From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,misc.health.alternative
Subject: Re: Quackwatch and Chiropractic
Date: 3 Jun 1998 08:35:16 GMT

In <6l26cj$o38$1@strato.ultra.net> wright@nospam.clam (David Wright)
writes (quoting a chiropractor):

>>>Chiropractic is based on the premise that every gland, organ and
>>>cell of the body needs a nerve supply to function properly.

   Then it has real problems as a discipline based on a good theory,
right there.  For it would predict that transplanted organs--- kidneys
or livers, for example, would not function properly.  Any nerves which
supply them, after all, are cut and cannot be reconnected.  They do not
(cannot) grow back.  Alas for chiropractic, however, these organs often
work just fine.  Not always, but often enough to put the lie to the
theory, it seems to me.

    Now let's get this straight: I'm supposed to remember the many
patients I've seen living completely healthy lives with completely
functional and completely nerveless and disconnected transplanted
kidneys-- and at the same time believe that some guy is fixing major
malfunction in kidneys by adjusting their nerve supply imbalances by
back manipulation?  You've got to be kidding.

                                       Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,misc.health.alternative
Subject: Re: Quackwatch and Chiropractic
Date: 3 Jun 1998 22:12:21 GMT

In <6l3e0f$ffc@ng1.icn.state.ia.us> agocs_s@dd.palmer.edu writes:

>Like I said, these organs are under SOME control by the body, no?


   The control is minor.  And in the cases where it's hormonal, it's
likely to be under hypothalamic-pituitary control, and not something
subject to a "subluxation".  Transplanted hearts are the best example
of general response to both adrenal and general sympathetic release of
norepinephrine and epinephrine, but even here most of the control in a
normal heart is direct, and the fact that people with transplanted
organs hearts do well, indicates that the direct control isn't that
important for health.  See the point?  For kidneys and livers the same
argument applies in spades.


> It serves to reason that the control mechanism of the nervous system
may be either direct or indirect.  I figured you'd have been taught
this in medical school...it's basic anatomy and physiology, really.<

   It's not.  It confuses influence with "control."   The fact that
most internal organs can be disconnected from the spinal nerves without
a bit of trouble is strong evidence that direct spinal nerve enervation
is not a major cause of disease and organ dysfunction.  That, I
believe, is contradictory to the views of many chiropractors, but is
never the less, the truth.

   As for indirect hormonal influence of organs, it mostly originates
from the brain.  If chiropractic manipulation influences that, it's not
by any mechanism related to vertebral subluxations or nerve
compressions (all that machinery is buried deep in your brain, inside
your skull).  Therefore this too is contrary to the Palmer subluxation
theory of chiropractic.

>  In any case, what is the
>number of transplantees that DC's treat, just out of curiosity?

   I don't know, but it's irrelevent.  I'm not merely making the
argument that chiropractic doesn't work on transplantees.  I'm pointing
out that the very existence of healthy transplantees gives real
problems to many "classic" chiropractic ideas of what it is that
maintains internal organ health.  If Ms. Jones's kidneys aren't working
well, it's a pretty dumb idea that the reason is some subluxation in
her back, cutting off the spinal root nerve supply to them.  Since we
know (as Palmer did not) that her kidneys would work fine with no
spinal nerve supply AT ALL.  Understand?

                                        Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,misc.health.alternative
Subject: Re: Quackwatch and Chiropractic
Date: 7 Jun 1998 04:00:29 GMT

In <Pine.A41.3.96a.980605162804.34146A-100000@dante07.u.washington.edu>
Ryan Maves <smithers@u.washington.edu> writes:

>I said "neither stop his heart from beating, nor kill you". I'm not sure
>why this ambiguous, since you seem to think that cutting the nerves to
>Dr. Harris's heart would somehow kill him. Rest assured, he'd live. I
>suppose you meant something else by "maybe if he dies he will believe
>it".
>
>
>> By the way, are you saying that if I cut all the nerves of the cardiac
>> plexus which originate from the superior cervical sympathetic ganglia,
>> the T1 thru T4 spinal levels, the right vagus nerve (which controls the
>> SA node) and the left vagus (which controls the AV node) that his
>> condition would be compatible with life? Boy, I'd sure hate to be your
>> patient.
>
>No, that's not what I'm saying. I'm saying that if you excise the
>specific nerves from the sympathetic ganglia and the vagi that innervate
>the heart, _that_ is compatible with life. The vagi would still be
>intact. Again, this is the situation in a transplant patient.


