By Donald K. Moon, D.C.
Vol. 2, No. 8, January, 1980
Today, almost 81 years after the discovery of chiropractic, our profession finds itself at the threshold of its golden opportunity -that of becoming a respected, accepted member of the scientific community. All of us have dreamed of the day that doctors of chiropractic would be considered as important to the health of mankind as any other health practitioners. How great it will be to have the words “vertebral subluxation” become as understood and respected as “penicillin” or “Salk vaccine”!
It would appear, on the surface at least, that it’s just a matter of time now that our dreams are realized. Yet there are disturbing clouds on our horizon and the irony is that we are responsible for their existence. The chiropractic profession is being drawn into a trap that it is setting for itself – and which ultimately could lead it into a most vulnerable position – a sort of professional limbo with no basic premise, philosophy, or scientific basis.
Somewhere in our quest for acceptance and respectability the major priorities of many chiropractors have become twisted and distorted. To some of them the vertebral subluxation appears to be the major stumbling block between them and these goals. A few have even been so bold as to say that a subluxation of a vertebra is an unscientific, unproved and therefore indefensible concept. Those same chiropractors have chosen to retreat behind the facade of ambiguous theories and have deluded themselves into believing that they will never be called upon to give a valid explanation of why they have the right to exist as a separate and distinct health discipline. They seem to be hoping that they will eventually be absorbed into the mainstream of the healing sciences by abandoning support of the subluxation concept. In its place they are embracing a Pandora’s box of theories and therapies. Is it any wonder that we are increasingly viewed as technicians or excellent physical therapists?! I need not remind you technicians are not primary health care providers.
This article will not concern itself with the relative value of other types of procedures used as adjuncts in many chiropractic offices. We must avoid the polarization that seems to always accompany discussions between those of different schools of thought in our profession. It is time to concentrate on those areas where we can, should, and must agree if we are to mature as respected members of the scientific community.
This writer is concerned with the emphasis or lack of same placed on the vertebral subluxation and its scientific reduction. Chiropractic authorities have agreed that the vertebral misalignment and its resultant effect on neurological components is the cornerstone of chiropractic practice. When the emphasis on the vertebral subluxation is relegated to a very minor concern in the doctor’s practice and when adjunctive care becomes primary we are treading on very dangerous ground. Yet this is precisely what is happening in many of our offices.
What are the reasons for this problem? Probably foremost has been the lack of true scientific research into the subluxation and its reduction. Instead of research data we have relied on clinical results which are not acceptable criteria for establishment of a relationship between subluxation reduction and restoration of health. As a result, many of our own practitioners have begun a flight from the subluxation. One voice in the wilderness which has remained strong and firm for increased research of the subluxation and its effects on neurological components has been the National Upper Cervical Chiropractic Association and its chief director, Dr. Ralph Gregory. Since NUCCA has concentrated its research on the upper cervical subluxation it has been viewed by some as a radical extension of the previously controversial so-called HIO concept.
Because of the polarization of thought mentioned earlier, many doctors are almost afraid to voice an interest in further research in the cervical region and its effect on neurological components. That is most unfortunate. To over-react against such work is equally as radical as the HIO practitioners were once accused of being. We have reached the point that opinions will no longer stand unless they are supported by valid research. This type of research is and has been an ongoing process in NUCCA. Substantiation of the subluxation concept and its mechanical reduction is now a matter of scientific documentation. While the research is just in its infancy, we have a firm foundation upon which to sow the seeds of a proliferating science. When we demonstrate the measurement of misalignment factors and their effect on neurological components we silence forever those who would relegate us to the role of technicians. We will conclusively prove the science of chiropractic.
There seems to be a prevailing attitude that it doesn’t make any difference which technique is used to correct a vertebral misalignment. The simple truth is that it does make a difference!
The corrective mechanical act must reduce the misalignment factors and not just reduce the symptoms. If in fact a vertebra is moved from one malposition to another it is possible to create a new subluxation involving different neurological components which may not be symptomatic for a period of time.
This leads of course to the incorrect conclusion that the patient is well and that the treatment was successful. We can no longer afford the luxury of relying on criteria based on symptoms and clinical results. The vertebral subluxation complex, a term coined by Dr. Gregory and used to denote the misalignment factors and all areas and tissues affected by them, must be given priority status in chiropractic. There is no health field that is not evolving through scientific research. Chiropractic is no exception. While we doctors of chiropractic are embracing and emulating many medical methods of treatment, the medical profession is showing increased concern with the subluxation. To leave the research of the vertebral subluxation to the medical profession is tantamount to abdication of the throne by a monarch. You can rest assured that they will someday engage in the type of research that we are failing to emphasize today. We cannot afford to lose our professional identity by default.
All practitioners are the product of the colleges from which they graduate. The colleges have an awesome responsibility to the profession. The material they present must represent the latest state of chiropractic science and research. Instead, our colleges have abdicated their responsibilities and have permitted opinions to dominate the presentation of material relative to spinal adjustment techniques. We field doctors must recognize this problem and must not blindly defend all that we have been taught as gospel. The emphasis in college curricula is frequently on diagnosis. For some strange reason this has caused another area of polarization and again division into two camps. To deny the right or ability to diagnose eliminates our right to determine the effects of the vertebral subluxation and its reduction. Diagnosis also enables the chiropractic doctor to make a simple evaluation of which cases to accept and which to refer. Conversely, the diagnosis does not determine the mathematics or measurements necessary for subluxation reduction. For some reason we have not allowed these two areas to peacefully co-exist. Yet, ideally they could and should. The problem arises again when we forget that the subluxation reduction is the mechanical act that gets the patient well. All the tests in the world are useless unless the cause of the problem is corrected. We must insist that our colleges teach technique procedures which are mechanically sound. Once this is accomplished the long sought and desired goal of standardized curriculum in all our colleges will be closer to a reality.
The central question is: Do we have the will to defend and research the subluxation complex before we forget who we are and why we have a right to exist as primary health care providers?