"Connecting the Dots on the Dark side"
Sludge's Favorite Quotes Of The Year to Prepare
You For The Coming Millenium

A Special Year End Report
By Dr. Matthew "Scrooge" McCoy

If you've been reading and following along with the events that have been transpiring over the past year or so, you're no doubt fully cognizant there have been some pretty screwed up things going on in the chiropractic political arena. And as you'll see in the following compilation of quotes from the past year and previously, what's happened has ties that go back over the past hundred or so years of our profession.

I have attempted over the past several years through my articles in The Chiropractic Journal and more recently through The Sludge Report to help tie together the political goings on that effect how you and I practice and how seemingly non-related events, people, or organizations really are related. In some cases even working together toward the destruction of chiropractic as we know it.

The use of the internet has allowed us to not sugar coat anything. I don't have the patience for it and there is no time for it. Especially when I see the deliberate attempt by people and groups in our profession to change forever the very fundamental nature of chiropractic. Changes which are sought purely for their own financial gain without regard for future generations of chiropractors or the patients we serve. A conspiracy? No, they really aren't hiding anything. As you read through the following quotes I've gathered to prove my point you must realize that they openly publish this stuff. They lay out their plans for everyone to see. The shame that we must all bear is that given we know what's going on we still allow it. Why?

To summarize what I see happening I'd say that in reality there isn't anything new. It's the same old story that's been going on inside and outside chiropractic for eons. There are forces of entrenched power, which are forces of darkness and greed and fear on this planet and they also exist within our profession. Regardless of the depth of that entrenchment however, these forces do get, at least unconsciously, what a threat the message of empowerment is to the system that now dominates. Truth comes around eventually. It is this truth that keeps me going.

The entrenched power in chiropractic is focusing on beating us into submission, forcing us to swallow a model of chiropractic that relinquishes its heritage, its foundation and its governing philosophy. Through changes in the governance and activities of politically and financially powerful organizations such as the CCE, NBCE, FCLB, ACA, WFC, NCMIC, COCSA, Triad etc., they are little by little attempting to erode the vitalistic basis of subluxation centered chiropractic practice which has existed for over a century. They are doing this through monopolistic attempts at control over accreditation, licensing, education, and even practice. And they spread their propaganda in Stalin like fashion everywhere they go. However, that's all it is: propaganda and rhetoric designed to make the weary in search of leadership fearful enough to follow them.

They cloak their propaganda in silky robes of legitimacy, science and rationality and some of what they say and write is even true. However, for the uninitiated, who are not aware of the underlying motivation of the Dark Side, they inadvertently agree and support a modus operandi that has as its principle goal the subversion of the profession.

I submit to you the following evidence of their campaign to create a new chiropractic. A chiropractic that they offer as promising but which in reality won't be chiropractic at all. It would be the bastard stepchild of a failing paradigm of health and healing. Accepting it would require the chiropractic profession to forsake the principles it was based on only to leave these principles for another group to pick up and place under their own banner. This is because the principles that chiropractic is based on is bigger than the profession itself and these principles, because of their nature, belong to the masses, not to self appointed individuals and groups who don't feel served by traditional chiropractic theory and are driven by a profit motive.

Let's start with a poignant example that gets to the heart of their next stage in tearing up the foundation of the profession. It used to be that subluxation in any way shape or form was disparaged. Over the years they succumbed to some degree and now there are those who will accept the notion of subluxation (and even with a neurological component). What is happening now is a very concerted attempt to divorce vitalism from subluxation and chiropractic. In some ways they are willing to accept a purely mechanistic concept of subluxation but refuse to accept the notion of vitalism playing a role. They maintain it sounds too much like religion. Here's what our esteemed colleagues Dr. Reed Phillips and Dr. Bob Mootz have to say on this topic:

"The chiropractic perspective on health and disease emphasizes two fundamental characteristics: (1) a testable principle suggesting that the structure and condition of the body influences how the body functions and heals and (2) an untestable metaphor that asserts that the mind-body relationship is instrumental in maintaining health and in healing processes." (1)

While they won't go so far as to say there is no mind-body relationship, they proclaim it is "untestable". An interesting comment coming from supposed research and scientifically oriented chiropractors. Are they aware that there are over 300 published studies on the relationship of prayer to healing? My point: anything can be tested. This was Dr. Ralph Boone's point in an article he wrote for JVSR. The only limitation is your imagination and the ability to design the study. Do you think Phillips and Mootz are ignorant of this? I don't. Think they deliberately deny it in the hopes that no one points out the truth and that the average Joe chiropractor goes on thinking that it can't be proven. Rest assured they are banking on their hope that you and I are ignorant enough to submit to this.

Phillips and Mootz shed more light on where they're going in this next paragraph: "On the other hand, chiropractic's fundamental perspective relating to a significant role for body structure in the healing process is more readily defined operationally, and hence can be evaluated with the tools of science. At times, chiropractors have attempted to merge both concepts (the testable principle relating body structure to function and the untestable metaphor asserting the role the mind-body relationship plays in healing) using one concept to rationalize the other (Mootz, 1992, 1995). For example, it is common to find references in the early chiropractic literature that incorporate vitalistic beliefs about how the body self-heals intermingled with conceptually reasonable discussions on physiology and anatomy."

What they're saying is: The only thing that can be seen and felt (scientific) is the biomechanical (structure) aspect of the subluxation. After all, they tell us in the last sentence, don't try and combine "reasonable" discussions of anatomy and physiology with this mind-body crap.

And why not you ask? They answer: "The concept of holism is difficult to approach with scientific methodology; it cannot be measured, tested, or operationally defined. Holism defies current methods of mechanistic determinism and reductionism because it is not finite (Mootz, 1995)."

This statement reveals a deep-seated ignorance since, if what they say were true, then why not study holism using non-mechanistic methodology? Remember folks, they don't want a solution to this, and their own ridiculous statements bear this out.

The next comment by Phillips and Mootz is difficult for me to decipher because they are making a big assumption: "A complete reliance on a holistic universal intelligence entails dogma and is not acceptable in current chiropractic philosophy or practice (Phillips, 1992). Although untestable scientifically, the concepts proposed by chiropractic's metaphor (and holistic models in general) can still be subject to critical review and refinement (Milus, 1995)."

Complete reliance on Universal Intelligence for what? And let's thank the good doctors for telling the rest of us what is "acceptable" and what is not. I'm waiting for them to tell us to go to our rooms without supper.

Their next paragraph shows us where they were going with this: "The terms "straight" and "mixer" were used by early chiropractors to distinguish between chiropractors whose therapeutic armamentaria included only manual adjusting and those who also used other therapies such as nutritional and lifestyle counseling or physiotherapeutic modalities. Historically, chiropractic schools would affiliate with a particular national professional association that gravitated toward a "straight" or "mixer" perspective. Although there are still remnants of this dichotomy, the situation has changed with the advent of federally recognized accreditation, research consortia, and more collaborative political agendas.

Ever read 1984 by Orwell? Back is white, white is black. "remnants of this dichotomy"? As you'll soon see, and actually already know, the straight/mixer debate is far from dead and buried. The idea that there are only "remnants" speaks to the extent to which they think you and I are asleep at the switch. Only "early" chiropractors used the term? Dr. Phillips, in his own articles this year discusses straight and mixer as alive and well. Why they lyin' to the government?

Maybe this will shed some light. They go on: "There are two significant, well-established national chiropractic trade associations. The largest is the American Chiropractic Association (ACA), which is believed to include about 25 percent of chiropractors in the United States as members. The ACA (and its precursor organization the National Chiropractic Association) has historically been associated with a broad-scope approach to chiropractic practice and appears to be most representative of the mainstream of the profession."

Really? According to an article in Dynamic Chiropractic the World Federation of Chiropractic reports that combined membership of the ACA and ICA is 16,000. This represents less than 16 percent of the chiropractors in the U.S. So the ACA numbers Phillips and Mootz told the government are a little skewed. Again, why they stretching the facts to the government?

