Chiropractic

Human spinal manipulation and the jump to animals
The practice of Chiropractic medicine continues to be a controversial treatment modality in spite of persisting efforts by the Association of Chiropractic Colleges (ACC) to “integrate” into general science based mainstream medicine. One of the main problems is that the foundational theory and basis for chiropractic rests upon tenuous non science based concepts.The “Chiropractic Paradigm” proclaims on the ACC web site that the theory of the "subluxation", a nebulous entity not demonstrated to exist (let alone be the originating cause of a plethora of human and animal diseases) as integral to the practice of modern chiropractic:

"Chiropractic is Concerned with the preservation and restoration of health, and focuses particular attention on the subluxation.

A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health.

A subluxation is evaluated, diagnosed, and managed through the use of chiropractic procedures based on the best available rational and empirical evidence."

In spite of efforts by more evidence based chiropractic practitioners such as Samuel Homola DC who strive to limit the extensive scope of unfounded treatment claims, a significant proportion of chiropractors continue to implement pseudo scientific methodologies.

One of the dilemmas for this profession is that a large part of its work involves spinal manipulative therapy (SMT) a separate practice often erroneously assumed to be only chiropractic in scope. In fact, physiatrists, orthopedists, sports medicine practitioners, physical therapists, athletic trainers all employ SMT in their practices. There seems to be some evidence that SMT relieves back pain to an extent and can be traced back to ancient history. Though this technique has beneficial qualities it does involve some components of the placebo such as the laying on of hands and perceived variations to pain.

Chiropractic differentiates itself from traditional SMT by prescribing to specific implausible theories such as the subluxation and that this entity is the root of nerves impingement's that lead to disease. Though the present chiropractic society strives to dress this concept with scientific legitimacy, the bottom line is that such theories have not met the criteria of quality research. Therefore, chiropractors who are working to reform the practice and limit its scope are faced with having to completely shift the “chiropractic paradigm” in a big way- a daunting task:

"The dilemma reformers face is that chiropractors do not perform any service or deal with any condition not covered by some other health profession. State laws that enable them to practice either specifically mention the subluxation theory or describe it as the basis for chiropractic as an entity. Renouncing chiropractic's theoretical basis would eliminate its justification for existing as a separate profession.

Reformers acknowledge that they offer mainly the specialized skill of SMT. They believe that SMT is underutilized and that a substantial market exists for their skills. Although other health professionals can legally perform SMT or treat functional back disorders, most do not. To become skilled at SMT requires more time and effort than most physicians or physical therapists are willing to invest, especially when they feel that they may achieve the same clinical results over the long term with less demanding modalities."

Chiropractic medicine has origins specifically from the strange metaphysical pondering of one layman; Daniel Palmer, who speculated that most disease was caused by spinal subluxations that impinged nerves thereby leading to disease:

“Obsessed with uncovering "the primary cause of disease," Palmer theorized that "95 percent of all disease" was caused by spinal "subluxations" (partial dislocations) and the rest by "luxated bones elsewhere in the body." Palmer speculated that subluxations impinged upon spinal nerves, impeding their function, and that this led to disease. He taught that medical diagnosis was unnecessary, that one need only correct the subluxations to liberate the body's own natural healing forces. He disdained physicians for treating only symptoms, alleging that, in contrast, his system corrected the cause of disease.

Palmer did not employ the term subluxation in its medical sense, but with a metaphysical, pantheistic meaning. He believed that the subluxations interfered with the body's expression, of the "Universal Intelligence" (God), which Palmer dubbed the "Innate Intelligence." (soul, spirit, or spark of life). [9] Palmer's notion of having discovered a way to manipulate metaphysical life force is sometimes referred to as his "biotheology."

Human chiropractic today, under the cover and dressage of “science” still has not gone past many of these implausible notions. It is therefore easy to imagine why other peculiar modalities such as odd and implausible diagnostics (applied kinesiology, contact reflex analysis, “nutritional” consultations, reflexology, and hair analysis among others) have taken root in chiropractic medicine.

The relationship to spiritual world views of the soul at least suggests that expanding these concepts beyond the human body were not immediately considered. Animal chiropractic and animal souls seem not to have been an initial part of the theory for this treatment modality. The leap to animals however, did take place using a similar “intuition” and integrative approach used in other alternative practices (Note the resemblance to the “natural correspondence” theory and “energy” pattern and flow concept of the "qi" found in TCM).

The transposing of chiropractic to animals seems to have little basis in research and relies on the general precepts of the slippery “subluxation” theory. In addition to being an unproven entity in humans it is interesting to note that “No part of chiropractic education deals with animals, and no part of veterinary education deals with manipulative forms of physiotherapy.”

However, a veterinarian or chiropractor can be “certified” to practice animal chiropractic after complying with about 150 hours of coursework. These educational courses are offered at five locations approved by the American Veterinary Chiropractic Association. A quick scan of two of the websites indicates that the concept of the “subluxation” is alive and well in the arena of animal chiropractic:

"Integrated Case management " -6.5 hours – (All of the following are addressed by lecture, in small group discussion and/or with expert panel debate through an open question forum.) Review of the chiropractic theories and the contemporary vertebral subluxation complex; define assess and apply animal chiropractic diagnosis of the vertebral subluxation complex; and, investigate the creation and application of appropriate clinical goals and applying them to our integrative treatment protocols.”-

"What is animal chiropractic? "
Animal Chiropractic understands the relationship of the spine and nervous system to proper function and over all well-being of small and large animals. The application of this art utilizes a small amplitude, high velocity thrust to areas of spinal subluxation in order to facilitate proper function of the nervous system resulting in enhanced performance and quality of life".

