INTRODUCTION

Complementary and alternative medicines describe a broad range of healing philosophies,

approaches, and therapies that focus on the whole person, including bio-psychosocial and
spiritual aspects. People have become more active in their health care, and often seek CAM
therapies. In an effort to promote primary health care, the World Health organization (WHO)
recommended in 1978 that traditional (Alternative) medicine can be promoted, developed and
integrated wherever possible with modern, scientific medicine, stressing the necessity to
ensure respect, recognition and collaboration among the practitioners of the various system
concerned.

The 2007 Centres for Disease Control and Prevention survey found the following (Barnes et
al, 2008; Nahin et al, 2009):

 38% of adult and 12% of children in U.S had used some time of CAM therapy in the
pass 12month.
 Compared to 2002, in 2007 individual reported using more acupuncture, deep
breathing, massage, meditation, naturopathy and yoga.
 In 2007, people in the United State spent nearly 34 billion out-of-pocket dollars for
CAM therapies, one third of which were for visits to CAM practitioners.

DEFINITION

The National Centre for Complementary and Alternative Medicine (CAM) defines
Complementary and Alternative Medicine as a group of diverse medical and healthcare
systems, practices and products that are not presently considered to be part of conventional
medicine.

Complimentary therapies are those used in conjunction with conventional medical practice.
Alternative therapies are those that are used instead of conventional medicine.

PRINCIPLES UNDERLYING ALTERNATIVE HEALING

In 1999, Eliopoulos identified FIVE basic principles underlying CAM:

1. The body has the ability to heal itself

2. Health and healing are related to a harmony of body and spirit.

3. Basic good health practices build the foundation for healing.

4. Healing practices are individualized.

5. The people are responsible for their own healing.

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REASONS WHY PEOPLE SEEK CAM THERAPIES:

 Wanting greater control over their lives.

 Having a sense of responsibility for their own health care.

 Wanting a more holistic orientation in health care.

 Concern over the side effects of conventional therapies.

 Finding the result of conventional treatments to be inadequate

 A desire for cultural and philosophical congruence with personal belief about health
and illness.

 Dissatisfaction with conventional health care.

 Unwilling to ‘grin and bear’ the effects of diseases.

 The rapid pace and ease of information sharing.

CAM’s SAFELY

DO’s DON’Ts

Choose a recognised practitioner who is a Take high doses of supplements unless

member of a recognised society confirmed with an experience health
professional.

Informed the professional involved in the Take complementary medicines without

care, including the CAM practitioner about knowing what they are for.
all the treatments and all the medication.
Take somebody else’s complementary
medicine.

Tell them if pregnant or plan to become or Stop conventional medicines without telling
breastfeed. the doctor

Seek medical advice incase of any unusual Give remedies to children without seeking
symptoms or experience. specialist advised.

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Informed them about the physical health and Take remedies from an unreliable sources
allergies. -this includes internet- eat or drink raw
materials such as flower, roots seeds etc.
Fine a reliable source for information about
the therapies.

MAJOR DOMAINS OF COMPLIMENTARY AND ALTERNATIVE

MEDICINE:

DOMAIN DESCRIPTION EXAMPLES

Alternative medical systems Complete system of theory Acupuncture

and practice that have
evolved independently of, Ayurveda
and often before, the
Homeopathy
conventional biomedical
approach. Naturopathy

Mind-body intervention Employed a variety of Meditation, relaxation,

techniques designed to hypnosis, art, music $ dance
facilitate the mind’s capacity therapy, prayer, imagery,
to affect body function and biofeedback, body-mind,
symptom spiritual intervention

Biological based therapy Natural and biological based Herbal therapies,

practices, interventions and aromatherapy, special diet
products many of which therapies, mega doses of
overlap with conventional vitamins or minerals
medicine’s use of dietary
supplements.

Manipulative and body- Methods based on Chiropractic, massage and

based methods manipulative and/or body work, yoga, Ta Chi,
movement of the body

Energy therapies Focus on either energy fields Therapeutic touch,

believed to originate within Reflexology, electromagnetic
the body(bio fields) or those therapy, light therapy
emanating from other sources

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 (electromagnetic fields)

Traditional alternative medicine includes:

 Acupuncture

 Ayurveda

 Homeopathy

 Naturopathy

 Chinese or Oriental medicine

Many different areas make up the practice of complementary and alternative medicine
(CAM). In addition, many parts of one field may overlap with the parts of another field. For
example, acupuncture is also used in conventional medicine. In the U.S., CAM is used by
about 38% of adults and 12% of children. Examples of CAM include:

Traditional alternative medicine. This field includes the more mainstream and accepted forms
of therapy, such as acupuncture, homeopathy, and Oriental practices. These therapies have
been practiced for centuries worldwide. Traditional alternative medicine may include:

ACUPUNCTURE:

Acupuncture dates back to 3000 BC in china. It is based on the belief that health is
determined by a balance of energy flow or Qi, which puts one in harmony with the universe.

Disease occurs with an imbalance of these forces and manifests as excesses or deficiencies of
basic life energy in the particular organs. If the energy balance is not restored, then physical
changes occur and disease becomes present in the body.

