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Complementary & Alternative Medicine (CAM) Naveen Mehrotra, MD, MPh, FAAP Clinical Assistant Professor Department of Pediatrics RWJMS BELIEFS About CAM Providers Consider mind and body to be single entity Good health is a positive state, not merely the absence of disease
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CAM use among Asian-AmericansResults of the National Health Interview Survey for 917 Asian Americans and 20,442 Non Hispanic WhitesJ Gen Intern Med. 2007; 22(6): 762-7
conventional medicine 14%
• More personalized attention 9%
• Other reasons 5%
Category of Expenditures Dollars (Billions)
Services of Providers of CAM 11.7
Megavitamin supplements 0.8
Commercial Diet Supplements 1.2
Estimated Total 13.7
Eisenberg DM et.al. Unconventional medicine in the US. N Engl J Med. 1993; 328: 246-252
Herbal Remedies, Nutritional supplements
Herbal medicine: extracts used from flowers, fruit, leaves, roots, stems, and seeds: one of the oldest form of medicine used all over the world (Ayurveda in India, Chinese herbal medicine)
Teas: green and black tea- polyphenols in tea protect body cells from damage, the fluoride wards off dental decay, tannins have antiviral and antibacterial properties, theophylline and theobromine dilate the airways, and the caffeine acts as a stimulant
Studies suggest that 4 to 6 cups of green tea a day have a decreased incidence of cancer of lungs, liver, pancreas, esophagus, breast, and skin.
A Eurasian variety Marticaria recutita is more widely used in the US.
Used to get a better night’s sleep, antiflatulent, inhaled chamomile tea relieves bronchial congestion, a sitz bath relieves hemorrhoids, improves eczema, moistens dry skin, etc.
Comes from Tanacetum parthenium, a member of the chrysanthemum family and is found all over the United States
Used against inflammation, fever, menstrual cramps, and migraines. (Migraine attacks are preceded by the clumping of platelets which produce excess serotonin; a chemical in the name of parthenolide found in feverfew acts by interfering with the aggregation of platelets.
Ginger: used for nausea and motion sickness
Ginseng: used to increase sex drive, longevity, energy, and appetite
Purity of herbal products, the processing, the age of the product all play a role in the effectiveness of the product.
Megavitamin and Megamineral Therapy
Vitamins and minerals in large doses are used as primary therapy for certain medical conditions (based on Pauling’s orthomolecular theory of the provision of the optimum concentration of substances normally present in the human body)
Ex: use of Vit C and the common cold
A diet that promotes physical, mental, emotional, and spiritual health and harmony to live life to the full potential
Diet aims to balance foods for their yin-yang qualities of the individual
Primary goal is to eat foods in the middle range such as grains, which are neither extreme yin nor yang and thereby achieve a healthy and harmonious life
Biofeedback (use of electrical or mechanical devices to increase the awareness of the physiological activity of a muscle by providing the patient with visual, verbal, and/or auditory information)
Patient learns to recognize the physiological activity of a muscle, a response that was previously not recognized but is under the patient’s control, and he/she can learn to respond appropriately and gain control over his muscle by trial and error (e.g. functional constipation)
Hypnosis used in nocturnal enuresis
Aim to relax and relieve the body, mobilize stiff joints, improve blood, muscular, and nervous systems
Swedish types of massage:
Effleurage (slow, rhythmic, light and deep-pressure fingertip, hand, knuckle, and thumbs massage strokes- often used in conjunction with aromatherapy oils)
Friction (use fingertips, thumb pads, and the heels of the hand in small, circular pressure movements to free stiff and locked joints, improve circulation, and treat damaged or strained ligaments)
Percussion (vigorous drumming massage in which the sides of the hand deliver fast, rhythmic chops to well-padded parts of the body, such as the back, buttocks, and thighs)
Petrissage (kneading dough like movements: hands grasp, squeeze, roll, and release whole sections of muscles, used to improve circulation and to relax controlled muscles.
Manipulation of spine and extremities by the hands to stretch muscles, unlock joint, and correct problems in other parts of the body that have originated from the spine. In addition, heat, ice, or ultrasound waves may be used.
Ancient Chinese form (life force called “qi” dominates every living being)
Yin and yang must be in balance or harmony before qi can get our vital functions to work normally
Qi flows along fourteen invisible, interconnected main channels on each side of the body.
These meridians surface at various locations on the body, called acupuncture points (about 360 have been identified)
Imbalance between the yin and yang and the five elements of the universe (wood, fire, earth, water, and metal) cause lactic acid and carbon monoxide to build up in the muscles
Stimulating the appropriate acupoints dissipates the buildup and restores the yin and yang
Western scientists have shown that stimulating an acupoint releases endorphins which reduces the perception of pain
Based on the theory that a substance that produces symptoms in a healthy individual could cure symptoms in a sick person
Substance is diluted into infinitessimal amounts (expressed as C1, C2, etc) and given to the patient as treatment
Homeopathic doctor studies the whole person and takes into account the idiosyncrasies, reactions to heat and cold, weather, and food, sleep and work patterns, age and environment, before he prescribes any medication