Illness and disease are not the same thing. It is quite possible to feel ill without a health care provider being able to diagnose a recognizable disease from physical symptoms, but without a diagnosis it is often quite difficult for conventionally trained health care providers to prescribe treatment. Complementary practitioners, on the other hand, work on the principle that health depends on the interaction of body and mind. They consider personality, lifestyle, and emotional state, as well as physical symptoms, and this can enable them to tailor treatment to restore the body's self-healing ability and enhance its natural resilience.

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DIAGNOSING DISEASE

When we feel ill we describe the physical symptoms we have noticed to the health care provider, who looks for clinical signs, such as a raised temperature, unusual sounds in the lungs, or an alteration in heart rhythm, which we may not have noticed. Blood tests and x-rays may be arranged to confirm that the body is working abnormally, and the health care provider then tries to relate these observations and test result to recognized patterns known to occur in certain named diseases. If a specific disease can be identified, there may be an appropriate treatment.

Conventional health care providers examine the body for a pattern of physical changes that helps to identify a recognized disease.

CONVENTIONAL DIAGNOSIS Conventional health care providers look for recognizable symptoms and clinical signs to enable a specific disease to be identified and treatment prescribed, for example: ILLNESS Sore throat CLINICAL SIGNS Red throat, raised temperature, swollen lymph nodes in neck. TEST Blood count shows increased white cells. DISEASE Streptococcal infection. TREATMENT Antibiotics

Some problems may have no obvious clinical signs, but are still diagnosable diseases, for example, a withdrawn patient complaining of no energy, loss of appetite, and early waking might be diagnosed as having clinical depression and treated with antidepressants. Other diseases, such as high blood pressure, can be revealed by tests despite the patient feeling well and have few or no symptoms.

Physical examination plays a part in complementary diagnosis, but a wide range of other factors are also considered.

COMPLEMENTARY DIAGNOSIS Complementary practitioners use a wide range of diagnostic techniques, assessing factors such as physical and emotional health, lifestyle, and personality. A clinical ecologist, for example, might approach symptoms and illness in the following way: ILLNESS Frequent colds and sore throat CLINICAL SIGNS Looks exhausted, poor circulation in skin, swollen glands in neck, bloated abdomen. TEST A diary of dietary intake, and an exclusion diet to establish any food intolerances. CONDITION Poor ability to absorb nutrients due to food intolerance. TREATMENT Restore energy with diet and supplements, and exclude irritant foods.

Treatment becomes more difficult when people feel ill without having a disease with an identifiable cause. In cases of chronic fatigue or persistent pain syndromes, for example, the patient's body tissues are normal, and tests reveal nothing unusual. Feelings of unwellness with no named cause are frustrating for conventional health care providers and also for the patient. A wise health care provider faced with such "undifferentiated illness" will generally wait for the patient to get over his or her symptoms, such as fatigue, indigestions, or vague headaches. If the patient does not get better, the health care provider may ask what factors, such as stress or poor diet, are obstructing the normal processes of self-restoration. However, a string of investigations may still reveal little basis for treatment. For conventional medicine, the treatment of such illnesses is a great challenge because drugs usually have no place, psychotherapy is probably irrelevant, and yet patients feel unwell in their body and often expect the health care provider to do something.

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A DIFFERENT VIEW

It is in such cases of "undifferentiated illness" that the strength of complementary medicine lies - conditions treated the most often are pain and stress-related illnesses that have not responded to conventional medicine. In traditional systems of medicine, such as Chinese or Western herbal medicine, the presence of a recognizable set of physical symptoms is less of a problem, since diagnoses are based more on what practitioners see or feel and how they interpret the patient's story. Each type of complementary therapy has its own diagnostic labels, such as "food intolerance", "stuck Liver chi (qi or ch'i)", or "sacroiliac torsion", that conventional medicine does not recogize. However, if it can be shown that the diagnosis leads to effective treatments that relieve pain and enable people to cope, especially if these treatments are more tolerable and less expensive than conventional ones, then mainstream medicine may eventually incorporate them.

Each major traditional health system classifies illness differently. An Ayurvedic practitioner bases diagnosis on an assessment of the patient's doshas, or "vital energies". His diagnosis may use terms not familiar to conventional medicine, such as "excess pitta", and he may prescribe a remedy of ten or more herbs to pacify any doshic excesses that are causing illness.

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RED LIGHT SYMPTOMS

The symptoms below can be a sign of serious disease. Check them with a health care provider as soon as possible. Some complimentary practitioners are not trained to detect the signs and symptoms of the disease recognized by conventional medicine. This may not matter, given the problems they usually deal with, but certainly would if a life-threatening disease were to go untreated. When seeking complementary advice, always tell the practitioner of any symptoms, medical diagnoses, or prescribed drugs you are taking. Chest pain or discomfort. Unusual shortness of breath; if accompanied by acute pain in the chest, arms, throat, or jaw, call an ambulance at once. Unexplained dizziness. Persistent hoarseness or cough; persistent sore throat. Difficulty in swallowing. Persistent abdominal pain or indigestion. Coughing up blood. Persistent unexplained weight loss. Persistent and unexplained fatigue. Changes in shape, size, color, or itching and bleeding in a mole. Unexplained change in bowel or bladder habits. Passing blood, either bright red or black, in the stool. Vaginal bleeding between periods, after sex or after the menopause, or unusual vaginal discharge. Thickening or lump in a breast; discharge or bleeding from the nipple; flattening of the nipple; change in shape or size of a breast; dimpling or puckering of the skin. Change in shape or size of testicles; lump or swelling in a testicle; total and persistent failure to get an erection. Unusual onset of severe headaches; persistent one-sided headaches; blurring or disturbances in vision. Any sore that does not heal. Persistent and unexplained lumps or swelling. Unexplained leg pain and swelling. Frequent back pain that persists even when resting.

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