alternatieve geneeskunde

[meneer]

Alternatieve geneeskunde, wie maakt er gebruik van ? Wie is voor, wie is tegen ? Post hier uw mening, liefst geargumenteerd, uw mogelijke ervaringen met " de andere manieren van genezen "...
Persoonlijk denk ik dat bepaalde alternatieve manieren van geneeskunde complementair met de conventionele geneeskunde kunnen zijn . Het één aanprijzen en het ander afbreken is bijzonder dom in mijn ogen.

[six]

Men kan in Leuven Homeopathie studeren aan de Universiteit.

[six]

Dit is wat Wikipedia schrijft over homeopathie:


Homeopathy
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Samuel Hahnemann, the founder of homeopathy
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Homeopathy Listeni/ˌhoʊmiˈɒpəθi/ (also spelled homoeopathy or homœopathy; from the Greek hómoios- ὅμοιος- "like-" + páthos πάθος "suffering") is a system of alternative medicine created in 1796 by Samuel Hahnemann, based on his doctrine of like cures like, according to which a substance that causes the symptoms of a disease in healthy people will cure similar symptoms in sick people.[1] Homeopathic remedies are found to be no more than a placebo,[2] and homeopathy is widely considered a pseudoscience.[3][4][5][6][7]

Hahnemann believed that the underlying causes of disease were phenomena that he termed miasms, and that homeopathic remedies addressed these. The remedies are prepared by repeatedly diluting a chosen substance in alcohol or distilled water, followed by forceful striking on an elastic body.[8] Dilution usually continues well past the point where no molecules of the original substance remains.[9] Homeopaths select remedies by consulting reference books known as repertories, and by considering the totality of the patient's symptoms, personal traits, physical and psychological state, and life history.[10]

The scientific community regards homeopathy as nonsense,[11] quackery[12][13][14] or a sham,[15] and homeopathic practice has been criticized as unethical.[16] The axioms of homeopathy are long refuted[17] and lack any biological plausibility.[18] Although some clinical trials produce positive results,[19][20] systematic reviews reveal that this is because of chance, flawed research methods, and reporting bias.[21][22][23][24] The postulated mechanisms of action of homeopathic remedies are not only scientifically implausible[21][25][26][27] but precluded by the laws of physics.[28]
Contents

1 History
1.1 Historical context
1.2 Hahnemann's concept
1.3 19th century: rise to popularity and early criticism
1.4 Revival in the 20th century
2 Remedies and treatment
2.1 Preparation
2.2 Dilutions
2.3 Provings
2.4 Physical, mental, and emotional state examination; repertories
2.5 Homeopathic pills
2.6 "Active" ingredients
2.7 Related treatments and practices
3 Evidence and efficacy
3.1 Plausibility
3.2 Efficacy
3.3 Explanations of perceived effects
3.4 Effects in other biological systems
3.5 Ethics and safety
4 Regulation and prevalence
5 Public opposition
6 References
7 External links

History
1857 painting by Alexander Beydeman showing historical figures and personifications of homeopathy observing the brutality of medicine of the 19th century
Historical context

Homeopaths have asserted that Hippocrates, in about 400 BC, "perhaps originated homeopathy" when he prescribed a small dose of mandrake root – which in larger doses produced mania – to treat mania itself;[29] in the 16th century the pioneer of pharmacology Paracelsus declared that small doses of "what makes a man ill also cures him."[30] Samuel Hahnemann (1755–1843) gave homeopathy its name and expanded its principles in the late 18th century. At that time, mainstream medicine used methods like bloodletting and purging, and administered complex mixtures, such as Venice treacle, which was made from 64 substances including opium, myrrh, and viper's flesh.[31] These treatments often worsened symptoms and sometimes proved fatal.[32][33] Hahnemann rejected these practices – which had been extolled for centuries[34] – as irrational and inadvisable;[35] instead, he advocated the use of single drugs at lower doses and promoted an immaterial, vitalistic view of how living organisms function, believing that diseases have spiritual, as well as physical causes.[36]
Hahnemann's concept
See also: Samuel Hahnemann

The term "homeopathy" was coined by Hahnemann and first appeared in print in 1807.[37]

Hahnemann conceived of homeopathy while translating a medical treatise by the Scottish physician and chemist William Cullen into German. Being skeptical of Cullen's theory concerning cinchona's use for curing malaria, Hahnemann ingested some of the bark specifically to investigate what would happen. He experienced fever, shivering and joint pain: symptoms similar to those of malaria itself. From this, Hahnemann came to believe that all effective drugs produce symptoms in healthy individuals similar to those of the diseases that they treat, in accord with the "law of similars" that had been proposed by ancient physicians.[38] An account of the effects of eating cinchona bark noted by Oliver Wendell Holmes, and published in 1861, failed to reproduce the symptoms Hahnemann reported.[39]:128 Hahnemann's law of similars is therefore a postulate rather than a true law of nature.[40]

Subsequent scientific work shows that cinchona cures malaria because it contains quinine, which kills the Plasmodium falciparum parasite that causes the disease; the mechanism of action is unrelated to the symptoms of cinchonism.[41]
Homeopathic "provings"

Hahnemann began to test what effects substances produced in humans, a procedure that would later become known as "homeopathic proving". These tests required subjects to test the effects of ingesting substances by clearly recording all of their symptoms as well as the ancillary conditions under which they appeared.[42] A collection of provings was published in 1805, and a second collection of 65 remedies appeared in his book, Materia Medica Pura, in 1810.[43]

Since Hahnemann believed that large doses of drugs that caused similar symptoms would only aggravate illness, he advocated extreme dilutions of the substances; he devised a technique for making dilutions that he believed would preserve a substance's therapeutic properties while removing its harmful effects.[9] Hahnemann believed that this process aroused and enhanced "the spirit-like medicinal powers of the crude substances".[44] He gathered and published a complete overview of his new medical system in his 1810 book, The Organon of the Healing Art, whose 6th edition, published in 1921, is still used by homeopaths today.[45]
A homeopathic remedy prepared from marsh tea: the "15C" dilution shown here exceeds the Avogadro constant, so contains no trace of the original herb.
Miasms and disease

In The Organon of the Healing Art, Hahnemann introduced the concept of "miasms" as "infectious principles" underlying chronic disease.[46] Hahnemann associated each miasm with specific diseases, and thought that initial exposure to miasms causes local symptoms, such as skin or venereal diseases; if however these symptoms were suppressed by medication, the cause went deeper and began to manifest itself as diseases of the internal organs.[47] Homeopathy maintains that treating diseases by directly opposing their symptoms, as is sometimes done in conventional medicine, is ineffective because all "disease can generally be traced to some latent, deep-seated, underlying chronic, or inherited tendency".[48] The underlying imputed miasm still remains, and deep-seated ailments can be corrected only by removing the deeper disturbance of the vital force.[49]

Hahnemann originally presented only three miasms, of which the most important was psora (Greek for "itch"), described as being related to any itching diseases of the skin, supposed to be derived from suppressed scabies, and claimed to be the foundation of many further disease conditions. Hahnemann believed psora to be the cause of such diseases as epilepsy, cancer, jaundice, deafness, and cataracts.[50] Since Hahnemann's time, other miasms have been proposed, some replacing one or more of psora's proposed functions, including tuberculosis and cancer miasms.[47]

The law of susceptibility implies that a negative state of mind can attract hypothetical disease entities called "miasms" to invade the body and produce symptoms of diseases.[51][dead link] Hahnemann rejected the notion of a disease as a separate thing or invading entity, and insisted it was always part of the "living whole".[52] Hahnemann coined the expression "allopathic medicine", which was used to pejoratively refer to traditional Western medicine.[53]

Hahnemann's miasm theory remains disputed and controversial within homeopathy even in modern times. In 1978, Anthony Campbell, then a consultant physician at the Royal London Homeopathic Hospital, criticised statements by George Vithoulkas claiming that syphilis, when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the central nervous system, saying that "The unfortunate layman might well be misled by Vithoulkas' rhetoric into refusing orthodox treatment".[54] Vithoulkas' claims conflict with scientific studies, which indicated penicillin treatment produces a complete cure of syphilis in more than 90% of cases.[55]

The theory of miasms has been criticized as an explanation developed by Hahnemann to preserve the system of homeopathy in the face of treatment failures, and for being inadequate to cover the many hundreds of sorts of diseases, as well as for failing to explain disease predispositions, as well as genetics, environmental factors, and the unique disease history of each patient.[56]:148–9
19th century: rise to popularity and early criticism

Homeopathy achieved its greatest popularity in the 19th century. Dr. John Franklin Gray (1804–1882) was the first practitioner of homeopathy in the United States, beginning in 1828 in New York City. The first homeopathic schools opened in 1830, and throughout the 19th century dozens of homeopathic institutions appeared in Europe and the United States.[57] By 1900, there were 22 homeopathic colleges and 15,000 practitioners in the United States.[58] Because medical practice of the time relied on ineffective and often dangerous treatments, patients of homeopaths often had better outcomes than those of the doctors of the time.[59] Homeopathic remedies, even if ineffective, would almost surely cause no harm, making the users of homeopathic remedies less likely to be killed by the treatment that was supposed to be helping them.[45] The relative success of homeopathy in the 19th century may have led to the abandonment of the ineffective and harmful treatments of bloodletting and purging and to have begun the move towards more effective, science-based medicine.[33] One reason for the growing popularity of homeopathy was its apparent success in treating people suffering from infectious disease epidemics.[60] During 19th century epidemics of diseases such as cholera, death rates in homeopathic hospitals were often lower than in conventional hospitals, where the treatments used at the time were often harmful and did little or nothing to combat the diseases.[61]

From its inception, however, homeopathy was criticized by mainstream science. Sir John Forbes, physician to Queen Victoria, said in 1843 that the extremely small doses of homeopathy were regularly derided as useless, "an outrage to human reason".[62] James Young Simpson said in 1853 of the highly diluted drugs: "No poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly."[63] 19th-century American physician and author Oliver Wendell Holmes, Sr. was also a vocal critic of homeopathy and published an essay in 1842 entitled Homœopathy, and its kindred delusions.[39] The members of the French Homeopathic Society observed in 1867 that some of the leading homeopathists of Europe not only were abandoning the practice of administering infinitesimal doses but were also no longer defending it.[64] The last school in the U.S. exclusively teaching homeopathy closed in 1920.[45]
Revival in the 20th century
Main article: Regulation and prevalence of homeopathy

According to Paul Ulrich Unschuld, the Nazi regime in Germany were fascinated by homeopathy, and spent large sums of money on researching its mechanisms, but – as ever – without gaining a positive result. Unschuld further argues that homeopathy never subsequently took root in the United States, but remained more deeply established in European thinking.[65]

In the United States the Food, Drug, and Cosmetic Act of 1938 (sponsored by Royal Copeland, a Senator from New York and homeopathic physician) recognized homeopathic remedies as drugs. In the 1950s, there were only 75 pure homeopaths practicing in the U.S.[66] However, by the mid to late 1970s, homeopathy made a significant comeback and sales of some homeopathic companies increased tenfold.[67] Greek homeopath George Vithoulkas performed a "great deal of research to update the scenarios and refine the theories and practice of homeopathy" beginning in the 1970s, and it was revived worldwide;[68][69] in Brazil during the 1970s and in Germany during the 1980s.[70] The medical profession started to integrate such ideas in the 1990s[71] and mainstream pharmacy chains recognized the business potential of selling homeopathic remedies.[72]

Bruce Hood has argued that the increased popularity of homeopathy in recent times may be due to the comparatively long consultations practitioners are willing to give their patients, and to an irrational preference for "natural" products which people think are the basis of homeopathic remedies.[12]
Remedies and treatment
See also: List of homeopathic preparations
Homeopathic remedy Rhus toxicodendron, derived from poison ivy.
a preparation made from D dilutions of dangerous materials like botulism, E-coli, thymus gland of unspecified origin, pneumonia, pseudomona, proteus, salmonella, scarlet fever, staph, strep and tuberculosis bacteria. Ethanol is listed as being redundantly diluted in alcohol.

Homeopathic practitioners rely on two types of reference when prescribing remedies: materia medica and repertories. A homeopathic materia medica is a collection of "drug pictures", organised alphabetically by "remedy," that describes the symptom patterns associated with individual remedies. A homeopathic repertory is an index of disease symptoms that lists remedies associated with specific symptoms.[73]

Homeopathy uses many animal, plant, mineral, and synthetic substances in its remedies. Examples include arsenicum album (arsenic oxide), natrum muriaticum (sodium chloride or table salt), Lachesis muta (the venom of the bushmaster snake), opium, and thyroidinum (thyroid hormone). Homeopaths also use treatments called "nosodes" (from the Greek nosos, disease) made from diseased or pathological products such as fecal, urinary, and respiratory discharges, blood, and tissue.[74] Homeopathic remedies prepared from healthy specimens are called "sarcodes".

Some modern homeopaths have considered more esoteric bases for remedies, known as "imponderables" because they do not originate from a substance, but from electromagnetic energy presumed to have been "captured" by alcohol or lactose. Examples include X-rays[75] and sunlight.[76] Today, about 3,000 different remedies are commonly used in homeopathy.[citation needed] Some homeopaths also use techniques that are regarded by other practitioners as controversial. These include "paper remedies", where the substance and dilution are written on pieces of paper and either pinned to the patients' clothing, put in their pockets, or placed under glasses of water that are then given to the patients, as well as the use of radionics to prepare remedies. Such practices have been strongly criticised by classical homeopaths as unfounded, speculative, and verging upon magic and superstition.[77][78]
Preparation
Mortar and pestle used for grinding insoluble solids, including quartz and oyster shells, into homeopathic remedies

In producing remedies for diseases, homeopaths use a process called "dynamisation" or "potentisation", whereby a substance is diluted with alcohol or distilled water and then vigorously shaken by 10 hard strikes against an elastic body in a process homeopaths call "succussion".[8][79] Hahnemann advocated using substances that produce symptoms like those of the disease being treated, but found that undiluted doses intensified the symptoms and exacerbated the condition, sometimes causing dangerous toxic reactions. He therefore specified that the substances be diluted, due to his belief that succussion activated the "vital energy" of the diluted substance[80] and made it stronger. To facilitate succussion, Hahnemann had a saddle-maker construct a special wooden striking board covered in leather on one side and stuffed with horsehair.[81][82] Insoluble solids, such as quartz and oyster shell, are diluted by grinding them with lactose ("trituration").
Dilutions
Main article: Homeopathic dilutions

Three logarithmic potency scales are in regular use in homeopathy. Hahnemann created the "centesimal" or "C scale", diluting a substance by a factor of 100 at each stage. The centesimal scale was favored by Hahnemann for most of his life. A 2C dilution requires a substance to be diluted to one part in 100, and then some of that diluted solution diluted by a further factor of 100. This works out to one part of the original substance in 10,000 parts of the solution.[83] A 6C dilution repeats this process six times, ending up with the original substance diluted by a factor of 100−6=10−12 (one part in one trillion or 1/1,000,000,000,000). Higher dilutions follow the same pattern. In homeopathy, a solution that is more dilute is described as having a higher potency, and more dilute substances are considered by homeopaths to be stronger and deeper-acting remedies.[84] The end product is often so diluted as to be indistinguishable from the dilutant (pure water, sugar or alcohol).[9][85][86] There is also a decimal potency scale (notated as "X" or "D") in which the remedy is diluted by a factor of 10 at each stage.[87]

Hahnemann advocated 30C dilutions for most purposes (that is, dilution by a factor of 1060).[8] In Hahnemann's time, it was reasonable to assume the remedies could be diluted indefinitely, as the concept of the atom or molecule as the smallest possible unit of a chemical substance was just beginning to be recognized. The greatest dilution reasonably likely to contain even one molecule of the original substance is 12C.
This bottle contains arnica montana (wolf's bane) D6, i.e. the nominal dilution is one part in a million (10-6).

Critics and advocates of homeopathy alike commonly attempt to illustrate the dilutions involved in homeopathy with analogies.[88] Hahnemann is reported to have joked that a suitable procedure to deal with an epidemic would be to empty a bottle of poison into Lake Geneva, if it could be succussed 60 times.[89][90] Another example given by a critic of homeopathy states that a 12C solution is equivalent to a "pinch of salt in both the North and South Atlantic Oceans",[89][90] which is approximately correct.[91] One-third of a drop of some original substance diluted into all the water on earth would produce a remedy with a concentration of about 13C.[92][88][93] A popular homeopathic treatment for the flu is a 200C dilution of duck liver, marketed under the name oscillococcinum. As there are only about 1080 atoms in the entire observable universe, a dilution of one molecule in the observable universe would be about 40C. Oscillococcinum would thus require 10320 more universes to simply have one molecule in the final substance.[94] The high dilutions characteristically used are often considered to be the most controversial and implausible aspect of homeopathy.[95]
Dilution debate

Not all homeopaths advocate extremely high dilutions. Remedies at potencies below 4X are considered an important part of homeopathic heritage.[96]

Many of the early homeopaths were originally doctors and generally used lower dilutions such as "3X" or "6X", rarely going beyond "12X". The split between lower and higher dilutions followed ideological lines. Those favoring low dilutions stressed pathology and a strong link to conventional medicine, while those favoring high dilutions emphasised vital force, miasms and a spiritual interpretation of disease.[97][98] Some products with such relatively lower dilutions continue to be sold, but like their counterparts, they have not been conclusively demonstrated to have any effect beyond that of a placebo.[99][100]
Provings

A homeopathic proving is the method by which the profile of a homeopathic remedy is determined.[101]

At first Hahnemann used undiluted doses for provings, but he later advocated provings with remedies at a 30C dilution,[8] and most modern provings are carried out using ultradilute remedies in which it is highly unlikely that any of the original molecules remain.[102] During the proving process, Hahnemann administered remedies to healthy volunteers, and the resulting symptoms were compiled by observers into a "drug picture". The volunteers were observed for months at a time and made to keep extensive journals detailing all of their symptoms at specific times throughout the day. They were forbidden from consuming coffee, tea, spices, or wine for the duration of the experiment; playing chess was also prohibited because Hahnemann considered it to be "too exciting", though they were allowed to drink beer and encouraged to exercise in moderation. After the experiments were over, Hahnemann made the volunteers take an oath swearing that what they reported in their journals was the truth, at which time he would interrogate them extensively concerning their symptoms.