Acupuncture helps correct and rebalance the energy flow and consequently relieves pain and
restores health. The needles draw energy away from organs with excess and redirect it to
organs with deficiencies. Treatment consist of practitioner inserting stainless steel needles
into the acu-points just under the skin and leaving them in place from a few minutes to more
than an hour.

The benefits of acupuncture include:

 Improvement of micro circulation

 Relaxation of muscles
 Release of endorphins encephalin, serotonin and adrenocorticotropic hormone
 Activation of B and T-lymphocytes

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  Improvement in the complete blood cell
 Relief of pressure and pain.
 Balancing the body to attain lasting good physical as well as mental health.

Recent studies suggest that acupuncture may aid in the treatment of cocaine dependence and
chronic daily headaches.

LIMITATION

Acupuncture is considered a safe therapy when the practitioner has been trained and uses
sterilized needles. The complications includes-Infection, Broken needle, puncture of an
internal organ, Bleeding, Fainting and Seizure etc.

CONRAINDICATION

 Person with bleeding disorders Thrombocytopenia, Skin infection

 Semi-permanent needles should not be used in a person with vascular heart disease
because of the risk of infection.
 Electro acupuncture should avoid in person with a pacemaker, epilepsy or in
pregnancy.

CONDITIONS TREATED BY ACUPUNCTURE

Migraines and tension, headaches, sinusitis, common cold addictions, quit smoking Meniere's
disease, arthritis, menstrual cramps, asthma, weight loss, infertility.

ACUPRESSURE:

The acupressure is a healing techniques based on the ancient philosophies of traditional

Chinese medicine. In acupressure, the fingers, thumbs, palms, or elbows are used to apply
pressure to the acupoints. This pressure is thought to dissolve any obstruction in the flow of
healing energy and to restore the body into a healthier functioning.

Advantage of acupressure

 Relief of tension.
 Improvement in the circulation of blood.
 Relief of pain
 Balancing the body to attain lasting good physical as well as mental health

Disadvantages of acupressure:

 An untrained person performing the treatment may tend to apply the pressure too
abruptly or may use too much force during the treatment- which could lead to
discomfort and even bruising.

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  Certain pressure points like those near the armpits, groin, abdomen or throat require a
greater amount of car because of the pain that they could cause if damage to certain
extends.

ARYUVEDA

Ayurveda is a traditional medical system of India, originating more than 4,000 years ago.
Ayurveda aims to integrate the body, mind and spirit (holistic). This balance is believed to
lead to contentment and health, and to help prevent illness. It is based on theory that illness
result from the imbalance of the body’s life force, or prana. The balancing of this life force is
determined by the equilibrium of three bodily qualities, called dohas: vata, pitta and kapha.

VATA DOSHA: The vatadosha is a combination of space and air. It controls movement and
is responsible for basic body processes such as breathing, cell division and circulation. Vata
body areas are the large intestine, pelvis, bones, skin, ears, and thighs. People with vataas
their main dosha are believed to be quick-thinking, thin, and fast, and are susceptible to
anxiety, dry skin, and constipation.

KAPHA DOSHA: The kapha dosha represents the elements of water and earth. Kapha is
believed to be responsible for strength, immunity, and growth. Kapha body areas are the
chest, lungs, and spinal fluid. People with kapha as their main dosha are thought to be calm,
have a solid body frame, and are susceptible to diabetes, obesity, sinus congestion, and
gallbladder problems.

PITTA DOSHA: The pitta dosha combines fire and water. It is thought to control hormones
and the digestive system. Pitta body areas are the small intestines, stomach, sweat glands,
skin, blood, and eyes. People with pitta as their primary dosha are thought to have a fiery
personality, oily skin, and are susceptible to heart disease, stomach ulcers, inflammation,
heartburn, and arthritis.

Ayurveda uses the diet, herb, massage, yoga, internal cleansing and lifestyle adjustments to
harmonize body, mind and spirit. Ayurveda seeks to remove the root cause of mental illness
in a holistic way. Ayurveda mental hospital used panchakarma to treat all kind of mental
illnesses. Ayurveda is a natural antidote to disease as well as powerful healer for stress. It can
be applied to wide range of emotional and mental issues like depression, bipolar disorders,
fear, anxiety, addictions and schizophrenia

HOMEOPATHIC MEDICINE

This medical system originated in Europe. Homeopathy seeks to stimulate the body’s ability
to heal itself by giving very small doses of highly diluted substances that in larger doses
could produce illness or symptoms ( an approach called ‘like cures like’). Homeopaths
believe that their remedies mobilize the body’s vital force to orchestrate co-ordinated healing
reponses throughout the body system. The body translates the information on the vital force

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into local physical changes that lead to recovery from acute and chronic diseases. A nurse
should know that remedies can be counteracted by strong chemicals, herbs and certain drugs.

CLINICAL APPLICATION OF HOMEOPATHY:

Diarrhea, Migraines, Motion sickness, flu.

