When patients in the University of Maryland Medical System are referred to a treatment center near Dickeyville, they are just as likely to receive acupuncture, Chinese herbs or a homeopathic remedy as they are a prescription drug.
Murry Nichelson, a 36-year-old man wracked with muscle spasms in his shoulder, went there after deciding surgery was too risky and anti-inflammatory drugs might irritate his stomach. Desperate for help, he said he felt as if a knitting needle were piercing his shoulder.
He saw Dr. Lixing Lao, a native of China who led him to a table and delicately inserted an array of acupuncture needles into his skin. The effect was immediate.
"For 20 years, if I exercised I'd get a pain radiating out from my shoulder to the point where I'd throw up," said Mr. Nichelson, whose problems began when a hit-and-run driver knocked him off his motorcycle on a road in Mount Washington.
"Three months ago, Dr. Lao did one treatment and the pain is gone."
Acupuncture centers and alternative drug stores have become commonplace, but what's unusual about this program is that it is part of an academic medical center. In the same institution where doctors rely on prescription drugs, vaccines and surgery to help patients fight illnesses, researchers are using acupuncture, herbs, homeopathy and even Chinese martial arts and are examining their effectiveness.
At the Project for the Integration of Orthodox and Complementary Medicine, researchers hope to bring these treatments from the exotic periphery into the center of American medicine by testing them in clinical trials.
The philosophy: If the treatments work, they ought to hold up under scrutiny.
The program, directed by Dr. Brian Berman, has been established at a time when the public is increasingly skeptical about orthodox medicine and hungry for alternatives. In 1990, the most recent year for which figures are available, 34 percent of Americans used at least one unconventional therapy. A study by researchers at Harvard University found those patients spent $13.7 billion on treatments such as acupuncture, chiropractic medicine and biofeedback.
UM scientists are in the midst of two studies evaluating acupuncture as a treatment for arthritis and postoperative dental pain.
They expect to broaden their inquiry to encompass treatments such as homeopathy, a 200-year-old system founded in Germany. Homeopathy employs an arsenal of 2,600 plant, animal and mineral substances, and Chinese herbal medicine, an ancient system that uses more than 6,000 substances to combat disease.
Now in its fourth year, the project is perhaps the most extensive at a mainstream medical center. Others have been established at Harvard, Columbia, Georgetown and the University of Virginia.
In 1992, the National Institutes of Health established its own Office of Alternative Medicine, which provides grants to institutions wishing to study unorthodox treatments. Although its million budget represents a sliver of the total NIH budget of $10.9 billion, its very existence amounts to official recognition that alternative regimens are being taken seriously.
Dr. Berman prefers "complementary" to "alternative" because it conveys the idea of different treatments working together. Similarly, he doesn't see the issue as a clash of East and West, but a blending of traditions for a common purpose.
"One is not right, and one is not wrong," said Dr. Berman, 43. "You can't be fixed on 'I only use acupuncture' or 'I only use homeopathy.' We need to look for what's best for our patients, whether it's conventional medicine or not."
Dr. Berman's medical career began conventionally enough. Trained at the University of Maryland, he went to work in the emergency room at Kent and Queen Anne's Hospital in Chestertown. Later he opened a family practice nearby.
"When I went into practice, I found that my training was excellent for acute diseases and trauma but when it came to some of the chronic diseases, I didn't have all the answers," he said.
He said he felt, for instance, that he could do little for the persistent pain of arthritis, back injuries and some neurological conditions.
In search of answers, he went to Los Angeles to study acupuncture, a 3,000-year-old branch of Chinese medicine that employs long slender needles to alleviate suffering. Later, he studied at the Royal London Homeopathic Hospital in England, where homeopathy enjoys a large following.
Founded in the 1790s, homeopathy is based on the principle of "like cures like." The premise is that illnesses can be relieved with extremely small doses of substances that, in larger concentrations, would produce similar symptoms in a healthy person.
He was skeptical at first.
"People were coming in with problems like asthma and arthritis, and after a while they seemed to be getting a lot better," he said. "It wasn't really what I was used to seeing. When I started to look into it, it was difficult to get my mind around to accept it."