When one hears this term, we tend to understand that this is a term used to describe something that offers a tested, tried alternative to mainstream systems of medicine. In India, we have three types of systems of treatment and diagnosis: the recognized, evidence-based one—the scientific system; the recognized but not evidence-based ones coming under the acronym AYUSH—Ayurveda, Unani, Siddha, and Homeopathy; and the third, which has a list that can almost never be complete, but common ones include electrohomeopathy, reiki, pranic healing, aromatherapy, music therapy, gem therapy, etc. The term “alternative medicine” perhaps describes the last class. This class seems to be the favorite hunting ground for quacks of all types.

The scientific system of medicine is popularly called allopathy, as the term was coined in those days when the more dominant system was called homeopathy, devised by a German called Hahnemann, who proposed that minute doses of those substances which could cause the symptoms of a particular disease in a healthy individual could cure that disease. Since the other system of medicine prevalent at that time believed otherwise, it was called allopathy, or “the other.” At that time, this system of medicine involved treatments like purging, bleeding, leech therapy, injections with toxic substances, etc. The side effects of these were so unpleasant that the patient many a time would be better off without the treatment! By contrast, homeopathy involved treatment with sugar pills and tinctures whose active ingredients, if any, were respectively milk sugar and ethanol. None of these could be harmful to normal people unless they were lactose intolerant! That explains why it became very popular. Those were the times when no treatment was better than drastic treatment, and the mortality rate was higher after treatment with the remedies described above under allopathy! Nomenclature apart, it was this scientific system that developed because it was not based on any irrefutable dogma and was subject to self-correction. Things that were the norm at one time got discarded when more sophisticated investigative methods showed that they were not desirable. Innumerable such examples can be given for this. For example, laxatives, which were prescribed at periodic intervals to all for cleaning the alimentary tract, are now no longer used unless needed for surgery or radiography; at one time, infection with malarial parasites was therapy for syphilis, etc. Once evidence to the contrary came up or less harmful methods of treatment or more efficient drugs were discovered, the older ones were discarded and consigned to the dustbins of history. Methods of diagnosis and treatment are not based on an individual’s idiosyncrasies, but on the methods of science. This system absorbed many things from other systems of medicine and knowledge, and grew.

On the contrary, the so-called alternative systems of medicine—many of which cannot be called that by any stretch of the most fertile imagination—are based on hypotheses unsupported by any evidence. They are based on the presumptions of certain individuals, pseudoscientific assumptions, and unsupported claims. They also peddle unproven remedies, devices, and books of dubious claims. There are arguments that these are very inexpensive, but facts prove otherwise. In quack therapies like “aromatherapy,” small phials of perfumes are sold at exorbitant prices. While one may claim that there are more expensive perfumes, there is no problem if a perfume is sold as such—one can decide whether one wants to purchase it at the quoted price. But when it is claimed as a curative, evidence is needed, which is never forthcoming. Most of the time, the so-called evidence offered by these proclaimers of alternative medicine consists of testimonials from well-known individuals.

Many countries have very effective laws to deal with these so-called alternative systems. If anyone claims that their concoction, device, or incantation can be used as a treatment for any disease, it is for them to prove it. If one fails, they are subjected to heavy penalties, including imprisonment. That is why many peddlers of such remedies do not carry on their activities in those countries. Some of our peddlers of such concoctions remain silent about their claims in such countries, and some of them pitch their sales by calling them nutritional supplements made from edible ingredients! Some of them could not be sold as such either, because of unacceptable levels of toxic metals and the like. But in our country, these people are lucky; although there are laws like the Consumer Protection Act, the section under unfair trade practices of the MRTP Act, and the Drugs and Magic Remedies (Objectionable Advertisements) Act, the peddlers of these dubious concoctions and quack remedies manage to get away through various loopholes, such as claiming them to be traditional remedies or under religious freedom, etc. Sometimes the advertisements are so cleverly worded that it is very difficult to pin them down. Under many of these laws, only affected parties can complain or go in for litigation, which they are loath to do. These practices are so rampant that even a Supreme Court judgment has not affected them. In 2004, the Supreme Court of India passed a judgment on more than a dozen so-called systems of medicine, stating that they have absolutely no scientific basis and should not be allowed to be practiced as systems of medicine. These include, in addition to those already mentioned above, things like magnetotherapy, gem therapy, color therapy, urine therapy, etc.