Provings have been described as important in the development of the clinical trial, due to their early use of simple control groups, systematic and quantitative procedures, and some of the first application of statistics in medicine.[103] The lengthy records of self-experimentation by homeopaths have occasionally proven useful in the development of modern drugs: For example, evidence that nitroglycerin might be useful as a treatment for angina was discovered by looking through homeopathic provings, though homeopaths themselves never used it for that purpose at that time.[104] The first recorded provings were published by Hahnemann in his 1796 Essay on a New Principle.[105] His Fragmenta de Viribus (1805)[106] contained the results of 27 provings, and his 1810 Materia Medica Pura contained 65.[107] For James Tyler Kent's 1905 Lectures on Homoeopathic Materia Medica, 217 remedies underwent provings and newer substances are continually added to contemporary versions.

Though the proving process has superficial similarities with clinical trials, it is fundamentally different in that the process is subjective, not blinded, and modern provings are unlikely to use pharmacologically active levels of the substance under proving.[108] As early as 1842, Holmes noted the provings were impossibly vague, and the purported effect was not repeatable among different subjects.[39]
Physical, mental, and emotional state examination; repertories
Homeopathic repertory by James Tyler Kent

Homeopaths generally begin with detailed examinations of their patients' histories, including questions regarding their physical, mental and emotional states, their life circumstances and any physical or emotional illnesses. The homeopath then attempts to translate this information into a complex formula of mental and physical symptoms, including likes, dislikes, innate predispositions and even body type.[109]

From these symptoms, the homeopath chooses how to treat the patient. A compilation of reports of many homeopathic provings, supplemented with clinical data, is known as a "homeopathic materia medica". But because a practitioner first needs to explore the remedies for a particular symptom rather than looking up the symptoms for a particular remedy, the "homeopathic repertory", which is an index of symptoms, lists after each symptom those remedies that are associated with it. Repertories are often very extensive and may include data extracted from multiple sources of materia medica. There is often lively debate among compilers of repertories and practitioners over the veracity of a particular inclusion.

The first symptomatic index of the homeopathic materia medica was arranged by Hahnemann. Soon after, one of his students, Clemens von Bönninghausen, created the Therapeutic Pocket Book, another homeopathic repertory.[110] The first such homeopathic repertory was Georg Jahr's Symptomenkodex, published in German (1835), which was then first translated to English (1838) by Constantine Hering as the Repertory to the more Characteristic Symptoms of Materia Medica. This version was less focused on disease categories and would be the forerunner to Kent's later works.[74][111] It consisted of three large volumes. Such repertories increased in size and detail as time progressed.

Some diversity in approaches to treatments exists among homeopaths. "Classical homeopathy" generally involves detailed examinations of a patient's history and infrequent doses of a single remedy as the patient is monitored for improvements in symptoms, while "clinical homeopathy" involves combinations of remedies to address the various symptoms of an illness.[68]
Homeopathic pills
Homeopathic pills, homeopathic remedy oscillococcinum

Homeopathic pills are made from an inert substance (often sugars, typically lactose), upon which a drop of liquid homeopathic preparation is placed.[112][113]
"Active" ingredients

The list of ingredients seen on remedies may confuse consumers into believing the product actually contains those ingredients. According to normal homeopathic practice, remedies are prepared starting with active ingredients that are often serially diluted to the point where the finished product no longer contains any biologically "active ingredients" as that term is normally defined.

James Randi and the 10:23 campaign groups have demonstrated the lack of active ingredients in homeopathic products by taking large overdoses.[114] None of the hundreds of demonstrators in the UK, Australia, New Zealand, Canada and the US were injured and "no one was cured of anything, either".[115]

While the lack of active compounds is noted in most homeopathic products, there are some exceptions such as Zicam Cold Remedy, which is marketed as an "unapproved homeopathic" product.[116] It contains a number of highly diluted ingredients that are listed as "inactive ingredients" on the label. Some of the homeopathic ingredients used in the preparation of Zicam are galphimia glauca,[117] histamine dihydrochloride (homeopathic name, histaminum hydrochloricum),[118] luffa operculata,[119] and sulfur. Although the product is marked "homeopathic", it does contain two ingredients that are only "slightly" diluted: zinc acetate (2X = 1/100 dilution) and zinc gluconate (1X = 1/10 dilution),[116] which means both are present in a concentration that contains biologically active ingredients. In fact, they are strong enough to have caused some people to lose their sense of smell,[120] a condition termed anosmia. This illustrates why taking a product marked "homeopathic", especially an overdose,[114] can still be dangerous because it may contain biologically active ingredients, though as discussed previously, most homeopathic preparations contain no active ingredients. Because the manufacturers of Zicam label it as a homeopathic product (despite the relatively high concentrations of active ingredients), it is exempted from FDA regulation by the Dietary Supplement Health and Education Act of 1994 (DSHEA).
Related treatments and practices
Isopathy

Isopathy is a therapy derived from homeopathy invented by Johann Joseph Wilhelm Lux in the 1830s. Isopathy differs from homeopathy in general in that the remedies, known as "nosodes", are made up either from things that cause the disease or from products of the disease, such as pus.[74][121] Many so-called "homeopathic vaccines" are a form of isopathy.[122]
Flower remedies

Flower remedies can be produced by placing flowers in water and exposing them to sunlight. The most famous of these are the Bach flower remedies, which were developed by the physician and homeopath Edward Bach. Although the proponents of these remedies share homeopathy's vitalist world-view and the remedies are claimed to act through the same hypothetical "vital force" as homeopathy, the method of preparation is different. Bach flower remedies are prepared in "gentler" ways such as placing flowers in bowls of sunlit water, and the remedies are not succussed.[123] There is no convincing scientific or clinical evidence for flower remedies being effective.[124]
Veterinary use

The idea of using homeopathy as a treatment for other animals, termed "veterinary homeopathy", dates back to the inception of homeopathy; Hahnemann himself wrote and spoke of the use of homeopathy in animals other than humans.[125] The FDA has not approved homeopathic products as veterinary medicine in the U.S. In the UK, veterinary surgeons who use homeopathy may belong to the Faculty of Homeopathy and/or to the British Association of Homeopathic Veterinary Surgeons. Animals may be treated only by qualified veterinary surgeons in the UK and some other countries. Internationally, the body that supports and represents homeopathic veterinarians is the International Association for Veterinary Homeopathy. The use of homeopathy in veterinary medicine is controversial; the little existing research on the subject is not of a high enough scientific standard to provide reliable data on efficacy.[126] Other studies have also found that giving animals placebos can play active roles in influencing pet owners to believe in the effectiveness of the treatment when none exists.[126]

The UK's Department of Environment, Food and Rural Affairs (DeFRA) has adopted a robust position against use of "alternative" pet remedies including homeopathy.[127]
Electrohomeopathy
Main article: Electrohomeopathy

Electrohomeopathy is a treatment devised by Count Cesare Mattei (1809–1896), who proposed that different "colors" of electricity could be used to treat cancer. Popular in the late nineteenth century, electrohomeopathy has been described as "utter idiocy".[128]
Evidence and efficacy
Homeopathy Claims Proponents claim that illnesses can be treated with specially prepared extreme dilutions of a substance that produces symptoms similar to the illness. Homeopathic remedies rarely contain any atom or molecule of the substance in the remedy.
Related scientific disciplines Chemistry, Medicine
Year proposed 1807
Original proponents Samuel Hahnemann
Subsequent proponents Organizations: Boiron, Heel, Miralus Healthcare, Nelsons, Zicam
Individuals: Deepak Chopra, Paul Herscu, Robin Murphy, Rajan Sankaran, Luc De Schepper, Jan Scholten, Jeremy Sherr, Dana Ullman, George Vithoulkas
Pseudoscientific concepts

The low concentration of homeopathic remedies, which often lack even a single molecule of the diluted substance,[112] has been the basis of questions about the effects of the remedies since the 19th century. Modern advocates of homeopathy have proposed a concept of "water memory", according to which water "remembers" the substances mixed in it, and transmits the effect of those substances when consumed. This concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to have any detectable effect, biological or otherwise.[129][130] Pharmacological research has found instead that stronger effects of an active ingredient come from higher, not lower doses.

Outside of the CAM community, scientists have long regarded homeopathy as a sham[15] or – as Bruce Hood puts it – as "supernatural quackery".[12] There is an overall absence of sound statistical evidence of therapeutic efficacy, which is consistent with the lack of any biologically plausible pharmacological agent or mechanism.[25] Abstract concepts within theoretical physics have been invoked to suggest explanations of how or why remedies might work, including quantum entanglement,[131] the theory of relativity and chaos theory. However, the explanations are offered by nonspecialists within the field, and often include speculations that are incorrect in their application of the concepts and not supported by actual experiments.[56]:255–6 Several of the key concepts of homeopathy conflict with fundamental concepts of physics and chemistry.[27] For instance, quantum entanglement is not possible as humans and other animals are far too large to be affected by quantum effects, and entanglement is a delicate state which rarely lasts longer than a fraction of a second. In addition, while entanglement may result in certain aspects of individual subatomic particles acquiring each other's quantum states, this does not mean the particles will mirror or duplicate each other, or cause health-improving transformations.[132]
Plausibility

The extreme dilutions used in homeopathic preparations often leave none of the original substance in the final product. The modern mechanism proposed by homeopaths, water memory, is considered implausible in that short-range order in water only persists for about 1 picosecond.[133] Existence of a pharmacological effect in the absence of any true active ingredient is inconsistent with the observed dose-response relationships characteristic of therapeutic drugs[134] (whereas placebo effects are non-specific and unrelated to pharmacological activity[135]). The proposed rationale for these extreme dilutions – that the water contains the "memory" or "vibration" from the diluted ingredient – is counter to the laws of chemistry and physics, such as the law of mass action.[133] Analysis shows proposed mechanisms for homeopathy are precluded from having any effect by the laws of physics and physical chemistry.[28]
High dilutions

The extremely high dilutions in homeopathy preclude a biologically plausible mechanism of action. Homeopathic remedies are often diluted to the point where there are no molecules from the original solution left in a dose of the final remedy.[136] Homeopaths contend that the methodical dilution of a substance, beginning with a 10% or lower solution and working downwards, with shaking after each dilution, produces a therapeutically active remedy, in contrast to therapeutically inert water. Since even the longest-lived noncovalent structures in liquid water at room temperature are stable for only a few picoseconds,[137] critics have concluded that any effect that might have been present from the original substance can no longer exist.[138] No evidence of stable clusters of water molecules was found when homeopathic remedies were studied using nuclear magnetic resonance.[139]

Furthermore, since water will have been in contact with millions of different substances throughout its history, critics point out that water is therefore an extreme dilution of almost any conceivable substance. By drinking water one would, according to this interpretation, receive treatment for every imaginable condition.[140] For comparison, ISO 3696: 1987 defines a standard for water used in laboratory analysis; this allows for a contaminant level of ten parts per billion, 4C in homeopathic notation. This water may not be kept in glass as contaminants will leach out into the water.[141]

Practitioners of homeopathy hold that higher dilutions — described as being of higher potency[142] — produce stronger medicinal effects.[143] This idea is inconsistent with the observed dose-response relationships of conventional drugs, where the effects are dependent on the concentration of the active ingredient in the body.[134] This dose-response relationship has been confirmed in myriad experiments on organisms as diverse as nematodes,[144] rats,[145] and humans.[146]

Physicist Robert L. Park, former executive director of the American Physical Society, is quoted as saying,

"since the least amount of a substance in a solution is one molecule, a 30C solution would have to have at least one molecule of the original substance dissolved in a minimum of 1,000,000,000,000,000,000,000,000,000,000,000,000, 000,000,000,000,000,000,000,000 [or 1060] molecules of water. This would require a container more than 30,000,000,000 times the size of the Earth."[147]

Park is also quoted as saying that, "to expect to get even one molecule of the 'medicinal' substance allegedly present in 3 pills, it would be necessary to take some two billion of them, which would total about a thousand tons of lactose plus whatever impurities the lactose contained".[147]

The laws of chemistry state that there is a limit to the dilution that can be made without losing the original substance altogether.[112] This limit, which is related to Avogadro's number, is roughly equal to homeopathic potencies of 12C or 24X (1 part in 1024).[88][147][148]

Scientific tests run by both the BBC's Horizon and ABC's 20/20 programs were unable to differentiate homeopathic dilutions from water, even when using tests suggested by homeopaths themselves.[82][149]
Efficacy
Old bottle of Hepar sulph made from calcium sulfide

The efficacy of homeopathy has been in dispute since its inception. One of the earliest double blind studies concerning homeopathy was sponsored by the British government during World War II in which volunteers tested the efficacy of homeopathic remedies against diluted mustard gas burns.[150]

No individual preparation has been unambiguously shown by research to be different from placebo.[25][151] The methodological quality of the primary research was generally low, with such problems as weaknesses in study design and reporting, small sample size, and selection bias. Since better quality trials have become available, the evidence for efficacy of homeopathy preparations has diminished; the highest-quality trials indicate that the remedies themselves exert no intrinsic effect.[20][24][56]:206 A review conducted in 2010 of all the pertinent studies of "best evidence" produced by the Cochrane Collaboration concluded that "the most reliable evidence – that produced by Cochrane reviews – fails to demonstrate that homeopathic medicines have effects beyond placebo."[152]
Publication bias and other methodological issues
Further information: Statistical hypothesis testing, P-value, and Publication bias

The fact that individual randomized controlled trials have given positive results is not in contradiction with an overall lack of statistical evidence of efficacy. A small proportion of randomized controlled trials inevitably provide false-positive outcomes due to the play of chance: a "statistically significant" positive outcome is commonly adjudicated when the probability of it being due to chance rather than a real effect is no more than 5%—a level at which about 1 in 20 tests can be expected to show a positive result in the absence of any therapeutic effect.[153] Furthermore, trials of low methodological quality (i.e. ones which have been inappropriately designed, conducted or reported) are prone to give misleading results. In a systematic review of the methodological quality of randomized trials in three branches of alternative medicine, Linde et al. highlighted major weaknesses in the homeopathy sector, including poor randomization.[154]

A related issue is publication bias: researchers are more likely to submit trials that report a positive finding for publication, and journals prefer to publish positive results.[155][156][157][158] Publication bias has been particularly marked in complementary and alternative medicine journals, where few of the published articles (just 5% during the year 2000) tend to report null results.[159] Regarding the way in which homeopathy is represented in the medical literature, a systematic review found signs of bias in the publications of clinical trials (towards negative representation in mainstream medical journals, and vice-versa in complementary and alternative medicine journals), but not in reviews.[20]

Positive results are much more likely to be false if the prior probability of the claim under test is low.[158]
Systematic reviews and meta-analyses of efficacy

Both meta-analyses, which statistically combine the results of several randomized controlled trials, and other systematic reviews of the literature are essential tools to summarize evidence of therapeutic efficacy.[160] Early systematic reviews and meta-analyses of trials evaluating the efficacy of homeopathic remedies in comparison with placebo more often tended to generate positive results, but appeared unconvincing overall.[161] In particular, reports of three large meta-analyses warned readers that firm conclusions could not be reached, largely due to methodological flaws in the primary studies and the difficulty in controlling for publication bias.[19][22][23] The positive finding of one of the most prominent of the early meta-analyses, published in The Lancet in 1997 by Linde et al.,[23] was later reframed by the same research team, who wrote:

The evidence of bias [in the primary studies] weakens the findings of our original meta-analysis. Since we completed our literature search in 1995, a considerable number of new homeopathy trials have been published. The fact that a number of the new high-quality trials ... have negative results, and a recent update of our review for the most "original" subtype of homeopathy (classical or individualized homeopathy), seem to confirm the finding that more rigorous trials have less-promising results. It seems, therefore, likely that our meta-analysis at least overestimated the effects of homeopathic treatments.[24]

In 2002, a systematic review of the available systematic reviews confirmed that higher-quality trials tended to have less positive results, and found no convincing evidence that any homeopathic remedy exerts clinical effects different from placebo.[25]

In 2005, The Lancet medical journal published a meta-analysis of 110 placebo-controlled homeopathy trials and 110 matched medical trials based upon the Swiss government's Program for Evaluating Complementary Medicine, or PEK. The study concluded that its findings were compatible with the notion that the clinical effects of homeopathy are placebo effects.[21]

A 2006 meta-analysis of six trials evaluating homeopathic treatments to reduce cancer therapy side-effects following radiotherapy and chemotherapy found that there was "insufficient evidence to support clinical efficacy of homeopathic therapy in cancer care".[162]

A 2007 systematic review of homeopathy for children and adolescents found that the evidence for attention-deficit hyperactivity disorder and childhood diarrhea was mixed. No difference from placebo was found for adenoid vegetation, asthma, or upper respiratory tract infection. Evidence was not sufficient to recommend any therapeutic or preventative intervention, and the delay in medical treatment may be harmful to the patient.[163]

In 2012, a systematic review evaluating evidence of homeopathy's possible adverse effects concluded that "homeopathy has the potential to harm patients and consumers in both direct and indirect ways".[164] One of the reviewers, Edzard Ernst, supplemented the article on his blog, writing: "I have said it often and I say it again: if used as an alternative to an effective cure, even the most 'harmless' treatment can become life-threatening."[165]

The Cochrane Library found insufficient clinical evidence to evaluate the efficacy of homeopathic treatments for asthma[166] dementia,[167] or for the use of homeopathy in induction of labor.[168] Other researchers found no evidence that homeopathy is beneficial for osteoarthritis,[169] migraines [170][171][172] or delayed-onset muscle soreness.[68]

Health organisations such as the UK's National Health Service,[173] the American Medical Association,[174] and the FASEB[138] have issued statements of their conclusion that there is "no good-quality evidence that homeopathy is effective as a treatment for any health condition."[173]

Clinical studies of the medical efficacy of homeopathy have been criticised by some homeopaths as being irrelevant because they do not test "classical homeopathy".[175] There have, however, been a number of clinical trials that have tested individualized homeopathy. A 1998 review[176] found 32 trials that met their inclusion criteria, 19 of which were placebo-controlled and provided enough data for meta-analysis. These 19 studies showed a pooled odds ratio of 1.17 to 2.23 in favor of individualized homeopathy over the placebo, but no difference was seen when the analysis was restricted to the methodologically best trials. The authors concluded "that the results of the available randomized trials suggest that individualized homeopathy has an effect over placebo. The evidence, however, is not convincing because of methodological shortcomings and inconsistencies." Jay Shelton, author of a book on homeopathy, has stated that the claim assumes without evidence that classical, individualized homeopathy works better than nonclassical variations.[56]:209

In a 2012 article published in the Skeptical Inquirer,[177] Edzard Ernst reviewed the publications of the research group that has published most of the clinical studies of homeopathic treatment from 2005 to 2010. A total of 11 articles, published in both conventional and alternative medical journals, describe three randomized clinical trials (one article), prospective cohort studies without controls (seven articles) and comparative cohort studies with controls (three articles). The diseases include a wide range of conditions from knee surgery, eczema, migraine, insomnia to "any condition of elderly patients". Ernst's evaluation found numerous flaws in the design, conduct and reporting of the clinical studies. Examples include: little detail of the actual homeopathic treatment administered, misleading presentation of controls (comparison of homeopathic plus conventional treatment with conventional treatment, but presented as homeopathic versus conventional treatment); and similar data in multiple articles. He concluded that the misinterpreted weak data made the homeopathy appear to have clinical effects which can be attributed to bias or confounding, and that the "casual reader can be seriously misled".[177]
Explanations of perceived effects

Science offers a variety of explanations for how homeopathy may appear to cure diseases or alleviate symptoms even though the remedies themselves are inert:[56]:155–167

The placebo effect — the intensive consultation process and expectations for the homeopathic preparations may cause the effect
Therapeutic effect of the consultation — the care, concern, and reassurance a patient experiences when opening up to a compassionate caregiver can have a positive effect on the patient's well-being
Unassisted natural healing — time and the body's ability to heal without assistance can eliminate many diseases of their own accord
Unrecognized treatments — an unrelated food, exercise, environmental agent, or treatment for a different ailment, may have occurred
Regression toward the mean — since many diseases or conditions are cyclical, symptoms vary over time and patients tend to seek care when discomfort is greatest; they may feel better anyway but because of the timing of the visit to the homeopath they attribute improvement to the remedy taken
Non-homeopathic treatment — patients may also receive standard medical care at the same time as homeopathic treatment, and the former is responsible for improvement
Cessation of unpleasant treatment — often homeopaths recommend patients stop getting medical treatment such as surgery or drugs, which can cause unpleasant side-effects; improvements are attributed to homeopathy when the actual cause is the cessation of the treatment causing side-effects in the first place, but the underlying disease remains untreated and still dangerous to the patient.

