ALTERNATIVE MODALITIES,

ALTERNATIVE SYSTEMS OF
HEALTH
DEFINITIONS
1. Alternative Modalities. A diverse group of therapies and practices used in place of
conventional medicine for the purpose of increasing comfort or relaxation, maintaining,
improving or restoring health and harmony of the body, mind, and/or spirit, improving coping
mechanisms, reducing stress, relieving pain and/or increasing the clients sense of well being.
2. Client. A person who is a consumer of health care services.
3. Complementary Modalities. A diverse group of therapies and practices used together with
conventional medicine for the purpose of increasing comfort or relaxation, maintaining,
improving or restoring health and harmony of the body, mind, and/or spirit, improving coping
mechanisms, reducing stress, relieving pain and/or increasing the clients sense of well being.
4. Integrative Care. The combination of both complementary modalities and alternative
approaches with conventional medicine. Integrative care includes multiple modalities in the
overall patient-centered plan of care.
5. Licensed Independent Practitioner.
An individual permitted by Oregon law to
independently make a medical diagnosis, provide care, treatment and services that are within the
individuals scope of practice.
6. Licensed Nurse. All RNs and LPNs licensed under ORS 678. In this document, licensed
nurse may also apply to the NP and CNS.
7. Nursing Diagnostic Statements. The nursing diagnoses or reasoned conclusions which are
developed as a result of nursing assessment. They describe a clients actual or potential health
problems which are amendable to resolution by means of nursing strategies, interventions or
actions.
With increasing client and professional interest in alternative and complementary care, registered
nurses are incorporating alternative and complementary modalities into their practices outside
the traditional health care setting. Alternative nursing is defined using nursing theory and models
of assessment, reflection and holism. Nursing and the concept of holism provides a framework
for the practice of complementary/alternative modalities inside and outside the institutional
setting. Further, charting of nursing diagnosis and nursing interventions with

alternative/complementary therapies demonstrate how they are incorporated into the nursing
process. Examples provided are a partial list of certification resources that are advantageous in a
professional alternative nursing practice.
Reviews of holistic nursing web sites support the premise that registered nurses are incorporating
complementary and alternative medicine (CAM) into their practices outside of traditional
nursing occupations. While some institutions have the monetary capital to encourage nurses to
integrate CAM practices into their workplace, most do not. For many administrators it is a
simple equation: if insurance covers the cost of complementary and alternative modalities, the
scientifically researchable ones are integrated; if insurance doesnt pay for them, they are not
incorporated.
Scores of individuals pursue careers in nursing because they yearn to work in a compassionate
manner, but traditional nursing positions are often perceived as stressful and the environments
uncaring. In some work places, the nurses quality of living perspectives are often overlooked or
not considered important.
Many studies have addressed the dissatisfaction that nurses find in their jobs and some quit their
mainstream nursing positions so that they can work in an environment that is more satisfying.
These departing nurses will tell you that they want to find an outlet to more fully express their
innate talents. They may even seek an education outside the nursing profession in a related
caring field such as psychology and theology.
They seek situations that match their value systems, and harmonize with their holistic beliefs.
They want the freedom to practice caring in a way that seems more natural to them. Large
numbers of nurses are attracted to CAM modalities but they must be creative when integrating
their healing techniques into their practices outside of the mainstream workplace.
The typical alternative nursing practices include such modalities as aromatherapy, herbal
medicine, energy work, meditation, guided imagery, medical massage and cranio sacral therapy
to name just a few. Nurses with alternative practices can be found in business and home based
offices as well as in beauty and health settings such as spas, cruise ships, and wellness centers.

Regulation of Practice
The practice of nursing is regulated by each state and the ability of nurses to bring alternative
and complementary modalities into a nursing framework depends upon how each state defines
CAM and integrates it into the profession. Nurses wanting to work outside the current traditional
health care system while maintaining a nursing license must contact their states board of nursing
and ask for a contact person who can help with the legalities of setting up an alternative nursing
practice .

Nursing Theory in Practice

In her article, Nursing as a Context for Alternative/Complementary Modalities,Noreen Cavan
Frisch, Ph.D. (2001), explains how nursing theories, that form conceptual models for practice,
and taxonomies such as nursing diagnoses, provide a unique and discipline specific view of
professional care. Theories help to articulate new worldviews, and they suggest how nurses think
about care. Each theory addresses concepts of the nursing paradigm in different ways. For
instance, Dr. Callista Roys theories asks the nurse to explore the relationships between the
client, the health of the client and their significant others, and the environment where healing
takes place (Roy, 1999). Such theories ensure that the nursing practice is consistent with
recognized nursing principles and values. Nursing theory provides the concepts, language and
worldview to conceptualize nursing care and, at the same time, a framework that tells how, why
and when to use alternative and complementary modalities. As CAM modalities are documented
according to theory and with the standard taxonomies, they are then acknowledged in peerreviewed journals and the modalities are slowly brought into the domain of nursing activities.
For instance, Margaret Neumans theory of pattern recognition gives the nurse a conceptual
framework for applying modalities that are based on recognizing patterns of archetypal
expression in such insight-producing therapies as astrology, Tarot counseling, guided imagery,
and dream interpretation. Neumans theory explains how client insights lead to an expanded
awareness that is a necessary component of growth and development (Neuman, 1999) This fits
nicely with what health psychology researchers like Jeanne Achterberg and others have told us
for over thirty years---that careful attention to the development of the mind and spirit are what is
needed for optimal psychological and physical healing to occur (Achterberg. 1985) Alternative
and complementary modalities that are incorporated into an alternative nursing practice that is
consistent with nursing theory are given significance by those theories. For instance, Martha
Rogers theoretical contribution brings reflection upon human and environmental energy fields
and guides the practice so that the nurse can incorporate concepts of energy exchange such as
Reiki and Therapeutic Touch for the benefit of client healing (Neuman, 1999). Jean Watsons
philosophy and theory of human caring opens the door for deep relating in an authentic
relationship and facilitates nursings expansion into the spiritual aspects of the person being
cared for. In part,
Watsons theory makes ministerial duties an accepted part of the nursing domain (Barrett, 2000).
Just as nursing theory is used to thoughtfully understand and interpret a nurses action, the
actions need proper documentation in order to incorporate them into a professional context.

