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Complementary / alternative
What is complementary and alternative
medicine (CAM)?
 It
is a group of diverse medical and
health care systems, practices and
products that are not presently
considered to be part of conventional
Are complementary medicine and
alternative medicine different
from each other?
Yes, they are different
 Complementary
medicine is used
together with conventional medicine. An
example of a complementary therapy is
using aromatherapy to help lessen a
patient’s discomfort following surgery.
 Alternative
medicine is used in place
of conventional medicine. An example of
an alternative therapy is using a special
diet to treat cancer instead of undergoing
surgery, radiation, or chemotherapy that
has been recommended by a conventional
What are the major types of
complementary and alternative
NCCAM classifies CAM
therapies into five
categories, or domains
Alternative Medical Systems. e.g.
Traditional Chinese Medicine and Ayurveda
Mind-Body Interventions. e.g. prayer,
meditation, art, music, or dance.
Biologically Based Therapies. e.g.
dietary supplements & herbal products
Manipulative and Body-Based
Methods. e.g. chiropractic manipulation &
Energy Therapies.
I. Biofield therapies. e.g. qi gong
II.Bioelectromagnetic-based therapies.
Medical Herbalism
 Medical
herbalism is the use of plant
remedies in the prevention and
treatment of illness.
 Today,
medical herbalism, practiced by
medical herbalists, draws on traditional
knowledge, but increasingly this is
interpreted and applied in a modern
Aspects of medical herbalism
Herbalism takes an holistic approach.
Herbalists select herbs on an individual basis for each
Herbalists aim to identify the underlying cause (e.g.
stress) of a patient’s illness and to consider this in the
treatment plan.
Herbs are used to stimulate the body’s healing
capacity, to ‘strengthen’ bodily systems and to
‘correct’ disturbed body functions rather than to treat
presenting symptoms directly.
Herbs may be used to provide long-term relief from
the particular condition.
One of the tenets of herbalism is that
the different constituents of a herb act
together in some way that has
beneficial effects. These could be:
Additive effect:
The combined effect of two drugs is
equal to the sum of their individual
Synergistic effect:
The combined effect of two drugs is
greater than the sum of the individual
Conditions treated
Medical herbalists treat a wide range
of acute and chronic conditions. e.g.
Irritable bowel syndrome
Premenstrual syndrome
Menopausal symptoms
Types of arthritis
Acne and other skin conditions
Cystitis (Inflammation of the urinary bladder)
Chronic fatigue syndrome
Herbalist’s prescriptions
 Generally,
a combination of several
different herbs (usually 4-6) is used in
the treatment of a particular patient.
 sometimes, a single herb may be given,
e.g. chasteberry (vitex agnus castus) for
premenstrual syndrome and
 Each patient’s treatment is reviewed
regularly and is likely to be changed
depending on whether or not there has
been a response.
Comparison of herbalism with
rational phytotherapy
Assume that synergy or
additive effects occur
between herbs.
Holistic prescribing.
Preparations mainly
formulated as tinctures.
Mainly uses combinations
of herbs.
Opposition towards
Not scientifically
Rational phytotherapy
Seek evidence that
synergy or additive effects
occur between herbs.
No holistic.
Preparations mainly
formulated as tablets and
Single-herb products used
Using standardization.
Science-based approach.
Generally, medicinal herbs fall into two basic
categories: tonic and stimulating.
Tonics help cells, tissues, and organs to maintain
tone, or balance, throughout the body. Some
tonics activate and invigorate bodily processes or
parts. Other tonics supply important nutrients
that cells, tissues, and organs need to function
properly. Tonics ordinarily are taken regularly for
three to nine months at a time to gently
strengthen and improve overall health and/or
certain organ functions.
Stimulating herbs have much stronger actions
and are used to treat particular ailments. They
should be taken in smaller doses than tonic
herbs, and for shorter periods of time.
Evidence of efficacy and safety
was founded
around 200 years ago by
Samuel Hahnemann (1755-1843),
a German physician and
Today, around 1200
Homoeopathic remedies are
commonly used.
Hahnemann outlined three basic principles
of homoeopathy, which form the basis of
classical Homoeopathy
A substance which, used in large doses, causes
a symptom(s) in a healthy person can be used
to treat that symptom(s) in a person who is ill.
For example, Coffee, a remedy prepared from
the coffee bean (a constituent, caffeine, is a
central nervous system stimulant) would be
used to treat insomnia. This is the so-called ‘like
cures like’ concept.
The minimal dose of the substance should be
used in order to prevent toxicity.
Only a single remedy or substance should be
used in a patient at any one time.
Modern homoeopathy
Hahnemann’s principles of homoeopathy still
form the basis of modern homoeopathic
practice, with the exception of the single
remedy rule, which is ignored by many
homoeopaths in favor of multiple prescribing.
Modern-day provings have involved rigorous
study design (randomized, double-blind,
placebo-controlled), while Hahnemann did not
use rigorous study design.
In addition to the basic principles of homoeopathy,
modern homoeopaths also believe:
That illness results from the body’s inability to
cope with challenging factors such as poor diet
and adverse environmental conditions.
2. That the signs and symptoms of disease
represent the body’s attempt to restore order.
