Australians deserve no-nonsense regulation of chiropractors

Andrew Arnold, the Melbourne based chiropractor whose manipulation of the spine of a two week old infant was described as “deeply disturbing” by the Victorian health minister is presently refraining from treating anyone under 12 years of age.

The ABC reported just over a week ago that health minister Jenny Mikakos also said in part;

It’s appalling that young children and infants are being exposed to potential harm. That’s why I’ve written to the Chiropractic Board of Australia and AHPRA (the Australian Health Practitioner Regulation Agency) to urge them to take the necessary action. There is nothing at the moment that prevents chiropractors from undertaking these risky practices… The advice that I’ve received is that the risk of undertaking spinal manipulation on small infants far outweighs any perceived benefit.

It’s worth noting that chiropractic treatment in general and the manipulation of infants specifically has a history of drawing harsh criticism from health and medical professionals and penalties from regulators. Fairfax reported in December 2011, Doctors take aim at chiropractors. One wonders at the lack of a cogent response to such serious statements from reputable professionals.

The inclusion of a chiropractic course at Central Queensland University prompted 34 scientists, professors and doctors to note federal government funding “gave their ‘pseudoscience’ credibility”. Fairfax reported that their statement included;

…it was also disturbing that some chiropractors spruiked the adjustment of children’s spines for many potentially serious conditions including fever, colic, allergies, asthma, hearing loss and learning disorders.

…the doctors said they were also concerned about chiropractors being the largest ”professional” group in the anti-vaccination network. [Now named The Australian Vaccination Risks Network]

At the time Australian Chiropractors Association president Lawrence Tassell responded by saying the criticism was ridiculous and misinformed. He further contended chiropractic was “evidence-based, including its use on children for the treatment of conditions such as colic.”

Note: The Australian Chiropractors Association was originally The Chiropractic Association of Australia (CAA). [Wikipedia]

Just colic? Was this an admission that fever, asthma, hearing loss, all allergies and all learning disorders did not benefit from chiropractic despite promotional claims that they did? Even so the question of evidence supporting chiropractic for the treatment of colic (crying) was not as Tassell suggested. Months later a Cochrane review consulted research into that very issue.

Conclusions note;

The studies included in this meta-analysis were generally small and methodologically prone to bias, which makes it impossible to arrive at a definitive conclusion about the effectiveness of manipulative therapies for infantile colic.

…most studies had a high risk of performance bias due to the fact that the assessors (parents) were not blind to who had received the intervention. When combining only those trials with a low risk of such performance bias, the results did not reach statistical significance.

This brings to mind criticism of anti-scientific training and ideological dogma favoured by what John Reggars calls fundamentalists. Reggars is past president of the Chiropractors Registration Board of Victoria and past vice president of the Chiropractic and Osteopathic College of Australasia.

In May 2011 Chiropractic and Manual Therapies published Reggars’ wonderfully honest and revealing article, Chiropractic at the crossroads or are we just going around in circles? Reggars is a firm proponent of evidence based therapy. As such he criticises the vertebral subluxation complex and B.J. Palmer’s notion of “dis-ease”. Consider this gem of a paragraph;

The irony of this fervent belief in the VSC and chiropractic philosophy is that its development was not founded on vitalistic theory but rather as a legal strategy, conjured up by an attorney, in the defence of a chiropractor charged with practicing medicine [7, 32, 33]: “Many in chiropractic never learned the origin of the pseudo-religion or chiropractic philosophy. It was nothing more than a legal tactic used in the Morriubo’s case.”[34], and “B.J. Palmer probably developed his disease theory as a result of the winning strategy used by his attorney Thomas Morris to defend Japanese chiropractor Shegatoro Morijubo in Wisconsin in 1907″[35].

– Author’s citations in place.

Reggars also concluded that the Chiropractic Association of Australia (CAA) abandoned science for fundamentalist ideologies. He observed that their “all-encompassing alternative system of healthcare is both misguided and irrational”.

Readers are handed the reality of what chiropractors genuinely offer;

Chiropractic trade publications and so-called educational seminar promotion material often abound with advertisements of how practitioners can effectively sell the VSC to an ignorant public. Phrases such as “double your income”, “attract new patients” and “keep your patients longer in care”, are common enticements for chiropractors to attend technique and practice management seminars.

Selling such concepts as lifetime chiropractic care, the use contracts of care, the misuse of diagnostic equipment such as thermography and surface electromyography and the x-raying of every new patient, all contribute to our poor reputation, public distrust and official complaints. […]

And;
For the true believer, the naive practitioner or undergraduate chiropractic student who accepts in good faith the propaganda and pseudoscience peddled by the VSC teachers, mentors and professional organisations, the result is the same, a sense of belonging and an unshakable and unwavering faith in their ideology.

