Complementary and Alternative Medicine Second edition pptx

Complementary and Alternative Medicine Complementary and Alternative Medicine Second edition Edited by Steven B Kayne PhD, MBA, LLM, MSc(SpMed), DAgVetPharm, FRPharmS, FCPP, FIPharmM, FFHom, MPS(NZ), FNZCP Honorary Consultant Pharmacist, Glasgow Homeopathic Hospital, UK Honorary Lecturer, University of Strathclyde School of Pharmacy, UK London и Chicago Published by the Pharmaceutical Press An imprint of RPS Publishing Lambeth High Street, London SE1 7JN, UK 100 South Atkinson Road, Suite 200, Grayslake, IL 60030-7820, USA © Pharmaceutical Press 2009 is a trade mark of RPS Publishing RPS Publishing is the publishing organisation of the Royal Pharmaceutical Society of Great Britain First edition published in 2001 Second edition published in 2009 Typeset by J&L Composition, Filey, North Yorkshire Printed in Great Britain by TJ International, Padstow, Cornwall ISBN 978 85369 763 All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission of the copyright holder The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made The right of Steven B Kayne to be identified as the editor of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act, 1988 A catalogue record for this book is available from the British Library Contents Preface vii About the editor ix Contributors x Abbreviations xii Part Introduction to complementary and alternative medicine Introduction to the complementary concept of healthcare Integrative medicine – incorporating complementary and alternative medicine into practice 23 Delivering complementary and alternative medicine 43 Complementary and alternative medicine in the USA 93 The evidence base for complementary and alternative medicine 121 Pharmacovigilance of complementary medicines 145 Part Therapies involving use of medicines Homeopathy and anthroposophy 187 Medical herbalism 269 Aromatherapy 341 Flower remedy therapy 383 185 10 393 11 12 13 Part Traditional medicine The traditional healthcare environment 395 Traditional Chinese medicine 415 Indian ayurvedic medicine 449 Part Other therapies and diagnostic techniques Naturopathy and its associated therapies 475 473 14 v vi 15 16 17 Contents Diagnostic therapies 511 Manual therapies 517 Mind and body therapies 561 Index 597 Preface Much has happened since the first edition of this book appeared in 2002 Despite the continuing paucity of robust scientific evidence to support most of its constituent therapies, complementary and alternative medicine (CAM) remains popular with clients who appreciate the holistic approach and have a belief in its effectiveness Some elements of CAM such as aromatherapy and herbalism have acquired a more dedicated following, whereas others including homeopathy have been subjected to a campaign of scepticism in the UK in recent years, resulting in a reduction in the services available under the country’s National Health Service Interest in traditional medicine, in particular Chinese and Indian medicine has increased both by the arrival of immigrants, making it important for health providers to have some knowledge of the principles and treatments involved, and by host communities, resulting in the opening of Chinese herbal medicine shops on the high streets of British cities Among healthcare providers there is an increasing realisation that CAM is here to stay and must at least be acknowledged as a credible option in appropriate circumstances The concept of integrative medicine is gaining ground As statutory control of practitioners in many CAM therapies and licensing of medicines becomes established full recognition must surely follow This second edition has been reorganised and expanded with three important new chapters covering integrative medicine, pharmacovigilance and the marketing of CAM products in the USA I am grateful to three highly experienced colleagues from New Zealand and the USA for agreeing to contribute to these chapters, thus strengthening the content The book also provides an introduction to a much wider range of CAM therapies It is divided into four parts: The first part serves as an introduction and deals with the concepts that underpin CAM practice The second part looks at therapies that generally, but not exclusively, involve the use of medicines after a consultation or through self-treatment vii viii Preface The third part gives information on traditional medicine The fourth part covers a range of other therapies and diagnostic procedures An abbreviated FASTtrack version of this book, covering the major topics and providing self-assessment exercises, was also published by the Pharmaceutical Press in 2008 It has been designed as a resource to assist students preparing for examinations Steven B Kayne Glasgow, August 2008 steven.kayne@nhs.net About the editor Dr Steven B Kayne practised as a Community Pharmacist in Glasgow for more than 30 years before retiring from active practice in 1999 He is currently Honorary Consultant Pharmacist at Glasgow Homeopathic Hospital and Honorary Lecturer