View source for Alternative medicine

{{short description|Form of non-scientific healing}}
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{{infobox alternative medicine
| name = 
| synonyms = <!--Please do not remove any synonym without prior consensus, seek consensus on the talk page-->AM, complementary and alternative medicine (CAM), complementary medicine, heterodox medicine, integrative medicine (IM), complementary and integrative medicine (CIM), new-age medicine, pseudomedicine, unconventional medicine, unorthodox medicine, altmed<!--Please do not remove any synonym without prior consensus, seek consensus on the talk page-->
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| caption = Alternative therapies often make bombastic claims, and frequently include anecdotes from healthy-looking individuals claiming successful treatment.
| classification = 
| modality = 
| claims = Alternatives to reality-based medical treatments
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{{Alternative medical systems|general}}

<!--References for the lead are contained in the article body. Also see article version ID 890900314, which contains the references in the comments.-->
'''Alternative medicine''' is any practice that aims to achieve the healing effects of [[medicine]], but which lacks [[biological plausibility]] and is [[Argument from ignorance|untested]], [[Pseudoscience|untestable]] or proven ineffective. '''Complementary medicine''' ('''CM'''), '''complementary and alternative medicine''' ('''CAM'''), '''integrated medicine''' or '''integrative medicine''' ('''IM'''), and '''holistic medicine''' are among many [[rebranding]]s of the same phenomenon. Alternative therapies share in common that they reside outside of [[medical science]] and instead rely on [[pseudoscience]]. [[Traditional medicine|Traditional practices]] become "alternative" when used outside their original settings without proper scientific explanation and evidence. Frequently used derogatory terms for the alternative are new-age or pseudo, with little distinction from [[quackery]].

Some alternative practices are based on theories that contradict the science of how the human body works; others resort to the [[supernatural]] or [[Superstition|superstitious]] to explain their effect. In others, the practice is plausibly effective but has too many [[side effect]]s. Alternative medicine is distinct from scientific medicine, which employs the [[scientific method]] to test plausible therapies by way of [[Guidelines for human subject research|responsible and ethical]] [[clinical trial]]s, producing [[evidence]] of either effect or of no effect. Research into alternative therapies often fails to follow proper research protocols (such as [[placebo]]-[[Scientific control|controlled]] trials, [[Blinded experiment|blind experiments]] and calculation of [[prior probability]]), providing invalid results.

Much of the perceived effect of an alternative practice arises from a belief that it will be effective (the [[placebo effect]]), or from the treated condition resolving on its own ([[regression to the mean|the natural course of disease]]). This is further exacerbated by the tendency to turn to alternative therapies upon the failure of medicine, at which point the condition will be at its worst and most likely to spontaneously improve. In the absence of this bias, especially for diseases that are not expected to get better by themselves such as [[cancer]] or [[HIV/AIDS|HIV infection]], multiple studies have shown significantly worse outcomes if patients turn to alternative therapies. While this may be because these patients avoid effective treatment, some alternative therapies are actively harmful (e.g. [[cyanide]] poisoning from [[amygdalin]], or the intentional ingestion of [[hydrogen peroxide]]) or actively interfere with effective treatments.

The alternative sector is a highly profitable industry with a strong lobby, and faces far less regulation over the use and marketing of unproven treatments. Its marketing often [[Appeal to nature|advertises the treatments as being "natural"]] or "[[wikt:holistic|holistic]]", in comparison to those offered by [[Big Pharma conspiracy theory|medical science]]. Billions of dollars have been spent studying alternative medicine, with few or no positive results. Some of the successful practices are only considered alternative under very specific definitions, such as those which include all [[physical activity]] under the umbrella of "alternative medicine". 
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== Definitions and terminology ==
{{see also|Terminology of alternative medicine}}

The terms ''alternative medicine'', ''complementary medicine'', ''integrative medicine,'' ''holistic medicine'', ''natural medicine'', ''unorthodox medicine'', ''fringe medicine'', ''unconventional medicine'', and ''[[new age]] medicine'' are used interchangeably as having the same meaning and are almost synonymous in most contexts.<ref name="Shapiro 08">{{Cite book|url=https://books.google.com/books?id=Ib_IbOu_d9gC&pg=PA1|title=Suckers: How Alternative Medicine Makes Fools of Us All|last=Shapiro|first=Rose|date=2010-09-30|publisher=Random House |isbn=9781409059165}}</ref><ref name="Bombardieri2000" /><ref name="Shuval2012" /><ref name="Freedman2011" /> Terminology has shifted over time, reflecting the preferred branding of practitioners.<ref name="SBM-brand">[https://sciencebasedmedicine.org/integrative-medicine-a-brand-not-a-specialty/ "Integrative medicine": A brand, not a specialty]. ''[[Science Based Medicine]]''</ref> For example, the [[United States National Institutes of Health]] department studying alternative medicine, currently named the [[National Center for Complementary and Integrative Health]] (NCCIH), was established as the ''Office of Alternative Medicine'' (OAM) and was renamed the ''National Center for Complementary and Alternative Medicine'' (NCCAM) before obtaining its current name. Therapies are often [[framing (psychology)|framed]] as "natural" or "holistic", implicitly and intentionally suggesting that conventional medicine is "artificial" and "narrow in scope".<ref name="ConsumerHealth9th"/><ref>{{Cite web|url=http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2004:136:0085:0090:en:PDF|title=Directive 2004/24/EC of the European Parliament and of the Council|date=2004-04-30|website=Official Journal of the European Union}}</ref>

[[File:Marcia.angell.jpg|thumb|upright|[[Marcia Angell]]: "There cannot be two kinds of medicine&nbsp;– conventional and alternative".]]

The meaning of the term "alternative" in the expression "alternative medicine", is not that it is an effective alternative to [[medical science]], although some alternative medicine promoters may use the loose terminology to give the appearance of effectiveness.<ref name="ATRAMM" /><ref name="Kolata">{{Citation|last=Kolata|first=Gina|title=On Fringes of Health Care, Untested Therapies Thrive|date=June 17, 1996|url=https://www.nytimes.com/1996/06/17/us/on-fringes-of-health-care-untested-therapies-thrive.html|author-link=Gina Kolata|work=[[The New York Times]]|access-date=December 22, 2015}}</ref> Loose terminology may also be used to suggest meaning that a dichotomy exists when it does not, e.g., the use of the expressions "Western medicine" and "Eastern medicine" to suggest that the difference is a cultural difference between the Asiatic east and the European west, rather than that the difference is between [[evidence-based medicine]] and treatments that do not work.<ref name="ATRAMM" />

=== Alternative medicine ===
'''Alternative medicine''' is defined loosely as a set of products, practices, and theories that are believed or perceived by their users to have the healing effects of [[medicine]],{{refn|name=NSFquote|group=n|"[A]lternative medicine refers to all treatments that have not been proven effective using scientific methods."<ref name=NSF_2002/>}}{{refn|"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."{{sfn|IOM Report|2005|p=19}}|name=IOMquote|group=n}} but whose [[efficacy|effectiveness]] has not been established using [[scientific method]]s,{{refn|name=NSFquote|group=n}}{{refn|name=Angellquote|group=n|"It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine&nbsp;– 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&nbsp;... speculation, and testimonials do not substitute for evidence."<ref name=Angell1998/>}}<ref name="ATRAMM" /><ref name="Hines_Sampson_Coulter_Sagan" /><ref name="IGPIAMAYP" /><ref name="NP" /> or whose theory and practice is not part of [[biomedicine]],{{refn|group=n|name=IOMquote}}{{refn|group=n|name=Harrisonquote |"The phrase complementary and alternative medicine is used to describe a group of diverse medical and health care systems, practices, and products that have historic origins outside mainstream medicine. Most of these practices are used together with conventional therapies and therefore have been called complementary to distinguish them from alternative practices, those used as a substitute for standard care.&nbsp;... Until a decade ago or so, 'complementary and alternative medicine' could be defined as practices that are neither taught in medical schools nor reimbursed, but this definition is no longer workable, since medical students increasingly seek and receive some instruction about complementary health practices, and some practices are reimbursed by third-party payers. Another definition, practices that lack an evidence base, is also not useful, since there is a growing body of research on some of these modalities, and some aspects of standard care do not have a strong evidence base."{{sfn|Harrison's Principles of Internal Medicine|2015|loc=chpt. 14-E|p=1}}}}{{refn |name=WebMD2014quote |group=n |"An alternative medical system is a set of practices based on a philosophy different from Western biomedicine."<ref name=WebMD2014/>}}{{refn |group=n |name=NCCIH2quote |"CAM is a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine."<ref name=NCCIH2/>}} or whose theories or practices are directly contradicted by [[scientific evidence]] or [[science|scientific principles]] used in biomedicine.<ref name="ATRAMM" /><ref name="Hines_Sampson_Coulter_Sagan" /><ref name="AMCER" /> "Biomedicine" or "medicine" is that part of [[medical science]] that applies principles of [[biology]], [[physiology]], [[molecular biology]], [[biophysics]], and other [[natural science]]s to [[clinical practice]], using scientific methods to establish the effectiveness of that practice. Unlike medicine,{{refn|name=Harrisonquote|group=n}} an alternative product or practice does not originate from using scientific methods, but may instead be based on [[testimonial|hearsay]], [[religion]], tradition, [[superstition]], belief in [[supernatural]] energies, [[pseudoscience]], [[fallacy|errors in reasoning]], [[propaganda]], [[fraud]], or other unscientific sources.{{refn|name=Angellquote|group=n}}<ref name="ATRAMM" /><ref name="NSF_2002" /><ref name="Hines_Sampson_Coulter_Sagan" /><ref name="AMCER" />

Some other definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare.<ref name="Saks1992" /> This can refer to the lack of support that alternative therapies receive from medical scientists regarding access to [[Medical research#Funding|research funding]], sympathetic coverage in the [[Medical literature|medical press]], or inclusion in the standard [[Medical education|medical curriculum]].<ref name="Saks1992" /> For example, a widely used{{sfn|IOM Report|2005|p=[http://books.nap.edu/openbook.php?record_id=11182&page=19 19]}} definition devised by the [[National Center for Complementary and Alternative Medicine|US NCCIH]] calls it ''"a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine"''.<ref name="NCCIH1" /> However, these descriptive definitions are inadequate in the present-day when some conventional doctors offer alternative medical treatments and introductory courses or modules can be offered as part of standard undergraduate medical training;<ref name="HOL_Kopelman_Wieland_Astin_Pelletier" /> alternative medicine is taught in more than half of [[Medical school in the United States|US medical schools]] and [[Health insurance in the United States|US health insurers]] are increasingly willing to provide reimbursement for alternative therapies.{{sfn|IOM Report|2005|pp=[http://books.nap.edu/openbook.php?record_id=11182&page=17 17], [http://books.nap.edu/openbook.php?record_id=11182&page=196 196–252]}}

=== Complementary or integrative medicine {{anchor|Complementary medicine|Integrative medicine|Integrated medicine}} ===
'''Complementary medicine''' ('''CM''') or '''integrative medicine''' ('''IM''') is when alternative medicine is used together with functional medical treatment in a [[belief]] that it improves the effect of treatments.{{refn|group=n|name=FinalReport|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."<ref name="whccamp.hhs.gov"/>}}<ref name="NSF_2002" /><ref name="Ernst_1995" /><ref name="Joyce_1994" /><ref name="BMJ_May" /> For example, [[acupuncture]] (piercing the body with needles to influence the flow of a supernatural energy) might be believed to increase the effectiveness or "complement" science-based medicine when used at the same time.<ref name="NCI_PDQ_CAM" /><ref name="Borkan2012" /><ref name="whatiscam" /> Instead, significant [[drug interaction]]s caused by alternative therapies may make treatments less effective, notably in [[Treatment of cancer|cancer therapy]].<ref name="autogenerated2">{{Cite journal |last1=Zeller |first1=T. |last2=Muenstedt |first2=K. |last3=Stoll |first3=C. |last4=Schweder |first4=J. |last5=Senf |first5=B. |last6=Ruckhaeberle |first6=E. |last7=Becker |first7=S. |last8=Serve|first8=H. |last9=Huebner |first9=J. |date=2013-03-01 |title=Potential interactions of complementary and alternative medicine with cancer therapy in outpatients with gynecological cancer in a comprehensive cancer center |journal=Journal of Cancer Research and Clinical Oncology |volume=139 |issue=3 |pages=357–65 |doi=10.1007/s00432-012-1336-6|issn=1432-1335|pmid=23099993|s2cid=29598970 }}</ref><ref name="Arye13">{{Cite journal|last1=Ben-Arye |first1=Eran |last2=Polliack |first2=Aaron |last3=Schiff |first3=Elad |last4=Tadmor |first4=Tamar |last5=Samuels |first5=Noah|date=2013-12-01|title=Advising patients on the use of non-herbal nutritional supplements during cancer therapy: a need for doctor-patient communication |journal=Journal of Pain and Symptom Management |volume=46 |issue=6 |pages=887–96 |doi=10.1016/j.jpainsymman.2013.02.010 |pmid=23707384 |issn=1873-6513|doi-access=free }}</ref><ref name="Li et al., 2018" /> Besides the usual issues with alternative medicine, integrative medicine has been described as an attempt to bring pseudoscience into academic [[science-based medicine]],<ref name="Gorski2010" /> leading to the pejorative term "[[Quackery#Criticism of quackery in academia|quackademic medicine]]". Due to its many names, the field has been criticized for intense [[rebranding]] of what are essentially the same practices.<ref name="Shapiro 08" />

'''CAM''' is an abbreviation of the phrase ''complementary and alternative medicine''.<ref name="ernstinterview" /><ref name="CassilethDeng2004" /> It has also been called sCAM or SCAM with the addition of "so-called" or "supplements".<ref name="skepdic.com">{{Cite web|url=http://skepdic.com/refuge/sdshort.html |title=The short and irreverent e-dition of The Skeptic's Dictionary&nbsp;– part 1&nbsp;– sCAM&nbsp;– so-called complementary and alternative medicine |website=skepdic.com |access-date=2016-10-15}}</ref><ref name="Tyreman 209–17">{{Cite journal |last=Tyreman |first=Stephen |date=2011-05-01 |title=Values in complementary and alternative medicine|journal=Medicine, Health Care and Philosophy |volume=14 |issue=2 |pages=209–17 |doi=10.1007/s11019-010-9297-5 |issn=1572-8633 |pmid=21104324|s2cid=32143622 }}</ref>

===Other terms===
{{see also|Traditional medicine}}
Traditional medicine refers to the pre-scientific practices of a certain culture, in contrast to what is typically practiced in cultures where medical science dominates. "[[Eastern medicine]]" typically refers to the traditional medicines of Asia where evidence-based medicine penetrated much later.

'''Holistic medicine''' is another rebranding of alternative medicine. In this case, the words ''balance'' and ''holism'' are often used alongside ''complementary'' or ''integrative'', claiming to take into account a "whole" person, in contrast to the supposed reductionism of medicine.<ref name="Beresford pp. 721–724">{{cite journal | last=Beresford | first=M. J. | title=Medical reductionism: lessons from the great philosophers | journal=QJM | publisher=Oxford University Press (OUP) | volume=103 | issue=9 | date=15 April 2010 | issn=1460-2725 | doi=10.1093/qjmed/hcq057 | pages=721–724 | pmid=20395240 | quote=Unfortunately, the term ‘holistic medicine’ has been somewhat hijacked by alternative therapists and is often thought mistakenly to be at odds with conventional medicine.}}</ref><ref name="ZUCKER 1979 pp. 39–42">{{cite journal | last=ZUCKER | first=A | title=Reductionism and holistic medicine | journal=Journal of Social and Biological Systems | publisher=Elsevier BV | volume=2 | issue=1 | year=1979 | issn=0140-1750 | doi=10.1016/0140-1750(79)90019-8 | pages=39–42}}</ref>

=== Challenges in defining alternative medicine ===

Prominent members of the science<ref name="Offit2013" /><ref name="Dawkins2003a" /> and biomedical science community<ref name="Angell1998" /> say that it is not meaningful to define an alternative medicine that is separate from a conventional medicine because the expressions "conventional medicine", "alternative medicine", "complementary medicine", "integrative medicine",  and "holistic medicine" do not refer to any medicine at all.<ref name="Angell1998" /><ref name="Offit2013" /><ref name="Dawkins2003a" /><ref name="Fontanarosa1998" /> Others say that alternative medicine cannot be precisely defined because of the diversity of theories and practices it includes, and because the boundaries between alternative and conventional medicine overlap, are porous, and change.{{sfn|Harrison's Principles of Internal Medicine|2015|loc=chpt. 14-E|p=1}}{{sfn|IOM Report|2005|pp=14–20}} Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, [[medical diagnosis|diagnostic technique]], [[therapy|therapeutic practice]] and in their relationship to the medical mainstream.{{sfn|Sointu|2012|p=[https://books.google.com/books?id=XC2UUP36bjAC&pg=PA13 13]}} Under a definition of alternative medicine as "non-mainstream", treatments considered alternative in one location may be considered conventional in another.<ref name="Nissen2013" />

Critics say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that ''complementary'' is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a [[placebo]].<ref name="ATRAMM" /><ref name="Gorski2010" /><ref name="Skep_Dic_comp_med" /><ref name="Novella2010" /> [[John Diamond (journalist)|John Diamond]] wrote that "there is really no such thing as alternative medicine, just medicine that works and medicine that doesn't",<ref name=Dawkins2003a/><ref name="Jeffrey2015">{{Cite journal |last=Jeffery |first=Nick |date=2015 |title=There is no such thing as alternative medicine |journal=Journal of Small Animal Practice |language=en |volume=56 |issue=12 |pages=687–688 |doi=10.1111/jsap.12427 |pmid=26735773 |issn=1748-5827|doi-access=free }}</ref> a notion later echoed by [[Paul Offit]]: "The truth is there's no such thing as conventional or alternative or complementary or integrative or holistic medicine. There's only medicine that works and medicine that doesn't. And the best way to sort it out is by carefully evaluating scientific studies—not by visiting Internet chat rooms, reading magazine articles, or talking to friends."<ref>{{Cite book |last=Offit |first=Paul A. |title=Do you believe in magic?: the sense and nonsense of alternative medicine |publisher=Harper |year=2013 |isbn=978-0-06-222300-5 |edition=1st |location=New York, NY |oclc=849738969}}</ref> Comedian [[Tim Minchin]] has also taken to the issue in his [[viral video|viral]] animation [[short film|short]] ''Storm'': "By definition alternative medicine has either not been proved to work, or been proved not to work. Do you know what they call alternative medicine that's been proved to work? Medicine."<ref>{{Cite AV media |url=https://www.youtube.com/watch?v=HhGuXCuDb1U |archive-url=https://ghostarchive.org/varchive/youtube/20211122/HhGuXCuDb1U| archive-date=2021-11-22 |url-status=live |title=Tim Minchin's Storm the Animated Movie |date=2011-04-07 |last=Minchin |first=Tim}}{{cbignore}}</ref>