Back in June 2016 Ian Rossborough published a similar video which also drew strong condemnation. The Australian Health Practitioner Regulation Agency (AHPRA) responded by banning him from manipulating the spines of children under six.

It is difficult to watch Andrew Arnold “manipulate” an infant. Yes a baby is distressed and crying. But it’s the manipulation of the parents I also find appalling.

Grabbing the infant’s feet he announces “I’m locking in here”. Really? He lifts the baby offering verbal distractions. “I’m just gunna go upside down for a second… yep and as we go back down just hold his head… Perfect!” Then comes the stick-that-goes-click. Or as chiropractors call it, the Activator. A spring loaded device which delivers an “impulse”. He demonstrates the lowest setting and releases it into what seems to be the right side of the infants cervical spine. Another still image (below) shows Arnold apparently applying the activator to the infants upper cervical spine at the base of the skull.

The application of the activator as seen in the video hurts or distresses the infant immediately and he begins to cry. “…and he’s going to squawk a bit”, Arnold offers as if he planned and expected this all along. Then, he does it again! And guess what? More crying. “Sorry mate” he offers for the parent’s sake. He checks the collar bones “…cause they get a bit crunched up inside”. He checks potential for collar bone crunching by moving the infants hand. “So with this, start to get in the habit of getting a grip here”, and the video finishes with what appears to be reference to the Palmer grasp aka Darwinian reflex.

This reflex in which babies grip fingers develops around three months of age. I do hope Andrew Arnold informed the parents of this. Then again, I hope someone informed Andrew Arnold of this.

There’s little doubt we’re slow to not merely evaluate most chiropractic therapy and indeed most chiropractors as offering nothing more than pseudoscience. That so people many in developed nations believe their demonstrably preposterous claims about treatment is quite surprising. With the amount of pseudoscience and junk medicine accessible online it is little wonder parents will fall for chiropractic claims about treating infants.

Chiropractic clients should be informed that mild to moderate adverse effects are frequently associated with manipulation of the upper spine in adults. Dissection of the vertebral artery and stroke may also occur. [Source]. It’s difficult to imagine more than a very few parents would be comfortable having infants, babies and young children treated if aware of this situation.

A 2008 study found there was very little supporting evidence for the claims chiropractors made regarding pediatric treatment. A 2007 systematic review found that serious adverse effects may be associated with pediatric spinal manipulation. However observation data could not support conclusions on incidence or causation.

It remains firmly demonstrable that evidence to sustain even a fraction of claims made by chiropractors as to how effective pediatric treatment is remains absent. The fact chiropractors themselves have not pursued large scale randomised controlled trials with a vigor akin to that with which they claim an ability to heal is concerning.

I have no doubt there are chiropractors who do strive to follow an evidence based approach to treatment. Yet with some influential chiropractors labelling this approach as out of date in favour of the approach of D.D. Palmer’s 19th century vitalism, they face a struggle to be heard.

As John Reggars noted since the adoption of the fundamentalist approach and application of the vertebral subluxation complex (VSC), chiropractic in Australia has taken a backward step. Chiropractors have abandoned a “scientific and evidence based approach to practice for one founded on ideological dogma”.

Australians are entitled to be protected from expensive, dangerous pseudoscience in the health industry. At present we are faced with regulators who need to develop some rather sharp teeth and make a meal of chiropractic pseudoscience.

 

♣ (4/3/19) NB: Colic may refer to severe abdominal pain caused by an intestinal blockage or gas. Infants are prone to the condition, responding with constant crying. In fact crying is the means by which “colicky” babies are diagnosed. Paediatricians may use the “rule of threes” in diagnosis, particularly items 2-4.

  1. Crying begins at around 3 weeks of age.
  2. Crying for more than 3 hours.
  3. Crying on more than 3 days per week.
  4. Crying this way for more than 3 weeks.

Because crying is what determines infantile colic there is ample disagreement as to the role of intestinal pain or even if colic itself is a myth. Other criticisms involve the convenient use of colic as a diagnosis for excessive crying.

Reading;

Seven Ways to Identify Pseudoscience

Original seven ways – © Relatively Interesting

  • The use of psychobabble – words that sound scientific and professional but are used incorrectly, or in a misleading manner;

Self-help books, folk and pop psychology, and motivational seminars often use psychobabble.  Deepak Chopra is a name that comes to mind at present. Nothing more than a fraud according to Professor Jerry Coyne, one may delight in the Wisdom of Chopra which is a Twitter stream made up of seeming quotes that are randomly generated by words that can be found in his genuine Twitter stream. If anybody breathes prescient life into the words of the late Carl Sagan it is the scoundrel and intellectual mobster Deepak Chopra.

