Complementary and Alternative Medicine (CAM): Wikipedia vs the Science

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In Wikipedia, Complementary and Alternative Medicine does not have a page. Instead, readers are directed to the entry for Alternative Medicine, which consists largely of negative propaganda. Wikipedia claims, "Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine are among many rebrandings of the same phenomenon. Alternative therapies share in common that they reside outside medical science, and rely on pseudoscience. … Frequently used derogatory terms for the alternative are new-age or pseudo, with little distinction from quackery." According to Wikipedia, CAM is not a practice, not a science, simply part of a "phenomenon". Science? Or Bullspit?

What does the science say? Science is not about good and bad, it is about proven and not proven. Medicines that are proven might be good in general, bad in specific situations. Sometimes, we later learn that they are very bad. Medicines that are not proven might be good in general and better in specific situations or sometimes just bad. Science is about understanding, not about rationalizing generalizations.

In Merck's 2006 Manual of Diagnosis and Therapy, we see their first appearance of the phrase alternative medicine and of CAM in the section titled Complementary and Alternative Medicine, which stated "Complementary and alternative medicine (CAM) includes various healing approaches and therapies that originate from around the world and that are not based on conventional Western medicine… called alternative medicine when they are used alone and complementary medicine when they are used in conventional medicineIntegrative medicine refers to the use of all appropriate therapeutic approaches… in a framework that focuses on the whole person and reaffirms the relationship between health care practitioner and patient." Merck also acknowledged that "Alternative medicine includes therapies and health care practices not widely taught in most medical schools, however, many such practices are used in hospitals and reimbursed by insurance companies." Merck discusses many alternative medical systems without judgement, including Ayurveda, Homeopathy, Naturopathy, Traditional Chinese Medicine, acupuncture, Mind body techniques: (biofeedback, guided imagery, hypnotherapy, and meditation), biologic therapies (diet, supplements, herbs, and orthomolecular therapies), manipulative therapies (chiropractic, massage, postural reeducation, reflexology, and Rolfing), energy therapies (magnets, pulsed electric field, Reiki, and therapeutic touch. It lists common treatments with nutritional supplements and herbs, discussing beneficial effects as well as possible interactions with drugs and other conditions.

In the 2019 - 20th and latest edition of Merck's manual, little has changed in their definition of alternative medicine, CAM, and integrative medicine. However, the 20th edition adds "CAM is often thought of as medicine that is not based on the principles of Western medicine. However, this characterization is not strictly correct… Some traditional medical schools, including 45 schools in the Consortium of Academic Health Centers for Integrative Medicine, provide information about CAM and Integrative Medicine."

What does Wikipedia say about Integrative Medicine? Wikipedia has no page for integrative medicine either, and a search for integrative medicine simply links to the propaganda page against alternative medicine, which states: "Complementary medicine (CM) or integrative medicine (IM) is when alternative medicine is used together with functional medical treatment, in a belief that", with no reference to science or conventional medical documents. Wikipedia has another entry about the Sage Publication: Journal of Evidence Based Integrative Medicine, which defines itself as "is a peer-reviewed open access journal which focuses on hypothesis-driven and evidence-based research in all fields of integrative medicine". But Wikipedia's page makes no attempt to acknowledge nor define integrative medicine as understood by Sage.

While claiming that Complementary medicine, Complementary and Alternative Medicine (CAM), alternative medicine, integrative medicine, holistic medicine are simply rebrandings of the same phenomena, Wikipedia fails to notice that:

  • the concept of "alternative medicine" is paradoxical because any treatment proven to work is by definition a "medicine". Whether it has been approved or not makes no difference to the benefits provided.
  • every treatment is an alternative and every cure is an alternative. Some treatments work in some cases, some don't (note: Works is rarely defined as 'cures')
  • alternative medicine cannot be precisely defined because of the diversity of theories and practices it includes, and because the boundaries between alternative and conventional medicine overlap, are gradations that are constantly changing
  • that conventional medicine, as defined by Wikipedia generally refers to bureaucratically approved medicine as opposed to alternative medicine which has not been approved by the bureaucracy in power.

How can Wikipedia authors get this so wrong?

The nonsense begins with the first sentence defining alternative medicine, which claims, "Alternative medicine describes any practice that aims to achieve the healing effects of medicine".

This might sound logical at first glance, until we ask "what are the true healing effects of medicine?" There are none. No medicine claims to heal any disease. Healing comes from within, not from medicine. In the mid-1700s, Voltaire stated"The art of medicine consists of amusing the patient while nature cures the disease." No medical authority, no medical treatments, and no medical science has challenged this statement. Nutrients, exercises, and a few medical treatments might aid healing, but, the "healing effects of medicine" simply do not exist. So where does the quote come from? After all, aren't Wikipedia authors required to provide references? Yes, of course. The quote comes from an obscure now deleted document of the National Science Foundation. No other medical authority has used a similar phrase to define alternative medicine or CAM except those quoting Wikipedia's flawed document.

