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Went all over the town with Sarah and Jesse and I saw this spot where I knew would make a great image using the Brenizer Method. But I don't why I torture myself with this method?! This took me forever to put together. Maybe it's because my version of photoshop decides to quit unexpectedly when I merge a photo--I had to do it all by hand. It's addictive though, once you start you can't stop. Your eye starts to see things "Brenzified."
Would you all be so kind a nominate me for Portland's best wedding photographer of 2010?! It only takes a minute to fill out the form and put in Daniel Stark Photography in the "wedding photography" section.
Thank you so much!
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Today I tried out the Brenizer method! Using a 50mm lens i took about 25 photographs of and around the model. Then used photoshop to photomerge them together.
My method for photography during this group ride was to use my handy Canon G12. Unlike my usual walk-about camera, the Canon G1x, the G12 actually fits into a pocket by virtue of its retractable lens. While at cruising speed and my right hand on the throttle, the left hand is free to operate the camera. My eyes don't leave my focus on the ride. I don't look at the camera. I just have to hit the on- button (settings have been preselected) and then the shutter that's next to it. All by touch. I simply take many images at slightly different angles, then slip it back in my pocket. On a motorcycle the left hand operates the clutch and once your at speed and in gear its possible to safely do this. My motorbike has a lot of low end torque so I can adjust speed without changing gears. In an emergency, I would ditch the camera. (But it could be tethered to my pocket). Alternatives to this method of motorcycle photography include a GoPro or head cam that can be more complicated to use (and even more distracting).
Photo taken at Cambridge University Botanic Gardens.
3d Cross-view - View the two images straight on and slightly cross eyes and the centre image which appears will be seen in 3d.
Guide to view stereo images using cross-eyed method
The hull of the "John B. Aird" showing a little 'wear & tear' as she navigates the Black River while arriving in Lorain, OH to take on a load.
Vanilla is a flavor derived from orchids of the genus Vanilla, primarily from the Mexican species, flat-leaved vanilla (V. planifolia). The word vanilla, derived from the diminutive of the Spanish word vaina (vaina itself meaning sheath or pod), translates simply as "little pod". Pre-Columbian Mesoamerican people cultivated the vine of the vanilla orchid, called tlilxochitl by the Aztecs. Spanish conquistador Hernán Cortés is credited with introducing both vanilla and chocolate to Europe in the 1520s.
Initial attempts to cultivate vanilla outside Mexico and Central America proved futile because of the symbiotic relationship between the vanilla orchid and its natural pollinator, the local species of Melipona bee. Pollination is required to set the fruit from which the flavoring is derived. In 1837, Belgian botanist Charles François Antoine Morren discovered this fact and pioneered a method of artificially pollinating the plant. The method proved financially unworkable and was not deployed commercially. In 1841, Edmond Albius, a slave who lived on the French island of Réunion in the Indian Ocean, discovered at the age of 12 that the plant could be hand-pollinated. Hand-pollination allowed global cultivation of the plant.
Three major species of vanilla currently are grown globally, all of which derive from a species originally found in Mesoamerica, including parts of modern-day Mexico. The various subspecies are Vanilla planifolia (syn. V. fragrans), grown on Madagascar, Réunion, and other tropical areas along the Indian Ocean; V. tahitensis, grown in the South Pacific; and V. pompona, found in the West Indies, and Central and South America. The majority of the world's vanilla is the V. planifolia species, more commonly known as Bourbon vanilla (after the former name of Réunion, Île Bourbon) or Madagascar vanilla, which is produced in Madagascar and neighboring islands in the southwestern Indian Ocean, and in Indonesia. Leptotes bicolor is used in the same way in South America.
Vanilla is the second most expensive spice after saffron, because growing the vanilla seed pods is labor-intensive. Despite the expense, vanilla is highly valued for its flavor, which author Frederic Rosengarten, Jr. described in The Book of Spices as "pure, spicy, and delicate"; he called its complex floral aroma a "peculiar bouquet". As a result, vanilla is widely used in both commercial and domestic baking, perfume manufacture and aromatherapy.
HISTORY
The Totonac people, who inhabit the East Coast of Mexico in the present-day state of Veracruz, were the first to cultivate vanilla. According to Totonac mythology, the tropical orchid was born when Princess Xanat, forbidden by her father from marrying a mortal, fled to the forest with her lover. The lovers were captured and beheaded. Where their blood touched the ground, the vine of the tropical orchid grew.
In the 15th century, Aztecs invading from the central highlands of Mexico conquered the Totonacs, and soon developed a taste for the vanilla pods. They named the fruit tlilxochitl, or "black flower", after the matured fruit, which shrivels and turns black shortly after it is picked. Subjugated by the Aztecs, the Totonacs paid tribute by sending vanilla fruit to the Aztec capital, Tenochtitlan.
Until the mid-19th century, Mexico was the chief producer of vanilla. In 1819, however, French entrepreneurs shipped vanilla fruits to the islands of Réunion and Mauritius in hopes of producing vanilla there. After Edmond Albius discovered how to pollinate the flowers quickly by hand, the pods began to thrive. Soon, the tropical orchids were sent from Réunion Island to the Comoros Islands Seychelles and Madagascar, along with instructions for pollinating them. By 1898, Madagascar, Réunion, and the Comoros Islands produced 200 metric tons of vanilla beans, about 80% of world production. According to the United Nations Food and Agriculture Organisation, Indonesia is currently responsible for the vast majority of the world's Bourbon vanilla production and 58% of the world total vanilla fruit production.
The market price of vanilla rose dramatically in the late 1970s after a tropical cyclone ravaged key croplands. Prices remained high through the early 1980s despite the introduction of Indonesian vanilla. In the mid-1980s, the cartel that had controlled vanilla prices and distribution since its creation in 1930 disbanded. Prices dropped 70% over the next few years, to nearly US$20 per kilogram; prices rose sharply again after tropical cyclone Hudah struck Madagascar in April 2000. The cyclone, political instability, and poor weather in the third year drove vanilla prices to an astonishing US$500 per kilogram in 2004, bringing new countries into the vanilla industry. A good crop, coupled with decreased demand caused by the production of imitation vanilla, pushed the market price down to the $40 per kilogram range in the middle of 2005. By 2010, prices were down to US$20/per kilo.
Madagascar (especially the fertile Sava region) accounts for much of the global production of vanilla. Mexico, once the leading producer of natural vanilla with an annual yield of 500 tons, produced only 10 tons of vanilla in 2006. An estimated 95% of "vanilla" products are artificially flavored with vanillin derived from lignin instead of vanilla fruits.
ETYMOLOGY
Vanilla was completely unknown in the Old World before Cortés. Spanish explorers arriving on the Gulf Coast of Mexico in the early 16th century gave vanilla its current name. Spanish and Portuguese sailors and explorers brought vanilla into Africa and Asia later that century. They called it vainilla, or "little pod". The word vanilla entered the English language in 1754, when the botanist Philip Miller wrote about the genus in his Gardener’s Dictionary. Vainilla is from the diminutive of vaina, from the Latin vagina (sheath) to describe the shape of the pods.
BIOLOGY
VANILLA ORCHID
The main species harvested for vanilla is Vanilla planifolia. Although it is native to Mexico, it is now widely grown throughout the tropics. Indonesia and Madagascar are the world's largest producers. Additional sources include Vanilla pompona and Vanilla tahitiensis (grown in Niue and Tahiti), although the vanillin content of these species is much less than Vanilla planifolia.
Vanilla grows as a vine, climbing up an existing tree (also called a tutor), pole, or other support. It can be grown in a wood (on trees), in a plantation (on trees or poles), or in a "shader", in increasing orders of productivity. Its growth environment is referred to as its terroir, and includes not only the adjacent plants, but also the climate, geography, and local geology. Left alone, it will grow as high as possible on the support, with few flowers. Every year, growers fold the higher parts of the plant downward so the plant stays at heights accessible by a standing human. This also greatly stimulates flowering.
The distinctively flavored compounds are found in the fruit, which results from the pollination of the flower. These seed pods are roughly a third of an inch by six inches, and brownish red to black when ripe. Inside of these pods are an oily liquid full of tiny seeds. One flower produces one fruit. V. planifolia flowers are hermaphroditic: They carry both male (anther) and female (stigma) organs; however, to avoid self-pollination, a membrane separates those organs. The flowers can be naturally pollinated only by bees of the Melipona genus found in Mexico (abeja de monte or mountain bee). This bee provided Mexico with a 300-year-long monopoly on vanilla production, from the time it was first discovered by Europeans. The first vanilla orchid to flower in Europe was in the London collection of the Honourable Charles Greville in 1806. Cuttings from that plant went to Netherlands and Paris, from which the French first transplanted the vines to their overseas colonies. The vines would grow, but would not fruit outside Mexico. Growers tried to bring this bee into other growing locales, to no avail. The only way to produce fruits without the bees is artificial pollination. And today, even in Mexico, hand pollination is used extensively.
In 1836, botanist Charles François Antoine Morren was drinking coffee on a patio in Papantla (in Veracruz, Mexico) and noticed black bees flying around the vanilla flowers next to his table. He watched their actions closely as they would land and work their way under a flap inside the flower, transferring pollen in the process. Within hours, the flowers closed and several days later, Morren noticed vanilla pods beginning to form. Morren immediately began experimenting with hand pollination. A few years later in 1841, a simple and efficient artificial hand-pollination method was developed by a 12-year-old slave named Edmond Albius on Réunion, a method still used today. Using a beveled sliver of bamboo, an agricultural worker lifts the membrane separating the anther and the stigma, then, using the thumb, transfers the pollinia from the anther to the stigma. The flower, self-pollinated, will then produce a fruit. The vanilla flower lasts about one day, sometimes less, so growers have to inspect their plantations every day for open flowers, a labor-intensive task.
The fruit, a seed capsule, if left on the plant, will ripen and open at the end; as it dries, the phenolic compounds crystallize, giving the fruits a diamond-dusted appearance, which the French call givre (hoarfrost). It will then release the distinctive vanilla smell. The fruit contains tiny, black seeds. In dishes prepared with whole natural vanilla, these seeds are recognizable as black specks. Both the pod and the seeds are used in cooking.
Like other orchids' seeds, vanilla seeds will not germinate without the presence of certain mycorrhizal fungi. Instead, growers reproduce the plant by cutting: they remove sections of the vine with six or more leaf nodes, a root opposite each leaf. The two lower leaves are removed, and this area is buried in loose soil at the base of a support. The remaining upper roots will cling to the support, and often grow down into the soil. Growth is rapid under good conditions.
CULTIVARS
Bourbon vanilla or Bourbon-Madagascar vanilla, produced from V. planifolia plants introduced from the Americas, is the term used for vanilla from Indian Ocean islands such as Madagascar, the Comoros, and Réunion, formerly the Île Bourbon. It is also used to describe the distinctive vanilla flavor derived from V. planifolia grown successfully in tropical countries such as India.
Mexican vanilla, made from the native V. planifolia, is produced in much less quantity and marketed as the vanilla from the land of its origin. Vanilla sold in tourist markets around Mexico is sometimes not actual vanilla extract, but is mixed with an extract of the tonka bean, which contains coumarin. Tonka bean extract smells and tastes like vanilla, but coumarin has been shown to cause liver damage in lab animals and is banned in food in the US by the Food and Drug Administration since 1954.
Tahitian vanilla is the name for vanilla from French Polynesia, made with the V. tahitiensis strain. Genetic analysis shows this species is possibly a cultivar from a hybrid-cross of V. planifolia and V. odorata. The species was introduced by French Admiral François Alphonse Hamelin to French Polynesia from the Philippines, where it was introduced from Guatemala by the Manila Galleon trade.
West Indian vanilla is made from V. pompona grown in the Caribbean and Central and South America.
The term French vanilla is often used to designate preparations with a strong vanilla aroma, containing vanilla grains and sometimes also containing eggs (especially egg yolks). The appellation originates from the French style of making vanilla ice cream with a custard base, using vanilla pods, cream, and egg yolks. Inclusion of vanilla varietals from any of the former French dependencies or overseas France noted for their exports may in fact be a part of the flavoring, though it may often be coincidental. Alternatively, French vanilla is taken to refer to a vanilla-custard flavor. Syrup labeled as French vanilla may include custard, hazelnut, caramel or butterscotch flavors in addition to vanilla.
CHEMISTRY
Vanilla essence comes in two forms. Real seedpod extract is an extremely complicated mixture of several hundred different compounds, including vanillin, acetaldehyde, acetic acid, furfural, hexanoic acid, 4-hydroxybenzaldehyde, eugenol, methyl cinnamate, and isobutyric acid. Synthetic essence consists of a solution of synthetic vanillin in ethanol.
The chemical compound vanillin (4-hydroxy-3-methoxybenzaldehyde) is a major contributor to the characteristic flavor and aroma of real vanilla, but hundreds of compounds contribute to a complex flavor that vanillin can only approximate. Another minor component of vanilla extract is piperonal (heliotropin). Vanillin was first isolated from vanilla pods by Gobley in 1858. By 1874, it had been obtained from glycosides of pine tree sap, temporarily causing a depression in the natural vanilla industry. Vanillin can be easily synthesized from various raw materials, but the majority of food grade (>99% pure) vanillin is made from guaiacol.
PRODUCTION
GENERAL GUIDELINES
In general, quality vanilla will only come from good vines and through careful production methods. Commercial vanilla production can be performed under open field and "greenhouse" operations. Both production systems share the following similarities:
Plant height and number of years before producing the first grains
Shade necessities
Amount of organic matter needed
A tree or frame to grow around (bamboo, coconut or Erythrina lanceolata)
Labor intensity (pollination and harvest activities)
Vanilla grows best in a hot, humid climate from sea level to an elevation of 1500 m. The ideal climate has moderate rainfall, 1500–3000 mm, evenly distributed through 10 months of the year. Optimum temperatures for cultivation are 15–30 °C during the day and 15–20 °C during the night. Ideal humidity is around 80%, and under normal greenhouse conditions, it can be achieved by an evaporative cooler. However, since greenhouse vanilla is grown near the equator and under polymer (HDPE) netting (shading of 50%), this humidity can be achieved by the environment. Most successful vanilla growing and processing is done in the region within 10 to 20° of the equator.
Soils for vanilla cultivation should be loose, with high organic matter content and loamy texture. They must be well drained, and a slight slope helps in this condition. Soil pH has not been well documented, but some researchers have indicated an optimum soil pH of around 5.3. Mulch is very important for proper growth of the vine, and a considerable portion of mulch should be placed in the base of the vine. Fertilization varies with soil conditions, but general recommendations are: 40 to 60 g of N, 20 to 30 g of P2O5 and 60 to 100 g of K2O should be applied to each plant per year besides organic manures, such as vermicompost, oil cakes, poultry manure and wood ash. Foliar applications are also good for vanilla, and a solution of 1% NPK (17:17:17) can be sprayed on the plant once a month. Vanilla requires organic matter, so three or four applications of mulch a year are adequate for the plant.
PROPAGATION, PREPARATION AND TYPE OF STOCK
Dissemination of vanilla can be achieved either by stem cutting or by tissue culture. For stem cutting, a progeny garden needs to be established. Recommendations for establishing this garden vary, but in general, trenches of 60 cm in width, 45 cm in depth and 60 cm spacing for each plant are necessary. All plants need to grow under 50% shade, as well as the rest of the crop. Mulching the trenches with coconut husk and micro irrigation provide an ideal microclimate for vegetative growth. Cuttings between 60 and 120 cm should be selected for planting in the field or greenhouse. Cuttings below 60 to 120 cm need to be rooted and raised in a separate nursery before planting. Planting material should always come from unflowered portions of the vine. Wilting of the cuttings before planting provides better conditions for root initiation and establishment.
Before planting the cuttings, trees to support the vine must be planted at least three months before sowing the cuttings. Pits of 30 x 30 x 30 cm are dug 30 cm away from the tree and filled with farm yard manure (vermicompost), sand and top soil mixed well. An average of 2000 cuttings can be planted per hectare. One important consideration is that when planting the cuttings from the base, four leaves should be pruned and the pruned basal point must be pressed into the soil in a way such that the nodes are in close contact with the soil, and are placed at a depth of 15 to 20 cm. The top portion of the cutting is tied to the tree using natural fibers such as banana or hemp.
TISSUE CULTURE
Tissue culture was first used as a means of creating vanilla plants during the 1980s at Tamil Nadu University. This was the part of the first project to grow V. planifolia in India. At that time, a shortage of vanilla planting stock was occurring in India. The approach was inspired by the work going on to tissue culture other flowering plants. Several methods have been proposed for vanilla tissue culture, but all of them begin from axillary buds of the vanilla vine. In vitro multiplication has also been achieved through culture of callus masses, protocorns, root tips and stem nodes. Description of any of these processes can be obtained from the references listed before, but all of them are successful in generation of new vanilla plants that first need to be grown up to a height of at least 30 cm before they can be planted in the field or greenhouse.
SCHEDULING CONSIDERATIONS
In the tropics, the ideal time for planting vanilla is from September to November, when the weather is neither too rainy nor too dry, but this recommendation varies with growing conditions. Cuttings take one to eight weeks to establish roots, and show initial signs of growth from one of the leaf axils. A thick mulch of leaves should be provided immediately after planting as an additional source of organic matter. Three years are required for cuttings to grow enough to produce flowers and subsequent pods. As with most orchids, the blossoms grow along stems branching from the main vine. The buds, growing along the 15 to 25 cm stems, bloom and mature in sequence, each at a different interval.
POLLINATION
Flowering normally occurs every spring, and without pollination, the blossom wilts and falls, and no vanilla bean can grow. Each flower must be hand-pollinated within 12 hours of opening. In the wild, very few natural pollinators exist, with most pollination being carried out by bees of the genus Melipona.[citation needed] These pollinators do not exist outside the orchid's home range, and even within that range, vanilla orchids have only a 1% chance of successful pollination. As a result, all vanilla grown today is pollinated by hand. A small splinter of wood or a grass stem is used to lift the rostellum or move the flap upward, so the overhanging anther can be pressed against the stigma and self-pollinate the vine. Generally, one flower per raceme opens per day, so the raceme may be in flower for over 20 days. A healthy vine should produce about 50 to 100 beans per year, but growers are careful to pollinate only five or six flowers from the 20 on each raceme. The first flowers that open per vine should be pollinated, so the beans are similar in age. These agronomic practices facilitate harvest and increases bean quality. It takes the fruits five to six weeks to develop, but it takes around six months for the bean to mature. Over-pollination will result in diseases and inferior bean quality. A vine remains productive between 12 and 14 years.
PEST AND DISEASE MANAGEMENT
Most diseases come from the uncharacteristic growing conditions of vanilla. Therefore, conditions such as excess water, insufficient drainage, heavy mulch, overpollination and too much shade favor disease development. Vanilla is susceptible to many fungal and viral diseases. Fusarium, Sclerotium, Phytophthora, and Colletrotrichum species cause rots of root, stem, leaf, bean and shoot apex. These diseases can be controlled by spraying Bordeaux mixture (1%), carbendazim (0.2%) and copper oxychloride (0.2%).
Biological control of the spread of such diseases can be managed by applying to the soil Trichoderma (0.5 kg) per plant in the rhizosphere) and foliar application of pseudomonads (0.2%). Mosaic virus, leaf curl and cymbidium mosaic potex virus are the common viral diseases. These diseases are transmitted through the sap, so affected plants must be destroyed. The insect pests of vanilla include beetles and weevils that attack the flower, caterpillars, snakes and slugs that damage the tender parts of shoot, flower buds and immature fruit, and grasshoppers that affect cutting shoot tips. If organic agriculture is practiced, insecticides are avoided, and mechanical measures are adopted for pest management. Most of these practices are implemented under greenhouse cultivation, since such field conditions are very difficult to achieve.
ARTIFICIAL VANILLA
Most artificial vanilla products contain vanillin, which can be produced synthetically from lignin, a natural polymer found in wood. Most synthetic vanillin is a byproduct from the pulp used in papermaking, in which the lignin is broken down using sulfites or sulfates. However, vanillin is only one of 171 identified aromatic components of real vanilla fruits.
The orchid species Leptotes bicolor is used as a natural vanilla replacement in Paraguay and southern Brazil.
NONPLANT VANILLA FLAVORING
In the United States, castoreum, the exudate from the castor sacs of mature beavers, has been approved by the Food and Drug Administration (FDA) as a food additive, often referenced simply as a "natural flavoring" in the product's list of ingredients. It is used in both food and beverages, especially as vanilla and raspberry flavoring. It is also used to flavor some cigarettes and in perfume-making.
STAGES OF PRODUCTION
HARVEST
The vanilla fruit grows quickly on the vine, but is not ready for harvest until maturity - approximately six months. Harvesting vanilla fruits is as labor-intensive as pollinating the blossoms. Immature dark green pods are not harvested. Pale yellow discoloration that commences at the distal end of the fruits is an indication of the maturity of pods. Each fruit ripens at its own time, requiring a daily harvest. To ensure the finest flavor from every fruit, each individual pod must be picked by hand just as it begins to split on the end. Overmatured fruits are likely to split, causing a reduction in market value. Its commercial value is fixed based on the length and appearance of the pod.
If the fruit is more than 15 cm in length, it belongs to first-quality product. The largest fruits greater than 16 cm and up to as much as 21 cm are usually reserved for the gourmet vanilla market, for sale to top chefs and restaurants. If the fruits are between 10 and 15 cm long, pods are under the second-quality category, and fruits less than 10 cm in length are under the third-quality category. Each fruit contains thousands of tiny black vanilla seeds. Vanilla fruit yield depends on the care and management given to the hanging and fruiting vines. Any practice directed to stimulate aerial root production has a direct effect on vine productivity. A five-year-old vine can produce between 1.5 and 3 kg pods, and this production can increase up to 6 kg after a few years. The harvested green fruit can be commercialized as such or cured to get a better market price.
CURING
Several methods exist in the market for curing vanilla; nevertheless, all of them consist of four basic steps: killing, sweating, slow-drying, and conditioning of the beans.
KILLING
The vegetative tissue of the vanilla pod is killed to stop the vegetative growth of the pods and disrupt the cells and tissue of the fruits, which initiates enzymatic reactions responsible for the aroma. The method of killing varies, but may be accomplished by heating in hot water, freezing, or scratching, or killing by heating in an oven or exposing the beans to direct sunlight. The different methods give different profiles of enzymatic activity.
Testing has shown mechanical disruption of fruit tissues can cause curing processes,[40] including the degeneration of glucovanillin to vanillin, so the reasoning goes that disrupting the tissues and cells of the fruit allow enzymes and enzyme substrates to interact.
Hot-water killing may consist of dipping the pods in hot water (63–65 °C) for three minutes, or at 80 °C for 10 seconds. In scratch killing, fruits are scratched along their length. Frozen or quick-frozen fruits must be thawed again for the subsequent sweating stage. Tied in bundles and rolled in blankets, fruits may be placed in an oven at 60 °C for 36 to 48 hours. Exposing the fruits to sunlight until they turn brown is a method originating in Mexico that was practiced by the Aztecs.
SWEATING
Sweating is a hydrolytic and oxidative process. Traditionally, it consists of keeping fruits, for seven to 10 days, densely stacked and insulated in wool or other cloth. This retains a temperature of 45–65 °C and high humidity. Daily exposure to the sun may also be used, or dipping the fruits in hot water. The fruits are brown and have attained much of the characteristic vanilla flavor and aroma by the end of this process, but still retain a 60-70% moisture content by weight.
DRYING
Reduction of the beans to 25–30% moisture by weight, to prevent rotting and to lock the aroma in the pods, is always achieved by some exposure of the beans to air, and usually (and traditionally) intermittent shade and sunlight. Fruits may be laid out in the sun during the mornings and returned to their boxes in the afternoons, or spread on a wooden rack in a room for three to four weeks, sometimes with periods of sun exposure. Drying is the most problematic of the curing stages; unevenness in the drying process can lead to the loss of vanillin content of some fruits by the time the others are cured.
CONDITIONING
Conditioning is performed by storing the pods for five to six months in closed boxes, where the fragrance develops. The processed fruits are sorted, graded, bundled, and wrapped in paraffin paper and preserved for the development of desired bean qualities, especially flavor and aroma. The cured vanilla fruits contain an average of 2.5% vanillin.
GRADING
Once fully cured, the vanilla fruits are sorted by quality and graded.
Several vanilla fruit grading systems are in use. Each country which produces vanilla has its own grading system, and individual vendors, in turn, sometimes use their own criteria for describing the quality of the fruits they offer for sale.