Selected Nursing Diagnoses and Nursing Interventions: Possible Pairings of Nursing

Concerns and Complementary/Alternative Interventions
Nursing
Diagnosis/concern

Nursing Intervention(s)

Rationale

Impaired Comfort

Acupressure, TT

to decrease perceived pain

Disturbed
Pattern

Massage

to promote relaxation, rest

Social Isolation

Animal-Assisted Therapy

to provide affection

Impaired Coping

Humor

to facilitate appreciation of that

which is funny, to relieve tensions

Hopelessness

Hope instillation

to promote a positive sense of the

future

Spiritual Distress

Spiritual support

to facilitate a sense of inner peace

Spiritual Well-Being

Spiritual growth facilitation

to
support
growth/reflection
reexamination of values

Anxiety or Fear

Guided imagery, relaxation therapy, to reduce sense of anxiety

biofeedback, calming techniques

Impaired
Communication

Sleep

Art therapy

to facilitate expression

Documentation in an Alternative Practice

Documentation of nursing care using CAM modalities makes it clear that the care provided is
practiced within the scope of the nursing profession. Using taxonomies such as NANDA
Classification of Nursing Diagnoses makes a statement of client problems and nursing concerns
as well as opportunities to promote wellness. As nurses use the classification system they are
accomplishing three important things: identification of work as within the scope of professional
nursing, appropriate documentation of care, and adding to a body of knowledge for nurses to use
about specific interventions (Cavan Frisch, 2001). The chart below is an example of how nursing
diagnoses (together with nursing theory) guide the interpretation of the clients situation and the
selection of appropriate nursing care.
The documents of nurses who use CAM chart the traditional assessment phase that begins with
first contact with the client. Nurses cordially greet the client, while conducting a visual scan for
clues about health and hygiene. They tune into intuitive sensations at the moment of the first
encounter, and continue to seek further evidence for support. During the initial interview the
nurse gains a perspective on the philosophy or religion the family values are based upon. This
forms the foundation for the nurse to gain an understanding of clients world, from their point of

view, as the nurse listens to their biographical stories. The nurse furthers her understanding by
paying attention to the clients emotional state and asking about that persons experiences and
beliefs about health. Eventually, the nurse and the client plan interventions that fit a clients
perceived needs. The nurse plans holistically, considering the individuals values when creating
treatments that treat the whole person. They discuss things like diet and exercise changes,
visualization, and various religious and non-religious rituals such as prayer and meditation. The
care given is documented in a nursing context using nursing diagnosis, goal directed actions, and
measurable outcomes.

Observations of Lay Alternative Practitioners

Generally speaking, unlicensed alternative practitioners in the healing arts are intelligent and
gifted. The masters among them are usually self taught and have focused upon their subject and
perfected their craft. Some among the alternative community have much to offer the nursing
profession and should be given consideration when offering health professionals continuing
education. Like professional practitioners, lay people may not reach their full potential as
healers until they have been practicing their healing techniques for 10 to 20 years. However,
careful attention should be used when consulting a lay practitioner. A good rule of thumb might
be to consider the lay person an apprentice if they have less than 10 years experience in the
techniques that they offer. If they have less than 3 years experience, they should not be taken
seriously as they may be in an idealistic stage or someone looking to cash in on the health care
market.
Further, when working with the lay alternative practitioner, keep in mind that they are not
required employing the same professional guidelines that the licensed nurse must follow. The lay
persons customs, conduct and knowledge may not be the same as the trained licensed nurse.

Integration within the Nursing Profession

Nursing theorists have made a difference in the way that the profession is perceived,
experienced and practiced, but because the nursing field has been slow to change, some nurses
have sought higher education degrees outside of the nursing profession. In part, this has
enhanced the growth of the ever expanding role of the professional nurse. Pioneering alternative
nurses explore esoteric therapeutic modalities and then introduce them to nursing in language
that can be understood. Modalities such as astrology and Tarot then become integrated with
traditional ones to become a part of the new holistic paradigm of complementary and alternative
care. Although we have a long way to go before we place a fully integrated profession within
the walls of our institutional workplaces, traditional practice and alternative practice nurses can
be proud of what they are accomplishing within the hallowed halls of the nursing profession.

COMPLEMENTARY THERAPY
Many people use complementary (sometimes known as alternative) health treatments to go along
with the medical care they get from their doctor. These therapies are called "complementary"
therapies because usually they are used alongside the more standard medical care you receive
(such as your doctor visits and the anti-HIV drugs you might be taking). They are sometimes
called "alternative" because they don't fit into the mainstream, Western ways of looking at
medicine and health care. These therapies may not fit in with what you usually think of as
"health care."
Some common complementary therapies include:
Physical (body) therapies, such as yoga, massage, and acupuncture
Relaxation techniques, such as meditation and visualization
Herbal medicine (from plants)

DEFINITION
Complementary therapy is based on the interaction between the mind, body and the energy
systems combining them; this holistic approach to healing is found useful for the treatment of
conditions such as asthma, migraine, eczema, insomnia, low energy levels and stress.

The Benefits of Complementary Therapy

Complementary therapies can help to restore the bodys natural equilibrium and balance
and when the body is relaxed and in balance it can cope with the everyday stresses and
strains of life much more effectively.
Complementary therapies can ; boost the immune system, help eliminate toxins, help
relieve pain, improve circulation, improve sleep patterns, increase energy levels, induce
deep relaxation, reduce stress and tension, restore balance to body systems.
Complementary therapies can be used to target a specific physical, mental, emotional or
spiritual problem, or as a preventative measure or purely for relaxation so whether you
have a specific health problem or you just want to increase your feeling of well-being or
simply relax more, why not try one of these beneficial therapies and see what it can do
for you.

REFLEXOLOGY

The technique for Reflexology is similar in principle to acupuncture, it involves working

with the reflex points on the hands or feet to release congestion or blockages in the vital
energy pathways that flow around the body, allowing the energy to flow freely and
restore the body back to its natural balanced state.

It is based on the principle that there are reflexes on the feet and hands that relate to each
organ, gland and structure in the body, in effect, the feet and hands are miniature maps of
the entire body and that tension, blockages or congestion in different parts of the body
will be reflected in the body reflexes found on the feet or hands.
Gentle stimulation of the appropriate reflex points on the hands or feet will restore the
flow of vital energy around the body, thereby allowing the body to heal itself at its own
pace.

