The Chiro Article

(Note: this is the infamous article on chiropractic that got Simon Singh sued. It is being reposted all over the web today by multiple blogs and online magazines.)

__________________________________________

Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results - and can even be lethal, says Simon Singh.

You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that "99% of all diseases are caused by displaced vertebrae". In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

In fact, Palmer's first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying - even though there is not a jot of evidence.

I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world's first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: "Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck."

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

---

Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

Guess they said it better

Well, I'm not the only one writing to the paper on the side of reason. There are a couple of letters in today's West pointing out pretty much the same thing as I did in my latest letter, although probably with more politeness.

Still, we plug away, in the hopes that reason will take its rightful place in human endeavours.

A little too strong?

Here's the body of my first response to A. Mitter, as yet unpublished:

Alan Mitter (letters, 9/7) wades into the debate, scattering unsupported assertions hither, thither and yon, quite possibly relying upon unnecessarily complicated verbiage to do the work of convincing us.

Unfortunately, he simply reiterates what is known as the Kalam cosmological argument, which may be a favourite of famed Christian apologeticist William Lane Craig (and dates back to the 9th century), but ultimately doesn't hold water. It certainly doesn't constitute evidence of anything other than that people will go to extraordinary lengths to defend their irrational beliefs.

The simple fact of the matter regarding the beginning of the universe is that we just don't, at the moment, know. We don't even know if the universe had a beginning, strictly speaking, although we do have some very interesting - and testable - ideas. Alan Mitter's argument is the 'argument from ignorance', which loosely stated goes along the lines of 'we don't actually know the answer, so I'll just make something up which fits my prejudices'.

Quite aside from anything else, this is all getting needlessly complicated and ridiculous. Even if the universe did have a beginning, and was caused by an "uncaused cause", that says nothing at all about the existence of souls, nor does it go anywhere toward supporting the notion that this uncaused cause is the Biblical God, or is in any way intelligent, conscious, or remotely interested in the doings of one species inhabiting an unremarkable planet in an unimaginably tiny part of the universe. It is an act of extreme arrogance to claim such a special place for humanity, the purpose and focus of the existence of the entire universe, and it is interesting to note that it is this same arrogance that allows us to claim a clean conscience whilst making laws designed to impose our opinions on others no matter the terrible cost to them - laws outlawing voluntary euthanasia, for example.

There is one other point to address, and it is this: even should the Biblical God exist and be intent on tossing people who end their own lives to cut short intolerable suffering into Hell (whatever that is), then that is fundamentally an issue between those people and God, and is nobody else's business. It certainly doesn't give license for Christians (or any other religious folk) to dictate laws based upon their dogma. The only reasonable approach to lawmaking is that it be for the greater good, and based upon what we can learn from evidence.

Word Salad

This, in response to my previous letter:

Regarding the questions of faith, the
"big bang" and the existence or
otherwise of God, dare I enter the
"Vale of Silliness" (Geoff Rogers,
Letters, 6 7) to make this offering?
The creation of the universe
presupposes the existence of
"something" pre-existing it with the
capacities to effect its creation by the
exercise of its generating power. So,
before anything was created,
something with this power and
capacities already existed. If ever
there was even a millisecond when
there was no existence of any kind,
still now it would be the same,
because no power or essence could
possibly emerge from non-existence.
This points to the fact that what
already existed had to be eternally
uncreated and self-existing in its
nature and essence without
beginning or end. This mysterious
external essence is the necessary
beginning and source of the creation.
So, the first moment of the
creation occurred when it was
"triggered" into existence by the
capacities of its uncreated source.
This was the first moment in time,
the first moment of created
existence, the moment which saw
the exercise and release of all the
power which drives and fills the
whole creation. This was the
moment of the "big bang". I
The trigger for that first moment
necessarily exists within the mystery
of the essence and power of the
eternal uncreated source, for it was
within it which the trigger acted and
the creation came into being.
For those who believe the
uncreated source to be the eternal,
living, intelligent, omnipotent power
and awesome mystery we call God,
the exercise of His power to create
was necessarily triggered by the
power of His will. It has been said:
"For those who believe in God, no
explanation is necessary. For those
who do not believe in God, no
explanation is possible. "
Alan Mitter. Langford

-----------------------------
Published 09/07/09

Response to M. Rowe

The following was my response to a response to my response to a letter in The West:

M. Rowe (Don't usurp God's power, 3/7) embarks upon a journey through the Vale of Silliness, and attempts to take us all along.

Firstly, near-death experiences are not evidence for the existence of souls, but they are evidence that the human brain, a highly complex biological machine, behaves very strangely when suffering a lack of oxygen or some other form of damage. This should not be surprising, as most complex systems behave oddly when they malfunction. I have a friend who once saw a six-foot tall cockroach when suffering from a high fever, which in no way serves as evidence for the existence of six-foot tall cockroaches.

Further, the wonders of the universe (and I grant, they are indeed wondrous) are evidence for the existence of the universe, but that's about all. They don't serve as evidence for the existence of God, and especially not for the existence of the Biblical God. Rather, they provide robust evidence that the Biblical God is the product of fanciful human imaginations. This has nothing to do with belief, which has been accorded all too much unwarranted credit. It is simply what the evidence shows. The universe was not created 6000 years ago in the space of a week, replete with vegetarian lions, talking snakes, and an entirely innocent pair of fully-grown humans doomed by their omniscient creator to be punished for a crime they couldn't avoid.

