Craniosacral therapy is a form of bodywork or alternative therapy using gentle touch to palpate the synarthrodial joints of the cranium. A practitioner of cranial-sacral therapy may apply light touches to a patient's spine and pelvic bones. Practitioners say that this palpation regulates the flow of cerebrospinal fluid and aids in "primary respiration". CST has been characterized as pseudoscience, its practice called quackery. According to the American Cancer Society, although CST may relieve the symptoms of stress or tension, "available scientific evidence does not support claims that craniosacral therapy helps in treating cancer or any other disease". Cranial osteopathy has no scientific basis for any claimed benefit. Craniosacral therapy was developed by John Upledger, D. O. in the 1970s, as an offshoot osteopathy in the cranial field, or cranial osteopathy, developed in the 1930s by William Garner Sutherland. According to the American Cancer Society, although CST may relieve the symptoms of stress or tension, "available scientific evidence does not support claims that craniosacral therapy helps in treating cancer or any other disease".
Cranial osteopathy has received a similar assessment, with one 1990 paper finding there was no scientific basis for any of the practitioners' claims the paper examined. In October 2012 Edzard Ernst conducted a systematic review of randomized clinical trials of craniosacral therapy, he concluded that "the notion that CST is associated with more than non-specific effects is not based on evidence from rigorous randomised clinical trials." Commenting on this conclusion, Ernst commented on his blog that he had chosen the wording as "a polite and scientific way of saying that CST is bogus." Ernst commented that the quality of five of the six trials he had reviewed was "deplorably poor", a sentiment that echoed an August 2012 review that noted the "moderate methodological quality of the included studies."Ernst criticized a 2011 systematic review performed by Jakel and von Hauenschild for inclusion of observational studies and including studies with healthy volunteers. This review concluded that the evidence base surrounding craniosacral therapy and its efficacy was sparse and composed of studies with heterogeneous design.
The authors of this review stated that available evidence was insufficient to draw conclusions. The evidence base for CST lacks a demonstrated biologically plausible mechanism. In the absence of rigorous, well-designed randomized controlled trials, it has been characterized as pseudoscience, its practice called quackery; the therapist palpates the patient's body, focuses intently on the communicated movements. A practitioner's feeling of being in tune with a patient is described as entrainment. Patients report feelings of deep relaxation during and after the treatment session, may feel light-headed. While sometimes thought to be caused by an increase in endorphins, research shows the effects may be brought about by the endocannabinoid system. There are few reports of adverse events from CST treatment. In one study of craniosacral manipulation in patients with traumatic brain syndrome, the incidence of adverse effects from treatment was 5%. Cranial osteopathy, a forerunner of CST, was originated by osteopath William Sutherland in 1898–1900.
While looking at a disarticulated skull, Sutherland was struck by the idea that the cranial sutures of the temporal bones where they meet the parietal bones were "beveled, like the gills of a fish, indicating articular mobility for a respiratory mechanism."John Upledger devised CST. Comparing it to cranial osteopathy he wrote: "Dr. Sutherland's discovery regarding the flexibility of skull sutures led to the early research behind CranioSacral Therapy – and both approaches affect the cranium and coccyx – the similarities end there." However, modern day cranial osteopaths consider the two practices to be the same, but that cranial osteopathy has "been taught to non-osteopaths under the name CranialSacro therapy."Practitioners of both cranial osteopathy and craniosacral therapy assert that there are small, rhythmic motions of the cranial bones attributed to cerebrospinal fluid pressure or arterial pressure. The premise of CST is that palpation of the cranium can be used to detect this rhythmic movement of the cranial bones and selective pressures may be used to manipulate the cranial bones to achieve a therapeutic result.