The jump from one mans “epiphany” for curing disease through spinal manipulations is difficult to comprehend. The leap to animal chiropractic becomes even harder to grasp, especially if you consider the enormous variation in body types and sizes found in the animal kingdom.

Though animal based chiropractic education seems to address some anatomical topography, there continues to be a theoretical gap in the transition from human focused approaches to animal techniques. Additionally, the obvious fact that human body architecture is based on a bipedal mechanics and the vast majority of other animals are quadrupeds needs serious attention when considering practical and functional chiropractic transitions from human treatment theory to the rest of the animal kingdom.

Chiropractic medicine seems to continue to base its efficacy more on a priori knowledge, belief, testimonials, and pseudo scientific modalities than evidence based research. It is prudent to review some of the basic strategies the American Veterinary Medical Association has developed for veterinarians that are considering alternative modalities:

"AVMA Guidelines for Complementary and Alternative Veterinary Medicine

(Approved by AVMA House of Delegates 2001; revised by the AVMA Executive Board April 2006)

Introduction These guidelines are intended to help veterinarians make informed and judicious decisions regarding medical approaches known by several terms including "complementary," "alternative," and "integrative." Collectively, these approaches have been described as Complementary and Alternative Veterinary Medicine (CAVM). The AVMA recognizes the interest in and use of these modalities and is open to their consideration. The AVMA believes that all veterinary medicine, including CAVM, should be held to the same standards. Claims for safety and effectiveness ultimately should be proven by the scientific method. Circumstances commonly require that veterinarians extrapolate information when formulating a course of therapy. Veterinarians should exercise caution in such circumstances. Practices and philosophies that are ineffective or unsafe should be discarded."

This is is a call to veterinarians (and in essence, to all health providers) that we have a responsibility to provide effective and sound options to a public that entrusts us to find and offer them. Human and animal chiropractic medicine for the most part, has not met those standards.

Ref:

www.chirobase.org/01General/controversy.html

www.chirobase.org/05RB/BCC?update.html (dated, but vigilent)

Animal therapy over the ages2. chiropractic 3. homeopathy. Haas BK. Veterinary heritage. 1999 Nov; 22(2):38-42

www.chirobase.org/06DD/chirovet.html

www.avma.org/issues/policy/comp_alt_medicine.asp

On Thinking

The concept of intelligence (as in I.Q.) has garnered far more perceived importance than it deserves. Edward De Bono in his book “Thinking Course” described the act of thinking as a malleable, teachable skill that should be considered more important than ones level of intelligence.

By improving this learnable skill we can better navigate the often confusing flood of information that is processed by our minds. According to De Bono “…perception is by far the most important part of thinking. Perception is how we look at the world, what things we take into account, how we structure the world.”

There is an imposing quagmire of socioeconomic, historical, religious, and political factors that create huge barriers to establishing an optimum environment for developing thinking skills. If this is not taken into account, we run the danger of being off balance from the very start of our thinking as De Bono notes: “If your perception is limited then flawless logic will give you an incorrect answer.”

Through the ages, patterns of social organization have developed and grown into ethnic groups, religious paradigms, local and regional institutions that basically , no matter their particular makeup, have an over arching interest in general survival. Many important benefits including organizational structure, protection, and food distribution have come to pass because of these burgeoning forms of human cooperation.

However, as De Bono points out these structures can have disadvantages: “It now seems very likely that perception works as a “self organizing informational system”…Such systems allow the sequence in which information arrives to set up patterns. Our thinking then remains trapped within these patterns. So we need some way of broadening perception and of changing perception (creativity).”

The elements of a free thinking populace have been slow in reaching the masses. Even today, most people are not skilled in the discipline of thinking about things and are basically conditioned early on to identify with a certain social framework. The following is a scorching description of a sociological mentality that we are all guilty of participating in one way or another. This quote from “A thinkers guide to Fallacies: the art of trickery and manipulation” bluntly summarizes many of the barriers to clear thinking: “They (we) are unreflective thinkers. Their minds are products of social and personal forces they neither understand, control, nor concern themselves with. Their personal beliefs are often based on prejudices. Their thinking is largely comprised of stereotypes, caricatures, oversimplifications, sweeping generalizations, illusions, delusions, rationalizations, false dilemmas, and begged questions.”

Philosophical and religious interpretations during the compilation or translation of works including the Tao Chi Ching, Biblical scripture, and the Qur’an, have tended to be influenced by the particular views of an author or translator in the context of their lives.

Stanley Rosenthal eloquently describes this phenomenon in his introduction to the Taoism Information Page in this way: There are already at least forty-two English translations of this work…, each, I am sure, carried out as ably and honestly as was possible. However, it is difficult, if not impossible, for any person not to be influenced by the philosophy, beliefs, culture and politics of their own society, historical period and education system.”

The bible is a confusing litany of different authors, from differing times, concerned about different things. In "Rejecting Pascual's Wager" Paul Tobin states that: "The Bible is an interesting and valuable collection of Middle Eastern myths, history, and literature...far from being inerrant, the Bible is filled with contradictions, mistakes, amd scientific errors common to other cultures of that era."