Then for them to go on and proclaim that the ACA is "most representative of the mainstream of the profession" is incredible. I just about had an aneurysm when I read that. For guys who are always talking about research, evidence, proof etc they sure do throw around a lot of statistical scat.

And they don't stop there: The International Chiropractors Association (ICA) is primarily a U.S.-based alternative to the ACA and has a much smaller membership (believed to count between 5-10 percent of chiropractors among its dues-paying members). The ICA tends to position itself as representative of members with more traditional chiropractic perspectives."

Guess they needed a little ICA bashing to go along with the rest of the fish stories to the government. Notice that they relegate the ICA to being "alternative" to the ACA. Hey guys let me ask you a question: how do you get your big ego filled heads through your front doors anyway? The ICA doesn't "tend" to position itself as representative of traditional perspectives. It states that it is, in fact, unequivocally representative of traditional perspectives. Phillips and Mootz throw that in because based on the other things they wrote the reader is then led to think that the ICA represents the uneducated, anti-scientific innate cultists of chiropractic. ICA members ought to be storming the castle, not turning the other cheek.

And far be it for Phillips and Mootz to leave this out: A few other national groups identify with more extreme perspectives. The National Association of Chiropractic Medicine (NACM) supports limiting chiropractors to only the treatment of certain musculoskeletal conditions, while the World Chiropractic Alliance (WCA) promotes addressing only a single chiropractic spinal lesion, the vertebral subluxation."

Smooth move on their part to clump the WCA into the "extreme perspective" along with NACM. As if it were shameful to promote subluxation based chiropractic. Just tell the government they are both extremists. And why portray WCA in such a manner? Obviously if it weren't for WCA none of us would know much of anything that these guys have been doing behind our backs over the years.

What I don't understand is why Phillips et al doesn't embrace NACM. Phillips just started his Academy of Chiropractic Physicians (more on this later). I'd love to know what the difference is between these groups? Although I must say I thought it was interesting that a spokesman for NACM couldn't tell me what homeostasis was recently.

Oh, I almost forgot to tell you where they published this trash. This was produced by a grant from the AHCPR (so you and I paid them to be less than intellectually honest, insult our intelligence, denigrate our profession and insult the ICA and WCA). The document is titled: Chiropractic in the United States: Training, Practice, and Research. And go round up the usual suspects 'cause here's a list of the Editors and contributors to this wonderful document: Daniel C. Cherkin, Ph.D., Robert D. Mootz, DC, Alan H. Adams, DC, Ian D. Coulter, Ph.D., Cheryl Hawk, DC, Ph.D., Gail A. Jensen, Ph.D., William C. Meeker, DC, MPH, Reed B. Phillips, DC, Ph.D., Ruth Sandefur, DC, Ph.D., Paul G. Shekelle, MD, Ph.D., Howard T. Vernon, DC.

Dr. Phillip's comments should come as no surprise to us. He's been writing a lot about the antiscientific, innatist, subluxation chasers. In a recent article in Dynamic Chiropractic titled: The Power of Perspective: The Education of the Profession's Next Generation he writes: "Exactly what is being taught at chiropractic colleges? The standards established by the Council on Chiropractic Education (CCE) have set the parameters or guidelines for the curriculum. However, the mission of the institution may influence the interpretation and application of these standards." (2)

Oh yeah, Dr. Phillips as VP of the ACC is not content with the fact that the CCE has monopolistic control over chiropractic education. Now he wants to ensure that each institution's mission is in line with how he perceives chiropractic to be. And just how does he and LACC perceive chiropractic?

"LACC remains grounded in the academic disciplines of the sciences and encourages intellectual inquiry as part of the educational program."

I suppose, according to his own words then, that Dr. Phillip's school doesn't feel that you must have an underlying philosophy that grounds you. It is science which grounds you and any school that doesn't do the same must not be encouraging "intellectual inquiry." Not just a buncha dolts sittin' 'round talkin' phlosphy at dem udder schools, eh, Dr. Phillips?

Thankfully the esteemed president of LACC tries to help us to understand why we sin: "This being the case, what is it we do at our institutions that causes us to be labeled as scientifically based or philosophically-based? Why do we label those who pursue research as "medical" as if "medicine" and "science" were equivalent that "chiropractic" and "science" were not? Could it be our religious zeal or lack thereof? Could it be our aversion to increased educational standards or the embracing of such?"

When Dr. Phillips wrote this I responded with a letter to the editor of Dynamic Chiropractic. Needless to say it wasn't published. I pointed out that there exists a field of study known as the Philosophy of Science and that you can't have science without a philosophy. Don't you think its strange the President of an educational institution that shouts how "scientific" they are doesn't know that? I also asked who in our profession equates research with medicine and who promotes that chiropractic and science were not equivalent. No answer. No answer because there isn't an answer. He doesn't want an answer. He wants the profession and others to believe that the "straight" chiropractors say these things. He paints with a broad brush to further his agenda.

Phillips goes on to further denigrate the subluxation based segment of the profession: "I would hope that a student seeking a strictly philosophical approach to chiropractic education would find, from the materials published, which school may be the best selection. Conversely, the student seeking a strong scientific-based chiropractic education complemented by philosophy would also find from the promotional materials presented that we, along with certain other schools, would be a more appropriate choice."

This was the most profoundly revealing statement Phillips has made. Based on what he wrote and the words on the paper we have to conclude that he really thinks that there are schools who teach only a "philosophical approach to chiropractic". "Strictly" means strictly. Notice how he twists the words to imply that the subluxation based schools are filled with anti-scientific, philosophical nuts as compared to the "strong scientific based" educators in schools like his. Its revealing because he either knows that science is taught and encouraged at all the schools and is lying or he doesn't know what the other schools are teaching. I don't know which scenario is worse.

And in an expected militaristic manner he goes on to demand: "I charge the ACC with the responsibility to provide the vehicle whereby all chiropractic educational programs can be clearly defined per their mission and their emphasis on philosophy, scientific reasoning and rational thinking."

What does he expect is going to happen? One of the schools is going to come out and say: "we don't emphasize philosophy, scientific reasoning or rational thinking". Bizarre.

Phillips suspicion and paranoia of subluxation centered chiropractic is evidenced by theses quotes in an article he wrote for Dynamic Chiropractic last year: (3)

"B.J. also created a National Board of Chiropractic Examiners (NBCE, not the same NBCE as today) at the 1921 lyceum in Davenport in an effort to inspect the chiropractic colleges to ensure compliance with straight chiropractic guidelines. Between the influence of the NBCE, the International Association of Colleges and Schools of Chiropractic (IACSC), the UCA and the 11 state boards of chiropractic examiners, B.J. sought to drive the "mixers" from the profession and control legislation and licensing."

Convenient that Phillips chooses to portray BJ's attempts at stopping the profession's drive into medicine as "controlling legislation and licensing". He goes on in the next two paragraphs to paint the "straight" chiropractors as anti-intellectuals, anti-scientific and anti-education: "Broad-scope and disaffected straight practitioners responded by forming the American Chiropractic Association (ACA -- not the same ACA of today) in 1922. The ACA raised the standard for chiropractic education above the Palmer minimum, organized a research bureau and sought independence from the influence of the "schools" by not allowing any officer in the ACA to be a member of any college faculty."

"B.J. opposed raising educational standards above the curriculum set by the Palmer School. He argued that expanded education would not produce better chiropractors and would prevent many (of the less educated) from entering the profession. In fact, he preferred to do away with any education beyond what was defined by him as "chiropractic." He used his political influence to create a federation of colleges, a national examining board, a national association and a collective of state licensing boards to prevent the profession from lifting standards above his mandated maximum."

Dr. Phillips in a 1994 article in Dynamic Chiropractic titled; The Bumble Bee Quandary, wrote the following: (4) "So often we are confronted with dichotomies of description in chiropractic such as "straights and mixers" or "subluxation based vs. disease based" chiropractors. In actuality, the dichotomy is not so well defined and our variations as a profession extend over a continuum with poorly demarcated intermediate boundaries. At LACC, we have latched onto a phrase that describes where our philosophical perspective fits into this continuum differentiation."

