Chiropractic Information in a Public Library

ABSTRACT

Background:  Chiropractic is based on a theory that most disease results from spinal subluxation and interference with nerves.  The theory is not supported by experimental evidence nor recognized as plausible by medical scientists.  Chiropractic manipulation is known to cause infrequent but devastating complications including death and paralysis.  Despite this knowledge, chiropractic has been increasingly accepted by the public.

Objective: The objective of this study was to find out what information about chiropractic is available to the public in a typical public library.

Design:  Each book on chiropractic listed in the catalog of the Pierce County Library System was read, the background of the author was determined, the content was summarized, and the text was evaluated for errors and supporting evidence.

Results:  Nine titles were found.  Three were general overviews of chiropractic (one favorable, two critical), one was a rebuttal of attacks on chiropractic, and the other five addressed particular chiropractic methods favored by the authors and included suggestions to buy products or attend the author’s clinic. Only the two books critical of chiropractic were error-free and supported by reasonable evidence.

Conclusion:  Adequate information is available in the public library for an intelligent layman to examine the pros and cons of chiropractic. Lack of accessible information does not appear to be a factor in the current trend of increasing acceptance of this pseudoscientific health care system.

BACKGROUND

Chiropractic is based on a theory that most diseases are caused by subluxations (partial dislocations) in the spine. These subluxations supposedly put pressure on nerves as they exit from the spine, thereby causing disease in all parts of the body, including intracranial and abdominal organs. Maintenance of spinal health by manipulation supposedly allows the body to prevent disease or to heal itself through the Innate, a kind of life force or body wisdom.[1]

Anatomical subluxations do exist but rarely cause symptoms, and they cannot be corrected by manipulation. Chiropractic subluxations are claimed to be visible on x-ray, but they cannot be detected by radiologists or even agreed upon by different chiropractors.  Spinal nerves do not control abdominal or intracranial organs; transplanted kidneys function well with no nerve connections at all. The theory that disease is caused by subluxation and nerve impairment is not supported by experimental evidence nor recognized as plausible by medical scientists[2]. Chiropractic manipulation can cause serious complications.[3]  Some chiropractors discourage conventional medical care; over half of chiropractors oppose immunizations.[4]

Chiropractic is thriving in the U.S.   Medicare and many insurance plans cover it, industrial accident case referrals are approved in many states, and Veterans Administration hospitals are now mandated by Congress to offer it.  This is puzzling in light of the overwhelming evidence that chiropractic is not scientifically valid.[5]

OBJECTIVE

In an attempt to understand the popular support for chiropractic, books in a typical public library were studied to find out what information is available to the general public about chiropractic.

DESIGN

 The electronic catalog of a public library, the Pierce County Library System in Washington State, was searched for all entries on “chiropractic,” including “chiropractic – popular works,” “chiropractic – complications,” “chiropractic – errors,” and “chiropractic- applied kinesiology.” Each book was read by the author and reviewed with particular attention to scientific accuracy.  The background of the author was noted. The content of each book was summarized and characterized.  Scientific errors were noted.  Supporting evidence was sought in the text and references.

RESULTS

Nine different titles were found (some were listed under more than one category).  Three books were general overviews of chiropractic (one favorable, two critical), one was a rebuttal of attacks on chiropractic, and five addressed particular chiropractic methods favored by the authors and advocated buying products or attending the author’s clinic.

  1. Everybody’s Guide to Chiropractic Health Care, by Nathaniel Altman. (Los Angeles: Jeremy P. Tarcher, Inc., 1990).

Author:  Nathaniel Altman is the author of several books on alternative health and mystical topics, including Sacred Trees, Sexual Palmistry, Oxygen Healing Therapies for Optimum Health and Vitality, and A Russian Herbal.

Content:  The basic premises are that the body heals itself, that it will stay healthy if there is an unobstructed flow of nerve impulses, and that subluxation impedes nerve flow.  The philosophy is vitalistic, recognizing something immaterial that makes us greater than the sum of parts.  Allopathic (conventional) medicine is criticized and described as “confrontational.”  Too many drugs are used: they can cause side effects. Too many operations are performed: organs interact and when an organ is removed the others may not be able to compensate; health is not usually as good as before surgery.

