COMPLEMENTARY & ALTERNATIVE

MEDICINE
PH 109
 COURSE
Course Code: PH 109

DESCRIPTIO
Rationale: This course is designed to enable the students to
understand their role in the practice of complementary and
alternative medicine/ integrative medicine domains that are
commonly used by Filipinos in medical healthcare; those which are

N
cost-effective, recognized by the government, a local and global
trend, and a basis for scientific research in improving the quality of
life of the individuals and the community as a whole.
Focus: This course covers complementary and integrative
approaches to health, regulations governing them; emphasizing the
role of the pharmacist in their implementation.
Outcomes: At the end of the course, the students are expected to:
1. Discuss the different domains of the complementary and alterative medicine/
integrative medicine according to use, availability, safety and efficacy;
2. Understand principles behind CAM/ Integrative medicine that can be safely and
effectively incorporated into acute and chronic diseases therapies;
3. Understand the role of the pharmacist in the practice of complementary and
alternative medicine/integrative medicine domains;
4. Apply the concepts learned in CAM/integrative medicine on areas that entail
problem solving, particularly in research and in patient counseling using
evidenced-based information.
PRELIM TERM COVERAGE
1 The Philosophy of Integrative Medicine

2 Complementary and Alternative Medicine in Pharmacy

Practice
3 PITAHC Guidelines

4 RA 8432

5 Alternative Medical System

MIDTERM COVERAGE

1 Mind- Body Intervention

2 Biologically-based Therapy
FINAL TERM COVERAGE

1 Manipulative and Body-based Methods

(MBM)

2 Energy Therapy
PRELIM
TERM
 The Philosophy of
Integrative Medicine
 COMPLEMENTARY MEDICINE – A collection of diagnostic
and therapeutic procedures used hand in hand with the
conventional and modern medicine.
 These can be any method or modality that intends
to enhance or supplement other forms of treatment.
 Other complementary forms of treatment can be
also classified as alternative or integrative
medicine.
 ALTERNATIVE MEDICINE – medical treatments that are
used instead of traditional medicine.

o It is a field of study that maintains a mind-body

connection that has an important impact on one’s
ability to prevent illness, regain health, and create a
biophysical balance.
 ALLOPATHIC MEDICINE– From the Greek words Allos
meaning “other” and Pathos meaning “disease or suffering”

o Methods for treatment of disease that attempt to

counteract the disease or cause of the disease directly
 SAFETY OF CAM APPROACH

 Some research suggested that the use of CAM therapies are safe and
effective. However, there are others that dispute this claim that can
even lead to harmful instances. The following reasons are the cause
on why CAM related research has been slower in the last years:

1. Time and funding problems

2. Regulatory issues
3. Conflict in finding researchers and institutions willing to conduct
ample research.
 ALTERNATIVE ALLOPATHIC
Examples of Alternative Other names for Allopathic
Medicine: Medicine:
Mnemonic “CHAHARA” Mnemonic “Western COMB”
● Chiropractic ● Western medicine
● Homeopathy ● Conventional medicine
● Ayurveda ● Orthodox medicine
● Herbal medicine ● Mainstream medicine
● Acupuncture ● Biomedicine
● Reflexology
● Aromatherapy
 COMPLEMENTARY ALTERNATIVE

Complementary practices are those that work Alternative practices are those that take the
in conjunction with standard Western place of standard
Medicine Western Medicine

This could be anything from massage therapy to
Traditional
Chinese Medicine, but it is always good practice
to inform the doctor of your complementary
treatment
When choosing to utilized alternative practices,
you
should always make sure you find the discipline
and
practitioner that is right for you
 PHARMACIST ROLE IN CAM USE

• Provide information on the appropriate use of CAM. This should

include not only those products sold in the pharmacy but also those
products and therapies received by patients outside the pharmacy.
• Ask questions to customers about their use of CAM.
• Being aware of potential adverse reactions and interactions with
conventional medicines.
• To ensure that stocks of homoeopathic medicines, herbal medicines, or
other complementary therapies are obtained from a reputable source of
supply.
• Pharmacist have a responsibility to ensure that all products they
recommend are of appropriate quality.
 INTEGRATIVE MEDICINE

