‘Diversity’ is now a magic word, showing up everywhere and often used to embrace many
aspects of human activity, whether in government, the arts, sciences, research, choice
of research subjects or so on. In many respects diversity represents an encompassing
teamwork, and we all know the success of teams in sports in popular terms and the
rewards of successful research teams. Thus, we can safely conclude that a diverse
team can be a creative team since when investigators of different points of view are
brought together, they ponder and question the interpretations, procedures and practices
of others. Such is the case for the scientific approach (1). Thus, often butting heads,
sometimes even locking horns in healthy debate, is most often resolved by the emergence
of creativity. I will now propose several ways in which eCAM approaches the question
of diversity and I hope that in the process we also engage in this act of creation.
First, the editorial board of eCAM is one that is diverse, and to ensure one aspect
of creativity, many of us have never worked together, thus allowing for the infusion
of different points of view. Our first purpose in establishing the eCAM editorial
board has been to gather a mixture of experienced biomedical scientists and to combine
them with newcomers from a variety of fields who are willing to embrace CAM and to
extend themselves beyond their better known academic classifications or ‘pigeonholes’.
As one of our bases is in Japan, our search for diversity began in Asia at biomedical
conferences and research centers in Japan, Taiwan, Korea, India, China, Hong Kong
and Thailand, at the same time visiting similar events and places in Mexico, Venezuela,
Brazil, Europe and the United States. And these journeys were just the beginning;
we are now in the planning stages for increased involvement in South America, the
Middle East and the African continent. In our official letter inviting scholars to
join our board, we include the following words: ‘CAM is a worldwide phenomenon and
eCAM will seek to be inclusive of new and old work all over the globe. With this same
broad view, we envision an active and varied Editorial Board on which philosophers
and historians will be engaged in dialogues with neuroscientists, immunologists, practitioners
and clinicians.’ To date, the editorial board numbers about 75 members, who reside
in most of the continents and many countries. What are most important are not so much
the numbers as the disciplines that they embrace, and the list is ever extending into
new and exciting areas of CAM. Clearly the crucial functions of editorial board members
are threefold: submitting their own manuscripts, critically reviewing papers and recruiting
papers. Their voices as contributors and referees have been critical in establishing
the unique worldview that can be found in each issue of eCAM.
As one peruses our disciplines there is, to be sure, a seeming focus on immunology—but
not to the exclusion of other disciplines. Thus, the triangle of the three regulatory
systems (nervous–endocrine–immune) is not so evenly distributed, but at least the
immunologists realize the intimate connectedness of this triumvirate. Going beyond
one's usual classification is best exemplified by invertebrate immunologists (2,3),
who bring fresh notions of using animal products as prime targets from which newer
technologies can be applied to CAM. Molecular approaches based upon antimicrobial
peptides promise to add to the emerging bioprospecting compendium, moving it from
the realm of invertebrate immunology to the CAM sector (4–6). (There was already a
historical precedent for using products from snails (7).) Moving to the apiary, biologists
who look at products from honeybees are already known internationally (8–12). The
lesson to be learned and eventually put into practice concerns a wider approach to
a search for useful drugs and applicable CAM products from diverse terrestrial and
marine sources (13–16). There is even room to consider a diverse array of complex
derivatives from certain vertebrates such as snakes (17). Botanists (qua ethnobotanists,
herbalists) have already made their mark, especially as they literally dig up more
mushrooms and cultivate diverse plants (11,12,18–23).
Second, the other essential ingredient for successful eCAM diversity is the inclusion
of experienced, recognized biomedical scientists who are bona fide members of the
CAM community and who are open to embracing somewhat tangential approaches that prescience
reveals will be fruitful paths to follow. These two tracks—especially this second—should
guard against the rather natural tendency of people of like kind (educational background,
use of similar techniques etc.) to want to work with their long-term colleagues, i.e.
people with whom they have associated before or have often been seen at meetings.
Couple these two strategies with an emphasis on the inclusion of newer technologies
with the insistence on evidence and we have designed a formula that should remove
some of the shroud around CAM, thus giving it a greater measure of acceptance within
the western medical community and even the CAM community itself. All eCAM is doing
is redirecting biomedical scientists well known in one discipline into thinking about
the utility of their work and its applicability to another discipline. In my view,
this is the creative thought and work that is needed to bring CAM into the arena of
western medicine.
Third, of course, recognizing and emphasizing diversity seems only natural since the
very discipline of CAM is itself diverse, complex and controversial. It includes such
diverse disciplines as osteopathy, homeopathy, chiropractic, acupuncture, herbal medicine,
energy medicine and meditation, which are associated with the ancient approaches of
China, India, Japan and Korea. Clearly other ancient cultures have much to offer and
will, we hope, be uncovered as we delve deeper into practices in other parts of the
world, such as Latin America, the Middle East, North America and the south Pacific,
that have not been so popularized. Some of the latter, less publicized ways of doing
things from these regions could well coincide with those from ancient Asia, differing
only as a result of the available natural products. In other words, plants or animal
products may differ but offer similar remedies for similar health problems. Thus,
remedies may to some extent be intertwined culturally and geographically. In every
instance barring cultural and geographical lumping together, all have been concerned
with improving the quality of life.
Finally, despite these examples of diversity in numbers, geographical origins and
disciplines and scientific approach, there is the difficulty of reconciling the very
nature of CAM with certain realities, i.e. the palpable need to undergird CAM with
evidence-based results that can, through rigor, occupy the pinnacle of the experimental
triangle devoted to immunological benefits as proposed by Goldrosen and Strauss (24).
For, as has been pointed out in previous editorials, there is a need for rigorous
science if CAM and indeed eCAM are to be taken more seriously, thus ensuring less
skepticism from its adherents and disciples and also from the traditional medical
establishment and pharmaceutical industry. Now and in the near future, eCAM is discussing
ways to consider seriously case reports, not the ideal within an acceptable scientific
context. An excellent example devoted to Alzheimer's disease has led the way (25).