Chiropractic is not interested in discovering or applying remedies. Chiropractors don’t cure disease, the body cures itself; 80% of all disease is self-limiting. Some people are exposed without getting sick; germs only work in weakened systems. Allopathy maintains that only what we can see and measure scientifically is of any value. Chiropractic “teaches that there is ‘something else’ that cannot be measured with scientific instruments” – the Innate.

Manipulation is also done by physical therapists and osteopaths, but adjustment is a more precise and sudden “dynamic thrust” that is only done by chiropractors. Chiropractors claim to be better trained in spinal anatomy, biomechanics, etc. than other health professionals. In addition to musculoskeletal problems, chiropractic is said to be effective for chronic fatigue, the common cold,  neurological disease, hypertension, gastrointestinal disorders, sinusitis, migraine, asthma, emotional problems, heart trouble, depression, hyperactivity, violence, rheumatoid arthritis, goiter, cerebral palsy, scleroderma, cirrhosis, liver cancer, epilepsy, encephalitis, hydrocephalus, and multiple sclerosis, among others.  Special needs groups include athletes, dancers, older adults, pregnancy (sacroiliac pain “affects 50%” and causes “extreme discomfort”), birth trauma, and scoliosis. Chiropractic can’t cure cancer, but will help the body fight it. A testimonial from an AIDS patient is included. Chiropractic is said to be valid because celebrities such as Hubert Humphrey and Burt Reynolds use it.

D.D. Palmer thought 95% of disease was due to the spine and 5% to other bones; B.J. Palmer (his son) treated only the spine. The profession eventually split into two divisions: the mixers (who use other treatment modalities) and the straights (who only use spinal adjustment). A battle ensued with organized medicine (“the enemy”) which supposedly conspired against chiropractic and denied it research funding. This led to the Wilks antitrust suit against the American Medical Association.

Adjunct treatment methods are described.  Acupressure may be used, although it stimulates the flow of energy, which is the opposite of what chiropractic purports to do. Applied kinesiology: “helps locate and correct imbalances in the body’s energy system through muscles relating to the body’s 12 major organs. It also can determine whether the imbalance is nutritional, psychological, or structural.” Chiropractors may use it for testing, and then treat with manipulation. Cranial therapy removes obstructions to the flow of cerebrospinal fluid, which nourishes the nerves, carries away impurities, and promotes nerve transmission throughout the body. Massage and physical therapy may be used as well.

It describes a visit to a chiropractor, with tests such as moiré contourography and thermography. It describes several types of adjustment, including sacro-occipital and cranial therapy. It discusses how to choose a chiropractor, and advises avoiding chiropractors who promise cures, offer contracts, or are unwilling to refer when appropriate.

General health advice is offered: stress reduction, breathing, communing with Innate Intelligence, healthy diet, exercise, avoiding overweight, and avoiding alcohol.  A balanced diet supposedly doesn’t provide adequate nutrition; many chiropractors sell vitamins and diet supplements.

Errors:  It states that “Palmer’s theory is now accepted by modern science,” which is false. The definition of subluxation is fuzzy, indicating that it is not anatomical but functional, due to excessive physical, chemical, or emotional stress. Symptoms of subluxation are compared to referred pain from a ruptured disc, a false analogy. It describes the “pop” of adjustment as an actual realignment rather than the “knuckle-cracking” phenomenon it really is.  It states that subluxation can compress the vertebral arteries.  (In fact, subluxation can’t, but manipulation can.  Patients with posterior circulation strokes under the age of 45 are 5 times more likely than controls to have visited a chiropractor within one week of the event).[6]   It claims that when chiropractic doesn’t work it is usually because the patient sought medical care first. It claims that chiropractic can treat slipped discs, whereas medical doctors and many chiropractors believe slipped discs are a contraindication to manipulation.

Although there is a whole chapter on exercise, there is nothing about smoking, the major preventable cause of death. Hours of instruction are compared, asserting that chiropractic students get 480 hours of training in diagnosis and medical students only get 174 hours, while at the same time claiming the chiropractor’s goal is not to diagnose. Nerve charts do not correspond to known anatomy. Nerves are shown connecting the neck to the ear (“whiplash injury can damage nerves affecting the ear”) although the nerves to the ear are contained within the skull, not the neck.  It claims complications occur only when chiropractic guidelines are not followed and it criticizes malpractice in conventional medicine. It does not address the known complications of manipulation itself.  It claims that the cost of chiropractic is half the cost of medical care (this is not substantiated by valid studies).  It states that chiropractic is preventive and helps us “become self-reliant rather than dependent on a health professional to periodically ‘fix’ our symptoms,” yet at the same time it advocates dependence on the chiropractor for manipulation at birth (for birth trauma) and continuing throughout life to maintain health.

