Complementary and Alternative Medicine
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known as complementary and alternative medicine (CAM) or as traditional medicine (TM). Alternative systems of medicine use elements from each of
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Chapter 69
Complementary and Alternative Medicine
Haile T. Debas, Ramanan Laxminarayan, and Stephen E. Straus
The objective of medicine is to address people’s unavoidable needs for emotional and physical healing. The discipline has evolved over millennia by drawing on the religious beliefs and social structures of numerous indigenous peoples, by exploiting natural products in their environments, and more recently by developing and validating therapeutic and preventive approaches using the scientific method. Public health and medical practices have now advanced to a point at which people can anticipate—and even feel entitled to—lives that are longer and of better quality than ever before in human history. Yet despite the pervasiveness, power, and promise of contemporary medical science, large segments of humanity either cannot access its benefits or choose not to do so. More than 80 percent of people in developing nations can barely afford the most basic medical procedures, drugs, and vaccines. In the industrial nations, a surprisingly large proportion of people opt for practices and products for which proof as to their safety and efficacy is modest at best, practices that in the aggregate are known as complementary and alternative medicine (CAM) or as traditional medicine (TM). Much of this book considers the formidable challenges to advancing human health through the further dispersion of effective and economical medical practices. This chapter considers both proven and unproven but popular CAM and TM approaches and attempts to portray their current and potential place in the overall practice of medicine. With globalization, the pattern of disease in developing countries is changing. Unlike in the past, when communicable diseases dominated, now 50 percent of the health burden in developing nations is due to noncommunicable diseases,
such as cardiovascular diseases, diabetes, hypertension, depression, and use of tobacco and other addictive substances. Because lifestyle, diet, obesity, lack of exercise, and stress are important contributing factors in the causation of these noncommunicable diseases, CAM and TM approaches to these factors in particular will be increasingly important for the development of future health care strategies for the developing world.
DEFINITIONS AND DOMAINS OF COMPLEMENTARY AND ALTERNATIVE MEDICINE AND TRADITIONAL MEDICINE
We refer to medical practices that evolved with indigenous peoples and that they have introduced to other countries through emigration as traditional medicine. We refer to approaches that emerged primarily in Western, industrial countries during the past two centuries as scientific or Western medicine, although we acknowledge that not all Western medicine is based on scientifically proven knowledge. The terms complementary and alternative describe practices and products that people choose as adjuncts to or as alternatives to Western medical approaches. Increasingly, the terms CAM and TM are being used interchangeably (Kaptchuk and Eisenberg 2001; Straus 2004). Endless varieties of practices are scientifically unproven and poorly accepted by medical authorities. For the sake of organizing an agenda for research into these approaches, the U.S. National Institutes of Health has grouped them into five
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