Complementary and alternative medicine (CAM)1 is now a major part of the healthcare
system in all advanced societies.2 It is also a common part of discourse in medicine and
healthcare. This growth of interest has only partially been matched by academic study of
it. Indeed, over recent years there has been an increasing recognition that CAM is
essentially under-researched (House of Lords 2000).
In defining a new paradigm it is difficult to know where to begin. How do you take fifteen years
of medical practice in pathology and ten years of clinical observation utilizing the theories of
traditional Chinese medicine, acupuncture, homeopathy, and therapeutic nutrition and meld them
into a model of biological understanding and medical practice? The answer is actually quite simple
— start from the beginning and build a convincing model based upon sound physics, physiology,
pathology, and clinical medicine and see if the model fits the expected outcome.
I’ve spent the last 28 years studying, practicing,
teaching, and evolving as a naturopathic
physician. Two themes have been consistent:
natural medicine and the health care of women.
Alternative medicine has come to be the
popular term used to distinguish natural, noninvasive
therapies from conventional medicine.
Botanical Medicine for Women’s Health is being published
at an interesting time and speaks simultaneously to a
number of converging constituencies. It is a time of growing
stress on both the medical system and the patient.
Medical care is in crisis with large numbers of underinsured
or uninsured patients needing care. Costs are
rising from the practice of increasingly technical medicine
while patients complain of the decreasing time and
attention they are receiving from their medical providers.
Further, the burden of chronic disease is growing in an
Alternative medicine is a term that causes confusion for most people.
What is alternative medicine? How does it compare with conventional
medicine? What is integrative medicine? Is integrative medicine the same
as alternative medicine? How does alternative medicine compare with
holistic health? What do all of these practices have in common, and what
are their differences? Do they work? Are they safe?
The reason most consumers choose to explore alternative approaches
to healing is a very simple one: what they’re currently doing isn’t working.
“Life, liberty, and the pursuit of happiness,” a phrase taken directly
from the Declaration of Independence, indicates the basic values identified
by the founders of our nation. Of the three, life is the most fundamental
as without it, liberty and the pursuit of happiness are meaningless.
Health, of course, is the underpinning of life and therefore, it is puzzling
that there is so little general demand for an explicit public emphasis on
nourishing health as a personal and social resource.
Falconers, from China through Central Asia down into the Middle East, up across Europe
and on to the Americas, awake daily to begin a time honored management routine to prepare
their birds for the field. The origins of the steps each falconer takes daily are often steeped in
tradition, gleaned from experiences through centuries, learned from the falconers who
We are delighted to present Integrative Women’s Health—the fi rst
such text created for health professionals. It is our hope that you
will fi nd it of great value as you care for your patients. As the largest
group of health care consumers, women have made it abundantly clear
that they desire a broader, more integrative approach to their care. In response
to this need, we have elected to cover both women’s reproductive health and
those conditions that manifest diff erently in wome
Shortly before I began research for this book on
alternative and complementary medicine, I
informed a dear friend of the pending task. His first
comment was “How many volumes?”
Those three words would haunt me throughout
the project. One book hardly scratches the surface;
therefore my objectives were to compile up-to-date
information on and explanations of as many alternative,
complementary, or integrative healing
methods as possible and to present them in an
unbiased and accessible A-to-Z format.
The field of Pain Medicine has evolved over the last 20 years to include an
increasing array of sophisticated and technologically complex diagnostic and therapeutic
procedures. Concurrent to this advancement has been the development of a
battery of pharmacological options to treat pain, from extended-release formulations
of analgesics to antidepressants and anticonvulsants designed to treat specific types of
What is alternative medicine? Attempts to define what is conventional
and what is not conventional introduce a bias, no matter
who the arbiter is who sets up the definitions (Table 1). Many
alternative therapies pre-date conventional medicine by hundreds
or thousands of years. Some are quite well known, others
seem mysterious or strange, and some pose serious risks (Murray
and Rubel 1992). Many of us use unconventional therapies acquired
from grandparents, parents, or friends (chicken soup is
perhaps the most famous) in our personal lives without a second
Diagnostic Hypothesis Generation Cognitive scientists studying the thought processes of expert clinicians have observed that clinicians group data into packets, or "chunks," which are stored in their memories and manipulated to generate diagnostic hypotheses. Because short-term memory can typically hold only 7–10 items at a time, the number of packets that can be actively integrated into hypothesis-generating activities is similarly limited.
Evidence-Based Medicine The "art of medicine" is traditionally defined as a practice combining medical knowledge (including scientific evidence), intuition, and judgment in the care of patients (Chap. 1). Evidence-based medicine (EBM) updates this construct by placing a much-greater emphasis on the processes by which the clinician gains knowledge of the most up-to-date and relevant clinical research. The key processes of EBM can be summarized in four steps:
Formulating the management question to be answered
This book is a compilation of chapters written by experts in their field on
various modalities and dimensions of holistic health care and aging. We
envision the book to be a compendium of reliable and authoritative information
on complementary and alternative therapies that health professionals
may use as they seek to improve the health and quality of life
of those in their care.
In the autumn of 1994, a New Yorker cartoonist imagined a clinical scene
in which a patient who is literally radiant with health, his body throwing
off a nearly blinding aura of wellness, is nevertheless being sternly admonished
by his physician because he has achieved his health the wrong way:
“You’ve been fooling around with alternative medicines, haven’t you?” the
New Yorker cartoons constitute the most sensitive of barometers to shifting
currents in America’s cultural atmosphere.
The rise of complementary and alternative medicine (CAM) – a whole array
of practices, products and approaches to health and illness1 – can certainly no
longer be characterised as cultural fad or fashion. Changes in the use of titles
(from ‘unscientific’ and ‘marginal’ to ‘complementary’ and ‘integrative’)
reflect a more substantive relocation and transformation of many of these
medicines from the fringe to the mainstream of both community and professional
health-care discourse and practice (Tovey et al. 2004).
Critical care nursing is a complex, challenging area of nursing
practice, where clinical expertise is developed over time
by integrating critical care knowledge, clinical skills, and
caring practices. Finding a textbook that comprehensively
yet succinctly presents essential information about how best
to safely and competently care for critically ill patients and
their families is a challenge for those charged with the education
of new critical care practitioners.
Mitochondria evolved from a bacterial endosymbiont ancestor in which the
integral outer membrane proteins would have been b-barrel structured
within the plane of the membrane. Initial proteomics on the outer mem-brane from yeast mitochondria suggest that while most of the protein
components are integral in the membrane, most of these mitochondrial pro-teins behave as if they have a-helical transmembrane domains, rather than
For centuries, blood has been considered to have mystical properties and
has been associated with vitality. In ancient times, bathing in or drinking
the blood of the strong was thought to invigorate the weak. For instance,
among Ancient Romans it was customary to rush into the arena to drink
the blood of dying gladiators ; among others, to drink or bathe in blood
was thought to cure a variety of ailments . Bleeding was practiced to let
out bad blood and restore the balance of humors, thus hopefully returning
the patient to health...
This symposium summary has been reviewed in draft form by
individuals chosen for their diverse perspectives and technical expertise,
in accordance with procedures approved by the National Research
Councils Report Review Committee. The purpose of this independent
review is to provide candid and critical comments that will assist the
institution in making its published summary as sound as possible and to
ensure that the report meets institutional standards for objectivity,
evidence, and responsiveness to the study charge.