Evidence: Few statements are supported by evidence.  Twelve pages of references are listed, mostly from chiropractic and popular sources. There is nothing in the references to support ideas that Altman accepts unquestioningly, such as thermography, moiré contourography, sacro-occipital technique and applied kinesiology.  A New Zealand study is quoted to support chiropractic effectiveness for non-musculoskeletal complaints:  “in some cases this is at least a possibility.”  This is apparently the strongest support available.

  1. At Your Own Risk – The Case Against Chiropractic by Ralph Lee Smith. (New York: Trident Press,

1969).

Author:  A medical journalist wrote this critique of chiropractic in 1969.  In his investigations, he visited chiropractic clinics as a patient, attended a chiropractor’s trial for murder, and attended a practice-building seminar.

Content:  He starts by describing the death of Linda Epping, a child with rhabdomyosarcoma whose parents were persuaded to forgo surgery in favor of spinal adjustments and a regimen of 124 pills a day including vitamins, minerals, food supplements, laxatives, desiccated ox bile and extract of beef eyes. A tumor covered one side of her face at death, so “monstrous” that pictures could not be shown to the jury at the chiropractor’s trial for murder.

A grocer, D.D. Palmer, who thought he cured a man of deafness by manipulating his spine, invented chiropractic. He  “…could hardly be expected to know that the nerves of hearing are self-contained in the head and do not reach the spine.”   He and his son founded a “sect of true believers” and developed a profitable business. According to his son, the principal functions of the spine were: “To support the head, To support the ribs, To support the chiropractor.”

Smith posed as a patient. When he presented the classic symptoms of a slipped disc, he was treated for subluxations in his upper neck, chest, and lower back; the treatments caused him to develop back pain. When he presented the classic symptoms of coronary artery disease, his symptoms were ignored and he was treated with an adjustment of the 5th thoracic vertebra and the hips.

He attended a “Chiropractic Research Seminar” which proved to be a program of sales tactics for attracting and keeping customers, taking as much money from them as possible, and steering them away from medical treatment. He researched gadgeteers such as Dr. Ruth Drown, who tested blood samples in her machine and treated patients by long distance (she once diagnosed chickenpox and mumps from samples that were actually from a healthy turkey, sheep and pig).  He describes inadequacies in chiropractic education, overuse of x-rays, attempts to treat cancer and other serious diseases with inpatient manipulations at the Spears Chiropractic Hospital, and devastating complications including stroke, paralysis, fracture and death.

Errors:  No obvious errors were noted.

Evidence:  He explains why testimonials are meaningless, what a placebo is, and how scientific investigation should be done. He quotes a McGill University medical faculty statement: “Biology is probably the most complex and difficult of sciences and human biology its most important branch.  To reduce it to one primary mechanical concept is simpleminded and dangerous.” He writes in a popular style, but supports his statements with specifics and quotes authorities.

  1. Chiropractic: The Victim’s Perspective, by George Magner. (Amherst, New York: Prometheus Books, 1995).

Author:   The late George Magner had a B.S. in biology and worked in research. He developed complications of shoulder pain, tinnitus and sensory impairment in the foot from inappropriate manipulations by a chiropractor.  His personal story occupies only five short paragraphs.

Content:  Mr. Magner made an extensive study of chiropractic. He covers its history, rationale, education and licensure, marketing tactics, dubious diagnostics and therapeutics, insurance abuses, risks, press coverage and research considerations. He includes numerous illustrations of chiropractic ads and quack devices such as the Nervo-scope, the Activator, the Toftness Radiation Detector and a Voll electrodiagnostic machine.

His writing is reasoned and unemotional. An entire chapter consists of constructive suggestions, such as a proposed statement of full disclosure to patients:

…The known risks of manipulative therapy include stroke, disc rupture, fractured bones, paralysis, permanent joint damage, and soft tissue damage. The rates of these complications are probably small, but they have not been reliably determined.

