Treatments - Alternative Treatments

By October 1998, alternative and complementary treatments of things that ail us had reached a certain maturity. At that time Congress established the National Center for Complementary and Alternative Medicine (NCCAM) as one of the National Institutes of Health (see also Chapter 3, Alternative Medicine in the Mainstream). Since then such things as art therapy, ginseng, and laying on of hands have taken on a certain respectability and are being studied in double-blind, randomized, highly rigorous clinical tests. No doubt NCCAM is the consequence of popular disaffection with conventional, western, "allophatic" medicine — the popularity of herbal remedies — and the Baby Boom's always dominant biases. But NCCAM is also, perhaps, a belated response to objective experience. Namely that many of the treatments and the natural medicines that have reached us from the Orient may actually work — and while we're at it, we might as well examine such home-grown (meaning Western) practices as chiropraxis and homeopathic medicines.

Since the National Center for Health Statistics does not (as yet) track such matters as acu- puncture and our consumption of chamomile tea — and the benefits we gain from such treatments — one way of gauging the interest in alternative and complementary medicines might be to look at the clinical trials that NCCAM funds.

NCCAM's budged in Fiscal Year 2003 was $113.2 million. We note that here because clinical trials are not cheap. The average cost in 1996 for all National Institutes of Health was $605,088. One should keep that number in mind in reading what follows — while remembering that costs of individual trials vary all over the lot.

NCCAM lists some 65 different categories of clinical tests conducted under its auspices or with other agencies — from acupressure to Yoga. Six of these categories have four or more clinical trials going on at present. They are shown in the graphic above. By far the most trials are clustered around acupuncture (17), the Chinese method of curing the body and of relieving pain by inserting needles at points in the body that correspond to a theoretical river-system of energies believed to circulate through the body.

In addition to the management of pain at various sites, acupuncture is being tested to control arthritis, cancer, cerebral palsy, depression, diarrhea in HIV patients, heart disease, and high blood pressure.

The leading categories also include such western practices as chiropractic manipulation and massage, the effects of the herb (leaf) ginkgu biloba on a variety of diseases, St. John's Wort as an antidepressant, and meditation techniques (which derive from Indian, Japanese, and western traditions) on mental and physical health.

All told, 22 categories (of the 65) have two or more trials under way. These include a variety of herbs (e.g., ginseng, echinacea), substances like shark cartilage, healing techniques like the Japanese "body energy" balancing, Reiki, the Chinese Tai-Chi, the Hindu Yoga. They include the western hypnosis as well as mind-body techniques blended from various cultural roots, minerals like selenium, and practices of naturopathic medicine. The remaining 43 categories have one trial running each. That list includes, to pick at random, garlic, distance healing, guided imagery, borage oil, and music therapy.

Do these alternative methods work? The answer must be a very qualified yes. Certainly the NCCAM is putting its money where its needles go — as regards acupuncture. Clinical trials have shown that St. John's Work works as well as patent medicines and sometimes much better than placebos. We can all attest to the benefits of a good massage — and chiropractic medicine is very much a going concern. Are there data to show the effectiveness of all of these techniques? The answer is an unqualified No. But someday large parts of alternative and complementary medicines will be just as much a part of normal medicine as are aspirin and radiation therapy.

Source: National Center for Complementary and Alternative Medicine, accessible at http://www.nccam.nih.gov/.