I guess he changed his mind about the dichotomy this past year when he wrote about "Subluxation based chiropractic" and "Condition based chiropractic". But I'll save that one for later.

The phrase LACC has "latched onto"?

"Our approach at LACC as articulated by Dr. Al Adams: Evidence based, health oriented, patient centered care. As opposed to the other end of the continuum: Belief based, subluxation oriented, doctor centered care."

Once again Dr. Phillips wastes no time insulting the intelligence of the subluxation based chiropractor and denigrating him/her at the same time. In his mind, and he wants this in your mind too, subluxation based care cannot be evidenced based or patient centered. How could his Board of Regents allow him to make such a stupid statement. I'm embarrassed for him. Also, how is LACC's approach "heath oriented" if it is "condition based"? I have a suggestion for Dr. Phillips. Change it to: "Anti-vitalistic, scientism based, disease oriented, patient centered around the condition, care".

Further on in his article Dr. Phillips gets to the meat of the matter: "An inadequate explanation of a physical phenomenon such as the flight of the bumblebee is hardly justification for the castigation of the perpetrators of the scientific method. Such a verbal display of impunity insinuates ignorance."

Phillip's insult is directed at Dr. Sid Williams who had recently defended chiropractic in a trashy anti-chiropractic article. The author was maintaining that chiropractic theory hadn't been proven by science. Dr. Williams pointed out that scientists also haven't figured out how bumble bees fly.

Phillips continues: "If chiropractic is a religion, a faith-based approach that disdains science as inadequate or too complex, is acceptable. If chiropractic desires a seat at the table of health care in this reductionistic, mechanistic, scientifically driven society of managed health care, a faith based religious context is unacceptable. Acceptability is predicated on accountability and accountability is evidence based."

Bravo! Finally the bottom line: Money. So, in order for us to eat with the big boys we should go against the non-linear models of health care which chiropractic is based on. Not only that but it is what all other health care professions are moving towards. Further still Phillips would have us bow down to the anti-Copernican propaganda of the "scientifically driven" Managed Health Care Industry. If Phillips thinks managed health care is driven by science then he is ignorant beyond belief. The only acceptability that is offered by managed health care to ANY health care provider is predicated on being accountable to the bottom line, not what is best for the patient. The question to ask is: What is the quality of the evidence?

And on that topic Dr. Phillips remains silent. In the November 30th issue of Dynamic Chiropractic Phillips wrote an article titled Analysis of the Diagnosis (5) stating that there was more evidence to support his whole body diagnosis and treatment based approach to chiropractic than there was supporting the subluxation based approach to care: "So where does this leave us? Both the subluxation-based and the condition-based chiropractic approach will argue that they are patient-centered. What they are doing is improving the patient's health. Both will argue that their methods of diagnosis or analysis are rigorous and demanding; that thorough training is essential to be competent. Both believe they are rendering a needed service and can cite numerous examples of success in the application of their services. Scientific support leans more to the condition-based approach primarily because of the long-standing relationship with traditional medical care. Furthermore, the subluxation-based approach suffers from multiple definitions and a short history of developing reliable detection methodologies.

No references and no evidence were offered to back up his ridiculous opinion. And when challenged by my evidence supporting a subluxation based approach in a rebuttal article I wrote for The Chiropractic Journal titled Lies our Leaders Tell Us (6) he still offered no evidence, just a boo-hoo letter to the editor letting us know his feathers were ruffled. Amazingly when challenged as to where he got his information about the evidence on subluxation and condition based approaches, he did admit: "I did indeed offer 'my opinion' regarding the amount of evidence supporting the two approaches to care. I have not attempted to conduct an elaborate study to determine where the weighty part of the evidence lies." (7)

I couldn't make this stuff up. Later in his article he contradicts his dichotomy stance once again: "The practice of chiropractic covers a wide spectrum. At the two ends of this spectrum are the two approaches to diagnosis previously described. If we are a mature profession dedicated to the health and well-being of our patients (the public), then it is imperative that we define ourselves as what we really are. We need to recognize that there are two kinds of chiropractors who have different objectives in their approach to patient care."

Duh. Took him all this time to figure that one out? A few years ago Phillips figured he'd trash on Stephenson and give us all a philosophy lesson. See if you pick up on the common theme in all his writings: (8) "Impingement, we are taught, is the result of subluxation which is defined by Stephenson: '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.'

"From an untestable premise, Stephenson moves quickly to a description of a mechanistic anatomical finding, a subluxation whose existence should be deductively measured but whose purpose remains beyond the scrutiny of scientific inquiry, interference with the transmission of mental impulses. Thus the sanctity of the Major Premise remains impervious to the rigors of critical inquiry. That the subluxation exists is held to be unquestionable. The effect or meaning of the subluxations existence remains clouded in metaphysical rhetoric "

Not to be outdone Dr. David Seaman of subluxation/nutrition/neurology fame doesn't even think we have a philosophical foundation even worthy of speaking about: (9) "It is my perception that the chiropractic profession and the 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."

"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."

Dr. Seaman thankfully points us uncritical mystics in the right direction: "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."

"In their words, according to most chiropractors, so called chiropractic philosophy constitutes a type of religion or metaphysical theology."

"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 chiropractors."

Echoing Phillips views about science and philosophy is Dr. Jeffrey Schneider in an article appearing in the Journal of Chiropractic Humanities titled Ethical and Legal Considerations of providing Chiropractic Treatment in Medical Facilities: (10) "Some colleges are very "philosophy" oriented, teaching Palmer's theories and encouraging manipulation for the treatment of organic conditions, while other colleges teach a more "scientific" approach, emphasizing the use of manipulation for primarily musculoskeletal conditions."

You see. If you stick to manipulating people for back pain you can call yourself scientific. If ya go 'round talkin' 'bout the fish monger, Palmer, you are an anti-scientific philosopher with your head in the clouds.

Perhaps the most disconcerting writings echoing this drivel comes from Andries Kleynhans who presented the following at a meeting of the WFC in Manila last year: (11) "It is further argued, that even within the closely knit culture of chiropractic, as a result of different life patterns such as those associated with a straight chiropractic practice as compared with a mixed practice (utilizing multiple modalities of therapeutic intervention) the necessary conditions exist for cultural multiplicity and pluralism to prevail."

"As an example, it is argued that while both of the major sub-cultures of chiropractic presumably accept the notions of homeostasis and hence the superseded, historico-philosophical expression of innate intelligence, it is interesting that one subculture, following the BJ palmer school of thought, attributed more to the concept of innate intelligence than mere homeostasis and brought a religious notion of mental rather than nerve impulses into the consideration of mechanisms for the maintenance of homeostasis. However this is a philosophico-chiropractic concept which decades ago was assigned to historical chiropractic, especially by scholars from the Canadian Memorial Chiropractic College."

So get with the program you ignorant chiropractors. The "scholars" from CMCC already decided that Innate Intelligence should be relegated to the history books! Let it go already you innatist swine! But wait, lets listen in as Kleynhans insults BJ Palmer: "A number of historical terms used in chiropractic had the seeds of a scientific foundation for chiropractic and can be readily explained, to a greater or lesser extent, in scientific terms. Most of these, while extensively used by DD Palmer, were over looked by BJ Palmer, who, it is argued, engaged in oversimplification of a rather complex phenomenon, at the same time making it appealing to large groups."

Now in the next paragraph professor Kleynhans tells us how to escape from the ruin of our dogmatic, innatist, subluxation-chasing ways: "Public education, improved diagnostic skills, a clear scope of practice, higher education requisites for admissions to chiropractic colleges, licensing and practice, careful monitoring of the growing number of chiropractors, a closer connection with the scientific establishment, improved relations with medical and other health professions and a positive and clear message to the public about chiropractic's role in the treatment of spine related pain are all components in the continued success of this discipline."

