Last issue (April), we discussed the unfortunate situation of the chiropractor arrested for practicing medicine without a license in Spain. Recently in California, there was a case involving a chiropractor who was arrested on felony charges for using vitamins to treat a baby who had a digestive disorder. The California Chiropractic Association (CCA), of course, defended him but a more important aspect was the position of the CCA. The District Attorney took the position of the Spanish court, stating that a digestive disorder is a medical condition therefore, no matter how you treat it, drugs or vitamins, you are practicing medicine. Interestingly, the CCA’s Council maintained that there is no such thing as a medical condition. Apparently the thinking of this group is that chiropractors are licensed and free to treat any condition of the body in any manner they choose (except those strictly forbidden in the law such as certain STD’s and the use of prescription drugs). Perhaps these two cases demonstrated that we are clarifying the conflict between medicine and chiropractic. The 100-year battle between the two professions comes down to how you define medicine.

Medicine defines its profession by its objective. The treatment of disease and its cause is the practice of medicine. Methods, procedures, techniques and modalities are not the issue. The issue to them is what you are trying to accomplish. This position has historically caused the rift between medicine and chiropractic as well as any alternative health-care system. The medical community saw D.D. Palmer’s treatment of disease (or its cause) as practicing medicine, granted with a very unorthodox method, but medicine nevertheless. Medicine continues to hold the position that disease is their domain and only reluctantly relents in the case of religion (faith healing) because of the constitutional protection afforded religion and in the case of professions which historically did not treat diseases but only performed mechanical procedures. For example, dentists basically just pulled out teeth and optometrists just fitted glasses. Physicians considered both to be technicians. There were a few others that the medical community simply allowed to exist, not because they recognized their right to practice medicine but because either it was not worth the trouble to prosecute them or it was not politically expedient. Remember, medicine is a political entity as well as a so-called healing art. Chiropractic was and is a different matter. Apparently, chiropractic posed a real threat to medicine as an alternative approach to treating disease and so they opposed chiropractic almost from its beginning. Given medicine’s relatively crude procedures at the turn of the century, chiropractic was an effective treatment of disease. However, for all its present failings, medicine has become more effective than chiropractic as a disease treatment. Conversely, chiropractic was as good at treating disease at its inception as it was ever going to be.

Chiropractors define themselves in many different ways, which has led to much confusion within the profession. The following is not a complete list of how chiropractors define their profession but probably represents the major ways.

1. Drugless treatment of disease. This approach clearly incorporates a multitude of modalities and offers a very diverse approach to the practice of chiropractic. It also is the approach that draws the ire of the medical profession because as they incorporate more non-drug, non-surgical procedures into their practice, there is more and more overlap between the professions.

2. By hand only. Correcting subluxations by hand only to correct the cause of disease is the traditional approach of chiropractic. This group has historically been attacked by medicine for its failure to refer and hence, delay life-saving medical care.

3. Disease treatment. This small but vocal group of chiropractors sees no difference between medicine and chiropractic. They would like to be absorbed into the medical community and be free to choose what disease to treat and have at their disposal whatever tools they deem appropriate for that treatment, including drugs and surgery.

4. Objective straight (non therapeutic) chiropractic. This group defines chiropractic by its objective, which is to correct vertebral subluxations to enable the innate intelligence of the body to be better expressed. This objective does not address disease nor does it in any way impinge upon the medical objective. This, of course, is the modern-day, straight chiropractic approach. It acknowledges the medical approach to defining itself (also by objective) and has chosen an objective that does not duplicate or conflict with medicine.

Of the four approaches, only objective straight chiropractic does not conflict with the practice of medicine because it does not address disease. It seems that for chiropractic to survive as a separate and distinct profession, the fourth approach must be taken. I am not sure whether most chiropractors care if the profession survives as separate and distinct. Those of us who want it to survive must begin to define ourselves by our objective. We cannot survive otherwise. We condemn those chiropractors who are moving toward medicine, but that is only half the danger that faces our profession. The other half is the fact that medicine is moving toward us so quickly that the lines that divide us are disappearing. Medicine is looking at alternative drugless procedures. It is incorporating nutrition, something scorned by them only a generation ago. They are incorporating manipulation. Many physicians are trying to be more conservative in their care. Medicine and those in the chiropractic profession who are addressing disease are getting closer and closer. It is very simple. It is not a spiritual awakening by the medics. They are looking for the best way to treat disease and will do anything to accomplish that objective. As medical doctors and chiropractors both search for the best way to treat disease and its cause, they will naturally become closer and closer in their approach. Until one day we will have a hybrid physician who will incorporate the best of medical, drugless, alternative and chiropractic procedures to treat disease. What will happen to the adjustment? Well, it will be used in treating those conditions for which it is deemed the most effective. And we all know what they are, with few exceptions they are bad backs and stiff necks.

