Journal of Chiropractic Humanities 1998; 8: 55–66
By: David Seaman, D.C.
NOTE: This article is reprinted with the permission of National College of Chiropractic and the Journal of Chiropractic Humanities. Our special thanks to the Editor, Dr. Dana Lawrence, D.C. for permission to reproduce this article exclusively at Chiro.Org
In the minds of many chiropractors, there is an
ongoing battle in the chiropractic profession between two factions, one
of which believes that the practice of chiropractic should be
guided by philosophy and another which believes that science
should guide the practice of chiropractic. It is my contention
that a battle between philosophy and science does not and cannot
exist within the chiropractic profession or any other discipline.
I contend that the real battle is between the great majority of
chiropractors who unknowingly allow dogmatism to guide the
practice of chiropractic and the extremely rare variety of
chiropractor who's practice of chiropractic is guided by
philosophy and science.
In this paper, I will attempt to utilize the so-called
"Socratic method" to guide the presentation of information. The
"Socratic method" is characterized by a demand for accurate
definitions, clear thinking, and exact analysis [1, p.8-9]. In
Durant's commentary on Socrates, he states:
"Philosophy begins when one learns to doubt-particularly
doubt one's cherished beliefs, one's dogmas, and one's axioms.
Who knows how these cherished beliefs became certainties with us,
and whether some secret wish did not furtively beget them,
clothing desire in the dress of thought? There is no real
philosophy until the mind turns around and examines itself.
Gnothi seauton, said Socrates: 'Know thyself' [1, p.8-9]
It is my perception that the chiropractic profession and
practice of chiropractic lacks a sound philosophical foundation,
and that this exists in part because we do not appropriately and
consistently examine our beliefs, dogmas, and supposed axioms.
This will become evident in the remainder of this article which
endeavors to define and describe key terms and concepts such as
relativism, dogmatism, philosophy, and science.
Analysis of Definitions
The word relativism is defined as "any theory
that criteria of judgment are relative, varying with individuals
and their environments" . It is thought that this philosophy
officially entered American dictionaries and/or texts around
1860-65(2). Indeed, Noah Webster's first American Dictionary of
the English language, published in 1828, provided a definition
only for "relative" and did not contain a definition for
relativity or relativism . However, more recent versions of
Webster's dictionary define both relative and
Interestingly enough, although the words "relative",
"relativity" and "relativism" are nearly identical, they have
entirely different meanings with no perceivable relationship to
each other. "Relative" is defined as "related to, referring to,
having connection with; relevant, pertinent," and "resulting
from, dependent on, existing in relation to, connection with
something else; proportionate, comparative; not absolute" . It
is intriguing to note that the definitions of relativity and
relativism ignore the precise context of the definition of
"relative" and focus only on the "not absolute" component of the
definition. In philosophy, relativity is defined as "the doctrine
that knowledge is not absolute or positive, but depends on the
relations in which things stand to each other, that it can be
concerned only with such relations, and is limited by the
changing conditions in of our perceptual faculties" .
Relativism is defined as the "doctrine of those who maintain the
relativity of knowledge" . Clearly, the definitions for
relativity and relativism suggest that there cannot be absolute
truths; instead, truths and falsehoods are equivalent. In other
words, the answer to the same question can be both true and
false; depending on your point of view. The obvious inherent
danger in the philosophy of relativism is that it permits us to
glorify personal opinions and dogma as fact and truth.
Unfortunately, relativism plays a significant role in
chiropractic practice. Chiropractors commonly state that, "this
is how I explain subluxation," and each goes on to promote
his/her own unique opinion about the nature of subluxation. For
nearly every chiropractor, there is a different description of
subluxation and equally different methods of correction.
Relativism in chiropractic, that is chiropractic relativism, also
permits each chiropractor to define the nature of chiropractic in
any way that he/she chooses. According to Bachop :
"The incoming students graft their personal philosophies
onto chiropractic teachings. The result is a hybrid each student calls
"chiropractic philosophy." The diversity of personal philosophies
results in a diversity of hybrids, that is, a diversity of
chiropractic philosophies; and henceforth each graduate will
think he knows what chiropractic philosophy is, or at least what
it should be."
