Western Systems of Healing 593The value of homeopathy as a treatment for depression
is presently unknown because of the lack of substantiation
by systematic research. Davidson, Morrison, Shore, and
Davidson (1997) reported a case study of a 47-year-old
woman whose depressive and anxious symptoms improved on
”uoxetine (Prozac) and calcarea carbonica (a homeopathic
remedy). The thorough review of homeopathy clinical trials
by Kleijnen et al. (1991) and the meta-analysis by Linde et al.
(1997) detected only one study related to depression.
Although this study (Ernst et al., 1998) produced a result in
favor of homeopathy, the study was of low methodological
quality. Furthermore, two large reviews of the role of home-
opathy in clinical medicine concluded that, except for the
occasionally demonstrated bene“t, there was little scienti“c
evidence to support the use of homeopathy in the majority of
clinical settings (Watkins, 1994).
Several problems exist in studying the ef“cacy of homeo-
pathic treatments. To provide some scienti“c rigor, most con-
ventional clinical research involves administering the same
remedy to all patients, which contradicts the philosophy of
the idiographic approach involved in homeopathic treat-
ments. Furthermore, most homeopathic studies are case re-
ports but do not include methodologies that include multiple
baselines or a reversal to baseline methodology.
Osteopathy
Osteopathy, founded by Andrew Taylor Still, M.D.
(1823...1917), is a complete system of prevention, diagnosis,
and treatment based on a •whole personŽ approach. It posits
that there is an interrelationship between the structure and
function of the human body and that the body has the ability
to self-regulate and self-heal. Speci“cally, when the body is
in a normal structural relationship with adequate nutrition, it
is capable of maintaining its own defenses against diseases
and other pathologic conditions (Micozzi, 1996; C. M. Nezu,
Nezu, Baron, & Roessler, 2000). However, when there are al-
terations in the structural relationships of the body parts, the
body has dif“culty resisting or recovering from illness. It has
been proposed that structural dif“culties in the body can
cause numerous problems such as arthritis, headaches, emo-
tional problems, breathing problems, heart problems, and
digestive problems depending on which area in the muscu-
loskeletal system is restricted or under stress (The Burton
Goldberg Group, 1995). Recovery from these conditions is
said to occur through normalization of body mechanics and
the neuromusculoskeletal system via osteopathic manipula-
tive treatment (OMT).
It is important to distinguish between the actual practices
of osteopathic physicians from osteopathic manipulative
treatments. Osteopathic training in the United States blends
conventional medical practices and training in biomedical
sciences with osteopathic manipulative treatment approaches
as an integrated system of health care. Depending on the
focus of the licensed osteopathic physicians, the actual prac-
tice of osteopathy may vary according to the area of specialty
(Sirica, 1995).Therapeutic ApproachesThe diagnostic process in osteopathy emphasizes a close and
personal relationship between the physician and patient
because it is based on the premise that familiarity with a
patient•s personality and habits is essential to providing high-
quality health care (Hruby, 1995). Because osteopathy
evaluates the human body as an integral unit, treatment
modalities are selected based on the patient•s report of signs
and symptoms, along with a comprehensive patient history
and examination in which the structure and function of the
musculoskeletal system provides important clues to dysfunc-
tion (Micozzi, 1996). OMT is a therapeutic means of correct-
ing these dysfunctions and is often prescribed in conjunction
with other clinical modalities, including education on nutri-
tion, lifestyle, breathing techniques, relaxation techniques,
and postural correction to reduce tension to the affected areas
of the body (C. M. Nezu et al., 2000). Although osteopathy is
considered a comprehensive system of healing, it is best
known for its reliance on the diagnostic and therapeutic value
of the musculoskeletal system and OMT, which is a distin-
guishing hallmark of the osteopathic profession. Different
manipulative approaches available to the osteopathic physi-
cian include muscle energy, myofascial, counterstrain, and
thrusting techniques (DiGiovanna & Schiowitz, 1991). Mus-
cle energy techniques focus on directing muscles against a
distinct counterforce such as increased tension or resistance.
The goal is to mobilize joints by gently tensing and releasing
speci“c muscles to produce relaxation. Myofascial tech-
niques, also known as soft tissue techniques, focus on the
continuous layer of connective tissue below the skin (i.e.,
fascia) that surrounds and bonds all of the body•s internal or-
gans. They are used to relax and release restrictions in the
soft tissues of body. In counterstrain techniques, somatic dys-
function is believed to have a neuromuscular basis. These are
functional and positional release methods used to relieve pain
by placing the patient in a speci“c position to allow the body
to relax and release muscular spasms that may have been
caused by strain or injury. Thrusting techniques are small,
high velocity forces applied by a practitioner in an effort to
alleviate joint dysfunction (e.g., by altering the range of
motion available at a joint).