How homeopathy works:

Homeopathy is based on rigorous dilutions and mixing, called successions. The dilution level
is printed on the bottle of medicine. A typical homeopathic dilution is 30X, where the X
represents 10. So, one part toxin (such as the aforementioned poison ivy) is mixed with 10
parts water or alcohol. The mix is shaken; one part of this mix is added to 10 parts of water or
alcohol again; and the whole process is repeated 30 times. 

The final dilution is one molecule of medicine in 10 to the 30th power (1030) of molecules of
solution — or 1 in a million trillion trillion. At this dilution level you'd need to drink 8,000
gallons of water to get one molecule of the medicine — physically possible but implausible. 

Other homeopathic solutions are 30C, which represents 100 to the 30th power (10030). 
There's not enough water in the solar system to accommodate this dilution.

Hahnemann didn't realize this because he developed his theory before the concept in
chemistry of the mole and Avogadro constant, which defines the number of particles in any
given amount of a substance. So, Hahnemann and his followers could do the mechanical
actions of dilution, but unbeknownst to them, they were diluting the medicine right out of the
solution.

Dangers of homeopathy:

 In some cases, the homeopathic medicine does contain traceable amounts of the

original medicinal substance. Consider the case of Zicam, a homeopathic cold
remedy pulled from the market in 2009 after reports of users permanently losing their
sense of smell. 
 Zicam is 2X, making it a 1-percent solution. A dose of Zicam contains more than 100
microliters of solution, and 1 percent of that is zinc gluconate.
 Zinc substances have been known for decades to cause hyposmia, a reduced ability to
smell, and anosmia, a loss of smell. In regards to zinc gluconate, a study published in
2009 in PLoS ONE summed it up with the damning title "Zicam-Induced Damage to
Mouse and Human Nasal Tissue." A 2010 study in the journal Archives of
 Otorhinolaryngology Head and Neck Surgery concluded "clinical, biological and
experimental data … demonstrate that intranasal zinc gluconate therapy causes
hyposmia and anosmia."

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  Similarly, in 2010, the Japanese government began investigating deaths of
babies resulting from homeopathic treatment instead of real medicine. Deaths
included babies born with a vitamin K deficiency, whose mothers' midwives
administered a homeopathic treatment instead of the much-needed vitamin K
injection, well known to prevent hemorrhaging. The infants died from bleeding in the
skull.

LIMITATION OF HOMEOPATHY:

A surgical problem which has progressed far beyond its initial stages might not respond to
homoeopathy.

2. Some sudden life threatening situations like heart attacks, paralytic strokes, diabetic comas
etc. might have to be initially treated with allopathy, till the patient is out of danger.

3. It is relatively slow acting as compared to the steroids.

4. The success rate is not 100%

NATUROPATHY:

Naturopathy focuses on self-healing and health-care is tailored to the individual needs. The
physician’s primary role is that of a teacher establishing and maintaining an optimum health
and balance, treatment of whole person, prevention of disease through a healthy lifestyle and
therapeutic used of nutrition

 Naturopathy uses body's natural healing abilities in prevention and treatment of

disease through a healthy lifestyle.

 It builds immunity, improves mental health, and enhances body functions.

 Naturopathy mainly focuses on finding the cause of the disease rather than merely
treating the symptoms of disease.

 It uses diet, homeopathy, hydrotherapy, herbal medicine, and other therapies to return
the body to a state where it can heal itself.

MIND BODY INTERVENTIONS

Mind-body medicine uses a variety of techniques designed to enhance the mind's capacity to
affect bodily function and symptoms. Some techniques that were considered alternative in the
past have become main stream (for example, patient support groups and cognitive-behavioral
therapy)

MEDITATION:

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 Meditation was used routinely in ancient Syria, India, Japan and monasteries of Europe.
Meditation is a kind of self-discipline that helps one achieve inner peace and harmony by
focusing uncritically on one thing at a time. Medical meditation—a coming together of
meditation and yoga—balances and regenerates spiritual and physical energies, thus forging a
healing alliance in which the spirit nurtures body and mind.

Mindful meditation refers to focusing on physical sensations, such as movement or

breath, and on the thoughts in order to increase awareness and enhance living in the
movement to the fullest extent possible. It promotes deep states of psychological and physical
relaxation. It is beneficial for patients with depression and anxiety. Nurses can provide the
time necessary for meditation. Nurses too could benefit from meditation practice and could
experience a brief meditation during breaks from patient care activities

MENTAL IMAGERY:

It is relaxations methods in which patients are instructed to imagine them in place

associated with pleasant and relax memories. Such image allow patient to enter a relaxed
state or experience a feeling of calmness and tranquillity. The frame of reference is very
personal, based on what each individual considers being a relaxing environment. Some might
select a scene at the seashore, some might choose a mountain atmosphere, and some choose
floating through the air. The choices are as limitless as one’s imagination.

The nurse using guided imagery can promote a sense of wellbeing in patients and help
them change their perceptions about their disease, treatment and healing abilities. Nurses can
assist patients with imagery during a painful and stressful event.

