Complementary therapies in family medicine

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???????????????? alternative Medicine

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• To be able to explain
• What are Alternative Medicine and CAM
• Overview of CAM
• Some CAM
• Energy medicine
• Homeopathy
• Role of MD in CAM/ Integrative Medicine

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• ???????????????? ?????????????????????????????????
  ????????? (Conventional Medicine)
• Complementary med is used together with
  conventional
• Aromatherapy
• Alternative used in place of conventional
  med.
• a special diet to treat cancer

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The rising of number of consumers
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Characteristic of CAM user (Astin JA
,JAMA1998279(19)1548-53

• Still accept conventional med
• Higher education
• More severe symptom
• chronic pain, anxiety,
• renal ,back pain
• Still used conventional med

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CAM ?????????????? 5 ?????
1.Alternative Medical Systems Ayurveda, Chinese, Native American, Aboriginal, African, Middle Eastern, Tibetan, Central and South American cultures, Homeopathy, Naturopathy
2.Mind-Body Interventions cognitive-behavioral app, meditation, hypnosis, dance, music, art therapy, prayer, mental healing
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3.Biological Based Therapies Dietary supplements, Herbs, Orthomolecular, Magnesium, Melatonin, Mega-doses of vitamins , individual biological therapies (laetrile, shark cartilage, bee pollen).
4. Manipulative ,Body-Based Chiropractic, Osteopathic, Manipulation, Massage
5. Energy Therapies Qi gong, Reiki, Therapeutic touch, Bioelectromagnetic-based therapies (pulsed fields, magnetic fields, or alternating or direct current )
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1800 different CAM modalities
Reiki
Humor
Hypnosis
Naturopathy
acupuncture
Chi gong
Ayurveda
Tai chi
Imagery
music
herbal medicine
magnets
distraction
Yoga
aromatherapy
Meditation
natural products
reflexology
Orthomolecular
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???????? (Ayurveda)

• Indian alternative medical system 5,000 years.
• emphasizes the use of body, mind, and spirit in
  prevention and treatment
• includes diet and herbal

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Ayurveda Sickness

• Absence of a balanced
• dietary habits,
• seasonal
• improper exercise
• erratic of sense organs

• incompatible body .... mind
• disturbed body-mind , diet, behaviour, drugs

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Homeopathy

• Aged ..230 years Dr. Samuel Hahnemann
• based on the principle of similars, Like cure
  like
• Remedies in high dilutions information is
  stored.
• may not contain any molecules of the original
  agents

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Homeopathy

• not by pharmacological means. .
• assessment of the deficits in vital force to
  guide dose
• energy medicine
• information on the vital force into local
  physical changes that lead to recovery .. acute
  and chronic

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Examples of the similia principle in homeopathy

• Peeling an onion ? sore, runny eyes, itchy nose
  and sneezing
• Allium cepa
• arsenic poisoning causes severe vomiting and
  diarrhoea with burning pains and chilliness
• Arsenicum alb. V.

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Examples of the similia principle in conventional
medicine

• Radiotherapy which is used to treat cancer also
  causes it
• Amphetamines which produce hyperactivity, are
  used to treat hyperactive children
• Immunisation

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Origins

• This principle was first described in Hindu
  writings over 3000 years ago
• Also mentioned by Hippocrates , Galen in the 2nd
  century and Paracelsus in16th century
• More recently researched by a German physician
  Samuel Hahnemann who developed Homoeopathy

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2. Mind-Body Interventions

• Enhance the mind's capacity to affect bodily
  function symp .
• meditation, prayer, mental healing,
• therapies that use art, music, or dance.

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3. Biologically Based Therapies

• Use substances found in nature
• Diet/nutritional herbs, foods, and vitamins.
  
• Aroma therapy
• Stem cell
• Other shark cartilage .cancer.

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4. Manipulative and Body-Based Methods

• manipulation / movement of one or more parts
  of the body.
• chiropractic
• osteopathic
• massage.

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5. Energy Therapies

• Biofield therapies affect energy fields
  ,surround penetrate the body..
• Qi gong, Reiki,
• Therapeutic Touch
• Universal energy ???????????
• Bioelectromagnetic-based
• electromagnetic fields, such as pulsed
  fields, magnetic fields,

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??????????????CAM?????

• ?? Efficacy . proven by RCT
• ????????????? Safety
• Quality
• (NCCAM states that formerly unproven remedies may
  be incorporated into conventional medicine if
  they are shown to be safe and effective.)
• The boundaries between CAM and conventional
  medicine are not absolute, and specific CAM
  practices may, over time, become widely accepted.

