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66th IFLA Council and General

Jerusalem, Israel, 13-18 August


Code Number: 049-130-E
Division Number: IV
Professional Group: Classification and Indexing
Joint Meeting with: -
Meeting Number: 130
Simultaneous Interpretation: No

A draft version of a consolidated thesaurus for the rapidly - growing field of alternative medicine

Moshe Yitzhaki *

Tzipi Shahar

Bar-Ilan University
Ramat, Israel, Israel


The field of alternative medicine has undergone a significant transformation in recent decades, emerging into a large and widely-recognized field, and undergoing a process of growing consolidation with the conventional scientific-medical establishment. Consequently, a growing number of articles, dealing with various aspects of alternative medicine, have appeared in scientific and professional journals. An on-line search limited to the 1975-1994 period, that was conducted on eighteen databases specializing in medical and scientific fields, and used by the medical profession, retrieved close to 4000 articles, most of which appeared quite recently, between 1985 and 1994. A draft of a consolidated thesaurus was constructed, based on keywords found in titles and in descriptors of the aforementioned articles. The principles and rules of the thesaurus' construction are described, and illustrative samples of descriptors and lead-in references are displayed.



The field of alternative medicine has undergone a significant transformation in recent decades. From a marginal and disregarded subject it has emerged into a large and widely-recognized field, undergoing a process of growing consolidation with the conventional scientific-medical establishment. Consequently, a growing number of articles, dealing with various aspects of alternative medicine, have appeared in scientific and professional journals.


The objectives of the present study were :
  1. to empirically assess, using a bibliometric approach, the growth of literature dealing with alternative medicine, in the recent twenty years (1975-1994), as reflected in the conventional medical and scientific bibliographical databases used by the medical profession.
  2. to build a draft of a consolidated thesaurus based on keywords and titles of the aforementioned articles included in databases used by the medical profession.


An on-line search, applying the search strategy of a uniform question, and limited to the 1975-1994 period, was conducted on eighteen databases (listed in the Appendix) specializing in medical and scientific fields, in order to retrieve a maximum number of publications dealing with alternative medicine. After eliminating irrelevant items, the final sample included close to 4000 articles, most of which (more than 80%) appeared quite recently, between 1985 and 1994. These articles were further sorted according to country and year of publication and their keywords (whether appearing in article titles or as descriptors) were counted and sorted too.

Findings and thesaurus construction

Evidently, a rapid growth occurred in the number of publications referring to alternative medicine : their number rose from only 195 in the first period (1975-1979) to 443 in the second one (1980-1984), then to 860 in 1985-1989, jumping to 2236 in the last period (1990-1994).

A word dictionary was compiled from all keywords found in these articles, i.e. in their titles as well as in their attached descriptors.

A distinction was made between terms indicating a positive attitude to the field of alternative medicine and those which indicate a negative or skeptical one.

A quantitative analysis showed that the number of keywords, including repetitions, increased considerably from only 405 in the first period to 4721 in the last one.

The number of different keywords in article titles grew from 36 in the first period (1975-1979) to 51 in the last one (1990-1994) while the parallel increase in the number of different descriptors was significantly higher, from 30 to 103. Altogether, the total number of different keywords, whether appearing in titles or in descriptors, was about 350. However, after eliminating synonyms and related-meaning words, it appeared that the 'net' increase was more than double, from about 40 different keywords in the first period to about 100 in the last one, meaning an addition of about 60 new keywords during fifteen years.

The findings of the bibliometric analysis concerning the growth of the field are reported in a separate paper. This paper discusses the construction of the thesaurus with regard to the word dictionary that was compiled. A prototype of a thesaurus was built, comprising the topics and subjects appearing in these keywords.

Time and space constraints precludea full-length presentation of our proposed thesaurus. Hopefully, though, it will be soon submitted for publication in one of our professional journals, thus eliciting the essential feedback needed for further improvement of our draft version.

