Thom Gelardi

In a recent letter to the editor of Dynamic Chiropractic, National College President Dr. J.F. Winterstein defended his recognition of philosophy as a legitimate means of inquiry. Perhaps Dr. Winterstein felt defensive because of the anti-philosophy attitude of his predecessor, Dr. Joseph Janse.

Dr. Janse, like Western States President William Dallas, argued that chiropractic had outgrown its need for philosophy. I commend Winterstein for his more enlightened stand, for without philosophy chiropractors would be mere technicians.

Winterstein writes that “a health care profession with no philosophy would be a profession without a strong sense of direction.” Later, in his letter, he takes a contradictory and erroneous view, stating, “I am opposed to using the word, ‘philosophy’ to describe a set of beliefs about how the human organism is constructed or how it functions and then expanding those beliefs to explain and support a concept of human health care.” Such use of philosophy is quite proper, and does not require one, as Winterstein proposes, to “ignore known facts about human anatomy and physiology.”

Describing the principles by which the organism is constructed and functions, and using those principles as the basis for a concept of health care, is a very proper use of philosophy. Philosophy attempts to explain phenomena through the use of all available information (including that gained through science). Philosophy leads one to be more, not less, scientific. In fact, the scientific method is, and could only be, a product of philosophy.

I find Winterstein’s reliance on the literal definition of philosophy “love of wisdom” to be no more helpful than chiropractic’s “done by hand.” Philosophy is the study of the fundamental nature of the structure and function of existence, of man and of man’s relationship to that existence. Unlike the special sciences which deal only with particular aspects, philosophy deals with those aspects of the universe that pertain to everything that exists.

Philosophy and science are complementary disciplines. Science gives us information about the parts and how a single force or a few forces affect them. But as the number of forces acting upon the parts increase, or the parts being acting upon become more dynamic, science quickly loses its ability to be predictive.

That is why, in highly complex disciplines such as economics, politics, or the healing arts, where an outcome is the result of numerous forces acting within a highly dynamic situation, philosophy plays the vitally important role of putting scientific facts into a meaningful context. That is why a blood or X-ray technician, who gathers facts, does not need philosophy and why the doctor, who must put those facts into a meaningful context, does. It is embarrassing to hear anti -philosophy people babble, “Philosophy is fine, but in practice you must be practical,” for it is impossible to be practical without philosophy.

Winterstein proposes that philosophy may help us answer such questions as, “Why do we recommend chiropractic treatment instead of some other form of health care for a particular condition or human circumstance. Why are we opposed to the indiscriminate use of drugs? Why would we recommend chiropractic health care for the young person who has a family history of cardiac disease? When should we recommend joint medical and chiropractic care for a specific patient? Is there a reason for a more “natural,” less invasive form of health care for human health needs?”

It doesn’t take an Aristotle to be opposed to the indiscriminate use of anything. Determining the best method (form of care) to accomplish an objective (correct a particular condition) is a question for empirical science rather than philosophy. The role of science is to observe or experience without regard for system or theory. To determine the best method to do anything, one carefully defines that which is to be done (the objective) and scientifically observes the results obtained from the use of proposed methods.

Winterstein seems to confuse the roles of philosophy and science when he states, “If a substituted therapy can produce the same positive health benefits, without the harmful effect of the drug, our philosophy would support the decision to use the less harmful form of therapy.” Although philosophy could answer such questions as, “Do we desire to use good or bad therapies,” once that philosophical question has been answered, the decision as to the most effective, least harmful therapy, would be supported by science rather than philosophy.

Philosophy determines the correctness and value of a personal or professional objective and the possible implications or consequences of achieving it. But the effectiveness of the methods used to reach an objective can only be measured by science. It does not help us to know that medicine is more or less effective in reaching a medical objective than chiropractic is in reaching a chiropractic objective, any more than it does to know that dentists are more effective at filling cavities than are oncologists in treating malignant brain tumors.

If Winterstein holds, as he appears to hold, that medicine and chiropractic share a common objective, philosophy can quickly show some of the implications and consequences of such a concept.

One consequence is that we then would be able to compare our different methods of reaching our common objective. Another consequence is that we no longer have a sufficient reason for being a profession separate and distinct from medicine. We can no longer justify separate licensing laws, accrediting agencies, etc.

If professions are created on the basis of different methods, then all professions would be endlessly fragmented. Of course, professions are founded and maintained for just the opposite reason: that they have separate and distinct objectives.

If our differences with medicine are based only on the fact that we believe a comparison of the present day methods of each profession would show those of chiropractic to be more effective or because of politics and/or economics, we should test our medical therapies and political and economic theories within the arena of orthodox medicine and not form a splinter medical group under the pretense that we have a different objective.

We should get inside the enemy camp and change it from within. Our colleges should “raise” their standards and work with the majority of mainstream colleges for unity within the medical accrediting association. After all, the public is being confused by this splintering of the medical profession. After students graduate from our legitimate “medical” colleges, they would be free to limit their practices to adjusting subluxations, and those who might want to do more things would be adequately prepared.

I happen to believe that the formation of chiropractic as a separate profession has a legitimate basis in its separate and distinct practice objective. I do not believe that D.O. Palmer was trying to escape medical standards by starting a new profession. I believe that a comparison of medical and chiropractic methods would show that our methods are superior in fulfilling the objective of contributing to health through the correction of vertebral subluxations.