What to expect during a Reflexology Treatment?

On your first visit there is a preliminary talk with the practitioner and you will be asked
to give a brief medical history, details of any problems you may be experiencing
currently and some pertinent information regarding your lifestyle.
On any subsequent visits a brief discussion will take place to enable you to update the
practitioner on any developments following on from the last session. Each case is looked
at holistically on an individual basis.
The number of treatments required will depend on the condition being treated and how
long it has existed and the practitioner will discuss and reassess this throughout the
course of treatments.
All treatments last approximately 1 to 1 hours and take place in the comfort and
serenity of my healing rooms surrounded by soothing aromas and gentle relaxing music.
The Reflexology treatment is carried out in the comfort of a reclining chair and can be
performed on the feet or the hands, if preferred. The stimulation of the reflexes is gentle
but firm so that the effect is soothing and does not tickle.
If there is any discomfort felt on any of the reflexes it is usually fleeting and is an
indication of congestion of imbalance in the related part of the body. Most people find the
sessions deeply relaxing and rejuvenating and all will benefit in a way most appropriate
to themselves.
For each person the application and effect of the therapy is unique.
All the details of the whole consultation are completely confidential and client modesty is
respected at all times.

MASSAGE

Massage has been used for centuries to prevent and aid recovery from diseases and heal
injuries.
Massage is a series of stroking, kneading, pressure and percussion movements applied to
the surface of the body using cream or oil as a lubricant.
The stresses and strains of modern living give rise to many physical complaints and as
anxiety and tension build up in the body, they cause harmful effects on the system which
often manifest themselves as muscular or skeletal problems.

One of the prime benefits of massage is to the musculature system, to restore muscle tone
by either loosening tight muscles or tightening loose muscle, removing toxic waste
products from the muscle and improving the circulation, and lymph drainage.
The relaxing rhythmic movements of massage soothe away the aches and pains of the day
and the effect that massage produces can help prevent the stresses and strains of modern
living from having the cumulative effect on the body that can lead to illness and disease.

What to expect during a massage treatment?

On your first visit there is a preliminary talk with the practitioner and you will be asked
to give a brief medical history, details of any problems you may be experiencing
currently and some pertinent information regarding your lifestyle.
On any subsequent visits a brief discussion will take place to enable you to update the
practitioner on any developments following on from the last session. Each case is looked
at holistically on an individual basis.
The number of treatments required will depend on the condition being treated and how
long it has existed and the practitioner will discuss and reassess this throughout the
course of treatments.
The length of the treatment varies depending on the composition of the massage session
and usually each session is tailored to the specific needs of the recipient at that time. A
full body massage lasts approximately 1 to 1 hours, a back, neck and shoulder massage,
a foot massage, a foot and leg massage or a hand, arm and shoulder massage all last for
30 minutes and a back, head, neck and shoulder massage lasts for approximately 45
minutes.
All treatments are carried out on a therapy couch and take place in the comfort and
serenity of my healing rooms surrounded by soothing aromas and gentle relaxing music.
If there is any discomfort felt on any parts of the body during the massage session it is
usually short lived and is an often an indication of a build up of tension in the muscles.
Most people find the sessions deeply relaxing and beneficial and for each person the
application and effect of the therapy is unique

PHYSICAL (BODY) THERAPIES

Physical, or body, therapies include such activities as yoga, massage, and aromatherapy. These types
of therapies focus on using a person's body and senses to promote healing and well-being. Here you
can learn about examples of these types of therapies.

YOGA

Yoga is a set of exercises that people use to improve their fitness, reduce stress, and increase
flexibility. Yoga can involve breathing exercises, certain stretches and poses, and meditation.
Many people, including people with HIV, use yoga to reduce stress and to become more
relaxed and calm.
Some people think that yoga helps make them healthier in general, because it can make a
person's body stronger.

If you would like to try yoga, talk to your health care provider. There are many different types
of yoga and various classes you can take.
You can also try out yoga by following a program on videotape.
Before you begin any kind of exercise program, always talk with your doctor.

ACUPUNCTURE

Acupuncture is part of a whole healing system known as traditional Chinese medicine.

During acupuncture treatment, tiny needles (about as wide as a hair) are inserted into
certain areas of a person's body. Most people say that they don't feel any pain at all from
the needles.
Many people with HIV use acupuncture. Some people think that acupuncture can help
treat symptoms of HIV and side effects from the medicine, like fatigue and stomach aches.
Some people say that acupuncture can be used to help with neuropathy (body pain caused
by nerve damage from HIV or the medicines used to treat HIV).
Others report that acupuncture gives them more energy.
If you are interested in trying it out, ask your doctor to recommend an expert. At the end
of this guide are links to Web sites where you can read more about the history of
acupuncture and how it works.

AROMATHERAPY

Aromatherapy is based on the idea that certain smells can change the way you feel. The smells
used in aromatherapy come from plant oils, and they can be inhaled (breathed in) or used in
baths or massages.
People use aromatherapy to help them deal with stress or to help with fatigue. For example,
some people report that lavender oil calms them down and helps them sleep better.
The oils used in aromatherapy can be very strong and even harmful. Always talk with an
expert before buying and using these oils yourself.

RELAXATION TECHNIQUES
Relaxation therapies, such as meditation and visualization, focus on how a person's mind and
imagination can promote overall health and well-being. In this section, you can read about some
examples of how you can use relaxation therapies to reduce stress and relax.

MEDITATION

Meditation is a certain way of concentrating that allows your mind and body to become
very relaxed. Meditation helps people to focus and be quiet.
There are many different forms of meditation. Most involve deep breathing and paying
attention to your body and mind.
Sometimes people sit still and close their eyes to meditate. Meditation also can be casual.

For instance, you can meditate when you are taking a walk or watching a sunrise.
People with HIV can use meditation to relax. It can help them deal with the stress that
comes with any illness. Meditation can help you to calm down and focus if you are
feeling overwhelmed.

VISUALIZATION

Visualization is another method people use to feel more relaxed and less anxious. People
who use visualization imagine that they are in a safe, relaxing place (such as the beach).
Most of us use visualization without realizing it--for example, when we daydream or
remember a fun, happy time in our lives.
Focusing on a safe, comfortable place can help you to feel less stress, and sometimes it
can lessen the pain or side effects from HIV or the medicines you are taking.

