Chiropractic/Archive 11

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Lead subluxation sentence structure

Mccready: Please look carefully at the language here "Chiropractic contends that spinal joint misalignments, which chiropractors call vertebral subluxations and for which there is no mainstream medical support, can interfere with the nervous system and result in diminished health"

This is very clearly a statement repoting a chiropractic claim, it's not an assertion about the truth of the claim, merely a statement that this is what chiropractic contends. Except chiropractic clearly does not contend that there is no mainstream scientific support for this. I am reverting your edit here because your change makes the sentence nonsenicalGleng13:31, 2 September 2006 (UTC)

"There is no mainstream medical support for this contention and chiropractic vertebral subluxation is thus distinguished from medical subluxation"

I'm really having trouble making any sense at all of this insertion, as the paragraph as worded and feel it has no place in the lead; I have trouble because the paragraph asserts a tautological truth; if there is a misalignment it will certainly cause problems; what is controversial is not this, but whether in fact such misalignments are commonly the causes of reported symptoms.Gleng17:06, 2 September 2006 (UTC)

This is probably a good spot to differentiate the difference between the scientific view and medical view of chiropractic. --Dematt00:13, 3 September 2006 (UTC)

I worked with it and came up with this. It is accurate, isn't it?

"There is no mainstream medical support for this contention and chiropractic vertebral subluxation is thus distinguished from medical subluxation"

versus

Though scientists suggest there is low level evidence supporting this contention, mainstream medicine does not believe that vertebral subluxations affect general health and differentiates it from the medical use of the term subluxation.

--Dematt00:38, 3 September 2006 (UTC)

Stuff related to safety

I'm looking to integrate some new information related to safety issues with chiropractic from http://www.nelh.nhs.uk/hth/chiro.asp NHS. It basically evaluates some of the methods that were used in coming up with some of the studies. We should probably work through this together so keep an eye on me. Thanks --Dematt00:50, 3 September 2006 (UTC)

Okay, finished. I copy edited the whole thing and made some small changes. I think it says the same thing and handles all the issues in a NPOV manner. But I also realize I am capable of missing something important so feel free to make more additions or change something back. --Dematt04:17, 3 September 2006 (UTC)

Homola:

It is hard I think to sustain the thesis that Homola is not a notable critic; a Google search gives over 9000 hits, he has published in peer reviewed journals and written 12 books, and is identified on the ACA site for instance as a prominent critic. I haven't yet been able to do a citation search on his published articles, am happy to do so if anyone thinks this is critical. I think though that by a long way he meets WP criteria for notability. It is true that his book can be accessed via chirobase; I don't know that this can be called an ad for his book in any disreputable sense as the book is freely available. Homola has written other very powerful and concise critiques in V RS accessible sources, so it might be that one of these might even be a better alternative, it's not for me only to judge. The book as cited, apart from Keating's review gets a very positive mention in the Scientific American site; I can look for more reviews. The bottom line I think is this - should Homola get a mention at least va a link because he is such a well known critic? I think the answer is probably yes. Then, if not the book, then what. Or if not Homola, then what more powerful, more notable critical link should be put in its place?

Come on guys, I've been praising you to the skies totally sincerely for you record of NPOV. Make all the article as strong as it can be.Gleng18:19, 3 September 2006 (UTC) P.S. This might be the answer: http://jmmtonline.com/documents/HomolaV14N2E.pdfx Gleng 18:46, 3 September 2006 (UTC)

Thanks Gleng. I think we can definitely use Homola (and that article) to represent the Reform POV. IMO we need to be able to present the straight, mixer and reform POVs without making any judgements about any of them. Chiropractic is given direction by the actions and reactions of all of them. If we neglect one, this article would not be a true representation of chiropractic. I would always assume good faith in editing toward this end and be careful not to appear to advocate any particular POV. If any of my edits head that way, please feel free to bring them to the talk page. --Dematt01:51, 4 September 2006 (UTC)

I concure Dematt, what if we had a paragraph covering "Notable criques within the profession"? I am thinking of either a paragraph or in the links section. If in a paragraph, their main overlapping points can be made...it might eliminate some of the "battle of the links" currently going on. :) Any thoughts?--Hughgr03:04, 4 September 2006 (UTC)

Thank goodness you feel that way:) I just wrote a new Reform section (before I saw this). Let me know what you think. It is just a start, but I think it wil work. --Dematt03:33, 4 September 2006 (UTC)

Thank you Gleng and Dematt for your reasoned suggestions. At this point, I am concerned with the ‘Critiques’ section. It seems that it has been inflated disproportionately compared to other sections with links. The section could now be called ‘Why a disgruntled retired chiropractor doesn’t like chiropractic and never will.’ by Samual Homola

The book and many of Homola’s so-called Luther-like musings can be found on his very biased privately owned site Chirobase (donations accepted) as can other skeptical (code word: bigoted) ‘essays’ and opinions. So this one link should do the trick. I still have an issue with the links in this section that lead to dozens of opportunities to get hit up for donations that benefit one ex-psychiatrist at the expense of compromising an encyclopedic endeavour. IMO, while Homola may be a critic, he is not that notable and has not really contributed anything to chiropractic except to let everyone know that he is retired now and has been pissed off for a long time. His books may have earned him lots of bucks, but I don’t see where he has plowed that into donations to research, schools, improved treatments, etc.

Keating writes with a very professional ability and one of his essays would reflect his views nicely. And there are NO links soliciting donations! Bravo!

The “Skeptic Dictionary” is a dreadful therapy session for a PhD (Piled high and Deep! ; - ) who put together a list of the things that he can’t stand. Oh, and what a surprise! There are a dozen or so links to Stephen Barrett Enterprises. (Donations accepted) Do you see a pattern here?

I do hope we can reign in this out-of-control section. More is not always better. Let’s trim the fat. Otherwise, where will it end? Steth04:01, 4 September 2006 (UTC)

Okay, I took a look at the critiques section again and I think Steth has a point. I am not as concerned about the particular links, but the shear number of Keating links just looks funny. Most of the articles say very similar things. Perhaps we could narrow the list somewhat. I think it would also be appropriate to add some positive articles (that aren't necessarily associations) from some notable sites as well. Any other suggestions to clean it up? --Dematt04:47, 4 September 2006 (UTC) (Oops- sorry about the It Works! link - I clicked on it and didn't see McAndrews name and thought the link must have been a left over from a previous edit)--x Dematt 04:54, 4 September 2006 (UTC)

I don't doubt that you have some good points; I also agree that more is not necessarily better, what matters is what is better. Looking at the links I think that "The Specter of Dogma - Joseph C. Keating, Jr., PhD" doesn't add much, and I propose eliminating that. I am indifferent to the Skeptics dictionary link, would be very open to replacing this with a different V RS. On Homola, I feel that the way forward will be to create a bio for him with a link, and then the explicit links to his works will be redundant here. Pending that, I suggest we leave those here for the present, but maybe it will be possible to start at least a stub for Homola quickly. I wholly agree that critiques need not be wholly critical, and would welcome the addition of constructive criticism. I think I see the present list as being dominated by criticism that is informed, well argued and intended as constructive. Gleng08:56, 4 September 2006 (UTC)

The skeptics dictionary item I'd be very happy to dispense with as I think the content is pretty weak. How about this as an alternative to it?

http://www.guardian.co.uk/health/story/0,,1402821,00.htmlGleng13:48, 4 September 2006 (UTC)13:47, 4 September 2006 (UTC)

Second thoughts maybe not appropriate, but any suggestions?Gleng13:52, 4 September 2006 (UTC)

Why do you have second thoughts? Professor Edzard Ernst is very notable, especially since he is "the first Professor of Complementary Medicine in the United Kingdom." He is also trained in manipulative therapy, among other things. -- Fyslee18:31, 4 September 2006 (UTC)

He is certainly notable. My second thoughts were only whether this item is really a reasoned critique - and the events referred to are already covered. I just thought we could probably do better.Gleng18:53, 4 September 2006 (UTC)

Gleng, if you feel that the "Skeptic's Dictionary" should be removed, then why don't you remove it? I have felt all along that it was nothing more than a list of things a PhD dislikes, not very encyclopedic. It is also a link farm for Stephen Barrett Enterprises (Donations gladly accepted!) And because it was placed here and defended strongly by an editor with a personal link featured prominently, that it really fails the smell test and should be removed as unverifiable. I have given you the reasons, so, why not remove it? Steth02:46, 5 September 2006 (UTC)

Notable Link/source

http://nccam.nih.gov/health/chiropractic/ NCCAM Research Report: About Chiropractic and Its Use in Treating Low-Back Pain - Gleng19:53, 3 September 2006 (UTC)

Chiropractic curing homosexuality?

Would editors please note the chiropractic related discussion on the Pseudoscience article. If it is true that chiropractic is notably claimed to cure homosexuality then perhaps it should be included somewhere on this page.Gleng12:24, 4 September 2006 (UTC)

Why would "anyone" want to cure homosexuality? Although, if chiropractors can "cure" it, it certainly should be included on this page:) --Dematt14:02, 4 September 2006 (UTC)

From the reference section at Pseudoscience, the source is titled "Ford, J. (2001). Healing homosexuals: A psychologist's journey through the ex-gay movement and the pseudo-science of reparative therapy. Journal of Gay Lesbian Psychotherapy, 5(3-4), 69-86." Sounds like an account of some of the crazy things that people in the ex-gay movement do. They may use Chevrolets to kidnap their victims and try to deprogram them, but that doesn't mean Chevrolet in general supports the movement. This just seems like more POV pushing from editor x KrishnaVindaloo and is without merit as a source for anything other than an anecdotal account. cheers, Jim Butler02:14, 5 September 2006 (UTC)

Yeah, unless some reference to a specific chiropractor or chiropractic organization is found, then it probably shouldn't be mentioned in here. --Havermayer05:20, 25 October 2006 (UTC)

Well its pretty obvious what type of chiropractor uses this kind of treatment. Its the type who uses the subluxation theory (most of them). We can't refuse information on the basis of pinpointing the abuser. That would give proponents a valid excuse to delete anything that doesn't suit their personal agendas. Which is also why it is not part of NPOV policy. KrishnaVindaloo07:10, 25 October 2006 (UTC)

Well that's fine, but at least there needs to be some evidence of how widespread the practice is. --Havermayer07:54, 25 October 2006 (UTC)

"'This is the third time I'm making this request for information from KV"'

Krishna, you provided this quote:

""Other methods employed by reparative therapists include hypnosis, medication, chiropractic adjustments and marital therapy.""

Now just where does it state that a "'chiropractor"' was doing this? No one but a chiropractor can provide a chiropractic "adjustment," which is not the same as a manipulation, the only difference often being the "intention." Only chiropractors believe in the chiropractic vertebral subluxation, and that this mythical lesion can be "corrected" by the use of spinal adjustments. (Now you know my bias!)

The quote seems to strongly imply that "'it is reparative therapists who are employing this method, and not chiropractors,"' and therefore it is not chiropractic and doesn't belong in this article! If it belongs anywhere, it would be the Reparative therapy article, and there the best you could do is claim that someone claims that reparative therapists use bla bla bla methods, including chiropractic adjustments. Even then you'd have an uphill battle, unless you could show it was a common practice among Reparative therapists, and not something done by one or two of them. To do that you'd need confirmation from third party sources. If the original claim is really true, it should be possible to find such sources. You'd then have a much stronger case for inclusion in the RT article. -- Fyslee18:44, 26 October 2006 (UTC)

Introducing criticism in a constructive way

Pursuing the theme of introducing criticism in a constructive way from a variety of angles - how about this as an option for the critiques? http://www.worldchiropracticalliance.org/tcj/1996/may/may1996kent.htm Gleng19:16, 4 September 2006 (UTC)

That article, http://www.worldchiropracticalliance.org/tcj/1996/may/may1996kent.htm "Critical thinking" by Dr. Christopher Kent, is an interesting one. With the exception of this very telling paragraph in the middle, it's quite good. But the paragraph is consistent with the author's usual thinking:

"The "high rollers" in our profession should give serious consideration to contributing generously to chiropractic research. So should any D.C. interested in the survival of the profession. Please note that I said "chiropractic research". This means research concerning the "'vertebral subluxation"' and its effects, not the symptomatic treatment of sore backs.

IOW, he still believes in the VS without evidence, and wants chiropractic research to focus on proving it. This isn't critical thinking, but confirmation bias led by true believer thinking.

Since this article is very typical, it's probably a good choice for a new section of links - "Encouragements to find proof that we're right." (Excuse the sarcasm, but I just couldn't resist.)

Homola criticizes Kent and the very subject of Kent's article, which is SEMG:

http://www.chirobase.org/06DD/semg.html Dubious Use of Surface Electromyography (SEMG)

-- Fyslee19:41, 4 September 2006 (UTC)

If you want to find some very good constructive criticism, try the links provided here:

http://www.geocities.com/healthbase/doug_andersen.html G. Douglas Andersen, DC - An Exceptional Chiropractor

Andersen is a regular columnist for Dynamic Chiropractic, and he has written a number of excellent articles which I have listed. Very specific criticisms and suggestions. -- Fyslee19:48, 4 September 2006 (UTC)

Looking through these. I think though that critiques links should cover a range of opinion, and we shouldn't expect all to agree with each other on all issues - there's a spectrum that needs reporting.

Another to think about... http://www.jcca-online.org/client/cca/JCCA.nsf/objects/Commentary:+Subluxation-the+silent+killer/$file/2-commentary.pdfsearch=%22Homola%20DC%22. Gleng20:02, 4 September 2006 (UTC)

That article - http://www.jcca-online.org/client/cca/JCCA.nsf/objects/Commentary:+Subluxation-the+silent+killer/$file/2-commentary.pdf Subluxation - The Silent Killer, by Ronald Carter, DC, MA is a good example from the JCCA, which has a number of excellent articles to choose from. We just need to compile a list of courageous chiros and professors who have the guts to criticize abuses and to point to solutions:

Joseph Joseph Keating Jr., PhD

Samuel Homola, DC

G. Douglas Andersen, DC

Timothy Mirtz, DC

Stephen M. Perle, DC

James Winterstein, DC

JC Smith, DC

Charles A. Bender, DC

David Seaman, DC

Jaroslaw Grod, DC

David Sikorski, DC

Charles DuVall, DC

Randy Ferrance, DC, MD

Preston Long, DC

Randall Lord, DC

Ronald Carter, DC, MA

to name a few.... -- Fyslee20:29, 4 September 2006 (UTC)

It's been a long time since I read that article. It contains an excellent quote:

"'Know your enemy"'

The direction of this paper will now examine and discuss the chaos “subluxation” has created in different contingencies of the chiropractic profession. It may well be the silent killer of the chiropractic profession. Understanding this threat will enable you to know our enemy. (Beware of the enemy for he is us.)

Do you find yourself asking: Why is there so much division in our profession? We all share the desire to be successful, to help people, to have the respect of our peers, to have the love of our families etc. Certainly how we define one word, subluxation, should not create these emotions which divide the profession. Its more than a word, it represents belief systems, different philosophies, it challenges our ethics, it provides the different factions an issue to fight about. Our own justification of this word allows us to keep, and observe our peers breaking, the Eleventh Commandment: Thou shalt not take advantage of the sick." From: http://www.jcca-online.org/client/cca/JCCA.nsf/objects/Commentary:+Subluxation-the+silent+killer/$file/2-commentary.pdf Subluxation - The Silent Killer, by Ronald Carter, DC, MA, Past President, Canadian Chiropractic Association

-- Fyslee20:42, 4 September 2006 (UTC)

OK I've modified critique links in the hope that I've interpreted provisional consensus. Think the principles we should follow are these:

1) We don't endorse criticism, but we report it and give the reader the opportunity to read for himself/herself. Thus we report criticism about e.g. a) the willingness of some chiropractors to accept low standards of evidence for reports of efficacy (Kent), b) maintaining faith in the concept of subluxation despite weak evidence (Carter) c) irresponsible use of advertising, etc but there is no need to imply that this article endorses any of these criticisms.

2) We report criticism from a variety of sources, rather than select a single critical "consensus" to report

3) We show that there is criticism from outside the profession, but also that there is a lot of self-criticism within the profession.

I am sensitive about this section because it should offer ready access to good sources of critical opinion, but should not "shout too loud". I personally think that the expression of robust healthy criticism from within the profession is itself a substantial implicit rebuttal of the attack elsewhere of chiropractic as dominated by dogma and pseudoscientific, and a demonstration of acute ethical sensibilities. I am removing Skeptics dictionary not in deference to pov but as a frank opinion of mine that it's not a particularly good authoritative or informative source, and that in context it is redundant. I think with a Homola link the references to his work here should be reduced.

On the issue of "shouting too loud", the titles of some of the works are a bit "yellow press". One alternative might be to suppress the titles but introduce each link with its unique subject of criticism. e.g.

Critism of:

the concept of subluxation (link)

ethical standards in advertising (link)

standards of evidence in support of claims of efficacy (link), etc.

Just a suggestion. I have to leave you guys for a while now - be back sometime

Gleng

08:36, 5 September 2006 (UTC)

Gleng, I agree that having the words Quackery and Cultism at the bottom of the page screams no matter how we re-arrange them. I like the idea of at least listing them without the title and describe them by their subject. I'll give it a try. --Dematt02:16, 7 September 2006 (UTC)

Fyslee, you responded with this edit summary:

It may look nice, but it's a very dangerous and far-reaching precedent. What are we afraid of here?

That is a very good question. I'm not sure "fear" is the word I would choose, but certainly "concerned about" is appropriate. I am concerned that the titles themselves "shout" quackery and cultism without them even reading the article. By using the titles in this manner, it leads to revert wars and hard feelings. If we are going to be able to get this article to the point where it can be read by all, it has to be stable. I'm not saying that chiropractic does not have issues that may be considered quackery (we may even one day be able to handle them in the article), but we won't be able to discuss them if they are deleted all the time. And that is not just by regular editors on this page, that would be by any chiropractor (straight/mixer/reformer or satisfied patient) that stopped by. We can still have the articles without drawing attention to the critical nature of the labeled issue (i.e. advertising, etc.). Yes, it is a precedent, but it may solve several problems that occur on lots of pages. I understand it can be dangerous and far reaching, and that is why it needs to be evaluted carefully. If anyone can make it work, it would be us here on the chiropractic page, then we might be able to use it elsewhere. A long term solution is going to have to be creative. What do you think? --Dematt14:05, 7 September 2006 (UTC)

If it weren't for the fact that it was Dematt that did it, this http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=74256727oldid=74250713 edit could be interpreted as revisionism. It certainly goes a long way towards accomplishing the suppressionist goals of certain editors who wouldn't hesitate to scrub the whole Critiques section if they could get away with it, and thus this edit inadvertently helps them to some degree. It is blatent POV suppresion. Such a tampering in the external links is an unheard of step, setting a dangerous precedent. No where else here is this type of thing allowed.

There are guidelines for external links, and these sentences are to the point:

"If you link to another website, you should give your reader a good summary of the site's contents, and the reasons why this specific website is relevant to the article in question." http://en.wikipedia.org/wiki/External_linksExternal_links_section

An http://en.wikipedia.org/w/index.php?title=James_Randicurid=16278diff=74288248oldid=73823019 example:

http://www.theness.com/articles.asp?id=10 NESS Participates in the Randi Psychic Challenge - Describes the type of testing done for the One million dollar challenge

Here we have a description, but no tampering with the actual title, especially to obscure it or enhance it! That type of editing would be POV suppressing or POV pushing, depending on whether it is obscuring or enhancing.

