Complementary Alternative Medicine

Question 1

Define Complementary and Alternative Medicines.

Answer 1

CAMs are treatments that fall outside of mainstream healthcare

Question 2

Define complementary medicine.

Answer 2

Use of CAM together with conventional medicine

Question 3

Define integrative medicine.

Answer 3

Blends use of conventional and complementary approaches

Question 4

Define alternative medicine.

Answer 4

Use of CAM in place of conventional medicine

Question 5

Define Naturopathy and Allopathy.

Answer 5

“Natural healing” and

“treatment of disease vs conventional means”

Question 6

Identify the five NCCAM categories of CAM treatments.

Answer 6

• Alternative medical systems
• Mind-body interventions
• Biologically based therapies
• Manipulative and body-based methods
• Energy therapies

Question 7

Give examples of alternative medical systems.

Answer 7

e.g. Traditional Chinese Medicine (TCM), homeopathy, naturopathy, indigenous healing systems

Question 8

Give examples of Mind-body interventions.

Answer 8

e.g. meditation, yoga, deep-breathing exercises, qi gong, tai chi

Question 9

Give examples of biologically based therapies.

Answer 9

e.g. herbal medicine, Bach flower remedies, bee venom therapy, chelation therapy, vegetable juice therapy

Question 10

Give examples of manipulative and body-based methods.

Answer 10

e.g. osteopathy, chiropractic, acupuncture

Question 11

Give examples of energy therapies.

Answer 11

e.g. therapeutic touch, healing touch, magnet therapy, light therapy

Question 12

What is the one-year prevalence of CAM use in the UK ? lifetime prevalence ?

Answer 12

41. 1 % (others suggest 26.3%)

51. 8% (others suggest 44%)

Question 13

Identify the most popular CAM modalities.

Answer 13

1. Herbal Medicine
2. Homeopathy
3. Aromatherapy
4. Massage
5. Reflexology

Question 14

Does the majority of patients interacting with CAM with or without practitioner ?

Answer 14

WITHOUT

Question 15

What was the cause of diseases, according to homeopathy ?

Answer 15

miasms (“impure airs that were responsible for the spread of epidemic diseases among groups of people”)

Question 16

What is the principle of Similars ?

Answer 16

” those symptoms that a substance is able to cause to appear in a person when exposed to it, that same substance also has the ability to cure those same symptoms in a person where they occur naturally as part of a disease process”

(Principle underlying homeopathy).

Question 17

Explain how to make a homeopathic preparation.

Answer 17

• Take substance which obeys the principle of similars
• Take herbal essence of this substance, extract it out into vehicle (e.g. ethanol), this is the mother tincture
• Serially dilute this, either in 1/10 or 1/100 dilutions
• Keep diluting it sequentially
• Thoretically, most potent medication is a 1 in 100^30 dilution
• Each time, solution is shook in machine (Succussion) to potentiate it and give it energy to transfer what is imbued in the chemical structure into the water
• The final solution is put in sugar pills

Question 18

What are the main risks associated with homeopathy ?

Answer 18

Direct harm
– No risk of interactions with ‘high potency’ medicines

Indirect harm
– Delay in receiving appropriate treatment
– Practitioner attitudes (e.g. vaccinations)

Question 19

What are the regulations surrounding homeopathy in the UK ?

Answer 19

No legal regulation of homeopaths in the UK (BUT Homeopathic products regulated by EU directive)
– Society of Homeopaths
– Faculty of Homeopathy
– British Homeopathic Association

Question 20

What is the difference between herbal and homeopathic medicine ?

Answer 20

In herbal medicine, active ingredients in the final product which may be beneficial to the patient

Question 21

Identify an example of herbal medicine, and an “indication”.

Answer 21

St John’s Wort (Hypericum)

-For major depression

Question 22

What are the main risks of herbal medicine ?

Answer 22

Direct harm
– Adverse drug reactions
– Drug interactions (hormonal contraceptives, anti-depressives, anti-coagulants…)
– Quality control

Indirect harm
– Delay in receiving appropriate treatment

Question 23

Describe regulations surrounding herbal medicine in the UK.

Answer 23

MHRA regulates herbal medicines in the UK market:
–Safety, quality, efficacy as per any regular medicine
• Marketing Authorisation (MA)

–Safety and quality (not efficacy) based on traditional usage
• Traditional Herbal Medicines Registration (THR)

–The “herbalist exemption”
• Regulation 3 of The Human Medicines Regulations 2012
• “Herbal practitioners do not need license to supply herbal medicine on your premises to patients following one-to-one consultations”

Question 24

Distinguish between straight and mixer chiropractic.

Answer 24

STRAIGHT- believes that misalignment of the spinal column, often referred to as vertebral subluxations, interfere with the body’s “innate intelligence”, which makes us vulnerable to illness, and diseases occur as secondary effects of vertebral subluxations. Disease symptoms will disappear once the underlying misalignment has been corrected properly. Most straight chiropractors do not wish to have any association with mainstream health care

MIXER- take more osteopathic angle and see it as more holistic part of healthcare that focuses more on MS conditions

Question 25

How are subluxations detected in chiropractic ?

Answer 25

Through X-rays or gadgets (e.g. Neurocalometers)

Question 26

What kinds of manipulations are performed to “fix” subluxations ?

Answer 26

Spinal manipulations (adjustments)
– Including high-velocity, low-amplitude thrusts
• Audible ‘crack’

Question 27

Identify the main risks of chiropractic and osteopathy.

Answer 27

Direct harm
– 50% of chiropractic patients suffer an adverse reaction
– Tearing of artery wall leading to stroke
– Injury to the spinal cord
– Chiropractic X rays

Indirect harm
– Delay in receiving appropriate treatment
– Attitudes of practitioner
• Anti-vaccination

Question 28

Describe regulation surrounding chiropractic and osteopathy.

Answer 28

Only two CAM modalities under statutory regulation
– General Chiropractic Council (GCC)
– General Osteopathic Council (GOsC)

i.e. people have to be registered under the corresponding one of these to be able to practice

Question 29

Describe the principles underlying acupuncture.

Answer 29

Ch’i (Qi, “ch-ee”) as a ‘vital energy’
– Flows through ‘meridians’
– Meridians associated with major organs
– Illness due to disrupted flow of Ch’i

Insertion of needles along meridians
– Restores flow of Ch’i

Question 30

How deep are the insertions in acupuncture, and how long are they left there ?

Answer 30

– 1 – 10cm in depth, with/without rotation

– Left in place for seconds to hours

Question 31

True or false: prior to acupuncture, a range of different procedures including inspection, auscultation, olfaction, palpitation and inquiring, and diagnosis may be performed.

Answer 31

TRUE

Question 32

Identify the main risks of acupuncture.

Answer 32

• Direct harm
– Infections
– Pneumothorax

• Indirect harm
– Delay in receiving appropriate treatment
– Attitudes of practitioner (e.g. does he/she view it as being complementary or alternative?)

Question 33

Describe regulations surrounding acupuncture.

Answer 33

• Premises and practitioners must be licensed
– Via local authority (same as tattooing/body piercing) (about safety, NOT about efficacy)

• Voluntary regulation
– with several organisations, e.g. British Acupuncture Council

Question 34

Explain the underlying principles of reflexology.

Answer 34

• Similar principles as those underlying acupuncture
• Pressure points on feet that represent different organs, and dysfunction in these organs can be addressed by massaging or manipulating those regions of the feet