   Yeah, what he said.  Tranplanted hearts are completely denervated.
Yet they work pretty well.

    One of the early heart physiology experiments involved removing the
hearts from retired greyhounds and then immediately reimplanting them
(thus assuring total denervation).  After recovery, they put the dogs
back on the track.  Guess what?  They could run nearly as fast as
before.  The body compensates in many ways.

                                         Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.alternative
Subject: Re: Homeopathy could be "bullshit" for all I know!
Date: 12 Feb 1999 12:20:59 GMT

In <Pine.GSO.3.95qL.990211174940.13529B-100000@ciao.cc.columbia.edu>
Aaron Andrew Fox <aaf19@columbia.edu> writes:

>On Thu, 11 Feb 1999, Ken wrote:
>
>> I'm sorry for accusing you lying, when I was the one who was mistaken.
>
>
>Apology happily accepted, no offense taken.  It's rare for someone to
>admit a mistake around here, so thank you.
>
>
>> Looking at that definition, it doesn't make much sense to me how
>> anything so diluted could work, how old is this practice? I fail to
>> understand how any reputable health food store owner could sell that
>> stuff.
>
>
>A very good question.  in fact, the weird thing is there is some
>peer-reviewed scientific evidence that homeopathy might work for some
>conditions.  But most thoughtful scientists think these studies are
>flawed.


    Actually, I don't know of any study of homeopathic treatment for
anything that has been repeated enough to be able to drive a wedge into
the thinking of science.

  Suppose I made the broad claim that "surgery was good for disease"
and my evidence to support such a thing was a bunch of studies of
varying quality, some positive, some negative, of various surgeries
used to treat various diseases.  Surely you'd accuse me of making claim
far to broad to be justified.

    If you were rational you'd ask me to pick one particular disease,
and one particular surgery, and start publishing.  Again and Again.
Group after group.  Result after result.  Until even the skeptics would
have to get into the act, and some of them found they were repeating
the positive result.  At THAT point, you would have suceeded in two
things:

1) Proving the lesser case that ONE particular surgery is useful in ONE
particular pathology, and, more importantly, that

2) Surgery is not ENTIRELY useless, and that it can no longer be
dismissed wholesale.  Following would be the conclusion that each
separate surgical claim must now be tested, and cannot be rejected a
priori out of hand on the basis that NO particular surgery is known to
work.

    Now, chiropractic finally got smart and took this track, and went
after low back pain.  In consequence, chiropractic may be MOSTLY BS,
but it is now no longer possible to simply ignore as COMPLETE BS.
That's a HUGE step.  If homeopathy were half smart, they've have gotten
together and done the same.  Science is not completely fair in how it
evaluates claims, but neither is it completely unfair.  It merely has
rules. If you to play the game, you have to follow them.

                                    Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med.diseases.cancer,sci.med,alt.health.oxygen-therapy,
	misc.health.alternative
Subject: Re: A Question for the ALT crowd, if they can drop into the real world 
	for a minute
Date: 26 Apr 1999 09:06:39 GMT

In <7g0tge$qgh$1@bgtnsc03.worldnet.att.net> "Allan&Teresa Widner"
<atwidner@worldnet.att.net> writes:

>As for my beef with modern medicine: A medical doctor tells me I would be
>better off treating my painful lower back with pain killers, muscle
>relaxers, and a week or so of bedrest, and tells me a chiroprator is
>worthless. A chiropractor tells me I need a few weeks of adjustments,
>some excercises, and maybe a topical analgesic. Ultimately, the two cost
>the same, get the same results - and if I follow the excercise program
>the chiroprator gave me, I will benefit more in the long run. So why does
>the MD say the chiropractor is worthless?