Effects in other biological systems
Old homeopathic belladonna remedy.

While some articles have suggested that homeopathic solutions of high dilution can have statistically significant effects on organic processes including the growth of grain,[178] histamine release by leukocytes,[179] and enzyme reactions, such evidence is disputed since attempts to replicate them have failed.[180][181][182][183][184]

In 1987, French immunologist Jacques Benveniste submitted a paper to the journal Nature while working at INSERM. The paper purported to have discovered that basophils, a type of white blood cell, released histamine when exposed to a homeopathic dilution of anti-immunoglobulin E antibody. The journal editors, sceptical of the results, requested that the study be replicated in a separate laboratory. Upon replication in four separate laboratories the study was published. Still sceptical of the findings, Nature assembled an independent investigative team to determine the accuracy of the research, consisting of Nature editor and physicist Sir John Maddox, American scientific fraud investigator and chemist Walter Stewart, and sceptic James Randi. After investigating the findings and methodology of the experiment, the team found that the experiments were "statistically ill-controlled", "interpretation has been clouded by the exclusion of measurements in conflict with the claim", and concluded, "We believe that experimental data have been uncritically assessed and their imperfections inadequately reported."[130][185][186] James Randi stated that he doubted that there had been any conscious fraud, but that the researchers had allowed "wishful thinking" to influence their interpretation of the data.[185]
Ethics and safety

The provision of homeopathic remedies has been described as unethical.[16] Michael Baum, Professor Emeritus of Surgery and visiting Professor of Medical Humanities at University College London (UCL), has described homoeopathy as a "cruel deception".[187]

Edzard Ernst, the first Professor of Complementary Medicine in the United Kingdom and a former homeopathic practitioner,[188][189][190] has expressed his concerns about pharmacists who violate their ethical code by failing to provide customers with "necessary and relevant information" about the true nature of the homeopathic products they advertise and sell:

"My plea is simply for honesty. Let people buy what they want, but tell them the truth about what they are buying. These treatments are biologically implausible and the clinical tests have shown they don't do anything at all in human beings. The argument that this information is not relevant or important for customers is quite simply ridiculous."[191]

Patients who choose to use homeopathy rather than evidence-based medicine risk missing timely diagnosis and effective treatment of serious conditions such as cancer.[163][192]
Adverse reactions

Some homeopathic remedies involve poisons such as Belladonna, arsenic, and poison ivy which are highly diluted in the homeopathic remedy, only in rare cases are the original ingredients present at detectable levels. This may be due to improper preparation or intentional low dilution. Serious adverse effects such as seizures and death have been reported or associated with some homeopathic remedies.[164][193] Instances of arsenic poisoning have occurred after use of arsenic-containing homeopathic preparations.[194] Zicam Cold remedy Nasal Gel, which contains 2X (1:100) zinc gluconate, reportedly caused a small percentage of users to lose their sense of smell;[195] 340 cases were settled out of court in 2006 for 12 million U.S. dollars.[196] In 2009, the FDA advised consumers to stop using three discontinued cold remedy products manufactured by Zicam because it could cause permanent damage to users' sense of smell.[197] Zicam was launched without a New Drug Application (NDA) under a provision in the FDA's Compliance Policy Guide called "Conditions Under Which Homeopathic Drugs May be Marketed" (CPG 7132.15), but the FDA warned Zicam via a Warning Letter that this policy does not apply when there is a health risk to consumers.[198]
Lack of efficacy

The lack of convincing scientific evidence supporting its efficacy[199] and its use of remedies without active ingredients have led to characterizations as pseudoscience and quackery,[200][201][202][203] or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst."[204] The Chief Medical Officer for England, Dame Sally Davies, has stated that homeopathic remedies are "rubbish" and do not serve as anything more than placebos.[205] Jack Killen, acting deputy director of the National Center for Complementary and Alternative Medicine, says homeopathy "goes beyond current understanding of chemistry and physics." He adds: "There is, to my knowledge, no condition for which homeopathy has been proven to be an effective treatment."[199] Ben Goldacre says that homeopaths who misrepresent scientific evidence to a scientifically illiterate public, have "...walled themselves off from academic medicine, and critique has been all too often met with avoidance rather than argument."[159] Homeopaths often prefer to ignore meta-analyses in favour of cherry picked positive results, such as by promoting a particular observational study (one which Goldacre describes as "little more than a customer-satisfaction survey") as if it were more informative than a series of randomized controlled trials.[159]

Referring specifically to homeopathy, the British House of Commons Science and Technology Committee has stated:

In the Committee's view, homeopathy is a placebo treatment and the Government should have a policy on prescribing placebos. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients, which usually relies on some degree of patient deception. Prescribing of placebos is not consistent with informed patient choice - which the Government claims is very important - as it means patients do not have all the information needed to make choice meaningful.

Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.[26]

The National Center for Complementary and Alternative Medicine of the United States' National Institutes of Health states:

Homeopathy is a controversial topic in complementary medicine research. A number of the key concepts of homeopathy are not consistent with fundamental concepts of chemistry and physics. For example, it is not possible to explain in scientific terms how a remedy containing little or no active ingredient can have any effect. This, in turn, creates major challenges to rigorous clinical investigation of homeopathic remedies. For example, one cannot confirm that an extremely dilute remedy contains what is listed on the label, or develop objective measures that show effects of extremely dilute remedies in the human body.[206]

In lieu of standard medical treatment

On clinical grounds, patients who choose to use homeopathy in preference to normal medicine risk missing timely diagnosis and effective treatment, thereby worsening the outcomes of serious conditions.[163][192][207][208] Critics of homeopathy have cited individual cases of patients of homeopathy failing to receive proper treatment for diseases that could have been easily diagnosed and managed with conventional medicine and who have died as a result[209][210] and the "marketing practice" of criticizing and downplaying the effectiveness of mainstream medicine.[159][210] Homeopaths claim that use of conventional medicines will "push the disease deeper" and cause more serious conditions, a process referred to as "suppression".[211] Some homeopaths (particularly those who are non-physicians) advise their patients against immunisation.[207][212][213] Some homeopaths suggest that vaccines be replaced with homeopathic "nosodes", created from biological materials such as pus, diseased tissue, bacilli from sputum or (in the case of "bowel nosodes") feces.[214] While Hahnemann was opposed to such preparations, modern homeopaths often use them although there is no evidence to indicate they have any beneficial effects.[215][216] Cases of homeopaths advising against the use of anti-malarial drugs have been identified.[208][217][218] This puts visitors to the tropics who take this advice in severe danger, since homeopathic remedies are completely ineffective against the malaria parasite.[208][217][218][219] Also, in one case in 2004, a homeopath instructed one of her patients to stop taking conventional medication for a heart condition, advising her on 22 June 2004 to "Stop ALL medications including homeopathic", advising her on or around 20 August that she no longer needed to take her heart medication, and adding on 23 August, "She just cannot take ANY drugs – I have suggested some homeopathic remedies ... I feel confident that if she follows the advice she will regain her health." The patient was admitted to hospital the next day, and died eight days later, the final diagnosis being "acute heart failure due to treatment discontinuation".[220][221]

In 1978, Anthony Campbell, then a consultant physician at The Royal London Homeopathic Hospital, criticised statements made by George Vithoulkas to promote his homeopathic treatments. Vithoulkas stated that syphilis, when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the central nervous system. Campbell described this as a thoroughly irresponsible statement that could mislead an unfortunate layperson into refusing conventional medical treatment. This claim echoes the idea that treating a disease with external medication used to treat the symptoms would only drive it deeper into the body and conflicts with scientific studies, which indicate that penicillin treatment produces a complete cure of syphilis in more than 90% of cases.[55]

A 2006 review by W. Steven Pray of the College of Pharmacy at Southwestern Oklahoma State University recommends that pharmacy colleges include a required course in unproven medications and therapies, that ethical dilemmas inherent in recommending products lacking proven safety and efficacy data be discussed, and that students should be taught where unproven systems such as homeopathy depart from evidence-based medicine.[222]

In an article entitled "Should We Maintain an Open Mind about Homeopathy?"[223] published in the American Journal of Medicine, Michael Baum and Edzard Ernst – writing to other physicians – wrote that "Homeopathy is among the worst examples of faith-based medicine... These axioms [of homeopathy] are not only out of line with scientific facts but also directly opposed to them. If homeopathy is correct, much of physics, chemistry, and pharmacology must be incorrect...".

In 2013, Sir Mark Walport, the new UK Government Chief Scientific Adviser and head of the Government Office for Science, had this to say about homeopathy: "My view scientifically is absolutely clear: homoeopathy is nonsense, it is non-science. My advice to ministers is clear: that there is no science in homoeopathy. The most it can have is a placebo effect – it is then a political decision whether they spend money on it or not."[224] His predecessor, Professor Sir John Beddington, referring to his views on homeopathy being "fundamentally ignored" by the Government, said: "The only one [view being ignored] I could think of was homoeopathy, which is mad. It has no underpinning of scientific basis. In fact all of the science points to the fact that it is not at all sensible. The clear evidence is saying this is wrong, but homoeopathy is still used on the NHS."[225]
Regulation and prevalence
Main article: Regulation and prevalence of homeopathy
Hampton House, the former site of Bristol Homeopathic Hospital, one of two homeopathic hospitals run by the NHS.[26]

Homeopathy is fairly common in some countries while being uncommon in others; is highly regulated in some countries and mostly unregulated in others. It is practised worldwide and professional qualifications and licences are needed in most countries.[226] Regulations vary in Europe depending on the country. In some countries, there are no specific legal regulations concerning the use of homeopathy, while in others, licences or degrees in conventional medicine from accredited universities are required. In Germany, to become a homeopathic physician, one must attend a three-year training program, while France, Austria and Denmark mandate licences to diagnose any illness or dispense of any product whose purpose is to treat any illness.[226] Some homeopathic treatment is covered by the public health service of several European countries, including France, the United Kingdom, Denmark, and Luxembourg. In other countries, such as Belgium, homeopathy is not covered. In Austria, the public health service requires scientific proof of effectiveness in order to reimburse medical treatments and homeopathy is listed as not reimbursable,[227] but exceptions can be made;[228] private health insurance policies sometimes include homeopathic treatment.[226] The Swiss government, after a 5-year trial, withdrew homeopathy and four other complementary treatments in 2005, stating that they did not meet efficacy and cost-effectiveness criteria,[229] but following a referendum in 2009 the five therapies are to be reinstated for a further 6-year trial period from 2012.[230] A May 2012 editorial in the Swiss Medical Weekly by David Martin Shaw described a 2011 government report on homeopathy. He described it as "a case study of research misconduct":

"This paper analyses the report and concludes that it is scientifically, logically and ethically flawed. Specifically, it contains no new evidence and misinterprets studies previously exposed as weak; creates a new standard of evidence designed to make homeopathy appear effective; and attempts to discredit randomised controlled trials as the gold standard of evidence. Most importantly, almost all the authors have conflicts of interest, despite their claim that none exist. If anything, the report proves that homeopaths are willing to distort evidence in order to support their beliefs, and its authors appear to have breached Swiss Academies of Arts and Sciences principles governing scientific integrity."[231]

Medicines at a Homeopathy pharmacy in Varanasi, India

The Indian government recognises homeopathy as one of its national systems of medicine,[232] it has established AYUSH or the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy under the Ministry of Health & Family Welfare.[233] The Central Council of Homoeopathy was established in 1973 to monitor higher education in Homeopathy, and National Institute of Homoeopathy in 1975.[234] A minimum of a recognised diploma in homeopathy and registration on a state register or the Central Register of Homoeopathy is required to practice homeopathy in India.[235]

In the United Kingdom, MPs inquired into homeopathy to assess the Government's policy on the issue, including funding of homeopathy under the National Health Service and government policy for licensing homeopathic products. The decision by the House of Commons Science and Technology Committee follows a written explanation from the Government in which it told the select committee that the licensing regime was not formulated on the basis of scientific evidence. "The three elements of the licensing regime (for homeopathic products) probably lie outside the scope of the ... select committee inquiry, because government consideration of scientific evidence was not the basis for their establishment," the Committee said. The inquiry sought written evidence and submissions from concerned parties.[236][237]

In February 2010 the House of Commons Science and Technology Committee concluded that:

... the NHS should cease funding homeopathy. It also concludes that the Medicines and Healthcare products Regulatory Agency (MHRA) should not allow homeopathic product labels to make medical claims without evidence of efficacy. As they are not medicines, homeopathic products should no longer be licensed by the MHRA.

The Committee concurred with the Government that the evidence base shows that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible.

The Committee concluded – given that the existing scientific literature showed no good evidence of efficacy – that further clinical trials of homeopathy could not be justified.

In the Committee's view, homeopathy is a placebo treatment and the Government should have a policy on prescribing placebos. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients, which usually relies on some degree of patient deception. Prescribing of placebos is not consistent with informed patient choice – which the Government claims is very important – as it means patients do not have all the information needed to make choice meaningful.

Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.[26]

The Committee also stated:

We conclude that placebos should not be routinely prescribed on the NHS. The funding of homeopathic hospitals – hospitals that specialise in the administration of placebos – should not continue, and NHS doctors should not refer patients to homeopaths.[238]

In July 2010 the newly appointed UK Secretary of State for Health deferred to local NHS on funding homeopathy. A nineteen-page document details the Government´s response, and it states that "our continued position on the use of homeopathy within the NHS is that the local NHS and clinicians, rather than Whitehall, are best placed to make decisions on what treatment is appropriate for their patients - including complementary or alternative treatments such as homeopathy - and provide accordingly for those treatments." The response also stated that "the overriding reason for NHS provision is that homeopathy is available to provide patient choice".[239] by February 2011 only one third of PCTs still funded homeopathy.[240]

In 2012 in the United Kingdom, Derby University dropped its homeopathy program, and the University of Westminster ceased enrolling new homeopathy students. Salford University had dropped its homeopathy program the previous year.[241] In 2013 the UK Advertising Standards Authority concluded that the Society of Homeopaths were targeting vulnerable ill people and discouraging the use of essential medical treatment while making misleading claims of efficacy for homeopathic products.[242]
Public opposition

Mock "overdosing" on homeopathic preparations by individuals or groups in "mass suicides" have become more popular since James Randi began taking entire bottles of homeopathic sleeping pills before giving lectures.[243][244][245][246] In 2010 The Merseyside Skeptics Society from the United Kingdom launched the 10:23 campaign encouraging groups to publicly overdose as groups. In 2011 the 10:23 campaign expanded and saw sixty-nine groups participate, fifty-four submitted videos.[247] In April 2012, at the Berkeley SkeptiCal conference, over 100 people participated in a mass overdose, taking caffea cruda which is supposed to treat sleeplessness.[248][249]

The non-profit, educational organizations Center for Inquiry (CFI) and the associated Committee for Skeptical Inquiry (CSI) have petitioned the U.S. Food and Drug Administration (FDA), criticizing Boiron for misleading labeling and advertising of Oscillococcinum. CFI in Canada is calling for persons that feel they were harmed by homeopathic products to contact them.[250]

In August 2011,[251] a class action lawsuit was filed[251] against Boiron on behalf of "all California residents who purchased Oscillo at any time within the past four years." The lawsuit charges that it "is nothing more than a sugar pill," "despite falsely advertising that it contains an active ingredient known to treat flu symptoms."[252]

CBC News reporter Erica Johnson for Marketplace conducted an investigation on the homeopathy industry in Canada, her findings were that it is "based on flawed science and some loopy thinking". Center for Inquiry (CFI) Vancouver skeptics participated in a mass overdose outside an emergency room in Vancouver, B.C., taking entire bottles of "medications" that should have made them sleepy, nauseous or dead, after 45 minutes of observation no ill effects were felt. Johnson asked homeopaths and company representatives about cures for cancer and vaccine claims. All reported positive results but none could offer any science backing up their statements, only that "it works". Johnson was unable to find any evidence that homeopathic preparations contain any active ingredient. Analysis performed at the University of Toronto's chemistry department found that the active ingredient is so small "it is equivalent to 5 billion times less than the amount of aspirin... in a single pellet". Belladonna and ipecac "would be indistinguishable from each other in a blind test."[253][254]
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^ Walchli, Chantal; Baumgartner, Stephan; Bastide, Madeleine (2006), "Effect of Low Doses and High Homeopathic Potencies in Normal and Cancerous Human Lymphocytes: An In Vitro Isopathic Study", Journal of Alternative and Complementary Medicine 12 (5): 421–7, doi:10.1089/acm.2006.12.421
^ Walach, H; Köster, H; Hennig, T; Haag, G (2001), "The effects of homeopathic belladonna 30CH in healthy volunteers — a randomized, double-blind experiment", Journal of Psychosomatic Research 50 (3): 155–60, doi:10.1016/S0022-3999(00)00224-5, PMID 11316508
^ Hirst, S. J.; Hayes, N. A.; Burridge, J.; Pearce, F. L.; Foreman, J. C. (1993), "Human basophil degranulation is not triggered by very dilute antiserum against human IgE", Nature 366 (6455): 525–7, Bibcode:1993Natur.366..525H, doi:10.1038/366525a0, PMID 8255290
^ Ovelgönne, J. H.; Bol, A. W. J. M.; Hop, W. C. J.; Wijk, R. (1992), "Mechanical agitation of very dilute antiserum against IgE has no effect on basophil staining properties", Experientia 48 (5): 504–8, doi:10.1007/BF01928175, PMID 1376282
^ Witt, Claudia M.; Bluth, Michael; Hinderlich, Stephan; Albrecht, Henning; Ludtke, Rainer; Weisshuhn, Thorolf E.R.; Willich, Stefan N. (2006), "Does Potentized HgCl2 (Mercurius corrosivus) Affect the Activity of Diastase and -Amylase?", Journal of Alternative and Complementary Medicine 12 (4): 359–65, doi:10.1089/acm.2006.12.359
^ Guggisberg, A; Baumgartner, S; Tschopp, C; Heusser, P (2005), "Replication study concerning the effects of homeopathic dilutions of histamine on human basophil degranulation in vitro", Complementary Therapies in Medicine 13 (2): 91–100, doi:10.1016/j.ctim.2005.04.003, PMID 16036166
^ a b Sullivan W (1988-07-27), "Water That Has a Memory? Skeptics Win Second Round", The New York Times, retrieved 2007-10-03
^ Benveniste defended his results by comparing the inquiry to the Salem witch hunts and asserting that "It may be that all of us are wrong in good faith. This is no crime but science as usual and only the future knows."
^ Hilly Janes (September 6, 2008), "The Lifestyle 50: The top fifty people who influence the way we eat, exercise and think about ourselves", The Times, archived from the original on 2011-07-27
^ Memorandum submitted by Edzard Ernst HO 16 to the House of Lords
^ Boseley S (21 July 2008), "The alternative professor", The Guardian (London)
^ "Complementary therapies: The big con?", The Independent (London), 2008-04-22, archived from the original on 2010-04-17, retrieved 2010-05-04
^ Sample I (21 July 2008), "Pharmacists urged to 'tell the truth' about homeopathic remedies", The Guardian (London)
^ a b Malik, Imtiaz A.; Gopalan, Sethuraman (2002), "Use of CAM results in delay in seeking medical advice for breast cancer", European Journal of Epidemiology 18 (8): 817–22, doi:10.1023/A:1025343720564, PMID 12974558, "CAM use [in the developing countries this study solely considered] was associated with delay in seeking medical advice (OR: 5.6; 95% CI: 2.3, 13.3) and presentation at an advanced stage of disease"
^ "Hyland’s Teething Tablets: Recall - Risk of Harm to Children". Food and Drug Administration. 23 October 2010. Retrieved August 2013.
^ Chakraborti, D; Mukherjee, SC; Saha, KC; Chowdhury, UK; Rahman, MM; Sengupta, MK (2003), "Arsenic toxicity from homeopathic treatment", Journal of toxicology. Clinical toxicology 41 (7): 963–7, doi:10.1081/CLT-120026518, PMID 14705842
^ Barrett S (4 November 2003), "Zicam marketers sued", Homeowatch.org, retrieved 2007-10-25
^ Boodman S (31 January 2006), "Paying through the nose", This Week in Health & Science, Washington Post, retrieved 2007-10-25
^ Sources:
Julianne Pepitone (2009-06-16), "Zicam may damage sense of smell - FDA", CNNMoney.com
Information on Zicam Cold remedy Nasal Gel, Zicam Cold remedy Nasal Swabs, and Zicam Cold remedy Swabs, Kids Size, FDA, 2009-06-16
^ Matrixx Initiatives, Inc. AKA Zicam LLC 6/16/09. Warning letter, FDA, 2009-06-16
^ a b Adler J (2004-02-04). "No way to treat the dying". Newsweek.
^ Wahlberg, A (2007), "A quackery with a difference—New medical pluralism and the problem of 'dangerous practitioners' in the United Kingdom", Social Science & Medicine 65 (11): 2307–16, doi:10.1016/j.socscimed.2007.07.024, PMID 17719708
^ National Science Board (2002), "Science Fiction and Pseudoscience", Science and engineering indicators 2002, Arlington, Virginia: National Science Foundation Directorate for Social, Behavioral and Economic Sciences
^ Atwood, K. C. (2003), ""Neurocranial Restructuring" and Homeopathy, Neither Complementary nor Alternative", Archives of Otolaryngology - Head and Neck Surgery 129 (12): 1356–7, doi:10.1001/archotol.129.12.1356, PMID 14676179
^ Ndububa, VI (2007), "Medical quackery in Nigeria; why the silence?", Nigerian journal of medicine 16 (4): 312–7, PMID 18080586
^ Ernst, E.; Pittler, MH (1998), "Efficacy of Homeopathic Arnica: A Systematic Review of Placebo-Controlled Clinical Trials", Archives of Surgery 133 (11): 1187–90, doi:10.1001/archsurg.133.11.1187, PMID 9820349
^ Rosa Silverman. "Homeopathy is 'rubbish', says chief medical officer". The Daily Telegraph (London: TMG). ISSN 0307-1235. OCLC 49632006. Retrieved 24 January 2013.
^ "Homeopathy: An Introduction". National Center for Complementary and Alternative Medicine. April, 2012. Retrieved January, 2013.
^ a b Ernst, E; White, AR (1995), "Homoeopathy and immunization", The British journal of general practice 45 (400): 629–30, PMC 1239445, PMID 8554846
^ a b c Jones M (2006-07-14), "Malaria advice 'risks lives'", Newsnight (BBC Television), retrieved 2009-03-24
^ Case of Baby Gloria, who died in 2002:
"Homeopath Thomas Sam guilty of daughter Gloria's death", The Daily Telegraph, June 5, 2009
"Parents guilty of manslaughter over daughter's eczema death", The Canberra Times, June 5, 2009
^ a b Alastair Neil Hope, State Coroner, Coroner's inquest into the death of Penelope Dingle. Ref No: 17/10
^ Schmukler AV (2006), Homeopathy: An A to Z Home Handbook, Llewellyn Worldwide, p. 16, ISBN 978-0-7387-0873-7
^ Ernst, E. (1997), "The attitude against immunisation within some branches of complementary medicine", European Journal of Pediatrics 156 (7): 513–5, doi:10.1007/s004310050650, PMID 9243229
^ Ernst, E (2001), "Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination", Vaccine 20: S90–3; discussion S89, doi:10.1016/S0264-41(01)00290-0, PMID 11587822
^ Pray WS (1996), "The Challenge to Professionalism Presented by Homeopathy", American Journal of Pharmaceutical Education 60: 198–204
^ Pray WS (1992), "A challenge to the credibility of homeopathy", Am J Pain Management (2): 63–71
^ English, J (1992), "The issue of immunization", British Homoeopathic journal 81 (4): 161–3, doi:10.1016/S0007-0785(05)80171-1
^ a b Jha A (14 July 2006), "Homeopaths 'endangering lives' by offering malaria remedies", The Guardian (London)
^ a b Starr, M. (2000), "Malaria affects children and pregnant women most", BMJ 321 (7271): 1288, doi:10.1136/bmj.321.7271.1288
^ Coffman, Becky. A Cautionary Tale: The Risks of Unproven Antimalarials. Centers for Disease Control
^ Bunyan N (2007-03-22), Patient died after being told to stop heart medicine, "Daily Telegraph", The Daily Telegraph (London), retrieved 2007-10-15
^ "Fitness To Practise panel hearing on Dr Marisa Viegas", General Medical Council (via archive.org), June 2007, archived from the original on 2007-12-22, retrieved 2009-01-25
^ Pray WS (2006), "Ethical, scientific, and educational concerns with unproven medications", Am J Pharm Educ 70 (6): 141, PMC 1803699, PMID 17332867
^ Baum, Michael; Ernst, Edzard (2009), "Should We Maintain an Open Mind about Homeopathy?", The American Journal of Medicine 122 (11): 973–4, doi:10.1016/j.amjmed.2009.03.038, PMID 19854319, "Homeopathy is among the worst examples of faith-based medicine… These axioms [of homeopathy] are not only out of line with scientific facts but also directly opposed to them. If homeopathy is correct, much of physics, chemistry, and pharmacology must be incorrect… To have an open mind about homeopathy or similarly implausible forms of alternative medicine (e.g., Bach Flower remedies, spiritual healing, crystal therapy) is, therefore, not an option"
^ Nick Collins, Science Correspondent. Homeopathy is nonsense, says new chief scientist. The Telegraph, 18 Apr 2013
^ Richard Gray, Science Correspondent, Homeopathy on the NHS is 'mad' says outgoing scientific adviser. The Telegraph, 09 Apr 2013
^ a b c Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review, World Health Organization, 2001, ISBN 978-92-4-154548-8
^ Hauptverband der österreichischen Sozialversicherungsträger (31 March 2004), "Liste nicht erstattungsfähiger Arzneimittelkategorien gemäß § 351c Abs. 2 ASVG (List of treatments not reimbursable by social service providers in Austria)", (German)
^ Rechtssatz (legal rule), RS0083796 (German) (Oberster Gerichtshof OGH - Austrian supreme court 28 February 1994).
^ The Lancet (2005), "The end of homoeopathy", The Lancet 366 (9487): 690, doi:10.1016/S0140-6736(05)67149-8
^ Dacey J (14 January 2011), Alternative therapies are put to the test, swissinfo.ch, retrieved 2011-01-17
^ Shaw, David M. The Swiss report on homeopathy: a case study of research misconduct. Swiss Medical Weekly, 31 May 2012, 2012;142:w13594, doi:10.4414/smw.2012.13594
^ "Alternative System of Health Care", Government of India, archived from the original on 2010-01-02, retrieved 2010-01-15
^ "AYUSH". Government of India. website.
^ "Professional Councils". University Grants Commission (UGC) website.
^ "The Homoeopathy Central Council Act, 1973, s. 15 and Sch. II", Central Council of Homeopathy, India, retrieved 2010-01-18
^ News in brief: Homeopathic assessment, Times Higher Education, 29 October 2009, timeshighereducation.co.uk
^ Evidence check: Homeopathy, House of Commons Science and Technology Committee, 20 October 2009, parliament.uk
^ Evidence Check 2: Homeopathy, Fourth Report of Session 2009–10, House of Commons Science and Technology Committee, 20 October 2009, parliament.uk
^ Secretary of State for Health Government Response to the Science and Technology Committee report 'Evidence Check 2: Homeopathy', July 2010 ISBN 978-0-10-179142-7
^ "Third of NHS trusts fund homeopathy". BBC News. 19 Feb, 2011. Retrieved September 7, 2011.
^ Bevanger, Lars (January 18, 2012). "UK universities drop alternative medicine degree programs". Deutsche Welle. Retrieved February 5, 2012.
^ "ASA adjudication on Society of Homeopaths". ASA. 3 July 2013. Retrieved 4 July 2013.
^ "James Randi's fiery takedown of psychic fraud". TED. Retrieved 2012-05-08.
^ Randi, James. "James Randi Speaks Homeopathy Week 2010". JREF.
^ Randi, James. "James Randi Lecture @ Caltech - Homeopathy". California Institute of Technology. Retrieved 2012-05-09.
^ Randi, James. "James Randi's Challenge to Homeopathy Manufacturers and Retail Pharmacies". JREF. Retrieved 2012-05-09.
^ "The 10:23 Challenge 2011 Gallery". Merseyside Skeptics Society. Retrieved 2011-04-11.
^ Munger, Kel. "Drugs, not bugs". Sacramento News Review. Retrieved 2012-05-04.
^ "Mixing Homeopathic "Remedies" for 2011 San Francisco 10:23 "Overdose"". 10:23 campaign. Retrieved 2012-05-09.
^ "Harmed by Homeopathy? CFI Wants to Hear from You". Center for Inquiry. 18 April 2012. Retrieved 2012-05-04.
^ a b "Suit Targets Homeopathic Flu Remedy Claims". Casewatch. 18 August 2011. Retrieved 2012-05-05.
^ "Boiron Oscillococcinum Class Action Lawsuit". Top Class Actions. 8 August 2011. Retrieved 2011-09-24.
^ Johnson, Erica. "CBC Marketplace - Homeopathy: Cure or Con? Part 1 of 2". CBC News. Retrieved 2012-06-26.
^ Johnson, Erica. "CBC Marketplace - Homeopathy: Cure or Con? Part 2 of 2". CBC News. Retrieved 2012-06-26.

External links
Wikimedia Commons has media related to Homeopathy.
Wikinews has related news: Parents prosecuted after homeopathic treatment leads to daughter's death
Wikisource has the text of the 1911 Encyclopædia Britannica article Homoeopathy.

Opposing views on homeopathy at the Open Directory Project
Stehlin, Isadora (1996), "Homeopathy: real medicine or empty promises?", FDA Consumer (USFDA)
"Diluting the scientific method: Ars looks at homeopathy (again)", arstechnica.com
Ramey DW, The scientific evidence on homeopathy, American Council on Science and Health
"Homeopathy: There's nothing in it", Merseyside Skeptics Society
Wikisource-logo.svg Egbert Guernsey (1879). "Homœopathy". The American Cyclopædia.

Videos

Randi J, "Homeopathy Explained: 14 minute portion of 2001 lecture at Princeton University",
Fisher, P., Goldacre, B., "Does homeopathy work? A debate on the evidence on both sides", [dead link]

Associations

Homeopathy organizations at the Open Directory Project

[show]

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Topics in homeopathy
[show]

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Pseudoscience

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Alternative medical systems
Homeopathy
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[six]

The scientific community regards homeopathy as nonsense,[11] quackery[12][13][14] or a sham,[15] and homeopathic practice has been criticized as unethical.[16] The axioms of homeopathy are long refuted[17] and lack any biological plausibility.[18] Although some clinical trials produce positive results,[19][20] systematic reviews reveal that this is because of chance, flawed research methods, and reporting bias.[21][22][23][24] The postulated mechanisms of action of homeopathic remedies are not only scientifically implausible[21][25][26][27] but precluded by the laws of physics.[

[meneer]

Oorspronkelijk geplaatst door six

The scientific community regards homeopathy as nonsense,[11] quackery[12][13][14] or a sham,[15] and homeopathic practice has been criticized as unethical.[16] The axioms of homeopathy are long refuted[17] and lack any biological plausibility.[18] Although some clinical trials produce positive results,[19][20] systematic reviews reveal that this is because of chance, flawed research methods, and reporting bias.[21][22][23][24] The postulated mechanisms of action of homeopathic remedies are not only scientifically implausible[21][25][26][27] but precluded by the laws of physics.[

Jaaa, even een ellenlange posting zodat niemand dat leest !
Zo ken ik je wel...

[maddox]

Water met geheugen, da's wat me voorstaat van alternatieve geneeskunde.

Klankschalen is ook zo iets prachtig.

Oftewel, ik ben er niet zo tuk op.

[DewareJakob]

Oorspronkelijk geplaatst door meneer

Jaaa, even een ellenlange posting zodat niemand dat leest !
Zo ken ik je wel...

Dat is toch het beste wat je met zijn posts kan doen. Ze zitten altijd volledig naast de zaak, enkel bedoeld om te trollen.

[DewareJakob]

Osteopaat: probleem: pijnlijke nek op 3 keer opgelost na een hoop kine die niets uithaalde.

[meneer]

Oorspronkelijk geplaatst door six

Men kan in Leuven Homeopathie studeren aan de Universiteit.

Je vergist je of je liegt, wat zal het zijn ?

http://www.veto.be/jg39/veto3923/gee...-aan-ku-leuven

Daar wil Onkelinx verandering in brengen, maar de universiteiten zijn niet bereid om opleidingen tot alternatieve geneeskunde aan te bieden. “Hier in Leuven willen wij geen zaken doceren die niet wetenschappelijk bewezen zijn. Voor homeopathie, accupunctuur en het grootste deel van osteopathie en chiropraxie bestaat geen enkel wetenschappelijk bewijs,” oordeelt Goffin genadeloos.

