Barbara Fitzpatrick wrote:DAR - It wasn't gas - please give me credit for knowing what was normal
DAR
I agree gas is very unlikely. That's why I used it. Because even as unlikely as it is that it was gas (and there are numerous other things it could have been), it is FAR more likely IMO than that a psychic discerned a correct diagnosis.
(Remember the late 19th Century brought us Christian Science...
DAR
Incidentally, those guys are dying and quickly. Pure claptrap and good ridance. Good people though, I know many of them and play piano at a Christian Science nursing home (no real nurses allowed of course), once a month.
Chiropractic College is very science-based medicine - the 1st 2 years are especially similar, practically interchangeable.
DAR
Since I don't think their main foundational belief "subluxations" is science based I am obviously not going consider Chiropractic "very science based." I do think they have their place and may be of some use for some people. Like many "alternative" methods, they are desperately trying to become mainstream and have had some progress, but limited, and quite rightly. And they are filled with quacks making all sorts of outrageous claims as I note above and have experienced first, second hand and in material have I have read.
Chiropractors don't prescibe drugs, as with psychologists, because they aren't dealing with organic/internal medicine problems.
DAR
Not so. I can bury you in examples of chiropractors making claims that deal with organic/internal medicine problems. I am sure there are a good percentage that don't. I think most do.
Subluxation is exceedingly provable by x-ray and Medicare requires x-rays before they will cover the treatment.
DAR
That runs quite contrary to what I have read regarding subluxation. You might give this a read:
Chiropractic's Elusive "Subluxation"
http://www.quackwatch.org/01QuackeryRel ... rosub.html
An excerpt:
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Are Subluxations Visible?
Chiropractors also disagree on whether their "subluxations" are visible on x-ray films. "Straight" chiropractors tend to believe that they cause nerve interference, are readily visible, and that virtually everyone gets them. Most other chiropractors (commonly referred to as "mixers") define subluxations loosely and see them when it suits their convenience. Chiropractors who reject subluxation theory consider them invisible but have been forced to acknowledge them to get paid by Medicare. When a respected chiropractic researcher was asked whether he had ever seen a subluxation on an x-ray film, he smiled and jokingly replied, "With my eyes closed." [2]
Old chiropractic textbooks show "before and after" x-rays that are supposed to demonstrate subluxations. In 1971, hoping to get a first-hand look at such x-rays, I challenged the local chiropractic society to demonstrate ten sets. They refused, suggesting instead that I ask the Palmer School to show me some from its "teaching files." When I did, however, a school official replied:
Chiropractors do not make the claim to be able to read a specific subluxation from an x-ray film. [They] can read spinal distortion, which indicates the possible presence of a subluxation and can confirm the actual presence of a subluxation by other physical findings [3].
In 1973, Congress authorized payment under Medicare for chiropractic treatment of "subluxations demonstrated by x-rays to exist." In 1972, to enable payment, chiropractors held a consensus conference that redefined "subluxations" to include common findings that others could see. The document, several pages long, described the supposed x-ray manifestations of 18 types of "subluxations," including "flexion malposition," "extension malposition," "lateral flexion malposition," "rotational malposition," "hypomobility" (also called "fixation subluxation"), "hypermobility," "aberrant motion," "altered interosseous spacing," "foraminal occlusion," scoliosis, and several conditions in which "gross displacements" are evident [4]. I have been unable to determine how many billions of dollars chiropractors have received from Medicare since the law took effect.
Some of these terms are fancy names for the minor degenerative changes that occur as people age. The conditions often have nothing to do with a patient's symptoms and are not changed by chiropractic treatment. Some, as acknowledged by the conferees, are not even visible on x-ray films. In 1997, Congress amended the law to permit payment for subluxations diagnosed by other means -- a policy scheduled to take effect on January 1, 2000.
Chiropractors also differ about how to find "subluxations" and where they are located. In addition to seeing them on x-ray films, chiropractors say they can find them by: (a) feeling the spine with their hand, (b) measuring skin temperature near the spine with an instrument, (c) concluding that one of the patient's legs is "functionally" longer than the other, (d) studying the shadows produced by a device that projects a beam of light onto the patient's back, (e) weighing the patient on special scales, and/or (f) detecting "nerve irritation" with a device. Undercover investigations in which many chiropractors have examined the same patient have found that the diagnoses and proposed treatments differed greatly from one practitioner to another.