   I think that since some reasonable studies came out, the medical
doctors would hesitate to say this about chiropractors and back pain.
The chiropractors did it right and got together some evidence for their
case there.  That's all that is asked in science.

   Historically, chiropractic has suffered from several problems which
certainly have not been of physicians' making: 1) Overclaims of
effectiveness.  Palmer decided that most disease is the result of
spinal misalignment.  2) Failure of chiropractic to do good double
blind studies  3) Failure of chiropractic to stay an identifiable
thing. With more than 30 schools of all kinds of techniques and claims,
some of which are mutually exclusive, even chiropractors couldn't
decide what they were.  It invites comparison with protestant religion.
All it's sure of is that it isn't Roman Catholic.  Finally 4) is
related to 3): chiropractic couldn't come up with a good mechanism for
its effects.  Studies on cadavers showed that there wasn't any pressure
on nerve roots at ungodly torques and compression pressures.
Chiropractors have responded that quick manipulation can generate huge
pressures.  But what about the nerve compression that chiropractic
claims to FIX?  Where does that come from in someone with no canal
narrowing from arthritis or herniation or fracture? Obviously it's a
figment of somebody's imagination.

   But the treatment for pain (wherever it comes from) may not be.
Recently there has been a suggestion that sound waves from
microcavitation bubbles in certain manipulations may have some
therapeutic effect.  This would be interesting, but mean that
chiropractors themselves have had it wrong all these years.  It's tough
to sell something underlain by a noticably bad theory, even if it
works.

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: sci.med
Subject: Re: Word for the day
Message-ID: <OXvD9.4619$It3.407373@newsread2.prod.itd.earthlink.net>
Date: Fri, 22 Nov 2002 19:54:22 GMT

KyroDoc wrote in message <20021122092308.17606.00000068@mb-mr.aol.com>...
>For future reference" the point NEVER changes.
>
>Many medical doctors prescribe drugs and promote treatments(radiate
>thyroids?hysterectomies etc.) based on "conventional wisdom" that as we
>see is always changing.

ROFL. And your point is that chiropractic "wisdom" ISN'T always changing?
You're sort of screwed no matter which way you want to argue that, so why
even start down this path?


>Well many people lose their lives as aresult of that "wisdom"


Since medicine is the last resort for the very ill and dying person (and
here I mean IV fluids, oxygen, ventilators, anaesthesia, surgical repair,
organ transplant, etc), it's always going to be more dangerous. If we gave
those people in shock and respiratory failure to you chiropractors, you'd
have some disasters also. Despirate problems require desperate remedies.

>So keep me in line when I make mistakes. I appreciate that .

But I haven't got time for it.


>But the philosophy of "use medicine as a last resort unless your life is
>in danger" Well, that's no mistake....and it's a philosophy that
>continually needs promoted.

Sorry, but that's also a mistake. Chiropractors don't do pap smears,
mammograms, and snip pre-cancerous polyps out of colons, last I checked. Are
you going to claim that spinal manipulation prevents or treats these things?
Where are your studies showing that your treatments prevent strokes or heart
attacks? Eh?

Yeah, wait to use "medicine" until you think your life is in danger-- that's
a GREAT idea. (not).


>Incidently DC's education is just as comprehensive as an MD's.(except
>pharmacy class) Dont insult... look for yourself


I looked, and concluded that it must be cargo cult science hours. I've yet
to meet a chiropractor with a basic understanding of physiology, let alone
pathophysiology, so what in the world are you-all learning in those classes?
Your comments about liver cancer and cholesterol lowering drugs are the tip
of the iceberg.  If I ask the average internist, even the average intern,
why the diabetic with the chest pain can actually be alkalemic despite a
huge metabolic acidosis, I'll get a good answer. The average chiropractor
will have no frigging idea what I'm talking about, and that's without us
even coming to what to DO about it (which is the "pharmacy" part you talk
about, even though a lot of it is fluid and electrolyte management).
"Pharmacy" also includes how to write hyperal orders on your patient in
renal failure, and so on. This is nuts and bolts stuff, and much of it has
nothing to do with drugs, unless you consider nutrients, fluids, and salts
to be drugs. The chiropractors here on the net generally would make a first
year chemistry student blush with what they say. I've followed them for
years. Are all the ignorant ones here on the net, do you suppose?

