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Complementary and
alternative healthcare and medical practices (CAM) are those healthcare
and medical practices that are not currently an integral part of conventional
medicine1. The list of practices that
are considered CAM changes continually as CAM practices and therapies
that are proven safe and effective become accepted as "mainstream" healthcare
practices. Today, CAM practices may be grouped within five
major domains2: (1) alternative medical
systems, (2) mind-body interventions, (3) biologically-based treatments,
(4) manipulative and body-based methods, and (5) energy therapies. The
individual systems and treatments comprising these categories are too
numerous to list in this document. Thus, only limited examples are provided
within each.
I.
ALTERNATIVE MEDICAL SYSTEMS
Alternative medical
systems involve complete systems of theory and practice that have evolved
independent of and often prior to the conventional biomedical approach.
Many are traditional systems of medicine that are practiced by individual
cultures throughout the world, including a number of venerable Asian approaches.
Traditional oriental
medicine emphasizes the proper balance or disturbances of qi (pronounced
chi), or vital energy, in health and disease, respectively. Traditional
oriental medicine consists of a group of techniques and methods, including
acupuncture, herbal medicine, oriental massage, and qi gong (a form of
energy therapy described more fully below). Acupuncture involves stimulating
specific anatomic points in the body for therapeutic purposes, usually
by puncturing the skin with a needle.
Ayurveda is India's
traditional system of medicine. Ayurvedic medicine (meaning "science of
life") is a comprehensive system of medicine that places equal emphasis
on body, mind, and spirit, and strives to restore the innate harmony of
the individual. Some of the primary Ayurvedic treatments include diet,
exercise, meditation, herbs, massage, exposure to sunlight, and controlled
breathing.
Other traditional
medical systems have been developed by Native American, Aboriginal, African,
Middle-Eastern, Tibetan, Central and South American cultures.
Homeopathic and naturopathic
medicine are also examples of complete alternative medical systems. Homeopathic
medicine is an unconventional Western system that is based on the principle
that "like cures like," i.e., that the same substance that in large doses
produces the symptoms of an illness, in very minute doses cures it. Homeopathic
physicians believe that the more dilute the remedy, the greater its potency.
Therefore, they use small doses of specially prepared plant extracts and
minerals to stimulate the body's defense mechanisms and healing processes
in order to treat illness.
Naturopathic medicine
views disease as a manifestation of alterations in the processes by which
the body naturally heals itself and emphasizes health restoration rather
than disease treatment. Naturopathic physicians employ an array of healing
practices, including diet and clinical nutrition; homeopathy; acupuncture;
herbal medicine; hydrotherapy (the use of water in a range of temperatures
and methods of applications); spinal and soft-tissue manipulation; physical
therapies involving electric currents, ultrasound and light therapy; therapeutic
counseling; and pharmacology.
II.
MIND-BODY INTERVENTIONS
Mind-body interventions
employ a variety of techniques designed to facilitate the mind's capacity
to affect bodily function and symptoms. Only a subset of mind-body interventions
are considered CAM. Many that have a well-documented theoretical basis,
for example, patient education and cognitive-behavioral approaches are
now considered "mainstream." On the other hand, meditation, certain uses
of hypnosis, dance, music, and art therapy, and prayer and mental healing
are categorized as complementary and alternative.
III.
BIOLOGICAL-BASED THERAPIES
This category of
CAM includes natural and biologically-based practices, interventions,
and products, many of which overlap with conventional medicine's use of
dietary supplements. Included are herbal, special dietary, orthomolecular,
and individual biological therapies.
Herbal therapies
employ individual or mixtures of herbs for therapeutic value. An herb
is a plant or plant part that produces and contains chemical substances
that act upon the body. Special diet therapies, such as those proposed
by Drs. Atkins, Ornish, Pritikin, and Weil, are believed to prevent and
or control illness as well as promote health. Orthomolecular therapies
aim to treat disease with varying concentrations of chemicals, such as,
magnesium, melatonin, and mega-doses of vitamins. Biological therapies
include, for example, the use of laetrile and shark cartilage to treat
cancer and bee pollen to treat autoimmune and inflammatory diseases.
IV. MANIPULATIVE
AND BODY-BASED METHODS
This category includes
methods that are based on manipulation and/or movement of the body. For
example, chiropractors focus on the relationship between structure (primarily
the spine) and function, and how that relationship affects the preservation
and restoration of health, using manipulative therapy as an integral treatment
tool. Some osteopaths, who place particular emphasis on the musculoskelatal
system, believing that all of the body's systems work together and that
disturbances in one system may have an impact upon function elsewhere
in the body, practice osteopathic manipulation. Massage therapists manipulate
the soft tissues of the body to normalize those tissues.
V.
ENERGY THERAPIES
Energy therapies
focus either on energy fields originating within the body (biofields)
or those from other sources (electromagnetic fields).
Biofield therapies
are intended to affect the energy fields, whose existence is not yet experimentally
proven, that surround and penetrate the human body. Some forms of energy
therapy manipulate biofields by applying pressure and/or manipulating
the body by placing the hands in, or through, these fields. Examples include
Qi gong, Reiki and Therapeutic Touch. Qi gong is a component of traditional
oriental medicine that combines movement, meditation, and regulation of
breathing to enhance the flow of vital energy (qi) in the body, to improve
blood circulation, and to enhance immune function. Reiki, the Japanese
word representing Universal Life Energy, is based on the belief that by
channeling spiritual energy through the practitioner the spirit is healed,
and it in turn heals the physical body. Therapeutic Touch is derived from
the ancient technique of "laying-on of hands" and is based on the premise
that it is the healing force of the therapist that affects the patient's
recovery and that healing is promoted when the body's energies are in
balance. By passing their hands over the patient, these healers identify
energy imbalances.
Bioelectromagnetic-based
therapies involve the unconventional use of electromagnetic fields, such
as pulsed fields, magnetic fields, or alternating current or direct current
fields, to, for example, treat asthma or cancer, or manage pain and migraine
headaches.
1
The term conventional
medicine refers to medicine as practiced by holders of M.D. (medical doctor)
or D.O. (doctor of osteopathy) degrees, some of whom may also practice
complementary and alternative medicine. Other terms for conventional medicine
are allopathy, Western, regular, and mainstream medicine, and biomedicine.
[
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2
These are the categories
within which NCCAM has chosen to group the numerous CAM practices; others
employ different, broad groupings.
[
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