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America's 125 medical schools are graduating about 15,000 physicians a year who will practice science-based medicine. Chiropractic's 16 colleges are producing about 4,000 graduates, most of whom will practice unscientifically. I find these relative numbers alarming.
To learn more about chiropractic education, I decided to visit a chiropractic college. I first called the American Chiropractic Association for information about such a visitation. I said that I was a medical journalist writing a weekly medical column and book in my retirement. They were most cooperative and arranged for a guided tour and an interview with the dean of New York Chiropractic College in Seneca, New York.
The tour guide was a young lady who was well versed in chiropractic philosophy, which she explained to a group of about 10 visitors, most of whom appeared to be prospective students. I asked several questions that the guide had some difficulty in answering. She referred me to the dean, whom I later interviewed.
New York Chiropractic College is located in the former Eisenhower College. The buildings are impressive, glitzy, alabaster structures surrounded by finely manicured, expansive lawns that would put to shame the medical school campuses of Yale (my alma mater) or Harvard. At the time of my visit (1997), the school had some 900 students and graduated about 300 chiropractors each year. Tuition was $4,170 each trimester, of which there were 10, for a total of $41,700 for 4 years. However, it is possible to complete chiropractic school in 3 years.
I saw 15 classrooms and laboratories, an ample number of x-ray film viewing boxes, and some strange looking examining tables designed for spinal manipulations and "adjustments." I noticed five medical doctors' names on the faculty but saw no evidence of any research department or activity to which the guide referred. The library contained a number of standard medical texts in addition to chiropractic publications.
The president of the college gave me a large package of information about chiropractic and a book entitled Principles and Practice of Chiropractic, edited by Dr. Scott Haldeman, a third-generation chiropractor who acquired a medical degree and now practices neurology. Some chiropractors appear to regard this book as their "chiropractic bible." It was to me a 600-page failed effort to explain exactly what chiropractic is supposed to be. An insert classified chiropractic as one of 45 major "alternative healthcare methodalities."
During my meeting with the dean, I said: "I am a medical columnist and admit to a scientific bias. I believe that chiropractic is the biggest medical hoax ever perpetrated on the American public. Please give me any evidence to the contrary. For starters, of the 14,000 or so diseases afflicting mankind, name one which chiropractic has proved scientifically to benefit or cure."
"Oh," the dean replied, "we do not treat disease. We treat wellness. We keep people healthy with periodic spinal adjustments."
"But," I pursued, "chiropractic in over 100 years has failed to demonstrate what is supposedly being adjusted. Despite surgery, autopsy, and sophisticated imagery, no spinal vertebral subluxation has ever been seen or shown to press on a nerve, interfering with the passage of energy down that nerve, causing disease, as chiropractic claims."
"That is because a vertebral subluxation is not an anatomical lesion. It is a 'dynamic lesion.' We call it a DSL or FSL, a dynamic or functional spinal lesion. (These definitions were corroborated in Haldeman's textbook.)
At this point, after a series of similar questions and answers, I suggested to the dean that there was clearly no satisfactory evidence of such an entity as chiropractic as defined and that they should convert their college into a medical school and abandon this phony chiropractic theory.
It is not difficult to see how young people can easily be seduced into this field by becoming a "doctor" in a few shorter and less expensive years. The college aura; the academic-appearing catalog; and the neat, shiny, scientific-looking classrooms certainly must be enticing.
To gain broader knowledge about what is being taught in chiropractic colleges, I visited the University of Bridgeport College of Chiropractic in Bridgeport, Connecticut. The college is 10 years old and has about 250 students. The admission requirements are 3 years of prechiropractic preparation. The total tuition and expense cost is about $13,000 per year for 4 years. It is the only university-affiliated chiropractic college in the United States.
A student guide was assigned to me for a tour of the buildings, which appeared adequate. I particularly wished to visit the college's clinic and view firsthand the performance of a spinal "adjustment" of a "vertebral subluxation." No patient was available, so the clinic director approved of my guide volunteering as a patient.
My guide then lay face-down on a low table with his face cradled in a hole in one end to allow breathing. The student adjuster then felt each side of the patient's neck and reported finding a cervical "subluxation" under his fingers. He then examined the thoracic and lumber spines in the same manner, finding a "subluxation" in each.
Grasping the patient's head with both hands, he hyperextended his head, twisted it to one side, and suddenly gave a series of jerks. He then repeated the twists and jerks on the other side, completing the cervical "adjustment." The procedure struck me as a form of hanging without a rope or gallows. I could only wonder what damage such twisting might be doing to the carotid and vertebral arteries serving the brain, as well as damage to the intervetebral disks.
The adjuster then turned the patient on his side, flexed the higher leg, clasped the leg and the thorax region, and gave a series of vigorous thrusts. The patient was then turned over and the thrusts repeated.
When the "adjustments" were completed, the adjuster asked whether I had heard the cracks and assured me that they were only the sound of gas escaping from the joints.
Following this shocking demonstration of a chiropractic "adjustment," I visited the dean and asked him to name the exact diseases that students were taught this procedure could effectively treat. His answer was similar to the "wellness" answer given by the dean of New York Chiropractic College. Students were being taught to how treat the "patient."
When I challenged this "patient" concept, he suggested that I read the writings of Anthony Rosner, PhD, a spokesman for chiropractic. I responded that if he would turn on the computer on his desk, he could find on Rosner's Web site my scientific medical reply to Rosner's essay on the treatment of otitis media.
He then brought out a book written by Walter I. Wardwell for me to read. I responded that Wardwell, a professor of sociology at the University of Connecticut, had just written his last piece of advice to the chiropractic community, recommending that they get their act together and that different factions and beliefs unite into a single definition and practice of chiropractic.
The dean quietly put the book aside and handed me a copy of the American Association of Chiropractic Colleges' chiropractic paradigm. After a few cordial exchanges, the visit ended.
Ludmil Adam Chotkowski, MD, FACP, is a board-certified specialist in internal medicine who retired in 1986. This article is excerpted from the second (2001) edition of his book Chiropractic: The Greatest Hoax of the Century?