in CAM at the University of Strathclyde School of Pharmacy Steven was a member of the UK Advisory Board on the Registration of Homeopathic Products from its formation in 1994 until he retired in 2008, and currently serves on two other UK Government Expert Advisory Bodies: the Herbal Medicines Advisory Committee and the Veterinary Products Committee He has also acted as an adviser to the WHO Collaborating Centre for Traditional Medicine and chaired the European Committee on Homeopathy Pharmacy subcommittee Steven’s current interests are in patient communication and the application of CAM in sports care and veterinary medicine He has written numerous papers and journal articles and has presented as an invited speaker at conferences around the world on a variety of topics associated with complementary and alternative medicine Steven is a member of the editorial advisory board of several journals and has authored, edited and contributed chapters to many books ix Index 605 spiritual healing 588 traditional medicine 403 Chinese 424–425, 441–442 yoga 568–570 evidence base for CAM 121 types of outcome measures 123 evidence-based medicine (EBM) 7, 28, 126–128 and CAM 128 evidence sources 133 clinical audit 134–135 literature searches 136–138 observational studies 135–136 randomised clinical trials 133–134 examination nerves, homeopathic medicines 223, 247 exercise, value of massage 535–538 extraction processes essential oils 348–349 herbalism 282–283 homeopathic medicines 200 eye problems, ayurvedic treatments 469 eyebright (Euphrasia) 295, 328 eyedrops, homeopathic 207 fabricated oils 352 factsheets, availability from RPSGB 74 faculty sensory appreciation, Alexander technique 518 faith healing, in veterinary medicine 85 farming practices, anthroposophy 257 fatty acids essential 492, 493–497 saturated and unsaturated 492–493 fear, homeopathic remedies 247, 249 feedback loop, in development of homeopathic drugs 113 ‘feel good factor’, herbalism 269 Feldenkreis method 520–521 feng shui 420 Ferrum phos 243, 255 feverfew (Tancetum parthenium) 319–320 toxic constituents 150, 308 fibrositis, massage therapy 537 financial issues in choice of CAM 54–57 fire, ayurveda 452 ‘fire-fighting’ approach, herbalism 273 first aid, homeopathic remedies 248, 252 five elements, ayurveda 451–452 five elements (phases), traditional Chinese medicine 418–419 five substances, traditional Chinese medicine 419–421 five tastes, Chinese herbal medicine 434 five-flower remedy (Rescue Remedy) 388, 391 flatulence, herbal medicines 328 flavonoids 279 flower remedies 383–384 evidence 390–391 history 384–386 practice 387–389 preparation 387 theory 386–387 flower therapy 575 follow-up, homeopathic treatment 226, 227 foot baths 484 Formica 258 formula development, homeopathic drugs 111 formula selection, homeopathic drugs 112 Foundation for Integrated Medicine 83–84 four energies, Chinese herbal medicine 434 ‘four gentlemen decoction’, Chinese herbal medicine 436–437 fragrancing 353–354 Framingham study 492 French Homeopathic Pharmacopoeia 197 friction, massage 531 frozen shoulder, use of Bowen technique 521–522 fruit, nutritional value 489–490 fu zi 439 fucus 306, 308 functional techniques, osteopathy 541 funding problems, CAM research 128–129 gamma-linolenic acid 493, 495 gap analysis, homeopathic drugs 110–111 gardening, therapeutic effect 167 606 Index garlic (Allium sativum) 306, 320 gastric fire (agni), ayurveda 441, 455 gastrointestinal problems, homeopathic remedies 245–246 Gattefossé, René-Maurice 342–343, 368 Gelsemium 211, 223, 243, 245, 247, 249 gemstones, use in ayurveda 461 gender differences in attitudes to CAM 71 in utilization of CAM 60, 99–100, 229 General Osteopathic Council 544–545 generating cycle 418 gentian (Gentiana amarella) 384 geranium oil 375 German Pharmacopoeia 197 Germany, homeopathic practitioners 215–216 ginger (Zingiberis officinalis) 306, 320–321 ginger oil 375 Ginkgo biloba 289, 302, 310, 321–322, 327, 410, 411 adverse reactions 161 interactions 35, 305 ginkgolic acids, variability 150 ginseng 294, 304, 308, 308, 322, 327 Glasgow Homeopathic Hospital Outcome Scale 123 glycosides 279–280 good practice guidelines, CAM disciplines 77 GPs, attitudes to CAM 70–4 GRADE Working group, definition of quality of evidence 124 graduated baths 485 grains, nutritional value 489 granule form, homeopathic medicines 205, 206 grapefruit juice, interactions 35 Graphites 248 green issues, role in choice of CAM 57 grief, homeopathic remedies 247 growing conditions, effect on essential oils 351 guras, ayurveda 453–454 haemorrhoids, herbal medicines 328 Hahnemann, Samuel 188–190, 192–193 Hahnemannian method of potentisation 202–203 Hamamelis (Hamamelis virginiana) 243 hatha yoga 568 Hawaii, prevalence of CAM use 63–64 hawthorn (Crataegus species) 198, 200, 306, 323 hay fever, placebo study in homeopathy 234 head massage, Indian 460 headaches, homeopathic remedies 247 healing 10 holistic approach 12–16 self-healing 10–12, 235, 524 healing crisis, naturopathy 477 healing (therapeutic) touch 