Quackery synonymous with health fraud, is the promotion of fraudulent or ignorant medical practices. A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, qualification or credentials they do not possess; the term quack is a clipped form of the archaic term quacksalver, from Dutch: kwakzalver a "hawker of salve". In the Middle Ages the term quack meant "shouting"; the quacksalvers sold their wares on the market shouting in a loud voice. Common elements of general quackery include questionable diagnoses using questionable diagnostic tests, as well as untested or refuted treatments for serious diseases such as cancer. Quackery is described as "health fraud" with the salient characteristic of aggressive promotion. Since it is difficult to distinguish between those who knowingly promote unproven medical therapies and those who are mistaken as to their effectiveness, United States courts have ruled in defamation cases that accusing someone of quackery or calling a practitioner a quack is not equivalent to accusing that person of committing medical fraud.
To be both quackery and fraud, the quack must know they are misrepresenting the benefits and risks of the medical services offered. In addition to the ethical problems of promising benefits that can not reasonably be expected to occur, quackery includes the risk that patients may choose to forego treatments that are more to help them, in favor of ineffective treatments given by the "quack". Stephen Barrett of Quackwatch defines quackery "as the promotion of unsubstantiated methods that lack a scientifically plausible rationale" and more broadly as: "anything involving overpromotion in the field of health." This definition would include questionable ideas as well as questionable products and services, regardless of the sincerity of their promoters. In line with this definition, the word "fraud" would be reserved only for situations in which deliberate deception is involved. Paul Offit has proposed four ways in which alternative medicine "becomes quackery": "...by recommending against conventional therapies that are helpful."
"...by promoting harmful therapies without adequate warning." "...by draining patients' bank accounts..." "...by promoting magical thinking..." Unproven ineffective, sometimes dangerous medicines and treatments have been peddled throughout human history. Theatrical performances were sometimes given to enhance the credibility of purported medicines. Grandiose claims were made for what could be humble materials indeed: for example, in the mid-19th century revalenta arabica was advertised as having extraordinary restorative virtues as an empirical diet for invalids. Where no fraud was intended, quack remedies contained no effective ingredients whatsoever; some remedies contained substances such as opium and honey, which would have given symptomatic relief but had no curative properties. Some would have addictive qualities to entice the buyer to return; the few effective remedies sold by quacks included emetics and diuretics. Some ingredients did have medicinal effects: mercury and arsenic compounds may have helped some infections and infestations.
However, knowledge of appropriate uses and dosages was limited. The science-based medicine community has criticized the infiltration of alternative medicine into mainstream academic medicine and publications, accusing institutions of "diverting research time and other resources from more fruitful lines of investigation in order to pursue a theory that has no basis in biology." R. W. Donnell coined the phrase "quackademic medicine" to describe this attention given to alternative medicine by academia. Referring to the Flexner Report, he said that medical education "needs a good Flexnerian housecleaning."For example, David Gorski criticized Brian M. Berman, founder of the University of Maryland Center for Integrative Medicine, for writing that "There evidence that both real acupuncture and sham acupuncture more effective than no treatment and that acupuncture can be a useful supplement to other forms of conventional therapy for low back pain." He castigated editors and peer reviewers at the New England Journal of Medicine for allowing it to be published, since it recommended deliberately misleading patients in order to achieve a known placebo effect.
With little understanding of the causes and mechanisms of illnesses marketed "cures" referred to as patent medicines, first came to prominence during the 17th and 18th centuries in Britain and the British colonies, including those in North America. Daffy's Elixir and Turlington's Balsam were among the first products that used branding and mass marketing to create and maintain markets. A similar process occurred in other countries of Europe around the same time, for example with the marketing of Eau de Cologne as a cure-all medicine by Johann Maria Farina and his imitators. Patent medicines contained alcohol or opium, while not curing the diseases for which they were sold as a remedy, did make the imbibers feel better and confusedly appreciative of the product; the number of internationally marketed quack medicines
Chiropractic treatment techniques
Chiropractors use manipulation of the spine as a treatment. It was founded in North America by DD Palmer in the 19th century. Spinal manipulation became more popular in the 1980s. There are about 200 chiropractic techniques, but there is a significant amount of overlap between them, many techniques involve slight changes of other techniques. According to the American Chiropractic Association the most used techniques by chiropractors are Diversified technique 95.9%, Extremity manipulating/adjusting 95.5%, Activator Methods 62.8%, Gonstead technique 58.5%, Cox Flexion/Distraction 58.0%, Thompson 55.9%, Sacro Occipital Technique 41.3%, Applied Kinesiology 43.2%, NIMMO/Receptor Tonus 40.0%, Cranial 37.3%, Manipulative/Adjustive Instruments 34.5%, Palmer upper cervical 28.8%, Logan Basic 28.7%, Meric 19.9%, Pierce-Stillwagon 17.1%. There is no evidence that chiropractic manipulation is effective for any medical condition, with the possible exception of treatment for lower back pain; the safety of manipulation on the cervical spine has been debated.