Bachop's comments were published in the first edition of
journal. Unfortunately, little has been done to correct the
problem of chiropractic relativism. Instead, it is urged that we
are tolerant of each other's dogmas no matter how absurd and
inaccurate they may turn out to be when analyzed from a
Dogmatism is defined as "unfounded positiveness
in matters of opinion," and the "arrogant assertion of opinions as
truths" . A dogmatist is "a person who asserts his or her
opinions in an arrogant manner" . When cornered with unavoidable
it is likely that a dogmatist would count on the philosophy of
relativism to support his/her claims.
The information in this section will demonstrate that
problem of dogmatism in chiropractic spreads throughout most
sectors of the profession, and that many chiropractic practices
are guided by dogmatism instead of philosophy and science. As a
profession, we should confess that if dogmatism is strong in our
graduate's practices, it must be equally strong in our colleges.
Despite this likely possibility, we would be hard-pressed to find
a chiropractor or educator who would proudly state that "I am a
dogmatist." Indeed, no one believes that he/she is a dogmatist,
and no one wants to be thought of as a dogmatist, because the
negative connotations are perceived to be quite significant. I
will try to offer a different perspective on the nature of
dogmatism, so we can more efficiently criticize our own
Dogmatists are typically viewed as having unchangeable
their minds are thought to be closed to different ideas and
information. Clearly, this description characterizes most of us
when we are confronted with information that is new to us. The
natural human reaction is to resist new information, because it
might require us to (a) alter the perceptions to which we are
accustomed, and (b) accept the fact that we may be ignorant about
issues we thought we understood. Based on this information it is
reasonable to conclude that dogmatism should be the norm, rather
than the exception. With this in mind, it should be obvious that
we all need to routinely go through the pain associated with
doubting our cherished beliefs and dogmas; it is the only healthy
way to learn and grow.
In the following paragraphs, I present examples of
obvious dogmatic writings in the chiropractic literature. Although I will
focus on the comments of specific contemporary chiropractors, I
believe that these comments represent the views of many
Consider the following title for a paper presented by
Barge at the 1991 International Conference on Spinal Manipulation: Is
there a true chiropractic philosophy? Yes, and there are no
alternatives . Despite the bold assertion found in the title,
the abstract of this paper tells us only that there is a
chiropractic philosophy, it is the philosophy put forth by the
founders of chiropractic and that it is "irrefutable." However,
Barge never discusses the nature of the philosophy and is
apparently unaware of the fact that a philosophy, by definition,
cannot be irrefutable. Comparatively speaking, papers presented
by Winterstein , Gelardi , and Donahue  provide clear
definitions and rational explanations which exemplify a
philosophical thought process.
We are provided with more information regarding the
one-and-only, irrefutable chiropractic philosophy in a text
entitled One Cause, One Cure. In it, Barge
"The art of adjustment evolved into the science of
chiropractic, the explanation of nerve encroachment caused by
vertebral subluxation and how it impaired health; and from this
sprang forth the philosophy of chiropractic which explains the
'One Cause, One Cure' of disease." [10, p.2]
It should be understood that Barge's assertions are
dogmatic. As an example, DD Palmer stated that there were three general
causes of disease, including trauma, toxins, and autosuggestion [11, p.359]. Foreign to DD Palmer's writings is the "one cause, one cure" dogma, which constitutes a "spiritual
disconnection theory" of chiropractic. This theory will be discussed more in the section devoted to philosophy.
In One Cause, One Cure, Barge also provides the
following quote which further demonstrates a strong reliance on
"I often say to chiropractor thick or thin, short or
tall, exercise daily or not at all, eat at McDonalds or dine a the
Ritz... it makes no difference, subluxation free you are healthy.
Yes, if your body is functioning properly you can live out of a
garbage can. Street people across the world prove this to be
true. In all of the filth and germ ridden existence of their
unsheltered world, these people survive. Certainly some do
consume (sic) to their environment, but the fact that many
survive is testimony to Innate adaptation. And this adaptation is
adequate as long as the nervous system is unimpaired in its
endeavors to provide Innate adaptation." [10, p.93]
Dr. Barge here again ignores the model of disease
set forth by DD Palmer, and strongly asserts his opinions about
chiropractic and health with unfounded positiveness.