565–566 health social determinants 13–14 WHO definition 13, 33 health behaviour factors, role in CAM use 100–103 Health Belief Model (HBM) 102 healthcare, new approach 48–50 healthcare providers, understanding of traditional medicine 403–404 healthcare systems integrative medicine 32–33, 80–84 patients’ requirements 43–44 heartburn herbal medicines 328 homeopathic remedies 250 heat effects, homeopathic treatment 252 heating compresses 482 heavy metals, use in ayurveda 463–464 Heilpraktikers 78 Helicobacter pylori 36 Hepar sulph 248 herb bennet (Geum urbanum) 293 herbal alchemy (spagyric medicine) 315 herbal medicines active constituents 276–280 adverse event reporting 164 improvements in pharmacovigilance 176–177 Index 607 prescription event monitoring 171–172 antipodean 295 ayurvedic 458–459 composition 149–150 contaminants 34, 307–309 counselling patients 296–299 evidence 299–302 market value 60 over-the-counter products 289–95 preparation and presentation 280–283 regulation in Australia 153–154 in Canada 156–157 in European Union 152–153 in New Zealand 154–155 in United Kingdom 151–152 repertory conditions 327–330 materia medica 316–327 safety 157–158, 302–312 standardization 36, 310 supply 283–284 therapeutic groups 276 toxic constituents 150–151 traditional use 397 utilisation 147, 148–149 herbal poisoning, treatment 312–313 herbal sources of drugs 274–275 herbal teas 281 herbalism 269–270 applications 285–286 association with pharmacy 73, 287–288 differences from orthodox medicine 275 future direction 314–315 history 270–271 perceived effectiveness 53 practitioners 284 reference sources 274 regulations 283–284 theory 273–274 see also Chinese herbal medicine; herbal medicines herbaria, Royal Pharmaceutical Society 313–314 Hering’s law, homeopathy 194 hierarchy of resort 80 highly unsaturated fatty acids (HUFAs) 495 hip baths 483 Hippocrates 10–11, 51 HIV susceptibility 11 see also AIDS patients holistic approach 50 in CAM practice 13–17, 103 definition 12–13 homeopathy 193–194 HomBRex database 240 homeopathic medicine types 210–214 homeopathic medicines 35, 107, 114 containers 207 counter prescribing 222–226 dispensing 219–220 dose regimens 225–226 interaction with essential oils 372 market size 226–228 methods of administration 216–217 nomenclature 195–197 over-the-counter preparations, development and marketing 110–113 precautions in taking the medicine 220 preparation 201 dose forms 205–207 extraction procedure 200 potentisation 200–205 regulation 208–210 in New Zealand 156–157 in USA 108, 110 repertory 244–252 requests for supply 218 source materials 198–200 supply 217 homeopathic pharmacopoeias 197 British Homeopathic Pharmacopoeia 197 French Homeopathic Pharmacopoeia 197 German Homeopathic Pharmacopoeia 197 Homeopathic Pharmacopeia of the United States (HPUS) 106, 197 homeopathic practitioners 214–216 608 Index homeopathy attitude of pharmacists 73 availability in UK healthcare system 80–81 cost minimisation 56–57 definition 187 evidence 230–232 attitude and awareness studies 242 audit 240–241 case studies 241–242 perception of benefit studies 241 placebo studies 234–235 randomised clinical trials 235–238 studies on mechanism of action 238–240 follow-up 226, 227 funding withdrawal 81 history 187–190 limitations 78 market value 60 materia medica 242–244 perceived effectiveness 53 postgraduate training 76 reasons for patient choice 45, 52 regulation in USA 106–107 safety 220–222 theory 191–95 use by role models 58 user characteristics 228–230 veterinary use 253–254 homocysteine, as risk factor for cardiovascular disease 36 homotoxicology 255 honey nutritional value 490 as wound dressing 503 see also apitherapy hops (Humulus lupulus) 293, 306, 329 horehound (Marubium vulgare) 328, 330 horse chestnut 308, 328 horseradish 306 horsetail (Equisetum arvense) 293 hospital pharmacies, provision of CAM products 75 ‘hot’ medicines 277 hot water therapy 482, 483, 484, 485 House of Lords, classification of CAM 17–18 House of Lords Report 121–122 huang lian (Coptis chinensis) 441 humour therapy 576–579 hydrotherapy 477, 481 baths 482–486 compresses 482 enemas 481–482 hygiene, relationship to allergic diseases 11–12 Hypercal 248, 249 Hypericum 211, 248, 252 hyperlipidaemia, herbal medicines 329 hypertension, aromatherapy 367 hypnosis, perceived effectiveness 53 hypnotherapy 579–580 hypothesis tests 129 identification, herbal plants 309 Ignatia 211, 243, 247 immersion baths 485 impatiens (Impatiens glandulifera) 385 imponderables, homeopathy 199–200 indigestion herbal medicines 328 homeopathic remedies 246, 252 individualized care 28–30 infant massage 533, 539 infants, osteopathy 542 influenza aromatherapy 361 CAM therapies 66 effect of probiotics 501 herbal medicines 329 homeopathic remedies 245 information gathering from patients 14–15 provision to patients 44 information sources 137 infusions 280–281 inhalation of essential oils 355–356, 358 inhibition, Alexander technique 519 insect bites aromatherapy 361 homeopathic remedies 248, 252 insect material, use in homeopathy 198 insect stings, homeopathic remedies 249 insomnia aromatherapy 367 Index 609 herbal medicines 329 homeopathic remedies 250, 252 insurance reimbursement 113, 115 for allopathic drugs 109 for chiropractic 526 impact on CAM use 104 for iridology 513 for probiotics 500 integrated healthcare 398–399 Integrated healthcare – a way forward for the next five years? 