BIOFEEDBACK:

Biofeedback is based on idea that the autonomic nervous system can come under
voluntary control through operant conditioning. Biofeedback is used of instrumentation to
become aware of processes in the body that usually go unnoticed and to help bring them
under voluntary control. Biological conditions, such as muscles tension, skin surface
temperature, blood pressure and heart rate are monitored by biofeedback equipment. People
learn to control these functions by hearing or seeing signals from instruments. With special
training, the individual learn to use relaxation and voluntary control to modify the biological
condition, in turn indicating a modification of the autonomic function it represents.

Indication : Biofeedback is being employed in migraine, hypertension, phobias, low

backache, cerebral palsy, upper motor neuron hemiplegia, irritable bowel syndrome, cardiac
problems and several others neuro-psychiatric problems.

HYPNOSIS:

Hypnosis is an artificially induced state in which the person is relaxed and usually and
suggestible. The relaxation is guided by a therapist. Hypnosis is a means for entering an

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altered system of consciousness and in this state using visualization and suggestion to bring
about desired changes in behaviour and thinking. Hypnosis can be induced in many ways
such as by using a fixed point for attention, rhythmic monotonous instructions, etc

In hypnotherapy, relaxation is guided by a therapist who has been trained in techniques of

trance formation and who then ask certain questions of the patient or uses guided imagery to
help picture the situation in an effort to find the cause of the problem. At the end of the
session, the therapist leaves some helpful hints for the patients. These are called posthypnotic
suggestions and typically include positive, affirming statements for the patient to think about
as well as instructions to help the person accomplish self-hypnosis.

RELAXATION THERAPIES

Relaxation produces physiological effects opposite those of anxiety: slow heart rate,
increased peripheral blood flow and neuro muscular stability. There are many methods which
can be used to induce relaxation. Relaxation techniques are aimed at relaxing muscles and
quieting the mind and are mainly designed to relieve tension and strain. It is also used as an
alternative treatment for insomnia.

PROGRESSIVE MUSCULAR RELAXATION

It is the method of deep muscle relaxations which is based on the premises that the body
responds to anxiety- provoking thoughts and events with musical tension. Excellent results
have been observed with this method in the treatment of muscular tension, anxiety, insomnia,
depression, fatigue, irritable bowel, muscle spasms, neck and back pain, high blood pressure,
mild phobias, and stuttering.

Techniques: Muscle relaxation can be done in sitting or lying down position. Each muscle
group is tensed for 5-7 seconds, and then relaxed for 20-30 seconds, during which time the
individual concentrates on the difference in sensation between two conditions. Soft, slow
background music may facilitate relaxation.

LIMITATION:

 Individuals undergoing relaxation therapy has report fearing loss of control.

 Feeling that they are floating and experiencing relaxation induced anxiety related to
thesis feeling
 Occasional relaxation techniques may result in continued intensification of symptoms.

ART, MUSIC AND DANCE THERAPY

Art therapy helps the patient express his thoughts, emotion and feelings through his drawings.
Music therapy is the systemic application of music in a therapeutic environment to bring
about the desirable changes in behaviour. Dance therapy is a psychotherapeutic use of
movement, which furthers the emotional and physical integration of the environment.

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Music therapy:

◦ Provide client with a tape recorder and headset.

◦ Ask client to select a favourite cassette of slow quiet music.

◦ Instruct client to get into a comfortable position and to close eyes and listen to music
through the headset.

◦ Instruct client to imagine floating with music

SPIRITUAL HEALING AND PRAYERS

Spiritual interventions focus on developing a sense of meaning, purpose and hope for
individuals in their current life experience. Spiritual interventions involve listening to the
person’s story and facilitating the person to connect to God, a greater power, perhaps by
using meditation or prayers. This may be a religious or non – religious experience depending
on the individual’s own spirituality.

BIOLOGICAL BASED THERAPIES

HERBAL THERAPIES:

Herbal medicine, the oldest known form of healthcare, uses plants to treat disease and
promote health. Health medicines are available as extracts (solutions obtained by steeping or
soaking a substance, usually in water), tinctures (usually alcohol-based preparations, with
alcohol acting as natural preservative), infusions (the most common method of internal herbal
preparation, usually referred to as a tea), decoctions, pills, and powders; even a moistened
cloth applied to the skin can act as a herbal remedy.

Use of herbal medicine poses many challenges and underscores the need for nurses at
every level to become knowledgeable of herbal medicine to ensure safe and effective
practice. Nurses should become familiar with contraindications and adverse effects. Nurses
should encourage patients to discuss with their healthcare provider all natural remedies that
they ingest. Some may potentiate the effects of psychotropic medications, while others may
block the effects. A few others may increase adverse side effects.

