|Year : 2017 | Volume
| Issue : 2 | Page : 63-64
Editorial message for IJMD volume 7 issue 2, July–December 2017
K M K Masthan
Department of Oral Pathology, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
|Date of Web Publication||28-Dec-2017|
K M K Masthan
Department of Oral Pathology, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Masthan K M. Editorial message for IJMD volume 7 issue 2, July–December 2017. Indian J Multidiscip Dent 2017;7:63-4
This editorial is unique since the topic I have chosen to discuss is complementary and alternative medicine (CAM), once perceived by me as unscientific and unreliable, but, now I consider as evidence-based medicine. The change in my attitude was not sudden, but gradual over a period of several years of seeing many patients, who were given CAM by alternate medical practitioners, recover or undergo remission of symptoms of their health issues, and lead normal lives. The popular Textbook of Internal Medicine Harrison's has exclusively allotted a chapter for CAM, and the most widely sold health book series Mayo Clinic on different diseases has come out with a separate book on this topic and has also managed to include a chapter on CAM in each of their book. “If a man will begin with certainties, he shall end in doubts; but if he will be content to begin with doubts, he shall end in certainties,” a quote by Francis Bacon in his popular oration – the advancement of learning.... holds good for revising the obstinate attitude of mainstream medical practitioners toward CAM. The benefits patients gain physically, mentally, and financially is the major supportive argument for CAM. I feel that the true benefit to the society will be reached if and only if the module of theory, hypothesis, research, animal studies, and endless number of double-blind human trials on CAM drugs and practices are done, documented, and the favourable results inducted into modern medicine. One argument by the present mainstream medical community is that CAM practitioners are more assertive. To this valid point, I put forth what was told by Charles Darwin in his discourse, The Descent of Man “Ignorance more frequently begets confidence than does knowledge: it is those who know little, not those who know much, who so positively assert that this or that problem will never be solved by science.” Their assertiveness genuinely stems from their desire to convince the common man to accept and use the medicines they advise and to a certain extent, to enhance marketing their products. But, this should not be the reason for the mainstream medicine to shun and shy away from CAM. Instead, an analytical approach and a helpful attitude to determine the correct dosage and identify the contraindications will lay the foundation to adopt CAM into health care.
If we go through the successive editions of any medical textbook, we realize that the once accepted and popular modes of treatment and drugs get considered as obsolete and downright and wrong and unethical within a span of two or three decades. If such is the radical revision of ideas, is it not right to assume that the patients of that period were receiving the wrong treatment in the hands of the best medical professionals? Were there AIDS patients before the 1980s or did we simply not know enough to diagnose those cases? I raise these questions not to defend CAM, but to show that persistence and bigotry are not virtues and not the robust attitude of a progressive science. Bertrand Russell once observed that “In all affairs it's a healthy thing now and then to hang a question mark on the things you have long taken for granted.”.... This summarizes best what I want to convey.
CAM is always viewed with doubt and is often dismissed as not plausible by the mainstream medical personnel. I have left this camp and am standing in the gray area, what they call as no man's land. I consider CAM as unconventional, though they are actually traditional and I may not win any argument with my learned colleagues, since I do not know enough to defend my stand and only that I have seen enough and more number of cured/remission achieved patients to adopt this view. When I interacted with a patient who had miraculous relief of symptoms from his prostate hyperplasia after eating Saw Palmetto (Palm fruits), I wondered whether this particular freely available fruit was ever taken up for double-blind study, ICMR clearance, etc.
Thinking laterally, at any particular period and place, what resources are available, what the technology can offer, and what skilled workforce is available within the financial reach of a patient always decide the outcome of the treatment, whether medical or surgical. Among the headings, CAM will definitely factor in and when you consider the financial reach, the traditional CAM will definitely fit in with what the patient can afford. If such is the status of CAM in medical care, whether the physicians like it or not, patient will definitely opt for it. Immigration and internet have played a major role in making CAM of one region available to the rest of the world.
Special diets, vitamins, minerals, and extracts of animal or plant products constitute the major share of CAM that reach patients. The downside of the product promotion is the exploitation by confidence tricksters, greedy corporates, and highly efficient and ruthless marketing people targeting the anxiety and suffering of the naive patients.
There are other CAMs, for example, biofeedback, meditation, massage, and music therapy which target the mind and solace of the patients. These practices are time tested and have been in use for centuries. They may or may not extend the life of the patients, but definitely improve the quality of their life.
Acupuncture, Ayurveda, Siddha, Unani, and Yoga are other alternative disciplines that have huge popularity. Many of their advocated medicines are highly result oriented and so, it is no wonder that patients flock the outpatient departments of AYUSH and other such disciplines. My humble suggestion for those practitioners is that their dosage system needs to focus on the age, weight, preexisting medical conditions, etc., since I have seen the same dose being given for all patients alike.
Some patients drift toward CAMs mainly to avoid the surgical procedures that the regular medicine offer, exorbitant cost of modern medicine, and apathy of the treating physician. There are some patients who feel chronic diseases such as skin diseases, cancers are less amenable to modern medicine, and only acute conditions get relieved by allopathy and they also drift toward CAMs.
In this context, it is worth mentioning about osteopathy and chiropractic medicine which were originally CAM and in due course, because they were in resonance with the regular medicine and also because of the untiring efforts of a few legendary practitioners of those disciplines, they got absorbed into modern medicine. My hope and expectation is that other disciplines of CAM should also follow their footsteps and weed out unscientific ideas of their respective disciplines and integrate their useful ideas. This will pave the way for a patient, wherever he/she maybe, to receive the best of the available medical care.
Through this editorial, I have shared a few aspects of the CAMs that I gathered from Harrison's textbook of medicine and internet. As to whether I am justified in bringing up this topic in this forum of multidisciplinary dentistry, only readers can tell. Probably, what Walter Lippmann told, quoted below, inspired me to take up this unusual 'topic for' discussion.
“F or the most part we do not first see, and then define, we define first and then see.”
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