Sagan proffered;

I worry that, especially as the Millennium edges nearer, pseudo-science and superstition will seem year by year more tempting, the siren song of unreason more sonorous and attractive.

  • A substantial reliance on anecdotal evidence;

Without a doubt the alternatives to medicine behemoth would be lost without dramatic tales of self-limiting illnesses merely running their course, or completely false or hugely exaggerated stories of serious, disabling or terminal disease executing an about face due to the power of some wonderful concoction. The frustrating hurdle here for those who promote reason is that almost all work undertaken to convince the patient occurs in their own mind. Scam artists from peddlers of herbs to chiropractors, Baptist religions and indeed even the Catholic Church are swift to take credit if they have been involved.

  • Extraordinary claims in the absence of extraordinary evidence;

From 9/11 being an inside job to images of the apparent exhumation of giant skeletons to alien autopsy videos and shaky vision of UFOs drifting across a grainy background it seems all these and other extraordinary claims have one thing in common. A powerful need to believe in their truth by those that ensure certain – in fact sometimes many – conspiracy theories indeed exist. Now thanks to Netflix we can wander through a range of delightful titles that offer everything from reasonable special effects to WW2 era reports and “experts” convinced our governments expect us to believe the laws of physics have been broken.

  • Claims which cannot be proven false;

Insisting oneself or perhaps a number of people in the world have communicated telepathically at infrequent and random intervals with aliens from a distant star is impossible to disprove on face value. The claimant can continue to insist he/she is unaware of who the other telepathic human recipients are, or when he/she will receive or has received a communication. The communication may be quite benign such as, “Happy Birthday Deepak”.

Ideally the burden of proof should be placed on the party making the claim.

  • Claims that counter established scientific fact;

Often going hand in hand with claims that rely on anecdotal evidence are those that defy scientific fact. Homeopathy stands atop the podium in this regard. Not only is it absolutely certain to not work but it’s adherents may insist on relaying impossible tales – often knowing they are outright lies – to besmear evidence based medicine and promote junk, bogus cures. For example pertussis (or Whooping Cough) is sometimes referred to as “the 100 day cough”. Prominent Australian antivaccinationist Meryl Dorey claimed on national TV both her vaccinated and unvaccinated children “got it”. She treated it homeopathically and “none of us were sick for more than two weeks and it was nothing worse than a bad cough”.

Countering established fact may be said of an enormous number of claims made about pseudoscientific “cures” for many ailments. Some treat energy meridians or “chakras” that don’t actually exist. These involve peddling herbs, acupuncture, acupressure, chiropractic, osteopathy, chanting, cupping, aligning activities with moon cycles, astrology and more.

Without a doubt denial of anthropogenic climate change should be mentioned here and we might again reflect upon to Carl Sagan’s worrying prediction.

  • Absence of adequate peer review;

In 2015 antivaccinationist and science fraud Judy Wilyman, under the auspicies of antivaccinationist and conspiracy sympathiser Dr. Brian Martin, finished her PhD at the University of Wollongong. The controversy surrounding inadequate peer review between 2012 to 2016 and indeed until today is a function of the copious inaccuracies in her thesis. Entitled “A critical analysis of the Australian Government’s rationale for its vaccination policy”, it was an immature an inaccurate antivaccination conspiracy rant. The fact that it was accepted, and indeed accepted with it’s discredited bibliography, indicates a clear absence of adequate peer review.

Tragically this eventuality has emboldened Wilyman to demand respect from academics and to level outrageous personal claims at her critics, rather than attempt to publish respectable material.

  • Claims that are repeated despite being refuted;

Whilst a great deal of the above intellectual repugnance deserves a slice of this pie, the authors at Relatively Interesting have populated it with the anti-vaccination obsession with the globally damaging claim that vaccines cause autism. Originally at a 1998 media conference designed to reassure parents, head author of the now rejected paper Andrew Wakefield proffered the baseless claim that rather than use the MMR trivalent vaccine, parents should consider choosing single shot vaccines. The “vaccines cause autism” claim has not only been shown to be false and cannot be replicated, but it is now well established that Wakefield acted with the sole aim of making tens and probably hundreds of millions of pounds via his plan to establish immuno-analysis laboratories for the new condition he was calling autistic enterocolitis. He also held patents for single shot measles, mumps and rubella vaccines.