In the President's Message column for the ICA Review ,
Barge opens by writing, "me thinks it is time to 'set something
straight'." He continues:
"You see, education constipates the mind. We have sacred
cows and beliefs that will not allow us to think clearly. BJ wanted
all chiropractors to 'get the Big Idea'. The 'Above Down, Inside
Out' philosophy of health and life ... He wanted chiropractors to
be cognizant of the force of Life and its flow from Universal to
Innate to Educated Intelligence; from God to man, so to
Apparently, Barge believes that BJ Palmer is the one
true forefather of chiropractic. He seems to suggest that BJ's ideas
are preeminent and educational endeavors unrelated to BJ's ideas
are detrimental because they create preconceived ideas that will
hinder the mind from comprehending the ideas of BJ. In this
regard, Barge states that, "this is why BJ Palmer always stated
it was easier to train an uneducated person to become a
chiropractor than an educated one" . First, such dogmatic
assertions run contrary to the nature of philosophy, as will be
seen in the following section. Second, such a view of education
is inconsistent with DD Palmer's, who believed that education was
"There are two classes of Chiropractors, those who
desire to know all they can of physiology, pathology, neurology and
anatomy, and those who have an aversion for intelligence, do not
want to take effect into consideration, depending only upon an
examination of the spinous processes." [11, p.334-35]
It should be understood that dogmatism also exists
within the community of chiropractors who claim to represent a
scientific perspective; the problem is just not so overt.
Consider the following opinion of one of the ACA's Board of
Governors, printed in the Journal of the American Chiropractic
"The spinal subluxation, though we have been correcting
it with spinal adjustment for 100 years, is not fully understood.
Scientific research presently is not sophisticated enough to
determine the neurophysiological impact that spinal subluxation
has on our patients" .
Specific questions should immediately come to mind after
reading this quote. First, how can we be sure that we have been
correcting anything for 100 years, if we do not fully understand
what we are supposedly correcting? Obviously, we cannot be sure.
We only know that we have been adjusting spines for 100 years and
people seem to feel and heal better as a consequence of our
intervention. Second, how is it possible for a private
practitioner to be knowledge-able enough on the depth and breadth
of scientific research to suggest that science is presently too
unsophisticated to determine the neurophysiological impact of
spinal subluxation? No rational scientist would make such a
dogmatic statement. In fact, months before the above statement
was made, scientists had proposed a reasonable neurophysiological
mechanism by which somatic dysfunction/subluxation could promote
symptoms of visceral disease . Some of the most convincing
neurophysiological evidence to support the contentions of these
authors was published before 1955 .
In another issue of the Journal of the American
Chiropractic Association, Harold Kieffer, an ACA Governor
"And while chiropractic procedure is curative and/or
beneficial for many types of health problems other than just
ailments of the back and spine, the 'one cause, one cure' claim
is unthinkable, unscientific, and unacceptable in today's
enlightened society" .
This quote illustrates the common dogmatic double-talk
of ACA members who, in one breath, castigate the so-called straight
chiropractic philosophy which often implies that Innate
Intelligence can heal anything and every-thing, and in the next
breath, confidently imply that chiropractic care can cure or
benefit numerous unmentioned or unstudied ailments.
Unfortunately, in recent years, a sophisticatedly
insidious variety of ACA styled dogmatism has emerged in the name of
science, which interestingly enough, bears a striking similarity
to the style of BJ Palmer. Recall that in the famous Green
Book collection, BJ Palmer predominantly transcribed his
thoughts onto tablet. Rarely, if ever, did BJ cite references to
support his claims. Apparently, his teaching style was no
different. Over time, impressionable students would come to
accept BJ's spoken or written opinions as fact, citing his
opinions as credible references. Even today, some students and
doctors continue to cite the opinions in the Green Books
as well-documented facts that should not be questioned, while
simultaneously pro-claiming that modern scientific texts are
deficient or outdated; a glaring example of dogmatism.
In the recent years, the work of Dr. Frederick Carrick,
president of the ACA Council on Neurology, has resulted in a
style of dogmatism that echoes that of BJ Palmer. In the case of
Carrick, students believe that his words represent
state-of-the-art, referenced material. Comments and conclusions
made on the web site of Dr. Mark Burdorf help to illustrate this
"Dr. Fred Carrick, who is my neurology professor,
recently published his dissertation, Neurophysiological Implications in
Learning, in order to fulfill his requirements for the
degree of Doctor of Philosophy in Education. He did a
study on five hundred participants where blind spot mappings were
produced with change noted before and after chiropractic
adjustments. The results of blind spot mappings should be equal.
Changes in function from right to left lead to dysfunction which
can lead to a variety of disease conditions. The importance of
this simple diagnostic tool has great neurologic significance in
determining how chiropractic care should be directed in order to
maximize your human potential.
