Dr. dr. Amarullah H.

Siregar, DIHom, DNMed, MSc, MA, PhD

Bulan Bhakti IDI 2012
MEDICINE TODAY

CONVENTIONAL

NON CONVENTIONAL
♣ Naturopathic Medicine
♣ Anti Aging Medicine
♣ Wellness Medicine
♣ Functional Medicine
♣ Restorative Medicine
 Kinesiology
Osteopathy
Chiropractic
ALLOPATHIC Chelation Manual therapy
Podiatry
MONO
SURGERY Glandular
Myotherapy COLOUR
Cell therapy
Mega-vitamin Enzyme Cranio-sacral
Nutritional Colonic Hakomi
Clinical ecology Ionization
Macrobiotic Metamorphic
Juice therapy Zero balance therapy
Food therapy Detoxification therapy Art therapy
Ozone therapy Meditation
Apitherapy Hypnotherapy
Aromatherapy Acupuncture Relaxation
Herbal medicine Naturopathy Do-in Biofeedback
Chinese medicine Hydrotherapy therapy
Neural therapy Dance
Homeopathy
Bach remedies Music therapy
Anthroposophy Dance Singing
Reiki
Ayurvedic Autogenic
Energy medicine Qigong
Aura-Soma KINSHIP
Eurythmic Geopathic
Tibetian
Taichi Yoga AMONG
Radionics
Spiritual Healing
Guided Imagery
Primal therapy
THERAPIES
Negative ion therapy
Sufi dance Biorhythm
Bio-energetic Psionic
Flotation therapy
Shen therapy Orgon
Colour therapy
Radiesthesia
 WORLD HEALTH ORGANIZATION
Executive Board 117th Session
January 2006

6. In cases where medicines are needed where significant numbers of patients have
higher incomes, there is disproportionate emphasis on products that do not provide
incremental benefits over existing ones. A breakdown of the 1,035 new drugs
approved by the US FDA (Federal Drug Administration) between 1989 and 2000
revealed that more than ¾ are classed as having no therapeutic benefit over existing
products, so called ‘me too’ drugs (NIHCM 2002). At the same time it was noted that
less than 1% addressed diseases that primarily afflict the poor and for which new
treatments would have the greatest effect on world healthcare (WHO 2003)
Complementary
Medicine

Complementary
Medicine
Indonesian Healing through the Ages

Jaman Neolitikum
Museum Jakarta
Penggunaan alat batu untuk menghancurkan tanaman untuk
menghasilkan serbuk dan ekstrak

800 – 900 SM
Candi Borobudur
Pengracikan tanaman untuk perawatan tubuh dan kecantikan;
juga terapi pijat

Akhir Millenium 1
Penaklukan Majapahit ke Bali
Pengaruh Hindu mulai memasuki sistem pengobatan Jawa;
prinsip dasar kehidupan menyebar ke nusantara

Abad ke XV
Pecahnya Majapahit dan mulai masuknya Islam

Tahun 1908
Awal mulai Kolonialisasi dan masuknya pedagang Cina
• 1940
Kongres ke 2 Ikatan Dokter Indonesia di Surakarta
 OBAT TRADISIONAL INDONESIA
 jamu menjadi komplementer
• 1942 – 1944
Pendudukan Jepang
 Dai Nippon mendukung jamu untuk perawatan kesehatan
 KOMITE KEDOKTERAN TRADISIONAL INDONESIA
(Juni 1944 – Prof. Dr. Sato)
• Perang Kemerdekaan
 Kedokteran konvensional sangat terbatas
 Medis & Paramedis lebih banyak menggunakan jamu/herbal
• Proklamasi Kemerdekaan
 Presiden Sukarno BERDIKARI
 Penggunaan jamu semakin populer
 Kongres, Seminar, Penelitian manfaat jamu
 KEDOKTERAN ASLI INDONESIA