I think following the Wikipedia guidelines above would be a helpful service to readers, without deliberately hiding existing POV, which is very unwikipedian. Even the heading itself is already accomplishing much of the suggestion above, so detailed descriptions of each link aren't even necessary. People are being forwarned when they look there. It won't affect their POV. Chiropractic believers will look at the Critiques section and just shrug it off as the rantings of fanatics, and skeptics will look at the Advocacy section as the place to find sources for examples of weird ideas and attacks on medicine, vaccinations, and science. -- Fyslee16:19, 7 September 2006 (UTC)

Fyslee, you know I totally respect your POV and thank you for understanding that this effort has nothing to do with being deletionist or revisionist, though Steth, I respect your POV as well and appreciate your restraint. I'm trying to keep information from getting deleted. All the information is still there, just more neutrally presented. --Dematt16:59, 7 September 2006 (UTC)

I understand "your" motivation, so don't worry about what I think of you. My concern is about the last two words - "neutrally presented." NPOV is not about neutralizing anything, but about not appearing to "support" or "suppress" any particular POV. They should be "presented as they are", in all their POV gore and glory (which will be interpreted by one's existing POV). The article and its resources shouldn't turn readers into spineless wimps who end up having no definite POV about chiropractic. They should be presented with all POV so strongly and clearly that they become more informed by this article than by any other article they have or ever will read. Then they can have an informed POV. Neutralizing shouldn't be a part of the article or of the links. -- Fyslee17:55, 7 September 2006 (UTC)

I like Dematt's approach. Personally, I think that both "sides" benefit from this. The reader is given access to criticism in a clear organised way that doesn't imply endorsement of the criticism, and doesn't entail publishing what might appear to be rather offensive statements at least out of context. The critical articles themselves are very much more measured and balanced that the titles seem to suggest; book titles often have a sensationalist tinge that frankly can wrongly predispose the reader to think that they are yellow journalism. This section as Dematt has laid it out looks to be what we should aim it to be, a thoughtful and balanced selection of excellent sources for the interested reader to find out more. Nobody surely wants people to draw conclusions, pro or con, from titles alone, but should encourage them to read and find the facts for themselves. So, IMO, I'm very strongly in favour; it seems a good way of neutrally opening access to sources of different viewpoints, and a way that other good sources can be added if appropriate without overburdening the article; this removes some of the burden of selection, which will always be tricky, and the organisation ensures that issues are mentioned and covered. My vote is strongly pro this change.Gleng16:15, 7 September 2006 (UTC)

Actually I don't think neutral presentation is the right way to look at this; more rationally presented is the aim I think. It could be argued both ways, identifying the issues clearly and coolly gives the criticisms respect; not flashing potentially misleading headlines treats us all with respect. If I thought this was about suppressing dissent I would oppose; I think the opposite, it's about finding a away of introducing it coollyGleng18:18, 7 September 2006 (UTC)

To expand slightly: to my eye a title like "Chiropractic is quackery" declares an opinion clearly, but actually doesn't look like something you'd read for a balanced appraisal. Some of these titles are clearly intentionally provocative presented to a chiropractic audience, and contain very thoughtful constructive and balanced criticism. Look at the title alone, you don't see it, see the context and you realise that these aren't rants. Judge a book by its content not its cover. Do we want people to read these, or do we just want people to register the existence of dissent?Gleng11:36, 8 September 2006 (UTC)

I would like this article to be something that a chiropractor can look at and read and learn something about his own profession. I certainly did not know some of this information and this entire experience has been very enlightening for me. But, if I had first read this page and saw Quackery, Pseudoscience, Cultism shouting at me, I would assume it was just another uninformed attack and moved on to something less threatening. If it is presented in a way that doesn't threaten me I will read it and, even if it ticked me off, I would learn from it. Hopefully, maybe it will help get through to some of those crazy advertisers. Chiropractors, more than anybody, need to read this stuff, too. I am open to anything that might help get this information out in a less threatening way. --Dematt12:44, 8 September 2006 (UTC)

You both make some good points and I sympathize to some degree. In another sense they aren't legitimate, because the one's you're complaining about are written by chiropractors as part of internal criticism. Chiropractors have already seen this stuff, and the article is for everyone, not just DCs. Even if we revised each title, who would do it, and how would it be done? Each article often contains multiple points, which would need to be summarized in a few words. The Wikipedia guidelines are still useful:

"If you link to another website, you should give your reader a good summary of the site's contents, and the reasons why this specific website is relevant to the article in question." http://en.wikipedia.org/wiki/External_linksExternal_links_section

The way to do it is shown here without any tampering with the title:

http://www.theness.com/articles.asp?id=10 NESS Participates in the Randi Psychic Challenge - Describes the type of testing done for the One million dollar challenge.

The heading (Advocacy or Critiques) is often sufficient to serve as a description of why the article has been chosen. -- Fyslee20:51, 8 September 2006 (UTC)

You both make the point that hits the nail on the head. These articles were not written for public viewing, they were meant as food for thought for chiropractors. Have we thought about the fact that since these articles were written, they may have had the effect that the authors intended and now we are bringing up old housecleaning and labeling it as internal conflict. Yes, this is a good example that shows that there is internal dialogue to correct behavior and encourage critical thinking, which is a necessary endeavor for advancement. Surely every organization has these debates, but only chiropractic displays them publicly. Is it only chiropractic that is public. The AMA ethics codes protect their own, chiropractic airs it all. That certainly shouldn't be considered a bad thing. In fact, it should be considered altruistic. Maybe we can combine the WP format with what we're considering here. Give me a minute. I'll try it on one or two, let me know what ou think. --Dematt00:47, 9 September 2006 (UTC)

Ummmm....chiropractic isn't the only profession who displays its debates. (Where is all the information on iatrogenesis and drug side effects first published?! All the critics get it from the medical profession itself, and then make it look like the profession is ignoring or hiding it.)

Chiropractic debates just happen to be of a very different nature than debates in other medical professions. This is because of the various types of internal division related to science/antiscience, quackery, practice building, advertising, philosophy, etc.. The language (often personal and vulgar attacks with lots of misspellings) is also uniquely different. Other professions have other types of debates. Chiropractic (which is more than the official profession, but includes chiropractors, their discussion lists and their websites) also censors debates on many discussion lists. But, debate and dissension is more accepted now than earlier, and that is a sign of progress. True believers will still react viscerally, personally, and viciously, while more informed and scientifically oriented chiros are reacting with well-reasoned and better resourced debate forms, with fewer logical errors. The more modern debates are often more informative, depending on the forum. -- Fyslee08:31, 10 September 2006 (UTC)

Okay, I did three of http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=74641417oldid=74486610 them What do you think? Are we on the right track? --Dematt02:22, 9 September 2006 (UTC)

Magisterial Dematt. My respects.

I would like to think that the article at the end is indeed one that can be considered good and fair by both critics and supporters of chiropractic. I still have a gut feeling that nobody should be forced to publicise a statement that they may see as a libel when they can make the content open and accessible without doing so, but I respect Fyslee's point, there are precedents here, and what might work here might be seen as a precedent for disguising or suppressing criticism, which is absolutely not anyone's intention. Personally, Dematt's suggestion is fine by me. Another alternative might be to summarise the annotations in a short paragraph and simply incorporate the references as links in the normal way. Whatever.

On this issue though, I hope this can be settled by agreement not by simple majority vote; it is a case when all sides need to feel happy with the outcome. I'm not saying Fyslee should have a veto, but that if he's not convinced, then perhaps we've not got it right.Gleng09:02, 9 September 2006 (UTC)

Gleng, I am good with your edits. I can live with that. Fyslee, thanks for your input. Are you satisfied with it? And Steth, does it work for you? --Dematt12:52, 9 September 2006 (UTC)

Dematt, my hat is off to you for your admirable efforts! It is more informative without setting any kind of potentially dangerous precedent. It's certainly an unusual approach, which can create a future battleground for editors who wish to emphasize different aspects in the articles or documents, but I'm certainly fine with the way you have done it, simply because you understand the NPOV policy and are attempting to cover the "subject" of chiropractic as thoroughly as possible. (This article is not about the "profession" or "chiropractors," but about anything and everything - past, present and future - that has to do with the "subject" of chiropractic, regardless of POV. This point evades those who wish to turn the article into a sales brochure to be sold from a Wikipedia soapbox.)

There is something I've come to realize, and that is that the "Internal criticism" heading is somewhat misleading. The criticism isn't all really "internal" criticism, but is criticism from chiropractic insiders, who sometimes are forced to publish their views outside of the profession, and whose views are pretty much universally (with few exceptions) denounced within the profession. That can't properly be considered "Internal criticism." Even some of it published in Dynamic Chiropractic is viciously attacked in the Letters to the Editor section, but it still does affect some chiros, who become polarized more towards reform. Some of them then come to Chirotalk, where they can express their frustrations without getting banned, which happens on nearly all other chiropractic discussion lists. Not all "internal criticism" from chiropractors is well-received or tolerated.

Therefore I suggest another heading: "Insider criticism." This doesn't imply anything about whether it's normal internal discussion that is accepted and leads to reform, or outright attacks by chiropractic rebels who have no recourse but to go outside to vent their views. It also covers different types of authors, and thus isn't limited only to DCs. That includes professors and researchers who are or have been employed by the profession. The "External criticism" heading still functions fine. -- Fyslee08:10, 10 September 2006 (UTC)

Professional?

Fyslee, your edit summary stated,"Prof. sounds nice, but they are a blend - all being chiropractic; Uniform formatting)", which of these are not "professional"?

http://www.amerchiro.org/ American Chiropractic Association (ACA)

http://www.chirocolleges.org/ Association of Chiropractic Colleges (ACC)

http://www.chiropractic-uk.co.uk British Chiropractic Association (BCA)

http://www.ccachiro.org/ Canadian Chiropractic Association (CCA)

http://www.chiropractic.co.za/ Chiropractic Association of South Africa (CASF)

http://www.cda.org.hk/English/ Chiropractic Doctors' Association of Hong Kong (CDAHK)

http://www.chiropractic-ecu.org/ European Chiropractors' Union (ECU)

http://www.straightchiropractic.com/ Federation of Straight Chiropractors and Organizations (FSCO)

http://www.f-a-c-e.com/ Foundation for the Advancement of Chiropractic Education (F.A.C.E.)

http://www.fcer.org/ Foundation for Chiropractic Education and Research (FCER)

http://www.hkca.org/ Hong Kong Chiropractors' Association (HKCA)

http://www.icpa4kids.com/ International Chiropractic Pediatric Association (ICPA)

http://www.chiropractic.org/ International Chiropractors Association (ICA)

http://www.jac-chiro.org/ Japanese Association of Chiropractors (JAC)

http://www.chiromed.org/ National Association for Chiropractic Medicine (NACM)

http://www.worldchiropracticalliance.org/ World Chiropractic Alliance (WCA)

http://www.wfc.org/ World Federation of Chiropractic (WFC)

Thanks--Hughgr20:57, 5 September 2006 (UTC)

Maybe I misunderstood you. I was thinking of membership organizations, as in national associations. Not all of them are for that purpose. Fyslee21:03, 5 September 2006 (UTC)

A division

To make it more clear what the list contains, I suggest a division. Let's see how it looks, and if it will work:

"'Official national organizations

"'http://www.wfc.org/ World Federation of Chiropractic (WFC) - International"'

http://www.amerchiro.org/ American Chiropractic Association (ACA)

http://www.chiropractic-uk.co.uk British Chiropractic Association (BCA)

http://www.ccachiro.org/ Canadian Chiropractic Association (CCA)

http://www.chiropractic.co.za/ Chiropractic Association of South Africa (CASF)

http://www.cda.org.hk/English/ Chiropractic Doctors' Association of Hong Kong (CDAHK)

http://www.chiropractic-ecu.org/ European Chiropractors' Union (ECU)

http://www.hkca.org/ Hong Kong Chiropractors' Association (HKCA)

http://www.jac-chiro.org/ Japanese Association of Chiropractors (JAC)

"'Special interest groups and associations"'

http://www.chirocolleges.org/ Association of Chiropractic Colleges (ACC)

http://www.straightchiropractic.com/ Federation of Straight Chiropractors and Organizations (FSCO)

http://www.f-a-c-e.com/ Foundation for the Advancement of Chiropractic Education (F.A.C.E.)

http://www.fcer.org/ Foundation for Chiropractic Education and Research (FCER)

http://www.icpa4kids.com/ International Chiropractic Pediatric Association (ICPA)

http://www.chiropractic.org/ International Chiropractors Association (ICA)

http://www.chiromed.org/ National Association for Chiropractic Medicine (NACM)

http://www.worldchiropracticalliance.org/ World Chiropractic Alliance (WCA)

How's that look? -- Fyslee21:18, 8 September 2006 (UTC)

I don't think that would work because most in the first groups titles have the word "associations" which creates confusion. I did a quick check on the WCA's website because of their title (World..) and it states, "The World Chiropractic Alliance was founded in 1989 as a non-profit organization dedicated to protecting and strengthening chiropractic around the world." http://www.worldchiropracticalliance.org/about/wca.htm Wouldn't that make them international as well? Why don't you like calling them all just "professional"? BTW, professional derives from profession which means, "An occupation that requires expertise or a high level of skill." http://en.wiktionary.org/wiki/profession. I feel that fits perfectly.--Hughgr21:45, 8 September 2006 (UTC)

While it looks good, and I don't have any trouble with changing the top one to "Professional organizations", I'm quite sure the ACA would love it, but the ICA would really take offense to it;) --Dematt00:32, 9 September 2006 (UTC)

It requires what could be considered OR to determine who really is an official national organization, when several make the claim (Hong Kong?), and the WCA, an advertising agency with a few hundred members (about the same as the NACM) and secret membership lists does call itself "World" CA. I guess it's an impossible task, so Professional (which also means "money making", which doesn't apply to several) will have to do. You're right about the ICA, since they carry the torch of "real" chiropractic.....;-) There is certainly no love lost between them. How about restoring http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=74032090oldid=74019151 the original "Chiropractic organizations"? That certainly covers it and it worked fine, since it can include national organizations, research and advertising groups, special interest groups, etc.. It worked fine and was never controversial. -- Fyslee07:30, 10 September 2006 (UTC)

The lead, again :)

This sentence:

"Mainstream medicine does not believe that such vertebral subluxations exist or affect general health, thus differentiating them from the medical use of the term subluxation."

Is using http://en.wikipedia.org/wiki/Wikipedia:Avoid_weasel_words weasle words to avoid. For example, "Mainstream scholars/scientists/researchers...", or "The (mainstream) scientific community". While "mainstream medicine" isn't explicitly listed, I feel it meets the same criteria. Further more, it is an anthropomorphism, mainstream medicine can't "believe" anything. And while I get the sentiment, I feel it needs to be re-worded. Any suggestions?--Hughgr04:22, 6 September 2006 (UTC)

Yes of course you're absolutely right and the sentence as written is gibberish; I guess the intent would be to assert that "In conventional medicine, such vertebral subluxations are not thought to be a common cause of many illnesses."??I really am going now for a while.Gleng08:07, 6 September 2006 (UTC)

Thank you Gleng, I think that is getting there. Does anyone else have any input?--Hughgr21:58, 6 September 2006 (UTC)

I agree with the weasel words (though I think they were mine:). Also, "thus" infers that one caused the other which would not be proper. If anything, I like Glengs version. Though, it really doesn't matter if that sentence just stays out. The science factor is mentioned at the bottom or the page. --Dematt22:02, 6 September 2006 (UTC)

Reply to Abotnick regarding NACM

I moved the discussion to this area to find it easier.

steth wroteHi Abotnick. Could you point us to the source for this claim. Maybe a membership list. Otherwise unverifiable. Determined that most reformers not members.)

Abotnick replied:

"What do you mean most reformers are not members? The platform stated on their website is the only reform message of any chiropractic organization. Their membership list is not available, try contacting them and ask for statistics. You are really picking nits here to try to keep NACM from being mentioned in the body and it's very immature. Just because you don't like their position doesn't give you the right to censor them from the body."

"NACM is a legitimate chiropractic organization and does represent the reform chiropractors. They have a discussion group and a website. I previously added a line to them in the reform section but someone snipped it out. I ask that this be restored in fairness to the group.Abotnick 20:36, 5 September 2006 (UTC)"

Hello Abotnick, I am not sure why you decided to now answer a question I posed in July, but maybe this will help you.

I don't feel it should be included in the article at all, but a link under 'Organizations' is more than adequate. My reasons are that real organizations have officers and elections, hold meetings, seminars, etc., and usually have some kind of directory of the members/officers. Otherwise it is just a secret club, hardly notable and not verifiable.

As for the website, well anyone can have a website. It is only one page and looks like it hasn't changed in a long time. I am also skeptical about this so-called 'organization' because of the four links at the bottom of the page, three are owned by Stephen Barrett Enterprises (donations gladly accepted!). He of course is the Supreme Commander of the anti-chiropractic fundamentalist extremists brigade. Now what kind of real chiropractic organization would promote that!?

So Abotnick, can you confirm any of the above? Who are the officers, members, when are elections, seminars, etc.? There seems to be no information regarding these points available on the internet.

You know, I was going to leave yours and Fyslee's additions of NACM alone, but now that you are bringing this up and reminding me of why it fails the smell test, I think references to NACM should be removed as unverifiable. BTW are you a member? Are you connected in some way with this 'organization'? I believe Fyslee mentioned that he is their internet discussion moderater, a fact which if true, lends itself to the personal, self-interest conflict issue which also fails the smell test. I think there is a WP policy about this. Does anyone know the specifics on this?

Does that answer your question? Steth18:24, 6 September 2006 (UTC)

OK, I really am gone but come on Steth, sometimes your sharpness is spot on and refreshingly blunt, (and sometimes well aimed) but we ALL have interests and we ALL try to maintain objectivity in our own ways despite this, and usually in the end we manage. Yes Fyslee has a role we all know about and you do and I do and none of us here hide those, Fyslee discusses here civilly openly and listens, what more can we ask? Gleng19:15, 6 September 2006 (UTC)

Sorry Gleng, I guess I should have been more clear. The interests I was referring to were the links to websites that editors add to articles when those same editors are in some way involved or connected to those websites. The editors I cited above have added many links that fall into this category and should probably be examined. Editors like you, Dematt, Levine, myself, etc. have never added links that we have had an iterest in. I hope that is more clear. Steth22:29, 6 September 2006 (UTC)

Reform sentence

I have two concerns with this sentence:

Later the reform group, the National Association for Chiropractic Medicine, was formed, but it has never grown very large or made any significant impact on the profession.

I have to check, but did the NACM form "later"(after Homola)?

"never grown large or made any significant impact on the profession"

If no significant impact, we shouldn't be writing about it. If we are giving it the credit for the pressure to become more scientific, then that is a pretty big impact, right? Which way does our information point us? If we want to get this right, who gets the credit for the science, ICA or ACA or NACM? Or are we performing OR. We probably need to sit back and work on it. Any input? --Dematt20:33, 6 September 2006 (UTC)

Exactly my point, Dematt. The so-called 'organizaation' (even though it doesn't seem to be organized) NACM, has made no impact whatsoever. This is because they have never held a seminar or produced any scientific research or studies on anything that I know of or ever heard of. If anything, the ACA has had a far greater impact through scientific seminars and symposiums. They have also been major contributors to the FCER (Foundation for Chiropractic Education and Research) which is engaged in many scientific studies at any given moment by giving grants to scholars at school research centers.

So why write about the NCAM at all? I have said this all along. It doesn't belong in the main body. A link at the bottom is more than generous. Steth22:38, 6 September 2006 (UTC)

In the context of this http://en.wikipedia.org/wiki/ChiropracticThe_Reform_movement section, I may have inadvertently been using OR and made a leap in suggesting that Homola had anything to do with chiropractic's direction turning toward science. I sure wouldn't mind if someone could find anything to that effect. Steth, you make a good point about the FCER and research. Maybe we need to investigate what happened between 1960 and 1970 and see what happened. Homola and Keating should both have something along those lines and then we can look into FCER history, etc. Lets see if we can tell where it all came from. Don't forget there is National college, Joe Janse, and Canadian MCC began to make the jump toward science. Keep in mind that also the US was in turmoil through that period (Kennedy assassinations, Martin Luther King, Vietnam, Kent State, Sex/Drugs/and Rock and Roll - you know - the good ole days:), so apparently there was a renewed interest in anything that was not considered authoritarian or from "The Man." Let me know what anybody finds. --Dematt23:27, 6 September 2006 (UTC)

Dematt has two concerns with this sentence:

Later the reform group, the National Association for Chiropractic Medicine, was formed, but it has never grown very large or made any significant impact on the profession.

Dematt: 1. I have to check, but did the NACM form "later"(after Homola)?

Fyslee: I believe Homola has stated that he is a member of the NACM, which was started much later than 1963 (http://www.jcca-online.org/client/cca/JCCA.nsf/objects/Commentary:+Subluxation-the+silent+killer/$file/2-commentary.pdfsearch=%22nacm%20started%20ron%20slaughter%22 in 1984).

