Alternative medicine or fringe medicine are practices claimed to have
the healing effects of medicine but which are disproven, unproven,
impossible to prove, or are excessively harmful in relation to their
Scientific consensus states that such therapies do not, or
cannot, work because the known laws of nature are violated by their
basic claims; or that the treatment is so much worse that its use is
unethical. Alternative therapies or diagnoses are not part of medicine
or science-based healthcare systems. Alternative practices, products,
and therapies – range from plausible but not well tested, to
having known harmful and toxic effects. Large amounts of funding go to
testing alternative medicine, with more than US$2.5 billion spent by
the United States government alone. Almost none show any effect
beyond that of false treatment, and most positive studies have been
shown to be statistical flukes. Perceived effects of alternative
medicine may be caused by: placebo; decreased effect of functional
treatment (and therefore potentially decreased side effects); and
regression toward the mean where alternative therapies are credited
for improvement which would have occurred anyway; or any combination
of the three. Alternative treatments are not the same as experimental
medicine or traditional medicine, although both can be used in a way
that is alternative or fringe.
Alternative medicine has grown in popularity and is used by a
significant portion of the population in many countries. The field
often rebrands itself: from quackery to complementary or integrative
medicine – but it promotes essentially the same practices. A large
alternative medicine lobby exists, and alternative therapies are far
less regulated than conventional ones. When used together with
functional medical treatment, alternative therapies have not been
shown to "complement" (improve the effect of, or mitigate the side
effects of) treatment. Significant drug interactions caused by
alternative therapies may instead negatively influence treatments,
making them less effective, notably cancer therapy. Despite being
illegal to market alternative therapies specifically for cancer
treatment in most of the developed world, many patients use them.
Alternative medical diagnoses and treatments are not taught as part of
science-based curricula in medical schools, and are not used in any
practice where treatment is based on scientific knowledge or proven
experience. Alternative therapies are often based on religion,
tradition, superstition, belief in supernatural energies,
pseudoscience, errors in reasoning, propaganda, fraud, or lies.
Regulation and licensing of alternative medicine and health care
providers varies between and within countries.
Alternative medicine is criticized for being based on misleading
statements, quackery, pseudoscience, antiscience, fraud, and poor
scientific methodology. Promoting alternative medicine has been called
dangerous and unethical. Testing alternative medicine that has no
scientific basis has been called a waste of scarce research resources.
Critics state "there is really no such thing as alternative medicine,
just medicine that works and medicine that doesn't", and the problem
with the idea of "alternative" treatments in this sense is that they
teach "underlying logic [which] is magical, childish or downright
absurd". It has been strongly suggested that the very idea of any
alternative treatment that works is paradoxical, as any treatment
proven to work is by definition "medicine".
1.2 A failure of mainstream medicine
1.3 Social factors
2 Definitions and terminology
2.1 Alternative medicine
2.2 Complementary or integrative medicine
2.3 Allopathic medicine
2.5 Traditional medicine
2.6 Problems with definition
2.7 Different types of definitions
3.1 Unscientific belief systems
3.2 Traditional ethnic systems
3.4 Holistic therapy
Herbal remedies and other substances used
3.6 Religion, faith healing, and prayer
4.1 Individual systems and practices
4.2 "Irregular practitioners"
4.3 Medical education
4.4 United States government
6 Criticism, legitimacy and effects
8 Use and regulation
8.1 Prevalence of use
8.1.1 In the US
8.1.2 Prevalence of use of specific therapies
8.1.3 In palliative care
9 Conflicts of interest
10.1 Adequacy of regulation and CAM safety
10.2 Interactions with conventional pharmaceuticals
10.3 Potential side-effects
10.4 Treatment delay
10.5 Unconventional cancer "cures"
12 See also
16 Further reading
16.1 World Health Organization
17 External links
Alternative therapies often make bombastic claims, and frequently
include anecdotes from healthy-looking individuals claiming successful
Practitioners of complementary medicine usually discuss and advise
patients as to available alternative therapies. Patients often express
interest in mind-body complementary therapies because they offer a
non-drug approach to treating some health conditions.[clarification
In addition to the social-cultural underpinnings of the popularity of
alternative medicine, there are several psychological issues that are
critical to its growth. One of the most critical is the placebo
effect – a well-established observation in medicine. Related
to it are similar psychological effects, such as the will to
believe, cognitive biases that help maintain self-esteem and
promote harmonious social functioning, and the post hoc, ergo
propter hoc fallacy.
Edzard Ernst, a leading authority on scientific study of alternative
treatments and diagnoses, and the first university professor of
Complementary and Alternative Medicine. Here in 2012, promoting his
Trick or Treatment
Trick or Treatment co-written with Simon Singh.
The popularity of complementary & alternative medicine (CAM) may
be related to other factors that
Edzard Ernst mentioned in an
interview in The Independent:
Why is it so popular, then? Ernst blames the providers, customers and
the doctors whose neglect, he says, has created the opening into which
alternative therapists have stepped. "People are told lies. There are
40 million websites and 39.9 million tell lies, sometimes outrageous
lies. They mislead cancer patients, who are encouraged not only to pay
their last penny but to be treated with something that shortens their
lives. "At the same time, people are gullible. It needs gullibility
for the industry to succeed. It doesn't make me popular with the
public, but it's the truth.
Paul Offit proposed that "alternative medicine becomes quackery" in
four ways: by recommending against conventional therapies that are
helpful, promoting potentially harmful therapies without adequate
warning, draining patients' bank accounts, or by promoting "magical
A failure of mainstream medicine
Friendly and colorful images of herbal treatments may look less
threatening or dangerous when compared to conventional medicine. This
is an intentional marketing strategy.
In a paper published in October 2010 entitled The public's enthusiasm
for complementary and alternative medicine amounts to a critique of
mainstream medicine, Ernst described these views in greater detail and
[CAM] is popular. An analysis of the reasons why this is so points
towards the therapeutic relationship as a key factor. Providers of CAM
tend to build better therapeutic relationships than mainstream
healthcare professionals. In turn, this implies that much of the
popularity of CAM is a poignant criticism of the failure of mainstream
healthcare. We should consider it seriously with a view of improving
our service to patients.
Authors have speculated on the socio-cultural and psychological
reasons for the appeal of alternative medicines among the minority
using them in lieu of conventional medicine. There are several
socio-cultural reasons for the interest in these treatments centered
on the low level of scientific literacy among the public at large and
a concomitant increase in antiscientific attitudes and new age
mysticism. Related to this are vigorous marketing of extravagant
claims by the alternative medical community combined with inadequate
media scrutiny and attacks on critics.
There is also an increase in conspiracy theories toward conventional
medicine and pharmaceutical companies, mistrust of traditional
authority figures, such as the physician, and a dislike of the current
delivery methods of scientific biomedicine, all of which have led
patients to seek out alternative medicine to treat a variety of
ailments. Many patients lack access to contemporary medicine, due
to a lack of private or public health insurance, which leads them to
seek out lower-cost alternative medicine. Medical doctors are also
aggressively marketing alternative medicine to profit from this
Patients can be averse to the painful, unpleasant, and
sometimes-dangerous side effects of biomedical treatments. Treatments
for severe diseases such as cancer and
HIV infection have well-known,
significant side-effects. Even low-risk medications such as
antibiotics can have potential to cause life-threatening anaphylactic
reactions in a very few individuals. Many medications may cause minor
but bothersome symptoms such as cough or upset stomach. In all of
these cases, patients may be seeking out alternative treatments to
avoid the adverse effects of conventional treatments.
Definitions and terminology
Alternative medicine is defined loosely as a set of products,
practices, and theories that are believed or perceived by their users
to have the healing effects of medicine,[n 1][n 2] but whose
effectiveness has not been clearly established using scientific
methods,[n 1][n 3] or whose theory and practice is not
part of biomedicine,[n 2][n 4][n 5][n 6] or whose theories or
practices are directly contradicted by scientific evidence or
scientific principles used in biomedicine. "Biomedicine"
or "medicine" is that part of medical science that applies principles
of biology, physiology, molecular biology, biophysics, and other
natural sciences to clinical practice, using scientific methods to
establish the effectiveness of that practice. Unlike medicine,[n 4] an
alternative product or practice does not originate from using
scientific methods, but may instead be based on hearsay, religion,
tradition, superstition, belief in supernatural energies,
pseudoscience, errors in reasoning, propaganda, fraud, or other
unscientific sources.[n 3]
In General Guidelines for Methodologies on Research and Evaluation of
Traditional Medicine, published in 2000 by the World Health
Organization (WHO), complementary and alternative medicine were
defined as a broad set of health care practices that are not part of
that country's own tradition and are not integrated into the dominant
health care system.
The expression also refers to a diverse range of related and unrelated
products, practices, and theories ranging from biologically plausible
practices and products and practices with some evidence, to practices
and theories that are directly contradicted by basic science or clear
evidence, and products that have been conclusively proven to be
ineffective or even toxic and harmful.[n 2]
The terms alternative medicine, complementary medicine, integrative
medicine, holistic medicine, natural medicine, unorthodox medicine,
fringe medicine, unconventional medicine, and new age medicine are
used interchangeably as having the same meaning and are almost
synonymous in some contexts, but may have different
meanings in some rare cases.
Marcia Angell: "There cannot be two kinds of medicine –
conventional and alternative".
The meaning of the term "alternative" in the expression "alternative
medicine", is not that it is an effective alternative to medical
science, although some alternative medicine promoters may use the
loose terminology to give the appearance of effectiveness.
Loose terminology may also be used to suggest meaning that a dichotomy
exists when it does not, e.g., the use of the expressions "western
medicine" and "eastern medicine" to suggest that the difference is a
cultural difference between the Asiatic east and the European west,
rather than that the difference is between evidence-based medicine and
treatments that don't work.
Complementary or integrative medicine 
Complementary medicine (CM) or integrative medicine (IM) is when
alternative medicine is used together with functional medical
treatment, in a belief that it improves the effect of treatments.[n
7] However, significant drug interactions caused by
alternative therapies may instead negatively influence treatment,
making treatments less effective, notably cancer therapy. Both
terms refer to use of alternative medical treatments alongside
conventional medicine, an example of which is use of
acupuncture (sticking needles in the body to influence the flow of a
supernatural energy), along with using science-based medicine, in the
belief that the acupuncture increases the effectiveness or
"complements" the science-based medicine.