Adverse results, including strokes and deaths, are rare. In the late 19th century in North America, therapies including osteopathy and chiropractic became popular. Spinal manipulation gained mainstream recognition during the 1980s. In this system, hands are used to manipulate, massage or otherwise influence the spine and related tissues, it is the most primary intervention used in chiropractic care. Diversified technique is a non-proprietary and eclectic approach to spinal manipulation, used by chiropractors; the technique, as it is applied today, is attributed to the work of Joe Janse Diversified is the most common spine manipulation technique used by chiropractors, with 96% of chiropractors using it for 70% of their patients. Diversified is the technique most preferred for use during future practice by chiropractic students. Diversified is the only spine manipulation technique taught in Canadian chiropractic programs. Like many chiropractic and osteopathic manipulative techniques, Diversified is characterized by a high-velocity, low-amplitude thrust.
It is considered the most generic chiropractic manipulative technique and is differentiated from other techniques in that its objective is to restore proper movement and alignment of spine and joint dysfunction. Atlas Orthogonal Technique is an upper cervical chiropractic treatment technique created by Frederick M. Vogel and Roy W. Sweat in 1979, it is a technique which uses a percussion instrument in attempts to adjust what is measured from specific X-rays and found to be a vertebral subluxation. It is based on the teachings of B. J. Palmer, who advocated the Hole-In-One version of spinal adjustment, it is used by straight chiropractors. Referring to the origins of upper cervical techniques, Dan Murphy, DC, DABCO, wrote: "Over the past 100 years, the practice of chiropractic has branched into dozens of specialty techniques; however for a third of this time, from the 1930s into the 1960s, the predominant practice of chiropractic involved the upper cervical spine." The Activator Method Chiropractic Technique is a chiropractic treatment method and device created by Arlan Fuhr as an alternative to manual manipulation of the spine or extremity joints.
The device is categorized as a mechanical force manual assisted instrument, regarded as a softer chiropractic treatment technique. The activator is a small handheld spring-loaded instrument which delivers a small impulse to the spine, it was found to give off no more than 0.3 J of kinetic energy in a 3-millisecond pulse. The aim is to produce enough force to move the vertebrae but not enough to cause injury; the AMCT involves having the patient lie in a prone position and comparing the functional leg lengths. One leg will seem to be shorter than the other; the chiropractor carries out a series of muscle tests such as having the patient move their arms in a certain position in order to activate the muscles attached to specific vertebrae. If the leg lengths are not the same, taken as a sign that the problem is located at that vertebra; the chiropractor treats problems found in this way moving progressively along the spine in the direction from the feet towards the head. Although prone "functional leg length" is a used chiropractic tool, it is not a recognized anthropometric technique, since legs are of unequal length, measurements in the prone position are not valid estimates of standing X-ray differences.
Measurements in the standing position are far more reliable. Another confounding factor is that moving the two legs held together and leaning them imperceptibly to one side or the other produces different results. Fuhr claims. In 2003, the National Board of Chiropractic Examiners found that 69.9% of chiropractors used the technique, 23.9% of patients received it. The majority of U. S. chiropractic schools and some schools in other countries teach the AMCT method, an estimated 45,000 chiropractors worldwide use AMCT or some part of the technique. There have been a number of studies of AMCT, including case reports, clinical studies and controlled trials, but there are still unanswered questions. A few low-quality studies have suggested that the activator may be as effective as manual adjustment in treatment of back pain. A single high-quality study has suggested that activator-assisted manipulation directed by leg-length testing was inferior to manual spinal manipulation guided by palpation and was more similar to the use of paracetamol for the treatment of low back pain.