In general, vanilla fruit grade is based on the length, appearance (color, sheen, presence of any splits, presence of blemishes), and moisture content of the fruit. Whole, dark, plump and oily pods that are visually attractive, with no blemishes, and that have a higher moisture content are graded most highly. Such pods are particularly prized by chefs for their appearance and can be featured in gourmet dishes. Beans that show localized signs of disease or other physical defects are cut to remove the blemishes; the shorter fragments left are called “cuts” and are assigned lower grades, as are fruits with lower moisture contents. Lower-grade fruits tend to be favored for uses in which the appearance is not as important, such as in the production of vanilla flavoring extract and in the fragrance industry.
Higher-grade fruits command higher prices in the market. However, because grade is so dependent on visual appearance and moisture content, fruits with the highest grade do not necessarily contain the highest concentration of characteristic flavor molecules such as vanillin, and are not necessarily the most flavorful.
USAGE
CULINARY USES
There are four main commercial preparations of natural vanilla:
- whole pod
- powder (ground pods, kept pure or blended with sugar, starch, or other ingredients)
- extract (in alcoholic or occasionally glycerol solution; both pure and imitation forms of vanilla contain at least 35% alcohol)
- vanilla sugar, a pre-packaged mix of sugar and vanilla extract
Vanilla flavoring in food may be achieved by adding vanilla extract or by cooking vanilla pods in the liquid preparation. A stronger aroma may be attained if the pods are split in two, exposing more of a pod's surface area to the liquid. In this case, the pods' seeds are mixed into the preparation. Natural vanilla gives a brown or yellow color to preparations, depending on the concentration. Good-quality vanilla has a strong aromatic flavor, but food with small amounts of low-quality vanilla or artificial vanilla-like flavorings are far more common, since true vanilla is much more expensive.
A major use of vanilla is in flavoring ice cream. The most common flavor of ice cream is vanilla, and thus most people consider it to be the "default" flavor. By analogy, the term "vanilla" is sometimes used as a synonym for "plain". Although vanilla is a prized flavoring agent on its own, it is also used to enhance the flavor of other substances, to which its own flavor is often complementary, such as chocolate, custard, caramel, coffee, cakes, and others.
The food industry uses methyl and ethyl vanillin. Ethyl vanillin is more expensive, but has a stronger note. Cook's Illustrated ran several taste tests pitting vanilla against vanillin in baked goods and other applications, and, to the consternation of the magazine editors, tasters could not differentiate the flavor of vanillin from vanilla; however, for the case of vanilla ice cream, natural vanilla won out. A more recent and thorough test by the same group produced a more interesting variety of results; namely, high-quality artificial vanilla flavoring is best for cookies, while high-quality real vanilla is very slightly better for cakes and significantly better for unheated or lightly heated foods.
It was once believed that the liquid extracted from vanilla pods had medical properties, helping with various stomach ailments.
WIKIPEDIA
Brenizer Method Senior Portrait - 17 images shot with my Canon 85mm 1.8 @f/2.2. Images combined using Microsoft ICE.
UFO landing area or Asphalt photograph .
Asphalt has been around for millions of years in crude oil, it doesn't last forever when used for paving roads. Few of us can have missed jolting over cracks and ruts in heavily trafficked roads.
A number of factors impinge on the performance of asphalt. These include its composition and the crude oil source, the type and amount of aggregate used, the presence of moisture, the method of road construction, temperature, and, of course, the volume of traffic.
Signs. Abstract. Nellie Vin @2010
Bend, Ore. -- A group of 45 federal snow surveyors gathered in Bend Jan. 10 - 15, 2016 to train on measuring mountain snowpack and cold-weather survival. USDA's Natural Resources Conservation Service (NRCS) hosts the Westwide Snow Survey training every year to support snow surveyors across 13 Western states.
“Often times our snow survey crews must traverse difficult mountain terrains to manually measure the snowpack in remote areas,” said Tony Tolsdorf, one of the organizers for this year’s training. “The Westwide Snow Survey training is absolutely essential to sustain our snow survey program. We ensure our people are prepared in the event of an emergency and keep them up-to-speed on the methods for measuring.”
Training topics included outdoor survival, mountain medicine, avalanche preparedness, a history of snow survey, shelter construction, methods of measurement, and more. Guest instructors included Brian Horner of Learn to Return Training based in Anchorage, Alaska and Nancy Pfeiffer of the Alaska Avalanche School also based in Anchorage.
Since its inception in 1935, USDA’s Snow Survey and Water Supply Forecasting Program has grown into a network of 1,185 manually-measured snow courses and 858 automated snow telemetry stations across 13 Western states, including Alaska. The program provides streamflow forecasts at 673 stream gages in the West. Data from the automated snow sites are available near real-time through an extensive web delivery system.
NRCS photos.
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It is always a good time to start a program at one our three locations as the #1 Karate For Kids schools in Las Vegas and Henderson. Together with kids their own age, every youngster can mature and grow with the self confidence that a karate kids program develops within them.
Martial Arts Classes For Women
In today’s world of fitness, women are looking for a structured and interesting workout in a manner to stay fit that breaks away from their traditional daily routine. Repeating the same exercise every day can be draining and break ones motivation and is rarely goal oriented. It isn’t the normal daily gym workout. ATA Martial Arts of Cave Creek, Chandler, Mesa, Glendale, Arizona is a training facility that women are finding the variety of goal oriented conditioning that is exciting. While the physical nature of martial arts is rewarding and a personal martial arts victory, it also teaches the self defense and survival tactics that is needed in todays ever changing world.
There are many important mental and physical health benefits in our women’s martial art classes in Las Vegas and Henderson. While toning vital muscles and building coordination will enhance self-confidence, awareness and increase cardiovascular is health. Women who Attend ATA karate classes will improve balance, flexibility, increase exercise stamina levels while developing a greater sense of self-esteem, hence the term… “Victory” in Martial Arts.
Martial Arts have been known to provide much needed stress relief, promote self-control, concentration, and boost the ability to remain calm under stress. ATA Martial Arts routines are even helping women keep their memory sharp on a day-to-day basis!
Cave Creek, Chandler, Mesa, Glendale, Arizona ATA Martial Arts facilities are the community martial arts experts that provide rigorous karate classes for women of all ages to develop their strength of body and mind.
It’s a fact! Women are breaking away from their traditional exercise routines such as gym workouts and finding balance, freedom and motivation at ATA Martial Arts. It’s time for you to experience the benefits of karate classes designed for women with the community Martial Art experts in Las Vegas and Henderson.
Adult Martial Arts Classes for Men
Martial Arts classes for men in Cave Creek, Chandler, Mesa, Glendale, Arizona is more then just kicking and punching. ATA Karate Classes create a stronger self awareness, enhanced confidence, greater focus, and a true Victory in Martial Arts for men of all ages.
In an adult class a karate student will train will practical concepts in a safe, clean and enjoyable facility, while incorporating life skills to de-stress from life’s everyday challenges. Las Vegas ATA Martial Arts and Henderson ATA Martial arts offers three location to serve our community. Learning a skill set that will stick with you for life, no matter what age, allowing you to gain the self confidence desired so that you can feel comfortable with confrontation in any real life situation.
As one of the top martial arts training facilities in the community our Martial Arts programs such as Karate for Kids, Taekwondo and MMA and Fitness is a key method of enhancing the body’s functions, including flexibility, coordination, and balance with strength and endurance. Yes! It relieves stress while having some fun as well as meeting new people. As an adult, you do not need to have prior training before you get into a Martial Arts class. ATA Martial Arts has a defined teaching curriculum designed to take each student to the peak of their performance while greatly enhancing their skills creating a personal “Martial Arts Victory”.
KRAV MAGA & MMA FITNESS
Krav Maga and ATA’s MMA and athletic training is combined to provide a diverse full body workout while incorporating real life scenario drills for self defense.
This class features a structured curriculum that is in continuous motion utilizing all levels of MMA and Krav Maga skills with self defense drills in a manner to enhance cardio-respiratory for your cardiovascular system. Krav Maga students don’t’ just perform blocks, punches, kicks and movements you would find at a gym to music or in the mirror, students train in an environment that is preparing them for real life conditions.
The Krav Maga & MMA Fitness in Cave Creek, Chandler, Mesa, Glendale, Arizona is a true Conditioning Program that specializes in a Total Body Workout that doesn’t feel like to boring fitness class you may have taken before. Krav Maga Conditioning Program brings a fresh experience and keeps each and every student motivated in class on a day to day basis.
With a strong dedication and commitment to the Krav Maga and MMA Fitness Training student, Krav Instructors teach a combination of strength training, combatives, flexibility skills, and workouts with our top notch academy training facility. There is a emphasize on muscular strength and cardiovascular endurance for Krav students in Henderson and Las Vegas while instilling the distinctive awareness and self defense techniques needed for street survival in our ever changing world.
Correct body alignment to maximize efficiency can be key, our team of professional instructors will work on refining Krav Maga technique through exciting repetition drills and training.
All levels of Krav Maga, MMA & Fitness from the beginner to the experienced can train at anyone of our three locations. Call today and don’t delay.
Bend, Ore. -- A group of 45 federal snow surveyors gathered in Bend Jan. 10 - 15, 2016 to train on measuring mountain snowpack and cold-weather survival. USDA's Natural Resources Conservation Service (NRCS) hosts the Westwide Snow Survey training every year to support snow surveyors across 13 Western states.
“Often times our snow survey crews must traverse difficult mountain terrains to manually measure the snowpack in remote areas,” said Tony Tolsdorf, one of the organizers for this year’s training. “The Westwide Snow Survey training is absolutely essential to sustain our snow survey program. We ensure our people are prepared in the event of an emergency and keep them up-to-speed on the methods for measuring.”
Training topics included outdoor survival, mountain medicine, avalanche preparedness, a history of snow survey, shelter construction, methods of measurement, and more. Guest instructors included Brian Horner of Learn to Return Training based in Anchorage, Alaska and Nancy Pfeiffer of the Alaska Avalanche School also based in Anchorage.
Since its inception in 1935, USDA’s Snow Survey and Water Supply Forecasting Program has grown into a network of 1,185 manually-measured snow courses and 858 automated snow telemetry stations across 13 Western states, including Alaska. The program provides streamflow forecasts at 673 stream gages in the West. Data from the automated snow sites are available near real-time through an extensive web delivery system.
NRCS photos.
IR HDR. IR converted Canon 40D AEB +/-3 total of 7 exposures processed with Photomatix. Levels adjusted in PSE. Colors swapped in GIMP
High Dynamic Range (HDR)
High-dynamic-range imaging (HDRI) is a high dynamic range (HDR) technique used in imaging and photography to reproduce a greater dynamic range of luminosity than is possible with standard digital imaging or photographic techniques. The aim is to present a similar range of luminance to that experienced through the human visual system. The human eye, through adaptation of the iris and other methods, adjusts constantly to adapt to a broad range of luminance present in the environment. The brain continuously interprets this information so that a viewer can see in a wide range of light conditions.
HDR images can represent a greater range of luminance levels than can be achieved using more 'traditional' methods, such as many real-world scenes containing very bright, direct sunlight to extreme shade, or very faint nebulae. This is often achieved by capturing and then combining several different, narrower range, exposures of the same subject matter. Non-HDR cameras take photographs with a limited exposure range, referred to as LDR, resulting in the loss of detail in highlights or shadows.
The two primary types of HDR images are computer renderings and images resulting from merging multiple low-dynamic-range (LDR) or standard-dynamic-range (SDR) photographs. HDR images can also be acquired using special image sensors, such as an oversampled binary image sensor.
Due to the limitations of printing and display contrast, the extended luminosity range of an HDR image has to be compressed to be made visible. The method of rendering an HDR image to a standard monitor or printing device is called tone mapping. This method reduces the overall contrast of an HDR image to facilitate display on devices or printouts with lower dynamic range, and can be applied to produce images with preserved local contrast (or exaggerated for artistic effect).
In photography, dynamic range is measured in exposure value (EV) differences (known as stops). An increase of one EV, or 'one stop', represents a doubling of the amount of light. Conversely, a decrease of one EV represents a halving of the amount of light. Therefore, revealing detail in the darkest of shadows requires high exposures, while preserving detail in very bright situations requires very low exposures. Most cameras cannot provide this range of exposure values within a single exposure, due to their low dynamic range. High-dynamic-range photographs are generally achieved by capturing multiple standard-exposure images, often using exposure bracketing, and then later merging them into a single HDR image, usually within a photo manipulation program). Digital images are often encoded in a camera's raw image format, because 8-bit JPEG encoding does not offer a wide enough range of values to allow fine transitions (and regarding HDR, later introduces undesirable effects due to lossy compression).
Any camera that allows manual exposure control can make images for HDR work, although one equipped with auto exposure bracketing (AEB) is far better suited. Images from film cameras are less suitable as they often must first be digitized, so that they can later be processed using software HDR methods.
In most imaging devices, the degree of exposure to light applied to the active element (be it film or CCD) can be altered in one of two ways: by either increasing/decreasing the size of the aperture or by increasing/decreasing the time of each exposure. Exposure variation in an HDR set is only done by altering the exposure time and not the aperture size; this is because altering the aperture size also affects the depth of field and so the resultant multiple images would be quite different, preventing their final combination into a single HDR image.
An important limitation for HDR photography is that any movement between successive images will impede or prevent success in combining them afterwards. Also, as one must create several images (often three or five and sometimes more) to obtain the desired luminance range, such a full 'set' of images takes extra time. HDR photographers have developed calculation methods and techniques to partially overcome these problems, but the use of a sturdy tripod is, at least, advised.
Some cameras have an auto exposure bracketing (AEB) feature with a far greater dynamic range than others, from the 3 EV of the Canon EOS 40D, to the 18 EV of the Canon EOS-1D Mark II. As the popularity of this imaging method grows, several camera manufactures are now offering built-in HDR features. For example, the Pentax K-7 DSLR has an HDR mode that captures an HDR image and outputs (only) a tone mapped JPEG file. The Canon PowerShot G12, Canon PowerShot S95 and Canon PowerShot S100 offer similar features in a smaller format.. Nikon's approach is called 'Active D-Lighting' which applies exposure compensation and tone mapping to the image as it comes from the sensor, with the accent being on retaing a realistic effect . Some smartphones provide HDR modes, and most mobile platforms have apps that provide HDR picture taking.
Camera characteristics such as gamma curves, sensor resolution, noise, photometric calibration and color calibration affect resulting high-dynamic-range images.
Color film negatives and slides consist of multiple film layers that respond to light differently. As a consequence, transparent originals (especially positive slides) feature a very high dynamic range
Tone mapping
Tone mapping reduces the dynamic range, or contrast ratio, of an entire image while retaining localized contrast. Although it is a distinct operation, tone mapping is often applied to HDRI files by the same software package.
Several software applications are available on the PC, Mac and Linux platforms for producing HDR files and tone mapped images. Notable titles include
Adobe Photoshop
Aurora HDR
Dynamic Photo HDR
HDR Efex Pro
HDR PhotoStudio
Luminance HDR
MagicRaw
Oloneo PhotoEngine
Photomatix Pro
PTGui
Information stored in high-dynamic-range images typically corresponds to the physical values of luminance or radiance that can be observed in the real world. This is different from traditional digital images, which represent colors as they should appear on a monitor or a paper print. Therefore, HDR image formats are often called scene-referred, in contrast to traditional digital images, which are device-referred or output-referred. Furthermore, traditional images are usually encoded for the human visual system (maximizing the visual information stored in the fixed number of bits), which is usually called gamma encoding or gamma correction. The values stored for HDR images are often gamma compressed (power law) or logarithmically encoded, or floating-point linear values, since fixed-point linear encodings are increasingly inefficient over higher dynamic ranges.
HDR images often don't use fixed ranges per color channel—other than traditional images—to represent many more colors over a much wider dynamic range. For that purpose, they don't use integer values to represent the single color channels (e.g., 0-255 in an 8 bit per pixel interval for red, green and blue) but instead use a floating point representation. Common are 16-bit (half precision) or 32-bit floating point numbers to represent HDR pixels. However, when the appropriate transfer function is used, HDR pixels for some applications can be represented with a color depth that has as few as 10–12 bits for luminance and 8 bits for chrominance without introducing any visible quantization artifacts.
History of HDR photography
The idea of using several exposures to adequately reproduce a too-extreme range of luminance was pioneered as early as the 1850s by Gustave Le Gray to render seascapes showing both the sky and the sea. Such rendering was impossible at the time using standard methods, as the luminosity range was too extreme. Le Gray used one negative for the sky, and another one with a longer exposure for the sea, and combined the two into one picture in positive.
Mid 20th century
Manual tone mapping was accomplished by dodging and burning – selectively increasing or decreasing the exposure of regions of the photograph to yield better tonality reproduction. This was effective because the dynamic range of the negative is significantly higher than would be available on the finished positive paper print when that is exposed via the negative in a uniform manner. An excellent example is the photograph Schweitzer at the Lamp by W. Eugene Smith, from his 1954 photo essay A Man of Mercy on Dr. Albert Schweitzer and his humanitarian work in French Equatorial Africa. The image took 5 days to reproduce the tonal range of the scene, which ranges from a bright lamp (relative to the scene) to a dark shadow.
Ansel Adams elevated dodging and burning to an art form. Many of his famous prints were manipulated in the darkroom with these two methods. Adams wrote a comprehensive book on producing prints called The Print, which prominently features dodging and burning, in the context of his Zone System.
With the advent of color photography, tone mapping in the darkroom was no longer possible due to the specific timing needed during the developing process of color film. Photographers looked to film manufacturers to design new film stocks with improved response, or continued to shoot in black and white to use tone mapping methods.
Color film capable of directly recording high-dynamic-range images was developed by Charles Wyckoff and EG&G "in the course of a contract with the Department of the Air Force". This XR film had three emulsion layers, an upper layer having an ASA speed rating of 400, a middle layer with an intermediate rating, and a lower layer with an ASA rating of 0.004. The film was processed in a manner similar to color films, and each layer produced a different color. The dynamic range of this extended range film has been estimated as 1:108. It has been used to photograph nuclear explosions, for astronomical photography, for spectrographic research, and for medical imaging. Wyckoff's detailed pictures of nuclear explosions appeared on the cover of Life magazine in the mid-1950s.
Late 20th century
Georges Cornuéjols and licensees of his patents (Brdi, Hymatom) introduced the principle of HDR video image, in 1986, by interposing a matricial LCD screen in front of the camera's image sensor, increasing the sensors dynamic by five stops. The concept of neighborhood tone mapping was applied to video cameras by a group from the Technion in Israel led by Dr. Oliver Hilsenrath and Prof. Y.Y.Zeevi who filed for a patent on this concept in 1988.
In February and April 1990, Georges Cornuéjols introduced the first real-time HDR camera that combined two images captured by a sensor3435 or simultaneously3637 by two sensors of the camera. This process is known as bracketing used for a video stream.
In 1991, the first commercial video camera was introduced that performed real-time capturing of multiple images with different exposures, and producing an HDR video image, by Hymatom, licensee of Georges Cornuéjols.
Also in 1991, Georges Cornuéjols introduced the HDR+ image principle by non-linear accumulation of images to increase the sensitivity of the camera: for low-light environments, several successive images are accumulated, thus increasing the signal to noise ratio.
In 1993, another commercial medical camera producing an HDR video image, by the Technion.
Modern HDR imaging uses a completely different approach, based on making a high-dynamic-range luminance or light map using only global image operations (across the entire image), and then tone mapping the result. Global HDR was first introduced in 19931 resulting in a mathematical theory of differently exposed pictures of the same subject matter that was published in 1995 by Steve Mann and Rosalind Picard.
On October 28, 1998, Ben Sarao created one of the first nighttime HDR+G (High Dynamic Range + Graphic image)of STS-95 on the launch pad at NASA's Kennedy Space Center. It consisted of four film images of the shuttle at night that were digitally composited with additional digital graphic elements. The image was first exhibited at NASA Headquarters Great Hall, Washington DC in 1999 and then published in Hasselblad Forum, Issue 3 1993, Volume 35 ISSN 0282-5449.
The advent of consumer digital cameras produced a new demand for HDR imaging to improve the light response of digital camera sensors, which had a much smaller dynamic range than film. Steve Mann developed and patented the global-HDR method for producing digital images having extended dynamic range at the MIT Media Laboratory. Mann's method involved a two-step procedure: (1) generate one floating point image array by global-only image operations (operations that affect all pixels identically, without regard to their local neighborhoods); and then (2) convert this image array, using local neighborhood processing (tone-remapping, etc.), into an HDR image. The image array generated by the first step of Mann's process is called a lightspace image, lightspace picture, or radiance map. Another benefit of global-HDR imaging is that it provides access to the intermediate light or radiance map, which has been used for computer vision, and other image processing operations.
21st century
In 2005, Adobe Systems introduced several new features in Photoshop CS2 including Merge to HDR, 32 bit floating point image support, and HDR tone mapping.
On June 30, 2016, Microsoft added support for the digital compositing of HDR images to Windows 10 using the Universal Windows Platform.
HDR sensors
Modern CMOS image sensors can often capture a high dynamic range from a single exposure. The wide dynamic range of the captured image is non-linearly compressed into a smaller dynamic range electronic representation. However, with proper processing, the information from a single exposure can be used to create an HDR image.
Such HDR imaging is used in extreme dynamic range applications like welding or automotive work. Some other cameras designed for use in security applications can automatically provide two or more images for each frame, with changing exposure. For example, a sensor for 30fps video will give out 60fps with the odd frames at a short exposure time and the even frames at a longer exposure time. Some of the sensor may even combine the two images on-chip so that a wider dynamic range without in-pixel compression is directly available to the user for display or processing.
en.wikipedia.org/wiki/High-dynamic-range_imaging
Infrared Photography
In infrared photography, the film or image sensor used is sensitive to infrared light. The part of the spectrum used is referred to as near-infrared to distinguish it from far-infrared, which is the domain of thermal imaging. Wavelengths used for photography range from about 700 nm to about 900 nm. Film is usually sensitive to visible light too, so an infrared-passing filter is used; this lets infrared (IR) light pass through to the camera, but blocks all or most of the visible light spectrum (the filter thus looks black or deep red). ("Infrared filter" may refer either to this type of filter or to one that blocks infrared but passes other wavelengths.)
When these filters are used together with infrared-sensitive film or sensors, "in-camera effects" can be obtained; false-color or black-and-white images with a dreamlike or sometimes lurid appearance known as the "Wood Effect," an effect mainly caused by foliage (such as tree leaves and grass) strongly reflecting in the same way visible light is reflected from snow. There is a small contribution from chlorophyll fluorescence, but this is marginal and is not the real cause of the brightness seen in infrared photographs. The effect is named after the infrared photography pioneer Robert W. Wood, and not after the material wood, which does not strongly reflect infrared.
The other attributes of infrared photographs include very dark skies and penetration of atmospheric haze, caused by reduced Rayleigh scattering and Mie scattering, respectively, compared to visible light. The dark skies, in turn, result in less infrared light in shadows and dark reflections of those skies from water, and clouds will stand out strongly. These wavelengths also penetrate a few millimeters into skin and give a milky look to portraits, although eyes often look black.
Until the early 20th century, infrared photography was not possible because silver halide emulsions are not sensitive to longer wavelengths than that of blue light (and to a lesser extent, green light) without the addition of a dye to act as a color sensitizer. The first infrared photographs (as distinct from spectrographs) to be published appeared in the February 1910 edition of The Century Magazine and in the October 1910 edition of the Royal Photographic Society Journal to illustrate papers by Robert W. Wood, who discovered the unusual effects that now bear his name. The RPS co-ordinated events to celebrate the centenary of this event in 2010. Wood's photographs were taken on experimental film that required very long exposures; thus, most of his work focused on landscapes. A further set of infrared landscapes taken by Wood in Italy in 1911 used plates provided for him by CEK Mees at Wratten & Wainwright. Mees also took a few infrared photographs in Portugal in 1910, which are now in the Kodak archives.
Infrared-sensitive photographic plates were developed in the United States during World War I for spectroscopic analysis, and infrared sensitizing dyes were investigated for improved haze penetration in aerial photography. After 1930, new emulsions from Kodak and other manufacturers became useful to infrared astronomy.
Infrared photography became popular with photography enthusiasts in the 1930s when suitable film was introduced commercially. The Times regularly published landscape and aerial photographs taken by their staff photographers using Ilford infrared film. By 1937 33 kinds of infrared film were available from five manufacturers including Agfa, Kodak and Ilford. Infrared movie film was also available and was used to create day-for-night effects in motion pictures, a notable example being the pseudo-night aerial sequences in the James Cagney/Bette Davis movie The Bride Came COD.