82–83 integrative medicine (IM) 23, 35–37, 80–84 complementary versus alternative therapies 27–28 definitions 23–25 history-taking 26 individualized care 28–30 integration into healthcare systems 32–33 natural products, context of use 30–31 practice models 25–26 practitioners 31 risks to the patient 33–35 intent-to-treat principle 126 interactions 26, 34, 138, 148 with ayurvedic medicines 464–465 with essential oils 371–372 with herbal medicines 299, 304, 304–305, 306 St John’s wort 326 with homeopathic medicines 222 intercessory prayer 588–589 internal locus of control, association with CAM use 100–101 Ipecacuanha 211, 243, 246 iridology 477, 511–513 irritable bowel syndrome aromatherapy 361 Chinese herbal treatment 28 placebo effect 15–16 Iscador 257 isodes 213 isopathic medicines 210–212 use as vaccines 212–213 Japan, definition of CAM jet lag ayurvedic treatments 469 homeopathic treatment 252 jing (essence) 420–421 joints, massage 532 juniper (Juniper communis) 294 juniper oil 361 Kali mur 255 Kali phos 255 Kali sulph 255 Kampo Kan Jang, use in influenza 66 kapha dosha 452, 453, 454, 457 karela (Momordica charantia) 465 kava-kava (Piper methysticum) 323–324, 327 contaminants 34 hepatotoxic reactions 151, 152, 175 UK regulatory response 165–166 interaction with benzodiazepines 305 keynotes, polychrests 225 Keys, Ancel 492 khat (Catha edulis) 462–463 kinesiology 513–515 knitbone (Symphytum officinale) 291 Korsakovian method of potentisation 203–204 labelling ayurvedic medicines 464 herbal medicines 311 homeopathic medicines 209, 219 Lac can 212 Lachesis 212 Lactobacillus species 501 laughter 577, 578–579 lavender (Lavendula angustifolia), use during pregnancy 297 lavender oil 350, 361, 363, 364, 367, 368, 375 use during pregnancy 373 law of minimum action, homeopathy 195 laws of cure, homeopathy 194–195 lay practitioners 79 lead, use in ayurveda 463 Ledum 248, 252 leg ulcers, magnetic therapy 581 lemon balm (Melissa officinalis) 327 use in aromatherapy 364 610 Index lemon oil 372, 375 Lewisham Hospital NHS Trust, complementary referral guidelines 54 licensing of practitioners 32 see also regulation of CAM; training of practitioners licensing of products 146 in United Kingdom 151–152 liferoot (Senecio aureus) 150 light box therapy 575 like cures like principle, homeopathy 188–189, 192 limitations of CAM 78 Ling, Per Henrik 530 linoleic acid 493, 495 liquid extracts, herbalism 282 liquorice (Glycyrrhiza species) 328 adverse effects 305, 306, 308 literature review, in homeopathic drug development 111 literature searches 136–138 LM method of potentisation 204 LOAD acronym 223–224 locus of control theory 100–101 macerates 282 Mag phos 255 magnetic therapy 580–581 malas (waste products), ayurveda 451, 455 manipulation chiropractic 525 osteopathy 542 manual therapies 97 Alexander technique 517–520 Bowen technique 521–522 Feldenkreis method 520–521 rolfing 549–550 in veterinary medicine 84 see also chiropractic; massage; osteopathy; reflexology manual therapy, comparison with osteopathy 543 marigold (Calendula officinalis) 291 marjoram (Origanum vulgare) 293 marjoram oil 361 market values for CAM 60 marketing authorisation (MA) 146 martial art therapy 443 massage 529–531 in aromatherapy 354–355, 356, 361, 363, 364, 366 in ayurveda 460 Chinese 436 evidence 533–538 sports massage and muscle fatigue 535–538 rhythmical massage therapy (RMT) 538–539 safety 539 therapeutic uses 532–533 materia medica herbalism 274 homeopathy 242–244 Materia Medica, William Cullen 188, 189 Maury, Margaret 343 means whereby, Alexander technique 518 mechanism of action, homeopathic medicines 238–240 media coverage of CAM 57 medical education, inclusion of CAM therapy 69–70, 73 medical homeopathy 215 medicinal plant trade 405–406, 409–410 meditation 581–583 in ayurveda 461 Medsafe, New Zealand 155 ‘memory of water’ concept 239 menopausal symptoms aromatherapy 363 herbal medicines 330 menstrual problems, herbal medicines 330 menthol 367 Merc sol 249 meridians, traditional Chinese medicine 423 acupuncture 427–428 herbal medicine 434 Mesmer 579 metal poisoning, chelation therapy 480–481 metals, use in ayurveda 460, 463–464 Metchnikoff, Elie 498 midwifery provision of CAM 83–84 Index 611 use of aromatherapy 365–366 use of reflexology 548 migraine, aromatherapy 361 migraine prophylaxis, homeopathic RCT 236 milk, nutritional value 490 milk thistle (Silybum marianus) 289, 324 mimulus (Mimulus gluttatus) 385 mind–body medicine 96 mineral baths (balneotherapy) 486–488 mineral supplements, value of complex mixtures 30 minimal acupuncture 429–430 minimal dose principle, homeopathy 193 mint oil 361 mistletoe 308 Mitchell relaxation technique 