Deze Jan Goffin, decaan van de Leuvense faculteit geneeskunde, is blijkbaar een sectair en niet vooruitstrevend persoon. Het typische voorbeeld van iemand die weliswaar intelligent genoeg is, om op de paats te geraken waar hij momenteel zit, maar door zijn koppige onwil belet word om ook andere manieren van geneeskunde te aanvaarden, als deze die hij zelf geleerd heeft. M.a.w één van die mensen die de wijsheid in pacht menen te hebben...Spijtig. De alternatieve en de conventionele geneeskunde kunnen zich perfect samen verder ontwikkelen.
En nog iets , six, alternatieve geneeskunde beperkt zich niet tot homeopathie. Informeer je hier :http://alternatieve-geneeswijzen.startkabel.nl/

[six]

Dit is wat Wikipedia over alternatieve geneeskunde schrijft:


Alternative medicine
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Alternative medical systems Acupuncture
Anthroposophic medicine
Bowen technique
Chiropractic
Homeopathy
Naturopathic medicine
Osteopathy
Zoopharmacognosy
Traditional medicine
Chinese · Korean · Mongolian · Tibetan · Unani · Siddha · Ayurveda
Previous NCCAM domains
Mind–body interventions
Biologically based therapies
Manipulative therapy
Energy therapies

v
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Alternative medicine
Intervention
MeSH D000529

Alternative medicine is any practice that is put forward as having the healing effects of medicine but is not based on evidence gathered using the scientific method.[1] It consists of a wide range of health care practices, products and therapies,[2] using alternative medical diagnoses and treatments which typically have not been included in the degree courses of established medical schools or used in conventional medicine. Examples of alternative medicine include homeopathy, naturopathy, chiropractic, and acupuncture.

Complementary medicine is alternative medicine used together with conventional medical treatment in a belief, not proven by using scientific methods, that it "complements" the treatment.[n 1][1][4][5] CAM is the abbreviation for Complementary and alternative medicine.[6][7] Integrative medicine (or integrative health) is the combination of the practices and methods of alternative medicine with conventional medicine.[8]

The term alternative medicine is used in information issued by public bodies in the Commonwealth of Australia[9] the United Kingdom[10] and the United States of America.[11] Regulation and licensing of alternative medicine and health care providers varies from country to country, and state to state.

Contents

1 Background
1.1 Terms and definitions
1.2 Regional definitions
1.2.1 Institutions
1.2.2 Special terminology used by selected individuals
2 History - 19th century onwards
2.1 Medical education since 1910
2.2 Proponents and opponents
3 Examples and classes
3.1 Ayurvedic medicine
3.2 Body manipulation
3.3 Energy therapies
3.3.1 Biofields
3.3.2 Electromagnetic fields
3.4 Herbs, diet and vitamins
3.5 Homeopathy
3.6 Mind body therapies
3.7 Naturopathy
3.8 Traditional Chinese medicine
4 Criticism
4.1 In US
4.2 Other critics (UK)
5 Placebo effect
6 Use and regulation
6.1 Prevalence of use
6.1.1 In US
6.1.2 Prevalence of use of specific therapies
6.1.3 In palliative care
6.2 Regulation
7 Efficacy
8 Safety
8.1 Adequacy of regulation and CAM safety
8.1.1 Interactions with conventional pharmaceuticals
8.1.2 Potential side-effects
8.1.3 Treatment delay
8.1.4 Unconventional cancer "cures"
8.2 Research funding
9 Appeal
9.1 In UK
9.2 In US and Canada
10 See also
11 Explanatory notes
12 References
13 Bibliography
14 Further reading
14.1 World Health Organization publications
14.2 Journals dedicated to alternative medicine research
15 External links
15.1 Criticism

Background
Terms and definitions
Vials displayed in a glass case at a homeopathic pharmacy in Varanasi, India

The expression "complementary and alternative medicine" (CAM) resists easy definition because the health systems and practices to which it refers are diffuse and its boundaries are poorly defined.[12][13][14][n 2] Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique, therapeutic practice and in their relationship to the medical mainstream.[16] Some alternative therapies, including traditional Chinese Medicine (TCM) and Ayurveda, have antique, non-Western origins and are entirely alternate medical systems;[17] others, such as homeopathy and chiropractic, are native to the West and emerged in the eighteenth and nineteenth centuries.[18] Some, such as osteopathy and chiropractic, employ manipulative physical methods of treatment; others, such as meditation and prayer, are based on mind-body interventions.[19] Treatments considered alternative in one location may be considered conventional in another.[20] Thus, chiropractic is not considered alternative in Denmark and likewise osteopathy in the US is no longer thought of as an alternative therapy.[20]

One common feature of all definitions of alternative medicine is its designation as "other than" conventional medicine.[21] For example, the widely referenced [22][23] descriptive definition of complementary and alternative medicine devised by the US National Center for Complementary and Altenative Medicine (NCCAM) of the National Institutes of Health (NIH), states that it is "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine."[24] This definition has been criticized as, if an alternative therapy, both effective and safe, is adopted by conventional medical practitioners, it does not necessarily follow that either it or its practitioners would no longer be considered alternative.[n 3]

Some definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare.[27] This can refer to the lack of support that alternative therapies receive from the medical establishment and related bodies regarding access to research funding, sympathetic coverage in the medical press, or inclusion in the standard medical curriculum.[27] In 1993, the British Medical Association (BMA), one among many professional organizations who have attempted to define alternative medicine, stated that it[n 4] referred to "those forms of treatment which are not widely used by the conventional healthcare professions, and the skills of which are not taught as part of the undergraduate curriculum of conventional medical and paramedical healthcare courses".[28] In a US context, an influential definition coined in 1993 by the Harvard-based physician,[29] David M. Eisenberg,[30] characterized alternative medicine "as interventions neither taught widely in medical schools nor generally available in US hospitals".[31] These descriptive definitions are inadequate in the present-day when some conventional doctors offer alternative medical treatments and CAM introductory courses or modules can be offered as part of standard undergraduate medical training;[32] alternative medicine is taught in more than 50 per cent of US medical schools and increasingly US health insurers are willing to provide reimbursement for CAM therapies.[33] In 1999, 7.7% of US hospitals reported using some form of CAM therapy; this proportion had risen to 37.7% by 2008.[34]

Complementary and alternative medicine is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes all such practices and ideas self-defined by their users as preventing or treating illness or promoting health or well-being. Boundaries within CAM and between the CAM domain and that of the dominant system are not always sharp or fixed.
“
”
CAM Research Methodology Conference, April 1995.[35]

An expert panel at a conference hosted in 1995 by the US Office for Alternative Medicine (OAM),[n 5] devised a theoretical definition of alternative medicine as "a broad domain of healing resources ... other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period."[35] This definition has been widely adopted by CAM researchers,[36] official government bodies such as the UK Department of Health,[37] has often been attributed as the definition used by the Cochrane Collaboration,[38] and, with slight modification, was preferred in the 2005 consensus report of the Committee on the Use of Complementary and Alternative Medicine by the American Public Board on Health Promotion and Disease Prevention issued by the US Institute of Medicine of the National Academies.[n 6]

The 1995 OAM conference definition, an expansion of Eisenberg's 1993 formulation, is silent regarding questions of the medical effectiveness of alternative therapies.[40] Its proponents hold that it thus avoids relativism about differing forms of medical knowledge and, while it is an essentially political definition, this should not imply that the dominance of mainstream biomedicine is solely due to political forces.[40] According to this definition, alternative and mainstream medicine can only be differentiated with reference to what is "intrinsic to the politically dominant health system of a particular society of culture".[41] However, there is neither a reliable method to distinguish between cultures and subcultures, nor to attribute them as dominant or subordinate, nor any accepted criteria to determine the dominance of a cultural entity.[41] If the culture of a politically dominant healthcare system is held to be equivalent to the perspectives of those charged with the medical management of leading healthcare institutions and programs, the definition fails to recognize the potential for division either within such an elite or between a healthcare elite and the wider population.[41]

There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking.
“
”
P.B. Fontanarosa, JAMA (1998).[42]

Normative definitions distinguish alternative medicine from the biomedical mainstream in its provision of therapies that are unproven, unvalidated or ineffective and support of theories which have no recognized scientific basis.[39] These definitions characterize practices as constituting alternative medicine when, used independently or in place of evidence-based medicine, they are put forward as having the healing effects of medicine, but which are not based on evidence gathered with the scientific method.[1][24][43][44][45] Exemplifying this perspective, a 1998 editorial co-authored by a former editor of the New England Journal of Medicine, Marcia Angell, argued that:

It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine – conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted. But assertions, speculation, and testimonials do not substitute for evidence. Alternative treatments should be subjected to scientific testing no less rigorous than that required for conventional treatments.[46]

This type of definition fails to adequately differentiate conventional from alternative medicine as, according to a review of Cochrane systematic reviews, approximately 20 per cent of standard medical procedures have no effect and an equal proportion had insufficient evidence to make a determination of efficacy.[47]

"Complementary medicine" refers to use of alternative medicine alongside conventional science based medicine, in the belief that it increases the effectiveness.[24][43][44] In Science and Technology: Public Attitudes and Public Understanding, chapter 7 of a report Science and Engineering Indicators – 2002, issued by a US government agency (The National Science Foundation), it was stated that the term "alternative medicine" was there being used to refer to all treatments that had not been proven effective using scientific methods.[1]
Regional definitions

Public information websites maintained by the governments of the US and of the UK make a distinction between "alternative medicine" and "complementary medicine", but mention that these two can overlap. The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH) (a part of the US Department of Health and Human Services) states that "alternative medicine" refers to using a non-mainstream approach in place of conventional medicine and that "complementary medicine" generally refers to using a non-mainstream approach together with conventional medicine, and comments that the boundaries between complementary and conventional medicine overlap and change with time.[24] The National Health Service (NHS) website NHS Choices (owned by the UK Department of Health), adopting the terminology of NCCAM, states that when a treatment is used alongside conventional treatments, to help a patient cope with a health condition, and not as an alternative to conventional treatment, this use of treatments can be called "complementary medicine"; but when a treatment is used instead of conventional medicine, with the intention of treating or curing a health condition, the use can be called "alternative medicine".[48]

Similarly, the public information website maintained by the National Health and Medical Research Council (NHMRC) of the Commonwealth of Australia uses the acronym "CAM" for a wide range of health care practices, therapies, procedures and devices not within the domain of conventional medicine. In the Australian context this is stated to include acupuncture; aromatherapy; chiropractic; homeopathy; massage; meditation and relaxation therapies; naturopathy; osteopathy; reflexology, traditional Chinese medicine; and the use of vitamin supplements.[9]

The Danish Knowledge and Research Center for Alternative Medicine an independent institution under the Danish Ministry of the Interior and Health (Danish abbreviation: ViFAB) uses the term “alternative medicine” for:

Treatments performed by therapists that are not authorized healthcare professionals, where authorized healthcare professionals are those practicing what is proven by science.
Treatments performed by authorized healthcare professionals, but those based on methods otherwise used mainly outside the healthcare system, which is based on science in Denmark. People without a healthcare authorisation must be able to perform the treatments.

Institutions

In General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine, published in 2000 by the World Health Organization (WHO), complementary and alternative medicine were there defined as a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system.[49][50]

Some herbal therapies are mainstream in Europe but are alternative in the US.[51]
Special terminology used by selected individuals

Two advocates of integrative medicine, writing in 2002 of the American healthcare system, claimed that it also addresses alleged problems with medicine based on science, which are not addressed by CAM; Ralph Snyderman and Andrew Weil stated that "integrative medicine is not synonymous with complementary and alternative medicine. It has a far larger meaning and mission in that it calls for restoration of the focus of medicine on health and healing and emphasizes the centrality of the patient-physician relationship."[52]
History - 19th century onwards
Main article: History of alternative medicine

Dating from the 1970s, medical professionals, sociologists, anthropologists and other commentators noted the increasing visibility of a wide variety of health practices that had neither derived directly from nor been verified by biomedical science.[53] Since that time, those who have analyzed this trend have deliberated over the most apt language with which to describe this emergent health field.[53] A variety of terms have been used, including heterodox, irregular, fringe and alternative medicine while others, particularly medical commentators, have been satisfied to label them as instances of quackery.[53] The most persistent term has been alternative medicine but its use is problematic as it assumes a value-laden dichotomy between a medical fringe, implicitly of borderline acceptability at best, and a privileged medical orthodoxy, associated with validated medico-scientific norms.[54] The use of the category of alternative medicine has also been criticized as it cannot be studied as an independent entity but must be understood in terms of a regionally and temporally specific medical orthodoxy.[55] Its use can also be misleading as it may erroneously imply that a real medical alternative exists.[56] As with near-synonymous expressions, such as unorthodox, complementary, marginal, or quackery, these linguistic devices have served, in the context of processes of professionalisation and market competition, to establish the authority of official medicine and police the boundary between it and its unconventional rivals.[54]

From a historical perspective, the emergence of alternative medicine, if not the term itself, is typically dated to the 19th century.[57] This is despite the fact that there are variants of Western non-conventional medicine that arose in the late-eighteenth century or earlier and some non-Western medical traditions, currently considered alternative in the West and elsewhere, which boast extended historical pedigrees.[54] Alternative medical systems, however, can only be said to exist when there is an identifiable, regularized and authoritative standard medical practice, such as arose in the West during the nineteenth-century, to which they can function as an alternative.[58]

During the late eighteenth and nineteenth centuries regular and irregular medical practitioners became more clearly differentiated throughout much of Europe and,[59] as the nineteenth century progressed, most Western states converged in the creation of legally delimited and semi-protected medical markets.[60] It is at this point that an "official" medicine, created in cooperation with the state and employing a scientific rhetoric of legitimacy, emerges as a recognizable entity and that the concept of alternative medicine as a historical category becomes tenable.[61] As part of this process, professional adherents of mainstream medicine in countries such as Germany, France, and Britain increasingly invoked the scientific basis of their discipline as a means of engendering internal professional unity and of external differentiation in the face of sustained market competition from homeopaths, naturopaths, mesmerists and other nonconventional medical practitioners, finally achieving a degree of imperfect dominance through alliance with the state and the passage of regulatory legislation.[54][56] In the US the Johns Hopkins University School of Medicine, based in Baltimore, Maryland, opened in 1893 and was the first medical school devoted to teaching "German scientific medicine".[62] Buttressed by the increased authority consequent to the significant advances in the medical sciences of the late 19th century onwards — including the development and application of the germ theory of disease by the chemist Louis Pasteur and the surgeon Joseph Lister, 1st Baron Lister, of microbiology co-founded by Robert Koch (in 1885 appointed professor of hygiene at the University of Berlin), and of the use of X-rays (Röntgen rays) — the 1910 Flexner Report called upon American medical schools to follow the model set by the Johns Hopkins School of Medicine and adhere to mainstream science in their teaching and research. This was in a belief, mentioned in the Report's introduction, that the preliminary and professional training then prevailing in medical schools should be reformed in view of the new means for diagnosing and combating disease being made available to physicians and surgeons by the sciences on which medicine depended.[n 7][64] An early instance of the influence of the Flexner Report outside North America is Peking Union Medical College.[65][n 8][n 9]

Among putative medical practices available at the time which later became known as "alternative medicine" were homeopathy (founded in Germany in the early 19c.) and chiropractic (founded in North America in the late 19c.). These conflicted in principle with the developments in medical science upon which the Flexner reforms were based, and they have not become compatible with further advances of medical science such as listed in Timeline of medicine and medical technology, 1900-1999 and 2000–present, nor have Ayurveda, acupuncture or other kinds of alternative medicine.

At the same time "Tropical medicine" was being developed as a specialist branch of western medicine in research establishments such as Liverpool School of Tropical Medicine founded 1898, London School of Hygiene & Tropical Medicine, founded 1899 and Tulane University School of Public Health and Tropical Medicine, founded 1912. A distinction was being made between western scientific medicine and indigenous systems. An example is given by an official report about indigenous systems of medicine in India, including Ayurveda, submitted by Mohammad Usman of Madras and others in 1923. This stated that the first question the Committee considered was "to decide whether the indigenous systems of medicine were scientific or not".[66][67][68]

By the later twentieth century the term 'alternative medicine' had come into use for the purposes of public discussion,[n 10][70] but it was not always being used with the same meaning by all parties. Arnold S. Relman remarked in 1998 that in the best kind of medical practice, all proposed treatments must be tested objectively, and that in the end there will only be treatments that pass and those that do not, those that are proven worthwhile and those that are not. He asked 'Can there be any reasonable "alternative"?'[71] But also in 1998 the then Surgeon General of the United States, David Satcher,[72] issued public information about eight common alternative treatments (including acupuncture, holistic and massage), together with information about common diseases and conditions, on nutrition, diet, and lifestyle changes, and about helping consumers to decipher fraud and quackery, and to find healthcare centers and doctors who practiced alternative medicine.[73]

In respect of alternative medicine since the 1970s in North America, Great Britain and elsewhere, there has been a tendency for the terms ‘alternative’ and ‘complementary’ to be used interchangeably to describe a wide diversity of therapies that attempt to use the self-healing powers of the body by amplifying natural recuperative processes to restore health. By 1990, approximately 60 million Americans had used one or more complementary or alternative therapies to address health issues, according to a nationwide survey in the US published in 1993 by David Eisenberg.[74] A study published in the November 11, 1998 issue of the Journal of the American Medical Association reported that 42% of Americans had used complementary and alternative therapies, up from 34% in 1990.[75] However, despite the growth in patient demand for complementary medicine, most of the early alternative/complementary medical centers failed.[76]
Medical education since 1910

Mainly as a result of reforms following the Flexner Report of 1910[77] medical education in established medical schools in the US has generally not included alternative medicine as a teaching topic.[n 11] Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology.[79] Medical schools' teaching includes such topics as doctor-patient communication, ethics, the art of medicine,[80] and engaging in complex clinical reasoning (medical decision-making).[81] Writing in 2002, Snyderman and Weil remarked that by the early twentieth century the Flexner model had helped to create the 20th-century academic health center in which education, research and practice were inseparable. While this had much improved medical practice by defining with increasing certainty the pathophysiological basis of disease, a single-minded focus on the pathophysiological had diverted much of mainstream American medicine from clinical conditions which were not well understood in mechanistic terms and were not effectively treated by conventional therapies.[52]

By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US.[82] Exceptionally, the School of Medicine of the University of Maryland, Baltimore includes a research institute for integrative medicine (a member entity of the Cochrane Collaboration).[83][84] Medical schools are responsible for conferring medical degrees, but a physician typically may not legally practice medicine until licensed by the local government authority. Licensed physicians in the US who have attended one of the established medical schools there have usually graduated Doctor of Medicine (MD).[85] All states require that applicants for MD licensure be graduates of an approved medical school and complete the United States Medical Licensing Exam (USMLE).[85]