False-color infrared photography became widely practiced with the introduction of Kodak Ektachrome Infrared Aero Film and Ektachrome Infrared EIR. The first version of this, known as Kodacolor Aero-Reversal-Film, was developed by Clark and others at the Kodak for camouflage detection in the 1940s. The film became more widely available in 35mm form in the 1960s but KODAK AEROCHROME III Infrared Film 1443 has been discontinued.
Infrared photography became popular with a number of 1960s recording artists, because of the unusual results; Jimi Hendrix, Donovan, Frank and a slow shutter speed without focus compensation, however wider apertures like f/2.0 can produce sharp photos only if the lens is meticulously refocused to the infrared index mark, and only if this index mark is the correct one for the filter and film in use. However, it should be noted that diffraction effects inside a camera are greater at infrared wavelengths so that stopping down the lens too far may actually reduce sharpness.
Most apochromatic ('APO') lenses do not have an Infrared index mark and do not need to be refocused for the infrared spectrum because they are already optically corrected into the near-infrared spectrum. Catadioptric lenses do not often require this adjustment because their mirror containing elements do not suffer from chromatic aberration and so the overall aberration is comparably less. Catadioptric lenses do, of course, still contain lenses, and these lenses do still have a dispersive property.
Infrared black-and-white films require special development times but development is usually achieved with standard black-and-white film developers and chemicals (like D-76). Kodak HIE film has a polyester film base that is very stable but extremely easy to scratch, therefore special care must be used in the handling of Kodak HIE throughout the development and printing/scanning process to avoid damage to the film. The Kodak HIE film was sensitive to 900 nm.
As of November 2, 2007, "KODAK is preannouncing the discontinuance" of HIE Infrared 35 mm film stating the reasons that, "Demand for these products has been declining significantly in recent years, and it is no longer practical to continue to manufacture given the low volume, the age of the product formulations and the complexity of the processes involved." At the time of this notice, HIE Infrared 135-36 was available at a street price of around $12.00 a roll at US mail order outlets.
Arguably the greatest obstacle to infrared film photography has been the increasing difficulty of obtaining infrared-sensitive film. However, despite the discontinuance of HIE, other newer infrared sensitive emulsions from EFKE, ROLLEI, and ILFORD are still available, but these formulations have differing sensitivity and specifications from the venerable KODAK HIE that has been around for at least two decades. Some of these infrared films are available in 120 and larger formats as well as 35 mm, which adds flexibility to their application. With the discontinuance of Kodak HIE, Efke's IR820 film has become the only IR film on the marketneeds update with good sensitivity beyond 750 nm, the Rollei film does extend beyond 750 nm but IR sensitivity falls off very rapidly.
Color infrared transparency films have three sensitized layers that, because of the way the dyes are coupled to these layers, reproduce infrared as red, red as green, and green as blue. All three layers are sensitive to blue so the film must be used with a yellow filter, since this will block blue light but allow the remaining colors to reach the film. The health of foliage can be determined from the relative strengths of green and infrared light reflected; this shows in color infrared as a shift from red (healthy) towards magenta (unhealthy). Early color infrared films were developed in the older E-4 process, but Kodak later manufactured a color transparency film that could be developed in standard E-6 chemistry, although more accurate results were obtained by developing using the AR-5 process. In general, color infrared does not need to be refocused to the infrared index mark on the lens.
In 2007 Kodak announced that production of the 35 mm version of their color infrared film (Ektachrome Professional Infrared/EIR) would cease as there was insufficient demand. Since 2011, all formats of color infrared film have been discontinued. Specifically, Aerochrome 1443 and SO-734.
There is no currently available digital camera that will produce the same results as Kodak color infrared film although the equivalent images can be produced by taking two exposures, one infrared and the other full-color, and combining in post-production. The color images produced by digital still cameras using infrared-pass filters are not equivalent to those produced on color infrared film. The colors result from varying amounts of infrared passing through the color filters on the photo sites, further amended by the Bayer filtering. While this makes such images unsuitable for the kind of applications for which the film was used, such as remote sensing of plant health, the resulting color tonality has proved popular artistically.
Color digital infrared, as part of full spectrum photography is gaining popularity. The ease of creating a softly colored photo with infrared characteristics has found interest among hobbyists and professionals.
In 2008, Los Angeles photographer, Dean Bennici started cutting and hand rolling Aerochrome color Infrared film. All Aerochrome medium and large format which exists today came directly from his lab. The trend in infrared photography continues to gain momentum with the success of photographer Richard Mosse and multiple users all around the world.
Digital camera sensors are inherently sensitive to infrared light, which would interfere with the normal photography by confusing the autofocus calculations or softening the image (because infrared light is focused differently from visible light), or oversaturating the red channel. Also, some clothing is transparent in the infrared, leading to unintended (at least to the manufacturer) uses of video cameras. Thus, to improve image quality and protect privacy, many digital cameras employ infrared blockers. Depending on the subject matter, infrared photography may not be practical with these cameras because the exposure times become overly long, often in the range of 30 seconds, creating noise and motion blur in the final image. However, for some subject matter the long exposure does not matter or the motion blur effects actually add to the image. Some lenses will also show a 'hot spot' in the centre of the image as their coatings are optimised for visible light and not for IR.
An alternative method of DSLR infrared photography is to remove the infrared blocker in front of the sensor and replace it with a filter that removes visible light. This filter is behind the mirror, so the camera can be used normally - handheld, normal shutter speeds, normal composition through the viewfinder, and focus, all work like a normal camera. Metering works but is not always accurate because of the difference between visible and infrared refraction. When the IR blocker is removed, many lenses which did display a hotspot cease to do so, and become perfectly usable for infrared photography. Additionally, because the red, green and blue micro-filters remain and have transmissions not only in their respective color but also in the infrared, enhanced infrared color may be recorded.
Since the Bayer filters in most digital cameras absorb a significant fraction of the infrared light, these cameras are sometimes not very sensitive as infrared cameras and can sometimes produce false colors in the images. An alternative approach is to use a Foveon X3 sensor, which does not have absorptive filters on it; the Sigma SD10 DSLR has a removable IR blocking filter and dust protector, which can be simply omitted or replaced by a deep red or complete visible light blocking filter. The Sigma SD14 has an IR/UV blocking filter that can be removed/installed without tools. The result is a very sensitive digital IR camera.
While it is common to use a filter that blocks almost all visible light, the wavelength sensitivity of a digital camera without internal infrared blocking is such that a variety of artistic results can be obtained with more conventional filtration. For example, a very dark neutral density filter can be used (such as the Hoya ND400) which passes a very small amount of visible light compared to the near-infrared it allows through. Wider filtration permits an SLR viewfinder to be used and also passes more varied color information to the sensor without necessarily reducing the Wood effect. Wider filtration is however likely to reduce other infrared artefacts such as haze penetration and darkened skies. This technique mirrors the methods used by infrared film photographers where black-and-white infrared film was often used with a deep red filter rather than a visually opaque one.
Another common technique with near-infrared filters is to swap blue and red channels in software (e.g. photoshop) which retains much of the characteristic 'white foliage' while rendering skies a glorious blue.
Several Sony cameras had the so-called Night Shot facility, which physically moves the blocking filter away from the light path, which makes the cameras very sensitive to infrared light. Soon after its development, this facility was 'restricted' by Sony to make it difficult for people to take photos that saw through clothing. To do this the iris is opened fully and exposure duration is limited to long times of more than 1/30 second or so. It is possible to shoot infrared but neutral density filters must be used to reduce the camera's sensitivity and the long exposure times mean that care must be taken to avoid camera-shake artifacts.
Fuji have produced digital cameras for use in forensic criminology and medicine which have no infrared blocking filter. The first camera, designated the S3 PRO UVIR, also had extended ultraviolet sensitivity (digital sensors are usually less sensitive to UV than to IR). Optimum UV sensitivity requires special lenses, but ordinary lenses usually work well for IR. In 2007, FujiFilm introduced a new version of this camera, based on the Nikon D200/ FujiFilm S5 called the IS Pro, also able to take Nikon lenses. Fuji had earlier introduced a non-SLR infrared camera, the IS-1, a modified version of the FujiFilm FinePix S9100. Unlike the S3 PRO UVIR, the IS-1 does not offer UV sensitivity. FujiFilm restricts the sale of these cameras to professional users with their EULA specifically prohibiting "unethical photographic conduct".
Phase One digital camera backs can be ordered in an infrared modified form.
Remote sensing and thermographic cameras are sensitive to longer wavelengths of infrared (see Infrared spectrum#Commonly used sub-division scheme). They may be multispectral and use a variety of technologies which may not resemble common camera or filter designs. Cameras sensitive to longer infrared wavelengths including those used in infrared astronomy often require cooling to reduce thermally induced dark currents in the sensor (see Dark current (physics)). Lower cost uncooled thermographic digital cameras operate in the Long Wave infrared band (see Thermographic camera#Uncooled infrared detectors). These cameras are generally used for building inspection or preventative maintenance but can be used for artistic pursuits as well.
Project by:
Federica Bardelli
Alessandro Marino Giuseppe Brunetti
Gabriele Colombo
Giulia De Amicis
Carlo Alessandro Morgan De Gaetano
Bali is an island and province of Indonesia. The province includes the island of Bali and a few smaller neighbouring islands, notably Nusa Penida, Nusa Lembongan, and Nusa Ceningan. It is located at the westernmost end of the Lesser Sunda Islands, between Java to the west and Lombok to the east. Its capital of Denpasar is located at the southern part of the island.
With a population of 3,890,757 in the 2010 census, and 4,225,000 as of January 2014, the island is home to most of Indonesia's Hindu minority. According to the 2010 Census, 83.5% of Bali's population adhered to Balinese Hinduism, followed by 13.4% Muslim, Christianity at 2.5%, and Buddhism 0.5%.
Bali is a popular tourist destination, which has seen a significant rise in numbers since the 1980s. It is renowned for its highly developed arts, including traditional and modern dance, sculpture, painting, leather, metalworking, and music. The Indonesian International Film Festival is held every year in Bali.
Bali is part of the Coral Triangle, the area with the highest biodiversity of marine species. In this area alone over 500 reef building coral species can be found. For comparison, this is about 7 times as many as in the entire Caribbean. There is a wide range of dive sites with high quality reefs, all with their own specific attractions. Many sites can have strong currents and swell, so diving without a knowledgeable guide is inadvisable. Most recently, Bali was the host of the 2011 ASEAN Summit, 2013 APEC and Miss World 2013.
HISTORY
ANCIENT
Bali was inhabited around 2000 BC by Austronesian people who migrated originally from Southeast Asia and Oceania through Maritime Southeast Asia. Culturally and linguistically, the Balinese are closely related to the people of the Indonesian archipelago, Malaysia, the Philippines, and Oceania. Stone tools dating from this time have been found near the village of Cekik in the island's west.
In ancient Bali, nine Hindu sects existed, namely Pasupata, Bhairawa, Siwa Shidanta, Waisnawa, Bodha, Brahma, Resi, Sora and Ganapatya. Each sect revered a specific deity as its personal Godhead.
Inscriptions from 896 and 911 don't mention a king, until 914, when Sri Kesarivarma is mentioned. They also reveal an independent Bali, with a distinct dialect, where Buddhism and Sivaism were practiced simultaneously. Mpu Sindok's great granddaughter, Mahendradatta (Gunapriyadharmapatni), married the Bali king Udayana Warmadewa (Dharmodayanavarmadeva) around 989, giving birth to Airlangga around 1001. This marriage also brought more Hinduism and Javanese culture to Bali. Princess Sakalendukirana appeared in 1098. Suradhipa reigned from 1115 to 1119, and Jayasakti from 1146 until 1150. Jayapangus appears on inscriptions between 1178 and 1181, while Adikuntiketana and his son Paramesvara in 1204.
Balinese culture was strongly influenced by Indian, Chinese, and particularly Hindu culture, beginning around the 1st century AD. The name Bali dwipa ("Bali island") has been discovered from various inscriptions, including the Blanjong pillar inscription written by Sri Kesari Warmadewa in 914 AD and mentioning "Walidwipa". It was during this time that the people developed their complex irrigation system subak to grow rice in wet-field cultivation. Some religious and cultural traditions still practised today can be traced to this period.
The Hindu Majapahit Empire (1293–1520 AD) on eastern Java founded a Balinese colony in 1343. The uncle of Hayam Wuruk is mentioned in the charters of 1384-86. A mass Javanese emigration occurred in the next century.
PORTUGUESE CONTACTS
The first known European contact with Bali is thought to have been made in 1512, when a Portuguese expedition led by Antonio Abreu and Francisco Serrão sighted its northern shores. It was the first expedition of a series of bi-annual fleets to the Moluccas, that throughout the 16th century usually traveled along the coasts of the Sunda Islands. Bali was also mapped in 1512, in the chart of Francisco Rodrigues, aboard the expedition. In 1585, a ship foundered off the Bukit Peninsula and left a few Portuguese in the service of Dewa Agung.
DUTCH EAST INDIA
In 1597 the Dutch explorer Cornelis de Houtman arrived at Bali, and the Dutch East India Company was established in 1602. The Dutch government expanded its control across the Indonesian archipelago during the second half of the 19th century (see Dutch East Indies). Dutch political and economic control over Bali began in the 1840s on the island's north coast, when the Dutch pitted various competing Balinese realms against each other. In the late 1890s, struggles between Balinese kingdoms in the island's south were exploited by the Dutch to increase their control.
In June 1860 the famous Welsh naturalist, Alfred Russel Wallace, travelled to Bali from Singapore, landing at Buleleng on the northcoast of the island. Wallace's trip to Bali was instrumental in helping him devise his Wallace Line theory. The Wallace Line is a faunal boundary that runs through the strait between Bali and Lombok. It has been found to be a boundary between species of Asiatic origin in the east and a mixture of Australian and Asian species to the west. In his travel memoir The Malay Archipelago, Wallace wrote of his experience in Bali:
I was both astonished and delighted; for as my visit to Java was some years later, I had never beheld so beautiful and well-cultivated a district out of Europe. A slightly undulating plain extends from the seacoast about ten or twelve miles inland, where it is bounded by a fine range of wooded and cultivated hills. Houses and villages, marked out by dense clumps of coconut palms, tamarind and other fruit trees, are dotted about in every direction; while between them extend luxurious rice-grounds, watered by an elaborate system of irrigation that would be the pride of the best cultivated parts of Europe.
The Dutch mounted large naval and ground assaults at the Sanur region in 1906 and were met by the thousands of members of the royal family and their followers who fought against the superior Dutch force in a suicidal puputan defensive assault rather than face the humiliation of surrender. Despite Dutch demands for surrender, an estimated 200 Balinese marched to their death against the invaders. In the Dutch intervention in Bali, a similar massacre occurred in the face of a Dutch assault in Klungkung.
AFTERWARD THE DUTCH GOVERNORS
exercised administrative control over the island, but local control over religion and culture generally remained intact. Dutch rule over Bali came later and was never as well established as in other parts of Indonesia such as Java and Maluku.
n the 1930s, anthropologists Margaret Mead and Gregory Bateson, artists Miguel Covarrubias and Walter Spies, and musicologist Colin McPhee all spent time here. Their accounts of the island and its peoples created a western image of Bali as "an enchanted land of aesthetes at peace with themselves and nature." Western tourists began to visit the island.
Imperial Japan occupied Bali during World War II. It was not originally a target in their Netherlands East Indies Campaign, but as the airfields on Borneo were inoperative due to heavy rains, the Imperial Japanese Army decided to occupy Bali, which did not suffer from comparable weather. The island had no regular Royal Netherlands East Indies Army (KNIL) troops. There was only a Native Auxiliary Corps Prajoda (Korps Prajoda) consisting of about 600 native soldiers and several Dutch KNIL officers under command of KNIL Lieutenant Colonel W.P. Roodenburg. On 19 February 1942 the Japanese forces landed near the town of Senoer [Senur]. The island was quickly captured.
During the Japanese occupation, a Balinese military officer, Gusti Ngurah Rai, formed a Balinese 'freedom army'. The harshness of war requisitions made Japanese rule more resented than Dutch rule. Following Japan's Pacific surrender in August 1945, the Dutch returned to Indonesia, including Bali, to reinstate their pre-war colonial administration. This was resisted by the Balinese rebels, who now used recovered Japanese weapons. On 20 November 1946, the Battle of Marga was fought in Tabanan in central Bali. Colonel I Gusti Ngurah Rai, by then 29 years old, finally rallied his forces in east Bali at Marga Rana, where they made a suicide attack on the heavily armed Dutch. The Balinese battalion was entirely wiped out, breaking the last thread of Balinese military resistance.
INDIPENDENCE FROM THE DUTCH
In 1946, the Dutch constituted Bali as one of the 13 administrative districts of the newly proclaimed State of East Indonesia, a rival state to the Republic of Indonesia, which was proclaimed and headed by Sukarno and Hatta. Bali was included in the "Republic of the United States of Indonesia" when the Netherlands recognised Indonesian independence on 29 December 1949.
CONTEMPORARY
The 1963 eruption of Mount Agung killed thousands, created economic havoc and forced many displaced Balinese to be transmigrated to other parts of Indonesia. Mirroring the widening of social divisions across Indonesia in the 1950s and early 1960s, Bali saw conflict between supporters of the traditional caste system, and those rejecting this system. Politically, the opposition was represented by supporters of the Indonesian Communist Party (PKI) and the Indonesian Nationalist Party (PNI), with tensions and ill-feeling further increased by the PKI's land reform programs. An attempted coup in Jakarta was put down by forces led by General Suharto.
The army became the dominant power as it instigated a violent anti-communist purge, in which the army blamed the PKI for the coup. Most estimates suggest that at least 500,000 people were killed across Indonesia, with an estimated 80,000 killed in Bali, equivalent to 5% of the island's population. With no Islamic forces involved as in Java and Sumatra, upper-caste PNI landlords led the extermination of PKI members.
As a result of the 1965/66 upheavals, Suharto was able to manoeuvre Sukarno out of the presidency. His "New Order" government reestablished relations with western countries. The pre-War Bali as "paradise" was revived in a modern form. The resulting large growth in tourism has led to a dramatic increase in Balinese standards of living and significant foreign exchange earned for the country. A bombing in 2002 by militant Islamists in the tourist area of Kuta killed 202 people, mostly foreigners. This attack, and another in 2005, severely reduced tourism, producing much economic hardship to the island.
GEOGRAPHY
The island of Bali lies 3.2 km east of Java, and is approximately 8 degrees south of the equator. Bali and Java are separated by the Bali Strait. East to west, the island is approximately 153 km wide and spans approximately 112 km north to south; administratively it covers 5,780 km2, or 5,577 km2 without Nusa Penida District, its population density is roughly 750 people/km2.
Bali's central mountains include several peaks over 3,000 metres in elevation. The highest is Mount Agung (3,031 m), known as the "mother mountain" which is an active volcano rated as one of the world's most likely sites for a massive eruption within the next 100 years. Mountains range from centre to the eastern side, with Mount Agung the easternmost peak. Bali's volcanic nature has contributed to its exceptional fertility and its tall mountain ranges provide the high rainfall that supports the highly productive agriculture sector. South of the mountains is a broad, steadily descending area where most of Bali's large rice crop is grown. The northern side of the mountains slopes more steeply to the sea and is the main coffee producing area of the island, along with rice, vegetables and cattle. The longest river, Ayung River, flows approximately 75 km.
The island is surrounded by coral reefs. Beaches in the south tend to have white sand while those in the north and west have black sand. Bali has no major waterways, although the Ho River is navigable by small sampan boats. Black sand beaches between Pasut and Klatingdukuh are being developed for tourism, but apart from the seaside temple of Tanah Lot, they are not yet used for significant tourism.
The largest city is the provincial capital, Denpasar, near the southern coast. Its population is around 491,500 (2002). Bali's second-largest city is the old colonial capital, Singaraja, which is located on the north coast and is home to around 100,000 people. Other important cities include the beach resort, Kuta, which is practically part of Denpasar's urban area, and Ubud, situated at the north of Denpasar, is the island's cultural centre.
Three small islands lie to the immediate south east and all are administratively part of the Klungkung regency of Bali: Nusa Penida, Nusa Lembongan and Nusa Ceningan. These islands are separated from Bali by the Badung Strait.
To the east, the Lombok Strait separates Bali from Lombok and marks the biogeographical division between the fauna of the Indomalayan ecozone and the distinctly different fauna of Australasia. The transition is known as the Wallace Line, named after Alfred Russel Wallace, who first proposed a transition zone between these two major biomes. When sea levels dropped during the Pleistocene ice age, Bali was connected to Java and Sumatra and to the mainland of Asia and shared the Asian fauna, but the deep water of the Lombok Strait continued to keep Lombok Island and the Lesser Sunda archipelago isolated.
CLIMATE
Being just 8 degrees south of the equator, Bali has a fairly even climate year round.
Day time temperatures at low elevations vary between 20-33⁰ C although it can be much cooler than that in the mountains. The west monsoon is in place from approximately October to April and this can bring significant rain, particularly from December to March. Outside of the monsoon period, humidity is relatively low and any rain unlikely in lowland areas.
ECOLOGY
Bali lies just to the west of the Wallace Line, and thus has a fauna that is Asian in character, with very little Australasian influence, and has more in common with Java than with Lombok. An exception is the yellow-crested cockatoo, a member of a primarily Australasian family. There are around 280 species of birds, including the critically endangered Bali myna, which is endemic. Others Include barn swallow, black-naped oriole, black racket-tailed treepie, crested serpent-eagle, crested treeswift, dollarbird, Java sparrow, lesser adjutant, long-tailed shrike, milky stork, Pacific swallow, red-rumped swallow, sacred kingfisher, sea eagle, woodswallow, savanna nightjar, stork-billed kingfisher, yellow-vented bulbul and great egret.
Until the early 20th century, Bali was home to several large mammals: the wild banteng, leopard and the endemic Bali tiger. The banteng still occurs in its domestic form, whereas leopards are found only in neighbouring Java, and the Bali tiger is extinct. The last definite record of a tiger on Bali dates from 1937, when one was shot, though the subspecies may have survived until the 1940s or 1950s. The relatively small size of the island, conflict with humans, poaching and habitat reduction drove the Bali tiger to extinction. This was the smallest and rarest of all tiger subspecies and was never caught on film or displayed in zoos, whereas few skins or bones remain in museums around the world. Today, the largest mammals are the Javan rusa deer and the wild boar. A second, smaller species of deer, the Indian muntjac, also occurs. Saltwater crocodiles were once present on the island, but became locally extinct sometime during the last century.
Squirrels are quite commonly encountered, less often is the Asian palm civet, which is also kept in coffee farms to produce Kopi Luwak. Bats are well represented, perhaps the most famous place to encounter them remaining the Goa Lawah (Temple of the Bats) where they are worshipped by the locals and also constitute a tourist attraction. They also occur in other cave temples, for instance at Gangga Beach. Two species of monkey occur. The crab-eating macaque, known locally as "kera", is quite common around human settlements and temples, where it becomes accustomed to being fed by humans, particularly in any of the three "monkey forest" temples, such as the popular one in the Ubud area. They are also quite often kept as pets by locals. The second monkey, endemic to Java and some surrounding islands such as Bali, is far rarer and more elusive is the Javan langur, locally known as "lutung". They occur in few places apart from the Bali Barat National Park. They are born an orange colour, though by their first year they would have already changed to a more blackish colouration. In Java however, there is more of a tendency for this species to retain its juvenile orange colour into adulthood, and so you can see a mixture of black and orange monkeys together as a family. Other rarer mammals include the leopard cat, Sunda pangolin and black giant squirrel.
Snakes include the king cobra and reticulated python. The water monitor can grow to at least 1.5 m in length and 50 kg and can move quickly.
The rich coral reefs around the coast, particularly around popular diving spots such as Tulamben, Amed, Menjangan or neighbouring Nusa Penida, host a wide range of marine life, for instance hawksbill turtle, giant sunfish, giant manta ray, giant moray eel, bumphead parrotfish, hammerhead shark, reef shark, barracuda, and sea snakes. Dolphins are commonly encountered on the north coast near Singaraja and Lovina.