Winterstein raises questions regarding “more ‘natural,’ less invasive” health care. Perhaps he should first define “natural” and “artificial.” Is opium natural? Is applying a force to a vertebra natural? The question of invasiveness is simpler and I believe that doctors of every description agree that it is better to use the least invasive methods possible to accomplish an objective. Again, it’s a matter of defining objectives. A chiropractic adjustment may be less invasive than surgery but it is not effective in the reconstruction of a face that has been injured in an accident.

I hope Dr. Winterstein will continue to write philosophical articles. As Dr. Scott Halderman said, in the talk that inspired Dr. Winterstein to write on philosophy, the profession would benefit by strengthening its ability to use philosophy, along with science, to advance itself.

There is not a true chiropractic philosophy. Only practices based on authority, such as those within a religion or the military, can have a true philosophy. Philosophy is an understanding of the fundamental nature of existence. This understanding, reached through a rational philosophy, is evolving at different rates and possibly along different epistemological lines for the various healing arts and for the practitioners within those arts. One philosophy can, and usually does, give rise to many practices.

Philosophy, like science and art, does not exist a priori to a particular practice. There is only one thing that is true to any practice, and that is objective. Every rationally based practice has an a priori objective, and that objective serves as the standard by which its effectiveness is measured. Professions concerned only with an area of study, have an a priori area of interest, and those that are also based on a practice have, additionally, an a priori objective.

A profession’s central area of interest and practice objective set every detail of its activity and give to it identity and direction. A profession’s main area of interest and practice objective are derived from and explained by philosophy. They are advanced through the interaction of philosophy and science and are expressed and achieved through art.

Philosophy in chiropractic began with the critical thinking of the Palmers. While the Palmers had developed an examined philosophy, that philosophy was accepted by many of their followers as dogma, based on the Palmers’ authority. In many quarters within chiropractic today, “philosophy” is either dogma, anecdotes, applied psychology, physiology, pep rallies and/or mysticism.

Straight chiropractic colleges are making an effort to strengthen their philosophy departments; teaching philosophy as critical thinking, as an attempt to formulate and evaluate principles concerning chiropractic practice, as an attempt to explain phenomena and understand the fundamental nature of existence through the use of all available information. Scientific facts are the fodder of philosophy, but as Sir. Charles Singer, a medical historian, wrote, “If from the facts no laws emerge, the facts themselves become an obstacle, not an aid to scientific advance.”

When we speak of chiropractic philosophy, we generally mean that branch of philosophy called metaphysics. I am speaking in a philosophical sense, not the supernatural. Metaphysics is the study that pertains to reality, to the nature of things, to existence. Metaphysics pertains to the search for the presuppositions and implications of all thought and action, and the inquiry about the ground and significance of the empirical world. Our metaphysics, like our science, has to do with man’s relationship to himself and to the rest of the universe.

Is there a need for the study of metaphysics in chiropractic? One might as well ask if a consciously developed understanding of reality is preferred to an unconscious acceptance of unrelated facts, slogans and feelings about things. Is it any wonder that with philosophy being assigned such low priority in chiropractic that so many in our profession value unity” over such things as truth, principle or correctness and happily hum the oxymoron “Unity Without Uniformity”?

The process used to develop a philosophy or the metaphysical basis for one’s life or profession is critical thinking, reasoning. Philosophy has no method other than critical thinking and perhaps dialectics. Reason is that which identifies and integrates the material provided by man’s senses, experience and by science. Reason integrates man’s perceptions by means of forming abstractions or conceptions, thus raising man’s knowledge from the perceptual level to the conceptual level. The method of reason involves another branch of philosophy called logic.

The process of acquiring new knowledge is the process of reasoning, hypothesizing and scientific testing, ie: the logical evaluation, integration and conceptualization of that which is perceived. Ute on the perceptual/eve/ would be little better than that of lower animals. We must integrate our evaluated perceptions and conceptualize new arrangements of the things of existence. We validate truth through science evaluating the part and philosophy examining the whole. Science serves the important task of validation with regard to speculations, hypotheses and assumptions. The special sciences tell us about the part and the effect of one or a few forces acting upon the part. This is very necessary to understanding the mosaic of reality. However, as the number of forces acting upon the part increase or the part being acted upon becomes more dynamic, the ability of science to be predictive decreases and one must turn to philosophy to determine a possible outcome.

Philosophy not only gives the impetus to scientific investigation, it also gives science its direction. It integrates and gives significance to scientific data. We all have seen students and doctors who want the facts – just the facts – or the techniques of correcting subluxations, and who do not want to be bothered with the principles of why or how vertebrae become subluxated, how or why subluxations are reduced, or how the production and correction of subluxation relates to the larger context of the other parts of the body and its environment.

It is ironic that some believe that philosophy and science are either helpfully antipodal, one reducing the evil of the other, or detrimentally antipodal, one reducing the good of the other. Some believe that if one is identified with philosophy, she must be anti-science and visa versa. I see philosophy and science as being symbiotic, the right and left hand attempting to applaud reality. Neither can do it alone.