Some in our profession long for that day. Some of us are already preparing to do something else should it occur and without question, it will occur. It will happen as sure as night follows day unless the great majority of chiropractors, those who claim to hold to traditional, B.J. chiropractic, who have the largest schools, and who are the most influential chiropractors in the country, wake up and realize that they are part of the problem and they need to be part of the solution. Objective straight chiropractic and its philosophy are now well established. Objective straight chiropractic is the only means by which we can insure that people can have their spines checked and adjusted a generation from now, not to treat a disease or its cause but to enable the innate intelligence of the body to express itself as fully as possible and to allow individuals to reach their potential in every aspect of life. The time is now, for those who truly love chiropractic, to begin to put aside differences and unite behind an objective approach to the practice of chiropractic, the objective that truly represents what D.D. and B.J. were all about, not disease and not its cause, but removing interference to the expression of life. D

Diagnosis and Chiropractic

Recently I had an opportunity to talk to a group of about 100 students at a chiropractic college, one that is not known for being straight, either traditional or objective. This particular group was a class whose instructor was gracious enough to give me two hours of her class time. Because the class had not come specifically to hear me speak, many of them were totally antagonistic toward my presentation of straight chiropractic. In fact, I can say that I have not ever experienced that kind of enmity before. (I guess I need to get out more often into less friendly environments. Or maybe the problem is that too many schools and groups will not allow me on campus to speak to their students). What I was not prepared for was the unwarranted confidence the students had in their ability to diagnose.

It is unfortunate that these students were actually taught the irrational and arrogant falsity that they are as good as medical doctors in screening people for medical conditions. Actually, one or two of them even thought they were better than medical doctors because, as students, they had found something that a medical doctor had missed. Perhaps, it does not take too much teaching or convincing to believe that you are as good or better than a medical doctor. It seems that prideful arrogance, the "first deadly sin," comes natural to most people. If that is the case, then it would be relatively easy to convince a medopractic student that he or she is as good a diagnostician as a medical doctor. Of course, criticizing the medical profession’s diagnostic skills help to convince ourselves that we are as competent as them. Forget the fact that even if we were equally as skilled in diagnosis as the medical doctors, we would still fall woefully short.

Thinking that a few hours of classroom lectures on diagnosis (usually taught by a chiropractor with no medical training) makes a chiropractor as competent as a medical doctor who spends at least as much time in the classroom plus two years in a sixty-hour-a week internship may be the greatest divorcement from reality that exists within our profession. To be able to properly diagnose you must see many people in all kinds of situations and see the non-classical conditions. Chiropractic students and even chiropractors do not have that kind of opportunity. For every chiropractor who finds something a medical doctor misses, there will be a hundred that miss something the average medical doctor will find.

The real humor is in the fact that many of these chiropractors believe that straights are a danger to the public.Who is more dangerous, an unqualified person trying to perform a procedure or someone who does not claim the ability and refuses to perform that procedure under any circumstances?

We may be turning out brighter students in our chiropractic colleges than we were fifty or sixty years ago, but from some of the irrational thinking that I recently heard, I would say that many, for all their education, truly do not have a clue as to the reality of a medical type chiropractic practice and are being taught by those who do not have a clue themselves.

A Philosophical Question

An interesting philosophical question was presented to me by a group of students. Why are the students always the ones to raise the insightful questions? Do we stop thinking once we get out of chiropractic college? There was a difference of opinion among the students as to the scope of the chiropractor’s responsibility in informing the patient regarding the effects of the adjustment on someone taking medication. The issue surrounded how the chiropractor should address a patient who is taking certain medications, specifically insulin and anti hypertensives. One group said that addressing it was a medical issue and outside the realm of straight chiropractic, therefore, the chiropractor should not even bring up the subject! The other group maintained that if the blood pressure or insulin level was normalized under chiropractic care, then the drug could have a detrimental effect on the body and actually cause problems. Of course, the other side responded that the drug was already having a detrimental effect even if it was relieving some symptoms and that was a choice the patient had made. What is a chiropractor to do?