==Types==
{{see also|List of forms of alternative medicine}}

Alternative medicine consists of a wide range of health care practices, products, and therapies. The shared feature is a claim to heal that is not based on the scientific method. Alternative medicine practices are diverse in their foundations and methodologies.<ref name="NCCIH1" /> Alternative medicine practices may be classified by their cultural origins or by the types of beliefs upon which they are based.<ref name="NSF_2002" /><ref name="ATRAMM" /><ref name="AMCER" /><ref name="NCCIH1" /> Methods may incorporate or be based on traditional medicinal practices of a particular culture, folk knowledge, superstition,{{sfn|O'Connor|1995|p=[https://books.google.com/books?id=JXFPb88KLZQC&pg=PA2 2]}} spiritual beliefs, belief in [[supernatural]] energies ([[antiscience]]), [[pseudoscience]], [[fallacy|errors in reasoning]], propaganda, fraud, new or different concepts of health and disease, and any bases other than being proven by scientific methods.<ref name="NSF_2002" /><ref name="ATRAMM" /><ref name="Hines_Sampson_Coulter_Sagan" /><ref name="AMCER" /> Different cultures may have their own unique traditional or belief based practices developed recently or over thousands of years, and specific practices or entire systems of practices.
{{Clear}}

===Unscientific belief systems===
Alternative medicine, such as using [[naturopathy]] or [[homeopathy]] in place of [[conventional medicine]], is based on belief systems not grounded in science.<ref name="NCCIH1" />

{| class="wikitable"
!
!Proposed mechanism
!Issues
|-
![[Naturopathy]]
|Naturopathic medicine is based on a belief that the body heals itself using a supernatural [[vitalism|vital energy]] that guides bodily processes.<ref name="SarrisWardle2010" />
|In conflict with the paradigm of [[evidence-based medicine]].<ref name="Jagtenberg2006" /> Many naturopaths have opposed [[vaccination]],<ref name="Ernst2001" /> and "scientific evidence does not support claims that naturopathic medicine can cure [[cancer]] or any other disease".<ref name="ACS" />
|-
![[Homeopathy]]
|A belief that a substance that causes the symptoms of a disease in healthy people cures similar symptoms in sick people.{{refn|In his book ''The Homœopathic Medical Doctrine'' [[Samuel Hahnemann]] the creator of homeopathy wrote: "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 (''{{lang|el|ὅμοιος πάθος}}'') to that against which it is employed."{{sfn|Hahnemann|1833|p=[https://books.google.com/books?id=EnEFAAAAQAAJ&pg=PR3 iii], [https://books.google.com/books?id=EnEFAAAAQAAJ&pg=PA48 48–49]}}|name=Hahnemannquote|group=n}}
|Developed before knowledge of [[atom]]s and [[molecule]]s, or of basic chemistry, which shows that repeated dilution as practiced in homeopathy produces only water, and that homeopathy is not scientifically valid.<ref name="Ernst2002" /><ref name="HCReport2010" /><ref name="shang" /><ref name="NCCIH_homeopathy" />
|}

[[Image:A person discovering that they have been transformed into se Wellcome V0011124.jpg|thumb|right|300px|"''They told me if I took 1000 pills at night I should be quite another thing in the morning''", an early 19th-century satire on [[Morison's Vegetable Pills]], an alternative medicine supplement.]]

===Traditional ethnic systems===
[[File:Xi'an traditionnal medecine market (18).JPG|thumb|Ready-to-drink [[traditional Chinese medicine]] mixture|right|200x200px]]

Alternative medical systems may be based on [[traditional medicine]] practices, such as [[traditional Chinese medicine]] (TCM), [[Ayurveda]] in India, or practices of other cultures around the world.<ref name="NCCIH1" /> Some useful applications of traditional medicines have been researched and accepted within ordinary medicine, however the underlying belief systems are seldom scientific and are not accepted.

Traditional medicine is considered alternative when it is used outside its home region; or when it is used together with or instead of known functional treatment; or when it can be reasonably expected that the patient or practitioner knows or should know that it will not work – such as knowing that the practice is based on superstition.
{| class="wikitable"
!
!Claims
!Issues
|-
|[[Traditional Chinese medicine]]
|Traditional practices and beliefs from China, together with modifications made by the Communist party make up TCM. Common practices include herbal medicine, [[acupuncture]] (insertion of needles in the body at specified points), massage (Tui na), exercise ([[qigong]]), and dietary therapy.
|The practices are based on belief in a supernatural energy called [[qi]], considerations of [[Chinese astrology]] and [[Numerology#Chinese numerology|Chinese numerology]], traditional use of herbs and other substances found in China, a belief that the tongue contains a map of the body that reflects changes in the body, and an incorrect model of the anatomy and physiology of internal organs.<ref name="ATRAMM" /><ref name="BeyersteinSampson1996" /><ref name="LuNeedham1980" /><ref name="Maciocia1995" /><ref name="Matuk2006" /><ref name="Deshpande1987" />
|-
|[[Ayurveda]]
|Traditional medicine of India. Ayurveda believes in the existence of three elemental substances, the [[Ayurveda#Tridosha system|doshas]] (called Vata, Pitta and Kapha), and states that a balance of the doshas results in health, while imbalance results in disease. Such disease-inducing imbalances can be adjusted and balanced using traditional herbs, minerals and heavy metals. Ayurveda stresses the use of plant-based medicines and treatments, with some animal products, and added minerals, including [[sulfur]], [[arsenic]], [[lead]] and [[copper sulfate]].{{Clarify|date=October 2017}}
|Safety concerns have been raised about Ayurveda, with two U.S. studies finding about 20 percent of Ayurvedic Indian-manufactured [[patent medicine]]s contained toxic levels of heavy metals such as [[lead]], [[Mercury (element)|mercury]] and [[arsenic]]. A 2015 study of users in the United States also found elevated blood lead levels in 40 percent of those tested.  Other concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities. Incidents of [[heavy metal poisoning]] have been attributed to the use of these compounds in the United States.{{sfn|Wujastyk|2003|p=xviii}}{{sfn|Mishra|2004|p=8}}<ref name="DaguptaHStabler2011" /><ref name="Valiathan2006" /><ref name="CDC" /><ref name="Saper2008" /><ref>{{cite web|last1=Hall|first1=Harriet|title=Ayurveda: Ancient Superstition, Not Ancient Wisdom|url=https://www.csicop.org/specialarticles/show/ayurveda_ancient_superstition_not_ancient_wisdom|website=Skeptical Inquirer|access-date=1 February 2018|date=2017-12-14}}</ref><ref>{{cite journal|vauthors=Breeher L, Mikulski MA, Czeczok T, Leinenkugel K, Fuortes LJ|title=A cluster of lead poisoning among consumers of Ayurvedic medicine|journal=International Journal of Occupational and Environmental Health|date=6 Apr 2015|volume=21|issue=4|pages=303–07|doi=10.1179/2049396715Y.0000000009|pmid=25843124|pmc=4727589}}</ref>
|}

===Supernatural energies===

Bases of belief may include belief in existence of supernatural energies undetected by the science of physics, as in biofields, or in belief in properties of the energies of physics that are inconsistent with the laws of physics, as in energy medicine.<ref name="NCCIH1" />
{| class="wikitable"
!
!Claims
!Issues
|-
|[[Energy medicine|Biofield therapy]]
|Intended to influence energy fields that, it is purported, surround and penetrate the body.<ref name="NCCIH1" />
|Advocates of [[scientific skepticism]] such as [[Carl Sagan]] have described the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.{{sfn|Sagan|1996}}
|-
|[[Bioelectromagnetism|Bioelectromagnetic]] therapy
|Use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in an unconventional manner.<ref name="NCCIH1" />
|Asserts that magnets can be used to defy the laws of [[physics]] to influence health and disease.
|-
|[[Chiropractic]]
|[[Spinal manipulation]] aims to treat "[[vertebral subluxation]]s" which are claimed to put pressure on nerves.
|Chiropractic was developed in the belief that manipulating the spine affects the flow of a supernatural [[vital energy]] and thereby affects health and disease. Vertebral subluxation is a pseudoscientific concept and has not been proven to exist.
|-
|[[Reiki]]
|Practitioners place their palms on the patient near [[Chakras]] that they believe are centers of supernatural energies in the belief that these supernatural energies can transfer from the practitioner's palms to heal the patient.
|Lacks credible scientific evidence.<ref name="rosa">{{cite journal | doi = 10.1001/jama.279.13.1005 | pmid=9533499 | volume=279 | issue=13 | title=A close look at therapeutic touch | date=April 1998 |vauthors=Rosa L, Rosa E, Sarner L, Barrett S| journal=JAMA | pages=1005–10| doi-access=free }}</ref>
|}
[[File:Acupuncture1-1.jpg|thumb|right|[[Acupuncture]] involves insertion of needles in the body.]]

===Herbal remedies and other substances===
{{Main|Herbal medicine}}
Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, animal and fungal products, and minerals, including use of these products in traditional medical practices that may also incorporate other methods.<ref name="NCCIH1" /><ref name="Abdulla1999">{{cite journal|last1=Abdulla|first1=Sara|title=Phytotherapy – good science or big business?|journal=Nature|date=May 13, 1999|doi=10.1038/news990513-8|quote=Science-based medicine, with its emphasis on controlled study, proof, evidence, statistical significance and safety is being rejected in favour of 'alternative medicine'&nbsp;– an atavistic portmanteau of anecdote, hearsay, rumour and hokum.&nbsp;... Probably the most commercially successful and widely used branch of alternative or complementary medicine is 'phytotherapy'. These are the tablets, powders and elixirs, otherwise known as herbal medicine, that are sold in most countries, through health shops and pharmacies as 'nutritional supplements'.&nbsp;... Only a tiny minority of these remedies have been shown to have mild-to moderately beneficial health effects&nbsp;... So why are affluent, otherwise rational, highly educated people (for this is the average user profile) so hungry for phytotherapy?&nbsp;... people still believe that 'natural' equals good and safe despite plenty of evidence to the contrary.&nbsp;... as far as the human body is concerned, 'natural' is meaningless&nbsp;... Equally, what's so safe about consuming substances that need meet no standards of contents?}}</ref><ref>{{cite journal|last1=De Smet|first1=Peter A.G.M.|title=The Role of Plant-Derived Drugs and Herbal Medicines in Healthcare|journal=Drugs|date=December 1997|volume=54|issue=6|pages=801–40|doi=10.2165/00003495-199754060-00003|pmid=9421691|s2cid=46970414}}</ref> Examples include healing claims for non-vitamin supplements, [[fish oil]], [[Omega-3 fatty acid]], [[glucosamine]], [[echinacea]], [[flaxseed oil]], and [[ginseng]].<ref name="NCCIHSurvey" /> [[Herbal medicine]], or phytotherapy, includes not just the use of plant products, but may also include the use of animal and mineral products.<ref name="Abdulla1999" /> It is among the most commercially successful branches of alternative medicine, and includes the tablets, powders and elixirs that are sold as "nutritional supplements".<ref name="Abdulla1999" /> Only a very small percentage of these have been shown to have any efficacy, and there is little regulation as to standards and safety of their contents.<ref name="Abdulla1999" />
[[File:Chiropractic spinal adjustment.jpg|thumb|right|A [[chiropractor]] "[[Spinal adjustment|adjusting]]" the spine]]

===Religion, faith healing, and prayer===
{{see also|Shamanism}}
{| class="wikitable"
!
!Claims
!Issues
|-
|[[Christianity|Christian]] [[faith healing]]
|There is a divine or spiritual intervention in healing.
|Lack of evidence for effectiveness.<ref name="Pearce_Simpson1998">{{cite journal|last1=Pearce|first1=Alison|last2=Simpson|first2=Neil|title=A paediatrician's guide to complementary medicine|journal=Current Paediatrics|date=March 1998|volume=8|issue=1|pages=62–67|doi=10.1016/S0957-5839(98)80061-4}}</ref> Unwanted outcomes, such as death and disability, "have occurred when faith healing was elected instead of medical care for serious injuries or illnesses".<ref>{{cite web|title=Faith Healing – Making Treatment Decisions|publisher=American Cancer Society|date=June 15, 2009|url=http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Faith_Healing.asp}}</ref> A 2001 double-blind study of 799 discharged coronary surgery patients found that "intercessory prayer had no significant effect on medical outcomes after hospitalization in a coronary care unit."<ref name="Aviles_et_al2001">{{cite journal|last1=Aviles|first1=Jennifer M.|last2=Whelan|first2=Sr Ellen|last3=Hernke|first3=Debra A.|last4=Williams|first4=Brent A.|last5=Kenny|first5=Kathleen E.|last6=O'Fallon|first6=W. Michael|last7=Kopecky|first7=Stephen L.|s2cid=7300728|title=Intercessory Prayer and Cardiovascular Disease Progression in a Coronary Care Unit Population: A Randomized Controlled Trial|journal=Mayo Clinic Proceedings|date=December 2001|volume=76|issue=12|pages=1192–98|doi=10.4065/76.12.1192|pmid=11761499}}</ref>
|}

=== NCCIH classification ===
A US agency, National Center on Complementary and Integrative Health ([[NCCIH]]), has created a classification system for branches of complementary and alternative medicine that divides them into five major groups. These groups have some overlap, and distinguish two types of [[energy]] medicine: ''veritable'' which involves scientifically observable energy (including [[magnet therapy]], [[colorpuncture]] and [[light therapy]]) and ''putative'', which invokes physically undetectable or unverifiable energy.<ref name="NCCIH_EMed" /> None of these energies have any evidence to support that they effect the body in any positive or health promoting way.<ref name="ConsumerHealth9th"/>

# Whole medical systems: Cut across more than one of the other groups; examples include traditional Chinese medicine, naturopathy, homeopathy, and ayurveda.
# Mind-body interventions: Explore the interconnection between the mind, body, and spirit, under the premise that they affect "bodily functions and symptoms". A connection between mind and body is conventional medical fact, and this classification does not include therapies with proven function such as [[cognitive behavioral therapy]].
# "Biology"-based practices: Use substances found in nature such as herbs, foods, vitamins, and other natural substances. (Note that as used here, "biology" does ''not'' refer to the science of [[biology]], but is a usage newly coined by NCCIH in the primary source used for this article. "Biology-based" as coined by NCCIH may refer to chemicals from a nonbiological source, such as use of the poison [[lead]] in traditional Chinese medicine, and to other nonbiological substances.)
# Manipulative and body-based practices: feature manipulation or movement of body parts, such as is done in bodywork, chiropractic, and osteopathic manipulation.
# Energy medicine: is a domain that deals with putative and verifiable energy fields:
#* [[Energy (spirituality)#Biofields|Biofield]] therapies are intended to influence energy fields that are purported to surround and penetrate the body. The existence of such energy fields have been disproven.
#* [[Bioelectromagnetism|Bioelectromagnetic]]-based therapies use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in a non-scientific manner.

== History ==
{{Main|History of alternative medicine}}
The history of alternative medicine may refer to the history of a group of diverse medical practices that were collectively promoted as "alternative medicine" beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled "irregular practices" by the western medical establishment.<ref name="ATRAMM" /><ref name="QMHCHF" /><ref name="CHBHAMA">Countercultural Healing: A brief History of Alternavie Medicine in America, James Whorton, [[PBS]], November 4, 2003, [https://www.pbs.org/wgbh/pages/frontline/shows/altmed/clash/history.html]</ref><ref name="NCHAMA">Nature Cures &nbsp;– The History of Alternative Medicine in America, James C. Whorton, Oxford University Press, 2002, {{cite web|url=http://ir.nmu.org.ua/bitstream/handle/123456789/130555/400a3b078ea853dd93607611eb31561f.pdf?sequence=1 |title=Archived copy |access-date=2015-06-08 |url-status=dead |archive-url=https://web.archive.org/web/20150608222948/http://ir.nmu.org.ua/bitstream/handle/123456789/130555/400a3b078ea853dd93607611eb31561f.pdf?sequence=1 |archive-date=2015-06-08 }}</ref><ref name="RRCAM">The Rise and Rise of Complementary and Alternative Medicine: a Sociological Perspective, Ian D Coulter and Evan M Willis, Medical Journal of Australia, 2004; 180 (11): 587–89</ref> It includes the histories of [[complementary medicine]] and of [[integrative medicine]]. Before the 1970s, western practitioners that were not part of the increasingly science-based medical establishment were referred to "irregular practitioners", and were dismissed by the medical establishment as unscientific and as practicing [[quackery]].<ref name="QMHCHF" /><ref name="CHBHAMA" /> Until the 1970s, irregular practice became increasingly marginalized as [[quackery]] and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had a corresponding increase in success of its treatments.<ref name="NCHAMA" /> In the 1970s, irregular practices were grouped with traditional practices of nonwestern cultures and with other unproven or disproven practices that were not part of biomedicine, with the entire group collectively marketed and promoted under the single expression "alternative medicine".<ref name="ATRAMM" /><ref name="QMHCHF">Quack Medicine: A History of Combating Health Fraud in Twentieth-Century America, Eric W. Boyle, [https://books.google.com/books?id=X2YCTohiBpYC&pg=PA170&lpg=PA170]</ref><ref name="CHBHAMA" /><ref name="NCHAMA" /><ref name="FrontlineAF">{{cite web|url=https://www.pbs.org/wgbh/pages/frontline/shows/altmed/etc/synopsis.html|title=The Alternative Fix – Introduction |publisher= Frontline – PBS|website=www.pbs.org}}</ref>

Use of alternative medicine in the west began to rise following the [[counterculture movement]] of the 1960s, as part of the rising [[new age movement]] of the 1970s.<ref name="ATRAMM" /><ref>Wallis, Claudia (November 4, 1991). [http://content.time.com/time/covers/0,16641,19911104,00.html "The New Age of Alternative Medicine, Why New Age Medicine Is Catching On"]. ''[[Time (magazine)|Time]]''.</ref><ref name="ENAB">{{cite book |title=New Age Medicine, Encyclopedia of New Age Beliefs |first1=John |last1=Ankerberg |first2=John |last2=Weldon |year=1996 |pages=470–508 |isbn=9781565071605 |url=https://books.google.com/books?id=SghdYBbMds0C&pg=PA479 }}</ref> This was due to misleading [[mass marketing]] of "alternative medicine" being an effective "alternative" to biomedicine, changing social attitudes about not using [[chemicals]] and challenging [[the establishment]] and [[authority]] of any kind, sensitivity to giving equal measure to beliefs and practices of other cultures ([[cultural relativism]]), and growing frustration and desperation by patients about limitations and [[side effect]]s of [[science-based medicine]].<ref name="ATRAMM" /><ref name="CHBHAMA" /><ref name="NCHAMA" /><ref name="RRCAM" /><ref name="FrontlineAF" /><ref name="ENAB" /><ref name="AMBMJ" /> At the same time, in 1975, the [[American Medical Association]], which played the central role in fighting quackery in the United States, abolished its quackery committee and closed down its Department of Investigation.<ref name="QMHCHF" />{{rp|xxi}}<ref name="AMBMJ">{{cite journal |quote=One of the few growth industries in contemporary Britain is alternative medicine. An apparently endless stream of books, articles, and radio and television programmes urge on the public the virtues of treatments ranging from meditation to drilling a hole in the skull to let in more oxygen. |pmc=1548588|year=1983|last1=Smith|first1=T|title=Alternative medicine|journal=British Medical Journal (Clinical Research Ed.)|volume=287|issue=6388|pages=307–08|pmid=6307462|doi=10.1136/bmj.287.6388.307}}</ref> By the early to mid 1970s the expression "alternative medicine" came into widespread use, and the expression became mass marketed as a collection of "natural" and effective treatment "alternatives" to science-based biomedicine.<ref name="ATRAMM" /><ref name="AMBMJ" /><ref>Other healers, other cures: A guide to alternative medicine, Helen Kruger, 1974, [https://www.amazon.com/Other-healers-other-cures-alternative/dp/0672517086]</ref><ref>{{cite web|url=https://www.amazon.com/Guide-Alternative-Medicine-Donald-Law/dp/B002K530DM/|title=A Guide to Alternative Medicine|last=Law|first=Donald|date=18 May 1975|publisher=Hippocrene Books, New York|via=Amazon}}</ref> By 1983, mass marketing of "alternative medicine" was so pervasive that the [[British Medical Journal]] (BMJ) pointed to "an apparently endless stream of books, articles, and radio and television programmes urge on the public the virtues of (alternative medicine) treatments ranging from meditation to drilling a hole in the skull to let in more oxygen".<ref name="AMBMJ" />

