Alternative therapies

Acupressure

This therapy involves pressing points on the body with fingers or hands to alter the internal flow of a supposed vital force or energy called chi (pronounced "chee"), strengthening it, calming it, or removing a blockage of the flow. Acupressure is one of a number of treatment methods regularly used in traditional Chinese medicine, or TCM, a system of healthcare that originated in China thousands of years ago and is still widely practiced in Asian countries today.

According to TCM, acupressure points are aligned along 14 bodily meridians, or pathways. Twelve of the meridians are bilateral; that is, identical versions of them (with the same sets of points) exist on both sides of the body. The other two are unilateral, running along the midline of the body. The 14 meridians do not correspond to any known physiological processes or anatomical structures in the body, such as nerves or blood vessels. Nevertheless, some well-controlled studies suggest that acupressure can be effective for a number of health problems, including nausea, pain, and stroke-related weak-ness. A single point may be pressed for relief from a particular symptom or condition; or to promote overall well-being of the body, a series of points can be worked on in a specific order.

Acupressure can be administered by someone trained in the technique or it may be practiced at home. The force used on different points varies, but in general, most points call for a steady, downward pressure lasting one to two minutes. If you are applying pressure to a point several times in succession, complete this process on one side of the body before switching to the other side.

The risks of acupressure are minimal, provided certain cautions are observed. During pregnancy, the points designated Spleen  and Large Intestine should never be used; avoid the abdominal area entirely, if possible. Never apply pressure to open wounds, varicose veins, tumors, inflamed or infected skin, sites of recent surgery, or areas where a broken bone is suspected.

Acupuncture

Acupuncture, like acupressure, is based on the traditional Chinese theory of meridians-energy pathways that are believed to run through the body, carrying the vital force or energy called chi. In this therapy, the flow of chi is controlled by the insertion of hair-thin needles at specific points-the same meridian-aligned ones used in acupressure. Unlike acupressure, acupuncture must be performed by a trained practitioner.

An average treatment involves the insertion of 5 to 15 fine needles. They may penetrate as little as a fraction of an inch (on the fingertips, for example) or as much as three or four inches (where a thick layer of fat or muscle exists). The procedure usually causes little pain, although often there may be a tingling or heavy sensation. In addition to (or sometimes instead of) inserting needles, acupuncturists may opt for a. treatment called moxibustion. This consists of applying heat directly above acupuncture points by means of small bundles of smoldering herbs, usually mugwort leaf.

The ability of acupuncture to relieve pain in many patients is well documented, and the physical basis of the pain relief has been demonstrated through laboratory tests on animals; acupuncture releases endorphins and other forms of neurotransmitters that serve as the body's natural painkillers. However, researchers remain unclear as to how acupuncture is able to provide long-lasting pain relief. Along with its pain-controlling benefits, acupuncture has been found effective in stroke rehabilitation and in providing relief from nausea. It has also been recommended as a treatment for drug addiction.

Aromatherapy

In aromatherapy, the essential oils of plants are used to pro-mote relaxation and help relieve the symptoms of certain ailments. Essential oils are extremely concentrated fragrant extracts, cold-pressed or steam-distilled from blossoms, leaves, or roots. The oils are diluted with so-called carrier oils, such as almond or soy, and can be applied through massage, mixed with water and used as compresses on the skin, added to a bath, or diffused into the air and inhaled. Essential oils should never be ingested; one drop of oil can be equivalent to an ounce or more of a whole plant. Taken internally, the oils of such plants as thuja, wormwood, mugwort leaf, tansy, hyssop, and sage are toxic, and they can even be lethal.

Aromatherapists believe that the fragrance of the oils has a soothing effect on the brain's limbic system, which is involved in memory, emotion, and hormone control. Some practitioners also theorize that the oils are absorbed through the skin and work directly in the body. However, critics of aromatherapy suggest that the relaxation attributed to the oils may actually be due to their application by massage, hot baths, and other pleasant methods.

Ayurvedic Medicine

Ayurvedic medicine is a system of diagnosis and treatment that has been practiced in India for more than 5,000 years. The term Ayurveda comes from the Sanskrit roots ayur, which means "life," and veda, meaning "knowledge." Ayurvedic theory holds that all diseases of the body arise from stresses in the awareness, or consciousness, of the individual; the stresses lead to unhealthy lifestyles, producing a cycle of ill health. Physical manifestations of disease are attributed to the imbalance of three basic physiological principles, called doshas. The vata dosha represents the kinetic energy of the body; vata makes the heart beat, causes blood to flow, and stimulates brain and nerve functions. The kapha dosha is potential energy, responsible for physical strength and the lubrication of tissues.

The pitta dosha, considered a mediator between vat a and kapha, governs the metabolic processes of the body, from digestion to cell operation. If these three principles cease to operate in harmony, sickness ensues. Evaluation of the doshas is performed by a technique called nadi vigyan, which involves taking the pulse at the wrist; this assessment determines the precise form treatment will take.

Ayurvedic practitioners prescribe a variety of precise body postures, all derived from the age-old discipline of yoga, along with breathing exercises and meditative techniques. In addition, practitioners use herbs, emetics and enemas, oil massage, and dosha-specific diets toward a goal of helping detoxify the system and bring it back into balance.

Some Ayurvedic herbal mixtures have been found to contain high levels of lead and can be toxic. Be sure to thoroughly investigate the ingredients of any remedy before using it; don't hesitate to ask the practitioner about this.

