THE ENCYCLOPEDIA OF COMPLEMENTARY AND ALTERNATIVE MEDICINE THE ENCYCLOPEDIA OF COMPLEMENTARY AND ALTERNATIVE MEDICINE Tova Navarra, B.A., R.N. Foreword by Adam Perlman, M.D., M.P.H. Siegler Center for Integrative Medicine St. Barnabas Health Care System, Livingston, New Jersey The Encyclopedia of Complementary and Alternative Medicine Copyright © 2004 by Tova Navarra All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage or retrieval systems, without permission in writing from the publisher. For information contact: Facts On File, Inc. 132 West 31st Street New York NY 10001 Library of Congress Cataloging-in-Publication Data Navarra, Tova The encyclopedia of complementary and alternative medicine / Tova Navarra; foreword by Adam Perlman. p.cm. Includes bibliographical references and index. ISBN 0-8160-4997-1 1. Alternative medicine—Encyclopedias. I. Title. R733. N38 2004 615.5'03—dc21 2003043415 Facts On File books are available at special discounts when purchased in bulk quantities for businesses, associations, institutions, or sales promotions. Please call our Special Sales Department in New York at (212) 967-8800 or (800) 322-8755. You can find Facts On File on the World Wide Web at http://www.factsonfile.com Text and cover design by Cathy Rincon Printed in the United States of America VB FOF 10 9 8 7 6 5 4 3 2 1 This book is printed on acid-free paper. For Frederic CONTENTS Foreword ix Preface xiii Acknowledgments xv Introduction xvii Entries A–Z 1 Appendixes 175 Bibliography 251 Index 255 FOREWORD t the age of 16 I began training in martial arts. their health and well-being. Although a number of AWhat started as a hobby, a way to get in shape careers would have afforded me the opportunity to and increase my self-confidence, soon turned into a teach and promote health, I decided to become a passion. I unexpectedly found myself on a path. physician. For is not the essence of medicine to This path was one of self-exploration and develop- teach people to improve and maintain their ment. As I progressed in rank and understanding health? In fact, the Latin root for doctor, docere, and began to appreciate the benefits of improved means “to teach.” I can still remember the phone health, discipline, and self-esteem, as did so many call to my parents when I informed them that I was students before me, I developed a desire to teach deferring my law school entrance and planned to and pass on what I had been taught. After a num- start premed classes in summer school less than a ber of years of assisting, several fellow instructors week after graduation. and I opened up a martial arts school. I was in col- Over the next year and a half, I completed lege at the time and frequently finished classes and the premed requirements and was ultimately immediately raced down to the school to teach or accepted to Boston University School of Medicine. train. I found those days extremely challenging and During that time, I continued on my path of self- rewarding. exploration. I continued teaching martial arts and However, I soon discovered that my parents and began to question why conventional medicine did family did not fully appreciate my vision of my life not often utilize methods from other healing tra- as a martial arts instructor. Although they were ditions. I had seen multiple examples of problems, always supportive, they encouraged me to consider such as back pain, improved through the use of other avenues of employment. Given that my t’ai ch’i, or asthma through the use of various father was a lawyer and I was a history major, law breathing exercises. I had seen multiple students seemed a reasonable way to make a living while lose weight, improve their control of stress, and in continuing my career as a martial artist. After going general improve their quality of life. To me a mar- through the application process, I was fortunate tial arts instructor, nothing felt more meaningful enough to be accepted for admission. As I began to and rewarding. To me, this was the essence of contemplate graduation from college and the good medicine. prospect of the first year of law school, I began to As I began my formal medical training, I quickly question my decision. I simply did not feel passion- realized that teaching patients to improve or main- ate about becoming a lawyer. I began to reevaluate tain their health was a part of medicine that often what I did feel passionate about. What was it about got lost in trying to provide patients with the latest teaching martial arts that made me feel so fulfilled? advancements in order to diagnose, treat, or cure What I soon concluded was that I enjoyed disease. I also realized that others were less than teaching and I enjoyed helping people improve understanding of my desire to expand the usual ix x The Encyclopedia of Complementary and Alternative Medicine treatment options to include “alternative” meth- is just now being researched and shown to be effec- ods. One day, during my second year of residency, tive for many ailments, such as nausea caused by the chairman of medicine asked me what I planned chemotherapy or pregnancy. Other treatments to do when I finished training. I told him that I was such as ma huang (or ephedra) to assist with weight interested in alternative medicine, to which he loss may be efficacious but when used improperly responded, “Show me the evidence,” and quickly are potentially dangerous (there have been more changed the subject. than 50 reported deaths). Other treatments are Although I was somewhat disappointed by this newly invented or conceived. Although some of reaction, his statement ultimately turned out to be these treatments will ultimately be shown to be of one of those seemingly innocent comments that value, individuals who seek to take advantage of a unintentionally have a profound effect. I began vulnerable public are often marketing fraudulent pondering the challenge of integrating alternative products or interventions. The Internet has led to medicine into conventional medicine and the con- increased empowerment of the public through ventional medical establishment. I began to appre- access to an endless amount of medical informa- ciate more fully the need for additional research on tion. Unfortunately it has also led to access to a alternative medicine. Only through that research seemingly endless amount of inaccurate or poten- can conventional medical providers know which tially misleading health information. therapies to recommend to their patients. Only Traditionally the public has turned to physicians through that research can the public truly know and other health care providers for reliable infor- which treatments are safe and effective. mation on health-related matters. But multiple Ultimately I decided to pursue a two-year studies have shown that the majority of people research fellowship and a master’s degree in public who use alternative medicine do so without telling health with the goal of obtaining the skills neces- their physicians or other health care providers. This sary to do research and further the integration of occurs for many reasons. Most health care nonconventional and conventional medicine. providers do not ask about alternative medicine Unfortunately I soon realized that it was not quite use, perhaps because of a lack of knowledge about that easy. Good research takes years and costs sig- the subject matter and a desire not to appear unin- nificant amounts of money. Clearly, multiple agen- formed. This omission often gives the impression cies are funding research on alternative medicine. that the subject is not important or they simply do Congress has established the National Center for not wish to know. At times physicians may be dis- the Study of Complementary and Alternative Med- missive of such therapies because of a perception icine under the National Institutes of Health, and that there is a lack of credible and authoritative evi- the amount and quality of research on alternative dence of their effectiveness. treatments are increasing exponentially. However, Patients, on the other hand, tend to believe that the various types of alternative treatments avail- it is unimportant for health care providers to know able are also increasing. No matter how much about their use of alternative treatments. They research is conducted, there will always be numer- often believe that the alternative therapy is irrele- ous treatment options available that have little or vant to the biomedical treatment course. They may no data beyond anecdotal evidence to support their think that a decision to pursue an alternative treat- use. There will always be treatments being utilized ment does not require input from the conventional that will ultimately be shown to be safe and effec- medical establishment, since they believe these tive as well as ones that will be harmful and futile. therapies are not truly harmful. Still others hesitate Many treatments are from healing traditions to speak openly about their use of or desire to use that have developed over hundreds, if not thou- alternative medicine because of concern that their sands, of years through a process of trial and error questions may be dismissed or they may be viewed on thousands of patients. Acupuncture, a tradi- as ungrateful, unrealistic, or gullible. tional Chinese medicine utilized for thousands of Regardless of the reason, lack of communication years, is an example of an alternative medicine that about alternative medicine is yet another obstacle Foreword xi to a strong doctor-patient relationship, in this era of on providing integrative medicine.