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, changes in the medical marketplace had influenced the type of response in the journals.<ref name="Winnick2005_2009" /> Changes included relaxed medical licensing, the development of managed care, rising consumerism, and the establishment of the USA Office of Alternative Medicine (later [[National Center for Complementary and Alternative Medicine]], currently [[National Center for Complementary and Integrative Health]]).{{refn|group=n|According to the medical historian [[James Harvey Young]]:{{blockquote|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."<ref>{{Cite journal |last1= Young |first1= J.H. |title= The Development of the Office of Alternative Medicine in the National Institutes of Health, 1991–1996 |doi= 10.1353/bhm.1998.0110 |journal= Bulletin of the History of Medicine |volume= 72 |issue= 2 |pages= 279–98 |year= 1998 |pmid=  9628052 |s2cid= 26685737 }}</ref>}}}}

=== Medical education ===
Mainly as a result of reforms following the [[Flexner Report]] of 1910<ref name="Flexner_Report" /> [[medical education]] in established [[medical schools]] in the US has generally not included alternative medicine as a teaching topic.{{refn|group=n|As the medical professor [[Kenneth Ludmerer|Kenneth M. Ludmerer]] noted in 2010: "Flexner pointed out that the scientific method of thinking applied to medical practice. By scientific method, he meant testing ideas with well-planned experiments to establish accurate facts. The clinician's diagnosis was equivalent to the scientist's hypothesis: both [[medical diagnosis]] and hypothesis required 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."<ref name=Ludmerer2010/>}} Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology.<ref name="Bianco" /> Medical schools' teaching includes such topics as doctor-patient communication, ethics, the art of medicine,<ref name="Stanford_Curriculum" /> and engaging in complex clinical reasoning (medical decision-making).<ref name="Yale_Curriculum" /> 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 that were not well understood in mechanistic terms, and were not effectively treated by conventional therapies.<ref name="Snyderman2002" />

By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US.<ref name="Berman2001" /> 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).<ref name="UM_CAM_Field" /><ref name="UM_CIM" /> 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 United States|physicians in the US]] who have attended one of the established medical schools there have usually graduated Doctor of Medicine (MD).<ref name="Medline_MD" /> All states require that applicants for MD licensure be graduates of an approved medical school and complete the [[United States Medical Licensing Examination|United States Medical Licensing Exam (USMLE)]].<ref name="Medline_MD" />

== Efficacy ==
There is a general scientific consensus that alternative therapies lack the requisite [[scientific validation]], and their [[efficacy|effectiveness]] is either [[Scientific method|unproved]] or [[Scientific evidence|disproved]].<ref name="NSF_2002" /><ref name="ATRAMM" /><ref name="Kent1997" /><ref name="Goldrosen2004" /> Many of the claims regarding the efficacy of alternative medicines are controversial, since research on them is frequently of low quality and methodologically flawed.{{sfn|IOM Report|2005}} [[Publication bias|Selective publication bias]], marked differences in product quality and standardisation, and some companies making unsubstantiated claims call into question the claims of efficacy of isolated examples where there is evidence for alternative therapies.<ref name="Sarris2012" />

''The Scientific Review of Alternative Medicine'' points to confusions in the general population&nbsp;– 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.<ref name="Alcock1999" />

[[Edzard Ernst]] characterized the evidence for many alternative techniques as weak, nonexistent, or negative<ref name="goodbadugly" /> and in 2011 published his estimate that about 7.4% were based on "sound evidence", although he believes that may be an overestimate.<ref name="Ernst2011" /> Ernst has concluded that 95% of the alternative therapies 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.<ref name="Economist2011" /><ref name="HHH2008" />

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]].<ref name="Katz2003" /> According to a 2005 book by a US [[Institute of Medicine]] panel, the number of RCTs focused on CAM has risen dramatically.

{{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, 0.7% 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.{{sfn|IOM Report|2005|pp=[http://books.nap.edu/openbook.php?record_id=11182&page=135 135–36]}}

Alternative therapies do not "complement" (improve the effect of, or mitigate the side effects of) functional medical treatment.{{refn|group=n|name=FinalReport}}<ref name=NSF_2002/><ref name=Ernst_1995/><ref name=Joyce_1994/><ref name=BMJ_May/> Significant [[drug interaction]]s caused by alternative therapies may instead negatively impact functional treatment by making [[prescription drug]]s less effective, such as interference by herbal preparations with [[warfarin]].<ref name=":0"/><ref name="Arye13" />

In the same way as for conventional therapies, drugs, and interventions, it can be difficult to test the efficacy of alternative medicine in [[clinical trial]]s. 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 [[Confounding|confounded]] or difficult-to-interpret results.<ref name="Bodeker2002" />

Cancer researcher [[Andrew J. Vickers]] has stated:

{{blockquote|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. The label "unproven" is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been "disproven".<ref name="Vickers" />}}

== Perceived mechanism of effect ==
Anything classified as alternative medicine by definition does not have a healing or medical effect.<ref name=Angell1998/><ref name="ATRAMM" /><ref name="Hines_Sampson_Coulter_Sagan" /><ref name="IGPIAMAYP" /><ref name="NP" /> However, there are different mechanisms through which it can be perceived to "work". The common denominator of these mechanisms is that effects are [[Causal model|mis-attributed]] to the alternative treatment.  [[Image:Altmed function 2.svg|thumb|right|350px|How alternative therapies "work":
<br />a) '''Misinterpreted [[Regression to the mean|natural course]]''' – the individual gets better without treatment.
<br />b) '''[[Placebo|Placebo effect]] or false treatment effect''' – an individual receives "alternative therapy" and is convinced it will help. The conviction makes them more likely to get better.
<br />c) '''[[Nocebo]] effect''' – an individual is convinced that standard treatment will not work, and that alternative therapies will work. This decreases the likelihood standard treatment will work, while the placebo effect of the "alternative" remains. 
<br />d) '''No adverse effects''' – Standard treatment is replaced with "alternative" treatment, getting rid of adverse effects, but also of improvement.
<br />e) '''Interference''' – Standard treatment is "complemented" with something that interferes with its effect. This can both cause worse effect, but also decreased (or even increased) side effects, which may be interpreted as "helping".

Researchers, such as [[epidemiology|epidemiologists]], [[clinical statistician]]s and [[pharmacology|pharmacologist]]s, use [[clinical trial]]s to reveal such effects, allowing physicians to offer a therapeutic solution best known to work. "Alternative treatments" often refuse to use trials or make it deliberately hard to do so.]]

=== Placebo effect ===
A [[placebo]] is a treatment with no intended therapeutic value. An example of a placebo is an inert pill, but it can include more dramatic interventions like [[sham surgery]]. The ''placebo effect'' is the concept that patients will perceive an improvement after being treated with an inert treatment. The opposite of the placebo effect is the ''nocebo effect'', when patients who expect a treatment to be harmful will perceive harmful effects after taking it.

Placebos do not have a physical effect on diseases or improve overall outcomes, but patients may report improvements in subjective outcomes such as pain and nausea.<ref name=CochraneHrob2010>{{cite journal | vauthors = Hróbjartsson A, Gøtzsche PC | title = Placebo interventions for all clinical conditions | journal = The Cochrane Database of Systematic Reviews | volume = 106 | issue = 1 | pages = CD003974 | date = January 2010 | pmid = 20091554 | doi = 10.1002/14651858.CD003974.pub3 | pmc = 7156905 | editor1-last = Hróbjartsson | editor1-first = Asbjørn | url = http://nordic.cochrane.org/sites/nordic.cochrane.org/files/public/uploads/ResearchHighlights/Placebo%20interventions%20for%20all%20clinical%20conditions%20(Cochrane%20review).pdf}}</ref> A 1955 study suggested that a substantial part of a medicine's impact was due to the placebo effect.<ref name="Hrob2001"/><ref name=CochraneHrob2010/> However, reassessments found the study to have flawed methodology.<ref name="Hrob2001">{{cite journal | vauthors = Hróbjartsson A, Gøtzsche PC | title = Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment | journal = The New England Journal of Medicine | volume = 344 | issue = 21 | pages = 1594–602 | date = May 2001 | pmid = 11372012 | doi = 10.1056/NEJM200105243442106 }}</ref><ref name="Kienle & Kiene"/> This and other modern reviews suggest that other factors like natural recovery and [[reporting bias]] should also be considered.<ref name=CochraneHrob2010/><ref name="Kienle & Kiene"/>

All of these are reasons why alternative therapies may be credited for improving a patient's condition even though the objective effect is non-existent, or even harmful.<ref name=":0"/><ref name=Gorski2010/><ref name=Novella2010/> [[David Gorski]] argues that alternative treatments should be treated as a placebo, rather than as medicine.<ref name=Gorski2010/> Almost none have performed significantly better than a placebo in clinical trials.<ref name="ATRAMM" /><ref name="Skep_Dic_comp_med" /><ref name="$2.5 billion"/><ref name=Abdulla1999/> Furthermore, distrust of conventional medicine may lead to patients experiencing the nocebo effect when taking effective medication.<ref name=":0"/>

=== Regression to the mean ===
A patient who receives an inert treatment may report improvements afterwards that it did not cause.<ref name=CochraneHrob2010/><ref name="Kienle & Kiene">{{cite journal | vauthors = Kienle GS, Kiene H | title = The powerful placebo effect: fact or fiction? | journal = Journal of Clinical Epidemiology | volume = 50 | issue = 12 | pages = 1311–8 | date = December 1997 | pmid = 9449934 | doi = 10.1016/s0895-4356(97)00203-5 }}</ref> Assuming it was the cause without evidence is an example of the [[regression fallacy]]. This may be due to a natural recovery from the illness, or a fluctuation in the symptoms of a long-term condition.<ref name="Kienle & Kiene"/> The concept of [[regression toward the mean]] implies that an extreme result is more likely to be followed by a less extreme result.

=== Other factors ===

There are also reasons why a placebo treatment group may outperform a "no-treatment" group in a test which are not related to a patient's experience. These include patients reporting more favourable results than they really felt due to politeness or "experimental subordination", [[observer bias]], and misleading wording of questions.<ref name="Kienle & Kiene"/> In their 2010 systematic review of studies into placebos, [[Asbjørn Hróbjartsson]] and [[Peter C. Gøtzsche]] write that "even if there were no true effect of placebo, one would expect to record differences between placebo and no-treatment groups due to bias associated with lack of [[Blinded experiment|blinding]]."<ref name=CochraneHrob2010/> Alternative therapies may also be credited for perceived improvement through decreased use or effect of medical treatment, and therefore either decreased [[side effects]] or [[Nocebo|nocebo effects]] towards standard treatment.<ref name=":0">{{Cite journal |last1=Zeller |first1=T. |last2=Muenstedt |first2=K. |last3=Stoll |first3=C. |last4=Schweder |first4=J. |last5=Senf|first5=B.|last6=Ruckhaeberle|first6=E.|last7=Becker|first7=S. |last8=Serve |first8=H. |last9=Huebner |first9=J. |date=2013-03-01 |title=Potential interactions of complementary and alternative medicine with cancer therapy in outpatients with gynecological cancer in a comprehensive cancer center|journal=Journal of Cancer Research and Clinical Oncology |volume=139 |issue=3 |pages=357–65 |doi=10.1007/s00432-012-1336-6 |issn=1432-1335|pmid=23099993|s2cid=29598970 }}</ref>

==Use and regulation==

===Appeal===
Practitioners of complementary medicine usually discuss and advise patients as to available alternative therapies. Patients often express interest in mind-body complementary therapies because they offer a non-drug approach to treating some health conditions.<ref name="Sobel2000"/>

In addition to the social-cultural underpinnings of the popularity of alternative medicine, there are several psychological issues that are critical to its growth, notably psychological effects, such as the will to believe,<ref name=Beyerstein /> [[cognitive bias]]es that help maintain self-esteem and promote harmonious social functioning,<ref name=Beyerstein /> and the ''[[post hoc, ergo propter hoc]]'' fallacy.<ref name=Beyerstein />

====Marketing====
[[File:Edzard ernst.jpg|thumb|right|[[Edzard Ernst]], a leading authority on scientific study of alternative therapies and diagnoses, and the first university professor of Complementary and Alternative Medicine. Here in 2012, promoting his book ''[[Trick or Treatment]]'' co-written with [[Simon Singh]].]]

Alternative medicine is a profitable industry with large media advertising expenditures. Accordingly, alternative practices are often portrayed positively and compared favorably to [[Big Pharma conspiracy theory|"big pharma"]].<ref name="ConsumerHealth9th" />

The popularity of complementary & alternative medicine (CAM) may be related to other factors that [[Edzard Ernst]] mentioned in an interview in ''[[The Independent]]'':

{{blockquote|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.<ref name="Con?">{{cite news |url= https://www.independent.co.uk/life-style/health-and-wellbeing/features/complementary-therapies-the-big-con-813248.html |title= Complementary therapies: The big con? |newspaper= [[The Independent]] |access-date= 2010-04-23 |location= London |date= 2008-04-22 |url-status= dead |archive-url= https://web.archive.org/web/20100417080412/http://www.independent.co.uk/life-style/health-and-families/features/complementary-therapies-the-big-con-813248.html | archive-date= 2010-04-17}}</ref>}}

[[Paul Offit]] proposed that "alternative medicine becomes quackery" in four ways: by recommending against conventional therapies that are helpful, promoting potentially harmful therapies without adequate warning, draining patients' bank accounts, or by promoting "magical thinking."<ref name=Offit2013/> Promoting alternative medicine has been called dangerous and [[ethics|unethical]].{{refn|name=Groopmanquote|group=n|"Kessler refers to a lack of efficacy but never pushes back at Hatch by enumerating the dangers that unregulated products pose to the public, the dangers that fill the pages of Offit's book."<ref name=Groopman>{{cite news |author=Jerome Groopman |title=The Quackish Cult of Alternative Medicine. Dr. Paul Offit's battle against charlatanism |url=http://www.newrepublic.com/article/114899/paul-offits-do-you-believe-magic-reviewed-dangers |newspaper=[[The New Republic]] |date= October 19, 2013 |access-date=2015-02-03 |author-link=Jerome Groopman }}</ref>}}<ref name=Weisleder>{{cite journal|last1=Weisleder|first1=P|s2cid=19719686|title=Unethical prescriptions: alternative therapies for children with cerebral palsy.|journal=Clinical Pediatrics|date=January 2010|volume=49|issue=1|pages=7–11|doi=10.1177/0009922809340438|pmid=19628756}}</ref>

[[File:Lemon-906141.jpg|thumb|Friendly and colorful images of herbal treatments may look less threatening or dangerous when compared to conventional medicine. This is an intentional marketing strategy.]]

====Social factors====

Authors have speculated on the socio-cultural and psychological reasons for the appeal of alternative medicines among the 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 [[antiscience|antiscientific]] attitudes and [[new age]] [[mysticism]].<ref name="Beyerstein" /> Related to this are vigorous [[marketing]]<ref name="Weber" /> of extravagant claims by the alternative medical community combined with inadequate media scrutiny and attacks on critics.<ref name="Beyerstein" /><ref name="Beyerstein2001" /> Alternative medicine is criticized for taking advantage of the least fortunate members of society.<ref name="ConsumerHealth9th"/>

There is also an increase in [[conspiracy theory|conspiracy theories]] toward conventional medicine and pharmaceutical companies,<ref name="Li et al., 2018" /> 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.<ref name="Beyerstein2001" /> 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.<ref name="Barnes2004" /> Medical doctors are also aggressively marketing alternative medicine to profit from this market.<ref name="Weber" />

Patients can be averse to the painful, unpleasant, and sometimes-dangerous [[adverse effect|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. 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 therapies to avoid the adverse effects of conventional treatments.<ref name="Beyerstein" /><ref name="Beyerstein2001" />

===Prevalence of use===

According to recent research, the increasing popularity of the CAM needs to be explained by moral convictions or lifestyle choices rather than by economic reasoning.<ref>{{cite book|last1=Martin|first1=Hélène|last2=Debons|first2=Jérôme|title=CAM and conventional medicine in Switzerland : divided in theory, united in practice. In N. K. Gale & J. V. McHale, Routledge Handbook of Complementary and Alternative Medicine. Perspectives from social science and law|date=2015|publisher=Routledge|location=London and New York|pages=271–91}}</ref>

In [[developing country|developing nations]], access to essential medicines is severely restricted by lack of resources and [[poverty]]. [[Traditional medicine|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.<ref name="WHO_tradmed_fact" />