Body Work

Body work is an umbrella term for the many techniques, both ancient and modern, that promote relaxation and treat ailments (especially those of the musculoskeletal system) through lessons in proper movement, postural reeducation, exercise, massage, and various other forms of bodily manipulation. Some types of body .work-including massage, qigong, reflexology, shiatsu, and t'ai chi-can be practiced at home. Others may require the guidance of a trained professional. Forms of body work include the following:

The Alexander technique focuses on correcting habitual posture and movement patterns that are believed to damage or impair the body's functioning.

Aston-Patterning is a technique that tailors guided movement and postural retraining to the particular characteristics of each client's body.

The Feldenkrais method features individual sessions performed by a trained practitioner, during which verbally directed exercises, touch, and movement are used to teach new patterns in order to improve posture, movement, and breathing.

Hellerwork, an offshoot of Rolfing (Structural Integration), combines touch and movement retraining to teach stress-free methods for performing everyday activities.

Massage includes an assortment of manual therapies that manipulate the soft tissues of the body in order to reduce tension and stress, increase circulation, aid the healing of muscle and other soft-tissue injuries, control pain, and promote overall well-being.

Myotherapy is a form of deep massage used to reduce tension and pain originating in specific points in the muscle layers of the body.

Qigong ("chee-goong"), an ancient Chinese discipline, emphasizes breathing, meditation, and stationary and moving exercises to enhance the flow of energy or chi (sometimes also spelled "qi") through the body.

Reflexology involves the manipulation of specific areas on the feet and sometimes the hands with the goal of bringing the body into homeostasis, or balance. According to reflexologists, distinct regions of the feet correspond to particular organs or body systems, and the stimulation of the appropriate region is intended to eliminate energy blockages thought to produce pain or disease in the associated structures. The arrangement of reflexology areas on the feet mirrors the organization of the body to the extent that organs on the right side of the body are represented on the right foot, and so with the left.

Reflexology features a few basic techniques that can be performed either by yourself or by a partner. The basic thumb technique uses the inside edge of the thumb pad (the side away from the fingers) to "walk" along re-flex areas; walking consists of a forward, creeping movement, with the first joint of the thumb bending and unbending slightly as the digit inches ahead. The finger technique uses the same walking motion but with the edge of the index finger closest to the thumb. When working a specific area, one hand should work and the other should hold the foot in a comfortable position with the sole flat and toes straight.

Practitioners of reflexology claim that it can relieve a wide variety of ailments. Critics say that treatments are no more than glorified foot massages.

Rolfing, also called Structural Integration, is based on the belief that proper alignment of the various parts of the body is necessary for physical and emotional health. The method uses deep massage and movement exercises to loosen or release adhesions in the fascia-the connective tissue covering muscles-in an effort to bring the body back into correct alignment.

Shiatsu, a Japanese technique similar to acupressure, uses finger and thumb pressure on precise body points to encourage the proper flow of chi-or ki, as the Japanese call it-a vital force or energy believed to circulate through the body.

T'ai chi, one style of qigong, is a martial art involving meditation and slow, flowing self-guided movements that follow set forms. It is intended to affect the flow of chi (energy) and bring about physical self-awareness.

Therapeutic Touch does not involve actual physical contact, despite its name. The practitioner's hands move in slow, rhythmic motions two to six inches above the patient in an effort to detect what are said to be blockages in the body's energy field that may cause or contribute to illness. The technique was devised a few decades ago as a contemporary version of various ancient practices in which a healer consciously strives to direct and focus energy to the receiver to balance and unblock energy flows. Sessions typically last about 20 minutes and are said to produce a sense of relaxed well-being as well as relief from pain and other symptoms.

Trager Psychophysical Integration (Trager approach) features gentle touch and rhythmic rocking and shaking movement, along with a series of directed body exercises intended to help identify and correct chronic tension patterns that affect posture and movement. Research suggests that it is beneficial for people with severe neuro-muscular problems produced by injury or such diseases as multiple sclerosis or muscular dystrophy.

Chinese Herbs

The use of herbs, along with acupuncture and acupressure, is a major component of the system of traditional Chinese medicine, or TCM. Doctors of traditional Chinese medicine usually practice under the title "licensed," or "certified," acupuncturist, and they prescribe herbal combinations ac-cording to complex rules of diagnosis, which are intended to help the body correct imbalances of energies. In TCM. ailments are believed to be caused by disturbances in the bodily flow of a type of energy called chi, or by a lack of balance in the complementary states of yin (which is char-acterized by darkness and quiet) and yang (which is characterized by light and activity).

Chinese herbs, like other TCM remedies (such as minerals and animal products, like hide and bone), can be pre-pared in numerous ways: steeped in hot water to make a tea or infusion; boiled to produce a stronger solution called a decoction; used to make powders, pills, or syrups that may all be taken internally; and fashioned into plasters or poultices that are applied to the skin. Treatments should be pre-scribed and monitored by a trained practitioner, because some Chinese herbs can be toxic in large doses; others, such as safflower flowers, should be used with caution during pregnancy. Complex mixtures should be formulated only by a trained practitioner.

In recent years, Chinese herbal medicine has been subjected to increasingly rigorous study in China, the United States, and elsewhere. The evidence indicates that although some remedies do not perform as claimed, others are effective. In China today, herbal remedies are often prescribed along with modern biomedical treatments.

Chiropractic

Chiropractic, a system of healing taught in its own five-year medical colleges and licensed in all 50 states according to standards set by the Council of Chiropractic Education and the Federation of Chiropractic Licensing Boards, is based on the idea at the human body has an innate self-healing ability and seeks homeostasis, or balance. According to chiropractic theory, the nervous system plays a significant role in maintaining homeostasis-and hence health. But problems in the joints, called subluxations, are believed to interfere with proper functioning of the nervous system, and as a result, the body's ability to maintain optimal health is diminished. Chiropractors seek to bring the body back into balance through manual manipulation of the spine and other joints and muscles, allowing the neuromusculoskeletal system to function smoothly.

