Dear Editor,
A review of traditional medicine articles supports the effectiveness of music in health and its role as part of traditional healing. According to the studies on therapeutic music applications by forebearers of Persian medicine (PM), as mentioned in their textbooks, music therapy was widely used [1]. However, there is no clear distinction between “music therapy” and “music medicine” definitions for applying music in the healing processes in traditional medicine, including PM. There are different views about the role and use of music in health and diseases; we would like to suggest complementary details to clarify this subject.
Music healing, a term used to describe the holistic healing effects of music, can be classified into various medical approaches, including music medicine, music therapy, and other music-based interventions. According to the American Music Therapy Association (AMTA), music therapy is the “clinical and evidence-based use of music interventions to accomplish individualised goals within a therapeutic relationship by a certified professional who has completed an approved music therapy program” [2].
Therapeutic settings in music therapy do not simply mean listening to music and may also include playing, composing, or interacting with music [2]. In contrast, music medicine is passive listening to recorded music for a specific therapeutic purpose, often used by healthcare professionals like relaxation therapists, physicians, or scientists who are not trained in music therapy [3].
The distinction between the mentioned definitions is important as music therapists are trained to evaluate patients using various active and passive music therapy techniques. In contrast, music medicine assesses a single aspect of a musical piece and its supposed effects. Many studies examining the scientific literature evaluating the impact of listening to passive music are inaccurately classified as “music therapy” research [4].
The third format might use musical activities such as choir singing or teaching music to patients as an intervention; these activities are neither pre-recorded, passively played for the intended audience, nor actively performed or participated under the licensed music therapists [3]. As most people in the past did not have the means to listen to professional music and as recording and replaying devices were not yet created, it might be possible to define ancient prescriptions of listening to a particular musical piece characterised by its name, rhythm, and mode – as Jorjani did for a specific type of insomnia – as “music medicine” [5]. When playing a particular piece by a physician capable of musical arts for the patient was recommended, we can describe the intervention as “music therapy.”
Conditions in which the patients were advised to listen to pleasant sounds and music without any further specifications and instructions can be categorised as “music listening.” However, with the limited data from ancient medical interventions, one cannot easily label the prescriptions as music therapy or music medicine.
A review of historical evidence shows that some ancient physicians were well-versed in music theory and wrote important textbooks, yet they did not play instruments. In contrast, some others were not experts in music theory but prescribed musical interventions based on the recommendations of older texts. It has also been mentioned that a physician’s participation is not mandatory in performing music, and a professional musician can help [6].
On the other hand, music is a construct with roots in the culture and traditions of the people who have formed and evolved it, and as such, ethnomusicology studies music in its social and cultural background and context. Ethnomusicology is an interdisciplinary study that integrates many science fields, including cultural anthropology, folklore, and many other related branches of cultural studies [7]. This approach to music introduces ethnomusic therapy and medical ethnomusicology [8].
Medical ethnomusicology is an academic and research-oriented field of holistic exploration of music’s role in health and healing cultural and clinical contexts. In this approach, specialists in this field study the relationship between ethnomusicology and medical anthropology [9, 10]. Ethnomusic therapy originates from music therapy and, as such, is performed by a certified professional who considers the ethnic and cultural properties of music in the healing process [8]. The music-based approaches used in healthcare are presented in Table 1.
Types of music-based interventions used in medicine
| Topic . | Definition . | Performers . |
|---|---|---|
| Music medicine | Passive listening to pre-recorded music for a specific therapeutic purpose | Healthcare professionals |
| Music therapy | Clinical use of music interventions within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program | Certified music therapists |
| Ethnomusic therapy | Clinical use of indigenous music in the healing process | Credentialed music therapists who consider the ethnic and cultural properties of music in the healing process |
| Medical ethnomusicology | Academic practice that explores the roles of music in any cultural and clinical context of health and healing holistically | Ethnomusicologists |
| Other music-based interventions | Other uses of music activities for health-promoting goals | Healthcare professionals, musicians, etc. |
| Topic . | Definition . | Performers . |
|---|---|---|
| Music medicine | Passive listening to pre-recorded music for a specific therapeutic purpose | Healthcare professionals |
| Music therapy | Clinical use of music interventions within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program | Certified music therapists |
| Ethnomusic therapy | Clinical use of indigenous music in the healing process | Credentialed music therapists who consider the ethnic and cultural properties of music in the healing process |
| Medical ethnomusicology | Academic practice that explores the roles of music in any cultural and clinical context of health and healing holistically | Ethnomusicologists |
| Other music-based interventions | Other uses of music activities for health-promoting goals | Healthcare professionals, musicians, etc. |
In conclusion, ancient PM practitioners always considered their patients’ cultural backgrounds and regions and adjusted their prescriptions accordingly. Such an approach even affected the musical interventions with changes applied to suit the individual differences of their patients, which can be described as a form of ethnomusic therapy.
Acknowledgments
This article was part of a PhD dissertation by Dr. Mona Haqiqi.
Conflict of Interest Statement
The authors declare that they have no conflict of interest.
Funding Sources
This study did not receive any funding.
Author Contributions
M. Dadmehr, MD, PhD: conceptualisation, data collection, and drafting of the article. M. Haqiqi, MD, PhD (principal investigator): conceptualisation and drafting of the article. E. Akhtari, MD, PhD: revising and final approval of the manuscript. M. Sadr, MD, PhD: revising and final approval of the manuscript.