Again, the term “therapy” is a very vague term! So a hotel could call itself an Institute of Nutritional Therapy—since there are some calling themselves Naturopathic hospitals and the practitioners Naturopathic doctors. If nature itself can heal, we don’t know why these so-called therapists are needed! One can get a certificate for many of these quack therapies from degree mills offering them, and then call themselves therapists and prefix “Dr.” to their names! I can always say that I am under treatment for “breathotherapy” and every day get my therapy from the Institute of Nutritional Sciences round the corner (of course, a fancy name for a restaurant!). A barber could call himself a tonsorial therapist (surgeons used to be those long back, and that is why surgeons have the title “Mr.” in England!), and so on.

How do these alternative therapies gain legitimacy? One way is through their ads and programs on TV channels. We can see many of these so-called specialists on TV channels—the “cancerologists,” the “kidneyologists,” the “sexologists,” and so on. That a qualified person in the field is barred from advertising is not known to the lay public, and hence they think that these are genuine. Of course, the terminology I have used for these so-called specialists is deliberate, as the respective specializations are named differently among really qualified practitioners. Then we have people with respectable qualifications endorsing such quacks. Once, I remember a professor of medicine who was also the Dean of a Medical College inaugurating the asthma relief camp of a steroid quack. The very same person, who went on to become the Vice Chancellor of a deemed university, also presided over a convocation of a quack and handed over degrees to other quacks. The quack who was the leader was hounded out of Mangalore and is now pursuing his quackery at Kolhapur, I am told! Some qualified people treat patients referred to them by such practitioners, treating them as if they were professional colleagues. One thing that has to be admired about these alternative medicine guys is their gift of the gab! Their bedside manner and their use of pseudoscientific jargon could put any genuine specialist to shame! Their easy accessibility, flexible terms of payment, money-back guarantees, and other such attractive qualities are another plus point.

For those who are very fond of alternatives from our ancient civilization—want an alternative mobile? Breed homing pigeons and carry them in your pocket; you can send home messages using your alternative mobile. Want an alternative idiot box? Take a cardboard box of the size you want and go to the performance you want to see—open it, hold it in front of your face, and you have an alternative TV with full stereo hi-fi audio! Want an alternative car? Go to our villages: you have the all-terrain one- or two-ox-power models! I am sure even the most vehement supporters of so-called alternative medicine would not want any of these! In that case, why does this so-called alternative medicine work sometimes? As any honest general practitioner will tell you, 80% of patients have some self-limiting disorder! These patients will get cured whether any treatment is taken or not. It is the main task of the family doctor to decide whether you need specialist treatment or not. This doctor also prescribes palliatives so that the symptoms become manageable.

So, that raises the question: how safe is it to go to these quacks? One has to remember that without proper training, these people are in no position to determine who comes under which category. Again, they refuse to admit failure and go on administering different things about which they have little knowledge and/or training. Some diseases that can be cured in the starting stages become untreatable later, like cancers. Some emergencies require immediate treatment, like an acute abdomen, internal bleeding, etc. So please remember that there are no alternative lives and no alternative to good health when you think of something like alternative medicine. Again, remember: a color therapist will not go to a gem therapist when he is ill! He will go to the nearest qualified specialist in scientific medicine with all the latest gadgets and drugs! To hell with alternative treatments! As a wag remarked, let us see a music therapist treat an aromatherapy practitioner, or vice versa!

Despite all the shortcomings that can be blamed on evidence-based, scientific medicine—it works, it is based on sound evidence, and it is peer-reviewed. It is not based on any individual’s untested hypothesis, divine revelations, or personal testimonials. It changes as new findings emerge, always subject to self-criticism and peer review. In fact, most published work is a review of past methods. More importantly, it changes and does not crow about the good old times when everything was so good and everyone was so healthy. It does not have any unquestionable central dogma.