The Bigger Picture: Stockholm, October 2005, Marshall and Warren, two Australian researchers, get a Nobel Prize in medicine for their discovery in 1983 that ulcers are caused by bacteria.
The Nobel citation states "with tenacity and a prepared mind they challenged prevailing dogma when stress and lifestyle were considered the main factors in this disease".
The prize winners stated that "nobody believed us for 10 years" and the president of American Gastroenterology Society admitted that "I thought they were crazy" at the time. This illustrates the time lapse between research discovery and acceptance of a new treatment.
As recent debates show, there are strong views for and against complementary medicine. While I am first and foremost a conventional medical doctor, I have had a special interest in complementary medicine for 20 years, and I am convinced, for all its shortcomings, there are many positive aspects to its usage.
Many complementary approaches have provided real, necessary and undeniably successful treatment, often to patients who conventional medicine had been unable to treat.
We should recognise that for all our scientific knowledge and labelling of disease, we do not know the fundamental cause of most illnesses which are often multi-factorial, ie a combination of genetic, infection, allergy, diet, lifestyle and unknown factors.
The practice of medicine is not as scientific as we would like to believe. Many commonly used treatments in medical practice have never been proven to the standards demanded of complementary medicine by its opponents.
For example, a recent trial showed topical treatment of conjunctivitis to be only 3 per cent more effective than placebo, the role of antibiotics in Otitis Media remains debatable, and anti-depressants are about only 10 per cent more effective than placebo.
Prescribing rates in operation vary widely between practitioners both in Ireland and overseas. There are many unproven aspects of other accepted treatments, for example, physiotherapy and psychiatry.
In reality, illness does not always present in the tidy forms shown in medical text books. Patients often present with multiple symptoms, eg tiredness, irritable bowel, joint pains.
However, further questioning will often reveal other apparently unrelated difficulties, eg sinus, bladder or hormonal symptoms.
Providing appropriate investigations are normal, the patient is assured that there is nothing "seriously wrong". Local treatment may be prescribed for each individual symptom. Complementary medicine has taught me that many of these symptoms can be linked and that, in general, parts of the body should not be considered in isolation.
For all the benefits of specialisation, the overall picture can be lost and specialists, in general, have a diminishing level of interest in symptoms outside their particular area.
As well as many chronic medical conditions, these multiple-symptom patients are often helped with appropriate complementary approaches including allergy management, acupuncture, nutritional supplements and herbal/homeopathic medicines.
Generalisations about complementary medicine are misleading in that it comprises more than 100 treatment forms with many differences between practitioners.
However, I share many of the concerns recently raised and strongly believe that regulation is both welcome and inevitable. In general, side effects from complementary medicine compares favourably to conventional medicine and professional indemnity is considerably less.
It is estimated that anti-inflammatory medication contributes to the deaths of 2,000 people annually in the UK and a considerable minority of hospital admissions are related to drugs' side effects.
I fully accept that serious issues need to be addressed in complementary medicine, such as delayed diagnosis, unreasonable expectations of success rate and continuation of treatment long after it is obviously unsuccessful. Other issues include pressure on patients to stop conventional medication with occasional disastrous consequences.
A particularly interesting arena of debate in recent years is that of food allergy/intolerance.
Food intolerance is the idea that commonly ingested foods such as milk, wheat, yeast, eggs, etc can play a significant role in many chronic medical conditions and have an impact on overall energy and wellbeing.
Doctors have largely dismissed food intolerance while many complementary practitioners have over-diagnosed allergies/intolerance due to unreliable allergy testing combined with inadequate history taking and follow-up.
This has delayed acceptance of a very valuable form of treatment. Allergy management is more than allergy testing and should always include a detailed questionnaire as well as evaluation of response to treatment.
In summary, healing is very complex. I strongly believe patients should not have to choose between complementary and conventional medicine and both patients and practitioners would benefit from more co-operation. I believe a combination of both methods often provides the best treatment and is the way forward in the future.
Dr Brendan Fitzpatrick is a medical doctor with a special interest in complementary medicine and is a practising GP in Donnybrook, Dublin.
Shalini Sinha is on leave.