[CriticalSection]

> The Osteopathic profession was the only group that was organized enough to survive the Medical Guild's purge of non-Rockefeller-approved approaches to medicine.

What? The Medical Guild purged (almost) all of the quacks and snake oil salesman out of medicine, and aimed American medicine to be directed by the scientific method and biology. This was a good thing.

You're right, most of the quacks, snake handlers, anti-vaccine charlatans and witch doctors were purged, thankfully. But the osteopathic so-called "alternative" medicine practitioners were well-organized enough, and legally and politically savvy enough to survive.

People on this web site tend to look favorably upon reason, the scientific method and so forth. Thus, I think they will look favorably upon this work of Rockefeller, and shed few tears for the faith healers, quacks, acupuncturists etc. which people are still free to go to, but which my tax and health plan dollars are (mostly) not going to, thankfully.

Then you mix in that primary care doctors don't spend enough time with their patients nowadays. This may be true, in fact, it probably is. It has absolutely nothing to do however with whether people are getting rational, scientific treatment tested through medical trials, or whether they're going into some voodoo ritual with some quack.

[dang]

We detached this subthread from https://news.ycombinator.com/item?id=13915838 and marked it off-topic.

[kolanos]

John D. Rockefeller's father was literally a snake oil salesman [1].

1: https://en.wikipedia.org/wiki/William_Rockefeller_Sr.

[liber8]

It's not that osteopaths were so well organized. It's that John D. was a devoted Osteopath for most of his life.

If you haven't read Titan, it's a fascinating bio.

[CriticalSection]

> John D. was a devoted Osteopath for most of his life. If you haven't read Titan, it's a fascinating bio.

That's interesting, I didn't know that.

More than osteopathy, the similar yet different practice of chiropractic is a better example of a legally and politically well-organized "alternative medicine". Through legal ( https://en.wikipedia.org/wiki/Wilk_v._American_Medical_Ass'n ) and political pressure from the 1970s to the 1990s, they got the American Medical Association to dissolve their committee on quackery, rewrite their medical ethics rules and so forth.

[lqdc13]

I would like to point out that chiropractic medicine is not necessarily quackery. There are certainly some elements that may not always work, but there are also many things that do.

The classes in the schools are certainly not a joke - they take real anatomy and real body mechanics, real radiology and real biochemistry - and the requirements for graduation are not trivial.

Additionally, although scientific method has been successful in medicine, a lot is still not well understood from the bottom up. That's why some alternative medicine solutions sometimes work as well and even better than modern medicine. It was arrived at through centuries of trial and error.

[cholantesh]

Chiropractic largely works because it has purged so much of its foundational ideas and is almost congruous to physiotherapy (albeit with more focus on manipulative therapy than exercise).

>That's why some alternative medicine solutions sometimes work as well and even better than modern medicine.

I can see some forms of alternative medicine being complementary (hence the name), such as meditation or yoga, but better? Could you point to some examples? Genuinely curious about this.

[lqdc13]

Well, the problem is that a lot of times there is no research into them and by the time there is research, the useful properties are extracted so that a better modern solution is available.

Basically, the only way to prove that it works is by showing that modern medicine adopted the approach after systematic evaluation and at that point it is part of modern medicine.

For example, Artemisinin wasn't known to be useful until 1979 but was a traditional Chinese medicine in plant form for a very long time.

Another example that still isn't fully accepted is cupping. Wikipedia page on it suggests that it is not useful beyond placebo. But here [1] is a recent study that says it's effective. Let's imagine that it is very effective for some kinds of pain. A modern medicine alternative might be to take some kind of painkiller that might damage the liver in large doses.

For sore throat, someone might take NiQuil. Some doctors would prescribe antibiotics just in case it's a bacterial or might have a bacterial follow-up. Alternative medicine solution is to grind up garlic and eat cabbage soup. Garlic h as Allicin which kills strep throat. This, I think, is less intrusive. But I don't know if anyone did a large-scale study where they compared the two common solutions head to head.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814666/

[cholantesh]

>Basically, the only way to prove that it works is by showing that modern medicine adopted the approach after systematic evaluation and at that point it is part of modern medicine.