So Kleynhans would have us get more education, stick to spine related pain, work more with the MD's, raise the licensing standards and for gods sake, man, monitor these inept chiropractors like a hawk!

Next, Kleynhans lets us know he's been talking to Phillips et al: "It is argued that the way in which the historical chiropractic symbol of innate intelligence is interpreted has played a major role in the development of the two main chiropractic sub-cultures."

"One group takes a scientific approach to clinical practice built on knowledge and understanding of the mechanism of homeostasis (even though it would be presumptuous to suggest that all or most is understood about homeostasis) and bases their therapeutic intervention on evidence, thereby improving their capacity to reproduce successful clinical interventions which are based on an evolving rationale."

"At the other extreme are some persons who rely on the innate intelligence of the body associated with the transmission of mental impulses between brain cell and tissue cell and could therefore be perceived by the community to engage in religious practice with an emphasis on belief rather than clinical rationale and would consequently have great difficulty in engaging in evidence based chiropractic practice - a requirement of the society in our age. This same group, while most certainly interested in research which validates the results of chiropractic practice and even the neurophysiological principles of its practice do, however, by overemphasis on the theistic symbols associated with innate intelligence, create a milieu which is not conducive to scientific inquiry or obtaining evidence about what is done in chiropractic or how it works - the very fundamental requirements which are set by society in the Western culture of which we are part and in which chiropractic has its roots."

The following statement by Kleynhans was also presented at the WFC Conference in Manila: (12) "A great deal of work lies ahead, however, to define clearly what a future 'standard' international chiropractic curriculum should include - a task which could be fruitfully coordinated by the World Federation of Chiropractic."

I won't go into detail here about the WFC (see related story in this issue of Sludge) but just keep in mind the "international" standard these guys are speaking of and the history and make-up of the WFC.

Are you getting the emerging theme of these guys? And so I don't appear chauvinistic, let's get a woman's opinion in here to show that anti-subluxation and innate hate is not gender biased. According to Dr. Karen Shields Wright in an article titled: Why Hold a 'Belief' in the 33 Chiropractic Principles? A Reflection on the Human Condition: (13) "Chiropractic philosophy is not philosophy in the classical sense. It is a set of ideas that has come down through our history. For some it has become dogma. The committed view of these principles is sometimes regarded as having religious or cult status, but chiropractic philosophy is not a religion, nor does belief in the principles make one a cultist. Any belief when taken to excess, of course, can produce zealots and dogmatism."

"I have not written this reflection to debate what chiropractic philosophy is. My concern is with some of the reasons why a chiropractor would hold views (beliefs) that are against scientific thinking and possibly antithetical, or at least confusing, to the chiropractor's own religious doctrines."

"My personal observations of why a minority of chiropractors would continue to force the debate to accept only the 33 chiropractic principles as the foundation of ethical practice and the ultimate philosophical grounding can be found in our most basic human needs: how we all share in a quest for belonging and a childlike desire for simplistic answers."

Where do these people hang out? Where do they get the impression that a chiropractor who acknowledges the 33 principles as representing a piece of the chiropractic philosophy puzzle accepts that "only"? And how dare she equate those who acknowledge the truthfulness of these principles as simpletons and children. And what study did she do to find out that its a "minority" of chiropractors. Note how so many of those who write about these issues are careful to use words indicating that the numbers of chiropractors that adhere to these ideas are small. If they are so small why expend so much energy and effort writing about them?

Dr. Joseph Donahue sheds some light on this in an article he wrote for Philosophical Constructs titled: The Trouble With Innate and the Trouble That Causes: (14) "Despite these efforts, the concept of II (Innate Intelligence) may even be gaining acceptance among chiropractors. Possibly as many as 80 percent of chiropractors subscribe to some version of it."

So despite Donahue's assertion, Wright contends the innatists are a "minority" and then she goes on to tell us we are emotionally insecure and so intellectually inept that we are uncritical (where'd we hear that before?): "Steadfast belief in these principles can be satisfying cognitively (for the uncritical) and emotionally (for the insecure), yet the principles seem to hold little truth for the majority. For those who hold to these principles, they are universal doctrines written for all time and for all circumstances. They appear to satisfy the need of a common vision."

"I have noticed that the doctors who use these principles as their intent to practice (i.e.,"principled chiropractors"), assume a kind of moral superiority. Labeling oneself a "principled chiropractor" can satisfy one's need to be recognized as a special doctor and to build an identity beyond oneself. It can enhance self-esteem and affirm one's actions. Belief in these principles can also satisfy one's search for wholeness and can even give doctors the sense of their place in society that offers a new model of the professional relationship: the universal priest-healer versus the common lay-provider. Uncritical belief in these principles can satisfy the search for cultural identity and security. I feel this is a major factor in holding so intensely to these principles, especially in light of the continuing dissociation we experience from the health care community because of those principles."

"Belief in innate intelligence as something more than a philosophical concept can satisfy one's search for the transcendent. For those who are put off by traditional religions, it can even satisfy one's spiritual needs and become the final answer to the ultimate cause and meaning of life. The answers to the ultimate questions of life can be answered via the removal of the subluxation. The adjustment becomes sacred. It becomes a way of personal freedom for the patient and a point of validation for the provider."

"These principles are presented as a clear set of answers even though they are not complete in and of themselves. Holding dogmatically to such beliefs needs a commitment that suppresses the natural inclination to question. This commitment requires continuing affirmation and guidance through a leadership that is highly charismatic."

Lets examine this a little since this is the crux of the debate these boys (and girls) use to put us anti-scientific religious cultists in our place. What Phillips, Mootz, Seaman, Kleynhans, Wright and the rest of them attempt to do, is equate mental impulse, innate and the 33 principles with religion and or a metaphorical premise that can't be studied. The problem is that they didn't do their homework. Or they did and again are just lying to serve their own self-interests.

BJ Palmer himself wrote: "My Innate Intelligence is not God…" (15). Furthermore according to Dr. Christopher Kent: "It is clear that the mental impulse, as described by the Palmers, is not synonymous with Innate Intelligence or the neurochemical action potential. It is a 'thought', which may be expressed through a variety of neurobiological mechanisms. These mechanisms include synaptic and non-synaptic processes" (16)

Modern day terminology to describe what the Palmers and Stephenson referred to as "mental impulse" includes such processes as: volume transmission, ephapsis, field effects, peptide messengers and even axoplasmic flow. Related to these topics is DD Palmer's concept of tone: (17) "Life is the expression of tone. In that sentence is the basic principle of chiropractic. Tone is the normal degree of nerve tension. Tone is expressed in functions by the normal elasticity, activity, strength and excitability of the various organs, as observed in a state of health. Consequently, the cause of disease is any variation in tone - nerves too tense or too slack."

Unfortunately for Phillips and his buddies, Palmer's idea of "tone" finds its modern day counter part in the concept of "tensegrity" (18): Tensegrity is maintained in: "A system that stabilizes itself mechanically because of the way tensional and compressive forces are distributed and balanced within the structure."

"Remarkably, tensegrity may even explain how all (these) phenomena are so perfectly coordinated in a living creature."

"Transmission of tension through a tensegrity array means to distribute forces to all interconnected elements and at the same time to couple or 'tune' the whole system mechanically as one."

As for the 33 Principles I refer Dr. Wright to the basics of quantum physics where she will find the corollaries of Stephenson's writings.

And because the truth about chiropractic is just too much for Dr. Phillips and his cohorts it appears they recently decided to join the ranks of NACM and other "extremist" groups within chiropractic and form a medically oriented organization to serve their needs (19). Dr. Phillips is a member and spokesperson for the newly formed Academy of Chiropractic Physicians. Phillips had this to say about the formation of the organization: "Doctors of chiropractic, and those closely associated with this science, realize there are at least two major philosophies of chiropractic: straight chiropractic, and health care that incorporates a broader view of what chiropractic physicians can and should provide their patients. The Academy's purpose is to unite those who embrace the latter philosophy and support their interests, concerns and needs across the country."

