naturae have? 3. The scientific method? 4. Today we are seeing an increasing degree of cooperation between practitioners of different backgrounds, as well as an increasing awareness of the need for preventative medicine, in both the individual and the public health setting. What role could/should naturopathic medicine play in guiding preventative policy? 5. In working in collaboration with other health care practitioners? 6. In providing individualized care? 7. We are also seeing significant overlap of the education as well as the modalities used by practitioners of different backgrounds. For example, some naturopaths now have very extensive prescription drug authority, and some “regular” medical doctors receive extensive training in nutrition and . What, if anything, do you believe clearly defines the difference between naturopathic doctors and other health care practitioners? 8. Many therapies used by naturopathic as well as allopathic doctors are lacking a solid research foundation. What role do you see research having in examining current modalities, as well as future therapies? Additionally, there is a tremendous degree of conflict-of-interest in today’s research, particularly but not limited to drug therapy. How do you see this problem best addressed? 9. Describe and discuss Naturopathic Medicine as a model for authentic medical integration of different therapeutic modalities, or “Integrative Medicine.” [Note see also Chapter 3]

Chapters 23 and 24—Electromagnetic Therapies: Light, Magnetism and Sound 1. Describe the relationships between electricity and magnetism. By what means could they have a role in health and healing? 2. What are the health effects of sunlight? How does sunlight act on the human body? 3. Name three medical devices that utilize electro-magnetic energy and briefly describe how they work. 4. What are some of the pros and cons of using laser therapy for pain conditions?

Chapter 25—Homeopathic Medicine 1. What is the physiologic meaning of a symptom in ? 2. Describe how homeopathy can be considered another example of “mind-body” medicine. 3. What is the “memory of water” theory for the mechanism of homeopathy? Is this another form of “energy medicine”? 4. Name three health conditions that are treated by homeopathy as documented by clinical research.

Chapter 26—Western Herbalism and Ethnobotany 1. Discuss the common themes of herbalism in this chapter, and as found throughout this book. Which of these themes do you see demonstrated in the health care industry on a regular basis? Which of these themes would you like to see used more in the health care industry? 2. What legislation exists in the United States regarding the regulation of herbal products as dietary supplements? 3. What are some potential benefits that herbalism offers in the treatment of diseases? 4. Why are herbal medicines not reimbursed by health insurers? Why are they not considered medical expenses for purposes of income tax deductions? Should they be? 5. What steps are the herbal industry, and the U.S. government, taking to make sure herbals are safe, pure, and of high quality? What more, if anything, do you think needs to be done? What do you think the government should not do?

Chapter 27—Plant Essential Oils and 1. How does the development of essential oil therapies relate the fragrance and cosmetic industry? 2. What are two ways essential oils can be used and how do they enter and influence the body? 3. What way should essential oils not be used? 4. List some specific plant oils used in the therapy, together with their physiologic effect(s). 5. What are the primary clinical settings in which essential oil therapy can be used?

Chapters 28 and 29—Nutrition, Water & Hydration and Diet Therapies 1. Describe the probable prehistoric diet of humans (prior to agriculture 10,000 years ago). How does it differ from the typical 20th–21st century diet? 2. Compare and contrast the following terms: vitamin, mineral, micronutrient, macronutrient, and phytochemical. 3. Discuss some differences among tap water, bottled waters, and mineral waters in terms of their effects on hydration and health. 4. What is cellular hydration? How do cells obtain water for intra-cellular fluid? 5. How does the quality of soil and water affect oneʼs diet, nutrition and health? 6. Compare and contrast Western versus Eastern approaches to treating diseases using diet and nutrition.

