The Third Paradigm ------------------------------------------------------------- ------------- by Reginald Gold,DC,PhC As I read the scientific writings of other chiropractors, I am sometimes aware of their tendency to so complicate ideas with technical jargon and convoluted thoughts that the main point of the article becomes lost or obscured. This is not criticism, but a realization that the authors are chiropractors first, scientists or philosophers second, and writers third. They undoubtedly have great expertise as chiropractors and scientists, but cannot transform ideas to simple writing that is easily understood by those who are not as dedicated to the subject matter. To capture the interest of the casual reader and prompt further investigation, which is presumably the goal of the author, requires simplicity. The average chiropractor does not necessarily have an avid interest in new theories and ideas, so the author's first job becomes to arouse interest. A simple, straightforward presentation of ideas is likely to create understanding, which alone can cause interest and result in further investigation on the part of the reader. In an attempt to follow my own advice, I shall offer a simplification of my own chiropractic theories for your consideration. When I am faced with a problem of logic or ethics, my methodology is to reduce an idea to its simplest possible expression. When all the camouflage and obfuscation is removed, an idea stands alone, and its strengths and weaknesses become patently obvious. Simplicity promotes clarity and makes avoidance of issues very difficult, leaving ideas to stand or fall based solely on their merits. Here, then, is chiropractic's number one issue in its simplest form: There are three paradigms of chiropractic thinking. Each chiropractor must choose one to live by or else exist in a clouded world of half truths, where refusing to face facts results not only in an inability to talk about chiropractic with clarity, but also to practice it. Paradigm one maintains that chiropractic cures all disease. This paradigm is evident in an advertisement which B.J. and D.D. Palmer ran in the Davenport Times in 1902, which proclaimed, "You have no right to be sick when chiropractic cures all disease." Practitioners of this paradigm, though few and far between, would live by such slogans as, "The power that made the body heals the body." They neglect to mention, however, that while it is true that the only power that heals the body is the power that made it, sometimes even that is not enough. Some people are beyond healing. The pretense that all sick people get well when properly adjusted merely holds us up to ridicule. Other slogans claim that "chiropractic gets sick people well" without adding the necessary word, "sometimes," which would make it true. This slogan, incidentally, even if true, would offer chiropractic care only to sick people and deny it to those who are not yet sick with clinical or laboratory symptoms. A second paradigm of chiropractic thinking and practice holds that only some sick people get better when their vertebral subluxations are corrected. Because of the nature of their disease, or the advanced stages of it, others require medical intervention or adjunctive therapy. This paradigm of treating some and referring others sounds logical and caring, and is most likely to earn us the respect of the community of health care providers. This paradigm represents the thinking of the vast majority of chiropractors. Though there is disagreement how patients should be treated, when to refer, and which treatments to administer in the chiropractic office, the second paradigm is heartily subscribed to by the two largest national associations. Since both organizations agree on this major issue, it makes one wonder why we have two separate major organizations. If they both agree to treat some diseases and refer others, what are they disagreeing about? There is, of course, one slight problem that arises when deciding which patients and diseases to treat and which to refer: all treatment or referral decisions are dependent upon diagnosis. Diagnosis is the one great area of weakness in this practice paradigm. Diagnosis is, after all, the greatest challenge and the area of greatest risk of mistakes being made. Yet chiropractors, who receive much less diagnostic training than MDs, think they are competent to diagnose for purposes of referral. How is this possible when they: Ô denied by law the use of all diagnostic methods that invade the body chemically or surgically; Ô are generally learn diagnosis out of textbooks without ever seeing cases of the diseases they purport to identify; Ô frequently learn diagnosis from other chiropractors who also learned from textbooks and have never seen cases of the diseases; Ô often couldn't pass national board exams in diagnosis without a crash course before the exam. Some say that to practice without diagnosis would be dangerous. I suggest that nothing is more dangerous than incompetent diagnoses. Every year tens of thousands of sick people visit chiropractors of the second paradigm. People seeing chiropractors complain of a variety of problems, which could be the manifestation of vertebral subluxation, or could