alternative medicine
breech baby
making sense
Medical milestone
yin yang3 DEC 1998 Nov. 11 marked a milestone in the uneasy relationship between conventional and alternative medicine. On that day, the American Medical Association, a citadel of Western medicine, devoted an entire issue of JAMA, its flagship journal, to alternative medicine.

That ill-defined category -- essentially whatever is seldom taught by medical schools, reimbursed by insurance companies, or proven by standard experiments -- includes such therapies as homeopathy, acupuncture, diet and self help.

Although alternative medicine includes practices that Western science can't explain and doesn't accept, patients are voting with their feet. In 1997, patients in the United States spent $21 billion during 627 million visits to alternative medicine practitioners. That was up 47 percent over 1990. Visits to primary care physicians dropped 1 percent during the same period (see "Trends in Alternative Medicine... " in the bibliography).

Visits to primary-care doctors are stagnant, but visits to alternative medicine practitioners are soaring.
Data source: Trends in Alternative Medicine... .

This news can't bring much solace to JAMA's sponsor. But the JAMA reports were the latest and most convincing evidence that conventional medicine, whether motivated by competition or a desire to heal, is starting to embrace -- or at least test -- alternative therapies.

From whatever motivation, there is good reason to welcome scrutiny that can separate fact from fiction, cure from curse, useful treatment from quack remedy. The dangers of alternative medicine include untested drugs, unknown drug interactions, and reliance on snake oil when proven cures could help.

So stand back, surgeons. Move over, medical establishment. Make way for massage, megavitamins, energy healing and relaxation.

Jammin' with JAMA
The JAMA issue carried reports on seven fringe therapies. These four worked:

Yoga improved carpal tunnel syndrome.

A technique practiced by acupuncturists helped babies shift to a safer position before birth.

A Chinese herbal concoction relieved a common digestive ailment.

An extract of the saw palmetto tree reduced the symptoms of benign prostate enlargement.

However, chiropractic manipulation did not reduce headaches, acupuncture did not ease one kind of AIDS pain, and the herb Garcinia cambogia did not cause weight loss.

I can see the light
Fifteen years ago, an athlete made headlines by using acupuncture to treat pain. Ten years ago, the idea that light could heal seasonal affective disorder (SAD, a seasonal malady that causes depression and weight gain) seemed absurd. And the notion that herbs -- simply dried, crushed plants -- could affect our biochemistry like something cooked up by Merck, was, well, fringe.

Welcome to the 90s, folks, and an alphabet soup of remedies -- ranging from ayurvedic medicine and chiropractic to relaxation techniques and self-prayer.

It's not shocking that JAMA's authors found that some alternative therapies worked and others failed. That's about what you'd expect for "conventional" drugs (meaning molecules synthesized in corporate or university labs). But when the "cures" involved holding burning herbs near the little toe, or a folk remedy extracted from a tree, or the ancient Indian practice of yoga -- our eyebrows start to rise.

Gotta take a look?

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