Some have proposed adopting a [[prize]] system to reward medical research.<ref name="Horrobin1986" /> However, public funding for research exists. In the US increasing the funding for research on alternative medicine is the purpose of the [[US National Center for Complementary and Alternative Medicine]] (NCCAM). NCCAM has spent more than US$2.5 billion on such research since 1992 and this research has not demonstrated the efficacy of alternative therapies.<ref name="$2.5 billion" /><ref>{{Cite web |url=https://www.forbes.com/sites/stevensalzberg/2018/03/26/142-million-for-quack-medicine-buried-inside-the-new-2018-budget/ |title=$142 Million For Quack Medicine Buried Inside The New 2018 Budget |last=Salzberg |first=Steven |website=Forbes |language=en |access-date=2019-02-14}}</ref><ref name="nccih_$" /><ref>{{Cite web |url=https://sciencebasedmedicine.org/nccih-strategic-plan-2016-2021-or-lets-try-to-do-some-real-science-for-a-change/ |title=NCCIH Strategic Plan 2016-2021, or: Let's try to do some real science for a change |date=2016-04-04 |website=Science-Based Medicine |language=en-US |access-date=2019-02-14}}</ref><ref name="Atwood2003" /><ref>{{cite journal|year=2001|title=Stated goals and grants of the Office of Alternative Medicine/National Center for Complementary and Alternative Medicine|journal=Scientific Review of Alternative Medicine|volume=5|issue=4|pages=205–07|author=Green S}}</ref> The NCCAM's sister organization in the NIC [[Office of Cancer Complementary and Alternative Medicine]] gives grants of around $105 million every year.<ref name="2011A">{{cite journal |title=Annual Report on CAM 2011 |url=https://cam.cancer.gov/docs/annual_report/cam_annual_report_fy11.pdf}}</ref> Testing alternative medicine that has no scientific basis has been called a waste of scarce research resources.
<ref name=Wadman>{{cite journal |title=Centre turns away from healing herbs |journal=Nature |volume=462 |issue=7274 |pages=711 |last1=Wadman |first1=Meredith |date=7 December 2009 |publisher= Nature Publishing Group |doi=10.1038/462711a |pmid=20010660 |doi-access=free }}</ref><ref>{{cite journal|last1=Gorski|first1=DH|last2=Novella|first2=SP|title=Clinical trials of integrative medicine: testing whether magic works?|journal=Trends in Molecular Medicine|date=September 2014|volume=20|issue=9|pages=473–76|doi=10.1016/j.molmed.2014.06.007 |pmid=25150944}}</ref>

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.<ref name="Coulter2004" />

====In the US====

In the United States, the 1974 [[Child Abuse Prevention and Treatment Act]] (CAPTA) required that for states to receive federal money, they had to grant religious exemptions to [[child neglect]] and [[child abuse|abuse]] laws regarding religion-based healing practices.<ref>{{Cite journal|last=Merrick |first=Janna | date=June 2003 |title=Spiritual Healing, Sick Kids and the Law: Inequities in the American Healthcare System |journal=American Journal of Law & Medicine |volume=29 |issue=2 |pages=269–99|doi=10.1017/S0098858800002847 |pmid=12961808 |s2cid=27122896 }}</ref> Thirty-one states have child-abuse religious exemptions.<ref>{{Cite web|url=http://www.childwelfare.gov/systemwide/laws_policies/statutes/define.pdf |title=Definitions of Child Abuse and Neglect |access-date=2009-02-27 |publisher=Child Welfare Information Gateway |year=2007 |url-status=dead |archive-url=https://web.archive.org/web/20071011062659/http://www.childwelfare.gov/systemwide/laws_policies/statutes/define.pdf |archive-date=11 October 2007 }}</ref>

The use of alternative medicine in the US has increased,<ref name="NSF_2002" /><ref name="Eisenberg1998">{{cite journal|last1=Eisenberg|first1=D.M.|last2=Davis|first2=R.B.|last3=Ettner|first3=S.L.|last4=Appel|first4=S.|last5=Wilkey|first5=S.|last6=Van Rompay|first6=M.|last7=Kessler|first7=R.C.|display-authors=1|year=1998|title=Trends in alternative medicine use in the United States, 1990–1997: Results of a follow-up national survey|journal=JAMA|volume=280|issue=18|pages=1569–75|doi=10.1001/jama.280.18.1569|pmid=9820257|ref={{harvid|Eisenberg et al.|1998}}|doi-access=free}}</ref> with a 50 percent increase in expenditures and a 25 percent increase in the use of alternative therapies between 1990 and 1997 in America.<ref name="Eisenberg1998" /> According to a national survey conducted in 2002, "36 percent of U.S. adults aged 18 years and over use some form of complementary and alternative medicine."<ref name="cdc2002">{{cite journal |author1=Patricia M. Barnes |author2=Eve Powell-Grine |author3=Kim McFann |author4=Richard L. Nahin |title=Complementary and Alternative Medicine Use Among Adults: United States, 2002 |journal=Advance Data from Vital and Health Statistics |date=May 27, 2004 |volume=343 |pages=1 to 20 |url=https://www.cdc.gov/nchs/data/ad/ad343.pdf |access-date=June 1, 2021 |publisher=CDC}}</ref> Americans spend many billions on the therapies annually.<ref name="Eisenberg1998" /> Most Americans used CAM to treat and/or prevent musculoskeletal conditions or other conditions associated with chronic or recurring pain.<ref name="Barnes2004" /> In America, women were more likely than men to use CAM, with the biggest difference in use of [[Terms and concepts in alternative medicine#Mind-body interventions|mind-body therapies]] including prayer specifically for health reasons".<ref name="Barnes2004" /> In 2008, more than 37% of American hospitals offered alternative therapies, up from 27 percent in 2005, and 25% in 2004.<ref name="Warner2006" /><ref name="AHA2008" /> More than 70% of the hospitals offering CAM were in urban areas.<ref name="AHA2008" />

A survey of Americans found that 88 percent thought that "there are some good ways of treating sickness that medical science does not recognize".<ref name="NSF_2002" /> 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 method|scientific]]", when it is not at all scientific.<ref name="NSF_2002" /> In 2002, at least 60 percent of US medical schools have at least some class time spent teaching alternative therapies.<ref name="NSF_2002" /> "[[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.<ref name="NSF_2002" /><ref name="rosa" />

====Prevalence of use of specific therapies====

The most common CAM therapies used in the US in 2002 were prayer (45%), [[herbalism]] (19%), [[Terms and concepts in alternative medicine#Breathing Meditation|breathing meditation]] (12%), [[meditation (alternative medicine)|meditation]] (8%), [[chiropractic medicine]] (8%), [[yoga (alternative medicine)|yoga]] (5–6%), [[body work (alternative medicine)|body work]] (5%), [[Terms and concepts in alternative medicine#Diet-based therapy|diet-based therapy]] (4%), [[Terms and concepts in alternative medicine#Progressive Relaxation|progressive relaxation]] (3%), [[Orthomolecular medicine|mega-vitamin therapy]] (3%) and [[Visualization (cam)|Visualization]] (2%)<ref name="Barnes2004" /><ref name="Barnes2008" />

In Britain, the most often used alternative therapies were [[Alexander technique]], [[aromatherapy]], Bach and other flower remedies, body work therapies including massage, Counseling stress therapies, [[hypnotherapy]], [[meditation]], [[reflexology]], [[Shiatsu]], [[Ayurvedic medicine]], nutritional medicine, and [[yoga as exercise|Yoga]].{{sfn|Sir Walton: Science and Technology Committee|2000}} Ayurvedic medicine remedies are mainly plant based with some use of animal materials.{{sfn|Wujastyk|2003}} Safety concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities.<ref name="Valiathan2006" /><ref name="Saper2008" />

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.<ref name="NHS_Careers_CAM" />

====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."<ref name="Kellhear2003" /> The non-pharmacologic interventions of complementary medicine can employ [[mind-body intervention|mind-body]] interventions designed to "reduce pain and concomitant mood disturbance and increase quality of life."<ref name="Menefee2005" />

=== Regulation ===
{{Further|Regulation of alternative medicine | Regulation and prevalence of homeopathy}}{{Expand section|date=May 2018}}[[File:Use Caution With Ayurvedic Products (FDA October 16, 2008).djvu|thumb|Health campaign flyers, as in this example from the [[Food and Drug Administration]], warn the public about unsafe products.]]

The alternative medicine lobby has successfully pushed for alternative therapies to be subject to far less regulation than conventional medicine.<ref name="ConsumerHealth9th" /> Some professions of complementary/traditional/alternative medicine, such as [[chiropractic]], have achieved full regulation in North America and other parts of the world{{sfn|WHO|2005}} 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.{{sfn|WHO|2005}} In some cases, promotion of alternative therapies is allowed when there is demonstrably no effect, only a tradition of use. Despite laws making it illegal to market or promote alternative therapies for use in cancer treatment, many practitioners promote them.<ref>{{cite web|url=http://www.cancerresearchuk.org/about-cancer/cancers-in-general/treatment/complementary-alternative/|title=Complementary and alternative therapies – Cancer in general |publisher= Cancer Research UK|website=www.cancerresearchuk.org}}</ref><ref>{{cite web|url=https://www.uclh.nhs.uk/OurServices/ServiceA-Z/INTMED/IMCAN/Pages/Home.aspx|title=Complementary cancer care service|website=www.uclh.nhs.uk}}</ref>

Regulation and licensing of alternative medicine ranges widely from country to country, and state to state.{{sfn|WHO|2005}} In Austria and Germany complementary and alternative medicine is mainly in the hands of doctors with [[Medical degree|MDs]],<ref name=ernstinterview/> and half or more of the American alternative practitioners are licensed MDs.<ref name="Cassileth1996"/> In Germany herbs are tightly regulated: half are prescribed by doctors and covered by health insurance.<ref name="JAMA_book_review"/>

Government bodies in the US and elsewhere have published information or guidance about alternative medicine. The [[U.S. Food and Drug Administration]] (FDA), has issued online warnings for consumers about medication health fraud.<ref>{{cite web|url=https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/default.htm|title=Medication Health Fraud|work=fda.gov|date=2019-02-09}}</ref> This includes a section on Alternative Medicine Fraud,<ref>{{cite web|url=https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/ucm207747.htm|title=Alternative Medicine Fraud|work=fda.gov}}</ref> such as a warning that Ayurvedic products generally have not been approved by the FDA before marketing.<ref>[https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm050798.htm FDA, ''Use Caution With Ayurvedic Products'']</ref>

==Risks and problems==

=== Negative outcomes ===
{{See also|List of herbs with known adverse effects}}
According to the [[Institute of Medicine]], use of alternative medical techniques may result in several types of harm:
*"'''Economic harm''', which results in monetary loss but presents no health hazard;"
*"'''Indirect harm''', which results in a delay of appropriate treatment, or in unreasonable expectations that discourage patients and their families from accepting and dealing effectively with their medical conditions;"
*"'''Direct harm''', which results in adverse patient outcome."<ref name="NAPCAM2005">{{cite book |author1=Committee on the Use of Complementary and Alternative Medicine by the American Public |author2=Committee on the Use of Complementary and Alternative Medicine by the American Public |author3=INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES |title=Complementary and Alternative Medicine in the United States |date=2005 |publisher=The National Academies Press |isbn=0-309-09270-1 |pages=298–308 |url=https://www.nap.edu/catalog/11182/complementary-and-alternative-medicine-in-the-united-states |access-date=June 14, 2021 |chapter=Appendix E |quote=APPENDIX E Model Guidelines for the Use of Complementary and Alternative Therapies in Medical Practice*}}</ref>

====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, and insulin potentiation therapy. Some herbal remedies can cause dangerous interactions with chemotherapy drugs, radiation therapy, or anesthetics during surgery, among other problems.<ref name=CassilethDeng2004/><ref name=":0"/><ref name="Arye13" /> An example of these dangers was reported by Associate Professor [[Alastair MacLennan (medicine)|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.<ref name="Hills1999"/>

To ''ABC Online'', MacLennan also gives another possible mechanism:

{{blockquote|And lastly 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.<ref name="SwanABC"/>}}

====Side-effects====

Conventional treatments are subjected to testing for undesired [[Adverse effect (medicine)|side-effects]], whereas alternative therapies, in general, are not subjected to such testing at all. Any treatment&nbsp;– whether conventional or alternative&nbsp;– 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 therapies sometimes use the ''[[appeal to nature]]'' fallacy, i.e., "That which is natural cannot be harmful." Specific groups of patients such as patients with impaired hepatic or renal function are more susceptible to side effects of alternative remedies.<ref>{{cite journal|title=Use of herbal remedies among patients undergoing hemodialysis|journal=Iran J Kidney Dis|pmid=24241097|url=https://www.researchgate.net/publication/258636639|volume=7|issue=6|date=Nov 2013|pages=492–95|last1=Roozbeh|first1=J|last2=Hashempur|first2=M. H.|last3=Heydari|first3=M}}</ref><ref>{{cite journal|title=Herbal products: benefits, limits, and applications in chronic liver disease|journal=Evid Based Complement Alternat Med|pmid=22991573|pmc=3443820|doi=10.1155/2012/837939|volume=2012|year=2012|pages=1–19|last1=Del Prete|first1=A|last2=Scalera|first2=A|last3=Iadevaia|first3=M. D.|last4=Miranda|first4=A|last5=Zulli|first5=C|last6=Gaeta|first6=L|last7=Tuccillo|first7=C|last8=Federico|first8=A|last9=Loguercio|first9=C|doi-access=free}}</ref>

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."<ref name=Stehlin/> 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.<ref name=Stehlin/>

====Treatment delay====

Alternative medicine may discourage people from getting the best possible treatment.<ref name=MHTG/> 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.<ref name="Navarro2006"/> 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.<ref name=Lilienfeld2002/> 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.<ref name=Hughes2010/>

====Unconventional cancer "cures"====

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.&nbsp;... The label 'unproven' is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been 'disproven'."<ref name=Vickers/>

[[Edzard Ernst]] has stated:

{{blockquote|any alternative cancer cure is bogus by definition. There will never be an alternative cancer cure. Why? Because if something looked halfway promising, then mainstream oncology would scrutinize it, and if there is anything to it, it would become mainstream almost automatically and very quickly. All curative "alternative cancer cures" are based on false claims, are bogus, and, I would say, even criminal.<ref name=Miller>{{Citation |last=Miller |first=Gabriel |date=2 September 2014 |title=Asking the Experts: Complementary and Alternative Medicine and Cancer |work=[[Medscape]] |url=http://www.medscape.com/viewarticle/830553_print |access-date=7 September 2014 }}</ref>}}

===Rejection of science===
{{Reduced pull quote|1=right
|2=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.
|3=P.B. Fontanarosa|4=''[[JAMA (journal)|Journal of the American Medical Association]]'' (1998)<ref name=Fontanarosa1998/>
}}

Complementary and alternative medicine (CAM) is not as well researched as conventional medicine, which undergoes intense research before release to the public.<ref name="Ernst_Cohen" /> Practitioners of science-based medicine also discard practices and treatments when they are shown ineffective, while alternative practitioners do not.<ref name="ConsumerHealth9th">{{Cite book|title=Consumer health: a guide to intelligent decisions|last1=Barrett|first1=Stephen|last2=London|first2=William M.|last3=Kroger|first3=Manfred|last4=Hall|first4=Harriet|last5=Baratz|first5=Robert S.|publisher=McGraw-Hill|year=2013|isbn=9780078028489|edition=9th|location=New York|pages=34–35, 134, 137|oclc=758098687}}</ref> Funding for research is also sparse making it difficult to do further research for effectiveness of CAM.<ref name="Ernst4" /> Most funding for CAM is funded by government agencies.<ref name="Ernst_Cohen" /> Proposed research for CAM are rejected by most private funding agencies because the results of research are not reliable.<ref name="Ernst_Cohen" />  The research for CAM has to meet certain standards from research ethics committees, which most CAM researchers find almost impossible to meet.<ref name="Ernst_Cohen" /> Even with the little research done on it, CAM has not been proven to be effective.<ref name="Ernst3" /> Studies that have been done will be cited by CAM practitioners in an attempt to claim a basis in science. These studies tend to have a variety of problems, such as small samples, various biases, poor research design, lack of controls, negative results, etc. Even those with positive results can be better explained as resulting in false positives due to bias and [[noisy data]].<ref>{{cite journal |last1=Hall |first1=Harriet |author-link1=Harriet Hall |title=Science Envy in Alternative Medicine |journal=[[Skeptical Inquirer]] |date=2019 |volume=43 |issue=4 |pages=21–23 |url=https://www.skepdoc.info/science-envy-in-alternative-medicine/ |archive-url=https://web.archive.org/web/20190917171017/https://www.skepdoc.info/science-envy-in-alternative-medicine/ |url-status=dead |archive-date=2019-09-17 |access-date=17 September 2019}}</ref>

Alternative medicine may lead to a false understanding [[Physiology|of the body]] and of [[Scientific method|the process of science]].<ref name=MHTG>{{Cite book|title=More harm than good? : the moral maze of complementary and alternative medicine|last=(Edzard)|first=Ernst, E.|others=Smith, Kevin|isbn=9783319699417|location=Cham, Switzerland|pages=18|oclc=1019807158|date = 2018-01-11}}</ref><ref name=Fisken2014>{{Cite journal |last=Fisken|first=Roger A.|date=2014-05-19|title=Teach evidence based, not alternative, medicine |url=http://www.bmj.com/content/348/bmj.g3218 |journal=BMJ |language=en |volume=348 |page=g3218 |doi=10.1136/bmj.g3218|pmid=24839973|s2cid=206902331|issn=1756-1833}}</ref> [[Steven Novella]], a neurologist at Yale School of Medicine, wrote that government-funded studies of integrating alternative medicine techniques into the mainstream are "used to lend an appearance of legitimacy to treatments that are not legitimate."<ref name="Brown2009" /> [[Marcia Angell]] considered that critics felt that healthcare practices should be classified based solely on [[evidence-based medicine|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.<ref name="Angell1998" /> It is possible for a method to change categories (proven vs. unproven), based on increased knowledge of its effectiveness or lack thereof. A prominent supporter of this position is [[George D. Lundberg]], former editor of the ''[[Journal of the American Medical Association]]'' (''JAMA'').<ref name="Fontanarosa1998" />

Writing in 1999 in ''CA: A Cancer Journal for Clinicians'' [[Barrie R. Cassileth]] mentioned 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).)<ref name="Cassileth1999" />

In March 2009, a staff writer for ''[[the Washington Post]]'' 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]]. They quoted one of these scientists, [[Steven Salzberg]], a genome researcher and computational biologist at the University of Maryland, as saying "One of our concerns is that NIH is funding pseudoscience."  They noted that the vast majority of studies were based on fundamental misunderstandings of [[physiology]] and [[disease]], and had shown little or no effect.<ref name="Brown2009" />

Writers such as [[Carl Sagan]], a noted astrophysicist, advocate of [[scientific skepticism]] and the author of ''[[The Demon-Haunted World|The Demon-Haunted World: Science as a Candle in the Dark]]'' (1996), have lambasted the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.{{sfn|Sagan|1996}}

Sampson has also pointed out that CAM tolerated [[fallacy|contradiction]] without thorough reason and experiment.<ref name="SampsonAtwood2005" /> Barrett has pointed out that there is a policy at the NIH of never saying something does not work, only that a different version or dose might give different results.<ref name="$2.5 billion" /> 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.<ref name="Quackwatch_wary" />