However, the degree of mobility and compliance of the cranial bones is considered controversial and is a critically important concept in craniosacral therapy. From 1975 to 1983, Upledger and neurophysiologist and histologist Ernest W. Retzlaff worked at Michigan State University as clinical researchers and professors, they assembled a research team to investigate the purported pulse and further study Sutherland's theory of cranial bone movement. Upledger and Retzlaff went on to publish their results, which they interpreted as support for both the concept of cranial bone movement, the concept of a cranial rhythm. Reviews of these studies have concluded that their research did not meet enduring standards to offer conclusive proof for the effectiveness of craniosacral therapy and the existence of cranial bone movement
Acupressure is an alternative medicine technique similar in principle to acupuncture. It is based on the concept of life energy. In treatment, physical pressure is applied to acupuncture points with the aim of clearing blockages in these meridians. Pressure may be applied by elbow, or with various devices; some medical studies have suggested that acupressure may be effective at helping manage nausea and vomiting, for helping lower back pain, tension headaches, stomach ache, among other things, although such studies have been found to have a high likelihood of bias. Like many alternative medicines, it may benefit from a placebo effect. According to Quackwatch, acupressure is a dubious practice and its practitioners use irrational methods. Acupoints used in treatment may not be in the same area of the body as the targeted symptom; the traditional Chinese medicine theory for the selection of such points and their effectiveness is that they work by stimulating the meridian system to bring about relief by rebalancing yin, yang and qi.
Many East Asian martial arts make extensive study and use of acupressure for self-defense and health purposes. The points or combinations of points are said to be used to incapacitate an opponent. Martial artists massage their own acupressure points in routines to remove supposed blockages from their own meridians, claiming to thereby enhance their circulation and flexibility and keeping the points "soft" or less vulnerable to an attack. A 2011 systematic review of acupressure's effectiveness at treating symptoms found that 35 out of 43 randomized controlled trials had concluded that acupressure was effective at treating certain symptoms; the authors of this systematic review concluded that this "review of clinical trials from the past decade did not provide rigorous support for the efficacy of acupressure for symptom management. Well-designed, randomized controlled studies are needed to determine the utility and efficacy of acupressure to manage a variety of symptoms in a number of patient populations."A 2011 Cochrane review of four trials using acupuncture and nine studies using acupressure to control pain in childbirth concluded that "acupuncture or acupressure may help relieve pain during labour, but more research is needed".
Another Cochrane Collaboration review found that massage provided some long-term benefit for low back pain, stated: It seems that acupressure or pressure point massage techniques provide more relief than classic massage, although more research is needed to confirm this. Quackwatch includes acupressure in a list of methods which have no "rational place" as massage therapy and states that practitioners "may use irrational diagnostic methods to reach diagnoses that do not correspond to scientific concepts of health and disease." An acupressure wristband, claimed to relieve the symptoms of motion sickness and other forms of nausea provides pressure to the P6 acupuncture point, a point, extensively investigated. The Cochrane Collaboration reviewed the use of P6 for nausea and vomiting, found it to be effective for reducing post-operative nausea, but not vomiting; the Cochrane review included various means of stimulating P6, including acupuncture, electro-acupuncture, transcutaneous nerve stimulation, laser stimulation, acustimulation device and acupressure.
EBM reviewer Bandolier said that P6 in two studies showed 52% of patients with control having a success, compared with 75% with P6. A variant system known as two point acupressure attempts to bypass a blockage of vital flow by using one acupoint to create a link with one of the collateral meridians, using one additional acupoint to stimulate or reduce the flow around the obstruction. Clinical use of acupressure relies on the conceptual framework of traditional Chinese medicine. There is no physically verifiable anatomical or histological basis for the existence of acupuncture points or meridians. Proponents reply. Acupuncturists tend to perceive TCM concepts in functional rather than structural terms. Any benefit from acupressure may derive from the placebo effect. There are several different instruments for applying nonspecific pressure by rubbing, rolling, or applying pressure on the reflex zones of the body; the acuball is a small ball made of rubber with protuberances, heatable. It is used to relieve muscle and joint pain.