Dematt: 2. "never grown large or made any significant impact on the profession"

Fyslee: That sentence is mine, and I see it can be misunderstood, since it's from my POV as a skeptic, and from the POV of some reformers in the profession who are disheartened by the lack of progress towards reform and the continued persecution of reformers. Subluxationism is still alive and kicking, so they have a hard time seeing much reform.

To reformers, Homola, NACM, and critics, reform is what happens as a positive reacton to the calls for rejection of Palmerian philosophy and belief in the vertebral subluxation. The calls are part of the reform efforts, but until they succeed in causing open rejection from the top and all the way down, not much reform is actually happening, and therefore the reform efforts haven't had much visible success.

Yet one could speak of a form for success, in that these calls for reform have gotten more chiropractors to individually drop those beliefs, and more chiropractors to cease to perform research to proof a metaphysical concept, and instead to do research to find out what actually happens when a joint is manipulated. This requires using scientific language, instead of old philosophical hypotheses. Progress will always happen, but reform will take a revolution of major consequences, since openly rejecting the VS as the foundation of the profession effectively exposes the whole foundation as an illusion. -- Fyslee21:39, 8 September 2006 (UTC)

Can you provide something to back up your statement:

""...these calls for reform have gotten more chiropractors to individually drop those beliefs, and more chiropractors to cease to perform research to proof a metaphysical concept, and instead to do research to find out what actually happens when a joint is manipulated.""

How do you know this has happened and that NACM is responsible for this? Who is doing this research? Are they members of NACM? What research has NACM funded and carried out? FCER provides large grants to school research departments to carry out this type of research. So does the ACA. If anything, they should be given some, if not most, of the credit.

Of course, to keep things in perspective, it must be kept in mind that the above viewpoint is coming from a member of another health discipline. Steth23:17, 8 September 2006 (UTC)

More than one type of reform

This comes from the NCAHF position paper on chiropractic on http://www.ncahf.org/pp/chirop.htmlreformers reformers in 1985: ("Italics" and "'bold"' emphasis is mine)

The Reformers

There is a small but growing number of chiropractors who recognize the failings of their profession, but sincerely believe that there is a place for chiropractic in the health marketplace. It is estimated that 70-80% of people will suffer back pain at some time in their lives. If, as studies seem to indicate, one third of these can find more rapid relief by having safe, conservative manipulative therapy, then there appears to be a large market for the services of scientifically oriented chiropractors. Further, a national study of health practices found that three-fourths of chiropractic patients seek relief from musculo-skeletal problems. (42) This means that a minority seek the type of treatments found in the plethora of nonsense practiced by the chiropractor/naturopaths. If chiropractic were to purge itself of its quackery and offer valid back care, it could expect a substantial increase in physician referrals.

One small faction of reformist chiropractors is conducting and publishing meaningful research in the field of manipulative therapy. This group is not openly critical of chiropractic's shortcomings and "'has not"' agitated for outright "'repudiation of the "subluxation" theory"'. They apparently seek to change chiropractic by evolution, "bypassing the theory by ignoring it or applying the term "subluxation" to a number of spinal aberrations in a general manner". It is NCAHF's view that these chiropractors are too greatly outnumbered and overshadowed by practitioners profiting from pseudoscience to effectively change chiropractic in this manner.

A more progressive-minded group has formed the National Association for Chiropractic Medicine "'(NACM)"', a professional association with views which are in harmony with science and consumer protection. Using guidelines set forth by the NCAHF Task Force on Chiropractic, NACM has openly "'renounced the "subluxation" theory"' and unscientific practices. Members limit their scope of practice to neuro musculo-skeletal conditions, and its modes of treatment to those which have scientific validity. NACM does not present itself as an alternative health care system to medical science.

This is what I was remembering. The first group this NCAHF paper is talking about is Joe Janse from National, those who started the JMPT (and others); Dana Lawrence, John Triano and the Texas Back Institute, and others from other mixer colleges. The second group is the NACM, who cooperated with the NCAHF and first made news when they announced that they wanted to prescribe certain drugs. They were not welcomed with open arms to say the least, particularly since they openly criticized the entire profession and alienated any potential allies. Fyslee, this is the group that you are talking about, and you are right, they have not made much of an impact and are at the other fringe. But, I think the first group is the group that the ACA and the silent majority have been moving toward since 1990 (right after the Wilk suit - even asked Homola back in 1991 - and remember ACA legal counsel George McAndrews letter in 1992). In other words, this particular reform movement was not renouncing subluxation, but researching it, which is what most chiropractors want according to the survey we have cited. I still think people like Homola (back in the 1960s) influenced these people indirectly to "prove what they preached." Along with the Wilk suit, which forced DCs to really look at the science behind their practices. After all, had it not been for Workers comp research and other testimony that forced the AMA to admit there was research that supported that chiropractic was better for some conditions, Wilk probably would not have won. As as additional note however, I think a lot of these same people have since begun advocating dropping subluxation. The question is if any of these people are members of the NACM, which we apparently will never know. --Dematt23:10, 10 September 2006 (UTC)

Yes, that's pretty much my understanding too. There are those who seek scientific validation of the subluxation theory and perform research to those ends; those who seek to bring the profession away from its former antiscientific attitudes; those who already have dropped attempting to prove subluxations, but seek to perform research to find out what really happens when a joint is manipulated; and those who openly denounce subluxationism, vitalism, and innate intelligence as the foundation of the profession, because they see them as detrimental to the profession's progress and acceptance, and because they consider them to be unscientific holdovers from the "old days," which are used to justify misuse of manipulation, the creation and use of a myriad of quack devices (like the Activator), and all kinds of outright quackish and nonsensical practices and claims, including the whole practice building thinking, with lifetime treatment of asymptomatic individuals and their families (Flesia). -- Fyslee04:54, 11 September 2006 (UTC)

Smith link

Apologies guys, the link to the Smith reference doesn't work (it did once, honest, and I did read it Steth ;)). However now I can't confirm it or amplify it. Suggest if we can't find an on-line access we find an alternative. Can anyone help?Gleng11:46, 9 September 2006 (UTC)

It works fine now. -- Fyslee07:08, 10 September 2006 (UTC)

Mainstream medicine

Mainstream medicine sounds so good and says a lot, but it as Hughgr suggests, it is a weasel word that is unverifiable. --Dematt14:52, 11 September 2006 (UTC)

Burden of proof. The principle is simple; an assertion needs V RS; you do not need V RS to eliminate an unsupported assertion. Gleng15:26, 11 September 2006 (UTC)

Perversion of WP principles to argue this line. Pls quote chapter and verse of policy if you disagree. I'm putting it back. Mccready16:02, 11 September 2006 (UTC)

RS "The burden of evidence lies with the editor who has made the edit in question, and any unsourced material may be removed by any editor."

In this case the statement in the lead declares the premise of chiropractic - i.e. its core assuption. This statement does not assert the validity of that assumption, only that chiropractors have it. Challenging its validity at this point in the text is inappropriate as you're challenging something not asserted. If you wish to argue at an appropriate place that medicine or science does not support this premise, fine, if it's not already covered, do so with V RSGleng16:13, 11 September 2006 (UTC)

Mccready accuses me of anti-science here.

http://en.wikipedia.org/w/index.php?title=User_talk:Glengaction=editsection=27

So let me spell this out very clearly. The statement as made in the lead at present is

“Chiropractic's premise is that spinal joint misalignments, which chiropractors call "vertebral subluxations", can interfere with the nervous system and result in diminished health.”

This seems an unobjectionable and wholly accurate statement. However if Mccready wants a V RS for it then can someone please like to point him to any statement of chiropractic philosophy and beliefs.

The statement does not assert that the premise is in fact true. However, the statement as posed is not only true it is tautologically true. Reduce the sentence by eliminating subsidiary clauses and it becomes: “spinal joint misalignments can interfere with the nervous system and result in diminished health.”

As it happens, "although the truth of this is not asserted", it is obviously true.

This statement can be criticised, as it has been (and see ongoing discussion), on the grounds that in fact chiropractors believe more than this, and believe that subluxations are the cause of many diseases. In some of these additional claims chiropractic indeed is in dispute with many in conventional medicine. However, this is not what the sentence says or appears to say at present.Gleng16:32, 11 September 2006 (UTC)

I'll work on a reference. --Dematt17:51, 11 September 2006 (UTC) Found Association of Chiropractic Colleges definition of subluxation that states something close. If you want, we can just quote them directly, leave it as is, or look for another source that is acceptable. --x Dematt 18:05, 11 September 2006 (UTC)

Your parsing is incorrect since it removes ref to vert subluxation. Please provide the actual words of V RS which you claim justify removal of the statement that science does not support vert subluxation. Your attempts at sophistry are trying and time wasting. Please try to edit cooperatively. Mccready16:48, 11 September 2006 (UTC) The sentence is also incorrect because it contains an inaccuate representation of the vert sub belief as you should know. x Mccready 16:57, 11 September 2006 (UTC)

Mccready, I disagree, The subluxation sentence appears to be an accurate and NPOV statement --Dematt18:11, 11 September 2006 (UTC)

Cancer, diabetes, infectious diseases

As per Mcready request, placing this on the talk page until a verifiable and reliable source can be found.

All Fact|date=April 2008 are trained to recognize signs of cancer, diabetes, and infectious diseases and refer these patients to medical physicians.

--Dematt15:35, 11 September 2006 (UTC)

I would think http://www.cce-usa.org/2006%20January%20STANDARDS.pdf this pdf covers any questions in the USA. This is from Australia http://www.ccea.com.au/images/PDF/Assessment/Competency%20Standards.pdf and in this somewhere from Europe, http://www.cce-europe.com/--Hughgr17:51, 11 September 2006 (UTC)

Thanks Hughgr, I was able to use the CCE definition and considering all the US schools are CCE accredited, that should cover it. --Dematt21:04, 11 September 2006 (UTC)

Where are we going

After throwing around some thoughts and ideas with Fyslee and Gleng on Fyslee's talk http://en.wikipedia.org/wiki/User_talk:FysleeVS_edit page, and putting together all the information that we have all brought to the table, I think we might be able to see some light at the end of the tunnel. This is what I was thinking:

I think it is important to show that there is a scientific following that has dropped subluxation, a following that wants to prove subluxation, and a following that wants to keep it a metaphysical concept. I think this is verifiable and true (its always nice when they both work out). I think it would also include all chiropractors, unless you can think of another type group. After we have done that, we can then try to determine how large each group is and that may give us an idea of a net effect of the chiropractic "conciousness", essentially being a NPOV with all POVs represented. The problem here is that those that scream loudest may not be the majority. What do you think. --Dematt14:58, 12 September 2006 (UTC)

I also think it would be important not to make judgements about any particular group, at least until we have been able to fully explain that group's POV. Any input would be greatly appreciated. With all of us on the same page, we might be able to get this thing right. --Dematt15:08, 12 September 2006 (UTC)

With all that in mind. Does this work in the lead:

The conventional use of the term subluxation in medicine does not typically include any relationship to health and is therefore differentiated from chiropractic's vertebral subluxation. Not all chiropractors subscribe to the definition of subluxation, though the majority apply at least some weight to its concept. Others still believe in its original metaphysical construction.

--Dematt15:47, 12 September 2006 (UTC)

I like that version Dematt. So I just reverted an anon user from Australia back to yours....--Hughgr04:12, 13 September 2006 (UTC)

Dematt, that was a good addition. A very simple, matter-of-fact statement. One word (in bold below) might improve it:

"The conventional use of the term subluxation in medicine does not typically include any relationship to "'general"' health, and is therefore different from chiropractic's vertebral subluxation."

A subluxation can have "health" consequences of a local nature, and if it pinches a nerve, affect the area served, but, unlike the VS, it isn't known to have general health consequences (disease, immune function, etc.) for the whole body. What do you think? If you think of another word that would do the trick, please suggest it. -- Fyslee21:31, 14 September 2006 (UTC)

I think yours is even more correct. I'll make the change. If anyone else has a problem, please bring it to the talk page and we'll work with it till we get it right. --Dematt01:29, 15 September 2006 (UTC)

That works for me.--Hughgr01:50, 15 September 2006 (UTC)

More Straight Mixer Clarity

I'm working to clarify the ongoing straight mixer struggles in the history section. Feel free to make some edits. --Dematt02:33, 14 September 2006 (UTC)

Science bits

Noticed this.

"DD Palmer qualified his vitalistic construct noting that knowledge of Innate Intelligence is not essential to the competent practice of chiropractic."

Nothing wrong with this, but it's a non-sequitur where placed, and while no doubt correct is this really going to be understood by a reader?

Gleng

08:53, 14 September 2006 (UTC)

I like your changes!

I think your right about the DD statement int he science section. That edit really went with the table that was moved to the subluxation section. I'll see if I can fit it in up there again. --Dematt12:19, 14 September 2006 (UTC)

New section

I just added some http://en.wikipedia.org/wiki/ChiropracticChiropractic.E2.80.99s_approach_to_healthcare Chiropractic approach to healthcare. Feel free to add to it!

gleng revert

gleng reverted me saying I should explain on the talkpage. My edit summary was sufficient. he should not have reverted without stating reasons. I used popups to do so because it saves me 5 mins on dialup. we don't need bully boy tactics from you gareth. please do not employ them. edit cooperatively and you will gain more respect. Mccready14:47, 19 September 2006 (UTC)

Mccready, what was the purpose for your edits. You basically just re-arranged the sentences into a sequence that did not flow well. The intro touched on all the different facets that are explained further in the article. We can't put the entire article in the intro. Personally, I see your edit was nonsensical and created redundancy in the introduction. --Dematt15:01, 19 September 2006 (UTC)

let's take this step by step so that there is no misunderstanding. your labelling and attack on me is unhelpful. First issue. Did my edits reduce redundancy? Yes or no? Mccready15:13, 19 September 2006 (UTC)

No. They eliminated a point of meaning, as I explained to you on your Talk page.Gleng15:26, 19 September 2006 (UTC)

Let's try this again. Step by step and then we'll return to your point of meaning claim. Did any of my edits today on chiro remove redundancy? Yes or no? Mccready15:46, 19 September 2006 (UTC)

How clear can this be. No. They instead removed a non-redundant point.Gleng16:07, 19 September 2006 (UTC)

It could be much clearer if you were to apply logic to your discussion. The question was did ANY of the edits, not the edits as a whole, remove redundancy? I have addressed your claim about removing a point of meaning below. Please answer the question. Mccready16:25, 19 September 2006 (UTC)

Gleng 2nd revert

This bullying is not helpful. Your summary claims your revert is according to talk. The talk is ongoing. Your claims are being discussed. Please stop your reverting and discuss.Mccready15:58, 19 September 2006 (UTC)

I think there is a misunderstanding here. The modus operandi on this page, for edits that might reasonably be expected to be contentious, and that I think is pretty universally observed on this page except by you, is that the edit is discussed first, and agreement obtained, before inserting. While you do not observe this etiquette, you must expect every edit that contains a contentious point to be reverted, and indeed, I don't even propose to discuss such changes unless you can be bothered to adhere to this etiquette in future; however your last edit was in fact discussed as above and on your Talk page.Gleng16:05, 19 September 2006 (UTC)

Gleng comments copied from my talkpage

"As stated, clearly and by other editors also, as phrased the statement stated what chiropractors believed to be the case; the V RS for the truth of this as a statement of what they believe was introduced by Dematt after I called (above) for someone to provide it. The statement did not affirm the truth of the belief, only that it was a belief.

"The particular issue of the status of vertebral subluxation is not disguised, but addressed later in the article, and is I think explored in the article on vertebral subluxation, I haven't contributed to that.

"Whether there is a religious fervour I don't know; I've never actually met a chiropractor. Are there good, honest chiropractors who make a coherent, intellectually honest case? I think there probably are, whether I agree with it or not, and "theirs" is the case that needs presenting, not a strawman caricature. The arguments of chiropractic are complex, sometimes confused and contradictory, sometimes phrased in ways that we would never phrase things. But phrased differently, many scientists might recognise many things as not even controversial. Does the body have intrinsic repair mechanisms? Certainly, a great many operating at many different levels, including DNA repair mechanisms and the immune system. Are these regulated by the nervous system? Some certainly are: neuroimmunology is a rapidly exploding field, and the power of the placebo effect itself testifies to the importance of mechanisms that we understand very poorly. Does chiropractic have a coherent scientific framework to explain these. No, not in my opinion; it has a body of empirical evidence from clinical practice, the reliability and interpretation of which is open to question. But exactly the same can be said about a "very" large part of conventional medicine. Often, the best we can do is evolve care systems from such an empirical basis while we develop a scientific understanding. In the meantime, we have "boxes" for things we don't fully understand, and give them names pro tem. Scientists use names like "stress" for instance; it's not meaningless, yet can't be pinned down in a wholly acceptable way.

Gleng15:57, 19 September 2006 (UTC)"

My response. Your first para I understand. But you have yet to provide the words of V RS which you not anyone else claims undermines my position. Your second para admits the truth was elsewhere in the article. My edit brought it to the top. On your earlier claim that I removed a meaning. You admit it was not well phrased. I rephrased it, did I not. Etiquette is for you to say why it wasn't well phrased. I'll address your earlier redundancy comment as soon as I can redial. meantime please address the issues. Succinctly if possible. Mccready16:18, 19 September 2006 (UTC)

Lead

Mccready, what is it that you don not like in the intro, maybe we can make some changes that will be acceptable to all of us. --Dematt16:09, 19 September 2006 (UTC)

Your latest revert was unhelpful. You have not discussed the issues. Your edit summary is erroneous -there is no consensus. Obviously the edits I have made are preferred. You fail to say what is wrong with them. You revert to a less useful version. Great stuff as usual eh? But let's take it point by point, step by step. Again. Were ANY of my edits removing redundancy? My edits cleaned up the misconception re alleged typical health focus of medical subluxation. Even Gleng admitted this. My edits tidied the intro (not top) section. My edits showed what the core belief is and how many believe it. My edits showed a more accurate distintion between the two subluxations. My edits showed the marginal evidence at the top (removing the redundancy from the intro). And you object???Mccready16:40, 19 September 2006 (UTC)

I don't agree that the edits that McCready made are obviously preferred, as he states. Basically, it appears he rearranged some text from the opeing paragraph and the introduction section. Honestly, in my opinion, I prefer the opening statement to be a pretty cut-and-dry definition of the subject, and save any of the subjective statements for the rest of the article. I feel that McCready's edit added an argument to the opener and I don't think that's a good way to start an article which is trying to acheive NPOV. Levine211216:56, 19 September 2006 (UTC)

I agree. Lets try this. Here is the original introduction. Please start with one sentence and lets try dealing with it that way:

"'Chiropractic"' is a complementary and alternative health care profession which focuses on diagnosing, treating, and preventing mechanical disorders of the musculoskeletal system, their effects on the nervous system, and on general health. Chiropractic's premise is that spinal joint misalignments, which chiropractors call "vertebral subluxations", can interfere with the nervous system and result in diminished health.Association of Chiropractic Colleges, http://www.chirocolleges.org/paradigm_scopet.html Chiropractic Paradigm The conventional use of the term subluxation in medicine does not typically include any relationship to general health, and is therefore different from chiropractic's vertebral subluxation.

--Dematt17:51, 19 September 2006 (UTC)

Whoa! Be very careful. The lead is not just a definition:

"'http://en.wikipedia.org/wiki/Wp:leadProvide_an_accessible_overview Provide an accessible overview"'

The lead section should briefly summarize the most important points covered in an article in such a way that it could stand on its own as a concise version of the article. It is even more important here than for the rest of the article that the text be accessible, and consideration should be given to creating interest in reading the whole article (see news style and summary style). The first sentence in the lead section should be a concise definition of the topic unless that definition is implied by the title (such as 'History of hellip;' and similar titles).

In general, specialized terminology should be avoided in an introduction. Where uncommon terms are essential to describing the subject, they should be placed in context, briefly defined, and linked. The subject should be placed in a context with which many readers could be expected to be familiar. For example, rather than giving the lattitude and longitude of a town, it is better to state that it is the suburb of some city, or perhaps that it provides services for the farm country of xyz county.