There are useful alternatives to spinal manipulation, and there are different types of manipulation, some of which are less likely to cause injury. The large majority of back problems do get better within two months of onset without treatment. Claims that spinal manipulation can remedy systemic diseases, boost immunity, improve general health, or prolong life, have neither scientific justification nor a plausible rationale.

Errors:  There are a few minor errors.  It says most physicians use the term partial dislocation rather than subluxation.  In fact, subluxation is a legitimate term with a precise definition; the problem is that chiropractors don’t use the accepted definition.  The author’s definition of spondylolisthesis is flawed, but this is irrelevant to the argument.

Evidence:  The coverage of chiropractic is thorough, scholarly, fair, and based on hard evidence. Every statement is substantiated. Numbers in brackets throughout the text refer to a list of 272 references, including chiropractic literature and scientifically oriented sources.

  1. Chiropractic Speaks Out: A Reply to Medical Propaganda, Bigotry and Ignorance, by Chester A. Wilk, D.C. (Park Ridge, Illinois: Wilk Publishing Co, 1973).

Author: The author of this self-published book is a chiropractor who later sued the AMA for conspiracy.

Content:  Dr.Wilk offers the following arguments in defense of chiropractic:

  1. Tissue manipulation has been used since antiquity.
  2. Famous people use chiropractic, including Lawrence Welk’s Champagne Lady, psychic Jeanne Dixon, and Kentucky Fried Chicken’s Col. Sanders.
  3. Chiropractic is accepted in several other countries.
  4. Some M.D.s accept chiropractic. There was an article on it in Medical Economics. A congressman said in the Congressional Record that medical research proves chiropractic. Wilk quotes medical sources that did not address chiropractic but are interpreted as supporting it; for instance, The Merck Manual says headache may result from “stimulation or traction of or pressure on, any pain sensitive structures of the head…and upper cervical nerves.”
  5. The fact that Daniel Palmer was a self-educated man does not mean chiropractic should be discarded. He is compared to Thomas Edison and Anton Leeuwenhoek.
  6. Some of the greatest contributors to the healing arts were persecuted at first. A list of “heretical giants” consists of Paracelsus, Servetus, Vesalius, Harvey, Bodington, Semmelweis, Pasteur, Lister, Florence Nightingale, Sister Kenny and two doctors of chiropractic: Lorraine Golden and Leo Spears.
  7. Medical propaganda against chiropractic uses unfair tools and conspires to maintain monopolistic control of the profession.
  8. If some chiropractors have made mistakes, so has the medical profession.
  9. Chiropractic education has been inadequate in the past, but so has medical education; just as medicine was reformed after the Flexner Report, chiropractic education has now developed standards.

 

Errors: The above arguments are less than convincing. A chapter on “The Tools of the Propagandists” lists innuendo, exception to the rule, obsolete material, material out of context and half-truths. Dr. Wilk uses all these tools in his book.  For instance, he characterizes our society as one of  “iatrogenic disease, drug addiction and a steadily declining life expectancy among the nations of the world.”  In our drug-oriented society, “the medical physician, as the prescriber of these drugs, is the obvious benefactor of this [pharmaceutical] advertising.”  After smallpox was eliminated in the U.S. and vaccination was no longer being recommended, he claimed that medicine was finally repeating what chiropractic had been saying all along. The whole tone of the book is polemical, as is the title itself.

Evidence:  There are 26 pages of bibliography. The references largely fall into 3 categories: chiropractic literature, medical literature that does not address chiropractic, and popular sources such as newspaper articles. There is very little on evaluation of chiropractic by non-chiropractors.

  1. Home Chiropractic Handbook by Dr. Karl V. Holmquist. (Forks, Washington: NE8Incorporated, 1985).

Author:  This self-published book by a chiropractor begins with a recommendation that every man, woman and child should have a weekly spine check and ends with an invitation to attend the author’s three-day seminar.

Content:  It describes how family members can adjust each other at home. Its philosophy includes the ideas of subluxation, nerve impairment, the innate mind, life force, the wisdom of the body to heal itself, and leg length assessment. It is a short book with many pictures; however, brief as it is, the text includes numerous misstatements of fact.