Some critics of alternative medicine are focused upon health fraud, misinformation, and quackery as public health problems, 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]].<ref name="NCAHF_mission" /> Grounds for opposing alternative medicine include that:
* It is usually based on [[religion]], tradition, [[superstition]], belief in [[supernatural]] energies, [[pseudoscience]], [[fallacy|errors in reasoning]], propaganda, or fraud.<ref name="Beyerstein2001" /><ref name="NSF_2002" /><ref name="ATRAMM" /><ref name="Other_sources" />
* Alternative therapies typically lack any [[scientific validation]], and their effectiveness is either [[Scientific method|unproved]] or [[Scientific evidence|disproved]].<ref name="ATRAMM" /><ref name="Kent1997" /><ref name="Goldrosen2004" />{{dubious|date=January 2013}}
* Treatments are not part of the conventional, science-based healthcare system.<ref name="WHO_Trad_Med_Defs" /><ref name="NCCIH1" />{{sfn|IOM Report|2005|pp=[http://books.nap.edu/openbook.php?record_id=11182&page=17 17–19]}}<ref name="Zollman1999" />
* Research on alternative medicine is frequently of low quality and methodologically flawed.<ref name="NCCIH1" />{{sfn|IOM Report|2005|p=[http://books.nap.edu/openbook.php?record_id=11182&page=146 146]}}
* Where alternative therapies have replaced conventional science-based medicine, even with the safest alternative medicines, failure to use or delay in using conventional science-based medicine has caused deaths.<ref name="Lilienfeld2002" /><ref name="Hughes2010" />
* Methods may incorporate or base themselves on [[traditional medicine]], [[Home remedy|folk knowledge]], spiritual beliefs, ignorance or misunderstanding of scientific principles, errors in reasoning, or newly conceived approaches claiming to heal.<ref name="Beyerstein2001" /><ref name="ATRAMM" /><ref name="Acharya2008" />

Many alternative medical treatments are not [[patent]]able,<ref>{{cite journal |last1=Fonfa |first1=Anne E. |date=September 1, 2017 |title=Patient Perspectives: Barriers to Complementary and Alternative Medicine Therapies Create Problems for Patients and Survivors |journal=Integrative Cancer Therapies |volume=6 |issue=September 2007 |pages=297–300 |doi=10.1177/1534735407306598 |pmid=17761643 |doi-access=free }}</ref> which may lead to less research funding from the private sector. In addition, in most countries, alternative therapies (in contrast to pharmaceuticals) can be marketed without any proof of efficacy&nbsp;– also a disincentive for manufacturers to fund scientific research.<ref name="Ernst2005" />

English evolutionary biologist [[Richard Dawkins]], in his 2003 book ''[[A Devil's Chaplain]]'', defined alternative medicine as a "set of practices that cannot be tested, refuse to be tested, or consistently fail tests."<ref name="Dawkins2003" /> Dawkins argued that if a technique is demonstrated effective in properly performed trials then it ceases to be alternative and simply becomes medicine.<ref name="Holloway2003" />

CAM is also often less regulated than conventional medicine.<ref name="Ernst_Cohen" /> There are ethical concerns about whether people who perform CAM have the proper knowledge to treat patients.<ref name="Ernst_Cohen" /> CAM is often done by non-physicians who do not operate with the same medical licensing laws which govern conventional medicine,<ref name="Ernst_Cohen" /> and it is often described as an issue of [[non-maleficence]].<ref name="Ernst2" />

According to two writers, [[Wallace Sampson]] and K. Butler, marketing is part of the training required in alternative medicine, and propaganda methods in alternative medicine have been traced back to those used by [[Hitler]] and [[Goebels]] in their promotion of pseudoscience in medicine.<ref name="ATRAMM" /><ref name="ButlerBarrett1992" />

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."<ref name="Ernst_Guardian" />

=== Conflicts of interest ===

Some commentators have said that special consideration must be given to the issue of [[Conflict of interest|conflicts of interest]] in alternative medicine. [[Edzard Ernst]] has said that most researchers into alternative medicine are at risk of "unidirectional bias" because of a generally uncritical belief in their chosen subject.<ref name="unid">{{cite journal|author=Ernst E|author-link=Edzard Ernst|year=2011|title=Conflicts of Interest in Alternative Medicine|url=http://www.csicop.org/si/show/conflicts_of_interest_in_alternative_medicine|journal=Skeptical Inquirer|volume=35|issue=4}}</ref> Ernst cites as evidence the phenomenon whereby 100% of a sample of acupuncture trials originating in China had positive conclusions.<ref name="unid" /> [[David Gorski]] contrasts [[evidence-based medicine]], in which researchers try to disprove hyphotheses, with what he says is the frequent practice in pseudoscience-based research, of striving to confirm pre-existing notions.<ref name="gorski">{{cite web|url=https://www.sciencebasedmedicine.org/conflicts-of-interest-in-science-based-medicine/|title=Conflicts of interest in science-based medicine|author=Gorski D|author-link=David Gorski|date=16 November 2009|website=[[Science-Based Medicine]]}}</ref> [[Harriet Hall]] writes that there is a contrast between the circumstances of alternative medicine practitioners and disinterested scientists: in the case of acupuncture, for example, an acupuncturist would have "a great deal to lose" if acupuncture were rejected by research; but the disinterested skeptic would not lose anything if its effects were confirmed; rather their change of mind would enhance their skeptical credentials.<ref name="hall">{{cite web|url=https://www.sciencebasedmedicine.org/conflicts-of-interest/|title=Conflicts of interest|author=Hall HA|author-link=Harriet A. Hall|date=27 April 2011|website=[[Science-Based Medicine]]}}</ref>

===Use of health and research resources===
Research into alternative therapies has been criticized for "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."<ref name="Novella2010" /><ref name="Gorski2010" /> Research methods expert and author of ''Snake Oil Science'', [[R. Barker Bausell]], has stated that "it's become politically correct to investigate nonsense."<ref name="$2.5 billion" /> A commonly cited statistic is that the US [[National Institute of Health]] had spent $2.5 billion on investigating alternative therapies prior to 2009, with none being found to be effective.<ref name="$2.5 billion" />

== Gallery ==
<gallery>
File:Fallerjfa.JPG|Christian [[laying on of hands]], [[prayer]] intervention, and [[faith healing]]
File:Dhanvantari-at-Ayurveda-expo.jpg|Indian [[Ayurvedic medicine]] includes a belief that the spiritual balance of mind influences disease.
File:Hierbas medicinales mercado medieval.jpg|Medicinal herbs in a traditional Spanish market
File:Market Pharmacy Tana MS5179.jpg|[[Traditional medicine]]s in [[Madagascar]]
File:Traditional Chinese medicine in Xi'an market.jpg|Assorted dried plant and animal parts used in traditional Chinese medicine
File:Doña ramona.jpg|[[Shaman]] healer in [[Sonora, Mexico]].
File:American medical botany, being a collection of the native medicinal plants of the United States, containing their botanical history and chemical analysis, and properties and uses in medicine, diet and (14764623455).jpg|[[Phytotherapy]] (herbal medicine): an engraving of ''[[magnolia]] glauca'' in [[Jacob Bigelow]]'s ''American Medical Botany''
</gallery>

== See also ==
{{col div|colwidth=20em}}
* [[Allopathic medicine]]
* [[Conservation medicine]]
* [[Ethnomedicine]]
* [[Gallbladder flush]]
* [[Homeopathy]]
* [[Hypnotherapy]]
* [[Osteopathic medicine]]
* [[Psychic surgery]]
* [[Siddha medicine]]
* [[Vertebral subluxation]]
{{colend}}

==Notes==
{{reflist|2|group=n}}

==References==

{{Reflist|30em|refs=
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<ref name=Acharya2008>{{cite book |last1= Acharya |first1= D. |first2= S. |last2= Anshu |year= 2008 |title= Indigenous Herbal Medicines: Tribal Formulations and Traditional Herbal Practices |publisher= Aavishkar Publishers |location= Jaipur, India |isbn= 9788179102527 |page= 440|display-authors= 1 }}</ref>

<ref name=ACS>{{Cite web  | publisher =[[American Cancer Society]]  | date =1 Nov 2008  | url =http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/MindBodyandSpirit/naturopathic-medicine  | title=Naturopathic Medicine|access-date =20 Nov 2010|url-status=dead|archive-url=https://web.archive.org/web/20150403092521/http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/mindbodyandspirit/naturopathic-medicine|archive-date=3 April 2015 }}</ref>

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<ref name=Bianco>{{Cite web |title= How Becoming a Doctor Works: Medical School Curriculum |last= Bianco |first= C. |url= http://people.howstuffworks.com/becoming-a-doctor9.htm |work= [[HowStuffWorks]] website |archive-url= https://web.archive.org/web/20131005044926/http://people.howstuffworks.com/becoming-a-doctor9.htm |archive-date= 2013-10-05 |url-status= live |date= April 2000 }}</ref>

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<ref name=CDC>{{cite journal|url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5326a3.htm |journal=Morbidity and Mortality Weekly Report |title=Lead Poisoning Associated with Ayurvedic Medications – Five States, 2000–2003|date=9 July 2004|volume=53|issue=26|pages=582–84|pmid=15241300 |pmc=2768057 |author1=Centers for Disease Control Prevention (CDC) }}</ref>

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<ref name=DaguptaHStabler2011>{{cite book |first2=Catherine A|last2=Hammett-Stabler|first1=Amitava|last1=Dasgupta |title=Herbal Supplements: Efficacy, Toxicity, Interactions with Western Drugs, and Effects on Clinical Laboratory Tests |publisher=John Wiley and Sons |location=Hoboken NJ|year=2011 |isbn=9780470433508  |pages=[https://books.google.com/books?id=oNrIvxlFG1sC&pg=PA204 202–05] }}</ref>

<ref name=Dawkins2003>{{cite book |last= Dawkins |first= R. |author-link= Richard Dawkins |title= A Devil's Chaplain: Selected Essays |editor-last= Menon |editor-first= L. |year= 2003 |isbn= 9780753817506 |publisher= Weidenfeld & Nicolson |location= London |title-link= A Devil's Chaplain }} (p. [https://books.google.com/books?id=loVMMlxC1XoC&pg=PA180 180] in 2004 US ed. {{ISBN|0618335404}}).</ref>

<ref name=Dawkins2003a>[[John Diamond (journalist)|Diamond, J.]] quoted in {{harvnb|Dawkins|2003}}. (p. [https://books.google.com/books?id=nBRYZtOuqZcC&pg=PA36 36] in 2004 US ed. {{ISBN|0618335404}}).</ref>

<ref name=Deshpande1987>{{cite journal|last=Deshpande|first=Vijaya|title=Medieval Transmission of Alchemical and Chemical Ideas between India and China|journal=Indian Journal of History of Science|volume=22|issue=1|date=January 1987|pmid=11622483|url=http://www.new1.dli.ernet.in/data1/upload/insa/INSA_1/20005abf_15.pdf|pages=15–28|url-status=dead|archive-url=https://web.archive.org/web/20150505233031/http://www.new1.dli.ernet.in/data1/upload/insa/INSA_1/20005abf_15.pdf|archive-date=2015-05-05}}</ref>

<ref name=Economist2011>{{cite news |magazine= [[The Economist]] |url= http://www.economist.com/node/18710090 |title= Alternative Medicine: Think yourself better |date= 2011-05-19 |pages= 83–84 |archive-url= https://web.archive.org/web/20110522121254/http://www.economist.com/node/18710090 |archive-date= 2011-05-22 |url-status= live}}</ref>

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<ref name=Eisenberg_Bio>{{cite web|title=David M. Eisenberg, M.D. |url=http://specertified.com/what/team-profile/david-m.-eisenberg-m.d |access-date=2013-03-14 |archive-date=2013-05-29 |archive-url=https://web.archive.org/web/20130529173804/http://specertified.com/what/team-profile/david-m.-eisenberg-m.d |work=Health Through Food website |publisher=[[SPE Certified|SPE]] Development US Inc. |url-status=dead }}</ref> -->

<ref name=Ernst2>{{cite journal |last= Ernst |first =E. |title= The ethics of complementary medicine |journal= Journal of Medical Ethics |year= 1996 |volume= 22 |pages= 197–98 |doi= 10.1136/jme.22.4.197 |pmid= 8863142 |issue= 4 |pmc= 1376996 }}</ref>

<ref name=Ernst3>{{cite book |editor1-first= .E |title= The Desktop Guide to Complementary and Alternative Medicine |year= 2001 |location= Edinburgh |publisher= Mosby |editor2-last= Pittler |editor2-first= M.H. |editor3-last= Stevinson |editor3-first= C. |editor4-last= White |editor4-first= A. |isbn= 9780723432074 |oclc= 492760852 |editor-last= Ernst }}</ref>

<ref name=Ernst4>{{cite journal |last= Ernst |first= E. |title= Funding research into complementary medicine: The situation in Britain |journal= Complementary Therapies in Medicine |year= 1999 |issue= 4 |pages= 250–53 |doi= 10.1016/S0965-2299(99)80011-9 |volume= 7 |pmid= 10709311 }}</ref>

<ref name=Ernst2001>{{cite journal | author = Ernst E | title = Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination | journal = Vaccine | volume = 20 | issue = Suppl 1 | pages = S89–93 | year = 2001 | pmid = 11587822 | doi = 10.1016/S0264-410X(01)00290-0 }}</ref>

<ref name=Ernst2002>{{Cite journal |last1= Ernst |first1= E. |title= A systematic review of systematic reviews of homeopathy |journal= [[British Journal of Clinical Pharmacology]] |volume= 54 |issue= 6 |pages= 577–82 |year= 2002 |pmid= 12492603 |pmc= 1874503 |doi= 10.1046/j.1365-2125.2002.01699.x }}</ref>

<ref name=Ernst2005>{{cite journal |last= Ernst |first= E. |s2cid= 2327655 |title= The efficacy of herbal medicine -- An overview |journal= Fundamental & Clinical Pharmacology |volume= 19 |issue= 4 |pages= 405–09 |year= 2005 |pmid= 16011726 |doi= 10.1111/j.1472-8206.2005.00335.x }}</ref>

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<ref name=Ernst2008>{{cite journal |title= Chiropractic: A critical evaluation |last= Ersnt |first= E. |journal= [[Journal of Pain and Symptom Management]] |year= 2008 |volume= 35 |issue= 5 |pages= 544–62 |doi= 10.1016/j.jpainsymman.2007.07.004 |pmid= 18280103 |url=http://www.jpsmjournal.com/article/S0885-3924(07)00783-X/fulltext }}</ref>
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<ref name=Ernst2011>{{cite journal |last= Ernst |first= E. |title= How Much of CAM Is Based on Research Evidence? |journal= Evidence-Based Complementary and Alternative Medicine |year= 2011 |volume= 2011 |page= 676490 |pmid= 19465405 |doi= 10.1093/ecam/nep044 | pmc= 3136881 }}</ref>

<ref name=ernstinterview>{{cite web|url=http://www.harcourt-international.com/ernst/interview.cfm |archive-url=https://web.archive.org/web/20020302075846/http://www.harcourt-international.com/ernst/interview.cfm |url-status=dead |archive-date=2002-03-02 |author=Elsevier Science |publisher=Harcourt International |title=Author interview (Edzard Ernst, editor of ''The Desktop Guide to Complementary and Alternative Medicine'') |year=2002 }}</ref>

<ref name=Ernst_1995>{{cite journal |last= Ernst |first= E. |author-link= Edzard Ernst |title= Complementary medicine: Common misconceptions |journal= [[Journal of the Royal Society of Medicine]] |year= 1995 |volume= 88 |issue= 5 |pages=244–47| pmid = 7636814 |pmc= 1295191|quote= Complementary medicine, defined as health care which lies for the most part outside the mainstream of conventional medicine.}}</ref>

<ref name=Ernst_Cohen>{{cite journal |last1= Ernst |first1= E. |last2= Cohen |first2= M.H. |last3= Stone |first3= J. |title= Ethical problems arising in evidence based complementary and alternative medicine |journal= [[Journal of Medical Ethics]] |year= 2004 |volume= 30 |issue= 2 |pages= 156–59 |doi= 10.1136/jme.2003.007021 |pmid= 15082809 |pmc= 1733834 |display-authors= 1 }}</ref>

<ref name=Ernst_Guardian>{{cite news |first= E. |last= Ernst |url=  https://www.theguardian.com/science/blog/2011/nov/08/alternative-medicine-ethics-free-zone |title= Alternative medicine remains an ethics-free zone |newspaper= [[The Guardian]]
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<ref name=Ernst_Lee_Choi>{{cite journal|last1=Ernst|first1=E.|last2=Lee|first2=Myeong Soo|last3=Choi|first3=Tae-Young|title=Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews|journal=Pain|volume=152|issue=4|year=2011|pages=755–64|issn=0304-3959|doi=10.1016/j.pain.2010.11.004|pmid=21440191|url=https://www.researchgate.net/publication/50866673_Acupuncture_does_it_alleviate_pain_and_are_there_serious_risks_A_review_of_reviews/file/504635268b703595fc.pdf|format=PDF}}</ref> -->

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<ref name=Ezzo2001>{{cite journal|title=Reviewing the reviews. How strong is the evidence? How clear are the conclusions?|last1= Ezzo|first1= J.|last2=Bausell|first2=B.|last3=Moerman|first3=D.E.|last4=Berman|first4=B.|last5=Hadhazy|first5=V.|date=Fall 2001| journal=International Journal of Technology Assessment in Health Care|volume=17|issue=4|pages=457–66|pmid=11758290|doi=10.1017/s0266462301107014}}</ref> -->

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<ref name="fda.gov">{{cite web |url= https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/ucm207747.htm |title= Alternative Medicine Fraud |date= 2010-10-25 |access-date= 2013-03-11 |archive-url= https://web.archive.org/web/20121018095742/https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/ucm207747.htm |archive-date= 2012-10-18 |url-status= live |series= Information for Consumers (Drugs) |work= FDA website}}</ref> -->

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<ref name=FDA_regulatory>{{cite web |url= https://www.fda.gov/RegulatoryInformation/Guidances/ucm144657.htm |title= Complementary and Alternative Medicine Products and their Regulation by the Food and Drug Administration |year= 2007 |publisher= Office of Policy and Planning, Office of the Commissioner, [[Food and Drug Administration]] (FDA), [[United States Department of Health and Human Services|Dept. of Health and Human Services]], [[Federal government of the United States|US Government]] |ref= {{harvid|FDA|2007}}}} {{PD-notice}}</ref> -->

<ref name=Flexner_Report>{{Cite journal |title= Medical Education in the United States and Canada Bulletin Number Four (The Flexner Report) |year= 1910 |last1= Flexner |first1= A. |author-link1= Abraham Flexner |author2= The Carnegie Foundation for the Advancement of Teaching (CFAT) |author-link2= Carnegie Foundation for the Advancement of Teaching |publisher= [[Daniel Berkeley Updike|D. B. Updike]], [[Merrymount Press]] |location= Boston |ref= {{harvid|Flexner Report|1910}} |title-link=  Flexner Report}} Available from CFAT: [http://www.carnegiefoundation.org/sites/default/files/elibrary/Carnegie_Flexner_Report.pdf The Flexner Report] {{Webarchive|url=https://web.archive.org/web/20131105125707/http://www.carnegiefoundation.org/sites/default/files/elibrary/Carnegie_Flexner_Report.pdf |date=2013-11-05 }}</ref>

<ref name=Fontanarosa1998>{{cite journal |title= Alternative medicine meets science |last1= Fontanarosa |first1= P.B. |last2= Derman |journal= [[JAMA (journal)|JAMA]] |year= 1998 |volume= 280 |issue= 18 |pages= 1618–19 |doi= 10.1001/jama.280.18.1618 |pmid= 9820267 |ref= {{harvid|Fontanarosa et al.|1998}} |first2= E |last3= Molloy |first3= GR |last4= Tamm |first4= I |last5= Darnell |first5= JE|s2cid= 5485601 |display-authors= 1 }}</ref>