Today, chiropractors are divided into two major camps. One, traditionalist in stance, sees subluxations as the cause of most ailments. The other, considered progressive, aims at establishing chiropractors as providers of primary care, emphasizing the treatment of back pain and musculoskeletal problems, along with manipulation.

Although chiropractic is categorized as alternative medicine, it has gained a degree of acceptance, in part be-cause of a number of recent studies that have shown it to be quite effective in treating problems such as acute lower-back pain. The services of chiropractors are covered by Medicare and, in many states, by Medicaid and most major private plans.

Herbal Therapies

Herbal medicines are prepared from a variety of plant materials-leaves, stems, roots, bark, and so on. They usually contain many biologically active ingredients and are used primarily for treating mild or chronic ailments. (At least a quarter of all conventional pharmaceuticals include some of the same ingredients, although generally in purified form.) Herbs can be prepared at home in many ways, using either fresh or dried ingredients. Herbal teas and infusions can be steeped to varying strengths. Roots, bark, or other plant parts can be boiled into strong solutions called decoctions. Honey or sugar can be added to infusions and decoctions to make syrups. In stores, herbal remedies can also be purchased in the form of pills, capsules, or powders, or in more concentrated liquid forms called extracts and tinctures. They can be applied topically in creams or ointments, soaked into cloths and used as compresses, or applied directly to the skin as poultices.

In the United States today, herbal remedies are not regulated and come in unpredictable strengths; the amount of the active ingredients varies greatly, depending on whether more than one species of the herb is used and how and when the herb is gathered and prepared. Because some herbs can be toxic or carcinogenic, all herbs should be used under the guidance of a healthcare practitioner familiar with herbal medicine.

Across the spectrum of alternative medicine, the use of herbs is varied: Naturopathic medicine, traditional Chinese medicine, and Ayurvedic medicine all differ in how diseases are diagnosed and what herbal remedies are prescribed. For more information on herbal medicines, see About Herbal Preparations.

Homeopathy

Homeopathy, founded by a German physician' named Samuel Hahnemann in the 1790s, is based on the idea that "like cures like"; that is, substances that cause certain symptoms in a healthy person can also cure those same symptoms in someone who is sick. This so-called law of similars gives homeopathy its name: "homea" for similar, "pathy" designating disease. In his experiments, Hahnemann developed a method of "potentizing" homeopathic remedies by diluting them in a water-alcohol solution and then vigorously shaking (or succussing) the mixtures. The results convinced him that a high degree of dilution not only minimizes the side effects of the remedies but also

simultaneously enhances their medical efficacy.

Modern homeopaths usually prescribe doses at dilution ratios ranging from 1 x (1 part substance to 9 parts dilution medium) to 200c (200 repetitions of diluting 1 part substance with 99 parts dilution medium); higher ratios are indicated with an "m," for a 1 to 999 ratio. Critics of homeopathy argue that, in the more extreme dilution ratios (which are considered higher potencies), the remedies may not contain even a single molecule of the original healing substance. Nonetheless, studies have shown that homeopathic remedies may be effective for certain disorders, such as childhood diarrhea, hay fever, asthma, and the flu. Further research is now being conducted under the auspices of the National Institutes of Health.

Most homeopathic remedies have undergone "provings," or medical observations in which healthy individuals are given doses of undiluted homeopathic substances. Mental, emotional, and physical changes brought on during these tests help provide homeopathic physicians with a better understanding of which remedy will best suit a particular set of symptoms. Over the past 200 years, provings for almost 2,000 substances have been conducted.

The majority of homeopaths practice "constitutional" homeopathy, based on the idea that each person's constitution or mental, physical, and emotional makeup-may need to be treated along with any specific ailments. Classically, only one homeopathic medicine is used at a time. An extensive patient history is taken and the patient's physical and psychological symptoms are observed, then an initial prescription is made. If the medication does not have the desired effect or if the symptoms persist, a second analysis is done and a second prescription is given. This process continues until the correct medication for the underlying ailment is found. Constitutional treatment is generally used for chronic problems; acute, or short-term, ailments are usually treated with remedies specific to the illness.

Recently, over-the-counter combination homeopathic remedies have become available for a wide variety of common ailments. These products contain several of the most common remedies for a particular problem and can be useful for self-treatment of minor conditions. For prolonged or serious illness, a professional homeopath can prescribe specific single remedies.

Homeopathic practitioners usually have prior medical training, such as a degree in medicine, osteopathy, or naturopathic medicine. The pharmaceuticals they prescribe are recognized and regulated by the FDA, and may be purchased over the counter at specialty drugstores.

Hydrotherapy

Hydrotherapy, literally meaning water therapy, uses ice, liquid, and steam to relieve the symptoms of numerous types of infections, acute and chronic pain, circulatory problems, and more. Treatments include wraps, sprays, and douches, as well as steam rooms and saunas, and both hot and cold baths-among them, whirlpool baths, hand or foot baths, and sitz baths, which involve immersion of only the pelvic area. The aim is to stimulate an immune response or to detoxify the body by changing body temperature. Hydrotherapy is often used by naturopaths.

Mind/Body Medicine

This umbrella term covers activities and therapies that focus on the interrelationship of mind and body; the goal in all forms of mind/body medicine is to address particular disorders and promote overall health by combining both mental and physical approaches. Yoga, for example, involves both physical movement and a meditative state of mind, and may serve the dual purpose of improving a person's physical condition and combating emotional problems such as depression and anxiety. As noted below, the two-way connection between mind and body is exploited in many ways to influence the hormonal, nervous, and immune systems.

