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 Problem:Vertebral subluxation as a philosophic concept • Chiropractic’s 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) withinneuro-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 – 1970’s • Recombinant DNA technology – 1990’s

12. The Other Side of the Problem • Chiropractic’s 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 – 1970’s), physiotherapy, physiatry all exploring spine/nerve connection

14. “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

16. 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 body’s innate intelligence and its relationship to coordination, adaptation and health