AROMATHERAPY:

Aromatherapy is concerned with the psychological, physiological and

pharmacological effects of essentials oils introduced by means of inhalation, olfaction and
dermal application. The essential oil that is used in the aromatherapy are distilled from
flowers, roots, bark, leaves, wood resins and lemon or orange rinds. When essential oil are
inhaled aromas are detected by the olfactory receptor cells in the nares. The stimuli travel
along the olfactory nerve to the brain where they are thought to play a role in emotions,
memory and variety of body functions and immune responds. Nurses should caution people

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who are considering aromatherapy to be aware that aromatic oils vary in quality, their
production is not regulated and some may be toxic when inhaled. The skin should always be
tested for allergies by applying a very small amount of diluted oil before a whole treatment is
tried. Oils should not be used near the eye and should always be diluted in suitable oil or
water before application to skin. Oil should be stored in dark colored glass bottles and kept
away from sunlight.

DIET AND NUTRITION:

The value of nutrition in the healing process has long been underrated. Good nutrition
can help with adaptation to the inevitable stresses of life by promoting a healthy body and a
feeling of wellbeing. A person’s nutritional state can protect him from or predisposes to
chronic disease. Only recently has it been discovered that nutrition influences our genetic
code.

Nutritional deficiencies often first appear in the form of mental symptoms.

Researchers believed that imbalances in the system can be regulated by nutritional
supplements. For example, depression may be caused by an amino acid imbalance or vitamin
deficiencies. The B-vitamins, omega 3 fatty acids and folic acid are helping for regulating
stress and balancing mood. Nurses must be sensitive to ethnic and cultural diets when
planning health care activities. Some of these diets may pose health risks because of a lack of
essentials ingredient or interaction with prescribed medications.

MANIPULATIVE AND BODY -BASED METHODS

CHINESE MEDICINE:

Traditional Chinese medicine (TCM) originated in ancient China and has evolved over
thousands of years. TCM practitioners use herbal medicines and various mind and body
practices, such as acupuncture and tai chi, to treat or prevent health problems. In the United
States, people use TCM primarily as a complementary health approach. This fact sheet
provides a general overview of TCM and suggests sources for additional information.

TCM encompasses many different practices, including acupuncture, moxibustion (burning

an herb above the skin to apply heat to acupuncture points), Chinese herbal medicine, tui na
(Chinese therapeutic massage), dietary therapy, and tai chi and qi gong (practices that
combine specific movements or postures, coordinated breathing, and mental focus). TCM is
rooted in the ancient philosophy of Taoism and dates back more than 2,500 years. Traditional
systems of medicine also exist in other East and South Asian countries, including Japan
(where the traditional herbal medicine is called Kampo) and Korea. Some of these systems
have been influenced by TCM and are similar to it in some ways, but each has developed
distinctive features of its own.

Side Effects and Risks

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 Herbal medicines used in TCM are sometimes marketed in the United States as
dietary supplements. The U.S. Food and Drug Administration (FDA) regulations for dietary
supplements are not the same as those for prescription or over-the-counter drugs; in general,
the regulations for dietary supplements are less stringent. For example, manufacturers don’t
have to prove to the FDA that most claims made for dietary supplements are valid; if the
product were a drug, they would have to provide proof.

 Some Chinese herbal products may be safe, but others may not be. There have been
reports of products being contaminated with drugs, toxins, or heavy metals or not
containing the listed ingredients. Some of the herbs used in Chinese medicine can interact
with drugs, can have serious side effects, or may be unsafe for people with certain medical
conditions. For example, the Chinese herb ephedra (ma huang) has been linked to serious
health complications, including heart attack and stroke. In 2004, the FDA banned the sale of
ephedra-containing dietary supplements, but the ban does not apply to TCM remedies.

 The FDA regulates acupuncture needles as medical devices and requires that the
needles be sterile, nontoxic, and labelled for single use by qualified practitioners only.
Relatively few complications from the use of acupuncture have been reported. However,
adverse effects—some of them serious—have resulted from the use of non-sterile needles or
improper delivery of acupuncture treatments.

 Tai chi and qi gong are considered to be generally safe practices.

 Information on the safety of other TCM methods is limited. Reported complications

of moxibustion include allergic reactions, burns, and infections, but how often these events
occur is not known. Both moxibustion and cupping (applying a heated cup to the skin to
create a slight suction) may mark the skin, usually temporarily. The origin of these marks
should be explained to health care providers so that they will not be mistaken for signs of
disease or physical abuse.

T’ai chi and Qi Gong

T’ai chi and Qi Gong (tie chee) sometimes defined as ‘moving meditation’ is a Chinese blend
of exercise and energy work consisting of a series of choreographed, continuous slow
movement performed with mental concentration and coordinated breathing. The purpose is to
improve circulation, balance, flow of chi, reduce stress and anxiety and restore energy and
health. Qigong is a therapeutic Chinese practice that includes gentle exercises for the breath,
body, mind and voice.

YOGA:

It is based on the ancient Indian philosophy principle of body-mind unity; a chronologically

restless or agitated mind will result in poor health and decreased mental clarity. The objective
of yoga is to integrate the physical mental and spiritual energies that enhance health and
wellbeing. Yoga uses the combination of physical postures (asanas) and breathing techniques

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(pranayamas) and meditation to promote relaxation and enhance the flows of vital energy
called prana. Yoga has been found to be especially helpful in relieving stress and in
improving overall physical and psychological wellness. Proper breathing is the major
component of yoga. It is believed that yoga breathing—a deep, diaphragmatic breathing—
increases oxygen to brain and body tissues, thereby easing stress and fatique, and boosting
energy.