Biofeedback uses computerized machines to measure and display body functions and states such as heart rate, skin temperature, muscle tension, and brain activity. By monitoring these functions through stages of rest and activity, patients are able to see how and why they change, and eventually can learn to control them.

Guided imagery teaches patients to imagine scenarios that may help influence certain physiological conditions. A cancer patient, for example, may imagine a tumor dissolving under an attack by immune system "bullets." While there are no conclusive studies on imagery, patients often report physical and psychological benefits.

Hypnotherapy, administered by a professional, uses a relaxed, focused state of awareness to help change physiological and psychological reactions to pain, illness, or anxiety. Self-hypnosis may be learned and applied to certain conditions as well.

Meditation includes a number of different Asian and Western practices. All share the basic characteristics of sitting or resting quietly, often with the eyes closed, and performing mental exercises designed to relax the body and focus concentration.

The relaxation response is a state of psychological and physiological rest characterized by lowered oxygen consumption and reduced heart rate. It can be induced by many different Jechniques, including meditation, yoga, t'ai chi, qigong, and hypnotherapy. This deep relaxation can relieve stress and its many symptoms.

Spirituality is a source of relaxation and comfort for many people, whether it involves practicing a particular religion or contemplating spiritual values outside of a religious context.

Support groups bring together people who are suffering from the same disease or similar types of trauma. Within the group, they can share experiences and feelings, which may yield great psychological benefits and per-haps improve the functioning of their natural bodily defenses as well.

Yoga is a series of body positions and movements developed over thousands of years to calm the mind, relax the body, and ease the spirit. Meditation and breathing exercises lead into cycles of stretches and poses that may vary from session to session. Yoga can be learned and practiced at home; however, modified movements may be required during pregnancy or if a person has a condition such as heart disease. A yoga specialist can recommend the appropriate adjustments.

Naturopathic Medicine

Naturopathic medicine provides holistic, or whole body, healthcare by taking advantage of resources drawn from numerous traditional healing systems. Dating back to the early part of the 20th century, naturopathy is organized around three fundamental principles: The physician should strive to aid the body's natural healing abilities; the root cause of an illness should be addressed rather than its symptoms; and above all, only therapies that cause no harm should be used (which means that toxic drugs and surgery are avoided whenever possible).

A naturopathic doctor, or ND, may pay considerable attention to a patient's lifestyle, since naturopathic theory holds that physical, psychological, and even spiritual elements can all contribute to disease. I n treating patients, the naturopathic practitioner may use a number of alternative therapies, including homeopathy, herbal remedies, traditional Chinese medicine, spinal manipulation, nutrition, hydrotherapy, massage, and exercise.

Doctors of naturopathy train at accredited four-year naturopathic medical schools. The first two years include many of the same core science classes as regular medical schools, while the final two years focus on training in natural healing techniques. At present, naturopathic doctors are licensed to practice in nine states; most other states allow them to practice in limited ways. Many private insurance plans cover naturopathic care.

Nutrition and Diet

Conventional and alternative practitioners alike acknowledge the importance of a healthful diet. Alternative practitioners, however, place more emphasis on dietary intervention in some conditions where conventional medicine would resort first to drugs or even surgery. Treatment of atherosclerosis, for example, may take the from of an extremely low-fat diet along with a programme of meditation, exercise, and support-group therapy.

Some diets, such as traditional Japanese and Mediterranean ones, contain small amounts of animal fat. Because they are low in saturated fats, these diets appear to protect against heart disease and some forms of cancer. Vegetarian diets have been shown to lower blood pressure and reduce the risk of cardiovascular disease and some cancers. Particular foods may be beneficial: Garlic, for example is said to reduce the levels of cholesterol in the bloodstream and protect against some forms of cancer.

Vitamins and mineral supplements figure in the dietary recommendations of many therapies. Although some vitamins, such as A and 0, are fat-soluble and can reach toxic levels in the body if not carefully monitored, others, like vitamin C, are water-soluble and are not stored; any bodily excess is usually excreted. Generally, vitamins and minerals are recommended for daily use as a preventive measure. They often come in tablet form, and doses are measured by weight in milligrams (mg), or thousandths of a gram; in micrograms (mcg), or millionths of a gram; or in a universal standard known as international units (IU). Orthomolecular medicine, a form of nutrient therapy, uses combinations of vitamins, minerals, and amino acids normally found in the body to treat specific conditions, such as asthma, heart disease, depression, and schizophrenia. Such therapy can also be used to maintain general good health.

Osteopathy

Osteopathy focuses on correcting structural problems in the musculoskeletal system to improve overall bodily functioning.

To restore structural balance and thus help a patient regain health, an osteopathic physician will combine manipulation of the joints, physical therapy, and instruction in proper posture. Because osteopathic care is holistic, or targeted at the whole body, the doctor also considers psychological factors, lifestyle, and diet in addressing an illness and maintaining health.

Ever since it was founded by an American doctor named Andrew Taylor Still in the late 19th century, osteopathy has blended all aspects of conventional medicine with its central tenets of the importance of the body's structure and its predisposition toward health over illness.

Doctors of osteopathy, or DOs, train at their own four-year medical colleges and can enter either MD or DO residency programs. They are licensed to practice in all 50 states, and can prescribe drugs, perform surgery, and further specialize in any of the medical subspecialties, such as cardiology, neurology, or obstetrics and gynecology.