HERBS AND DIETARY SUPPLIMENTS

These therapies may involve the use of herbs such as Echinacea, garlic, goldenseal, chamomile,
and Chinese herbs. Health professionals may also prescribe foods and vitamins as part of a
biological-based therapy. Multivitamins and minerals such as Vitamin A, C, and E contain
antioxidants, which neutralize the effects of dangerous particles called free-radicals. These
free-radical particles are natural by-products of the bodys functions, but they cause damage to
cells and lead to disease.

ESSENTIAL OILS
Essential oils can fight routine bacterial and viral infections in place of prescription antibiotics
that can weaken the immune system. Essential oils also aid immune cells to fight viruses and
bacteria. Some essential oils such as lavender, bergamot, and eucalyptus perform both of these
functions. Essential oils of rosemary, geranium and black pepper also support the immune
system. Tea Tree oil is an excellent natural antiseptic. Any use of essential oils should be
discussed with your doctor.

MIND- BODY TECHNIQUES

These activities enhance the mind's ability to affect bodily functions and symptoms. Mind-body
techniques often include patient support groups, meditation, prayer, mental healing, and
therapies that use creative outlets such as art, music, or dance.
Deep Relaxation involves using audiotapes to guide you in accessing deep states of relaxation.
Techniques include meditation, mindfulness, guided visualization, progressive muscle relaxation,
prayer or Chinese exercises such as Chi Gong, and Tai Chi.
Developing a sense of purpose and meaning also enhances immune functions. Research has
found that cancer patients who find purpose in life often experience physical improvements, and
even long-term survival. In a study of people who survived AIDS-related deaths, survivors had a
strong will to live and were engaged in meaningful activities and relationships. Other studies

show that prayer and other spiritual activities have also been associated with better overall
health, healing, and long term survival with HIV.

How can managing stress improve immune functions?

Mind-body techniques decrease stress, which can physically affect the body. The basic
premise of mind/body medicine is that our thoughts, feelings, and mental states influence
our bodies at the physical level and express themselves in our health.
The brain has often been called the organ of the mind because it connects to the immune
system through nerve fibers that reach into all of the organs and systems. When you
experience stress, the nervous system becomes hyperactive and provokes the effects of
the immune systems over and over again.
This causes the body to move into a state commonly called fight or flight. In this state,
the immune system becomes weakened and the adrenal glands become exhausted causing
the body to feel weak and lethargic. You can also experience dizziness, headaches,
memory loss, irritability, allergies, cold and flu symptoms and more serious illnesses.
Studies have shown that people with high levels of social support and intimate
relationships have stronger immune systems and fewer illnesses.
Research at Southern Methodist University in Dallas has shown that confiding thoughts
and feelings about traumas -- if only by writing them down -- improves immune function.
Seeking a support group in your area can reduce stress and benefit overall health.

What kind of complementary treatment may my

doctor prescribe?
When prescribing complementary treatment, the doctor makes decisions based on the patients
condition and other factors such as the patients strengths, lifestyle, medical history, support
systems, and all other factors relating to ones health and wellness. This enables the physician to
knit together a program tailored for each patient and may involve the following:

Diet Change: Replacing refined/ enriched carbohydrates with whole grains, fresh
vegetables, and fruits for overall health. Your doctor may also suggest choosing low-tomoderate fat sources of protein such as turkey, chicken, and fish and limiting dairy and
red meats.
Vitamin and mineral supplements: Your doctor may prescribe multivitamin/mineral
supplements that must include Vitamins A, D, E, K, and C (these are free- radical
fighting anti- oxidants). B-vitamins, calcium, iron, iodine, magnesium, copper, zinc,
manganese, potassium, chromium, and selenium can all enhance the immune system in
proper dosage.
Herbs: A variety of herbs support body functions. These include garlic, Echinacea,
goldenseal, and myrrh. Doctors may prescribe Chinese herbs, such as Astragulus,

Ganoderma, Atractylodes, and Schizandra support immune functions and contain

antiviral, antibacterial and stress reduction properties.
Digestive health treatments: Herbs such as black walnut, berberine, grapefruit seed
extract, and wormwood support digestive functions. Acidophyllus helps maintain a
healthy digestive system, but should be used with caution. Mainstream antiparasitic
(drugs which kill parasites or bugs in the body) drugs also relieve digestion problems.
Exercise: Each day, one-half hour of enjoyable exercise that causes sweating, signals the
removal of waste from the body (and possibly the reduction of virus replication).
Cardiovascular fitness can strengthen the heart and circulatory system. This is done by
simply increasing ones heart rate about 20 percent more than resting heart rate, and
keeping it up for at least 20 minutes, at least six times per week.
Stress reduction: Deep relaxation practice two times per day for 15-20 minutes can
reduce many health risks and maintain ones focus on practicing good health and
wellness.

ALTERNATIVE SYSTEMS OF HEALTH

Alternate Systems of Medicine
Ayurveda is that knowledge of life, which deals elaborately and at length with conditions
beneficial or otherwise to the humanity. It deals with getting to the root of the issue and
treatments involve the usage of natural/ herbal products.
Yoga is a science as well an art of healthy living physically, mentally, morally and
spiritually. It is not limited by race, age, sex, religion, cast or creed and can be practiced
by those who seek fitness and well-being.
Naturopathy or Nature Cure treatment primarily stresses on the curing of the body in the
most natural manner i.e. give the body time to heal on its own. The five main modalities
of treatment are air, water, heat, mud and space.
Homeopathy has been practiced in India for more than a century and a half. It is
recognized as one of the National Systems of Medicine and plays an important role in
providing health care to a large number of people. Its strength lies in its holistic approach
towards the sick individual through promotion of inner balance at mental, emotional,
spiritual and physical levels.
Unani postulates that the body contains a self-preservative power, which strives to restore
any disturbance within the limits prescribed by the constitution or State of the individual.
The physician merely aims to help and develop rather than supersede or impede the
action of this power.
Siddha is very similar to Ayurveda. In the Siddha system, chemistry has been well
developed into a science auxiliary to medicine and alchemy. The knowledge of plants and
mineral are of very high order in this form of treatment.