The energy roller is a small cylinder with protuberances. It is rolled back and forth to apply acupressure; the foot roller is a cylindrical roller with protuberances. It is placed on the floor and the foot is rolled back and forth over it; the power mat is a mat with small pyramid-shaped bumps. The spine roller is a bumpy roller containing magnets, rolled up and down the spine; the Teishein is one of the original nine classical acupuncture needles described in the original texts of acupuncture. Though it is described as an acupuncture needle it did not pierce the skin, it is used to apply rapid percussion pressure to the points being treated. Shiatsu, a Japanese form of acupressure massage
A biopharmaceutical known as a biologic medical product, or biologic, is any pharmaceutical drug product manufactured in, extracted from, or semisynthesized from biological sources. Different from synthesized pharmaceuticals, they include vaccines, blood components, somatic cells, gene therapies, recombinant therapeutic protein, living cells used in cell therapy. Biologics can be composed of sugars, proteins, or nucleic acids or complex combinations of these substances, or may be living cells or tissues, they are isolated from living sources—human, plant, fungal, or microbial. Terminology surrounding biopharmaceuticals varies between groups and entities, with different terms referring to different subsets of therapeutics within the general biopharmaceutical category; some regulatory agencies use the terms biological medicinal products or therapeutic biological product to refer to engineered macromolecular products like protein- and nucleic acid-based drugs, distinguishing them from products like blood, blood components, or vaccines, which are extracted directly from a biological source.
Specialty drugs, a recent classification of pharmaceuticals, are high-cost drugs that are biologics. The European Medicines Agency uses the term advanced therapy medicinal products for medicines for human use that are "based on genes, cells, or tissue engineering", including gene therapy medicines, somatic-cell therapy medicines, tissue-engineered medicines, combinations thereof. Within EMA contexts, the term advanced therapies refers to ATMPs, although that term is rather nonspecific outside those contexts. Gene-based and cellular biologics, for example are at the forefront of biomedical research, may be used to treat a variety of medical conditions for which no other treatments are available. In some jurisdictions, biologics are regulated via different pathways than other small molecule drugs and medical devices; the term biopharmacology is sometimes used to describe the branch of pharmacology that studies biopharmaceuticals. Some of the oldest forms of biologics are extracted from the bodies of animals, other humans especially.
Important biologics include: Whole blood and other blood components Organs and tissue transplants Stem cell therapy Antibodies for passive immunization Human breast milk Fecal microbiota Human reproductive cellsSome biologics that were extracted from animals, such as insulin, are now more produced by recombinant DNA. As indicated the term "biologics" can be used to refer to a wide range of biological products in medicine. However, in most cases, the term "biologics" is used more restrictively for a class of therapeutics that are produced by means of biological processes involving recombinant DNA technology; these medications are one of three types: Substances that are identical to the body's own key signalling proteins. Examples are the blood-production stimulating protein erythropoetin, or the growth-stimulating hormone named "growth hormone" or biosynthetic human insulin and its analogues. Monoclonal antibodies; these are similar to the antibodies that the human immune system uses to fight off bacteria and viruses, but they are "custom-designed" and can therefore be made to counteract or block any given substance in the body, or to target any specific cell type.
Receptor constructs based on a occurring receptor linked to the immunoglobulin frame. In this case, the receptor provides the construct with detailed specificity, whereas the immunoglobulin-structure imparts stability and other useful features in terms of pharmacology; some examples are listed in the table below. Biologics as a class of medications in this narrower sense have had a profound impact on many medical fields rheumatology and oncology, but cardiology, gastroenterology and others. In most of these disciplines, biologics have added major therapeutic options for the treatment of many diseases, including some for which no effective therapies were available, others where existing therapies were inadequate. However, the advent of biologic therapeutics has raised complex regulatory issues, significant pharmacoeconomic concerns, because the cost for biologic therapies has been higher than for conventional medications; this factor has been relevant since many biological medications are used for the treatment of chronic diseases, such as rheumatoid arthritis or inflammatory bowel disease, or for the treatment of otherwise untreatable cancer during the remainder of life.