The British Medical Association, in its publication Complementary Medicine, New Approach to Good Practice (1993), gave as a working definition of non-conventional therapies (including acupuncture, chiropractic and homeopathy): "those forms of treatment which are not widely used by the orthodox health-care professions, and the skills of which are not part of the undergraduate curriculum of orthodox medical and paramedical health-care courses".[86] By 2000 some medical schools in the UK were offering CAM familiarisation courses to undergraduate medical students while some were also offering modules specifically on CAM.[87]
Proponents and opponents

The Cochrane Collaboration Complementary Medicine Field explains its "Scope and Topics" by giving a broad and general definition for complementary medicine as including practices and ideas which are outside the domain of conventional medicine in several countries and defined by its users as preventing or treating illness, or promoting health and well being, and which complement mainstream medicine in three ways: by contributing to a common whole, by satisfying a demand not met by conventional practices, and by diversifying the conceptual framework of medicine.[88]

Proponents of an evidence-base for medicine[n 12][90][91][92][93] such as the Cochrane Collaboration (founded in 1993 and from 2011 providing input for WHO resolutions) take a position that all systematic reviews of treatments, whether "mainstream" or "alternative", ought to be held to the current standards of scientific method.[84] In a study titled Development and classification of an operational definition of complementary and alternative medicine for the Cochrane Collaboration (2011) it was proposed that indicators that a therapy is accepted include government licensing of practitioners, coverage by health insurance, statements of approval by government agencies, and recommendation as part of a practice guideline; and that if something is currently a standard, accepted therapy, then it is not likely to be widely considered as CAM.[36]

That alternative medicine has been on the rise "in countries where Western science and scientific method generally are accepted as the major foundations for healthcare, and 'evidence-based' practice is the dominant paradigm" was described as an "enigma" in the Medical Journal of Australia.[94]

Critics in the US say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because the word implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines which have been tested nearly always have no measurable positive effect compared to a placebo.[95][96][97][98]

Some opponents, focused upon health fraud, misinformation, and quackery as public health problems in the US, are highly critical of alternative medicine, notably Wallace Sampson and Paul Kurtz founders of Scientific Review of Alternative Medicine and Stephen Barrett, co-founder of The National Council Against Health Fraud and webmaster of Quackwatch.[99]

Grounds for opposing alternative medicine which have been stated in the US and elsewhere are:

that it is usually based on religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, or fraud.[1][95][100][101]

that alternative therapies typically lack any scientific validation, and their effectiveness is either unproved or disproved.[95][102][103][dubious – discuss]

that the treatments are those that are not part of the conventional, science-based healthcare system.[24][49][104][105]
that research on alternative medicine is frequently of low quality and methodologically flawed.[106][full citation needed]

that where alternative treatments are used in place of conventional science-based medicine, even with the very safest alternative medicines, failure to use or delay in using conventional science-based medicine has resulted in deaths.[107][108]

Paul Offit has proposed four ways in which "alternative medicine becomes quackery":[109]

"...by recommending against conventional therapies that are helpful."
"...by promoting potentially harmful therapies without adequate warning."
"...by draining patients' bank accounts,..."
"...by promoting magical thinking,..."

Alternative medicine practices and beliefs are diverse in their foundations and methodologies, and typically make use of preparations and dosages other than such as are included in the Pharmacopeia recognised by established medical schools. Methods may incorporate or base themselves on traditional medicine, folk knowledge, spiritual beliefs, ignorance or misunderstanding of scientific principles, errors in reasoning, or newly conceived approaches claiming to heal.[95][100][110] African, Caribbean, Pacific Island, Native American, and other regional cultures have traditional medical systems as diverse as their diversity of cultures.[24]
Examples and classes
Further information: List of branches of alternative medicine
A botánica of traditional Hispanic medicines

Alternative medicines include a wide range of treatments and practices. Some stem from nineteenth century North America, such as Chiropractic and Naturopathy, some, mentioned by Jütte, originated in eighteenth- and nineteenth-century Germany, such as homeopathy and hydropathy,[56] some have originated in China or India.

The following examples include some of the more common methods in use. Most therapies can be considered as part of five broad classes; biological based approaches, energy therapies, alternative medical systems, muscle and joint manipulation and mind body therapies.
Indian Dhanvantari, an incarnation of Krishna[111] and the Lord of Ayurveda worshiped at an ayurveda expo, Bangalore
In Japanese Reiki, it is believed that supernatural energies flow from the palms of the healer into the patient near Chakras, influencing disease.

Alternative medical systems are complete health systems with their own approaches to diagnosis and treatment that differ from the conventional biomedical approach to health. Some are cultural systems such as Ayurveda and Traditional Chinese Medicine, while others, such as Homeopathy and Naturopathy are relatively recent and were developed in the West.[103]

Writing as a historian Matthew Ramsey has asked whether some counter-hegemonic medicines are better understood as manifestations of more general developments in the larger society, or as the product of a coherent alternative world view.[61]
Ayurvedic medicine

Ayurvedic medicine is a traditional medicine of India and has strong links with Hinduism. It is based on the belief that health is controlled by 3 "humours" with disease caused by an imbalance of these "humours". The basis of treatment has some similarities with "Western medicine". Remedies are mainly plant based with some use of animal materials.[112] Safety concerns have been raised about Ayurveda, with two U.S. studies finding about 20 percent of Ayurvedic Indian-manufactured patent medicines contained toxic levels of heavy metals such as lead, mercury and arsenic. Other concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities.[113][114]
Body manipulation

Body-based therapies such as massage, chiropractic and osteopathy use movement and physical manipulation of joints and muscles.

Manipulative and body-based practices feature manipulation or movement of body parts, such as is done in chiropractic manipulation.
Energy therapies

Energy therapies are designed to influence energy fields (biofields) that practitioners believe surround and enter the body. Some energy therapies involve the use of crystals, while others use magnets and electric fields. NCCAM has distinguished two types of energy medicine: one, "Veritable" involving scientifically observable energy, including magnet therapy, colorpuncture and light therapy; the other "Putative" which invoke physically undetectable or unverifiable energy.[115]
Biofields
In acupuncture it is believed that insertion and manipulation of needles affects the flow of qi, or "life energy".[116]
Chiropractic was developed in the US in the belief that manipulation of the spine affects a supernatural vital energy that influences health and disease.[117][118]

Biofield therapies are intended to influence energy fields that, it is purported, surround and penetrate the body.[24] Writers such as Carl Sagan (1934-1996), a noted astrophysicist, advocate of skeptical thinking (Scientific skepticism) and the author of The Demon–Haunted World: Science as a Candle in the Dark (1996), have described the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.[119]

Acupuncture is a component of Traditional Chinese Medicine. In acupuncture theory, an energy called qi flows through through the body and helps propel the blood. Disease and pain occur when this flow is blocked.[120] Insertion of needles at specific points of the body restores balance to the blocked area, and thereby cures any disease or removes any pain.[120]

Chiropractic was developed in the belief that manipulating the spine affects the flow of a supernatural vital energy termed "innate intelligence" that governs health and disease.[117][118]

In reiki, practitioners claim to channel a "universal life energy" to induce a healing effect.[121] This putative energy is transferred through the palms or through tapping or blowing or similar means.
Electromagnetic fields

Alternative therapies based on electricity or magnetism use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in an unconventional manner rather than claiming the existence of imponderable or supernatural energies.[24] Magnetic healing asserts that magnets can be used in defiance of the laws of physics to influence health. These uses are generally unrelated to electromagnetic therapies.
Herbs, diet and vitamins

Biological approaches include the use of herbal medicines, special diets or very high doses of vitamins.

Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, and minerals, and includes traditional herbal remedies with herbs specific to regions in which the cultural practices arose.[24] "Herbal" remedies in this case, may include use of nonherbal toxic chemicals from nonbiological sources, such as use of the poison lead in Traditional Chinese Medicine.[citation needed] Nonvitamin supplements include fish oil, Omega-3 fatty acid, glucosamine, echinacea, flaxseed oil or pills, and ginseng, when used under a claim to have healing effects.[122]
Homeopathy

Homeopathy is based on the belief that a disease can be cured by a very low dose of substance that creates similar symptoms in a healthy person. These ideas are known as 'like cures like' and the 'law of the minimum dose'[123][n 13] This conflicts with fundamental concepts of physics and chemistry and there is no good evidence from reviews of research to support its use.[125][126][127][128]
Mind body therapies

Mind–body therapies attempt to use the mind to affect bodily symptoms and functions; examples include yoga, spirituality and relaxation.

Mind-body medicine takes a holistic approach to health that explores the interconnection between the mind, body and spirit. It works under the premise that the mind can affect "bodily functions and symptoms".[24] Mind body medicine includes healing claims made in yoga, meditation, deep-breathing exercises, guided imagery, hypnotherapy,[129] progressive relaxation, qi gong and tai chi.[24]

Yoga, a method of traditional stretches, exercises and meditations in Hinduism, may also be classified as an energy medicine insofar as its healing effects are believed to be due to a healing "life energy" that is absorbed into the body through the breath, and is thereby believed to treat a wide variety of illnesses and complaints.[130]
Christian priest Faith healer laying hands on sick girl in belief in divine healing.

Religion based healing practices, such as use of prayer and the laying of hands in Christian faith healing, rely on belief in divine intervention for healing.

Meditation practices including Mantra meditation, Mindfulness meditation, Yoga, Tai Chi, and Qi Gong have many uncertainties. According to an AHRQ review, the available evidence on meditation practices through September of 2005 is of poor methodological quality and definite conclusions on the effects of meditation in healthcare cannot be made using existing research.[3][4]
Naturopathy

Naturopathy is based on a belief in vitalism, which posits that a special energy called vital energy or vital force guides bodily processes such as metabolism, reproduction, growth, and adaptation.[131] Naturopathy favors a holistic approach with non-invasive treatment and, similar to conventional medicine, encourages minimal use of surgery and drugs.

The term "naturopathy" is derived from Greek and Latin, and literally translates as "nature disease".[132] Modern naturopathy grew out of the Natural Cure movement of Europe.[133][134][unreliable source?] The term was coined in 1895 by John Scheel and popularized by Benedict Lust,[135] the "father of U.S. naturopathy".[136] Beginning in the 1970s, there was a revival of interest in the United States and Canada in conjunction with the holistic health movement.[136][137] Today, naturopathy is primarily practiced in the United States and Canada.[138] The scope of practice varies widely between jurisdictions, and naturopaths in unregulated jurisdictions may use the Naturopathic Doctor designation or other titles regardless of level of education.[139]
Traditional Chinese medicine

Traditional Chinese Medicine is based on a concept of vital energy, or Qi,[140] flowing in the body along specific pathways. These purported pathways consist of 12 primary meridians. TCM has many branches including, acupuncture, massage, feng shui, herbs, as well as Chinese astrology.[120] TCM diagnosis is primarily based on looking at the tongue, which is claimed to show the condition of the organs, as well as feeling the pulse of the radial artery, which is also claimed to show the condition of the organs.[141]
Criticism

Use of the terms "Complementary and alternative medicine (CAM)" and "alternative medicine" have been criticized.

CAM is a broader term for unorthodox treatment and diagnosis of illnesses, disease, infections, etc.[142] Examples of CAM include yoga, acupuncture, aromatherapy, chiropractic, herbalism, homeopathy, hypnotherapy, massage, osteopathy, reflexology, relaxation, spiritual healing and tai chi.[142] CAM differs from conventional medicine. It is normally private medicine and not covered by health insurance.[142] It is paid out of pocket by the patient and is an expensive treatment.[142] CAM tends to be a treatment for upper class or more educated people.[143] CAM is often done by non-physicians and does not operate with the same medical licensing laws as conventional medicine.[142]

There are ethical concerns about whether people who perform CAM have the proper knowledge to perform the treatments they give to patients.[142] It is an issue of non-maleficence.[144] CAM is not as well researched as conventional medicine which undergoes intense research before being released to the public.[142] This creates an issue of whether the patient is receiving all the information about the treatment that is necessary for the patient to be well informed.[142] CAM creates issues since it is not as well regulated as conventional medicine.[142]

Even with the little research done on it, CAM has not been proven to be effective.[145] Funding for research is also sparse making it difficult to do further research for effectiveness of CAM.[146] Most funding for CAM is funded by government agencies.[142] The research for CAM has to meet certain standards from research ethics committees which most CAM researchers find almost impossible to meet.[142] Proposed research for CAM are rejected by most private funding agencies because the results of research are not reliable.[142]

CAM is thought to help the patient in a mental or psychological sense since research for CAM is hit and miss.[142] Because the results of CAM are not quantifiable, it is hard to prove its effectiveness and appears to work in a more holistic sense.[142]
In US

A 2002 report on public attitudes and understanding issued by the US National Science Foundation defines the term "alternative medicine" as treatments that had not been proven effective using scientific methods.[1]

Criticisms have come from individuals such as Wallace Sampson in an article in Annals of the New York Academy of Sciences, June 1995.[95] Sampson argued that proponents of alternative medicine often used terminology which was loose or ambiguous to create the appearance that a choice between "alternative" effective treatments existed when it did not, or that there was effectiveness or scientific validity when it did not exist, or to suggest that a dichotomy existed when it did not, or to suggest that consistency with science existed when it might not; that the term "alternative" was to suggest that a patient had a choice between effective treatments when there was not; that use of the word "conventional" or "mainstream" was to suggest that the difference between alternative medicine and science based medicine was the prevalence of use, rather than lack of a scientific basis of alternative medicine as compared to "conventional" or "mainstream" science based medicine; that use of the term "complementary" or "integrative" was to suggest that purported supernatural energies of alternative medicine could complement or be integrated into science based medicine. "Integrative medicine" or "integrated medicine" is used to refer to the belief that medicine based on science would be improved by "integration" with alternative medical treatments practices that are not, and is substantially similar in use to the term "complementary and alternative medicine".[8] Sampson has also written that CAM is the "propagation of the absurd", and argues that alternative and complementary have been substituted for quackery, dubious, and implausible.[147]

Another critic, with reference to government funding studies of integrating alternative medicine techniques into the mainstream, Steven Novella, a neurologist at Yale School of Medicine, wrote that it "is used to lend an appearance of legitimacy to treatments that are not legitimate." Another, Marcia Angell, argued that it was "a new name for snake oil."[148] Angell considered that critics felt that healthcare practices should be classified based solely on scientific evidence, and if a treatment had been rigorously tested and found safe and effective, science based medicine will adopt it regardless of whether it was considered "alternative" to begin with.[46] It was thus possible for a method to change categories (proven vs. unproven), based on increased knowledge of its effectiveness or lack thereof. Prominent supporters of this position include George D. Lundberg, former editor of the Journal of the American Medical Association (JAMA).[42]

In an article first published in CA: A Cancer Journal for Clinicians in 1999, "Evaluating complementary and alternative therapies for cancer patients.", Barrie R. Cassileth mentioned that a 1997 letter to the US Senate Subcommittee on Public Health and Safety, which had deplored the lack of critical thinking and scientific rigor in OAM-supported research, had been signed by four Nobel Laureates and other prominent scientists. (This was supported by the National Institutes of Health (NIH).)[149]

In March 2009 a Washington Post staff writer reported that the impending national discussion about broadening access to health care, improving medical practice and saving money was giving a group of scientists an opening to propose shutting down the National Center for Complementary and Alternative Medicine, quoting one of them, Steven Salzberg, a genome researcher and computational biologist at the University of Maryland, saying "One of our concerns is that NIH is funding pseudoscience." They argued that the vast majority of studies were based on fundamental misunderstandings of physiology and disease, and have shown little or no effect.[148] Stephen Barrett, founder and operator of Quackwatch, has argued that practices labeled "alternative" should be reclassified as either genuine, experimental, or questionable. Here he defines genuine as being methods that have sound evidence for safety and effectiveness, experimental as being unproven but with a plausible rationale for effectiveness, and questionable as groundless without a scientifically plausible rationale.[150] Sampson has also pointed out that CAM tolerated contradiction without thorough reason and experiment.[147] Barrett has pointed out that there is a policy at the NIH of never saying something doesn't work only that a different version or dose might give different results.[151] Barrett also expressed concern that, just because some "alternatives" have merit, there is the impression that the rest deserve equal consideration and respect even though most are worthless, since they are all classified under the one heading of alternative medicine.[150]

According to two writers, Wallace Sampson and K. Butler, marketing is part of the medical training required in chiropractic education, and propaganda methods in alternative medicine have been traced back to those used by Hitler and Goebels in their promotion of pseudoscience in medicine.[95][152]

The NCCAM budget has been criticized[148] because, despite the duration and intensity of studies to measure the efficacy of alternative medicine, there had been no effective CAM treatments supported by scientific evidence as of 2002, according to the QuackWatch website; the NCCAM budget has been on a sharp and sustained rise.[153] Critics of the Center argue that the plausibility of interventions such as diet, relaxation, yoga, and botanical remedies should not be used to support research on implausible interventions based on superstition and belief in the supernatural, and that the plausible methods can be studied just as well in other parts of NIH, where they should be made to compete on an equal footing with other research projects.[148]
Other critics (UK)

Richard Dawkins, an English evolutionary biologist and author, in an essay in his book A Devil's Chaplain (2003) (chapter 4.4), has defined alternative medicine as a "set of practices that cannot be tested, refuse to be tested, or consistently fail tests."[154] Another essay in the same book (chapter 1.4) quoted from an article by John Diamond in The Independent: "There is really no such thing as alternative medicine, just medicine that works and medicine that doesn't."[155] Dawkins has argued that, if a technique is demonstrated effective in properly performed trials, it ceases to be alternative and simply becomes medicine.[156]

As it relates to ethics, in November 2011 Edzard Ernst stated that the "level of misinformation about alternative medicine has now reached the point where it has become dangerous and unethical. So far, alternative medicine has remained an ethics-free zone. It is time to change this."[157] Ernst requested that Prince Charles recall two guides to alternative medicine published by the Foundation for Integrated Health, on the grounds that "[t]hey both contain numerous misleading and inaccurate claims concerning the supposed benefits of alternative medicine" and that "[t]he nation cannot be served by promoting ineffective and sometimes dangerous alternative treatments."[158] In general, he believes that CAM can and should be subjected to scientific testing.[159][n 14]
Placebo effect

A research methods expert and author of "Snake Oil Science", R. Barker Bausell, has stated that "it's become politically correct to investigate nonsense."[151] There are concerns that just having NIH support is being used to give unfounded "legitimacy to treatments that are not legitimate."[148]

Use of placebos in order to achieve a placebo effect in integrative medicine has been criticized as “diverting research time, money, and other resources from more fruitful lines of investigation in order to pursue a theory that has no basis in biology”.[97][98]

Another critic has argued that academic proponents of integrative medicine sometimes recommend misleading patients by using known placebo treatments in order to achieve a placebo effect.[n 15] However, a 2010 survey of family physicians found that 56% of respondents said they had used a placebo in clinical practice as well. Eighty-five percent of respondents believed placebos can have both psychological and physical benefits.[162]

Integrative medicine has been criticized in that its practitioners, trained in science based medicine, deliberately mislead patients by pretending placebos are not. "Quackademic medicine" is a pejorative term used for “integrative medicine”, which is considered to be an infiltration of quackery into academic science-based medicine.[98]

An analysis of trends in the criticism of complementary and alternative medicine (CAM) in five prestigious American medical journals during the period of reorganization within medicine (1965–1999) was reported as showing that the medical profession had responded to the growth of CAM in three phases, and that in each phase there had been changes in the medical marketplace which influenced the type of response in the journals.[163] Changes included relaxed medical licensing, the development of managed care, rising consumerism, and the establishment of the USA Office of Alternative Medicine (now National Center for Complementary and Alternative Medicine).[n 16] In the "condemnation" phase, from the late 1960s to the early 1970s, authors had ridiculed, exaggerated the risks, and petitioned the state to contain CAM; in the "reassessment" phase (mid-1970s through early 1990s), when increased consumer utilization of CAM was prompting concern, authors had pondered whether patient dissatisfaction and shortcomings in conventional care contributed to the trend; in the "integration" phase of the 1990s physicians began learning to work around or administer CAM, and the subjugation of CAM to scientific scrutiny had become the primary means of control.
Use and regulation
Prevalence of use
Studies show that prayer is a common "complementary" practice, in the belief it might increase the efficacy of science based medicine.