On a similar note, but focusing on language, Wikipedia notes that the translation of the Qur’is and has been “ an extremely difficult endeavor, because each translator must consult his/her own opinions and aesthetic sense in trying to replicate shades of meaning in another language; this inevitably changes the original text…Just as Jewish and Christian scholars turn to the earliest texts, in Hebrew or Greek… so Muslim scholars turn to the Qur’an in Arabic.”

However, even turning to the earliest sources can be challenging; “…as Islam burst out of Arabia… language rapidly changed…losing complexities of case and obscure vocabulary. Several generations after the prophet’s death, many words used in the Qur’an had become opaque to ordinary sedentary Arabic-speakers, as Arabic changed so much, so rapidly.” Today the importance of the disciplines of Arabic grammer and lexicography are responses to the need to explain and clarify the Qur’an utilizing older and more original (Quranic) speech (Interestingly, this illustrates the natural tendency for change to inevitably affect events through time in spite of Herculean efforts to prevent it).

Layered on to this foundation are the “real time” teachers, preachers, and rulers of different periods that further color and relay additional interpretations and beliefs to a populace. Many of these earlier leaders, influential individuals, and organizations tended to foster paternalistic, or top to bottom structures that provided little room for flexibility. These have been historically more rigid societies less open to critical evaluation and prone to preconceived notions of reality. Even today, in an era replete with republics and democracies these patterns persist (It is revealing that many CAM modalities, while claiming a certain openness, actually have similarly rigid and inflexible structures).

It is not difficult to see how many of these organizational structures, including those of the present, tend to become stoic ideologies and dogmatic beliefs providing an illusory foundation with a heavily filtered and altered world view. This fairly inflexible societal hierarchy gives little opportunity for open inquiry and change.

Even Plato stumbled over the concept of open inquiry as he held to the belief that only a few need be “enlightened” with knowledge facilitating the creation and formulation of a “wise elite”. Indeed, this world view may in part, have given rise to the imposing concept of separate “magesteria” eloquently described by Stephen J Gould as he made the case, I think erroneously, for separating religion and science as individual bastions of knowledge.

Critical thinking skills to this day have yet to be acknowledged as indispensable components of an inquiring and open society. Notwithstanding we, as a society, need to find effective techniques for teaching these important skills to our youth. Creating models and methods that stimulate people to learn and think effectively under varying conditions may help reduce some confusion within the context of, for example, science based medicine and open venues of understanding and tolerance.

Unfortunately, this implies that the society from where true thinking springs and thrives is indeed an open one. Not all societies fit this description. Such an open society has the resilience and confidence to evaluate itself, sometimes quite critically without resorting to suppression. There have been some encouraging advances and perhaps our current democracies will give way to ever superior open societies.

From humanities perspective, attaining a truer understanding of the balance and evolution of science, medicine, culture, religion, and government becomes a necessary and achievable goal in an increasingly global world. Indeed, this may be our only ticket to survival as a species.

Ref:
De Bono, Edward. Thinking Course. Barnes & Noble. New York. 2005.

www.religiousworlds.com Rosenthal, Stan. Introduction. Taoism information page. Accessed 4/27/06.

www.geocities.com/paulntobin/bibleanalysis.html#bibleintro The Rejection of Pascal's Wager. Accessed 5/29/07

en.wikipedia.org/wiki/Talk:Qur%27an wikipedia

www.criticalthinking.org. The thinkers guide to fallacies. 2004. Accessed 2/14/06.

The Monkey Trial

As part of his high school final theatre exam, my son needed to choose and act out a segment from a selection of several famous stage scenes. To my pleasant surprise he chose a scene from the “Scopes Monkey trial”.

In “Inherit the Wind”, a fictionalized version of the 1925 Scopes trial, Clarence Darrow defense lawyer for John Thomas Scopes makes the case for intellectual freedom and of holding on to some reason in an often far too irrational world. In times like today, these scripted words seem strangely appropriate ….

“The individual human mind. In a child’s power to master the multiplication table, there is more sanctity than in all your shouted “Amens!”, “Holy, Holies!” and “Hosannahs!” An idea is a greater monument than a cathedral. And the advance of man’s knowledge is more of a miracle than any sticks turned to snakes, or the parting of waters.....Darwin moved us forward to a hilltop, where we could look back and see the way from which we came. But for all this view, this insight, this knowledge, we must abandon our faith in the pleasant poetry of Genesis. If not, why did God plague us with the power to think? Mr. Brady, why do you deny the one faculty which lifts man above all other creatures on the earth; the power of his brain to reason. What other merit have we?....."

Acupuncture Point Physiology 2007: still mirages in the desert

Acupuncture efficacy has been under increasing scrutiny during the last several years. Although there are scant good quality studies regarding actual mechanisms of action and associated physiological mechanisms, there seems to be no shortage of recent investigations discussing specific acupuncture point effects as well as at least one apparently newly proposed theory of acupuncture mechanisms.

A variety of recent reports discuss the effects of acupuncture point (AP) therapy on varying conditions including beneficial results of AP on canine toxicology , the reduction of hot flashes in menopausal women, and anxiety related hyperventilation syndrome. Other studies review the composition of anatomical areas relating to specific AP in an attempt to associate them to some larger physiological effect.

Although the implications of many of these studies are potentially interesting, it is important to note that the origin of much of this research raises major concerns. Many of these studies are published in sources such as the Journal of Alternative and Complementary Medicine, BMC Complementary and Alternative Medicine, or originate from countries implicated in significant research bias. Complementary and alternative medicine (CAM) is not immune from interpretive problems and questionable evidence.