A team of scientists conducted a survey from 29 April 2011 to 11 May 2011 at 33 sea sites around Bali. They discovered 952 species of reef fish of which 8 were new discoveries at Pemuteran, Gilimanuk, Nusa Dua, Tulamben and Candidasa, and 393 coral species, including two new ones at Padangbai and between Padangbai and Amed. The average coverage level of healthy coral was 36% (better than in Raja Ampat and Halmahera by 29% or in Fakfak and Kaimana by 25%) with the highest coverage found in Gili Selang and Gili Mimpang in Candidasa, Karangasem regency.
Many plants have been introduced by humans within the last centuries, particularly since the 20th century, making it sometimes hard to distinguish what plants are really native.[citation needed] Among the larger trees the most common are: banyan trees, jackfruit, coconuts, bamboo species, acacia trees and also endless rows of coconuts and banana species. Numerous flowers can be seen: hibiscus, frangipani, bougainvillea, poinsettia, oleander, jasmine, water lily, lotus, roses, begonias, orchids and hydrangeas exist. On higher grounds that receive more moisture, for instance around Kintamani, certain species of fern trees, mushrooms and even pine trees thrive well. Rice comes in many varieties. Other plants with agricultural value include: salak, mangosteen, corn, kintamani orange, coffee and water spinach.
ENVIRONMENT
Some of the worst erosion has occurred in Lebih Beach, where up to 7 metres of land is lost every year. Decades ago, this beach was used for holy pilgrimages with more than 10,000 people, but they have now moved to Masceti Beach.
From ranked third in previous review, in 2010 Bali got score 99.65 of Indonesia's environmental quality index and the highest of all the 33 provinces. The score measured 3 water quality parameters: the level of total suspended solids (TSS), dissolved oxygen (DO) and chemical oxygen demand (COD).
Because of over-exploitation by the tourist industry which covers a massive land area, 200 out of 400 rivers on the island have dried up and based on research, the southern part of Bali would face a water shortage up to 2,500 litres of clean water per second by 2015. To ease the shortage, the central government plans to build a water catchment and processing facility at Petanu River in Gianyar. The 300 litres capacity of water per second will be channelled to Denpasar, Badung and Gianyar in 2013.
ECONOMY
Three decades ago, the Balinese economy was largely agriculture-based in terms of both output and employment. Tourism is now the largest single industry in terms of income, and as a result, Bali is one of Indonesia's wealthiest regions. In 2003, around 80% of Bali's economy was tourism related. By end of June 2011, non-performing loan of all banks in Bali were 2.23%, lower than the average of Indonesian banking industry non-performing loan (about 5%). The economy, however, suffered significantly as a result of the terrorist bombings 2002 and 2005. The tourism industry has since recovered from these events.
AGRICULTURE
Although tourism produces the GDP's largest output, agriculture is still the island's biggest employer; most notably rice cultivation. Crops grown in smaller amounts include fruit, vegetables, Coffea arabica and other cash and subsistence crops. Fishing also provides a significant number of jobs. Bali is also famous for its artisans who produce a vast array of handicrafts, including batik and ikat cloth and clothing, wooden carvings, stone carvings, painted art and silverware. Notably, individual villages typically adopt a single product, such as wind chimes or wooden furniture.
The Arabica coffee production region is the highland region of Kintamani near Mount Batur. Generally, Balinese coffee is processed using the wet method. This results in a sweet, soft coffee with good consistency. Typical flavours include lemon and other citrus notes. Many coffee farmers in Kintamani are members of a traditional farming system called Subak Abian, which is based on the Hindu philosophy of "Tri Hita Karana". According to this philosophy, the three causes of happiness are good relations with God, other people and the environment. The Subak Abian system is ideally suited to the production of fair trade and organic coffee production. Arabica coffee from Kintamani is the first product in Indonesia to request a Geographical Indication.
TOURISM
The tourism industry is primarily focused in the south, while significant in the other parts of the island as well. The main tourist locations are the town of Kuta (with its beach), and its outer suburbs of Legian and Seminyak (which were once independent townships), the east coast town of Sanur (once the only tourist hub), in the center of the island Ubud, to the south of the Ngurah Rai International Airport, Jimbaran, and the newer development of Nusa Dua and Pecatu.
The American government lifted its travel warnings in 2008. The Australian government issued an advice on Friday, 4 May 2012. The overall level of the advice was lowered to 'Exercise a high degree of caution'. The Swedish government issued a new warning on Sunday, 10 June 2012 because of one more tourist who was killed by methanol poisoning. Australia last issued an advice on Monday, 5 January 2015 due to new terrorist threats.
An offshoot of tourism is the growing real estate industry. Bali real estate has been rapidly developing in the main tourist areas of Kuta, Legian, Seminyak and Oberoi. Most recently, high-end 5 star projects are under development on the Bukit peninsula, on the south side of the island. Million dollar villas are being developed along the cliff sides of south Bali, commanding panoramic ocean views. Foreign and domestic (many Jakarta individuals and companies are fairly active) investment into other areas of the island also continues to grow. Land prices, despite the worldwide economic crisis, have remained stable.
In the last half of 2008, Indonesia's currency had dropped approximately 30% against the US dollar, providing many overseas visitors value for their currencies. Visitor arrivals for 2009 were forecast to drop 8% (which would be higher than 2007 levels), due to the worldwide economic crisis which has also affected the global tourist industry, but not due to any travel warnings.
Bali's tourism economy survived the terrorist bombings of 2002 and 2005, and the tourism industry has in fact slowly recovered and surpassed its pre-terrorist bombing levels; the longterm trend has been a steady increase of visitor arrivals. In 2010, Bali received 2.57 million foreign tourists, which surpassed the target of 2.0–2.3 million tourists. The average occupancy of starred hotels achieved 65%, so the island is still able to accommodate tourists for some years without any addition of new rooms/hotels, although at the peak season some of them are fully booked.
Bali received the Best Island award from Travel and Leisure in 2010. The island of Bali won because of its attractive surroundings (both mountain and coastal areas), diverse tourist attractions, excellent international and local restaurants, and the friendliness of the local people. According to BBC Travel released in 2011, Bali is one of the World's Best Islands, ranking second after Santorini, Greece.
In August 2010, the film Eat Pray Love was released in theatres. The movie was based on Elizabeth Gilbert's best-selling memoir Eat, Pray, Love. It took place at Ubud and Padang-Padang Beach at Bali. The 2006 book, which spent 57 weeks at the No. 1 spot on the New York Times paperback nonfiction best-seller list, had already fuelled a boom in Eat, Pray, Love-related tourism in Ubud, the hill town and cultural and tourist center that was the focus of Gilbert's quest for balance through traditional spirituality and healing that leads to love.
In January 2016, after music icon David Bowie died, it was revealed that in his will, Bowie asked for his ashes to be scattered in Bali, conforming to Buddhist rituals. He had visited and performed in a number of Southest Asian cities early in his career, including Bangkok and Singapore.
Since 2011, China has displaced Japan as the second-largest supplier of tourists to Bali, while Australia still tops the list. Chinese tourists increased by 17% from last year due to the impact of ACFTA and new direct flights to Bali. In January 2012, Chinese tourists year on year (yoy) increased by 222.18% compared to January 2011, while Japanese tourists declined by 23.54% yoy.
Bali reported that it has 2.88 million foreign tourists and 5 million domestic tourists in 2012, marginally surpassing the expectations of 2.8 million foreign tourists. Forecasts for 2013 are at 3.1 million.
Based on Bank Indonesia survey in May 2013, 34.39 percent of tourists are upper-middle class with spending between $1,286 to $5,592 and dominated by Australia, France, China, Germany and the US with some China tourists move from low spending before to higher spending currently. While 30.26 percent are middle class with spending between $662 to $1,285.
SEX TOURISM
In the twentieth century the incidence of tourism specifically for sex was regularly observed in the era of mass tourism in Indonesia In Bali, prostitution is conducted by both men and women. Bali in particular is notorious for its 'Kuta Cowboys', local gigolos targeting foreign female tourists.
Tens of thousands of single women throng the beaches of Bali in Indonesia every year. For decades, young Balinese men have taken advantage of the louche and laid-back atmosphere to find love and lucre from female tourists—Japanese, European and Australian for the most part—who by all accounts seem perfectly happy with the arrangement.
By 2013, Indonesia was reportedly the number one destination for Australian child sex tourists, mostly starting in Bali but also travelling to other parts of the country. The problem in Bali was highlighted by Luh Ketut Suryani, head of Psychiatry at Udayana University, as early as 2003. Surayani warned that a low level of awareness of paedophilia in Bali had made it the target of international paedophile organisations. On 19 February 2013, government officials announced measures to combat paedophilia in Bali.
TRANSPORTATION
The Ngurah Rai International Airport is located near Jimbaran, on the isthmus at the southernmost part of the island. Lt.Col. Wisnu Airfield is found in north-west Bali.
A coastal road circles the island, and three major two-lane arteries cross the central mountains at passes reaching to 1,750m in height (at Penelokan). The Ngurah Rai Bypass is a four-lane expressway that partly encircles Denpasar. Bali has no railway lines.
In December 2010 the Government of Indonesia invited investors to build a new Tanah Ampo Cruise Terminal at Karangasem, Bali with a projected worth of $30 million. On 17 July 2011 the first cruise ship (Sun Princess) anchored about 400 meters away from the wharf of Tanah Ampo harbour. The current pier is only 154 meters but will eventually be extended to 300–350 meters to accommodate international cruise ships. The harbour here is safer than the existing facility at Benoa and has a scenic backdrop of east Bali mountains and green rice fields. The tender for improvement was subject to delays, and as of July 2013 the situation remained unclear with cruise line operators complaining and even refusing to use the existing facility at Tanah Ampo.
A Memorandum of Understanding has been signed by two ministers, Bali's Governor and Indonesian Train Company to build 565 kilometres of railway along the coast around the island. As of July 2015, no details of this proposed railways have been released.
On 16 March 2011 (Tanjung) Benoa port received the "Best Port Welcome 2010" award from London's "Dream World Cruise Destination" magazine. Government plans to expand the role of Benoa port as export-import port to boost Bali's trade and industry sector. The Tourism and Creative Economy Ministry has confirmed that 306 cruise liners are heading for Indonesia in 2013 – an increase of 43 percent compared to the previous year.
In May 2011, an integrated Areal Traffic Control System (ATCS) was implemented to reduce traffic jams at four crossing points: Ngurah Rai statue, Dewa Ruci Kuta crossing, Jimbaran crossing and Sanur crossing. ATCS is an integrated system connecting all traffic lights, CCTVs and other traffic signals with a monitoring office at the police headquarters. It has successfully been implemented in other ASEAN countries and will be implemented at other crossings in Bali.
On 21 December 2011 construction started on the Nusa Dua-Benoa-Ngurah Rai International Airport toll road which will also provide a special lane for motorcycles. This has been done by seven state-owned enterprises led by PT Jasa Marga with 60% of shares. PT Jasa Marga Bali Tol will construct the 9.91 kilometres toll road (totally 12.7 kilometres with access road). The construction is estimated to cost Rp.2.49 trillion ($273.9 million). The project goes through 2 kilometres of mangrove forest and through 2.3 kilometres of beach, both within 5.4 hectares area. The elevated toll road is built over the mangrove forest on 18,000 concrete pillars which occupied 2 hectares of mangroves forest. It compensated by new planting of 300,000 mangrove trees along the road. On 21 December 2011 the Dewa Ruci 450 meters underpass has also started on the busy Dewa Ruci junction near Bali Kuta Galeria with an estimated cost of Rp136 billion ($14.9 million) from the state budget. On 23 September 2013, the Bali Mandara Toll Road is opened and the Dewa Ruci Junction (Simpang Siur) underpass is opened before. Both are ease the heavy traffic congestion.
To solve chronic traffic problems, the province will also build a toll road connecting Serangan with Tohpati, a toll road connecting Kuta, Denpasar and Tohpati and a flyover connecting Kuta and Ngurah Rai Airport.
DEMOGRAPHICS
The population of Bali was 3,890,757 as of the 2010 Census; the latest estimate (for January 2014) is 4,225,384. There are an estimated 30,000 expatriates living in Bali.
ETHNIC ORIGINS
A DNA study in 2005 by Karafet et al. found that 12% of Balinese Y-chromosomes are of likely Indian origin, while 84% are of likely Austronesian origin, and 2% of likely Melanesian origin. The study does not correlate the DNA samples to the Balinese caste system.
CASTE SYSTEM
Bali has a caste system based on the Indian Hindu model, with four castes:
- Sudra (Shudra) – peasants constituting close to 93% of Bali's population.
- Wesia (Vaishyas) – the caste of merchants and administrative officials
- Ksatrias (Kshatriyas) – the kingly and warrior caste
- Brahmana (Bramhin) – holy men and priests
RELIGION
Unlike most of Muslim-majority Indonesia, about 83.5% of Bali's population adheres to Balinese Hinduism, formed as a combination of existing local beliefs and Hindu influences from mainland Southeast Asia and South Asia. Minority religions include Islam (13.3%), Christianity (1.7%), and Buddhism (0.5%). These figures do not include immigrants from other parts of Indonesia.
Balinese Hinduism is an amalgam in which gods and demigods are worshipped together with Buddhist heroes, the spirits of ancestors, indigenous agricultural deities and sacred places. Religion as it is practised in Bali is a composite belief system that embraces not only theology, philosophy, and mythology, but ancestor worship, animism and magic. It pervades nearly every aspect of traditional life. Caste is observed, though less strictly than in India. With an estimated 20,000 puras (temples) and shrines, Bali is known as the "Island of a Thousand Puras", or "Island of the Gods". This is refer to Mahabarata story that behind Bali became island of god or "pulau dewata" in Indonesian language.
Balinese Hinduism has roots in Indian Hinduism and Buddhism, and adopted the animistic traditions of the indigenous people. This influence strengthened the belief that the gods and goddesses are present in all things. Every element of nature, therefore, possesses its own power, which reflects the power of the gods. A rock, tree, dagger, or woven cloth is a potential home for spirits whose energy can be directed for good or evil. Balinese Hinduism is deeply interwoven with art and ritual. Ritualizing states of self-control are a notable feature of religious expression among the people, who for this reason have become famous for their graceful and decorous behaviour.
Apart from the majority of Balinese Hindus, there also exist Chinese immigrants whose traditions have melded with that of the locals. As a result, these Sino-Balinese not only embrace their original religion, which is a mixture of Buddhism, Christianity, Taoism and Confucianism, but also find a way to harmonise it with the local traditions. Hence, it is not uncommon to find local Sino-Balinese during the local temple's odalan. Moreover, Balinese Hindu priests are invited to perform rites alongside a Chinese priest in the event of the death of a Sino-Balinese. Nevertheless, the Sino-Balinese claim to embrace Buddhism for administrative purposes, such as their Identity Cards.
LANGUAGE
Balinese and Indonesian are the most widely spoken languages in Bali, and the vast majority of Balinese people are bilingual or trilingual. The most common spoken language around the tourist areas is Indonesian, as many people in the tourist sector are not solely Balinese, but migrants from Java, Lombok, Sumatra, and other parts of Indonesia. There are several indigenous Balinese languages, but most Balinese can also use the most widely spoken option: modern common Balinese. The usage of different Balinese languages was traditionally determined by the Balinese caste system and by clan membership, but this tradition is diminishing. Kawi and Sanskrit are also commonly used by some Hindu priests in Bali, for Hinduism literature was mostly written in Sanskrit.
English and Chinese are the next most common languages (and the primary foreign languages) of many Balinese, owing to the requirements of the tourism industry, as well as the English-speaking community and huge Chinese-Indonesian population. Other foreign languages, such as Japanese, Korean, French, Russian or German are often used in multilingual signs for foreign tourists.
CULTURE
Bali is renowned for its diverse and sophisticated art forms, such as painting, sculpture, woodcarving, handcrafts, and performing arts. Balinese cuisine is also distinctive. Balinese percussion orchestra music, known as gamelan, is highly developed and varied. Balinese performing arts often portray stories from Hindu epics such as the Ramayana but with heavy Balinese influence. Famous Balinese dances include pendet, legong, baris, topeng, barong, gong keybar, and kecak (the monkey dance). Bali boasts one of the most diverse and innovative performing arts cultures in the world, with paid performances at thousands of temple festivals, private ceremonies, or public shows.
The Hindu New Year, Nyepi, is celebrated in the spring by a day of silence. On this day everyone stays at home and tourists are encouraged to remain in their hotels. On the day before New Year, large and colourful sculptures of ogoh-ogoh monsters are paraded and finally burned in the evening to drive away evil spirits. Other festivals throughout the year are specified by the Balinese pawukon calendrical system.
Celebrations are held for many occasions such as a tooth-filing (coming-of-age ritual), cremation or odalan (temple festival). One of the most important concepts that Balinese ceremonies have in common is that of désa kala patra, which refers to how ritual performances must be appropriate in both the specific and general social context. Many of the ceremonial art forms such as wayang kulit and topeng are highly improvisatory, providing flexibility for the performer to adapt the performance to the current situation. Many celebrations call for a loud, boisterous atmosphere with lots of activity and the resulting aesthetic, ramé, is distinctively Balinese. Often two or more gamelan ensembles will be performing well within earshot, and sometimes compete with each other to be heard. Likewise, the audience members talk amongst themselves, get up and walk around, or even cheer on the performance, which adds to the many layers of activity and the liveliness typical of ramé.
Kaja and kelod are the Balinese equivalents of North and South, which refer to ones orientation between the island's largest mountain Gunung Agung (kaja), and the sea (kelod). In addition to spatial orientation, kaja and kelod have the connotation of good and evil; gods and ancestors are believed to live on the mountain whereas demons live in the sea. Buildings such as temples and residential homes are spatially oriented by having the most sacred spaces closest to the mountain and the unclean places nearest to the sea.
Most temples have an inner courtyard and an outer courtyard which are arranged with the inner courtyard furthest kaja. These spaces serve as performance venues since most Balinese rituals are accompanied by any combination of music, dance and drama. The performances that take place in the inner courtyard are classified as wali, the most sacred rituals which are offerings exclusively for the gods, while the outer courtyard is where bebali ceremonies are held, which are intended for gods and people. Lastly, performances meant solely for the entertainment of humans take place outside the walls of the temple and are called bali-balihan. This three-tiered system of classification was standardised in 1971 by a committee of Balinese officials and artists to better protect the sanctity of the oldest and most sacred Balinese rituals from being performed for a paying audience.
Tourism, Bali's chief industry, has provided the island with a foreign audience that is eager to pay for entertainment, thus creating new performance opportunities and more demand for performers. The impact of tourism is controversial since before it became integrated into the economy, the Balinese performing arts did not exist as a capitalist venture, and were not performed for entertainment outside of their respective ritual context. Since the 1930s sacred rituals such as the barong dance have been performed both in their original contexts, as well as exclusively for paying tourists. This has led to new versions of many of these performances which have developed according to the preferences of foreign audiences; some villages have a barong mask specifically for non-ritual performances as well as an older mask which is only used for sacred performances.
Balinese society continues to revolve around each family's ancestral village, to which the cycle of life and religion is closely tied. Coercive aspects of traditional society, such as customary law sanctions imposed by traditional authorities such as village councils (including "kasepekang", or shunning) have risen in importance as a consequence of the democratisation and decentralisation of Indonesia since 1998.
WIKIPEDIA
Project by:
Federica Bardelli
Alessandro Marino Giuseppe Brunetti
Gabriele Colombo
Giulia De Amicis
Carlo Alessandro Morgan De Gaetano
Maxim Gorky
Alexei Maximovich Peshkov (Russian: Алексе́й Макси́мович Пешко́в or Пе́шков;[1] 28 March [O.S. 16 March] 1868 – 18 June 1936), primarily known as Maxim Gorky (Russian: Макси́м Го́рький), was a Russian and Soviet writer, a founder of the socialist realism literary method, and a political activist.[2] He was also a five-time nominee for the Nobel Prize in Literature.[3] Around fifteen years before success as a writer, he frequently changed jobs and roamed across the Russian Empire; these experiences would later influence his writing. Gorky's most famous works were The Lower Depths (1902), Twenty-six Men and a Girl (1899), The Song of the Stormy Petrel (1901), My Childhood (1913–1914), Mother (1906), Summerfolk (1904) and Children of the Sun (1905). He had an association with fellow Russian writers Leo Tolstoy and Anton Chekhov; Gorky would later mention them in his memoirs.
Gorky was active with the emerging Marxist social-democratic movement. He publicly opposed the Tsarist regime, and for a time closely associated himself with Vladimir Lenin and Alexander Bogdanov's Bolshevik wing of the party. For a significant part of his life, he was exiled from Russia and later the Soviet Union. In 1932, he returned to the USSR on Joseph Stalin's personal invitation and lived there until his death in June 1936.
Contents
1 Life
1.1 Early years
1.2 Political and literary development
1.3 Capri years
1.4 Return from exile
1.5 Povolzhye famine
1.6 Second exile
1.7 Death of Lenin
1.8 Return to Russia: last years
1.9 Apologist for the gulag
1.10 Hostility to gays
1.11 Conflicts[citation needed] with Stalinists
1.12 Death
2 Depictions and adaptations
3 Selected works
3.1 Novels
3.2 Novellas
3.3 Short stories
3.4 Drama
3.5 Non-fiction
3.6 Collections
4 See also
5 Notes
6 Sources
7 Further reading
8 External links
Life
Early years
Born as Alexei Maximovich Peshkov on 28 March [O.S. 16 March] 1868, in Nizhny Novgorod, Gorky became an orphan at the age of eleven. He was brought up by his grandmother[2] and ran away from home at the age of twelve in 1880. After an attempt at suicide in December 1887, he travelled on foot across the Russian Empire for five years, changing jobs and accumulating impressions used later in his writing.[2]
As a journalist working for provincial newspapers, he wrote under the pseudonym Иегудиил Хламида (Jehudiel Khlamida).[4] He started using the pseudonym "Gorky" (from горький; literally "bitter") in 1892, when his first short story, "Makar Chudra", was published by the newspaper Kavkaz (The Caucasus) in Tiflis, where he spent several weeks doing menial jobs, mostly for the Caucasian Railway workshops.[5][6][7] The name reflected his simmering anger about life in Russia and a determination to speak the bitter truth. Gorky's first book Очерки и рассказы (Essays and Stories) in 1898 enjoyed a sensational success, and his career as a writer began. Gorky wrote incessantly, viewing literature less as an aesthetic practice (though he worked hard on style and form) than as a moral and political act that could change the world. He described the lives of people in the lowest strata and on the margins of society, revealing their hardships, humiliations, and brutalisation, but also their inward spark of humanity.[2]
Political and literary development
Anton Chekhov and Gorky. 1900, Yalta
Gorky's reputation grew as a unique literary voice from the bottom strata of society and as a fervent advocate of Russia's social, political, and cultural transformation. By 1899, he was openly associating with the emerging Marxist social-democratic movement, which helped make him a celebrity among both the intelligentsia and the growing numbers of "conscious" workers. At the heart of all his work was a belief in the inherent worth and potential of the human person. In his writing, he counterposed individuals, aware of their natural dignity, and inspired by energy and will, with people who succumb to the degrading conditions of life around them. Both his writings and his letters reveal a "restless man" (a frequent self-description) struggling to resolve contradictory feelings of faith and scepticism, love of life and disgust at the vulgarity and pettiness of the human world.[citation needed]
In 1916, Gorky said that the teachings of the ancient Jewish sage Hillel the Elder deeply influenced his life: "In my early youth I read...the words of...Hillel, if I remember rightly: 'If thou art not for thyself, who will be for thee? But if thou art for thyself alone, wherefore art thou'? The inner meaning of these words impressed me with its profound wisdom...The thought ate its way deep into my soul, and I say now with conviction: Hillel's wisdom served as a strong staff on my road, which was neither even nor easy. I believe that Jewish wisdom is more all-human and universal than any other; and this not only because of its immemorial age...but because of the powerful humaneness that saturates it, because of its high estimate of man."[8]
He publicly opposed the Tsarist regime and was arrested many times. Gorky befriended many revolutionaries and became a personal friend of Vladimir Lenin after they met in 1902. He exposed governmental control of the press (see Matvei Golovinski affair). In 1902, Gorky was elected an honorary Academician of Literature, but Tsar Nicholas II ordered this annulled. In protest, Anton Chekhov and Vladimir Korolenko left the Academy.[9]
Leo Tolstoy with Gorky in Yasnaya Polyana, 1900
From 1900 to 1905, Gorky's writings became more optimistic. He became more involved in the opposition movement, for which he was again briefly imprisoned in 1901. In 1904, having severed his relationship with the Moscow Art Theatre in the wake of conflict with Vladimir Nemirovich-Danchenko, Gorky returned to Nizhny Novgorod to establish a theatre of his own.[10] Both Konstantin Stanislavski and Savva Morozov provided financial support for the venture.[11] Stanislavski believed that Gorky's theatre was an opportunity to develop the network of provincial theatres which he hoped would reform the art of the stage in Russia, a dream of his since the 1890s.[11] He sent some pupils from the Art Theatre School—as well as Ioasaf Tikhomirov, who ran the school—to work there.[11] By the autumn, however, after the censor had banned every play that the theatre proposed to stage, Gorky abandoned the project.[11]
As a financially successful author, editor, and playwright, Gorky gave financial support to the Russian Social Democratic Labour Party (RSDLP), as well as supporting liberal appeals to the government for civil rights and social reform. The brutal shooting of workers marching to the Tsar with a petition for reform on 9 January 1905 (known as the "Bloody Sunday"), which set in motion the Revolution of 1905, seems to have pushed Gorky more decisively toward radical solutions. He became closely associated with Vladimir Lenin and Alexander Bogdanov's Bolshevik wing of the party, with Bogdanov taking responsibility for the transfer of funds from Gorky to Vpered.[12] It is not clear whether he ever formally joined, and his relations with Lenin and the Bolsheviks would always be rocky. His most influential writings in these years were a series of political plays, most famously The Lower Depths (1902). While briefly imprisoned in Peter and Paul Fortress during the abortive 1905 Russian Revolution, Gorky wrote the play Children of the Sun, nominally set during an 1862 cholera epidemic, but universally understood to relate to present-day events. He was released from the prison after a European-wide campaign, which was supported by Marie Curie, Auguste Rodin and Anatole France, amongst others.[13]
In 1906, the Bolsheviks sent him on a fund-raising trip to the United States with Ivan Narodny. When visiting the Adirondack Mountains, Gorky wrote Мать (Mat', Mother), his notable novel of revolutionary conversion and struggle. His experiences in the United States—which included a scandal over his travelling with his lover (the actress Maria Andreyeva) rather than his wife—deepened his contempt for the "bourgeois soul" but also his admiration for the boldness of the American spirit.[citation needed]
Capri years
In 1909–1911 Gorky lived on the island of Capri in the burgundy-coloured "Villa Behring".