A five member General Medical Council panel found Wakefield guilty of over 30 charges including 12 of causing children to endure “clinically unjustified” invasive testing procedures, buying blood at children’s birthday parties and managing four counts of dishonesty. Then, his “continued lack of insight” into his conduct, and consequences thereof, meant that only “total erasure” from the medical register was warranted. Today on the back of countless refutations of Wakefields claims he now pushes the fraudumentary Vaxxed full of false information and complete with the tampered audio of phone conversations.

 

Regrettably today more than in recent years we can benefit from keeping an eye out for these seven markers of pseudo-science.

Vaccines contain no aborted fetal cells

One of the most offensive lies peddled about vaccines is that they “contain aborted foetal cells”.

Consider this April 2013 screenshot from AVN Facebook:

Aborted fetal tissue

I noticed an even more absurd take when reading Anti-vaccine chiropractors redux-1, c/o reasonablehank. He was reviewing the anti-vaccine rantings of one “Dr” Koe Davidson who is a chiropractor running Peak Potential Health and Wellness in Mentone, Melbourne. One screenshot includes Davidson addressing vaccine ingredients as listed by the CDC. It includes:

Oh and “egg protein” = fancy word for aborted fetus cells. This wording was changed in mid 2012… Scary stuff.

For a document last updated in February 2012 I’m not sure what he’s trying to convey. The CDC cannot have changed egg protein to aborted “fetus” cells in 2012 as this would be complete nonsense. Thus one must conclude he is either utterly confused on the topic of cell cultures or – as is common with chiropractors aligned with the CAA – misinforming readers.

The CDC write about egg protein as a vaccine additive:

Egg protein is found in yellow fever and most influenza vaccines, which are prepared using chicken eggs. Ordinarily, persons who are able to eat eggs or egg products safely can receive these vaccines.

So how can such confusion on cell cultures come to pass? Today strains of human diploid cell culture are grown in containers in laboratories. In the manufacture of vaccines, viruses that infect humans are grown in these human diploid cell lines. One strain of human diploid cell culture was made in the USA in 1961. Labelled WI-38 this strain came from the lung tissue of an aborted female of three months gestation.

Another human diploid cell culture was produced in the UK in 1966. The tissue came from the lungs of a 14 week old male foetus and the strain is labelled MRC-5. W.I. refers to the Wistar Institute. M.R.C. refers to the Medical Research Council.

The abortions did not take place with the intent of producing human diploid cell culture for use in vaccine manufacture. The biologists who produced the diploid cultures did not induce the abortions. Both abortions were intentional and would have been carried out whether the foetal tissue had that fate or not, post abortion.

These cells used to grow viruses have been reproducing since 1961 (WI-38) and 1966 (MRC-5), respectively. The viruses produced this way are further processed and sterilised in the production of the vaccine. In this way any potential for contamination with foetal material is eliminated. Furthermore, strict quality control measures are employed to examine each vaccine to ensure no foetal material is present.

♣ The USA National Network for Immunization Information state (bold mine):

These two cell strains have been growing under laboratory conditions for more than 35 years. The cells are merely the biological system in which the viruses are grown. These cell strains do not and cannot form a complete organism and do not constitute a potential human being. The cells reproduce themselves, so there is no need to abort additional fetuses to sustain the culture supply. Viruses are collected from the diploid cell cultures and then processed further to produce the vaccine itself. ♣

Vaccines produced using WI-38 and MRC-5 human diploid cell lines include hepatitis A, rabies, rubella, MMR, varicella and Pentacell DTaP-IPV/Hib.

Another abortion was performed on a rubella virus-infected mother in 1968. Both mother and foetus were infected with wild rubella and this posed the risk of major birth defects. Foetal tissues were obtained and wild rubella virus (RA27/3) was isolated. This has been grown in human foetal diploid cell line WI-38. No foetal tissue is present in the vaccine. No further abortions are necessary to produce more vaccines.

Prior to isolation of RA27/3 the USA experienced 800 cases of congenital rubella annually. At the turn of the century only three babies with congenital rubella were born. Research was carried out to study the possibility of using other animal cells to produce the RA27/3 rubella vaccine. However these proved less effective and less safe.

The Vatican accepts the use of human diploid cells in the manufacture of vaccines. A June 9th 2005 Vatican City Statement on Aborted Fetal Vaccines acknowledges this. It notes use of these cell lines is:

…to avoid a serious risk not only for one’s own children but also, and more specifically, for the health conditions of the population as a whole – especially for pregnant women.

For example, the severe epidemic of German measles which affected a huge part of the United States in 1964 thus caused 20,000 cases of congenital rubella2, resulting in 11,250 abortions (spontaneous or surgical), 2,100 neonatal deaths, 11,600 cases of deafness, 3,580 cases of blindness, 1,800 cases of mental retardation. It was this epidemic that pushed for the development and introduction on the market of an effective vaccine against rubella, thus permitting an effective prophylaxis against this infection.