The cost of treatment with a typical monoclonal antibody therapy for common indications is in the range of €7,000–14,000 per patient per year. Older patients who receive biologic therapy for diseases such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis are at increased risk for life-threatening infection, adverse cardiovascular events, malignancy; the first such substance approved for therapeutic use was biosynthetic "human" insulin made via recombinant DNA. Sometimes referred to as rHI, under the trade name Humulin, was developed by Genentech, but licensed to Eli Lilly and Company, who manufactured and marketed it starting in 1982. Major kinds of biopharmaceuticals include: Blood factors Thrombolytic agents Hormones (insulin, growth hormone, gonadotr
Traditional medicine comprises medical aspects of traditional knowledge that developed over generations within various societies before the era of modern medicine. The World Health Organization defines traditional medicine as "the sum total of the knowledge and practices based on the theories and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, improvement or treatment of physical and mental illness". Traditional medicine is contrasted with scientific medicine. In some Asian and African countries, up to 80% of the population relies on traditional medicine for their primary health care needs; when adopted outside its traditional culture, traditional medicine is considered a form of alternative medicine. Practices known as traditional medicines include traditional European medicine, traditional Chinese medicine, traditional Korean medicine, traditional African medicine, Siddha medicine, ancient Iranian Medicine, Islamic medicine, Ifá.
Scientific disciplines which study traditional medicine include herbalism, ethnomedicine and medical anthropology. The WHO notes, that "inappropriate use of traditional medicines or practices can have negative or dangerous effects" and that "further research is needed to ascertain the efficacy and safety" of several of the practices and medicinal plants used by traditional medicine systems; the World Health Organization has implemented a nine year strategy to "support Member States in developing proactive policies and implementing action plans that will strengthen the role traditional medicine plays in keeping populations healthy." In the written record, the study of herbs dates back 5,000 years to the ancient Sumerians, who described well-established medicinal uses for plants. In Ancient Egyptian medicine, the Ebers papyrus from c. 1552 BC records a list of folk remedies and magical medical practices. The Old Testament mentions herb use and cultivation in regards to Kashrut. Many herbs and minerals used in Ayurveda were described by ancient Indian herbalists such as Charaka and Sushruta during the 1st millennium BC.
The first Chinese herbal book was the Shennong Bencao Jing, compiled during the Han Dynasty but dating back to a much earlier date, augmented as the Yaoxing Lun during the Tang Dynasty. Early recognised Greek compilers of existing and current herbal knowledge include Pythagoras and his followers, Aristotle, Theophrastus and Galen. Roman sources included Pliny the Elder's Natural History and Celsus's De Medicina. Pedanius Dioscorides drew on and corrected earlier authors for his De Materia Medica, adding much new material. Latin manuscripts of De Materia Medica were combined with a Latin herbal by Apuleius Platonicus and were incorporated into the Anglo-Saxon codex Cotton Vitellius C. III; these early Greek and Roman compilations became the backbone of European medical theory and were translated by the Persian Avicenna, the Persian Rhazes and the Jewish Maimonides. Some fossils have been used in traditional medicine since antiquity. Arabic indigenous medicine developed from the conflict between the magic-based medicine of the Bedouins and the Arabic translations of the Hellenic and Ayurvedic medical traditions.
Spanish indigenous medicine was influenced by the Arabs from 711 to 1492. Islamic physicians and Muslim botanists such as al-Dinawari and Ibn al-Baitar expanded on the earlier knowledge of materia medica; the most famous Persian medical treatise was Avicenna's The Canon of Medicine, an early pharmacopoeia and introduced clinical trials. The Canon was translated into Latin in the 12th century and remained a medical authority in Europe until the 17th century; the Unani system of traditional medicine is based on the Canon. Translations of the early Roman-Greek compilations were made into German by Hieronymus Bock whose herbal, published in 1546, was called Kreuter Buch; the book was translated into Dutch as Pemptades by Rembert Dodoens, from Dutch into English by Carolus Clusius, published by Henry Lyte in 1578 as A Nievve Herball. This became John Gerard's General Hiftorie of Plantes; each new work was a compilation of existing texts with new additions. Women's folk knowledge existed in undocumented parallel with these texts.
