"... Philosophy Should Reflect Our Scientific Knowledge"
Dear Editor:
Webster's New World Dictionary defines the following in pertinent part:
Philosophy as, "2) general principles of a field of knowledge."1
Principle as, "1) a fundamental truth, law, etc., on which others are based. 4 a.) the scientific law explaining a natural action."2
Doctrine as, "something taught, esp. as the principles of a religion, political party, etc., tenet or tenets, dogma."3
In the July 17, I992 issue of "DC," under the column titled "Viewpoints from Involvement," Dr. Fred Barge quoted a medical anthropologist, Dr. A.E. Moring, as follows: "... Chiropractors have generally diminished the role of philosophy in their practice, and as a result, it seems to me, have themselves lost faith in the philosophy."4 Dr. Barge agreed. Taking a closer look at the quote and utilizing the above-noted definitions, which would not change the point of the quote, it would read: " ... have themselves lost faith in the general scientific law explaining the natural action of the field of chiropractic." How does one lose "faith" in a "general scientific law?"
The philosophy of chiropractic, as I was taught in the post 1960 era, was that the nervous system controls every system of the body.5 This control is centered in the brain and spinal cord, with communication occurring through the spinal nerves and the peripheral nerves. Interference in the control takes place when the vertebrae subluxates and blocks or hinders the communication. The science of chiropractic is the methods used to determine where the subluxation exists and the determination of quantity and quality of the subluxation(s). The art of chiropractic is the performance of a method to remove such interference by correcting the subluxation.
In his article, Dr. Barge states his opinion about chiropractic students: "They question our principles and our doctrine."4 Is not questioning essential in and to the learning process or should they merely ask questions about, but never dare to question our (or should we say the profession's) philosophy? Does the profession want students to accept everything they are taught as fact? Or perhaps they should only ask the right questions. Without unrestricted questioning minds in the profession, we would not have research being performed and progress in the profession would come to a grinding halt. D.D. Palmer "questioned" the philosophy of the health care system in his day. This "questioning" begat the profession. Today, China is the only powerful nation on earth where you do not question the principles or doctrines taught to you!
Surely this should not be the "state of affairs" of the chiropractic profession -- a totalitarian profession where you do as you are told, without regard to individuality, thought or truth.
In the 1890s the "principles" of chemistry were, compared to today, crude, unrefined, and some even incorrect. Today, the incorrect "principles" of the 1890s are no longer taught. The crude and unrefined have been sharpened and refined. Dr. Einstein's originally proposed Theory of Relativity, that matter and energy are neither created nor destroyed, has even been altered to reflect current scientific knowledge to include that they are interchangeable. The actual splitting of the atom proved this to be true. These and many more changes in principles and philosophy could never have occurred if not for questioning and inquisitive minds.
Take, for example, the "original concept" in chiropractic that hard bone pushes on soft nerve to create the interference. Through our profession's research, we have found that this picture of a soft nerve being pinched by two hard bones is inaccurate. That is not to say that the interference does not occur through the encroachment upon the nerve by the physiological effects of the subluxation.
The most important point to remember was phrased almost perfectly by Dr. G.A. Robertson of La Jolla, California, who wrote, "We do not need to compromise our profession to preserve our philosophy but, rather, the philosophy should reflect our scientific knowledge."6 He continues to address the question of why practice management seminars are so successful. His theory is: "... This shortcoming is the lack of education in basic principles of business. ... This produces the phenomenon of practice management consultants."6 Confidence in one's own methods"4 is not enough, in and of itself, to produce success. Knowledge of sound business principles is also a necessity.
In closing, let me point out that 500 years ago in 1492, when Columbus set out on his historic journey, the philosophy at that time was that the world was flat and he would sail right off the edge. Columbus, probably unknowingly, brought some scientific method into the picture. He theorized that the world was round, and making his journey he proved his theory and his experimental journey was repeated with the same results he reported -- no ship sailed off the edge of the earth. This changed the philosophy of the time.
If a philosophy is truly a philosophy, one need not "believe" in it, for belief is placed in that which is not factual; it is an opinion.8 Philosophy is based on proven facts or laws of nature, whether you believe it or not, they still are facts.
