Alternative Medicine, also called unconventional
medicine, therapeutic practices, techniques, and beliefs that are outside the
realm of mainstream Western health care. Alternative medicine emphasizes
therapies that improve quality of life, prevent disease, and address conditions
that conventional medicine has limited success in curing, such as chronic back
pain and certain cancers. Proponents of alternative medicine believe that these
approaches to healing are safer and more natural and have been shown through
experience to work. In certain countries, alternative medical practices are the
most widely used methods of health care. However, many practitioners of modern
conventional medicine believe these practices are unorthodox and unproven.
By some estimates 83 million
United States residents use alternative medicine, spending more than $27
million a year. Reports from Canada, the United Kingdom, and Australia also
indicate a widespread interest in alternative therapies.
A special report prepared
for the National Institutes of Health (NIH), Alternative Medicine: Expanding
Medical Horizons, categorizes alternative medicine practices into six
fields. The first field, mind-body intervention, explores the mind’s capacity
to affect, and perhaps heal, the body. Studies have shown that the mental state
has a profound effect on the immune system, and these studies have provoked
interest in the mind’s role in the cause and course of disease. Specific
mind-body interventions include meditation, hypnosis, art therapy, biofeedback,
and mental healing.
Bioelectromagnetic applications,
the second field of alternative medicine, make use of the body’s response to
nonthermal, nonionizing radiation. Current uses involve bone repair, nerve
stimulation, wound healing, treatment of osteoarthritis, and immune system
stimulation.
The third field is alternative
systems of medical practice. Each of these systems is characterized by a
specific theory of health and disease, an educational program to teach its
concepts to new practitioners, and often a legal mandate to regulate its
practice. Examples include acupuncture, Ayurvedic medicine, homeopathy, and
naturopathy.
Touch and manipulation
are the mainstays of the manual healing methods, which constitute the fourth
field of alternative medicine. Practitioners of chiropractic and massage
therapies such as Rolfing structural integration believe that dysfunction of
one part of the body often affects the function of other, not necessarily
connected, parts. Health is restored by manipulating bones or soft tissues or
realigning body parts.
The pharmacological and
biological treatments that make up the fifth field of alternative medicine
consist of an assortment of drugs and vaccines not yet accepted in mainstream
medicine. Compounds such as antineoplastins (from human blood and urine) for
acquired immunodeficiency syndrome (AIDS), various products of the honey bee
for arthritis, and iscador (a liquid extract from mistletoe) for tumors have
not been scientifically evaluated because of the expense of conducting safety and
effectiveness studies.
Throughout the ages people
have turned for healing to herbal medicine, the sixth field of alternative
medicine. All cultures have folk medicine traditions that include the use of
plants and plant products. Many licensed drugs used today originated in the
herbal traditions of various cultures, such as the medication commonly used for
heart failure, digitalis, which is derived from foxglove. In the United States,
herbal products may be marketed only as food supplements. Since they are not
regulated by the Food and Drug Administration (FDA), there is no guarantee of
their purity or safety. The World Health Organization (WHO) estimates that 4
billion people, or 80 percent of the world’s population, use herbal medicine
for some aspect of primary health care.
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POPULAR
THERAPIES
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Acupuncture
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Acupuncture
Acupuncture is a traditional Chinese medical
technique that involves stimulating specific points in the body to restore
health. The practice is used to treat a range of conditions, including chronic
pain, drug addiction, bronchitis, and insomnia.
Acupuncture, a Chinese
traditional medicine dating from 3000 to 2000 bc,
involves stimulating specific points in the body for therapeutic purposes.
Puncturing the skin with a needle is the usual method of application, but
acupuncturists may also use heat, pressure, friction, suction, or impulses of
electromagnetic energy to stimulate acupuncture points. Stimulated acupuncture
points alter the chemical neurotransmitters released and the therapeutic effects
result from the associated changes in the chemical balance of the body.
Acupuncture is used for many ailments, including chronic pain, drug addiction,
arthritis, chemotherapy-induced nausea, and mental illness.
In the past 40 years acupuncture
has become a well-known and widely available treatment in both developed and
developing countries. More than 50 schools of acupuncture in the United States
are accredited or candidates for accreditation by the National Accreditation
Commission for Schools and Colleges of Acupuncture and Oriental Medicine. Many
conventionally trained physicians take courses in acupuncture and incorporate
it into their practices. Licensure or registration in acupuncture is available
in 35 states plus the District of Columbia. It is estimated that some 12
million health-care visits per year are for acupuncture.
Acupuncture is one of
the most thoroughly researched and documented alternative medical practices. In
1998 an NIH panel reviewed scientific studies of acupuncture and concluded that
the technique is effective at relieving nausea and vomiting caused by
chemotherapy and surgical anesthesia. Good evidence suggests that it also
relieves nausea during pregnancy and pain after dental surgery. Controlled
studies have also demonstrated some positive effects of acupuncture on a
variety of other conditions, but so far the statistical results have not been
conclusive.
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Homeopathy
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Homeopathy is a 200-year-old
system of medicine that uses pills or medicinal drops made from diluted
extracts of herbs and other substances. Developed by German physician Samuel
Hahnemann, homeopathy is based on two main principles. The first states that a
substance that can cause certain symptoms when given to a healthy person can
cure those same symptoms in someone who is sick. The second states that,
contrary to teachings of modern chemistry and physics, the more a substance is
diluted, the more potent it becomes. Proponents of homeopathy claim there
remains a so-called molecular memory of the original substance. Critics say
water molecules vibrate and change constantly, so that any impressions made by
a substance previously dissolved in them are quickly lost.