Patients that have unequal blind spots can present with
a variety of symptoms. Realize that if you have a large blind spot
in your left eye compared to your right eye you cannot perceive
vision as well from that left eye and you will have to tilt your
head to compensate for this. The changes in head position have
major effects on body mechanics. Patients that have a large blind
spot often remark that they have a tendency to walk into walls or
worse, end up in your office because they were involved in an
auto accident because they didn't see the other car coming.
To make matters worse, people that are in an accident
and do not receive proper care for their injuries often find that they
keep getting into more accidents because their blind spots
continue to worsen and they suffer an increasingly poor state of
Most of the above statements and conclusions about blind
spots are not supported by the literature devoted to chiropractic care
and vision [18-27]. Even Carrick's recently published paper on
blind spots  does not provide any evidence to support the
definitive conclusions made by Burdorf.
In an article published in the ACA's Journal of
Chiropractic, entitled "The New Vertebral Subluxation," the
author supports most of his claims by referencing Carrick's
lecture series, course notes (referred to as a Textbook of
Neurology) and videos, none of which offer supportive
citations. This Textbook of Neurology was made available
to students during the mid- 1980's through the early 1990's .
Unfortunately, some errors are present in the section devoted to
the cerebellar afferent and efferent pathways, such that Carrick
promotes the existence of pathways that do not actually exist in
humans and other mammals. For example:
"The information from the lower part of the body will
enter the dorsal horn where there is a synapse with secondary neurons
which rise rostrally in the ventral spinal cerebellar tract of
the lateral columns... The information from the proprioceptors
coming from the upper part of the body is through a different
pathway. These fibers travel along the dorsal spinocerebellar
tract where they synapse with secondary neurons in Clarke's
Long before Carrick ever began teaching diplomate
courses in neurology, it was a well-known fact that both the dorsal and
ventral spinocerebellar tracts are concerned with transmission of
impulses from the lower extremity, while the rostral
spinocerebellar and cuneocerebellar tracts are concerned with the
upper extremities . Simply stated, when an instructor implies
that he is correct and accepted scientific texts are wrong, he
fosters an instructor/student relationship that leads to
In addition, the manner in which instructors respond to
questions can also lead to dogmatism. As an example, an
instructor can create an atmosphere of intimidation which causes
students to be afraid to ask questions for fear of being
embarrassed in front of their peers. This situation promotes a
classroom environment of passivity and receptivity on the part of
students, which naturally fosters a compliance to, and a reliance
on, the dictates and dogmas of an instructor. Carrick
demonstrates this tendency in recent letters to the editor. When
asked to explain or clarify certain concepts and issues [31,32],
Carrick responds by discussing the theoretical shortcomings and
ineptitude of the questioner ' or simply avoids answering
certain questions and instead reasserts the veracity of his
original points . On the other hand, when Carrick is
complimented by students who do not question the veracity of his
contentions [35, 36], he praises them for their inspiring vision
and foresight [37, 38]. Such methods of negative and positive
reinforcement can engrain dogmatic beliefs in those who are
In summary, it is clear that dogmatism plagues the
chiropractic profession at large. Neither the so-called straights
nor mixers, as groups, have been spared from this plague.
Unfortunately, the leadership for each faction of the profession
refuses to initiate a thorough examination of their respective
dogmas; instead, each side focuses on the inadequacies of the
other's dogma. Gelardi stated the problem clearly :
"Both sides use their counterparts as convenient
whipping boys for their own shortcomings in leadership. The leadership on both
sides, in their efforts to build a following and call it to
action, often rely on instilling fear of the other side to get
the job done. Each side blames the other for the division and for
lack of any substantial professional progress."
It is painfully clear that our profession, at large,
needs to undergo a process of self-examination and re-education. It
appears appropriate that we should begin this process by
developing a better understanding for the meaning of philosophy
As with many words, philosophy has several
definitions, all of which clearly demonstrate the need for
philosophy in both our professional and personal lives. It is
unfortunate that many in chiropractic confuse dogmatism with
philosophy, and subsequently suggest that philosophy has no
utility in the practice of chiropractic. Naturally, and rightly
so, such assertions outrage the proponents of philosophy, even
though the majority of these so-called "proponents of philosophy"
are really supporters of dogmatism. The end result is an
ill-founded, profession-wide dispute over the topic of
philosophy. In reality, this dispute has little to do with
philosophy and centers mostly around the posturing associated
with defending strong personal attachments to respective dogmas.