Subluxation is also a medical term. The medical definition is incomplete or partial dislocation -- a condition, visible on x-ray films, in which the bony surfaces of a joint no longer face each other exactly but remain partially aligned. No such condition can be corrected by chiropractic treatment.
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Some of the "alternative" diagnostic procedures are quite valid and are moving into "traditional" medicine (hair analysis, nutritional deficiencies and allergy testing, etc).
DAR
They are trying and I wish them the best of luck. I have been agnostic about acupuncture and they have had some of their claims verified, however no chi energy meridians or chakras ever detected in anyway. And the latest shows it doesn't matter where you stick the needles (also electrical stimulation works just as well).
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5. ACUPUNCTURE: IT DOESN'T MATTER WHERE YOU STICK THE NEEDLE.
According to an article in Lancet Neurology, German researchers
found that Chinese acupuncture worked about as well as drugs in
treating arthritis, but so did sham acupuncture, in which the
needle is inserted in the wrong place. --Bob Park, What's New
***
As I like to say, there is regular science based medicine which we use because it has been shown to work, and then there is everything else. If the "alternative" category wants to join the mainstream category, then they just need to get on board. Survival of the fittest. But they want to change the rules, see below.
A number of "alternative" medical techniques are hitting mainstream that were considered quackery when your 1981 study was done.
DAR
I watch this topic pretty close with a couple of my skeptic magazines. I think the alternative folks are exaggerating their acceptance into mainstream unless you mean just the regular gullible folks dabbling with things on their own.
Consider:
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Under the rules of science, people who make the claims bear the burden of proof. It is their responsibility to conduct suitable studies and report them in sufficient detail to permit evaluation and confirmation by others. Instead of subjecting their work to scientific standards, promoters of questionable "alternatives" would like to change the rules by which they are judged and regulated. "Alternative" promoters may give lip service to these standards. However, they regard personal experience, subjective judgment, and emotional satisfaction as preferable to objectivity and hard evidence. Instead of conducting scientific studies, they use anecdotes and testimonials to promote their practices and political maneuvering to keep regulatory agencies at bay. As noted in a recent New England Journal of Medicine editorial:
What most sets alternative medicine apart . . . is that it has not been scientifically tested and its advocates largely deny the need for such testing. By testing, we mean the marshaling of rigorous evidence of safety and efficacy, as required by the Food and Drug Administration (FDA) for the approval of drugs and by the best peer-reviewed medical journals for the publication of research reports. Of course, many treatments used in conventional medicine have not been rigorously tested, either, but the scientific community generally acknowledges that this is a failing that needs to be remedied. Many advocates of alternative medicine, in contrast, believe the scientific method is simply not applicable to their remedies. . . .
Alternative medicine also distinguishes itself by an ideology that largely ignores biologic mechanisms, often disparage modern science, and relies on what are purported to be ancient practices and natural remedies (which are seen as somehow being simultaneously more potent and less toxic than conventional medicine). Accordingly, herbs or mixtures of herbs are considered superior to the active compounds isolated in the laboratory. And healing methods such as homeopathy and therapeutic touch are fervently promoted despite not only the lack of good clinical evidence of effectiveness, but the presence of a rationale that violates fundamental scientific laws -- surely a circumstance that requires more, rather than less, evidence [5].
[5] # Angell M, Kassirer J. Alternative Medicine -- The risks of untested and unregulated remedies. New England Journal of Medicine 339:839-841, 1998.
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And then there is:
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The NIH Debacle
Many news reports have exaggerated the significance of the National Institutes of Health (NIH)'s Office of Alternative Medicine (OAM). Creation of this office was spearheaded by promoters of questionable cancer therapies who wanted more attention paid to their methods. Most of OAM's advisory panel members have been promoters of "alternative" methods, and none of its publications have criticized any method. In 1994, the OAM's first director resigned, charging that political interference had hampered his ability to carry out OAM's mission in a scientific manner [9]. In 1998, Congress upgraded OAM into an NIH center with an annual budget of $50 million. Today the agency is called the National Center for Complementary and Alternative Medicine (NCCAM) and has an annual budget exceeding $100 million [10].