just as easily be symptomatic of something else, possibly a life-threatening disease. Instead of practicing chiropractic, the paradigm two chiropractor does a medical diagnostic examination, followed by a medical report of findings in which the DC claims to have identified the cause of the problem. And with such blithe and dangerous comments as, "We do not treat the symptom, we correct the cause," the DC proceeds to offer treatment, which delays medical care for what may be a life- threatening medical emergency. Was that backache really caused by vertebral subluxation, or is it perhaps a manifestation of prostate cancer, kidney stones, or referred angina from an impending heart attack? Is that headache caused by subluxation or is there an aneurysm at the Circle of Willis, or a brain tumor causing the symptom? How good is the chiropractor's diagnosis? Another point to consider is that while thousands of people go to chiropractors every day, but millions more stay subluxated because they have no symptoms. For 104 years we have exposed people to the limited understanding of chiropractic that results from paradigm two. The treatment of some diseases by adjustment and the referral of others based upon our diagnostic knowledge is not chiropractic at all, it is the practice of manipulative medicine, and it is even more dangerous than paradigm one. Paradigm one is obviously stupid, so stupid that nobody really believes it. Nobody believes that all disease is caused by vertebral subluxation, so nobody gets hurt by it except the chiropractor who tries to make a living at it. Paradigm two, however, sounds logical. It is saleable and, subsequently, dangerous. If paradigm one is stupid, and paradigm two is dangerous, let us consider a third paradigm. This paradigm makes sense to me. It is a paradigm that thousands of chiropractors practice on their families, yet neglect to offer the public. Paradigm three is neither based upon a claim to cure all disease, nor an attempt to prejudge which diseases might become cured if vertebral subluxations are corrected. In fact, it has no disease treatment basis at all. It is totally nontherapeutic in its intent and practice. Chiropractic holds that a vertebral subluxation, by its very existence, inhibits the body's ability to fully express its inherent potential. Every vertebral subluxation, by definition, includes some alteration of nerve function from perfection to something else. Vertebral subluxation is, at the very least, a change in the body's structure, and every scientist knows that a change in structure must inevitably result in a change in function. Therefore, all vertebral subluxations must result in altered function. In short, people with vertebral subluxations would be better off without them. It does not matter if a subluxated person has a disease or if any disease would be best treated by manipulative medicine or some other treatment. The presence or absence of disease is irrelevant. Every human being, sick or well, newborn or aged, regardless of nutrition, exercise, occupation, sex, race, religion, and all other factors of life, is better off without vertebral subluxation. Why then do some chiropractors and organizations want to limit chiropractic correction of subluxations to certain categories? Is the person with AIDS or terminal cancer better off left subluxated? Should an infant with a vertebral subluxation but no determinable disease symptoms be left subluxated until symptoms occur? Symptoms are the last stages of malfunction, not the first. By the time symptoms have occurred, years of opportunity for repair may have been lost. Why not correct vertebral subluxations when they occur, rather than wait for years of damage to produce symptoms? To restrict chiropractic to sick people is as stupid as restricting vitamin C to people who have a cold. Furthermore, to treat disease by manipulation is necessarily to delay alternative treatment and thus, possibly endanger a life. The third paradigm of chiropractic practice is the only that makes sense. It makes so much sense that thousands of chiropractors use it for themselves and their own families, yet because medical insurance does not pay for it, they do not teach its value to the public at large. We live in a country that spends billions of dollars a year on the treatment of sickness and disease, but precious little on health. Our chiropractic profession is supposed to lead the world into a new and more intelligent way of thinking, not follow the mistakes of the past. Paradigm three is not about health and sickness. It is about the recognition that vertebral subluxation causes more than just lost health potential and loss of every human potential. The nervous system is the coordinating system whereby the countless billions of body cells interact in harmony to express mind, body, spirit, emotion, artistic talent, speed, stamina, coordination and family relations. Vertebral subluxation is a cause of disharmony to this beautiful thing we call life. Paradigms one and two are about backaches; paradigm three is about life. We can choose to conform to the errors of the past, or we can step proudly to the forefront and lead the way into the future. To comment, email me at chiroreggi@aol.com .