567 mobilisation of circulation, herbalism 273 monounsaturated fats 493 morning sickness herbal medicines 330 homeopathic remedies 223, 246, 250 Moschus 212 mother tinctures, homeopathy 200, 207 motion sickness elasticated travel bands 432 herbal medicines 328 homeopathic remedies 252 mouth ulcers, homeopathic remedies 249 movement of herbs, Chinese herbal medicine 434 moxa 427 moxibustion 432 Mozart listening, beneficial effects 585 MRSA (meticillin-resistant Staphylococcus aureus) infection, value of honey 483 mullein (Verbascum) 328 Multibionta 500 muscle fatigue homeopathic treatment 251 massage therapy 537–538 muscle testing, kinesiology 514–515 musculoskeletal conditions, use of CAM 66–7 aromatherapy 361 homeopathic remedies 251 music therapy 583–586 Musk, use in homeopathy 198 mycotoxin contamination, herbal products 309 myrrh 295, 306 National Center for Complementary and Alternative Medicine (NCCAM) 93, 94, 129 classification of CAM 18 domains of CAM 96–97 National Health Service (NHS), availability of CAM 80–84 homeopathic hospitals 215 national healthcare systems, integration of traditional medicine 398–399 National Institute of Health (NIH), funding of CAM research 93–96 National Institute of Medical Herbalists 284–285 ADR reporting 170 Natrum mur 211, 247, 255 natural health products (NHPs), Canadian regulations 156–157 context of use 30–31, 36 nature imagery, beneficial effects 572–573 naturopathy 475 accreditation 32 chelation therapy 480–481 detoxification therapy 479–480 evidence 478 history 475–476 iridology 511–513 nutritional therapy 488–491 practice 477–478 qualifications 32, 479 theory 476–477 see also balneotherapy; hydrotherapy; nutraceuticals nauli 460 nausea aromatherapy 361 herbal medicines 328 homeopathic remedies 246 see also morning sickness 612 Index needling procedure, acupuncture 429 negative outcomes, herbal medicines 301–302 nerves, massage 532 nettle (Urtica species) 192, 248, 249, 252, 293–294, 328 neutral water therapy 482, 483, 485 New Zealand, regulation of herbal medicines 154–155 non-medically qualified practitioners (NMQPs) 77–79 North American essences, flower remedy therapy 386 nosodes 199, 211–212, 217 legal classification 208 names 196 use as vaccines 213 veterinary use 253 Nottingham Health Profile (NHP) 56 nourishment and repair stage, herbalism 273 nurses, attitudes to CAM 76–77 nutraceuticals 491 apitherapy 502–504 essential fatty acids 492–497 probiotics 497–501 nutritional supplements contaminants 34 value of complex mixtures 30 nutritional therapy 488–491 in ayurvedic medicine 456–457 in traditional Chinese medicine 442–443 nuts, nutritional value 489 Nux vomica 198, 211, 243, 245, 246, 252 objectivism observational studies 28, 29, 125, 135–136 ‘off-label’ use, veterinary homeopathy 254 Office of Alternative Medicine , USA 129 oils, nutritional value 490 olfactory remediation 354 olfactory stimulation, aromatherapy 343–344 omega-3 oils 492 benefits in cystic fibrosis 496 see also essential fatty acids (EFAs) omega-6:omega-3 fatty acid ratio 494 opium poppy (Papaver somniferum) 271 oral administration, essential oils 357, 358, 369 orange oil 361 Organon of the Rational Art of Healing, Samuel Hahnemann 189 organs, traditional Chinese medicine 421–422 orthodox drugs, decreased efficacy with time 53 orthodox medicine (OM), disenchantment with 47, 48–51 Oscillococcinum, use in influenza 66 Osteopaths Act (1993) 544 osteopathy 539–540 comparison with other manual therapies 542–545 evidence 543–544 history 540 perceived effectiveness 53 practice 541–542 regulation 544–545 safety 544 theory 540–541 training 545 outcome measures 123, 131 over-the-counter (OTC) products 16, 147, 148 homeopathic drugs 229–30 development and marketing 110–113 Overall Progress Interactive Chart 123 ozone depletion 406–407 pain control aromatherapy 363–364, 365 Bach flower remedies 390 humour 578 reiki 564–565 transcendental meditation 582 palliative care, value of yoga 569 Palmer, Daniel David 523 pancha karma 456 Panex quinquefolium extract, use in influenza 66 Index 613 Papworth relaxation technique 567–568 Paracelsus 271, 315 Parkinson’s disease, effect of Alexander technique 520 PARTS acronym, chiropractic 524 Passiflora 252 patchouli oil 375 patent acquisition, homeopathic drugs 111 patent medicines, Chinese 436–437 patenting of herbal products 405 patient counselling about essential oils 374 about herbal products 296–299 about homeopathic medicines 219–220 patient-led consultations 51 patient–practitioner relationships 43–44 patients characteristics of CAM users, USA 62–63 definition as integrators of therapies 31–32 reasons for choosing CAM 44–46 belief in value of CAM 51–54 culture 58 disenchantment with OM 48–50 dissatisfaction with OM consultation 50–51 financial reasons 54–57 ‘green’ association 57 media coverage 57 role models 58 safety concerns 46–48 reasons for not selecting CAM 58 Patients’ Charter 48 PC-SPES, contaminants 34 pennyroyal 373, 440 pentacyclic triterpenoid saponins 278 peppermint (Mentha piperita) 279, 295 