Acupressure is the application of pressure or localized massage to specific sites on the

body to control symptoms such as pain or nausea. This therapy is also used to stop
bleeding. It is derived from traditional Chinese medicine, which is a form of treatment for
pain that involves pressure on particular points in the body knows as "acupressure
points".
Acupuncture (External website that opens in a new window) is an ancient Chinese form
of medicine, which involves the insertion of pins in certain vital points of the body. It is
used for the treatment of chronic pain conditions such as arthritis, bursitis, headache,
athletic injuries, and posttraumatic and post surgical pain. It is also used for treating
chronic pain associated with immune function dysfunction such as psoriasis (skin
disorders), allergies, and asthma. Some modern application of acupuncture is in the
treatment of disorders such as alcoholism, addiction, smoking, and eating disorders.
Telemedicine refers to the use of communication and information technologies for the
delivery of clinical care. It may be as simple as two health professionals discussing a case
over the telephone, or as complex as using satellite technology and video-conferencing
equipment to conduct a real-time consultation between medical specialists in two
different countries. The Department of Information Technology (DIT) - External website
that opens in a new window had taken up the initiative for defining the Standards for
Telemedicine Systems in India, through the deliberations of the committee on
"Standardization of digital information to facilitate implementation of Telemedicine
system using IT enabled services(External website that opens in a new window)" under
the chairmanship of the Secretary, DIT. Simultaneously, DIT undertook another
initiative, in a project mode, for defining "The framework of Information Technology
Infrastructure for Health (ITIH)" to efficiently address information needs of different
stakeholders in the healthcare sector. The department has issue specific guidelines for
practicing telemedicine in India.

AYURVEDA
Ayurveda ( yurveda, "the complete knowledge for long life") or ayurvedic medicine is a
system of traditional medicine native to India and practiced in other parts of the world as a form
of alternative medicine. In Sanskrit, the word ayurveda consists of the words yus, meaning
"longevity", and veda, meaning "related to knowledge" or "science". Evolving throughout its
history, ayurveda remains an influential system of medicine in South Asia. The earliest literature
on Indian medical practice appeared during the Vedic period in India. The Suruta Sahit and
the Charaka Sahit were influential works on traditional medicine during this era. Over the
following centuries, ayurvedic practitioners developed a number of medicinal preparations and
surgical procedures for the treatment of various ailments. In Western medicine, ayurveda is
classified as a system of complementary and alternative medicine (CAM) that is used to
complement, rather than replace, the treatment regimen and relationship that exists between a
patient and their existing physician.

Eight disciplines of ayurveda treatment, called ashtangas , are given below:

Internal medicine (Kaaya-chikitsa)

Paediatrics (Kaumarabhrtyam)
Surgery (Shalya-chikitsa)
Eye and ENT (Shalakya tantra)
Demonic possession (Bhuta vidya): Bhuta vidya has been called psychiatry.
Toxicology (Agadatantram)
Prevention diseases and improving immunity and rejuvenation (rasayana)
Aphrodisiacs and improving health of progeny (Vajikaranam)
Diagnosis
The Charaka Samhita recommends a tenfold examination of the patient.[14] The qualities to be
judged are: constitution

abnormality
essence
stability
body measurements
diet suitability
psychic strength
digestive capacity
physical fitness
age

In addition, Chopra (2003) identifies five influential criteria for diagnosis:

origin of the disease

prodrominal (precursory) symptoms
typical symptoms of the fully developed disease
observing the effect of therapeutic procedures
the pathological process'

Ayurvedic practitioners approach diagnosis by using all five senses. Hearing is used to observe
the condition of breathing and speech. The study of the vital pressure points or marma is of
special importance.
Homeopathy (also spelled homoeopathy or homopathy) is a form of alternative medicine in
which practitioners treat patients using highly diluted preparations that are believed to cause
healthy people to exhibit symptoms that are similar to those exhibited by the patient. The
collective weight of scientific evidence has found homeopathy to be no more effective than
aplacebo.

The basic principle of homeopathy, known as the "law of similars", is "let like be cured by like".
Explanations of effects
Further information: Statistical hypothesis testing, P-value, and Publication bias
Mainstream science offers a variety of explanations for how homeopathy, if the preparations
themselves are ineffective, may appear to cure diseases or alleviate symptoms:

Unassisted natural healing time and the body's ability to heal without assistance can
eliminate many diseases of their own accord
Unrecognized treatments an unrelated food, exercise, environmental agent or treatment
for a different ailment, may have occurred
Regression toward the mean since many diseases or conditions are cyclical, symptoms
vary over time and patients tend to seek care when discomfort is greatest, they may feel
better anyway but because the timing of the visit to the homeopath they attribute
improvement to the remedy taken
Non-homeopathic treatment patients may also receive non-homeopathic care
simultaneous with homeopathic treatment, and this is responsible for improvement though a
portion or all of the improvement may be attributed to the remedy
Cessation of unpleasant treatment often homeopaths recommend patients stop getting
conventional treatment such as surgery or drugs, which can cause unpleasant side effects;
improvements are attributed to homeopathy when the actual cause is the cessation of the
treatment causing side effects in the first place
Lifestyle changes homeopaths often recommend diet and exercise, as well as limitations
in alcohol or coffee consumption and stress reduction, all of which can increase health and
decrease symptoms
The placebo effect the intensive consultation process and expectations for the
homeopathic preparations can result in the release of endorphins or other body-effecting
chemicals which alleviate pain or other symptoms, or otherwise affect an individual's biology
Psychological healing the care, concern and reassurance provided by a homeopath as part
of the consultation can assure the patient the symptoms are minor and easily treated, or
alleviate tension that could exacerbate a preexisting condition. This caring engagement can
prove particularly effective when conventional physicians have limited time with the patient
or cannot provide a diagnosis or treatment.
Publishing standards, p-value - Even if something is not effective, the way publishing works
means that you must still expect about 1 in 20 tests to show that it is effective. The standard
to publish a positive effect is as follows - If something is assumed to be false, and then the
outcome of the experiment has only about a 1 in 20 chance of happening, then you can
publish that it is effective. This means that about 1 in 20 tests will show homeopathy works,
even if it is in fact false.

Publication bias - If a believer in something conducts a test of homeopathy and the test says
that something is wrong, they might not publish that there will be no effect, because that
would mean they are wrong in their belief. But they would be expected to publish when
there is a positive effect, because this means their belief is not wrong. So many of the
disproving tests of that something may not get published. Even though something is false,
since we already expect about 1 in 20 tests to erroneously show it is true, we get even more
than about 1 in 20 publications showing that homeopathy is not false. This is called
publication bias.