Worse still, a lot of the problem with chiropractors isn't what they don't
know, but what they think they know that is simply wrong. I heard a
chiropractor the other night advising people to get an alkaline water source
to neutralize the body's acid. And buy a detoxifying shower head to get rid
of chlorine which is supposedly absorbed through the skin. This is all nuts,
and self-evidently so, if you know ANYTHING about chemistry or physiology.


>And stay tuned for the next word of the day

Don't count on it. But you will find me to be your banana peel every so
often. Think of it as a catalyst to decrease the time it takes for something
to happen, that is going to happen anyway.

SBH

--
I welcome email from any being clever enough to fix my address. It's open
book.  A prize to the first spambot that passes my Turing test.

From: David Rind <drind@caregroup.harvard.edu>
Newsgroups: sci.med
Subject: Re: Chiropractic Neck Manipulation and Artery Dissection?
Date: Fri, 06 Jun 2003 20:27:06 -0400
Message-ID: <bbrbh4$383$1@reader1.panix.com>

Dan wrote:
> I have only read the Boston Globe article on the recent UC study of
> stroke patients and possible relationship to chiropractic neck
> manipulation.  The study only used 51 stroke patients which is not
> statistically significant.  Of the 51, only 7 recalled recent
> chiropractic visits.  And the study was only a correlation study.  So
> how does this prove anything?  I am not a chiropractor, but this appears
> to be bad science.  Only a double blind study can conclusively prove
> cause-effect, and I realize in this case such a study would be hard to
> do, if not impossible.  I am curious to hear what others have to say. To
> me the news reports are simply alarmist and should be taken with a grain
> of salt.
>
>    -- Dan

I don't have the study in front of me at the moment, but assuming
we are discussing the same recent study, it showed that among
young people presenting with a stroke, many more of those who
had a stroke from vertebral artery dissection than those who had
a stroke from some other cause had undergone recent chiropractic
neck manipulation.

Overall, the study is quite believable that chiropractic manipulation
causes vertebral dissection, however there is really no way to tell
from the study what the magnitude of the risk is. It could be quite
small, since there is no underlying measure of how many people had
manipulation.

It is simply false to say "only a double blind study can
conclusively prove cause-effect". Double blind studies are just
particularly strong evidence, but on their own do not prove
cause and effect. Proof of cause and effect is often accomplished
(to the satisfaction of nearly everyone -- the only real measure
of "proof" outside of the realm of mathematics) without such
studies. Nearly everyone reading this believes it is proven that
smoking causes lung cancer in humans. They are correct, and there
has never been a double blind study (or a controlled trial of any
sort) looking at the issue in humans.

--
David Rind
drind@caregroup.harvard.edu

From: David Rind <drind@caregroup.harvard.edu>
Newsgroups: sci.med
Subject: Re: Chiropractic Neck Manipulation and Artery Dissection?
Date: Mon, 09 Jun 2003 22:17:29 -0400
Message-ID: <bc3f40$m6k$1@reader1.panix.com>

Dan wrote:
  > "Chiropractic Manipulation and Stroke - A Population-Based Case-Control
> Study" states that of the 582 VBA (vertebrobasilar accident) cases, only
> 9 had a cervical manipulation within 1 week of their VBA.  Not half as
> you said.  So to me it looks like a small risk to have cervical
> manipulation as a person predisposed to a VBA could trigger it reaching
> for bowl in a cabinet and turning the head just so.  So I still think
> there is a alot of uncertainty on this topic and that given how rare the
> condition is, we shouldn't have alarmist newspaper articles.  I
> personally have cervical manipulation done once a month as it releases
> upper back/neck tightness and increases mobility of my neck.  But I will
> certainly ask my Chiropractor about the risk.  It is too bad a test
> can't be done to determine who is susceptible to VBA.

Not the study I was thinking of, in any case. See Smith et al. in
Neurology, May 13, 2003. Young patients presenting with a stroke
from arterial dissection were 6.5 times more likely to have had spinal
manipulation than young patients presenting with stroke from some
other cause.