Adam and Eve did not exist. This is not a matter of faith, it is a matter of fact. Nor is anyone claiming that humans descended from monkeys, which is a farcical claim that has nothing to do with anything, and betrays a severe lack of knowledge of what science (based upon evidence) tells us. We share a common ancestor with monkeys, and it was quite some time ago. We share a more recent common ancestor with chimpanzees, and a more distant one with cabbages. The "humans descended from monkeys" line is what is known as a "straw man fallacy".

On top of all this, the Biblical God is a repugnant character, behaving in such ways that, were they exhibited by a modern citizen of this nation, would result in his rapid removal from the broader society and incarceration, quite probably under some sort of sedation.

Threats of hellfire and brimstone and days of judgment are simply that: empty threats, and as such they have no place in the creation of legislation.

----------------------------------------------------------------------
The above was reply to a reply to my previous letter.

Ya Gots Ta Have Soul

The body of a letter I sent to the West Australian, published 01/07/09:

Geoff Doust (Letters, 30/06) pertly asserts: "We are not just animals - we are spiritual beings with a soul and our bodies are merely our 'earth suits'."

It really must be about time we started to base our laws on observable reality rather than mere assertion, no matter how vociferously said assertion may be made. Accordingly, I would like to ask Mr Doust (and his fellow believers) to present the evidence that supports this claim. It's an old claim, to be sure, and has in the past been the basis for many laws and other social conventions, but that does not qualify as evidence for the factuality of the claim. Faith, too, falls far short of qualifying as evidence. As does the number of people who believe - popularity does not reflect truth.

For time out of mind, laws have been made based on nothing other than the assertions of those who wield political or social power, often with the aim of maintaining their grasp on that power. One of the greatest of these assertions is that humans are somehow special, the pinncle of creation, different to other animals and possessed of souls. It is a wonderful assertion, of course, and allows us to behave in morally repugnant ways with a clear conscience. You can even use it against other people: witness the history of slavery, all too readily maintained through the assertion that they were less than entirely human, or somehow spiritually impure.

It has become abundantly clear that this bald, unsupported assertion is not something upon which to base our laws. If there is no evidence for something, it cannot be taken into account. It may be that we do have souls (I highly doubt it) but until their existence becomes evidentially demonstrated as anything other than fanciful nonsense, they have no place in legislation, just as fairies have no place in legislation without there being evidence of their existence.

Your alleged soul, Mr Doust, is your own business. Kindly keep it out of public business.

Tim Minchin in Perth

I just got home from seeing Tim Minchin live at the Perth Concert Hall. It was, not to put too fine a point on it, a fucking good show.

Now, I have to be honest here, I've been a fan of Minchin for a while now, but I've never seen him perform live. I have a tendency to be cynical about live performances, having been involved in too many to really get excited about being in the audience. But this was the best, most enjoyable performance that I've ever paid to watch (and far better than most I've been paid to watch).

We'll get the fawning out of the way first: Minchin is an extremely accomplished performer, and I'm incredibly jealous that he is married to someone who so obviously fits him. I wish I could find someone who would put up with my shit as well, and top it when required. On top of that, he sings marvelously well, plays piano as good as Elton John (Tim, if you're reading this, I know you'll get the joke), and is not just a good musician, but a real, honest-to-fuck great comedian.

Right, adoration out of the way, let's get to the meat of things. He was on-stage on-time (show was listed as starting at 8pm, he was on-stage at ten-past, which is pretty good compared to many acts I've seen). He played the audience like he did his piano: with precision and skill, freely improvising, or at least giving the impression that he was doing so. Sound was good, the venue was good, everything was good.

But one thing was better. The audience. Or, rather, the make-up of the audience. No, no-one rocked up wearing mascara, black jeans, and insanely teased hair (or if they did, I didn't see them). I'm talking about the wide-ranging ages and appearance of those in the audience. I saw teenagers, through to people in their 60's. I saw blokes in t-shirts and jeans, and others in suits. I saw pregnant women and borderline goth/punks. I, of course, rocked up looking like an unreconstructed bogan, but then I like doing that, because it might make people think (and, of course, I'm somewhat of an unreconstructed bogan).

I looked around, and saw the range of people, and I was reassured. Especially given their enthusiastic enjoyment of Minchin's act (and let us not pull any punches, it basically consists of singing songs about how fucking stupid irrationalists are, using as his targets the religious, woo-merchants, and those who thrive on exploiting others). I was reassured, because this is a Wednesday night, and there were few seats unoccupied. This bodes well, in my mind, because if this performance was effectively sold out, then the others almost certainly are too, and there are a lot of people out there who share the view that irrationality is a bloody stupid thing to base your life on. And that makes me happy.

One final note: In his encore, he sang "White Wine in the Sun", a beautiful little song about family, and how religion really isn't needed for connection and love. It includes a line: "I'd rather break bread with Dawkins than Desmond Tutu".

I'd rather break bread with Dawkins and Minchin. Actually, fuck that. Let's have a couple of glasses of red, and we can ponder the fact that my brain somehow is compelled to place importance on such a meaningless coincidence as myself sharing a birthday (day, month, and year... and city) with Minchin - and that we share a birthdate (day and month) with Desmond Tutu.

I can have a dumb side too.