Alternative medicines are forms of medical treatment that do not use synthetic drugs or surgery in response to the symptoms of a disease, but aim to treat the patient as a whole (holism). The emphasis is on maintaining health (with diet and exercise) and on dealing with the underlying causes rather than just the symptoms of illness. It may involve the use of herbal remedies and techniques like acupuncture, homeopathy, and chiropractic. Some alternative treatments are increasingly accepted by orthodox medicine, but the absence of enforceable standards in some fields has led to the proliferation of eccentric or untrained practitioners .

( Special thanks to Wong Kai Hsia, for her research into Chinese medicine).

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• Acupressure
• Acupuncture
• Alexander technique
• Aromatherapy
• Bach flower healing
• Balneotherapy (see also hydrotherapy )
• Biofeedback
• Chinese medicine
• Chiropractic
• Colonic irrigation
• Colour therapy
• Herbalism
• Homeopathy
• Hydrotherapy (see also balneotherapy )
• Hypnotherapy
• Kinesiology, applied
• Magnet therapy
• Massage
• Overtone chanting
• Psychic healing /Spiritual healing
• Reflexology
• Reichian therapy
• Rolfing
• Shiatsu
• Sound therapy
• Spiritual healing / Psychic healing
• Yoga

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Acupressure - A generic term covering several massage techniques, mostly Chinese, in which fingertip pressure is applied to points on the body to stimulate the vital energy in corresponding organs. These techniques include shiatsu , developed in Japan from Chinese roots, do-in, and acu-yoga. Acupressure may be used for immediate relief of symptoms, for the maintenance of general health, and in supporting other forms of treatment. It lends itself to application as a self-help technique.

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Acupuncture - A system of medical treatment in which the body surface is punctured by needles at specific points to relieve pain, cure disease or produce anaesthesia. Acupuncture is an ancient Chinese therapy. The acupuncture points lie along invisible energy channels called meridians which are believed to be connected to internal organs. The needles are said to unblock, increase or decrease a flow of energy (called chi) through the meridians. Traditional Chinese medicine views the body as a balance between two opposing, yet complementary natural forces called 'yin' and 'yang'. An imbalance of yin and yang is believed to cause diseases and ailments. For example, too much yang may cause sudden pain, inflammation, spasm, headaches and high blood pressure; too much yin may cause dull aches and pains, chilliness, fluid retention, discharges and fatigue. Acupuncture identifies any imbalance and corrects it by inserting needles at the appropriate of up to 2000 points. Many of these points are on the 14 meridians, each named after the organ which it represents: heart, bladder, kidney, etc., Physical, emotional and environmental disorders are said to alter the flow of chi making it either too fast or too slow; or it may even be blocked or diverted to the wrong organ. The acupuncturist aims to restore the flow to its normal rate. Sometimes after the initial treatment the patient can feel worse - but this usually means that the practitioner has over stimulated the body's energies and will use fewer needles in a shorter session the next time. If there is no improvement after 6-8 sessions then acupuncture is unlikely to work for you. Numerous studies and surveys have attested the efficacy of the method, which is widely conceded by orthodox practitioners despite the lack of an acceptable scientific explanation. See also Acupuncture.com web page

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Alexander technique - A method of correcting bad habits of posture, breathing, and muscular tension, which Australian therapist F M Alexander maintained cause many ailments. The technique is also used to promote general health and relaxation and enhance vitality. Back troubles, migraine, asthma, hypertension, and some gastric and gynaecological disorders are among the conditions said to be alleviated by the technique, which is also said to be effective in the prevention of disorders, particularly those of later life.