I think there are a number of issues to be explored relative to this question. First, we must realize that the ramifications are actually far greater than just the two medications raised in the question. If we accept the premise behind the "Chemistry of Life," then every drug affects body chemistry. At the same time, every adjustment has the potential to normalize body chemistry. For a chiropractor to know the effects of all drugs including psychotropic drugs, tranquilizers, antidepressants, heart medications, and on and on, and how they individually impact on the body in any combination might be impossible. Not only do we not have the necessary pharmacological education but every drug is different in every person, the effects of which are virtually impossible to predict with any certainty. We could not possibly explain every drug action, but perhaps we do need to say something.

I believe this issue falls into the same area as apprising patients of a contraindication to a chiropractic adjustment in a certain area either because of a medical problem (diagnosed by their medical doctor) or an unusual finding (found by you incidental to your spinal examination). Further, as chiropractors, we should always explain to patients the four options that they have regarding care and the ramifications of those options (see Case Management for Straight Chiropractors, pp. 103-104). This particular case is a ramification of receiving both medical care and chiropractic care, option number four. It seems to me that we are obligated to explain this to patients. Perhaps we do not have to get into specifics and, of course, we are not going to make any claims that chiropractic is going to definitely normalize their body chemistry but the potential is there. From a patient-education perspective, this is a perfect place to explain how chiropractic affects body chemistry. This is a personal application of the "Chemistry of Life" talk. I think it has the potential to be a great tool for patient education. Of course, the patient must understand that your responsibility as a chiropractor ends with informing them that chiropractic care has the potential to normalize their body chemistry and that their medication may have an increasingly greater negative effect on their body. It is then necessary for the patient and their medical doctor to monitor those effects and make the necessary adjustments.

This question brings up two other issues. The first relates to what I call "doctor syndrome," or the traditional chiropractor who wants to replace the medical doctor as the family doctor and do medical tests. In this particular scenario he would have to engage in even more medical procedures to monitor possible changes that might occur because of the adjustments. He would have to do regular blood tests and understand all of the ramifications of drug actions and interactions upon body chemistry. Of course, if disease is not your concern, then you merely have to inform the patient that he or she and their doctor are going to have to monitor their disease and its need for treatment or a change in treatment and get on with the business of locating, analyzing and correcting vertebral subluxation.

The other issue relates to a discussion that was included in the last Pivot (Vol. 14, Number 3), regarding whether chiropractic is a health profession or not. Whether we are or not, the fact remains that chiropractic care does impact upon issues of health and we need to be prepared to explain that to every person that comes into the office. However, the sword cuts both ways. Not only do we relate to health issues but our care can impact almost every area of an individual’s life and it is incumbent upon us to explain that to every patient that comes in the office as well. Granted, we do not have to warn the patient that their golf game may improve or that they may be more effective and efficient in their job or that they will sleep better or have more energy, because those are not potentially negative results. But if this whole issue is about educating the patient as we said at the beginning, then it behooves us to explain that chiropractic may affect body chemistry in any number of ways and that those affects may greatly impact the individual’s life.

Illegitimate Chiropractic

An article appeared recently in the JCCA (no, I do not read that journal, someone sent me the article over the internet). In criticizing the philosophical chiropractors, a chiropractic DABCO made the following statement: "Today, Innate Intelligence remains an untestable enigma that isolates chiropractic and impedes its acceptance as a legitimate health science." I find this type of thinking to be very perplexing. How can people become a member of a profession ostensibly because they think it is a superior method of optimizing health and then later want to destroy that which makes it superior? Of course, I do not mean superior in accomplishing the medical objective but in offering a service that can have more benefit and a far more widespread effect on mankind than the practice of medicine. I guess I should not be surprised. We have people in this country who want to destroy our republic form of government which is the very thing that made this country great. If we give up the concept of innate intelligence, we might well be accepted as a "legitimate health science." Without innate intelligence, chiropractic is nothing more than the practice of medicine and that is the most legitimate health science. Without innate intelligence, there would be no chiropractic profession for the author of that journal article to be a member of or to provide the opportunity to call for innate intelligence’s expulsion. Similarly, those people who want to change our form of government would not have the freedom to call for that change if it was not for our form of government. There is no such thing as freedom of speech in a totalitarian government. Would chiropractic be around today if all it entailed was pushing on backs to relieve musculoskeletal problems? Would a person like B.J. Palmer have dedicated his life to that? Would chiropractors have gone to jail and fought for licensure to practice manipulative medicine? Would the thousands upon thousands of chiropractors, who created the environment we now enjoy and who gave us the freedom we now have, done so if chiropractic was for bad backs and stiff necks? Without men and women committed to perpetuating the principle of innate intelligence, we would not have a profession today for its members to talk about abandoning its most basic principles.