Apart from the emphasis they place on musculoskeletal function and alignment (an emphasis that can vary from doctor to doctor), most osteopathic physicians practice much like conventional medical doctors.

Alternative therapies

Acupressure This therapy involves pressing points on the body with fingers or hands to alter the internal flow of a supposed vital force or energy called chi (pronounced chee), strengthening it, calming it, or removing a blockage of the flow. Acupressure is one of a number of treatment methods regularly used in traditional Chinese medicine, or TCM, a system of healthcare that originated in China thousands of years ago and is still widely practiced in Asian countries today. According to TCM, acupressure points are aligned along 14 bodily meridians, or pathways. Twelve of the meridians are bilateral; that is, identical versions of them (with the same sets of points) exist on both sides of the body. The other two are unilateral, running along the midline of the body. The 14 meridians do not correspond to any known physiological processes or anatomical structures in the body, such as nerves or blood vessels. Nevertheless, some well-controlled studies suggest that acupressure can be effective for a number of health problems, including nausea, pain, and stroke-related weak-ness. A single point may be pressed for relief from a particular symptom or condition; or to promote overall well-being of the body, a series of points can be worked on in a specific order. Acupressure can be administered by someone trained in the technique or it may be practiced at home. The force used on different points varies, but in general, most points call for a steady, downward pressure lasting one to two minutes. If you are applying pressure to a point several times in succession, complete this process on one side of the body before switching to the other side. The risks of acupressure are minimal, provided certain cautions are observed. During pregnancy, the points designated Spleen and Large Intestine should never be used; avoid the abdominal area entirely, if possible. Never apply pressure to open wounds, varicose veins, tumors, inflamed or infected skin, sites of recent surgery, or areas where a broken bone is suspected. Acupuncture Acupuncture, like acupressure, is based on the traditional Chinese theory of meridians-energy pathways that are believed to run through the body, carrying the vital force or energy called chi. In this therapy, the flow of chi is controlled by the insertion of hair-thin needles at specific points-the same meridian-aligned ones used in acupressure. Unlike acupressure, acupuncture must be performed by a trained practitioner. An average treatment involves the insertion of 5 to 15 fine needles. They may penetrate as little as a fraction of an inch (on the fingertips, for example) or as much as three or four inches (where a thick layer of fat or muscle exists). The procedure usually causes little pain, although often there may be a tingling or heavy sensation. In addition to (or sometimes instead of) inserting needles, acupuncturists may opt for a. treatment called moxibustion. This consists of applying heat directly above acupuncture points by means of small bundles of smoldering herbs, usually mugwort leaf. The ability of acupuncture to relieve pain in many patients is well documented, and the physical basis of the pain relief has been demonstrated through laboratory tests on animals; acupuncture releases endorphins and other forms of neurotransmitters that serve as the bodys natural painkillers. However, researchers remain unclear as to how acupuncture is able to provide long-lasting pain relief. Along with its pain-controlling benefits, acupuncture has been found effective in stroke rehabilitation and in providing relief from nausea. It has also been recommended as a treatment for drug addiction. Aromatherapy In aromatherapy, the essential oils of plants are used to pro-mote relaxation and help relieve the symptoms of certain ailments. Essential oils are extremely concentrated fragrant extracts, cold-pressed or steam-distilled from blossoms, leaves, or roots. The oils are diluted with so-called carrier oils, such as almond or soy, and can be applied through massage, mixed with water and used as compresses on the skin, added to a bath, or diffused into the air and inhaled. Essential oils should never be ingested; one drop of oil can be equivalent to an ounce or more of a whole plant. Taken internally, the oils of such plants as thuja, wormwood, mugwort leaf, tansy, hyssop, and sage are toxic, and they can even be lethal. Aromatherapists believe that the fragrance of the oils has a soothing effect on the brains limbic system, which is involved in memory, emotion, and hormone control. Some practitioners also theorize that the oils are absorbed through the skin and work directly in the body. However, critics of aromatherapy suggest that the relaxation attributed to the oils may actually be due to their application by massage, hot baths, and other pleasant methods. Ayurvedic Medicine Ayurvedic medicine is a system of diagnosis and treatment that has been practiced in India for more than 5,000 years. The term Ayurveda comes from the Sanskrit roots ayur, which means life, and veda, meaning knowledge. Ayurvedic theory holds that all diseases of the body arise from stresses in the awareness, or consciousness, of the individual; the stresses lead to unhealthy lifestyles, producing a cycle of ill health. Physical manifestations of disease are attributed to the imbalance of three basic physiological principles, called doshas. The vata dosha represents the kinetic energy of the body; vata makes the heart beat, causes blood to flow, and stimulates brain and nerve functions. The kapha dosha is potential energy, responsible for physical strength and the lubrication of tissues. The pitta dosha, considered a mediator between vat a and kapha, governs the metabolic processes of the body, from digestion to cell operation. If these three principles cease to operate in harmony, sickness ensues. Evaluation of the doshas is performed by a technique called nadi vigyan, which involves taking the pulse at the wrist; this assessment determines the precise form treatment will take. Ayurvedic practitioners prescribe a variety of precise body postures, all derived from the age-old discipline of yoga, along with breathing exercises and meditative techniques. In addition, practitioners use herbs, emetics and enemas, oil massage, and dosha-specific diets toward a goal of helping detoxify the system and bring it back into balance. Some Ayurvedic herbal mixtures have been found to contain high levels of lead and can be toxic. Be sure to thoroughly investigate the ingredients of any remedy before using it; dont hesitate to ask the practitioner about this. Body Work Body work is an umbrella term for the many techniques, both ancient and modern, that promote relaxation and treat ailments (especially those of the musculoskeletal system) through lessons in proper movement, postural reeducation, exercise, massage, and