Therefore, the current paper will focus on the background, the general frame and principles (found in Aitchison's Manual, 1997, as well as in Lancaster 1986 and Drabenstott 1994) accompanied by some illustrative examples :

  1. For each group of synonyms or almost-synonyms one term was selected to serve as the authorized one, and the rest were discarded as unauthorized terms. Thus, about 120 key-words were designated as authorized terms (descriptors) of the newly-constructed thesaurus and the rest (about 100) were recommended to serve only as 'lead-in terms'.

  2. One basic dilemma concerned the very name of the field : its proponents call it 'alternative medicine', while the medical establishment usually prefers the term 'complementary medicine'. The first option has been adapted since most databases use it.

  3. All terms used in the thesaurus were taken from the searched literature, in compliance with the 'literary warrant' rule.

  4. The following terms were proposed to serve as authorized main descriptors : Alternative Medicine - [specific term] Aromatherapy, Body & Mind, Chinese Medicine, Complementary Medicine, Healing, Herbal Medicine, Holism, Homeopathy, Manipulative Medicine, Naturopathy, Nutritional Medicine, Oils, Osmology, Preventive Medicine, Spiritual Healing, and Touch. Most of them are on the same hierarchical level, related to each other as RT (Related Term) but a few are related as NT (Narrow Term) to others, like for example 'Spiritual Healing' and 'Touch'. Although they are NT of 'Healing' they were included above since they have their own list of NT terms. All main descriptors are accompanied by a short definition (SN=Scope Note) taken from dictionaries and other reference sources dealing with Alternative Medicine.

  5. The abovementioned literature search in the eighteen databases yielded a great number of synonymous or almost- synonymous terms, bearing identical or very close meaning, indicating the yet unstabilized and unstandartized state of the terminology of Alternative Medicine field. It was necessary to choose one term to be the authorized one, to which USE references lead from all other 'unauthorized' terms, which in turn are also listed under the authorized term, under a UF (Used For) note.

    The following 'lead-in' references exemplify one of these cases :

    • Complementary Alternative Medicine USE Complementary Medicine
    • Complementary Approach USE Complementary Medicine
    • Complementary Health Care USE Complementary Medicine
    • Complementary Methods USE Complementary Medicine
    • Comprehensive Health Care USE Complementary Medicine

  6. Another case in point is the term 'Alternative Medicine', for which more than twenty synonymous terms were found in the literature, like : Alternative Approach, Alternative Care, Alternative Concept, Alternative Cure, Alternative Health Care, Alternative Health Technologies, Alternative Medical Care, Alternative Medical Treatment, Alternative Medication, Alternative Methods, Alternative Nursing, Alternative Practices, Alternative Remedies, Alternative Services, Alternative System Services, Alternative Therapies, Alternative Treatment, Alternative Vision Therapy, Medical Alternative, Medicare Alternative, and Medicine, Alternative.

    All these terms were assigned a USE note, referring the user to the only authorized term 'alternative medicine'.

  7. However, the term 'Alternative Medicine' by itself could not, of course, serve as an authorized descriptor, but it could serve so when accompanied by a more specific subheading, like : case study, demographic aspects, directories, economics, history, insurance, marketing, moral and ethical aspects, media coverage, religious aspects, research and statistics, standards, study and teaching, and others. All in all, close to 38 such authorized descriptors were established.