UNANI
Unani-tibb or Unani Medicine also spelled Yunani Medicine means "Greek Medicine", and is
a form of traditional medicine widely practiced in South Asia. It refers to a tradition of GraecoArabic medicine, which is based on the teachings of Greek physicianHippocrates, and Roman
physician Galen, and developed in to an elaborate medical System
by Arab and Persian physicians, such as Rhazes, Avicenna (Ibn Sena), Al-Zahrawi, Ibn Nafis.
Unani medicine is based around the concepts of the four
humours: Phlegm (Balgham), Blood (Dam), Yellow bile (afr') and Black bile (Saud')
As an alternative form of medicine, Unani has found favor in India. These Unani practitioners
can practice as qualified doctors in India, as the government approves their practice. Unani
medicine is very close to Ayurveda. Both are based on theory of the presence of the elements (in
Unani, they are considered to be fire, water, earth and air) in the human body. (The elements,
attributed to the philosopher Empedocles, determined the way of thinking in Medieval Europe.)
According to followers of Unani medicine, these elements are present in different fluids and their
balance leads to health and their imbalance leads to illness.
In India, there are forty(40) Unani Medical Colleges where Unani System of medicine is taught,
in five and half year courses and the graduates are awarded BUMS (Bachelor of Unani Medicine
and Surgery). There are about 8 Unani medical Colleges where a Postgraduate degree is being
awarded to BUMS Doctors. all these colleges are affiliated to reputed universities and
recognized by the Governments.

SIDDHA
A Siddha in Sanskrit means "one who is accomplished" and refers to perfected masters who,
according to Hindu belief, have transcended the ahamkara (ego or I-maker), have subdued their
minds to be subservient to their Awareness, and have transformed their bodies (composed mainly
of dense Rajo-tama gunas) into a different kind of body dominated by sattva. This is usually
accomplished only by persistent meditation.

According to Jain belief Siddha are liberated souls who have destroyed all the karma bondings.
Siddha do not have any kind of body, they are soul at its purest form.
A siddha has also been defined to refer to one who has attained a siddhi. The siddhis as
paranormal abilities are considered emergent abilities of an individual that is on the path to
siddhahood, and do not define a siddha, who is established in the Pranav or Aum the spiritual
substrate of creation. The Siddha in its pure form means "the attainment of flawless identity with
Reality (Brahman); perfection of Spirit."

ACUPUNCTURE
Acupuncture is an alternative medicine that treats patients by insertion and manipulation of
needles in the body. Its proponents variously claim that it relieves pain, treats infertility,
treats disease,
prevents
disease,
promotes
general health,
or
can
be
used
for therapeutic purposes. Acupuncture
typically
incorporates
traditional
Chinese
medicine (TCM) as an integral part of its practice and theory. The term acupuncture is
sometimes used to refer to insertion of needles at points other than traditional ones, or to
applying an electric current to needles in acupuncture points. Acupuncture dates back
to prehistoric times, with written records from the second century BCE. Different variations of
acupuncture are practiced and taught throughout the world.
Traditional diagnosis
The acupuncturist decides which points to treat by observing and questioning the patient in order
to make a diagnosis according to the tradition which he or she utilizes. In TCM, there are four
diagnostic methods: inspection, auscultation and olfaction, inquiring, and palpation.

Inspection focuses on the face and particularly on the tongue, including analysis of the
tongue size, shape, tension, color and coating, and the absence or presence of teeth marks
around the edge.
Auscultation and olfaction refer, respectively, to listening for particular sounds (such as
wheezing) and attending to body odor.
Inquiring focuses on the "seven inquiries", which are: chills and fever; perspiration; appetite,
thirst and taste; defecation and urination; pain; sleep; and menses and leukorrhea.
Palpation includes feeling the body for tender "ashi" points, and palpation of the left and
right radial pulses at two levels of pressure (superficial and deep) and three positions Cun,
Guan, Chi(immediately proximal to the wrist crease, and one and two fingers' breadth
proximally, usually palpated with the index, middle and ring fingers).
Tongue and pulse diagnosis and acupuncture treatment
Examination of the tongue and the pulse are among the principal diagnostic methods in
traditional Chinese medicine. The surface of the tongue is believed to contain a map of the entire
body, and is used to determine acupuncture points to manipulate. For example, teeth marks on

one part of the tongue might indicate a problem with the heart, while teeth marks on another part
of the tongue might indicate a problem with the liver.

YOGA
The concepts and practices of Yoga originated in India about several thousand rational
interpretation of their experiences of Yoga and brought about a practical and scientifically sound
method within every ones reach. Yoga years ago. Its founders were great Saints and Sages. The
great Yogis presented today, is no longer restricted to hermits, saints, and sages; it has entered
into our everyday lives and has aroused a worldwide awakening and acceptance in the last few
decades. The science of Yoga and its techniques have now been reoriented to suit modern
sociological needs and lifestyles. Experts of various branches of medicine including modern
medical sciences are realising the role of these techniques in the prevention and mitigation of
diseases and promotion of health.
Yoga is one of the six systems of Vedic philosophy. Maharishi Patanjali, rightly called "The
Father of Yoga" compiled and refined various aspects of Yoga systematically in his "Yoga
Sutras" (aphorisms). He advocated the eight folds path of Yoga, popularly known as "Ashtanga
Yoga" for all-round development of human beings. They are:- Yama, Niyama, Asana,
Pranayama, Pratyahara, Dharana, Dhyana and Samadhi. These components advocate certain
restraints and observances, physical discipline, breath regulations, restraining the sense organs,
contemplation, meditation and samadhi. These steps are believed to have a potential for
improvement of physical health by enhancing circulation of oxygenated blood in the body,
retraining the sense organs thereby inducing tranquility and serenity of mind. The practice of
Yoga prevents psychosomatic disorders and improves an individuals resistance and ability to
endure stressful situations.
Salient features of Yoga
Yoga a universal practical discipline
Yoga is universal in character for practice and application irrespective of culture,
nationality, race, caste, creed, sex, age and physical condition. Neither by reading the
texts nor by wearing the garb of an ascetic, one can become an accomplished Yogi.
Without practice, no one canexperience the utility of Yogic techniques nor can realise of
its inherent potential. Only regular practice (sadhana) creates a pattern in body and mind
to uplift them. It requires keen desire on the part of the practitioner to experience the
higher states of consciousness through training the mind and refining the gross
consciousness
Yoga as evolutionary process
Yoga is an evolutionary process in the development of human consciousness. Evolution
of total consciousness does not necessarily begin in any particular man rather it begins
only if one chooses it to begin. The vices like use of alcohol and drugs, working
exhaustively, indulging too much in sex and other stimulation is to seek oblivion, a return