Main article: Allopathic medicine
Allopathic medicine or allopathy is an expression commonly used by
homeopaths and proponents of other forms of alternative medicine to
refer to mainstream medicine. Apart from in India, the term is not
used outside alternative medicine and not accepted by the medical
Allopathy refers to the use of pharmacologically active agents or
physical interventions to treat or suppress symptoms or
pathophysiologic processes of diseases or conditions. The German
version of the word, allopathisch, was coined in 1810 by the creator
Samuel Hahnemann (1755–1843). The word was coined
from allo- (different) and -pathic (relating to a disease or to a
method of treatment). In alternative medicine circles the
expression "allopathic medicine" is still used to refer to "the broad
category of medical practice that is sometimes called Western
medicine, biomedicine, evidence-based medicine, or modern medicine"
(see the article on scientific medicine).
Use of the term remains common among homeopaths and has spread to
other alternative medicine practices. The meaning implied by the label
has never been accepted by conventional medicine and is considered
pejorative. More recently, some sources have used the term
"allopathic", particularly American sources wishing to distinguish
between Doctors of
Medicine (MD) and Doctors of Osteopathic Medicine
(DO) in the United States. William Jarvis, an expert on
alternative medicine and public health, states that "although many
modern therapies can be construed to conform to an allopathic
rationale (e.g., using a laxative to relieve constipation), standard
medicine has never paid allegiance to an allopathic principle" and
that the label "allopath" was from the start "considered highly
derisive by regular medicine".
Many conventional medical treatments clearly do not fit the nominal
definition of allopathy, as they seek to prevent illness, or remove
CAM is an abbreviation of complementary and alternative
medicine. It has also been called sCAM or SCAM with the
addition of "so-called" or "supplements". The words balance
and holism are often used, claiming to take into account a "whole"
person, in contrast to the supposed reductionism of medicine. Due to
its many names the field has been criticized for intense rebranding of
what are essentially the same practices: as soon as one name is
declared synonymous with quackery, a new name is chosen.
Main article: Traditional medicine
Traditional medicine refers to the pre-scientific practices of a
certain culture, contrary to what is typically practiced in other
cultures where medical science dominates.
"Eastern medicine" typically refers to the traditional medicines of
Asia where conventional bio-medicine penetrated much later.
Problems with definition
Prominent members of the science and biomedical science
community say that it is not meaningful to define an alternative
medicine that is separate from a conventional medicine, that the
expressions "conventional medicine", "alternative medicine",
"complementary medicine", "integrative medicine", and "holistic
medicine" do not refer to any medicine at all.
Others in both the biomedical and CAM communities say that CAM cannot
be precisely defined because of the diversity of theories and
practices it includes, and because the boundaries between CAM and
biomedicine overlap, are porous, and change. The expression
"complementary and alternative medicine" (CAM) resists easy definition
because the health systems and practices it refers to are diffuse, and
its boundaries poorly defined.[n 8] Healthcare practices
categorized as alternative may differ in their historical origin,
theoretical basis, diagnostic technique, therapeutic practice and in
their relationship to the medical mainstream. Some alternative
therapies, including traditional Chinese medicine (TCM) and Ayurveda,
have antique origins in East or South Asia and are entirely
alternative medical systems; others, such as homeopathy and
chiropractic, have origins in Europe or the United States and emerged
in the eighteenth and nineteenth centuries. Some, such as
osteopathy and chiropractic, employ manipulative physical methods of
treatment; others, such as meditation and prayer, are based on
mind-body interventions. Treatments considered alternative in one
location may be considered conventional in another. Thus,
chiropractic is not considered alternative in Denmark and likewise
osteopathic medicine is no longer thought of as an alternative therapy
in the United States.
Critics say the expression is deceptive because it implies there is an
effective alternative to science-based medicine, and that
complementary is deceptive because it implies that the treatment
increases the effectiveness of (complements) science-based medicine,
while alternative medicines that have been tested nearly always have
no measurable positive effect compared to a placebo.
Different types of definitions
One common feature of all definitions of alternative medicine is its
designation as "other than" conventional medicine. For example,
the widely referenced descriptive definition of complementary and
alternative medicine devised by the US National Center for
Complementary and Integrative Health (NCCIH) of the National
Institutes of Health (NIH), states that it is "a group of diverse
medical and health care systems, practices, and products that are not
generally considered part of conventional medicine". For
conventional medical practitioners, it does not necessarily follow
that either it or its practitioners would no longer be considered
Some definitions seek to specify alternative medicine in terms of its
social and political marginality to mainstream healthcare. This
can refer to the lack of support that alternative therapies receive
from the medical establishment and related bodies regarding access to
research funding, sympathetic coverage in the medical press, or
inclusion in the standard medical curriculum. In 1993, the British
Medical Association (BMA), one among many professional organizations
who have attempted to define alternative medicine, stated that it[n
10] referred to "...those forms of treatment which are not widely used
by the conventional healthcare professions, and the skills of which
are not taught as part of the undergraduate curriculum of conventional
medical and paramedical healthcare courses". In a US context, an
influential definition coined in 1993 by the Harvard-based
physician, David M. Eisenberg, characterized alternative
medicine "as interventions neither taught widely in medical schools
nor generally available in US hospitals". These descriptive
definitions are inadequate in the present-day when some conventional
doctors offer alternative medical treatments and CAM introductory
courses or modules can be offered as part of standard undergraduate
medical training; alternative medicine is taught in more than 50
per cent of US medical schools and increasingly US health insurers are
willing to provide reimbursement for CAM therapies. In 1999, 7.7%
of US hospitals reported using some form of CAM therapy; this
proportion had risen to 37.7% by 2008.
An expert panel at a conference hosted in 1995 by the US Office for
Medicine (OAM),[n 11] devised a theoretical
definition of alternative medicine as "a broad domain of healing
resources ... other than those intrinsic to the politically
dominant health system of a particular society or culture in a given
historical period". This definition has been widely adopted by CAM
researchers, cited by official government bodies such as the UK
Department of Health, attributed as the definition used by the
Cochrane Collaboration, and, with some modification,[dubious –
discuss] was preferred in the 2005 consensus report of the US
Institute of Medicine, Complementary and Alternative
Medicine in the
United States.[n 2]
The 1995 OAM conference definition, an expansion of Eisenberg's 1993
formulation, is silent regarding questions of the medical
effectiveness of alternative therapies. Its proponents hold that
it thus avoids relativism about differing forms of medical knowledge
and, while it is an essentially political definition, this should not
imply that the dominance of mainstream biomedicine is solely due to
political forces. According to this definition, alternative and
mainstream medicine can only be differentiated with reference to what
is "intrinsic to the politically dominant health system of a
particular society of culture". However, there is neither a
reliable method to distinguish between cultures and subcultures, nor
to attribute them as dominant or subordinate, nor any accepted
criteria to determine the dominance of a cultural entity. If the
culture of a politically dominant healthcare system is held to be
equivalent to the perspectives of those charged with the medical
management of leading healthcare institutions and programs, the
definition fails to recognize the potential for division either within
such an elite or between a healthcare elite and the wider
Normative definitions distinguish alternative medicine from the
biomedical mainstream in its provision of therapies that are unproven,
unvalidated, or ineffective and support of theories with no recognized
scientific basis. These definitions characterize practices as
constituting alternative medicine when, used independently or in place
of evidence-based medicine, they are put forward as having the healing
effects of medicine, but are not based on evidence gathered with the
scientific method. Exemplifying this
perspective, a 1998 editorial co-authored by Marcia Angell, a former
editor of The New England Journal of Medicine, argued that:
It is time for the scientific community to stop giving alternative
medicine a free ride. There cannot be two kinds of medicine –
conventional and alternative. There is only medicine that has been
adequately tested and medicine that has not, medicine that works and
medicine that may or may not work. Once a treatment has been tested
rigorously, it no longer matters whether it was considered alternative
at the outset. If it is found to be reasonably safe and effective, it
will be accepted. But assertions, speculation, and testimonials do not
substitute for evidence. Alternative treatments should be subjected to
scientific testing no less rigorous than that required for
This line of division has been subject to criticism, however, as not
all forms of standard medical practice have adequately demonstrated
evidence of benefit,[n 4] and it is also unlikely in most
instances that conventional therapies, if proven to be ineffective,
would ever be classified as CAM.
Similarly, the public information website maintained by the National
Health and Medical Research Council (NHMRC) of the Commonwealth of
Australia uses the acronym "CAM" for a wide range of health care
practices, therapies, procedures and devices not within the domain of
conventional medicine. In the Australian context this is stated to
include acupuncture; aromatherapy; chiropractic; homeopathy; massage;
meditation and relaxation therapies; naturopathy; osteopathy;
reflexology, traditional Chinese medicine; and the use of vitamin
The Danish National Board of Health's "Council for Alternative
Medicine" (Sundhedsstyrelsens Råd for Alternativ Behandling (SRAB)),
an independent institution under the National Board of Health (Danish:
Sundhedsstyrelsen), uses the term "alternative medicine" for:
Treatments performed by therapists that are not authorized healthcare
Treatments performed by authorized healthcare professionals, but those
based on methods otherwise used mainly outside the healthcare system.
People without a healthcare authorisation are [also] allowed to
perform the treatments.
Proponents of an evidence-base for medicine[n 12] such
Cochrane Collaboration (founded in 1993 and from 2011 providing
input for WHO resolutions) take a position that all systematic reviews
of treatments, whether "mainstream" or "alternative", ought to be held
to the current standards of scientific method. In a study titled
Development and classification of an operational definition of
complementary and alternative medicine for the Cochrane Collaboration
(2011) it was proposed that indicators that a therapy is accepted
include government licensing of practitioners, coverage by health
insurance, statements of approval by government agencies, and
recommendation as part of a practice guideline; and that if something
is currently a standard, accepted therapy, then it is not likely to be
widely considered as CAM.