It is my hope that the following commentary on philosophy will
help to add clarity to an issue that should never have been
muddled in the first place.
Philosophy has been defined in the following ways:
Literally, the love of wisdom .
The rational investigation of the truths and principles
of being, knowledge or conduct
The critical study of the basic principles of and
concepts of a particular branch of knowledge, especially with a
view to improving or reconstituting them .
A system of principles for guidance in practical affairs
A discipline comprising logic, aesthetics, ethics,
metaphysics, and epistemology [40, 41].
As indicated by these definitions, philosophy connotes a
clarity of thinking and the willingness and commitment to conduct
a critical inquiry and examination of one's beliefs for the
purpose of abandoning incorrect notions. When applied to
chiropractic, philosophy demands that we examine our concepts
about subluxation/joint complex dysfunction and methods of
chiropractic care for the purpose of disposing in-correct
concepts and methods. Unfortunately, this activity has not been
effectively pursued by our colleges and research organizations.
We talk and write about philosophy, yet many of our actions and
words, outside of such conversations, are guided by dogma, as
illustrated in the previous section.
Many in chiropractic have demonstrated that they have an
understanding of the true nature of philosophy [8, 41-45]. In
fact, Gelardi provided a particularly elegant and succinct
description of philosophy for the profession to consider .
Despite the availability of such information, philosophy in
chiropractic typically echoes that of mysticism, rather than
critical thinking. This is perhaps because chiropractors
overemphasize and misinterpret the nature of metaphysics as it
relates to chiropractic practice.
Translated from Greek, metaphysics literally means after
physics. "It is said that this name was given to the science by
Aristotle or his followers, who considered the science of natural
bodies, physics, as the first in the order of studies, and the
science of mind or intelligence to be the second' . Is it
possible that this description is telling us to first study,
understand, and master human biology before leaping into
metaphysics? In my opinion, the answer is an obvious yes. We
should first study and understand that which exists, and second
study that which underpins or lies beyond that which exists.
Durant states that Aristotle's metaphysics grew out of
his biology (1, p.56). Regarding Aristotle's biology,
Durant maintains that "they form the greatest monument ever
raised to the science by any one man" [1, p.55]. Indeed, "before
Aristotle, science was an embryo; with him it was born" [1, p.51].
Whether one chooses to accept the above implications regarding
the study of science and metaphysics is his/her own decision;
however, one thing is certain, Aristotle himself did not place
metaphysics above science or any of the other areas he studied,
including political science, logic, psychology, ethics, or
aesthetics. Why, then would chiropractors want to put all of
their eggs into a metaphysical basket when attempting to describe
and develop a philosophy of chiropractic (i.e., done by hand on a
It must be remembered that metaphysics, while consisting
of many divisions, still constitutes only one component of the
discipline of philosophy [see definition #5 above]. The ancient
schools taught that the science of metaphysics had numerous
divisions including ontology, cosmology, anthroposophy,
psychology, pneumatology, and metaphysical theology .
Pneumatology is the study of spirits and angels, while
metaphysical theology, called theodicy by Leibnitz and others,
deals with the existence, essence and attributes of God .
As it relates to the philosophy of chiropractic, Gelardi
 and Koch  correctly maintain that metaphysics should not
involve the supernatural; rather, "metaphysics is the study that
pertains to reality, to the nature of things, to existence" .
Unfortunately, Gelardi and Koch are greatly outnumbered by those
who see no difference among philosophy, metaphysics and
metaphysical theology. In other words, according to most
chiropractors, so-called chiropractic philosophy constitutes a
type of religion or metaphysical theology.
For example, consider the following quote from "an open letter
to the profession," published in Parker's Share magazine. Burnier
"Chiropractic philosophy was ahead of its time but it is
now at the very crest of the contemporary wave of consciousness They
[the public] need Teachers and Mentors and Friends, who set
examples of how to live from above down inside out. People are
yearning for a return to spirituality and this begins with
an immutable trust in Universal Intelligence without and Innate
Intelligence within" (my emphasis).