<ref name=Freedman2011>{{cite web|title=The Triumph of New-Age Medicine |work=[[The Atlantic]] |first=David H.|last=Freedman|date= July–August 2011|url=https://www.theatlantic.com/magazine/archive/2011/07/the-triumph-of-new-age-medicine/308554/|access-date=6 June 2015|archive-date=10 May 2015|archive-url=https://web.archive.org/web/20150510142230/http://www.theatlantic.com/magazine/archive/2011/07/the-triumph-of-new-age-medicine/308554/|url-status=live}}</ref>

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<ref name=Goldrosen2004>{{cite journal |title= Complementary and alternative medicine: assessing the evidence for immunological benefits |last1= Goldrosen |first1= M.H. |last2= Straus |first2= S.E. |journal= [[Nature Reviews Immunology]] |department= Perspective |volume= 4 |issue= 11 |pages= 912–21 |year= 2004 |doi= 10.1038/nri1486 |pmid= 15516970 |s2cid= 11708302 |url= https://zenodo.org/record/1233538 |display-authors= 1 |doi-access= free }}</ref>

<ref name=goodbadugly>{{cite web |url= http://www.healthwatch-uk.org/awardwinners/edzardernst.html |title= The HealthWatch Award 2005: Prof. Edzard Ernst: Complementary medicine: The good the bad and the ugly |last= Ernst |first= E. |publisher= [[HealthWatch]] |location= UK |archive-url= https://web.archive.org/web/20131016024908/http://www.healthwatch-uk.org/awardwinners/edzardernst.html |archive-date= 2013-10-16 |url-status= dead }}</ref>

<ref name=Gorski2010>{{cite web |last= Gorski |first= D. |author-link= David Gorski |title= Credulity about acupuncture infiltrates ''The New England Journal of Medicine'' |url= http://www.sciencebasedmedicine.org/acupuncture-infiltrates-the-new-england-journal-of-medicine/ |date= 2010-08-03 |work= [[Science-Based Medicine]] |archive-url= https://web.archive.org/web/20130928202243/http://www.sciencebasedmedicine.org/acupuncture-infiltrates-the-new-england-journal-of-medicine/ |archive-date= 2013-09-28 |url-status= live}}</ref>

<ref name=HCReport2010>{{cite report|last=House of Commons: Science and Technology Committee|title=Evidence Check 2: Homeopathy|date=22 February 2010|series=HC 45, Fourth Report of Session 2009–2010|publisher=The Stationery Office|location=London|url=https://publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/45.pdf}}</ref>

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<ref name=HHH2008>{{cite book |last= Ernst |first= E. |chapter= Placebo and other Non-specific Effects |title= Healing, Hype, or Harm? A Critical Analysis of Complementary or Alternative Medicine |year= 2008 |editor-last= Ernst |editor-first= E. |publisher= Imprint Academic, Societas |isbn= 9781845401184}}</ref>

<ref name="Hills1999">{{cite web |url= http://benhills.com/articles/medical-mayhem/item/94-fake-healers |archive-url= https://web.archive.org/web/20120315061425/http://benhills.com/articles/medical-mayhem/item/94-fake-healers |url-status= dead |archive-date= 2012-03-15 |title=Fake healers: Why Australia's $1 billion-a-year alternative medicine industry is ineffective and out of control |date= 2011-09-23 |orig-year= 1999 |access-date= 2008-03-06 |last= Hills |first= B. |author-link= Ben Hills |work= BenHills.com }}</ref>

<ref name=Hines_Sampson_Coulter_Sagan>{{cite book|last=Hines|first=Terence|author-link=Terence Hines|title=Pseudoscience and the Paranormal|location=Amerst, New York|publisher=Prometheue Books|year=2003|edition=2nd|isbn=9781573929790}}; {{cite journal|last=Sampson|first=Walter|title=The Need for Educational Reform in Teaching about Alternative Therapies|journal=Academic Medicine|volume=76|issue=3|date=March 2001|pages=248–50|pmid=11242574|doi=10.1097/00001888-200103000-00011|doi-access=free}}; {{cite journal|last1=Coulter|first1=Ian D|last2=Willis|first2=Evan M|title=The Rise and Rise of Complementary and Alternative Medicine: a Sociological Perspective|journal=Medical Journal of Australia|volume=180|issue=11|date=June 2004|pmid=15174992|pages=587–89|url=https://www.mja.com.au/journal/2004/180/11/rise-and-rise-complementary-and-alternative-medicine-sociological-perspective|doi=10.5694/j.1326-5377.2004.tb06099.x|s2cid=15983789}}; {{harvnb|Sagan|1996}}</ref>

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<ref name="HoC_Evidence_Check2_homeopathy">{{cite book |title= Fourth Report: Evidence Check 2: Homeopathy |author1= Science and Technology Committee, [[House of Commons of the United Kingdom|House of Commons]] |url= https://publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/45.pdf |orig-year= Session 2009–2010 HC 45 |date= 2010-02-08 |location= London |publisher= The Stationery Office}} [https://publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/4502.htm html version].</ref> -->

<ref name="Holloway2003">{{cite news |url= https://www.theguardian.com/books/2003/feb/15/scienceandnature.highereducation1 |last= Holloway |first= R. |title= A callous view |newspaper= [[The Guardian]] |access-date= 2010-04-23| location= London |date= 2003-02-14 |department= Books |archive-url= https://web.archive.org/web/20100411001657/http://www.guardian.co.uk/books/2003/feb/15/scienceandnature.highereducation1| archive-date= 2010-04-11| url-status= live}}</ref>

<ref name="HOL_Kopelman_Wieland_Astin_Pelletier">{{harvnb|Sir Walton: Science and Technology Committee|2000|loc= [http://www.parliament.the-stationery-office.co.uk/pa/ld199900/ldselect/ldsctech/123/12303.htm Chapter 1: Introduction]}}.<br />{{harvnb|Kopelman|2004}}.<br />{{harvnb|Wieland et al.|2011}}.<br />{{cite journal |last1= Astin |first1= J.A. |last2= Marie |first2= A. |last3= Pelletier |first3= K.R. |last4= Hansen |first4= E. |last5= Haskell |first5= W.L. |title= A review of the incorporation of complementary and alternative medicine by mainstream physicians |journal= [[JAMA Internal Medicine]] |year= 1998 |volume= 158 |issue= 21 |pages= 2303–10 |doi= 10.1001/archinte.158.21.2303 |pmid= 9827781 |display-authors= 1 |doi-access= free }}<br />{{cite journal |last1= Pelletier |first1= K.R. |last2= Marie |first2= A. |last3= Krasner |first3= M. |last4= Haskell |first4= W.L. |title= Current trends in the integration and reimbursement of complementary and alternative medicine by managed care, insurance carriers, and hospital providers |journal= American Journal of Health Promotion |volume= 12 |issue= 2 |year= 1997 |pages= 112–22 |doi= 10.4278/0890-1171-12.2.112 |pmid= 10174663 |s2cid= 46772634 |display-authors= 1 }}</ref>

<ref name="Horrobin1986">{{cite journal |last= Horrobin |first= D.F. |year= 1986 |title= Glittering prizes for research support |journal= Nature |volume= 324 |issue= 6094 |page= 221 |doi= 10.1038/324221a0 |bibcode= 1986Natur.324..221H |s2cid= 28273314 }}</ref>

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<ref name=Hufford2004>{{harvc |last=Hufford|first=D.J.|chapter=CAM and Cultural Diversity: Ethics and Epistemology Converge|in=Callahan|year=2004|pp=[https://books.google.com/books?id=ryEnQlgMCT0C&pg=PA15 15–35]|}}</ref> -->

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<ref name=Hufford2004a>{{harvnb|Hufford|2004}}. In {{harvnb|Callahan|2004|p= [https://books.google.com/books?id=ryEnQlgMCT0C&pg=PA29 29]}}. Quoted in {{harvnb|IOM Report|2005|p= [http://books.nap.edu/openbook.php?record_id=11182&page=17 17]}}.</ref> -->

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<ref name=HuffordUPenn>{{cite web |title= David J. Hufford |publisher= Dept. of Folklore and Folklife, [[University of Pennsylvania]] |access-date= 2013-03-12 |url= http://www.sas.upenn.edu/folklore/faculty/dhufford.html |archive-url= https://web.archive.org/web/20130626163749/http://www.sas.upenn.edu/folklore/faculty/dhufford.html |archive-date= 2013-06-26 |url-status= live}}</ref>-->

<ref name=Hughes2010>{{cite news |last= Hughes |first= D. |title= Alternative remedies 'dangerous' for kids says report |url= https://www.bbc.co.uk/news/health-12060507 |date= 2010-12-23 |archive-url= https://web.archive.org/web/20101224181102/http://www.bbc.co.uk/news/health-12060507 |archive-date= 2010-12-24 |url-status= live |work= [[BBC News]]}}</ref>

<ref name=IGPIAMAYP>{{cite journal | author = Kent Heather | year = 1997 | title = Ignore Growing Patient Interest in Alternative Medicine at Your Peril - MDs Warned | journal = Canadian Medical Association Journal | volume = 157 | issue = 10 |pages=1427–28|url=http://www.cmaj.ca/content/157/10/1427.full.pdf+html | pmc = 1228476 | pmid=9371077}}</ref>

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<ref name=Kong2005>{{cite journal |title= The Incidence of self-prescribed oral complementary and alternative medicine use by patients with gastrointestinal diseases |last1= Kong |first1= S.C. |last2= Hurlstone |first2= D.P. |last3= Pocock |first3= C.Y. |last4= Walkington |first4= L.A. |last5= Farquharson |first5= N.R. |last6= Bramble |first6= M.G. |last7= McAlindon |first7= M.E. |last8= Sanders |first8= D.S. |journal= [[Journal of Clinical Gastroenterology]] |year= 2005 |issue= 2 |volume= 39 |pages= 138–41 |pmid= 15681910 |display-authors= 1 }}</ref> -->

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<ref name=Maciocia1995>{{cite book|title=Tongue Diagnosis in Chinese Medicine|first=Giovanni|last=Maciocia|year=1995|publisher=Eastland Press|location=Seattle|isbn=9780939616190}}</ref>

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<ref name=Matuk2006>{{cite journal |title=Seeing the Body: The Divergence of Ancient Chinese and Western Medical Illustration |author=Camillia Matuk |journal=Journal of Biocommunication |volume=32 |issue=1 |year=2006 |url=http://www.sesp.northwestern.edu/docs/publications/6074956944509ac426aaa6.pdf }}</ref>

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<ref name="Menefee2005">{{cite journal |last1= Menefee |first1= L.A. |last2= Monti |first2= D.A. |url= http://www.jaoa.org/cgi/content/full/105/suppl_5/S15#SEC5 |title= Nonpharmacologic and complementary approaches to cancer pain management |volume= 105 |issue= 5 Supplement |year= 2005 |pages= S15–20 |pmid= 16368903 |journal= The Journal of the American Osteopathic Association |url-status= dead |archive-url= https://web.archive.org/web/20081201185728/http://www.jaoa.org/cgi/content/full/105/suppl_5/S15#SEC5 |archive-date= 2008-12-01 }}</ref>

<ref name="Navarro2006">{{cite journal |title= Drug-related hepatotoxicity |doi= 10.1056/NEJMra052270 |year= 2006 |volume= 354 |pages= 731–39 |last1= Navarro |first1= V.J. |last2= Senior |first2=J.R. |s2cid= 41793815 |journal= New England Journal of Medicine |pmid= 16481640 |issue= 7 |display-authors= 1 }}</ref>

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<ref name=NCCIH1>{{Cite journal|url=http://nccih.nih.gov/health/whatiscam/ |title=Complementary, Alternative, or Integrative Health: What's In a Name? |access-date=2006-07-11 |publisher=[[NCCIH|National Center for Complementary and Integrative Health (NCCIH)]], [[National Institutes of Health|National Institutes of Health (NIH)]], [[United States Department of Health and Human Services|US Dept. of Health and Human Services (US HHS)]] |archive-url=https://web.archive.org/web/20051208040402/http://nccam.nih.gov/health/whatiscam/ |archive-date=2005-12-08 |url-status=live |date=May 2002 |volume=NCCIH Pub. No. D156 }}</ref>

<ref name=NCCIH2>{{cite web |url=https://nccih.nih.gov/research/statistics/2007/camsurvey_fs1.htm |title=The Use of Complementary and Alternative Medicine in the United States |publisher=[[NCCIH|National Center for Complementary and Integrative Health]] |date=2015-04-07 |archive-date=2015-06-01 |archive-url=https://web.archive.org/web/20150601182114/https://nccih.nih.gov/research/statistics/2007/camsurvey_fs1.htm |url-status=dead |access-date=2015-06-04 }}</ref>

<ref name=NCCIHSurvey>{{cite press release|title=According to a New Government Survey, 38 Percent of Adults and 12 Percent of Children Use Complementary and Alternative Medicine|url=http://nccih.nih.gov/news/2008/121008.htm|publisher=National Center for Complementary and Integrative Medicine|series=NIH News|location=Bethseda, Maryland|date=10 December 2008|access-date=4 June 2015}}</ref>

<ref name=nccih_$>{{cite web|url=http://nccih.nih.gov/about/budget/appropriations.htm |title=NCCIH Funding: Appropriations History |access-date=2008-04-02 |date=2008-01-09 |publisher=NCCIH |archive-url=https://web.archive.org/web/20090625060212/http://nccam.nih.gov/about/budget/appropriations.htm |archive-date=2009-06-25 |url-status=live }}</ref>

<ref name=NCCIH_EMed>{{cite web |title=Energy Medicine: An Overview |publisher= NCCIH |year= 2005 |orig-year= 2004 |url= http://nccih.nih.gov/health/backgrounds/energymed.htm |archive-url= http://arquivo.pt/wayback/20160522145806/http://nccih.nih.gov/health/backgrounds/energymed.htm |url-status= dead |archive-date= 2016-05-22 |series= Backgrounders |issue= NCCIH Publication No. D235}}</ref>

<ref name=NCCIH_homeopathy>{{cite web|url= http://nccih.nih.gov/health/homeopathy |title= Homeopathy: An Introduction |publisher= NCCIH|orig-year= 2009 |year= 2013 |series= Backgrounders |issue= NCCIH Publication No. D339 |archive-url= https://web.archive.org/web/20131015122846/http://nccih.nih.gov/health/homeopathy |archive-date= 2013-10-15 |url-status= live}}</ref>

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<ref name="NCCIH_naturopathy">{{cite web |title= Naturopathy: An Introduction |series= Backgrounders |volume= NCCIH Publication No. D372 |publisher= NCCIH |year= 2010 |orig-year= 2007 |url= http://nccih.nih.gov/health/naturopathy/D372.pdf |access-date= 2010-11-20}}{{dead link|date=July 2016|bot=medic}}{{cbignore|bot=medic}}</ref>-->
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<ref name=NCIDictionary1>{{cite web|title=orthodox medicine|url=http://www.cancer.gov/publications/dictionaries/cancer-terms?CdrID=454746|website=NCI Dictionary of Cancer Terms|publisher=NIH National Cancer Institute|access-date=4 June 2015|archive-url=https://web.archive.org/web/20150604194705/http://www.cancer.gov/publications/dictionaries/cancer-terms?CdrID=454746|archive-date=4 June 2015|url-status=live}}</ref> -->

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<ref name=NCIDictionary2>{{cite web|title=standard medical care|url=http://www.cancer.gov/publications/dictionaries/cancer-terms?CdrID=689630| archive-url=https://web.archive.org/web/20150604194432/http://www.cancer.gov/publications/dictionaries/cancer-terms?CdrID=689630|archive-date=4 June 2015|url-status=live | website=NCI Dictionary of Cancer Terms|publisher=NIH National Cancer Institute| access-date=4 June 2015}}</ref> -->

<ref name=NCI_PDQ_CAM>{{cite web |title= Complementary and Alternative Medicine in Cancer Treatment (PDQ®): Questions and Answers About Complementary and Alternative Medicine in Cancer Treatment |url= http://www.cancer.gov/cancertopics/pdq/cam/cam-cancer-treatment/patient/page2 |work= NCI website |series= Physician Data Query (PDQ®) |publisher= [[National Cancer Institute|National Cancer Institute (NCI)]], NIH |access-date= 2012-12-11 |archive-date= 2012-12-15 |archive-url= https://web.archive.org/web/20121215060456/http://www.cancer.gov/cancertopics/pdq/cam/cam-cancer-treatment/patient/page2 |url-status= dead}}</ref>

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<ref name=NHMRC_CAM>{{Cite journal |title= Complementary and alternative medicines |url= http://www.nhmrc.gov.au/your-health/complementary-and-alternative-medicines |journal= NHMRC Website |series= Your health |date= 2013-09-27 |access-date= 2013-09-30 |archive-url= https://web.archive.org/web/20130928174904/http://www.nhmrc.gov.au/your-health/complementary-and-alternative-medicines |archive-date= 2013-09-28 |url-status= live |author1= NHMRC }}</ref> -->

<ref name=NHS_Careers_CAM>{{cite web|url=http://www.nhscareers.nhs.uk/explore-by-career/wider-healthcare-team/careers-in-the-wider-healthcare-team/clinical-support-staff/complementary-and-alternative-medicine-(cam)/ |title=Complementary and alternative medicine (CAM) |publisher=National Health Service in England (NHS), UK Dept. of Health |work= NHS Careers website |access-date= 2013-03-11 |archive-date= 2013-04-03 |archive-url= https://web.archive.org/web/20130403110352/http://www.nhscareers.nhs.uk/explore-by-career/wider-healthcare-team/careers-in-the-wider-healthcare-team/clinical-support-staff/complementary-and-alternative-medicine-%28cam%29/ |url-status= live}}</ref>

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<ref name=NHS_Choices_CAM>{{Cite web |title= All about complementary and alternative medicine |url= http://www.nhs.uk/Livewell/complementary-alternative-medicine/Pages/complementary-alternative-medicines.aspx |date= 2012-11-23 |archive-date= 2013-02-28 |archive-url= https://web.archive.org/web/20130228185229/http://www.nhs.uk/Livewell/complementary-alternative-medicine/Pages/complementary-alternative-medicines.aspx |url-status= live |series= Live Well |work= NHS Choices }}</ref> -->

<ref name=Nissen2013>{{cite journal |title= Researching alternative and complementary therapies: Mapping the field |last1= Nissen |first1= N. |last2= Manderson |first2= L. |journal= Medical Anthropology |volume= 32 |issue= 1 |pages= 1–7 |year= 2013 |doi=10.1080/01459740.2012.718016 |pmid= 23206171 |s2cid= 31843233 |ref= {{harvid|Nissen et al.|2013}}|display-authors= 1 }}</ref>

