breech baby
making sense

why can't we all just get along?.
Summing it up
What to make of the new science of alternative medicine? Just by itself, the demonstration that holding burning herbs near an acupuncture point can rotate breech-position babies indicates that Western medicine has more work ahead of it as it attempts to explain alternative medicine.

But proof that some of the techniques work may be more important than the explanation given the growth of alternative medicine. A recent national survey (see "Trends in Alternative Medicine... " in the bibliography) found that the most popular therapies -- relaxation, herbal medicine, massage and chiropractic -- were all visited by more than 10 percent of the national population sample during the previous year.

Alternative medicine is also booming at the federal level. The annual allowance of the Office of Alternative Medicine at the National Institutes of Health was just raised from $20-million to $50-million. The six-year-old office was also grandly retitled the National Center for Complementary and Alternative Medicine and given the ability to fund research. The office has been part of a slowly growing -- call it a tidal ripple -- interest in evaluating alternative therapies by the same standards as prescription drugs.

What's the draw?
Why is alternative medicine so popular? Partly because of frustration and fear among the patients who can't be cured with standard therapies. Partly because conventional medicine is expensive and can cause serious side effects. Partly because alternative healers can afford to spend more time with patients than conventional doctors.

And partly because some of the techniques work.

For all these reasons, these outsider therapies must be put to the test. "Alternative medicine is here to stay," writes Wayne Jonas, head of the National Center for Complementary and Alternative Medicine at the National Institute of Health. "It is no longer an option to ignore it or treat it as something outside the normal processes of science and medicine." The challenge, he says, "is to move forward carefully, using both reason and wisdom, as we attempt to separate the pearls from the mud" (see "Alternative Medicine -- Learning..." in the bibliography).

harmony, manSome therapies -- notably the ones that derive from Chinese medicine -- reflect a long tradition of trial and error, and reflect a view of the human body that Western medicine thinks "comes from far left field," writes Alan Bensoussan, a Chinese doctor who does research at the University of Western Sydney Macarthur in Australia. "You must remember these are routine medicines used in very large public hospitals in China and Korea at least. Western medicos would prefer to wait and see until the 'active ingredient' has been found, isolated, concentrated and standardized, but I suspect they'll be waiting a long time to find any single pharmaceutical agent that matches the benefit of a whole, albeit complex, Chinese formula. We don't really have good models in pharmacology to explore the interaction of a large number of potentially active substances. Yet in traditional terms these formulas are designed on the basis that, for example, one herb will support the action of another whilst detoxifying a third."

Despite such difficulties, the growth of alternative medicine has spawned talk of "integration," a sort of joint venture through which alternative medicine can learn from the scientific scrutiny of conventional medicine, while Western doctors learn about dealing with patients as whole human beings. As Jonas writes, "Empowerment, participation in the healing process, time, and personal attention are essential elements of all medicine. Conventional medicine must develop a better language for managing illness and suffering" which is part of the "essential message that alternative medicine provides."

What do we know?
A few studies -- even in a journal as prestigious as JAMA (the journal of the American Medical Association) are unlikely to change many minds in the entrenched dispute between Western and alternative medicines.

Take one of the most unusual therapies -- using burning herbs to change the position of a baby in the womb. Although it worked well, one prominent skeptic still has reservations. Stephen Barrett, a retired psychiatrist who runs a website called Quackwatch, points out that one study is never definitive. He also notes that moxibustion is commonly administered by acupuncturists "who want to maintain energy flow to the body's organs." Yet, as he correctly asserts, this energy cannot be measured by Western science, and thus, "I don't believe it's good to be in the clutches of someone who manipulates non-existent energy fields."

To those who believe in Western scientific methods, but also think alternative medicine sometimes works, the ongoing courtship between the two can only be beneficial. Now that the testing has begun, the field of alternative medicine really gets interesting.

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