Complementary and alternative medicine (CAM) has been described as a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes all such practices and ideas self-defined by their users as preventing or treating illness or promoting health and well-being. Boundaries within CAM and between the CAM domain and that of the dominant system are not always sharp or fixed.[36][dubious – discuss]

About 50% of people in developed countries use some kind of complementary and alternative medicine other than prayer for health.[165][166][167] A British telephone survey by the BBC of 1209 adults in 1998 shows that around 20% of adults in Britain had used alternative medicine in the past 12 months.[168] About 40% of cancer patients use some form of CAM.[169]

In developing nations, access to essential medicines is severely restricted by lack of resources and poverty. Traditional remedies, often closely resembling or forming the basis for alternative remedies, may comprise primary healthcare or be integrated into the healthcare system. In Africa, traditional medicine is used for 80% of primary healthcare, and in developing nations as a whole over one-third of the population lack access to essential medicines.[170]
In US

In respect of taxation in the US the Internal Revenue Service has discriminated in favour of medical expenses for acupuncture and chiropractic (and others including Christian Science practitioners) but against homeopathy and the use of non-prescription required medicine.[n 17]

The use of alternative medicine in the US has increased,[1][75] with a 50 percent increase in expenditures and a 25 percent increase in the use of alternative therapies between 1990 and 1997 in America.[75] Americans spend many billions on the therapies annually.[75] Most Americans used CAM to treat and/or prevent musculoskeletal conditions or other conditions associated with chronic or recurring pain.[166] In America, women were more likely than men to use CAM, with the biggest difference in use of mind-body therapies including prayer specifically for health reasons".[166] In 2008, more than 37% of American hospitals offered alternative therapies, up from 26.5 percent in 2005, and 25% in 2004.[172][173] More than 70% of the hospitals offering CAM were in urban areas.[173]

A survey of Americans found that 88 percent agreed that "there are some good ways of treating sickness that medical science does not recognize".[1] Use of magnets was the most common tool in energy medicine in America, and among users of it, 58 percent described it as at least “sort of scientific”, when it is not at all scientific.[1] In 2002, at least 60 percent of US medical schools have at least some class time spent teaching alternative therapies.[1] "Therapeutic touch," was taught at more than 100 colleges and universities in 75 countries before the practice was debunked by a nine-year-old child for a school science project.[1][174]

A 1997 survey found that 13.7% of respondents in the US had sought the services of both a medical doctor and an alternative medicine practitioner. The same survey found that 96% of respondents who sought the services of an alternative medicine practitioner also sought the services of a medical doctor in the past 12 months. Medical doctors are often unaware of their patient's use of alternative medical treatments as only 38.5% of the patients alternative therapies were discussed with their medical doctor.[75]
Prevalence of use of specific therapies

The most common CAM therapies used in the US in 2002 were prayer (45.2%), herbalism (18.9%), breathing meditation (11.6%), meditation (7.6%), chiropractic medicine (7.5%), yoga (5.1%-6.1%), body work (5.0%), diet-based therapy (3.5%), progressive relaxation (3.0%), mega-vitamin therapy (2.8%) and Visualization (2.1%)[166][175]

In Britain, the most often used alternative therapies were Alexander technique, Aromatherapy, Bach and other flower remedies, Body work therapies including massage, Counselling stress therapies, hypnotherapy, Meditation, Reflexology, Shiatsu, Ayurvedic medicine, Nutritional medicine, and Yoga.[176]

According to the National Health Service (England), the most commonly used complementary and alternative medicines (CAM) supported by the NHS in the UK are: acupuncture, aromatherapy, chiropractic, homeopathy, massage, osteopathy and clinical hypnotherapy.[10]

"Complementary medicine treatments used for pain include: acupuncture, low-level laser therapy, meditation, aroma therapy, Chinese medicine, dance therapy, music therapy, massage, herbalism, therapeutic touch, yoga, osteopathy, chiropractic, naturopathy, and homeopathy."[177]
In palliative care

Complementary therapies are often used in palliative care or by practitioners attempting to manage chronic pain in patients. Integrative medicine is considered more acceptable in the interdisciplinary approach used in palliative care than in other areas of medicine. "From its early experiences of care for the dying, palliative care took for granted the necessity of placing patient values and lifestyle habits at the core of any design and delivery of quality care at the end of life. If the patient desired complementary therapies, and as long as such treatments provided additional support and did not endanger the patient, they were considered acceptable."[178] The non-pharmacologic interventions of complementary medicine can employ mind-body interventions designed to "reduce pain and concomitant mood disturbance and increase quality of life."[179]
Regulation
Further information: Regulation of alternative medicine and Regulation and prevalence of homeopathy

In Austria and Germany complementary and alternative medicine is mainly in the hands of doctors with MDs,[6] and half or more of the American alternative practitioners are licensed MDs.[180] In Germany herbs are tightly regulated: half are prescribed by doctors and covered by health insurance.[181]

Some professions of complementary/traditional/alternative medicine, such as chiropractic medicine, have achieved full regulation in North America and other parts of the world[182] and are regulated in a manner similar to that governing science-based medicine. In contrast, other approaches may be partially recognized and others have no regulation at all. Regulation and licensing of alternative medicine ranges widely from country to country, and state to state.[182]

Government bodies in the USA and elsewhere have published information or guidance about alternative medicine. One of those is the U.S. Food and Drug Administration (FDA), which mentions specifically homeopathic products, traditional Chinese medicine and Ayurvedic products.[11] A document which the FDA has issued for comment is headed Guidance for Industry: Complementary and Alternative Medicine Products and Their Regulation by the Food and Drug Administration, last updated on March 2, 2007. The document opens with three preliminary paragraphs which explain that in the document:

- "complementary and alternative medicine" (CAM) are being used to encompass a wide array of health care practices, products, and therapies which are distinct from those used in "conventional" or "allopathic" medicine.

- some forms of CAM, such as traditional Chinese medicine and Ayurvedic medicine, have been practiced for centuries, and others, such as electrotherapy, are of more recent origin.

- in a publication of The Institute of Medicine it has been stated that more than one-third of American adults reported using some form of CAM and that visits to CAM providers each year exceed those to primary care physicians (Institute of Medicine, Complementary and Alternative Medicine in the United States, pages 34-35, 2005).

- no mention (in the document) of a particular CAM therapy, practice or product should be taken as expressing FDA's support or endorsement of it or as an agency determination that a particular product is safe and effective.[2]

Efficacy

Alternative therapies lack the requisite scientific validation, and their effectiveness is either unproved or disproved.[1][95][102][103] Many of the claims regarding the efficacy of alternative medicines are controversial, since research on them is frequently of low quality and methodologically flawed.[106][full citation needed] Selective publication of results (misleading results from only publishing positive results, and not all results), marked differences in product quality and standardisation, and some companies making unsubstantiated claims, call into question the claims of efficacy of isolated examples where herbs may have some evidence of containing chemicals that may affect health.[183] The Scientific Review of Alternative Medicine points to confusions in the general population - a person may attribute symptomatic relief to an otherwise-ineffective therapy just because they are taking something (the placebo effect); the natural recovery from or the cyclical nature of an illness (the regression fallacy) gets misattributed to an alternative medicine being taken; a person not diagnosed with science based medicine may never originally have had a true illness diagnosed as an alternative disease category.[184]

Edzard Ernst characterized the evidence for many alternative techniques as weak, nonexistent, or negative[159] and in 2011 published his estimate that about 7.4% were based on "sound evidence", although he believes that may be an overestimate due to various reasons.[185] Ernst has concluded that 95% of the alternative treatments he and his team studied, including acupuncture, herbal medicine, homeopathy, and reflexology, are "statistically indistinguishable from placebo treatments", but he also believes there is something that conventional doctors can usefully learn from the chiropractors and homeopath: this is the therapeutic value of the placebo effect, one of the strangest phenomena in medicine.[186]

In 2003, a project funded by the CDC identified 208 condition-treatment pairs, of which 58% had been studied by at least one randomized controlled trial (RCT), and 23% had been assessed with a meta-analysis.[187] According to a 2005 book by a US Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically. The book cites Vickers (1998), who found that many of the CAM-related RCTs are in the Cochrane register, but 19% of these trials were not in MEDLINE, and 84% were in conventional medical journals.[188]

As of 2005, the Cochrane Library had 145 CAM-related Cochrane systematic reviews and 340 non-Cochrane systematic reviews. An analysis of the conclusions of only the 145 Cochrane reviews was done by two readers. In 83% of the cases, the readers agreed. In the 17% in which they disagreed, a third reader agreed with one of the initial readers to set a rating. These studies found that, for CAM, 38.4% concluded positive effect or possibly positive (12.4%), 4.8% concluded no effect, 0.69% concluded harmful effect, and 56.6% concluded insufficient evidence. An assessment of conventional treatments found that 41.3% concluded positive or possibly positive effect, 20% concluded no effect, 8.1% concluded net harmful effects, and 21.3% concluded insufficient evidence. However, the CAM review used the more developed 2004 Cochrane database, while the conventional review used the initial 1998 Cochrane database.[189]

Most alternative medical treatments are not patentable, which may lead to less research funding from the private sector. In addition, in most countries, alternative treatments (in contrast to pharmaceuticals) can be marketed without any proof of efficacy—also a disincentive for manufacturers to fund scientific research.[190] Some have proposed adopting a prize system to reward medical research.[191] However, public funding for research exists. Increasing the funding for research on alternative medicine techniques is the purpose of the US National Center for Complementary and Alternative Medicine. NCCAM and its predecessor, the Office of Alternative Medicine, have spent more than $2.5 billion on such research since 1992; this research has largely not demonstrated the efficacy of alternative treatments.[151][192][193]

In the same way as for conventional therapies, drugs, and interventions, it can be difficult to test the efficacy of alternative medicine in clinical trials. In instances where an established, effective, treatment for a condition is already available, the Helsinki Declaration states that withholding such treatment is unethical in most circumstances. Use of standard-of-care treatment in addition to an alternative technique being tested may produce confounded or difficult-to-interpret results.[194]

Cancer researcher Andrew J. Vickers has stated:

Contrary to much popular and scientific writing, many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective. In this article, clinical trial data on a number of alternative cancer cures including Livingston-Wheeler, Di Bella Multitherapy, antineoplastons, vitamin C, hydrazine sulfate, Laetrile, and psychotherapy are reviewed. The label "unproven" is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been "disproven."[195]

Safety
See also: List of herbs with known adverse effects
Adequacy of regulation and CAM safety

Many of the claims regarding the safety and efficacy of alternative medicine are controversial. Some alternative treatments have been associated with unexpected side effects, which can be fatal.[citation needed]

One of the commonly voiced concerns about complementary alternative medicine (CAM) is the manner in which is regulated. There have been significant developments in how CAMs should be assessed prior to re-sale in the United Kingdom and the European Union (EU) in the last 2 years. Despite this, it has been suggested that current regulatory bodies have been ineffective in preventing deception of patients as many companies have re-labelled their drugs to avoid the new laws.[196] There is no general consensus about how to balance consumer protection (from false claims, toxicity, and advertising) with freedom to choose remedies.

Advocates of CAM suggest that regulation of the industry will adversely affect patients looking for alternative ways to manage their symptoms, even if many of the benefits may represent the placebo affect.[197] Some contend that alternative medicines should not require any more regulation than over-the-counter medicines that can also be toxic in overdose (such as paracetamol).[198]
Interactions with conventional pharmaceuticals

Forms of alternative medicine that are biologically active can be dangerous even when used in conjunction with conventional medicine. Examples include immuno-augmentation therapy, shark cartilage, bioresonance therapy, oxygen and ozone therapies, insulin potentiation therapy. Some herbal remedies can cause dangerous interactions with chemotherapy drugs, radiation therapy, or anesthetics during surgery, among other problems.[7] An anecdotal example of these dangers was reported by Associate Professor Alastair MacLennan of Adelaide University, Australia regarding a patient who almost bled to death on the operating table after neglecting to mention that she had been taking "natural" potions to "build up her strength" before the operation, including a powerful anticoagulant that nearly caused her death.[199]

To ABC Online, MacLennan also gives another possible mechanism:

And lastly [sic] there's the cynicism and disappointment and depression that some patients get from going on from one alternative medicine to the next, and they find after three months the placebo effect wears off, and they're disappointed and they move on to the next one, and they're disappointed and disillusioned, and that can create depression and make the eventual treatment of the patient with anything effective difficult, because you may not get compliance, because they've seen the failure so often in the past.|[200]

Potential side-effects

Conventional treatments are subjected to testing for undesired side-effects, whereas alternative treatments, in general, are not subjected to such testing at all. Any treatment – whether conventional or alternative – that has a biological or psychological effect on a patient may also have potential to possess dangerous biological or psychological side-effects. Attempts to refute this fact with regard to alternative treatments sometimes use the appeal to nature fallacy, i.e., "that which is natural cannot be harmful".

An exception to the normal thinking regarding side-effects is Homeopathy. Since 1938, the U.S. Food and Drug Administration (FDA) has regulated homeopathic products in "several significantly different ways from other drugs."[201] Homeopathic preparations, termed "remedies," are extremely dilute, often far beyond the point where a single molecule of the original active (and possibly toxic) ingredient is likely to remain. They are, thus, considered safe on that count, but "their products are exempt from good manufacturing practice requirements related to expiration dating and from finished product testing for identity and strength," and their alcohol concentration may be much higher than allowed in conventional drugs.[201]
Treatment delay

Those having experienced or perceived success with one alternative therapy for a minor ailment may be convinced of its efficacy and persuaded to extrapolate that success to some other alternative therapy for a more serious, possibly life-threatening illness.[202] For this reason, critics argue that therapies that rely on the placebo effect to define success are very dangerous. According to mental health journalist Scott Lilienfeld in 2002, "unvalidated or scientifically unsupported mental health practices can lead individuals to forgo effective treatments" and refers to this as "opportunity cost". Individuals who spend large amounts of time and money on ineffective treatments may be left with precious little of either, and may forfeit the opportunity to obtain treatments that could be more helpful. In short, even innocuous treatments can indirectly produce negative outcomes.[107] Between 2001 and 2003, four children died in Australia because their parents chose ineffective naturopathic, homeopathic, or other alternative medicines and diets rather than conventional therapies.[108]


Unconventional cancer "cures"

Perhaps because many forms of cancer are difficult or impossible to cure, there have always been many therapies offered outside of conventional cancer treatment centers and based on theories not found in biomedicine. These alternative cancer cures have often been described as "unproven," suggesting that appropriate clinical trials have not been conducted and that the therapeutic value of the treatment is unknown. However, many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective. [195]
Research funding

Although the Dutch government funded CAM research between 1986 and 2003, it formally ended funding in 2006.[203]
Appeal

Physicians who practice complementary medicine usually discuss and advise patients as to available complementary therapies. Patients often express interest in mind-body complementary therapies because they offer a non-drug approach to treating some health conditions.[204] Some mind-body techniques, such as cognitive-behavioral therapy, were once considered complementary medicine, but are now a part of conventional medicine in the United States.[205]

Against alternative medicine it has been argued that in addition to the social-cultural underpinnings of the popularity of alternative medicine, there are several psychological issues that are critical to its growth. One of the most critical is the placebo effect, which is a well-established observation in medicine.[206] Related to it are similar psychological effects such as the will to believe,[207] cognitive biases that help maintain self-esteem and promote harmonious social functioning,[207] and the post hoc, ergo propter hoc fallacy.[207]
In UK

CAM's popularity may be related to other factors which Edzard Ernst mentioned in an interview in The Independent:

Why is it so popular, then? Ernst blames the providers, customers and the doctors whose neglect, he says, has created the opening into which alternative therapists have stepped. "People are told lies. There are 40 million websites and 39.9 million tell lies, sometimes outrageous lies. They mislead cancer patients, who are encouraged not only to pay their last penny but to be treated with something that shortens their lives. "At the same time, people are gullible. It needs gullibility for the industry to succeed. It doesn't make me popular with the public, but it's the truth.[208]

In a paper published in October 2010 entitled The public's enthusiasm for complementary and alternative medicine amounts to a critique of mainstream medicine, Ernst described these views in greater detail and concluded:

[CAM] is popular. An analysis of the reasons why this is so points towards the therapeutic relationship as a key factor. Providers of CAM tend to build better therapeutic relationships than mainstream healthcare professionals. In turn, this implies that much of the popularity of CAM is a poignant criticism of the failure of mainstream healthcare. We should consider it seriously with a view of improving our service to patients.[209]

In US and Canada

A study published in 1998 indicates that a majority of alternative medicine use was in conjunction with standard medical treatments.[167] Approximately 4.4 percent of those studied used alternative medicine as a replacement for conventional medicine. The research found that those having used alternative medicine tended to have higher education or report poorer health status. Dissatisfaction with conventional medicine was not a meaningful factor in the choice, but rather the majority of alternative medicine users appear to be doing so largely because "they find these healthcare alternatives to be more congruent with their own values, beliefs, and philosophical orientations toward health and life." In particular, subjects reported a holistic orientation to health, a transformational experience that changed their worldview, identification with a number of groups committed to environmentalism, feminism, psychology, and/or spirituality and personal growth, or that they were suffering from a variety of common and minor ailments – notable ones being anxiety, back problems, and chronic pain.