<ref name=Novella2010>{{cite web |last= Novella |first= S. |author-link= Steven Novella |title= Acupuncture pseudoscience in ''The New England Journal of Medicine'' |url= http://www.sciencebasedmedicine.org/nc/ |date= 2010-08-04 |work= [[Science-Based Medicine]] |archive-url= https://web.archive.org/web/20130928202231/http://www.sciencebasedmedicine.org/nc/ |archive-date= 2013-09-28 |url-status= live}}</ref>

<ref name=NP>{{cite journal |vauthors=Goldrosen MH, Straus SE |year = 2004 |title = Complementary and alternative medicine: assessing the evidence for immunological benefits |journal = Nature Reviews Immunology |volume = 4 |issue = 11| pages = 912–21 |doi=10.1038/nri1486 |pmid=15516970|s2cid = 11708302 |url = https://zenodo.org/record/1233538 |doi-access = free }}</ref>

<ref name="NSF_2002">{{cite book |chapter= Chapter 7: Science and Technology: Public Attitudes and Public Understanding, Section: Belief in Alternative Medicine |chapter-url= https://www.nsf.gov/statistics/seind02/c7/c7s5.htm#c7s5l2a |title= Science and Engineering Indicators  |url= https://www.nsf.gov/statistics/seind02/ |year= 2002 |author= National Science Board |publisher= Division of Science Resources Statistics, [[National Science Foundation]], [[Federal government of the United States|US Government]] |location= Arlington, Virginia |url-status= dead |archive-url= https://web.archive.org/web/20090312070444/https://www.nsf.gov/statistics/seind02/ |archive-date= 2009-03-12 |author-link= National Science Board }}</ref>

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<ref name=Nuffield_Trust>{{cite web |title= Our work |url= http://www.nuffieldtrust.org.uk/our-work |work= Nuffield Trust website |publisher= The Nuffield Trust for Research and Policy Studies in Health Services |archive-url= https://web.archive.org/web/20130928221647/http://www.nuffieldtrust.org.uk/our-work |archive-date= 2013-09-28 |url-status= live|date= 2016-12-20 }}</ref> -->

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<ref name=Nuffield2>{{cite web |title= Research methods & information tools |url= http://www.nuffieldtrust.org.uk/our-work/research-methods-information-tools |work= Nuffield Trust website |publisher= The Nuffield Trust for Research and Policy Studies in Health Services |archive-url= https://web.archive.org/web/20130927122218/http://www.nuffieldtrust.org.uk/our-work/research-methods-information-tools |archive-date= 2013-09-27 |url-status= live |date= 2019-01-28 }}</ref> -->

<ref name=Offit2013>{{cite book |last= Offit |first= P. |author-link= Paul Offit |title= Do You Believe in Magic?: The Sense and Nonsense of Alternative Medicine |year= 2013 |publisher= HarperCollins |isbn= 978-0062222961}} Also published in the UK as {{cite book |title= Killing Us Softly: The Sense and Nonsense of Alternative Medicine |isbn= 9780007491735|last1= Offit|first1= Dr Paul|date= 2013-06-09}}</ref>

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<ref name="OpsinaBond2007">{{cite book |year= 2007 |last1= Ospina |first1= MB |last2 =Bond |first2= K |last3= Karkhaneh |first3= M |last4= Tjosvold |first4= L |last5= Vandermeer |first5= B |last6= Liang |first6= Y |last7= Bialy |first7= L |last8= Hooton |first8= N |last9= Buscemi |first9= N |last10= Dryden |first10= DM |last11= Klassen |first11= TP |title= Meditation Practices for Health: State of the Research |volume= No. 155 |issue= AHRQ Pub. No. 07-E010 |series= Evidence Reports/Technology Assessments |url= http://archive.ahrq.gov/downloads/pub/evidence/pdf/meditation/medit.pdf |location= Rockville, MD |publisher= [[Agency for Healthcare Research and Quality]] (AHRQ): (Prepared by the University of Alberta Evidence-based Practice Center under Contract No. 290-02-0023)|display-authors= 1 }} [https://www.ncbi.nlm.nih.gov/books/NBK38360/ Archived] at PubMed. {{cite journal | pmid = 17764203 | pmc=4780968 | issue=155 | title=Meditation practices for health: state of the research | year=2007 | vauthors=Ospina MB, Bond K, Karkhaneh M, Tjosvold L, Vandermeer B, Liang Y, Bialy L, Hooton N, Buscemi N, Dryden DM, Klassen TP | journal=Evid Rep Technol Assess (Full Rep) | pages=1–263 }}</ref> -->

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<ref name="QuackWatch_defund_NCCAM">{{cite web |last= Sampson |first= W.I. |url= http://www.quackwatch.org/01QuackeryRelatedTopics/nccam.html |title= Why the National Center for Complementary and Alternative Medicine (NCCAM) Should Be Defunded |publisher= QuackWatch |date= 2002-12-10 |access-date= 2013-03-11 |archive-url= https://web.archive.org/web/20130326020026/http://www.quackwatch.org/01QuackeryRelatedTopics/nccam.html |archive-date= 2013-03-26 |url-status= live}}</ref> -->

<ref name="Quackwatch_wary">{{cite news |first= S. |last= Barrett |title= Be Wary of "Alternative" Health Methods |url= http://www.quackwatch.org/01QuackeryRelatedTopics/altwary.html|author-link= Stephen Barrett |publisher=[[Quackwatch]]|date= 2004-02-10 |access-date = 2008-03-03 |archive-url= https://web.archive.org/web/20080509100851/http://www.quackwatch.org/01QuackeryRelatedTopics/altwary.html |archive-date= 2008-05-09 |url-status= live}}</ref>

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<ref name=Salomonsen_AHA>{{cite journal |title= Use of complementary and alternative medicine at Norwegian and Danish hospitals |url= |journal= [[BMC Complementary and Alternative Medicine]] |last1= Salomonsen |first1= L.J. |last2= Skovgaard |first2= L. |last3= La Cour |first3= S.R. |last4= Nyborg |first4= L. |last5= Launsø |first5= L. |last6= Fønnebø |first6= V. |volume= 11 |page= 4 |doi= 10.1186/1472-6882-11-4 |pmid= 21244655 |pmc= 3033860 |year= 2011 |display-authors= 1 |issue=1}}<br />{{harvnb|American Hospital Association|2008}}</ref> -->

<ref name=Saper2008>{{cite journal |title= Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet |last1= Saper |first1= R.B. |last2= Phillips |first2= R.S. |last3= Sehgal |first3= A. |last4= Khouri |first4= N. |last5= Davis |first5= R.B. |last6= Paquin |first6= J. |last7= Thuppil |first7= V. |last8= Kales |first8= S.N. |journal= JAMA |year= 2008 |volume= 300 |issue= 8 |pages= 915–23 |doi= 10.1001/jama.300.8.915 |pmc= 2755247 |pmid= 18728265 |display-authors= 1 }}</ref>

<ref name="Sarris2012">{{cite journal |last=Sarris |first= J. |title= Current challenges in appraising complementary medicine evidence |journal= Medical Journal of Australia |volume= 196 |issue= 5 |pages=310–11 |year= 2012 |pmid= 22432660 |doi= 10.5694/mja11.10751 |s2cid= 31044567 |url= https://www.mja.com.au/system/files/issues/sar10751_fm_0.pdf |doi-access= free }}</ref>

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<ref name=Shine2003>{{Cite journal |url= http://harvardmagazine.com/2003/11/hypnosis-heals.html |last1= Shine |first1= J. |year= 2003 |title= Hypnosis Heals |magazine= [[Harvard Magazine]] |pages= 13–15 |access-date= 2013-06-16 }}</ref> -->

<ref name=Shuval2012>{{cite journal|title=Complementary and Alternative Healthcare in Israel|first1=Judith T.|last1=Shuval|first2=Emma|last2=Averbuch|journal=Israel Journal of Health Policy Research|date=2012|volume=1|issue=7 |page=7|pmc=3424827|doi=10.1186/2045-4015-1-7|pmid=22913721}}</ref>

<ref name=Skep_Dic_comp_med>{{cite book |title= The Skeptics Dictionary |last= Carroll |first= R.T. |author-link= Robert Todd Carroll |chapter= complementary medicine |chapter-url= http://www.skepdic.com/compmed.html |date= 2011-05-14 |edition= Online |archive-url= https://web.archive.org/web/20130927214632/http://www.skepdic.com/compmed.html |archive-date= 2013-09-27 |title-link= The Skeptics Dictionary }}  2013-09-27.</ref>

<ref name=Snyderman2002>{{cite journal |title= Integrative medicine: Bringing medicine back to its roots |last1= Snyderman |first1= R. |last2= Weil |first2= A.T. |s2cid= 46177131 |author-link= Ralph Snyderman |journal= JAMA Internal Medicine |volume= 162 |issue= 4 |pages= 395–97 |year= 2002 |pmid= 11863470 |doi= 10.1001/archinte.162.4.395 |display-authors= 1 }}</ref>

<ref name="Sobel2000">{{cite book |last= Sobel |first= D.S. |chapter= Chapter 28: The Cost-effectiveness of Mind-body Medicine Interventions |volume= 122 |pages= 393–412 |year= 2000 |pmid= 10737073 |doi=10.1016/S0079-6123(08)62153-6 |isbn= 9780444500496 |editor1-last= Mayer |editor1-first= E.A. |editor2-last= Saper |editor2-first= C.B. |title= The Biological Basis for Mind Body Interactions |series= Progress in Brain Research }}</ref>

<ref name=Stanford_Curriculum>{{cite web |title= Stanford's medical curriculum |url= http://med.stanford.edu/md/curriculum/ |publisher= [[Stanford University School of Medicine]] |work= Stanford University website |archive-url= https://web.archive.org/web/20130509161924/http://med.stanford.edu/md/curriculum/ |archive-date= 2013-05-09 |url-status= dead |access-date= 2013-01-26 }}</ref>

<ref name=Stehlin>{{cite journal |first= I. |last= Stehlin |archive-url= https://web.archive.org/web/20071012070120/https://www.fda.gov/fdac/features/096_home.html |url= https://www.fda.gov/fdac/features/096_home.html |title=  Homeopathy: Real medicine or empty promises? |journal= FDA Consumer Magazine |date=December 1996 |archive-date= 2007-10-12 }}</ref>

<!-- remark out unused ref
<ref name="Stratten_in_Hahnemann">{{harvc|last=Stratten|first=S.|chapter=Preface|in=Hahnemann|year=1833|p=[https://books.google.com/books?id=EnEFAAAAQAAJ&pg=PR3 iii]}}</ref> -->

<ref name="SwanABC">{{cite episode |first= N. |last= Swan |title= Alternative Medicine – Part Three |date= 2000-10-02 |network= [[Australian Broadcasting Corporation]] |station= [[Radio National]] |url= http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s195441.htm | series =The Health Report |access-date = 2008-03-06 | archive-url= https://web.archive.org/web/20080306230537/http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s195441.htm| archive-date= 2008-03-06 | url-status= dead}}</ref>

<!-- remarked out
<ref name=UKDoH_CAM>{{cite web |title= Complementary and Alternative Medicine |url= http://www.dh.gov.uk/en/Publichealth/Healthimprovement/Complementaryandalternativemedicine/index.htm |archive-date= 2010-04-07 |archive-url= http://webarchive.nationalarchives.gov.uk/20100407164951/http://www.dh.gov.uk/en/Publichealth/Healthimprovement/Complementaryandalternativemedicine/index.htm |work= UK Dept. of Health website |ref= {{harvid|UKDoH_CAM}}}}</ref> -->

<ref name=UM_CAM_Field>{{cite web |title= Cochrane CAM Field |publisher= Center for Integrative Medicine, School of Medicine, University of Maryland |work= University of Maryland website |url= http://www.compmed.umm.edu/cochrane.asp |archive-url= https://web.archive.org/web/20130928113542/http://www.compmed.umm.edu/cochrane.asp |archive-date= 2013-09-28 |url-status= dead }}</ref>

<ref name=UM_CIM>{{cite web |title= Center for Integrative Medicine |url= http://www.compmed.umm.edu |work= University of Maryland website |publisher= University of Maryland School of Medicine |archive-url= https://web.archive.org/web/20100323121138/http://www.compmed.umm.edu/ |archive-date= 2010-03-23 |url-status= dead }}</ref>

<ref name=Valiathan2006>{{cite journal | url=http://www.currentscience.ac.in/Downloads/article_id_090_01_0005_0006_0.pdf | title=Ayurveda: Putting the house in order |department= Guest Editorial |last= Valiathan | first= M.S. |journal= [[Current Science]] |year= 2006 |volume= 90 |issue= 1 | pages= 5–6 }}</ref>

<ref name=Vickers>{{cite journal |last1= Vickers |first1= A. |title= Alternative cancer cures: 'Unproven' or 'disproven'? |journal= CA – A Cancer Journal for Clinicians |volume= 54 |issue= 2 |pages= 110–18 |year= 2004 |pmid= 15061600 |doi= 10.3322/canjclin.54.2.110 |citeseerx= 10.1.1.521.2180 |s2cid= 35124492 }}</ref>

<!-- remarked out
<ref name=VIFAB_definition>{{cite web|url=http://www.srab.dk/alternativ+behandling/hvad+er+alternativ+behandling-c7-/vifabs+definition |archive-url=https://web.archive.org/web/20130924061206/http://www.srab.dk/alternativ%2Bbehandling/hvad%2Ber%2Balternativ%2Bbehandling-c7-/vifabs%2Bdefinition |url-status=dead |archive-date=2013-09-24 |title=ViFABs definition af alternativ behandling |website=srab.dk }}</ref> -->

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<ref name=Wahlberg>{{Cite journal |last1=Wahlberg |first1=A |title=A quackery with a difference – New medical pluralism and the problem of 'dangerous practitioners' in the United Kingdom |journal=Social Science & Medicine |volume=65 |pages=2307–16 |year=2007 |doi=10.1016/j.socscimed.2007.07.024 |pmid=17719708 |issue=11}}</ref> -->

<ref name="Warner2006">{{cite web |last= Warner |first= J.|url= http://www.cbsnews.com/stories/2006/07/20/health/webmd/main1823747.shtml |title= Alternative Medicine Goes Mainstream |publisher= [[CBS News]] |work= [[WebMD]] |date= 2006-07-20 |access-date= 2013-03-11 |archive-url= https://web.archive.org/web/20130928001238/http://www.cbsnews.com/stories/2006/07/20/health/webmd/main1823747.shtml |archive-date= 2013-09-28 |url-status= live}}</ref>

<ref name=Weber>{{cite journal |last= Weber |first= D.O. |title= Complementary and alternative medicine considering the alternatives |journal= [[Physician Executive]] |volume= 24 |issue= 6 |pages= 6–14 |year= 1998 |pmid= 10351720 }}</ref>

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<ref name="WebMD2011">{{cite web |url= http://www.webmd.com/balance/tc/complementary-medicine-mind-body-interventions |title= Complementary Medicine – Mind-Body Interventions |publisher= WebMD |work= Healthwise |date= 2011-06-29 |access-date= 2013-03-11 |archive-url= https://web.archive.org/web/20121015144134/http://www.webmd.com/balance/tc/complementary-medicine-mind-body-interventions |archive-date= 2012-10-15 |url-status= live }}</ref> -->

<ref name=WebMD2014>{{cite web|url=http://www.webmd.com/balance/tc/complementary-medicine-alternative-medical-systems|website=WebMD|title=Complementary Medicine – Alternative Medical Systems|archive-url=https://web.archive.org/web/20150601195452/http://www.webmd.com/balance/tc/complementary-medicine-alternative-medical-systems|access-date=2015-06-04|archive-date=2015-06-01|date=2014-01-14|url-status=live}}</ref>

<ref name=whatiscam>{{cite web |url=http://nccam.nih.gov/health/whatiscam/ |title=What is Complementary and Alternative Medicine (CAM)? |access-date=2006-07-11 |publisher=[[NCCAM|National Center for Complementary and Alternative Medicine]] |archive-url=https://web.archive.org/web/20051208040402/http://nccam.nih.gov/health/whatiscam/ |archive-date=2005-12-08 |url-status=dead }}</ref>

<ref name="whccamp.hhs.gov">{{cite book |title=Final Report |author1=White House Commission on Complementary and Alternative Medicine Policy |chapter=Overview of CAM in the United States: Recent History, Current Status, And Prospects for the Future |isbn=978-0160514760 |volume=[[National Institutes of Health|NIH]] Pub. 03-5411 |publisher=US Government Printing Office |url=http://whccamp.hhs.gov/finalreport.html |year=2002 |chapter-url=http://whccamp.hhs.gov/fr2.html |url-status=dead |archive-url=https://web.archive.org/web/20130215040532/http://www.whccamp.hhs.gov/finalreport.html |archive-date=2013-02-15 }} Chapter 2 [https://web.archive.org/web/20110902075517/http://whccamp.hhs.gov/fr2.html archived] 2011-08-25.</ref>

<ref name="WHO_tradmed_fact">{{cite web|url=https://www.who.int/mediacentre/factsheets/fs134/en/ |title=Traditional medicine |access-date=2008-03-06 |year=2003 |issue=Fact sheet 134 |publisher=WHO |archive-url=https://web.archive.org/web/20080727053337/http://www.who.int/mediacentre/factsheets/fs134/en/ |archive-date=2008-07-27 |url-status=dead }}</ref>

<ref name="WHO_Trad_Med_Defs">{{Cite journal |title= Traditional Medicines: Definitions |url=https://www.who.int/medicines/areas/traditional/definitions/en/index.html |journal= WHO Website |series= Medicines |access-date= 2012-11-11 |archive-url= https://web.archive.org/web/20130927045217/http://www.who.int/medicines/areas/traditional/definitions/en/index.html |archive-date= 2013-09-27 |url-status= live |author1= Xiaorui Zhang }} Extracted from {{harvnb|WHO|2000}}.</ref>

<ref name="Li et al., 2018">{{cite journal| author=Li B, Forbes TL, Byrne J| title=Integrative medicine or infiltrative pseudoscience? | journal=Surgeon | year= 2018 | volume= 16 | issue= 5 | pages= 271–277 | pmid=29305045 | doi=10.1016/j.surge.2017.12.002 | s2cid=19580427 }}</ref>

<ref name="Winnick2005_2009">{{Cite journal |doi= 10.1525/sp.2005.52.1.38 |volume= 52 |issue= 1 |pages= 38–61 | last = Winnick| first = T.A.| title = From quackery to "complementary" medicine: The American medical profession confronts alternative therapies |journal= [[Social Problems (journal)|Social Problems]] |year= 2005 |jstor= 10.1525/sp.2005.52.1.38 }}<br />{{cite book |first= T.A. |last= Winnick |year= 2009 |chapter= From Quackery to "Complementary" Medicine: The American Medical Profession Confronts Alternative Therapies |title= The Sociology of Health and Illness |edition= 8th |editor-first= P. |editor-last= Conrad |location= New York |publisher= Worth |pages= 261–77 |isbn= 9781429205580}}</ref>