In addition, there are continuing attempts to relate AP sites directly to physiological effects that can influence disease processes. A recently published study “A musculoskeletal model of low grade connective tissue inflammation in patients with thyroide associated ophthalmopathy (TAO): the WOMED concept of lateral tension and its general implications in disease” claims, among other things, to establish a real link between acupuncture sites and the treatment of musculoskeletal disease. This 2007 paper caught my eye because there is an attempt to link specific AP sites to at least one disease if not to many diseases by implication. This is a paper many in the CAM arena might jump on and run with.

The study supports the familiar concept of combining a spectrum of loosely associated findings such as inflammation, biochemical mineral abnormalities, and posture associating them with an “integrative” medicine philosophy.

“The WOMED concept of medical care can be summarized as an integral care of the individual. Within this concept elements of TCM and Western medicine are intermingled. Some of the evaluation parameters used in each patient are posture, locomotion, structural cohesion, previous infectious diseases, nutrition habits, nutritional status, internal medicine evaluation, and gynecological evaluation when needed. In addition to this both endocrinological and immunological aspects are included. Examples of this medical approach have been published.”

This approach becomes much stranger on closer inspection. One of the published medical approaches referenced is replete with pseudo science. It seems the very foundation of WOMED and any implications towards a new theory of acupuncture point anatomy or efficacy is based to some degree on older “holistic” concepts that comprise a confusing litany of unsubstantiated links.

One of the alluded to references “New diagnostic and therapeutic approach to thyroide associated orbitopathy based on Applied Kinesiology and homeopathic therapy, Altern Complement. Med 2004” uses two unrealistic CAM approaches as the basis for the study. Remember this is a paper with which the WOMED authors use to support their medical philosophy.

One interesting 2007 study however was published in the American Journal of Chinese Medicine by a more reliable group with regards to objectivity. The research group, including Ernst, a well known CAM supporter who applies critical evidence base research techniques when evaluating alternative medicine, concludes that acupuncture's effectiveness continues to be “controversial” , finding some emerging evidence implying support that acupuncture is effective for some conditions. This is hardly neither impressive nor conclusive information for establishing acupuncture as a well defined modality.

To date, there is no new information that can clearly define what an acupuncture point is or that there is any difference between “needling” anywhere on a body or on an AP. Additionally, the phenomena of counter irritation, natural inflammatory responses to a foreign object, and placebo effects among others seem plausible explanations for any perceived AP, non AP, or sham AP exercises.

Therefore, as information regarding AP technique, physiology, and theory continue to be reported, it is critical to step back and allow this information to be processed and filtered through scientific analytic methods so that coherent and significant information can be properly interpreted.

Applied Kinesiology: imaginary diagnostics

Recently, I have been presented with inquiries regarding the use of applied kinesiology (AK) in animals. Though this fringe practice does not come up very frequently among the back ground noise of alternative medicine discussions I have (acupuncture and chiropractic being more common) it does provide a clear example of the power of the placebo effect in action.

Not surprisingly, there is little detailed information about the use of AK in animals, though I have looked at manuals and diagrams designed for small animals. What I have seen has been adapted “a la” acupuncture point method transposing techniques, in this case, from human AK literature based on a theory created by a chiropractor named George J Goodheart, Jr in 1964.

This pseudo medical modality, well described in critiques by Dr Barrett and others, is based on the notion that organ dysfunctions are accompanied by specific muscular weakness. This enables a practitioner to detect pathologies through a bizarre series of techniques generally involving “tasting” possible causative agents (i.e., suspected allergens), placing them on the patients’ body, or using surrogates in the case of children or animals. By testing muscle strength (i.e., resistance to pulling down a raised arm) in the patient or surrogate and often utilizing a meridian chart reminiscent of acupuncture, the practitioner can detect these presumed pathologies.

Barrett notes that a surprising number of practitioners use this technique in some form siting survey numbers from 1991 up to 1998 at or above 30% for chiropractors. Although usually practiced in the realm of chiropractors, naturopaths, and “nutritionists” some medical doctors and veterinarians utilize AK in their practice. The results of a given treatment can be readily confused with other unrelated phenomena. This illusion is related to placebo effect and non placebo effect components of perception including psychosomatic perceptual illusions affecting the practitioner, patient, or surrogate.

It is interesting to note that even the International College of Applied Kinesiology seems to qualify this practice with certain standards claiming that only the stimulation of gustatory receptors of the tongue or olfactory receptors represents true AK. Additionally, the college recommends that AK should be used as an adjunct to other diagnostic modalities, a common pseudo medical "addendum". These are typical tactics alternative medicine practitioners often use in order to cloak a given non conventional procedure with a veneer of credibility.

Not surprisingly, studies relating to AK practice reveal its “effect” to be random placebo related phenomena. Like many other alternative techniques, different practitioners produced different results in diagnosis and treatment.

In veterinary medicine, similar “qualifiers” can be found relegating AK to adjunct roles in alternative practice. However, in spite of these disclaimers, the practice is not excluded or disregarded as ineffective. In fact the Veterinary Institute of Integrative Medicine web site has a post discussing the “pros and cons” of AK and generally places it within the realm of blood chemistry analysis and radiography!

This strange article is replete with false associations, assumptions, and fallacious reasoning that may serve as fodder for another post. For example, most people may not interpret AK correctly because:

“Most people have not reached that level of personal growth where they are totally non-judgmental and are willing to leave the results of the treatment up to the animal, or the universe, or God or whatever you want to call the higher power. Practitioners often feel responsible for doing the healing.”

