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    Opening the door a crack
    Chiropractic: Dr. Jean Moss versus mainstream medicine

    National Post, with files from Maclean's and The Ottawa Citizen Monday, November 23, 1998

    Dr. Moss: 'We have made far more personal commitment than many health professionals in ensuring that there has been funding for research.'

    In 1895 in Davenport, Iowa, a self-taught healer named Daniel David Palmer, originally from Port Perry, Ont., manipulated the spine of Harvey Lillard, allegedly restoring his hearing. And with a snap, crackle, and pop, chiropractic was born. It was a difficult birth: a year later, Palmer was jailed for practising medicine without a licence, the beginning of decades of opposition from government and from the medical establishment.

    More than a hundred years later, chiropractic, now an established health-care profession with thousands of practitioners and clients worldwide, is still smarting. That much was evident late last week when scientists at Toronto's York University held a public forum to debate and denounce a proposed merger between York and the Canadian Memorial Chiropractic College (CMCC), fearing the affiliation will compromise the university's reputation for scientific research.

    "Chiropractic does have some very metaphysical, anti-scientific overtones still imbedded in it," said Michael De Robertis, a physics and astronomy professor in the Faculty of Pure and Applied Science. "Any scientist would be very, very uneasy with some of the attitudes they hold."

    Last February, the science faculty voted 30-13 against the proposal; in May, York's senate voted 57-13 for it. Which put Brock Fenton, associate vice president of research at York, on the defensive: "I mean they didn't come right out and say it, but basically [the scientists] said, 'You guys are witch doctors.' "

    The chiropractors have heard it all before. At the eye of the current storm is Dr. Jean Moss, president of the CMCC and a teacher and chiropractor at the college for half of its 53-year existence.

    Moss first became interested in the profession when she was a high-school student and her mother was successfully treated for a back condition by a chiropractor. By coincidence, a college had just opened in her home town of Bournemouth, England. Moss applied and was accepted. After receiving her degree, she came to Canada to do advanced study at the CMCC. She graduated from there in 1970 and started teaching in 1971.

    "Once I got into it, I found it quite fascinating," she said. "It seemed to me that this was an area where many people had complaints where they weren't getting good relief through the medical approach. And the fact that there wasn't the use of drugs matched many of my own beliefs."

    Leaving aside whatever aspirations the scientists, the bureaucrats, and the chiropractors might have for the "public good" or the "good of science," the CMCC conflict at its crudest level is a struggle for money and power. Moss is candid about what the CMCC stands to gain from joining forces with York to grant a doctor of chiropractic through the university: "In the past, many of the large granting agencies would not grant funds to chiropractors because we were not affiliated with a university," she said. "So chiropractic researchers have not been able to get funding the same way university professors would." For the CMCC, then, York is the gateway to more money, power, and respect. The latter is not insignificant for a discipline that, despite being the third-largest health-care profession in North America, is still regarded as marginal by mainstream medicine.

    For its part, York will get a $25-million research and teaching facility (courtesy of the CMCC) as well as an increased profile in the burgeoning field of health sciences. Which, presumably, will attract more students and more funding.

    But the scientists insist their gatekeepers have failed them. The university has much to lose, they say, if the CMCC deal is approved. Scientific credibility, for one thing. "It is an embarrassment," John Goodings, a chemistry professor, told The Ottawa Citizen. "We are quite worried about it because I think some of the basis of chiropractic is not scientific."

    De Robertis went so far as to suggest York science students applying to medical schools might not be accepted because of the taint of being connected to a chiropractic school. "Whether chiropracty is legitimate or not," he said,"medical faculties are very strongly against it."

    And if that didn't rankle enough, science faculty will have to teach the courses if the deal goes through.

    But the scientists have more troubling concerns as well. A few years ago, for example, a group of doctors at Stanford University warned a chiropractor's snap of the neck could lead to tearing of an artery and, ultimately, to stroke. (Chiropractors at the time suggested stroke occurs in only one in a million to three million cases.)

    The York group is also skeptical of chiropractors' claims that they can cure such childhood ailments as colic, earache, and even bed-wetting. This in turn echoes a larger debate over whether chiropractic should be considered as simply a nonsurgical relief for back pain or an all-out alternative to traditional medicine.

    Moss noted that in the absence of public money the chiropractic profession has turned to its own for research funding. "So rather than being unscientific, I think we have made far more personal commitment than many health professionals in ensuring that there has been funding for research."

    Some of this research is now being published in highly rated medical journals. She pointed to a recent study conducted by three CMCC faculty and written up in the august New England Journal of Medicine that concluded that "chiropractic spinal manipulation . . . had no effect on the control of childhood asthma." An editorial even called the researchers "courageous."

    "This is why you do research," said Moss. "You pose a question and then you try and prove or disprove your hypothesis. That's exactly the sort of thing everyone is claiming scientists do and chiropractors don't do. They can't have it both ways."

    As for the claims related to children's health, she will say only: "There is research going on in all those areas right now. There are anecdotal case reports where chiropractors have noticed a beneficial effect in these conditions."

    Moss laments the fact that "a small group" of dissenters have chosen to take their concerns to the media, but she is as calm and implacable as the scientists are voluble. She insists nothing will change, and she expects the deal with York to go through by next spring.

    Fenton invoked the language of academic freedom: "The university is supposed to be a crucible of thought and new ideas," he said. After all, it was only a hundred years ago that mainstream medicine believed blood-letting could cure disease. "If you say you won't allow these people in you're really violating the whole spirit of what is a university."

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