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The Scientific Brief Against Chiropractic
Discussion of the Clinical Argument:
The Satisfied Customer

Nonetheless, chiropractors seem entirely satisfied with their theory, even though it has not changed since its invention, except for a few terms of nomenclature. They argue that even if their method is not scientifically proven, it is clinically. They mean by this that a legion of satisfied clients bear eloquent witness to their success. We freely admit that certain clients have been pleased with chiropractic treatment, and that some of them had previously consulted physicians and have preferred chiropractic treatment. The opposite is also true. This type of testimonial can readily be obtained on either side.

The same argument is invoked to assert that the public wants chiropractic, that it is no longer necessary to question the validity of the theory, that the public has judged. It may be permissible, however, to submit this point to the enlightened judgment of a Royal Commission.

The argument of the satisfied customer, which philosophers call the argument of "consensus universalis," falls in the category of moral certitude. In contrast to physical certitude -- based on the immutable laws of nature, which scientific method provides, moral proof -- based on the fallible and variable judgment of human beings according to their subjective impressions and previous experience -- is necessarily of a much lower order, especially when applied to natural phenomena. To neglect physical certitude and fall back on moral proof is in itself a confession of the weakness of the argument.

Further, it would be necessary for that moral proof to be based on a unanimous consensus of uniform testimonials for its validity to be accepted. In the case in point, not all clients are satisfied with chiropractic; some who were satisfied at one time become dissatisfied later on. Further still, the quality of the proof depends on the quality of the testimony; and the quality of testimony is largely determined by the understanding which the witness has of the subject in question. To what degree can a person unaware of the nature and cause of his illness, and of chiropractic theory and the effects of chiropractic treatment, give valid evidence of a cause-and-effect relationship? It is surely unnecessary to emphasize to this Commission that thousands of unproven testimonials do not by sheer numbers constitute valid proof.

Indeed, it is well known that the patient's satisfaction is not always a reliable index of the value of the treatment he has received. Even if one were to overlook the fallacy of the moral proof and take it for granted for the sake of hypothesis, it would still be necessary to reject the argument. Disease is one of the phenomena of nature, and is therefore governed by natural laws; only by recognizing the laws of nature can one hope to cure disease. Any method of treatment which is not founded on the laws of nature is inevitably doomed to fail. To accept moral proof alone in the case of chiropractic would be to deny not only the existence of science but the order of nature as well.

One would nevertheless have to be blind to deny that chiropractors and their clients have increased in number. The explanation of this phenomenon would require a more extensive study than is possible here. Certain observations, however, would indicate where the sociologic reasons are to be found. In the early part of this century, up till the 1930's, physical medicine and rehabilitation had not received the attention of the medical profession, nor been given the importance they enjoy today. Nowadays the physiatrist, or physician specializing in physical medicine and rehabilitation, is certified in his specialty by the College of Physicians just as are surgeons, obstetricians and gynecologists, et al.

During those years, medical efforts were directed towards more urgent tasks, such as the development of bacteriology, the struggle against contagious diseases, the evolution of precision and finesse in diagnosis, the enlargement and reinforcement of the therapeutic arsenal, the invention of techniques in surgery of the heart and brain, the improvement of therapy in mental illness, etc. In short, there were matters of greater urgency to be dealt with, conditions which are still found today in under-developed areas to an even more serious degree. Thus, chiropractic has seemed to offer hope in an area which medicine had appeared to overlook.

Since most people are very exacting of the physician, and therefore tend not to refer to any errors they may have made in consulting other persons but to get inordinate pleasure from any apparent success, failures do less harm to the chiropractor's reputation -- especially since he can take refuge in the statement that the problem is not in his domain. But if the patient experiences a spontaneous cure while undergoing a series of chiropractic treatments, the value of the treatment is claimed to be nothing short of miraculous.

We shall see later on that there are indeed a small number of painful conditions of the spine which can be helped by manipulation. We must add forthwith that this does not mean that the chiropractic theory is valid, nor that chiropractic treatment is without danger. We shall see later that quite the opposite is true.

Having achieved considerable success against the scourges of the early part of the century, medicine turned to the development of physiatry, the objectives of which are not only the application of existing treatments, but their improvement and the discovery of more effective methods. At best, chiropractic could only hope to fill a role which medicine had not yet sufficiently developed. Nevertheless, it retains for certain people that mystic attraction which empirical and unaccepted theories and practices seem to have.

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