Errors:  The following errors were noted:

  1. There are just two types of scoliosis: normal curve and curve caused by injury. (Stedman’s Medical Dictionary defines scoliosis as “lateral curvature of the spine,” which is not normal, and lists 10 types of scoliosis).
  2. A herniated disc is usually due to a misaligned vertebra that has been neglected for a number of years. (No misalignment is seen on x-rays in this condition.)
  3. The “pop” of manipulation is the vertebra moving back into place. (It is caused by nitrogen filling a potential space as the joint is distracted, just as occurs in cracking the knuckles.)
  4. Immunizations are un-necessary but one might consider immunization if traveling to an area where malaria is common. (Immunizations are necessary to prevent certain infectious diseases, but there is no immunization for malaria).
  5. Germs cannot cause disease in a healthy body. If the germ theory of disease were true, there would be no one alive to tell about it.
  6. There is not a single disease that someone has not recovered from.
  7. Heat detection devices locate inflamed spinal nerve roots. (“Heat detectors” used by chiropractors respond to pressure as well as heat, and findings are not reproducible.)

Potentially dangerous advice is given:

  1. Scoliotic patients who have been told they need a back brace need not be alarmed, because every human being has a unique shape to his body. (Mild scoliosis does not need treatment; but if severe scoliosis is not treated, it leads to progression of the curve with permanent deformity and disability.)
  2. Babies should be evaluated as soon as possible after birth and should have atlas adjustments. (Neck manipulations have led to stroke, paralysis, and other complications. Physicians and some conservative chiropractors believe manipulation is never indicated in children.)
  3. Prescription drugs and immunizations are discouraged.
  4. Sterile precautions for surgery are ridiculed.
  5. If not overweight, one can eat as much fat as one wants, irregardless of cholesterol level.

Unproven nutritional theories are advocated, such as the need to eat fruits and vegetables that are “alive,” and the classification of foods into builders, eliminators, lubricators and sweets and starches. It also recommends that the aspiring manipulator practice feeling a single human hair through a sheet of paper. “When you can feel and find that one hair under a ream of one hundred sheets of paper, you will have developed intuition with regard to physical sensitivity.”

Evidence: No evidence is given to support any of the book’s allegations.

  1. The Food Allergy Cure: A New Solution to Food Cravings, Obesity, Depression, Headaches, Arthritis, and Fatigue by Dr. Ellen W. Cutler. (New York: Harmony Books, 2001).

Author: Dr. Cutler is a chiropractor who uses the BioSET system and WellZyme products, which are promoted in the book.

Content:  According to Dr. Cutler, “undigested food is the single most prevalent cause of allergic reactions, and most of the everyday health problems we experience….come from these.” Food allergies can be due to “poor diet, not chewing food sufficiently, or sensitivity to enzymes found in food and in the body;” one fifth of babies are allergic to breast milk, and patients may be allergic to their own blood, glands and organs, to vitamins, hormones, amino acids, sugars, and even to water.

To test for allergies, she puts a glass vial containing the allergen in the patient’s hand and presses down on the opposite arm. If the patient is allergic, the muscle feels weaker. Plastic vials won’t work. Actually, the reagents she uses “do not contain the actual substances but instead are energetic carriers of substance signatures made by various homeopathic suppliers.”

Allergies supposedly cause symptoms by blocking the body’s electromagnetic energy pathways. To cure an allergy, the patient holds the “allergen” while chiropractic techniques stimulate the acupuncture site connected to the appropriate meridian. This cures the allergy. The author admits she doesn’t know how it works.

Other recommendations include detoxification by fasting, juicing, macrobiotic diet, exercise, massage, drinking water, breathing, dry skin brushing, baths and saunas, coffee enemas, and homeopathy. Toxicity can be prevented by counseling, flower remedies, laughter therapy, and eliminating electromagnetic stress in homes  (“locate your bedroom as far away as you can from where electric current enters into your house”).

Enzyme therapy is recommended, specifically 22 different WellZyme products. Each has a specific purpose, including bone health, male vigor, blood sugar balance, mental focus, lung health, etc. If you don’t take enzyme supplements, you must “chew each morsel of food at least thirty times.”

