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CHIROPRACTICS: 19th CENTURY QUACKERY

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At the bottom of this article are min-articles on Chelation, applied kinesiology, immunization, and middle-ear infecctions.  Thus you do not need to use the off my site's links in my paste.  If you want to visit the sites its address is http://www.canoe.ca/ChiroYork/


Unscientific Ideas and Practices

By Paul Benedetti and Wayne MacPhail

When members of the audience at a conference on the proposed affiliation of York University and the Canadian Memorial Chiropractic College confronted chiropractor panelists about the profession's use of unscientific and pseudoscientific practices they got what has become a standard response.

It goes something like this: Sure, some chiropractors use unproven treatments, but it's a small minority, a fringe element. You can't judge the profession on the behaviour of a few "bad apples".

When it was pointed out that many chiropractors in Ontario and in the rest of Canada used unconventional techniques in their day-to-day practices, Ian Coulter, former president of CMCC, said this faction was small in number. Besides, said Coulter, you can't blame the school for the behaviour of its graduates.

In a report to York University, CMCC president Jean Moss repeated the same defence. She says the number of chiropractors who hold anti-immunization views and use bogus therapies are "few in number". She said it's unfair to hold chiropractic to a higher standard than other professions whose members have unconventional beliefs and use unconventional procedures.

In its presentations to York, CMCC paints a picture of chiropractic as part of a team of science-based health-care professionals working within the biomedical model and in a defined scope of practice, publishing in scientific journals and conducting scientific research. Though it is accurate that CMCC is probably more science-based than most chiropractic colleges in North America, the picture presented to York is anything but accurate.

An investigation by CANOE has found that:

  • CMCC exposes its students to pseudoscientific practices and beliefs

              • the chiropractic profession is riddled with unscientific and unproven practices

                • that CMCC's members routinely operate outside their legislated scope of practice, and

                • a significant proportion of the profession is actively anti-scientific in its beliefs and practices

                  CMCC's unscientific teaching

                  One of the textbooks used to teach the CMCC course in pediatrics is called Pediatric Chiropractic. One of its co-authors, Dr. Carol Phillips, is a graduate of CMCC. The book is relentlessly negative about immunization and presents chiropractic manipulation as a credible treatment for virtually every childhood disorder, including middle-ear infection, colic, bedwetting, meningitis, stomach pain, attention deficit disorder, and a host of other serious illnesses. College textbooks and courses also teach students about subluxations, unproven spinal problems chiropractors claim to treat. There is no scientific evidence subluxations exist.

                  Acupuncture

                  The college also offers a 220-hour advanced training programme in clinical acupuncture.

                  The textbook for the course, The Foundations of Chinese Medicine, presents the students with acupuncture as an alternative medical model including the ancient Chinese notion of moxabustion - the burning of herbs on the ends of acupuncture needles to facilitate the energy flow along meridian lines. This is done to balance Yin and Yang and the five elements: fire, earth, wood metal and water. The book also discusses a life force called Qi.

                  The text says this about the organs of the body:

                  "The Spleen is the mother of the Lungs: Spleen-Qi provides Food-Qi to the Lungs where it interacts with air to form the Gathering-Qi. The Lungs are the mother of the Kidneys: Lung-Qi descends to meet Kidney-Qi. The Lungs also send fluids down to the Kidneys."

                  There is no scientific evidence to support these concepts and they are incompatible with modern knowledge of the human body.

                  In submissions to York, CMCC officials said that "acupressure is taught as a soft tissue technique involving pressure over trigger/tender points in myofascial structures responsible for local or referred pain."

                  But the brochure for the course goes much further, explaining to would-be students that it covers, among other things, Acupunture and Moxabustion Treatment of Painful Conditions, the Pathology of Qi, Chinese Dietary Therapy and how to integrate acupuncture into an existing chiropractic clinic.

                  In the submission, CMCC states that acupressure "may also be used along with acupuncture meridians and this use is supported by a significant body of knowledge which substantiates the underlying benefits and mechanisms of acupuncture."

                  In fact, numerous scientific studies have failed to find any support for the notion of "meridians". Acupuncture, as described in the text used at CMCC, has not been substantiated by modern science in any way.

                  Unscientific practices

                  Though CMCC claims it conducts a science-based program, it is impossible to ignore that about 75 per cent of licensed chiropractors in Canada are CMCC graduates and a significant number of them use unscientific and pseudo-scientific modalities - many of which have been shown to be bogus - in their practices.