Additionally, it claims that “allopathic" medicine relies on ancillary diagnostics over and above the history and examination:

“The basic philosophy behind holistic medicine is to get away from the crutch of the blood test, the x-ray, and the technologically-derived diagnosis and to develop a sensitivity to the animal and its whole self. The more the muscle testing is relied upon and not sensitivity to the animal, complete histories and physical exams as well as intuition, those items that we should be particularly good at as "wholistic" practitioners, the more the muscle test becomes another blood test or x-ray.”

This is in complete contradistinction to the very definition of the study of Semiology a crucial part of medical training involving the study of signs and symptoms* of disease which implicitly teaches the importance of the physical examination and history. This creates a false straw man version of “that other” allopathic approach.

The essence of the practice of AK in animals and humans relies on implausible assumptions and misinterprets many other phenomena including variable explainable events that are part of the natural history of disease as well as the ever intoxicating placebo effect. AK is a delusional pseudo diagnostic modality that should be avoided.

*Animals can not relay symptoms

One Hominids Path: from sound to symbol

To gain any understanding of how it is humans are "human", it helps to step back a moment and take in all the “madness’- images, histories, emotions, logic - of "us". Searching for threads linking who we are today back through to our distant evolutionary past can shed light on understanding "humanness". The unique blending of community, language, and sensory/cognitive perceptions that is the homind story has, through the eons, come together to create a unique human community.

If you think about it, on our own, as animals go, we are fairly weak, ugly, hairless little primates that would have pretty low odds for survival on our own. Put a bunch of us together, however, and things change. Humans are amazingly gregarious and seem to posses a powerful capacity to exponentially increase our survival capacity by coming together. Like the primordial coming together of cellular colonies to produce a more effective whole, human civilization seems to be another manifestation of possible outcomes bubbling out of the ever changing cauldron of the force of natural selection.

Among the many supreme and awesome varieties of living organisms that have risen and fallen, it seems, this little hominid; Homo sapiens, may belong to a unique group.Whether an accident, freak anomaly, or more likely just another possible direction for natural selection to take, humans have stumbled upon a supreme survival tool- the ability to communicate with empathy for their brethren. That is, to communicate an infinite amount of meaning through language to other humans, while at the same time having the capability to be in some else’s head; to imagine how they think and feel- these are huge jumps in informational capacity that truly makes us unique.

If you think about it, this evolutionary development created a virtual world, like a computer game, where perceived objects and instinctual reactions to danger for example, were progressively transformed into ideas, theories, social constructs, beliefs, and a profound capacity for creating meaning and possibilities.

This plays a profound role in our societies and seems to have spun off a variety of side effects or by-products that have varying degrees of importance depending upon the circumstance of a given group, culture, or nation. Religiosity, national patriotism, sport affiliation could all be considered differing forms of cooperation stemming from the human ability to communicate ideas to others while at the same time imagining what others might be thinking. The roots of empathy, love, society, tribalism…etc., to some extent, have deep roots here.

To understand the flow from simple reaction; from grunts and gesture, to the infinite flow of information of today’s human language provides insight to what we are and how we came about in a rather hostile and contingent environment. To some degree, this trick of language, this jump from immediate moment to moment perception toward an ability to project mentally into a future, or examine possible futures when making decisions lies at the core of what it is to be conscious in a human sense.

Imagine a species that reacted to an immediate danger. Rita Carter^* describes this reaction as a direct result of actually seeing the danger. Through time this quality could have favored individuals who were better able to “read” danger by hearing or seeing warning signs, like the rustling sound of a predator and reacting to that instead of waiting to actually see that danger.

Through the force of natural selection and time, this species may have developed sophisticated capabilities of warning and reading each others reactions and movements in anticipation of danger. From here, having basic reactive meaning to communicative barks or grunts is easy to imagine.

A short evolutionary jump would expand meaning and elaborate “reading” an individuals reactions and emotional states progressively favoring ones survival odds. Combining these traits with other unique hominid evolutionary circumstances such as bipedalism and the ability to gesture with hands could have given the hominid species a toe hold towards a whole new level of interactive communication that took off.

Comparing the communication capabilities of differing animals helps to understand how human language is constructed as well as how it might have come about. A lot of the basic evolutionary literature regarding language deals with the tactics of communication in different species. A common thread is that, although some species have remarkably complex combinations of sound, they are fairly limited in flexibility especially with respect to creating syntax, or flexible meanings to words and phrases. In order for there to be interactive and meaningful communication, it is essential that there are basic and consistent rules in place that provide a foundation from where humans “agree” on a general framework.

According to Deacon,^** there are three basic elements that characterize human language and that make it unique in the animal kingdom. This framework jelled and coalesced through time and the force of selective attributes favoring survival. First, there needs to be basic units of language, such as vowels, that provide the building blocks for more complex structure. A crucial characteristic of these units is their inherent lack of meaning.

Second, groups of these building blocks can be grouped together forming a meaning, for example, as words describe objects in the natural environment. These grouping are described as “morphemes” by Deacon and provide a basic language structure. Some species, however rudimentary, attain a form of morpheme language. Vervet monkeys have a repertoire of sounds that correlate directly to specific predator animals. Humpback whales will string together long songs of elements that have a resemblance to phrases, but do not have the structure or coherence defining any clear meaning. They seem to be more related to procreation, mimicry, and competition, varying and changing in sound combinations and order from season to season.

