Complementary medicine defined

Demographic surveys of many alternative or complementary medicines have been conducted in a range of locations, but there is usually a problem in clearly defining and categorizing individual types of product however, the usual outcome of these surveys is that the typical patient is middle-aged, middle-income, and female. One recent survey carried out in Washington State, United States, on patients aged 50-76 established the prevalence of their medical conditions, and prevalence of use of a number of nutraceuticals by both men (n = 29,435) and women (n = 32,152). Table 3 outlines the incidence of diseases treated with nutraceuticals. 

Even a perfectly safe remedy (mainstream or unorthodox) can become unsafe when used incompetently. Medical competence can be defined as doing everything in the best interest of the patient according to the best available evidence. There are numerous circumstances, both in orthodox and complementary medicine, when competence is jeopardized ... 

The past twenty years have seen a dramatic increase in the popularity and use of various complementary or alternative therapies. These can be referred to by many different names such as unorthodox, natural, fringe, complementary or alternative. In 1993 the British Medical Association in its report on Complementary Medicine used the term non-conventional therapies which it defined as those forms of treatment which are not widely used by the orthodox health-care professions and the skills of which are not taupfht as part of the underptraduate curriculum of orthodox medical and paramedical healthcare courses . 

Widespread medicinal use of colloidal bismuth subcitrate (CBS) has prompted extensive studies of bismuth compounds involving the citrate anion. Bismuth citrate is essentially insoluble in water, but a dramatic increase in solubility with increasing pH has been exploited as a bio-ready source of soluble bismuth, a material referred to as CBS. Formulation of these solutions is complicated by the variability of the bismuth anion stoichiometry, the presence of potassium and/ or ammonium cations, the susceptibility of bismuth to oxygenation to Bi=0, and the incorporation of water in isolated solids. Consequently, a variety of formulas are classified in the literature as CBS. Solids isolated from various, often ill-defined combinations of bismuth citrate, citric acid, potassium hydroxide, or ammonium hydroxide have been assigned formulas on the basis of elemental analysis data or by determination of water and ammonia content, but are of low significance in the absence of complementary data other than thermal analysis (163), infrared spectroscopy (163), or NMR spectroscopy (164). In this context, the Merck index lists the chemical formula of CBS as KgfNHJaBieOafOHMCeHsCbh in the 11th edition (165), but in the most recent edition provides a less precise name, tripotassium dicitrato bismuthate (166). 

Figure 1 Five major CAM domains. NCCAM defines complementary and alternative medicine (CAM) practices as those not presently considered an integral part of conventional medicine. As CAM modalities are proven safe and effective, they may become adopted into mainstream medical practice. The five areas shown in the schematic represent but one way to array CAM approaches. Examples in each area are provided below (see NCCAM strategic plan at http //www.nccam.nih.gov for more details) ... 

Complementary and alternative medicine (CAM) is a broad domain of healing resources that encompass all health systems, practices, accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture, within a defined historical period. CAM includes all such practices and ideas self-defined by their users for prevention or treatment of disease, or promotion of health and well being. Boundaries within CAM and between the CAM domain and that of the dominant system are not always sharp or fixed . 

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