[And observes that]

…the parents who did not accept the vaccination of their own children become responsible for the malformations [due to rubella infection] in question, and for the subsequent abortion of fetuses, when they have been discovered to be malformed.

Think of an apple orchard. The organic material nourishing the trees includes (say) manure, bird droppings, animal carcases, rotting vegetation and so on. If one eats an apple one is not eating manure or the carcass of an unfortunate passing mammal. To say vaccines contain cellular material is to employ exactly such flawed thinking.

A vaccine initially made using human diploid cells that passed FDA requirements via another production method is the RabAvert rabies vaccine by Chiron Corporation. When safe and effective alternatives can replace the methodology involving human diploid cells we shall begin to see them. It is a fact that the human strains are superior in many ways. However they are not, in any way shape or form, “aborted foetal cells”.

The claim that vaccines contain the cells of aborted foetuses or are contaminated with any organic material is quite simply false.

Of chiropractic tripe and the odd zebra stripe

When we think of chiropractic and Equidae, it’s usually unicorns that come to mind.

The search for the chiropractic subluxation has been as fruitful as the search for the unicorn. In fact perhaps less fruitful, as we know with a high degree of accuracy what the unicorn looks like. Yet with the chiropractic subluxation our fairy tale is limited to conjuring mystical malaise or blaming dastardly disease as the work of this elusive evil.

chiro face palm

Do not be alarmed. This man has not seen a unicorn.

Rather, he had just been told that chiropractic subluxations

involve some type of “static” in the spinal cord.

Doctors (real doctors) report that he made a full recovery

after his palm was removed from his face.

Interestingly enough, whilst chiropractic teaches that areas of subluxation are invisible and can be “detected” only by the presence of symptoms, Simon Floreani, erstwhile president of the Chiropractors Association of Australia, has other ideas.

Check out the Catalyst video below at 1min, 45sec. Using the apparently magical Activator – or the “stick that goes click” – on an infant, Floreani announces:

Areas of subluxation that I can feel there, that are immediately improved after you adjust it like that…

You can read more about the Sonic Screwdriver-like Activator here in The Medical Observer. Just be prepared for some tongue in cheek observations. In September 2011 it was reported in Australian Doctor that the Federal Government had been asked to investigate both the Activator and “the Nervoscope” as they had been reported as having, “no biomechanical or physiological effect and cannot diagnose or treat any health condition”.

Fortunately, whilst new-age chiropractors continue to push their ineffective devices, practices and claims onto an unsuspecting public, genuinely motivated supporters of evidence based medicine are busy exposing their scams.

Check out the videos below to see just how devoid of facts claims made by the resurgent followers of Daniel David Palmer, really are. And keep an eye out for Simon and his zebra.

Catalyst – July 11th 2013


Floreani’s penchant for cutting his own path may help explain why he has chosen the zebra over the unicorn.

zebra floreaniFloreani positions a young subluxee on his treatment table cunningly disguised as a zebra

Lateline – July 6th 2009


Zebra floreani2

Floreani seems to be watched over by a zebra

Today Tonight – December 2011


Today Tonight – March 14th 2013

Complementary medicines’ problem with evidence

Evidence aplenty for complementary medicines-by ex-head of the AMA-Take THAT Friends of Science-enemies of truth!

Anti-vaccine lobbyist Meryl Dorey seizing legitimacy from Dr. Kerryn Phelps

Last week Dr. Kerryn Phelps wrote an article for The Australian defending the view that alternatives to medicine are in fact, a type of medicine.

The article’s heading, Evidence aplenty for complementary medicines itself touched on a unique feature of the massive Wellness Industry. Semantics. We have witnessed natural medicine become alternative medicine become complementary medicine become integrative medicine or more frequently complementary and integrative medicine. These are semantic costume changes designed to market integrity. To divert attention away from the fact that evidence for the efficacy of alternatives to medicine is lacking. Simply put, this is not medicine.

Dr. Phelps criticised Friends Of Science In Medicine [FSM], suggesting their “agenda was a declaration of war”. Yet I would conclude FSM are providing a long overdue and organised response to the rise of demonstrably non efficacious and potentially dangerous practices gaining undeserved academic credence. These have always shared a hostility toward evidence based medicine and science itself.

FSM president Professor John Dwyer writes:

We strongly support sound research to determine the effectiveness or otherwise of any biologically plausible areas of ‘alternative’ interventions. We do not seek to prevent consumers from making informed choices about alternative interventions, but wish to see the public better informed and therefore protected from false claims.