SECTION SIX: GLOBAL ETHNOMEDICAL SYSTEMS: ASIA AND THE MIDDLE EAST

Chapter 30—Social and Cultural Factors in Medicine: East and West 1. Is biomedicine culturally coded? What are some of the characteristics of this medicine that show its cultural and historical origins? Why has it become dominant? Give examples that show you understand cultural coding. 2. What are some social, economic, and political implications of being culturally coded? 3. What is a “fact”? How do we know it is factual? If another explanatory model says it is not factual, what can you do then? 4. Suppose a patient is very resistant to your medical suggestions. What can you do about that and still be an effective medical practitioner? 5. Suppose a patient reports that he is taking herbs to treat his condition, but you do not know anything about herbs. What can you do about that as a responsible medical practitioner? 6. Are all medical practitioners MDs? Is a shaman a medical practitioner? Is a chiropractor a medical practitioner? An acupuncturist? A master? Why or why not? 7. Study the Cultural Medical System model. Why is technology a part of this model? Why are social sanctions a part of this model? What part of the model do you think is MOST important to the “shape” of the resultant medical system? Explain your answer. 8. Do you think in the future the United States will have an “integrated” medical system? What might this look like? Will biomedicine still be “in charge,” or do you think a pluralistic system in which several systems are readily available for the patient’s choice will emerge (as is the norm in most of the world)? 9. Pick two different medical systems and discuss them sufficiently so that you think you can identify their medical models adequately. Then try to map them on the maps provided in the chapter. How do they fit on the maps in comparison with Oriental medicine and biomedicine, the two systems that the chapter models for you?

Chapter 31—Ethnomedicine, and Cultural Origins

1. While awaiting controlled clinical trials (which may or not be done), discuss some of the other scientific methods for gathering scientific information about the effects of traditional healing practices. 2. Can controlled clinical trials capture all the information relevant to health and healing in the practice of traditional ethnomedical healing? Why or why not? 3. Define and describe a shaman and shamanistic medicine. 4. What are the ancient origins of shamans and shamanistic healing? 5. What is meant by the term “hierarchy of resort” for choosing from among different available kinds of medical care?

Chapter 32— of China and East Asia

1. The chapter author suggests that part of the genius of Chinese medicine lies in the ability of its theory to generalize effectively about complex systems. Based on content in this chapter, and looking ahead to the next chapter on chapter as well, do you agree? Why or why not? 2. Explore tongue diagnosis by either. 3. Examining your tongue over five successive mornings (do not brush the tongue before examining it) or. 4. Comparing the tongue of three friends or colleagues. 5. In either case, note color of tongue tissue, thickness, distribution and color of tongue coat, and presence of cracks, prickles, tooth marks, and other distinguishing characteristics of tongue tissue. 6. Chinese medicine in the United States, and in the West in general, has predominantly transformed the idea of into a metaphysical entity as opposed to a complex and evanescent substance that travels throughout the body accompanied by blood and spirit in classic Chinese medicine. Why do you think practitioners in the West are apparently more comfortable with the idea of qi as “energy”? 7. Reflect on the Chinese medical tradition and the concept of holism. In what way, if any, is this medical system holistic? In your opinion, is it any more or less holistic than biomedicine? Why? [see also Chapter 30] 8. It can be said that Chinese medicine views the body as a landscape or a micro- climate, even as a “garden.” Please discuss this idea from the perspective of the six evils.

Chapter 33 —Classical Acupuncture 1. How is conceptualizing qi as energy a useful way to understand the traditional Chinese paradigm, or does it obscure potentially broader meanings? 2. Very often, acupuncture concepts such as the location at which needles are applied or the channels described in traditional theory are referred to using the expression “point” or the term “meridian,” respectively. Both point and meridian express the idea of arbitrary, fixed locations in space. Do you think these terms can adequately capture what the Chinese were trying to express with the words xue (“hole”) and jing luo (“channels and networks”). Why or why not? 3. Contemporary western neurophysiological perspectives on acupuncture can be said to either expand the usefulness of acupuncture or limit our understanding of this complex system. What arguments could be made for either position? 4. Based on the discussion of channel categories and pathways, do you think that acupuncture needling at non-indicated sites could be an effective placebo control for an acupuncture treatment? Why or why not? 5. It can be said that Chinese medicine views the body as a landscape or a micro- climate, or “garden.” Please discuss this idea from the perspective of the channels and networks.