Forty-four drugs, flavouring agents and emollients mentioned by Dioscorides are still listed in the official pharmacopoeias of Europe. The Puritans took Gerard's work to the United States where it influenced American Indigenous medicine. Francisco Hernández, physician to Philip II of Spain spent the years 1571–1577 gathering information in Mexico and wrote Rerum Medicarum Novae Hispaniae Thesaurus, many versions of which have been published including one by Francisco Ximénez. Both Hernandez and Ximenez fitted Aztec ethnomedicinal information into the European concepts of disease such as "warm", "cold", "moist", but it is not clear that the Aztecs used these categories. Juan de Esteyneffer's Florilegio medicinal de todas las enfermedas compiled European texts and added 35 Mexican plants. Martín de la Cruz wrote an herbal in Nahuatl, translated into Latin by Juan Badiano as Libellus de Medicinalibus Indorum Herbis or Codex Barberini, Latin 241 and given to King Carlos V of Spain in 1552, it was written in haste and influenced by the European occupation of the previous 30 year
Crystal healing is a pseudoscientific alternative medicine technique that uses semiprecious stones and crystals such as quartz, amethyst or opals. Adherents of the technique claim that these have healing powers, although there is no scientific basis for this claim. In one method, the practitioner places crystals on different parts of the body corresponding to chakras. Despite this, scientific investigations have not validated claims that chakras or energy grids exist, nor is there any evidence that crystal healing has any greater effect upon the body than any other placebo. Precious stones have been thought of as healing objects by a variety of cultures worldwide. Crystal healing is associated with the New Age spiritual movement: "the middle-class New Age healing activity par excellence". In contrast with other forms of complementary and alternative medicine, participants in crystal healing view the practice as "individuated", i.e. dependent on extreme personalization and creative expression.
Practitioners of crystal healing purport that certain physical properties—e.g. Shape and markings—determine the ailments that a stone can heal. Paradoxically, practitioners "hold the view that crystals have no intrinsic qualities but that, their quality changes according to both" participants. After selecting the stones by color or their believed metaphysical qualities, they place them on parts of the body. Color selection and placement of stones are done according to concepts of grounding, chakras, or energy grids. Many other cultures have developed traditions of crystal healing over time, including the Hopi Native Americans of Arizona and Hawaiian islanders, some of whom continued to use it as of 1997; the Chinese have traditionally attributed healing powers to microcrystalline jade. There is no peer-reviewed scientific evidence. Alleged successes of crystal healing can be attributed to the placebo effect. Furthermore, there is no scientific basis for the concepts of chakras, being "blocked", energy grids requiring grounding, or other such terms.
Energy, as a scientific term, is a well-defined concept, measurable and bears little resemblance to the esoteric concept of energy used by proponents of crystal healing. In 1999, researchers French and Williams conducted a study to investigate the power of crystals compared with a placebo. Eighty volunteers were asked to meditate with either a quartz crystal, or a placebo stone, indistinguishable from quartz. Many of the participants reported feeling typical "crystal effects". In 2001 Christopher French, head of the anomalistic psychology research unit at the University of London and colleagues from Goldsmiths College outlined their study of crystal healing at the British Psychological Society Centenary Annual Conference, concluding "There is no evidence that crystal healing works over and above a placebo effect.”Crystal healing effects could be attributed to cognitive bias. Crystal healing techniques are practiced on animals, although some veterinary organizations, such as the British Veterinary Association, have warned that these methods are not scientifically proven and state that people should seek the advice of a vet before using alternative techniques.