From 1906 to 1913, Gorky lived on the island of Capri in southern Italy, partly for health reasons and partly to escape the increasingly repressive atmosphere in Russia.[2] He continued to support the work of Russian social-democracy, especially the Bolsheviks and invited Anatoly Lunacharsky to stay with him on Capri. The two men had worked together on Literaturny Raspad which appeared in 1908. It was during this period that Gorky, along with Lunacharsky, Bogdanov and Vladimir Bazarov developed the idea of an Encyclopedia of Russian History as a socialist version of Diderot's Encyclopedia. During a visit to Switzerland, Gorky met Lenin, who he charged spent an inordinate amount of his time feuding with other revolutionaries, writing: "He looked awful. Even his tongue seemed to have turned grey".[14] Despite his atheism,[15] Gorky was not a materialist.[16] Most controversially, he articulated, along with a few other maverick Bolsheviks, a philosophy he called "God-Building" (богостроительство, bogostroitel'stvo),[2] which sought to recapture the power of myth for the revolution and to create a religious atheism that placed collective humanity where God had been and was imbued with passion, wonderment, moral certainty, and the promise of deliverance from evil, suffering, and even death. Though 'God-Building' was ridiculed by Lenin, Gorky retained his belief that "culture"—the moral and spiritual awareness of the value and potential of the human self—would be more critical to the revolution's success than political or economic arrangements.
Return from exile
An amnesty granted for the 300th anniversary of the Romanov dynasty allowed Gorky to return to Russia in 1913, where he continued his social criticism, mentored other writers from the common people, and wrote a series of important cultural memoirs, including the first part of his autobiography.[2] On returning to Russia, he wrote that his main impression was that "everyone is so crushed and devoid of God's image." The only solution, he repeatedly declared, was "culture".
After the February Revolution, Gorky visited the headquarters of the Okhrana (secret police) on Kronversky Prospekt together with Nikolai Sukhanov and Vladimir Zenisinov.[17] Gorky described the former Okhrana headquarters, where he sought literary inspiration, as derelict, with windows broken, and papers lying all over the floor.[18] Having dinner with Sukhanov later the same day, Gorky grimly predicated that revolution would end in "Asiatic savagery".[19] Initially a supporter of the Socialist-Revolutionary Alexander Kerensky, Gorky switched over to the Bolsheviks after the Kornilov affair.[20] In July 1917, Gorky wrote his own experiences of the Russian working class had been sufficient to dispel any "notions that Russian workers are the incarnation of spiritual beauty and kindness".[21] Gorky admitted to feeling attracted to Bolshevism, but admitted to concerns about a creed that made the entire working class "sweet and reasonable-I had never known people who were really like this".[22] Gorky wrote that he knew the poor, the "carpenters, stevedores, bricklayers", in a way that the intellectual Lenin never did, and he frankly distrusted them.[22]
During World War I, his apartment in Petrograd was turned into a Bolshevik staff room, and his politics remained close to the Bolsheviks throughout the revolutionary period of 1917. On the day after the Bolshevik coup of 7 November 1917, Gorky observed a gardener working the Alexander Park who had cleared snow during the February Revolution while ignoring the shots in the background, asked people during the July Days not to trample the grass and was now chopping off branches, leading Gorky to write that he was "stubborn as a mole, and apparently as blind as one too".[23] Gorky's relations with the Bolsheviks became strained, however, after the October Revolution. One contemporary remembered at how Gorky would turn "dark and black and grim" at the mere mention of Lenin.[24] Gorky wrote that Lenin together with Trotsky "have become poisoned with the filthy venom of power", crushing the rights of the individual to achieve their revolutionary dreams.[24] Gorky wrote that Lenin was a "cold-blooded trickster who spares neither the honor nor the life of the proletariat. ... He does not know the popular masses, he has not lived with them".[24] Gorky went on to compare Lenin to a chemist experimenting in a laboratory with the only difference being the chemist experimented with inanimate matter to improve life while Lenin was experimenting on the "living flesh of Russia".[24] A further strain on Gorky's relations with the Bolsheviks occurred when his newspaper Novaya Zhizn (Новая Жизнь, "New Life") fell prey to Bolshevik censorship during the ensuing civil war, around which time Gorky published a collection of essays critical of the Bolsheviks called Untimely Thoughts in 1918. (It would not be re-published in Russia until after the collapse of the Soviet Union.) The essays call Lenin a tyrant for his senseless arrests and repression of free discourse, and an anarchist for his conspiratorial tactics; Gorky compares Lenin to both the Tsar and Nechayev.[citation needed]
"Lenin and his associates," Gorky wrote, "consider it possible to commit all kinds of crimes ... the abolition of free speech and senseless arrests."[25]
In 1921, he hired a secretary, Moura Budberg, who later became his unofficial wife. In August 1921, the poet Nikolay Gumilev was arrested by the Petrograd Cheka for his monarchist views. There is a story that Gorky hurried to Moscow, obtained an order to release Gumilev from Lenin personally, but upon his return to Petrograd he found out that Gumilev had already been shot – but Nadezhda Mandelstam, a close friend of Gumilev's widow, Anna Akhmatova wrote that: "It is true that people asked him to intervene. ... Gorky had a strong dislike of Gumilev, but he nevertheless promised to do something. He could not keep his promise because the sentence of death was announced and carried out with unexpected haste, before Gorky had got round to doing anything."[26] In October, Gorky returned to Italy on health grounds: he had tuberculosis.
Povolzhye famine
In July 1921, Gorky published an appeal to the outside world, saying that millions of lives were menaced by crop failure. The Russian famine of 1921–22, also known as Povolzhye famine, killed an estimated 5 million, primarily affecting the Volga and Ural River regions.[27]
Second exile
Gorky left Russia in September 1921, for Berlin. There he heard about the impending Moscow Trial of 12 Socialist Revolutionaries, which hardened his opposition to the Bolshevik regime. He wrote to Anatole France denouncing the trial as a "cynical and public preparation for the murder" of people who had fought for the freedom of the Russian people. He also wrote to the Soviet vice-premier, Alexei Rykov asking him to tell Leon Trotsky that any death sentences carried out on the defendants would be "premeditated and foul murder."[28] This provoked a contemptuous reaction from Lenin, who described Gorky as "always supremely spineless in politics", and Trotsky, who dismissed Gorky as an "artist whom no-one takes seriously."[29] He was denied permission by Italy's fascist government to return to Capri, but was permitted to settle in Sorrento, where he lived from 1922 to 1932, with an extended household that included Moura Budberg, his ex-wife Andreyeva, her lover, Pyotr Kryuchkov, who acted as Gorky's secretary for the remainder of his life, Gorky's son Max Peshkov, Max's wife, Timosha, and their two young daughters.
He wrote several successful books while there,[30] but by 1928 he was having difficulty earning enough to keep his large household, and began to seek an accommodation with the communist regime. The Soviet dictator Joseph Stalin was equally keen to entice Gorky back to the USSR. He paid his first visit in May 1928 – at the very time when the regime was staging its first show trial since 1922, the so-called Shakhty Trial of 53 engineers employed in the coal industry, one of whom, Pyotr Osadchy, had visited Gorky in Sorrento. In contrast to his attitude to the trial of the Socialist Revolutionaries, Gorky accepted without question that the engineers were guilty, and expressed regret that in the past he had intervened on behalf of professionals who were being persecuted by the regime. During the visit, he struck up friendships with Genrikh Yagoda, the corrupt and murderous head of the Ogpu and two other Ogpu officers, Semyon Firin and Matvei Pogrebinsky, who held high office in the Gulag. Pogrebinsky was Gorky's guest in Sorrento for four weeks in 1930. The following year, Yagoda sent his brother-in-law, Leopold Averbakh to Sorrento, with instructions to induce Gorky to return to Russia permanently.[31]
Death of Lenin
After the death of Lenin in 1924, Gorky wrote the following:
Vladimir Lenin, a big, real man of this world, has passed away. His death is a painful blow to all who knew him, a very painful blow! But the black line of death shall only underscore his importance in the eyes of all the world - the importance of the leader of the world’s working people. If the clouds of hatred for him, the clouds of lies and slander woven round him were even denser, it would not matter, for there is no such force as could dim the torch he has raised in the stifling darkness of the world gone mad. Never has there been a man who deserves more to be remembered forever by the whole world. Vladimir Lenin is dead. But those to whom he bequeathed his wisdom and his will are living. They are alive and working more successfully than anyone on Earth has ever worked before.[32]
Return to Russia: last years
Avel Enukidze, Joseph Stalin and Maxim Gorky celebrate 10th anniversary of Sportintern. Red Square, Moscow USSR. Aug 1931
Gorky's return from Fascist Italy was a major propaganda victory for the Soviets. He was decorated with the Order of Lenin and given a mansion (formerly belonging to the millionaire Pavel Ryabushinsky, which was for many years the Gorky Museum) in Moscow and a dacha in the suburbs. The city of Nizhni Novgorod, and the surrounding province were renamed Gorky. Moscow's main park, and one of the central Moscow streets, Tverskaya, were renamed in his honour, as was the Moscow Art Theatre. The largest fixed-wing aircraft in the world in the mid-1930s, the Tupolev ANT-20 was named Maxim Gorky in his honour.
He was also appointed President of the Union of Soviet Writers, founded in 1932, to coincide with his return to the USSR. On 11 October 1931 Gorky read his fairy tale "A Girl and Death" to his visitors Joseph Stalin, Kliment Voroshilov and Vyacheslav Molotov, an event that was later depicted by Viktor Govorov in his painting. On that same day Stalin left his autograph on the last page of this work by Gorky: "Эта штука сильнее чем "Фауст" Гёте (любовь побеждает смерть)"[33] ["This piece is stronger than Goethe's Faust (love defeats death)]".
Apologist for the gulag
In 1933, Gorky co-edited, with Averbakh and Firin, an infamous book about the White Sea-Baltic Canal, presented as an example of "successful rehabilitation of the former enemies of proletariat". For other writers, he urged that one obtained realism by extracting the basic idea from reality, but by adding the potential and desirable to it, one added romanticism with deep revolutionary potential.[34] For himself, Gorky avoided realism. His denials that even a single prisoner died during the construction of the aforementioned canal were refuted by multiple accounts of thousands of prisoners who froze to death not only in the evenings from the lack of adequate shelter and food, but even in the middle of the day.[35]
On his definitive return to the Soviet Union in 1932, Maxim Gorky received the Ryabushinsky Mansion, designed in 1900 by Fyodor Schechtel for the Ryabushinsky family. The mansion today houses a museum about Gorky.
Hostility to gays
Gorky strongly supported efforts in getting a law passed in 1934, making homosexuality a criminal offense. His attitude was coloured by the fact that several leading members of the Nazi Sturmabteilung, or Brownshirts, were overtly homosexual. Writing in Pravda on 23 May 1934, Gorky claimed "exterminate all homosexuals and fascism will vanish."[36]
Conflicts[citation needed] with Stalinists
By the summer of 1934, Gorky was increasingly in conflict with the Soviet authorities. He was angry that Leopold Averbakh, whom he regarded as a protege, was denied a role in the newly created Writers Union, and objected to interference by the Central Committee staff in the affairs of the union. This conflict, which may have been exacerbated by Gorky's despair over the early death of his son, Max, came to a head just before the first Soviet Writers Congress, in August 1934. On 11 August, he submitted an article for publication in Pravda which attacked the deputy head of the press department, Pavel Yudin with such intemperate language that Stalin's deputy, Lazar Kaganovich ordered its suppression, but was forced to relent after hundreds of copies of the article circulated by hand. Gorky's draft of the keynote speech he was due to give at the congress caused such consternation when he submitted it to the Politburo that four of its leading members – Kaganovich, Vyacheslav Molotov, Kliment Voroshilov, and Andrei Zhdanov – were sent to persuade him to make changes.[37] Even in its toned-down version – very unusually for the Stalin era – he did not praise Stalin, did not mention any of the approved writers turning out 'socialist realist' novels, but singled out Fyodor Dostoevsky for "having painted with the most vivid perfection of word portraiture a type of egocentrist, a type of social degenerate in the person of the hero of his Memoirs from Underground. ... Dostoyevsky in the figure of his hero has shown the depths of whining despair that are reached by the individualist from among the young men of the nineteenth and twentieth centuries who are cut off from real life."[38]
Death
With the increase of Stalinist repression and especially after the assassination of Sergei Kirov in December 1934, Gorky was placed under unannounced house arrest in his house near Moscow. His long-serving secretary Pyotr Kryuchkov had been recruited by Yagoda as a paid informer.[39] Before his death from a lingering illness in June 1936, he was visited at home by Stalin, Yagoda, and other leading communists, and by Moura Budberg, who had chosen not to return to the USSR with him but was permitted to stay for his funeral.
The sudden death of Gorky's son Maxim Peshkov in May 1934 was followed by the death of Maxim Gorky himself in June 1936 from pneumonia. Speculation has long surrounded the circumstances of his death. Stalin and Molotov were among those who carried Gorky's coffin during the funeral. During the Bukharin trial in 1938 (one of the three Moscow Trials), one of the charges was that Gorky was killed by Yagoda's NKVD agents.[40]
In Soviet times, before and after his death, the complexities in Gorky's life and outlook were reduced to an iconic image (echoed in heroic pictures and statues dotting the countryside): Gorky as a great Soviet writer who emerged from the common people, a loyal friend of the Bolsheviks, and the founder of the increasingly canonical "socialist realism".
Depictions and adaptations
The Gorky Trilogy is a series of three films based on the three autobiographical books: The Childhood of Maxim Gorky, My Apprenticeship, and My Universities, directed by Mark Donskoy, filmed in the Soviet Union, released 1938–1940. The trilogy was adapted from Gorky's autobiography.[41]
The German modernist Bertolt Brecht based his epic play The Mother (1932) on Gorky's novel of the same name.
Gorky's novel was also adapted for an opera by Valery Zhelobinsky in 1938. In 1912, the Italian composer Giacomo Orefice based his opera Radda on the character of Radda from Makar Chudra. Our Father is the title given to Gorky's The Last Ones in its English translation by William Stancil.
The play[clarification needed] made its New York debut in 1975 at the Manhattan Theater Club, directed by Keith Fowler.
In 1985 Enemies was performed in London with a multi-national cast directed by Ann Pennington in association with Internationalist Theatre. The cast included South African Greek actress Angelique Rockas and Bulgarian Madlena Nedeva playing the parts of Tatiana, and Kleopatra respectively.[42] Tom Vaughan of The Morning Star affirmed "this is a great revolutionary play, by a great revolutionary writer, performed with elegance and style, great passion and commitment".[43] BBC Russian Service was no less complimentary.[44]
Selected works
Main article: Maxim Gorky bibliography
Source: Turner, Lily; Strever, Mark (1946). Orphan Paul; A Bibliography and Chronology of Maxim Gorky. New York: Boni and Gaer. pp. 261–270.
Novels
Goremyka Pavel, 1894. Published in English as Orphan Paul[45]
Foma Gordeyev (Фома Гордеев), 1899. Also translated as The Man Who Was Afraid
Three of Them (Трое), 1900. Also translated as Three Men
The Mother (Мать), 1907. First published in English, in 1906
The Life of a Useless Man (Жизнь ненужного человека), 1908
A Confession (Исповедь), 1908
Okurov City (Городок Окуров), 1908
The Life of Matvei Kozhemyakin (Жизнь Матвея Кожемякина), 1910
The Artamonov Business (Дело Артамоновых), 1927
Life of Klim Samgin (Жизнь Клима Самгина), unfinished:[46]
The Bystander, 1927
The Magnet, 1928
Other Fires, 1930
The Specter, 1936
Novellas
The Orlovs (Супруги Орловы), 1897
Creatures That Once Were Men (Бывшие люди), 1897
Varenka Olesova (Варенька Олесова), 1898
Summer (Лето), 1909
Great Love (Большая любовь), 1911
Short stories
"Makar Chudra" (Макар Чудра), 1892
"Old Izergil" (Старуха Изергиль), 1895
"Chelkash" (Челкаш), 1895
"Konovalov" (Коновалов), 1897
"Malva" (Мальва), 1897
"Twenty-six Men and a Girl" (Двадцать шесть и одна), 1899
"Song of a Falcon" (Песня о Соколе), 1902. Also referred to as a poem in prose
Drama
The Philistines (Мещане), translated also as The Smug Citizens and The Petty Bourgeois (Мещане), 1901
The Lower Depths (На дне), 1902
Summerfolk (Дачники), 1904
Children of the Sun (Дети солнца), 1905
Barbarians (Варвары), 1905
Enemies, 1906.
The Last Ones (Последние), 1908. Translated also as Our Father[47]
Children (Дети), 1910. Translated also as The Reception (and called originally "Встреча")
Queer People (Чудаки), 1910. Translated also as Eccentrics
Vassa Zheleznova (Васса Железнова), 1910, 1935 (revised version)
The Zykovs (Зыковы), 1913
Counterfeit Money (Фальшивая монета), 1913
The Old Man (Старик), 1915, Revised 1922, 1924. Translated also as The Judge
Workaholic Slovotekov (Работяга Словотеков), 1920
Somov and Others (Cомов и другие), 1930
Yegor Bulychov and Others (Егор Булычов и другие), 1932
Dostigayev and Others (Достигаев и другие), 1933
Non-fiction
Chaliapin, articles in Letopis, 1917[48]
Untimely Thoughts, articles, 1918
My Recollections of Tolstoy, 1919
Reminiscences of Tolstoy, Chekhov, and Andreyev, 1920–1928
V.I. Lenin (В.И. Ленин), reminiscence, 1924–1931
The I.V. Stalin White Sea – Baltic Sea Canal, 1934 (editor-in-chief)
Literary Portraits [c.1935].[49]
Poems
"The Song of the Stormy Petrel" (Песня о Буревестнике), 1901
Autobiography
My Childhood (Детство), Part I, 1913–1914
In the World (В людях), Part II, 1916
My Universities (Мои университеты), Part III, 1923
Collections
Sketches and Stories, three volumes, 1898–1899
Creatures That Once Were Men, stories in English translation (1905). This contained an introduction by G. K. Chesterton[50] The Russian title, Бывшие люди (literally "Former people") gained popularity as an expression in reference to people who severely dropped in their social status
Tales of Italy (Сказки об Италии), 1911–1913
Through Russia (По Руси), 1923
Project by:
Federica Bardelli
Alessandro Marino Giuseppe Brunetti
Gabriele Colombo
Giulia De Amicis
Carlo Alessandro Morgan De Gaetano
Gathering Kokoro: Tony DeVarco & Mayako Nakamura
CINCINNATI, OH - Marta Hewett Gallery is pleased to present new photographs, paintings and mixed media works by Tony DeVarco (Santa Cruz, CA) & Mayako Nakamura (Tokyo, Japan) in their most recent cross cultural, collaborative effort in the exhibition, Gathering Kokoro, presented in conjunction with FotoFocus 2018. The exhibition will be on view from August 24st – October 20th. The gallery will host a reception for the artists on Friday, September 7th from 6 - 8pm. DeVarco and Nakamura will lead a discussion describing their working methods across thousands of miles on Saturday, September 8th at 1 pm. Both events are free and open to the public.
DeVarco and Nakamura met in Japan in 2013. After exchanging pieces, the two decided to work on a series that would engage each of their unique styles of photography and painting. “Gathering Kokoro” will feature a selection from the artists’ latest series of collaborative works. “Kokoro” is naturally understood in Japanese culture, but there is no direct translation in English. Conceptually, kokoro unites the notions of the physical heart, the intellectual mind, and the ephemeral, indomitable spirit and sees these three elements as being indivisible from one other. This exhibition will feature unique aspects of each artists’ chosen mediums including paintings from Nakamura’s "The Playground" series presented as an Emaki scroll and their latest collaborative works on paper from the "Figure|Ground" series.
In addition, "Gathering Kokoro" will include an Orihon Book which is presented in conjunction with the FotoFocus Biennial 2018: Open Archive. Recasting digital photos, photomontage and ink sketches into an elegant artifact, this collaborative artwork is created in the ancient style of an ‘Orihon’ book (‘ori' means fold and 'hon' means book’). As both art and artifact, the Orihon Book is a unique specimen for the digital age and carries with it the spirit of the 2018 FotoFocus theme, Open Archive, which “examines our fundamental need to preserve photographs and to tell stories through their collection, organization, and interpretation”. Paying homage to the ancient Asian tradition of bookmaking as a “folding scroll”, this object measures 8 feet long when fully displayed. Printed in Japanese on one side and English on the other, its pages open up concertina style and feature a series of Tony DeVarco’s photographs that capture the age old ritual of Mayako donning her kimono and Mayako Nakamura’s atmospheric ink studies printed on fine mulberry paper.
Archivist and curator Bonnie DeVarco designed the interior of the book to present an unfolding ‘story’ in the Japanese style of Orihon with folds sewn with 24 karat gold thread using the "stabbed” binding technique. As an object both vintage and familiar, the book’s covers and case are designed and bound by master bookmaker and Cincinnati artist Judith Serling-Sturm.
U.S. Department of Agriculture, Marketing and Regulatory Program Under Secretary Jenny Moffitt visits the Animal and Plant Health Inspection Service Forest Pest Methods Laboratory in Massachusetts to see the tools for detection, survey, and control of various invasive plant pests.