The third quality for truly expressive language as contrasted to more basic reactive communications is the ability to put these morphemes into groupings that begin to symbolize the world. This is uniquely human and opens the door to developing cognitive capacity for projecting into the future, or imagining what others are thinking- the possible building blocks of society, religion, and culture.

Associated with this expansion in communicative ability, there coincides a fascinating series of evolutionary developments in the human brain. Unlike other animals, the human brain has an asymmetrical arrangement with a large region in the left hemisphere dedicated to language and meaningful symbolic communication.

This asymmetry seems to be the result of a progressive interaction of hominid social development through the eons. Areas in the left hemisphere in the temporal and frontal lobes dedicated to environmental sound and spatial direction were slowly co-opted by areas dedicated to motor speech, meaning in language, and complex connections to deeper parts of the brain have developed including to limbic and cortical areas implying a cohesive relationship between consciousness and language. These language centers process sensory stimuli, such as hearing and touch bringing them together and reassembling them into coherent memories. Other animals do not have a language center like this and their sounds are processed along with environmental sound and spatial direction.

It seems human language came about in a region where several important and different functions converged. These functions may have merged through human evolutionary pressures combining for example, hand gestures with sound and these to sensual memories that later became virtual symbolic thinking. This would have created the conditions for the human brains asymmetrical set up as language centers “rearranged” areas of the brain. Other areas influenced these processes such as the prefrontal cortex involving the ability to infer about another persons’ state of mind and suggests how and where empathy and cooperative behavior may have evolved.

The evolution of language probably has been tied to several developmental changes in the human brain and it is likely that our consciousness, our human consciousness is an intimate part of this process either as a “by-product”, or a natural emergent quality of the brain.

This incredible journey of sound to symbol in human evolution is well summarized by Rita Carter:

“Just as each separate brain cell reaches out to make contact with others, so each brain is designed to communicate with its like. Our ability to enter the minds of others , by intuition and by speech, gives human beings a singular advantage over other species. It allows us to create and live in the highly organized hives we call civilization, and as a species we can join in endeavors so grandiose that they alter our environment on a global scale.”

Ref: *Jones, S, Martin,R, et al. Human Evolution.Cambridge Univ. Press. Cambridge,UK.2005

**Carter, R. Mapping the mind.Univ. of CA Press. LA, CA.1999

Skeptics' Circle

The 61st Sepics' Circle is up at Memoirs of a Skepchick. Go & partake of some great reading!

12 Tips for Recognizing Solid Research and Real Science

(oldy but goody)

Sandy at JunkFood Science has put together a nice list that can help if you are often frustrated by confusing and frequent contradictory studies. Having a basic and reasonable framework from where to start can reduce a lot of headache.

Check it out then make your own list.

Free Trade Medicine: Let The Market Decide?

Towards a dangerous anarchy

Once upon a time, the world of US medicine was very different. As recently as the 19th century medical practice was a chaotic quagmire of often bizarre modalities each competing one against the other in a "war of each against all" for unwitting patients. This was a medicine where blood letting, faith healing, herbology, healing elixirs, potent tonics, and homeopathy were among the many choices available for the prospective patient. It was a time of little consensus and even less theoretical agreement among a heterogeneous mass of "practitioners" each plying their wares, spells, and potions to a clueless public. This era in the United States is a reminder of disjointed "pre-enlightenment" periods of other cultures and could be safely described as a form of anarchy. Add to this that none of these practices were evidenced based, and you can get an idea the sorry state of affairs medicine was in.

This was before the dominance of evidence based and scientifically trained physicians, that in the 2oth century revolutionized an aimless and ineffectual medicine into a results oriented proposition that quickly gained the acknowledgement and respect of the general population and won hard earned government support. Since that time, the medical profession has gained a special status and position in large part due to demonstrable effectiveness. This position, however, is being challenged by those who support a "freedom of choice in medicine" arguing that the special societal status of science based medicine impugns this basic right.

Indeed, there is a movement successfully inserting alternative non science based medical practices into science based strong holds such as governmental research projects, hospitals, and even medical schools. It is helpful to get an idea of the 19th century societal environment that was so conducive and fertile to the state of medicine of the time as this provides insight into today's issues.

Social attitudes and historical precedents supporting medical anarchism

A study by K. Patrick Ober on the status of 19th century medicine before the dominance of evidence based medicine provides a unique insight on the mindset of the times. According to Ramey & Rollins:

"...the proliferation of medical modalities was to an extent a reflection of Jacksonian democracy and its bias against special privilege. Legislative favoring of any approach to medicine was seen as limiting choice. Control of medical licensure by state legislatures had almost disappeared by 1850, and the resultant "free trade in medicine" allowed for anyone to practice regardless of qualification or training."

In addition the success of "Adam Smith's theory of laissez-faire economical free enterprise combined with Mills classical liberalism" together created an unrestricted form of free enterprise that shied away from any form of regulation. In other words, the philosophy of "let the market decide" took a firm hold in this societies mindset.

The problem though is, as noble as this idea may be, it has limits as the disastrous and dangerous medical anarchy of the times demonstrated. As Ramey & Rollins suggest, when it came to medicine the stakes were too high. People were not buying or selling goods, they were playing a game of life and death. It became apparent that the benefits of having a reliable knowledge base used by a group of responsible providers far out weighed the attractions of "freedom of choice" in the medical context.

