Chiropractic response also ‘spurious’

Justin Vodane’s letter (NZ Skeptic 91) is a classic defence of the indefensible.

This is illustrated by his referring to the Viox problem. Whilst the actions of some drug companies are questionable, and may actually be criminal in the Viox matter, this has absolutely nothing to do with the central question.

Despite a history of over a hundred years, the basis of chiropractic theory remains unproven. Spinal subluxations are yet to be validated as existing in reality, and have yet to be shown to cause disease states peripheral to the spine.

Vodane’s reference to neck manipulation is intriguing. Whilst there may be a very occasional indication for controlled neck manipulation for an uncomplicated musculoskeletal problem, there is no justification for such treatment when it is based purely on chiropractic vertebral subluxation theory. (Homola S.: Chiropractic, cervical spine manipulation and stroke. Scientific Review of Alternative Medicine 2007; 11:19-22. The author of this article is himself a chiropractor). The defence of neck manipulation given by Vodane misses the point – there is no justification for neck manipulation, so any risk of stroke is unacceptable. Also, even if only 20 percent of the cerebrovascular accidents occurred because of the manipulation, that is so high as to rule the treatment dangerous as well as unnecessary.

Finally, Vodane has not declared a potential conflict of interest in his letter. He defends the chiropractic registration procedure as being robust and fair without revealing that he is an examiner for the examination pertaining to that registration process.

Graham Sharpe

Consultant Anaesthetist (for purposes of open disclosure)

‘Psychological’ processes inadequate

The ‘psychological’ processes that Martin Wallace describes in his article, The physiology of the placebo effect (NZ Skeptic 91), are wholly inadequate. Pavlov’s respondent conditioning would shed little light if any at all on the placebo effect.

However, Skinner’s operant conditioning would provide an excellent explanation of the placebo effect, particularly in the analysis of the verbal behaviours of both doctor and patient.

In contrast, the expectancies of cognitive psychology don’t explain anything at all. Cognitive psychology gives names to a set of behaviours which are then used to explain the behaviours they name. Road-rage and Attention Deficit Disorder are good examples. And so is placebo analgesia.

Behaviour analysis emphasises the importance of the environment (or ‘context’ if you like). It does this without resorting to the ‘mind’ or mental states as (non-existing) entities.

To explain the physiology of the placebo effect, no relationship between the ‘mind’ and body is necessary. The relationship proper is between the verbal behaviours of the doctor and patient and the body’s physiology.

John Lok Dargaville

Obesity and osteoporosis

Really enjoy the mag.

Two items: The BMI index of obesity (excess fat, excess food consumption) takes no account of bodily type; Sheldon’s index in 1950’s did.

The person with long bones, minimal musculature and much fat has a low BMI but is obese, and the person with large muscles can have a high BMI. I think it’s not a good index to rely on. And then all the talk about osteoporosis never mentions the controlling role of parathyroid hormone, surely more important than all the calcium supplements (which can cause urinary stones?) And what about glucosamine? Breaks down into glucose and polyamine, can’t go directly into joint cartilage.

Bill Tucker Auckland

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