3. That homoeopathic remedies work by
stimulating the body’s own healing activity
(the ‘vital force’) rather than by acting directly
on the disease process.
4. That the ‘vital force’ is expressed differently in
each individual, so treatment must be chosen
on an individual (holistic) basis.
Homoeopathic remedies
Homoeopathic remedies and herbal medicines
are often confused and/or deemed to be
similar. The fundamental differences between
the two types of preparation are:
Homoeopathic remedies are (mostly) highly
dilute whereas herbal medicines are used at
material strengths.
Many homoeopathic remedies (around 65%)
originate from plants, whereas by definition all
herbal medicines originate from plants.
Many of the plants from which homoeopathic
remedies are derived have a history of
medicinal use.
 Other types of material used in the
preparation of homoeopathic remedies
include animal, insect, biological,
drug/chemical and mineral.
 The starting point for the production of most
homoeopathic remedies is a mother tincture,
usually an alcohol/water extract of crude
plant material. The mother tincture is then
diluted according to either the decimal
(dilution steps of 1 in 10; denoted by D or X)
or centesimal (dilution steps of 1 in 100;
denoted by C or cH) scale to form
homoeopathic remedies or potencies.
For example, on the decimal dilution scale, a 1X (or
D1) remedy is prepared by taking one part mother
tincture and adding it to nine parts diluent (dilute
alcohol) and succussing the resulting 1 in 10
dilution. A 2X remedy is prepared by taking one part
1X remedy and adding it to nine parts diluent and
succussing the resulting dilution, which is now a
dilution of 1 in 100, and so on. The centesimal scale
uses the same procedure except that each step
involves adding one part mother tincture to 99 parts
diluent so that the first step produces a 1 in 100
dilution (1C or 1cH), the second step a 1 in 10,000
dilution (2C) and so on.
There are also LM potencies which involve serial
dilutions of 1 in 50,000 at each step.
Dosage forms and potentization
Homeopathic remedies come in pellets,
tablets, and dilutions (liquids).
The potentizing (mixing) affects the way a
homeopathic medicine works. Generally
speaking, the lower potencies, such as 3x or
6x, have a greater effect on the organs and
are suited to acute illness. Medium
potencies, such as 12x and 30x, affect the
senses and nervous system. High potencies,
60x and above, affect mental condition.
The following is a rough guide to the various
potencies, their effects, and uses:
What It Affects
Frequency of
6x, 12x, 6c, 12c
Body organs. Used
for symptoms of
acute conditions
One dose every ¼
hour to every 4
30x, 30c
Body organs plus
the senses and
nervous system.
Used for symptoms
of chronic
One a day to 3
times a day
200x, 1m, 10m, LM
Body organs,
senses, nervous
system, mind, and
Once a month to
once a year
typical dose of a homeopathic remedy is
3 tablets or 10 pellets for adults, 2 tablets
or 5 pellets for children.
 Remedies
should be taken on an empty
 The
tablets should be placed under the
tongue and held there for as long as
possible while they dissolve. If possible,
you should not swallow the tablets.
Aromatherapy is the therapeutic use
of aromatic substances extracted from
The most important group of these
substances is the essential oils.
How essential oils are obtained ?
Solvent extraction
Essential oils
Typically, essential oils contain around 100 or
more chemical constituents, mostly present at
concentrations below 1%, although some
constituents are present at much lower
concentrations. Some essential oils contain one or
two major constituents, and the therapeutic and
toxicological properties of the oil can largely be
attributed to those constituent(s).
The composition of an essential oil will vary
according to the plant's environment and growing
conditions, the plant part used and on methods of
harvesting, extraction and storage.
The constituents of essential oils are largely
volatile compounds which are sensitive to the
effects of light, heat, air and moisture and
should therefore be stored in a cool place in
tightly closed, darkened bottles.
There is the possibility of adulteration and
contamination occurring during processing.
Gross adulteration can be detected using
established analytical techniques such as gas
chromatography-mass spectrometry (GC-MS).
Essential oils should be referred to by the Latin
binomial name of the plant species from which a
particular oil is derived.
Aspects of aromatherapy
Aromatherapists believe that essential oils can be
used not only for the treatment and prevention of
disease, but also for their effects on mood and
Aromatherapy is claimed to be an holistic therapy.
Aromatherapists believe that the constituents of
essential oils work synergistically.
Essential oils are described not only with
reference to reputed pharmacological properties
(e.g. antibacterial), but also by terms that are not
recognized in conventional medicine (e.g.
balancing, energizing).
How Essential Oils Work
Essential oils are believed to act both
by exerting pharmacological effects
Absorption into the circulation.
The effects of their odor on the
olfactory system.
Conditions treated
Aromatherapy is widely used as an approach
to relieving stress, and many essential oils
are claimed to be ‘relaxing’.
 Many aromatherapists also claim that
essential oils can be used in the treatment of
a wide range of conditions. For example:
digestive problems, eczema, headaches,
 Aromatherapy is also used in a variety of
conventional healthcare settings, such as
mental health units and in specialized units
caring for patients with HIV/AIDS, physical
disabilities and severe learning disabilities.
Ways of Using Essential Oils
Inhaling through vaporization
Special considerations
 Some
oils should be avoided by people
with certain conditions, such as:
1. High
blood pressure
2. Epilepsy
3. pregnancy