USDA photo by Hajar Faal
Go to the Book with image in the Internet Archive
Title: United States Naval Medical Bulletin Vol. 14, Nos. 1-4, 1920
Creator: U.S. Navy. Bureau of Medicine and Surgery
Publisher:
Sponsor:
Contributor:
Date: 1920
Language: eng
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Table of Contents</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;"> </p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Number 1</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;"> </p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">PREFACE V</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">NOTICE TO SERVICE CONTRIBUTORS VI</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">SPECIAL ARTICLES:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">ANTHROPOMETRIC STUDY AT ANNAPOLIS.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant L. B. Solhaug, Medical Corps, U. S. N 1</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Medical and Hygienic Aspects of Submarine Service.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander E. W. Brown, Medical Corps, U. S. N 8</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Report on Facial and Jaw Injuries.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander L. W. Johnson, Medical Corps, U. S. N 17 </p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Military Orthopedic Hospitals in the British Isles.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant R. Hammond. Medical Corps, U. S. N. R. F. 65</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">HISTORICAL :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Medicine in Rome 103</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">EDITORIAL :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">The New Year — Standards of Duty 127</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">IN MEMORIAM :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Edward Grahame Parker.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Captain C. E. Riggs, Medical Corps, U. S. N 135</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">SUGGESTED DEVICES:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Changes in Scuttle Butts Aboard Ship.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander J. A. B. Sinclair, Medical Corps,</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">U. S. N. R. F 137</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">An Emergency Evacuation Device 145</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">CLINICAL NOTES :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Bronchopulmonary Spirochetosis in an American.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant G. W. Lewis, Medical Corps, U. S. N 149 </p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Encephalitis Lethargica.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant A. F. Kuhlman, Medical Corps, U. S. N 151</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Defense of the Open-Air Treatment of Pneumonia.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant D. Ferguson, jr., Medical Corps, U. S. N 153</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">NOTES AND COMMENTS :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Carbon tetrachloride poisoning. —Civil service positions. — Serum treatment
in yellow fever. —" Deer-fly disease." — Request for specimens.—
Medical personnel of the French Navy.—Centenary celebrations. —Situs inversus.
—Italian view of prohibition. — Effects of prohibition In Chicago. — Treatment
of sterility. — Pilocarpine in influenza. —A death from anesthesia.- — Free
hospital service in Oklahoma City. —Birth rate of Manila. —Expansion of the
Faculty of Medicine, Paris. —Statistics on blindness. —French eight-hour law. —
Corporation philanthropy 155</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">REPORTS :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">The Receiving Ship Barracks, New York.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Commander W. G. Farwell and Lieutenant R. M. Krepps, Medical Corps,
U. S. N 163</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Grounding of the U. S. S. Northern Pacific.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant J. C. Ruddock, Medical Corps, U. S. N 185</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Impressions of a Reservist.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Commander L. R. G. Crandon, Medical Corps, U. S. N. R. F <span> </span>188</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;"> </p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Number 2</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;"> PREFACE v</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">NOTICE TO SERVICE CONTRIBUTORS vi</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">SPECIAL ARTICLES:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Types of Neurological and Psychiatric Cases.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander E. C Taylor, Medical Corps, U. S. N. R. F 191</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Yellow Fever.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander T. Wilson, Medical Corps, U. S. N 200</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Asepsis of Abdominal Incisions.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander F. H. Bowman, Medical Corps, U. S. N 208</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Calcium Chloride Intravenously for Hemoptysis.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander W. H. Fickel, Medical Corps, U. S. N<span> </span><span> </span>210</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Hospital Records 213</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">HISTORICAL:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">The Arabians and the First Revival of Learning 225</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">SUGGESTED DEVICES:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Hospital Garbage Disposal.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Captain A. Farenholt, Medical Corps, U. S. N 237</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">The Flat-Foot Ladder 240</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">CLINICAL NOTES:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Chondrodysplasia with Exostoses.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant R. W. Hutchinson, Medical Corps, U. S. N 243</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A Case of Vascular Syphilis.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant A. E. Kuhlmann, Medical Corps, U. S. N., and Lieutenant
Commander C. C. Ammerman, Medical Corps, U.S.N.R. F 245</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Two Cases of Encephalitis Lethargica.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander R. I. Longabaugh, Medical Corps, U. S. N 249</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A Case of Foreign Body in the Head.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander L. M. Schimdt, Medical Corps, U. S. N. 254</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">The Late Treatment of War Osteomyelitis.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant E. I. Salisbury, Medical Corps, U. S. N. R. F 255</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Two Cases of Gas Gangrene.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander L. M. Schmidt, Medical Corps. U. S. N 257</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Gastric Ulcer with Perforation.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant G. G. Holladay, Medical Corps, U. S. N. R. F 259</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Internal Ophthalmoplegia.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander E. E. Woodland, Medical Corps, U.S.N<span> </span><span> </span>260</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Open Treatment of a Fractured Metacarpal Bone.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant R. W. Auerbach, Medical Corps, U. S. N 263</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Supernumerary Phalanx.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant R. S. Reeves, Medical Corps, U. S. N. R. F 265</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A Cask of Ruptured Kidney.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Commander K. It. Richardson, Medical Corps, U. S. N</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Mustard Gas and the Cardiovascular System.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Ry Lieutenant Commander W. H. Michael, Medical Corps, U. S. N</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A Case of Ulcer of the Sigmoid Flexure.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant H. R. Coleman, Medical Corps, U. S. N</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A Case of Malposition.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant A. C. Toll inner, Dental Corps, U. S. N</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">PROGRESS IN MEDICAL SCIENCES :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">General Medicine — Blood pressure and posture —Intramuscular Injections
of quinine in malaria — Vincent's disease Surgery — Appendicitis amongst
sailors— Transplanting of bone— Rectal ether anesthesia</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Hygiene and Sanitation — Destruction of lice by steam</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Eye, Ear. Nose, and Throat — Ocular phenomena in the psychoneuroses of
warfare —Ocular complications due to typhoid inoculations</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">NOTES AND COMMENTS:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Syphilis and the war—Bone surgery —National Research Council— Laboratories
in Poland— National Anaesthesia Research Society — Vanderbilt Medical School —
Municipal education in Detroit — Female medical matriculates— Degrees conferred
by Royal College of Surgeons of Edinburgh — Speech defects — Typhoid fever in
New York — Venereal diseases in California- — Omissions in the Annual Report of
the Surgeon General, 1919</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">REPORTS :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">U. S. Navy Ambulance Boat No. 1.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Chief Pharmacist's Mate D. V. De Witt, U. S. N</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Physical Development in the Navy.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant B. G. Baker, Medical Corps, U. S. N</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Venereal Prophylaxis at Great Lakes, III.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenants D. It. Blender and L. A. Burrows, Medical Corps, U. S.
N. R. F</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Report of 505 Tonsillectomies.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant W. P. Vail, Medical Corps, U. S. N. R. F</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">BOOK NOTICES</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;"> </p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Number 3</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;"> </p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">PREFACE v</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">NOTICE TO SERVICE CONTRIBUTORS vi</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">SPECIAL ARTICLES :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">History of the U. S. Naval Hospital, Chelsea, Mass.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Captain N. J. Blackwood, Medical Corps, U. S. N 311</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">INSTRUCTION FOR THE HOSPITAL CORPS.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander W. M. Kerr, Medical Corps, U. S. N. 338</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Study of Two Cases of Diabetes Mellitus.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant L. F. Craver, Medical Corps, TJ. S. N 345</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Flat Foot in the Navy.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant C. F. Painter, Medical Corps, U. S. N. R. F 359</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Static Defects of the Lower Extremities.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant A. A. Marsteller, Medical Corps, U. S. N 365</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Treatment of Malaria.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander W. H. Michael, Medical Corps, U. S. N 367</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Navy Recruiting.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant W. H. Cechla, Medical Corps, U. S. N 371</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">HISTORICAL:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">American Founders of Gynecology 373</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">EDITORIAL :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">"Bring Forth Your Dead "—Is Educational Prophylaxis Effective
381</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">William Martin —John Wolton Ross —Oliver Dwight Norton, Jr<span> </span>389</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">CLINICAL NOTES:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Interdental Ligation for Jaw Fractures.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant W. F. Murdy, Dental Corps, U. S. N 391</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A Temporary Stopping.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander H. E. Harvey, Dental Corps, U. S. N<span> </span>394</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">ASCARIASIS AND APPENDICITIS.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander E. G. Hakansson, Medical Corps, U. S. N 394</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Malarial Crescents.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander W. H. Michael, Medical Corps, U. S. N_ 395</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Poisoning by Jelly Fish.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Commander A. H. Allen, Medical Corps, U. S. N 396</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Traumatic Rupture of Kidney.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander F. H. Bowman, Medical Corps, U. S. N 397</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A Case of Erythema Multiforme.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant M. F. Czubak, Medical Corps, U. S. N 399</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">PROGRESS IN MEDICAL SCIENCES:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">General Medicine. — Static back trouble—Benzyl benzoate —Relation of
anaphylaxis to asthma and eczema —High enema —Treatment of typhus —Thilerium
hominis 401</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Mental and Nervous Diseases. —Insanity as a defense in crime —The nervousness
of the Jew— The Babinski reflex —Problems of delinquency —Encephalomyelitis in
Australia 408</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Surgery. — Radium — Surgery of peripheral nerves — Referred symptoms in
diseases of gall-bladder and appendix—Intracranial pressure —Protection of the
skin in surgical operations—Anesthesia</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">from drugs administered by the mouth —A new skin-suture material —
Roentgen-ray problems , 414</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Hygiene and Sanitation. — Birth control—Typhoid fever in vaccinated
troops —Detection of typhoid carriers —Streptococci in market milk
—Tuberculosis in San Francisco —An experiment in sanitary education —Oral
hygiene —Differential diagnosis between trachoma and follicular conjunctivitis
—Left - handedness —The Negritos of the Philippine Islands —Tropical Australia
425</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">NOTES AND COMMENTS :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">American Society for the Control of Cancer — Pay of Italian medical officers
— The passing of the book worm— The neurotic girl —Control of druggists in
Michigan — English statistics on alcoholism —Prevention of simple goiter— Value
of quarantine against influenza in Australia —W. P. C. Barton, first chief of
the Bureau of Medicine and Surgery—Information on blood-pressure estimation
—Automobile accidents —Egyptian Medical School — Educational movement In U. S.
Army 443</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">REPORTS :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Health Conditions in Santo Domingo.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander G. F. Cottle, Medical Corps, U. S. N 453</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">History of U. S. S. Pocahontas During the War,</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander M. Boland, Medical Corps, U. S. N 460</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">With the American Peace Commission.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Commander A. D. McLean, Medical Corps, U. S. N 500</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Testing Water for Storage Batteries.<span>
</span>502</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Report from Naval Medical School Laboratory 505</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">BOOK NOTICES 505</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;"> </p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Number 4</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">PREFACE V</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">NOTICE TO SERVICE CONTRIBUTORS VI</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">SURGICAL <span> </span>ACTIVITIES AT THE NAVAL
HOSPITAL, NEW YORK.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Interesting bone cases 512</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Fractubes of the anterior tuberosity of the tibia and Osgood-Schlatter's
disease 516</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Carrel-Dakin technique for empyema 527 </p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Physical therapy 535</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Occupational therapy 536</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">War wounds of the joints.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Dr. L. Delrez, Faculty of Medicine Liege 537</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A case or joint treatment by Willems's method 545</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Chronic intestinal stasis 545</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Carrel-Dakin technique in treatment of carbuncle 549</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A case of sarcoma of the foot 550</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A case of Jacksonian epilepsy with spastic contracture 551</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A Case Of Osteoma Of The Humerus 552</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A Case Of Bone Infection Resembling Sarcoma 552</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Wound closures after Carrel-Dakin treatment 553</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Ether in peritonitis 557</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">HISTORICAL:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">The founders ok naval hygiene. Lind, Trotter, and Blane 563</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">EDITORIAL:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Hospital standards —As seen from within 629</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">SUGGESTED DEVICES :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Vision test apparatus.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander H. W. Glltner, Medical Corps, U. S.N. R. F 637</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Treatment of cement floors.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Captain A. Farenholt, Medical Corps, U. S. N 638</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">CLINICAL NOTES:</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Ophthalmitis in secondary syphilis.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander W. H. Whitmore, Medical Corps, U. S. N 639</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">TWO CASES OF OPTIC ATROPHY.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander C. B. Camerer, and Lieutenant G. L. McClintock,
Medical Corps, U. S. N 641</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Arsphenamine in malaria.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander W. H. Michael, Medical Corps, U. S. N 643</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Ureteral calculus. </p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Commander W. J. Zalesky and Lieutenant Commander P. F. Prioleau,
Medical Corps, U. S. N 644</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">PROGRESS IN MEDICAL SCIENCES :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">General medicine. — Treatment of respiratory catarrhs.—Tests of thyroid
hypersensitiveness. —A diet sheet for nephritics.— Delayed arsenical poisoning
647</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Surgery. —Open treatment of fractures. — Treatment of crushed extremities.
—Nerve injuries of the war 653</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Hygiene and sanitation. —Disinfection of tubercular sputum. — Syphilis
in railroad employees 659</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Tropical diseases. —Ulcerating granuloma 663</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Eye, ear, .nose, and throat. — Frontal sinus drainage. —Anesthetics in throat
surgery. —Correction of nasal deformities</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">NOTES AND COMMENTS :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">American Library Association.— Mental defects in the United States. —
"Tea-taster's " cough. — Scientific basis of carelessness. — "The
case against the prophylactic packet." —Treatment of leprosy. — Medical
training in London. —A new Army and Navy Club. — The Navy Mutual Aid
Association. — Medical school of the University of Virginia. —A new medical
quarterly. —Solar therapy. — Novarsenobenzol subcutaneously. —Economic loss
from rats. —The flight of mosquitoes. —A medical centenarian. — A French hospital
ship. — Potassium-mercuric-iodide.— Dermatitis in industrial work. —</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Radium.— A twelfth century epitaph 663</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">REPORTS :</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Arsenical preparations used intravenously.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Captain E. S. Bogert, Medical Corps, U. S. N 679</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Venereal disease in the Dominican Republic.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant J. W. Vann and Lieutenant B. Groesbeck, Medical Corps, U.
S. N 681</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">American legation guard, Managua, Nicaragua.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant Commander F. F. Murdock, Medical Corps, U. S. N_ 684</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Sanitary conditions in Vladivostok.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant A S. Judy, Medical Corps, U. S. N 689</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Hospital records.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Commander H. W. Smith, Medical Corps, U. S. N 698</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">HOSPITAL RECORDS.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Commander E. U. Reed, Medical Corps, U. S. N 706</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">A DEATH FROM ETHER DUE TO STATUS LYMPHATICUS.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Captain A. W. Dunbar, Medical Corps, U. S. N 714</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">Medical prophylaxis against venereal diseases.</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">By Lieutenant P. W. Dreifus, Medical Corps, U. S. N 715</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">BOOK NOTICES 718</p>
<p class="MsoNormal" style="margin-bottom:.0001pt;line-height:normal;">INDEX 721</p>
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Mise en place d'aiguilles au niveau de points d'acupuncture du poignet.
Les médecines non conventionnelles (encore appelées médecines alternatives, médecines parallèles, médecines holistiques, médecines naturelles, médecines douces) regroupent plusieurs centaines de pratiques thérapeutiques dont l'efficacité n'est pas démontrée, c'est-à-dire non testée, non supérieure au placebo, ou bien insuffisamment démontrée1 d'où le qualificatif de pseudo-médecines qui peut leur être appliqué2. Elles se distinguent donc de la médecine fondée sur les faits, parfois dite « conventionnelle », dont l'efficacité est prouvée scientifiquement. En France, le terme de thérapies complémentaires (ThC) est recommandé par l'Académie nationale de médecine3. Le Conseil de l'Ordre des médecins utilise l'expression médecines alternatives et complémentaires (MAC)4 tout en indiquant que « l'utilisation médiatique [de ces termes], concernant notamment l’homéopathie, entretient une ambigüité qui est source de confusion et de litiges d’interprétation5 ».
Un certain nombre de médecines non conventionnelles se réclament de traditions anciennes et sont alors considérées comme médecines traditionnelles (par exemple la phytothérapie, l'acupuncture ou la médecine ayurvédique), mais d'autres sont apparues à la fin du xviiie siècle ou au cours du xixe siècle (comme l'hypnose, l'ostéopathie, l'homéopathie, la naturopathie ou l'oligothérapie). Certaines thérapies se revendiquent comme « holistiques », déclarant examiner l'individu dans sa « globalité », y compris son histoire et mode de vie.
Ces pratiques non conventionnelles sont dénuées de fondement scientifique et ne sauraient se comparer, ni se substituer, à la médecine proprement dite, bien que pouvant être parfois utilisées en complément, en tant que « techniques empiriques » ou « méthodes adjuvantes »3. Elles sont diversement contrôlées par des instances officielles et, selon les pays, leurs traditions et législations sont plus ou moins répandues et reconnues6. Elles se développent en complément ou en alternative à la médecine et sont utilisées par 20 à 50 % des populations de plusieurs pays de la Communauté européenne selon les résultats d'enquêtes d'opinion de la fin du xxe siècle7, voire par près de 4 Français sur 10, en particulier les patients atteints de cancer3. Elles sont parfois utilisées dans des hôpitaux, cela ne valant toutefois pas reconnaissance de leur validité.
Le concept de « médecine intégrative » a été inventé pour désigner le recours simultané à la médecine dont l'efficacité est avérée et aux thérapies alternatives dans la prise en charge d'un patient. Ces dernières n'ont cependant, par définition, pas d'effet bénéfique au-delà de l'effet placebo8,9,10, à très peu d'exceptions près ayant montré une efficacité spécifique mais faible11. Leur action spécifique peut entraîner des effets secondaires12, et elles peuvent avoir des effets négatifs en interférant avec les traitements efficaces, notamment dans le traitement de cancer13,14. Des problèmes peuvent survenir lors du recours à des traitements alternatifs en lieu et place de soins ayant fait leurs preuves d'efficacité, d'autant plus en fonction de la gravité de la maladie.
Des mouvances font l'objet de surveillance de la part des autorités du fait du risque d'escroquerie, d'abus de faiblesse et de dérive sectaire lié à l'utilisation de certaines méthodes, régimes alimentaires et thérapies alternatives : « charlatanisme et amateurisme peuvent avoir des conséquences graves pour des personnes fragilisées physiquement et psychologiquement par des pathologies lourdes et/ou chroniques15 ».
Sommaire
1Origines
1.1Origine de l'appellation
1.2Origines et histoire des médecines regroupées sous cette appellation
1.2.1Influences antiques et orientalistes
1.2.2Fin XVIIe - début XXe siècles
1.2.3Du New Age à l'époque contemporaine (XXe - début XXIe siècles)
2Typologie de pratiques
3Conventionnelle, non conventionnelle, une approche différente
3.1Le naturel et la tradition ancienne
3.2L'interprétation des troubles
3.3Les postulats
4Aspect légal
4.1Union européenne
4.2France
4.2.1Cas de l'herboristerie et de la phytothérapie
4.3Suisse
4.4Allemagne
5Utilisation des médecines non conventionnelles
5.1France
5.2États-Unis
5.3Pays en développement
5.4En Europe
6Pratique des médecines non conventionnelles en France
6.1Par des médecins, en milieu hospitalier
6.2Caractéristiques problématiques de certaines thérapies
7Une économie publique
8Recherches
8.1L'approche scientifique
8.2Relations entre médecins conventionnels et non-conventionnels
9Affaires
10Notes et références
11Voir aussi
11.1Bibliographie
11.2Articles connexes
11.3Liens externes
Origines[modifier | modifier le code]
Origine de l'appellation[modifier | modifier le code]
Le terme « médecine non conventionnelle » est celui retenu par la Commission européenne7 . Ce terme désigne selon le rapport du Parlement européen :
"L'ensemble des systèmes médicaux et disciplines thérapeutiques couverts par la dénomination "médecines non conventionnelles" ont en commun le fait que leur validité n'est pas reconnue ou n'est que partiellement reconnue".
L'appellation « médecine non conventionnelle » se bâtit aussi par opposition à la définition de la « médecine conventionnelle », une médecine à l'efficacité prouvée, telle que définie par le Ministère des Solidarités et de la Santé16 :
« La médecine « conventionnelle » s’appuie sur des traitements qui ont toujours obtenu une validation scientifique, soit par des essais cliniques, soit parce qu’ils bénéficient d’un consensus professionnel fort. Les essais cliniques sont soumis à des autorisations et à des contrôles rigoureux sur le plan de l’éthique, des conditions de réalisation et de la pertinence scientifique . Les consensus professionnels, quant à eux, sont obtenus après plusieurs années de recul, avec l’accord et l’expérience de la majorité des professionnels de la discipline concernée. Les conditions d’utilisation des techniques y sont définies avec précision. En s’appuyant sur cette méthodologie rigoureuse, l’efficacité de la médecine conventionnelle est prouvée. »
Ce terme qualifie donc des méthodes de soin parfois également appelées « médecine douce », « médecine complémentaire », « médecine naturelle », « médecine alternative », « médecine parallèle » ou encore « médecine holistique ». La médecine conventionnelle est généralement désignée par les tenants de certaines médecines non conventionnelles sous le terme de médecine allopathique (terme provenant de l'homéopathie).
L'Organisation mondiale de la santé (OMS) inclut les médecines complémentaires et alternatives dans les médecines traditionnelles. Elle précise : « Le terme « médecine complémentaire » ou « médecine alternative » est utilisé de manière interchangeable avec « médecine traditionnelle » dans certains pays. Elles concernent une large gamme de pratiques de soins qui ne font pas partie des traditions du pays et qui ne sont pas intégrées dans le système de santé dominant17. »
Cependant, le choix des termes induit souvent des partis-pris. En effet, parler de « médecine parallèle » semble signifier qu’il y aurait deux conceptions équivalentes de la médecine impliquant deux systèmes de soins fonctionnant indépendamment l’un de l’autre, avec le même degré d’efficience et de scientificité : les patients auraient donc le choix entre deux thérapeutiques qu’ils peuvent envisager comme alternatives et concurrentes ou comme complémentaires l’une de l’autre. D'autre part, l’appellation « médecine douce » semble considérer comme agressives les pratiques de la médecine conventionnelle : selon Jean Brissonet « l’utilisation de l’adjectif « douce » n’étant là que pour faire paraître « dure » la médecine moderne. En fait une technique médicale n’est ni « dure », ni « douce », elle est, ou n’est pas, efficace. Ensuite, tout est question d’utilisation et de rapport efficacité/risque. »18. L'idée de « médecine naturelle » s'appuie sur un présupposé rousseauiste selon lequel la nature est bonne et les œuvres de l'Homme mauvaises, et que certaines méthodes thérapeutiques seraient plus proches de cette supposée harmonie naturelle18. En disant « médecine alternative », on envisage ces pratiques de soins comme substitutives, donc susceptibles de remplacer une démarche thérapeutique classique et conventionnelle. D'autres préféreront parler de pseudo-médecines ou pseudo-sciences afin d'éviter cet effet de rhétorique2.
Le terme « médecine complémentaire » privilégie l’idée d’associer des traitements impliquant des « philosophies thérapeutiques » différentes mais capables de coopérer dans l’intérêt du malade19,20.
L'Académie nationale de médecine française recommande dans un rapport de 2013 l'appellation « thérapies complémentaires » (« ThC ») : « L’ANM rappelle que les pratiques souvent dites médecines complémentaires ne sont pas des "médecines", mais des techniques empiriques de traitement pouvant rendre certains services en complément de la thérapeutique à base scientifique de la médecine proprement dite. Elle recommande de ce fait de les désigner par la dénomination de thérapies complémentaires, qui correspond mieux à leur nature3. »
Dans tous les cas, ces appellations regroupent un grand nombre de pratiques aux fondements scientifiques très variables, et rarement contrôlées par des instances officielles. La liste du MeSH comporte ainsi 17 catégories de thérapies complémentaires et la MIVILUDES dénombre 400 pratiques « à visée thérapeutique »3. Certaines d'entre elles sont étroitement surveillées par les pouvoirs publics en raison des éventuels dangers qu'elles présentent pour la santé ou du risque de dérive sectaire21.
Origines et histoire des médecines regroupées sous cette appellation[modifier | modifier le code]
Influences antiques et orientalistes[modifier | modifier le code]
Article détaillé : Histoire de la médecine.
L'Occident a été marqué pendant plusieurs siècles par la théorie des humeurs d'Hippocrate, qui reste considéré comme le « père de la médecine occidentale » aujourd'hui22. Un parallèle notable peut être fait entre la médecine européenne de l'époque médiévale et les systèmes de la médecine traditionnelle chinoise et d'ayurveda en Inde : des parties du corps et organes sont de façon similaire associés à des saisons, des signes astrologiques, ou des éléments23. Ces théories ont fait leur réapparition dans un certain nombre de pratiques paramédicales depuis le xixe siècle, et font l'objet d'un effet de mode dans certains milieux.