A United States government agency, the National Center on
Complementary and Integrative Health (NCCIH), created its own
classification system for branches of complementary and alternative
medicine that divides them into five major groups. These groups have
some overlap, and distinguish two types of energy medicine: veritable
which involves scientifically observable energy (including magnet
therapy, colorpuncture and light therapy) and putative, which invokes
physically undetectable or unverifiable energy.
NCCIH classification system is -
Whole medical systems: Cut across more than one of the other groups;
examples include traditional Chinese medicine, naturopathy,
homeopathy, and ayurveda
Mind-body interventions: Explore the interconnection between the mind,
body, and spirit, under the premise that the mind can affect "bodily
functions and symptoms"
"Biology"-based practices: Use substances found in nature such as
herbs, foods, vitamins, and other natural substances. (Note that as
used here, "biology" does not refer to the science of biology, but is
a usage newly coined by
NCCIH in the primary source used for this
article. "Biology-based" as coined by
NCCIH may refer to chemicals
from a nonbiological source, such as use of the poison lead in
traditional Chinese medicine, and to other nonbiological substances.)
Manipulative and body-based practices: feature manipulation or
movement of body parts, such as is done in bodywork, chiropractic, and
Energy medicine: is a domain that deals with putative and verifiable
Biofield therapies are intended to influence energy fields that are
purported to surround and penetrate the body. No empirical evidence
has been found to support the existence of the putative energy fields
on which these therapies are predicated.
Bioelectromagnetic-based therapies use verifiable electromagnetic
fields, such as pulsed fields, alternating-current, or direct-current
fields in an unconventional manner.
List of forms of alternative medicine
List of forms of alternative medicine and Pseudomedicine
§ List of fields characterized as pseudomedicine
Ready-to-drink traditional Chinese medicine mixture
Alternative medicine consists of a wide range of health care
practices, products, and therapies. The shared feature is a claim to
heal that is not based on the scientific method. Alternative medicine
practices are diverse in their foundations and methodologies.
Alternative medicine practices may be classified by their cultural
origins or by the types of beliefs upon which they are
based. Methods may incorporate or be based on
traditional medicinal practices of a particular culture, folk
knowledge, superstition, spiritual beliefs, belief in
supernatural energies (antiscience), pseudoscience, errors in
reasoning, propaganda, fraud, new or different concepts of health and
disease, and any bases other than being proven by scientific
methods. Different cultures may have their own unique
traditional or belief based practices developed recently or over
thousands of years, and specific practices or entire systems of
Unscientific belief systems
Alternative medicine, such as using naturopathy or homeopathy in place
of conventional medicine, is based on belief systems not grounded in
Naturopathic medicine is based on a belief that the body heals itself
using a supernatural vital energy that guides bodily processes.
In conflict with the paradigm of evidence-based medicine. Many
naturopaths have opposed vaccination, and "scientific evidence
does not support claims that naturopathic medicine can cure cancer or
any other disease".
A belief that a substance that causes the symptoms of a disease in
healthy people cures similar symptoms in sick people.[n 13]
Developed before knowledge of atoms and molecules, or of basic
chemistry, which shows that repeated dilution as practiced in
homeopathy produces only water, and that homeopathy is not
Traditional ethnic systems
Alternative medical systems may be based on traditional medicine
practices, such as traditional Chinese medicine (TCM),
India, or practices of other cultures around the world. Some
useful applications of traditional medicines have been researched and
accepted within ordinary medicine, however the underlying belief
systems are seldom scientific and are not accepted.
Traditional Chinese medicine
Traditional practices and beliefs from China, together with
modifications made by the Communist party make up TCM. Common
practices include herbal medicine, acupuncture (insertion of needles
in the body at specified points), massage (Tui na), exercise (qigong),
and dietary therapy.
The practices are based on belief in a supernatural energy called qi,
considerations of Chinese
Astrology and Chinese numerology,
traditional use of herbs and other substances found in China –
a belief that the tongue contains a map of the body that reflects
changes in the body, and an incorrect model of the anatomy and
physiology of internal organs.
Traditional medicine of India.
Ayurveda believes in the existence of
three elemental substances, the doshas (called Vata, Pitta and Kapha),
and states that a balance of the doshas results in health, while
imbalance results in disease. Such disease-inducing imbalances can be
adjusted and balanced using traditional herbs, minerals and heavy
Ayurveda stresses the use of plant-based medicines and
treatments, with some animal products, and added minerals, including
sulfur, arsenic, lead and copper sulfate[clarification needed].
Safety concerns have been raised about Ayurveda, with two U.S. studies
finding about 20 percent of Ayurvedic Indian-manufactured patent
medicines contained toxic levels of heavy metals such as lead, mercury
and arsenic. A 2015 study of users in the United States also found
elevated blood lead levels in 40 percent of those tested. Other
concerns include the use of herbs containing toxic compounds and the
lack of quality control in Ayurvedic facilities. Incidents of heavy
metal poisoning have been attributed to the use of these compounds in
the United States.
Bases of belief may include belief in existence of supernatural
energies undetected by the science of physics, as in biofields, or in
belief in properties of the energies of physics that are inconsistent
with the laws of physics, as in energy medicine.
Intended to influence energy fields that, it is purported, surround
and penetrate the body.
Writers such as noted astrophysicist and advocate of skeptical
thinking (Scientific skepticism)
Carl Sagan (1934–1996) have
described the lack of empirical evidence to support the existence of
the putative energy fields on which these therapies are
Use verifiable electromagnetic fields, such as pulsed fields,
alternating-current, or direct-current fields in an unconventional
Asserts that magnets can be used to defy the laws of physics to
influence health and disease.
Spinal manipulation aims to treat "vertebral subluxations" which are
claimed to put pressure on nerves.
Chiropractic was developed in the belief that manipulating the spine
affects the flow of a supernatural vital energy and thereby affects
health and disease.
Vertebral subluxation is a pseudoscientific
concept and has not been proven to exist.
Practitioners place their palms on the patient near
Chakras that they
believe are centers of supernatural energies in the belief that these
supernatural energies can transfer from the practitioner's palms to
heal the patient.
Lacks credible scientific evidence.
Acupuncture involves insertion of needles in the body.
The mind can affect "bodily functions and symptoms" and there is an
interconnection between the mind, body, and spirit.
Herbal remedies and other substances used
See also: Phytotherapy
Substance based practices use substances found in nature such as
herbs, foods, non-vitamin supplements and megavitamins, animal and
fungal products, and minerals, including use of these products in
traditional medical practices that may also incorporate other
methods. Examples include healing claims for nonvitamin
supplements, fish oil, Omega-3 fatty acid, glucosamine, echinacea,
flaxseed oil, and ginseng.
Herbal medicine, or phytotherapy,
includes not just the use of plant products, but may also include the
use of animal and mineral products. It is among the most
commercially successful branches of alternative medicine, and includes
the tablets, powders and elixirs that are sold as "nutritional
supplements". Only a very small percentage of these have been
shown to have any efficacy, and there is little regulation as to
standards and safety of their contents. This may include use of
known toxic substances, such as use of the poison lead in traditional
A chiropractor "adjusting" the spine.
Religion, faith healing, and prayer
Christian faith healing
There is a divine or spiritual intervention in healing.
A practitioner can reach an altered states of consciousness in order
to encounter and interact with the spirit world or channel
supernatural energies in the belief that they can heal.
The history of alternative medicine may refer to the history of a
group of diverse medical practices that were collectively promoted as
"alternative medicine" beginning in the 1970s, to the collection of
individual histories of members of that group, or to the history of
western medical practices that were labeled "irregular practices" by
the western medical establishment. It includes
the histories of complementary medicine and of integrative medicine.
Before the 1970s, western practitioners that were not part of the
increasingly science-based medical establishment were referred to
"irregular practitioners", and were dismissed by the medical
establishment as unscientific and as practicing quackery.
Until the 1970's, irregular practice became increasingly marginalized
as quackery and fraud, as western medicine increasingly incorporated
scientific methods and discoveries, and had a corresponding increase
in success of its treatments. In the 1970s, irregular practices
were grouped with traditional practices of nonwestern cultures and
with other unproven or disproven practices that were not part of
biomedicine, with the entire group collectively marketed and promoted
under the single expression "alternative
Use of alternative medicine in the west began to rise following the
counterculture movement of the 1960s, as part of the rising new age
movement of the 1970s. This was due to misleading mass
marketing of "alternative medicine" being an effective "alternative"
to biomedicine, changing social attitudes about not using chemicals
and challenging the establishment and authority of any kind,
sensitivity to giving equal measure to beliefs and practices of other
cultures (cultural relativism), and growing frustration and
desperation by patients about limitations and side effects of
science-based medicine. At the same
time, in 1975, the American Medical Association, which played the
central role in fighting quackery in the United States, abolished its
quackery committee and closed down its Department of
Investigation.:xxi By the early to mid 1970s the expression
"alternative medicine" came into widespread use, and the expression
became mass marketed as a collection of "natural" and effective
treatment "alternatives" to science-based
biomedicine. By 1983, mass marketing of
"alternative medicine" was so pervasive that the British Medical
Journal (BMJ) pointed to "an apparently endless stream of books,
articles, and radio and television programmes urge on the public the
virtues of (alternative medicine) treatments ranging from meditation
to drilling a hole in the skull to let in more oxygen". In this
1983 article, the
BMJ wrote, "one of the few growth industries in
contemporary Britain is alternative medicine", noting that by 1983,
"33% of patients with rheumatoid arthritis and 39% of those with
backache admitted to having consulted an alternative
By about 1990, the USA alternative medicine industry had grown to a
US$27 billion per year, with polls showing 30% of Americans were using
it. Moreover, polls showed that Americans made more visits
for alternative therapies than the total number of visits to primary
care doctors, and American out-of-pocket spending (non-insurance
spending) on alternative medicine was about equal to spending on
biomedical doctors.:172 In 1991,
Time magazine ran a cover story,
"The New Age of Alternative Medicine: Why New Age
Medicine Is Catching
On". In 1993, the New England Journal of
one in three Americans as using alternative medicine. In 1993,
Public Broadcasting System
Public Broadcasting System ran a
Bill Moyers special,
the Mind, with Moyers commenting that "...people by the tens of
millions are using alternative medicine. If established medicine does
not understand that, they are going to lose their clients."