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Aromatherapy - is the use of oils and essences derived from plants, flowers, and wood resins. Bactericidal properties and beneficial effects upon physiological functions are attributed to the oils, which are sometimes ingested but generally massaged into the skin. Aromatherapy was first used in ancient Greece and Egypt, but became a forgotten art until the 1930s, when a French chemist accidentally spilt lavender over a cut and found that the wound healed without a scar. However, it was not until the 1970s that it began to achieve widespread popularity. By the 1990s aromatherapy had gained a degree of acceptance in mainstream health treatment in Britain, and had started to become available on the National Health Service. In 1996, the Royal Liverpool University Hospital became the first in Britain to provide aromatherapy as part of a range of alternative treatment. According to the Office of National Statistics 1996, sales of the oils in Britain had risen by 40% since 1994 to a value of £340 million. Each essential oil has its own distinctive properties which have an effect on both body and mind and influence the emotions. By far, the best way to utilise essential oils is in massage. The action of rubbing stimulates the nerve endings and circulation of blood at the surface of the skin. Oils can be added to a warm bath where they not only come into contact with the skin but are inhaled too. A word of caution though; concentrated oils, resins and absolutes must be used with care as they can cause allergy or damage the skin. Oils should only be ingested when prescribed by a medically qualified practitioner. Aromatherapists claim improvements in all nervous disorders such as depression, anger, stress and related symptoms like insomnia and headaches. Below is a list of the most commonly used essential oils in the treatment of symptoms of GBS.

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Bach flower healing - A homoeopathic system of medical therapy developed in the 1920s by English physician Edward Bach. Based on the healing properties of wild flowers, it seeks to alleviate mental and emotional causes of disease rather than their physical symptoms.

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Balneotherapy - In alternative medicine, the use of baths of various types to relieve pain, muscle spasm, or stress and promote healing; an aspect of hydrotherapy . The tonic and therapeutic effects of the mineral-rich waters of spas, for example. Water at different temperatures affects the nervous system by stimulating or soothing the spinal nerves. Hot water opens the pores and increases surface circulation, promoting elimination through the skin. Cold water has an overall tonic effect, increasing the circulation but closing the pores. Alternate applications of hot and cold water are believed by practitioners to be particularly beneficial. This therapy can be contraindicated for patients with high blood pressure or heart problems. Foot baths are also considered to benefit the whole body, as points on the foot have been found to correspond with all the internal organs (see reflexology ). Epsom salts or bicarbonate of soda may be added to therapeutic baths to assist in detoxification and strengthen the immune system. Steam baths (Turkish baths) are still used therapeutically to hasten the elimination of toxins, and in some cases to facilitate elimination of substances with which the body cannot cope unaided.

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Biofeedback - Developed in the USA in the 1960s, independently by neurophysiologist Barbara Brown and neuropsychiatrist Joseph Kamiya. It is a method of regulating involuntary body functions, e.g. heartbeat, by conscious mental control. The principle behind it is that once you become aware of some bodily function you can learn to control that function. It employs a certain degree of self-awareness and employs the technology of modern biofeedback machinery and some techniques of yoga . Biofeedback has some value in GBS which probably lies with the stress factor of the illness. The ability to cope with stress depends upon recognising stress reactions in the body. Many people are never fully aware of the effects of stress and struggle on in a state of tension becoming prone to psychosomatic problems which may aggravate the GBS. Using a biofeedback machine can help the user to recognise the body's reaction to stress and warn them that they need to relax. The machine itself doesn't affect the body in any way but simply provides information. How biofeedback training techniques work is not fully understood, but it is clear that they can affect the part of the nervous system that determines how active or relaxed our bodies are. This is the autonomic nervous system, and governs responses such as blood pressure, skin temperature and muscular tension.

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Chinese medicine - (see also Basic Principles of Chinese Medicine web page.) A system based on the theory of energy currents in the body associated with the physical organs; there are a number of pathways, called meridians, along which energy is considered to flow. Each organ, or group of organs, has its own meridian; and each has a number of associations; for example, one of the five Chinese elements, as well as a time of day, so that if a person is restless or depleted at a particular time daily, identification of the location of the organic imbalance is facilitated. Vitality is identified as chi (or qi); and promotion of the regular and vigorous flow of chi in the body is the object of medical practice. Many physical factors are taken into account in diagnosis, including four distinct pulses on each wrist, and colour of tongue. Chinese physicians use acupuncture and related massage techniques to stimulate the energy of the meridians, and a vast repertory of herbs.