Graston Technique is a trademarked therapeutic method for dia
Anthroposophic medicine is a form of alternative medicine. Devised in the 1920s by Rudolf Steiner in conjunction with Ita Wegman, anthroposophical medicine is based on occult notions and draws on Steiner's spiritual philosophy, which he called anthroposophy. Practitioners employ a variety of treatment techniques based upon anthroposophic precepts, including massage, exercise and substances. Many drug preparations used in anthroposophic medicine are ultra-diluted substances, similar to those used in homeopathy. Homeopathic remedies are not medically effective and are considered harmless, except when used as a substitute for a scientifically proven and effective cure. In certain European countries, people with cancer are sometimes prescribed remedies made from specially harvested mistletoe, but research has found no convincing evidence of clinical benefit; some anthroposophic doctors oppose childhood vaccination, this has led to preventable outbreaks of disease. Anthroposophic medicine departs from fundamental biological principles in several respects.
For example, Steiner said that blood propels itself along. Anthroposophic medicine proposes that patients' past lives may influence their illness and that the course of an illness is subject to karmic destiny. Professor of complementary medicine Edzard Ernst and other physicians and scientists including Simon Singh and David Gorski have characterized anthroposophic medicine as pseudoscientific quackery with no basis in reason or logic; the first steps towards an anthroposophic approach to medicine were made before 1920, when homeopathic physicians and pharmacists began working with Rudolf Steiner, who recommended new medicinal substances as well as specific methods for preparation along with an anthroposophic concept of man. In 1921, Ita Wegman opened the first anthroposophic medical clinic, now known as the Klinik Arlesheim, in Arlesheim, Switzerland. Wegman was soon joined by a number of other doctors, they began to train the first anthroposophic nurses for the clinic. At Wegman's request, Steiner visited the clinic and suggested treatment regimes for particular patients.
Between 1920 and 1925, he gave several series of lectures on medicine. In 1925, Wegman and Steiner wrote the first book on the anthroposophic approach to medicine, Fundamentals of Therapy. Wegman opened a separate clinic and curative home in Ascona. Wegman lectured visiting the Netherlands and England frequently, an increasing number of doctors began to include the anthroposophic approach in their practices. A cancer clinic, the Lukas Clinic, opened in Arlesheim in 1963. In 1976 anthroposophic medicine in Germany got regulated by law as a specific therapeutic system by the Medicines Act-Arzneimittelgesetz and by the Code of Social Law In the 1990s the Witten/Herdecke University in Germany established a chair in anthroposophical medicine; the press described the appointment as a "death sentence" and the perception that pseudoscience was being taught damaged the university's reputation, bringing it close to financial collapse. It was saved by a cash injection from Software AG, a technology corporation with a history of funding anthroposophic projects.
In 2006, anthroposophical medicine was practised in 80 countries. In 2012 the University of Aberdeen considered establishing a chair in holistic health jointly funded by Software AG, by the Anthroposophic Health and Social Care Movement, each of which would provide £1.5 million of endowment. Edzard Ernst commented "that any decent university should consider an anthroposophical medicine unit seems incomprehensible; the fact that it would be backed by people who have a financial interest in this bogus approach makes it worse." The University's governance and nominations committee decided not to proceed with the appointment. The categorization of anthroposophical medicine is complex since in part it complements conventional medicine, in part it substitutes for it. In 2008, Ernst wrote that it was being promoted as an "extension to conventional medicine". Ernst writes that Steiner used imagination and insight as a basis for his ideas, drawing mystical knowledge from the occult Akashic Records, a work, situated on the astral plane, which Steiner said was accessible to him via his intuitive powers.
On this basis, Steiner proposed "associations between four postulated dimensions of the human body, plants and the cosmos". Steiner proposed a connection betweens planets and organs so that, for example, the planet Mercury, the element mercury and the lung were all somehow associated; these propositions form the basis of anthroposophical medicine. Ernst has said that anthroposophical medicine "includes some of the least plausible theories one could imagine", categorized it as "pure quackery", said that it "has no basis in science". According to Quackwatch, anthroposophical medicine practitioners regard illness as a "rite of passage" necessary to purge spiritual impurities carried over from past lives, according to the precepts of "karmic destiny". In anthroposophic pharmacy drugs are prepared according to ancient notions of alchemy and homeopathy which are not related to the science underlying modern pharmacology. During the preparation process, patterns formed by crystallization are interpreted to see which "etheric force" they most resemble.