Another explosive growth began in the 1990s, when senior level
political figures began promoting alternative medicine, investing
large sums of government medical research funds into testing
alternative medicine, including testing of scientifically implausible
treatments, and relaxing government regulation of alternative medicine
products as compared to biomedical
products.:xxi Beginning with a
1991 appropriation of US$2 million for funding research of alternative
medicine research, federal spending grew to a cumulative total of
about US$2.5 billion by 2009, with 50% of Americans using alternative
medicine by 2013.
In 1993, Britain's Prince Charles, who claimed that homeopathy and
other alternative medicine was an effective alternative to
biomedicine, established The Prince's Foundation for Integrated Health
(FIH), as a charity to explore "how safe, proven complementary
therapies can work in conjunction with mainstream medicine". The
FIH received government funding through grants from Britain's
Department of Health. In 2008, London's
The Times published a
Edzard Ernst that asked the FIH to recall two guides
promoting alternative medicine, saying: "the majority of alternative
therapies appear to be clinically ineffective, and many are downright
dangerous." In 2010, the FIH closed after allegations of fraud and
money laundering led to arrests of its officials.
MEDLINE introduced a
MeSH term to index scientific
publications in alternative medicine.
In 2004, modifications of the European Parliament's 2001 Directive
2001/83/EC, regulating all medicine products, were made with the
expectation of influencing development of the European market for
alternative medicine products. Regulation of alternative medicine
in Europe was loosened with "a simplified registration procedure" for
traditional herbal medicinal products. Plausible "efficacy"
for traditional medicine was redefined to be based on long term
popularity and testimonials ("the pharmacological effects or efficacy
of the medicinal product are plausible on the basis of long-standing
use and experience."), without scientific testing. The
Committee on Herbal Medicinal Products (HMPC) was created within the
European Medicines Agency
European Medicines Agency in London (EMEA). A special working group
was established for homeopathic remedies under the Heads of Medicines
Through 2004, alternative medicine that was traditional to Germany
continued to be a regular part of the health care system, including
homeopathy and anthroposophic medicine. The German Medicines Act
mandated that science-based medical authorities consider the
"particular characteristics" of complementary and alternative
medicines. By 2004, homeopathy had grown to be the most used
alternative therapy in France, growing from 16% of the population
using homeopathic medicine in 1982, to 29% by 1987, 36% percent by
1992, and 62% of French mothers using homeopathic medicines by 2004,
with 95% of French pharmacists advising pregnant women to use
homeopathic remedies. As of 2004[update], 100 million people in
India depended solely on traditional German homeopathic remedies for
their medical care. As of 2010[update], homeopathic remedies
continued to be the leading alternative treatment used by European
physicians. By 2005, sales of homeopathic remedies and
anthroposophical medicine had grown to €930 million, a 60% increase
Since 2009, according to Art. 118a of the Swiss Federal Constitution,
the Swiss Confederation and the
Cantons of Switzerland
Cantons of Switzerland shall within
the scope of their powers ensure that consideration is given to
By 2013, 50% of Americans were using CAM. As of 2013[update], CAM
medicinal products in Europe continued to be exempted from documented
efficacy standards required of other medicinal products.
Individual systems and practices
Much of what is now categorized as alternative medicine was developed
as independent, complete medical systems. These were developed long
before biomedicine and use of scientific methods. Each system was
developed in relatively isolated regions of the world where there was
little or no medical contact with pre-scientific western medicine, or
with each other's systems. Examples are traditional Chinese medicine
Ayurvedic medicine of India.
Other alternative medicine practices, such as homeopathy, were
developed in western Europe and in opposition to western medicine, at
a time when western medicine was based on unscientific theories that
were dogmatically imposed by western religious authorities. Homeopathy
was developed prior to discovery of the basic principles of chemistry,
which proved homeopathic remedies contained nothing but water. But
homeopathy, with its remedies made of water, was harmless compared to
the unscientific and dangerous orthodox western medicine practiced at
that time, which included use of toxins and draining of blood, often
resulting in permanent disfigurement or death.
Other alternative practices such as chiropractic and osteopathic
manipulative medicine were developed in the United States at a time
that western medicine was beginning to incorporate scientific methods
and theories, but the biomedical model was not yet totally dominant.
Practices such as chiropractic and osteopathy, each considered to be
irregular practices by the western medical establishment, also opposed
each other, both rhetorically and politically with licensing
legislation. Osteopathic practitioners added the courses and training
of biomedicine to their licensing, and licensed Doctor of Osteopathic
Medicine holders began diminishing use of the unscientific origins of
Main article: History of alternative medicine
Further information: History of medicine
Until the 1970s, western practitioners that were not part of the
medical establishment were referred to "irregular practitioners", and
were dismissed by the medical establishment as unscientific, as
practicing quackery. The Irregular practice became increasingly
marginalized as quackery and fraud, as western medicine increasingly
incorporated scientific methods and discoveries, and had a
corresponding increase in success of its treatments.
Dating from the 1970s, medical professionals, sociologists,
anthropologists and other commentators noted the increasing visibility
of a wide variety of health practices that had neither derived
directly from nor been verified by biomedical science. Since that
time, those who have analyzed this trend have deliberated over the
most apt language with which to describe this emergent health
field. A variety of terms have been used, including heterodox,
irregular, fringe and alternative medicine while others, particularly
medical commentators, have been satisfied to label them as instances
of quackery. The most persistent term has been alternative
medicine but its use is problematic as it assumes a value-laden
dichotomy between a medical fringe, implicitly of borderline
acceptability at best, and a privileged medical orthodoxy, associated
with validated medico-scientific norms. The use of the category
of alternative medicine has also been criticized as it cannot be
studied as an independent entity but must be understood in terms of a
regionally and temporally specific medical orthodoxy. Its use can
also be misleading as it may erroneously imply that a real medical
alternative exists. As with near-synonymous expressions, such as
unorthodox, complementary, marginal, or quackery, these linguistic
devices have served, in the context of processes of
professionalisation and market competition, to establish the authority
of official medicine and police the boundary between it and its
Peking Union Medical College
An early instance of the influence of this modern, or western,
scientific medicine outside Europe and North America is Peking Union
Medical College.[n 14][n 15]
From a historical perspective, the emergence of alternative medicine,
if not the term itself, is typically dated to the 19th century.
This is despite the fact that there are variants of Western
non-conventional medicine that arose in the late-eighteenth century or
earlier and some non-Western medical traditions, currently considered
alternative in the West and elsewhere, which boast extended historical
pedigrees. Alternative medical systems, however, can only be said
to exist when there is an identifiable, regularized and authoritative
standard medical practice, such as arose in the West during the
nineteenth century, to which they can function as an alternative.
During the late eighteenth and nineteenth centuries regular and
irregular medical practitioners became more clearly differentiated
throughout much of Europe and, as the nineteenth century
progressed, most Western states converged in the creation of legally
delimited and semi-protected medical markets. It is at this point
that an "official" medicine, created in cooperation with the state and
employing a scientific rhetoric of legitimacy, emerges as a
recognizable entity and that the concept of alternative medicine as a
historical category becomes tenable.
As part of this process, professional adherents of mainstream medicine
in countries such as Germany, France, and Britain increasingly invoked
the scientific basis of their discipline as a means of engendering
internal professional unity and of external differentiation in the
face of sustained market competition from homeopaths, naturopaths,
mesmerists and other nonconventional medical practitioners, finally
achieving a degree of imperfect dominance through alliance with the
state and the passage of regulatory legislation. In the US
the Johns Hopkins University School of Medicine, based in Baltimore,
Maryland, opened in 1893, with
William H. Welch
William H. Welch and William Osler
among the founding physicians, and was the first medical school
devoted to teaching "German scientific medicine".
Buttressed by increased authority arising from significant advances in
the medical sciences of the late 19th century onwards –
including development and application of the germ theory of disease by
Louis Pasteur and the surgeon Joseph Lister, of
microbiology co-founded by
Robert Koch (in 1885 appointed professor of
hygiene at the University of Berlin), and of the use of X-rays
(Röntgen rays)—the 1910
Flexner Report called upon American medical
schools to follow the model of the Johns Hopkins School of Medicine,
and adhere to mainstream science in their teaching and research. This
was in a belief, mentioned in the Report's introduction, that the
preliminary and professional training then prevailing in medical
schools should be reformed, in view of the new means for diagnosing
and combating disease made available by the sciences on which medicine
Putative medical practices at the time that later became known as
"alternative medicine" included homeopathy (founded in Germany in the
early 19th century) and chiropractic (founded in North America in the
late 19th century). These conflicted in principle with the
developments in medical science upon which the Flexner reforms were
based, and they have not become compatible with further advances of
medical science such as listed in Timeline of medicine and medical
technology, 1900–1999 and 2000–present, nor have Ayurveda,
acupuncture or other kinds of alternative medicine.
At the same time "tropical medicine" was being developed as a
specialist branch of western medicine in research establishments such
as Liverpool School of Tropical
Medicine founded in 1898 by Alfred
Lewis Jones, London School of
Hygiene & Tropical Medicine, founded
in 1899 by Patrick Manson, and Tulane University School of Public
Health and Tropical Medicine, instituted in 1912. A distinction was
being made between western scientific medicine and indigenous systems.
An example is given by an official report about indigenous systems of
medicine in India, including Ayurveda, submitted by Mohammad Usman of
Madras and others in 1923. This stated that the first question the
Committee considered was "to decide whether the indigenous systems of
medicine were scientific or not".
By the later twentieth century the term "alternative medicine" entered
public discourse,[n 17] but it was not always being used with the
same meaning by all parties.
Arnold S. Relman remarked in 1998 that in
the best kind of medical practice, all proposed treatments must be
tested objectively, and that in the end there will only be treatments
that pass and those that do not, those that are proven worthwhile and
those that are not. He asked "Can there be any reasonable
'alternative'?" But also in 1998 the then Surgeon General of the
United States, David Satcher, issued public information about
eight common alternative treatments (including acupuncture, holistic
and massage), together with information about common diseases and
conditions, on nutrition, diet, and lifestyle changes, and about
helping consumers to decipher fraud and quackery, and to find
healthcare centers and doctors who practiced alternative
By 1990, approximately 60 million Americans had used one or more
complementary or alternative therapies to address health issues,
according to a nationwide survey in the US published in 1993 by David
Eisenberg. A study published in the November 11, 1998 issue of
the Journal of the
American Medical Association
American Medical Association reported that 42% of
Americans had used complementary and alternative therapies, up from
34% in 1990. However, despite the growth in patient demand for
complementary medicine, most of the early alternative/complementary
medical centers failed.