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5 CAM used widely

• Traditional Chinese Medicine
• Ayurveda
• Chiropractic
• Homeopathy
• Unani

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Acupuncture

• the most prominent therapy to promote qi flow
  along the meridians.
• has been extensively studied effective in
  certain forms of pain
• its mechanism to be elucidated.
• effects on neurotransmitter expression

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Energy Medicine The Scientific Basis
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Mechanism vs Vitalism 

• Mechanism the laws of physics and chemistry
• Vitalism
• mysterious life force
• separate from the normal laws of nature
• distinguishes living from non living.

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A Brief History

• electric eels electricity for healing 2700 BC
  
• Magnet healing
• African mine gt 100,000 years old
• bloodstone red iron ore
• Magnetite Egypt, Chinese, Greeks

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Mesmer

• 1773 Mesmer began using magnets for healing
• unusual currents flowing through their bodies
  prior to an illness
• produce the change without the magnets just
  using his hands

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Early electrotherapy

• Medical electricity has it golden era between the
  late 1700 and early 1900
• Clinical electrotherapy was thriving at the same
  time that vitalism was being rejected by
  mainstream.
• By 1884 10000 MDs were using electricity for
  therapeutic purposes

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The rising of sciences

• Discovery of cellular and molecular basis of life
  
• Bacterial origin of infectious disease
• Darwins theory of evolution

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Flexner report (1910)

• Energy med absence of standards for medical
• Established Science as the basis for medicine and
  clinical practice.
• The triad of academic institution
  Research/Education/Clinical practice
• Led to the passage of Pure Food and Drugs Act
  1906

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Fields in Diagnosis 

• Changes in electrical resistance
• Every pathological (normal) event produces an
  electrical disturbance. Ovulation
• Burr detected electrical changes 10 days to 2
  weeks prior to the development of tumors 

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Measuring the Fields of Life 

• Heart Electricity
• Brain Electricity
• SQUID

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quantum theory Josephson effects

• tunneling the movement of pairs of electrons
  through a material (called an insulator)
  (Anderson Rowell 1963, Shapiro 1963)
• electrons are waves
• Josephson effects.. ?????????????????????(tunneli
  ng)?????????????
• (In 1973 Josephson received a Nobel Prize for his
  work.)

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Fields projected from the hands
In the early 1980s, Zimmerman studies on
therapeutic touch with a SQUID / magnetometer at
the University of Colorado School of Medicine in
Denver (Zimmerman 1990).
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the SQUID detected

• a large biomagnetic field a variable frequency,
  0.3 to 30 Hz, In other words, the signal
  'sweeps' or 'scans'
• Seto et al (1992) hands of healing and
  martial arts QiGong, Yoga, Meditation, Zen,
  etc. 1000 times stronger

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Properties of the living matrix

• ??????????????????????? ??????????????????
  .....created tensions carried through
• ????? ??? ?????????? gtgtgt the crystalline lattice
  (connective tis) gtgt -----gt ????????????????(bio
  electronic signals)
• ???????????????????????? ??????????
  semiconducting communication network carry the
  bioelectronic signals every part

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Movement generate electricity
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Cybernetics

• Kybernetes ????????????????/??????
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• a small energy field at the appropriate place
  and time can shift the course of an organism.
• Receptors ??????????......the primary sites of
  action

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• ??????????????????????????????????????????????
  ? ???????????????????????? ???????????????????
• the circuitry and machinery is there the problem
  is simply to discover how to turn on the right
  switches (Weil 1995).
• CAM ?????????????????????????????????????????????
  ???????

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• Hormones , neurotransmitters,
• Taste and smell
• Pheromones,
• Light ,electromagnetic signals.
• eg. Iymphocytes
• 3 Hz sharply reduced calcium influx
• 60 Hz signal, under identical conditions
  increased calcium influx (Adey 1996)

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'The scientist knows that in the history of ideas, magic always precedes science, that the intuition of phenomena anticipates their objective knowledge(Gauguelin 1974).
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Integrative medicine piechart
Body
Community
Spirit
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Defining Integrative care
Relationship-centered care
Integration CAM ..treatment and prevention
Invoves removeing barriers .activated the bodys innate healing process
Use natural, less invasive interventions before costly,invasive
Engages mind,body,spirit,and community to facilitate healing
Healing is possible ,even when curing is not
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The best practice is integrative medicine
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References
David Rakel. Integrative Medicine.Second Edition 2007. Sanders James L. Oschman Energy Medicine The ScientificBasis CHURCHILL .LlVINGSTONE New Hampshire, USA Energy Medicine An Overview. NCCAM Health Information.httm.
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