Extracts from - Longevity The Tao of Eating & Healing - Aileen Yeoh
Pains of Muscles and Nerves, Sciatica, Trigeminal Neuralgia, Muscular Spasms.
Pain can be so intense that people resort to having the nerves frozen or surgically removed. Traditional Chinese physicians believe that this pain is not caused by nerve dysfunction or damage to the nervous system.  Rather, it is a sign that there is a blockage or obstruction of the flow of chi and blood in the channels.  Nerves are the body's information carriers and should not be surgically removed; they should be nourished so they can inform us if the body is in danger.
To Chinese physicians, the blockage or obstruction of the flow of chi and blood in the channels is caused by the elements: wind, cold and damp. According to a Chinese saying, 'The wind is the cause of a hundred diseases.' Wind is the most damaging of the four elements because it can combine with cold and damp and give rise to wind cold and wind damp. Wind cold and wind damp, however, are the more common causes of arthritis and rheumatism especially in damp countries like Britain.  Wind can also drive the elements deeper into the body, especially if the wei chi (or defensive chi) is weak. To avoid this the Chinese always wrap themselves in long silk or cotton padded jackets with high collars in the winter.
These conditions can be divided into 5 syndromes:
1. Wandering bi where wind predominates.
2. Painful bi where cold predominates.
3. Fixed bi where damp predominates.
4. Febrile bi where heat predominates.
5. Bony bi with extra deposits of bone.
(Note:  bi means the obstruction of the flow of chi and blood by wind, cold, damp and heat. It is possible to suffer from a combination of the above bi syndromes).

1. Wandering bi where wind predominates
Wandering pain (characteristic of the nature of wind which moves constantly).
Widespread pain involving many joints.
Sore, painful or hot muscles and joints.
Attacks can be brought on from exposure to wind, draughts and sudden temperature changes

2. Painful bi where cold predominates
Severe, biting or stabbing pain.
Limitation of movement.
Pain decreases with hot applications.
Pain increases when cold.
No local inflammation.
This type of condition often occurs after exposure to cold, e.g. from working in cold-storage rooms, near freezers, outdoors in winter, or even from washing hands often in cold water.

3. Fixed bi where damp predominates
Stiffness and numbness more than pain.
Fixed pain.
Heavy body and limbs.
Swelling or oedema around the affected joint.
This type condition is usually brought on by damp, humid weather, living in damp places (like basement flats), living in misty or foggy places (near ponds, lakes, streams, etc.), or sleeping, lying, sitting, kneeling or walking barefoot on marble, tiled or cement floors, damp ground or wet grass.

4. Febrile bi where heat predominates
Painful, red, hot and swollen joints.
Pressure makes pain more severe.
More than one joint affected.
Limitation in movement.
This kind condition is usually a result of other types of bi syndromes that have been neglected.  After a long period of time, wandering, painful and fixed bi can turn into febrile bi because accumulated wind, cold or damp can turn into heat.

5. Bony bi with extra deposits of bone
Deformity of joints.
Limitation of movement.
Swelling of joints.
Muscular atrophy.
This is usually a result of long-term untreated bi syndromes where the obstruction of chi and blood to the joints has allowed toxins and mucus, catarrh or phlegm to accumulate and cause pain and deformity.

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Chiropractic - A technique of manipulation of the spine and other parts of the body, based on the principle that physical disorders are attributable to aberrations in the functioning of the nervous system, which manipulation can correct. Developed in the 1890s by US practitioner Daniel David Palmer, chiropractic is widely practised today by accredited therapists, although orthodox medicine remains sceptical of its efficacy except for the treatment of back problems.

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Colonic irrigation - The washing out of the colon to remove decayed and therefore toxic faecal material that has not been expelled, and has accumulated, adhering to the walls of the bowel. The digestive function is acutely sensitive to stress and the effects of overeating, eating 'junk' food, or drinking insufficient water. As a result, practitioners believe, excretion is not always fully efficient; the residual faecal matter tends to dry out and become sticky; further such material sticks to it; and the colon can become distorted in shape, and restricted in function as its walls are blocked. The presence of this toxic matter in the body is then thought to overstrain the immune defence system, so that the individual is more prone to disease. Colonic irrigation involves the introduction of pure water, sometimes with a herbal extract, gently into the colon from the anus; a valve on the tube along which it passes allows the therapist to stop the flow when appropriate, and then to let the water out, along with faecal matter. The tube is transparent, to allow observation of the material expelled so that the presence of parasites or other conditions can be detected. The therapist usually advises a detoxification diet, and an acidophilus preparation to restore the 'friendly' intestinal flora that may be washed out as well as toxins. This type of cleansing has been in use for many years; it is mentioned in the Ebers Papyrus, an Egyptian document from 1500 BC. It was also used by Hippocrates, Galen, and the Essenes.

