Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Letter to the Editor Med Princ Pract 2005;14:441–443 DOI: 10.1159/000088120 Complementary and Alternative Medicine: An Academic View G.F. Gensini a D. Lippi b A. Conti c A.A. Conti a a Department of Critical Care Medicine and Surgery, University of Florence, and Don Carlo Gnocchi Foundation, Departments of b Anatomy, Histology and Legal Medicine, and c Pathophysiology, University of Florence, Florence, Italy that it is first necessary to escape a terminology that in- volves the concept of ‘alternative’: this definition, which has been used in recent years, considers the practice of CAM as optional, justifying its use when scientifically sanctioned treatment is not available, or has failed. In English, the terms ‘alternative’ and ‘complemen- tary’ are mostly used, underlining a specific relationship with biomedicine. However, in France, CAM is known as ‘médecines parallèles’, with the precise intention of stressing the constant distance between orthodoxy and non-conventional medicine. Often, it is a negative defini- tion such as ‘not orthodox’, ‘not official’ that is used high- lighting what these medicines are not. CAM treatments greatly differ from one another, but they have a common feature in that they often do not have their theoretical foundation in basic biological sciences. CAM therapies were very widely promoted in the late 19th and early 20th centuries in many western countries, particularly North America. In the western world, their use is currently on the increase, especially in English- speaking societies. Recent data from the National Health Interview Survey (USA) indicate that in the 12 months previous to the interview, 33.5% of American women used CAM. Caucasian, elderly and educated individuals were more likely to use CAM [3]. Other recent data point In the last 20 years international scientific literature has shown a steady increase in discussions concerning complementary and alternative medicine (CAM) [1]. When dealing with this subject, many issues arise. It is imperative to understand firstly the kind of medical real- ity concealed beyond the names of these practices and secondly, the problems posed to the medical profession by their increased therapeutic usage. Important questions further arise regarding the introduction of CAM therapies in medical curricula. The reconstruction of the cultural context within which CAM has developed cannot escape a historical and lin- guistic reflection: a semantic analysis clearly indicates that this terminology is a well-defined historical product and conceals a specific conceptualisation that very often also involves a value judgement. In 2000, the British House of Lords, through a select committee, commissioned research to illuminate the then current status of ‘complementary therapies’, in an at- tempt to understand the CAM therapies that could be considered real medical treatments [2]. The Commission classified therapies into three well-defined groups: Prin- ciple Disciplines, Complementary Treatments and Alter- native Disciplines. The linguistic problem here revealed is substantial rather than formal. The Commission stated Received: September 10, 2004 Revised: March 14, 2005 Andrea A. Conti Dipartimento di Area Critica Medico Chirurgica Università degli Studi di Firenze, Viale Morgagni 85 IT–50134 Firenze (Italy) Tel. +39 055 417928, Fax +39 055 4379384, E-Mail aa.conti@dac.unifi.it © 2005 S. Karger AG, Basel 1011–7571/05/0146–0441$22.00/0 Accessible online at: www.karger.com/mpp