Note once again the authoritarian view held by Phillips and this group. Not only do they feel chiropractors can provide a broader diagnostic and treatment approach but they insist it is what we "should" do.

"The public, government officials and health care organizations have been confused for too long about the different chiropractic philosophies that exist in today's health care culture. With the development of the Academy, we are confident that all who seek chiropractic care, especially for their primary health care needs, will now have the knowledge to make decisions in their best interests. This is a group that will be bonded in a universal belief that our doctors of chiropractic provide care using a wide variety of treatment measures which are clinically indicated, and who reject the concept of a single cause or cure for ailments."

Somebody should have proofread his statement. Notice that he writes that this group is "bonded by a universal belief". Sounds like religious zealotry to me! And to take his reasoning one step further he is ignoring all the literature that's been written by the profession itself on how we will never be considered truly "primary care" unless and until we incorporate the use of drugs, minor surgery and immunization into our practices. Phillips maintains that while he respects those in the profession who want to incorporate drugs into their practice that is not the goal of this group. And since we've seen the honesty with which Reed operates we can trust him on that, can't we?

Enough about Dr. Phillips. Lets take a look at his co-author on this chapter about Chiropractic Belief Systems and see where he's coming from. According to Dr. Bob Mootz (20): "Another word used in chiropractic that means other things to some is 'subluxation'. Oh, I know we add all kinds of clarifying elements like "vertebral" and "complex" to try and communicate our perspective that it has something to do with function of the nervous system, but to everyone else it usually just implies a teeny alignment problem".

Tell that to your patients tomorrow: "You see Mrs. Jones you have this "teeny alignment problem" No biggie. More vintage Mootz: "When you consider the difficulty the chiropractic profession itself has had with it over the years, its no wonder that everyone else doesn't get it right the first time either. I like the term, particularly the concept of it as a model of 'spinal lesion' of sorts we can adjust. But I'm not sure I like it as a diagnosis per se, because everyone seems to have it (or someone's definition of it) regardless of their observable health status."

I am not sure I like Dr. Mootz per se. If a condition is pandemic, it doesn't exist? I guess dentists should abandon the concept of periodontal disease, since 80% of people over 40 have it, and there are differences of opinion regarding how to treat it. And finally the true colors come out: "I would also recommend caution in using it as a means to convey some kind of vague chiropractic uniqueness or way of life. It's not that I don't support holism, chiropractors as primary care givers, the use of adjustments as part of a healthy lifestyle, wellness, prevention, and all of that. I do -- very strongly. But I think we should be careful not to isolate ourselves from the overall health care system simply because our unique syntax means so many different things to different people."

Harmless ramblings of a solitary chiropractor you might say? Hardly. Mootz is the Associate Medical Director for Labor and Industries in the State of Washington. We did a story on an IME doc who used these very quotes to substantiate his claims of malpractice and insurance fraud against a chiropractor whose care he was reviewing. Mootz is also one of the Mercy boys in case you forgot, and he is Editor of Topics in Clinical Chiropractic. Better known as "Topics in how to cater to managed care". Topics in Clinical Chiropractic is published by Aspen. Remember them? They also published Mercy and word has it that they are going to be financial backers of Mercy II. Now that you know who employs Mootz' and a little of his background, it shouldn't come as any surprise why he takes the stance he does. And don't take my word for it, you can get it straight from the horse's mouth (21): "This is not a medical versus chiropractic philosophy issue. This is not a case of medical ostracism toward chiropractic. It is not a matter of wellness-centered, subluxation-based chiropractic against the allopathic medical model of disease. Quite simply this is a straightforward case of consumer driven, market-centered economics."

Sickening, isn't it? How about this (22): "Myth: Managed care will destroy the chiropractic profession. Fat chance. No one loves managed care (except maybe for some executives or stockholders of MCO's), but it's nothing more than a private sector response to market forces. U.S. health care costs now account for 1/6 of our gross national product, up from about 1/20th in 1970! That is a really, really big deal. The idea behind managed care is to make doctors share in the financial risk so they won't order unnecessary tests and perform unnecessary treatment."

If these aren't the ramblings of an insurance industry (and labor and industries insurance) lap dog I don't know what is.

What about another contributor to this AHCPR document, Dr. William Meeker. What's he got to say (23)?: "What PPO's and other managed care organizations want to deliver is value. Value is defined as quality divided by cost. The AAPPO wanted me discuss the integration of chiropractic into managed care, should it be done, and how could it be done."

Do all these people spend their time figuring out how to help managed care contain chiropractic or what? Meeker continues: "The AHCPR guideline on acute low back pain is a good example how health services research can support the chiropractic profession."

The AHCPR low back guideline didn't say two words about chiropractic. It said that manipulation is OK for acute pain of a non-radiating quality. The connection to chiropractic was made by the public and others who are aware that chiropractors manipulate. Yes, we did make lemonade out of it, but contrary to Meeker' assertion the AHCPR Guideline is an example of how two chiropractors who sat on the panel could sell out their profession. Meeker continues to educate us: "Basically, both audiences think that at least the four following integration issues must be considered: 1) the nature of patient access to chiropractic providers (i.e., the gatekeeper problem); 2) credentialing; 3) the quality assurance process, and 4) utilization management."

Ah, there's the rub "Utilization management". And Dr. Meeker is more than happy to provide guidelines on utilization management via the Mercy Guidelines which he so conveniently got added to the National Guideline Clearinghouse of the AHCPR. In a letter to William Meeker D.C. Director of Research, Palmer College of Chiropractic Anne Eder M.D., Ph.D. and Vivian Coates of ECRI write (24):

Dear Dr. Meeker, "Thank you for your assistance in preparing the Mercy guidelines for presentation in the National Guideline Clearinghouse (NGC)"

"Thank you for your careful review of this material. The content will not be released to appear on the NGC's web site until you verify its accuracy."

Oh yes. A thousand thank yous to Dr. Meeker. Palmer should give him a raise and the ACA should honor him as chiropractor of the Millenium. More insights from Meeker: "The important thing to note about our new visibility with these two new audiences is our increased risk. The risk to which I refer is the one whereby a few bad examples of chiropractic care can result in the total collapse of any opportunities inherent in the new visibility. Both audiences were aware of negative publicity concerning chiropractic, and many had false perceptions about the teachings of chiropractic. The point is that increased professional visibility must be supported by a growing sense of professional and personal responsibility by individual chiropractors and their organizations. Chiropractic simply cannot afford to be tarnished by embarrassing chiropractors, or by embarrassing chiropractic organizations."

I'd love to know Meeker's definition of an embarrassing chiropractor or an embarrassing chiropractic organization. I guess he doesn't consider it embarrassing that he personally saw to it that the Mercy document was put on AHCPR's web site despite the fact that every credible organization in chiropractic denounced it. Somebody needs to knock these guys off their high horses. Subluxation based chiropractors beware since Dr. Meeker has some concerns about the state of the subluxation theory (25): "The truth is that subluxation is a concept in need of operational definition, description, explanation and predictability. That defines good theory. Read any of the excellent textbooks written by chiropractors on subluxation, and they all say the same thing. Good theories are always subject to refinement and evolution as more is learned."

As you might recall if you read the articles regarding the nonsense that went on at the Research Agenda Conference this past summer the subluxation theory isn't serving our researchers any more according to this group. Try as they might have to take back what they said there was too much collaboration from too many respected people who all heard the same thing. Worse still is that they tried to deny it even after they put pen to paper. Maybe they were taking a cue from Clinton. "I did not say that subluxation should be abandoned" as they shake their finger in your face.

Again, don't take my word for it, just read what Anthony Rosner, Director of Research at the Foundation for Chiropractic Education and Research, had to say about the Research Agenda Conference and the subluxation theory (26): "Subluxation may be a useful and possibly defining concept of chiropractic, but it is premature to accept it as a clinical reality. One must be both prepared and willing to modify (and possibly relinquish) it as a model should it become incompatible with new evidence as it becomes available."