Un certain nombre de pratiques non conventionnelles disponibles en Europe déclarent aujourd'hui s'inspirer plus ou moins directement de traditions asiatiques antiques (chinoises, indiennes, tibétaines, etc.) ou parfois africaines ou amérindiennes, et se réclament des philosophies et cultures de ces pays. Leur promotion peut alors reposer sur l'argument fallacieux de l'« appel à la tradition » ou « argument d'historicité » qui prétend que comme ces pratiques existent depuis longtemps, elles on fait leur preuve et sont toujours valables aujourd'hui24.
Certains utilisent le terme « médecine occidentale » pour qualifier la médecine moderne, même si celle-ci a en réalité puisé à des sources extrêmement diverses pendant sa longue histoire, et pas uniquement occidentale (notamment égyptiennes et arabes). Par ailleurs, la plupart des asiatiques qui y ont accès ont largement recours à la médecine moderne, et des chercheurs de tous les pays contribuent aujourd'hui au progrès de la médecine mondiale : les notions de médecine « occidentale » ou « orientale » comme leur fixité dans le temps (les « traditions » évoluent) ne reflètent donc pas, pour certains auteurs, l'importante diversité interne des différentes traditions historiques des pays invoqués25.
Fin XVIIe - début XXe siècles[modifier | modifier le code]
À la fin du xviie siècle, la moxibustion fait son apparition en Europe, ses vertus étant vantées par des auteurs tels que Hermann Busschof (de) et Willem ten Rhijne (en) pour lutter contre la goutte26. L'acupuncture est également expliquée aux Européens par Willem ten Rhijne suite à ses observations au Japon sur des praticiens et des documents. Le naturaliste Engelbert Kaempfer étudiera de même ces deux thérapies, en constatant lui aussi leurs effets apparents, mais avec un regard beaucoup plus critique concernant la théorie des méridiens sur laquelle elles reposent27. L'historienne Roberta Bivins remarque que cette intégration de thérapies traditionnelles chinoises en dehors de leur cadre culturel d'origine aurait pu sembler improbable, pourtant elles sont encore utilisées aujourd'hui en Occident28.
Deux pseudo-médecines datant de la fin du xviiie siècle, l'homéopathie et le mesmérisme, particulièrement populaires au xixe siècle, sont des exemples de thérapies qui reposent sur la seule expérience subjective comme preuve d'efficacité29.
Malgré des appels récurrents à des héritages millénaires, la plupart des pratiques non conventionnelles qui subsistent de nos jours trouvent en fait leur origine dans des théories occidentales relativement récentes. Par exemple, la naturopathie naît en Allemagne en 1885, et se développe avec la mode de la lebensreform germanique du xixe siècle, qui sert de tribune à de nombreuses théories alternatives auparavant plus ou moins confidentielles ou expérimentales, qui voient le jour en Occident entre la fin du XIXe et le début du xxe siècle : ostéopathie (USA, 1874), chiropratique (USA, 1895), aromathérapie (France, 1910), médecine anthroposophique (Allemagne, années 1920), élixirs floraux de Bach (Angleterre, 1936)... Certaines para-médecines asiatiques populaires en Occident datent de la même époque, notamment au Japon avec le shiatsu (élaboré en 1919 par Tenpeki Tamai) ou le reiki (développé par l'homme d'affaires japonais Mikao Usui à partir de 1922).
La plupart des systèmes médicaux qui étaient encore utilisés au xixe siècle ne survivent pas à l'essor de la médecine scientifique moderne qui débute à la fin du xixe siècle pour s'industrialiser au xxe siècle30. Cependant, un certain nombre ont eu le temps de pénétrer les États-Unis, pays encore très arriéré sur le plan médical31, et où médecines archaïques et charlatans prospèrent : c'est là que naissent la chiropratique et l'ostéopathie, et que la naturopathie connait un second essor (et devient rapidement une marque déposée, par l'homme d'affaires d'origine allemande Benedict Lust). En 1910, la Fondation Carnegie pour la promotion de l'enseignement mandate un vaste audit des pratiques de santé aux États-Unis, condensé dans le Rapport Abraham Flexner31 : celui-ci est accablant, et met en évidence l'énorme écart de santé entre les Américains encore essentiellement sous l'emprise d'une médecine pré-scientifique et les Européens qui commençaient à bénéficier à cette époque de nombreux médicaments modernes (comme la pénicilline), permettant de réduire drastiquement la plupart des maladies et la mortalité. Les progrès fulgurants de la médecine moderne importée d'Europe conduisent donc progressivement les Américains de l'Est à délaisser une partie de leurs pratiques hasardeuses, même si celles-ci perdurent dans l'ouest et sur la côte pacifique.
En Allemagne, un certain nombre de pratiques alternatives reconquièrent pendant les années 1920-30 une partie du public germanique à la faveur de la vogue post-romantique et anti-scientifique, préparée par l'idéologie de la lebensreform et l'ésotérisme théosophique, culminant dans les divers courants mystiques en vogue à cette époque comme l'anthroposophie de Rudolf Steiner qui développe une médecine anthroposophique. Mettant fin à la « liberté de soigner » (kurierfreiheit) alors en vigueur depuis 1871 et permettant à toute personne de prodiguer des soins médicaux sans formation particulière, l'Allemagne nazie est le premier État européen à institutionnaliser la pratique de médecines non-scientifiques à travers une loi de 1939 (Heilpraktikergesetz (de)) qui institue la profession de « heilpraktiker »32,33. Après-guerre, naturopathie et homéopathie demeurent populaires en Suisse et en Bavière, et s'installent progressivement en Angleterre et en France, avec tout un cortège de théories associées.
Du New Age à l'époque contemporaine (XXe - début XXIe siècles)[modifier | modifier le code]
Une seconde vague de création de théories alternatives a lieu aux États-Unis eu lieu à partir des années 1960, en se diffusant par la côte Ouest sous l'impulsion du mouvement New Age : rebirth, multiples « pratiques énergétiques », diverses psychothérapies telles que la « thérapie primale », l'« analyse bioénergétique »34 ou encore la programmation neurolinguistique (PNL). De très nombreuses pratiques nouvelles prolifèrent ainsi, malgré des critiques toujours constantes de la part des institutions médicales face à l'absence d'effet démontré pour la plupart des soins proposés35. En 1968, un rapport du Département de la Santé et des Services sociaux des États-Unis dénonce ainsi l'absence de fondements empiriques comme théoriques de la plupart des théories alternatives alors en vogue en Amérique, ainsi que leur absence d'efficacité clinique, et invite à leur éviction des systèmes de sécurité sociale36.
Seule une partie de ces théories survit aux années 1980, qui voit aussi passer une mode des thérapies à prétention high-tech (comme la soi-disant « médecine quantique »), ainsi que l'essor des régimes pseudo-thérapeutiques et du coaching en « développement personnel », à grand renfort de marketing.
Au début du xxie siècle, on constate en Occident une structuration de l'offre autour, d'une part, d'un certain nombre de disciplines assez populaires (homéopathie, ostéopathie, acuponcture, etc.) et en quête de respectabilité institutionnelle (création d'écoles, de diplômes, de certification, utilisation dans les hôpitaux en tant que « thérapie complémentaire »3), souvent soutenues par un appareil industriel très lucratif37 malgré l'absence de résultats cliniques réellement satisfaisants, et d'autre part d'une prolifération de sous-disciplines plus ou moins ésotériques souvent fondées sur une opposition dogmatique à la médecine scientifique, et de plus en plus liées à la mouvance complotiste (notamment autour de la controverse sur la vaccination) ou à diverses dérives sectaires21. Entre les deux, on trouve une grande diversité de pratiques thérapeutiques plus ou moins bien identifiées, et à durée d’existence souvent courte car fondée essentiellement sur le charisme de leur promoteur, qui donne parfois son nom à la discipline (comme la « technique Alexander », la « méthode Vodder » ou encore la sophrologie caycédienne d'Alfonso Caycedo)38.
Typologie de pratiques[modifier | modifier le code]
Plus de 400 pratiques thérapeutiques « alternatives », « complémentaires » ou « traditionnelles » sont recensées par l’OMS4.
L’OMS et l’Inserm distinguent quatre familles de pratiques4 :
Les thérapies biologiques, utilisant des produits naturels issus de plantes, de minéraux ou d’animaux (ex : phytothérapie, aromathérapie).
Les thérapies manuelles (ex : ostéopathie, chiropraxie, réflexologie).
Les approches corps-esprit (ex : hypnose médicale, méditation, sophrologie).
Les systèmes reposant sur des fondements théoriques propres (ex : acupuncture, homéopathie).
Conventionnelle, non conventionnelle, une approche différente[modifier | modifier le code]
Le naturel et la tradition ancienne[modifier | modifier le code]
Il existe deux principes fréquemment mis en avant par les promoteurs des médecines non conventionnelles et qui feraient la différence avec la médecine conventionnelle :
le recours à la « Nature », la référence au naturel ; le fait qu’une substance est « naturelle » serait un gage de qualité. Cependant les catastrophes naturelles, les maladies, les champignons vénéneux et la plupart des toxines sont également naturels, et pas bienfaisants pour autant. De fait, de nombreux médicaments ont pour principe actif des molécules extraites des plantes ou d'autres organismes, simplement isolés, purifiés et plus ou moins concentrés (l'aspirine en est un exemple)18. Inversement, la notion de « médecine naturelle » (conçue comme traitement basé sur l'utilisation d'un organisme tel quel, comme une plante) a des limites thérapeutiques, la substance active étant, soit diluée parmi les autres composés parfois toxiques ou inhibiteurs, soit présente à des concentrations non thérapeutiques, c'est-à-dire toxiques ou insuffisantes pour entraîner un bénéfice pour le patient ;
la référence à la « tradition » ; il s'agit principalement des traditions attribuées à plus ou moins juste titre à l'Asie (Chine, Inde, Tibet...), à l'Afrique ou à l'Amérique latine, liées aux philosophies et aux cultures de ces pays et dont l'ancienneté annoncée serait garante d'efficacité (voir tradipraticien, médecine traditionnelle). Le journaliste scientifique Florian Gouthière rappelle toutefois que « l’ancienneté d’une pratique n’est jamais une preuve, en soi, de sa validité »39, et qu'il peut y avoir une fixation à des principes pseudo-scientifiques comme la théorie des méridiens dans le cas de l'acuponcture, laquelle a d'ailleurs connu un siècle de désuétude, au xixe siècle, face au progrès de la dissection, avant d'être « ressuscitée » au xxe siècle (dans un but politique et patriotique)39.
L'interprétation des troubles[modifier | modifier le code]
Les thérapies non conventionnelles et la médecine classique diffèrent sur l'interprétation des troubles. Par exemple, la naturopathie élabore les concepts de détoxication/détoxination (les toxines en question n'étant pas toujours spécifiées), alors que ceux-ci n'ont pas de définition en médecine classique40. D'autres parleront en termes de karma, d'« énergie » ou encore d'humeurs, se plaçant donc dans un cadre conceptuel sans fondement scientifique.
Les postulats[modifier | modifier le code]
Cette section est vide, insuffisamment détaillée ou incomplète. Votre aide est la bienvenue ! Comment faire ?
Les médecines non conventionnelles reposent sur certains postulats :
les médecines énergétiques (acupuncture, qi gong, shiatsu…) partent du principe que l'être humain possède un influx vital (prana en indien, ki en japonais ou qi en chinois) qui peut circuler de manière harmonieuse, la maladie étant une perturbation de cette harmonie qu'il convient de ré-équilibrer ;
l'homéopathie est fondée sur des principes selon lesquels :
le mal provient d'un problème inhérent à la personne[réf. nécessaire], le « terrain » est ce qui assure la guérison, et c'est ce terrain qu'il faut traiter,
le traitement se fait selon le principe de similitude : on administre une substance réputée provoquer un symptôme pour soigner ledit symptôme,
plus un produit est dilué et « dynamisé » (secoué vigoureusement) plus il est actif,
l'ostéopathie part du principe que le trouble provient d'un blocage des structures anatomiques entre elles, d'un mauvais fonctionnement « mécanique ». Elle se fonde sur quatre principes : la structure gouverne la fonction, la fonction modèle la structure, l'unité du corps, et l'artère est suprême.
la balnéothérapie postule les bienfaits de l'eau et des bains, méthode à rapprocher du thermalisme.
D'autres font appel à des théories pré-scientifiques comme la théorie des humeurs, ou à des principes plus ou moins occultes (comme le Karma).
Aspect légal[modifier | modifier le code]
Circle-icons-globe.svg
Cette section adopte un point de vue régional ou culturel particulier et doit être internationalisée (septembre 2017).
Selon les pays, les médecines non conventionnelles sont reconnues ou seulement tolérées41. Certains pays exigent toutefois un titre médical ou paramédical pour la pratique de certaines approches.
Union européenne[modifier | modifier le code]
Selon la Commission des questions sociales, de la santé et de la famille du Conseil de l’Europe :
« Les médecines alternatives sont devenues à présent de véritables industries. Dès lors, des abus et des dérives sont possibles, certains étant toujours tentés, par goût du pouvoir ou esprit de lucre, d’utiliser ces médecines à des fins détournées. Il existe donc des risques certains de voir ces médecines exploitées par des charlatans, des groupes sectaires etc…, tous voyant en elles un profit immédiat.
Pour les sectes, la santé est un thème porteur : elles s ’en servent pour attirer de nouveaux adeptes, et sont tentées d’utiliser ces médecines parallèles pour couper les adeptes du monde médical extérieur à la secte. Dans la mesure où elles prônent l’inutilité de la médecine traditionnelle et la nécessité d’arrêter tout traitement, y compris dans le cas de maladies graves comme le cancer et le SIDA, les dangers sont considérables pour les individus. Les médias se sont fait l’écho de plusieurs cas d’adeptes atteints de cancer et décédés après avoir abandonné toute thérapie37. »
France[modifier | modifier le code]
La commission Nicolas de 2002 a permis la reconnaissance de l'acupuncture et de l'homéopathie comme des pratiques médicales légales. Le titre professionnel d'ostéopathe a lui été reconnu, de même que celui de chiropracteur, par la loi du 4 mars 200242. Cependant, ces reconnaissances de titres professionnels ne sont pas pour autant des validations de ces théories, et l'Académie de Médecine considère que « l’insertion des ThC [thérapies complémentaires, en l'occurrence pour ce document l'acupuncture, l'hypnose, l'ostéopathie et le tai-chi] dans les soins dispensés par les hôpitaux, notamment les CHU, semble présenter un réel intérêt si elle est comprise non comme une reconnaissance et une valorisation de ces méthodes, mais comme un moyen de préciser leurs effets, de clarifier leurs indications et d’établir de bonnes règles pour leur utilisation3. ». De ce fait, un certain nombre de ces pratiques thérapeutiques se sont ajoutées à la liste des médecines à exercice particulier, pratiquées à titre subsidiaire par des médecins généralistes, mais non reconnues par la Sécurité sociale. Parmi celles-ci, nous pouvons notamment compter l'acupuncture, l'homéopathie, la médecine gériatrique ou la nutrition.
Selon l'article 39 du code de déontologie médicale et l'article R4127-39 du code de la santé publique43 : « Les médecins ne peuvent proposer aux malades ou à leur entourage comme salutaire ou sans danger un remède ou un procédé illusoire ou insuffisamment éprouvé. Toute pratique de charlatanerie est interdite44 ». Le code de déontologie et le code de santé publique impliquent de potentielles sanctions ordinales comme pénales pour la pratique de méthodes insuffisamment éprouvées, même si certaines pratiques alternatives sans risque restent de fait tolérées.
Selon la Question Parlementaire no 11662 intitulée « Médecines douces et risques de dérives sectaires »45 : « Le ministère rappelle que les pratiques dites de « médecines douces », si elles ne sont pas exercées par des membres du corps médical, doivent strictement rester dans le champ du bien-être et de la détente. Tout acte à visée diagnostique ou thérapeutique ne peut être pratiqué que par les membres du corps médical. »
Cas de l'herboristerie et de la phytothérapie[modifier | modifier le code]
En raison de l'existence de composants actifs potentiellement dangereux dans de nombreuses plantes, l'usage des plantes médicinales est très réglementé en France46. « En France, les médicaments à base de plantes sont dispensés exclusivement dans les officines pharmaceutiques du fait de l’existence du monopole pharmaceutique. Il existe toutefois une possibilité de laisser certains de ces médicaments en libre accès pour les clients ; le libre accès est limité à certaines spécialités pharmaceutiques ayant des indications thérapeutiques bien précises définies par décret. [...] Certaines plantes très actives, donc potentiellement toxiques, sont inscrites sur l’une des listes (I ou II) des substances vénéneuses et ne peuvent de ce fait être délivrées en pharmacie que sur prescription médicale47. » Les plantes sont donc à utiliser avec précaution : une huile essentielle peut contenir jusqu'à 2 000 principes actifs48. Un certain nombre de ces principes actifs possèdent des propriétés médicalement intéressantes, mais leur usage doit être contrôlé car comme pour toute substance ayant un effet sur le métabolisme, un mauvais dosage ou une mauvaise utilisation peuvent avoir des effets indésirables graves. Il est donc important de respecter la posologie et la durée de la prise, et d'être encadré si possible par un spécialiste diplômé. Ainsi, le millepertuis, le ginkgo ou le pamplemousse peuvent provoquer une diminution ou une augmentation de l’effet thérapeutique d’autres médicaments par interaction médicamenteuse. De même, l’absinthe ou le thuya peuvent être toxiques pour le système nerveux : c’est pourquoi en France certaines huiles essentielles ne peuvent être délivrées que par un pharmacien49.
Un régime dérogatoire est prévu pour les herboristes, et près d’un tiers des plantes médicinales inscrites à la pharmacopée, jugées sans risque à dosage raisonnable, a été libéralisé en 200850.
La plupart des médicaments de phytothérapie sont disponibles sans ordonnance en France mais ils peuvent aussi être prescrits47.
Suisse[modifier | modifier le code]
La Suisse a décidé, en juillet 1999, d’intégrer à l’essai cinq nouvelles médecines parallèles (après le succès de la chiropratique) dans le remboursement de l’assurance maladie obligatoire : l’homéopathie, la thérapie neurale, la phytothérapie, la médecine anthroposophique et la médecine traditionnelle chinoise. Après évaluation, ces médecines se sont avérées inefficaces et l’essai a été stoppé en juin 200551,52. En outre, l’usage de ces médecines ne réduisait pas la consommation des autres médecines. Ainsi, le 3 juin 2005, Pascal Couchepin (Conseiller fédéral) a donc décidé d’exclure ces méthodes de l’assurance de base. Selon l’ATS — Le Temps53, « il n’a pas été suffisamment prouvé que les cinq méthodes complémentaires satisfaisaient aux critères d’économicité, mais surtout d’efficacité et d’adéquation selon la loi sur l’assurance maladie (LAMal). »
Après une interruption du remboursement en juin 200551, il a été décidé de recommencer à rembourser temporairement ces médecines complémentaires à partir de 2012, pour une période d'essai de 5 ans54. La proposition d'inscrire la « prise en compte des médecines complémentaires » dans la Constitution a en outre été acceptée par 67 % des votants lors de la votation populaire du 17 mai 200955.
Par décision du Conseil fédéral du 16 juin 2017, les prestations médicales de la médecine anthroposophique, de l'homéopathie classique, de la médecine traditionnelle chinoise, de la phytothérapie et de l'acupuncture devaient être définitivement remboursées par l’assurance maladie de base à partir du 1er août 2017. Les nouvelles dispositions mettent ainsi sur un pied d’égalité les médecines complémentaires administrées par des médecins avec les autres disciplines médicales conventionnelles. Par cette décision, le gouvernement reconnaît que la médecine complémentaire remplit les exigences légales, notamment celles de l’article 32 de la loi sur l’assurance-maladie qui « permet de rembourser uniquement des prestations efficaces, appropriées et économiques ». Les prestations controversées et/ou nouvelles seront examinées sur demande, en cas de problème ou de doute, par une Commission fédérale des prestations générales et des principes (CFPP)56,57.
Allemagne[modifier | modifier le code]
Article détaillé : Heilpraktiker.
En Allemagne et dans certains cantons suisses existe depuis 1939 un statut officiel de « Heilpraktiker », regroupant les praticiens de diverses écoles alternatives sélectionnés sur la base d'un examen d'admission (essentiellement utilisé par des naturopathes et certains psychanalystes d'écoles marginales).
Utilisation des médecines non conventionnelles[modifier | modifier le code]
France[modifier | modifier le code]
Il existe peu de statistiques sur l'usage de ces médecines par la population. Un sondage SOFRES en 1985, CSA en 1988, une enquête chez des personnes hospitalisées en 1993, une étude réalisée par le CREDES en 1997 et les chiffres du rapport de l’OMS en 2002 sur la médecine traditionnelle sont les points de référence pour cette question58. Les résultats sont fluctuants, l’OMS donne un taux de 75 % et de 49 % dans le même rapport, mais il est généralement avancé que la moitié de la population française a recours à une médecine non conventionnelle et que les femmes sont les plus nombreuses à les utiliser.
La revue Science et Vie de janvier 2015 montre que « la mesure scientifique de l’efficacité des médecines alternatives se heurte à de nombreuses difficultés que la multiplication des études ne parvient pas vraiment à résoudre. Mais cette incertitude scientifique ne semble nullement entamer la confiance des français envers ces thérapies. Ainsi, 40 % d’entre eux y font appel et 78 % les jugent efficaces lorsqu’elles sont utilisées en prévention et 72 % estiment que, même dans le cas du cancer, les médecines complémentaires sont importantes en plus des traitement médicaux classiques59. »
L'Académie de médecine française a publié en 2013 un rapport intitulé « Thérapies complémentaires - acupuncture, hypnose, ostéopathie, tai-chi - leur place parmi les ressources de soin »3. Ce rapport, qui se fonde sur une synthèse de la bibliographie disponible sur le sujet, constate que « l’intérêt qui leur est porté dont témoigne le grand nombre de publications qui leur sont relatives, la croissance en nombre dans notre pays des projets de recherche clinique les concernant, et les connaissances en neurobiologie qui permettent d’en approcher le mécanisme obligent à les considérer avec sérieux, quand bien même leur efficacité n’est évoquée que dans un nombre limité de situations et fondée sur un niveau de preuve insuffisant. Cela ne justifie pas pour autant l'engouement probablement excessif du public en leur faveur. Ces pratiques doivent rester à leur juste place : celle de méthodes adjuvantes pouvant compléter les moyens de la médecine. »
La Mission interministérielle de vigilance et de lutte contre les dérives sectaires (MIVILUDES) a mis gratuitement à disposition dans son Guide santé et dérives sectaires21 une fiche intitulée « Comment reconnaître un charlatan ou un pseudo thérapeute sectaire ? ». Parmi les principaux traits récurrents qui définissent un pseudo-thérapeute, la mission note le dénigrement systématique de la médecine conventionnelle, la promesse d'une guérison miracle, la mise en valeur de bienfaits impossibles à évaluer ou mesurer (en termes de karma, d'aura, d'énergétique, etc.), la promesse d'une prise en charge globale (prétention holiste) agissant autant sur le corps que l'esprit voire l'âme, et l'utilisation d'un vocabulaire technique opaque (« ondes cosmiques, cycles lunaires, dimension vibratoire, purification, énergies, cosmos, conscience... »).
Le médecin et criminologue Jean-Marie Abgrall est l'auteur de plusieurs enquêtes sur le sujet (comme La mécanique des sectes en 1996 ou Les Charlatans de la santé en 1998). Il décrit ainsi le phénomène :
« Profitant de l’attirance grandissante du public pour les thérapies alternatives et les médecines douces, les groupes les plus divers investissent, depuis plusieurs décennies mais plus encore aujourd’hui dans des proportions inquiétantes, le domaine de la santé et du bien-être par une multitude d’offres de soins et d’accompagnement au développement personnel, assorties de promesses de guérison et de vie harmonieuse ici-bas et même au-delà.
Ce succès génère des risques divers, depuis l’escroquerie pure et simple jusqu’à la dérive « thérapeutique », voire sectaire au sens des critères retenus par les pouvoirs publics60. »
En mars 2018, 124 médecins et professionnels de santé publient un appel « contre les « médecines alternatives » qu'ils qualifient de « fake médecine » (« fausse médecine ») mettant en garde contre le risque d'arnaque, de charlatanerie et de dérive sectaire, et dénonçant le manque d'éthique des personnes proposant des soins dont l'efficacité n'est pas prouvée. Ils demandent l'exclusion de ces disciplines du champ médical, face au constat d'un entrisme de plus en plus prononcé61,62. Le philosophe Roger-Pol Droit indique en conclusion d'une analyse sur le sujet :
« En fait, derrière le débat « vraie médecine » contre « fausses médecines », plus de questions se profilent qu'on ne le voit d'abord. Il se pourrait qu'il indique un symptôme majeur de la crise contemporaine de la pratique médicale. Décider si la médecine est une science ou un art est une question qui traverse les siècles. Oublier qu'elle doit être les deux est un trait du nôtre63. »
États-Unis[modifier | modifier le code]
Aux États-Unis, cinquante-sept pour cent des femmes atteintes de cancer du sein auraient recours aux médecines non conventionnelles et plus la personne se sent malade plus elle aurait tendance à multiplier ces traitements. À côté des traitements biologiques (fortifiants), les méthodes les plus habituelles sont les thérapies de relaxation tête et corps, les cassettes de musique ou de vidéo64.