Chapter 34—Southeast Asia: Malaysia, Indonesia, Vietnam, Burma, and Thailand 1. Name at least three historical influences on the practice of traditional medicine in Malaya? In Indonesia? In Vietnam? How do these influences differ and how are they similar? 2. Name at least three different types of healers that practice in Southeast Asia today. 3. How do they differ and how are they similar? 4. What is appropriate health care technology relative to effectiveness, completeness, acceptance and costs/infrastructure? 5. How is Thai Medicine unique, and how is it similar to Chinese Medicine?? Other Southeast Asian traditions? 6. Say something about Burmese Medicine.

SECTION SEVEN: MIDDLE ASIA

Chapter 35—Tibetan Medicine 1. Describe how Tibetan Medicine may be seen as a bridge between Chinese and Ayurvedic (Indian) Medicines? How is it different from each? 2. How do Buddhist teachings influence the theory and practice of Tibetan Medicine? 3. What are the factors influencing availability of traditional Tibetan Medicine?

Chapter 36—Traditional Medicines of and Nepal 1. Have you seen different variations of Ayurvedic practices demonstrated in today’s health care system? If so, where and how? 2. How does Siddha differ from Ayurveda? 3. Where and how do you see both Ayurveda, and Siddha, medicines each being integrated, or not, into western health care today? 4. List three common medical conditions treated by Ayurveda. 5. List three common South Asian herbal remedies and their principle uses. 6. What are three different medical traditions widely practiced in India today? 7. How is Nepali Medicine unique, and how is it similar to Tibetan Medicine, Unani Medicine? Ayurvedic Medicine?

Chapters 37 and 38—Unani Medicine, Sufism and Healing in the Middle East

1. Explain the concept of humoral imbalance and how it is used in Unani medicine diagnosis. 2. How is the Unani medical system different from the allopathic Western medical system? 3. Do you think writers such as (Ibn Sina) made important empirical observations and developed theories historically that can be interpreted in light of today’s findings from basic and clinical research? 4. How did historical observers like Avicenna incorporate observations about such factors as climate and environment (that are missing from contemporary medical evaluations and theories)? 5. What are mechanisms by which the human mind-body enters into trance-like states? How can such states influence the process of healing? 6. Is the healing of “deliberately-caused bodily damage” different from the classic response to injury, and immune response? How?

SECTION EIGHT: GLOBAL ETHNOMEDICAL SYSTEMS: AFRICA, AMERICA AND THE PACIFIC

Chapters 39 and 40—Western Africa; Southern Africa 1. How do concepts of “magic” and “witchcraft” relate to traditional ethnomedicine and shamanism? 2. Is an emphasis on sharing in traditional society a means of resolving envy and the “image of limited good”? 3. What are some of the problems of contemporary “neo-shamanism” as currently practiced? 4. Describe the attributes and process for becoming a traditional healer? 5. How do you think the differences between Western medicine and African traditional healers would affect caregiving practices and policies? 6. What are the implications of these differences for schooling of Africaʼs children? 7. How can mechanisms be developed to allow the integration of different systems of knowledge in medicine?

Chapter 41—Native North American Healing and Herbal Remedies 1. In what ways can conventional health care providers partner with traditional American Indian healers? What are some of the obstacles to such partnerships? 2. What traditional American Indian healing ceremonies have you observed or participated in? Did your participation challenge or reinforce any views or stereotypes you may have had about traditional healing methods? If not, what do you think from your reading of this chapter and textbook? 3. What factors do you think influence Indian people to seek out healing from their traditional medicine men, elders, and other traditional healers? What factors do you think impede or delay traditional Indian people from seeking conventional medical treatment? 4. Identify reasons why a traditional American Indian older adult would not disclose the traditional healing practices they are receiving from their respective traditional healers. What could conventional health care providers and physicians do to build trust and better understanding with their traditional American Indian patients? 5. Do you see any attributes of the traditional “medicine man” in the physicians you consult with today? Why or why not?

