Alternative Medicine

<br><EM>BUDDHA BASNYAT, MD</EM>

Jan. 16, 2012, 5:45 p.m. Published in Magazine Issue: Vol. : 05 No.-13 Jan. 13 -2012 (Poush 29,2068)<BR>

Many countries including Nepal have a long tradition of their own local medicine which is different from Western or allopathic medicine. There is much to be said about this local form of therapy which is termed alternative medicine. In China and Taiwan if you check the regular pharmacies sometimes you will be hard- pressed to find Western style drugs. Medical procedures and herbal therapy from India, China, Taiwan and other countries holds sway for many people, and people have tremendous faith in this form of therapy. However there may be some limitations.


If you are having a heart attack, it is probably not a good idea to seek immediate treatment with homeopathy, herbal medicine or acupuncture. In that setting it is best to be treated with Western( allopathic) medicine where available. However there are many illnesses where Western medicine has nothing effective to offer. These diseases range from terminal cancer, certain neurological problems like amyotrophic lateral sclerosis( Lou Gehrig’s disease) to common colds where you can only treat the symptoms. There are also diseases like rheumatoid arthritis, diabetes mellitus, and hypertension where there is clearly effective control with Western medicine but no cure. Many people desire a cure and choose alternative medicine.


Also in cases of many common allergies which do not pose any immediate danger to life, there may be a role for alternative medicine as the drug can take its time to work. However especially in an emergency situation you want a drug or procedure that will work promptly. In addition you would like to be assured that the life-saving therapy is based on good evidence.


However reports based on recently published findings show that 95 % of alternative or complementary medicine is not evidence-based and borders on quackery. This is strong medicine to swallow for the practitioners of alternative medicine. Western medicine as mentioned often in this column is based on randomized controlled trials which try to show that a drug for a certain disease is better than a placebo (sugar pill). However alternative medicine therapydoes not look better than a placebo. Many alternative medicine researchers have reached a point where they do not want to carry out more trials because the trials show the ineffectiveness of their medicine and risk hurting their trade in the long run. Even meta analysis ( putting together small trials to see if the sum effect shows efficacy of the drug in question) of these alternative medicine drugs have increasingly shown negative results.


Rather than giving up, more rigorous trialsof diseases using herbal and other complimentary medicine drugs with adequate sample size of the population being tested needs to be carried out.There may be many useful herbs with an effective drug molecule that needs to be tested  to show benefits. Making use of the placebo effect for certain patients may also be a great idea. But in reality most people who have a clear- cut disease will want to know if there is proper evidence for use of that particular drug for them.What needs to be dispelled is that that unlike Western medicine, alternative medicine drugs have no adverse effects. Not true.


What also needs to be shunned are statements by “scientifically- challenged” celebrities and godmen(in our part of the world) who think that alternative medicine is outside the realm of scientific scrutiny.That is superstition.

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