As I said in my rebuttal article to all you subluxation chasers: take heed from Dr. Rosner that the thing you are adjusting in your patients every day is not a clinical reality!

Well, Dr. Rosner couldn't leave well enough alone. He had to respond (27): "Only when one describes the subluxation as a fully defined anatomical lesion (equivalent, for instance, to an aneurysm) does one get into trouble. At this stage, the lesion appears to be not fully defined; rather, the subluxation is a concept put forward to encompass what we believe are the successes of chiropractic health care, compared to the disease-oriented concepts, which lie at the epicenter of current models of allopathic medicine."

Got that? It is not a "fully defined anatomical lesion". How many subluxations has Dr. Rosner analyzed and managed? Contrary to Rosner's assertion, the subluxation is indeed an anatomical lesion and it is defined enough that we have outcome assessment tools that can be used to quantify and qualify it. We can indeed characterize its various components and judge its severity as well as monitor its reduction under chiropractic care. I'm sorry if these people are not aware of the literature regarding the epidemiology of subluxation but until they do some reading they should refrain from commenting.

Rosner didn't stop there: "Should our future research continue to contradict or violate the principles of subluxation as we envision them, then the model (like any scientific theory) should be modified further or discarded. Given the facts that: I: Subluxations cannot be defined by x-rays or other imaging procedures; II: Interexaminer reliability of identifying motion or end feel restriction at specific segmental levels has been recently shown to vary from good to poor; and III: Both animal models and more circumstantial observations in humans provide the best current evidence linking spinal derangements with pain and/or dysfunction.

I addressed Rosner's absurd comments in detail in the last issue of Sludge and I refer you to that article for commentary. And finally Rosner provides a link to Phillips, Mootz et al: "We should not find it much of an imposition if we were to insert the word "presumed" in front of our current descriptions of phenomena involving the "S" word. In even the worst case scenario (in which traditional research designs fail to support the subluxation model), it may be that subluxation may be more effective - as Palmer himself suggested a century ago - as a metaphor than as a testable theory."

"Like Freud's evolving concept of the unconscious, subluxation has required (and will likely continue to require) many transformations and modifications prior to its emergence into a new branch of medicine."

Notice Rosner's revealing choice of words: "new branch of medicine". Makes my spine tingle. And what about tools to characterize the subluxation? What do the folks directing our research agenda say about that? Dr. Ed Owens sheds light on this topic when he tells of his experience at the first meeting of these nudniks (28): "The researchers seemed to be of the opinion that investigation of subluxation measures was a dead end and that no research using such measures would never receive serious consideration for funding"

Truth is, they don't want to measure it. If you can measure it, it exists. And if it exists it can be managed and if it can be managed then insurance companies have to pay for that. Better to stick to pain and symptoms. Twelve visits at 30 bucks a shot, no payment for x-rays and no technology. $360 a year. Sportelli can sell that to insurance companies. You catching on yet? If not I demand you go back to the first issue of Sludge and read each article in order.

What does it matter anyway since according to Dr. Craig Nelson, another presenter at the RAC, chiropractic theory has already failed. His presentation: "The Failure of Chiropractic Theory".

Another contributing author to the AHCPR tome and participant in the Research Agenda Conference Dr. Cheryl Hawk has this to say about our profession in an article titled Chiropractic: More than Manipulation (29): "If chiropractic is a complete system of health care, then it must have more to offer than the procedure of spinal manipulation."

"However, chiropractors believe that the chiropractic adjustment has a specific corrective effect on an area of spinal dysfunction (the subluxation). Although this lesion and the effects of its correction have yet to be well documented through rigorous investigations… " Affecting people's lives through the analysis of subluxation and its correction through adjustment just isn't enough for some of our peers. We need more they proclaim. But one of Dr. Hawk's co-contributors on the AHCPR document disagrees with her. In an article in the New England Journal of Medicine Dr. Paul Shekelle had this to say (30): "There is a debate, both within the chiropractic profession and outside of it, about whether chiropractic should be considered a nonsurgical musculoskeletal specialty or a broadly based alternative to medicine." "Because these data on direct costs are compatible with observational data I conclude that chiropractic care for low back pain, at least as practiced in the United States, costs more than the usual supportive medical care delivered by health maintenance organizations. Whether the small symptomatic benefit and the enhanced satisfaction of patients, as consistently reported by studies of patients treated by chiropractors, are worth this cost is debatable."

"I think it is currently inappropriate to consider chiropractic as a broad based alternative to traditional medical care. However, for some musculoskeletal conditions chiropractic care does provide some benefit to some patients. The challenge for chiropractors is to demonstrate that they can achieve this benefit at a cost that patients or health insurers are willing to bear."

Got that everyone: "inappropriate". Stick to acute low back pain of a non-radiating nature and shut the hell up. You cost too much anyway. Drugging these people is cheaper for managed care plans. And chances are they won't have to pay for the chronic kidney and liver disease caused by the drugs because the patient will probably have a different plan by then and they'll be stuck with it.

Another contributor to the AHCPR document was Dr. Ian Coulter who you might recall was the individual who told the Palmer grad at the RAC IV conference that he would be stupid to hang on to subluxation theory. Based on what Coulter wrote in an article titled: Uses and Abuses of Philosophy in Chiropractic it should come as no surprise (31): "This situation led the present author to propose at the Australian Conference three philosophical propositions:

1. Chiropractic philosophy has no future;
2. Chiropractic philosophy has no past; and
3. Chiropractic has no philosophy.

Disturbing as this might seem to most chiropractors, no other conclusion is possible to anyone who is either conversant with chiropractic history and the origin's of Palmers ideas, or with philosophy. Writers such as Kleynhans have gone further and suggested that even a philosophy of chiropractic is not possible."

In the same article Dr. Coulter tells us that "Palmer for all his intellect, was himself confused about philosophy and its role and passed this confusion on to the profession." Coulter echoes Phillips about two kinds of present day chiros: the science based and a philosophy based: "The new voices, however, are increasingly from the camp of 'rational' chiropractic. This traditional schism created a very false dichotomy in chiropractic between those who choose a science verses those who choose philosophy and the result has been described elsewhere as the chiropractic wars."

Coulter (a dentist) once again pompously insults the profession for its stances relative to founding principles: "For most of their history, chiropractors have identified themselves in two philosophical camps, straight and mixers, and have done considerable battle under these banners as if they meant something important - worth living or dying professionally for"

Naw, you're right Dr. Coulter they aren't important. Unity and the resultant acceptance that comes with it are what's important. The donning of a socially acceptable pattern of beliefs and behaviors is what's best for us, eh? Afta all we chirapractas be so dumb we don't have no notion what all dis phlosophy stuff be 'bout: "Of course the truth is most chiropractors have no notion of what kind of concept (innate) it is. It is for this reason that Donahue concluded that the concept could not survive the critical evaluation of an undergraduate student in philosophy."

And speaking of Donahue, let's hear what he has to say about us intellectually bankrupt innatists (32): "If innatists retain the importance of the nervous system to their definition of the subluxation, they must conclude that II does not use it to give life. Their II then slips into a foggy vitalism that lacks anything, 'distinctly' chiropractic. Their chiropractic philosophy becomes just a trite (and unnecessary) example of 'new age' philosophy".

And with an Amen to Phillips et al Donahue adds salt to the wounds: Since the concept of II is both untestable and falsified by everyday experience, it has no place in a scientific healing profession's philosophizing. Certainly the question can be posed: 'Is it a harmful belief?' I believe that question can be answered in the affirmative."

Donahue goes on in his tirade to explain how innate is a religious doctrine and how the doctrine is detrimental to normal scientific activity. That we violate all caveats of good thinking, do not reject authority and ignore peer reviewed publications. This behavior, he maintains, shackles legitimate efforts at science and philosophy. You see the only legitimate science and philosophy is that which they tell us is legitimate. And it is that science and philosophy that lines their pockets with cash and subjugates us to a socially acceptable model of what a good chiropractor should be.