▪ ISLAMIC MEDICINE
▪ AYURVEDA (HINDU) MEDICINE
▪ GRAECO-ROMAN MEDICINE
▪ CHINESE MEDICINE
▪ THURSTONISM (CHRISTIANT) MEDICINE Susan-Jane Beers (2001)
▪ ECLETISM (CHRISTIANT) MEDICINE Njonja E. van Gent-Detelle (875)
Njonja van Blokland (1899)
◘ Pendekatan Kosmologi
◘ Pendekatan Holistik
◘ Pendekatan Kultural
◘ Pendekatan Sibernatika
Pendekatan Kosmologi
INDIVIDU ≈ ALAM
NATURALISTIK
Cuaca, Iklim, Makanan, Racun,
Kuman, Bakteri, Trauma, Stres
BODY - MIND
Manusia
MIKROKOSMOS
KESEIMBANGAN HARMONIS
&
YANG UTUH
MAKROKOSMOS
Alam Semesta

SPIRIT
Intervensi suatu agen aktif
(makhluk gaib, sihir, roh jahat)
PERSONALISTIK
Lieban 1977:27
Foster and Anderson 1986: 64
Jordaan 1985: 224
Pendekatan Holistik
PENYAKIT
Ketidakseimbangan

Fisik, Emosional, Spritual,

Sosial dan Lingkungan

INDIVIDUALISTIK

KAUSAL
Pendekatan Kultural
SEHAT

BioPsikoSosioKultural

Health Quotient

Perilaku Sehat

NILAI & BELIEVE

 INDIVIDUAL CONSEQUENCES

EVALUATION

B
Biological E
PERSONALITY
Need COPING
STYLES H
VALUES
Closeness A
BELIEFS Separateness HABITS V
Socio ATTITUDES Pattern I
BEHAVIOUR O
Cultural CAPABILITIES DISPOSITION
U
Component R

Cognitive Affective
evaluation evaluation
Pendekatan Sibernatika
SEHAT

Basic Need

Komunikasi Kendali Biologis Mekanistik

VITALITAS

Quality of Life
◘ Holistic & Wholistic (Holism)
◘ Nature & Nurture
◘ Disease & Dis-ease
◘ Medicatrix Naturae
Holism
► Penanganan individual
► System not symptom
► Holistic & Wholistic
Nature & Nurture
► Manusia ≈ Alam
► Penyakit: kasih sayang alam ??

Disease & Dis-ease

► Penyakit ↔ ketidakselarasan
► Ketidakselarasan = Patologis

Medicatrix Naturae
► Alam sang Penyembuh
Sehat – Sakit ≈ RESILIENSI
VITAL FORCE
Alam ≈ KOMPONEN ENERGI
Sisi SEHAT vs Sisi SAKIT

Subjectivity
ILLNESS
Inter-Subjectivity
SICKNESS

Objectivity
DISEASE
 ILLNESS, SICKNESS & DISEASE
Perspectives

DISEASE
Underlying pathology;
biological defined
The practitioner’s view and
perspectives

ILLNESS
A person’s
subjective SICKNESS
experience Social & cultural conceptions of the
of their symptoms. person’s condition.
What the patient brings Cultural beliefs and reactions such
to the practitioner as fear or rejection.
Affect how the patients react.

Marinker M. Why make people patients? Journal of Medical Ethics 1975:I:81–4

Boyd K.M.. Disease, illness, sickness …….Med Humanities 2000;26:9-17
 • Tidak hanya terbebas dari penyakit
• Pendekatan menyeluruh secara holistik
• Melibatkan perspektif individu secara utuh
• Tidak hanya kesehatan fisik; tetapi juga emosi,
intelektual, sosial, okupasi dan spiritual

Konsep SEHAT
WELLNESS ORIENTED HOLISTIC PROGRAM THROUGH WELLBEING

RESILIENSI

• Tingkat kesehatan tertinggi

• Tumbuh dan kembang yang positif
• Rujukan pilihan terhadap perilaku kehidupan
• Kehidupan yang seimbang menyangkut aspek fisik
emosi, intelektual, sosial, okupasi dan spiritual
Susser M. Causal thinking in the health sciences. New York: Oxford University Press; 1973
RESILIENCE = VITAL FORCE
 EMIK ETIK
An "emic" account is a description of behavior or a belief in terms
meaningful (consciously or unconsciously) to the actor; that is, an
emic account comes from a person within the culture.

An "etic" account is a description of a behavior or belief by an

observer, in terms that can be applied to other cultures; that is, an etic
account attempts to be "culturally neutral."