Each year in the United
States 2.5 million people use homeopathy and make 5 million visits to
homeopathic practitioners. The number of homeopathic practitioners in the
United States has increased from less than 200 in the 1970s to approximately
3,000 in 1996. The FDA allows homeopathic products to be sold as long as
specific health claims are not made in advertising or on product labels.
A number of studies in
reputable scientific journals have suggested that homeopathic remedies are
useful for diarrhea, asthma, hay fever, influenza, and migraine headaches.
However, critics claim that these studies were flawed and that more
scientifically rigorous investigations would likely show no benefit.
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Chiropractic
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Chiropractic Exam
Practitioners of chiropractic believe that
many ailments and diseases can be healed by the manual adjustment of bone and
tissue. Chiropractors offer non-surgical remedies for back and neck pain,
headaches, and other conditions. Chiropractic is also considered a preventative
health-care method.
The field of chiropractic
was founded by David Daniel Palmer in the 1890s. He believed that joint
subluxation, or a partial dislocation, is a causal factor in disease and that
removal of the subluxation by thrusting on the bony projections of the
vertebrae restores health.
In addition to manipulating
and adjusting bone and tissue, particularly in the spinal column, chiropractors
use a variety of manual, mechanical, and electrical treatments. Chiropractors
are most widely recognized for providing drug-free, non-surgical management of
back and neck pain as well as of headaches. Some chiropractors also treat a
variety of other ailments—such as bladder infections, arthritis, and
depression—with spinal adjustments and other manipulations. Disease prevention
and health promotion through proper diet, exercise, and lifestyle are other
important features of chiropractic medicine.
There are about 80,000
licensed chiropractors in the United States. Licensing is required in all
states. Chiropractors are allowed to use manual procedures and interventions
but not surgery or chemotherapy.
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Biofeedback
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Biofeedback in Progress
A patient at a biofeedback clinic sits
connected to electrodes on his head and finger. Biofeedback is a technique in
which patients attempt to become aware of and then alter bodily functions such
as muscle tension and blood pressure. It is used in treating pain and
stress-related conditions, and may help some paralyzed patients regain the use
of their limbs.
Biofeedback is a treatment
method that uses monitoring instruments to provide patients with physiological
information of which they are normally unaware. In the 1960s, experimental psychologist
Neal Miller demonstrated that the autonomic nervous system—which controls heart
rate, blood pressure, blood flow to various organs, and gastrointestinal
activity—is entirely trainable. In succeeding decades the validity of Miller’s
observations was documented in thousands of articles and books, leading to
widespread application of this technique. Today, biofeedback is used to treat a
wide variety of conditions and diseases including stress, drug addiction, sleep
disorders, epilepsy, fecal and urinary incontinence, headaches, and high blood
pressure.
By watching a monitoring
device, patients learn by trial and error to adjust their mental processes in
order to control bodily processes. Electrodes are attached to the area of the
patient being monitored—for instance, to the involved muscles during muscle
therapy, or to the head during brain-wave monitoring. These electrodes feed the
electrical information to a small monitoring box. The results are registered by
a tone that varies in pitch or by a visual meter that varies in brightness as
the function being monitored changes. The patient engages in mental exercises,
in an attempt to reach the desired result, such as muscle relaxation or
contraction. Voluntary control may be achieved in as few as ten sessions,
although chronic or severe disorders may require longer therapy. Eventually,
patients may learn to control symptoms without the use of the monitoring
device.
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Naturopathy
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Naturopathy was founded
in the beginning of the 20th century by a group of therapists who were
followers of Sebastian Kneipp, a 19th-century proponent of the healing powers
of nature. At the height of its popularity, there were more than 20
naturopathic medical schools (today there are only three) in the United States
and naturopathic physicians were licensed in most states. The practice of
naturopathic medicine declined as the use of pharmaceutical drugs increased.
However, in the past several decades there has been a resurgence of interest in
naturopathy.
Naturopathic medicine
integrates alternative medical practices—such as botanical medicine,
homeopathy, acupuncture, and Oriental medicine—with modern scientific
diagnostic methods and standards of care. Naturopathic physicians are trained
in conventional medical disciplines as well as in alternative approaches. They
integrate this knowledge according to principles that recognize the body’s
inherent ability to heal itself, the importance of prevention, and the
possibility of therapeutic use of nutrition to promote health and fight
disease.
Most of the research on
naturopathy has been based on observation of treatments rather than on
controlled clinical trials that compare naturopathic therapy with no treatment
(a placebo) or with an alternative treatment.
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CURRENT OUTLOOK
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There remains considerable
skepticism among practitioners of conventional medicine and among biomedical
researchers regarding the efficacy of alternative medicine. Many of the claims
made by practitioners of alternative medicine have not been supported by
rigorously controlled scientific study. However, in recent years many
scientists have begun to conduct such studies to evaluate alternative
therapies. A division of the NIH, the National Center for Complementary and
Alternative Medicine (NCCAM, originally the Office of Alternative Medicine),
was established by the Congress of the United States in 1992 to facilitate the
fair scientific evaluation of alternative therapies. The NCCAM seeks to reduce
barriers that may keep promising alternative therapies from gaining widespread
use. Physicians are also gaining more confidence in alternative therapies. By
the late 1990s, some 75 U.S. medical schools had incorporated courses in
alternative medicine into their curricula. It is possible that what was
considered alternative in the past will become mainstream in years to come.