adverse reactions 161 peppermint oil 368, 375 perception of benefit studies, homeopathy 241 perceptions of CAM 9–10 personality traits 15, 61 association with CAM use 103 pétrissage 531 Petroleum 252 pharmacists ADR reporting 167–169 attitudes to CAM 74–76 pharmacopoeias, herbalism 274, 301 pharmacovigilance 145–146 case-control and cohort studies 172–173 Chinese herbal medicine 441 communication of safety information 172–175 future initiatives 175–177 prescription event monitoring 171–172 randomised clinical trials 173 regulations in Australia 153–154 in Canada 156–157 in European Union 152–153 in New Zealand 154–155 in united Kingdom 151–152 in USA 155–156 spontaneous reporting schemes 159–166 by complementary medicine practitioners 169–171 by pharmacists 167–169 strengths and weaknesses 166–167 pharmacy record-linkage 176–177 pheromones 345 philosophy, use of the term Phosphorus 246 phototoxicity, essential oils 370–371, 373 physical therapy in naturopathy 478 see also massage physiotherapy, comparison with osteopathy 543 Phytonet 170–171 phytotherapy 270 PICO questions 136 pitta dosha 452, 453, 454, 457 Pittilo Report 284, 439 placebo effect 7–8, 15–16, 232, 233–234 practitioner bias 133 614 Index placebo studies homeopathy 234–235 massage 537 problems in CAM 129–130 placebos, definition 233 plant material, use in homeopathic medicines 198 plant maturity, effect on essential oils 351 pluralist prescribing, homeopathy 217 Podophyllum 246 polychrests 210, 211, 229–30 keynotes 225 polysaccharides 280 polyunsaturated fats 493 positivism post-exercise massage 536, 538 postoperative pain control, aromatherapy 363 postoperative rehabilitation, value of osteopathy 544 potency, homeopathic medicines 218 potentisation, homeopathy 193, 200–202 effects 204–205 Hahnemannian method 202–203 Korsakovian method 203–204 LM method 204 powdered drugs, use in herbalism 290 powerful others health locus of control (PHLC) 101 practitioner bias 133 practitioner–patient interaction, effect on placebo response 234 pragmatic clinical studies 28, 29 prakriti, ayurveda 453, 454 prayer 587–590 pre-exercise massage 535–536 pregnancy aromatherapy 373–374 homeopathic remedies 250 use of complementary medicines 147–148 use of herbal products 296–297 Chinese 440–441 see also midwifery; morning sickness premature amnion rupture, RCT of Caulophyllum D4 236–237 premature ejaculation, value of yoga 570 premenstrual syndrome herbal medicines 330 homeopathic remedies 250 massage therapy 534 reflexology 548 prescription event monitoring (PEM) 171–173, 177 prescriptions, for homeopathic medicines 218 prevalence of utilization in Australia 64 in Canada 63 prevention of disease 45 primary care groups (PCGs), availability of CAM 83 Prince of Wales’ Initiative on Integrated Medicine 83 principle of similars, homeopathy 106 probiotics 497 definition 498–499 evidence 500–502 history 497–498 practice 499–500 safety 502 types 499 propolis 277, 503–504 prostate cancer, use of CAM therapies 48 ‘proving’, homeopathy 111, 189, 195 psychosocial drivers to CAM use 100–104 publishing bias 132–133 Pulsatilla 211, 229, 243, 250 pulse reading, traditional Chinese medicine 424 pyridoxine (vitamin B6), high-dose 34 qi (chee, chi) 419–420, 422, 429 qianbai biyan pian 150 qigong 443–444 quality of evidence definition 124 influencing factors 124–126 quality problems, Chinese herbal medicines 439–440 quenching, aromatherapy 350 racial differences in CAM utilization 63 radionics 587 Index 615 rainforest destruction 404–405 rajas, ayurveda 454 randomised clinical trials 7, 28, 128, 133–134, 173 in acupuncture 430 in aromatherapy 362, 364, 365, 366 in ayurvedic medicine 465–466 in chiropractic 525–526 homeopathic 235, 235–238 in influenza prevention and treatment 66 in massage therapy 537–538 quality of evidence 125–126 in reflexology 548 relevance to everyday practice 29, 32–33 in spiritual healing 588 raspberry leaf products, use during pregnancy 297 Reckeweg, Hans-Heinrich 255 rectal administration, essential oils 357 rectal irrigation 481–482 reductionism reflexology 545 evidence 547–548 history 546–547 safety 549 theory and practice 547 reflexology map 546 Register of Chinese Herbal Medicine (RCHM), ADR reporting 170 regulation of CAM 36, 67–68, 78 in Australia 153–154 ayurvedic medicine 466 in Canada 156–157 Chinese herbal medicine 437–438, 439 chiropractic 528 in European Union 152–153 herbalism 284–284 homeopathic medicines 208–210 House of Lords Report 122 naturopathy 479 in New Zealand 154–155 osteopathy 544–545 pharmacovigilance 146 traditional medicine 399, 400–401 in United Kingdom 151–152 in USA 105 homeopathy 106–113 products 105–106, 155–156 veterinary homeopathy 253–254 reiki 563–565 relaxation techniques 566–568 remedium cardinale, herbal teas 281 renal disease, value of yoga 569 repertories herbalism 274 conditions 327–330 materia medica 316–327 homeopathic medicines 224–225, 244–252 rescue remedy (five-flower remedy) 388, 391 research into CAM criticisms 130–133 problems 128–130 see also evidence; randomised