ALTERNATIVE TREATMENT : Maybe snake oil works.

If my eyes don't stop watering and itching I'm going to go to an acupuncturist. But will I tell my doctor? He, God bless him, has cured my hyperthyroid condition (Graves disease) by burning out my thyroid with radiation and prescribing a daily dose of Synthroid. Yet this medicine doesn't deter the antibody that attacks my eyes.

A chronic health problem that medicine has trouble controlling presents a perfect occasion to try alternative medicine or AM. I won't be alone. In 1997 more than 42 percent of Americans used some form of alternative medicine, and consumers made 629 million visits to alternative practitioners. They paid more than $27 billion out of pocket to do so. When asked why they use AM, patients, a.k.a. clients or consumers, report that it works.

In the past I would dismiss such reports out of hand. As my doctor still does. Yet, I too am a science-loving true believer in reason. When I appeared in my doctor's office with a copy of The Skeptical Inquirer I scored points, then doubled my advantage by being the first of his patients to recognize the picture of Richard Feynman, the physicist, hanging next to his desk. Yes, I reported, I always quote Feynman to my students, "Science is about not fooling yourself." (Of course, I also quote Saint Augustine who said that one thing he could know for sure is that he didn't want to be deceived.) I told my doctor that I read atheistic humanist magazines because I was a religious believer and felt duty bound to do so. You know, like Baron von Hugel who claimed Christians should study science in order to cultivate a healthy, nonsuperstitious faith. Hence I am now willing to explore AM only because it seems reasonable to do so.

While I have changed my mind, AM's critics still hurl charges of "quackery," "snake oil," a "holistic hoax"-an irrational aberration that is dangerously unscientific. But many others in conventional medicine have begun to accept some forms of AM and to collaborate with alternative practitioners. Today we hear of integrated medicine or CAM, complementary and alternative medicine. Why the change?

Cynics assert that a power struggle between conventional medicine and AM is taking place motivated by money. Consumer pressure and booming profits explain movements to integrate AM into conventional medical systems. Granted, the history of American medicine provides many instances of greed in which one group of powerful physicians organized to drive out other differently trained physicians and health practitioners by labeling them "unscientific." In other unacknowledged maneuvers, treatments pioneered by AM are co-opted and assimilated into conventional medicine.

Surely struggles over money, status, and hegemony appear always and everywhere, but something else appears to be going on in the acceptance of CAM. There's been a change in the intellectual weather. Modern medicine's positivist vision of a deterministic materialistic world is cracking under the strain of new discoveries in physics, psychology, and the philosophy of science. Good-by, Descartes; so long, Newton; farewell, dualism. The body can no longer be confidently assessed as a biological machine completely separated from the workings of the mind and consciousness. Repairing physiological mechanisms is different from healing a person.

Many conventional physicians are renewing their interest in the art of medicine and healing. They recognize that conventional medicine is not now, and never has been, as scientific as it claimed to be. Evidence- based medicine is a new movement to research scientifically which treatments actually work. The gold standard of experimentation is a series of randomized controlled trials that test the efficacy of a treatment. But such trials take time and money, and are beset with many of the conceptual problems that plague all research. In any event, a generally efficacious treatment has to be used by a physician on a unique patient with a distinctive history living in specific circumstances. Making good medical decisions is an art.

It's also becoming clear to science that much of the healing that takes place in conventional medicine centers on the doctor-patient relationship and the mysterious placebo effect. For some reason, individual expectations of being helped make treatments, even fake treatments, more effective. But no one understands why. Belief may stimulate the body's self-healing capacities or interact in some way with drugs or other interventions. Some observers hypothesize that people use alternative medicine because it produces more reliable placebo effects, in addition to other benefits.

I contend that, once you know about the placebo effect and new pluralistic developments in science, the use of alternative medicine isn't irrational. Many treatments may not be able to pass rigorous scientific testing but will still work for some people in some circumstances. If these so-called "fragile therapies" sometimes work, and are not harmful, why not try them? As long as an AM treatment is not toxic and does not require repudiating conventional medicine, it can be a reasonable choice.

Indeed, Western medicine may have a lot to learn from AM's holistic approach to healing persons. Anyone who has been hospitalized recently and been treated as if they were no more than their disease can see why holistic alternative healing looks attractive. Worse still, the sterile aspects of materialistic medicine, with its technological fixations and obsessive specialization, have been exacerbated by the adoption of market methods of management.

By contrast, while AM is a huge heterogeneous enterprise, almost all practitioners take the individual's uniqueness seriously. Clients are asked about their whole life and current environment, and expected to take responsibility for their health. The spiritual nature of persons is not ignored and spiritual transcendent healing forces are often invoked. (I'll deal with the theological implications of AM in a future column.) Like good conventional physicians, AM practitioners want to employ interventions that "work." But AM focuses upon what works for the patient from the patient's own point of view. No more "successful operations" where the patient dies.

AM may be tapping into some healing forces of human consciousness that science has not yet explored. I don't believe in Chinese medicine's assumptions of Chi, but I do believe in placebo effects. The fact that I don't accept the materialistic world view of much of modern medicine doesn't stop me from taking my pills. By their fruits you shall know them. Here's to eyes that can see sans tears.