Donahue contends that "psychologically, Innatists live in another world from his/her more sober colleagues" and that we engage in "childish retorts" when challenged. He states we don't care about standards like symptom relief or improvement in biological measures, instead: "the innatists subjective judgement about the state of the patient's subluxations is the overriding consideration." We frighten patients into care by "dire predictions of the 'devastating effects of subluxation degeneration' and other "quasi-scientific information."

He blames the lack of public acceptance on Innate philosophy: "It is an ethical problem and a professional obstacle to scientific growth and thereby, public acceptance. II philosophy will not go away until a significant portion of the profession recognizes and deals with it appropriately."

With all of this chiropractic theory bashing comes some semblance of reason from Dr. Bruce Rock (33): "Research should not challenge the paradigms key features, but set about solving puzzles within the paradigm. This provides the practitioners in the field, those working within the paradigm, the necessary knowledge to underpin their daily practice."

"Thus, the chiropractic paradigm, like all good paradigms, seeks its validation internally, and the chiropractic profession need not lament its conceptual differences with other, nearby, but at least partially inconsistent paradigms inhabited by other health professions"

This is my main argument with the conclusion of the RAC group and with all these others who want to abandon the traditional theory because it isn't serving them.

Recently I read something from someone who had spent a great deal of time bashing subluxation in the print media for many years but we hadn't heard from him in awhile. Word had it that the powers that be had shut him up because he was barking too loud. Well something woke Dr. Joe Keating from his slumber since he wrote a response to Dr. Koch's essay regarding the profession rallying around subluxation. Keating had this to say (34): "There may well still be a majority of chiropractors who adhere to, or at least pay lip service to, the meaningfulness of the subluxation complex (VSC), but I'll guess that this majority is proportionately smaller than at any previous moment in the profession's history. Partial confirmation of my suspicion may be found in the recent discussion concerning the viability of the VSC as a research construct, which reportedly took place at the Palmer-sponsored Research Agenda Conference. (I bow to Dr. Koch on this detail, since he was present and I was not.) Further confirmation may be found in the growing number of scholarly works from within the profession which in recent years have challenged the meaningfulness of the traditional chiropractic lesion (Haldeman, 1999; Nelson, 1997; Seaman, 1999).

So according to Keating the subluxation is dead because a room full of researchers who were hand picked and invited to the RAC decided the theory was failing and because of three articles that have been published. Keating continues: "Second (and more important) is the continuing reality that the meaningfulness of VSC has not been scientifically established. There is no gold standard for the construct (Keating, 1996). Notwithstanding consensus definitions on conceptualization (Association, 1996) and political maneuvers to have the subluxation declared the exclusive province of chiropractors within Medicare reimbursement, no one has yet demonstrated that any operational definition of VSC is meaningfully related to health or illness. Neither has it been experimentally demonstrated that detection and correction of this inadequately operationalized phenomenon (if it exists) will produce any change in health or illness."

"Given the lack of evidence to substantiate the subluxation complex, efforts to promote chiropractic by association with this elusive spinal target seem like folly. The subluxation complex may not be real, in which case mounting a PR campaign organized around the VSC amounts to building a house of cards. Even if chiropractors are some day able to validate some version of the subluxation complex, to promote the (currently unproved) construct now is unethical."

Got that fellow chiropractor? Just as Rosner told us subluxations are not a clinical reality, now Keating tells us its unethical to be adjusting them since according to him we have no proof they exist. Keating finishes his letter: "Members of scientific professions ought not make claims for unproved theories and methods. Dr. Koch recommends that the profession proclaim 'Chiropractic: Correcting Subluxations Since 1895,' but is this true? Given the legitimate uncertainty about subluxation complex, should the profession hang its hat on this hypothetical construct? Should marketing needs supercede scientific and professional values?"

It always amazes me how it seems to be the people who sit on their ass chastising the profession for focusing on subluxation seem to be those who don't practice chiropractic or never have. And if they do practice, they usually spend a good amount of their time as isolated academicians who don't adjust or working as IME whores. I find it amazing that Keating's employers keep him around and trust his interpretation of chiropractic history given his careless, unreferenced remarks about subluxation. Where and when did Keating receive his training in the epidemiology of subluxation? While he was getting his Ph.D. in bed-wetting?

Keating, who must be the one true intellectual working within the chiropractic profession, pushes the "anti-intellectual" stigma on chiropractors (35): This general lack of awareness of the evolution of chiropractic ideas may be attributable partly to the anti-intellectualism which has permeated much of the profession"

Dr. J.F. Winterstein doesn't go so far as Keating to suggest we have "permeated much of the profession" but instead relegates us to a "fragment" (36): "Daniel David Palmer, the founder of the chiropractic profession, propounded a 'philosophy' for the profession. This philosophic position was maintained by his son Bartlett Joshua Palmer and has been handed down through the years until, at the present time, the most vociferous proponents of this 'chiropractic philosophy' are the zealots who represent the fragment of the profession they call 'straight chiropractic.'"

Case in point for the argument about anti-subluxation chiros being IME shills is none other than John Triano D.C.( a former favorite of State Farms): "Little clinical or scientific evidence exists to suggest that direct nerve compression plays an important role with functional spinal lesions. Unfortunately far more is speculated than is truly and scientifically known about the effects of and mechanisms of actions of manipulation or adjustment" (37)

Guess Triano hasn't read Sato's or Sharpless' work on compression physiology of nerve roots. Guess he hasn't read Chris Kent's review of subluxation models. More interesting is that Triano's involvement in a research project designed to teach MD's how to manipulate. According to the wording of a grant application to the Department of Health and Human Services through the Public Health Service entitled "Manual Therapy in Primary Care of Low Back Pain the proposal was to train 25 primary care physicians to give spinal manipulations. The project was to be overseen by none other than John Triano D.C. (38)

"In the past, research on manual therapy has sometimes been confused with research on chiropractic. Chiropractic can by definition only be performed by chiropractors; whereas a range of different health care professionals perform spinal manipulations or adjustment."

"If manual therapy, as performed by primary care physicians, is effective in improving patient functional status, then physicians will have an effective tool to add to their very limited armamentarium in the treatment of acute low back pain. A good case could be made for the inclusion of manual therapy instruction in Family Medicine and Internal Medicine training programs, and for the expansion f continuing medical education programs in manual therapy."

Never mind teaching MD's to adjust and his disparaging of subluxation, Triano takes the gloves off in an interview for Health magazine (39): "People like Sid Williams believe they have the answer, that subluxations are the root of all evil. But there's no evidence that their belief system is true. In fact, there is evidence that the main tenets of chiropractic are not true."

When asked, by the author of the article, if he had ever seen a subluxation Triano answered: "With my eyes closed."

Rick Weiss, the author of the article wrote: "Triano is a leader in the nascent effort to get chiropractic free of it's fundamentalist past and into the scientific fold: In his view, people like Dr. Sid do the profession more harm than good."

"Triano takes nothing for granted. He's among the new breed of chiropractors who commit the ultimate blasphemy of suggesting that subluxations may not exist."

Dr. Meeker got all upset when we exposed the crap that our researchers were involved in and pissed and moaned that they don't get any thanks for all the hard work they do for the profession. Well folks I suggest we all send Dr. Triano, a participant in the RAC, a thank you card for all his hard work representing you and I. Teaching MD's how to adjust, his work for the Mercy Document, The AHCPR low back guidelines, the above insults of Dr. Williams and his bashing of subluxation theory. Lest you have forgotten where Triano is, he can be reached at the Texas Back Institute where, according to copies of IME reports I have with TBI on the letterhead, he is doing IME work. So come on whaddya say? Send Triano some holiday cheer!