It is essentials for the nurse to have based line information and awareness of yoga which is
purely Indian in origin. The yoga system advocates identification of the soul (atma) with its
final aim being union with the supreme being (paramatma). This is brought about by the
following eight steps:

1. Self control (yama), obtained by such devices as chastity, non-stealing, non-violence,

truthfulness, and avoidance of greed.
2. Religious observance (niyama), through chanting of the vedic hymns, austerity, purity
and contentment
3. Assumptions of certain positions (aasana)
4. Regulation of breath (pranayama), with controlled rhythmic exhalation, inhalation,
and temporary suspension of breathing
5. Restraint of senses (pratyahara)
6. Steadying of the mind (dharana), through fixation on some part of the body, such as
the nose or the navel
7. Meditation (dhyana), on the true object of knowledge, the supreme spirit, to the
exclusion of other things in life

Profound contemplation (Samadhi), with such complete absorption and detachment that there
is insensitivity to heat and cold, pain and pleasure

CHIROPRACTIC MEDICINE:

Chiropractic medicine is one of the most widely states. It was developed in the late in
the 1800s by a self-taught healer named David Palmer. It was later reorganized and expanded
by his son Joshua, a trained practitioner. Palmer’s objective was to find cure for disease and
illness that did not use drugs, but instead relied on more natural methods of healing.

Palmer’s theory behind chiropractic medicine was that energy flows from the brain to all
parts of the body through spinal cord and spinal nerves. When vertebrae of the spinal column
become displaced, they may press on a nerve and interfere with the normal nerve
transmission. Palmer names the displacement of these vertebrae subluxation, and he alleged
that the way to restore normal function was to manipulate the vertebrae back into their
normal positions. These manipulations are called adjustments.

Adjustments are usually performed by hand, although some chiropractors have special
treatment tables equipped to facilitate these manipulations. Other processes used to facilitate

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the outcome of the spinal adjustment by providing muscle relaxation include massage tables,
application of heat or cold, and ultrasounds treatment.

The chiropractor takes a medical history and performs a clinical examination, which
usually includes x-ray films of the spine. Today’s chiropractors may practice ‘straight’
therapy, that is, the only therapy provided is that of subluxation adjustments. ‘Mixer’ is the
termed applied to a chiropractor who combines adjustments with adjunct therapies, such as
exercise, heat treatments, or massage.

Individuals seek treatment from chiropractors for many types of ailments and illness;
the most common is back pain. In addition, chiropractors treat clients with headaches, neck
injuries, scoliosis, carpel tunnel syndrome, respiratory and gastro-intestinal disorders,
menstrual difficulties, allergies, sinusitis, and certain sports injuries.

Chiropractors are licensed to practice in all 50 states, and treatment costs are covered by
government and most private insurance plans

MASSAGE

Massage is a systematic and scientific manipulation of the soft tissue of the body, first noted
in the Verdict literature of India in 8000 BC.

The eastern style of massage focuses on balancing the body’s vital energy as it flows through
pathways, as described earlier in acupressure and acupuncture. The western style of massage
affects muscles, connective tissue and the cardiovascular system.

Alleged benefits include decreased stress and anxiety; enhance body-mind connection for
greater mental clarity, energy and performance; performance of vitality; personal growth and
emotional release. Massage also has a sedative effect on the nervous system, promotes
voluntary muscle relaxation and improves self-image through reorganized poster.

Nurses have traditional used massage to ease a patient’s discomfort and to develop a
connection with the patient. Increasing numbers of nurses focus on this CAM modalities as
licensed massage therapists in private practice and are affiliated with the American massage
therapy association (AMTA)

ENERGY THERAPIES

Biofield therapies are intended to affect energy fields that purportedly surround and penetrate
the human body. The existence of such fields has not yet been scientifically proven. Some
forms of energy therapy manipulate biofields by applying pressure and/or manipulating the
body by placing the hands in, or through, these fields

BIOFIELD THERAPIES

 Therapeutic touch:

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Therapeutic touch was developed in the 1970’s by Dolores Krieger, a nurse associated with
the New York university school of nursing. It is based on the philosophy that the human body
projects a field of energy. When this field becomes blocked, pain or illness occurs.
Therapeutic touch (TT) is a process by which practitioners believed that they can transmit
energy to a person who is ill or injured to potentiate the healing process.

It is derived from religious philosophies principle “laying on of hands”, which may also
involve the healer passing hands over the body without actually touching it, to detect energy
imbalance and redirect them through the energy of the therapist.

The therapist hands are passed over the client’s body, remaining 2-4 inches from the skin.
The goal is to re-pattern the energy field by performing slow, rhythmic, sweeping hand
motions over the entire body. Heat should be felt where the energy is blocked. The therapist
massages the energy field in that area, smoothing it out, and thus correcting the obstruction.
Therapeutic touch is thought to reduce pain and anxiety and promote relaxation and health
maintenance. It has proved to be useful in treatment of chronic health conditions.