Toujours dans le cadre du cancer du sein, des études préliminaires portent sur la classique Grande Camomille de nos grands-mères dont une substance, le parthénolide, permettrait in vivo la lutte contre la résistance des cellules au tamoxifène65.
En 2008 l'American Hospital Association (en) faisait état de 37 % des hôpitaux qui rendent disponible l'utilisation de thérapies alternatives et complémentaires. Bien qu'appréciées de certains patients, ces pratiques ne sont pas toujours bien accueillies par les médecins dans les hôpitaux66.
Une étude clinique de 2017 a pointé que dans le cadre de cancers traitables, le recours aux médecines non conventionnelles (« alternative medicines ») sans aucun traitement conventionnel du cancer (« conventional cancer treatment ») diminuait drastiquement les chances de survies. Ce cas de figure reste cependant rare67.
Pays en développement[modifier | modifier le code]
Selon l'OMS : « Jusqu’à 80 % des populations des pays en développement s’en remettent à la médecine traditionnelle pour les soins de santé primaires, par tradition culturelle ou faute d’autres alternatives68. »
En Europe[modifier | modifier le code]
Une revue systématique publiée en 2018 a identifié les facteurs prédictifs qui font que les personnes issues de la population générale en Europe se tournent vers les médecines alternatives et complémentaires69. Les facteurs prédictifs de recours à des praticiens de ces médecines sont le fait d'être de sexe féminin et le fait de reporter être atteint d'une maladie chronique. Le statut marital n'est cependant pas un facteur prédictif. Le fait d'être de sexe féminin est aussi un facteur prédictif du recours à des produits issus des médecines alternatives et complémentaires. Les auteurs concluent cependant que ces facteurs prédictifs ne sont pas différents de ceux concernant le recours à des praticiens de santé plus conventionnels.
Pratique des médecines non conventionnelles en France[modifier | modifier le code]
Par des médecins, en milieu hospitalier[modifier | modifier le code]
Le serment d'Hippocrate réactualisé indique que le médecin doit respecter « toutes les personnes […] sans aucune discrimination selon leur état ou leurs convictions70. » Pour autant, l'utilisation d'une médecine non-conventionnelle par un médecin, éventuellement au sein d'un hôpital, n'est pas une forme de validation de la méthode. D'un point de vue juridique, les médecins ne doivent pas divulguer dans les milieux médicaux un procédé nouveau de diagnostic ou de traitement insuffisamment éprouvé sans accompagner leur communication des réserves qui s'imposent. Ils ne doivent pas faire une telle divulgation dans le public non médical71. Les médecins ne peuvent proposer aux malades ou à leur entourage comme salutaire ou sans danger un remède ou un procédé illusoire ou insuffisamment éprouvé. Toute pratique de charlatanisme est interdite43. D'un point de vue pragmatique, tant que la méthode apporte bien-être et réconfort au patient, le médecin peut parfois l'utiliser même s'il est convaincu que l'effet n'est que placebo (la médecine conventionnelle utilise d'ailleurs fréquemment des placebos). Dans le même ordre d'idées, la présence de lieux de prière et d'aumôneries au sein d'un hôpital n'indique pas que le personnel soignant soit croyant, mais qu'il respecte la croyance des patients et accepte de mettre en œuvre tout ce qui n'est pas néfaste et apporte du réconfort.
Certains professionnels de santé médicaux (médecin, sage-femme) et paramédicaux (infirmier, kinésithérapeute, etc.) ont parfois recours à des pratiques non conventionnelles en milieu hospitalier3. Mais ces pratiques peuvent aussi être proposées par des personnes qui ne sont ni médecins ni paramédicaux. Certains praticiens ne peuvent procéder à aucun acte médical, tel que le diagnostic, la thérapie ou la prescription de médicaments. Face à la diversité de ces pratiques non conventionnelles avec des praticiens très hétérogènes, des tentatives de réglementation et de contrôle tentent de se mettre en place, notamment pour surveiller les éventuelles dérives sectaires en dehors des établissements hospitaliers publics21. Le Pr Loïc Capron, président de la Commission médicale d’établissement de l’Assistance publique - Hôpitaux de Paris, déclare en 2015 : « Il existe une continuité entre ces pseudo-thérapies et les sectes, qui peuvent pénétrer par cette voie dans l’hôpital. En tant que responsable de la qualité et de la sécurité des soins, je lutte contre tout ce qui n’est pas evidence based72. »
D'après un rapport de l'Académie de médecine française, l'utilisation de ces pratiques dans les hôpitaux publics, « et notamment dans les CHU, est acceptable dans la mesure où l’hôpital n’est pas considéré comme garant de leur efficacité, mais comme lieu d’exemplarité de leur pratique et espace ouvert à la recherche les concernant. L’expérience de ces établissements devrait contribuer à terme à l’élaboration d’un guide de bonnes pratiques destiné à tous les intervenants publics ou privés ». Le rapport recommande que ces pratiques demeurent « à leur juste place : celle de méthodes adjuvantes pouvant compléter les moyens de la médecine. Elles ne doivent être préconisées que dans les cas où leur utilité est plausible, et au terme d’une démarche médicale par laquelle on se sera assuré qu’il n’y a pas, parmi les moyens éprouvés de la thérapeutique, une solution plus nécessaire ou plus recommandable. En conséquence, elles ne doivent jamais être choisies par le patient comme une solution de premier recours, ni comme une solution de remplacement qui exposerait à des erreurs ou retard de diagnostic et à des pertes de chance. Une attention particulière doit d’autre part être portée au risque de complications (notamment des manipulations cervicales), au risque de diffusion abusive de méthodes d’utilité improbable (telle l’ostéopathie crânienne préventive du nouveau né), et au risque de dérive sectaire avec éloignement définitif de la médecine conventionnelle, particulièrement redoutable en cancérologie3. »
Un état des lieux en 2013 des thérapies complémentaires utilisées à l'Assistance publique - Hôpitaux de Paris indique qu'elles sont « mises en pratique, dans 95 % des cas, par des professionnels de santé : médecins, sages-femmes, infirmières, infirmières anesthésistes, masseurs-kinésithérapeutes, psychomotriciens, psychologues. Les médecins titulaires qui sont impliqués dans ces soins ne les pratiquent qu'à temps partiel. On remarque toutefois que dans 5 % des cas, les pratiques complémentaires sont réalisées par des intervenants indéterminés, professionnels de santé ou non, exerçant éventuellement de façon bénévole3. »
Caractéristiques problématiques de certaines thérapies[modifier | modifier le code]
Certaines thérapies non-conventionnelles peuvent partager un certain nombre de caractéristiques21[travail inédit ?] :
absence de formation médicale des praticiens : si certaines méthodes bien établies comme l'ostéopathie bénéficient de nos jours de formations reconnues par l’État (ce qui n'implique cependant en aucun cas une reconnaissance d'efficacité de la méthode), un certain nombre de médecines non conventionnelles sont pratiquées par des personnes sans formation médicale (ou avec une formation sans rapport avec la technique concernée, ce qui est le cas des « médecins homéopathes »), et généralement formées elles-mêmes par une simple poignée de stages sans valeur institutionnelle15. Ainsi, « L’absence de reconnaissance par l’État des formations et des diplômes délivrés [...] peut induire un amateurisme de la part de certains pseudo-thérapeutes. D’autant que n’importe qui peut se déclarer « kinésiologue » ou « maître reiki » et enseigner ces techniques. [...] Il est possible de devenir maître reiki en trois ou quatre stages de formation accélérée les week-ends »15. Cette facilité à monter en grade fait partie pour la MIVILUDES de la stratégie de nombreuses mouvances suspectes : « On fait également miroiter à l’adepte la possibilité de devenir lui-même « praticien » voire formateur, ce qui est en soi très valorisant et réconfortant pour une personne en perte de repères »15. De fait, la plupart des médecines non-conventionnelles sont officiellement « accessible sans diplôme particulier » selon la fiche Rome K1103 de Pôle Emploi73, même si certains instituts délivrent des diplômes, souvent coûteux et sans valeur institutionnelle15.
Selon le ministère des Affaires sociales et de la Santé, « l’enseignement de ces pratiques [non conventionnelles] ne donne pas lieu à des diplômes nationaux, à l’exception de l’acupuncture. Cependant, certaines formations font l’objet de diplômes d’université (DU) ou de diplômes interuniversitaires (DIU) placés sous la seule responsabilité d’une ou de plusieurs universités. Ces diplômes ne signifient pas, ipso facto, que l’efficacité et l’innocuité de la technique sont prouvées. Ce sont des diplômes complémentaires qui, à eux seuls, ne donnent pas le droit à l’exercice d’une profession de santé. Certaines formations sont par ailleurs délivrées au sein d’organismes privés sans aucun contrôle des institutions publiques quant à leur contenu, et sans reconnaissance par l’Etat des diplômes délivrés74. » Le Canard enchaîné relève en 201575 certains diplômes universitaires éloignés de la médecine fondée sur les preuves et proposés à des prix élevés par quelques universités, et relate l’envoi d’une lettre la même année (restée sans réponse) aux ministres de la Santé et de l’Éducation nationale, signée par une douzaine de personnalités médicales et scientifiques76 demandant la suppression « de ces diplômes universitaires se rapportant au domaine médical, mis en place localement et donc sans évaluation nationale »72.
absence de preuves de l'efficacité du soin : toute méthode thérapeutique qui a prouvé son efficacité et son innocuité est rapidement intégrée à la médecine dite ici « conventionnelle ». Ainsi, la médecine non-conventionnelle regroupe des techniques dont l'efficacité n'a pas été démontrée, à quelques exceptions près, ou bien qui présentent des risques de blessure (voir la section « Recherche » ci-après). Par exemple comme dans le cas de l'homéopathie, l'inefficacité de la méthode a au contraire été démontrée à de multiples reprises, mais les promoteurs de la méthode trouvent toujours des artifices rhétoriques pour discréditer les preuves scientifiques (en).
utilisation de concepts sans définition : de nombreuses techniques reposent sur des concepts flous et sans définition concrète77, qu'ils soient empruntés à des religions asiatiques (karma, ki...), à des théories européennes des siècles passés (dynamisation, humeurs...) ou à un jargon scientifique détourné (onde, énergie, « mysticisme quantique »...). D'autres termes simplement vagues sont également utilisés, comme la prétention « holiste » ou « orientale », la promotion du « bien-être », une mystérieuse « purification » (ou « détoxication ») ou surtout l'appel à la « nature », qui peut justifier tout et son contraire. L'entretien de ce flou a pour effet de faire cohabiter sous des mêmes bannières de simples « remèdes de grand-mère », des arnaques organisées, des groupes New Age et des mouvances sectaires, souvent difficiles à distinguer. Un certain nombre de ces pratiques se sont structurées commercialement, et infiltrent notamment les réseaux écologistes et bio pour diffuser sous couvert de « naturel » des méthodes fantaisistes au mieux inefficace et au pire dangereuses : un véritable florilège y est notamment présent chaque année au Salon Marjolaine, à l'origine dédié à l'agriculture biologique78.
Avertissement des autorités françaises sur les dérives de certaines thérapies non conventionnelles : panneau affiché au salon Marjolaine, organisé par Nature et progrès.
recours à la pensée magique : face à l'absence de preuve scientifique de l'efficacité d'une technique, les promoteurs de « traitements miracles » vont souvent faire appel à la pensée magique, c'est-à-dire à la croyance en des mécanismes occultes que la science moderne ne parviendrait pas à détecter alors que le praticien, lui, en maîtrise les arcanes grâce à son processus initiatique79. Ce mécanisme permet de discréditer les études scientifiques portant sur la méthode concernée, et justifie l'absence de nécessité pour le thérapeute d'avoir à prouver ses affirmations. Enfin, cela constitue aussi une échappatoire ad hoc, puisque l'inefficacité de la méthode peut être reprochée au patient (« incrédule », porteur de « mauvaises ondes »...) plutôt qu'au praticien.
risque d'emprise psychologique ou de dérive sectaire : de nombreuses thérapies non conventionnelles se posent comme des alternatives non seulement thérapeutiques mais aussi ontologiques, assurant reposer sur un système de pensée radicalement différent de celui de la science, et invitent donc les patients à embrasser non pas une simple technique de soin mais toute une vision du monde, souvent qualifiée de « holiste » ou attribuée à l'« orient ». À partir de là, le risque d'emprise psychologique est majeur, et la Mission interministérielle de vigilance et de lutte contre les dérives sectaires met régulièrement en garde contre les nombreuses dérives existantes, consistant le plus souvent à « valoriser la victime pour mieux asseoir l’emprise du gourou thérapeute. Il s’agira de convaincre l’adepte qu’il est exceptionnel et que pour aller mieux et retrouver son énergie, sa joie de vivre et tout son potentiel, il devra se séparer de son conjoint, se couper de ses amis, et surtout suivre des stages, généralement coûteux, mais nécessaires pour accéder au bien-être. [...] Petit à petit la relation va se baser sur l’admiration du patient envers son thérapeute, qui pourra imposer toutes ses exigences, allant jusqu’à la soumission totale de l’adepte qui aura subi des pressions réitérées afin d’altérer son jugement »15.
Une économie publique[modifier | modifier le code]
Des études réalisées ces dernières années montrent une amélioration du confort des utilisateurs, une diminution au recours des méthodes conventionnelles et une diminution des dépenses de santé80,81.
Certains admettent que des pratiques non-conventionnelles soient remboursées par l'assurance maladie en France pour réaliser une diminution des dépenses de santé. Selon Frédéric Adnet, professeur de médecine d’urgence à l'université Paris-XIII : « Si la sécurité sociale rembourse certains traitements dénués de fondements scientifiques, cela résulte très probablement d’un calcul mercantile. Ces mêmes patients pourraient devenir – en cas de non-remboursement – des sur-consommateurs de soins lourds dans leur quête d’un soulagement psycho-affectif bien plus pénalisant en termes de finances publiques et probablement plus dangereux en termes de iatrogénie. Cet état de fait n’est donc, finalement, pas choquant82. »
L'expérience de la Suisse entre 1999 et 2005 semble montrer que le remboursement de médecines non-conventionnelles ne génère pas d'économie, ni de surcoût. Elles ne représentaient que 0,16 % des dépenses de l'assurance obligatoire, mais de nombreuses dépenses sont prises en charge par les patients ou de plus en plus par leurs assurances ou mutuelles complémentaires.
Il existe de possibles effets nuisibles : ainsi des malades se tournant exclusivement vers des thérapies dont l'efficacité n'a pas été prouvée ne pourront pas bénéficier d'un diagnostic précoce par la médecine scientifique, mettant leurs jours en danger3.
Recherches[modifier | modifier le code]
Selon l'OMS : « Il existe des données empiriques et scientifiques qui mettent en évidence les bénéfices de l’acupuncture, des médecines manuelles et de plusieurs plantes médicinales dans le traitement de maladies chroniques ou bénignes68. ».
Dans une notice de lecture de l'ouvrage Médecines douces : info ou intox ? de Simon Singh et Edzard Ernst, qui se présente comme « l’évaluation des médecines alternatives la plus honnête et la plus précise du monde » Martin Brunschwig pour Science et pseudo-sciences considère que « le défi est brillamment relevé : S. Sing et E. Ernst offrent en effet un travail d’une rigueur et d’une richesse exemplaire, émaillé d’explications et de références aux études qui ont permis d’apporter les preuves d’efficacité de certains traitements plus que d’autres11 » ; il indique par ailleurs que « les médecines alternatives sont en grande partie évaluées, et un nombre infime d’entre elles ont prouvé un effet spécifique mais faible. Les auteurs indiquent d’ailleurs fort justement que lorsque c’est le cas, au lieu de « s’accrocher » à une efficacité très faible, pour certains effets, à la limite du démontrable (que les tenants des médecines alternatives ne manqueront pas de monter en épingle), on ferait mieux, dans tous les cas, de se tourner vers les traitements conventionnels, plus efficaces11. »
Dans le cas de l'acupuncture, la collaboration Cochrane cite un cas où une efficacité est démontrée légèrement supérieure au placebo83 mais récuse ou ne peut conclure, faute de preuve pour les autres indications où l'acupuncture a été scientifiquement évaluée84. On sait en revanche que l'expérience qui a lancé la mode de l’acupuncture aux États-Unis dans les années 1970 avait été falsifiée par les services chinois39. On retrouve également dans la littérature des cas d'iatrogénie de l'acupuncture85.
Aux États-Unis le National Center for Complementary and Alternative Medicine (NCCAM) qui dépend des National Institutes of Health, a pour mission de financer et mener des recherches scientifiques rigoureuses dans le domaine des médecines complémentaires et alternatives. L'institut a été créé en 1991 sous le nom Office of Alternative Medicine (OAM) avant de devenir le NCCAM en 1998, son budget était de 2 millions de dollars à sa création, il a atteint 50 millions en 1999 et 128,8 millions en 201086. Les critiques reprochent au NCCAM l'absence de résultats significatifs malgré son budget important et la promotion des pseudo-sciences pour des raisons politiques et démagogiques87,88.
The Scientific Review of Alternative Medicine est un magazine américain évalué par les pairs, soutenu par la Commission for Scientific Medicine and Mental Health, consacré à l'étude des médecines non conventionnelles89.
Depuis les années 2000, la base de données MEDLINE a introduit une indexation facilitant les recherches sur le sujet des médecines complémentaires et alternatives. The Cochrane Library (en) dispose d'une importante base de données d'essais contrôlés ainsi que des revues systématiques1.
On trouve dans la littérature scientifique de plus en plus d'études sur les médecines non conventionnelles, cependant des méta-analyses montrent que certaines de ces études sont de qualité trop faible pour être scientifiquement significatives90, et sont parfois financées par des conglomérats de praticiens dans un but publicitaire (voir l'article junk science), voire dans le cas de la médecine traditionnelle chinoise par un État dans un but politique91.
L'approche scientifique[modifier | modifier le code]
La médecine conventionnelle applique un traitement si son efficacité est prouvée (ou dans certains cas semble prouvée, car la méthode scientifique peut parfois composer avec la logique mercantile ou culturelle92), s'il a une supériorité sur la physiologie de l'homéostasie mise dans les meilleures conditions (effet placebo). L'efficacité d'un traitement est mesuré à partir de critères de mesures : un paramètre biologique (ex : la glycémie), psychologique (ex : l'anxiété), épidémiologique (ex : la survie à cinq ans, la mortalité). On peut ainsi utiliser des molécules ayant réussi les tests expérimentaux sans connaître, dans un premier temps, les mécanismes biochimiques de l'action thérapeutique de ces substances (exemple : aspirine, la pénicilline) 93. L'explication de leur action évoluerait par l'avancée des connaissances scientifiques, cela ne changerait rien au résultat des mesures expérimentées.
D'une manière générale, le fait qu'une théorie, une conception a priori, soit vraie ou fausse est indépendant du résultat atteint ; on peut expliquer un fait réel par une théorie fausse, et le fait que la théorie soit fausse n'empêche pas le fait d'être vrai. Par exemple, au Moyen Âge, on savait fabriquer du fer et du savon, pourtant, la théorie qui expliquait les transformations de la matière, l'alchimie, n'est plus reconnue comme vérité aujourd'hui94.
Donc :
si l'on prouve que la théorie sous-jacente à une médecine donnée est fausse, cela n'implique pas que les traitements liés à cette médecine soient inefficaces (même principe épistémologique que celui évoqué pour le savon et l'alchimie) ;
le fait qu'un traitement soit efficace ne valide pas pour autant la théorie médicale qui le justifie (même principe épistémologique que celui évoqué pour le savon et l'alchimie) ;
la preuve de l'efficacité doit se faire par comparaison avec la physiologie dans les conditions d'un placebo positif, sur un nombre suffisant de cas pour que l'on puisse avoir une différence significative statistiquement (cf. Essai clinique)
L'efficacité visible d'une technique ne justifie pas forcément son utilisation, qui peut avoir des effets négatifs. Par exemple, on a longtemps soigné la syphilis avec du mercure ou en inoculant la malaria, ce qui donnait lieu à une rémission apparente, mais tua sans doute indirectement plus de patients que la maladie elle-même95 (cf. Autorisation de mise sur le marché).
Relations entre médecins conventionnels et non-conventionnels[modifier | modifier le code]
Des médecins ont été poursuivis en France pour avoir utilisé des méthodes thérapeutiques sans validation scientifique. La notion « d’exercice illégal de la médecine » condamne par ailleurs toute personne qui s’aventurerait à manipuler la santé d'un patient par des traitements ou méthodes invasifs sans qu’il en ait été prouvé l’innocuité et l’efficacité.
Les laboratoires pharmaceutiques sont alors soupçonnés de faire pression auprès des gouvernements pour avoir une législation restrictive. À l’inverse, est cité le cas des Laboratoires Boiron (France), des Laboratoires Lehning (France), Heel et DHU Schwabe (Allemagne), grands pourvoyeurs d’emplois en Europe, et qui ont obtenu du gouvernement français que les préparations homéopathiques soient remboursées en 198496, puis de l’Union européenne que les mêmes préparations puissent avoir une autorisation de mise sur le marché sans procéder à des essais cliniques97.
L’effet placebo et le réconfort sans danger qu’apportent, entre autres, certaines méthodes ont un certain intérêt. Les promoteurs de certaines médecines non-conventionnelles s’appuient sur cet effet placebo pour montrer que le psychisme est fondamental dans la guérison ; cependant, l’effet placebo peut agir alors même que l’on sait qu’il s’agit d’un effet placebo98.
Affaires[modifier | modifier le code]
Le recours aux médecines parallèles devrait être parcimonieux et adapté : le traitement d’une maladie grave et avancée nécessitant des soins médicaux importants peut être retardé par le recours exclusif à une médecine non conventionnelle3.
Au xxie siècle, il existe encore de nombreuses maladies incurables et parfois mal comprises, telles que certains cancers ou encore la maladie d'Alzheimer. Ces maladies peuvent entraîner une grande anxiété chez les malades et leurs familles, ainsi qu'un douloureux complexe d'impuissance99. Cette fragilité émotionnelle a attiré de nombreux thérapeutes para-médicaux malintentionnés et autres escrocs, qui face à l'impuissance de la médecine moderne proposent des méthodes « alternatives » soi-disant miracles, facturées à des prix souvent astronomiques99,100. On assiste ainsi à la prolifération de tout une pseudo-science autour de certaines maladies comme l'autisme, de leurs causes hypothétiques et de leur soi-disant traitement, impliquant autant de simples charlatans que de riches fondations, ainsi que certaines mouvances sectaires100, surfant sur des effets de mode (comme le régime sans gluten101) ou la théorie du complot (voir notamment la Controverse sur le rôle de la vaccination dans l'autisme102,103). Grâce aux importants revenus générés par ces pseudo-thérapies, de puissants instituts se sont formés aux États-Unis pour promouvoir et centraliser ce genre de méthodes (comme la Strategic Autism Initiative), appuyés par une communication et un lobbyisme actifs, impliquant des personnalités du show-business et certains politiciens populistes, jusqu'à Donald Trump104. Cette communication est généralement basée sur des témoignages isolés et invérifiables et une grande force de persuasion, parfois assortis de fausses études scientifiques99. En réponse, la FDA américaine a publié des guides d'aide aux victimes (comme le « Beware of False or Misleading Claims for Treating Autism [archive] »99), et des associations d'aide aux victimes se sont montées, comme la Autism Rights Watch. En France, c'est notamment la Mission interministérielle de vigilance et de lutte contre les dérives sectaires qui a été saisie du problème (voir par exemple son Guide santé et dérives sectaires21).
En France, le procès d’un couple, accusé de mauvais traitement sur son enfant décédé en 2000, à la suite d'une carence alimentaire (l'autopsie a révélé une « infection aiguë secondaire à une malnutrition chronique