By 1864, the epidemic to fear was meningitis.
The disease progressed rapidly with fatal consequences, especially among children.
Little was known about her, but doctors at the time associated her with previous terrible outbreaks.
One of them, at the end of the 16th century, killed at least 12,000 people in Madrid, according to a report published in a medical journal of the time.
In 1864, Andrew Tailor Still lost three of his nine children to illness.
A month later, another daughter died of pneumonia.
With them died his faith in conventional medicine.
Still, the son of a Methodist physician and preacher, he had begun healing without much training other than what his father could give him and what he drew from books on bleeding, purging, and other techniques of the time.
He overcame the loss with a project: if medicine had not been able to save his children, it was necessary to change it.
His specialty,
anatomy, set the course for him
;
His hands became protagonists, the key tool demanded by his patients.
In the end there were more than he could care for, and in 1892 he founded the American College of Osteopathy.
Today, thousands of medical professionals have followed in his wake and perfected his legacy, which is based on the mobilization of joints and muscle groups to achieve pain relief and improvement of the patient's quality of life.
There are
dozens of manual techniques,
many also used by massage therapists, chiropractors and physiotherapists, for a treatment that, they say, can be preventive, curative, palliative or adjuvant.
120,000 doctors in the United States - about 10% of all doctors in the country - today share the typically American tradition that Still inaugurated, and the number continues to grow because there are more than 30,000 students.
They are usually family doctors practicing, above all, in rural areas.
But they also make decisions in the White House.
A myth born of a pandemic
Donald Trump's
contagion of
covid-19 has made Sean Conley rise to fame.
The name of the president's general practitioner since 2018 went unnoticed until he has been commissioned to subject his illustrious patient to an experimental treatment with a cocktail of antibodies and to report - in confusing and, at times disturbing, press conferences - about the evolution of Trump.
In the midst of a pandemic, his image draws worldwide attention to osteopathy, although not as much as the so-called Spanish flu did at the beginning of the last century.
With that pandemic, a myth was born: osteopaths treated more than 100,000 infected patients throughout the United States, of whom just 257 died. A true statistical miracle ... of which it is healthy, and from which, doubt.
The data come from a study published in a journal of the sector that the professionals themselves have quarantined due to its low reliability and the lack of epidemiological context of this disease.
It is not the only doubt that this typically American healing tradition raises.
"The problem is that osteopathy contains parts that have good scientific evidence and, at the same time, others that there is no way to take them", explained to BUENAVIDA Rubén Tovar, physiotherapist and professor of the Master of Neuromusculoskeletal Physiotherapy at the International University of The Rioja.
And he added that Spain is the only country in the world where
physiotherapy
is included in it
.
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Why should I go to the physical therapist and not the osteopath
Coexistence is anything but harmonious.
It seems that physical therapists live in a constant confrontation with osteopaths, although this is not entirely true:
most osteopaths are also physical therapists
.
Many professionals and the official physiotherapy colleges that represent them prefer not to talk about the subject so as not to fuel rivalries.
"I'm sorry, but we don't want to get into more controversy in that field," they say from an Andalusian one.
While the conflict remains in a latent state, osteopaths have a loyal clientele, in part because they attend to them in a close way: they tend to ask them about many aspects of their life, getting closer to their global state than to a specific ailment, even recommended physical activity or healthy eating habits instead of medicines.
That can be a balm in some cases, but also a double-edged sword in general.
"If someone decides to go to an osteopath, they have to make sure that they have a degree in Physiotherapy or a degree in Medicine or some branch of Health
Sciences
and that, later, they have added osteopathy to their studies," says an academic professional from the sector of the physiotherapy, which underlines that the main difference between physiotherapy and osteopathy, at least in Spain, is the lack of formal training and an official qualification.
In Trump's country, the fact that an osteopath is the president's doctor is not surprising, but in Spain osteopathy walks a wire in the form of legal limbo that leads a large part of society to doubt its effectiveness.
There are university studies in countries such as Australia, the United Kingdom and Portugal;
in fact, many Spaniards go to our neighboring country to train.
At the dawn of the discipline, which is not well known from what influences it drank to take shape, the religious community rejected Still's ideas because of their unacceptable similarity to the laying on of hands, and when he wanted to present them at Baker University, that his father had helped establish in the fifties, he again suffered rejection.
Today
osteopathy is taught in 38 universities in the United States
.
There the career requires a first few years common to the degree of Medicine and then others in Osteopathy, hence Sean Conley is considered an osteopathic doctor —not a doctor
and an
osteopath— and has the same recognition as a conventional doctor.
And that is why he can prescribe drugs such as Remdesivir to Trump, while in Spain the only osteopath who is authorized to issue prescriptions is the one who has first graduated in Medicine.
They are by no means a majority.
Becoming an osteopath in a weekend is possible (and harmful)
Unlike conventional medicine, whose roots go back to ancient cultures and has a great scientific base that has grown and corrected treatments over the centuries, the history of osteopathy does not reach 200 years - Hippocrates, the of the oath, he lived almost two and a half millennia ago.
Some scientific evidence can be found for some treatments, but most are lacking.
The Ministry of Health, Consumption and Social Welfare itself considers it a "therapy still under evaluation" - at the level of yoga, naturopathic medicine, quiromassage, laughter therapy, acupuncture and reiki - and in a document published in December of 2011, the Government also reflects that, in osteopathy, scientific research is “less developed”.
Specifically, he points out that many of those carried out in the field of manual therapies generally have “important methodological defects”.
"It should be noted that in our country the lack of proven training of many of its practitioners, doctors or not, more and more numerous and without the need for an official qualification, mean that it
should be considered a dangerous practice
," they indicate from the General Council of Official Medical Associations.
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Despite the efforts of those who defend it, osteopathy, which arrived in Spain in the early eighties, remains unregulated in the country.
The only legal text in which it is cited is CIN Order 2135/2008, which establishes the training criteria in Physiotherapy.
It is defined as a "method of intervention".
The General Council of Colleges of Physiotherapists of Spain considers it "a specific competence of the physiotherapist", that is to say, a branch within said discipline, although it is not so indicated in the aforementioned Order.
"This means that professionals with a wide variety of training —sometimes adequate and others, unfortunately minimal— can practice in Spain without the slightest control," emphasizes Lluís Horta, manager of the Spanish Osteopathic Registry (ROE).
"It goes without saying that this may represent a potential danger and that the existence of a regulatory framework for the safety of the users of these services would be a priority," he insists.
From the ROE they argue that there is scientific evidence on the efficacy and safety of osteopathic treatment in numerous clinical situations, especially in the musculoskeletal field.
According to this entity, osteopathic treatment is effective for spinal pain and headache, in addition to helping psychological factors such as
anxiety
and fear.
But they themselves define the studies on which they are based as "of moderate quality", something that they attribute to the difficulties of obtaining evidence in manual therapy.
Its manager also highlights that "in some fields of this discipline the evidence is scarce or even non-existent and the plausibility of some interventions needs to be reviewed".
As if there were few reasons to be cautious, there are centers in Spain that offer short courses, even just one weekend, that allow their participants to self-determine osteopaths.
It is something highly pursued by professional physiotherapy associations and can even generate significant legal problems when they lack liability insurance.
"
Anyone can be called an 'osteopath' after a minimum training,
" they recognize from the ROE.
The same cannot be said of a doctor ...