From: BLANTON@VAX2.DSEG.TI.COM Subject: Healthy Skepticism Message-ID: <9303211925.AA25119@lll-winken.llnl.gov> Date: Sat, 20 Mar 1993 23:19:33 -0600 The following appears in the March issue of The Skeptic, the newsletter of the North Texas Skeptics. This material may be distributed for noncommercial use. Other use requires the permission of the author. John Blanton Secretary, The North Texas Skeptics blanton@lobby.ti.com ================================================ Healthy Skepticism Medical "Pathies" By Tim Gorski, M.D. (Last in a Series) Osteopathy Andrew T. Still gave osteopathy it's start in the 19th Century. Still, like his Methodist minister father, practiced medicine largely as a self-taught see-and-do profession. With this kind of religious background, and after watching helplessly as three of his own children died of spinal meningitis, Still went into the magnetic healing business. Later, he developed an interest in bonesetting and gained a reputation as a "lightning bonesetter." From this he went on to becoming convinced of the benefits of spinal manipulation therapy, which he claimed could cure heart disease and other illnesses besides those of a musculoskeletal nature. Still's osteopathy incorporated obvious religious elements. He regarded it as "God's law" and theorized the divine infusion into human beings of "the highest known order of force (electricity)" which, "when it plays freely all through your system, you feel well. Shut it off in one place and congestion may result; in this case a medical doctor, by dosing you with drugs, would increase this congestion until it resulted in decay. ...Not so with an Osteopath. He removes the obstruction, lets the life-giving current have full play, and the man is restored to health." Still taught that obstruction of the flow of this force is the cause of all disease and that, excepting osteopaths, physicians were treating only effects that manifested as different diseases. 1 Daniel David Palmer, the founder of chiropractic, evidently borrowed freely from the ideas of Still. His name was said to have appeared in Still's guest book in the early 1890s and Palmer is said to have been directly instructed by an osteopath. But whereas chiropractic remains to this day strongly wedded to its "one cause" theory of disease and the notion that spinal manipulation can effectively treat every disorder, osteopathy was almost immediately directed back towards the mainstream. This was because, soon after Still opened his American School of Osteopathy in Kirksville, Missouri, a visiting Scottish physician, seeing some promise in Still's methods, agreed to become an instructor in the newly founded school. Smith saw to it that the faculty soon included a number of members who were highly trained in the scientific and medical knowledge of the day. Still objected to such "medicalization" of his system, but he never seriously challenged it, probably in large part because it enabled graduates of his school to obtain their medical licenses. And with this auspicious beginning, the passage of time saw osteopathy's gradual accommodation with and eventual acceptance of the use of medication, of surgery, and other theories of disease causation. By the 1950s, Still's metaphysical notions had almost entirely withered away, to the extent that a study committee of the American Medical Association (AMA) was able to say that "modern osteopathic education teaches the acceptance and recognition of all etiological factors and all pathological manifestations of disease as well as the utilization of all diagnostic and therapeutic procedures taught in schools of medicine." 2 As a result, the main difficulty with osteopathy today is that it is in something of an identity crisis. About the only thing that distinguishes osteopathic training is the continued inclusion in the curriculum of spinal manipulation, which does appear to have a place in the management of certain musculoskeletal disorders. But many osteopaths go on to make little or no use of this practice. Meanwhile, Medical Doctor physicians who have an interest in manipulative techniques can learn them. There is even an Academy of Manual Medicine, just as there are professional societies for other aspects of the contemporary practice of scientific medicine. Allopathy Double-talk Allopathy, as it turns out, was another invention of homeopath Samuel Hahnemann, being his term for all medical theories and practices which didn't fit into his like cures like superstition. (Whereas "homeo" means "same, "allo" means "other.") Today, allopathy is sometimes applied to the kind of medicine learned and practiced by M.D. degree physicians, although many of them may not know it. Often it's an innocent usage by D.O. degree physicians who are trying to distinguish themselves from the M.D.s. But because most physicians with either degree are practicing the same sort of medicine, the term allopathy is of no more use than that of osteopathy, except as a sort of anachronism. More often, allopathy is a term used by quacks to smear their opposition. There are several advantages in their doing so. One is that it appears to ally them with osteopaths, even though most D.O.s, like most M.D.s, are practicing legitimate medicine. Another reason is that quacks wish to portray their enemy as an exclusive medical sectarian establishment, for the public will understandably let them get away with failing to address objections to their methods that can be cast as the jealous and idiosyncratic disapproval of self-interested competition. Finally, and most importantly, quacks need very much to avoid facing up to the fact that their detractors are defending an honest and open scientific approach. And above all, quacks need their victims to believe that their methods are an "alternative," not to the continually evolving facts and reason of medical science, but to some nebulous (and nefarious) scheme of "allopathic," "orthodox," and/or "traditional" medicine. Medical "-pathies" have a vestigial use as identifiers of outworn and outdated ideas about health and disease from medicine's prescientific infancy. They are irrelevant when it comes to modern medical science. Notes: 1. A.T. Still, Autobiography of Andrew T. Still, pp. 235, 289-290, self-published, Kirksville, Mo., 1897, cited in Fuller, Robert C., Alternative Medicine and American Religious Life, Oxford University Press, 1989. 2. "Report of the Committee for the study of relations between Osteopathy and Medicine," Journal of the American Medical Association, 152:734, cited in Fuller. This information is provided by the D/FW Council Against Health Fraud. For more information, or to report suspected health fraud, please contact the Council at Box 202577, Arlington, TX 76007, or call metro 214-263-8989. Dr. Gorski is a practicing physician, chairman of the D/FW Council Against Health Fraud and an NTS Technical Advisor.