clinical trials resins 274 responsibility for health 48, 49 revulsive hip baths 483 rheumatological patients, use of CAM 53–54 herbal medicines 329 homeopathic medicines 225 rhubarb (Rheum palmatum) 312, 328 Rhus tox 211, 225, 229, 243, 251 RCTs 235 rhythmical massage therapy (RMT) 538–539 risk–benefit ratio, role in choice of CAM 46–48 risks of CAM use 138–139 see also adverse effects; safety rock rose (Helianthemum nummularium) 385 role models, use of CAM 58 rolfing 549–550 rosemary oil 361, 367, 375 royal jelly 504 Royal Pharmaceutical Society of Great Britain (RPSGB) attitude to CAM 74–76 herbaria 313–314 rubifacients 535 Ruta 211, 243, 251 safety of CAM 35, 138–139 of acupuncture 431 616 Index of aromatherapy 369–370 potential toxic effects 370–371 of ayurvedic medicine 462–465 of Chinese herbal medicine (CHM) 439–441 of chiropractic manipulation 527–528 of detoxification therapy 480 of herbal medicines, lack of information 157–158 of homeopathy aggravations 221–222 inappropriate treatment 220 interactions 222 toxicity 220–221 of hypnotherapy 580 of massage 539 of osteopathy 544 of probiotics 502 of reflexology 549 of traditional medicine 402–403 safety concerns, role in choice of CAM 46–48 sage (Salvia officinalis) 294, 306 St John’s wort (Hypericum perforatum) 283, 300, 305, 306, 324–325, 327 adverse reactions 161, 162, 175 communication of information 174–175 interactions 34, 151–152, 305, 306, 326 variability of preparations 150 salvia oil 368 Sambucus nigra, use in influenza 66 samkhya philosophy 451 san jiao 422 sandalwood oil 361, 366, 368, 375 saponins 277–278 sarcodes 199, 212, 213 sassafras 369 saturated fatty acids 492–493 satvas, ayurveda 454 savory (Satureja species) 294 saw palmetto (Sabal serrulata) 308, 326, 328 schizophrenia, yoga therapy 569 Schüssler, Wilhelm Heinrich 254 science of healing 6–8 scleranthus (Scleranthus annuus) 385 screening programmes 45 sedative oils 360 sedatives, herbal medicines 327 seeds, nutritional value 489 self-healing response 10–12, 235, 524 self study materials 57 self-treatment 16, 57, 80 homeopathic medicines 229–30 Senecio species, senecionine 150 senna 328 adverse reaction 161, 306 sensitising components, essential oils 371 Sepia 211, 250 sequential muscle relaxation 566–567 Set Aside scheme 408 shamans 400 shen 421 sickle cell anaemia, dance project 562 Silica 248, 255 Silicea comp 258 silver birch (Betula pendula) 294 single medicine principle, homeopathy 193 sinusitis, anthroposophical treatment 258 skin, structure 346 skin conditions aromatherapy 361, 369 ayurvedic treatments 469 herbal medicines 329 homeopathic remedies 248–249, 252 use of honey 503 skin occlusion, effect on essential oil absorption 347 skullcap (Scutellaria baicalensis) 327 sleep induction, value of massage 533 Smilax myosotiflora products, adulteration 309 Smuts, Jan Christian 12 social considerations 16 social determinants of health 13–14 sociodemographic drivers to CAM use 99–100 sore throat aromatherapy 361 ayurvedic treatments 469 herbal medicines 329 Index 617 homeopathic remedies 252 spa treatment (balneotherapy) 486–488 Spagynk therapy 74 spagyric medicine 315 speedwell (Veronical officinalis) 294 spinal baths 483–484 spinal manipulation therapy (SMT) differentiation from chiropractic 525 evidence 526, 527 spiritual healing 587–589 Spongia 246 sports massage 531, 535–538 sportspeople homeopathic remedies 251 use of herbal products 299 squill 308 standardisation of herbal medicines 150, 310 problems in clinical trials 130 steam baths 484–485 Steiner, Rudolph 256 steroidal saponins 278 steroids, possible interaction with homeopathic medicines 222 Still, Andrew Taylor 539, 540 stimulant oils 360 storage, essential oils 352, 353 Streptococcus thermophilus 498 stress herbal medicines 327 spa treatment 487 value of yoga 570 stroke, prevention and treatment 67 study design, effect on quality of evidence 124 subjective outcome measures 131 succussion, homeopathy 202, 204–205 Sulphur 247 surgery in ayurvedic practice 462, 465 in naturopathy 478 placebo effects 233 Sushruta 450, 462 Swedish massage 530, 531 synergistic effects in aromatherapy 349–350 in herbalism 275 systematic reviews of research 124 systems approach to treatment 51 Tabacum 246, 252 tablets, homeopathic medicines 205–206 tai ji quan (tai c’hi) 444 tai ji symbol 417 tamas, ayurveda 454 Tamus 248 Tan Tock Seng Hospital, art of healing programme 571–572 tangerine oil 361 tannins 278 tapotement 531 tastes, ayurveda 456–457 tautodes 199, 212 taxol production, effect on yew tree populations 406 tea tree oil (Melaleuca) 295, 357, 361, 368–369, 370, 375, 400 temperature, effect on essential oil absorption 346–347 tennis elbow, homeopathic treatment 251 thalidomide 47, 145 therapeutic clowns 578 Therapeutic Goods Regulations, Australia 153–154 therapeutic groups, herbal medicines 276 therapeutic touch 565–566 Thomson, Samuel 272 throat massage 533 Thuja 249 thyme (Thymus species) 295, 328 essential oils 350, 368 Tibet, traditional medicine 444 tinctures, herbalism 282, 283 