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Colour therapy - The application of light of appropriate wavelength to alleviate ailments or facilitate healing. Coloured light affects not only psychological but also physiological states - for instance, long exposure to red light raises blood pressure and speeds up heartbeat and respiration rates, whereas exposure to blue has the reverse effect. Colour therapy can be traced back to ancient Chinese and Egyptian cultures, and it was revived in Europe in the 19th century by the Austrian scientist Rudolf Steiner. Colour therapists maintain that some ailments, such as asthma, can be treated by colour therapy alone, and that many others respond better to conventional treatments with its aid.

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Herbalism - (see also Grey Wings Herbal web page) is the prescription and use of plants and their derivatives for medication. Herbal products are favoured by alternative practitioners as 'natural medicine', as opposed to modern synthesized medicines and drugs, which are regarded with suspicion because of the dangers of side effects and dependence. Many herbal remedies are of proven efficacy both in preventing and curing illness. Medical herbalists claim to be able to prescribe for virtually any condition, except those so advanced that surgery is the only option. Herbal medicines are extracted from plants and contain no added chemicals. Persons with GBS may find some herbal treatments helpful. If approaching a herbalist it is worth checking that the practitioner is registered. Natural remedies tend to take a little while to begin working so consistency is important. GBS will not be cured by herbal medication but symptoms may be alleviated and better health in general can be promoted. Herbalists state that their medicines may benefit most people suffering from most kinds of illnesses, including long-standing conditions such as arthritis and migraine. Herbs can be used to medicate in the form of drinks (decoctions, infusions, tinctures, tisanes), dressings (compresses, poultices) or ointments and essential oils. More commonly useful in GBS are:

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Homeopathy - Developed by German physician Samuel Hahnemann (1755- 1843), homeopathy is widely practised today as an alternative to allopathic (orthodox) medicine, and many controlled tests and achieved cures testify its efficacy. It is a system which aims at curing diseases by administering in small doses medicines which would produce in healthy persons symptoms similar to those they are designed to remove. Homeopathic medicines can be animal, vegetable or mineral in origin and are so dilute it is hard to believe that there is any potency left. Results are good, but often slow. In GBS homeopathy may provide specific remedies for symptoms such as pain. Homeopaths say that the more closely a remedy imitates the patient's symptoms, the better it promotes healing; and the more dilute the dose, the greater its effect. Remedies rarely cause any effects other than the symptoms already present, although occasionally these may worsen at first - known as a 'healing crisis' - but usually this does not last long, and is taken to herald improvement. The severity of symptoms within each bodily system is graded in order of importance, but unusual symptoms have greater significance. So a person's emotional and mental state, general problems such as insomnia, and additional 'peculiar' symptoms (such as tingling on the left side of the body only) may receive more attention than a symptom such as a rash, although this may have been the original reason for seeking help. In 1992, the German health authority, the Bundesgesundheitsamt, banned 50 herbal and homeopathic remedies containing alkaloids because they are toxic, and set dose limits on 550 other natural remedies.

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Hydrotherapy - (Hydropathy) see also Balneotherapy . The treatment of disease by the internal and external application of water. Water is a natural and thorough cleansing agent, internally as well as externally and hydrotherapy is much valued by natural therapists but rarely recommended by conventional doctors. At the root of hydrotherapy is the belief that water is the essence of life. In its various forms - liquid, ice, steam or gas - it can be used to induce relaxation, to stimulate blood flow, to remove impurities, drugs or alcohol, to ease pain and stiffness and to treat disease. The patient may benefit from water in several ways - in a compress, as a spray or from a bath, for example - but the most significant point is its temperature. Hot water or steam dilates blood vessels, encourages sweating, relaxes muscles and joints, and draws heat to the surface. Cold applications constrict blood vessels, reduce inflammation and congestion on the surface and stimulate the flow of blood to internal organs. Some hydrotherapists specialize in colonic or high colonic irrigation , the thorough washing-out and detoxification of the digestive system. T here are some dangers to avoid in hydrotherapy. Anyone allergic to iodine should avoid any treatment with seaweed or its extracts. Patients with heart disease or high blood pressure should see a doctor before having any form of hydrotherapy. Hot and cold water treatments always need to be administered with caution to avoid dramatic changes in blood pressure, or fainting. There are also similar hazards in taking too cold a shower or dip after a steam bath.

