Philosophy

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Dear Editor:

I am writing on behalf of the Federation of Straight Chiropractors and Organizations in response to an article by Dr. Curl, Vitalism's Roots in Chiropractic: Part II (Dynamic Chiropractic, December 16, 1996). The article is ostensibly a challenge to chiropractors to give some thought to the subject of vitalism and to debate its place in chiropractic through DC.

In reality, no debate is necessary. This is not a matter for debate any more than whether the Earth revolves around the sun. Vitalism is a doctrine, a system of reasoning which attributes life to the existence of a vital force acting through matter. Its adherents are vitalists. Its counterpart is mechanism which explains life as a consequence of physical and chemical mechanisms occurring in matter. Its adherents are mechanists. This is not an issue specific to chiropractors. Individuals of all different professions or backgrounds, whether consciously or unconsciously, make this choice and apply either vitalistic or mechanistic reasoning to life's situations.

Because we have differing viewpoints in chiropractic, there will be those chiropractors who are vitalists and those who are mechanists. For vitalistic chiropractors, vitalism is appropriate. For mechanists, it's not. Case closed on whether vitalism belongs in modern-day chiropractic. It does, at least for one group of chiropractors.

There is the matter, however, of which you will choose. Should chiropractors be vitalists or mechanists? On that there will probably be great debate. It's the same question as whether you should choose to practice as an objective straight chiropractor or practice according to the other school of thought. You want argument, controversy, debate? This question will provide plenty. The fact that we, as chiropractors, have each made that choice, knowingly or by default, means there should be plenty of grist for the debate mill.

Any meaningful debate, though, must begin with agreement on terms. As alluded to in the article, it serves no purpose if everyone enters this with their own unique definitions. If, for instance, we are to discuss who is the "greatest" athlete, we have to define the term "greatest." Do we mean the athlete with the greatest size, height, or bulk? Do we mean the one with the most fame and recognition? Do we mean the one with the most wins or championships? Or something else entirely? Unless and until we can define how we're measuring "greatest," the debate will be lively but quite meaningless! It makes it impossible to build a strong case of any kind, for or against. Many sports fans enjoy discussing their views on their heroes, but I don't think I've ever known a time when one fan was able to offer consequential proof why someone should think the Yankees were better to root for than the Red Sox, or proof that the '95-'96 Bulls was the best basketball team of all time, or that Secretariat was the greatest racehorse instead of Man-O-War. There's no agreement on the exact meaning of the "greatness" each fan perceives.

So, first, it's appropriate to agree on the terms vitalism and chiropractic before they are discussed through such a forum.

To be a credible discussion, the moderator should demonstrate understanding of the terms. Dr. Curl offers that vitalism is "...the form of healing which is most closely attached to the idea of natural healing..." and that "chiropractic claims to be about natural healing." I disagree on these statements. Vitalism is not a form of healing at all (as noted earlier, vitalism is a doctrine) and not all chiropractors claim chiropractic to be about natural healing. Straight chiropractic, or objective straight chiropractic, the term first used by Dr. Joseph Strauss, is that branch of chiropractic defined by the objective of locating and correcting subluxations because they, in and of themselves, are detrimental to the optimum performance of the body. Subluxations, in vitalistic terms, interfere with optimum expression of life force through the matter of the body.

The objective straight chiropractor understands that people function better without subluxation, whatever the other circumstances. They do not claim to heal or practice a form of healing. A lifeguard understands that drowning, in and of itself, is detrimental, i.e., people function better with their heads above water, breathing air, whatever the other circumstances may be. He pulls people out of the surf for that reason alone. It doesn't matter if the person is a diabetic, suffers form migraines or has back pain. The lifeguard does not claim to heal anything by this method. He is simply, though significantly, removing an interference to the person's ability to perform at their best. In correcting a subluxation, the objective straight chiropractor also removes an interference to that ability. This is not to equate objective straight chiropractic with lifeguard duty, but they do share a vitalistic, non-therapeutic approach in what they do.

A critical difference between objective straight chiropractic and any other branch in chiropractic is that the objective ends with the correction of the subluxation as contrasted with attempting to evaluate or determine the effects of the adjustment. The point is that someone with asthma or without asthma, with sciatica or without sciatica, with a stiff neck or without a stiff neck, etc., is better off without subluxation than with, even if the asthma, sciatica, stiff neck, or whatever persists after the subluxation has been corrected.

Dr. Curl asks how chiropractors would "use vitalistic principles to assist their patients in getting well." "Chiropractic gets people well!" is not even a matter of vitalistic thinking. It's not applicable within objective straight chiropractic. Getting people well would mean taking responsibility for alleviating their sickness. Vitalistic principles are not applicable to attempts to control or purposely alter body functions. "Correcting the cause" is another expression unsuitable for objective straight chiropractic. One must ask, the cause ... of what? The answer, unavoidably, though it is rarely made explicit, is of the symptoms or illness. In each of these instances, it's difficult for a vitalist to be so logically inconsistent as to appreciate the animating power of a life force yet at the same time attempt to direct how it should be expressed. Objective straight chiropractic, owing to its vitalistic principles, is not meant to control life functions in any way.

I believe there are chiropractors who find this difficult to appreciate. They talk about it being merely semantics. Perhaps it is because of what Dr. Curl says he's observed: In most colleges we teach about vitalism, but we don't teach vitalism. Many chiropractors talk about things as if they were vitalists, but practice as mechanists! How many times have you heard someone say, "We don't treat symptoms or diseases," only to have them say in the next breath that adults with asthma or kids with ear infections (or those with whatever) "respond so well to chiropractic care!" What do they mean "respond"? It means that the asthma or the ear infection (or the whatever) went away. The patient was cured! This is addressing the disease/symptom! It's mechanistic thinking to take responsibility for deciding whether the body's function is right or wrong and whether it should be altered. It's not enough to simply deny treating the diseases or symptoms. Intending to alleviate asthma and ear infections, even if only natural methods (such as manipulation) are used, is still treating them. That's mechanism.

For those chiropractors who choose to alleviate symptoms or to treat conditions, who offer to cure conditions, who offer to find and correct the causes of the conditions, who offer to get people well, etc., mechanism is exactly what they need to follow. I personally question the wisdom and desirability of such an approach, but I don't question their freedom to pursue it if they wish.

It seems clear, though, that both vitalism and mechanism currently have their places in chiropractic.

James Healey, DC
Executive Committee,
FSCO Board of Directors

March 1997
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