  8. Over forty synonymous terms were found for expressing negative attitudes towards various aspects of Alternative Medicine and one may rightly assume that the high number indicates and illustrates the controversiality of the field. Most of these terms hint at some criticism of Alternative Medicine, mainly its so-claimed and so-called lack of scientific base and evidence. these critical terms are : Anti-Intellectual Medicine, Irrational Medicine, Non-Academic Medicine, Non-Compromist, Non-Conventional Therapy, Non-Medical Practitioners, Non-Medication Alternative, Non-Medicine Treatments, Non-Medicine Treatments, Non-Orthodox Health Care, Non-Orthodox Medicine, Non-Rational Medicine, Non-Scientific Healing Methods, Non-Traditional Nursing, outsider Methods in Medicine, Pseudomedicine, Quackery, Unconventional Healers, Unconventional Medical Care, Unconventional Medicine, Unconventional Methods, Unconventional Remedies, Unconventional Therapy, Unconventional Treatment, Unorthodox Healing Arts, Unorthodox in Health Care, Unorthodox Medicine, Unorthodox Methods, Unorthodox Remedy, Unorthodox Therapies, Unorthodox Treatment, Unproven Medical Alternatives, Unproven Remedy, Unproven Therapy, Unproven Treatment Methods, Unscientific Medicine, Unusual Medicine, Unusual Therapy, Unproven Medical Alternatives, Unproven Remedy, Unproven Therapy, Unscientific Medicine.

    All these terms were included in a newly-assigned term 'Alternative Medicine - Criticism', proposed as the only authorized term, while all others were discarded and not recommended for use in the processes of indexing and query formulation.

Two sample Descriptors, Chinese Medicine and Complementary Medicine, are displayed here to demonstrate the thesaurus :
    Example no. 1 :

    Chinese Medicine

    SN A very ancient school of therapy, with an academic tradition of its own. Based on the holistic view of man, as a system in which all components are interwoven and mutually connected and affected. Many of its techniques are widely accepted today as an integral part of common treatment in the area of complementary medicine.

    UF Chinese Medical Care
    Chinese Traditional Medicine
    Medicine, Chinese Traditional
    Traditional Chinese Medicine

    NT Acupressure
    Chinese Herbal Therapy
    Chinese Medicine Herbs
    Medicine Chinese Therapeutic
    Qi Gong
    Traditional Chinese Acupuncture
    Yin and Yang

    RT Aromatherapy
    Flower Essences
    Herbal Medicine

    Example no. 2 :

    Complementary Medicine

    SN The combination of conventional scientific medicine with alternative medicine. Specifically, it means those parts, techniques and therapies of alternative medicine, which have been adapted by conventional medicine and formally and institutionally introduced into its treatment system.

    UF Complementary Alternative Medicine
    Complementary Health Care
    Comprehensive Health Care
    Complementary Approach
    Complementary Methods

    NT Complementary Healing Therapies
    Complementary Therapies
    Complementary Treatment

    RT Alternative Medicine
    Body & Mind
    Chinese Medicine
    Herbal Medicine
    Manipulative Medicine
    Nutritional Medicine

Finally, as an initial draft, the proposed thesaurus presumably contains some mistakes and erroneous decisions. We would be grateful to receive feedback from colleagues, specializing either in the field of Alternative Medicine or in the art of thesaurus construction, so that the current draft can be corrected and improved. It is hoped that feedback from experts and practitioners will help us improve this draft, upgrading it to a useful and practical tool for indexing and information retrieval purposes.

List of Databases Searched

(DIALOG number is given in parenthesis)
  1. AIDSLINE (157)
  2. AMA Online (442)
  4. BNA Daily News from Washington (655)
  5. CANCERLIT (159)
  6. DIGENES (158)
  7. Dissertation Abstracts
  8. EMBASE (73)
  9. Health Periodical Database (149)
  10. Health Planning and Administration (151)
  11. INSPEC (2)
  12. International Pharmaceutical Abstracts (74)
  13. MEDLINE (155)
  14. PASCAL (144)
  15. PMS (457)
  16. SciSearch (434)
  17. SPORT (48)
  18. TOXLINE (156)


Aitchison, J., and others. Thesaurus construction and use : a practical manual. 3rd ed. London, Aslib, 1997.

Drabenstott, K.M. and Vizine-Goetz, D. Using subject headings for online retrieval: theory, practice and potential. San Diego, CA, Academic Press, 1994.

Foskett, A.C. The Subject approach to information. 5th ed. London, Library Association, 1996.

Lancaster, W.F. Vocabulary control for information retrieval. 2nd ed. Arlington, VA, Information Resources Press, 1986.


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