It is probably true that the concept of innate intelligence keeps us from being truly welcomed into the medical community. It probably also keeps us from being accepted into the scientific community because innate intelligence is not a scientifically demonstrable fact. Perhaps we need to start realizing we occupy a paradigm that is not medical, not scientific and not religious. While it keeps us out of the medical fraternity, it is also the concept of innate intelligence that enables us to do something no one in the medical community can do and to give to humanity what no one in the medical community can give. Medical doctors can move bones and today many of them do. Physical therapists can manipulate joints and they do. But when you add innate intelligence to the equation, moving the bone takes on a totally different purpose. Without innate intelligence we lose what makes us, not just a great profession, but what makes us a profession. I suppose if we cease to exist, then we would truly be accepted and embraced by the "scientific" community. And I understand that we all want acceptance. But frankly, I think that professional suicide is too high a price to pay for it.

Further Thoughts on Preventing Subluxations

The subject of preventing subluxations undoubtedly causes frustration among straight chiropractors. I once heard a good, straight chiropractor say, "If I know something is causing a patient to resubluxate, I’ll tell them to avoid that activity." He knew it was not consistent with his straight chiropractic objective but he felt obligated to the patient. Other chiropractors are in the same situation. They know it is not in line with the objective but cannot see anything philosophically wrong with it. Unfortunately, it does conflict with our philosophy. There are a number of philosophical issues to be addressed, a number which have been explained in Chiropractic Philosophy. One issue in particular, however, I believe has not been previously covered.

By trying to prevent subluxations, by changing outside or external factors, we may be interfering with this part of life. We berate the medical community for fooling around with outside factors such as bacteria. We are quick to show how they have upset the balance of nature and created super germs by trying to alter the environment with antibiotics (defined as "against life"). Yet most of the activities that cause subluxation are also a natural part of life. Suppose the physical, chemical or emotional stress that causes a vertebral subluxation, also builds up positive survival values (PSV). Should we deny the individual the opportunity to gain that positive survival value? By analogy, I am sure that a case of the measles can cause subluxation in a child. Yet we consider it absurd to vaccinate to avoid that disease. That is exactly what medicine does. It tries to alter the environment so even the weakest of individuals are not affected by it. In so doing it only serves to make us all weaker. If we prevent stresses, because they may be subluxation producing, we deny ourselves the opportunity to adapt and to build positive survival values? How can a person adapt to a particular stress, or stress in general, if we do not allow them the opportunity to experience it? I believe it is wholly possible, consequently, to reduce a person’s ability to adapt to life in general. That is inconsistent with our philosophy. In fact, that is exactly what medicine does. Medicine says the cause of disease is external, it is not the body working incorrectly but an outside factor that must be changed. Although it may not be considered the practice of medicine to give advice or to do things for the patient to prevent subluxations, it is surely buying into the outside-in philosophy of medicine.

Let’s look at a specific example. If a person came to the office and you believed that exercising was causing them to subluxate, would you tell them to stop exercising? Of course not! You can adjust the subluxations. The benefit of the exercise outweighs the correctable subluxations and will eventually enable the person to be healthier and perhaps subluxate less from the exercise. Maybe you are thinking that you would not tell them to stop exercising but you might suggest different exercises. Well, if we are trying to get them to listen to their body, they should be the ones to determine what exercises are best for them. We do not know what is best for them. We often quote B.J. by saying, "You never know how far reaching something you may think, say or do today will affect the lives of millions tomorrow." But do we ever think about the negative side of that saying. We still affect millions of people’s lives when we say and do the wrong thing.

Medicine interferes with only the catabolic side of life and we know what a mess they make of it. They do not consciously try to upset what they consider to be normal aspects of life. Of course, when you interfere with one side of the cycle, you automatically interfere with the other side. The uniqueness of chiropractic is that we do not interfere at all. We do not interfere, not just because it is not chiropractic but because it is dangerous. It always has side-effects. Our deductive philosophy teaches us that any time we interfere with nature we are reducing the perfect expression of the wisdom of the universe. Even if our intentions are good, that is a negative side-effect.