                  A 1993 survey of Canadian chiropractors by the National Board of Chiropractic Examiners found that:

                • 27.4% used homeopathic remedies

                • 31% used applied kinesiology

                • 66.3% used acupressure/meridian therapy

                  And, CMCC does little to distance itself from those practices. A recentchelation therapy information session by CMCC graduate Katrina Kulhay was advertised on a bulletin board near the CMCC library.

                  According to the September issue the CMCC newsletter, Dr. Jean Moss told a gathering of students, "We must work hard to be at the policy-making table, to ensure that Canadians have access to chiropractic and holistic health care."

                  A recent issue of Primary Contact, the magazine put out by CMCC, contained a back-page ad for homeopathic remedies. The advertisement noted that they are easy to sell because "the claim is right on the bottle". The homeopathic remedies are advertised as "available at the CMCC Supply Centre and Bookstore".

                  The Bookstore and Supply Centre at CMCC, which is near the school's library, provides students and chiropractors with textbooks and chiropractic equipment. It offers the following items for sale: acupuncture charts, copies of Pediatric Chiropractic, reflexology charts, a wall full of naturopathic remedies, chiropractic stickers for kids, a nutritional book full of quackery and a book on the dangers of immunization.

                  In an interview, Moss suggested that chiropractors using unorthodox modalities may be doing so while wearing another professional hat. "This is really quite a difficult issue to deal with. A number of chiropractors hold a dual naturopathic degree, and a chiropractic degree, and I think we have to be very clear that some of the things that are discussed in the media are actually being done by chiropractors (acting as) naturopaths," said Moss.

                  Moss agreed that many chiropractors incorporate "nutrition" into their practices and are taught nutrition at CMCC. In the CMCC bookstore, the shelves contained popular alternative nutrition books and the most prominent book on nutrition was Prescription for Nutritional Healing, co-written by Dr. James F. Balch, a medical doctor, and his wife, Phyllis Balch, whose nutritional credentials come from a mail-order house that has sold their professional membership certificate as a nutritional consultant to several household pets. The book recommends long lists of supplements for virtually every disease and is filled with nutrition quackery, including vitamin megadosing, chelation therapy, glandular treatments, hair analysis, shark cartilage for cancer and many other unproven and discredited remedies.

                  Dr. Stephen Barrett, an American psychiatrist and alternative medicine expert, says these practices and beliefs are part of the problem. He says CMCC should draw up a list of unacceptable practices and teach students that subluxation theory and the listed practices are wrong. He said they should also announce this position publicly and encourage the chiropractic community to abandon its improper practices and treatments.

                  Using alternative treatments may be about to turn into a legal mine field for chiropractors. An article in the latest issue of Canadian Lawyer points out that because of the stroke death of Laurie Jean Mathiason, lawyers have become aware of potentially lucrative cases involving alternative treatments.

                  The article quotes Mississauga, Ont. lawyer Brian Jenkins, who points to chiropractic claims about being able to treat "everything from birth canal trauma to ear infections." Comments Jenkins, "when you've got an organization making claims like that, it better be able to support them." Silas Halyk, a Saskatoon lawyer, is even more direct. He urges other lawyers to take seriously, "any clients who come in with complaints after chiropractic treatment and feel some harm has come to them, even if the harm is not permanent."

                  Beyond the scope of practice

                  Chiropractic is a health profession under the Regulated Health Professions Act. In it, the practice of chiropractic is the assessment of conditions related to the spine, nervous system and joints. It empowers chiropractors in the "diagnosis, prevention and treatment, primarily by adjustment of dysfunctions or disorders arising from the structures or functions of the spine and the effects of those dysfunctions or disorders on the nervous system; and (b) dysfunctions or disorders arising from the structures or functions of the joints."

                  Despite this, studies show that the vast majority of chiropractors reject the idea that they should only treat musculoskeletal problems. In fact, according to a 1997 survey in the Journal of the Canadian Chiropractic Association, only 14 per cent believed that chiropractic should be limited to musculoskeletal conditions. The same study showed that almost 30 per cent of chiropractors believed that "subluxations are the cause of many diseases."

                  And though the college paints chiropractors as members of the mainstream health-care team specializing in musculoskeletal conditions, the profession sees itself quite differently, with 32 per cent viewing chiropractic as an "alternative form of care." Some chiropractors limit themselves to the treatment of musculoskeletal problems only, but a survey suggests they comprise a small minority of the entire profession in Canada.

                  On their Web sites, in their pamphlets and promotional material, Canadian chiropractors promote chiropractic as specializing in the "detection and correction of subluxation" which can interfere with "internal organ function" and "immune response" and "neurological disturbance" which can result in a host of diseases including asthma, ear infections, stomach problems, bowel disorders, etc.