Most anthroposophic preparations are diluted, like homeopathic remedies. This means that, while they are harmless in themselves, using them in place of conventional medicine to treat serio
Pseudoscience consists of statements, beliefs, or practices that are claimed to be both scientific and factual, but are incompatible with the scientific method. Pseudoscience is characterized by contradictory, exaggerated or unfalsifiable claims; the term pseudoscience is considered pejorative because it suggests something is being presented as science inaccurately or deceptively. Those described as practicing or advocating pseudoscience dispute the characterization; the demarcation between science and pseudoscience has scientific implications. Differentiating science from pseudoscience has practical implications in the case of health care, expert testimony, environmental policies, science education. Distinguishing scientific facts and theories from pseudoscientific beliefs, such as those found in astrology, alternative medicine, occult beliefs, religious beliefs, creation science, is part of science education and scientific literacy. Pseudoscience can cause negative consequences in the real world.
Antivaccine activists present pseudoscientific studies that falsely call into question the safety of vaccines. Homeopathic remedies with no active ingredients have been promoted as treatment for deadly diseases; the word pseudoscience is derived from the Greek root pseudo meaning false and the English word science, from the Latin word scientia, meaning "knowledge". Although the term has been in use since at least the late 18th century the concept of pseudoscience as distinct from real or proper science seems to have become more widespread during the mid-19th century. Among the earliest uses of "pseudo-science" was in an 1844 article in the Northern Journal of Medicine, issue 387: That opposite kind of innovation which pronounces what has been recognized as a branch of science, to have been a pseudo-science, composed of so-called facts, connected together by misapprehensions under the disguise of principles. An earlier use of the term was in 1843 by the French physiologist François Magendie.
During the 20th century, the word was used pejoratively to describe explanations of phenomena which were claimed to be scientific, but which were not in fact supported by reliable experimental evidence. From time-to-time, the usage of the word occurred in a more formal, technical manner in response to a perceived threat to individual and institutional security in a social and cultural setting. Philosophers classify types of knowledge. In English, the word science is used to indicate the natural sciences and related fields, which are called the social sciences. Different philosophers of science may disagree on the exact limits – for example, is mathematics a formal science, closer to the empirical ones, or is pure mathematics closer to the philosophical study of logic and therefore not a science? – but all agree that all of the ideas that are not scientific are non-scientific. The large category of non-science includes all matters outside the natural and social sciences, such as the study of history, religion and the humanities.
Dividing the category again, unscientific claims are a subset of the large category of non-scientific claims. This category includes all matters that are directly opposed to good science. Un-science includes pseudoscience, thus pseudoscience is a subset of un-science, un-science, in turn, is subset of non-science. Pseudoscience is differentiated from science because – although it claims to be science – pseudoscience does not adhere to accepted scientific standards, such as the scientific method, falsifiability of claims, Mertonian norms. A number of basic principles are accepted by scientists as standards for determining whether a body of knowledge, method, or practice is scientific. Experimental results should be verified by other researchers; these principles are intended to ensure experiments can be reproduced measurably given the same conditions, allowing further investigation to determine whether a hypothesis or theory related to given phenomena is valid and reliable. Standards require the scientific method to be applied throughout, bias to be controlled for or eliminated through randomization, fair sampling procedures, blinding of studies, other methods.
All gathered data, including the experimental or environmental conditions, are expected to be documented for scrutiny and made available for peer review, allowing further experiments or studies to be conducted to confirm or falsify results. Statistical quantification of significance and error are important tools for the scientific method. During the mid-20th century, the philosopher Karl Popper emphasized the criterion of falsifiability to distinguish science from nonscience. Statements, hypotheses, or theories have falsifiability or refutability if there is the inherent possibility that they can be proven false; that is, if it is possible to conceive of an argument which negates them. Popper used astrology and psychoanalysis as examples of pseudoscience and Einstein's theory of relativity as an example of science, he subdivided nonscience into philosophical, mythological and metaphysical formulations on one hand, pseudoscientific formulations on the other, though he did not provide clear criteria for the differences.
Another example which shows the distinct need for a claim to be f
Acupressure is an alternative medicine technique similar in principle to acupuncture. It is based on the concept of life energy. In treatment, physical pressure is applied to acupuncture points with the aim of clearing blockages in these meridians. Pressure may be applied by elbow, or with various devices; some medical studies have suggested that acupressure may be effective at helping manage nausea and vomiting, for helping lower back pain, tension headaches, stomach ache, among other things, although such studies have been found to have a high likelihood of bias. Like many alternative medicines, it may benefit from a placebo effect. According to Quackwatch, acupressure is a dubious practice and its practitioners use irrational methods. Acupoints used in treatment may not be in the same area of the body as the targeted symptom; the traditional Chinese medicine theory for the selection of such points and their effectiveness is that they work by stimulating the meridian system to bring about relief by rebalancing yin, yang and qi.