 Reflexology:

People in India and China in 5000 BC and Egypt in 2330 BC recorded the use of reflexology.
Reflexology involves massaging specific areas of the hands or feet to relieve stress or pain in
the corresponding related areas of the body. It is based on the premise that pressure to
specific part of the feet, hands and ears can create physiologic changes and promote overall
wellbeing. The main goal is to provide relaxation by removing tension in a zone area.

It is believed that foot reflexology, like other massages of the feet, can stimulate relaxation,
which affects the autonomic response, which in turn affects the endocrine and immune
systems and neuropeptides. Nurses need to instruct the patient to consult experienced
reflexologist when he/she has circulatory disorders of the extremities.

 Bioelectromagnetic based therapies:

Bioelectromagnetic therapy involves the use of magnetic fields in the prevention and
treatment of disease. Magnetic field therapy uses two methods—static and pulsed. The static
method involves placing magnets in the belts, shoe inserts and mattresses for 2 to 24 hrs. The
pulses method involves using a machine to direct alternating electromagnetic fields. Nurses
should caution patients with pacemakers, defibrillators on other metallic parts in their bodies
that they should avoid using magnets or magnetic bodies.

 Light therapy:

Light therapy, sometimes called phototherapy, involves exposing the patient to an artificial
light source during winter months to relieve seasonal depression. The light source must be
very bright, full spectrum light, usually 2,500 lux.

Indications: bulimia, sleep maintenance insomnia, seasonal depression

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Adverse effects: nausea, eye irritation and headache

Contraindications: glaucoma, cataract, use of photosensitizing medications

Nurse’s role: the patient is instructed to sit in front of the light at a distance of about 3 feet,
engaging in a variety of other activities, but glancing directly into the light every few
minutes. The duration of administration is 1-2 hours daily

 Pet therapy:

The therapeutic value of pets is no longer just theory. Evidence has shown that animals can
directly influence a person’s mental and physical well-being, many pet-therapy programs
have been established across the country and the numbers are increasing regularly.

Several studies have provided information about the positive results of human interaction
with pets. Some of these include:

a) Petting a dog or cat has been shown to lower blood pressure

b) Bringing a pet into a nursing home or other institution for the elderly has been shown
to enhance a client’s mood and social interaction.
c) Individuals with AIDS who have pets are less likely to suffer from depression than
people with AIDS who don’t own pets

Some researchers believe that animals actually may retard the aging process among those
who live alone. Loneliness often results in premature death, and having apet mitigates the
effects of loneliness and isolation

Pets provide unconditional, non-judgemental love and affection, which can be perfect
antidote for a depressed mood or a stressful situation.

SIDDHA

The siddha is one of the oldest systems of medicine in India. The term siddha implies
achievement. It was practiced by “sidharas” who aimed to maintain perfect health in order to
achieve sidhi or heavenly bliss. Siddha system believes to be evolving in Tamil Nadu.

The basic philosophy is that there is an intimate link between man and environment. It
believes that all objects in the universe including human body are composed of 5 elements—
earth, water, fire, air, and space or ether. The food we eat and the drugs which are in use are
also made up of these elements.

The diagnosis of disease involves identifying its cause. Causative factors are
identified by examination of pulse, eyes, color of body, tongue, status of digestive system,
urine and study of voice. The treatment of siddha system is not only oriented to disease but
also it takes into account patient as a whole—age, sex, habits, mental frame, diet, appetite,

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physical conditions, physiological constitution, his habit, environment, meteorological
conditions.

Thus the treatment is individualized according to the diagnosis in totality. Siddha medicine
make used of mercury, silver, arsenic, lead, sulphur, etc.

UNANI

The Unani system of Medicine has its origin in Greece before Christ under the
patronage of Hippocrates and Galen. It was introduced in India around the eleventh century
by the Arabs and Persians. Theunani system of medicine is not only therapeutic in nature but
also deals with health promotion and preventions of disease. It treats diseases and provides
remedies in a systematic manner. Based on 4 hormones theory of Hippocrates, that is blood,
phlegm, yellow bile and black bile; blood is hot and moist; phlegm is cold and moist; yellow
bile is hot and dry and black bile is cold and dry. Any changes in the harmones brings about
change in temperament of a person affecting his health status.

The diagnosis is done by feeling pulse, observation of urine, stool, color of skin, gait
etc. the treatment comprise of three components namely preventive, promotive and curative.
It seeks the restoration of a body as a whole to its original state.For prevention of diseases
and promotion of health, the Unani system of medicine lays emphasis on developing defense
mechanism of the body and advocates 6 essentials. These essentials are exercise and rest,
psychic movement and rest, sleep, wakefulness, evacuation and retention. Unani practitioners
recommend immunization against diseases, precaution in maintaining a balance in diets and
general health habits.