Supported by certain organizational rules and expectations along with dependable funding, the development of modern medicine took hold. The rumblings of "free choice" promulgated today by many in the alternative medicine arena does not take into account the hard lessons learned from this recent past.

The Bottom line is responsibility

As I discussed in a previous post, science based medicine is not without its problems. Every effort should be made to maintain a science based methodology allowing for the examination of new or old practice modalities for effectiveness. To date, a science based approach has allowed for an overall process that sooner or later accepts what works. The bottom line is that the medical community has a basic and foundational responsibility to practice effective medicine. As Ramey & Rollins notes:

" The alternative to establishing science-based practitioners as the socially accepted filters of medical therapies is medical anarchy. However, while such anarchism is in some respects attractive on its face, it is ultimately unacceptable for a variety of reasons. It would leave no rational decision procedure for choosing among competing therapies. Society, on reflection, is unlikely to want such a state of therapeutic anarchism"

I only hope that this optimistic outlook for our societies judgement holds true. It is up to the science based community to share their knowledge and educate the public regarding the importance of evidenced based science so that we may avoid repeating mistakes of the past.

ref: Complementary and Alternative Veterinary Medicine considered. Ramey,D,Rollin,B. Blackwell Pub. Iowa.2004

Hello Gertrude Weise

"Spirit and its twin rover, Opportunity, completed their original three-month prime missions in April 2004. Both are still operating, though showing signs of age. One of Spirit's six wheels no longer rotates, so it leaves a deep track as it drags through soil. That churning has exposed several patches of bright soil, leading to some of Spirit's biggest discoveries at Gusev, including this recent discovery."

The Mars rover Spirit continues its amazing adventure of exploration at Gusev Crater, this time discovering possibly the best evidence yet that the dry planet was once wetter and more amenable to life as we know it. Spirit's crippled wheel exposed a patch, affectionately named Gertrude Weis so rich in silica that it scientists believe water must have played a role in forming it. The incredible tale of this rover as well as its sister, continue revealing martian mysteries for humanity to contemplate and consider.

More on Vitamin Study

Junkfood Science has a nice post regarding the epidemiological vitamin study I discussed recently. She did a much better job of pinning down some important concerns relative to the whole concept of these types of associative research studies and noted an interesting finding regarding vitamin use in general.

A bottom line conclusion when analyzing this study is what is not noted. If you consider that a broad "end point" here concerns benefits of vitamin and supplement intake then you will note that there aren't any.

This eloquent "evidence of nothing" conclusion succinctly sums up one underlying issue concerning supplements that paints a bigger picture than one studies finding. This perspective is helpful and also provides some added tools when examining the mountains of information out there when searching for meaningful information.

The Scientific Endeavour

Adventures in Ethics and Science has an interesting post on the apparent cynicism some have regarding the often cumbersome process of how science is done. In essence if you think about it, it is very difficult to get anywhere with any group of a determined, mostly intelligent, and stubborn group of people no matter what their stripes and qualifications.

The scientific community is by no means immune from the vagaries and pettiness of the human condition. There are a broad swath of problems that tends to beset any large institutionalized community and this one has its share. Concerns ranging from publication biases, publication inaccuracies, and peer review quality makes true progress towards clear relevant scientific knowledge harder.

What is unique about this human community though is that there are self correcting mechanisms that sooner or later steer it's sometimes meandering and distracted direction toward substantive truth. Through all this often frustrating process there is reason to hope and take heart that the critical and unique qualities of the scientific community can keep it from becoming a brittle and barren place, like the fate of so many other human endeavors.

Some of these qualities are:

• Question everything.
• Share information.
• Hold that information as a tentative true reflection of reality until or if something comes up that better fits the "puzzle" of all accumulated information.

These qualities provide encouragement that, in spite of our human frailties, there is good reason to continue and strive for a reasonable truth using these very human scientific methodologies.

A lot of what can happen to this noble endeavour is up to all of us. As Janet's post notes:

"I don't think we can have it both ways. I don't think we can trumpet the reliability of Science and wallow in cynicism about the actual people and institutional structures involved in the production of science."

It seems to me, that if we can continue to espouse the very qualities that define the scientific endeavour in our daily work then we will contribute significantly to a truly worthwhile, robust, and trustworthy human scientific community.

Tribute to Carl Linnaeus

This week marks the three hundredth birthday of Carl Linnaeus, father of modern biological taxonomy. Thanks to his organizational skills, supported later by Darwin's masterpiece "On the Origin of Species", humankind was better able to comprehend life's profound inter relatedness.

Linnaeus's original seven ranks of life has become a far more complex "Tree of Life" today as a result of DNA analysis, burgeoning into a massive weave of bushy lineages. Even if eventually, his ranking system gives way to another type of ranking system that increasingly utilizes evolutionary DNA relatedness for organizing life, Carl Linnaeus and his contribution to science will be celebrated through the ages as one of the greatest biological achievements in history.

Herbs, Botanicals, and Animal Product Therapy

A closer look

On its face, the concept of receiving therapeutic treatments from whole natural sources such as plants or concentrated food sources makes intuitive sense. After all, observational studies and general sound nutritional recommendations support eating a balanced whole food diet. Receiving our nutritional needs through this natural and simple approach really seems to benefit an individuals health.

Additionally there is a long historical precedent for the use of botanical and animal substances to treat and alleviate maladies. The history of human culture is replete with mention of the use of medicinal herbs and plants, as well as animal organs, bones, and other accessory appendages for the treatment of many varying afflictions.

