The Intersection between Philosophical and Operational Concepts of Vertebral Subluxation

1
The Intersection between Philosophical and
Operational Concepts of Vertebral Subluxation

• Chiropractic Philosophy
• in the
• 21st Century
• David B. Koch, D.C., Professor of Philosophy, PCC

2
The ProblemVertebral subluxation as a
philosophic concept

• Chiropractics vitalistic paradigm creates a
  holistic perspective on health and function
• Existence of the nerve-endocrine-immune system
  implies that holistic function emerges from
  internal (cell-cell) and external
  (organism-environment) communication

3
The Problem

• The observation of dysfunction implies the
  existence of dis-communication (aka interference)
• Interference necessarily implies the existence of
  meaningfulness (information) within
  neuro-imuno-endocrine interactions

4
The Problem

• Information within any signal is immaterial until
  received, interpreted and expressed through an
  appropriate (adaptive) response
• Philosophically, vertebral subluxation is a
  metaphor, significant primarily as a possible
  source of interference to normal
  internal/external communication

5
The Problem

• At this point, any definition of how the
  vertebral column (or any subluxatable
  articulation for that matter) interacts with the
  neuro-imuno-endocrine system is purely
  speculative in the absence of factual knowledge
  of the mechanisms involved.

6
Example

• A subluxation is the condition of a vertebra that
  has lose its proper juxtaposition with the one
  above, the one below or both (speculation), to an
  extent less than a luxation (definitional), which
  occludes an opening (speculation), impinges a
  nerve (How? When?) and interferes with the
  transmission of adaptively meaningful efferent
  (Why not and/or afferent?) nerve impulses, aka
  mental impulses.

7
The Other Side of the ProblemOperational
definitions of vertebral subluxation

• Scientifically, vertebral subluxation is a
  phenomenon, worth studying (investing time and
  in) only in proportion to its significance to
  human life and purposes.
• Chiropractors proposed that it held a greater
  level of significance earlier than any other
  health care theory

8
The Other Side of the Problem

• The possible significance of vertebral
  subluxation was proposed in the absence of any
  but the most rudimentary knowledge of both spinal
  biomechanical function and neuro-imuno-endocrine
  function.

9
The Other Side of the Problem

• Most exploration has been clinical, leading to
  operational definitions of vertebral
  subluxation
• Leg checks, palpable findings, radiographic
  comparisons, instrumentation readouts
• Influenced by ongoing theoretical speculation,
  lack of scientific rigor and

10
The Other Side of the Problem

• The concept of the vitalistic significance of
  vertebral subluxation (as an energetic challenge
  to holistic self-awareness and self-regulation)
  has had to compete with the greatest explosion of
  biological mechanism (pharmacology and genetic
  determinism) ever seen

11
The Other Side of the Problem

• Aspirin 1895
• Antibiotics 1928
• DNA structure 1953
• Immuno-suppression and organ transplant 1970s
• Recombinant DNA technology 1990s

12
The Other Side of the Problem

• Chiropractics vertebral subluxation metaphor
  both defined and alienated the profession
• Philosophic paradigm nearly discredited
• Philosophic speculation became dogma
• The simplicity of the metaphor belies the
  complexity of the phenomenon itself

13
Vertebral Subluxation Today

• Explosive increase in both chiropractic
  subluxation research and interest in the
  phenomenon by other professions
• JMPT, RACI-VIII, CCCR, FCER, JVSR
• Multiple technique driven theories of VS
  increasing research into specific aspects of VS
• Osteopathy (Korr 1970s), physiotherapy,
  physiatry all exploring spine/nerve connection

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Vertebral Subluxation Today

• The Challenges
• Disconnecting the scientific exploration from
  narrow historical, philosophical or technique
  dogmas
• Maintaining the value of the VS metaphor through
  the open-ended, skepticism-driven process of
  scientific hypothesis generation and testing

15
Vertebral Subluxation Today

• The Challenges
• Solving the afferent vs. efferent dis-ease
  problem
• Integrating multiple mechanisms into a
  comprehensive neuro-immuno- endocrine/spinal
  biomechanical theory of coordination, adaptation
  and health enhancement

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Summary

• Philosophically derived definitions of vertebral
  subluxation may serve us well as metaphors, but
  tend to be too specific and thus too restrictive
  to be operationalized
• As scientific research on subluxation progresses,
  multiple operational definitions, theories and
  investigative foci tend to develop simultaneously

17
Summary

• The challenge is to maintain a simple and clear
  metaphorical model of vertebral subluxation
  throughout the skepticism-driven scientific
  inquiry into its true nature
• Ultimately, we should seek to create a
  comprehensive neuro-immuno-endocrine/ spinal
  biomechanical theory of the bodys innate
  intelligence and its relationship to
  coordination, adaptation and health