Subluxation in Chiropractic: TIC VLOG Episode 5

The chiropractic literature periodically has problems with bias and incorrect facts about history. The profession needs to correct the mistakes. I will be dedicating several TIC VLOGS and blog posts in the coming months to the literature. Please let me know if this is useful to you.

This week’s question comes from Steve Tullius about a paper published in 2014 on professional attitudes in chiropractic. It is based on a survey conducted in Canada on more than 700 chiropractors. That survey is based on an older survey used in McGregor-Triano’s dissertation. The paper itself has several problems apart from the survey.

I applaud their efforts to try to understand chiropractor’s attitudes. I offer this critique with the best intentions. We need to improve the quality of our literature and stop citing old references that have been debunked.

BIG IDEAS FROM THIS EPISODE

  • It is time for the literature to start reflecting a more accurate history of subluxation in chiropractic. The literature on subluxation was developed at every school. There are a few papers that reflect this such as Kent, Faye, Good, and Vernon.
  • It would be great if papers in the literature would stop repeating the idea that subluxation and philosophy first showed up at the Morikubo trial in 1907. Also, that subluxation and philosophy were based on the work of Solon Langworthy. These myths started in Lerner’s report in 1952, and are based on Lerner’s conjectures from incomplete facts. He wrote his report as though it was true but when you look at his meager sources, his assertions on the topic DO NOT PAN OUT.
  • Philosophy and subluxation were certainly used in court to demonstrate that chiropractic was separate and distinct from medicine and osteopathy. However, they were already developed by D.D. Palmer and his students prior to 1907.
  • Unfortunately, Lerner’s report is the main source of Rehm’s influential article on the topic. This led to more articles and textbooks that can all be traced to the unsubstantiated claims by Lerner. For those in the profession who care about facts and scientific rigor, this fact should be included in the future literature.
  • In 2003, McDonald’s study was published. It demonstrated that 88.1% of chiropractors in the United States felt vertebral subluxation should be retained by the profession. It was also published as a book and later expanded upon with three essays in Chiropractic Peace.
  • In 2006, a paper was published based on a planning conference on chiropractic. It was held by academics. They found that only 30% of academic chiropractors wanted to retain subluxation. They compared this to the 90% of chiropractors who want to keep the term.

The 64 Chiropractors at the Heart of the McGregor Study

  • One element of the McGregor/Puhl paper that I did not address in the video blog is the original survey. They based the validity of the survey instrument on a previous study conducted in November of 2000. That study examined 64 individuals.
  • The survey was handed out at the WFC conference on philosophy in Fort Lauderdale, Florida. (Download WFC’s report here: ChiroReport.)
  • The conference itself was a bit surreal. I was there. Perhaps I will dedicate another blog post to it in the future. I got to meet my friend Joe Keating for the first time in person as well as Nell Williams and many other legends.
  • A big consensus was forced upon the attendees. It was embraced by the WFC and ACC, which included every school in the United States. The consensus was based on the Coulter paradigm of chiropractic philosophy. It was developed at LACC/SCUHS in the 1990’s and the basis of Coulter’s 1999 text. Every school embraced the tenets that chiropractic is based on “holism, vitalism, naturalism, humanism, and therapeutic conservatism.”
  • McGregor even gave a talk on the philosophical basis for condition-centered chiropractic.
  • The highlight of the conference for me was John Astin’s paper integrating Ken Wilber’s Integral Theory into a chiropractic framework.
  • The McGregor survey was handed out at the conference and was described in her dissertation. The 64 chiropractors included 10 college presidents, 16 practicing chiropractors, 1 student, 23 lecturers or deans at colleges, 7 from various chiropractic organizations, and 7 who were not chiropractors. It is difficult to fathom how this could be considered an accurate picture of what chiropractors think about subluxation!

SEND ME YOUR QUESTIONS FOR FUTURE EPISODES

 

* Music written, arranged, and performed by Dan Mills, Mark Goodell, Adam Podd

Chiropractic Games & Distortions of Truth

Do you remember a game from your
childhood called, “telephone operator?”

You know the game; everyone sits in a circle, the first person then whispers in the ear of the person next to them. The whisper makes its way around the circle until the originator of the message receives the final word. The funny part of the game is that the message usually gets morphed as it travels often into an unrecognizable shadow of its original meaning.

When you were a child, this game was probably fun. When it gets played at the professional level, real CONSEQUENCES ensue. This is often the case in the chiropractic peer-reviewed journals.

Let me explain what I mean…

There are at least three messages that have been “whispered” in the chiropractic literature (and I write whispered because most chiropractors DON’T read the literature – unfortunately).