According to the perfect article guideline, a lead "begins with a clear description of the subject at hand. This is made as absolutely clear to the nonspecialist as the subject matter itself will allow. The purpose of an encyclopedia is to codify human knowledge in a way that is most accessible to the most people, and this demands clear descriptions of what the subject matter is about. So we aren't just dropped into the middle of the subject from the first word—we are eased into it."

That's a pretty good description. A definition should definitely be included, and the first two sentences do that just fine. The rest of the lead should mention key elements of the rest of the article. In practice this means that the lead will need small additions and modifications as the article grows and significant points are added:

"The lead section should briefly summarize the most important points covered in an article in such a way that it could stand on its own as a concise version of the article."

-- Fyslee20:29, 19 September 2006 (UTC)

Just for claification... we have a section called "Introduction". Is this the lead as well? If not, what purpose should the introduction serve if not to summaraize the most important points covered in the article? As it is, the section entitled "Introduction" seems to fullfill that purpose. Levine211220:50, 19 September 2006 (UTC)

Levine! After reviewing the lead and the intro, I agree. Between the lead and the Introduction, we handle almost everything in a very similar order that we do in the rest of the article. That was on purpose;) --Dematt02:19, 22 September 2006 (UTC)

We must be doing something right. Levine211202:49, 22 September 2006 (UTC)

Actually there shouldn't be a section entitled "Introduction." I learned this quite early here at Wikipedia. I went and added that heading on several articles and was severely chastised by other editors, who informed me that here the Lead served that purpose.

If there is any duplication, then it should be deleted from the current Intro and the rest be incorporated. IOW the two sections need to be merged. Anything that's important, but not appropriate for the Lead, should be moved to the appropriate place in the article.

The Lead in this article can be rather long, since the article is itself long and covers much territory. The Lead will grow and undergo some changes with time, since it should be a mini version of the article. We just need to be careful that nothing important gets lost. -- Fyslee11:34, 22 September 2006 (UTC)

Lets bring the entire lead in then. But lets not change anything on the article page until all of us are satisfied here on the talk page, including Mccready. That way we can avoid wasting all of our time. I don't expect this to be finished in one day, so be patient and take your time. --Dematt21:47, 19 September 2006 (UTC)

"'Chiropractic"' is a complementary and alternative health care profession which focuses on diagnosing, treating, and preventing mechanical disorders of the musculoskeletal system, their effects on the nervous system, and on general health. Chiropractic's premise is that spinal joint misalignments, which chiropractors call "vertebral subluxations", can interfere with the nervous system and result in diminished health.Association of Chiropractic Colleges, http://www.chirocolleges.org/paradigm_scopet.html Chiropractic Paradigm The conventional use of the term subluxation in medicine does not typically include any relationship to general health, and is therefore different from chiropractic's vertebral subluxation.

Some chiropractors specialize in treating low back problems or sports injuries, or combine chiropractic with manipulation of the extremities, physiotherapy modalities, nutrition, or exercises to increase spinal strength or improve overall health. Some also use other complementary and alternative methods as a part of a holistic treatment approach. Chiropractors are not trained or licensed to prescribe drugs. Depending on the country or state in which the Chiropractic school is located, some train in minor surgery. When indicated, the doctor of chiropractic consults with, co-manages, or refers to other health care providers.The Council on Chiropractic Education (2006), Standards for Doctor of Chiropractic Programs and Requirements for Institutional Status http://www.cce-usa.org/2006%20January%20STANDARDS.pdf available online

There is both evidence for and evidence against spinal manipulation, a technique used by chiropractors, in the treatment of acute low back pain, tension headaches and certain musculoskeletal issues.Ernst E (2006) A systematic review of systematic reviews of spinal manipulation" J R Soc Med" 99:192-6 http://www.jrsm.org/cgi/content/full/99/4/192 Available on-line There are no objective controlled trials with definitive conclusions for or against chiropractic claims concerning other health benefits.McCrory DC, et al. "Evidence Report: Behavioral and Physical Treatments for Tension-type and Cervicogenic Headache". Duke University Evidence-Based Practice Center, Durham, North Carolina, January 2001 http://www.fcer.org/html/Research/DukeEvidenceReport.htm available online (PDF format) Balon J. (1998) A Comparison of Active and Simulated Chiropractic Manipulation as Adjunctive Treatment for Childhood Asthma. "New Eng J Med 339:1013-20 http://content.nejm.org/cgi/content/abstract/339/15/1013 available online

One thing at a time. What needs changing?

Very good question. Tails in a spin here, there are some weak areas of the article (weak against high expectations I'd hasten to add) but this doesn't seem one of them to me. I'd rather see consolidation of the material, re-consideration of the sources (always, can they be added to, improved?) Are they accurately cited or have we slipped in some unintentional POV, don't think so but any comments? Check the style, could be tightened in places - omissions - we know about advertising, still to be addressed. The science part is a bit wordy and could be tightened. Some enigmatic clues to interesting asides here in places - DDs "controversial" death - begs a question etc. Still like to see another pic that's not a portrait. Look at the article as a whole, please let's not get bogged down again in trying to fix something unless we see it's broke, and I don't know that this is.

My only reservation was about the ambiguity of the phrase "general health" - not really clear what is meant. But a trivial point in context.Gleng22:13, 19 September 2006 (UTC)

We're getting there. There are certainly things that I do not like, such as:

Chiropractors are not trained or licensed to prescribe drugs.

In my opinion, this is a derogatory way to say that chiropractors do not prescribe drugs. (Its because they don't want to) But I'll settle for this if it makes others feel better about it.

Have you got a "vision" of a picture that you would like? I may be able to create something. The problem of course is copyrights for things after 1923, so that leaves a lot of color pictures out. There are lots of black and whites of schools, groups of people, flyers, advertising(that we can use when we bring that up). Or are you looking for something a little more modern? I was.

I can work on the DD death part and I'm sure others can chime in.

I have the same feeling about "general health." --Dematt22:33, 19 September 2006 (UTC)

With regards to the prescribing of drugs, perhaps this article should get into the general chiropractic philosophy of drugs... Most just mask symptoms and all have known side-effects. Drug cannot cure anything; only the body cures. By helping the body function properly, chiropractic helps the body fight off disease naturally. Thus chiropractic eschews the use of drugs for the most part... I'm sure this could be worded better and - better yet - cited from a source. It should also lay open for other opinions about the use of drugs within the chiropractic community. I'll start looking for references. Levine211222:46, 19 September 2006 (UTC)

This from the WCA (and ACC):

"In its Position Paper 1, The Association of Chiropractic Colleges states that "chiropractic is a health care discipline which emphasizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery." This statement has won the approval and support of the majority of chiropractic organizations, including the World Chiropractic Alliance (WCA), and has been signed by the presidents of all accredited North American chiropractic colleges."

"In addition, the World Federation of Chiropractic -- an affiliation of several chiropractic organizations around the world -- has officially stated that, "for reasons of chiropractic principle, patient welfare and interdisciplinary cooperation the practice of chiropractic does not include the use of prescription drugs...""

"The adherence to a strict "no drugs or surgery" axiom is based on more than historic tradition but on the increasing awareness of the dangers inherent in the use of drugs and surgery as practiced today."

Should this be included somewhere in the article? Levine211222:55, 19 September 2006 (UTC)

That's a good question. One thing for sure, that would explain why the NACM gave up trying to reform chiropractic. I would be willing to bet that the statement was drafted after the NACM announced they wanted to prescribe drugs. I'll check it out. --Dematt23:44, 19 September 2006 (UTC)

Bottomline is that chiropractic - for the most part - chooses to be holistic. Chiropractors don't prescribe drugs because they don't believe that drugs are the best way to promote health. That chiropractors aren't allowed to prescribe drugs is incidental. Even if they were allowed to prescribe, the use of drugs goes far against the mainstream chiropractic philosophy so I doubt very many would actually take advantage of this ability. It's funny that NACM wants chiropractors to be able to prescribe. It furthers my belief that the NACM is a shill organization of the AMA and "Big Pharma". I bet if all chiropractors suddenly started prescribing all of these drugs, all of a sudden Big Pharma wouldn't have a problem with chiropractic. As it stands now, Big Pharma is like the Oil companies, the AMA is GM-Ford-Chevy, and chiropractic is trying to manufacture an electric car. Levine211200:06, 20 September 2006 (UTC)

The ACC policies were developed n 1996 and 1997 with the WCA signing in 2001. NACM announced drug prescription wishes in 1986, so I doubt there is a significant link there. I think the "position paper 1" above certainly can be considered with significant weight as it represents almost all chiropractic schools and organizations (not NACM) including WCA. The second sentence represents 85 worldwide groups with the ACA and ICA from the USA. The last sentence is certainly http://www.worldchiropracticalliance.org/positions/drugs.htm WCA. It does show a subtle difference between the groups, showing that none want to prescribe drugs, but for slightly different reasons.

I know but it's fun to postulate sometimes. Levine211202:30, 20 September 2006 (UTC)

No problem, you keep right on doing it, but in your next one I want to be the Big Oil company!:)

Suggestions

A) "Chiropractors do not prescribe drugs, believing this to be the province of conventional medicine to do so, and believing that their role is to pursue drug-free alternative treatments (refs); they are accordingly not trained or licensed to prescribe."

However, and this is a question not knowing the answer - what do chiropractors consider to be drugs, and do they for instance co-operate with homeopathic or herbalist treatments? Should the relationship between chiropractic and other alternative medicine be discussed? Open question, I don't know the answer.Gleng07:49, 20 September 2006 (UTC)

Long story short: Chiropractic has nothing to do with homeo or herbs, especially from the standpoint of both Palmers (one of the things they did agree on) and straight POV. BUT, mixers from National, etc. actually had training, and in fact National used to give a Naturopath degree, but stopped in a conciliatory effort in order to facilitate the joining of the two membership organizations citing that Naturopathy was actually beginning to compete with Chiropractic and it did not think it was proper to train both. These schools still teach about nutrition and vitamin therapy, etc., but it is more as an adjunct to chiropractic rather than a treatment in its own right. This is what some of the straight/mixer battles have been about. BJ would go to court against DCs who were combining other methods and calling it chiropractic. This gave him a bad name among mixers. He was apparently afraid that chiropractic would get lost in the other methods, just as osteopathy got lost in medicine.

IOW, some states that have straight laws do not use vitamins, etc. while other laws are more related to all drugless healers and chiropractors are allowed greater latitude as long as they have the training. Those are the states that you will find chiropractors who use perhaps homeopathy and herbs among other things. So, the short of it is, Chiropract"ic" does not include the use of homeopathic remedies or herbs, some chiropract"ors" do use each.

Also - in the second paragraph of the lead, there is a sentence: "Some also use other complementary and alternative methods as a part of a holistic treatment approach." So, perhaps this is all we need in the lead, though we could expound on it in the body. However - these therapies are not really chiropractic and could be linked (there is a Alt Med box to the right of the lead). The question is whether you think we need more.

Just flagging it really; just wondering whether this was confined to prescription drugs or extended to all presumed active substances, and if so wondering whether this needed specifying. I think as phrased my suggestion seems OK; it's not misleading, but doesn't get into the grey area of what some do and some don't. If they took this attitude to all "medicinal substances" for want of a good catch all, that would be worth sayingGleng14:13, 20 September 2006 (UTC)

I'm good with your statement. Any other input on this change: "Chiropractors do not prescribe drugs, believing this to be the province of conventional medicine to do so, and believing that their role is to pursue drug-free alternative treatments (refs); they are accordingly not trained or licensed to prescribe." --Dematt23:35, 20 September 2006 (UTC)

B) w.r.t. "The conventional use of the term subluxation in medicine does not typically include any relationship to general health"

Suggest:

"The term "subluxation", as used in medicine, is not usually associated with effects on health other than those which can be objectively demonstrated to be a direct consequence of spinal nerve injury."

Is this correct Fyslee? Know V RS for this if so?Gleng07:59, 20 September 2006 (UTC)

That looks good Gleng, ""The term "subluxation", as used in medicine, is not usually associated with effects on health other than those which can be objectively demonstrated to be a direct consequence of spinal injury"", except I took out "nerve". And to hopefully answer your question about "all drugs or confined to prescription drugs or extended to all presumed active substances." The "all active substances" part is the most accurate. Allow me to illustrate:

A physician makes a diagnosis, usually a hypo or hyper condition of a muscle, organ, or gland.

He prescribes an anti to the condition, to hypo the hyper or hyper the hypo. Thus, any substance which artifically changes physiology would fit this.

The chiropractor believes the cause could be from an irritated (causing hyper) or pinched (causing hypo) nerve. So adjusting the vertebra into its proper position removes this cause. The body will then normalize itself.

To further clarify, take the example of a fever. Historically, the medical approach is to lower the fever, drugs (aspirin) or ice bath. In contrast, the homeopath would say, we need to introduce a fever producing substance to "break" the fever. Where as a chiropractor would look at a fever and say its a normal function of the body. By giving an adjustment to a subluxation, the body will be better able to do whatever it feels is right. If you were to give an adjustment to lower the fever, you'd be practicing medicine. Does that make sense?--Hughgr20:53, 20 September 2006 (UTC)

Gleng, it's basically correct. I see that "general" (health) has been removed. This was specifically to show the contrast to the chiropractic vertebral subluxation, which is claimed to affect general health, including the immune system, infectious diseases, and other systemic diseases. (That word needs to be restored.) Medical subluxations can cause local problems, and if they impinge on a spinal nerve, can cause problems in the area served by that nerve. There is no evidence that they affect the immune system or the other conditions mentioned above.

I'd word it this way:

"The term "subluxation", as used in medicine, is not usually associated with effects on general health conditions, and its effects are thus limited to those local and specific conditions which can be objectively demonstrated to be a direct consequence of injury to joint-related structures anywhere in the body, including spinal joints and nerves."

That may need some copy editing.....;-)

You ask if I "know V RS for this if so?" Hmmm. I guess I take breathing for granted and don't question the existence of air. It's common knowledge. All medical definitions I've seen are limited to the short version, which doesn't discuss effects. An examination of the way the term is used in the medical world provides the rest of the information. Your question regards the type of subject matter for which the principle of falsifiability would be applicable. There are exceptions to every rule, and if a doubter can find an example that goes against that description, then they have found the "exception that proves the rule." For us to prove the definition using V RS, we'd have to quote large excerpts from dozens of pathological descriptions, which would be quite unreasonable. If you claimed that most Norwegians speak Norwegian, and a doubter questioned that claim, would it be reasonable to force you to quote 51% of Norwegians to them to prove the point? Common knowledge is usually exempted from such demands. Those who aren't familiar with medical matters show their ignorance when making such demands. That may sound like a cop-out, but that's the way things work in the real world.

Definitions:

Subluxation: Partial dislocation of a joint. A complete dislocation is a luxation.

Subluxation is the term for a lesser degree of displacement than dislocation - where the joint surfaces are completely displaced and are no longer in contact - such that the articular surfaces are still partly apposed.

One way to get an idea of the differences in use of the term "subluxation" between chiropractors and the rest of the healthcare system, is to do a Google search. If one searches just for the word "subluxation" ones gets everything, and a huge preponderance of chiropractic sites:

http://www.google.com/search?hl=enlr=rls=GGLJ%2CGGLJ%3A2006-37%2CGGLJ%3Aenq=subluxation

If one excludes the word chiropractic from the search, one gets far more medical uses, but some chiropractic sites still show up:

http://www.google.com/search?sourceid=navclientie=UTF-8rls=GGLJ,GGLJ:2006-37,GGLJ:enq=subluxation+%2dchiropractic

-- Fyslee21:46, 20 September 2006 (UTC)

From what I'm seeing, the only thing we're missing in the differentiation of medical v chiro definition of subluxation is that medical "requires misalignment" in position of one bone on top of the other, while chiropractic "also includes" joints that are properly aligned but are not functioning properly (hypermobile, hypomobile, or otherwise irritated) and affecting the nervous system in such a way as to affect "general" health. But, using the criteria that Fyslee added earlier about the lead being easy for someone with a limited education to understand, I don't feel it necessary to confuse the issue. We have them wikilinked.

Okay, then as far as I am concerned, the lead should be left alone. None of us are totally satisfied, yet none are terribly upset. Lets leave it alone. I agree we all have better things to do than fix things that aren't broken. What do you think? --Dematt01:14, 21 September 2006 (UTC)

We may be missing other things, but the requirement of objectively identifiable misalignment is certainly an important difference, since that "is" the medical definition. The other conditions are just that, and therefore have other diagnostic definitions. Medicine works with many specific diagnoses, while chiropractic tends to lump many of them into one diagnostic criteria, that always includes the word "subluxation," and often only that word. This contributes to a lack of diagnositic specificity, confusion, and breakdowns in communication between professions. Uniformly accepted definitions is essential to good communication. -- Fyslee11:43, 21 September 2006 (UTC)

I definitely agree, as I think a lot of what we treat is very similar. I think it is important to point out that chiropractors diagnose and treat sprains and strains, intervertebral disc syndromes, spinal stenosis, spondylolisthesis, spondylolysis, brachial neuaralgia, etc., etc. along with their ICD9 codes (apparenlty 90% of the time). The difference is when I say to my patient that their indigestion may also be part of the thoracic pain that they are experiencing. The confusion comes when they don't have thoracic pain and we are treating only for the indigestion. If there is no treatable medical condition, it requires the VS construct - which has little scientific evidence to support it. Am I thinking correctly from your POV? --Dematt13:03, 21 September 2006 (UTC)

Precisely. We actually do treat many of the same conditions, AND you understand the POV very well. We may use different methods to treat the same conditions, use different terminology, and even disagree at times, but if we understand each other's POV, we can still communicate and collaborate, and it's a pleasure to do so. -- Fyslee13:17, 21 September 2006 (UTC)

I think we'll all get there. It just may take awhile. Only because there are those who don't want us to get there;) --Dematt16:01, 21 September 2006 (UTC)

&quot;evidence for and evidence against spinal manipulation&quot;

I second that, but :) this got changed somewhere along the way and now it sounds like gibberish. "There is both evidence for and evidence against spinal manipulation," I propose it gets simplified...--Hughgr02:44, 21 September 2006 (UTC)

I'm pretty sure that was a line that was a compromise from Levine and either Fyslee or Mccready. As long as they are happy with it, and of course you, I'm living with that one, too. --Dematt03:33, 21 September 2006 (UTC)

That was me in part at least; I'm sorry,"There is both evidence for and evidence against" replaced the phrase "evidence both for and against.." which I thought needed replacing as, being pedantic.....Gleng09:09, 21 September 2006 (UTC)

Maybe it's the words "for" and "against". Are there better scientific ways of saying those. --Dematt13:15, 21 September 2006 (UTC)

Hughgr was of course right in that the sentence as a whole is now gibberish (Doooh). It reads

"There is both evidence for and evidence against spinal manipulation, a technique used by chiropractors, in the treatment of acute low back pain, tension headaches and certain musculoskeletal issues."

Ok trying hard here...

"There is evidence that spinal manipulation, as used by chiropractors, is effective for the treatment of acute low back pain, tension headaches and some musculoskeletal issues, but not all studies support this conclusion."

My honest take on this is that it is not controversial to state that it is an effective treatment, what is controversial is the explanation of its effectiveness (I.e. how much is placebo effect etc.) and its comparative effectiveness vs other approaches. But this is a subtlety that might escape easy parsing...Gleng13:32, 21 September 2006 (UTC)

If you remove "as used by chiropractors," it would be true. There are studies that show spinal manipulation to have some effect as performed by chiropractors and other practitioners, and sometimes the studies that showed effect have been as practiced by others, without chiropractors being tested. Leaving that phrase out makes it an "all-truism".....;-)

To catch that subtlety, how's this version:

"There is evidence that spinal manipulation, the mainstay of chiropractic treatment methods, is effective for the treatment of acute low back pain, tension headaches and some musculoskeletal issues, but not all studies support this conclusion."

This acknowledges its role in the profession, and doesn't limit it as a possibly effective method in the hands of others. -- Fyslee14:15, 21 September 2006 (UTC)

AceGleng14:35, 21 September 2006 (UTC)

I'm okay with it that way. Is it V RS. Which studies are we thinking to use to cite this. I suppose Ernst for "against" and who do we use for "for". It needs to be solid. --Dematt15:23, 21 September 2006 (UTC)

Aaaargh. Absolutely. ?? Fyslee ?? these?