<ref name=Yale_Curriculum>{{cite web |title= Medical Student Education Program: Curriculum Overview |url= http://medicine.yale.edu/education/curriculum/curriculum/overview/index.aspx |work= Yale University website |publisher= [[Yale School of Medicine]] |archive-url= https://web.archive.org/web/20131004214032/http://medicine.yale.edu/education/curriculum/curriculum/overview/index.aspx |archive-date= 2013-10-04 |url-status= dead }}</ref>

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<ref name=Yip2002>{{cite journal|last=Yip|first=Y. L.|title=Pivot&nbsp;– Qi|journal=The Journal of Traditional Eastern Health and Fitness|volume=12|issue=3|publisher= Insight Graphics Publishers |date=Autumn 2002|issn=1056-4004}}</ref> -->

<!-- remarked out
<ref name=ZollChanCoulRobeAdamArtu>{{harvnb|Zollman et al.|1999}}.<br />{{cite journal |title= Complementary and alternative therapies in childhood attention and hyperactivity problems |last1= Chan |first1= E. |last2= Rappaport |first2= L.A. |last3= Kemper |first3= K.J. |journal= Journal of Developmental & Behavioral Pediatrics |year= 2003 |volume= 24 |issue= 1 |pages= 4–8 |pmid= 12584479 |doi= 10.1097/00004703-200302000-00003 |display-authors= 1 }}<br />{{cite journal |title= Complementary and alternative medicine utilisation in NHS and private clinic settings: A United Kingdom survey of 400 infertility patients |last1= Coulson |first1= C. |last2= Jenkins |first2= J. |journal= Journal of Experimental & Clinical Assisted Reproduction |year= 2005 |volume= 2 |page= 5 |url= |doi= 10.1186/1743-1050-2-5 |pmid= 15807886 |pmc= 1084360 |issue= 1 |display-authors= 1 }}<br />{{cite journal |title= The social demand for a medicine focused on the person: The contribution of CAM to healthcare and healthgenesis |last= Roberti di Sarsina |first= P. |journal= [[Evidence-Based Complementary and Alternative Medicine]] |volume= 4 |issue= S1 |year= 2007 |pages= 45–51 |doi= 10.1093/ecam/nem094 |pmid= 18227933 |pmc= 2206228 }}<br />{{cite journal |title= The use of complementary and alternative medicine by cancer patients |last1= Adams |first1= M. |last2= Jewell |first2= A.P. |journal= International Seminars in Surgical Oncology |year= 2007 |volume= 4 |page= 10 |doi= 10.1186/1477-7800-4-10 |pmid= 17470282 |pmc= 1872026 |display-authors= 1 |issue=1}}<br />{{harvnb|Artus et al.|2007}}.</ref> -->

<ref name=Zollman1999>{{cite journal |last1= Zollman |first1= C. |last2= Vickers |first2= A. |title= What is complementary medicine? |department= ABC of complementary medicine |doi= 10.1136/bmj.319.7211.693 |pmid= 10480829 |pmc= 1116545 |journal= BMJ |volume= 319 |issue= 7211 |pages= 693–96 |year= 1999 |ref= {{harvid|Zollman et al.|1999}}|display-authors= 1 }}</ref>
}}

==Bibliography==
* {{cite book |last= Bivins |first= R. |title= Alternative Medicine? A History |publisher= Oxford University Press |isbn= 9780199218875 |year= 2007 }}
* {{cite book |author1= Board of Science and Education, [[British Medical Association]] |title=Complementary Medicine: New Approaches to Good Practice |year= 1993 |publisher= Oxford University Press |isbn= 9780192861665 |ref= {{harvid|BMA|1993}}}}
* {{cite book |editor-last= Callahan |editor-first= D. |year= 2004 |title= The Role of Complementary and Alternative Medicine: Accommodating Pluralism |publisher= Georgetown University Press |location= Washington, D.C. |isbn= 9781589014640 }}
* {{cite book |title= Complementary & Alternative Medicine: Legal Boundaries and Regulatory Perspectives |first= Michael H. |last= Cohen|author-link=Michael H. Cohen |location= Baltimore|publisher= Johns Hopkins University Press |year= 1998|isbn= 9780801856891 }}
* {{cite book |author1= Committee on the Use of Complementary and Alternative Medicine by the American Public for the Board on Health Promotion and Disease Prevention, [[Institute of Medicine]] |title= Complementary and Alternative Medicine in the United States |url= https://archive.org/details/complementaryalt00inst |year= 2005 |publisher= National Academy Press |location= Washington, D.C. |isbn= 978-0309092708 |ref= {{harvid|IOM Report|2005}} }}
* {{cite book |last= Gevitz |first= N. |author-link= Norman Gevitz |editor1-last= Bynum |editor1-first= W.F. |editor2-last= Porter |editor2-first= R.S. |title= Companion Encyclopedia of the History of Medicine |volume= 1 |chapter= Chapter 28: Unorthodox Medical Theories |year= 1997 |orig-year= 1993 |isbn= 9780415164191 |publisher= Routledge |location= New York & London |editor2-link= Roy Porter }}
* {{cite book |title= The Homœopathic Medical Doctrine, or "Organon of the Healing Art" |url= https://archive.org/details/bub_gb_EnEFAAAAQAAJ |publisher= W.F. Wakeman |last= Hahnemann |first= S. |author-link= Samuel Hahnemann |year= 1833 |location= Dublin | translator=Devrient, C.H. |others=Annotated by Stratten, S.}}
* {{cite book|first1=Dennis L|last1=Kasper|first2=Anthony S.|last2=Fauci|first3=Stephen L.|last3=Hauser|first4=Dan L.|last4=Longo|first5=J. Larry|last5=Jameson|first6=Joseph|last6=Loscalzo|title=Harrison's Principles of Internal Medicine|publisher=McGraw Hill Education|year=2015|location=New York|isbn=9780071802154|edition=19th|ref={{harvid|Harrison's Principles of Internal Medicine|2015}}}}
* {{harvc |last=Kopelman|first=L.|chapter=The Role of Science in Assessing Conventional, Complementary, and Alternative Medicines|in=Callahan|year=2004|pp=[https://books.google.com/books?id=ryEnQlgMCT0C&pg=PA36 36–53]}}
* {{cite book |title=Scientific Basis for Ayurvedic Therapies |first=Lakshmi Chandra|last= Mishra |publisher=CRC Press|location=Boca Raton|year=2004 |isbn=978-0849313660}}
* {{cite book|last=O'Connor|first=Bonnie Blair|title=Healing Traditions: Alternative Medicine and the Health Professions|url=https://archive.org/details/healingtradition0000ocon|url-access=registration|location=Philadelphia|publisher=University of Pennsylvania Press|year=1995|isbn=9780812213980}}
* {{cite book |last= Ruggie |first= M.|title= Marginal to Mainstream: Alternative Medicine in America |year= 2004 |publisher= Cambridge University Press |isbn=9780521834292 }}
* {{cite book |last= Sagan |first= C. |author-link= Carl Sagan |title= The Demon-Haunted World: Science As a Candle in the Dark |year= 1996 |publisher= Random House |location= New York |isbn= 9780394535128  |title-link= The Demon-Haunted World }}
* {{cite book |last=Saks |first= M.|title= Orthodox and Alternative Medicine: Politics, Professionalization and Health Care |year= 2003 |publisher= Sage Publications |isbn= 9781446265369 }}
* {{cite book |last= Sointu |first= E. |title= Theorizing Complementary and Alternative Medicines: Wellbeing, Self, Gender, Class |year= 2012 |publisher= Palgrave Macmillan |location= Basingstoke, England |isbn= 9780230309319}}
* {{cite book |title= Sixth Report: Complementary and Alternative Medicine |url= http://www.parliament.the-stationery-office.co.uk/pa/ld199900/ldselect/ldsctech/123/12301.htm |author1= Walton J. |year= 2000 |isbn=  9780104831007 |orig-year= Session 1999–2000, HL 123 |location= London |publisher= The Stationery Office |ref= {{harvid|Sir Walton: Science and Technology Committee|2000}}}}
* {{cite book | last = Taylor | first = Kim | title = Chinese Medicine in Early Communist China, 1945–63: a Medicine of Revolution | year = 2005 | isbn = 978-0415345125 |location=London and New York|series=Needham Research Institute Studies| publisher = RoutledgeCurzon}}
* {{cite journal |title= Development and classification of an operational definition of complementary and alternative medicine for the Cochrane Collaboration |last1= Wieland |first1= L.S. |last2= Manheimer |first2= E. |last3= Berman |first3= B.M. |journal= Alternative Therapies in Health and Medicine |year= 2011 |volume= 17 |issue= 2 |pages= 50–59 |pmid= 21717826 |pmc= 3196853 |ref={{harvid|Wieland et al.|2011}}|display-authors= 1 }}
* {{cite book |title= The Roots of Ayurveda: Selections from Sanskrit Medical Writings |editor-last=Wujastyk|editor-first= D.|others=Translated by D. Wujastyk|year= 2003 |location= London and New York |publisher= [[Penguin Books]] |isbn= 978-0140448245}}

==Further reading==
* {{cite book |last= Bausell |first= R.B |year= 2007 |title= Snake oil science : the truth about complementary and alternative medicine |publisher= Oxford University Press |isbn= 9780195313680 |url= https://archive.org/details/isbn_9780195313680 }}
* {{cite journal |last1= Benedetti |first1= F. |last2= Maggi |first2= G. |last3= Lopiano |first3= L. |last4= Lanotte |first4= M. |last5= Rainero |first5= I. |last6= Vighetti |first6= S. |last7= Pollo |first7= A. |title= Open versus hidden medical treatments: The patient's knowledge about a therapy affects the therapy outcome |journal= Prevention & Treatment |year= 2003 |volume= 6 |issue= 1 |doi= 10.1037/1522-3736.6.1.61a |display-authors= 1 }}
* {{cite book |editor-last= [[John Diamond (journalist)|Diamond]] |editor-first= J. |title= Snake Oil and Other Preoccupations |year= 2001 |isbn= 9780099428336 |chapter= Foreword |first= R. |last= Dawkins |author-link= Richard Dawkins |publisher= Vintage |location= London |chapter-url-access= registration |chapter-url= https://archive.org/details/snakeoilotherpre0000diam }} Reprinted in {{harvnb|Dawkins|2003}}.
* {{cite journal |vauthors=Downing AM, Hunter DG | title = Validating clinical reasoning: A question of perspective, but whose perspective? | journal = Manual Therapy | volume = 8 | issue = 2 | pages = 117–19 | year = 2003 | pmid = 12890440 | doi = 10.1016/S1356-689X(02)00077-2 | url = http://eprints.uwe.ac.uk/493/ }}
* {{cite journal | author = Eisenberg DM | title = Advising patients who seek alternative medical therapies | journal = Annals of Internal Medicine | volume = 127 | issue = 1 | pages = 61–69 | date = July 1997 | pmid = 9214254 | doi = 10.7326/0003-4819-127-1-199707010-00010 | s2cid = 23351104 }}
* {{cite journal | author = Gunn IP | title = 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'' | journal = AANA Journal |issn=0094-6354 | volume = 66 | issue = 6 | pages = 575–82 | date = December 1998 | pmid = 10488264 }}
* {{cite book |last=Hand |first= W.D. |year=1980 |chapter=Folk Magical Medicine and Symbolism in the West |title=Magical Medicine |location=Berkeley |publisher=University of California Press |pages=305–19 |isbn= 9780520041295 |oclc=6420468}}
* {{cite book |author-link= Ivan Illich |last= Illich |first= I. |title= Limits to Medicine: Medical Nemesis: The Expropriation of Health |publisher= Penguin |year= 1976 |isbn= 9780140220094 |oclc= 4134656 |url= https://archive.org/details/limitstomedicine00illi }}
* {{cite book |author= Mayo Clinic |title= Mayo Clinic Book of Alternative Medicine: The New Approach to Using the Best of Natural Therapies and Conventional Medicine |location= Parsippany, New Jersey |publisher= [[Time Inc|Time]] Home Entertainment |year= 2007 |isbn= 9781933405926 |author-link= Mayo Clinic |url-access= registration |url= https://archive.org/details/mayoclinicbookof0000unse }}
* {{cite journal |first= P., Jr. |last= Stevens |date=November–December 2001 |title= Magical thinking in complementary and alternative medicine |journal=[[Skeptical Inquirer]] |url= http://www.csicop.org/si/show/magical_thinking_in_complementary_and_alternative_medicine }}
* {{cite book |last= Planer |first= F.E. |year= 1988 |title= Superstition |edition= Rev. |location= Buffalo, New York |publisher= Prometheus Books |isbn= 9780879754945 |oclc= 18616238 |url-access= registration |url= https://archive.org/details/superstition0000plan }}
* {{cite web |url= http://www.cwru.edu/med/epidbio/mphp439/Sources_of_Healthcare.htm |last= Rosenfeld |first= A. |title= Where Do Americans Go for Healthcare? |publisher= Case Western Reserve University |location= Cleveland, Ohio |year= c. 2000 |access-date= 2010-09-23 |archive-url= https://web.archive.org/web/20060509074143/http://www.cwru.edu/med/epidbio/mphp439/Sources_of_Healthcare.htm |archive-date= 2006-05-09 |url-status= dead }}
* {{cite journal|last1=Snyder|first1=Mariah|last2=Lindquist|first2=Ruth|title=Issues in Complementary Therapies: How We Got to Where We Are|journal=Online Journal of Issues in Nursing|date=May 2001|volume=6|issue=2|pages=1|url=http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume62001/No2May01/ComplementaryTherapiesIssues.aspx|pmid=11469921|access-date=2017-01-18|archive-url=https://web.archive.org/web/20170203005253/http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume62001/No2May01/ComplementaryTherapiesIssues.aspx|archive-date=2017-02-03|url-status=dead}}
* {{cite journal | author = Tonelli MR | title = The limits of evidence-based medicine | journal = Respiratory Care | volume = 46 | issue = 12 | pages = 1435–40; discussion 1440–1 | year = 2001 | pmid = 11728302 }}
* {{cite book |last= Trivieri |first= L. Jr. |editor-last= Anderson |editor-first= J.W. |title= Alternative Medicine: The Definitive Guide |location= Berkeley |publisher= Ten Speed Press |year= 2002 |isbn= 9781587611414 |url-access= registration |url= https://archive.org/details/isbn_9781587611414_0 }}
* {{cite book |last1= Wisneski |first1= L.A. |last2= Anderson |first2= L. |title= The scientific basis of integrative medicine |publisher= CRC Press |year= 2005 |isbn= 9780849320811 |display-authors= 1 }}
* {{cite journal |last= Zalewski |first= Z. |title= Importance of philosophy of science to the history of medical thinking |journal= [[CMJ]] |year= 1999 |volume= 40 |issue= 1 |pages= 8–13 |url= http://www.bsb.mefst.hr/cmj/1999/4001/400102.htm  |archive-url= https://web.archive.org/web/20040206092548/http://www.bsb.mefst.hr/cmj/1999/4001/400102.htm |archive-date= 2004-02-06 |pmid= 9933889 }}

===World Health Organization===
* {{cite book |title= General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine |url= http://whqlibdoc.who.int/hq/2000/WHO_EDM_TRM_2000.1.pdf |volume= WHO/EDM/TRM/2001.1 |author= World Health Organization |author-mask=0 |year= 2000 |location= Geneva |publisher= World Health Organization (WHO) |quote= 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. |ref= {{harvid|WHO|2000}}}}
* {{cite book |title= WHO Guidelines on Basic Training and Safety in Chiropractic |url=https://www.who.int/medicines/areas/traditional/Chiro-Guidelines.pdf |author= World Health Organization |author-mask=0 |year= 2005 |location= Geneva |publisher= WHO |isbn= 978-9241593717 |ref= {{harvid|WHO|2005}}}}
* {{cite book |title= WHO Global Atlas of Traditional, Complementary and Alternative Medicine |last1= WHO Kobe Centre |last2= Bodeker |first2= G. |last3= Ong |first3= C.K. |last4= Grundy |first4= C. |last5= Burford |first5= G. |last6= Shein |first6= K. |year= 2005 |publisher= WHO |isbn= 9789241562867|display-authors=2 }} [https://web.archive.org/web/20131004213942/http://apps.who.int/bookorders/anglais/detart1.jsp?codlan=1&codcol=15&codcch=614 Summary.]
* [https://web.archive.org/web/20110421082710/http://www.who.int/medicines/areas/traditional/trm_benchmarks/en/ Benchmarks for training in traditional / complementary and alternative medicine]

===Journals===
* Alternative Therapies in Health and Medicine. Aliso Viejo, California : InnoVision Communications, c1995- NLM ID: [http://locatorplus.gov/cgi-bin/Pwebrecon.cgi?DB=local&v2=1&ti=1,1&Search_Arg=9502013&Search_Code=0359&CNT=20&SID=1 9502013]
* [http://altmedrev.com/ Alternative Medicine Review: A Journal of Clinical Therapeutics]. Sandpoint, Idaho : Thorne Research, c. 1996 NLM ID: [http://locatorplus.gov/cgi-bin/Pwebrecon.cgi?DB=local&v2=1&ti=1,1&Search_Arg=9705340&Search_Code=0359&CNT=20&SID=1 9705340]
* [http://www.biomedcentral.com/1472-6882 BMC Complementary and Alternative Medicine]. London: BioMed Central, 2001 NLM ID: [http://locatorplus.gov/cgi-bin/Pwebrecon.cgi?DB=local&v2=1&ti=1,1&Search_Arg=101088661&Search_Code=0359&CNT=20&SID=1 101088661]
* Complementary Therapies in Medicine. Edinburgh; New York : Churchill Livingstone, c. 1993 NLM ID: [http://locatorplus.gov/cgi-bin/Pwebrecon.cgi?DB=local&v2=1&ti=1,1&Search_Arg=9308777&Search_Code=0359&CNT=20&SID=1 9308777]
* [https://web.archive.org/web/20090916003115/http://ecam.oxfordjournals.org/ Evidence Based Complementary and Alternative Medicine: eCAM]. New York: Hindawi, c. 2004 NLM ID: [http://locatorplus.gov/cgi-bin/Pwebrecon.cgi?v1=1&ti=1,1&Search_Arg=Evidence%20Based%20Complementary%20and%20Alternative%20Medicine&Search_Code=TKEY&CNT=10&PID=fpUDGDBAnYWR-hE7tDjwdrxtvHm&SEQ=20130926044311&SID=2 101215021]
* [http://content.karger.com/ProdukteDB/produkte.asp?Aktion=JournalHome&ProduktNr=224242 Forschende Komplementärmedizin / Research in Complementary Medicine]
* [http://www.liebertpub.com/products/product.aspx?pid=26 Journal for Alternative and Complementary Medicine] New York : Mary Ann Liebert, c. 1995
* [http://www.sram.org/index.html Scientific Review of Alternative Medicine (SRAM)]

==External links==
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* {{Curlie|Health/Alternative/}}

{{Alternative medicine}}
{{Traditional Medicine}}
{{Medicinal herbs & fungi}}
{{Pseudoscience}}
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{{DEFAULTSORT:Alternative Medicine}}
[[Category:Alternative medicine| ]]
[[Category:Pseudoscience]]