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Alternative Whole Medical Systems

Alternative medical systems are complete systems with explanation of disease, diagnosis, and therapy.

Ayurveda, the traditional medical system of India, originated > 4000 yr ago. It is based on the theory that disease results from an imbalance of the body's life force (prana). The balance of prana is determined by equilibrium of the 3 bodily qualities (doshas): vata, pitta, and kapha. Most people have a dominant dosha; the specific balance is unique to each person. Evidence: Few well-designed studies of Ayurvedic practices have been done. Use of Ayurvedic herbal combinations to relieve symptoms in patients with RA and to treat diabetes is being studied.

Uses: After determining the balance of doshas, practitioners design a treatment specifically tailored to each patient. Ayurveda uses diet, herbs, massage, meditation, yoga, and therapeutic detoxification (panchakarma)typically with enemas, oil massages, or nasal lavageto restore balance within the body and with nature.

Possible adverse effects: In some of the herbal combinations used, heavy metals (mainly lead, mercury, and arsenic) are included because they are thought to have therapeutic effects. Cases of heavy metal toxicity have been reported.

Developed in Germany in the late 1700s, homeopathy is based on the principle that like cures like. A substance that, when given in large doses, causes a certain set of symptoms is believed to cure the same symptoms when it is given in minute doses. The minute dose is thought to stimulate the body's healing mechanisms. Treatments are based on the patient's unique characteristics, including personality and lifestyle, as well as symptoms and general

health. Remedies used in homeopathy are derived from naturally occurring substances, such as plant extracts and minerals. Extremely low concentrations are prepared in a specific way. The more dilute the homeopathic remedy, the stronger it is considered to be. Some solutions are so dilute that they contain no molecules of the active ingredient. There is no compelling, scientific explanation for how these dilutions could work. Evidence: Efficacy of homeopathic remedies for various disorders has been studied. No study has clearly shown efficacy for any specific homeopathic remedy, although some studies have shown positive results (eg, one well-conducted, randomized, placebo-controlled clinical study showed a therapeutic benefit greater than placebo in the treatment of diarrhea in children). Homeopathy is commonly incorporated into health care practices in Europe and India.

Uses: Homeopathy has been used to treat various disorders, such as allergies, rhinitis, digestive problems, musculoskeletal pain, and vertigo. The effect of homeopathic solutions on joint pain and tenderness and quality of life in fibromyalgia is being studied.

Possible adverse effects: Homeopathy is well-tolerated and has few risks; rarely, an allergic or toxic reaction occurs.

Unlike herbal and nutritional supplements, homeopathic remedies are regulated by the FDA as drugs; they are available over the counter or by prescription. Because so little active ingredient is left after dilution, active ingredients are tested before dilution. Homeopathic remedies have been temporarily exempted from limits on the amount of alcohol (the usual diluent) that they can contain. However, the label is required to list the following:

Manufacturer The label homeopathic At least one indication Instructions for safe use Unless specifically exempted, the active ingredient and degree of dilution

Conventional clinicians should not assume that a homeopathic remedy taken by a patient is biologically inactive. Patients often use the term homeopathic erroneously in reference to a dietary supplement they are taking. Also, the FDA allows many medicinal herbs to be registered and labeled as homeopathic if they undergo a particular pharmaceutical process.

This therapy began as a formal health care system in the US during the early 1900s. Founded on the healing power of nature, naturopathy emphasizes prevention and treatment of disease through a healthy lifestyle, treatment of the whole patient, and use of the body's natural healing abilities. This system also focuses on finding the cause of a disease rather than merely treating symptoms. Some of this system's principles are not that different from those of traditional healing systems such as Ayurveda and traditional Chinese medicine. Naturopathy uses a combination of therapies, including acupuncture, counseling, exercise therapy, medicinal herbs, homeopathy, hydrotherapy, natural childbirth, nutrition, physical therapies (eg, heat or cold therapy, ultrasound, massage), guided imagery, and stress management.

Traditional Chinese Medicine

Originating > 2000 yr ago, traditional Chinese medicine is based on the theory that disease results from improper flow of the life force (qi). The movement of qi is restored by balancing the opposing forces of yin and yang, which manifest in the body as heat and cold, external and internal, and deficiency and excess. Various practices (eg, acupuncture, diet, massage, medicinal herbs, meditative exercise called qi gong) are used to preserve and restore qi and thus health. Evidence: Chinese medicine traditionally uses formulas containing mixtures of herbs to treat various disorders. Traditional formulas can be studied; for example, efficacy in the treatment of irritable bowel syndrome has been shown. One herb, used by itself, may not be as effective and may have side effects. Nevertheless, current conventional research favors study of single herbs. For example, Tripterygium wilfordii (thunder god vine) has demonstrated antiinflammatory properties and clinical efficacy in treating RA, and Astragalus may benefit patients with lung cancer. Various Chinese herbs have been studied as treatments for hepatitis and hepatic fibrosis. Some studies suggest efficacy, but data are limited.

Possible adverse effects: One problem is the standardization and quality control of Chinese herbs. Many are unregulated in Asia; they may be contaminated with heavy metals from polluted ground water or may be adulterated with drugs such as antibiotics or corticosteroids. However,

high-quality products are available through certain manufacturers that comply with FDA Good Manufacturing Practices.

Last full review/revision February 2010 by Steven Rosenzweig, MD Content last modified February 2012