Common Diagnostic and Therapeutic Procedures of the Lumbosacral Spine," The North American Spine Society - Ad Hoc Committee of Diagnostic and Therapeutic Procedures. Spine, October 1991; 16:10, 1161-1167.

"The Appropriateness of Spinal Manipulation for Low-Back Pain, Report 1: Project Overview and Literature Review, Report 2: Indications and Ratings by a Multi-Disciplinary Expert Panel," Shekelle et al, RAND Reports R-4025/1 and R-4025/2, August 1991. Santa Monica, California.

Gleng

16:00, 21 September 2006 (UTC)

Thanks all for taking the time with this. Good job Fyslee with that version. :) The only part that I'd change is "mainstay", I don't know why but..... How about,

"'There is evidence that spinal manipulation, the primary treatment in chiropractic, is effective for the treatment of acute low back pain, tension headaches and some musculoskeletal issues, but not all studies support this conclusion."'

I only changed that one part, the rest is excellent.--Hughgr18:35, 21 September 2006 (UTC)

That's just fine. You understood what I meant. -- Fyslee20:44, 21 September 2006 (UTC)

Last word from me on this

Many thanks to you all, you have patiently led me to a clearer understanding. Maybe my role here is just to be ask stupid questions - after all this article is for the reader, whatever his background, not for those who know the answers.

This discussion "has" revealed a) a piece of unnecessary derogatory POV, b) points of ambiguity in the lead and 3) an unexpected insight into the philosophy regarding drugs. Maybe it's there somewhere, but for me this is such a distinctive flag separating chiropractic from other professions that it is notable.

So its not broke, but now we've done this, let's gain the benefits, because it seems to me that there "is" agreement on these.

So the replacement element I'd propose is:

"'Chiropractic's premise is that spinal joint misalignments (which chiropractors call vertebral subluxations), by interfering with the nervous system, can result in many different conditions of diminished health.1. By contrast, the term "subluxation" as used in conventional medicine is usually associated with specific conditions which are a direct consequence of injury to joints or associated nerves."'

"'Some chiropractors specialize in treating low back problems or sports injuries, or combine chiropractic with manipulation of the extremities, physiotherapy, nutrition, or exercises to increase spinal strength or improve overall health. Some also use other complementary and alternative methods as a part of a holistic treatment approach. However, chiropractors do not prescribe drugs; they believe this to be the province of conventional medicine, and that their role is to pursue drug-free alternative treatments (refs)."'

If there's no energy to look at this further now, I'd suggest shifting this to the top of the Talk page to preserve it through archiving, so it's there to come back to at some time in the future without having to re-cover this ground. I'll say no more on this, whatever is good for you is for meGleng09:02, 21 September 2006 (UTC)

I'm re-energized! So we're here right now. (Changes in bold):

"'Chiropractic"' is a complementary and alternative health care profession which focuses on diagnosing, treating, and preventing mechanical disorders of the musculoskeletal system, their effects on the nervous system, and on general health. "'Chiropractic's premise is that spinal joint misalignments (which chiropractors call vertebral subluxations), by interfering with the nervous system, can result in many different conditions of diminished health.1. By contrast, the term "subluxation" as used in conventional medicine is usually associated with specific conditions which are a direct consequence of injury to joints or associated nerves."'

"'Some chiropractors specialize in treating low back problems or sports injuries, or combine chiropractic with manipulation of the extremities, physiotherapy, nutrition, or exercises to increase spinal strength or improve overall health. Some also use other complementary and alternative methods as a part of a holistic treatment approach. However, chiropractors do not prescribe drugs; they believe this to be the province of conventional medicine, and that their role is to pursue drug-free alternative treatments (refs)."' Depending on the country or state in which the Chiropractic school is located, some train in minor surgery. When indicated, the doctor of chiropractic consults with, co-manages, or refers to other health care providers.The Council on Chiropractic Education (2006), Standards for Doctor of Chiropractic Programs and Requirements for Institutional Status http://www.cce-usa.org/2006%20January%20STANDARDS.pdf available online

There is both evidence for and evidence against spinal manipulation, a technique used by chiropractors, in the treatment of acute low back pain, tension headaches and certain musculoskeletal issues.Ernst E (2006) A systematic review of systematic reviews of spinal manipulation" J R Soc Med" 99:192-6 http://www.jrsm.org/cgi/content/full/99/4/192 Available on-line There are no objective controlled trials with definitive conclusions for or against chiropractic claims concerning other health benefits.McCrory DC, et al. "Evidence Report: Behavioral and Physical Treatments for Tension-type and Cervicogenic Headache". Duke University Evidence-Based Practice Center, Durham, North Carolina, January 2001 http://www.fcer.org/html/Research/DukeEvidenceReport.htm available online (PDF format) Balon J. (1998) A Comparison of Active and Simulated Chiropractic Manipulation as Adjunctive Treatment for Childhood Asthma. "New Eng J Med 339:1013-20 http://content.nejm.org/cgi/content/abstract/339/15/1013 available online

--Dematt16:07, 21 September 2006 (UTC)

That looks great. Any objections?--Hughgr18:46, 21 September 2006 (UTC)

I've gone ahead and put in the changes with some minor copy edits, although the "Chiropractic's premise..." sentence looks funny now. Anyone care to correct my flawed grammerical sentencory structorally.--Hughgr22:15, 21 September 2006 (UTC)

Added some new movement toward science stuff

I added some more science stuff from Keating. We're getting close to the end and then there is some filling in to do as well. Let me know where the weak spots are. --Dematt03:36, 21 September 2006 (UTC)

Suggested merge of Lead and Introduction

"Copied from above:"

Actually there shouldn't be a section entitled "Introduction." I learned this quite early here at Wikipedia. I went and added that heading on several articles and was severely chastised by other editors, who informed me that here the Lead served that purpose.

If there is any duplication, then it should be deleted from the current Intro and the rest be incorporated. IOW the two sections need to be merged. Anything that's important, but not appropriate for the Lead, should be moved to the appropriate place in the article.

The Lead in this article can be rather long, since the article is itself long and covers much territory. The Lead will grow and undergo some changes with time, since it should be a mini version of the article. We just need to be careful that nothing important gets lost. -- Fyslee11:34, 22 September 2006 (UTC)

Hmm. That is an interesting idea. It should be able to reduce some of the repetition and most of it could be summarized and then detail moved to other sections, but we're talking about a major change that opens a new bag of worms. The old - if it ain't broke - concept hits me. I'll try some. We can revert back if we want. Definitely need some feedback from everybody! --Dematt12:52, 22 September 2006 (UTC)

I fully sympathize with the concern and I share it, but if it's done carefully, I hope the end result will be an improvement, if not in content, but in form. The most sensitive pitfall to avoid is in the deleting process. Any deletions that aren't of actual duplications need to be discussed, and when moving items, that should likely be discussed as well. It might be a good idea to "copy" sensitive items to their new location before actually "deleting" them. If the move is accepted, then the old item can be deleted.

One way to do it is to make small changes and save them. That's usually a good idea anyway. Then it's easy to see what's going on and no one will feel the need to make large reverts. We just need to assume good faith and be patient. Go for it! -- Fyslee13:26, 22 September 2006 (UTC)

Hmmm - okay, I've been staring at it and a little apprehensive, but I'll try copying without deleting, that should take the anxiety out of it;) --Dematt13:29, 22 September 2006 (UTC)

Input? Okay - copied two paragraphs to Approach to healthcare. How are we sure we aren't just going to have to repeat this stuff again in the lead?

If anyone's uncertain of what I'm trying to do with my recent and ongoing copyedits - I'm just trying to tighten the article as a whole, to keep it reasonably compact, trimming detail that I think is redundant but keeping that which I think is interesting even if it's relatively minor. Please check and don't hesitate to restore any deletion that you think is mistaken because it's not my intent to do anything controversial (without flagging it here)Gleng16:06, 22 September 2006 (UTC)

You are doing an excellent job! If I see anything that looks like it should go back, I'll bring it here. Meanwhile, keep it up. --Dematt16:14, 22 September 2006 (UTC)

WOW, that's going to take a lot of work. :( From a quick look at what should be done, part of the intro will go into the lead and part into a re-written first paragraph. In fact a bunch of the article will have to be reconfigured. This is such a big project, I think we should "let" Dematt do it. :) HAHA But seriously, maybe we should start a "project page" or something to make it easier for us all to collaborate together vs. one edit here then the next one screws up that edit. Kinda like how Dematt and Fyslee worked on their disk herniation article. Any thoughts?--Hughgr18:17, 22 September 2006 (UTC)

Not a bad idea at all. Fyslee took charge of that and it went really easy. What do you say Fyslee? --Dematt19:00, 22 September 2006 (UTC)

That project worked out pretty well. The Spinal disc herniation article was well received, and no one complained that we used it to replace the other two articles. How about you starting a project page and you call the shots and coordinate things? I trust your judgment. Invite a few editors that can work together and the end result should be pretty good. -- Fyslee20:35, 22 September 2006 (UTC)

Chiropractic Assistants (CA)

I just noticed that you DCs employ assistants "to perform therapeutic activities"

Want to comment anyone?Gleng19:12, 22 September 2006 (UTC)

What's your question? :)--Hughgr20:28, 22 September 2006 (UTC)

Just wondering if you could recommend any particular agency or just put small ads in personal columns.Gleng22:31, 22 September 2006 (UTC)

I think your asking "where do these assistants come from?". If so, it most likely depends on what the state law dictates, but if they are performing therapeutics they are likely PT's. There are also CT's (chiropractic assistants http://www.palmer.edu/pcc%5Facademics/ct/assocprograms.htm)--Hughgr01:25, 23 September 2006 (UTC)

I suspect you mean CA rather than CT. -- Fyslee06:59, 24 September 2006 (UTC)

I was just wondering if the phrase "perform therapeutic activities" would always be understood so innocently. :)Gleng09:27, 23 September 2006 (UTC)

Formatting question

I'd like to know what you think about the formatting for longer quotes. There probably are some guidelines somewhere, but we have a couple possibilities:

1. Indentation alone.

2. Indentation and use quotation marks

3. Indentation and italicize.

Personally I like the first option, since longer passages that are italicized are difficult for me to read, but my eyes aren't the only ones here.....;-) Right now we're using several different formats, and it should be more uniform. Take a look and get back to me with your preferences. -- Fyslee20:16, 22 September 2006 (UTC)

Yes, they should be uniform, so I'd go with the first one too.--Hughgr20:29, 22 September 2006 (UTC)

I defintiely don't like italics, but do we "have" to always indent? IOW, sometimes it's easier to just use quotations within the paragraph. So how about no italics, use quotations, may or may not indent (depending on how long the quote). --Dematt21:00, 22 September 2006 (UTC)

Yes. I usually like to indent if it's a quote of say three or more sentences, depending on how long they are. I have my Hodges' Harbrace College Handbook right here and it has this to say:

In printed matter, small type usually sets off quoted material of ten or more lines. No quotation marks are used, unless the original carries quotation marks. In typewritten papers, such quoted passages are single-spaced and indented from both sides five spaces.

I translate this to mean a single indentation (one colon) should be enough, but not for very short quotes, which can be in the paragraph, using quotation marks instead of indentation. -- Fyslee21:26, 22 September 2006 (UTC)

Whatever you like; loosely I put long verbatim quotes in italics simply to keep it clear that they are verbatim quotes, leaving shorter quotes in plain text. However I don't really like italics as it's less readable, so I guess I'm neutral. However I do think it's important with longer quotes to keep them clearly identified as verbatim quotes, not least because it's rather easy to copy edit them inadvertently; the last thing we want is for some later naive editor (or me) to set about "improving" a direct quote.Gleng22:29, 22 September 2006 (UTC)

Okay, so lets say no italics, always use quotes and if long enough then indent with quotes. --Dematt22:43, 22 September 2006 (UTC)

Though after seeing some of the edits after using the indent rule, it looked kind of funny, so I'm okay with only using them when it looks good:) --Dematt23:18, 22 September 2006 (UTC)

[[User:Dematt/ChiroPractice]]

Okay - you asked for it - you got it. The new practice page for us to try to merge the intro with the lead and integrate into the rest of the article is on the User:Dematt/ChiroPractice. Don't make any significant changes on this page temporarilyor they may getreverted when we replace this page. Soooo, anybody stopping by - join us on the User:Dematt/ChiroPractice page. --Dematt23:23, 22 September 2006 (UTC)

Two important research findings

Hey guys, note to us that there are two important research findings that we have overlooked and should be noted in the science section.

There was a project that pinned a rat's http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmedcmd=Retrievedopt=AbstractPluslist_uids=15129196query_hl=7itool=pubmed_docsum spine in one position and they found that the joint began to develop spurs and arthritic changes.

Fyslee has brought to our attention twice that there are research findings that somatosomatic referred pain from the spine to remote regions that mimic visceral pain is a possible explanation for the pain that doctors sometimes mistake for http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmedcmd=Retrievedopt=AbstractPluslist_uids=7595111query_hl=11itool=pubmed_docsum visceral pain.

We need to discuss these from the standpoint as a rationale for treating to prevent arthritic changes and the possibilty that a lot of misdiagnosed "visceral" pain is treated in a DCs office. --Dematt04:43, 24 September 2006 (UTC)

That would be a good way to talk about the preventative aspect of chiropractic, which still needs to be addressed.--Hughgr20:31, 25 September 2006 (UTC)

I agree. I'm not sure where to start. If you start it, Levine and Fyslee can argue it, I'll blend it in with everything else, and then Gleng can edit it:) Steth and Mccready can keep us honest:) --Dematt00:05, 26 September 2006 (UTC)

Nah, it'll prolly jus get reverted. :)--Hughgr00:16, 26 September 2006 (UTC)

By whom, there's nobody left! Oops - Arthur! Okay, Arthur can reference it:) --Dematt00:47, 26 September 2006 (UTC)

After reviewing Strangs book for "auditory" below, I came across this. I couldn't find a ref online so I'll type what he quoted for review. This is a quote in Strangs book by Joseph Janse of National Chiropractic College in 1976 titled "The Wholistic Concept of Health Care Management", in "Principles and Practice of Chiropractic" p.26

"Unless pathology is demonstrable under the microscope, as in the laboratory or by roentgenograms, to them allopaths it does not exist. For years the progressive minds in chiropractic have pointed out this deficiency. With emphasis they chiropractors have maintained the fact that prevention is so much more effective than attempts at a cure. They pioneered the all-important principle that effective eradication of disease is accomplished only when it is in its functional (beginning) phase rather than its organic (terminal) stage. It has been their contention that in general the doctor, the therapist and the clinician have failed to realize exactly what is meant by disease processes, and have been satisfied to consider damaged organs as disease, and to think in terms of sick organs and not in terms of sick people. In other words, we have failed to contrast disease with health, and to trace the gradual deteriorization along the downward path, believing almost that mild departures from the physiological normal were of little consequence, until they were replaced by pathological changes..."

I like that Hughgr. That would go nicely in the Approach to healthcare section. I have been looking for a reason to bring Janse into the discussion. Go ahead and put it in and we can work with it and keep adding more stuff to it. I think we need to expand that section anyway. --Dematt23:37, 28 September 2006 (UTC)

I would appreciate it if you would, you know where it should go and your such a great writer! Pretty please...:)--Hughgr05:10, 29 September 2006 (UTC)

Dematt's attempt to consolidate the lead and introduction

Okay, we're bringing it here. This is what we have put to gether from the lead and intro. There is some stuff left over that can be reviewed and placed later.

"'Chiropractic"' is a complementary and alternative health care profession which focuses on diagnosing, treating, and preventing mechanical disorders of the musculoskeletal system, their effects on the nervous system, and on general health. Chiropractic's premise is that spinal joint misalignments, which chiropractors call "vertebral subluxations", can interfere with the nervous system and result in many different conditions of diminished health. Association of Chiropractic Colleges, http://www.chirocolleges.org/paradigm_scopet.html Chiropractic Paradigm In contrast, the term "subluxation", as used in conventional medicine, is usually associated with specific conditions which are a direct consequence of injury to joints or associated nerves.

Manipulation of the spine is the main technique in today's chiropractic adjustment, or treatment. Though its use has been documented from the time of the ancient Egyptians, spinal manipulation in an attempt to correct the theoretical vertebral subluxation is solely a chiropractic endeavor. Chiropractic's contribution to the field of manipulative therapies is the concept of applying a precise adjustment to a specific affected vertebra, as opposed to the generalized maneuvers of the early osteopaths. While some chiropractors adhere strictly to the use of only spinal manipulation in their adjustment, others include a broad range of methods directed at correcting the subluxation and/or just relieving musculoskeletal pain.

Some chiropractors specialize in treating specific musculoskeletal problems or sports injuries, or they may combine chiropractic with manipulation of the extremities, physiotherapy, nutrition, or exercises to increase spinal strength or improve overall health. Some also use other complementary and alternative methods as a part of a holistic treatment approach. However, chiropractors do not prescribe drugs; they believe this to be the province of conventional medicine, and that their role is to pursue drug-free alternative treatments. Depending on the country or state in which the Chiropractic school is located, some train in minor surgery. When indicated, the doctor of chiropractic consults with, co-manages, or refers to other health care providers.The Council on Chiropractic Education (2006), Standards for Doctor of Chiropractic Programs and Requirements for Institutional Status http://www.cce-usa.org/2006%20January%20STANDARDS.pdf available online

Chiropractic was founded in 1895 by Daniel David Palmer, based on his assertion that all health problems could be prevented or treated using "adjustments" of the spine, and sometimes other joints, to correct what he termed "subluxations." He, and later his son, B.J. Palmer, proposed that subluxations were misaligned vertebrae which caused nerve compression that interfered with the transmission of what he named Innate Intelligence. This interference interrupted the proper flow of Innate Intelligence from "above, down, inside, and out" to the organ to which it traveled. As a result, the human body would experience "dis-ease" or disharmony which would result in loss of health. He compared this process to stepping on a hose that slowed the flow of water to a garden: if you take your foot off the hose, the flow returns to normal and the garden will flourish.

While the "pinched garden hose theory" has mostly been abandoned, it is still used in a modified form by some chiropractors to explain vertebral subluxation. However, the concept of the subluxation, which has marginal evidence, remains integral to typical chiropractic practice, and in 2003 90% of chiropractors believed the vertebral subluxation complex played a significant role in all or most diseases.McDonald W (2003) "How Chiropractors Think and Practice: The Survey of North American Chiropractors." Institute for Social Research, Ohio Northern University

There is evidence that spinal manipulation, the primary treatment in chiropractic, is effective for the treatment of acute low back pain, tension headaches and some musculoskeletal issues, but not all studies support this conclusion.McCrory DC, et al. "Evidence Report: Behavioral and Physical Treatments for Tension-type and Cervicogenic Headache". Duke University Evidence-Based Practice Center, Durham, North Carolina, January 2001 http://www.fcer.org/html/Research/DukeEvidenceReport.htm available online (PDF format)Ernst E (2006) A systematic review of systematic reviews of spinal manipulation" J R Soc Med" 99:192-6 http://www.jrsm.org/cgi/content/full/99/4/192 Available on-line There are no objective controlled trials with definitive conclusions for or against chiropractic claims concerning other health benefits. Balon J. (1998) A Comparison of Active and Simulated Chiropractic Manipulation as Adjunctive Treatment for Childhood Asthma. "New Eng J Med 339:1013-20 http://content.nejm.org/cgi/content/abstract/339/15/1013 available online

Today, there are 17 http://www.cce-usa.org/CCE%20Publication%20of%20Accredited%20Programs.pdf accredited chiropractic colleges in the USA and two in Canada, and an estimated 70,000 chiropractors in the USA, 5000 in Canada, 2500 in Australia, 1300 in the UK, and smaller numbers in about 50 other countries. In the USA and Canada, licensed individuals who practice chiropractic are commonly referred to as chiropractors, doctors of chiropractic, (DC) or chiropractic physicians.

There are four main groups of chiropractors: "traditional straights", "objective straights", "mixers", and "reform". All groups, except reform, treat patients using a subluxation-based system. Differences are based on the philosophy for adjusting, claims made about the effects of those adjustments, and various additional treatments provided along with the adjustment.

Any input? --Dematt17:41, 24 September 2006 (UTC)

Cite (and spelling) for Egyptians? mdash; Arthur Rubin | (talk) 01:03, 25 September 2006 (UTC)

Check out http://www.aquilahealth.co.za/services.htm this page...