I don't think that's true. That study you linked to indicates that it is possible to do clinical research on many alternative modalities. Indeed, I see plenty of papers coming out that make the attempt, and lots of reviews and meta-analyses thereof. They tend to conclude one of two things:

- the methodology of the stud[y|ies] is poor

- the research is positive but too small in scale/particular in conditions to base decisions on

- they don't demonstrate a strong correlation between the application of the treatment and the desired outcome

If some of those studies from the second block were repeated with larger, more diverse samples, I'd be less wary of alt med in general, I think.

>Another example that still isn't fully accepted is cupping. Wikipedia page on it suggests that it is not useful beyond placebo. But here [1] is a recent study that says it's effective.

The Wiki page seems to suggest that cupping, when recommended for chronic neck/shoulder pain, is treated with cautious optimism by most scientists, for the reasons noted above. The study you mentioned is strong methodologically, but the sample size is tiny, and composed primarily of women.

>A modern medicine alternative might be to take some kind of painkiller that might damage the liver in large doses.

I think this is a pretty unfair stereotype; certainly painkillers are over-prescribed, but that doesn't mean that all of modern medicine is wrapped up in the use of pharmaceuticals. Lifestyle changes, physical therapy, massage, etc. are all things that conventional physicians will recommend.

[jimmyjohnson1]

But the purging hasn't gone far enough. You have the likes of Life College, Sherman and even Cleveland who still hold to the debunked foundational ideas. Those who graduate from these schools are taught to be high visibility charlatans who are the ones seen by the decisionmakers (legislators, etc.) and keep the majority of chiropractors (evidenced based) from moving forward in the healthcare world.

[jimmyjohnson1]

No it hasn't--not as far as the decision makers (legislators) are concerned. Graduates of the schools who espouse the debunked foundational ideas (Life, Sherman and Cleveland) are generally high visibility charlatans who are seen by the legislators and those who work in mainstream healthcare. They also speak out against any progression by evidenced based chiropractors.

[cholantesh]

The first sentence in my reply ought to have been prefaced with a 'when'. I'm not aware of how prevalent evidence-based chiropractic is, or the politics associated with the original practice, but regardless my point is that it can hardly be called chiropractic and is probably redundant since physio exists.

[kingkawn]

they failed to make it be guided by scientific method, but rather taught the quacks that the only way forward was to use scientific terminology, and if they could do so propery would even be admitted deeper into medicine than they ever could've hoped before

[kbenson]

Just think of them as the random mutation in the genetic algorithm. Keeping the progress facing forward is the job of the scientific method, but occasionally you get a big leap as some of the more outlandish claims are finally tested and found to have some merit. It's a fine line, and one we don't always walk all that well.

[kingkawn]

The ultimate groundless hubris that what is called the scientific method is an attempt to lay claim to being the only legitimate form of trial and error

[teslabox]

The Medical Guild didn't have much to offer in the early part of the 20th century. The Osteopaths [possibly] had much better results at their hospitals during the Great Flu of 1918, for example.

Science started to make some progress figuring things out, but then the snake oil salesmen regrouped and used the cloak of 'science' to sell their 'prescriptions'. For example, Statin drugs might prevent a few heart attacks, but just cause side effects for 90+% of the patients who take them.

Pfizer, et al, are trying to restore estrogen/Premarin (a prescription derived from PREgnant MARes' urIN [1]) to its former glory, even though estrogen treatment was always known by actual scientists to be harmful [2].

Robert Whitaker has provided an indictment of conventional psychiatry's use of 'snake oil' [3], and a science writer recently voted to indict [4].

[1] https://en.wikipedia.org/wiki/Premarin [2] http://web.archive.org/web/20110719210324/http://leda.law.ha... [3] https://blogs.scientificamerican.com/cross-check/are-psychia... [4] https://blogs.scientificamerican.com/cross-check/psychiatris...