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Hypnotherapy - Treatment by hypnotism. Hypnotherapy helps you, through hypnotism, to come to terms with your feelings and emotions. Symptoms may disappear or reduce as you relax. It is frequently the most effective method of discovering the stresses you are under and helps relieve you of them. By no means does this work for everyone as you need to be susceptible to hypnosis to some degree. Many doctors still have doubts about the value of hypnosis, but others are themselves qualified hypnotherapists, who use hypnosis as one of their standard techniques. It is always best to find a hypnotherapist who is also a doctor, thus avoiding the danger of hypnosis being used for a wrongly diagnosed condition which needs a different treatment. Doubts about the nature of a hypnotic trance do not prevent recognition of its effectiveness in giving drug-free release from pain and the easing of a variety of conditions rooted in stress and anxiety. Though it is an effective method of modifying behaviour, its effects are of short duration unless it is used as an adjunct to psychotherapy .

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Kinesiology, applied - In alternative medicine, an extension of chiropractic developed in the USA in the 1960s and 1970s, principally by US practitioner George Goodheart. Kinesiology, or muscle testing, relates to the Chinese principle that there exist energy pathways in the body and that disease results from local energy blockages or imbalances. Goodheart developed both diagnostic and therapeutic techniques, working on the body's musculature, which are used particularly with stress-related ailments.

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Magnet therapy - The use of applied magnetic fields to regulate potentially pathogenic disorders in the electrical charges of body cells and structures. Physicians Hippocrates and Galen in the ancient world, Paracelsus in the Middle Ages, and more recently the founder of homoeopathy , Samuel Hahnemann, practised magnet therapy. Today practitioners apply it as a stimulant of the body's self- healing processes, to enhance tissue repair and the healing of bone fractures, as an adjunct of structural therapies such as chiropractic , and as an alternative to needling in acupuncture .

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Massage - The benefits of massage were known to the ancient Chinese, Egyptian, and Greek cultures. The techniques most widely practised today were developed by the Swedish physician Per Henrik Ling (1776-1838). Massage is treatment by kneading or rubbing the muscles and body, usually with the hands. Massage both relaxes and stimulates, improving the circulation of the blood, aiding the nervous and immune systems to work at maximum efficiency. Massage can also focus on relieving muscle tension and spasm. Massage works well in combination with bathing. Although tiring at first a tolerance to it needs to be built up in order to benefit from its beneficial long term effects. Mentally, on a psychological and emotional level, the calm and soothing effects of massage have helped people plagued by anxiety or depression, allowing them to deal more constructively with everyday worries and problems. Physically, massage therapies are aimed at improving the blood, muscular and nervous systems, and also in helping the body to assimilate food and get rid of waste products. Massage therapy has wide applications for many conditions. However, it should not be seen as a treatment for any specific disease - or as a substitute for conventional medical treatment. Its effect is more to do with its soothing, relaxing qualities and the close and sympathetic contact with another human being. As a complementary therapy it is finding favour with many doctors in the course of various methods of treatment.

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Overtone chanting - A type of sound therapy with roots in Tibetan meditational practices. The technique involves chanting in such a way as to produce overtones or harmonics; these are sounds pitched above the voice, with no fixed spatial location, but appearing to come from all round. They resemble the sound produced by running a wet finger around the rim of a glass. The practice is used to reduce stress levels and enhanced wellbeing; a version of it, developed in the 1970s and 1980s in the USA and Britain by Rudolph Murley, uses different sounds to correct energy imbalances affecting different physical organs.

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Psychic healing - Transmission of energy from or through a healer, who may practise hand healing or absent healing through prayer or meditation. In religions worldwide, from shamanism to latter-day charismatic Christianity, healing powers have been attributed to gifted individuals, and sometimes to particular locations (Delphi, Lourdes) or objects (religious relics), and the anecdotal evidence for the reality of spiritual healing is substantial and cross- cultural. Since both healers and beneficiaries can only adduce metaphysical explanations for the effects, medical science remains sceptical, at most allowing that in exceptional cases faith and will may bring about inexplicable cures or remissions, which, however, also occur in cases where no spiritual contribution is claimed.