It should be mentioned that Burnier was the winning
author of Share's Article of the Month. Nearly every member of the
chiropractic profession receives this publication, which equates
philosophy with religion. In another magazine that is distributed
to significant sectors of the chiropractic profession, Barge
discusses the above down, inside out philosophy of health and
life . He emphasizes that BJ Palmer "wanted chiropractors to
be cognizant of the force of Life and its flow from Universal to
Innate to Educated Intelligence ... from God to man, so to
speak." Indeed, the writings of BJ Palmer make very clear that he
often focussed on religion instead of philosophy. Consider the
following comments by BJ Palmer:
"Innate is God in human beings; is good in human beings,
is life in human beings, is health in human beings, is sane in human
beings. Let Innate flow in and through us and we can accomplish
the great wonders." [48, p.56]
"In studying Innate, we have accomplished what all
religions have always wanted to do, viz., make 'The Kingdom of God Is
Within You' a tangible working integral part of living man. We
have accomplished what medical therapies have always tailed to do
but wanted to do, viz., found a specific cause for all disease
(as there is but one) and a specific for the correction of that
cause, thus making a living healthy sane God live healthily and
sanely in man." [48, p.119]
Verily, I say unto you, all power cometh from within,'
is no longer a mysticism of the East, but a practical, working, human
principal of the West. Chiropractors who apply the science are
proving the wisdom of Him who said, 'there is nothing from
with-out a man that entering into him can defile him, germ
theorists and dietitians, notwithstanding." [48, p.27]
"Within us, it is said "The Kingdom of God is within
you." It is! Innate Intelligence is the Great I am that I am. Innate
Intelligence is the internal source of all and everything."
[48, p.48] "Within all natural animals, including man and woman,
courses in active flow the wisdom of all time, the sage of the
ages call it what you may-Universal Intelligence, God, Jehovah,
etc" [48, p.23].
"May God flow from above-down its bounteous strengths,
courages, and understandings to carry on; and may your Innate
receive and act on that free flow of wisdom from
above-down-inside-out; for you have in your possession a sacred
trust. Guard it well" [10, p.148].
In summary, BJ states that Innate Intelligence (or God)
transmits information from the Innate Brain above, down to the
body via mental impulses. According to BJ, mental impulses are
very different than nerve impulses. BJ proposes that mental
impulses are Godly or spiritual impulses, and that subluxations
can interfere with, or block, the transmission of these spiritual
impulses. In essence, as mentioned in the dogmatism section, this
explanation offers a "spiritual disconnection theory" of
subluxation, such that subluxations disconnect one from the
consciousness of God and His healing forces. Within this belief
system it is held that the chiropractor, through spinal
adjustments, is directly responsible for releasing God's healing
forces that were previously blocked by subluxations. With good
reason, this explanation is unacceptable to many
I should make it clear that I do not dispute the
potential of God's healing power; however, I do dispute the visionary
presumption that God's influence on human beings can be
encumbered by subtle spinal misalignments or even overt
neurocompressive lesions. Such claims defy reason and the basic
tenets of philosophy, and moreover, these claims cannot be
supported by a spectrum of religious texts including the Bible,
Tanakh, Quran, and Upanishads. Nonetheless, when a chiropractor
questions the unsupported "spiritual disconnection theory" of
chiropractic, he or she is typically characterized as a cold,
heartless, God-less mechanist who worships the false god of
I should emphasize that my opposition to the "spiritual
disconnection theory" should not be confused with an opposition
to the concept of "nerve interference." In fact, it is clear that
at least two situations can interfere with neural conduction, one
being neurocompression and the other being reduced
mechanoreceptor afferentation as a consequence of reduced joint
mobility. A great deal more could be said about these topics;
however, the focus of this section is philosophy and not
neuroscience. Numerous papers discuss neurocompression, and a
recent paper discussed reduced mechanoreception in some detail
Unfortunately, our profession's problem with philosophy
does not end with the misconstruing of religion for philosophy. A
great misconception that pervades significant sectors of the
chiropractic profession is the notion that "philosophy" is
motivational and should make people feel good about themselves
and what they do. For example, after attending a chiropractic
motivational seminar, a chiropractic assistant stated that, "the
chiropractic philosophy of love and togetherness is what healing
is all about" . Quite to the contrary, by demanding that we
honestly and critically examine our profession's basic principles
and concepts, philosophy can and should evoke some degree of
doubt and discomfort, which would then motivate us to ask
questions about chiropractic, which would in turn drive us to
learn more about the nature of chiropractic care and the spinal
phenomenon we claim to effect.
The extent to which chiropractors embrace dogmatism,
mysticism, religion, and psychological motivation instead of
philosophy is staggering. Rather than conduct an on-going
philosophical investigation of chiropractic-related topics, the
great majority of our profession espouses one side or the other
of a false argument which pits science against philosophy.