tissue salts 254–255 tonification, ayurveda 458 topical preparations essential oils 356–357, 358 skin irritation 370 herbal medicines 291–295 adulteration 308–309 homeopathy 207 tormentil root (Potentilla) 295 618 Index touch therapies reiki 563–565 therapeutic touch 565–566 toxicity of herbal medicines 303–309 ayurvedic 462–464 Chinese 150–151, 439 treatment of herbal poisoning 312–313 traditional Chinese medicine (TCM) 27, 415 Chinese massage 442 dietary therapy 442–443 evidence 424–425 history 415–416 martial art therapy 443 modernisation 425 practice 423–424 qigong 443–444 tai ji quan (tai c’hi) 444 theory 416 five elements (phases) 418–419 five substances 419–421 meridians 423 organs 421–422 yin and yang 416–417 toxic constituents 150, 151 see also acupuncture; Chinese herbal medicine Traditional Herbal Medicines Registration Scheme (THMRS) 438 traditional medicine 395 definition 395–396 evidence 403 and healthcare providers 403–404 integration into national healthcare systems 398–399 practice 396–400 safety 400–402 WHO strategy 409 see also traditional Chinese medicine traditional naturopaths 479 traditional Tibetan medicine 444 traditions, art and science of healing 6–8 training of practitioners 32, 35–36 in Chinese herbal medicine 439 in chiropractic 528–529 in herbalism 284–285 in homeopathy 215 in hypnosis 580 in osteopathy 545 traditional practitioners 400, 402 transcendental meditation (TM) 582–583 trauma, homeopathic RCTs 236, 237 Treuhertz, Francis 72 trigger points, acupuncture 429–430 triphala 458–459 trituration, homeopathy 200 tryptophan supplements, contaminants 34 turmeric, extraction of curcumoids 30 Turner, William 271 unicist prescribing, homeopathy 216 United Kingdom regulation of herbal medicines 151–152 Yellow Card scheme 160–162 unsaturated fatty acids 493 upper respiratory tract infections, homeopathic RCTs 237, 238 Uppsala Monitoring Centre (UMC) 159–160 urinary tract infections, herbal medicines 329 Urtica (Urtica urens) 192, 248, 249, 252, 293–294, 328 USA CAM utilization 62–63, 64–65, 93, 97–99 chiropractic 522–523 delivery of CAM 104–105 drivers to CAM use insurance reimbursement 104 psychosocial 100–104 sociodemographic 99–100 future of CAM 115 homeopathic medicines, terminology 213 NCCAM domains of CAM 96–97 NIH funding of CAM research 93–96 registration of homeopathic medicines 208–209 regulation of CAM 105, 155–156 homeopathy 106–113 products 105–106 Index 619 user characteristics, homeopathy 228–230 Usui, Mikao 563–564 vaccines, homeopathic 212–213, 253 vaginal administration, essential oils 357 valerian (Valeriana officinalis) 283, 306, 327, 329, 440 adverse reactions 161 Valnet, Jean 343 variability, herbal medicines 149, 310 vata dosha 452, 453, 454, 457 vegetables, nutritional value 489 vervain (Verbena officinalis) 385 veterinary practice 84–85 homeopathy 215, 244, 253–254 vibratory massage 531, 536, 537 visceral techniques, osteopathy 542 vital force (dynamis), homeopathy 191–192 vitamin supplements complex mixtures, value 30 vitamin B6 (pyridoxine), high-dose 34 vitamin E, high-dose, interactions 35 volatile oils see essential oils vomeronasal system 345 action of homeopathic medicines 240 vomiting herbal medicines 328 homeopathic treatment 252 see also morning sickness warfarin, interactions 35 warts, homeopathic remedies 249 water ayurveda 452 effect on essential oil absorption 347 importance in traditional Chinese medicine 418 see also balneotherapy; hydrotherapy water violet (Hottonia palustris) 385 wild carrot (Daucus carota) 308 wild cherry bark (Prunus serotina) 328 wintergreen 295 wintergreen oil 352 witch-hazel 278, 295 women’s conditions aromatherapy 363 ayurvedic medicines 458, 459 herbal medicines 330 homeopathic remedies 250 massage therapy 534 reflexology 548 see also midwifery; morning sickness; pregnancy World Health Organization (WHO) Commission on Social Determinants of Health 13–14 definition of health 13, 33 definition of herbal medicines 270 definition of pharmacovigilance 145, 146 definition of traditional medicine 395–396 traditional medicine strategy 409 wormwood (Artemesia absinthium) 295 yang organs 422 Yellow Card schemes 159–162, 163, 441 pharmacist reporting 167–169 yin organs 422 yin and yang 416–417 yin-chen hao (Artemesia scoparia) 441 ylang ylang oil 345–346, 367, 375 yoga 461, 568 evidence 568–570 yoghurt 497, 498 yohimbine, adverse effects 303–304 Young’s rule (paediatric doses) 298 zoological names, use in homeopathy 196 ... complementary and alternative medicine 43 Complementary and alternative medicine in the USA 93 The evidence base for complementary and alternative medicine 121 Pharmacovigilance of complementary medicines... complementary and alternative medicine Introduction to the complementary concept of healthcare Integrative medicine – incorporating complementary and alternative medicine into practice 23 Delivering complementary. . .Complementary and Alternative Medicine Complementary and Alternative Medicine Second edition Edited by Steven B Kayne PhD, MBA, LLM, MSc(SpMed),