Errors: None of this material holds up to scientific scrutiny. True allergies are to proteins only.  Enzyme therapy cannot work because the enzymes are destroyed by digestion in the stomach and jejunum. The only effect of prolonged chewing is jaw muscle fatigue and reduced enjoyment of meals.  Acupuncture meridians cannot be demonstrated, nor can “electromagnetic pathways.”

The muscle testing method described is a type of applied kinesiology, which has been proved ineffective when the patient holds the substance under the tongue. Holding the allergen in a glass vial would only compound the ineffectiveness, particularly when the solution is so dilute there is not likely to be even one molecule of the allergen left. The idea that some ill-defined “toxicity” requires detoxification is not supported by any known facts.

Evidence:  No evidence is given. There are no references to substantiate any of the claims. The bibliography contains 17 works such as Foods That Fight Pain, The New Pritikin Program, and two of the author’s own books.

  1. Life Beyond Headaches, by Dr. Jeffry Finnigan. (Olympia, Washington: Finnigan Clinic, 1999).

 Author:  Dr. Finnigan is a practitioner of atlas orthogonal chiropractic. The book is self-published and self-promotional and was donated to the library by its author. It ends with testimonials, product information and an invitation to the author’s clinic.

Content:  It offers to help the reader rediscover his vital “life force,” and tune into it for health amplification.  It describes six foundational keys to health amplification:

  1. Air: practice deep breathing of clean air in a way that is empowering.
  2. Food and water: drink water without poisons (such as chlorine and fluorine); eat fruit on an empty stomach so it won’t stick behind the other food; eat living, unadulterated, unprocessed whole foods that have not been canned, fried, micro-waved, cooked or heated. Natural foods have unknown ingredients that work together that science doesn’t know about.
  3. Exercise: to oxygenate the body. Use it or lose it. Inactivity causes chronic fatigue.
  4. Sleep: on the back or side, on a supportive mattress, with a proper pillow.
  5. Positive mental attitude: because the mind influences the body.
  6. The Master Key: treatment with the Atlas Orthogonal procedure.

Dr. Finnigan’s theory is that subluxation of the first cervical vertebra, the atlas, can clog the entire nerve system and affect blood flow throughout the body. His method requires precision analysis and treatment via an imperceptible percussion wave directed toward the atlas vertebra at a precise vector determined by the Atlas Orthogonal Instrument. This procedure requires “years of clinical experience and post graduate studies” and there are “only about 45 doctors world-wide who are certified.”

Errors:  Incorrect statements include:

  1. Antibiotics are virtually useless in fighting most infections.
  2. Since prescription drugs given to a healthy person would only cause bad effects, they can’t be expected to make a sick person well.
  3. Protein and starch should not be eaten together because the first is digested by acid and the second by alkaline digestive juices, so they cancel each other out.
  4. Doctors only treat symptoms, not causes.
  5. A chart of cervical nerve function is anatomically incorrect, for example it indicates that the first cervical nerve affects the head, scalp, bones of the face, brain, inner and middle ear, and sympathetic nervous system (Actually, it is a motor nerve to the suboccipital region, with a few associated sensory fibers for proprioception).

Evidence:  Many statements are vague, mystical and not amenable to validation:

  1. “Internal wisdom” creates healing miracles we can never understand.
  2. The brain generates electrical power that can be drawn out of your body by old injuries and current habits.
  3. The body has Innate Intelligence that must be close to God.

No references are given to substantiate any of the claims made. There is no scientific validity to the methods described, and the theory is fanciful.

  1. Different Bodies, Different Diets: Men’s Edition, by Dr. Carolyn L. Mein. (San Diego:Vision Ware Press, 1997). and
  2. Different Bodies, Different Diets: Women’s Edition, by Dr. Carolyn L. Mein. (San Diego:Vision Ware Press, 1997).

Author: Dr. Mein is a chiropractor who specializes in Transpersonal Physiology and is trained in acupuncture, kinesiology and bio-nutrition. She invented the “25 Body Type System.” These books promote her system and advertise various items including books, videos, questionnaires, and a dietary guide.

