Foreword

Article Outline

• Copyright

Increased awareness of forms of medical therapy outside the confines of allopathic medicine, due in part to the easy availability of modern day knowledge and information as well as increased worldwide travel, make this approach to healthcare impossible to ignore. Complementary and alternative medicine (CAM) encompasses a wide variety of approaches to health and disease, some of which have preceded allopathic medicine and been practiced for thousands of years. It is ironic that, in some cultures, allopathic medicine would, indeed, be the “alternative” medicine.

Regardless of whether or not CAM is acceptable to the modern day practitioner, it cannot be denied that the layperson's implicit faith in some folk remedies appears to have withstood the test of time. Additionally, most forms of CAM require that the practitioner spend time with the patient, which by itself goes a long way in the healing process. Some CAM treatments aim to promote health and not merely treat disease, and the effect of mind over body, on which they are based, is not to be easily dismissed. Modern practitioners should find this approach to “preventive medicine” very attractive.

While the efficacy of some of these treatments appears to have been proven, our inability to assess them, with any degree of objectivity, stems from our lack of understanding of their basis. While the systems of Homeopathy, Indian Ayurveda, Yoga, Chinese medicine, acupuncture, and various forms of herbal and “gypsy” medicine have been known for centuries, they have not, for the most part, been subjected to modern scientific analysis. Efforts are underway in some parts of the world to study the chemical basis of some herbal therapies and a better understanding of their action may soon be possible. Additionally, controlled trials to compare allopathic medicine and other forms of CAM are being undertaken. Incorporation of the study of CAM into mainstream curricula and scientific pursuits is a big step in the direction to understanding these therapies and proving whether, and how, these medicines are effective. More collaborative effort between conventional medicine and CAM practitioners can only take us further along the road to a holistic approach to the patient.

The appeal of most forms of CAM to patients may lie in their being touted as “natural” therapy. And, indeed, while many medicines in use today, such as digitalis, reserpine, and taxol, have their origins in nature, it is difficult for the layperson to understand that “natural” is not always harmless. The lack of stringent regulation of CAM as well as easy availability of over-the-counter CAM medications has spawned a surge of “self-care” in the US today, spurred on by the current economic climate and the relative inexpensive nature of some CAM. Moreover, patients do not always share CAM information with their physicians. While many forms of CAM are harmless, interactions, some as yet unknown, with treatment being prescribed by allopaths is fraught with danger.

In essence, while CAM has both critics and proponents, while some treatments may appear to, indeed, bring about better responses, while some may owe their “efficacy” to the well-recognized placebo effect and others may appear detrimental to health, there is no denying that it is time for us to talk about CAM. This issue of Disease-a-Month is dedicated to CAM and illuminates some of these issues. It is hoped that this focus will give pause to consider this area of medicine rationally and promote interest, on both sides, in studying CAM further. Regardless of mindset, this issue is sure to be very revealing to readers who have not, until now, taken CAM treatment into consideration.