How do other, more authoritative sources define Complementary and Alternative Medicine?

World Health Organization: "The terms "complementary medicine" or "alternative medicine" refer to a broad set of health care practices that are not part of that country's own tradition or conventional medicine and are not fully integrated into the dominant health-care system. They are used interchangeably with traditional medicine in some countries."

Medicine.net: "Alternative medicine is the term for medical products and practices that are not part of … what medical doctors, doctors of osteopathy, and allied health professionals, such as nurses and physical therapists, practice."

Cancer.gov: "Treatments that are used instead of standard treatments. Standard treatments are based on the results of scientific research and are currently accepted and widely used. Less research has been done for most types of alternative medicine."

WebMD.com: "Alternative medicine is a term that describes medical treatments that are used instead of traditional (mainstream) therapies. Some people also refer to it as "integrative," or "complementary" medicine." Note: Most alternative treatments are more "traditional" than most FDA approved conventional medicines.

Merriam Webster: "any of various systems of healing or treating disease (such as chiropractic, homeopathy, or faith healing) not included in the traditional medical curricula of the U.S. and Britain"

Cambridge Dictionary: "a range of treatments for medical conditions that people use instead of or with western medicine"

US Department of Health and Human Services: "CAM is a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine. Integrative medicine combines conventional and CAM treatments for which there is evidence of safety and effectiveness. While scientific evidence exists regarding some CAM therapies, for most there are key questions that are yet to be answered through well-designed scientific studies--questions such as whether these therapies are safe and whether they work for the purposes for which they are used."

What do the major scientific medical journals say about alternative treatments? We must, of course, be aware that when a treatment is successfully published in a major scientific journal, it can hardly be called an alternative medicine. Medical journals tend to avoid alternative medicine by definition. However, Complementary and Alternative Medicine (CAM) does appear in major journals, sometimes labelled as such, sometimes labelled as conventional medicine. The line between CAM and conventional medicine is neither simple nor clear.

The New England Journal of Medicine reported, in Nonnarcotic Methods of Pain Management, published in 2019, that "Many patients with chronic pain use complementary therapies, which include meditation, yoga, acupuncture, music therapy, heat therapy, massage, chiropractic, guided imagery, and biofeedback. Complementary therapies such as acupuncture and massage are recommended by the American College of Physicians for chronic low back pain. These therapies may support active self-care, and meditation and yoga are recommended to improve psychological well-being."

The Lancet says that "The field of CAM is vast and complex" in an article that unfortunately views CAM as "patients rejecting evidence-based medicine" as if complementary and alternative medicine cannot possibly be complementary.

PubMed lists thousands of studies of Complementary and Alternative Medicine, although many might be characterized as "fear of CAM" or the potential danger it might present to conventional medicine. A closer look reveals many issues in the definition and discussion of CAM. For example, a study of Complementary and alternative medicine use for treatment and prevention of late-life mood and cognitive disorders researched previously published studies of the effects of omega 3 supplements, Folate and B12 supplements, and exercise - which appear to be classified as CAM when the patient is not known to be deficient, and conventional treatment when the patient is known to be suffering a deficiency.

CURE?

Perhaps the largest problem facing today's medical establishment with regards to Complementary and Alternative Medicine (CAM) is the absence of a definition of CURED for most diseases treated by conventional medicine or alternative medicine. Because cured is not defined, no cures can be found. Conventional medicine and alternative medical treatments are limited to comparing and debating the benefits and risks of "treatments that cannot cure".

If, or when a cure occurs, it is out of scope for most clinical research studies - including all research studies of any non-infectious disease. This becomes (painfully) obvious (pun intended), for example, with regards to research into conditions like "low back pain". Conventional medicine appears unaware that low back pain might be caused by any number of single conditions, which when successfully addressed leads to a cure. As a result, when a patient in a research study of low back pain is CURED, the cure cannot be documented. Research studies measure benefits in a group of patients with similar signs and symptoms, without attention to cause, without attention to cure. What happens when a patient is cured of a non-infectious disease in a clinical study? what happens when a chiropractor cures a patient? What happens when a Traditional Chinese Practitioner cures a patient? What happens after an naturopathic cure? What happens after a homeopathic cure? What happens when a cancer patient is cured? The cure disappears. Cured is rarely defined in clinical studies, not defined for any cancer. When cures occur they are simply out of scope.