This study does not answer the question of how risk spinal manipulation
is, but it strongly suggests that manipulation causes dissection
and strokes -- something that, in my experience, most chiropractors
deny.

While you're asking your chiropractor how risky manipulation is, you
might try asking your local Jiffy Lube how often you should have
your oil changed and your chimney cleaner how often your chimney
needs to be cleaned.

--
David Rind
drind@caregroup.harvard.edu

From: David Rind <drind@caregroup.harvard.edu>
Newsgroups: sci.med
Subject: Re: Chiropractic Neck Manipulation and Artery Dissection?
Date: Fri, 13 Jun 2003 18:55:41 -0400
Message-ID: <bcdkpo$a23$1@reader1.panix.com>

Dan wrote:
> David Rind wrote:
>
>> Dan wrote:
>>  > "Chiropractic Manipulation and Stroke - A Population-Based
>> Case-Control
>>
>>> Study" states that of the 582 VBA (vertebrobasilar accident) cases,
>>> only 9 had a cervical manipulation within 1 week of their VBA.  Not
>>> half as you said.  So to me it looks like a small risk to have
>>> cervical manipulation as a person predisposed to a VBA could trigger
>>> it reaching for bowl in a cabinet and turning the head just so.  So I
>>> still think there is a alot of uncertainty on this topic and that
>>> given how rare the condition is, we shouldn't have alarmist newspaper
>>> articles.  I personally have cervical manipulation done once a month
>>> as it releases upper back/neck tightness and increases mobility of my
>>> neck.  But I will certainly ask my Chiropractor about the risk.  It
>>> is too bad a test can't be done to determine who is susceptible to VBA.
>>
>>
>>
>> Not the study I was thinking of, in any case. See Smith et al. in
>> Neurology, May 13, 2003. Young patients presenting with a stroke
>> from arterial dissection were 6.5 times more likely to have had spinal
>> manipulation than young patients presenting with stroke from some
>> other cause.
>>
>
> One question I have is why isn't a similar correlation seen in the over
> 45 yrs old persons.  Most of the persons I see at the chiropractor are
> in that age bracket.  What is the median age for someone under
> chiropractic care?  I am very curious to see a more complete study, but
> I think in our (i.e. US) climate of malpractice litigation that is far off.
>
>   -- Dan

It's not that the study showed no correlation in older people -- it
only looked at younger people with strokes. This was presumably
a way to find more people with arterial dissections. Older people
presenting with strokes will almost all have some other explanation.
Younger people don't usually have strokes, so dissection will be
a more common explanation in them and so allowed the researchers
to find enough dissections to perform the study.

--
David Rind
drind@caregroup.harvard.edu

From: "Howard McCollister" <hmac@nospam.net>
Newsgroups: misc.health.alternative,misc.kids.pregnancy,sci.med
Subject: Re: Are chiropractors physicians?
Date: 23 Aug 2003 12:48:33 -0500
Message-ID: <3f47a803$0$68929$45beb828@newscene.com>

"giselle" <giselle@atlantic.not> wrote in message
news:E_M1b.789$if4.445883@newshog.newsread.com...
> Mein wrote:
>
> > Used to?  They ARE.  Your mind is going backwards.
>
> There is no need to be insulting.  After you've
> gone through approximately 100 m of paperwork
> wherein neurologists and sports physicians send
> their injured patients to chiropractors, you might
> see things a little differently, too. I would not have
> believed it myself until I saw it. I didn't say that
> chiropractors accomplished anything. I just said that
> they provide a service. Some people  find value in it.



Many physcians send some patients to chiropracters, including me. However,
it's been my experience that this is done, not because the chiropracters
have specific medical treatments that are more effective, but because
chiropracters are generally less constrained by scientific honesty. They can
do a great song and dance for the patient and really make it believable. The
resultant placebo effect is significant and can "cure" many patients that
haven't responded to allopathic diagnosis and treatment primarily because
their symptoms are either entirely psychological, or psychologically
augmented symptoms of real physical complaints.

HMc