Content: Dr. Mein read Dr. Abravanel’s Body TypeDiet and Lifetime Nutritional Plan, and expanded his theory to include 25 body types, which she discovered and verified by muscle testing (applied kinesiology).  The types are: adrenal, balanced, blood, brain, eye, gallbladder, gonadal, heart, hypothalamus, intestinal, kidney, liver, lung, lymph, medulla, nervous system, pancreas, pineal, pituitary, skin, spleen, stomach, thalamus, thymus, thyroid. She claims that the dominant organ determines physical characteristics such as the shape of the torso and the appearance of the musculature. Each body type is associated with a different personality, according to symbolic connections; for example,  “…just as the intestines openly accept everything that comes in and then discern between nutrients and waste material…the Intestinal body type is discerning. They approach life with an openness, taking everything in, and then letting go of what isn’t appropriate….their initial response to life is emotional (but) they generally don’t trust their emotions, so they gather as much information as possible to make a logical decision.”  Each type has distinct dietary and exercise requirements.

Around 14 pages are devoted to each body type, describing distinguishing features, weight gain areas, potential health problems, recommended exercise, psychological type, characteristic personality traits, motivation, best and worst trends, healthy food list, sensitive food list, foods to avoid, detailed plans for weight loss or gain, advice on what to eat, how often, and what time of day. For example, the hypothalamus type assimilates raw vegetables best at lunch, cooked vegetables best at dinner, and should always eat broccoli, zucchini and yellow squash raw; and  “For the heart type, exercise is optional.”

Readers are advised to drink half a gallon daily of water that is free of chlorine, fluoride, bacteria, etc.  If your water is not quite right,  “…there are devices available that can be used to polarize water, such as the Harmonizer by Rainbow Crossings or polarizer wands or pillows by Spring Life Polarity. Both will neutralize chemicals and bacteria…” An illustration shows what appears to be a metal bar lying across the top of a glass of water.

Errors:   There is very little in this book that is not an error, a misinterpretation, or an unevaluated speculation.  An example: “When an atom loses an electron, it loses it’s [sic] positive spin and spins counterclockwise…Polarization supplies the missing electron by bringing in positive energy or electrons, thereby neutralizing the negative effects of the bacteria.”

Evidence:  There is no reference or bibliography. The information presented is based solely on anecdote and on a muscle testing method known to be invalid. There was no attempt to verify findings.  There is no scientific validity to the information presented.

Conclusion:  Nine books on chiropractic were found in the catalog of a public library.  One was a general overview of chiropractic from a favorable point of view. Two were critiques of chiropractic by laymen. One was a chiropractor’s polemical rebuttal of anti-chiropractic criticism. The other five were descriptions of specific methods used by certain individual chiropractors, containing what amounted to a sales pitch for those methods. Three of the pro-chiropractic books were self-published.  Books published in the last five years were uniformly pseudoscientific. Only two books (Magner and Smith) were found to be dispassionate, reasoned, based on acceptable evidence and scientifically accurate: both were critiques of chiropractic.

Although books favorable to chiropractic outnumbered those critical of chiropractic, the critical books were distinctly superior in scientific accuracy and supporting evidence. Adequate information is available in the public library for an intelligent layman to examine the pros and cons of chiropractic. Lack of accessible information does not appear to be a factor in the current trend of increasing acceptance of this pseudoscientific health care system.

[1] Palmer, DD. The Chiropractor. (Facsimile reprint: Montana, Kessinger Publishing Co., no date listed): 1914.

[2] Homola, S. Inside Chiropractic: A Patient’s Guide. Amherst, New York: Prometheus, 1999.

[3] Stewart, B. Canadian Neurologists warn against neck manipulation. Available at http://www.chirobase.org/15News/neurol.html. Accessed November 9, 2002.

[4] Barrett, S. Chiropractors and immunization. Available at .http://www.chirobase.org/06DD/chiroimmu.html Accessed November 9, 2002.

[5] Chotkowski, L. Chiropractic: The Greatest Hoax of the Century? Kensington, Connecticut: New England Books, 2002.

[6] Rothwell DM, Bondy SJ, Williams I. Case control study of chiropractic manipulation and stroke. Stroke 2001 (5) 1054-1060.

This article was originally published in the Scientific Review of Alternative Medicine.

Dr. Hall is a contributing editor to both Skeptic magazine and the Skeptical Inquirer. She is a weekly contributor to the Science-Based Medicine Blog and is one of its editors. She has also contributed to Quackwatch and to a number of other respected journals and publications. She is the author of Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon and co-author of the textbook, Consumer Health: A Guide to Intelligent Decisions.