Wikipedia
 SEHAT SAKIT

ETIK EMIK ETIK EMIK

• Jasmani Tidak merasakan adanya

 Fungsi mekanistik kelainan • PERSONALISTIK • ILLNESS
• Mental fisik atau psikis  Lingkungan  Penilaian individu
 Berfikir jernih (Supranatural) (Subjektif)
• Emosi
 Aspek Budaya
 Kendali perasaan Walau sakit
• Sosial • NATURALISTIK
 Inter-relasi sesama  Keseimbangan • DISEASE
• Spiritual Tetap dapat menjalankan (Homeostasis)  Penilaian biologis
 Kepercayaan peran (Objektif)
• Lingkungan dan akitifitasnya  Aspek Medi
 Hubungan sekitar

WELLNESS QoL KOSMOS DIAGNOSA

Komprehensif
Diagnostik
♣ EMIK
► Illness & Sickness
♣ ETIK
► Disease
♣ DIS-EASE
♣ PERSONALITAS
♣ PNEI
♣ WELLNESS
 PENGOBATAN KEDOKTERAN PENDEKATAN
NENEK MOYANG NATUROPATI BIOMEDIK

BATANG TUBUH
PENGOBATAN ASLI INDONESIA
EMIK – ETIK Symptom
DISEASE (ICD) Laboratories 1 2
Radio-imaging
DIS-EASE System
- Organic
- Central Nervous
- Cardiovascular
- Pulmonary
- Hepato-billiary
- Gastrointestinal
- Urinary tract
- etc
3
- Functional
- Circulatory
- Hormonal
- Metabolism
- Detoxification
- etc
Cellular aspect
Energy analyze
INDIVIDUAL Constitutional aspect
BLUE PRINT - Sanguin
- Phlegmatic 4
- Melancholic
- Choleric

PNIE Body Mind Spirit

- Symphatic
- Para-symphatic 5

WELLNESS Resilience
- Physical
- Intellectual
- Spiritual 6
- Social
- Emotional
- Occupational
- Environmental
 Analisa keluhan secara langsung atau allo-anamnesa

EMIK – ETIK
DISEASE (ICD) 1 2
Telusuri wawancara lebih lanjut untuk mengetahui faktor
aggravasi dan faktor ameliorasi

ILLNESS SICKNESS DISEASE plus DIS-EASE

Persepsi Masyarakat Pendekatan ilmiah medis

Keluhan Pencetus Kelengkapan diagnosa
Kebiasaan Pemberat Sistem yang terganggu
Awam Budaya
 3

DIS-EASE
CELLULAR AFFAIR 3
Human body make up by 100 trillion cells
 UNDERSTAND CELL FUNCTIONS
CELL DIVISION LIMITATION
Hand in hand with Waste Accumulation. Waste >>  cell fall apart
 few cell division

HAYFLICK LIMIT
Cell are control by biological clock that limits their lifespan.

TELOMERASE
Nucleic acid from tips of chromosome broken

AUTOIMMUNE
Immune attack its own

LIPOFUSCINS
Free radical attack cell membrane and create metabolic waste
 Bio-energy Source Function

Metabolic energy Fats, sugar, protein, Fuel, to power basic

essential nutrients cellular processes

Bioelectrical Nerves, muscles, Movement of body,

energy heart, GI tract, brain blood, food, urine.
Communication and
information of body’s
organ

Bone matrix Remodeling for

3 optimal strength

Intracellular electrons Regulate internal

from mitochondria cellular process

Circulatory systems Repair of tissue damage

and healing response
 Bio-energy Source Function

Biophotonic DNA in cell nucleus Cell communications

energy

Subtle energy Life energy Nutritive support

(Magnetic Life Organ coordination
energy) Defense mechanism

Oxygen and sun Support the organs

light and tissues activity

Etheric energy Growth, development

and repair of trauma

Astral energy Regulate emotion

Mental energy Intellectual, creativity

and abstract thought

Spiritual energy Repository of soul

memories
 4
HUMAN
a
PHYSICAL

Hot Cool
[A] [B]