1. The Philosophy of Chiropractic was developed by lawyer Tom Morris.

2. The Subluxation is an untestable entity.

3. Anyone who uses philosophy or subluxation in chiropractic are “Dogmatists.”

The more you tell a message, the more it seems like TRUTH even if it is distorted. The more you pass on a DISTORTED TRUTH, the less truthful it becomes even if there was a kernel of truth in the original message. In a profession, when a distorted truth gets passed on through the literature, it gains in credibility with each new publication! It seems to be TRUER. And this influences accrediting agencies (CCE), boards (FCLB), examiners (NBCE), trade organizations, and eventually legislation.

I plan to discuss these “truths” in more detail in future blogs, and, I have written about them already (most of my articles are posted on this website), and I have developed a series of online courses exploring these issues (SHAMELESS PLUG). But for now, let’s just explore the latest assault on the foundations of chiropractic in the literature…

In a recent article by Keith Simpson in the journal, Chiropractic and Manual Therapies, he describes the five eras of chiropractic, yet he relies on whispered and distorted truths from the literature and he even invents some new ones.

Simpson, who decides to tell us about his credentials in the article (Doctor of Chiropractic and Doctorate of Sociology), takes on all three of the messages above and embraces them whole-heartedly. Not only does he pass on the tired and very distorted interpretation of the philosophy of chiropractic, but he makes up a new distorted truth (which is an obvious mistake, but you might think a Ph.D. and a journal editor would catch it…)

The first tired distorted truth:
“Tom Morris was the architect of the philosophy of chiropractic.”

The new distorted truth:
“Solon Langworthy started the 1922 ACA.”

By now, you might be asking…”What does this have to do with me or my practice?” Or more directly, “Why should I keep reading?”
KEEP READING…it relates directly to you and the future of chiropractic!

Remember, these whispers continue through the chiropractic generations precisely because most chiropractors are NOT paying attention to the peer-review literature!

The idea that Tom Morris was the architect of the philosophy of chiropractic is rooted in facts, first espoused in the 1950s by Cyrus Lerner in his unpublished Report. In order to win the first landmark case for chiropractic, philosophy was used as part of the defense; “Chiropractic has a separate and distinct philosophy.” Soon after, B.J. Palmer and even D.D. Palmer wrote and taught about the philosophy as central to chiropractic, one of its three pillars. They also codified philosophical terminology to distinguish the differences between chiropractic and medicine such as adjustment and analysis.

The defense was used thereafter to win 90% of 3,300 cases against chiropractors in the next twenty years. This aspect of the facts has been whispered through the literature by Rehm, Keating, Seaman and several others in the last thirty years. THIS is how it goes from partial fact to distorted truth.

None of these arguments including Simpson take into consideration the FACT that D.D. Palmer had been studying the philosophy of healing for thirty years prior to the Morkibubo case. (I explore these issues in more detail with the actual texts D.D. was studying in two of my books (ANOTHER PLUG)!) Nor do they account for the FACT that the philosophy of chiropractic has many similarities to the 20th century philosophies of biology, philosophies that led to the current trends in systems theory, complexity theory, chaos theory, and other more interesting approaches such as Non Equilibrium Thermodynamics and Subtle Energy Systems. Basically, there were many factors that led to the importance of the philosophy in chiropractic and these dismissivist approaches merely point to ONE and suggest it is EVERYTHING.

You ask, “Why is this important?” Well, by dismissing the philosophy of chiropractic as a relic of an earlier time, when there were not many licensing laws, it gets erroneously argued that we no longer need philosophy because we don’t need that “phony” defense anymore! This of course leads to licensing boards (GCC) and accrediting agencies (CCE) to diminish the need for philosophy and subluxation, which leads to changes of scope and education.

Before I get to the subluxation part, let’s address the new distorted truth

Simpson, WRONGLY asserts that Solon Langworthy (the man credited with writing the first chiropractic textbook and coining the term vertebral subluxation), started the ACA in 1922. This is a mistake and hopefully the journal will publish a retraction. In 1903, Langworthy started The American School of Chiropractic in Cedar Rapids, Iowa. The association he started in 1905 was called the American Chiropractic Association, and was probably an alumni group. It had no relationship to the ACA, which formed in 1922, which later became the NCA, which in 1963 became the ACA of today.

And so you ask, “Who cares about all this history Simon?” Let’s look at the problem and the new whispers that will start from this very scholarly article of Simpson’s. It goes something like this… Since Tom Morris used Langworthy’s textbook to establish chiropractic as separate and distinct, and Morris was the architect of the philosophy, and since Langworthy started the ACA…well…that organization and their beliefs must hold the real flame of chiropractic legitimacy… and the whispers go on.