I do not doubt for a moment that Dr. Phelps and many other GPs who support alternatives to medicine are above reproach. Nor am I suggesting that all naturopaths and chiropractors (for example) are incapable of establishing a meaningful patient-focused reciprocal relationship with conventional medicine. What I am suggesting is that they are a minority and it is thus in error to suggest alternatives to medicine are generally based on evidence. Dr. Phelps’ insistence that these practices “compliment” or effectively “integrate” with conventional medicine is simply wishful thinking.

I strongly agree with Kerryn Phelps in that individuals taking more responsibility for their health is positive. I support and defend the right of patients to have more choice in managing their health. What I find deeply troubling is that once these two conditions are met, patients and wellness consumers are faced with bogus claims, unnecessary expense and a cornucopia of charlatans. That this is in no small part due to paper tiger regulation reflects that the system itself is broken and failing Australians.

That 19 of Australia’s 39 universities offer courses in scientifically implausible practices is alarming. The role of FSM in highlighting the perils of affording academic credibility to these practices is vital. It can be argued, as Dr. Phelps has previously, that universities will ensure rigid standards are met. Or as now, that FSM should support “an increase in university-based education for practitioners”. Sound reasoning to be sure. Until one considers that these very practices depend upon denial of the scientific method and graduates often emerge highly defensive of an ideology.

There is also an inescapable convolution of practice, integrity and accountability. A belief system associated with one modality may open the way for increasingly absurd practices. The anti-science, anti-medicine, post modernist culture so crucial to new age chiropractic is conducive to opposition, not integration.

This convolution raises the question of where the line is drawn. Few understand what constitute homeopathic principles beyond assuming they provide a “natural” therapy. Yet I would be surprised and disappointed if Dr. Phelps agued it had a role in medicine beyond placebo. Basic chemistry confirms there is no ingredient at all in homeopathic products, beyond expensive sugar. For those who seek to understand more about this “informed choice” there await increasingly bizarre claims most often concluding quantum physics will one day reveal all. This is the same mechanism behind theta healing – even remote theta healing.

For the purposes of this post it’s important to focus primarily on Dr. Phelps’ defence of chiropractic. But what type of chiropractor? John Reggars is past president of the Chiropractors Registration Board of Victoria and present vice president of the Chiropractic and Osteopathic College of Australasia. Focused on science, he is concerned by the rise of “ideological dogma” and the anti-scientific fundamentalist training that FSM have identified as problematic. In a paper by Reggars published in May 2011 he notes that in Australia the 1990s saw a resurgence of “chiropractic philosophy” and with it the belief in VSC, or Vertebral Subluxation Complex.

Reggars is highly critical of such chiropractic pseudoscience, pointing out misuse of diagnostic treatment, schemes to “double your income”, selling the notion of lifelong chiropractic care “to an ignorant public” and locking patients into contract plans. He also writes:

For the true believer, the naive practitioner or undergraduate chiropractic student who accepts in good faith the propaganda and pseudoscience peddled by the VSC teachers, mentors and professional organisations, the result is the same, a sense of belonging and an unshakable and unwavering faith in their ideology.

Belief in the unseen VSC is accompanied by the insistence all disease – including infectious disease – has its origin or cure in the spine. Chiropractic is the invention of 19th century magnetic healer Daniel David Palmer. Perhaps nothing reinforces the value of Friends Of Science In Medicine better than this modern scam of chiropractic. Represented in Australia by the Chiropractor’s Association of Australia [CAA] its aim is:

To achieve a fundamental paradigm shift in healthcare direction where chiropractic is recognised as the most cost efficient and effective health regime of first choice that is readily accessible to all people.

In other words they seek to displace the GP as the primary care physician. It is impossible to broach the many areas of medicine or do the same with the many pseudosciences chiropractic endorses to elaborate on this. Yet from vitamin therapy to homeopathy new age chiropractors have a positive word. Efficacy matters not. The CAA seem to instill fear and confusion about conventional medicine as a key mechanism in their “fundamental paradigm shift in healthcare direction”.

When we understand what seeking to usurp the family doctor entails, we can see that FSM can scarcely be accused of declaring war. The article Recent Controversies in Chiropractic and RMIT courses/clinic provides exceptional insight into the very concerns FSM seek to address with quackery in universities. Palmer argued humans have “a god-given energy flow” which when disrupted leads to illness. Exhuming such nonsense and contending that the doctrine is “evidence-based education and practice”, as suggested by Dr. Ray Myers, head of RMIT University’s School of Health Sciences is shameful.

One area the CAA has chosen to immerse itself in is the anti-vaccine movement. Many graduates emerge convinced that vaccination is a toxic medical trick. As one put it, raging on Meryl Dorey’s anti-vaccine Facebook page; “Of course we don’t support vaccination, it’s the biggest medical sham since bloodletting!”. The reason for his outburst was the article Doctors accuse chiropractors of selling anti-vaccination message.