The roots of chiropractic lie in antiquity. The first evidence of spinal manipulation was discovered in prehistoric cave paintings in south-western France dating back to 17,500 B.C.

From historical records we know that the ancient Chinese, Egyptians, Greeks and Babylonians used spinal manipulation for back problems.

Hippocrates (460-377 B.C.), the ‘Father of Medicine’, said “Get knowledge of the spine, for this is the requisite for many diseases’.

Levine2112

01:19, 25 September 2006 (UTC)

"'Levine2112"', that sounds like good information that could be included in the appropriate place.

"'Dematt"', you've done an excellent job with this. I recommend that you make the substitution in the article now, so any further editing will be "the real thing." The few things that have been removed are not lost or discarded, and can be found http://en.wikipedia.org/w/index.php?title=User:Dematt/ChiroPracticediff=prevoldid=77711496Things_we_want_in_the_lead here and http://en.wikipedia.org/w/index.php?title=User:Dematt/ChiroPracticediff=prevoldid=77711496Things_that_need_to_go_elsewhere here, so after you have done the above, we can start working on incorporating that stuff in the appropriate places. Go for it! -- Fyslee14:30, 25 September 2006 (UTC)

Wow! Great work, I couldn't find anything to change or copyedit. Looks great!--Hughgr18:21, 25 September 2006 (UTC)

history of spinal manipulation

While looking for an answer for Arthur about a reference to spinal manipulation, I put this together. Anybody have aproblem with this:

Hippocrates, "the Father of Modern Medicine," and an early proponent of spinal manipulation, believed that it was the physician's job to remove any obstruction that would prevent the body from healing. He recommended that healers "Get knowledge of the spine, for this is the requisite for many diseases." Prehistoric cave paintings in southwestern France dating back to 17,500 B.C. were the first known depictions of spinal manipulation, a technique also utilized by the Chinese, Greek, Egyptians and other ancient peoples. Primitive American Indian hieroglyphics showed back walking (walking on the back of a patient) as a method of curing the sick. Many of these techniques were preserved in hand me down fashion from the early bonesetter families for hundreds of years. DD claimed to be the first to use the short levers of the spinous process and transverse process in his technique.

Any input?

Auditory nerve

I inserted this in the "The first chiropractic adjustment" section:

A common criticism of this story is that the auditory nerve does not pass through a vertebral foramen, but rather connects directly to the brain. While that is accurate, one should consider that a portion of the autonomic nervous system that supplies different structures of the head, such as the blood vessels of the auditory apparatus, do arise from the upper thoracic region, namely the first and second thoracic levels. This can be a possible explanation for the mechanisms of this event.citation needed

Then Dematt added a citation needed tag. This is neuroanatomy 101, what kind a citation do you want? Guytons or something online? I felt that was needed because on most skeptic websites, they make it sound as though it's impossible, when in fact there is a possible explanation. Also, I don't believe I phrased it as though it were true, only a possibility.--Hughgr22:36, 27 September 2006 (UTC)

You're definitely preaching to the choir on that one;) What I was hoping for was that you had found a source of someone saying that about DD's adjustment. If not, lets find a different spot for it than the history. By putting it in the history, I feel it opens the door for others to argue the other POV and I would like that to take place somewhere that a proper discussion can occur. We might even open another section where we can discuss the common criticisms. Am I making any sense? --Dematt22:54, 27 September 2006 (UTC)

As I recall, Virgil Strang's book mentions it. Would that do? It's not available online, but I could type the exact quote if you like.--Hughgr23:21, 27 September 2006 (UTC)

It sure could. What exactly did he say and when did he say it? We can quote it as his opinion at least. --Dematt02:53, 28 September 2006 (UTC)

OK, I finally found it. He doesn't explicitly deal with DD's hearing case as I thought it did though. Here is what Strang says in his book "The Essencial Principles of Chiropractic" (c)1984 on this issue:

"On occasion, critics will observe that a spinal adjustment cannot affect certain areas -like the brain- because the spinal nerves do not extend into the encephalon. This kind of statement reveals an incomplete understanding of neural anatomy. Sympathetic nerves arising in the lateral horns of the upper thoracic levels of the spine form the upper cervical ganglion with postganglionic fibers ascending to supply, among other things, blood vessels of the brain."

It should be readily apparent that those same postganglionic fibers supply the blood vessels of the hearing apparatus as I explained in my edit. Thoughts? Do we need a more specific ref, or will this do?--Hughgr18:56, 28 September 2006 (UTC)

Christianson, Beckstead, and Morrow refs

Krishna, you added the following:

"Christianson (2005:13) states that chiropractic is used to treat homosexuality (reparative therapy), and Beckstead and Morrow (2004:655) say that chiropractic is reported to be "ineffective in resolving sexual orientation conflicts". "

References:

Beckstead, A L. Morrow S. L. Mormon clients' experiences of conversion therapy: The need for a new treatment approach. . Counseling Psychologist. College Park: Sep 2004.Vol.32, Iss. 5; pg. 651

Christianson, A.. A Re-emergence of Reparative Therapy. A Peer-Reviewed Article for Contemporary Sexuality readers Contemporary Sexuality, Oct2005, Vol. 39 Issue 10, p8-17, 10p;

and you used this edit summary:

""Christianson and BnM are peer reviewed and satisfy NPOV policy, which trumps consensus""

You are correct that policies trump consensus. That those policies are often the subject of interpretation is another matter.....;-) But your basic premise is correct.

You still have to work with other editors in a collaborative manner to get your edits to "stick," even when you have turned your back. Otherwise editors who do not respect policies or who interpret them differently than you do will delete your work. IOW, without collaboration you will be wasting time - your own and ours.

To satisfy other editors here, you will need to provide your references in a better manner, and please do it here so we can evaluate them:

a. Provide the precise quotes with some context;

b. Provide on-line sources in the form of URLs.

c. Format your references using the "ref" format we're using here.

I am well aware that on-line sources are not a requirement here, since books are allowable, but we'd like to be able to check this out, and you are the one "making the claim," so we'd like you to help us. -- Fyslee14:06, 16 October 2006 (UTC)

KV, you explained that Christianson, writing in a Society newsletter, states that "Other methods employed by reparative therapists include hypnosis, medication, chiropractic adjustments and marital therapy."

Did she give or cite any evidence for this disputed assertion? If so we might at least find the primary sources. How widespread did she say this was? I am curious because in my professional experience as a chiropractor have never heard of this use that you say she says is widespread. Thanks Steth14:35, 16 October 2006 (UTC) (Also asked on PS talk page)

I too want to know more. Even if this were backed up by excellent resources, and fulfilled all the Wikipedia policies normally used to justify inclusion, I think it is such an extremely limited matter as to not be worthy of inclusion, IOW it does not meet the Notability threshhold. It would have the same value as a case study, which often is no better than an anecdote or gossip. I think one could find just about any type of weird action being performed by some idiot in just about any profession. Such rare and extremely fringe actions aren't worthy of mention here. Let's find out just how widely practiced this unusual use of chiropractic adjustments really is. I doubt one could find more than a handful who do it, and they are probably all members of the Christian Chiropractors Association (no offense intended to Christians). There are plenty of other fringe practices that are practiced by many chiros, and they aren't even mentioned yet. Start with them and leave this type of atypical thing alone. If this practice were more widely known and had some type of notoriety and controversiality, IOW had achieved Notability, it would be a very different matter. -- Fyslee18:22, 16 October 2006 (UTC)

The fact satisfies all of the above. WPNotability states that for an article to be notable, it must be notable enough that it will be described by multiple sources. The line is not an article, yet it already satisfies the multiple sources requirement. Two peer reviewed sources say chiropractic is used for RT (treating homosexuality). Thats enough for any inclusion. All stated as it is in the sources. KrishnaVindaloo19:25, 16 October 2006 (UTC)

Okay, then let's see the content as requested above. -- Fyslee19:51, 16 October 2006 (UTC)

KV, you appear to misunderstand notability, and still have not addressed Fyslee's point above. Sources also must pertain sig POV's "with respect to the article's subject matter", not fringe ones. For example, a V RS on the Prince of Waikikamukau might say that he likes sticking Zoloft tablets in his ears because he thinks it improves his hearing. That source could be used in the article on the Prince of Waikikamukau, but not in the articles on Zoloft or hearing impairment, unless it could be shown that a notable portion of the medical community believes in such things.

Thus, your sources may be notable in an article on reparative therapy, which might list the many things (talk therapy, drugs, EMDR, chiro etc.) that would-be reparative therapists have used. But you haven't shown that your sources say (or even that they are V RS's to make the assertion) that using chiro to "cure" gayness represents a sig POV within the chiropractic profession. That's the threshold you need to meet to include it here, if my understanding of NPOV, VER and OR is correct. As a thought experiment, imagine how editors would react if you attempted to add an analogous statementhttp://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=81750574, with the same sources, to articles on marital therapy or medication. They'd object for the same reasons editors here have objected.

Your persistence in being sloppy and downright disingenuous with sources (see: Talk:Pseudoscience, esp. here), editing against consensus, and continuing to wave the red herring of "censorship" is disruptive and inappropriate. Several editors have expressed their frustration with your approach. Having to keep tabs on your edits to make sure they're within guidelines is a waste of editors' time and a source of wikistress. Unless you change course, I believe it's time the WP community considered a sanction of some sort. Jim Butler21:53, 16 October 2006 (UTC)

No Jim Butler. I believe the solution is in Gleng's last edit summary here. Its presently miscited. Not a problem, easily corrected. KrishnaVindaloo02:03, 17 October 2006 (UTC)

It's true that your citations need improvement, but Jim Butler has explained it very well. He is correct and you haven't answered his points yet, nor, for that matter, my request above. Your addition of this material is not going to be a success until you deal with our concerns, and deal with them right here on the talk page. Please stop wasting your own and our time. Either you satisfy our concerns or you won't get anywhere here. Those citations may be appropriate for the article on Reparative therapy, but I don't see them as appropriate here. Keep in mind that I'm a chiroskeptic, but skepticism and criticism needs to be reasonable. What you're proposing smacks of desperation to find some kind of dirt, and you're scraping the bottom of the barrel. As I wrote above, there are plenty of other fringe practices that are practiced by many chiros, and they aren't even mentioned yet. Start with them and leave this type of atypical thing alone. You will be able to find multiple criticisms from many good sources from both within and outside the profession in regards to those matters. There are a couple whole sections that aren't even in the article yet. Start working on them, or, on second thought, don't. Your involvement would likely ruin what could be a valuable addition to the article.

Now please provide the quotes in context here, and the proper and "'complete"' citations. Then we can all look at them and determine if they are suitable. Right now we only have your word for them, and we are skeptical of anything you touch. -- Fyslee05:13, 17 October 2006 (UTC)

Well lets have a close look at whats happened in chiropractic shall we? Whats notable is the fact that chiropractic is used as a kind of panacea for all ills due to its pseudoscientific application. So what we really need to do here is to list all of the PS treatments that they use that are mentioned by good sources. So far we have two corroborating sources that state very very clearly that chiropractic is used to treat homosexuality. Schizophrenia, ear ache, asthma, and others come to mind. Does anyone have good references for these conditions so we can list them alongside the chiropractic homosexuality cure? KrishnaVindaloo05:16, 17 October 2006 (UTC)

Those other matters will be dealt with in due time, but right now we're dealing with the subject of this thread. Don't get off-track here. We have made requests and are waiting for you to provide what we have requested. Please stop wasting our time.

BTW, I don't see that you have yet attempted to add those cites to the Reparative therapy article. That's where they belong, IF they are properly cited. -- Fyslee05:39, 17 October 2006 (UTC)

Fyslee. Here is the core quote: "Other strategies include changing the person's sexual orientation label. According to this idea, the gay person is no longer homosexual by simply adopting a new label as an ex-gay or as a heterosexual - "name it and claim it" theology (Ford, 2001, p. 80). Other methods employed by reparative therapists include hypnosis, medication, chiropractic adjustments and marital therapy."

I don't need to satisfy your concerns at all. I need to take into account your particular bias. I have already satisfied NPOV policy on the lines in question. You have absolutely no choice at all but to assume good faith. I have provided adequate evidence (the citations) that support the lines presented. They are relevant here. In addition, we do need to list all those other pseudoscientific applications of chiropractic, such as schizophrenia treatments, cancer treatments and so on. I seem to remember that some were already on the article a while back, but now they seem to be conspicuously absent. This situation certainly needs remedying. Inclusion of all relevant views is paramount to maintaining NPOV policy. KrishnaVindaloo10:13, 17 October 2006 (UTC)

I think the nature of the evidence is now clear. B and M report that one person reported to them that he or she had been treated by chiropractic adjustment to alter sexual orientation and that it failed.

I think we have already set the bar to exclude anecdotal evidence, mainly of course to exclude anecdotal reports of beneficial effects of chiropractic. C a private counsellor writing in a society newsletter doesn't report or cite any evidence but makes a casual anecdotal aside, from; doesn't look like objective evidence and certainly no evidence of scale. We know there are occasional loonies around, and it would be extraordinary if there weren't at mleast as many loonies amongst scientists as there are amongsts MDs. Or should we be citing the case of Harold Shipman as evidence that medics are mass murderers?.Gleng12:37, 17 October 2006 (UTC)

Unfortunately Gleng, the problem with chiropractic is it is chockablock with such loonies, just as Keating describes in his literature. The homosexuality cure is one of many similar cases. Your interpretation of the source is clearly meant to dismiss the fact. I have written it in a way that is perfectly suited to the source. It is written in a way as to satisfy NPOV policy. No exaggerations, or boosterisms. Just plainly stated views. Chiropractors commonly claim to be able to cure anything with a quick twist of the spine. You can see them making their claims on the street wherever they set up a promotional kiosk. They show diagrams of qi flowing around nerves, with big glowing auras around the body. Their ads are exaggerated and their claims are wild. That doesn't happen with normal medical practitioners. So lets get that list together then! Shall we start with chiropractic cancer treatments? KrishnaVindaloo13:05, 17 October 2006 (UTC)

Ok, I don't know if I am doing this right, kinda learning as I go and if this needs to be deleted so be it. I wanted to comment that while Chiropractic is not being used to treat cancer directly it can be of valuable benefit to patients to ease pain and reduce stress upon the body. Also as some of the research going on right now will show when published, Chiropractic adjustments can effect the sympathetic and parasympathetic nervous system including but not limited to Heart Rate Variablility. And on a personal note I don't know how to send users direct messages to ask questions but I do have some for KrishnaVindaloo, which for the time being shall remain unasked until I figure out how to ask directly and/or in the proper place.91z4me06:02, 3 December 2006 (UTC)

""Chiropractors commonly claim to be able to cure anything with a quick twist of the spine. You can see them making their claims on the street wherever they set up a promotional kiosk. They show diagrams of qi flowing around nerves, with big glowing auras around the body. Their ads are exaggerated and their claims are wild. That doesn't happen with normal medical practitioners."" - if that's so patantly true, you should be able to find a V RS stating as much, rather than (as Fyslee aptly put it) scraping the bottom of the barrel for examples that you believe are consistent with a premise you haven't justified. -Jim Butler18:07, 17 October 2006 (UTC)

Gleng. You have once again accused me of dishonesty. Now show your evidence. KrishnaVindaloo15:12, 17 October 2006 (UTC)

You insert these references knowing a) that B and M's paper merely mentions that one (1) of the 40 participants in their study claimed (it's a self report study from volunteers) that they had been treated with chiropratic adjustments but claimed that it had not changed their sexual orientation.

As evidence for the ineffectiveness of chiropractic in this respect this seems weak. As evidence for the rarity of this as a treatment (only 1 of 40 participants) it seems stronger. It is ludicrous to assert this as evidence of commonusage, yet you insert it nonetheless. C's evidence is even vaguer, she mentions in passing without details or citation of sources that chiropractic has been used to alter sexual orientation, but she provides no evidence; it is a passing aside in a Society newsletter in an article about reparatory therapy for goodness sake. The newsletter does not claim to be peer reviewed, or indeed to be an academic journal. If her paper was peer reviewed it was an an exception. C has an MA but no academic publications listed by ISI, is a private relationship counsellor, and not obviously an authority on chiropractic. Knowing all this, through having it spelt out over and over you persist in claiming that these are reliable and significant sources for this assertion of fact. Dishonest is the civil description of this.Gleng15:55, 17 October 2006 (UTC)

So, Gleng. You spend weeks trying to brand me a liar, you chase me across Wikipedia in the process, leaving a trail of OR behind you for me to clean up, and now, after I have provided corroborating evidence for my original peer reviewed evidence, you still call me a liar. Now I'm a pretty tolerant chap, but I have my methods. I believe you are going to look pretty shifty now you realize I am going to take a snapshot of your little dismissive episode. Say cheese! KrishnaVindaloo03:13, 18 October 2006 (UTC)

Agree with Gleng and others above; this article is about chiropractic, not reparative therapy. KV's references don't show that the use of chiro to cure gayness is anything more than a fringe view regarding chiropractic: there is nothing to suggest that it's a sig view held among practitioners of chiropractic, consumers of chiro, critics of chiro, etc. The aspect of NPOV that KV is missing is undue weight. ""Undue weight applies to more than just viewpoints. Just as giving undue weight to a viewpoint is not neutral, so is giving undue weight to other verifiable and sourced statements."" - Jim Butler17:44, 17 October 2006 (UTC)

Hello Jim Butler and Gleng. Do you really think that BnM's study actually proves that chiropractic is good for making homosexuals straight, just because there is only one in forty Mormons who use the treatment? We already have proof from a peer reviewed source (The Resurgence of Reparative Therapy, A Peer Revewed Study.... ) that chiro is used. BnM corroborate Christianson and say it was reported to be useless. NPOV policy is satisfied. End of story. If you don't like it, talk to the administrators or try to get NPOV policy to support pseudoscience yourselves. KrishnaVindaloo13:13, 18 October 2006 (UTC)

Look, KV, you're still not addressing the notability issue. Whether that's out of disingenuousness or incomprehension doesn't even matter anymore. You either won't or can't collaborate effectively. Jim Butler17:55, 18 October 2006 (UTC)

Krishna, you provided this quote:

""Other methods employed by reparative therapists include hypnosis, medication, chiropractic adjustments and marital therapy.""

Now just where does it state that a "'chiropractor"' was doing this? No one but a chiropractor can provide a chiropractic "adjustment," which is not the same as a manipulation. The only difference often being the "intention." Only chiropractors believe in the chiropractic vertebral subluxation, and that this mythical lesion can be "corrected" by the use of spinal adjustments. (Now you know my bias!)

The quote seems to strongly imply that it is reparative therapists are employing this method. What's going on here?

You also quite arrogantly wrote:

""I don't need to satisfy your concerns at all. I need to take into account your particular bias. I have already satisfied NPOV policy on the lines in question. You have absolutely no choice at all but to assume good faith.""

Tough luck, but you "'do"' have to satisfy mine and others concerns. You don't own Wikipedia, and you must collaborate with other editors, including those who hold opposing viewpoints. You can be right as hell, but your edits won't survive the moment you turn your back, unless they have been approved by other editors. Get used to it.

As far as my bias, I happen to basically hold the same skeptical POV as yourself, but I am disgusted by the way you are doing this. My well-developed and conscious bias (not the same as an uninformed prejudice) is that of chiroskepticism: (http://chirolinks.quackfiles.com/http://quackfiles.blogspot.com/2006/12/chiropractic-index-to-all-entries-here.htmlhttp://quackfiles.blogspot.com/)

I do have a choice -- I choose to side with your antagonists on this one, until you start collaborating.

-- Fyslee20:48, 17 October 2006 (UTC)

Well, Fyslee, you know, I'm not really what I would call a skeptic. I had no particular feeling about chiropractic before I came to the PS article, but I found a bunch of people who were urging me towards the literature to prove that there is no PS issue there. I found PS written explicitly all over the more reliable literature. I have NPOV policy to guide me, so what do I do? I state the facts and find more of the same people calling me a liar. I double check with NPOV policy, and find that those people are working directly against NPOV policy on inclusion of rel views. You can be as disgusted with me as you like. You're not going to blinker me or bully me into restricting views. KrishnaVindaloo03:17, 18 October 2006 (UTC)

"'Second attempt to get an answer"' (never got it, so I'll try again):

Now just what don't you understand here?:

Krishna, you provided this quote:

""Other methods employed by reparative therapists include hypnosis, medication, chiropractic adjustments and marital therapy.""

