British Medical Journal's “ABC's of CAM” Series

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:     Frankp@chiro.org

	Complementary Medicine and the General Practitioner British Medical Journal 1986 (Jun 7); 292 (6534): 1498–1500 ~ FULL TEXT The attitudes to complementary medicine of a random sample of general practitioners in Avon were assessed. A questionnaire was sent to 200 general practitioners, of whom 145 responded. The treatments studied were acupuncture, homoeopathy, herbal medicine, spinal manipulation, faith healing, and hypnosis. Of the 145 general practitioners, 55 (38%) had received some training in complementary medicine and 22 (13%) wished to arrange training.
	Complementary Medicine in Europe British Medical Journal 1994 (Jul 9); 309 (6947): 107–111 ~ FULL TEXT Complementary or unconventional treatments are used by many doctors and other therapists throughout Europe. The major forms are acupuncture, homoeopathy, manual therapy or manipulation, and phytotherapy or herbal medicine. The relative popularity of therapies differs between countries, but public demand is strong and growing. Regulation of practitioners varies widely: in most countries only registered health professionals may practice, but in the United Kingdom practice is virtually unregulated. Germany and some Scandinavian countries have intermediate systems.
	Double Standards Exist in Judging Traditional and Alternative Medicine British Medical Journal 1998 (Jun 6); 313: 1694 ~ FULL TEXT The double standards that exist in judging orthodox and alternative medicine should be challenged, and reliable tools that can validate both approaches need to be found. The call came last week in London at a conference on integrated medicine which was organised by the Prince of Wales.
	Complementary Medicine and the Doctor British Medical Journal 1999 (Sep 11); 319: 693–696 ~ FULL TEXT Doctors deal with complementary medicine in a variety of professional situations. Patients may ask for advice about whether to pursue complementary therapies or which therapist to consult; they may request referral or delegation, either privately or on the NHS; or they may want to discuss treatment or advice given by complementary practitioners. Doctors prescribing drugs to patients taking complementary treatments may have concerns about possible interactions. Doctors should therefore consider strategies for minimising risk and facilitating sensible and appropriate discussions with patients and complementary practitioners.
	Users and Practitioners of Complementary Medicine British Medical Journal 1999 (Sep 25); 319: 836–838 ~ FULL TEXT Complementary medicine seems to be becoming more popular in Britain. Media coverage, specialist publications, and numbers of complementary therapists have all increased dramatically in the past 20 years. In this chapter we analyse this phenomenon and review available evidence about the use of complementary medicine.
	Complementary Medicine in Conventional Practice British Medical Journal 1999 (Oct 2); 319: 901–904 ~ FULL TEXT The past 10 years has seen a significant increase in the amount of complementary medicine being accessed through the NHS. These services are not evenly distributed, and many different delivery mechanisms are used, some of which (such as homoeopathic hospitals) predate the inception of the NHS. Others depend on more recent NHS reorganisations, like general practice fundholding and health commission contracting, or have been set up as evaluated pilot projects.
	Acupuncture British Medical Journal 1999 (Oct 9); 319: 973–976 ~ FULL TEXT Acupuncture is the stimulation of special points on the body, usually by the insertion of fine needles. Originating in the Far East about 2000 years ago, it has made various appearances in the history of European and north American medicine. William Osler, for example, used acupuncture therapeutically in the 19th century. Acupuncture's recent popularity in the West dates from the 1970s, when President Nixon visited China.
	Herbal Medicine British Medical Journal 1999 (Oct 16); 319: 1050–1053 ~ FULL TEXT The use of plants for healing purposes predates human history and forms the origin of much modern medicine. Many conventional drugs originate from plant sources: a century ago, most of the few effective drugs were plant based. Examples include aspirin (from willow bark), digoxin (from foxglove), quinine (from cinchona bark), and morphine (from the opium poppy). The development of drugs from plants continues, with drug companies engaged in large scale pharmacological screening of herbs.
	Homoeopathy British Medical Journal 1999 (Oct 23); 319: 1115–1118 ~ FULL TEXT Homoeopaths treat disease using very low dose preparations administered according to the principle that "like should be cured with like." Practitioners select a drug that would, if given to a healthy volunteer, cause the presenting symptoms of the patient. For example, the homoeopathic remedy Allium cepa is derived from the common onion. Contact with raw onions typically causes lacrimation, stinging and irritation around the eyes and nose, and clear nasal discharge. Allium cepa might be prescribed to patients with hay fever, especially if both nose and eyes are affected.