• Integrative medicine arises from a need to appreciate the wholeness of an individual

person.
• This means learning to view a person from a biological/psychological/social/spiritual
perspective. Moreover, integrative medicine is healing oriented and emphasizes the
centrality of the doctor-patient relationship.
• It focuses on the least invasive, least toxic, and least costly methods to help facilitate
health by integrating the best of both worlds—allopathic (conventional) and
complementary therapies.
• The founder of allopathic medicine, Sir William Osler, wrote, “It is much more
important to know what sort of patient has a disease than what sort of disease a
patient has.”
 HEALING
• Health comes from the Old English word “Hal,” meaning wholeness, soundness, or
spiritual wellness.
• “Health” is defined by the World Health Organization as “a state of complete physical,
mental, and social wellbeing, and not merely the absence of disease or infirmity.”
• To “cure,” conversely, refers to doing something (such as giving drugs or performing
surgery) that alleviates a troublesome condition or disease.
• Healing does not equal curing.
• Healing facilitates change that reduces stress, improves diet, promotes exercise, and
increases the person’s sense of community and connection.
• In doing this, we help improve the balance of health of the body, mind, and spirit that
may result in the ability to discontinue a pharmaceutical, thereby reducing the need for
the cure.
WHAT DOES AN INTEGRATIVE
MEDICINE DOCTOR DO?
• Integrative medicine uses a combination of modern
healthcare practices to diagnose and treat a patient.

• Treatments may include yoga, acupuncture or

massage.

• This practice focuses on the nutritional and exercise

habits of the patient.
 PRINCIPLES OF INTEGRATIVE MEDICINES

1. The patient and practitioner are partners in the healing process.

2. All factors that influence health, wellness and disease are taken
into consideration.
3. The care addresses the whole person, including body, mind, and
spirit in the context of community.
4. Providers use all appropriate healing sciences to facilitate the
body’s innate healing response.
5. Effective interventions that are natural and less invasive are used
whenever possible.
PRINCIPLES OF INTEGRATIVE
MEDICINES
 6. Because good medicine is based in good science, integrative
medicine is inquiry driven and open to new models of care.
7. Alongside the concept of treatment, the broader concepts of
health promotion and the prevention of illness are paramount.
 8. The care is individualized to best address the person’s unique
conditions, needs and circumstances.
 9. Practitioners of integrative medicine exemplify its principles
and commit themselves to self-exploration and self-development.

RA 8423
Also known as: "Traditional and Alternative Medicine Act (TAMA) of
1997.“
 Approved: December 9, 1997
 Objectives:
 (a) To encourage scientific research on and develop traditional and
alternative health care systems that have direct impact on public health care;
 (b) To promote and advocate the use of traditional, alternative, preventive
and curative health care modalities that have been proven safe, effective,
cost effective and consistent with government standards on medical practice;
 (c) To develop and coordinate skills training courses for various forms of
traditional and alternative health care modalities;
 (d) To formulate standards, guidelines and codes of ethical practice
appropriate for the practice of traditional and alternative health care as
well as in the manufacture, quality control and marketing of different
traditional and alternative health care materials, natural and organic
products, for approval and adoption by the appropriate government
agencies;
 (e) To formulate policies for the protection of indigenous and natural
health resources and technology from unwarranted exploitation, for
approval and adoption by the appropriate government agencies;
 (f) To formulate policies to strengthen the role of traditional and
alternative health care delivery system; and
 (g) To promote traditional and alternative health care in
international and national conventions, seminars and meetings in
coordination with the Department of Tourism, Duty Free
Philippines, Incorporated, Philippine Convention and Visitors
Corporation and other tourism-related agencies as well as non-
government organizations and local government units.
Definition of Terms