Maybe Triano et al agree with what Brantingham said over ten years ago in an article titled: A Critical look at the Subluxation Hypothesis: "It is this author's opinion that the continuing use of the term subluxation impedes the development of a biomechanical, functional chiropractic science. The term subluxation should be used only in its correct etymological sense: pathology secondary to degenerative joint disease, profound trauma or autoimmune destructive disease, such as rheumatoid arthritis." (40)

Or maybe Triano agrees with Dr. Charles Duvall: "It's like a religion. It's the first church of the holy subluxation." (41)

I wonder if Dr. Triano agrees with the professional chiropractic basher Dr. Stephen Barrett of Quackwatch fame: "If a chiropractor limited his practice to muscular conditions such as simple back aches, if he saw patients only on referral from medical doctors after medical diagnosis has been made, if he were not overly vigorous in his manipulations, if he consulted and referred to medical doctors when he couldn't handle a problem, and if he avoided the use of x-rays, his patients might be relatively safe. But he might not be able to earn a living." (42)

I haven't figured out yet why the ACA, Triano, Phillips and the rest of the Mercy Boys and Dark Siders in our profession haven't just embraced people like Barret, Duvall and the NACM. They're saying the same thing. My guess is it has to do with market share within the profession. Most chiropractors would ostracize them if they took that hard a stance so they stay just on the safe side of the line. This way they appear "rational". Doesn't anybody have any courage in this profession?

Some light is shed on this question by the recent upsurge on the part of the Dark Side to get us to unite. Just because they did not succeed at it over a decade ago doesn't mean they aren't going to try again. There have been a few articles written by ACA people sending out feelers. Point in fact is this quote from Michael Pedigo (43): "As I reflect back over those years of service to the profession and the associations, the fundamental reasons for this profession to unite under the roof of one association are unchanged. At the recent House of Delegates meeting, the ACA reconfirmed its willingness to meet and discuss any serious efforts to unify the profession. Unfortunately, I have seen no such indication from ICA."

And lets all hope that the leadership of the ICA is still strong enough to resist the temptation of the Dark Side to join them. Perhaps if the ACA would refrain from insulting the ICA they might have a better chance of convincing the weak within it. Dr. Pedigo informs us: "ACA is still the only national association that has made (and is consistently making) a difference in legislation and the legal arena."

Have you, like me, caught all the condescending, pompous remarks made by these people in all these quotes? And they wonder why we won't cooperate. Another attempt at luring us over to the Dark Side was recently made by James Edwards, an ACA Governor and Executive Committee Member in an article in Dynamic Chiropractic titled: The Four BIGGEST Lies in Chiropractic. He maintains (44): "There are four big lies currently circulating in the chiropractic profession:

1. The ACA supports mandatory immunizations and the ICA does not.
2. The ACA is pro-drugs and pro-surgery and the ICA is not.
3. The ACA does not support chiropractic as being a separate and distinct science and the ICA does.
4. The ACA does not recognize the vertebral subluxation complex and the ICA does.

There! As distasteful as it was, I was able to repeat all four of them. How many times have you heard one or more of these big lies? Two times, five times, 100 times? Have you wondered who started them? No one knows for sure, but they certainly did not originate within the ICA or ACA.

It's important that the profession know the truth because the telling and re-telling of the four biggest lies has become a major obstacle to national unity. It is also why so many DCs do not support the crucial work that needs to be done at the national level.

To set the record straight, it will be necessary to mention the ICA several times. The reader should understand that none of the references to the ICA are intended to be critical in any way. That is especially true because, as you will see, the policies of the ICA and ACA are essentially the same."

"To set the record straight I wrote a letter to Dr. Edwards which has so far remained unanswered:

Dear Dr. Edwards,
"There's one small fact regarding the ACA's opinion on immunization you left out of your article concerning the "Biggest Lies" in chiropractic. This quote can be found on the CDC's website: 'The American Chiropractic Association advises the public that vaccination has been shown to be a cost effective and clinically practical public health preventive procedure for certain viral and microbial diseases. They also note that vaccine use is not without risk and support informed awareness about risks and benefits and individual choice.'

While the statement you offered says the ACA is opposed to "mandatory" vaccination, the quote I provide more clearly illustrates the ACA's stance. Also, I refer readers to a paper printed in the ACA Journal by none other than Craig Nelson titled: Why chiropractors should embrace immunization. ACA Journal of Chiropractic 30(5):79-85, 1993.

When you don't tell the whole truth, that is a lie as well.

Regarding your comparison of ACA and ICA policies on subluxation I ask you this: Is it the ACA's position that there is a vitalistic basis to the subluxation and the chiropractic profession? Or does the ACA feel the way the RAC participants do: that vitalism is an "untestable metaphor" and should be abandoned? The ICA is crystal clear regarding the vitalistic basis of the profession.

As far as your other contentions regarding the similarities of the ACA and ICA I can only say that this offers the most compelling evidence to date for chiropractors to drop their memberships in the ACA and join and support the ICA. Since the ACA has no distinct identity why waste your money on them? These facts coupled with the exodus of leaders from the ranks of the ACA over the past few years due to ACA's policies and practices add even more impetus to join the ICA.

If you think the profession has such severe memory deficits as to think that it forgets what the ACA has historically stood for regarding immunization, drugs, and subluxation you are in serious denial.

I look forward to your response."

After writing this response I also stumbled upon some other choice quotes from ACA leadership including this from Dr. Lynch an ACA Governor in the Journal of the ACA: "The spinal subluxation, though we have been correcting it with spinal adjustment for 100 years, is still not fully understood. Scientific research presently is not sophisticated enough to determine the neurophysiological impact that spinal subluxation has on our patients." (45)

And let's not overlook this bit of criticism from another ACA Governor, Dr. Harold Keiffer: "And while chiropractic procedures are 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." (46)

Merger? Yeah, right. In your dreams.

I will close this year end and millenium ending issue of The Sludge Report with the following quote from Dr. Walter Wardwell in an article for the Journal of Chiropractic Humanities titled: Why Did Chiropractic Survive?

"Since chiropractic did not disappear, become ancillary to medicine, or follow the path of osteopathy to fusion with medicine, only one real alternative remains - for it to become an independent limited medical profession like dentistry, podiatry, optometry, and psychology"

"It is too early to tell whether that will be the ultimate fate of chiropractors, but it is clear that chiropractic and chiropractors have survived until now and they are at the point where becoming a limited medical profession is a viable possibility." (47)

Got that? A "limited medical profession". Couple that with all the above quotes from the "leaders" of our profession and look at it within the context of some of the "priority goals" of some of the organizations involved in the Recent COCSA meeting: The Council on Chiropractic Education (CCE) is going to reorganize, revise their educational standards and develop clinical standards.

The National Board of Chiropractic Education (NBCE) is setting out to do a Job analysis of chiropractic study, establish a Chiropractic college assessment test (CCAT) and continue to shove the $895 Part IV national practical examination down the throats of our graduates. I guess they are hoping to add to the already 8 million dollars a year they bilk from the profession. And why shouldn't they. You haven't spoken out against it have you? (See related NBCE story in the previous issue of Sludge).

And last but certainly not least: The World Federation of Chiropractic is going to develop educational standards worldwide. (See related article on WFC and Lou Sportelli in this issue of Sludge). (48)

If you are a little bothered in any way shape or form by what's been presented here then do yourself and your profession a favor: Call, write, join, march, protest or in any way shape or form raise a little hell and let these people know you won't stand for it. Remember that their behavior and comments are unacceptable and need an appropriately strong response. If you are unsure of what to do contact us here at Sludge and we'll give you some suggestions. See you in the next millennium! I close with a quote from Ayn Rand: PHILOSOPHY, WHO NEEDS IT?

"As a human being, you have no choice about the fact that you need a philosophy. Your only choice is whether you define your philosophy by a conscious, rational, disciplined process of thought and scrupulously logical deliberation or let your subconscious accumulate a junk heap of unwarranted conclusions, false generalizations, undefined contradictions, undigested slogans, unidentified wishes, doubts and fears, thrown together by chance, but integrated by your subconscious into a kind of mongrel philosophy and fused into a single, solid weight: self doubt, like a ball and chain in the place where your minds wings should have grown."

Ayn Rand, 1974

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