Hot Cold
Warm Cool
MATERIAL
HERBS

INDIIDUAL BLUE PRINT

Individual Personality
VIRTUOSO CONQUEROR
HANGAT PANAS

DINGIN KALEM
SAVANT THESPIAN
 Jayengresmi
Jayengsari
Rancangkapti

sisi perilaku dan watak manusia

kekuatiran, kekuatan,
kecemasan dan mencinta dan
keingintahuan menghamba

mengalahkan nafsunya sendiri

 Symphatetic
Organ-System
STRESS
Weakness
Total Wellness, 2000 Para Symphatetic

Neurochemical
imbalance Deficiency
Immune
System

Hormonal
DEGENERATIVE
imbalances
5
 STRESS

Recognition
Central Nervous System
Organization of Biological defense

BIOLOGICAL RESPONSE
Behavioural, Autonomic, Endocrine and Immune
Response
Disturbances normal biological function

Altered biological function

Result
Pre-Pathological state

Development of Pathology

AGING
Radicalization
Degenerative and Disease
 STRESOR
Cortex & Limbic

HIPOTALAMUS

JANGKA PENDEK JANGKA PANJANG

Jalur Elektrik Jalur kimiawi

Brainstem Pituitari
Adrenal Medulla Adrenal Cortex

Adrenalin Cortisol

Gangguan Mekanik Gangguan

& Kinetik Regenerasi

Mitochondrial cytopathy

TELOMERASE
 B-M-S BIOMARKER CHECK
PNEI
Hypothalamus
&
Pituitary

ACTH Negative feedback

Catecholamines

Adrenal Cortex
Pregnenolone

DHEA CORTISOL
Anabolic Catabolic
Sex hormones Gluconeogenesis
Anti – atherogenic Anti – inflammatory
Immune protective Immune suppression
APPLICATION PRACTICE
- More than just the absence of disease
- Be in good health and truly well 6
- Sense of vitality of body, mind and spirit
 RESILIENCE TO ILLNESS

DIS-EASE vs DISEASE

If you are ill, treatments is important but don’t stop at the neutral point
REACTIVE PRO-ACTIVE

DISEASE DIS-EASE AVERAGE GOOD OPTIMAL

Multiple medications Symptoms No symptoms Regular exercise Revitalize function
Poor Quality of Life Drug therapy Nutrition inconsistent Good nutrition Active participation
Potential becomes limited Surgery Exercises sporadic Health conscious Wellness lifestyle
Body has limited function Losing normal function Health is low priority Minimal nerve interference Continuous development
 WELLNESS DIMENSIONS
PHYSICAL
Measures both how one maintains fitness and strength, and behaviors
that help one to prevent or detect early illnesses

INTELLECTUAL
Measures the degree that one engages in creative, stimulating mental
activities

SPIRITUAL
Measures one’s ongoing involvement in seeking meaning and purpose
in human existence

SOCIAL
Measures the individuals contribution to the common welfare of the
community

OCCUPATIONAL
Measures the satisfaction gained from one’s work and the degree to
which one is enriched by the work

EMOTIONAL
Measures the degree of awareness and the acceptance that one has of
one’s feeling

ENVIRONMENTAL
Measures the involvement accepting the impact we have on our world
and doing something about it
[1] Detoks (Pembersihan racun)
 penyakit terjadi adalah akibat ketidak mampuan
tubuh untuk membersihkan racun;
[2] Pemanasan (Melancarkan sirkulasi)
 panas identik dengan vitalitas (penyakit adalah
akumulasi energi negative);
[3] Pendinginan (Penenangan pencernaan)
 penyakit adalah akibat terlalu beratnya kerja saluran
cerna sehingga perlu dicooling down;
[4] Tonifikasi (Penguatan fungsi)
 penyakit terjadi akibat debilitas atau menurunnya
vitalitas; termasuk pada penderita yang membutuh
kan proses recovery.
B
i
o
m
e
d
i
k
 AROMATERAPI
RAMUAN HIDROTERAPI
PIJAT
ENERGI
JAMPI