 (a) "Traditional and alternative health care" - the sum total of knowledge,
skills and practices on health care, other than those embodied in biomedicine,
used in the prevention, diagnosis and elimination of physical or mental
disorder.
 (b) "Traditional medicine" - the sum total of knowledge, skills, and practice
on health care, not necessarily explicable in the context of modern, scientific
philosophical framework, but recognized by the people to help maintain and
improve their health towards the wholeness of their being, the community
and society, and their interrelations based on culture, history, heritage, and
consciousness.
 (c) "Biomedicine" - that discipline of medical care advocating
therapy with remedies that produce effects differing from those
of the diseases treated. It is also called "allopathy","western
medicine", "orthodox medicine", or "cosmopolitan medicine".
 (d) "Alternative health care modalities" – other forms of non-
allopathic, occasionally non-indigenous or imported healing
methods, though not necessarily practiced for centuries nor
handed down from one generation to another. Some alternative
health care modalities include reflexology, acupressure,
chiropractics, nutritional therapy, and other similar methods.
 (e) "Herbal medicines" - finished, labelled, medicinal products
that contain as active ingredient/s serial or underground part/s of
plant or other materials or combination thereof, whether in the
crude state or as plant preparations.
 (f) "Natural product" - those foods that grow spontaneously in
nature whether or not they are tended by man. It also refers to
foods that have been prepared from grains, vegetables, fruits, nuts,
meats, fish, eggs, honey, raw milk, and the like, without the use or
addition of additives, preservatives, artificial colors and flavors, or
manufactured chemicals of any sort after harvest or slaughter.
 (g) "Manufacture" - any and all operations involved in the production, including
preparation, propagation, processing, formulating, filling, packing, repacking, altering,
ornamenting, finishing, or otherwise changing the container, wrapper, or labelling of a
consumer product in the furtherance of the distribution of the same from the original
place of manufacture to the person who makes the final delivery or sale to the ultimate
consumer.
 (h) "Traditional healers" - the relatively old, highly respected people with a profound
knowledge of traditional remedies.
 (i) "Intellectual property rights" - is the legal basis by which the indigenous
communities exercise their rights to have access to, protect, control over their cultural
knowledge and product, including, but not limited to, traditional medicines, and
includes the right to receive compensation for it.
• The Institute shall be attached to the Department of Health. Its principal flag office shall be in Metro
Manila, but it may establish other branches or offices elsewhere in the Philippines as may be necessary
or proper for the accomplishment of its purposes and objective.
MANDATE:
Republic Act 8423 (R.A. 8423) mandates the Philippine Institute of Traditional
and Alternative Health Care (PITAHC) “to improve the quality and delivery of health
care services to the Filipino people through the development of traditional and
alternative health care and its integration into the national health care delivery system “.

VISION: “People’s health through traditional and alternative health care”

MISSION: “We lead in the research and development, promotion and advocacy, and
development of standards on traditional and complementary medicine (T&CM); and we
ensure its accessibility, availability,
sustainability and integration into the national health care system.”
 Western Medicine
• Is the term used to describe the treatment of medical conditions
with medications, by doctors, nurses and other conventional
healthcare providers who employ methods developed according to
Western medical and scientific tradition.
• Encompasses all types of conventional medical treatment,
including surgery, chemotherapy, radiation, and physical therapy
• It is also called “Traditional” or “Allopathic“ medicine”
4 Main Focus of Allopathic Medicine

1. There is only one cause of any disease (the Doctrine of Specific

Etiology)
2. The body is a material entity, not unlike a machine with
clockwork mechanisms
3. The opposite cures
4. Only methods found to be effective through rigorous scientific
study are appropriate means to a cure
 2 Major Philosophical differences between
Allopathic medicine and Alternative medicine

1. Allopathic medicine constantly treats the disease, not the

individual. Whereas “alternative,” holistic approaches maintain the
connectedness of the human being to its environment, both internal
and external.