various other forms of bodily manipulation. Some types of body .work-including massage, qigong, reflexology, shiatsu, and tai chi-can be practiced at home. Others may require the guidance of a trained professional. Forms of body work include the following: The Alexander technique focuses on correcting habitual posture and movement patterns that are believed to damage or impair the bodys functioning. Aston-Patterning is a technique that tailors guided movement and postural retraining to the particular characteristics of each clients body. The Feldenkrais method features individual sessions performed by a trained practitioner, during which verbally directed exercises, touch, and movement are used to teach new patterns in order to improve posture, movement, and breathing. Hellerwork, an offshoot of Rolfing (Structural Integration), combines touch and movement retraining to teach stress-free methods for performing everyday activities. Massage includes an assortment of manual therapies that manipulate the soft tissues of the body in order to reduce tension and stress, increase circulation, aid the healing of muscle and other soft-tissue injuries, control pain, and promote overall well-being. Myotherapy is a form of deep massage used to reduce tension and pain originating in specific points in the muscle layers of the body. Qigong (chee-goong), an ancient Chinese discipline, emphasizes breathing, meditation, and stationary and moving exercises to enhance the flow of energy or chi (sometimes also spelled qi) through the body. Reflexology involves the manipulation of specific areas on the feet and sometimes the hands with the goal of bringing the body into homeostasis, or balance. According to reflexologists, distinct regions of the feet correspond to particular organs or body systems, and the stimulation of the appropriate region is intended to eliminate energy blockages thought to produce pain or disease in the associated structures. The arrangement of reflexology areas on the feet mirrors the organization of the body to the extent that organs on the right side of the body are represented on the right foot, and so with the left. Reflexology features a few basic techniques that can be performed either by yourself or by a partner. The basic thumb technique uses the inside edge of the thumb pad (the side away from the fingers) to walk along re-flex areas; walking consists of a forward, creeping movement, with the first joint of the thumb bending and unbending slightly as the digit inches ahead. The finger technique uses the same walking motion but with the edge of the index finger closest to the thumb. When working a specific area, one hand should work and the other should hold the foot in a comfortable position with the sole flat and toes straight. Practitioners of reflexology claim that it can relieve a wide variety of ailments. Critics say that treatments are no more than glorified foot massages. Rolfing, also called Structural Integration, is based on the belief that proper alignment of the various parts of the body is necessary for physical and emotional health. The method uses deep massage and movement exercises to loosen or release adhesions in the fascia-the connective tissue covering muscles-in an effort to bring the body back into correct alignment. Shiatsu, a Japanese technique similar to acupressure, uses finger and thumb pressure on precise body points to encourage the proper flow of chi-or ki, as the Japanese call it-a vital force or energy believed to circulate through the body. Tai chi, one style of qigong, is a martial art involving meditation and slow, flowing self-guided movements that follow set forms. It is intended to affect the flow of chi (energy) and bring about physical self-awareness. Therapeutic Touch does not involve actual physical contact, despite its name. The practitioners hands move in slow, rhythmic motions two to six inches above the patient in an effort to detect what are said to be blockages in the bodys energy field that may cause or contribute to illness. The technique was devised a few decades ago as a contemporary version of various ancient practices in which a healer consciously strives to direct and focus energy to the receiver to balance and unblock energy flows. Sessions typically last about 20 minutes and are said to produce a sense of relaxed well-being as well as relief from pain and other symptoms. Trager Psychophysical Integration (Trager approach) features gentle touch and rhythmic rocking and shaking movement, along with a series of directed body exercises intended to help identify and correct chronic tension patterns that affect posture and movement. Research suggests that it is beneficial for people with severe neuro-muscular problems produced by injury or such diseases as multiple sclerosis or muscular dystrophy. Chinese Herbs The use of herbs, along with acupuncture and acupressure, is a major component of the system of traditional Chinese medicine, or TCM. Doctors of traditional Chinese medicine usually practice under the title licensed, or certified, acupuncturist, and they prescribe herbal combinations ac-cording to complex rules of diagnosis, which are intended to help the body correct imbalances of energies. In TCM. ailments are believed to be caused by disturbances in the bodily flow of a type of energy called chi, or by a lack of balance in the complementary states of yin (which is char-acterized by darkness and quiet) and yang (which is characterized by light and activity). Chinese herbs, like other TCM remedies (such as minerals and animal products, like hide and bone), can be pre-pared in numerous ways: steeped in hot water to make a tea or infusion; boiled to produce a stronger solution called a decoction; used to make powders, pills, or syrups that may all be taken internally; and fashioned into plasters or poultices that are applied to the skin. Treatments should be pre-scribed and monitored by a trained practitioner, because some Chinese herbs can be toxic in large doses; others, such as safflower flowers, should be used with caution during pregnancy. Complex mixtures should be formulated only by a trained practitioner. In recent years, Chinese herbal medicine has been subjected to increasingly rigorous study in China, the United States, and elsewhere. The evidence indicates that although some remedies do not perform as claimed, others are effective. In China today, herbal remedies are often prescribed along with modern biomedical treatments. Chiropractic Chiropractic, a system of healing taught in its own five-year medical colleges and licensed in all 50 states according to standards set by the Council of Chiropractic Education and the Federation of Chiropractic Licensing Boards, is based on the idea at the human body has an innate self-healing ability and seeks homeostasis, or balance. According to chiropractic theory, the nervous system plays a significant role in maintaining homeostasis-and hence health. But problems in the joints, called subluxations, are believed to interfere with proper functioning of the