Noah Webster provided several definitions for
science. One suggests that science is, "in a general sense, knowledge, or
certain knowledge; the comprehension of understanding of truth or
facts by the mind; in philosophy, a collection of the general
principles or leading truths relating to any subject; any art or
species of knowledge"  Similar definitions are provided by
contemporary dictionaries [2, 4]. For example, science is defined
as "systemized, coordinated knowledge based upon the accurate
observation of facts, and the relation of these to general
principles or laws; an inquiry into the causes and conditions
which determine the character of the phenomena observed" . By
comparing the definitions of philosophy and science it becomes
obvious that they can never he at odds with one another. Indeed,
Geraldi states that, "I see philosophy and science as being
symbiotic, the right and left hand attempting to applaud reality"
. It can also be said that the scientific method of
investigation should be viewed as a practical application of
Unfortunately, the topic of science, like philosophy,
has historically been a source of arguments within the chiropractic
profession. For example, it is argued that so-called scientific
chiropractors are mechanists who refuse to consider the existence
of vital functions in the body and, in so doing, abandon a major
tenet of chiropractic. It is also argued that science is
extremely limiting because it can only "take us so far." I
believe that science-related arguments arise because
chiropractors are notorious for confusing the "scientific method"
The scientific method of investigation is applicable in
the case of either clinical or basic science research. However, the
scientific method is rarely used in the standard clinical
practice because it is the rare medical or chiropractic doctor
who conducts research in his/her office. It can also be said that
the "scientific method" does not apply in clinical chiropractic
or medical practice, because caring for patients does not
typically involve research. However we cannot say that science
does not apply in clinical practice, simply because every day
practitioners interact with the physiology and physiopathology of
Physiology is defined as "the branch of science dealing
with the functions and activities of living organisms and their parts,
including all physical and chemical processes" .
Physiopathology is defined as "the science dealing with the
disturbances of bodily function resulting from disease" .
Thus, a scientific or science-oriented practitioner is one whose
approach to patient care is by guided clinical research and by
the dictates of science, i.e., physiology, physiopathology,
biochemistry, neurology, anatomy, etc.
Within the chiropractic profession there is also a
serious misconception regarding the nature of a "scientific,
evidence-based" practitioner. For example, it is incorrectly
assumed that such a chiropractor believes that adjustments are
only useful for patients with certain forms of acute low back
pain, because that is what was determined by a specific
controlled clinical trial or an analysis of relevant controlled
clinical trials. It must be understood that it is the extremely
rare "scientific, evidence-based chiropractor" who determines
his/her patient population based solely on such studies. In fact,
I know of no chiropractor who practices in this fashion.
Moreover, if all chiropractic and medical doctors were required
to treat patients based solely on the outcome of controlled
clinical trials, very few patients with any condition would ever
be treated by any doctor.
It should be understood that all health care
practitioners use untested methods, and all training institutions in the health
care arts currently teach unproven methods ; and believe it
or not, none of this is typically characterized as unscientific
behavior. In principle, this means that chiropractic care is
probably no more or less scientific than any other health care
Why, then, are chiropractors chastised as being
"unscientific quacks," while medical doctors and other practitioners have
managed to avoid that stigma? Mostly, it has to do with the
claims that chiropractors make in marketing their services.
Chiropractors are notorious for making treatment claims about
chiropractic care that go well beyond the limits of our
supportive data , whereas other professionals do not.
Consequently, it is the chiropractor who looks like, and
subsequently deserves to be called, an amateurish, unscientific
Unfortunately, chiropractors typically respond to this
problem by claiming that there is not enough scientific research to
support chiropractic care or, as mentioned above, by claiming
that science is not yet sophisticated enough to determine the
impact of subluxation . In actual fact, science has provided
a great deal of valuable information relevant to chiropractic.
The problem is that the chiropractic profession at large is
either unaware of this material or does not understand how to
apply it to chiropractic care. Indeed, Nelson, commenting on a
recent text devoted to subluxation, stated that "there is no
nexus between basic science and subluxations except that both
concern the spine" .
Clearly, the chiropractic profession has the same
problem with science as it has with philosophy. We like to talk and write
about the need to talk, write and focus on the nexus between
science and subluxation; however, this activity does not extend
beyond the idea that we need to do something at some time in the
future. As a consequence, our descriptions of subluxation have
not evolved to any notable degree in over 100 years. Consider the
following attempts to describe subluxation:
1828: An incomplete dislocation .