Now just where does it state that a "'chiropractor"' was doing this? No one but a chiropractor can provide a chiropractic "adjustment," which is not the same as a manipulation, the only difference often being the "intention." Only chiropractors believe in the chiropractic vertebral subluxation, and that this mythical lesion can be "corrected" by the use of spinal adjustments. (Now you know my bias!)

The quote seems to strongly imply that it is reparative therapists who are employing this method, and not chiropractors, and therefore it is not chiropractic and doesn't belong in this article! If it belongs anywhere, it would be the Reparative therapy article, and there the best you could do is claim that someone claims that reparative therapists use bla bla bla methods, including chiropractic adjustments. Even then you'd have an uphill battle, unless you could show it was a common practice among Reparative therapists, and not something done by one or two of them. To do that you'd need confirmation from third party sources. If the original claim is really true, it should be possible to find such sources. You'd then have a much stronger case for inclusion in the RT article. -- Fyslee18:17, 18 October 2006 (UTC)

Arbitration

Editors here please note this http://en.wikipedia.org/wiki/Wikipedia:Requests_for_arbitration/Pseudoscience/EvidenceEvidence_presented_by_User:_Gleng; they might wish simply to comment on its accuracy, or might wish to add their own evidence. (I really have gone, but I guess this is unfinished business ;) ). On this page, many editors from many different perspectives have contributed to a balanced, thoughtful, reliable, authoritative article, because they have listened to each other with respect, despite differing opinions; it is clearly possible, I just wish that it were more common. Gleng08:13, 17 October 2006 (UTC)

Yep, the more the merrier. KrishnaVindaloo08:19, 17 October 2006 (UTC)

3RR Violation for KrishnaVindaloo

http://en.wikipedia.org/w/index.php?title=User_talk:KrishnaVindaloodiff=82011466oldid=81975663 FYI. Levine211216:34, 17 October 2006 (UTC)

The more, the merrier? ;-) -Jim Butler06:51, 19 October 2006 (UTC)

NPOV and [[:Category:Pseudoscience]] and core NPOV (pseudoscience issues)

As I've argued RRR_User:Jim_Butler/Pseudocat_RRR elsewhere, I think that those who wish to add cat:PS to alt-med articles that have some sci support (as manipulation does) need to address what NPOVTCategorisation and related guidelines such as CG and Wikipedia:Categorization of people say. "For some "sensitive" categories, it is better to think of the category as a set of representative and unquestioned examples, while a list is a better venue for an attempt at completeness." - Jim Butler03:45, 19 October 2006 (UTC)

Jim Butler, I've heard your arguments before, and they are strongly against core NPOV policy. Explaining PS as science sees it is core NPOV policy. That involves helping the reader to browse articles pertaining to PS. You have persistently worked against that core Wikipedia rule. Your actions have been noted. KrishnaVindaloo05:08, 19 October 2006 (UTC)

No, "core NPOV policy" is adequately described in the first few sections of NPOV, which general principles (along with VER and OR) are the "forest" that some editors miss for the "trees" of those parts of the NPOV tutorial that mention PS specifically. -Jim Butler06:49, 19 October 2006 (UTC)

Jim Butler. You clearly are working against the core reasons for making an encyclopedia, you are certainly doing your best to fight NPOV policy, and your abusive comments here reflect your attitude. This is a problem article, and a problem group who behave as if they can exempt themselves from common policies. I will put it to the authorities to put you straight. KrishnaVindaloo07:18, 19 October 2006 (UTC)

KV, you made the suggestion that the PS category include concepts that have PS qualities. I accepted your suggestion in good faith and applied the category here on the chiro page along with the science category, as using your logic, chiropractic includes science as well. Unfortunately, other editors kept removing the science category and the PS cat went with it. So, it seems that your solution has not worked. While it was a valiant effort to solve a problem, there is nothing in WP policy to support a categorie's use in this manner. On the contrary, Jim Butler's argument is solid and I have yet to see anyone who has been able to make a stronger one. Until it is refuted by policy from higher authority, I find Jim's argument stronger than yours. You are welcome to bring a stronger argument to the table. --Dematt13:22, 19 October 2006 (UTC)

KV, again you don't acknowledge the other aspects of NPOV that I raised. Your point about cats helping readers browse is reasonable, but long ago I pointed out that "what links here" accomplishes the same thinghttp://en.wikipedia.org/w/index.php?title=Category_talk:Pseudosciencediff=60204781oldid=60124094, and you've never bothered to address my point. So, I'm sorry, but we're at an impasse and I've lost patience with you. If I need to change course, I'll accept feedback from other editors and will do so. I hope you consider the same. It's possible that this isn't a "problem group", and you need to consider a course correction. sincerely, Jim Butler03:14, 20 October 2006 (UTC)

No, the situation is crystal clear. I will leave it to the authorities to put you straight. A very clear case is emerging. Btw, nobody yet has mentioned any treatments beyond backpain or headache that chiropractors still do. The literature is very clear; chiropractors commonly still do their alternative medicine using vitalism concepts, talk of holism, and claim they can treat conditions outside the range of the one they have some poor support for. They say it can be used to treat anything. So this list of everything else; give me a hint, is the list long, or really long? KrishnaVindaloo04:46, 20 October 2006 (UTC)

A hint: I've never heard talk of chiropractic curing blindness, nightmares, madness, or stupidity for instance - but there was one well reported cure of curing deafness (see the article), so there might be hope. Many editors have worked hard to exclude any claims of efficacy or otherwise that are supported only by weak or anecdotal evidence. Not only do you want to insert one of your own, you are now inviting others to do so. Chiropractic does I think claim some efficacy in curing headache - are you trying to drum up custom for them by any chance?Gleng13:29, 20 October 2006 (UTC)

No, but if I don't present relevant views, then I am whitewashing the subject. KrishnaVindaloo15:27, 20 October 2006 (UTC)

Whitewash???? See http://en.wikipedia.org/wiki/ChiropracticInternal_criticismGleng15:48, 20 October 2006 (UTC)

Yes, whitewash. See http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=82642845oldid=82640232.KrishnaVindaloo15:56, 20 October 2006 (UTC)

If we're going to cite "conditions" for which chiro is used, then the source has to be a V RS presenting a notable view. As NPOVUndue_weight says: "views that are held by a tiny minority should not be represented except in articles devoted to those views." If we can't show that use of chiro to "treat", e.g., gayness, can't be shown to be more than a tiny minority view, then it doesn't belong in WP except perhaps in reparative therapy. KV's pressing this and related points is not only contrary to most editors' interpretation of NPOV, it's disruptive and an e.g. of POINT. - Jim Butler19:20, 20 October 2006 (UTC)

Please note: "8. Categories appear without annotations, so be careful of NPOV when creating or filling categories. Unless it is self-evident and uncontroversial that something belongs in a category, it should not be put into a category." From Wikipedia:Categorization --Hughgr20:28, 20 October 2006 (UTC)

Concerning including all things that chiropractors treat brings us back to the subluxation. Chiropractors treat subluxations, or some formation of it. Most people go to chiropractors for musculoskeletal problems that chiropractors treat with manual procedures and some, if not most, probably use various physiotherapies such as electrical modalities, ultrasound, diathermy, etc. and probably some level of other health advice relating to exercise and activity as well as nutritional advice. The vast majority are pretty cut and dry low back pain or neck pain or sport and repetitive type injuries related to their lifestyles. I would venture to guess that most of these patients may also have concomittant conditions such as diabetes, obesity, allergies, gastritis, and just about anything else that you can think of. The difficulty is in determining whether the adjustment is affecting these conditions while treating the spinal condition. Occasionally, if signs and symptoms suggest, we use some blood analysis to assess things such as rheumatoid arthritis, Lupus, Reiters, or other systemic inflammatory conditions using C-reactive protein, and Sed rates. Occasionally, midback pain will cause abdominal pain that might mimic pancreatitis or cholecystitis, so the we might run a serum amylase or SGOT, etc. to rule out organ dysfunction. Occasionally, patients will have positive blood work for one of these conditions and after being properly informed, they decide to try adjustments for a period. Some respond and some don't. Those that don't follow up with their MD or we'll refer them through my network.

All the while, it is important to note that we must always be vigilant in watching for things that are red flags; night pain, contractures, hyperreflexias, double vision, sudden onset headaches, ataxias, etc., so we constantly evaluate for signs and symptoms that require other services.

Essentially, I think our daily routines are similar to the GP who handles 90% of his (medical type)cases easily with conservative methods, all the while looking out for those life threatening conditions that require the tougher decisions and specialists. They have the added complicated medication algorithoms to work through and the major problems require more advanced hospital based procedures. Some of his patients have back pain as well and he treats with medication. Some respond and some don't. Those that don't may get referred to Fyslee or myself or orthopedists or neurologists.

So, basically we treat patients with all kinds of conditions, but we concentrate on the spine and overall health of the patient and let the MDs take care of the medicine. -- Dematt 07:32, 21 October 2006

Yep well thats all very convincing and has machines that go "ping!" but your treatment is extremely limited and weakly supported. You have just described a con setup whereby the patient is led to believe that a chiropractor is a primary care expert, whereas, they are really just an alternative therapy provider who applies placebos. KrishnaVindaloo07:41, 21 October 2006 (UTC)

I do think some consider us primary care experts, but an argument is made for the newer noemclature of portal of entry. What you have described could apply to all healthcare providers. That's the point that Gleng has been trying to make; that if we call chiropractic PS then we would have to call all healthcare PS. Thanks for bringing that out. --Dematt10:30, 21 October 2006 (UTC)

Fine by me, Dematt. I'll call chiropractic PS, and you can call all healthcare PS. Thats pretty much how scientists see chiropractors, and pretty much how chiropractors see the rest of the world, according to the literature (Keating etc). KrishnaVindaloo11:22, 21 October 2006 (UTC)

Please understand that I am saying that I have yet to see verifiable and reliable sources that have determined either chiropractic or medicine PS. I have seen biased and unreliable or unverifiable sources and I have seen improperly referenced sources. I am saying that if we use your rationale for calling some behaviors pseudoscientific, we would have to call some MD behavior pseudoscientific as well, and I think everyone agrees that is not a correct use of the word. Are you at least seeing my POV, or are you just seeing a chiropractor using a "pseudoscientific defense mechanism", because if that is the case, any further conversation with you is only digging a deeper hole. I don't think WP wants us to have that kind of relationship. We are supposed to be fellow editors using NPOV. --Dematt01:42, 23 October 2006 (UTC)

What Dematt? Are you saying that you are tired of going 'round and 'round in Krishna's circle game? We have been doing this for months thanks largely to KV trying to pass off his opinions as facts, unsourced as they may be. Because he seems to have some kind of bias against chiropractic, then editors in several articles will continue to go 'round and 'round in Krishna's circle game.

But he is entitled to his opinions, after all this is WP and we must assume good faith on all editors musn't we?(and you know what happens when you assume) Steth02:19, 23 October 2006 (UTC)

Length

Can section 5 be trimmed/ moved into other articles? Good stuff but maybe overdetailed for this, the lead article?Gleng15:48, 20 October 2006 (UTC)

I agree Gleng, perhaps a short description and move the bulk to Chiropractic school but rename that article to cover the broader info. What do you think? --Hughgr20:31, 20 October 2006 (UTC)

Agreed. It would be easier to do it real justice where it has more space. The Chiropractic school article is misnamed anyway (should have been schools, plural...). How about starting an article named Chiropractic education moving the bulk of section five there, and all of Chiropractic school. (Okay, I've done it now.) Then track down the very few places that link to them and leave redirects.

Of course section five should be replaced with a short paragraph and the wikilink. -- Fyslee12:00, 21 October 2006 (UTC)

Now the FCLB information needs to be removed from both articles, leaving only a short paragraph. I can't do it now, so I'll let others finish and polish up these changes. -- Fyslee12:06, 21 October 2006 (UTC)

Fylsee, that was a simply awesome job! Great job with the chiropractic education article. That was really good work. Thank you very much. --Dematt01:19, 23 October 2006 (UTC)

Again, you talk of removing things, but nothing about making the article concise in encyclopedic terms. Why that particular bias I wonder? KrishnaVindaloo04:06, 22 October 2006 (UTC)

That sounds like a veiled accusation... If you would just read the subject of this thread and look at my edit history at the time, you'd see that within a few minutes I created a new article by copying information that makes this article far too long. This was done in response (the reason for this thread) to the "Long" article template being http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=82440844oldid=82387789 added to the top of the article by an administrator. This is one way of making an article more concise and encyclopedic. The information is good, so it shouldn't get deleted, but just moved. -- Fyslee07:43, 22 October 2006 (UTC)

Question - answering source

I am skeptical about The New England Skeptics Society. An MD with a bug up his craw about why he hates things, writes articles in a negative and highly editorialized tone. (No, I am not talking about Stephen Barrett Enterprises...donations gladly accepted!) Worse, he makes statements and his 'ideas' are not sourced. Just plain nonsense. So why is this allowed in an encyclopedia? It is unverified, unreliable, and the statements are not referenced. Notable? Why are they notable? New England Skeptics Society? Like the Witches and Warlocks Society? OR The He-man's Women Hatin' Society? (From the Little Rascals)

I think it should be removed, so I have. Steth03:34, 23 October 2006 (UTC)

I have restored it. It is a significant opposing viewpoint, so POV deletism and suppressionism is definitely unwelcome, very unwiki behavior, and no wiki-legitimate policy reasons have been given, only personal dislike. You are welcome to your dislike, but this is the section for critical External links. We are writing an encyclopedia that covers all sides of the subject. There are rules governing links used as External links. Familiarize yourself with those rules. -- Fyslee04:53, 23 October 2006 (UTC)

Does every critical external link has to be fought over? This is ridiculous. Its a legitamate skeptics society (ie its a real organization with members and meetings, and they even put out a neat podcast), and it follows the rules for external links. And he is a Neurologist. I see no problem. --Havermayer06:59, 23 October 2006 (UTC)

Yes its a reliable organization and a reliable source (author). I do see a problem though. The article is full of useful explanations that clarify the majority view and it is not being used as such. It is full of clarifications of the pseudoscientific status of the theories of chiropractic and explains why they are pseudoscientific. It also explains why the group behaviour is pseudoscientific. Thus it is one of the sources (it corroborates closely with others) that can help to give the majority view the primacy that it so desperately needs in this article. Your suggestions are welcome. And if you could help me compile that list of PS applications of chiropractic, it would also help highlight the distinct features of chiropractic. Sort of blow away the fog, and resolve the whitewash. I'm hoping for some "critical mass" on this one. KrishnaVindaloo09:36, 23 October 2006 (UTC)

Why is it significant? A neurologist writes most of the articles on his website, makes lots of highly editorialized statements about what he feels, doesn't source them, and this is significant? Do we just accept them because he is a neurologist? Then why doesn't he write about neurology!? This so-called society is more of a coven. Not significant in my view. We heard from the supporters, any views opposing this being used as a 'source'? Steth11:30, 23 October 2006 (UTC)

Oh, and who are the officers/members? Steth11:44, 23 October 2006 (UTC)

As for your question, Perry DeAngelis is the executor director, Evan Bernstein is the technical consultant and chairman of the Conneticut chapter. Robert Novella is the vice president. There's probably more, as I only know about the above because they're featured on the podcast.

The New England skeptical Society itself has hundreds of members, and their podcast is one of the more popular science podcasts and is listened to over 7000 people. The hold frequent meetings and picnics www.theness.com/home.asp. The James Randi Educational Foundation helps produce it, and James Randi has a regular spot on the show. Steven Novell's appeared on several television programs, such as Bullshit!. How "significant" does someone have to be in your view? Also, part 2 is referenced. His training as an MD and a Neurologist would help him asses the validity of chiropractic theory.

--Havermayer12:32, 23 October 2006 (UTC)

The prof in question represents the majority scientific view, as can be corroborated by the petition signed by thousands and circulated to keep chiropractic out of various universities in the States: based mostly upon chiropractic's relentless pseudoscientific doctrines. Not only is his view strongly representative, it also has high explaining power, and is eminently quotable. He understands fully the pseudoscientific nature of chiropractic because he is a neurologist, and sees the banal stupidity of chiropractic's ridiculously faulted and superstitious subluxation theory. KrishnaVindaloo14:58, 23 October 2006 (UTC)

Nice to see a rational discussion again. Steth asks a fair question, because any list of external links requires some selection. If the answer is it's there because this is one of the strongest, that's a good case in itself. Steth doesn't think it appears to be a very strong source of criticism, because it seems to be a parochial organisation and because the content isn't argued logically and rationally, but in the absence of better links, why not leave it? In the end it is the reader who sees these things and decides.Gleng16:08, 23 October 2006 (UTC)

I do agree it does not use good argument technique and does not reference reliable sources, so as an opinion article, I think it does state opinions held by several skeptical groups in the "ring". At least is does not use advertising. So, if we do have to have critical opinion papers resourced, perhaps it is more of a heading problem again. --Dematt16:22, 23 October 2006 (UTC)

My only issue here is that User:131.104.138.61 seems to be here to just spam that link on many articles. Review the user's edit history and you will see. Is there a Wikipedia policy against such actions? Levine211219:43, 23 October 2006 (UTC)

Ack, sorry about that. User 131.104.138.61 is me when I use a public computer and forget to log in. I'm fond of the ness site and think its a great resource up there with skepdic, so I figured that I could add their links to various articles since I'm usually too timid to actually change the article themselves (I have difficulty thinking out how to rephrase things). So sorry again. --Havermayer20:54, 23 October 2006 (UTC)

Okay. Please make note of http://en.wikipedia.org/wiki/Wikipedia:SpamExternal_link_spamming external link spamming policy. To an outside admin, it may seem as though you may be abusing Wikipedia to boost the amount of external links pointing to your favorite site. Levine211221:03, 23 October 2006 (UTC)

Oh sorry. I'll make sure to check to see if its completely neccesary to post a link next time, or do some googling to see if there's other links if skepdic and other skeptical sites don't have anythign on it. --Havermayer21:20, 23 October 2006 (UTC)

Havermayer's actions have nothing to do with link spamming, since the links are specifically chosen, are on-topic, as well as being to a non-commercial information site. The link spamming problem is concerned with commercial links, especially when placed by bots. They are to a website or specific URL that gets placed all over the place, often off-topic, to great annoyance to editors who have to then delete them. Fortunately there are also bots who do that job. Using various sources is of course a good idea, but if an article or website is on topic, then use it. -- Fyslee21:27, 23 October 2006 (UTC)

Perhaps it would've been better to cite http://en.wikipedia.org/wiki/Wikipedia:SpamHow_not_to_be_a_spammer this section instead which specifically states:

"Contribute cited text, not bare links. Wikipedia is an encyclopedia, not a link farm. If you have a source to contribute, first contribute some facts that you learned from that source, then cite the source. Don't simply direct readers to another site for the useful facts; add useful facts to the article, then cite the site where you found them. You're here to improve Wikipedia -- not just to funnel readers off Wikipedia and onto some other site, right?"

and...

"Don't gratuitously set off our spam radar. There are certain stylistic behaviors that will say "spam!" loud and clear to anyone who's watching:" ... "Adding the same link to many articles. The first person who notices you doing this will go through all your recent contributions with an itchy trigger finger on the revert button. And that's not much fun."

As I said, we know Havermayer's intention here may very well be altuistic/innocent, however to an outside admin, it may seem as though he may be abusing Wikipedia to boost the amount of external links pointing to his favorite site. I'm just trying to protect him and inform us all. Levine211201:35, 24 October 2006 (UTC)

Its not a problem at all. I have taken note of the Novella information, and will write it into the article with appropriate corroboration. KrishnaVindaloo02:28, 24 October 2006 (UTC)

I'll do the same as well. --Havermayer05:18, 25 October 2006 (UTC)

Because...

