Dr. Chung, in an editorial entitled "Why Alternative Medicine?" (American Family Physician, 11-25-1996, pp 2184,2187), noted how "frontier medicine" is used to aptly describe the role alternative medicine plays in medicine today. Frontiers by definition are largely unexplored with the potential for both danger and disaster or conquest and riches. It was with both these potentials in mind that Christopher Columbus set sail. Columbus probably tossed and turned at night with visions of sea monsters, the edge of the world, fabulous treasures and of medals draped around his neck. Research in alternative medicine carries with it the same potential risks and rewards. 

In order to systematically explore this frontier the Office of Alternative Medicine (OAM) was established at the NIH in 1992. There are a myriad of complementary/alternative medical (CAM) treatments, over 300 by some counts, which seem to defy categorization. Nonetheless the OAM has narrowed this broad frontier to seven main categories: 

Alternative Systems of Medicine 
Bioelectromagnetic Therapies
Diet & Nutrition 
Herbalism 
Manual Therapies
Mind-Body Therapies 
Pharmacologic/Biologic Therapies

Dr. Gordon, in his article "Alternative Medicine and the Family Physician" (American Family Physician, 11-25-1996, pp 2205-2212), gives examples of specific therapies that fall within each of the seven OAM groupings.

Although there are avid proponents for researching each of the above categories I believe the most exciting frontier (the one with the most risks and rewards) is the study of bioelectromagnetic therapies and alternative systems of medicine. In fact both of these categories can be logically combined under the broader umbrella of "energy therapies." The reason I believe the energy therapies hold the most potential is that they are the ones that most challenge our biomedical model. They are the ones that are most intellectually, academically and professionally risky because they cannot be explained by prevailing dogma. They also hold the most potential for expanding our understanding of how the body works. The other categories can all be explained in terms compatible with the underlying framework of the biomedical or biopsychosocial models.

In its simplest form the Western biomedical consists of anatomic structures and systems which are sustained by biochemical processes. Traditional Chinese Medicine (TCM) is based on the flow of "chi" energy in the body with illness caused by energetic imbalances and the restoration of health depending on the correction of energetic imbalances. From the Western biomedical perspective this is all nonsense and the clinically observed effects of acupuncture are explained in terms of the biochemistry of endorphin release. Although anatomic studies cannot find consistent anatomic structures associated with acupuncture points and meridians several studies have documented that these areas have low electrical resistance and high electrical conductivity*. With this knowledge the concept of electrons (current) following the paths of least resistance in the body becomes plausible and the TCM description of "chi," or the Ayurvedic description of "prana," becomes less far-fetched. 

Several researchers have found that abnormal physiology is associated with abnormal electrical activity*. Dr. Bjorn Nordenstrom, the radiologist who originated the skinny needle biopsy technique used around the world, used similar needles as electrodes to measure electrical activity in areas with abnormal radiologic findings. Dr. Nordenstrom found that self-sustaining abnormal electrical circuits occur in areas of pathology*. Even more interesting has been the use of external electric currents to stimulate healing of wounds or electromagnetic fields used in the treatment of arthritis and mood disorders*. 

Homeopathy, which has well documented effectiveness in certain clinical conditions*, makes absolutely no sense from the biochemical perspective. A clue to its possible mechanism of action is that homeopathic remedies are inactivated by strong electromagnetic fields. Rather than casually tossing aside studies showing the effectiveness of homeopathic interventions because they can't be explained by our biomedical model we should be asking ourselves, is there something missing or incomplete in our understanding of how the body works?

Therapeutic Touch (TT), which paradoxically often has no actual touch occurring, is another type of energy therapy that has been casually tossed aside by skeptics. In fact there are scores of well designed scientific studies documenting physiologic changes such as accelerated wound healing, increased hemoglobin and oxygen levels, and even in vitro altered enzyme activity*. On the last observation it is interesting that the same alterations in enzyme activity can be achieved by altering the polarity of electromagnetic fields near the substrates. This should not be surprising since many biochemical reactions are dependent on the three dimensional electrochemical interactions of polar molecules. Unfortunately the studies on TT are only published in nursing or CAM journals. Despite impeccable scientific rigor these studies are systematically excluded from publication in mainstream medical journals. The reason is that the biomedical model is clearly called into question once you acknowledge that one person can cause physiologic changes in another person without even touching them. This type of controversy undoubtedly causes intellectual indigestion and potential fears of lost credibility in the typically conservative editorial boards that decide what is worthy of publication in medical journals. 

Clearly the Western biomedical model is inadequate to explain many of the well documented responses to energetic interventions. Of all the frontiers worthy of research in CAM the energy therapies are the most exciting in that they have the greatest potential to challenge our thinking and thus cause quantum (rather than incremental), advances in understanding. We know that at the subatomic level all matter depends on the energetic interactions of electrons, protons, neutrons, muons, pions and a host of other particles. The move from Newtonian (mechanical), physics to quantum (energetic), physics has been remarkable. As we research these frontiers the "splitting of the atom" will cause equally remarkable changes in the field of medicine. 

* References available upon request.