Chiropractic Postulates and the Failure of the Literature

One of the real problems with the chiropractic peer-reviewed literature is that a handful of flawed articles have had a very large impact. This problem is exacerbated because there are not enough scholars or scientists taking the time to debunk and critique the flawed papers.

The Chiropractic as Spine Care Paper

One great example of this popped up in my latest scan through the Facebook pages. I came across an interesting fact; some chiropractic international organizations and teaching programs base their rationale on one of these flawed papers. The paper was published in 2005 in Chiropractic & Osteopathy, a journal known for publishing articles with historical errors, circular reasoning, and self-referential citation patterns.(1) The article is, Chiropractic as spine care: a model for the profession by Nelson et al.(2)

I will write more about this paper in the future. In the meantime, let’s just acknowledge for a moment, it is cited 127 times in google scholar and 57 times in PubMed Central.(3) Also, it was listed as a rationale for the new Keiser chiropractic college and is cited by leaders of the WFC. One paper, big impact.(4)

I will write more about this paper in the future. In the meantime, let’s just acknowledge for a moment, it is cited 127 times in google scholar and 57 times in PubMed Central.(3) Also, it was listed as a rationale for the new Keiser chiropractic college and is cited by leaders of the WFC. One paper, big impact.(4)

No Critiques Means the Literature is Failing Us

Unfortunately, the critiques of the article are few and far between. There are no letters to the editor complaining about its flaws and no published opinion papers tearing apart its arguments.

What does that tell us? Is it beyond critique? Or do other papers in the literature just assume it is correct because it made it through peer-review? Or that it has so many credentialed authors that it must be right? Or, is it possible that there are not enough experts knowledgeable about the main suppositions in the paper to properly evaluate it? These are the questions we must address.

Beginning a Critical Review

In Part 2 of the recent series on Chiropractic Vertebral Subluxation, I included a section critically reviewing the literature. In that section I was able to point out one of the problems with the Nelson et al paper. I will describe it and add another below. However, there are more than two.

The problems I focused on were related to their proposed “Palmer Postulates.” The “postulates” they developed were based on some mistaken facts and inaccurate assumptions about D.D. Palmer and his theories. Whether the postulates accurately depict Palmer’s chiropractic paradigm should be explored separately.

The point I want to share today is that the evidence they use to support the development of their postulates is flawed. This affects more than just the fact that the authors derived their postulates from faulty data, but it also weakens the whole paper substantially. After all, they find the postulates invalid and then propose their own model for the profession.

When viewed from the evidence, or the primary sources, their whole argument falls apart. It is flawed.

D.D. Palmer Conducted a Systematic Investigation of the Cause of Disease

In Part 2, I point out that Nelson et al’s assessment about how D.D. Palmer developed his initial theories was incorrect.(5) My main reference for this were his own words, direct quotes. For example, Nelson et al write, “there is no evidence that Palmer undertook any sort of systematic exploration of the spine/health relationship,” following the first chiropractic adjustment.

The fact is, he did. He even said, after the Lillard adjustment, “I then began a systematic investigation for the cause of all diseases and have been amply rewarded.” Other primary sources demonstrate that he did as well. So, one proof of their argument was incorrect.

Nelson et al, also suggest that D.D. Palmer’s “method of discovery was by inspiration and revelation.” That is just not accurate. An analysis of D.D. Palmer’s writings from 1892 to 1910 demonstrates otherwise. Sure, he had sources of inspiration, and I write about the strangest elements of that in the article and more so in The Definitive Guide.(6) But his main approach was empirical and guided by book studies.

Innate Intelligence is Better Described as the Law of Organization than Vitalism

Even though the philosophy of chiropractic was described in terms of Vitalism, mainly starting in the 1990s with Dean Black, Ian Coulter, David Koch, Sid Williams, Ralph Boone, and Graham Dobson, it is not necessarily the most adequate way to describe D.D. Palmer’s theory of Innate Intelligence. Dismissing the theory of Innate Intelligence as merely Vitalism ignores the complexity of chiropractic theory as it was developed and described between 1902 and 1999.(7)

After all, much of the theory is better described in terms of self-organizing systems, which are now a common viewpoint about how organisms are defined as alive.

My first approach to an evidence-based history of chiropractic was to count every usage of the term “organization” found in the Palmer Chiropractic Green Books. I analyzed each definition and found at least 88 uses that were distinct. Innate Intelligence was defined in the same ways the early theoretical biologists were using the term; as a unique type of organization of the parts comprising the dynamic and adaptive whole. After all, Stephenson defined it as “the law of organization.” Thus, I demonstrated that chiropractic theory developed alongside biological theory in the twentieth century. I published those findings twenty years ago.(8)

So, when I read a paper like this classifying Innate Intelligence as just vitalism, implausible, metaphysical, and indefensible from a scientific perspective, I am awestruck at the lack of understanding about the term. After all, the literature is there for all to study. Why not get it right? Or at least complete?

D.D. Palmer’s first use of the term Innate Intelligence was in relation to the development of bony osteophytes.(9) His later uses of the term included a non-materialist viewpoint. The complexity of D.D. Palmer’s ideas are not included in the proposed “postulates,” leaving yet another hole in Nelson et al’s argument.

If the Postulates are Based on Faulty Facts and Reasoning, What Else is Wrong?

I will plan to dissect this paper in more detail in coming months. But just from this preliminary view, we are forced to question some of the basic assumptions. If the postulates are not based on good sound reason and evidence, what else is wrong with the paper? Just because a paper has yet to be critiqued in the literature does not mean it is correct. The organizations that base their rationale on this paper should study it more carefully.

This paper and more like it are dissected in the new course at TIC: The CVS Lectures

Some References:

  1. Examples: The New Chiropractic; The Five Eras of Chiropractic; Chiropractic Background
  2. Chiropractic as spine care: a model for the profession
  3. PubMed; Google Scholar
  4. WFC President; Keiser University Dean
  1. The Chiropractic Vertebral Subluxation Part 2: The Earliest Subluxation Theories From 1902 to 1907; Palmer Chiropractic Green Books: The Definitive Guide
  2. You may read the section here: Assumptions in the Literature
  3. Coulter’s Institutional Philosophy of Chiropractic; Koch’s Has Vitalism Been a Help?; Boone and Dobson’s Proposed VSM Part 2; What is Life?
  4. Causation Related to Self-Organization and Health Related Quality of Life Expression based on the Vertebral Subluxation Model, The Philosophy of Chiropractic, and the New Biology
  5. Innate Intelligence Part 2 (1903)
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