Why not then, use substances that combine these concepts, such as utilizing herbal treatments, or animal parts that contain a plethora of elements that work together "synergistically" to heal? Seems sound- until you take a closer look.

Unfortunately, there is a wide chasm between the superficial perception of botanical and animal therapeutic use and actual reality. There is also a lapse in critical observation as an illogical thread is created between the use of many of these substance and efficacy. In essence, as beautiful as these concepts may be, they are tenuous mirages of ideas that seem to take on the trappings of a belief system more than a treatment practice.

Consider the observation that in times when herbal, botanical, or animal products were widely used there was no measurable improvement in general human health. Mortality and morbidity for 19th century cities were in general the same as those of preagrarian societies. This life span hovered at around the mid thirties in spite of plant and animal therapies. In other words, Paleolithic societies had the same life expectancy as the many diverse cultures and societies that followed until the advent of scientific methodologies in the 20th century.

Another important observation is that these botanical and animal products would seem far more attractive to many of the other archaic practices in existence in those times. Treatments such as blood letting provided a harsh back drop and powerful impetus to search for other more benign forms of therapy. Knowledge of disease etiology, pathology, and biological infectious processes were basically unknown to healing practitioners of these times and treatments had largely random results that focused on symptoms more than treating the cause of disease. It's no wonder that the "more benign" herbal or whole medicinal approach took root. It is easier then to trace and better understand the origin and enduring popularity of today's botanical, herbal, and animal therapeutic products.

The problem though, is that things have changed since these prescientific days. The 20th century discovery and implementation of scientific theory was a true "medical enlightenment" that gave light to a dramatic shift in general populational health and longevity. A new branch of medical practice began to pin down what worked and what did not. Many ancient practices were discarded, others refined, and still others incorporated into a new armamentorium of therapeutic practice. This robust process continues today as our understanding of biology, physiology, and genomics sheds more light on disease and how to treat it.

Although many herbals, botanicals, and animal products may have several different kinds of physiological qualities including anti inflammatory, antibiotic, and hormonal effects they are often broad and difficult to pin down. It is important to realize that the source of these products are from animals and plants that are evolutionarily geared for the survival of their own kind. The sum total of a plant or animal contains the constituents that favor there unique biological needs.

Many of these substance are toxic or noxious to humans. That we, as human healers, can find beneficial compounds or elements in the environment is a function of luck. How these substances actually interact with our own physiological make up will vary. In other words, using a whole plant product for treating human disease implies that there may be indeed be some therapeutic action, but there are likely toxic elements to consider as well. The scientific foundation of evidence based medicine provides a consistent methodology that effectively considers these issues.

The history of medicine is replete with archaic, harsh, and brutal therapies due mostly to the fact there was no method to discern knowledge of disease from opinion, myth, and magic. Rumblings of modern medicine can be found in the idea of botanical, herbal, and animal product usage, though it is for the most part archaic. Modern pharmaceutical practice, in many ways, can be reasonably considered a refinement of this ancient practice.

Some thoughts and concerns about using herbal, botanical, and "whole" animal products

When considering some of the problems with many "whole" herbal or animal products, three important general concerns are:

1) Using "whole" products. There is some evidence supporting the idea that there are synergistic and buffering actions when using unpurified extracts of plants for example. However, these are limited observations making it difficult to generalize to all products. In addition, many products are not tested for consistency and active ingredients. The companies that do these tests still use ingredients that do not have evidence based efficacy, or that have limited and anecdotal efficacy. (This does not even broach the subject of toxicity and adulterated products)

2) Combining herbs, botanicals, and animal products. Again, the concept of synergy and buffering is claimed to produce a potentiated effect above what only one substance could produce. This concept has roots in the idea that the cause of many diseases were unknown and many "whole" therapies focused on symptoms rather than causes. Again, there is little evdence to support these claims. Today, many treatment approaches are discouraged as pharmaceuticals are often very specific and well targeted to the problem.

3) Diagnosing disease. Many "whole" product practitioners use archaic or unproven alternative practices that focus more on belief, magic, and opinion than a true problem solving science based diagnostic methodology. These diagnostic modalities often focus on generalities such as "toxins", "stressed organs", or accumulations of noxious materials in the gut instead of an actual pathology.

These practitioners also often encourage the concept of eating wholesome foods, exercising, and avoiding unhealthy habits- all sound recommendations. The problem is many diseases require an actual diagnosis to be properly addressed and the illusion of the placebo effect can lead to inappropriate treatments beyond general healthy advise.

In general, the advances of modern evidence based medicine has been able to discern and understand the process of disease much more clearly than in the past. Many older treatment concepts have passed the critical eye of modern medicine while many others have been discarded. This process continues today.

Many ancient and archaic healing practices that have little evidence based efficacy have waxed and waned in popularity even before the advent of modern medicine in the 20th century. The practice and use of "whole" herbal, botanical, and animal products has roots in prescientific history where other harsh ineffectual methods were in practice.

That these therapies seemed benign then contribute to their popularity today. Combined with the gentle and "holistic" promise of today's alternative medicine, they remain popular. However, our present day understanding of biology, physiology, evolution, and pharmacology brings more questions and doubts than answers regarding any place for these products in today's medicine.

ref:

Natural Medicine Comprehensive Data Base

Complementary and Alternative Veterinary Medicine Considered. Ramey, D, Rollin ,B. Blackwell Pub. Iowa. 2004