Color healing Energy medicine Magnet therapy List of topics characterized as pseudoscience Lawrence E. Jerome.. Crystal Power: The Ultimate Placebo Effect. Prometheus Books. ISBN 978-0-87975-514-0 Crystal Healing: Stone-cold Facts About Gemstone Treatments - LiveScience James Randi debunks Crystal Power
Chinese food therapy
Chinese food therapy is a mode of dieting rooted in Chinese beliefs concerning the effects of food on the human organism, centered on concepts such as eating in moderation. Its basic precepts are a mix of folk concepts drawn from traditional Chinese medicine. Food therapy has long been a common approach to health among Chinese people both in China and overseas, was popularized for western readers in the 1990s with the publication of books like The Tao of Healthy Eating and The Wisdom of the Chinese Kitchen. A number of ancient Chinese cookbooks and treatises on food display an early Chinese interest in food, but no known focus on its medical value; the literature on "nourishing life" integrated advice on food within broader advice on how to attain immortality. Such books, are only precursors of "dietary therapy", because they did not systematically describe the effect of individual food items. In the volume on "Fermentations and Food Science" of Joseph Needham's Science and Civilization in China, H. T. Huang considers the Recipes for Fifty-Two Ailments and the Yellow Emperor's Inner Canon as precursors of the "dietary therapy" tradition, the former because it recommends food products as remedies for various illnesses, the latter because it discusses the impact of food on health.
The materia medica literature, exemplified by the Shennong Bencao Jing discussed food products, but without specializing on them. The earliest extant Chinese dietary text is a chapter of Sun Simiao's Prescriptions Worth a Thousand Gold, completed in the 650s during the Tang dynasty. Sun's work contains the earliest known use of the term "food therapy". Sun stated that he wanted to present current knowledge about food so that people would first turn to food rather than drugs when suffering from an ailment, his chapter contains 154 entries divided into four sections – on fruits, vegetables and meat – in which Sun explains the properties of individual foodstuffs with concepts borrowed from the Yellow Emperor's Inner Canon: qi, the viscera, vital essence, as well as correspondences between the Five Phases, the "five flavors", the five grains. He set a large number of "dietary interdictions", some based on calendrical notions, others on purported interactions between foods or between different flavors.
Sun Simiao's disciple Meng Shen compiled the first work devoted to the therapeutic value of food: the Materia Dietetica. This work has not survived, but it was quoted in texts – like the 10th-century Japanese text Ishinpō – and a fragment of it has been found among the Dunhuang manuscripts. Surviving excerpts show that Meng gave less importance to dietary prohibitions than Sun, that he provided information on how to prepare foodstuffs rather than just describe their properties; the works of Sun Simiao and Meng Shen established the genre of materia dietetica and shaped its development in the following centuries. An abundant literature developed in China around the medicinal uses of food. A mid-ninth-century work called Candid Views of a Nutritionist-Physician discussed how food could treat various disorders, whereas several works from the Song dynasty explained how to feed the elderly to extend their life. In the early 14th century, Hu Sihui, who served as Grand Dietician at the court of the Mongol Yuan dynasty, compiled a treatise called the Proper and Essential Things for the Emperor's Food and Drink, still recognized in China as a classic of both materia medica and materia dietetica.
Influenced by the culinary and medical traditions of the Turko-Islamic world and integrating Mongol food stuffs like mutton into its recipes, Hu's treatise interpreted the effects of food according to the scheme of correspondences between the Five Phases, systematized by northern Chinese medical writers of the Jin and Yuan eras. Before that period, food materials had not yet been comprehensively assigned to one of five flavors systematically correlated with specific internal organs and therapeutic effects. Chinese understandings of the therapeutic effects of food were influential in East Asia. Cited in Japanese works as early as the 10th century, Chinese dietary works shaped Korean literature on food well into the Joseon period. In the late 17th and early 18th centuries, the imperial court of the Qing dynasty ordered several works on Chinese food therapy translated into Manchu. Although the precepts of Chinese food therapy are neither systematic nor identical in all times and places, some basic concepts can be isolated.