Mainly as a result of reforms following the
Flexner Report of
1910 medical education in established medical schools in the US
has generally not included alternative medicine as a teaching topic.[n
18] Typically, their teaching is based on current practice and
scientific knowledge about: anatomy, physiology, histology,
embryology, neuroanatomy, pathology, pharmacology, microbiology and
immunology. Medical schools' teaching includes such topics as
doctor-patient communication, ethics, the art of medicine, and
engaging in complex clinical reasoning (medical decision-making).
Writing in 2002, Snyderman and Weil remarked that by the early
twentieth century the Flexner model had helped to create the
20th-century academic health center, in which education, research, and
practice were inseparable. While this had much improved medical
practice by defining with increasing certainty the pathophysiological
basis of disease, a single-minded focus on the pathophysiological had
diverted much of mainstream American medicine from clinical conditions
that were not well understood in mechanistic terms, and were not
effectively treated by conventional therapies.
By 2001 some form of CAM training was being offered by at least 75 out
of 125 medical schools in the US. Exceptionally, the School of
Medicine of the
University of Maryland, Baltimore
University of Maryland, Baltimore includes a research
institute for integrative medicine (a member entity of the Cochrane
Medical schools are responsible for
conferring medical degrees, but a physician typically may not legally
practice medicine until licensed by the local government authority.
Licensed physicians in the US who have attended one of the established
medical schools there have usually graduated Doctor of Medicine
(MD). All states require that applicants for MD licensure be
graduates of an approved medical school and complete the United States
Medical Licensing Exam (USMLE).
The British Medical Association, in its publication Complementary
Medicine, New Approach to Good Practice (1993), gave as a working
definition of non-conventional therapies (including acupuncture,
chiropractic and homeopathy): "...those forms of treatment which are
not widely used by the orthodox health-care professions, and the
skills of which are not part of the undergraduate curriculum of
orthodox medical and paramedical health-care courses." By 2000
some medical schools in the UK were offering CAM familiarisation
courses to undergraduate medical students while some were also
offering modules specifically on CAM.
United States government
Main article: National Center for Complementary and Integrative Health
Tom Harkin at a press conference.
In 1991, pointing to a need for testing because of the widespread use
of alternative medicine without authoritative information on its
efficacy, United States Senator
Tom Harkin used US$2 million of his
discretionary funds to create the Office for the Study of
Unconventional Medical Practices (OSUMP), later renamed to be the
Office of Alternative
Medicine (OAM).:170 The OAM was
created to be within the
National Institute of Health
National Institute of Health (NIH), the
scientifically prestigious primary agency of the United States
government responsible for biomedical and health-related
research.:170 The mandate was to investigate, evaluate,
and validate effective alternative medicine treatments, and alert the
public as the results of testing its efficacy.
Sen. Harkin had become convinced his allergies were cured by taking
bee pollen pills, and was urged to make the spending by two of his
influential constituents. Bedell, a longtime friend of
Sen. Harkin, was a former member of the United States House of
Representatives who believed that alternative medicine had twice cured
him of diseases after mainstream medicine had failed, claiming that
cow's milk colostrum cured his Lyme disease, and an herbal derivative
from camphor had prevented post surgical recurrence of his prostate
cancer. Wiewel was a promoter of unproven cancer treatments
involving a mixture of blood sera that the Food and Drug
Administration had banned from being imported. Both Bedell and
Wiewel became members of the advisory panel for the OAM. The company
that sold the bee pollen was later fined by the Federal Trade
Commission for making false health claims about their bee-pollen
products reversing the aging process, curing allergies, and helping
with weight loss.
In 1994, Sen. Harkin (D) and Senator
Orrin Hatch (R) introduced the
Dietary Supplement Health and Education Act
Dietary Supplement Health and Education Act (DSHEA). The act
reduced authority of the FDA to monitor products sold as "natural"
treatments. Labeling standards were reduced to allow health
claims for supplements based only on unconfirmed preliminary studies
that were not subjected to scientific peer review, and the act made it
more difficult for the FDA to promptly seize products or demand proof
of safety where there was evidence of a product being dangerous.
The Act became known as "The 1993 Snake Oil Protection Act" following
New York Times
New York Times editorial under that name.
Senator Harkin complained about the "unbendable rules of randomized
clinical trials", citing his use of bee pollen to treat his allergies,
which he claimed to be effective even though it was biologically
implausible and efficacy was not established using scientific
methods. Sen. Harkin asserted that claims for alternative
medicine efficacy be allowed not only without conventional scientific
testing, even when they are biologically implausible, "It is not
necessary for the scientific community to understand the process
before the American public can benefit from these therapies."
Following passage of the act, sales rose from about US$4 billion in
1994, to US$20 billion by the end of 2000, at the same time as
evidence of their lack of efficacy or harmful effects grew.
Senator Harkin came into open public conflict with the first OAM
Joseph M. Jacobs
Joseph M. Jacobs and OAM board members from the scientific
and biomedical community. Jacobs' insistence on rigorous
scientific methodology caused friction with Senator
Harkin. Increasing political resistance to the use of
scientific methodology was publicly criticized by Jacobs and another
OAM board member complained that "nonsense has trickled down to every
aspect of this office...It's the only place where opinions are counted
as equal to data." In 1994, Senator Harkin appeared on
television with cancer patients who blamed Jacobs for blocking their
access to untested cancer treatment, leading Jacobs to resign in
In 1995, Wayne Jonas, a promoter of homeopathy and political ally of
Senator Harkin, became the director of the OAM, and continued in that
role until 1999. In 1997, the
NCCAM budget was increased from
US$12 million to US$20 million annually. From 1990 to 1997, use
of alternative medicine in the US increased by 25%, with a
corresponding 50% increase in expenditures. The OAM drew
increasing criticism from eminent members of the scientific community
with letters to the Senate Appropriations Committee when discussion of
renewal of funding OAM came up.:175 Nobel laureate Paul Berg
wrote that prestigious NIH should not be degraded to act as a cover
for quackery, calling the OAM "an embarrassment to serious
scientists.":175 The president of the American Physical
Society wrote complaining that the government was spending money on
testing products and practices that "violate basic laws of physics and
more clearly resemble witchcraft".:175 In 1998, the
President of the North Carolina Medical Association publicly called
for shutting down the OAM.
In 1998, NIH director and Nobel laureate
Harold Varmus came into
conflict with Senator Harkin by pushing to have more NIH control of
alternative medicine research. The NIH Director placed the OAM
under more strict scientific NIH control. Senator Harkin
responded by elevating OAM into an independent NIH "center", just
short of being its own "institute", and renamed to be the National
Center for Complementary and Alternative
NCCAM had a
mandate to promote a more rigorous and scientific approach to the
study of alternative medicine, research training and career
development, outreach, and "integration". In 1999, the
was increased from US$20 million to US$50 million. The
United States Congress approved the appropriations without dissent. In
2000, the budget was increased to about US$68 million, in 2001 to
US$90 million, in 2002 to US$104 million, and in 2003, to US$113
In 2009, after a history of 17 years of government testing and
spending of nearly US$2.5 billion on research had produced almost no
clearly proven efficacy of alternative therapies, Senator Harkin
complained, "One of the purposes of this center was to investigate and
validate alternative approaches. Quite frankly, I must say publicly
that it has fallen short. It think quite frankly that in this center
and in the office previously before it, most of its focus has been on
disproving things rather than seeking out and
approving." Members of the scientific community
criticized this comment as showing Senator Harkin did not understand
the basics of scientific inquiry, which tests hypotheses, but never
intentionally attempts to "validate approaches". Members of the
scientific and biomedical communities complained that after a history
of 17 years of being tested, at a cost of over US$2.5
testing scientifically and biologically implausible practices, almost
no alternative therapy showed clear efficacy. In 2009, the
NCCAM's budget was increased to about US$122 million. Overall NIH
funding for CAM research increased to US$300 Million by 2009. By
2009, in the USA US$34 billion was spent annually on CAM.
In 2012, the Journal of the
American Medical Association
American Medical Association (JAMA)
published a criticism that study after study had been funded by NCCAM,
but "failed to prove that complementary or alternative therapies are
anything more than placebos". The JAMA criticism pointed to large
wasting of research money on testing scientifically implausible
treatments, citing "
NCCAM officials spending US$374,000 to find that
inhaling lemon and lavender scents does not promote wound healing;
US$750,000 to find that prayer does not cure AIDS or hasten recovery
from breast-reconstruction surgery; US$390,000 to find that ancient
Indian remedies do not control type 2 diabetes; US$700,000 to find
that magnets do not treat arthritis, carpal tunnel syndrome, or
migraine headaches; and US$406,000 to find that coffee enemas do not
cure pancreatic cancer." It was pointed out that negative results
from testing were generally ignored by the public, that people
continue to "believe what they want to believe, arguing that it does
not matter what the data show: They know what works for them".
Continued increasing use of CAM products was also blamed on the lack
of FDA ability to regulate alternative products, where negative
studies do not result in FDA warnings or FDA-mandated changes on
labeling, whereby few consumers are aware that many claims of many
supplements were found not to have not to be supported.
In 2014 the
NCCAM was renamed to the National Center for Complementary
and Integrative Health (NCCIH) with a new charter requiring that 12 of
the 18 council members shall be selected with a preference to
selecting leading representatives of complementary and alternative
medicine, 9 of the members must be licensed practitioners of
alternative medicine, six members must be general public leaders in
the fields of public policy, law, health policy, economics, and
management, and 3 members must represent the interests of individual
consumers of complementary and alternative medicine.
