In the UK there were 13 million visits to practitioners of complementary and alternative medicine (CAM) in 1981, a third of the number of visits made to general practitioners.1 The use of CAM has grown substantially over the last 10 years; between 1986 and 1991 the proportion of Which readers using CAM increased by 70%,2 and a more recent Which survey of 9000 readers in 1995 revealed that 25% had seen a CAM practitioner over the last year with 75% claiming benefit.3 Eisenberget al noted a similar situation in the United States, estimating that the US public spent $13.7 billion out of pocket in 1990 on CAM,4 a figure no doubt substantially increased by recent interest. Similar data document the rise and importance of CAM in Australia to much the same levels of interest and expenditure as those in the USA and the UK.5

As yet we have no definite answers as to why people seek CAM. We know that the public perceives these treatments as often being more successful for chronic illness than conventional medicine.6 It also seems that patients who attend CAM practitioners feel more empowered by the process and therefore more in control of their illness.7 ,8 Thomas et alfound that 40% of general practices offered access to at least one complementary therapy.9

This growing interest in complementary medicine is not confined to the general public; in 1983 80% of trainee general practitioners wished to receive training in CAM,10 and by 1987 this had risen to 92%.11 In 1986 it was reported that 38% of general practitioners in Avon and 31% in Oxfordshire had received training in complementary therapy.12 ,13

One area of concern to respiratory physicians is the increased incidence of …