                  A recent investigation by the Toronto Star in which 15 local chiropractors were visited found that all treated children, five offered brochures stating that chiropractic manipulation could help everything from "gall bladders to hypertension to heart arrythmia".

                  Anti-scientific views

                  Perhaps the most contentious anti-scientific view espoused by the chiropractic profession is the antipathy that a significant number have for immunization. Though CMCC has told York that "few in number" hold this view, chiropractic literature, Web sites and pamphlets tell a different story.

                  For example, the Chiropractic Awareness Council (C.A.C.) a splinter group listing more than 230 chiropractors in its directory, believe the "single cause of all sickness is lowered resistance of the body and that "subluxation robs the body's ability to focus, think, organize and heal". Currently, their site includes an article questioning the safety of vaccines.

                  Other high-profile chiropractic practitioners, CMCC graduate Dr. Katrina Kulhay, campaign against immunization and even the official position by the Ontario Chiropractic Association and the Canadian Chiropractic Association is "pro-choice", which translates into providing almost exclusively negative information on immunization to parents.

                  More importantly, surveys of chiropractors show that despite CMCC's position that it is "scientifically based", a significant proportion of the profession holds anti-scientific views. And they argue, only about 15% of medicine is based on scientific studies anyway, but that's based on a misreading of a 1963 British study of family doctors.

                  A 1997 study by Saskatchewan researcher Lesley Biggs found that 74 per cent of chiropractors do not accept the view that controlled trials are the best way to validate chiropractic methods. In fact, only 8 per cent agree that controlled trials are the gold standard for evaluating efficacy. Most - 51 per cent - believe that personal clinical experience is the best way to validate chiropractic treatments.

                  Biggs, who co-wrote the study, says she believes that chiropractic was founded and continues to operate in an "empiricist tradition", that is basing knowledge on observation and experience. Modern medicine, on the other hand, says Biggs, is involved in a rationalist tradition. It is theoretically driven, it is based on the principles of scientific research." Chiropractic still clings to its central founding tenet, that energy or "Innate Intelligence" flows through the body and is sometimes interrupted by subluxations.

                  American chiropractor Lon Morgan, writing in the Journal of Canadian Chiropractic Association, addresses this highly divisive issue. "Innate Intelligence clearly has its origins in borrowed mystical and occult practices of a bygone era. It remains untestable and unverifiable and has an unacceptably high penalty/benefit ratio for the chiropractic profession. The chiropractic concept of Innate Intelligence is an anachronistic holdover from a time when insufficient scientific understanding existed to explain human physiological processes. It is clearly religious in nature and must be considered harmful to normal scientific activity."

                  Many observers say that the use of pseudo-science in chiropractic and the unscientific beliefs of it members are not aberrations as claimed by CMCC, but intrinsic to the profession.

                  "To me what we are seeing is two competing paradigms about the way in which knowledge is constructed in our society," explains Biggs. "They don't share the same epistemological principles; they don't see the world in the same way. They don't understand knowledge, they don't understand what evidence is, they don't have any similarity on any of those kinds of dimensions."

                • Subluxation

                  By Paul Benedetti and Wayne MacPhail

                  What's a subluxation?

                  Here's a simple definition. It's the thing, whatever it is, and whether it exists or not, which chiropractors claim to treat to help you get well.

                  That definition is both vague and accurate. Because, 100 years after D.D. Palmer invented the profession of chiropractic, chiropractors still can't agree on what a subluxation is. And, they still don't know if it really exists.

                  Now, if you had asked D.D. Palmer, what a subluxation is, he would have said it's just a "bone out of place", that is, a misaligned vertebra.

                  Palmer thought that if a mysterious force called Innate Intelligence could flow freely through the body, that body would stay in optimal health. A misaligned vertebra impinged nerves and somehow stifled the flow of Innate and, therefore, good health.

                  Chiropractors could bring the body back to its natural healthy state, Palmer taught, by racking the errant vertebra back into line.

                  Unfortunately for Palmer and chiropractic, there's no evidence that vertebra go "out of place" in a way that can be fixed by chiropractic adjustment. There's also no scientific evidence that wayward vertebra have any effect on general health at all. And, although he was influenced by popular 19th century notions like animal magnetism, Mesmerism and vitalism, Palmer just made up the idea of the subluxation and its relationship to disease all by himself.

                  Both he and his son B.J. Palmer were unwilling and unable to put the idea to a scientific test. And human anatomy just wasn't put together the way Palmer thought it was.

