[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.