	The Manipulative Therapies: Osteopathy and Chiropractic British Medical Journal 1999 (Oct 30); 319: 1176–1179 ~ FULL TEXT Osteopathy and chiropractic share a common origin. Their roots can be found in folk traditions of "bone setting," and both were systematised in the late 19th century in the United States: Daniel D Palmer, the founder of chiropractic, is said to have met with Andrew Taylor Still, the founder of osteopathy, before setting up his own school. The therapies remain relatively similar, and many textbooks and journals are relevant to both. The term "manipulative therapy" refers to both osteopathy and chiropractic.
	Unconventional Approaches to Nutritional Medicine British Medical Journal 1999 (Nov 27); 319: 1419–1422 ~ FULL TEXT Although nutrition, as a science, has always been part of conventional medicine, doctors are not taught, and therefore do not practise, much in the way of nutritional therapeutics. Dieticians in conventional settings tend to work mainly with particular patient groups---such as those with diabetes, obesity, digestive or swallowing problems, or cardiovascular risk factors. Apart from the treatment of gross nutritional deficiencies and rare metabolic disorders, other nutritional interventions generally fall outside the mainstream and can therefore be described as complementary medicine.
	Complementary Medicine and the Patient British Medical Journal 1999 (Dec 4); 319: 1558–1561 ~ FULL TEXT In surveys of users of complementary medicine, about 80% are satisfied with the treatment they received. Interestingly, this is not always dependent on an improvement in their presenting complaint. For example, in one UK survey of cancer patients, changes attributed to complementary medicine included being emotionally stronger, less anxious, and more hopeful about the future even if the cancer remained unchanged.
	What is Complementary Medicine? British Medical Journal 1999 (Dec 11); 319: 1558–1561 ~ FULL TEXT Complementary medicine refers to a group of therapeutic and diagnostic disciplines that exist largely outside the institutions where conventional health care is taught and provided. Complementary medicine is an increasing feature of healthcare practice, but considerable confusion remains about what exactly it is and what position the disciplines included under this term should hold in relation to conventional medicine
	Complementary Medicine and Medical Education British Medical Journal 2001 (Jan 20); 322: 121–122 ~ FULL TEXT Complementary and alternative medicine is no longer an obscure issue in medicine. Our patients are using alternative therapies in addition to conventional care (1, 2) and sometimes do not share this information with us. But even if they did would we know how best to advise them about safety issues or about the effectiveness of a particular therapy for their problem? Surveys indicate that doctors and medical students are increasingly interested in complementary and alternative therapy,3–5 yet lack of knowledge is one of the greatest barriers to its appropriate use.
	Integrative Medicine British Medical Journal 2001 (Jan 20); 322: 119–120 ~ FULL TEXT Integrated medicine (or integrative medicine as it is referred to in the United States) is practising medicine in a way that selectively incorporates elements of complementary and alternative medicine into comprehensive treatment plans alongside solidly orthodox methods of diagnosis and treatment. The concept is better recognised in the US than in the United Kingdom, but a conference in London next week, organised by the Royal College of Physicians and the US National Center for Complementary and Alternative Medicine, may help to raise its profile in the UK.
	Research into Complementary and Alternative Medicine: Problems and Potential British Medical Journal 2001 (Jan 20); 322: 161–164 ~ FULL TEXT The growing use of unsubstantiated complementary and alternative medicine therapies by people in the United States1 along with its increasing coverage by third party payers (2) encouraged Congress to create the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health. The centre's mission is "to explore complementary and alternative healing practices in the context of rigorous science; to educate and training CAM researchers; and to disseminate authoritative information to the public and professionals." (3)
	Time For a Fresh Look at Complementary Medicine British Medical Journal 2003 (Jun 14); 326: 1322 ~ FULL TEXT Lord Baldwin—who chaired the British Acupuncture Accreditation Board 1990-9, was joint chairman of the Parliamentary Group for Alternative and Complementary Medicine 1992–2002, and served on the House of Lords Science and Technology Select Committee inquiry into complementary and alternative medicine in 2000—asks that both complementary and conventional practitioners keep an open mind

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