                  But, that didn't mean the idea of subluxation disappeared. The word just changed its meaning for chiropractors, and that meaning got more vague and more complex as the 20th century rolled on and neuroscience and anatomy got more clear on what nerves and the spine do and don't do.

                  In 1906 some chiropractors laid aside the "bone out of place" idea and decided that a subluxation was a vertebra that has "an altered field of motion". Others still held to the "bone out of place" idea.

                  In the 1920s B.J. Palmer, D.D. Palmer's son, had another idea. He said he knew what a subluxation was. It was nerve pressure that could only be detected with his new invention, the "neurocalometer" a hand-held, heat-seeking device that B.J. Palmer claimed could spot subluxations of the spine by detecting temperature variations. He said that any chiropractor that didn't use the neurocalometer shouldn't be practicing.

                  A lot of chiropractors ignored him and some even started their own schools and came up with their own ideas of what a subluxation was.

                  So did B.J. In 1930 he decided that by adjusting only the top vertebrae in the spine, subluxations in the rest of the spine would fall into place. He called this technique the Hole In One.

                  Unfortunately for chiropractic, none of the schools had any data to back up their theories. But, medical doctors had data to the contrary.

                  Twenty-five years ago Yale anatomist Edmund Crelin experimented on six human spines from cadavers and determined that the amount of force needed to twist and bend the spine so that nerves were impinged was enough to snap the spine itself.

                  The American Chiropractic Association ignored Crelin's experiment and stated, "nerve encroachment ... is a dynamic occurrence and cannot be reproduced in a dead body."

                  In the last couple of decades some chiropractors have looked for more complicated neurological and dynamic definitions of a subluxation.

                  Some theorized that a subluxation was a limited range of motion in all or part of the spine. That abnormal range of motion caused, according to some chiropractic theorists, nerve pressure. Others said it produced nerve interference. Still others said it caused nerve compression. But, in general, the idea was that through a complicated neurophysiological feedback process called subluxation complex, the subluxations caused all sorts of bodily problems called subluxation syndrome.

                  Things got pretty confusing. And, current definitions for this sort of subluxation are anything but elegant. Here's one drafted in 1996 by the Association of Chiropractic Colleges in the U.S.:

                  "A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health. A subluxation is evaluated, diagnosed and managed through the use of chiropractic procedures based on the best available rational and empirical evidence."

                  That definition, though, is just theoretical. Dr. Howard Vernon, in the CMCC text Foundations of Chiropractic - Subluxations, sums up the current state of affairs this way, "The profession, it seems, is either still 'fixated on' or feels more satisfied with its conceptual models and its elaborate speculative pictures than with pursuits of more basic scientists, who seek to depict or study subluxations as it really occurs." In the text, Vernon details 18 studies that attempted to create and test the effects of subluxations in animals.

                  He concludes that there have been no sustained lines of investigation in the studies, no replications and no clinical implications. No real proof, the blame for which Vernon lays squarely on the shoulders of chiropractic.

                  Another textbook that's required reading at the CMCC, The Chiropractic Theories, calls the subluxation a manipulable lesion. The book, written in 1994, asks these questions:

                  "Is there a manipulable lesion? Indeed, is there a specific, identifiable lesion that responds favourably to spinal manipulation or to chiropractic manipulation therapy ... Or, are there physiological and clinical effects of [chiropractic manipulation therapy] that can be reliably and reproducibly measured whether or not a lesion is detected? ... Tireless efforts to quantify and qualify the [subluxation] and to find a suitable outcome measure or measures capable of predicting manipulative effectiveness have met with mixed and often disappointing results."

                  A hundred years after the chiropractic profession was founded, there is no agreement on what a subluxation is, if it exists, no proof that manipulation of a subluxation does any good and no good answer to the question: what is a subluxation?

                  To appreciate the situation, imagine that doctors, 100 years after modern medicine came into existence, couldn't prove germs cause disease or that the human body contains DNA. That's the position chiropractors are in at the end of the 20th century.

                  Chiropractors Claim They Can Treat Ear Infections with Neck Manipulation

                  Pediatricians say they lack training, proof and authority

                  By Paul Benedetti and Wayne MacPhail

                  When babies and young children complain of earaches it's often due to a condition doctors call otitis media.

                  Pediatricians treat otitis media with antibiotics, or in some extreme cases, by surgically inserting tubes that drain the fluid. Left untreated, the condition can cause permanent hearing loss.