One central tenet is that "medicine and food share a common origin", that food materials can therefore be used to prevent or treat medical disorders. Like medicinal drugs, food items are classified as "heating" or "cooling". In popular understanding, "heating" or "hot" food is "high-calorie, subjected to high heat in cooking, spicy or bitter, or'hot' in color", includes red meat, innards and deep-fried goods, alcohol, they are to be avoided in the summer and can be used to treat "cold" illnesses like excessive pallor, watery feces, fatigue and low body temperature caused by a number of possible causes, includi
Quackery synonymous with health fraud, is the promotion of fraudulent or ignorant medical practices. A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, qualification or credentials they do not possess; the term quack is a clipped form of the archaic term quacksalver, from Dutch: kwakzalver a "hawker of salve". In the Middle Ages the term quack meant "shouting"; the quacksalvers sold their wares on the market shouting in a loud voice. Common elements of general quackery include questionable diagnoses using questionable diagnostic tests, as well as untested or refuted treatments for serious diseases such as cancer. Quackery is described as "health fraud" with the salient characteristic of aggressive promotion. Since it is difficult to distinguish between those who knowingly promote unproven medical therapies and those who are mistaken as to their effectiveness, United States courts have ruled in defamation cases that accusing someone of quackery or calling a practitioner a quack is not equivalent to accusing that person of committing medical fraud.
To be both quackery and fraud, the quack must know they are misrepresenting the benefits and risks of the medical services offered. In addition to the ethical problems of promising benefits that can not reasonably be expected to occur, quackery includes the risk that patients may choose to forego treatments that are more to help them, in favor of ineffective treatments given by the "quack". Stephen Barrett of Quackwatch defines quackery "as the promotion of unsubstantiated methods that lack a scientifically plausible rationale" and more broadly as: "anything involving overpromotion in the field of health." This definition would include questionable ideas as well as questionable products and services, regardless of the sincerity of their promoters. In line with this definition, the word "fraud" would be reserved only for situations in which deliberate deception is involved. Paul Offit has proposed four ways in which alternative medicine "becomes quackery": "...by recommending against conventional therapies that are helpful."
"...by promoting harmful therapies without adequate warning." "...by draining patients' bank accounts..." "...by promoting magical thinking..." Unproven ineffective, sometimes dangerous medicines and treatments have been peddled throughout human history. Theatrical performances were sometimes given to enhance the credibility of purported medicines. Grandiose claims were made for what could be humble materials indeed: for example, in the mid-19th century revalenta arabica was advertised as having extraordinary restorative virtues as an empirical diet for invalids. Where no fraud was intended, quack remedies contained no effective ingredients whatsoever; some remedies contained substances such as opium and honey, which would have given symptomatic relief but had no curative properties. Some would have addictive qualities to entice the buyer to return; the few effective remedies sold by quacks included emetics and diuretics. Some ingredients did have medicinal effects: mercury and arsenic compounds may have helped some infections and infestations.
However, knowledge of appropriate uses and dosages was limited. The science-based medicine community has criticized the infiltration of alternative medicine into mainstream academic medicine and publications, accusing institutions of "diverting research time and other resources from more fruitful lines of investigation in order to pursue a theory that has no basis in biology." R. W. Donnell coined the phrase "quackademic medicine" to describe this attention given to alternative medicine by academia. Referring to the Flexner Report, he said that medical education "needs a good Flexnerian housecleaning."For example, David Gorski criticized Brian M. Berman, founder of the University of Maryland Center for Integrative Medicine, for writing that "There evidence that both real acupuncture and sham acupuncture more effective than no treatment and that acupuncture can be a useful supplement to other forms of conventional therapy for low back pain." He castigated editors and peer reviewers at the New England Journal of Medicine for allowing it to be published, since it recommended deliberately misleading patients in order to achieve a known placebo effect.
With little understanding of the causes and mechanisms of illnesses marketed "cures" referred to as patent medicines, first came to prominence during the 17th and 18th centuries in Britain and the British colonies, including those in North America. Daffy's Elixir and Turlington's Balsam were among the first products that used branding and mass marketing to create and maintain markets. A similar process occurred in other countries of Europe around the same time, for example with the marketing of Eau de Cologne as a cure-all medicine by Johann Maria Farina and his imitators. Patent medicines contained alcohol or opium, while not curing the diseases for which they were sold as a remedy, did make the imbibers feel better and confusedly appreciative of the product; the number of internationally marketed quack medicines