When OAM was created, I stated: "It remains to be seen whether such studies will yield useful results. Even if some do, their benefit is unlikely to outweigh the publicity bonanza given to questionable methods." In 2002, Wallace I. Sampson, M.D., editor of the Scientific Review of Alternative Medicine summed up what has happened:
It is time for Congress to defund the National Center for Complementary and Alternative Medicine. After ten years of existence and over $200 million in expenditures, it has not proved effectiveness for any "alternative" method. It has added evidence of ineffectiveness of some methods that we knew did not work before NCCAM was formed. NCCAM proposals for 2002 and 2003 promise no more. Its major accomplishment has been to ensure the positions of medical school faculty who might become otherwise employed -- in more productive pursuits [10].
http://www.quackwatch.org/01QuackeryRel ... twary.html
The standard medical treatment for pinched nerves is muscle relaxants and pain killers & hope it rights itself. Chiropractic standard response is move the vertebra back so it's not pinching the nerve.
DAR
You're right. My ex-wife had all the symptoms of a pinched nerve in her neck (she's a violinist). Very painful. Neither doctor nor chiropractor helped in the least. It went away about a week later as I remember.
Oh, and while chiropractors can't prescribe drugs, they can prescribe hot tubs. I got a prescription for one once about 12 years ago. I'll be using it tonight. Very effective! (and I wrote it off since I had the prescription)
...even as late Dr. Palmer the best way to kill your wife was to made sure she got the best medical treatment money could buy when she was pregnant -
DAR
I agree. Send her to the homeopathic fellow for a good placebo! I am not joking.
now am I supposed to base my opinion of the current state of medical science on that?)
DAR
No, but it is interesting to see where it came from. I think a lot of them still do believe a lot of the older nonsense, but this shouldn't tarnish the good fellows who don't.
I judge chiropractic by the current state of practice and I still say they are filled with quacks. Just a few years I called around and did a little survey myself while looking for someone to help me with my neck. The list I gave in the last post of all the wacky things they promote, really are (largely) being promoted locally by these quacks. That list again:
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(applied kinesiology), projecting lines on his back to read body contours (Moire contour analysis), reading the iris and comparing markings with a chart (iridology), measuring leg lengths for unevenness (one chiropractor said Brown's right leg was shorter, another said his left leg was shorter), measuring skin surface temperature differences, and palpation [16]. Other dubious diagnostic methods used by some chiropractors include pendulum divining, electroacupuncture, reflexology, hair analysis, herbal crystallization analysis, computerized "nutritional deficiency" questionnaires, a cytotoxic food allergy test, and the Reams urine and saliva test.
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And lots of other crap too.
D.
----------------------------
"Don't Let Chiropractors Fool You
"X-rays and Medicare
Most chiropractors claim that x-rays help them locate the "subluxations" that D.D. Palmer envisioned. But they do not agree among themselves about what subluxations are. Some chiropractors believe they are displaced bones that can be seen on x-rays and can be put back in place by spinal adjustments. Others define subluxations vaguely or say they do not necessarily show on x-rays. But what chiropractors contend about x-rays also depends upon who asks and how the question is posed.
Chiropractic coverage under Medicare, which began in 1973, was limited to manual manipulation of the spine for the treatment of "subluxations demonstrated by x-rays to exist." To enable payment, federal officials accepted an elaborate chiropractic "definition" of subluxations for which payment could be made. During the mid-1980s, the U.S. Department of Health and Human Services' Office of the Inspector General (OIG) surveyed 145 chiropractors by telephone about their billing practices. Eighty-four percent said that some subluxations do not show on x-rays. Nearly half responded that when billing Medicare, they "could always find something" (by x-ray or physical examination) to justify the diagnosis, or they actually tailored the diagnosis to obtain reimbursement. The OIG's report noted that chiropractic manipulation was the ninth most frequently billed procedure under Medicare during 1983.
In 1997, after many years of intense lobbying, chiropractors persuaded Congress to remove the mandatory x-ray provision. The Balanced Budget Act of 1997 eliminates the requirement as of January 1, 2000, and requires the Secretary of Health and Human Services to develop and implement utilization guidelines for chiropractic coverage when a subluxation has not been demonstrated by X-ray. The new policy is expected to increase the number of claims Medicare pays for chiropractic services."
http://www.quackwatch.org/01QuackeryRel ... chiro.html