So, when a cure appears, it disappears. Cured is not defined. There are no statistics for cured for any disease. Cure statistics for a few infectious diseases are tracked by medical treatment - not by disease. Cure rate statistics for cancers are actually survival statistics, cured being undefined and therefore contestable, much less provable for any cancer.

Why is the Wikipedia definition of alternative medicine in conflict with all authoritative sources?

Why does the US Department of Health and Human Services state that there are "key questions that are yet to be answered", while Wikipedia propaganda advises: "Western medicine good, alternative medicine bad."

The dimensions of effective to ineffective, and of high or low risk are independent of their label as conventional, CAM, alternative, or integrative medicine. Effectiveness and risk must be measured individually for each treatment and for each medical condition, as illustrated in this diagram:

Effectiveness, and risk can also change depending on many attributes of the individual patient. Every cure is an individual case, an anecdote, not a clinical study.

I believe the creator of Wikipedia, Jimmy Wales, does not believe in alternative medicine. This not about science, it's about faith. Wikipedia does not present the science, it supports Jimmy Wales' beliefs. When we read Wikipedia, we read scribbles by people who support his unscientific beliefs, searching for scientific anecdotes to support their position.

There is another reason to be considered. Perhaps more fundamental to the reality of Wikipedia. Wikipedia does not allow experts authors. If you are an expert in your field, you are excluded from entering your research, your knowledge into Wikipedia. As a result, Wikipedia often suffers from a smart-aleck (spelled with two s's) syndrome. As if every question has a single answer. Posts are written, updated, and refined by people who are very smart, writing in a field where they know little. Their research consists of sound-bytes that support their views (or Jimmy Wales' views), not a summary of actual knowledge and research. If they dare to create actual research - they might become experts and therefore be excluded from Wikipedia authorship. This is especially apparent in the medical area.

Why doesn't Wikipedia treat Complementary and Alternative Medicine with scientific respect? Fear. Distrust. Fear gives rise to ignorance and disgust. It began a long time ago.

In 1992, the Merck Manuals made no reference to alternative medicine, the concept hardly existed. Instead, a section titled Cross Cultural Issues, labelled Folk Medicines and Ethnomedicine, and advised doctors - who expressed concern and perhaps fear, "For the physician to cope with culture-bound syndromes, humoral medicine, and 'odd' ideas of physiology, the key is tolerance and acceptance of cultural variation without judgement (cultural relativism)… If the goal is the maintenance of, or a return to health, all available mechanisms should be used… This requires mutual trust and respect between practitioners and is facilitated by a relativistic rather than a judgmental attitude." Merck clearly recognized that many physicians fear alternative medical systems and techniques - even fear the success of such methods. Unfortunately, this is not the Wikipedia approach. Wikipedia is still hiding behind the fear that doctors began to show in the 1990s.

The JAMA Internal Medicine journal, the 2012 study of Nondisclosure of Complementary and Alternative Medicine Use to Primary Care Physicians recommended "Incorporating more education about CAM into medical curricula can better equip physicians to initiate conversations with patients relating to their use. In addition, including CAM physicians in groups such as accountable care organizations can improve communication between physicians and streamline patient records.5 Clinical and organizational incentives that encourage patient disclosure of CAM use may facilitate better coordination of care, reduce the risk of adverse interactions between conventional medications and CAM products, and lead to better patient outcomes." But Wikipedia wants to admonish doctors and patients who dare to consider alternative medical treatments.

The science has changed little in 30 years. Wikipedia authors consistently ignore most science, ignore most medical practice, and cherry-pick science supporting their propaganda goals.

Unfortunately, this is not the only example of Wikipedia medical nonsense.

The Wikipedia page on CURE, for example, is largely fiction, for a different reason.

There are no experts of CURE.

There is no medical science of cure. As a result, Wikipedia authors are forced to avoid cure, or perhaps to quote dictionary definitions of cure or to make something up. And that's exactly what they have done. Wikipedia's page on cure looks credible, and it has many references that appear to provide authority at first glance. But it's largely fiction, and the references - those that actually exist - are mostly bunk, or simply incorrect. The reference that defines "What is the difference between a treatment and a cure?" for example, is a link to a kidshealth.org page for teens. Many of the other references to support Wikipedia's CURE page are links to cancer pages (cancer being a disease where cured is not defined) and cancer cure rates - which are clearly defined by medical science as "not cures".

Health is the best medicine, the best cure, and also the best preventative.

Unfortunately, today's "health-care" systems study disease to death, but make scant studies of health. Health is not defined medically in any measurable fashion. Wikipedia has no entry for healthicine, the arts and sciences of health and healthiness, it's too busy trying to exorcise the devil of alternative medicine.

If you are searching for medical information on the internet, or health information, steer clear of Wikipedia. They've strayed, far away from the practice of medicine, and farther away from the science.

to your health, tracy

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