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Reflexology - A form of therapy where certain areas of the soles of the feet are massaged to stimulate supposedly corresponding areas of the body's circulation and nerves, and so release tension. Reflexology was discovered early in the 20th century by US physician William Fitzgerald, who also found that pressure and massage applied to these reflex points beneficially affect the related organ or function. R eflexology can be beneficial to people with GBS. It is based on the principle of the body being divided into zones, each linked to a key point on one of the feet. By massaging the appropriate area of the foot it is possible to treat problems in the related body zone or organ. Simple and harmless it often produces surprising results. Reflexologists regard the feet as a mirror of the body, with the left foot representing the left-hand side and the right foot the right-hand side. Different parts of the sole connect in some way to such organs as the liver, kidney's, heart etc,; big toe to the head and brain; little toe to the sinuses. The massage alone is said to prompt the body to heal itself. Treatment should be carried out by a fully trained practitioner though doctors believe that very little harm can come from this therapy and many people find the massage particularly soothing.

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Reichian therapy - Any of a group of body therapies based on the theory, propounded in the 1930s by Austrian doctor Wilhelm Reich, that many functional and organic illnesses are attributable to constriction of the flow of vital energies in the body by tensions that become locked into the musculature. Bioenergetics and Rolfing are related approaches.

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Rolfing - The technique of deep muscular manipulation developed in the 1960s and 1970s by US physiologist Ira Rolf. Also known as `structural integration“, the treatment is designed to correct gravitational imbalance in body postures and movements, and to relieve muscular rigidities and inflexibilities, thus enhancing general health and vitality. See Rolf Institute web page.

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Shiatsu - Shiatsu is Japanese for 'finger pressure' but, in fact, the palms, heels of the hands, elbows, knees and feet are used, and especially the thumbs. Shiatsu uses pressure on hundreds of surface points along the body's meridians (see Acupuncture ) to stimulate the flow of chi through the paths. It is a safe and effective technique, largely preventive but also used as a form of physiotherapy for specific ailments. It is said to act on the electromagnetic forces of the body, which are particularly high or low in the areas of the pressure points. By stimulating or calming these points, shiatsu aims at rebalancing the quality and quantity of electromagnetic energy being distributed along the meridians - benefiting not only the body but also the mind, feelings and spirit. Shiatsu is a whole body programme designed to tone up the circulation, nervous system and immune system. Shiatsu is useful in the prevention of pain. It may be that the strongly applied pressure stimulates the body to produce endorphins, its own painkillers. The therapy is unlikely to cause harm in most people - especially if only the thumbs, fingers and palms are used - but should not be used on inflamed, infected or damaged areas or on a person who is taking steroids such as cortisone. See also - Shiatsu web page.

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Sound therapy - Treatment based on the finding that human blood cells respond to sound frequencies by changing colour and shape, and the hypothesis that therefore sick or rogue cells can be healed or harmonized by sound. The therapy was in 1991 being developed and researched by French musician and acupuncturist Fabien Maman and US physicist Joel Sternheimer. It is claimed that sound frequencies applied to acupuncture points are as effective as needles.

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Yoga - (Sanskrit 'union') Hindu philosophical system attributed to Patanjali, who lived about 150 BC at Gonda, Uttar Pradesh, India. He preached mystical union with a personal deity through the practice of self-hypnosis and a rising above the senses by abstract meditation, adoption of special postures, and ascetic practices. As practised in the West, yoga is more a system of mental and physical exercise, and of induced relaxation as a means of relieving stress. 'Hatha yoga' is the form of yoga most common in the West, emphasising the importance of physical exercises and breathing control. Because it works on body and mind together yoga is recommended for the relief of stress and stress-related conditions. Yoga can be practiced by people of all religious beliefs or by people with none, though spiritual and mental development are necessary to reinforce the benefits that the physical exercises can bring. Breathing plays an important part in yoga. Breath embodies the individual's life-force. Although breathing is an unconscious function it can be consciously modified with a consequent effect on well-being. People with problems of movement and posture benefit from the twisting and bending exercises which develop flexibility in the spine and back muscles. Because the spine carries nerves from the brain to the trunk and limbs its well-being is involved in many reflex movements and the control of pain. Yoga has been used particularly in the treatment of back pain, headaches, high blood pressure and tension and some forms of chronic illness. If the exercises are carried out properly they will improve mobility and circulation and should pose no danger of injury. Most doctors, though, only see yoga as a beneficial form of gentle exercise.

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Last modified on: 8 July, 2008 .

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