Authors have speculated on the socio-cultural and psychological reasons for the appeal of alternative medicines among that minority using them in lieu of conventional medicine. There are several socio-cultural reasons for the interest in these treatments centered on the low level of scientific literacy among the public at large and a concomitant increase in antiscientific attitudes and new age mysticism.[207] Related to this are vigorous marketing[210] of extravagant claims by the alternative medical community combined with inadequate media scrutiny and attacks on critics.[100][207]

There is also an increase in conspiracy theories toward conventional medicine and pharmaceutical companies, mistrust of traditional authority figures, such as the physician, and a dislike of the current delivery methods of scientific biomedicine, all of which have led patients to seek out alternative medicine to treat a variety of ailments.[100] Many patients lack access to contemporary medicine, due to a lack of private or public health insurance, which leads them to seek out lower-cost alternative medicine.[166] Medical doctors are also aggressively marketing alternative medicine to profit from this market.[210]

Patients can also be averse to the painful, unpleasant, and sometimes-dangerous side effects of biomedical treatments. Treatments for severe diseases such as cancer and HIV infection have well-known, significant side-effects. Even low-risk medications such as antibiotics can have potential to cause life-threatening anaphylactic reactions in a very few individuals. Also, many medications may cause minor but bothersome symptoms such as cough or upset stomach. In all of these cases, patients may be seeking out alternative treatments to avoid the adverse effects of conventional treatments.[100][207]

Schofield and others, in a systematic review published in 2011, make ten recommendations which they think may increase the effectiveness of consultations in a conventional (here: oncology) setting, such as "Ask questions about CAM use at critical points in the illness trajectory"; "Respond to the person's emotional state"; and "Provide balanced, evidence-based advice". They suggest that this approach may address "... concerns surrounding CAM use [and] encourage informed decision-making about CAM and ultimately, improve outcomes for patients".[211]
See also

Folk medicine
Glossary of alternative medicine
Health freedom movement
Program for Evaluating Complementary Medicine
Shakoor v Situ
Medicines and Healthcare products Regulatory Agency- UK government agency 'responsible for ensuring medicines and medical devices work and are acceptably safe'.

Explanatory notes

Jump up ^ The Final Report (2002) of the White House Commission on Complementary and Alternative Medicine Policy states:

The Commissioners believe and have repeatedly stated in this Report that our response should be to hold all systems of health and healing, including conventional and CAM, to the same rigorous standards of good science and health services research. Although the Commissioners support the provision of the most accurate information about the state of the science of all CAM modalities, they believe that it is premature to advocate the wide implementation and reimbursement of CAM modalities that are yet unproven.[3]

Jump up ^ Mary Ruggie in Chapter 2 of Marginal to Mainstream: Alternative Medicine in America said, "By the mid-1990s, the notion that some alternative therapies could be complementary to conventional medicine began to change the status of...alternative medicine. The 21st century is witnessing yet another terminological innovation, in which CAM and conventional medicine are becoming integrative."[15][full citation needed]
Jump up ^ As David J. Hufford, Professor and Director at the Doctors Kienle Center for Humanistic Medicine at the Penn State College of Medicine,[25] has argued: "Simply because an herbal remedy comes to be used by physicians does not mean that herbalists cease to practice, or that the practice of the one becomes like that of the other."[26]
Jump up ^ The BMA used the term non-conventional medicine instead of alternative medicine.[28]
Jump up ^ The Office for Alternative Medicine, part of the National Institutes of Health, was renamed NCCAM in 1998.[2]
Jump up ^ The exact wording adopted in this 2005 report was:

Complementary and alternative medicine (CAM) is a broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. CAM includes such resources perceived by their users as associated with positive health outcomes. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed.[39]

Jump up ^ In his introduction to the Flexner Report, Henry S. Pritchett stated, "The fundamental sciences upon which medicine depends have been greatly extended. The laboratory has come to furnish alike to the physician and to the surgeon a new means for diagnosing and combating disease. The education of the medical practitioner under these changed conditions makes entirely different demands in respect of both preliminary and professional training." [63]
Jump up ^ Peking University Health Science Center (formerly Beijing Medical University) was the first of the kind in China to teach western medicine and train medical professionals.[citation needed]
Jump up ^ For an encyclopaedic account of the development of "western" medicine in the period leading up to the reforms in the medical schools of US resulting from the Flexner Report, published at the time of that report, see the article, "Medicine", in the 1911 Encyclopædia Britannica by Thomas Clifford Allbutt.
Jump up ^ According to the Oxford English Dictionary, the earliest recorded English language usage in a print medium of the term "alternative medicine" is found in a 1974 text by Helen Kruger.[69]
Jump up ^ As the medical professor Kenneth M. Ludmerer noted in 2010:

Flexner pointed out that the scientific method of thinking applied to medical practice. By scientific method, he meant the testing of ideas by well-planned experiments in which accurate facts were carefully obtained. The clinician's diagnosis was equivalent to the scientist's hypothesis: both medical diagnosis and hypothesis needed to be submitted to the test of an experiment... Flexner argued that mastery of the scientific method of problem solving was the key for physicians to manage medical uncertainty and to practice in the most cost-effective way."[78]

Jump up ^ Two definitions of evidence based medicine are:

"Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients'.[89]

"Evidence based medicine, whose philosophical origins extend back to mid-19th century Paris and earlier, remains a hot topic for clinicians, public health practitioners, purchasers, planners, and the public. British centres for evidence based practice have been established or planned in adult medicine, child health, surgery, pathology, pharmacotherapy, nursing, general practice, and dentistry; the Cochrane Collaboration and Britain's Centre for Review and Dissemination in York are providing systematic reviews of the effects of health care".[89]

Jump up ^ In his book The Homœopathic Medical Doctrine Samuel Hahnemann the creator of homeopathy stated:

Observation, reflection, and experience have unfolded to me that the best and true method of cure is founded on the principle, similia similibus curentur. To cure in a mild, prompt, safe, and durable manner, it is necessary to choose in each case a medicine that will excite an affection similar (ὅμοιος πάθος) to that against which it is employed.[124]

Jump up ^ In an article in The British Journal of General Practice Edzard Ernst et al. stated,

Complementary medicine is diagnosis, treatment and/or prevention that complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine.[160]

Jump up ^ As a 2010 article in the New England Journal of Medicine concluded:

real acupuncture treatments were no more effective than sham acupuncture treatments. There was, nevertheless, evidence that both real acupuncture and sham acupuncture were more effective than no treatment, and that acupuncture can be a useful supplement to other forms of conventional therapy for low back pain.[161]

Jump up ^ According to the medical historian James Harvey Young:

In 1991 the Senate Appropriations Committee responsible for funding the National Institutes of Health (NIH) declared itself "not satisfied that the conventional medical community as symbolized at the NIH has fully explored the potential that exists in unconventional medical practices.[164]

Jump up ^ The US Internal Revenue Service provides the following definition of medical expenses:

Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body. These expenses include payments for legal medical services rendered by physicians, surgeons, dentists and other medical practitioners.... primarily to alleviate or prevent a physical or mental defect or illness. Medicines: You can include expenses amounts you pay for prescribed medicines and drugs. A prescribed drug is one that requires a prescription by a doctor for its use by an individual.[171]

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Winnick, T.A. (2009). "From Quackery to "Complementary" Medicine: The American Medical Profession Confronts Alternative Therapies". In Conrad, P. The Sociology of Health and Illness (Eighth ed.). New York: Worth. pp. 261–77. ISBN 9781429205580.
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Bibliography

Bivins, R. (2007). Alternative Medicine? A History. Oxford University Press. ISBN 9780199218875.
Board of Science and Education, British Medical Association (1993). Complementary Medicine: New Approaches to Good Practice. Oxford University Press. ISBN 9780192861665.
Callahan, D., ed. (2004). The Role of Complementary and Alternative Medicine: Accommodating Pluralism. Washington, DC: Georgetown University Press. ISBN 9781589014640.
Committee on the Use of Complementary and Alternative Medicine by the American Public, Board on Health Promotion and Disease Prevention, Institute of Medicine, US National Academies (2005). Complementary and Alternative Medicine in the United States. Washington, DC: National Academy Press. ISBN 0309092701.
Ruggie, M. (2004). Marginal to Mainstream: Alternative Medicine in America. Cambridge University Press. ISBN 9780521834292.
Saks, M. (2003). Orthodox and Alternative Medicine: Politics, Professionalization and Health Care. Sage. ISBN 9781446265369.
Sointu, E. (2012). Theorizing Complementary and Alternative Medicines: Wellbeing, Self, Gender, Class. Basingstoke, England: Palgrave Macmillan. ISBN 9780230309319.

Further reading

Bausell, R.B (2007). Snake Oil Science: The Truth About Complementary and Alternative Medicine. Oxford University Press. ISBN 9780195313680.
Benedetti, F. et al. (2003). "Open versus hidden medical treatments: The patient's knowledge about a therapy affects the therapy outcome". Prevention & Treatment 6 (1). doi:10.1037/1522-3736.6.1.61a.
Dawkins, R. (2001). "Foreword". In Diamond, J. Snake Oil and Other Preoccupations. London: Vintage. ISBN 9780099428336. Reprinted in Dawkins 2003.
Downing, A.M. et al. (2003). "Validating clinical reasoning: A question of perspective, but whose perspective?". Manual Therapy 8 (2): 117–9. doi:10.1016/S1356-689X(02)00077-2. PMID 12890440.
Eisenberg, D.M. (July 1997). "Advising patients who seek alternative medical therapies". Annals of Internal Medicine 127 (1): 61–9. doi:10.1059/0003-4819-127-1-199707010-00010. PMID 9214254.
Gunn, I.P. (December 1998). "A critique of Michael L. Millenson's book, Demanding Medical Excellence: Doctors and Accountability in the Information Age, and its Relevance to CRNAs and Nursing". AANA Journal 66 (6): 575–82. PMID 10488264.
Hand, W.D. (1980). "Folk Magical Medicine and Symbolism in the West". Magical Medicine. Berkeley: University of California Press. pp. 305–19. ISBN 978-0-520-04129-5. OCLC 6420468.
Illich, I. (1976). Limits to Medicine: Medical Nemesis: The Expropriation of Health. Penguin. ISBN 978-0-14-022009-4. OCLC 4134656.
Mayo Clinic (2007). Mayo Clinic Book of Alternative Medicine: The New Approach to Using the Best of Natural Therapies and Conventional Medicine. Parsippany, New Jersey: Time Inc Home Entertainment. ISBN 978-1-933405-92-6.
Stevens, P., Jr. (November/December 2001). "Magical Thinking in Complementary and Alternative Medicine". Skeptical Inquirer Magazine.
Planer, F.E. (1988). Superstition (Revised ed.). Buffalo, New York: Prometheus Books. ISBN 9780879754945. OCLC 18616238.
Rosenfeld, A. (c. 2000). "Where Do Americans Go for Healthcare?". Cleveland, Ohio: Case Western Reserve University. Retrieved 2010-09-23.
Singh, S.; Ernst, E. (2008). Trick or Treatment: The Undeniable Facts About Alternative Medicine. Norton. ISBN 9780393066616. OCLC 181139440.; preview at Google Books.
Tonelli, M.R. (December 2001). "The limits of evidence-based medicine". Respiratory Care 46 (12): 1435–40; discussion 1440–1. PMID 11728302.
Trivieri, L., Jr. (2002). Anderson, J.W., ed. Alternative Medicine: The Definitive Guide. Berkeley: Ten Speed Press. ISBN 9781587611414.
Wisneski, L.A. et al. (2005). The Scientific Basis of Integrative Medicine. CRC Press. ISBN 9780849320811.
Zalewski, Z. (1999). "Importance of philosophy of science to the history of medical thinking". CMJ 40 (1): 8–13. Archived from the original on 2004-02-06.

World Health Organization publications

General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine. WHO/EDM/TRM/2001.1. Geneva: World Health Organization (WHO). 2000. "This document is not a formal publication of the WHO. The views expressed in documents by named authors are solely the responsibility of those authors."
WHO Guidelines on Basic Training and Safety in Chiropractic. Geneva: WHO. 2005. ISBN 9241593717.
WHO Kobe Centre; Bodeker, G. et al. (2005). WHO Global Atlas of Traditional, Complementary and Alternative Medicine. WHO. ISBN 9789241562867. Summary.

Journals dedicated to alternative medicine research

Alternative Therapies in Health and Medicine. Aliso Viejo, CA : InnoVision Communications, c1995- NLM ID: 9502013
Alternative Medicine Review: A Journal of Clinical Therapeutics. Sandpoint, Idaho : Thorne Research, Inc., c1996- NLM ID: 9705340
BMC Complementary and Alternative Medicine. London: BioMed Central, 2001- NLM ID: 101088661
Complementary Therapies in Medicine. Edinburgh ; New York : Churchill Livingstone, c1993- NLM ID: 9308777
Evidence Based Complementary and Alternative Medicine: eCAM. New York: Hindawi, c2004 NLM ID: 101215021
Evidence Based Journal of Integrative Medicine
Forschende Komplementärmedizin / Research in Complementary Medicine
Journal of Integrative medicine.
Journal for Alternative and Complementary Medicine New York, NY : Mary Ann Liebert, Inc., c1995
Scientific Review of Alternative Medicine (SRAM)

External links
Wikiquote has a collection of quotations related to: Alternative medicine

The National Center for Complementary and Alternative Medicine: U.S. National Institutes of Health
The Office of Cancer Complementary and Alternative Medicine: U.S. National Cancer Institute, National Institutes of Health
Knowledge and Research Center for Alternative Medicine: Denmark, the Ministry of the Interior and Health
Guidelines For Using Complementary and Alternative Methods: from the American Cancer Society
Complementary and Alternative Medicine Index: from the University of Maryland Medical Center
Integrative Medicine Podcasts and Handouts: Teaching modules from the University of Wisconsin Integrative Medicine Program
"Alternative Medicine": A BBC/Open University television series that examines the evidence scientifically
"Complementary and alternative medicine: What is it?": from the Mayo Clinic
Natural Standard Research Collaboration
Alternative Medicine Health Directory
A Different Way to Heal? and Videos: from PBS and Scientific American Frontiers
Who Gets to Validate Alternative Medicine?: from PBS
Governmental information about alternative medicine in Denmark

Criticism

What is Complementary and Alternative Medicine? – Steven Novella, MD
"Alternative" health practice – Skeptic's Dictionary
Quackwatch.org – Stephen Barrett (See also: Quackwatch)
Purday, K.M. (2009-01-27). "Review - Healing, Hype, or Harm? A Critical Analysis of Complementary or Alternative Medicine, by Edzard Ernst (Editor)". Metapsychology online reviews 13 (5).
What's the harm? Website created by Tim Farley listing cases of people harmed by various alternative treatments

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[meneer]

Oorspronkelijk geplaatst door DewareJakob

Dat is toch het beste wat je met zijn posts kan doen. Ze zitten altijd volledig naast de zaak, enkel bedoeld om te trollen.

Tja, six dat is zo éne die denkt dat hij slim is, hé...Behalve er eens schamper mee lachen zie ik niet wat ik zou kunnen doen met zo een gast...

[meneer]

Oorspronkelijk geplaatst door maddox

Water met geheugen, da's wat me voorstaat van alternatieve geneeskunde.

Klankschalen is ook zo iets prachtig.

Oftewel, ik ben er niet zo tuk op.

Het s wel wat meer dan dat...http://alternatieve-geneeswijzen.startkabel.nl/

__________________

Alles werkt misschien niet, en bedriegers zullen er ook wel bijziten, maar die vind je overal. Daarom moet je het kind niet met het badwater weggooien.

[Xenophon]

Oorspronkelijk geplaatst door maddox

Water met geheugen, da's wat me voorstaat van alternatieve geneeskunde.

Klankschalen is ook zo iets prachtig.

Oftewel, ik ben er niet zo tuk op.

Thomas!

[meneer]

Oorspronkelijk geplaatst door Xenophon

Thomas!

Den ongelovige Thomas ?

[ZION]

Oorspronkelijk geplaatst door meneer

Den ongelovige Thomas ?

Ik heb het zo niet voor alternatieven....

Ben je dan achteraf, alternatief gezond?

[meneer]

Oorspronkelijk geplaatst door ZION

Ik heb het zo niet voor alternatieven....

Ben je dan achteraf, alternatief gezond?

Hangt er van af. Je kan alternatief begraven worden ook.

[lombas]

Voor alles wat fysieke handelingen betreft, kan ik volgen.

Voor de farmaceutische tegenhangers, denk ik eerder "complete quatsch".

[six]

Oorspronkelijk geplaatst door lombas

Voor alles wat fysieke handelingen betreft, kan ik volgen.

Voor de farmaceutische tegenhangers, denk ik eerder "complete quatsch".

Chiropraxie is niet zonder gevaar.

[lombas]

Oorspronkelijk geplaatst door six

Chiropraxie is niet zonder gevaar.

Ik zei "kan ik volgen", niet: "leg ik me even op de tafel?"

[meneer]

Oorspronkelijk geplaatst door six

Chiropraxie is niet zonder gevaar.

Niets is zonder gevaar. Geregeld lezen we over fouten begaan door artsen, soms met dodelijke afloop, of medicamenten die men van de markt moet halen wegens ongewenste & te schadelijke bijwerkingen.