2. Allopathic medicine believes in simple, one-cause disease states.

Whereas “alternative,” holistic medicine purports a multifactorial
etiological model of disease. Meaning stress causes disease, as do
bad water, bad air, bad food, bad parenting and bad society.
 Alternative medicine is used in place of conventional
medicine

 Complementary medicine is used together with conventional

medicine

 Integrative medicine is used together with conventional

medicine in a deliberate manner that is personalized, evidence
based, and safe.
CATEGORIES OF CAM

 1. Alternative Medical System

 2. Mind- Body Intervention
 3. Biologically-based Therapy
 4. Manipulative and Body-based Methods (MBM)
 5. Energy Therapy
 Alternative Medical System

• Homeopathic Medicine
• Naturopathy
• Oriental Medicine
• Ayurveda
• Traditional Chinese Medicine
 Homeopathic Medicine

a. founded by 19th-century German physician Samuel Hahnemann

b. based on two major principles:

• similia similibus curentur—"like is cured by like" (ie, an illness, such
as dermatitis, can be treated by a substance, such as poison ivy extract,
which produces similar symptoms in a healthy person)
•doses minimae—"potentiation through dilution" (ie, more dilute
concoctions are more powerful and therapeutic).

c. prepared by serial dilutions and vigorous shaking (sucussion) and contain

little or no measurable active ingredients
 Naturopathy
• Describes a wide range of therapies that are considered "natural medicines.“

• Curing disease requires natural methods to restore the proper balance and health to the
body.

• Naturopathic doctors (NDs) believe that:

• The body has a strong, vital, and innate power to heal itself;
• Symptoms of disease reveal the body's attempt to reach a natural balance
• Practitioners must consider the entire person (including mental,
emotional, and social health) in treatment.
•
Naturopathy
Naturopathic therapies focus on:

 Eliminating bad habits and on detoxification (eliminating or reducing the use

of tobacco, alcohol, and coffee and detoxification of the liver and bowel);

 Eating clean, organic food (a pesticide-free, high- fibre, low-protein diet and
taking nutritional and herbal supplements);

 Corrective habits and lifestyle modification (exercise, meditation, imagery,

counselling, biofeedback, and breathing techniques);

 Hydrotherapy (steam, sitz, and Turkish baths; hot tub use, colonic irrigation,
and poultices).

Naturopathy
Six Fundamental Principles of Naturopathic Medicine:
1. The Healing Power of Nature- trust in the body’s inherent wisdom to heal itself
2. Identify and Treat the Causes- look beyond the symptoms to the underlying
cause
3. First Do No Harm- utilize the most natural, least invasive and least toxic
therapies.
4. Doctor as Teacher- educate patients in the steps to achieving and maintaining
health.
5. Treat the Whole Person- view the body as an integrated whole in all its physical
and spiritual dimensions.
6. Prevention- focus on overall health, wellness and disease prevention.
 Naturopathic Medicine Homeopathy

Herbal medicine, nutrition, Homeopathic remedies

lifestyle, hydrotherapy, only, which are made
Methods of treatment homeopathy, natural from diluted natural
supplements, physical
substances.
medicine/body work,
counseling.
Yes.
Naturopathic doctors (NDs) are
No.
You do not need a
NATUROPATH
medical degree to use
Requires a clinical
degree to practice
trained at accredited
naturopathic medical schools
and go on to get a degree and
homeopathy; but often
medical practitioners Y VS
(MDs, NDs, etc) use
license.
homeopathy as a tool.
HOMEOPATH
The Law of Similars – “Like

Philosophy
The Six Principles of
cures Like” – a homeopathic
remedy can resolve symptoms
in a sick person if it can cause
Y
Naturopathic Medicine
those same symptoms in a
healthy person.

Conditions it can treat All types All types

 ORIENTAL MEDICINE

• Describe the relationship of humanity to the environment.