To better understand why we must travel back over 100 years. In 1909 D.D. Palmer’s son, Bartlett Joshua (or B.J.) Palmer wrote (Ref; 2003), (Ref; 2014):

If we had one hundred cases of small-pox, I can prove to you where, in one, you will find a subluxation and you will find the same conditions in the other ninety-nine. I adjust one and return his functions to normal… . There is no contagious disease… . There is no infection… . ♠

Herein lies a major problem for Dr. Phelps who is under no such illusions about vaccination. As seen above Meryl Dorey has hitched a ride on Dr. Phelps’ reputation. On another email list Dorey simply copied the entire article and sent it off with the opening line, “If only we could get her to look at the vaccination issue as well… <sigh>”.

As well?! Dr. Phelps opined in The Australian about the “us and them” attitude. Yet these two words reflect just how rusted on and integral to many who entertain alternatives to medicine the “us and them” mindset is.

Some months back Dorey was also using Phelps’ prior role as AMA president, in the AVN attack on all conventional medicine. I wondered if Dr. Phelps knew of her unofficial patronage.

Past president of the CAA, Simon Floreani, has promoted homeoprophylaxis, showcasing Isaac Golden. Anti-vaccine activist and “paediatric chiropractor” Warren Sipser went as far as testifying in the family court against the immunisation of a five year old girl. Sipser informed reporters at the time “there is credible evidence they [vaccines] may do more harm than good”. Nimrod Weiner of Newtown Chiropractic ran anti-vaccine workshops using information garnered from the same AVN to whom Dr. Phelps is “diametrically opposed”.

Weiner informed pregnant mothers at a public talk that homeopathic immunisation (water) was superior to regular immunisation. That Andrew Wakefield’s fraudulent paper attempting to causally link MMR to autism was “scientifically good”. Last July Dr. Phelps tweeted:

WIN News Wollongong recently aired a comment from Meryl Dorey claiming that “all vaccines” are linked to autism in the medical literature. This is complete opportunistic nonsense and is now quite properly the subject of a complaint to ACMA. As Jonathon Holmes observed on Media Watch “there’s evidence and there’s bulldust” and that “Dorey’s claim about the medical literature linking vaccination and autism is pure, unadulterated baloney.”

Quite right. Which raises my point on convolution again. Where do we draw the line? Of the 222 listed professional members of Dorey’s anti-vaccine group over 60%, or 135 are chiropractors. The next largest is homeopaths with 16 members, or a comparatively small 7%. Naturopaths number 15 members. Then kinesiologists, then acupuncturists with 5 and 4 members respectively. Aside from one physiotherapist and one occupational therapist, all “professional members” sell alternatives to medicine of some description.

A US study published in Vaccine showed that parents who deny their children vaccination are four times more likely to see a chiropractor as the primary care physician. When Floreani was CAA president his chiropractor wife wrote of their newborn son’s pertussis. Including [bold hers]:

We performed chiropractic checks on our baby daily and utilised a whooping cough homeopathic. I dosed myself with an array of vitamins to boost his immunity via breast milk and kept him hydrated with constant breastfeeding. Whooping cough is often slow to develop and may respond well to conservative management, including chiropractic, osteopathy, homeopathy, herbs, acupuncture or acupressure.

Magically, it resolved within two weeks. Which means it wasn’t pertussis but a self limiting infection and all that woo did nothing but correlate to the illness. But I am sure Dr. Phelps would be the first to agree herbs, acupressure, homeopathy and so on would do nothing to manage pertussis. It is very dangerous misinformation with potentially fatal consequences.

So not only are unvaccinated children more likely to see a chiropractor and be subject to such abuse, but by not seeing a GP they are unlikely to become a recorded notification. Officially whilst only 5% of 0-4 year olds in Australia are not fully vaccinated for pertussis they make up 27% of cases. Thus, this figure may well be conservative. Dr. Phelps must ask herself; If vaccine deniers will choose chiropractors, might chiropractors influence parents to reject vaccination? The above rubbish is by Dr Jennifer Barham-Floreani – B.App.Clin.Sci, B.Chiropractic after all.

Australian Doctor wrote in part about the study in Vaccine:

Are naturopathic and complementary healthcare providers reinforcing parental concerns and ‘anti-vaccine’ opinions or promoting exemptions, or are they providing healthcare without emphasizing vaccinations?