(first two entries copied from Talk:MDBrownMSW)

http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=prevoldid=83884005 Because it's quoting from the report. Otherwise that section is an attempt to deflect attention from the actual involvement of chiropractors in the rate of injuries. They are still the major players. That report just showed that there were a few cases where injuries caused by a non chiropractor had been attributed to chiropractors. This is an error of misattribution. Another more serious error is underreporting. I have collected much of the research on this subject http://quackfiles.blogspot.com/2006/12/must-see-dangers-of-chiropractic.html here. The risks are small, but are catastrophic when they occur. The lucky ones die. There is no excuse, considering that most upper cervical manipulations/adjustments are unnecessary, and other -- less risky -- techniques are available. -- Fyslee18:12, 26 October 2006 (UTC)

I understand why the misattribution is of merit. However, the ethnicity of the barber is meaningless, unless it would have been better or worse if the barber were Brazilian, Icelandic, Pangean or whatever. If is actually quoting the report, it belongs in quotation marks. (I am copying this to the talk page for Chiropractic.)Mdbrownmsw18:20, 26 October 2006 (UTC)

The mention of the Indian barber is the responsibility of the original author. The ethnicity isn't totally off-base, since Indian barbers, unlike modern American or British barbers, actually include treatments of various kinds among their services, including neck manipulation and tongue scraping. -- Fyslee18:25, 26 October 2006 (UTC)

Agree on all counts. There was a point when American barbers treated all sorts of conditions up into the middle of the 20th century as well. Without knowing, the fact that it was an Indian barber may be significant. I didn't see it as derogatory or discriminatory or inflammatory, just a properly referenced statement. --Dematt18:37, 26 October 2006 (UTC)

I wouldn't say that the report just showed that there were "a few cases" where injuries caused by a non chiropractor had been attributed to chiropractors. The report actually statesthat this was quite common: "This study reveals that the words chiropractic and chiropractor "'commonly"' appear in the literature to describe SMT, or practitioner of SMT, in association with iatrogenic complications, regardless of the presence or absence of professional training of the practitioner involved." Commonly. Please don't dismiss this as a "few" cases. "Commonly" is the word the report used. I also went back and completed the quote from the conclusion. This report is certainly insinuating that the SMT researchers either had an agenda or were grossly negligent in their work. Either way, the full quote should stand; considering that we are taking up so much of this article with mention of such a minor/nonexistent risk. You have more of a risk of stroke putting your head back to get washed at a salon (or Indian barber as it were) than an upper cervical adjustment by a chiropractor; yet I'm quite certain that the articles for Shampoo or Salon or Hair Cut have not mention of strokes as a safety risk. I really think this whole stroke thing is petty propoganda brought to the media's attention by fearful competitors. It's Wilk all over again. Honestly, I think our article makes too big a deal about it and if we are trying to be economical, I think there's a lot of fat in the "Safety" which could use some trimming. Levine211219:53, 26 October 2006 (UTC)

Do you have access to Terrett's full report? NCMIC used to have it, but I didn't download it back then, and now they have removed access to it. I'd love to really see the statistics, because the short summary is ambiguous and doesn't reveal all the details.

The best study to date on the safety issue is this one:

http://www.ptjournal.org/cgi/content/full/79/1/50 Manipulation of the cervical spine: risks and benefits. Richard P Di Fabio, PhD, PT. "PHYS THER, Vol. 79, No. 1, January 1999, pp. 50-65"

It has abundant proof of many deaths and injuries, and he adjusts his figures to take account of Terrett's observations. Still plenty of deaths caused by chiropractors, even after removing the few cases wrongly attributed to them. This is a misattribution error, which is not the same as the under-reporting error, which Ernst found to be nearly 100%. Yes, the risk is small, but it is avoidable and inexcusable. I have collected a lot of the evidence http://quackfiles.blogspot.com/2006/12/must-see-dangers-of-chiropractic.html here. I know the title is rather harsh, but it wasn't my idea. It does catch people's attention! Make sure you read my introductory disclaimer and my concluding recommendations. I don't limit them to chiropractors.

We haven't even begun to deal with the safety issue. Right now it's a whitewash that totally ignores patient safety, in exchange for a defense of the profession. That's a pretty unethical use of priorities. I have just left it alone, but it needs to be cleaned up and the patient placed back in the high seat. It is the "patient's" safety that is supposed to be the subject of that section (it was originally before you totally revamped it), not the profession's reputation. Whitewashing isn't NPOV. -- Fyslee00:31, 28 October 2006 (UTC)

Again, the research you are pointing to above deals specifically with upper cervical manipulations administered by Physical Therapists... not Chiropractors. Taking this research in conjunction with the chiropractic research about upper cervical adjustments, it is a fair assessment to say that you are much safer getting a chiropractic upper cervical adjustment than a physical therapist's neck manipulation.

Oh, and not that you are in any way obligated to show both sides, but your website only shows evidence in favor of your side... that chiropractors are dangerous. Clearly, there is much evidence to the contrary. Perhaps you only list the research which supports your conclusion because you are falling victim to confirmation bias or True Disbeliever's Syndrome. I would find it less disingenous to accurately depict both sides of the argument... but then your website would actually be promoting chiropractic instead of bashing it (as the accurate depicition is that http://chiropracticissafe.org/ chiropractic is safe! Levine211223:35, 30 October 2006 (UTC)

"'???? Did you even read it?"' The study was designed to examine the role of PTs in ALL injuries related to manipulation of the cervical spine (MCS). Thus it studied the role of chiropractors and others as well. It revealed that some injuries were caused by PTs, and no deaths were caused by them. It also revealed many injuries and many deaths caused by chiropractors. It is the most complete and in depth study of the subject to my knowledge. It didn't sweep anything under the carpet, or whitewash the role of PTs in the process. But it also reveals the large role of chiropractors in the problem. Lest anyone think I'm picking on chiropractors, they can read the disclaimer and conclusions written in my coverage of the subject http://quackfiles.blogspot.com/2006/12/must-see-dangers-of-chiropractic.html here. -- Fyslee06:35, 31 October 2006 (UTC)

Page size

This page is far too long. Suggestions for splitting welcome.--Light current22:51, 27 October 2006 (UTC)

On Oct. 22 I moved a large portion and thus reduced the size. -- Fyslee23:50, 27 October 2006 (UTC)

Any idea how long is too long? --Dematt23:51, 27 October 2006 (UTC)

Well, the current recommendation is still around 32k --Light current00:06, 28 October 2006 (UTC)

Check out the http://en.wikipedia.org/wiki/Article_length official Wikipeadia article length recomendations. Chiropractic is currently 87 KB. The official recommendation is: "50 KB Probably should be divided (although the scope of a topic can sometimes justify the added reading time)." The questions are: Does the scope of Chiropractic justify the added reading time? (How in the hell do we determine that!) And, if we are going to split, how? Does "Chiropractic History" get its own article? Do we tighten the safety section as I recommend above? Other suggestions? Do we do anything? Levine211200:08, 28 October 2006 (UTC)

It would take some awful patient NPOV work, but the safety and science sections could be shortened and then given their own articles. Then Practice styles could be shortened and given articles, too. But we would lose a lot of cohesion that helps keeps this article neutral and stable and interesting. --Dematt00:18, 28 October 2006 (UTC)

I know. It's almost too daunting to fathom. Levine211200:21, 28 October 2006 (UTC)

Well Im not an expert on this by any means and indeed am a very recent newcomer to this page. However, having had a quick look at the content, it seems to me that the easiest first step would be to split off the history of chiropractic into a new page. That would halve the article size. Comments? --Light current00:21, 28 October 2006 (UTC)

I have to agree. The history section is Dematt's baby, and he's done a tremendous job, but it is by far the largest section, and could be summarized shortly, with a link to it's own article, where he could place even more of all the good stuff he's been collecting. I suggest Dematt copy (only deleting when ready) the material to the new Chiropractic history article and write a good lead there. Then he could use the lead as the replacement here, with a link to the main article. I suspect the average person might get bored with reading a lot of history, which to us is fascinating, but, for the average reader, is probably like reading the geneologies in the Old Testament: "UI begat II, which begat EI, which was interpreted by DDP, who begat BJP, who begat marketing, which begat.....ad libitum....;-)" -- Fyslee00:42, 28 October 2006 (UTC)

I agree with this, with some hesitation about taking the Wilk mention from this page. It already has a reference to its main article, and I think that the little we do say about it puts a huge perspective on the science section. Levine211200:46, 28 October 2006 (UTC)

We should be careful to always leave a short description (by using the header from the main article) in place of the moved material. -- Fyslee01:03, 28 October 2006 (UTC)

How about we just delete the rest of the article and leave the history:)

Okay, Okay, you win, give me a few days to get it together. I know you're right.

--Dematt01:27, 28 October 2006 (UTC)

History delete record

First http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=84160792oldid=84159840 delete goes from 87 to 73 Kb --Dematt01:55, 28 October 2006 (UTC)

Second http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=84162351oldid=84160792 delete goes from 73 to 68 Kb --Dematt02:06, 28 October 2006 (UTC)

Third http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=84163060oldid=84162702 delete goes from 68 to 64 Kb --Dematt02:13, 28 October 2006 (UTC)

Fourth http://en.wikipedia.org/w/index.php?title=Chiropracticdiff=84164418oldid=84163735 delete goes from 64 to 61 Kb --Dematt02:25, 28 October 2006 (UTC)

OK, I'll stop there and start working on the Chiropractic history article. --Dematt02:25, 28 October 2006 (UTC)

Wow! Nice work on this. I was amazed to see all of this progress when I woke up this morning! Thank you so much. Levine211217:28, 28 October 2006 (UTC)

Thanks, it wasn't exactly a labor of love, but sometimes you have to clean out the closets in order to fit more in;) BTW, we still have a large article. I think Safety and Science sections need work, too. We can say exactly the same thing with 1/4 the words. What do you think. --Dematt00:29, 29 October 2006 (UTC)

I'd ditch the entire Safety section all together. It basically says that chiropractic is safe. Is a one-in-a-million hypothesis of danger even worth mentioning? The only reason why the stroke risk cold even be considered notable is that organizations such as Neck911 and Chirobase have an agenda of blowing this propaganda out of proportion just to keep it controversial. Basically, whether it is 0 in 5 million, 1 in 3 million or even 1 in a million, is it really worth mentioning in our encyclopedic article? My POV is "no". If there needs to be a sub-article called "Chiropractic Safety" so be it. Levine211201:52, 29 October 2006 (UTC)

Have you seen anything else within healthcare with a safety section? --Dematt01:59, 29 October 2006 (UTC)

Some yes, some no. For instance, acupuncture does while surgery does not. Herbalism does while pharmaceuticals does not. Seems odd, no? Levine211203:34, 29 October 2006 (UTC)

There does seem to be a double standard. What about moving it all to spinal manipulation? --Dematt03:41, 29 October 2006 (UTC)

It does seem that the brunt of this does focus on Spinal Manipulation. However, because of the confusion (deliberate or not) the safety issues are inextricably tied together. This is a tough. But I guess my main contention is that Chiropractic is one of the safest healthcare systems going today and yet we are devoting so much precious article real estate to the discussion of safety statistics which at the worst rival your chances of getting struck by lightning. Levine211203:45, 29 October 2006 (UTC)

Okay, we leave a snippet here and move the details of SMT related stuff to SMT. What do you think? --Dematt03:56, 29 October 2006 (UTC)

Sounds okay by me... depending on the snippet of course. Levine211204:20, 29 October 2006 (UTC)

I'll give it a try. Feel free to chime in. --Dematt04:58, 29 October 2006 (UTC)

Okay, moved a lot, but it still leaves the jist of it. The article after First Safety Delete goes from 61 to 54 Kb. --Dematt05:27, 29 October 2006 (UTC)

And according to Wiki policy, page size limits don't include charts and graphics and references and external links, so I think we should be all right now. Levine211201:55, 30 October 2006 (UTC)

Well that is certainly good news! Thank goodness. I was getting depressed. --Dematt02:55, 30 October 2006 (UTC)

Safety edits

Fyslee, I think the edit you did http://en.wikipedia.org/w/index.php?title=Chiropracticcurid=7738diff=84626120oldid=84527036 here is fine and is better than what I had since it re-phrases the text (which I was lazy and copied word-for-word). I just wanted to note however, that in your edit summary you stated you are removing a piece of it because it is a POV and untrue statement. As for the absolute truth of the statement... well that is not for us to determine, but do note that the POV is from the author of the sourced material and not myself. (As I said I was lazy and I copied it verbatim.) Regardless, I prefer your rewritten version as it is more concise. (Smaller page size!) Levine211217:15, 30 October 2006 (UTC)

Yes, I know it's Bill Lauretti's POV (1995 and outdated), and the whole document is essentially the ACA's position on the subject (he works for them.) We had him on the Healthfraud Discussion List for quite some time, with many interesting discussons. No matter what arguments and evidence were presented by MDs, PTs, laymen, and several other DCs, he always twisted the evidence to ensure that patient safety was forgotten, and the profession was portrayed as safe, which is the old apples and oranges problem, placed within a straw man framework. No one is questioning that chiropractic, as a profession, is relatively safe since DCs don't treat the same types of serious and emergency problems as MDs and surgeons. The comparison he made was very misleading and unfair. It's still in there doing it's misleading best, but now worded slightly less POV. I would have considered it better to retain the actual quotes and conclusion from some of the best chiropractic researchers in the world, right here from Denmark. These people are really sharp and do good research! They don't recommend upper cervical adjustments.

The best study so far on the subject hasn't even been mentioned, and it has plenty of good statistics:

In a study of the risks and benefits of cervical spine manipulation (MCS), 177 cases that were reported in 116 articles published between 1925 and 1997, were analyzed. Di Fabio RP. "Manipulation of the Cervical Spine: Risks and Benefits" Phys Ther. 1999 Jan;79(1):50-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrievedb=PubMedlist_uids=9920191dopt=Abstract PMID: 9920191 Current http://web.archive.org/web/20040624204354/http://www.ptjournal.org/Jan99/v79n1p50.cfm link

"'Summary:"'

Manipulation of the cervical spine (MCS) is used in the treatment of people with neck pain and muscle-tension headache. The purposes of this article are to review previously reported cases in which injuries were attributed to MCS, to identify cases of injury involving treatment by physical therapists, and to describe the risks and benefits of MCS. One hundred seventy-seven published cases of injury reported in 116 articles were reviewed. The cases were published between 1925 and 1997. The most frequently reported injuries involved arterial dissection or spasm, and lesions of the brain stem. Death occurred in 32 (18%) of the cases. Physical therapists were involved in less than 2% of the cases, and no deaths have been attributed to MCS provided by physical therapists. Although the risk of injury associated with MCS appears to be small, this type of therapy has the potential to expose patients to vertebral artery damage that can be avoided with the use of mobilization (nonthrust passive movements). The literature does not demonstrate that the benefits of MCS outweigh the risks. Several recommendations for future studies and for the practice of MCS are discussed. Di Fabio RP. Manipulation of the cervical spine: risks and benefits. Phys Ther. 1999;79:50-65.

Key Words: Effectiveness, Physical therapy, Risk, Spinal manipulation, Vertebrobasilar accident.

When the type of practitioner was determined using Terrett's modifications, Terrett AGJ: "Misuse of the literature by medical authors in discussing spinal manipulative therapy injury." JMPT 1995;18:203. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmedcmd=Retrievedopt=AbstractPluslist_uids=7636409itool=pubmed_Abstract PubMed - PMID: 7636409 the number of chiropractors involved in cases of MCS injury decreased slightly, and the numbers of cases attributed to physicians, physical therapists, and other individuals (ie, a barber, a kung-fu practitioner, and a masseur) increased (http://web.archive.org/web/20040624203346/www.ptjournal.org/Jan99/v79n1p50-figs.cfm Fig. 2). In addition, the number of cases where the practitioner was later reported (by the original authors of the case report) to be unknown increased slightly (Fig. 2). The overall pattern of practitioners involved in MCS-related injuries, however, did not change with Terrett's adjustments.

I find the misuse of Terrett's discovery of minor "misattributions" (not the same as the http://www.cmaj.ca/cgi/content/full/166/1/40 nearly 100% rate of "underreporting") to be disingenuous, and it undermines the credibility of those who do it. I hope you can help to combat this prioritizing of a profession's reputation at the expense of patient safety. The risk is indeed low, but it shouldn't be hidden or denied, especially since other methods of treating the upper cervical spine are available, most adjustments of this area are totally unnecessary, and the Danish chiropractic researchers clearly recommend against it.

The more it gets denied and downplayed, the greater will be the determination to place more emphasis on it. The denial itself creates a situation that makes it a greater issue. The ethical thing to do is ask "just how many really do get injured and die because of upper cervical adjustments?" We don't know for sure, but we know it happens, and that even the confirmed cases are often unreported, remaining the exclusive knowledge of some local neurologists, but never making it into the national statistics. That doesn't even take into account those who are simply buried without anyone having a clue about the real cause of death.

The issue applies to all who use upper cervical manipulation, and not just to chiropractors. It just happens to be more of an issue with them, because they are the ones who do it most, and they are the ones who deny the risks. Other groups are documenting their injuries and requiring informed consent. -- Fyslee22:55, 30 October 2006 (UTC)

The possibility of an ever-so-slight risk is still mentioned here in the article. I believe the amount of space dedicated to its mention is now more proportional with the theoretically tiny possibility of a risk. The Terrett's discovery of accidental and purposeful "misattribution" is not mentioned here any longer. I certainly feel it still should remain intact on the Spinal Adjustment page. The misattibutions speak a lot about the researchers who associated VBAs with chiropractic upper cervical adjustments. They were poor researchers; either glossly negligent in their data collection or extremely biased and agenda-motivated. Just more evidence of the very real conspiracy against chiropractic. With Wilk, Neck911, those ridiculous billboards and bus ads in Bridgeport, clearly this assessment is not disingenuous.

The research mentioned above deals with Physical Therapists. Their track record with upper cervical manipulation appears to be worse than chiropractors, according to this research compared to the ones specically about chiropractic adjustments. Given this, the research all seems to suggest that you are much safer getting a upper cervical chiropractic adjustment by a chiropractor than an upper cervical spinal manipulation by a PT. This isn't a surprise, since chiropractors are specifically trained to administer this very precise adjustment.

If you are more partial to believe Danish researchers than others, you might want to read http://www.journals.elsevierhealth.com/periodicals/ymmt/article/PIIS0161475406001655/abstract this one from JMPT. It seems that chiropractors in Denmark do take x-rays and receive an inceasing number of referrals from Danish MDs. Levine211223:24, 30 October 2006 (UTC)

"'???? Did you even read it?"' The study was designed to examine the role of PTs in ALL injuries related to manipulation of the cervical spine (MCS). Thus it studied the role of chiropractors and others as well. It revealed that some injuries were caused by PTs, and no deaths were caused by them. It also revealed many injuries and many deaths caused by chiropractors. It is the most complete and in depth study of the subject to my knowledge. It didn't sweep anything under the carpet, or whitewash the role of PTs in the process. But it also reveals the large role of chiropractors in the problem. Lest anyone think I'm picking on chiropractors, they can read the disclaimer and conclusions written in my coverage of the subject http://quackfiles.blogspot.com/2006/12/must-see-dangers-of-chiropractic.html here. -- Fyslee06:34, 31 October 2006 (UTC)

Sorry, I just read the summary which you provided above which makes no reference to chiropractic. Only PTs. Next time please be more clear in your instructions. Thanks. Levine211221:07, 31 October 2006 (UTC)

Fyslee makes a good point that the surgeries are for the more difficult cases. BUT, one needs to consider what percent of those that may have responded to a more conservative care such as mobilization or adjustment. If one in 4000 deaths - how many deaths is that? We also have to consider the medication option; complications from Ibuprofen and Tylenol and Vioxx and Celebrex and Naproxen and Flexeril (what is it; something like 400,000 deaths a year from properly used prescription medication?)- I imagine the numbers start to equal out. There are other factors that neurologists do consider; that the symptoms of eminant CVA are headaches and neck pain. The patients have just shown up at the DC first. The challenge is to predict who these people are. So far there is no sure fire way to know, but that doesn't mean we don't keep trying to find out. Also, there is also the consideration that these types of accidents seem to happen only in patients with connective tissue disorders. And these numbers include patients that had been to a chiropractor several months prior - is that important? Did they have other predisposing factors? Until somebody writes something important about these numbers, we're all just barking at each other with no end in sight. So really we probably have it pretty close. --Dematt04:30, 31 October 2006 (UTC)

I agree. All of these reports are just speculations. Who is to say whose speculation is truly better? Levine211221:08, 31 October 2006 (UTC)