nervous system, and as a result, the bodys ability to maintain optimal health is diminished. Chiropractors seek to bring the body back into balance through manual manipulation of the spine and other joints and muscles, allowing the neuromusculoskeletal system to function smoothly. Today, chiropractors are divided into two major camps. One, traditionalist in stance, sees subluxations as the cause of most ailments. The other, considered progressive, aims at establishing chiropractors as providers of primary care, emphasizing the treatment of back pain and musculoskeletal problems, along with manipulation. Although chiropractic is categorized as alternative medicine, it has gained a degree of acceptance, in part be-cause of a number of recent studies that have shown it to be quite effective in treating problems such as acute lower-back pain. The services of chiropractors are covered by Medicare and, in many states, by Medicaid and most major private plans. Herbal Therapies Herbal medicines are prepared from a variety of plant materials-leaves, stems, roots, bark, and so on. They usually contain many biologically active ingredients and are used primarily for treating mild or chronic ailments. (At least a quarter of all conventional pharmaceuticals include some of the same ingredients, although generally in purified form.) Herbs can be prepared at home in many ways, using either fresh or dried ingredients. Herbal teas and infusions can be steeped to varying strengths. Roots, bark, or other plant parts can be boiled into strong solutions called decoctions. Honey or sugar can be added to infusions and decoctions to make syrups. In stores, herbal remedies can also be purchased in the form of pills, capsules, or powders, or in more concentrated liquid forms called extracts and tinctures. They can be applied topically in creams or ointments, soaked into cloths and used as compresses, or applied directly to the skin as poultices. In the United States today, herbal remedies are not regulated and come in unpredictable strengths; the amount of the active ingredients varies greatly, depending on whether more than one species of the herb is used and how and when the herb is gathered and prepared. Because some herbs can be toxic or carcinogenic, all herbs should be used under the guidance of a healthcare practitioner familiar with herbal medicine. Across the spectrum of alternative medicine, the use of herbs is varied: Naturopathic medicine, traditional Chinese medicine, and Ayurvedic medicine all differ in how diseases are diagnosed and what herbal remedies are prescribed. For more information on herbal medicines, see About Herbal Preparations. Homeopathy Homeopathy, founded by a German physician named Samuel Hahnemann in the 1790s, is based on the idea that like cures like; that is, substances that cause certain symptoms in a healthy person can also cure those same symptoms in someone who is sick. This so-called law of similars gives homeopathy its name: homea for similar, pathy designating disease. In his experiments, Hahnemann developed a method of potentizing homeopathic remedies by diluting them in a water-alcohol solution and then vigorously shaking (or succussing) the mixtures. The results convinced him that a high degree of dilution not only minimizes the side effects of the remedies but also simultaneously enhances their medical efficacy. Modern homeopaths usually prescribe doses at dilution ratios ranging from 1 x (1 part substance to 9 parts dilution medium) to 200c (200 repetitions of diluting 1 part substance with 99 parts dilution medium); higher ratios are indicated with an m, for a 1 to 999 ratio. Critics of homeopathy argue that, in the more extreme dilution ratios (which are considered higher potencies), the remedies may not contain even a single molecule of the original healing substance. Nonetheless, studies have shown that homeopathic remedies may be effective for certain disorders, such as childhood diarrhea, hay fever, asthma, and the flu. Further research is now being conducted under the auspices of the National Institutes of Health. Most homeopathic remedies have undergone provings, or medical observations in which healthy individuals are given doses of undiluted homeopathic substances. Mental, emotional, and physical changes brought on during these tests help provide homeopathic physicians with a better understanding of which remedy will best suit a particular set of symptoms. Over the past 200 years, provings for almost 2,000 substances have been conducted. The majority of homeopaths practice constitutional homeopathy, based on the idea that each persons constitution or mental, physical, and emotional makeup-may need to be treated along with any specific ailments. Classically, only one homeopathic medicine is used at a time. An extensive patient history is taken and the patients physical and psychological symptoms are observed, then an initial prescription is made. If the medication does not have the desired effect or if the symptoms persist, a second analysis is done and a second prescription is given. This process continues until the correct medication for the underlying ailment is found. Constitutional treatment is generally used for chronic problems; acute, or short-term, ailments are usually treated with remedies specific to the illness. Recently, over-the-counter combination homeopathic remedies have become available for a wide variety of common ailments. These products contain several of the most common remedies for a particular problem and can be useful for self-treatment of minor conditions. For prolonged or serious illness, a professional homeopath can prescribe specific single remedies. Homeopathic practitioners usually have prior medical training, such as a degree in medicine, osteopathy, or naturopathic medicine. The pharmaceuticals they prescribe are recognized and regulated by the FDA, and may be purchased over the counter at specialty drugstores. Hydrotherapy Hydrotherapy, literally meaning water therapy, uses ice, liquid, and steam to relieve the symptoms of numerous types of infections, acute and chronic pain, circulatory problems, and more. Treatments include wraps, sprays, and douches, as well as steam rooms and saunas, and both hot and cold baths-among them, whirlpool baths, hand or foot baths, and sitz baths, which involve immersion of only the pelvic area. The aim is to stimulate an immune response or to detoxify the body by changing body temperature. Hydrotherapy is often used by naturopaths. Mind/Body Medicine This umbrella term covers activities and therapies that focus on the interrelationship of mind and body; the goal in all forms of mind/body medicine is to address particular disorders and promote overall health by combining both mental and physical approaches. Yoga, for example, involves both physical movement and a meditative state of mind, and may serve the dual purpose of improving a persons physical condition and combating emotional problems such as depression and anxiety. As noted below, the two-way connection between mind and body is exploited