to unconsciousness. Indian yogis begin from the point where western psychology end. If
Frauds psychology is the psychology of disease and Maslows psychology is the
psychology of the healthy man then Indian psychology is the psychology of
enlightenment
Yoga as soul therapy
All paths of Yoga (Japa, Karma, Bhakti etc.) have healing potential to shelter out the
effects of pains. However, one especially needs proper guidance from an accomplished
exponent, who has already treaded the same track to reach the ultimate goal. The
particular path is to be chosen very cautiously in view of his aptitude either with the help
of a competent counselor or consulting an accomplished Yogi. In Yoga, it is not a
question of psychology of man rather it is a question of higher consciousness. It is not
also the question of mental health, rather, it is question of spiritual growth
Types of yoga
Japa Yo
To concentrate ones mind on divine name or holy syllable, mantra etc. like OM,
Rama, Allah, God, Vahe Guru etc. through repeated recitation or remembrance
Karma Yoga
Teaches us to perform all actions without having any desire for their fruit. In this
sadhana, a Yogi considers his duty as divine action, perform it with whole-hearted
dedication but shuns away all desires.
Gyana Yoga
Teaches us to discriminate between self and non-self and to acquire the knowledge of
ones spiritual entity through the study of scriptures, company of Saints and practices of
meditation
Bhakti Yoga
Bhakti Yoga, a system of intense devotion with emphasis on complete surrender to divine
will. The true follower of Bhakti Yoga is free from egoism remains humble and
unaffected by the dualities of the world
Raja Yoga
Raja Yoga popularly known as Ashtanga Yoga is for all-round development of human
beings.These are Yama, Niyama, Asana, Pranayama, Pratyahara, Dharana, Dhyana and
Samadh Swara Yoga
Swara Yoga is the Science which is about the realisation of cosmic consciousness, through the
awareness/ observation then control/ manipulation of the flow of breath in the nostrils. Swara
Yoga involves the systematic study of the breath flowing through the nostril (or Swara) in
relation to the prevailing phases of the Sun, Moon, time of day and direction. It is the association
of the breath in relation to the activities or phases or positions of the Sun, Moon, Planets,
Seasons, Time of day, with the physical and mental conditions of the individual and then taking
the appropriate action according to these subtle relations

NATUROPATHY
Definition of Naturopathy
Naturopathy is a system of man building in harmony with the constructive principles of Nature
on physical, mental, moral and spiritual planes of living. It has great health promotive, disease
preventive and curative as well as restorative potential.
According to the manifesto of British Naturopathic Association, "Naturopathy is a system of
treatment which recognizes the existence of the vital curative force within the body." It therefore,
advocates aiding human system to remove the cause of disease i.e. toxins by expelling the
unwanted and unused matters from human body for curing diseases
Salient Features of Naturopathy
The main features of Naturopathy are as under:
1. All diseases, their causes and treatment are one. Except for traumatic and environmental
conditions, the cause of all diseases is one i.e. accumulation of morbid matter in the body.
The treatment of all diseases is elimination of morbid matter from the body.
2. The primary cause of disease is accumulation of morbid matter. Bacteria and virus enter
and survive in the body only after the accumulation of morbid matter when a favourable
atmosphere for their growth is established in body. Hence, the basic cause of disease is
morbid matter and bacteria secondary causes.
3. Acute diseases are self-healing efforts of the body. Hence, they are our friends, not the
enemy. Chronic diseases are outcome of wrong treatment and suppression of the acute
diseases.
4. Nature is the greatest healer. The human body itself has the healing power to prevent
itself from disease and regain health if unhealthy.
5. In Nature Cure it is not the disease but the entire body of the patient which is caused and
is renewed.
6. Naturopathy Cures Patients suffering from chronic ailments are also treated successfully
in comparatively less time by Naturopathy.
7. In Nature Cure the suppressed diseases are brought to surface and are removed
permanently.
8. Naturopathy treats all the aspects like physical, mental, social and spiritual at the same
time.
9. Naturopathy treats the body as a whole.
10. According to Naturopathy, Food is only the Medicine, no external medications are
used.
11. Performing prayer according to ones spiritual faith is an important part of treatment
(According to Gandhiji Rama Nama is the best Natural Treatment

Some Important Treatments of Naturopathy

Mud pack, Mud Applications
Mud Bath, Underground Mud Bath, Mud Pool Bath
Hip Bath
Spinal Bath, Spinal Spray Bath
Immersion Bath, Friction Bath
Foot Bath, Arm Bath
Steam Bath, Sauna Bath
Sun Bath, Colour Sun Bath (Chromo Bath),
Green Leaves Sun Bath
Hot & Cold Fomentation
Wet Sheet Pack, Chest Pack, Abdomen Pack, Trunk Pack
Knee Pack, Neck Pack, Wet Girdle Pack
Enema-Warm Water, Butter Milk, Tender Coconut Water etc.
Circular Jet Bath
Colon Irrigation
Deluxe Hydro Massage, Jacuzi
Hot and Cold Water Douches, Effusions
Whirlpool Bath
Under Water Exercises
Magnet Therapy
Colour Therapy
Acupuncture
Acupressure
Reflexology
Physiotherapy Treatments - Exercise Therapy, Electro Therapy