KETRAMPILAN
1. Magis atau Supranatural
- penggunaan turun temurun
- berdasarkan wangsit
- berhubungan dengan aspek spiritual
2. Energetik
- anggapan ramuan ≈ membangun energi
- berdasarkan energi positif – negatif
- tanpa aspek supranatural
3. Fungsi dinamis
- konsep fisiomedicalism
- berkaitan dengan aspek kedokteran
- tanaman tidak selalu berkaitan dengan fisik tetapi lebih
dominan fisiologis
4. Kimiawi
- praktisi era modern
- kerja ramuan ↔ kandungan kimia
- efektifiatas = sinergi komponen kimia
PRINSIP DASAR
1. Tubuh ↔ natural self healing power.
 Tujuan penggunaan jamu
- mendukung mekanisme internal
- mempertahankan fungsinya
2. Penyakit ≈ ketidakberesan pencernaan
 pengambilan nutrisi terganggu
- kapasitas energi menurun
3. Kekuatan quasi-material (humor ) = sehat
 Jamu untuk restorasi dan harmonisasi
4. Pemberian luar – dalam
 saluran cerna sangat sensitif
- evakuasi zat asing
- cegah keluarnya zat penting
- optimalisasi sistem humor
 VITALISTIK
- makhluk hidup tersusun komponen
kimia dan fisik
- reaksi bersifat kompleks
 tumpuan utama kelangsungan
hidup
- membutuhkan organisasi dan
kordinasi
 system homeostasis.
- agar stabil dibutuhkan vitalitas
(biological intelegence )
- JAMU: Bio-intelegensi sel
 Revitalisasi energi
MEKANISTIK
- Dianut oleh dunia kedokteran
 makhluk hidup adalah
komponen materi
 bukan reaksi kimia dan fisik
- Penyakit = ketidak beresan organ
 ganggu reaksi kimia dan fisik
 akibat aktifitas patogenik
- Konsep dasar REDUKTIONISM
 pendekatan simptomatik
- Tidak mampu pada kasus kronis
 terutama untuk pencegahan
- Mengabaikan konsep QoL
 EINSTENIAN
• Tubuh sebagai sistem energi yang
dinamis
• Mind dan Spirit sebagai operator
utama sistem tubuh
• Emosi dan spirit dapat mempenga-
ruhi melalui jalur neuro-hormonal
dan energi
• Keselarasan jasmani, rohani dan
spiritual sangat penting
• Pengobatan bertujuan untuk
menyelaraskan kompleksitas energi
melalui jasmani, rohani & spiritual
NEWTONIAN
• Tubuh sebagai sistem biomekanik
• Otak merupakan operator utama
yang berperan sebg biokomputer
melalui jalur aktifitas listriknya
• Emosi dapat mempengaruhi
melalui neurohormonal di otak
• Keutamaan kondisi fisik lebih
penting untuk menilai kondisi sakit
• Pengobatan dengan obat atau bedah
bertujuan untuk perbaiki kondisi
biomekanik tubuh yang abnormal
• Reduktionism sebagai pilar utama
 ENERGY

ANATOMICAL
PRINSIP HARMONISASI

Harmonisasi
pasien dengan lingkungan
energy positif dan negatif
unsur panas dan dingin

Tri Hita Karana

“Sang Hyang Jagat Karana”
individu dengan Tuhan
“Bhuana Agung”
manusia makhluk makrokosmos terkait
dengan lingkungan
“Bhuana Alit”
manusia makhluk mikrokosmos
memerlukan pikiran dan perasaan.
PRINSIP PENGGUNAAN

JAMU
kandungan utama
unsur pendukung
penyedap rasa atau bau

Mengatasi masalah
Mempertahankan tingkat kesehatan
Menenangkan sistem tubuh
Melakukan restorasi fungsi tubuh
PRINSIP PENGOBATAN

the power of body responsible to maintain health

KEGAGALAN

SISTEM TERGANGGU

[1] Eliminasi faktor penyebab

[2] Normalisasi sistem humor
[3] Normalisasi organ
Kategori Reaksi
Reaksi “healing crisis”
- bersifat sesaat
- seolah bertambah buruk
- tidak lebih dari 24 jam
Reaksi “aggravasi”
- reaksi perburukan
- bersifat perlahan tetapi berlanjut
- ramuan tidak sesuai.
Reaksi “ameliorasi”
- gambaran positif
- adanya perbaikan
- kesesuaian ramuan
 HEALTH – DISEASE FRAMEWORK
RAMUAN PIJAT TERAPI AIR  Naturalistik & Personalistik
≈ Body Mind and Spirit

MODALITAS

PENGOBATAN
PHILOSOPICAL APPROACH
TRADISIONAL  ISLAMIC and HINDUS MEDICINE
INDONESIA

CONCEPTUAL PRACTICE
 4 methods
(Cleansing, Warming, Cooling & Tonification)
 JAMUOLOGI