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  1. E Ernst,
  2. A Fugh-Berman
  1. Correspondence to:
 Professor Edzard Ernst, Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, 25 Victoria Park Road, Exeter EX2 4NT, UK;

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Long a source of primary care in most countries, complementary/alternative medicine (CAM) has recently become a focus of interest in industrialised nations.1,2 Terms often used synonymously reflect conflicting perspectives. Proponents may prefer the terms holistic, natural, non-toxic, integrative, médecine douce (gentle medicine); opponents employ the words unproven, unscientific, fringe, non-traditional, or “Auβenseitermedizin” (outsiders' medicine). Perhaps the most neutral terms are “practiques paralleles” (parallel practices), unconventional, or complementary medicine. “Alternative medicine” is more widely used in the USA (it is also the term employed by Medline), “complementary medicine” in the UK. We consider the latter most accurate but bow to the current convention of referring to CAM.

The aim of this article is to provide a short general introduction to CAM. It is written predominantly with occupational and environmental healthcare professionals in mind; its aim is to familiarise them with this increasingly important topic.


Complementary therapies seem to have little in common other than their exclusion from the mainstream. Many supporters are convinced of the superiority and universal applicability of their treatment. CAM encompasses primary care systems of medicine (including traditional Chinese medicine and Ayurvedic medicine, which have unique diagnostic criteria and diverse therapeutic options), discrete therapies (shark cartilage, bee pollen, ozone therapy, etc) and almost everything in between. Besides comprising over 150 treatment modalities,3 CAM also embraces a large variety of diagnostic methods.4 A positive definition, describing CAM by what it is rather than by what it is not, has recently been adopted by the Cochrane Collaboration: CAM is diagnosis, treatment and/or prevention which complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine.4


Both in Europe5 and the USA6 CAM has enjoyed periods of popularity only to …

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