COMPLIMENTARY AND ALTERNATIVE THERAPIES: AN INDIAN

PERSPECTIVE:

 The Indian system of medicine and homeopathy consist of ayurveda, sidha, unani and
homeotherapy and therapies such as yoga and naturopathy
 The central government of India created the department of the ISM&H in1995 to
provide focused attention for development and optimal utilization of ISM&H for the
health care of the population.
 18 states also have separate directorates of ISM&H
 There are at present 22,735 dispensaries which provide primary health care services
 The central council for research in ayurveda and siddha has set up advanced centre for
ayurveda in mental health and neuro sciences in NIMHANS in 1971

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 RESEARCH

1. Effects of acupuncture therapy on insomnia

Sok SR, Erlen JA, Kim KB

Abstract

Background: Acupuncture therapy, commonly used in clinical practice in oriental cultures,

has the potential to produce a positive effect with patients experiencing insomnia

Aim: The purpose of this systematic review were:1) to assess the trends across intervention
studies using acupuncture for insomnia from 1975-2002; 2) to examine dependent variables;
3) to evaluate the effect of acupuncture therapy on insomnia in elderly people.

Methods: data was collected from November 2001 to January 2003. A systematic review was
done on different studies using acupuncture therapy to treat insomnia. Eleven reports meet
these criteria.

Findings: Most of the studies had been conducted since 1990. The findings show that the
author was usually a chinese medical doctor (n=9) employed in a traditional department.
Most of the papers were published in two journals. The studies have small samples which
were composed mainly of older women who had a variable duration of insomnia from 3 days
to 34 years. The main method used to assess outcomes was questionnaire. All the studies
reported statistically significant positive result.

Conclusion

The results of this review suggest that acupuncture may be an effective intervention for the
relief of insomnia. Further research, using a randomized clinical trial design, are necessary to
determine the effectiveness of acupuncture. More work is also needed to promote he long-
term therapeutic effects of acupuncture and to compare it with other therapies for insomnia.

2. Evidence-based practice and reviews of therapeutic touch.

O’MathunaDP.

Abstract

Purpose: To present principles for accurately representing research for evidence-based

practice and health care policies, and to evaluate how original research results indicated
adherence to those principles in literature reviews of therapeutic touch.

Organizing constructs: Critical thinking and scientific integrity.

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Sources: Reviews of therapeutic touch literature published in nursing journals between1994
and 1998 and the research studies cited in those reviews.

Methods: Statements made in reviews about the efficacy of therapeutic touch were compared
with the results and conclusion of the research cited. General conclusions reported in reviews
were evaluated against a broad range of therapeutic touch research studies, including many
not cited in reviews. How accurately reviewers represented the research studies were
evaluated by comparing reviewers’ conclusions with those of the researchers. Findings were
organized into the principles to guide evidence-based reviews.

Findings: Literature reviews about the therapeutic touch often cited only research with
favourable findings. When citing studies with contradictory findings, only the favourable
findings were usually mentioned. In many reviews, research cited as indicating the efficacy
of the therapeutic touch indicated it was ineffective. Every review examined had at least one
significant mistake concerning how research studies were represented.

Conclusions: Accurate presentation of original research results is needed to make evidence-

based decisions and to ensure that limited health care resources are used effectively and
safely. Evidence-based principles should be followed in reviewing therapies and practices,
including alternative therapies.

CONCLUSION:

Complementary and alternative medicine offers nurses the potential for innovative practice
models. Advanced preparation or certification in a specific modalities enables nurses to offer
a wider range of services to patient in traditional care settings. This new skills also enable
nurses to establish private practices in which patients directly contact nurses for specific
therapies. Well designed CAM research studies in mental health and psychiatric disorder are
beginning to provide empirical evidence for practice. Nurses must continue to inform
themselves of research findings related to CAM because nurses play an important role in
educating consumers about the evidence supporting these new therapies, as well as the
dangers involving in using some of the.

Ethical concerns include issues of safety and effectiveness, the expertise and
qualifications of the practitioner, and communicating the use of CAM therapies to the
traditional health care provider.

BIBLIOGRAPHY

1. Use of complementary and alternative medicines [internet]. Available from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3058881/
2. Park K “Textbook of Preventive and Social Medicine”, 24 th edition, M/s Banarsidas
Bhanot Publishers 1167, Prem Nagar, Jabalpur, 482001 (M.P.) India.
3. Gulani KK “Community Health Nursing Principles and Practices”2 nd edition, Kumar
Publishing House, Delhi-110034 (India).

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4. www.asm.com

RESEARCH

 Derebail G, Kaori H. Effect of Yoga on mental health: Comparative study between

young and senior subjects in Japan. International Journal of Yoga .[online]4(1), 7,
2011 Accessed from -https://www.ncbi.nlm.nih.gov>articles/PMC3099103/.
 SokSR,et al. Effects of acupuncture therapy on insomnia. J AdvNurs. [online]
2003Nov;44(4):375-84.
Accessed from https://www.ncbi.nlm.nih.gov>pubmed/14651709
 DP O’ Mathuna . Evidence-based practice and reviews of therapeutic touch. J
NursScholarsh.[online] 2000;32(3):279-85.
Accessed from- https://www.ncbi.nlm.nih.gov>pubmed/12462823/

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