I will just end this rant by noting that Simpson’s assumption that evidence based practice and subluxation are mutually exclusive does not have any foundation except what is whispered in his carefully chosen references. He misses the important study called How Chiropractors Think and Practice (2003), which shows 88% in North America prefer to keep the term subluxation. He also misses much of the current literature on subluxation and history.

Finally, Simpson uses this tired group of distorted facts to dredge up yet another and another, that somehow philosophical chiropractors and subluxation chiropractors must ALL be following a “dogma” that believes the idea of ONE-CAUSE ONE-CURE and whatever goes with it. For the one cure issue, I refer you to the 2003 study mentioned above, for the worn out use of the term “dogma” in discussing chiropractic and its philosophers, you may just have to take my 12 hour online course, where I go into it in detail. (LAST SHAMELESS PLUG!)

With sincerity,

Dr. Simon Senzon

References

For a fascinating, albeit slanted, view of the interconnections between the CCE, FCLB, NBCE, and the ACA, please read the online pdf version of Moore and Wise’s book, A Report on Chiropractic Politics and Education (1979).

Dr. Senzon’s most recent series of articles published in the Journal of Chiropractic Humanities explicitly address the “legal ploy argument,” and its implications for modern chiropractors, especially in terms of the policies of the GCC and the CCE.

Keith Simpson’s recent article, The Five Eras of Chiropractic was published in the Journal of Chiropractic and Manual Therapies.

To learn more about Tom Morris, please go to the Earliest Philosophers section and click on the Tom Morris page.

To read Cyrus Lerner’s 1952 report on chiropractic’s origins, please click here for the pdf: Lerner Report

Simpson references an article by Keating to support his claims about Morris as “the architect of chiropractic philosophy.” Keating also uses this piece to discuss his opinion on “dogma” in chiropractic.

Seaman’s articles on the “Curse of Chiropractic” are good examples of how this “legal ploy argument” is used to attempt to discredit traditional philosophical concepts in chiropractic. Unfortunately, Seaman chose an obscure passage from Stephenson’s Chiropractic Textbook (1927) to make his point, and it seems that he misquoted Stephenson…

D.D. Palmer’s traveling library is discussed in detail in Dr. Senzon’s books.

  • The impact of Langworthy and the Morikubo case are discussed in: Secret History of Chiropractic
  • The traveling library is published in abridged version in Dr. Senzon’s book: Chiropractic Foundations

To read more about the Dismissivist approach, please read McAulay’s article from the JCH:

To learn more about the GCC’s attempt to dismiss chiropractic philosophy and define the vertebral subluxation as an historical artifact, please see

To explore the latest controversy over the CCE’s new standards please see:

To learn more about Solon Langworthy, please please read Gibbon’s paper: Solon Massey Langworthy: Keeper of the Flame (posted with permission from the Association of Chiropractic History).

How Chiropractors Think and Practice was published as a book but the findings are available online:
New Study Finds Unity in Chiropractic

Finally the ideas of Dogma in chiropractic go along with the spurious claim that subluxation cannot be tested and is somehow mutually exclusive of evidenced base practice.

Dr. Senzon addresses many of these issues in his current series in the JCH on Constructing a Philosophy of Chiropractic:

But nowhere are the issues of dogma, subluxation, worldviews, and the philosophy of chiropractic addressed in more detail than in Dr. Senzon’s new online 12 hour curriculum.

What recent students are saying about Dr. Senzon’s online courses:

  • Dr. Gregg Stern of Stern Chiropractic writes, “It was like a great book you just could not put down!  I don’t know if 2 days is a record but I finished the 12 hrs and look forward to the next 2.”
  • Dr. Jay Komarek of Boulder Sol Chiropractic writes, “”Simon, I want to take a moment to thank you. I am just about to finish your 12 hour program online. I have to say that I did it for CE. That being said, I would do it again just for the joy of it! After 34 years of mostly joyous practice I was uplifted by your program on so many levels…your message stands like a lighthouse pointing a way out. I am greatly appreciative of what you have done.”
  • Dr. Martha Nessler of Innate Expressions writes, “”Simon’s passion for the historical preservation of chiropractic is inspiring and contagious. With his focus on BJ and the journey he traveled as he developed the profession of chiropractic, you are instantly re-connected to your roots. His blend of information and photos allows you to see where chiropractic has been and to realize your role in where it is headed. Simon is brilliant, devoted, and knowledgeable. His dedication to chiropractic’s heritage is what we need to preserve this profession.
    A must do for ALL chiropractors!”
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