• In primordial times, our early ancestors lived in a respectful and mutually supportive balance
with nature, and not only observed, but also honoured, the perennial changes of seasons
• The ancient Chinese sought to harmonize the structures and rituals of their culture with the
manifold and mysterious symmetries that they observed in the heavens
• Viewed the Five Planets of their cosmography as being related to the Five Elements:
 Venus: Metal
 Mars: Fire
 Mercury: Water

 Jupiter: Wood

 Saturn: Earth
 ORIENTAL MEDICINE

• The function of our body interrelates closely to the natural laws of the world around us.
• Oriental medicine: Life is seen arising from the magnetic interplay of the polar force
• Five Major Branches of Oriental Medicine:
• Tuina
• Chinese Herbal Medicine
• Oriental nutrition and Dietary therapy
• Tai chi
• Qi gong
o
Tuina

1. massage originated in ancient China and is

believed to be the oldest system of bodywork. It’s
based on the theory that imbalances of qi, which is
the body’s vital life force or energy, can cause
blockages or imbalances that lead to symptoms
such as pain and illness.
2. Tuina massage stimulates the flow of qi to promote
balance and harmony within the body using many
of the same principles of acupuncture.
3. Tuina massage is often used in combination with
acupuncture.
Tai chi & Qi gong

 Combine slow, deliberate movements, meditation

and breathing exercises
 Martial arts that help your circulation, balance and
alignment
 Help restore your energy, called chi or qi

 Benefits:
 Pregnant: increase flexibility and improve balance
 Patients with high blood pressure: help lower BP
and cholesterol levels
 Good for diabetics
 AYURVEDA
• Ayurveda means "the science of life"

• Natural healing system developed in India.

• Sanskrit: “Ayur”- life; “Veda”- science or knowledge

 AYURVEDA
• Comprehensive system of medicine that places equal emphasis on
the body, mind, and spirit, and strives to restore the innate
harmony of the individual
• Some of the primary Ayurvedic treatments include diet, exercise,
meditation, herbs, massage, exposure to sunlight, and controlled
breathing
• Goals of treatment aid the person by eliminating impurities,
reducing symptoms, increasing resistance to disease, reducing
worry, and increasing harmony in life.
 AYURVEDA
• Those who practice Ayurveda believe every person is made of five
basic elements found in the universe: space, air, fire, water, and
earth. These combine in the human body to form three life forces
or energies, called doshas.

• They control how your body works. They are Vata dosha (space
and air); Pitta dosha (fire and water); and Kapha dosha (water
and earth)
vata dosha
• most powerful of all three doshas
• controls the basic body functions, like how cells
divide
• controls the mind, breathing, blood flow, heart
function, and ability to get rid of waste through
the intestines
• Things that can disrupt it include eating again too
soon after a meal, fear, grief, and staying up too
late.
• If vata dosha is the main life force, the patient is
more likely to develop conditions like anxiety,
asthma, heart disease, skin problems, and
rheumatoid arthritis.
pitta dosha
• controls the digestion, metabolism, and
certain hormones that are linked to the
appetite
• Things that can disrupt it are eating sour
or spicy foods and spending too much
time in the sun.
• If it is the main life force, the patient is
more likely to develop conditions like
Crohn’s disease, heart disease, high blood
pressure, and infections
kapha dosha
• controls muscle growth, body strength
and stability, weight, and the immune
system.
• Things that can disrupt it is by sleeping
during the day, eating too many sweet
foods, and eating or drinking things that
contain too much salt or water.
• If it is the main life energy patients may
develop asthma and other breathing
disorders, cancer, diabetes, nausea after
eating, and obesity
 TRADITIONAL CHINESE MEDICINE

• Complete system of healing that dates back to 200 B.C. in written form
 The body is a delicate balance of two opposing and inseparable forces: Yin
and Yang

• Yin represents the cold, slow, or passive principle, while Yang represents the
hot, excited, or active principle


• Health is achieved by maintaining the body in a "balanced state" and that

disease is due to an internal imbalance of yin and yang.

• Imbalance leads to blockage in the flow of qi (or vital energy) along pathways
known as meridians.
 TRADITIONAL CHINESE MEDICINE

• TCM practitioners typically use herbs, acupuncture, and

massage to help unblock qi in patients in an attempt to bring the
body back into harmony and wellness
• There are three main therapeutic modalities:
 Acupuncture and moxibustion (the burning of an herb above
the skin to apply heat to the acupuncture point)
 Chinese Materia Medica (the catalogue of natural products
used in TCM)
 Massage and manipulation
END