There is a general scientific consensus that alternative therapies
lack the requisite scientific validation, and their effectiveness is
either unproved or disproved. Many of the claims
regarding the efficacy of alternative medicines are controversial,
since research on them is frequently of low quality and
methodologically flawed. Selective publication bias, marked
differences in product quality and standardisation, and some companies
making unsubstantiated claims call into question the claims of
efficacy of isolated examples where there is evidence for alternative
The Scientific Review of Alternative
Medicine points to confusions in
the general population – a person may attribute symptomatic
relief to an otherwise-ineffective therapy just because they are
taking something (the placebo effect); the natural recovery from or
the cyclical nature of an illness (the regression fallacy) gets
misattributed to an alternative medicine being taken; a person not
diagnosed with science-based medicine may never originally have had a
true illness diagnosed as an alternative disease category.
Edzard Ernst characterized the evidence for many alternative
techniques as weak, nonexistent, or negative and in 2011
published his estimate that about 7.4% were based on "sound evidence",
although he believes that may be an overestimate. Ernst has
concluded that 95% of the alternative treatments he and his team
studied, including acupuncture, herbal medicine, homeopathy, and
reflexology, are "statistically indistinguishable from placebo
treatments", but he also believes there is something that conventional
doctors can usefully learn from the chiropractors and homeopath: this
is the therapeutic value of the placebo effect, one of the strangest
phenomena in medicine.
In 2003, a project funded by the CDC identified 208
condition-treatment pairs, of which 58% had been studied by at least
one randomized controlled trial (RCT), and 23% had been assessed with
a meta-analysis. According to a 2005 book by a US Institute of
Medicine panel, the number of RCTs focused on CAM has risen
As of 2005[update], the
Cochrane Library had 145 CAM-related Cochrane
systematic reviews and 340 non-Cochrane systematic reviews. An
analysis of the conclusions of only the 145 Cochrane reviews was done
by two readers. In 83% of the cases, the readers agreed. In the 17% in
which they disagreed, a third reader agreed with one of the initial
readers to set a rating. These studies found that, for CAM, 38.4%
concluded positive effect or possibly positive (12.4%), 4.8% concluded
no effect, 0.7% concluded harmful effect, and 56.6% concluded
insufficient evidence. An assessment of conventional treatments found
that 41.3% concluded positive or possibly positive effect, 20%
concluded no effect, 8.1% concluded net harmful effects, and 21.3%
concluded insufficient evidence. However, the CAM review used the more
developed 2004 Cochrane database, while the conventional review used
the initial 1998 Cochrane database.
In the same way as for conventional therapies, drugs, and
interventions, it can be difficult to test the efficacy of alternative
medicine in clinical trials. In instances where an established,
effective, treatment for a condition is already available, the
Helsinki Declaration states that withholding such treatment is
unethical in most circumstances. Use of standard-of-care treatment in
addition to an alternative technique being tested may produce
confounded or difficult-to-interpret results.
Andrew J. Vickers has stated:
Contrary to much popular and scientific writing, many alternative
cancer treatments have been investigated in good-quality clinical
trials, and they have been shown to be ineffective. The label
"unproven" is inappropriate for such therapies; it is time to assert
that many alternative cancer therapies have been "disproven".
Criticism, legitimacy and effects
There is no alternative medicine. There is only scientifically proven,
evidence-based medicine supported by solid data or unproven medicine,
for which scientific evidence is lacking.
— P.B. Fontanarosa, Journal of the American Medical Association
"CAM", meaning "complementary and alternative medicine", is not as
well researched as conventional medicine, which undergoes intense
research before release to the public. Funding for research is
also sparse making it difficult to do further research for
effectiveness of CAM. Most funding for CAM is funded by
government agencies. Proposed research for CAM are rejected by
most private funding agencies because the results of research are not
reliable. The research for CAM has to meet certain standards from
research ethics committees, which most CAM researchers find almost
impossible to meet. Even with the little research done on it, CAM
has not been proven to be effective.
Steven Novella, a neurologist at Yale School of Medicine, wrote that
government funded studies of integrating alternative medicine
techniques into the mainstream are "used to lend an appearance of
legitimacy to treatments that are not legitimate." Marcia Angell
considered that critics felt that healthcare practices should be
classified based solely on scientific evidence, and if a treatment had
been rigorously tested and found safe and effective, science-based
medicine will adopt it regardless of whether it was considered
"alternative" to begin with. It is possible for a method to change
categories (proven vs. unproven), based on increased knowledge of its
effectiveness or lack thereof. A prominent supporter of this position
is George D. Lundberg, former editor of the Journal of the American
Medical Association (JAMA).
Writing in 1999 in CA: A
Cancer Journal for Clinicians Barrie R.
Cassileth mentioned a 1997 letter to the
US Senate Subcommittee on
Public Health and Safety, which had deplored the lack of critical
thinking and scientific rigor in OAM-supported research, had been
signed by four Nobel Laureates and other prominent scientists. (This
was supported by the
National Institutes of Health
National Institutes of Health (NIH).)
In March 2009 a staff writer for the Washington Post reported that the
impending national discussion about broadening access to health care,
improving medical practice and saving money was giving a group of
scientists an opening to propose shutting down the National Center for
Complementary and Alternative Medicine. They quoted one of these
scientists, Steven Salzberg, a genome researcher and computational
biologist at the University of Maryland, as saying "One of our
concerns is that NIH is funding pseudoscience." They noted that the
vast majority of studies were based on fundamental misunderstandings
of physiology and disease, and had shown little or no effect.
Writers such as Carl Sagan, a noted astrophysicist, advocate of
scientific skepticism and the author of The Demon-Haunted World:
Science as a Candle in the Dark (1996), have lambasted the lack of
empirical evidence to support the existence of the putative energy
fields on which these therapies are predicated.
Sampson has also pointed out that CAM tolerated contradiction without
thorough reason and experiment. Barrett has pointed out that
there is a policy at the NIH of never saying something doesn't work
only that a different version or dose might give different
results. Barrett also expressed concern that, just because some
"alternatives" have merit, there is the impression that the rest
deserve equal consideration and respect even though most are
worthless, since they are all classified under the one heading of
Some critics of alternative medicine are focused upon health fraud,
misinformation, and quackery as public health problems, notably
Wallace Sampson and
Paul Kurtz founders of Scientific Review of
Medicine and Stephen Barrett, co-founder of The National
Council Against Health
Fraud and webmaster of Quackwatch. Grounds
for opposing alternative medicine include that:
It is usually based on religion, tradition, superstition, belief in
supernatural energies, pseudoscience, errors in reasoning, propaganda,
Alternative therapies typically lack any scientific validation, and
their effectiveness is either unproved or
disproved.[dubious – discuss]
Treatments are not part of the conventional, science-based healthcare
Research on alternative medicine is frequently of low quality and
methodologically flawed.[full citation needed]
Where alternative treatments have replaced conventional science-based
medicine, even with the safest alternative medicines, failure to use
or delay in using conventional science-based medicine has caused
Methods may incorporate or base themselves on traditional medicine,
folk knowledge, spiritual beliefs, ignorance or misunderstanding of
scientific principles, errors in reasoning, or newly conceived
approaches claiming to heal.
Many alternative medical treatments are not patentable,[citation
needed], which may lead to less research funding from the private
sector. In addition, in most countries, alternative treatments (in
contrast to pharmaceuticals) can be marketed without any proof of
efficacy – also a disincentive for manufacturers to fund
English evolutionary biologist Richard Dawkins, in his 2003 book A
Devil's Chaplain, defined alternative medicine as a "set of practices
that cannot be tested, refuse to be tested, or consistently fail
tests." Dawkins argued that if a technique is demonstrated
effective in properly performed trials then it ceases to be
alternative and simply becomes medicine.
CAM is also often less regulated than conventional medicine.
There are ethical concerns about whether people who perform CAM have
the proper knowledge to treat patients. CAM is often done by
non-physicians who do not operate with the same medical licensing laws
which govern conventional medicine, and it is often described as
an issue of non-maleficence.
According to two writers,
Wallace Sampson and K. Butler, marketing is
part of the training required in alternative medicine, and propaganda
methods in alternative medicine have been traced back to those used by
Goebels in their promotion of pseudoscience in
In November 2011
Edzard Ernst stated that the "level of misinformation
about alternative medicine has now reached the point where it has
become dangerous and unethical. So far, alternative medicine has
remained an ethics-free zone. It is time to change this."
A research methods expert and author of "Snake Oil Science", R. Barker
Bausell, has stated that "it's become politically correct to
investigate nonsense." There are concerns that just having NIH
support is being used to give unfounded "legitimacy to treatments that
are not legitimate."
Use of placebos to achieve a placebo effect in integrative medicine
has been criticized as, "...diverting research time, money, and other
resources from more fruitful lines of investigation in order to pursue
a theory that has no basis in biology."
Another critic has argued that academic proponents of integrative
medicine sometimes recommend misleading patients by using known
placebo treatments to achieve a placebo effect.[n 19] However, a 2010
survey of family physicians found that 56% of respondents said they
had used a placebo in clinical practice as well. Eighty-five percent
of respondents believed placebos can have both psychological and
Integrative medicine has been criticized in that its practitioners,
trained in science-based medicine, deliberately mislead patients by
pretending placebos are not. "quackademic medicine" is a pejorative
term used for integrative medicine, which medical professionals
consider an infiltration of quackery into academic science-based
An analysis of trends in the criticism of complementary and
alternative medicine (CAM) in five prestigious American medical
journals during the period of reorganization within medicine
(1965–1999) was reported as showing that the medical profession had
responded to the growth of CAM in three phases, and that in each
phase, changes in the medical marketplace had influenced the type of
response in the journals. Changes included relaxed medical
licensing, the development of managed care, rising consumerism, and
the establishment of the USA Office of Alternative
National Center for Complementary and Alternative Medicine, currently
National Center for Complementary and Integrative Health).[n 20] In
the "condemnation" phase, from the late 1960s to the early 1970s,
authors had ridiculed, exaggerated the risks, and petitioned the state
to contain CAM; in the "reassessment" phase (mid-1970s through early
1990s), when increased consumer utilization of CAM was prompting
concern, authors had pondered whether patient dissatisfaction and
shortcomings in conventional care contributed to the trend; in the
"integration" phase of the 1990s physicians began learning to work
around or administer CAM, and the subjugation of CAM to scientific
scrutiny had become the primary means of control.