in many ways to influence the hormonal, nervous, and immune systems. Biofeedback uses computerized machines to measure and display body functions and states such as heart rate, skin temperature, muscle tension, and brain activity. By monitoring these functions through stages of rest and activity, patients are able to see how and why they change, and eventually can learn to control them. Guided imagery teaches patients to imagine scenarios that may help influence certain physiological conditions. A cancer patient, for example, may imagine a tumor dissolving under an attack by immune system bullets. While there are no conclusive studies on imagery, patients often report physical and psychological benefits. Hypnotherapy, administered by a professional, uses a relaxed, focused state of awareness to help change physiological and psychological reactions to pain, illness, or anxiety. Self-hypnosis may be learned and applied to certain conditions as well. Meditation includes a number of different Asian and Western practices. All share the basic characteristics of sitting or resting quietly, often with the eyes closed, and performing mental exercises designed to relax the body and focus concentration. The relaxation response is a state of psychological and physiological rest characterized by lowered oxygen consumption and reduced heart rate. It can be induced by many different Jechniques, including meditation, yoga, tai chi, qigong, and hypnotherapy. This deep relaxation can relieve stress and its many symptoms. Spirituality is a source of relaxation and comfort for many people, whether it involves practicing a particular religion or contemplating spiritual values outside of a religious context. Support groups bring together people who are suffering from the same disease or similar types of trauma. Within the group, they can share experiences and feelings, which may yield great psychological benefits and per-haps improve the functioning of their natural bodily defenses as well. Yoga is a series of body positions and movements developed over thousands of years to calm the mind, relax the body, and ease the spirit. Meditation and breathing exercises lead into cycles of stretches and poses that may vary from session to session. Yoga can be learned and practiced at home; however, modified movements may be required during pregnancy or if a person has a condition such as heart disease. A yoga specialist can recommend the appropriate adjustments. Naturopathic Medicine Naturopathic medicine provides holistic, or whole body, healthcare by taking advantage of resources drawn from numerous traditional healing systems. Dating back to the early part of the 20th century, naturopathy is organized around three fundamental principles: The physician should strive to aid the bodys natural healing abilities; the root cause of an illness should be addressed rather than its symptoms; and above all, only therapies that cause no harm should be used (which means that toxic drugs and surgery are avoided whenever possible). A naturopathic doctor, or ND, may pay considerable attention to a patients lifestyle, since naturopathic theory holds that physical, psychological, and even spiritual elements can all contribute to disease. I n treating patients, the naturopathic practitioner may use a number of alternative therapies, including homeopathy, herbal remedies, traditional Chinese medicine, spinal manipulation, nutrition, hydrotherapy, massage, and exercise. Doctors of naturopathy train at accredited four-year naturopathic medical schools. The first two years include many of the same core science classes as regular medical schools, while the final two years focus on training in natural healing techniques. At present, naturopathic doctors are licensed to practice in nine states; most other states allow them to practice in limited ways. Many private insurance plans cover naturopathic care. Nutrition and Diet Conventional and alternative practitioners alike acknowledge the importance of a healthful diet. Alternative practitioners, however, place more emphasis on dietary intervention in some conditions where conventional medicine would resort first to drugs or even surgery. Treatment of atherosclerosis, for example, may take the from of an extremely low-fat diet along with a programme of meditation, exercise, and support-group therapy. Some diets, such as traditional Japanese and Mediterranean ones, contain small amounts of animal fat. Because they are low in saturated fats, these diets appear to protect against heart disease and some forms of cancer. Vegetarian diets have been shown to lower blood pressure and reduce the risk of cardiovascular disease and some cancers. Particular foods may be beneficial: Garlic, for example is said to reduce the levels of cholesterol in the bloodstream and protect against some forms of cancer. Vitamins and mineral supplements figure in the dietary recommendations of many therapies. Although some vitamins, such as A and 0, are fat-soluble and can reach toxic levels in the body if not carefully monitored, others, like vitamin C, are water-soluble and are not stored; any bodily excess is usually excreted. Generally, vitamins and minerals are recommended for daily use as a preventive measure. They often come in tablet form, and doses are measured by weight in milligrams (mg), or thousandths of a gram; in micrograms (mcg), or millionths of a gram; or in a universal standard known as international units (IU). Orthomolecular medicine, a form of nutrient therapy, uses combinations of vitamins, minerals, and amino acids normally found in the body to treat specific conditions, such as asthma, heart disease, depression, and schizophrenia. Such therapy can also be used to maintain general good health. Osteopathy Osteopathy focuses on correcting structural problems in the musculoskeletal system to improve overall bodily functioning. To restore structural balance and thus help a patient regain health, an osteopathic physician will combine manipulation of the joints, physical therapy, and instruction in proper posture. Because osteopathic care is holistic, or targeted at the whole body, the doctor also considers psychological factors, lifestyle, and diet in addressing an illness and maintaining health. Ever since it was founded by an American doctor named Andrew Taylor Still in the late 19th century, osteopathy has blended all aspects of conventional medicine with its central tenets of the importance of the bodys structure and its predisposition toward health over illness. Doctors of osteopathy, or DOs, train at their own four-year medical colleges and can enter either MD or DO residency programs. They are licensed to practice in all 50 states, and can prescribe drugs, perform surgery, and further specialize in any of the medical subspecialties, such as cardiology, neurology, or obstetrics and gynecology. Apart from the emphasis they place on musculoskeletal function and alignment (an emphasis that can vary from doctor to doctor), most osteopathic physicians practice much like conventional medical doctors.