SUMMARY The characteristics of the principal categories of more professional heterodox practice are examined. It is concluded that rheumatic diseases are one of the likeliest fields for conflcit between orthodox and fringe medicine. The distribution of manpower engaged in alternative systems of health care is compared with that of orthodox medical services. The limited data on utilization of unorthodox remedies are reviewed. Far from conflict ensuing, it is argued that dialogue must develop in order to submit procedures like manipulation to satisfactory clinical trial.