Use and regulation
Prevalence of use
Complementary and alternative medicine (CAM) has been described as a
broad domain of healing resources that encompasses all health systems,
modalities, and practices and their accompanying theories and beliefs,
other than those intrinsic to the politically dominant health system
of a particular society or culture in a given historical period. CAM
includes all such practices and ideas self-defined by their users as
preventing or treating illness or promoting health and well-being.
Boundaries within CAM and between the CAM domain and that of the
dominant system are not always sharp or fixed.[dubious –
According to recent research, the increasing popularity of the CAM
needs to be explained by moral convictions or lifestyle choices rather
than by economic reasoning.
About 50% of people in developed countries use some kind of
complementary and alternative medicine other than prayer for
health. A British telephone survey by the BBC of 1209
adults in 1998 shows that around 20% of adults in Britain had used
alternative medicine in the past 12 months. About 40% of cancer
patients use some form of CAM.
In developing nations, access to essential medicines is severely
restricted by lack of resources and poverty. Traditional remedies,
often closely resembling or forming the basis for alternative
remedies, may comprise primary healthcare or be integrated into the
healthcare system. In Africa, traditional medicine is used for 80% of
primary healthcare, and in developing nations as a whole over
one-third of the population lack access to essential medicines.
Some have proposed adopting a prize system to reward medical
research. However, public funding for research exists. Increasing
the funding for research on alternative medicine techniques is the
purpose of the US National Center for Complementary and Alternative
NCCIH and its predecessor, the Office of Alternative
Medicine, have spent more than US$2.5 billion on such research since
1992; this research has largely not demonstrated the efficacy of
That alternative medicine has been on the rise "in countries where
Western science and scientific method generally are accepted as the
major foundations for healthcare, and 'evidence-based' practice is the
dominant paradigm" was described as an "enigma" in the Medical Journal
In the US
In the United States, the 1974 Child Abuse Prevention and Treatment
Act (CAPTA) required that for states to receive federal money, they
had to grant religious exemptions to child neglect and abuse laws
regarding religion-based healing practices. Thirty-one states
have child-abuse religious exemptions.
The use of alternative medicine in the US has increased, with
a 50 percent increase in expenditures and a 25 percent increase in the
use of alternative therapies between 1990 and 1997 in America.
Americans spend many billions on the therapies annually. Most
Americans used CAM to treat and/or prevent musculoskeletal conditions
or other conditions associated with chronic or recurring pain. In
America, women were more likely than men to use CAM, with the biggest
difference in use of mind-body therapies including prayer specifically
for health reasons". In 2008, more than 37% of American hospitals
offered alternative therapies, up from 27 percent in 2005, and 25% in
2004. More than 70% of the hospitals offering CAM were in
A survey of Americans found that 88 percent thought that "there are
some good ways of treating sickness that medical science does not
recognize". Use of magnets was the most common tool in energy
medicine in America, and among users of it, 58 percent described it as
at least "sort of scientific", when it is not at all scientific.
In 2002, at least 60 percent of US medical schools have at least some
class time spent teaching alternative therapies. "Therapeutic
touch", was taught at more than 100 colleges and universities in 75
countries before the practice was debunked by a nine-year-old child
for a school science project.
Prevalence of use of specific therapies
The most common CAM therapies used in the US in 2002 were prayer
(45%), herbalism (19%), breathing meditation (12%), meditation (8%),
chiropractic medicine (8%), yoga (5–6%), body work (5%), diet-based
therapy (4%), progressive relaxation (3%), mega-vitamin therapy (3%)
and Visualization (2%)
In Britain, the most often used alternative therapies were Alexander
technique, Aromatherapy, Bach and other flower remedies, Body work
therapies including massage, Counseling stress therapies,
hypnotherapy, Meditation, Reflexology, Shiatsu, Ayurvedic medicine,
Nutritional medicine, and Yoga.
Ayurvedic medicine remedies are
mainly plant based with some use of animal materials. Safety
concerns include the use of herbs containing toxic compounds and the
lack of quality control in Ayurvedic facilities.
According to the National Health Service (England), the most commonly
used complementary and alternative medicines (CAM) supported by the
NHS in the UK are: acupuncture, aromatherapy, chiropractic,
homeopathy, massage, osteopathy and clinical hypnotherapy.
In palliative care
Complementary therapies are often used in palliative care or by
practitioners attempting to manage chronic pain in patients.
Integrative medicine is considered more acceptable in the
interdisciplinary approach used in palliative care than in other areas
of medicine. "From its early experiences of care for the dying,
palliative care took for granted the necessity of placing patient
values and lifestyle habits at the core of any design and delivery of
quality care at the end of life. If the patient desired complementary
therapies, and as long as such treatments provided additional support
and did not endanger the patient, they were considered
acceptable." The non-pharmacologic interventions of complementary
medicine can employ mind-body interventions designed to "reduce pain
and concomitant mood disturbance and increase quality of life."
Regulation of alternative medicine and Regulation
and prevalence of homeopathy
Health campaign flyers, as in this example from the Food and Drug
Administration, warn the public about unsafe products.
In Austria and Germany complementary and alternative medicine is
mainly in the hands of doctors with MDs, and half or more of the
American alternative practitioners are licensed MDs. In Germany
herbs are tightly regulated: half are prescribed by doctors and
covered by health insurance.
Some professions of complementary/traditional/alternative medicine,
such as chiropractic, have achieved full regulation in North America
and other parts of the world and are regulated in a manner
similar to that governing science-based medicine. In contrast, other
approaches may be partially recognized and others have no regulation
at all. Regulation and licensing of alternative medicine ranges widely
from country to country, and state to state.
Government bodies in the USA and elsewhere have published information
or guidance about alternative medicine. The U.S. Food and Drug
Administration (FDA), has issued online warnings for consumers about
medication health fraud. This includes a section on Alternative
Medicine Fraud, such as a warning that Ayurvedic products
generally have not been approved by the FDA before marketing.
Conflicts of interest
Some commentators have said that special consideration must be given
to the issue of conflicts of interest in alternative medicine. Edzard
Ernst has said that most researchers into alternative medicine are at
risk of "unidirectional bias" because of a generally uncritical belief
in their chosen subject. Ernst cites as evidence the phenomenon
whereby 100% of a sample of acupuncture trials originating in China
had positive conclusions.
David Gorski contrasts evidence-based
medicine, in which researchers try to disprove hyphotheses, with what
he says is the frequent practice in pseudoscience-based research, of
striving to confirm pre-existing notions.
Harriet Hall writes
that there is a contrast between the circumstances of alternative
medicine practitioners and disinterested scientists: in the case of
acupuncture, for example, an acupuncturist would have "a great deal to
lose" if acupuncture were rejected by research; but the disinterested
skeptic would not lose anything if its effects were confirmed; rather
their change of mind would enhance their skeptical credentials.
See also: List of herbs with known adverse effects
Adequacy of regulation and CAM safety
Many of the claims regarding the safety and efficacy of alternative
medicine are controversial. Some alternative treatments have been
associated with unexpected side effects, which can be fatal.
A commonly voiced concerns about complementary alternative medicine
(CAM) is the way it's regulated. There have been significant
developments in how CAMs should be assessed prior to re-sale in the
United Kingdom and the European Union (EU) in the last 2 years.
Despite this, it has been suggested that current regulatory bodies
have been ineffective in preventing deception of patients as many
companies have re-labelled their drugs to avoid the new laws.
There is no general consensus about how to balance consumer protection
(from false claims, toxicity, and advertising) with freedom to choose
Advocates of CAM suggest that regulation of the industry will
adversely affect patients looking for alternative ways to manage their
symptoms, even if many of the benefits may represent the placebo
affect. Some contend that alternative medicines should not
require any more regulation than over-the-counter medicines that can
also be toxic in overdose (such as paracetamol).
Interactions with conventional pharmaceuticals
Forms of alternative medicine that are biologically active can be
dangerous even when used in conjunction with conventional medicine.
Examples include immuno-augmentation therapy, shark cartilage,
bioresonance therapy, oxygen and ozone therapies, and insulin
potentiation therapy. Some herbal remedies can cause dangerous
interactions with chemotherapy drugs, radiation therapy, or
anesthetics during surgery, among other problems. An anecdotal
example of these dangers was reported by Associate Professor Alastair
MacLennan of Adelaide University, Australia regarding a patient who
almost bled to death on the operating table after neglecting to
mention that she had been taking "natural" potions to "build up her
strength" before the operation, including a powerful anticoagulant
that nearly caused her death.
To ABC Online, MacLennan also gives another possible mechanism:
And lastly [sic] there's the cynicism and disappointment and
depression that some patients get from going on from one alternative
medicine to the next, and they find after three months the placebo
effect wears off, and they're disappointed and they move on to the
next one, and they're disappointed and disillusioned, and that can
create depression and make the eventual treatment of the patient with
anything effective difficult, because you may not get compliance,
because they've seen the failure so often in the past.
Conventional treatments are subjected to testing for undesired
side-effects, whereas alternative treatments, in general, are not
subjected to such testing at all. Any treatment – whether
conventional or alternative – that has a biological or
psychological effect on a patient may also have potential to possess
dangerous biological or psychological side-effects. Attempts to refute
this fact with regard to alternative treatments sometimes use the
appeal to nature fallacy, i.e., "That which is natural cannot be
harmful." Specific groups of patients such as patients with impaired
hepatic or renal function are more susceptible to side effects of
An exception to the normal thinking regarding side-effects is
Homeopathy. Since 1938, the U.S.
Food and Drug Administration
Food and Drug Administration (FDA)
has regulated homeopathic products in "several significantly different
ways from other drugs." Homeopathic preparations, termed
"remedies", are extremely dilute, often far beyond the point where a
single molecule of the original active (and possibly toxic) ingredient
is likely to remain. They are, thus, considered safe on that count,
but "their products are exempt from good manufacturing practice
requirements related to expiration dating and from finished product
testing for identity and strength", and their alcohol concentration
may be much higher than allowed in conventional drugs.
Those having experienced or perceived success with one alternative
therapy for a minor ailment may be convinced of its efficacy and
persuaded to extrapolate that success to some other alternative
therapy for a more serious, possibly life-threatening illness.