                   

                  And, as of Nov. 18, the Chiropractic Canada Web site (which is endorsed by the Ontario Chiropractic Association) offers this advice to visitors worried about their child's ear infection:

                  Some children suffer from recurrent ear infections, revealing that the chronic ear infections are merely a symptom of a larger problem. Chiropractic adjustments to the neck and upper back can help eliminate the cause of chronic ear infections ...Chiropractic adjustments to the neck and upper back help restore proper motion to the vertebrae. Once proper joint motion is restored, elimination of nervous interference and drainage of the Eustachian tube can occur, allowing your body's immune system to effectively fight the infection ... If your children have ear infections, chances are they have nerve interference, and they need to have their neck examined by a chiropractor. Your chiropractor will be able to make additional recommendations to help your child and to promote better health.

                  Chiropractors and Vaccination

                  By Paul Benedetti and Wayne MacPhail

                  Despite sound medical evidence of the safety and benefit of immunizations, chiropractic, since its birth at the turn of the century, has been anything but friendly to vaccination. One of the founders of chiropractic, B.J. Palmer, called immunization a form of poisoning. In the late 1950s, in the midst of an epidemic, the U.S. National Chiropractic Association campaigned against the polio vaccine. Why do chiropractors feel so strongly about a medical breakthrough that has saved millions of lives worldwide? Because Chiropractic philosophy holds that a body with a spine free of subluxations, or misalignments, is capable of insuring its own health.

                   

                  Applied Kinesiology

                  Applied kinesiology (AK) is a pseudo-scientific system of muscle testing invented in 1964 by Detroit chiropractor George J. Goodheart Jr. D.C. The system is based on the idea that every internal organ is connected by "energy pathways" to a specific muscle, so that testing the muscle's strength allows the practitioner to diagnose the organ problem.

                  Applied kinesiology should not be confused with kinesiology (biomechanics), which is the legitimate, scientific study of movement.

                  AK is used by some chiropractors, naturopaths, medical doctors, dentists, nutritional consultants, physical therapists and others. In 1991 a survey by the National Board of Chiropractic Examiners found that 37 per cent of full-time American chiropractors who responded used AK in their practice. A similar survey found 31 per cent in Canada, 60 per cent in Australia, and 72 per cent in New Zealand. Applied kinesiology proponents say that allergies, nutritional deficiencies and other physical problems can be detected by having the subject put a substance (food extract or vitamin) in their mouth while the practitioner pushes down on their extended arm.

                  Some practitioners simply have the patient hold the substance in their hand, or touch it to a body part. There are even cases of testing by proxy, in which a child will hold hands with his mother and the mother's arm will be tested to determine a weakness in the child's body.

                  Treatments based on the "findings" can include nutritional supplements, acupressure, special diets, and spinal manipulation. Though the concepts of applied kinesiology do not conform to scientific facts about the body or the causes and treatments of disease and are viewed as absurd by medical science, researchers have nonetheless tested AK in several well-designed controlled studies of AK.

                  The studies show no difference in muscle response from one substance to another, or no difference in test results between substances and placebos. In short, there is no scientific evidence to support AK.

                   

                  Chelation Therapy

                  Chelation therapy is a series of intravenous injections of an animo acid complex called ethylenediamine tetraacetic acid, more commonly known as EDTA. Chelationists believe that the therapy is effective against coronary heart disease, vascular disease and atherosclerosis, or hardening of the arteries.

                  Supporters tout it as a cheaper, safer alternative to bypass surgery. Today, in the U.S. and Canada many people (about 500,000 in the U.S.) receive chelation therapy each year.

                  But does it work?

                  Chelation therapy is an accepted effective therapy for heavy metal poisoning. EDTA binds with mercury, copper, lead and other metals and removes them from the blood. Based on this, some doctors speculated that chelation could help remove calcium, one of the components, along with cholesterol, in the plaque that clogs arteries.

                  The doctors who deliver chelation therapy also claim that is effective for treating arthritis, MS, Parkinson's disease, Alzheimer's disease, diabetes, and can even slow the aging process.

                  Unfortunately, chelation theory is flawed because even if the process removed calcium, it is not the major problem in artery disease. Other theories proposed by chelationists - and there are many - remain unproven.

                  What is the evidence? Again, controlled studies show that chelation has no effect on diseased arteries, or any other disease. Even study patients who say they feel better show no objective improvement in blood flow in their arteries. There is a mountain of anecdotal evidence and testimonials from patients who say they feel better after chelation, but it is likely due to the placebo effect, the attention they receive from practitioners and other lifestyle improvements they make.

                  Despite the fact that therapists have chelated hundreds of thousands of people in the last 40 years, they have produced no solid evidence that their treatment is effective.