1910: A subluxated vertebra
is one that is displaced from its normal position by traumatism
or poison. Chiropractic displacements are fixed, exaggerated
lateral movements. Subluxations impinge upon nerves [11,
1927: A subluxation is the
condition of a vertebra that has lost its proper juxtaposition
with the one above or the one below, or both, to an extent less
than a luxation, which impinges nerves and interferes with the
transmission of mental impulses .
1992: A misalignment of one
or more articulations of the spinal column or its immediate
weightbearing articulations, to a degree less than luxation,
which by inference causes alteration of nerve function and
interference to the transmission of mental impulses, resulting a
lessening of the body's innate ability to express its maximum
health potential [54, p.29].
1992: An aberration of normal spinal biomechanics, usually
involving a restriction or loss of normal movement of a motion
segment, and associated with aberrations in the tissues which
support articular motion (e.g., nerve, muscle, connective and
1996: 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 .
Clearly, these are incomplete descriptions as they provide
minimal information about subluxation and body physiology; in
short, there is simply no nexus between science and subluxation.
These descriptions demonstrate that a basic science aptitude
problem exists within the ranks of the chiropractic profession.
This becomes particularly obvious when we realize that no
additional information or research is presented to support the
many descriptions listed above. Unfortunately, this problem is
not acknowledged by most of today's chiropractors.
Our obvious lack of an integrated, foundational and scientific
description upon which to build our profession should cause us to
be concerned about our future role in the care of patients, but
it does not. This anti-philosophical sentiment was clearly
expressed in a special issue of Chiropractic Products
magazine, which celebrated the Chiropractic Centennial by
inviting authors to provide their vision of the chiropractic
profession during the next 100 years. The great majority of
contributors neglected to discuss any real problems that may
retard professional growth and, instead, focused on how
chiropractors will finally be vindicated and then properly viewed
as physician-saviors. Consider the following examples:
"The ICA (Interplanetary Chiropractic Association) announced
that applications will be taken to allow the few remaining
medical doctors still in active practice to have hospital
privileges on a very limited basis" .
In the next hundred years, we won't be talking in terms of
global chiropractic, but in terms of galactic chiropractic ...
What a profound blessing it is to be able to work with the human
nervous system and its vitalistic mental impulse. Wow! What
an inspiration to become a master of masters, a doctor of
It is likely that such visionary, cavalier, and capricious
views about chiropractic begin for many in their first year of
chiropractic college when they are told, by "experienced" third
and forth year students, that the basic sciences are only
necessary to pass board exams, after which one can go out and
dispense the gift of making sick people well.
Regretfully, a poor science aptitude can be readily seen in
our college students and in field practitioners. I was recently
told by a reputable college instructor that most students
entering neurological diagnosis classes are unable to adequately
draw a cross-section of the spinal cord; a problem which is then
taken into the field. At a recent state chiropractic association
convention, I asked an audience of over 100 chiropractors to list
the different nerve fiber types which make up a peripheral nerve.
Not one chiropractor in this group could list a single specific
afferent or efferent nerve fiber or its related functions.
In light of these types of problems, it should not be
surprising that little progress has been made to create a nexus
between science (particularly neuroscience) and subluxation.
Indeed, how can a profession put forth appropriate theories or
reject inappropriate theories if an adequate knowledge base
regarding body function, particularly neuroscience, is sore
lacking? In such an anti-intellectual and dogmatic environment,
it is likely that research efforts [14, 49, 59-63] which could
ultimately help to bridge the gap between science and subluxation
will either go unnoticed by many due to a poor readership within
the chiropractic profession, be misinterpreted and used to
support inconsistent views, and/or be viewed as threatening and
anti-chiropractic in nature.
Although the chiropractic profession has existed
for over one hundred years, we have yet to adequately engage in a
critical examination our cherished beliefs and dogmas.
Consequently, personal opinions about subluxation, philosophy,
science, and the nature of chiropractic will continue to dominate
the chiropractic profession. We should all oppose this trend of
chiropractic relativism and endeavor to build a chiropractic
profession that is guided by real philosophy and real science
instead of dogmatism.
Although the views presented in this paper are my own, I
want to express a special thanks to Dr. David Koch, President of
Sherman College of Straight Chiropractic, for his helpful
comments during the development and preparation of this
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