CONCEPT OF AYUSH UNDER NRMH

Mainstreaming AYUSH under NRHM
RATIONALE
The Indian systems of medicine have age old acceptance in the communities in India and in most
places they form the first line of treatment in case of common ailments. Of these, Ayurveda is
the most ancient medical system with an impressive record of safety and efficacy. Other
components such as Yoga, Naturopathy are being practised by the young and old alike, to
promote good health. Now days, practice of Yoga has become a part of everyday life. It has
aroused a worldwide awakening among the people, which plays an important role in prevention
and mitigation of diseases. Practice of Yoga prevents Psychosomatic disorders and improves an
individuals resistance and ability to endure stressful situation. Ayurveda, Yoga, Unani, Siddha
and Homoeopathy (AYUSH) are rationally recognised systems of medicine and have been

integrated into the national health delivery system. India enjoys the distinction of having the
largest network of traditional health care, which are fully functional with a network of registered
practitioners, research institutions and licensed pharmacies. The NRHM seeks to revitalize local
health traditions and mainstream AYUSH (including manpower and drugs), to strengthen the
Public Health System at all levels. It is decided that AYUSH medications shall be included in the
drug kit of ASHA, The additional supply of generic drugs for common ailments at SC/PHC/CHC
levels under the Mission shall also include AYUSH formulations. At the CHC level two rooms
shall be provided for AYUSH practitioner and pharmacist under the Indian Public Health
Standards (IPHS) model. There are 9 Ayurvedic Dispensaries, 5 Homoeopathic Dispensaries.
Strategies:

Integrate and mainstream ISM &H in health care delivery system including National
Programmes.
Encourage and facilitate in setting up of specialty centres and ISM clinics.
Facilitate and Strengthen Quality Control Laboratory.
Strengthening the Drug Standardization and Research Activities on AYUSH.
Develop Advocacy for AYUSH. Establish Sectoral linkages for AYUSH activities
Broad Objectives:
Mainstreaming of AYUSH in the health care service delivery system to strengthen the
existing public health system.
Activities:
Improving the availability of AYUSH treatment faculties and integrating it with the existing
Health Care Service Delivery System.
Integration of AYUSH services in 314 CHC / Block PHC with appointment of
contractual AYUSH Doctors.
Appointment of 200 paramedics where AYUSH Doctors shall be posted.
Appointment of a Data assistant to support the ISM&H Directorate.
Strengthening of AYUSH Dispensaries with provision of storage equipments.
Making provision for AYUSH Drugs at all levels.
Establishment of specialized therapy centers in District Head Quarter Hospitals & 3
Medical Colleges.
AYUSH doctors to be involved in all National Health Care programmes, especially in the
priority areas like IMR, MMR, JSY, Control of Malaria, Filaria, and other communicable
diseases etc.
Training of AYUSH doctors in Primary Health Care and NDCP.
All AYUSH institutions will be strengthened with necessary infrastructure like building,
equipment, manpower etc.
One Yoga Therapy Centre will be opened in district Headquarters Hospitals to provide
Yogic therapy for specific diseases and also as a synergistic therapy to all other systems
of treatment.

Block level School Health Programmes to be conducted twice in a year in two groups
consisting of 100 students in each group to improve the physical and mental health of the
school children.
Integration of AYUSH with ASHA.
Training module for ASHA and ANMs have to be updated to incorporate information of
AYUSH.
Training & capacity building to be undertaken by the Director, SIHFW, Bhubaneswar
and necessary training material for the purpose to be modified and provided accordingly.
Drug kit that will be provided to ASHA will contain one AYUSH preparation in the form
of iron supplement. But other drugs which are used in the treatment of common diseases,
control of communicable diseases as well as drugs promoting the maternal and child
health as well as improving quality of life could be included subsequently.
Drug Management:
Priority will be given to manufacture drugs in Govt. Sector Pharmacies as per their
capacity. In case of any surplus funds, drugs will be procured from the market observing
all financial formalities of the Govt.
Provision of Rs. 25,000/- to supply drugs per AYUSH dispensary has been projected as
per NRHM norm.
Provisions of medicines for District AYUSH wings and Specialty Therapy Centres
proposed to be operated in the State.
Special Initiatives For Mainstreaming And Strengthening Of Ayush.
Strengthening the Quality Control Laboratory:
The quantum of Ayurvedic and Homoeopathic medicines used / procured in both public
and private health sectors is huge. There has been wide ranging concern about spurious,
counterfeit and sub standard drugs. In order to prevent the spread of sub standard drugs
and to ensure that the drugs manufactured or sold or distributed throughout the state are
of standard quality, drug regulation and enforcement unit has to be established in the
state.
The drug regulatory mechanism to be strengthened at the state level to improve the
quality of drugs used in AYUSH and ensure proper standardization. The existing State
Drug Testing and Research Laboratory (ISM) at Bhubaneswar shall also be modernised
and strengthened for the purpose.
Strengthening the Drug Standardisation and Research Activities on AYUSH:
Standardisation and research is an important activity in the process of development of a drug
used for preventive and curative purpose. The major drawback in the development of AYUSH is
lack of research and development activity on the drugs used for the System. It is estimated that
there are 10,000/- plant species are found all over the world having medicinal properties. The
following activities will be undertaken to strengthen the drug standardisation and research
activities on AYUSH:

It has been proposed to evaluate the chemical, pharmacological and clinical efficacy of
the plant drugs.
The phytochemical entities responsible for the therapeutic activity of the plant drugs used
in AYUSH system will be evaluated through intensive R & D activity.
The pharmacologically viable drugs will be screened clinically under WHO guideline to
establish the therapeutic activity.
Clinical trial on different diseases like Psoriasis, Liver disorders, Diabetics, Asthma will
be conducted to establish the effect of various drugs used for such diseases.
It has also been proposed to conduct literary research like translation of manuscripts and
its publications.
Re-vitalisation of the local health traditions and the knowledge of traditional drugs used
by experienced local health traditioners will be gathered and documented.
Development of Herbariums and crude drug museums:
Herbarium will be developed in collaboration with the Forest Dept. in 15 selected
Districts of the State.
The existing Herbal gardens under the D.I.M. & H (O) will be strengthened with
necessary infrastructure.
One State Herbarium at DTL, Bhubaneswar shall be developed. This shall enable greater
research and study on development and innovation in AYUSH Drugs.
Plant extraction centres 10 selected areas will be developed for extraction and
preservation of the plants for medicinal use.
Strengthening of the State and District Management System of AYUSH:
It is proposed to create necessary Managerial post in the State and District level for
effective supervision and implementation of different activities.
Necessary vehicles with supporting manpower has also been proposed to strengthen the
supervisory
Joint monitoring visits to health centres to be undertaken by both AYUSH and Health Care
Officials at the District levels/State level.