As for me, I will place my belief in my religious tenet and my God, but will base my philosophy of chiropractic on the science of chiropractic and of the day.
References
Dear Editor:
It started with a feeling of unreality. It couldn't be a dream though. The paper he was browsing through was tangible; its ink had even stained his fingers. He used to read before going to bed. It helped to sedate him, and to fall asleep. Chiropractic literature in that case proved more efficient than sleeping tablets.
An ad had caught the eyes of Dr. Ingenuous. The professional journal he was reading displayed, as usual, a proliferation of publicity for various training courses, and he generally paged through it without paying attention to them. But there it was, more dreadful than ever, even nightmarish. He was plunged at once in an unknown planetary system. This couldn't happen on earth!
In his daily environment he was having social intercourse, he was taking care of people with a soul and all of a sudden he felt propelled in a foreign bleak microcosm. The words, the grammar he recognized, the meaning he feared to understand.
This is how the ad sounded:
"How to serve 1,200 people per week in a town of 3,000." "How to process over 50 new patients in one day."
And at last his eyes froze on the following sentence:
"Maximize your power to achieve $2,000,000 in service."
Dr. Ingenuous realized how pitiable he was. Now he wouldn't dare confess his income or the number of patients he treated. He personally felt overworked, but he definitely rated low in the hit parade of success as measured by the dollar standard.
On second thought, he decided that what he had just read couldn't be true. He was unable to slander, therefore, he imagined the advertisement fit a world quite different from his, where the hours of the day numbered much more than 24. This explained why so many people could be treated in such a period of time. He decided that these therapists had unlimited diagnostic acumen and used sophisticated tools so as to read into their patients' brains without wasting time in fruitless discourse. He also considered that in that part of the universe, scope of practice was unlimited and the therapeutic armamentarium flawless to the point of guaranteed success.
Could it be that the population of this world had no mind and the doctors didn't need to worry about an ethical conduct? A world of almighty practitioners with a population of totally submitted and compliant patients? A world with no medical challenge where happy issues were taken for granted?
But then why did so many patients need so much care? All this just didn't make sense. He considered at this point that he was analyzing the ad with inappropriate values. The remainder of his Judeo-Christian scruples and classical education were playing tricks on him again.
Being practical he wondered, though, how come the dollar was not integrated into the international system of unit. What a beautiful tool to measure success. Why waste time with randomized trials when it is so easy to quote income? Why bother with clinical skill and therapeutic know-how when patients' interest and well-being are not at stake?
The anticipated narcotic effect of the journal failed to work that night.
Jean-Paul Ladermann, D.C.
Geneva, Switzerland
Dear Editor:
In your August 14, 1992 issue of Dynamic Chiropractic, you ran a story, "Infrared Thermography," by Dr. David BenEliyahu. On page 12, Figure 2, is a radiographic print of the lumbar spine. At a glance I cringed in pain because of the severe hypolordosis and increased Ferguson's angle.
Though the print isn't clear enough to actually measure Ferguson's, angle, Ferguson's line, which is clearly demonstrable, and George's line demonstrates a severe straightening of the lordotic curve. When measuring lines of mensuration of angles of lumbar curvature, the line across the superior aspect of the bodies of 11 and 15 are approximately parallel or zero degrees, and there should be an angle of approximately 37 degrees for a normal lumbar lordosis.
When I read the copy and patient thermographic results I wasn't surprised, but when the author said that the lumbar radiograph was unremarkable, I was shocked. I instantly cringed thinking what a field day a medical school radiology class would have with an x-ray misread like that.
William L. Brotherton, D.C.
Fort Collins, Colorado
Dear Editor:
I wish to say that the two letters to the editor, "Authority of All That Is Chiropractic Is Right," and "The Necessary Tools," in August 14, 1992 issue were the best I have read in quite awhile. Both addressed the issue of, "Are we truly doctors of chiropractic or are we really chiropractic technicians?"
There is much more to being a "doctor" than finding a subluxation and reducing it, as some would like it to mean. Although that should be our central focus, it cannot be a "doctors" only focus. If it is your only focus, then your title should be technician instead of doctor, and you should only be able to adjust under a chiropractic doctor's supervision.
R.E. Miller, D.C.
Omaha, Nebraska
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