Chapter 42—Central and South American Healing & Herbal Remedies; Latin American Curanderismo

1. What is and the ayahuasca ceremony? Can it be considered a form of alternative healing? Why or why not? 2. What is peyote? Can its use be considered a form of alternative medicine? A form of religious practice? A form of substance abuse? All of the above? Why or why not? 3. What are some of the reasons that the Amazon rain forest may hold undiscovered “cures” for contemporary medical conditions? What are some of the barriers to accessing new herbal remedies from the rainforest? 4. Many traditional healing systems have a complex blend of natural, spiritual, scientific, and supernatural theories about health and healing. How would you describe this blend of ideas and practices for Curanderismo? 5. The most important credentials for come from community acceptance and the belief that curanderos have a “gift” for healing that is not from formal classes or institutional degrees. How does the difference between the credentials of curanderos and those of physicians and nurses have an impact on their healing practices? On their acceptance and effectiveness? 6. Curanderismo has three areas of healing theory and practice: the material level (nivel material), the spiritual level (nivel spiritual), and the mental or psychic level (nivel mental). How do these three areas of practice overlap, or not, with the practice of “modern medicine”? 7. How do the three Curanderismo areas of healing theory and practice mentioned in #3 overlap, or not, with the other forms of complementary and alternative medicine such as Ayurvedic medicine, or traditional Chinese medicine, vibrational medicine, homeopathy, naturopathy, or various forms of shamanism?

Chapter 43—Hawaii, South Pacific and Philippine Islands; Alaska and Pacific Northwest 1. Describe the use and effects of kava. 2. How does traditional Hawaiian Medicine represent a system of healing? 3. Discuss two major influences on traditional medicine in the Philippines. 4. How did developments in the coastal areas of the Pacific NW, Canada and Alaska influence international attitudes regarding the value of traditional ethnomedical beliefs and practices, indigenous rights, and the environment?

Chapter 44—Modern Asia, Africa, Americas and the Pacific 1. What is medical pluralism? 2. Discuss three factors influencing the development of western biomedicine as the predominant healthcare system in the world today. 3. Discuss three factors preventing western biomedicine from becoming the primary healthcare system throughout the modern world. 4. Discuss the view of the World Health Organization regarding primary care for the worlds peoples.

GENERAL QUESTIONS ON COMPLETION OF TEXT

1. Is a single entity? 2. Discuss the role of metaphor in complementary and alternative medicine (CAM) descriptions of physiology. 3. Do conventional medicine and CAM differ in the emphasis they place on structure/organization and energy/change? 4. How important is subjective experience to the way we think about CAM? 5. Describe your own subjective experiences of flow and the breath-soul in the context of health. 6. Explore how possible connections between Indian and Chinese traditional models of body function are presented on the World Wide Web. 7. Does spirit have a place in Western medicine? 8. When you next read a novel, check how often the language reflects an awareness of flow and heat in the body. Does this language differ between novels written by men and novels written by women? Does it vary with type of novel (romance, war story, “Gothic” fantasy or horror, historical epic, or other)? 9. Does orthodox Western medicine view the body as a machine? Why or why not? 10. Does contemporary practice of such therapies as , chiropractic, , psychotherapy, and homeopathy maintain a vitalist perspective? If not, why not? 11. Having read this textbook has your understanding of the term “energy” changed when used in the context of health and healing? 12. Are you more of a fluidist, or do you think this vitalist property is just all in the mind? 13. Has reading this textbook helped you understand what underlies many seemingly disparate forms of CAM?