For this reason, critics argue that therapies that rely on the placebo
effect to define success are very dangerous. According to mental
health journalist Scott Lilienfeld in 2002, "unvalidated or
scientifically unsupported mental health practices can lead
individuals to forgo effective treatments" and refers to this as
"opportunity cost". Individuals who spend large amounts of time and
money on ineffective treatments may be left with precious little of
either, and may forfeit the opportunity to obtain treatments that
could be more helpful. In short, even innocuous treatments can
indirectly produce negative outcomes. Between 2001 and 2003, four
children died in Australia because their parents chose ineffective
naturopathic, homeopathic, or other alternative medicines and diets
rather than conventional therapies.
Unconventional cancer "cures"
There have always been "many therapies offered outside of conventional
cancer treatment centers and based on theories not found in
biomedicine. These alternative cancer cures have often been described
as 'unproven,' suggesting that appropriate clinical trials have not
been conducted and that the therapeutic value of the treatment is
unknown." However, "many alternative cancer treatments have been
investigated in good-quality clinical trials, and they have been shown
to be ineffective....The label 'unproven' is inappropriate for such
therapies; it is time to assert that many alternative cancer therapies
have been 'disproven'."
Edzard Ernst has stated:
...any alternative cancer cure is bogus by definition. There will
never be an alternative cancer cure. Why? Because if something looked
halfway promising, then mainstream oncology would scrutinize it, and
if there is anything to it, it would become mainstream almost
automatically and very quickly. All curative "alternative cancer
cures" are based on false claims, are bogus, and, I would say, even
Christian laying on of hands, prayer intervention, and faith healing
Ayurvedic medicine includes a belief that the spiritual balance
of mind influences disease.
Medicinal herbs in a traditional Spanish market
Traditional medicines in Madagascar
Assorted dried plant and animal parts used in traditional Chinese
Shaman healer in Sonora, Mexico.
Phytotherapy (herbal medicine): an engraving of magnolia glauca in
Jacob Bigelow's American Medical Botany
Alternative medicine portal
^ a b "[A]lternative medicine refers to all treatments that have not
been proven effective using scientific methods."
^ a b c d "Complementary and alternative medicine (CAM) is a broad
domain of resources that encompasses health systems, modalities, and
practices and their accompanying theories and beliefs, other than
those intrinsic to the dominant health system of a particular society
or culture in a given historical period. CAM includes such resources
perceived by their users as associated with positive health outcomes.
Boundaries within CAM and between the CAM domain and the domain of the
dominant system are not always sharp or fixed."
^ a b "It is time for the scientific community to stop giving
alternative medicine a free ride. There cannot be two kinds of
medicine – conventional and alternative. There is only medicine
that has been adequately tested and medicine that has not, medicine
that works and medicine that may or may not work... speculation, and
testimonials do not substitute for evidence."
^ a b c "The phrase complementary and alternative medicine is used to
describe a group of diverse medical and health care systems,
practices, and products that have historic origins outside mainstream
medicine. Most of these practices are used together with conventional
therapies and therefore have been called complementary to distinguish
them from alternative practices, those used as a substitute for
standard care. ... Until a decade ago or so, "complementary and
alternative medicine" could be defined as practices that are neither
taught in medical schools nor reimbursed, but this definition is no
longer workable, since medical students increasingly seek and receive
some instruction about complementary health practices, and some
practices are reimbursed by third-party payers. Another definition,
practices that lack an evidence base, is also not useful, since there
is a growing body of research on some of these modalities, and some
aspects of standard care do not have a strong evidence base."
^ "An alternative medical system is a set of practices based on a
philosophy different from Western biomedicine."
^ "CAM is a group of diverse medical and health care systems,
practices, and products that are not generally considered part of
^ The Final Report (2002) of the White House Commission on
Complementary and Alternative
Medicine Policy states: "The
Commissioners believe and have repeatedly stated in this Report that
our response should be to hold all systems of health and healing,
including conventional and CAM, to the same rigorous standards of good
science and health services research. Although the Commissioners
support the provision of the most accurate information about the state
of the science of all CAM modalities, they believe that it is
premature to advocate the wide implementation and reimbursement of CAM
modalities that are yet unproven."
^ Mary Ruggie in Chapter 2 of Marginal to Mainstream: Alternative
Medicine in America said, "By the mid-1990s, the notion that some
alternative therapies could be complementary to conventional medicine
began to change the status of...alternative medicine. The 21st century
is witnessing yet another terminological innovation, in which CAM and
conventional medicine are becoming integrative."
^ As David J. Hufford, Professor and Director at the Doctors Kienle
Center for Humanistic
Medicine at the Penn State College of
Medicine, has argued: "Simply because an herbal remedy comes to be
used by physicians does not mean that herbalists cease to practice, or
that the practice of the one becomes like that of the other."
^ The BMA used the term non-conventional medicine instead of
^ The Office for Alternative Medicine, part of the National Institutes
of Health, was renamed
NCCAM in 1998.
Evidence based medicine is the conscientious, explicit, and
judicious use of current best evidence in making decisions about the
care of individual patients"; "
Evidence based medicine, whose
philosophical origins extend back to mid-19th century Paris and
earlier, remains a hot topic for clinicians, public health
practitioners, purchasers, planners, and the public. British centres
for evidence based practice have been established or planned in adult
medicine, child health, surgery, pathology, pharmacotherapy, nursing,
general practice, and dentistry; the
Cochrane Collaboration and
Britain's Centre for Review and Dissemination in York are providing
systematic reviews of the effects of health care".
^ In his book The Homœopathic Medical Doctrine
Samuel Hahnemann the
creator of homeopathy wrote: "Observation, reflection, and experience
have unfolded to me that the best and true method of cure is founded
on the principle, similia similibus curentur. To cure in a mild,
prompt, safe, and durable manner, it is necessary to choose in each
case a medicine that will excite an affection similar (ὅμοιος
πάθος) to that against which it is employed."
^ Peking University Health
Science Center (formerly Beijing Medical
University) was the first of the kind in China to teach western
medicine and train medical professionals.
^ For an encyclopaedic account of the development of "western"
medicine in the period leading up to the reforms in the medical
schools of US resulting from the Flexner Report, published at the time
of that report, see the article, Allbutt, Thomas Clifford
(1911). "Medicine". In Chisholm, Hugh. Encyclopædia Britannica. 18
(11th ed.). Cambridge University Press.
^ In his introduction to the Flexner Report, Henry S. Pritchett
stated, "The fundamental sciences upon which medicine depends have
been greatly extended. The laboratory has come to furnish alike to the
physician and to the surgeon a new means for diagnosing and combating
disease. The education of the medical practitioner under these changed
conditions makes entirely different demands in respect of both
preliminary and professional training."
^ The earliest occurrence of the term "alternative medicine" in an
English language publication was only in 1974, according to the Oxford
^ As the medical professor Kenneth M. Ludmerer noted in 2010: "Flexner
pointed out that the scientific method of thinking applied to medical
practice. By scientific method, he meant testing ideas with
well-planned experiments to establish accurate facts. The clinician's
diagnosis was equivalent to the scientist's hypothesis: both medical
diagnosis and hypothesis required the test of an experiment. Flexner
argued that mastery of the scientific method of problem solving was
the key for physicians to manage medical uncertainty and to practice
in the most cost-effective way."
^ As a 2010 article in the New England Journal of
real acupuncture treatments were no more effective than sham
acupuncture treatments. There was, nevertheless, evidence that both
real acupuncture and sham acupuncture were more effective than no
treatment, and that acupuncture can be a useful supplement to other
forms of conventional therapy for low back pain.
^ According to the medical historian James Harvey Young:
In 1991 the Senate Appropriations Committee responsible for funding
National Institutes of Health
National Institutes of Health (NIH) declared itself "not satisfied
that the conventional medical community as symbolized at the NIH has
fully explored the potential that exists in unconventional medical
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National Institutes of Health
National Institutes of Health - Office of Dietary Supplements
Knowledge and Research Center for Alternative Medicine: Denmark, the
Ministry of the Interior and Health
Guidelines for Using Complementary and Alternative Methods: from the
Complementary and Alternative
Medicine Index: from the University of
Maryland Medical Center
Medicine Podcasts and Handouts: Teaching modules from the
University of Wisconsin
University of Wisconsin Integrative
"Alternative Medicine": A BBC/
Open University television series that
examines the evidence scientifically
"Complementary and alternative medicine: What is it?": from the Mayo
Natural Standard Research Collaboration
A Different Way to Heal? and Videos: from
PBS and Scientific American
Who Gets to Validate Alternative Medicine?: from PBS
What is Complementary and Alternative Medicine? – Steven Novella,
"Alternative" health practice – Skeptic's Dictionary
Stephen Barrett (See also: Quackwatch)
Purday, K.M. (2009-01-27). "Review – Healing, Hype, or Harm? A
Critical Analysis of Complementary or Alternative Medicine, by Edzard
Ernst (Editor)". Metapsychology online reviews. 13 (5).
What's the harm? Website created by Tim Farley listing cases of people
harmed by various alternative treatments
Medicine Racket A video investigation of
state-supported quackery at the National Institutes of Health. –
Alternative medical systems
Traditional Chinese medicine
Biologically based therapy
Manual and body-based methods
Alternative medicine advocates
Glossary of alternative medicine
Siddha (South Indian)
& Middle Eastern
Medicinal herbs and fungi
Tea tree oil
Doctrine of signatures
List of plants used in herbalism
Cargo cult science
Superseded scientific theories
Aquatic ape hypothesis
9/11 conspiracy theories
Chemtrail conspiracy theory
Climate change denial
Moon landing conspiracy theories
Doktor Koster's Antigaspills
Electronic Voice Phenomenon
Flat Earth Theory
Germ theory denialism
Hollow Earth theory
Voice stress analysis
Suppressed research in the Soviet Union
Committee for Skeptical Inquiry
Cults of Unreason
Encyclopedia of Pseudoscience
Fads and Fallacies in the Name of Science
The Psychology of the Occult
The Ragged Edge of Science
The Skeptic Encyclopedia of Pseudoscience
The Skeptic's Dictionary
List of topics characterized as pseudoscience
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