I hope Dr. Phelps is asking herself that question also. As I stress above I’m sure Dr. Phelps and her colleagues are above reproach. But that’s not the point. The larger message being advanced here is that alternatives to medicine not only complement but “integrate” with conventional medicine. Not only does available evidence show this is not true but to generalise is to lend credence to dangerous charlatans.

This post has focused primarily on chiropractors, because they not only serve as a hub for health focused pseudosciences, but also seek to replace the family GP. I will contend that my point on convoluted overlap is valid. Once a patient is referred to one pseudoscience how does the referring GP control for pollution as it were? More material on the dubious ethics of new age chiropractic, including catastrophic neck injury and paediatric “improvement” by parental proxy can be found here.

St. John’s Wort seems to be trotted out in almost every article claiming alternatives to medicine have an evidence base. What is forgotten is that hyperforin, the antidepressant extract of St. John’s Wort, and other extracts are both inducers and inhibitors of P450 cytochrome enzymes. These liver cytochromes are involved in the metabolism of over 50% of marketed medication.

In the case of opioid pain relief studies have demonstrated a decrease of blood plasma levels of oxycodone of up to 50% and reduced half life of 27%. In the case of alprazolzm (a benzodiazapine), prescribed for anxiety and panic attacks a doubling of clearance rate has been documented.

Chronic pain is associated with depression and depression with anxiety. Opioids and benzodiazapines are causally linked to respiratory depression overdose death. Hence the clinical significance of any “integration” of serious pain management with a herbal choice for the depression it may cause is likely to be anything but “complementary” for the patient. Many patients choose not to inform their GP of herbal supplements.

Proper diagnosis following treatment with medication will be hampered by St. John’s Wort. Excessive doses of actual medication may be prescribed. Should a patient cease St. John’s Wort whilst on opioid, benzodiazapine or both medication regimes a spike in blood plasma of the active metabolites will ensue. More likely, as St. John’s Wort is improperly regulated and dose concentration varies widely a patient may unwittingly expose themselves to respiratory depression and possibly death with no change in their daily medication/St. John’s Wort routine.

In short whilst the concentration (dose) of actual medication is stable, the drug interaction outcome due to St. John’s Wort mimics an unstable medication dose. Patients may easily find themselves unsuitable to drive, work, operate machinery, bathe or sleep without potential for disaster. Consequently many medication regimes may be deleteriously effected by St. John’s Wort.

Thus the wider picture of evidence pertaining to St. John’s Wort is not quite the basis for “integration” proponents of alternatives to medicine would have us believe.

My response to the ongoing insistence that placebo effects derived from acupuncture constitute evidence is likely to be here in Acupuncture: essential facts about a major scam. Over and again it emerges that subjects who think they are receiving acupuncture, whether they are or not, demonstrate a response.

Findings aside, how would Dr. Phelps explain meridians, invisible forces, chakra or vital energies? It is too easy to point to apparently positive findings when the mechanism by which they arise is implausible, unknown or assumed to be related to endorphin release. The technology to manufacture acupuncture needles did not exist until the 1600s and the only nation to seriously try to ban acupuncture was China under the Chinese Nationalist Government. Western marketing has done much for this “traditional” Chinese medicine.

What of naturopaths who insist on Black Salve [2]? Or who use herbal balls from China with high levels of elemental mercury, arsenic and lead? What of poor hygiene and bacterial infection from acupuncturists or masseurs? The astonishing story of Monika Milka and non-sterile syringes used in biomesotherapy, leaving her patients seriously infected with mycobacterium chelonae?

Tragic cases like Penelope Dingle and Isabella Denley indicate that the notion of integration or proper supervision is seriously flawed. One point raised repeatedly by FSM is that whilst ill patients waste time being exploited by pseudoscience acting as a health choice, the chance of genuine care, full recovery or even survival is lost.

These are the real issues Dr. Phelps could constructively help Aussies understand before raging at FSM. How is it that so many various practices have come to exist that are beholden to ideology, not evidence? How is it they can convince parents to withhold treatment from their children and in doing so undermine the health of our entire community?

FSM exists to address an unacceptable situation in our educational institutions. They have taken a stand because those in a position to defend academia seemingly chose to act unethically. When it comes to “informed choice” there is an excess of non evidence based, expensive pseudoscience. It is pervaded by a combative, arrogant anti-science and anti-medicine mindset. It is amply equipped with scams.

This madness must stop and Dr. Kerryn Phelps is most welcome to clearly state just what aspects of non conventional medicine are high risk ideology and what is safe, effective and backed by evidence. Real evidence that can be trusted alone.

Presently, there appears to be a scarcity.

♠ This quote has been attributed to D.D. Palmer. However in 2013 the Journal of the Canadian Chiropractic Association, cited the author as B.J. Palmer.