Defining Alternative Therapies

Western medical therapies are those generally used by a medical doctor trained in the United States or by a standard Western medical curriculum. This involves a disease model approach, performing a detailed history and physical examination to

identify a specific condition and attempting to treat the condition with specific medications, rehabilitative therapies, and sometimes surgery. The terms conventional and allopathic are often used when referring to Western-based therapies. A larger variety of terms are used when referring to alternative therapies. These include alternative, Eastern medicine, complementary medicine, CAM, integrative, functional, natural, and holistic medicine. In essence, what all of these terms imply is a form of therapy not considered to be a standard Western medical approach. Hence, the list of alternative therapies is infinite and might include a variety of treatments such as aroma therapy, magnet therapy, chelation, acupuncture, and meditation. Because there is such a vast array of different alternative approaches, it is important to define the specific therapy such as a particular herbal remedy or exercise when discussing and assessing the response to a therapy rather than using the term "alternative."

There is also considerable confusion about whether to classify the numerous therapies available as alternative or conventional. For instance, chiropractics, often labeled as alternative, has gained wider acceptance among Western society such that it is frequently considered to be conventional by many Western laypersons and has always been viewed as such by most European societies. In fact, what is typically viewed as alternative by Western society is often accepted as mainstream therapy by non-Western societies. The frame of reference or culture may determine whether a particular therapy is defined as conventional or alternative. In 1995, the Office of Alternative Medicine in an effort to alleviate some of this confusion came up with the following definition:

CAM 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 uses as preventing or treating illness or promoting well-being. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed (4)[12].

Another way of defining CAM is any therapy that is not within the dominant healthcare system, i.e., outside of the accepted medical practices, scientific knowledge, or university teachings. This chapter will focus mostly on Eastern medical therapies, but recognizes that potentially beneficial treatments and medical approaches that may exist beyond those discussed herein. Another important point is that the term "alternative" does not imply that one should use CAM in place of conventional therapy or that one approach is exclusive of or better than the other when in fact both have value. Western therapies have been more rigorously studied for their proven efficacy in the treatment of the motor symptoms of PD than Eastern therapies, yet Eastern medical models have been in existence for thousands of years as effective systems of health promotion and disease treatment and prevention. It is recommended that alternative therapies may be considered supplemental rather than replacements for conventional treatments of PD. The terms complementary, inte-grative, or holistic may be more appropriate as they imply and encourage the use of a combination of a variety of Eastern and Western modalities as well as other non-conventional therapies for a more comprehensive health program.

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