Many East Asian martial arts make extensive study and use of acupressure for self-defense and health purposes. The points or combinations of points are said to be used to incapacitate an opponent. Martial artists massage their own acupressure points in routines to remove supposed blockages from their own meridians, claiming to thereby enhance their circulation and flexibility and keeping the points "soft" or less vulnerable to an attack. A 2011 systematic review of acupressure's effectiveness at treating symptoms found that 35 out of 43 randomized controlled trials had concluded that acupressure was effective at treating certain symptoms; the authors of this systematic review concluded that this "review of clinical trials from the past decade did not provide rigorous support for the efficacy of acupressure for symptom management. Well-designed, randomized controlled studies are needed to determine the utility and efficacy of acupressure to manage a variety of symptoms in a number of patient populations."A 2011 Cochrane review of four trials using acupuncture and nine studies using acupressure to control pain in childbirth concluded that "acupuncture or acupressure may help relieve pain during labour, but more research is needed".
Another Cochrane Collaboration review found that massage provided some long-term benefit for low back pain, stated: It seems that acupressure or pressure point massage techniques provide more relief than classic massage, although more research is needed to confirm this. Quackwatch includes acupressure in a list of methods which have no "rational place" as massage therapy and states that practitioners "may use irrational diagnostic methods to reach diagnoses that do not correspond to scientific concepts of health and disease." An acupressure wristband, claimed to relieve the symptoms of motion sickness and other forms of nausea provides pressure to the P6 acupuncture point, a point, extensively investigated. The Cochrane Collaboration reviewed the use of P6 for nausea and vomiting, found it to be effective for reducing post-operative nausea, but not vomiting; the Cochrane review included various means of stimulating P6, including acupuncture, electro-acupuncture, transcutaneous nerve stimulation, laser stimulation, acustimulation device and acupressure.
EBM reviewer Bandolier said that P6 in two studies showed 52% of patients with control having a success, compared with 75% with P6. A variant system known as two point acupressure attempts to bypass a blockage of vital flow by using one acupoint to create a link with one of the collateral meridians, using one additional acupoint to stimulate or reduce the flow around the obstruction. Clinical use of acupressure relies on the conceptual framework of traditional Chinese medicine. There is no physically verifiable anatomical or histological basis for the existence of acupuncture points or meridians. Proponents reply. Acupuncturists tend to perceive TCM concepts in functional rather than structural terms. Any benefit from acupressure may derive from the placebo effect. There are several different instruments for applying nonspecific pressure by rubbing, rolling, or applying pressure on the reflex zones of the body; the acuball is a small ball made of rubber with protuberances, heatable. It is used to relieve muscle and joint pain.
The energy roller is a small cylinder with protuberances. It is rolled back and forth to apply acupressure; the foot roller is a cylindrical roller with protuberances. It is placed on the floor and the foot is rolled back and forth over it; the power mat is a mat with small pyramid-shaped bumps. The spine roller is a bumpy roller containing magnets, rolled up and down the spine; the Teishein is one of the original nine classical acupuncture needles described in the original texts of acupuncture. Though it is described as an acupuncture needle it did not pierce the skin, it is used to apply rapid percussion pressure to the points being treated. Shiatsu, a Japanese form of acupressure massage
Auriculotherapy is a form of alternative medicine based on the idea that the ear is a micro system, which reflects the entire body, represented on the auricle, the outer portion of the ear. Conditions affecting the physical, mental or emotional health of the patient are assumed to be treatable by stimulation of the surface of the ear exclusively. Similar mappings are used in many areas of the body, including the practices of reflexology and iridology; these mappings are not based on or supported by any medical or scientific evidence, are therefore considered to be pseudoscience. Auriculotherapy was proposed in the “Treatise of Auriculotherapy”, by the neurologist Paul Nogier; the developments were made by clinical trials based upon a phrenological method of projection of a fetal Homunculus on the ear, for reference of physical complaints and points for medical treatment. Nogier soon presented his discovery to the public, where members of the Chinese Army picked up the map and took it to the barefoot doctors of China, farmers with minimal training in basic medical and in paramedical skills, so provide medical services in rural China.
Moreover, Nogier published what he called the “Vascular Autonomic Signal”, a distinct change in the amplitude of the pulse felt with the tip of the thumb at the radial artery. That mechanism would only produce a signal upon the introduction of new information to the electromagnetic field of the patient. Nogier was working with the principle of matching resonance, said that he could use the vascular autonomic signal to detect the active points of the auricular microsystem