A few weeks ago, my post on the anti-vaccination bias in the alternative medical community raised the ire of some readers when I suggested that chiropractors have been culpable in the spread of dangourous anti-vax rhetoric. Some were incredulous at the suggestion that chiropractic as a practice originally included a denial of the germ-theory of disease and as such, was poised to be biased against vaccination as a preventative therapy for deadly childhood diseases.
In Canada, at least, it appears we were both right.
Chiropractic was born out of a curious, apocryphal experience by the magnetic healer D.D. Palmer in 1885, when he supposedly cured the long-standing deafness of a Davenport, Iowa janitor by manipulating the vertebrae in his neck. Palmer went on to develop his ideas that he said were nothing else but a result of his training in "animal magnetism" by postulating the presence of a force that flowed through the nerves of the body called "innate intelligence;" a force that, if disrupted, was the cause of all disease in the body. By resetting the subluxations, or misaligned joints, of the vertebrae, this force could be restored, with the health of the patient along with it.
The second half of the 19th century was a monumental time for the development of modern science. The periodic table of elements was being filled in quickly, discoveries that would underpin a relativistic universe were being uncovered, and a human physiology based in biochemistry was rapidly displacing the vitalistic idea of an animating force, like innate intelligence. It was not surprising then that a rift soon developed between the "straight" chiropractors like D.D. Palmer and later, his son B.J. Palmer and those "mixers" who had a more mechanical view and adopted other therapies as well. As Ted Kaptchuk and David Eisenberg detail in their article "Chiropractic: Origins, Controversies and Contributions," at the beginning of the 20th century, innate intelligence was considered more religion than science by the Palmer's detractors and other schools of chiropractic sprang up that took a mechanical point of view.
Jump ahead to the 1940s and the widespread use of penicillin and soon, other antibiotics, and the germ-theory of disease -- once anathema to many chiropractors -- was gradually accepted by the "mixer" crowd. However, these ideas -- which were at its lowest point of popularity in the 1970s (see link above) -- have been on the rise as a result of the public's growing dissatisfaction with the quick and alienating culture in medicine, along with the concerted efforts of several factions to raise the specter of "big pharma" and corporate greed while casting doubt on the use of vaccines as safe and effective. In their efforts to become primary care doctors, chiropractors in all parts of the world (save for Canada) have failed to include support for vaccinations as an essential public health measure, and have even continued to argue against their use.
All we have to do is look at the myriad organizations that represent chiropractors around the world to see what they recommend as essential preventative measures to avoid illness and injury for children. In his 2002 paper in the Journal of the Canadian Chiropractic Association, Dr. R.J. Ferrence argues that in many cases worldwide, including in organizations like the American Chiropractic Association., the International Chiropractic Association and the World Chiropractic Association, support for childhood vaccinations is non-existent and anti-vax rhetoric -- like a focus on the dangers of vaccines and not the benefits -- is normal practice. The sole dissenter from this is the Canadian Chiropractic Association, which states unequivocally on its website:
"The CCA accepts vaccination as a cost-effective and clinically efficient public health preventative procedure for certain viral and microbial diseases, as demonstrated by the scientific community."
So, despite a traditional aversion to the idea that germs cause disease, as well as growing anti-vax sentiment in the chiropractic community, the CCA defends the importance of vaccination as an important public health measure. Curiously, the Ontario College of Chiropractic developed a standard for vaccination (S-015) in 2004 but it was later revoked in 2011. What is clear is that while the leading advocate for chiropractic in Canada states clearly that it supports childhood vaccination, the chiropractic community is not fully behind these efforts.
Many chiropractors continue to cling to the chiropractic subluxation theory of disease, that the spine is the mediator of all disease and through its manipulation better health can be achieved. This has been thoroughly discredited in the literature and even the British Chiropractic Association has called it an historic artifact. Recently, an update of a Cochrane Review on spinal manipulation for low back pain, the mainstay of chiropractic business, found it "...no more effective for acute low back pain than inert interventions."
With the last bastion of credibility of chiropractic care slipping from their fingers, we should be cautious when turning to chiropractors for advice on childhood infectious disease.