Can a paradigm shift like this actually have any effect on my human immune system? Can psychological, neurological, pharmacological, and environmental stress impact on individual and societal immune competence? You bet! But what are children really learning? Most biological and health care educational programs are mired in a mechanistic foundation consistent with a culture of "science-based intellectuals"1 intent on generating a distrust and disdain for information and individuals from that other persuasion. Hence, the need to embrace our educationally malnourished children with a mechanistic vitalism beckons from the mire.
As you know, mechanism (reductionism) has characterized health care and education of health professionals, including most chiropractors, this century. Mechanistic systems are characterized by possessing the following: a hierarchical approach, categorization, either/or thinking, patients/victims as diseases, curatives, and a dismissive attitude toward mind/body interactions.2 Vitalistic (holistic) systems are characterized by utilizing the following: a cooperative approach, individualization, both/and thinking, patient responsibility, imbalance healing, and mind/body interactions.2 Cassidy's 1994 article provides an excellent review of these paradigms and the superiority of the holistic approach for the future of health care.
Reductionists such as allopaths view the human body within a limited framework in which chemistry, structure and function mutually interact. Pathology and disease management occur with chemical and/or structural intervention to affect function. Vitalists retain the mechanisms of bodily systems, but acknowledge the direct influence of energy/information, i.e., energy/information-chemistry-structure-function. The profound realization emerges from appreciating that chemical and structural alterations directly affect the energy/information component. Therefore, patient management focuses on the entire individual. They are not simplistically viewed as disease entities or spines to adjust. Gerber's Vibrational Medicine reviews the wealth of scientific evidence supporting energy/information roles in biologic systems.3 Integrating data from quantum physics, physicians such as D. Chopra, L. Dossey, B. Siegel and L. Laskow witness to the emergence of yet a third paradigm of health care based on our connections to a universal mind, a collective consciousness.
Mechanistic science and medicine refute any notion of energy/information affecting or being affected by the body. Their paradigm disallows its incorporation. On the other hand, vitalists who conform to a "faith-based fundamentalism" accept the energy component (i.e., innate intelligence) and ignore the rest. Both cultures exemplify either/or thinking, resulting in what the medical anthropologist Robert Anderson describes as a "cultural schizogenesis."4 The popular impression, Anderson delineates, labels chiropractic as "anti-science" and medicine as "pseudo-science."4 The global impact of health care practices such as vaccines and antibiotics, therefore, varies dramatically with each frame of reference. People have learned that neither side has all the answers, and neither side alone can be trusted.
I often wonder what our children and grandchildren will think about the biological education and health care foci during the 20th century. How blind and stupid you were! Clueless! Einstein provided evidence in the early 1900s to satisfy the evidence-based mechanists. Energy equates with matter directly. Unified fields are scientific reality. Mechanism is obsolete. So what did we do with this information? Well, it took us four decades to figure out how to incinerate each other with this information, and another 50 years to clue in on the role of energy techniques for healing and system imbalance determinations. The chiropractic energy concept of innate intelligence survived a 100 years of berating, despite the Einsteinian axiom to support its existence.
The ability of energy/information to influence the nervous and immune systems was incorporated into the concept of psychoimmunology in the 1960s. The concept reached textbook status with the superlative work of Ader, Cohen and Felten in 1991.5 The discoveries in the 1980s of receptors on T cells, the control cells of the immune system, for neurochemicals as well as receptors in the brain for immunochemicals, proved that the two are in concert and can modulate the functions of both systems.
In spite of the scientific evidence, mechanistic scientists and physicians continue to dismiss the psychoneuroimmunology (PNI) concept. PNI does not enjoy a place in medical, osteopathic, or chiropractic curriculum. The microbiology and immunology text adopted by the chiropractic colleges provides a brief mention of the PNI concept,6 but the college instructors have no clue of how to begin teaching such a radical concept. These instructors, like myself, were taught that the nervous and immune systems were separate and distinct.
Furthermore, the PNI concept conjures a notion of witchcraft and voodoo. In spite of evidence to the contrary, special immune system reviews in National Geographic7 and Scientific American8 present the immune system as a totally autonomous and independent system with no mention of the decade old discoveries of the PNI concept. David Felten perhaps summarized it best when he stated that the bad news for immunologists, neuroscientists and endocrinologists "is that now we have to start talking each other's language. And in the past, heaven forbid that immunologists and neuroscientists would ever use each other's language. They'd rather use each other's toothbrushes. But that's no longer a viable approach. We have to learn how to talk to each other and to educate each other."9 Reluctance to breakdown the barriers of basic science compartments and incorporate holistic scientific concepts into biologic and health care education continues. The resulting educational disservice especially compromises the chiropractor's ability to properly educate their constituents. The impact of vertebral subluxations on body energy fields and functions (and vice versa) needs to be learned, taught, and researched.
Holistic scientific concepts direct us at this point to consider the impact of vaccines and antibiotics on PNI. However, research remains limited to only the immune system, and even those studies are limited. Pertinent immunologic evidence delineating the differences in T helper cell, interleukin, and cytokine responses to natural infections as compared to artificial immunization have not be done. Safety and efficacy studies on the fashionable use of vaccines in combination have not been done. The attitude for their implementation, in spite of insufficient evidence in support of their use, seems to be to let the vaccines loose on society and see what happens.
The Vaccine Safety Forum of the Institute of Medicine, an adviser to the federal government, has recognized that children are exposed to vaccines at an age when medical, genetic or congenital factors are manifesting. Yet these contraindications to vaccination are not ascertained beforehand.10 Safety and efficacy data on vaccines used in combination has skipped scrutiny prior to implementation. Adverse events associated with vaccines are currently detected through the Public Health Service's Vaccine Adverse Event Reporting System (VAERS).11 However, with only an estimated 10% of actual adverse events being reported, coupled with an inability for rapid follow-up, damaging vaccines remain on the market. To date, no vaccine lot has ever been recalled by the government or drug companies.
The Vaccine Safety Forum has provided some explanation for the paucity of adverse event reporting by indicating that public health surveillance measures are passive in nature, resulting in underreporting. Surveillance measures are usually aimed at detecting a single specific disease outcome or adverse event following exposure to a single agent.12 Current surveillance methods are not equipped to manage reports of adverse events following the use of vaccines in combination. Meager vaccine side effect reports also result from a medical mind set that "What can't be won't be," coupled with a fear of legal liability for recognizing an adverse event. Biology and health care students need to learn what the Institute of Medicine has determined to be the "demonstrated" adverse events associated with childhood vaccines: death, encephalopathy, demyelinating diseases, brachial neuritis, Guillain-Barre' syndrome, infections generated by vaccine agents, anaphylaxis, subacutesclerosing panencephalitis, seizure disorder, optic neuritis, arthritis, transverse myelitis, thrombocytopenia, diabetes mellitus, aseptic meningitis, deafness, sterility, susceptibility to infection, etc., and a multitude of sequelae still listed as "theoretical" due to insufficient research and report data.13,14 One of my students reacted to this list with the statement, "Oh, thank you, may I have another vaccine please."
A faith-based fundamental trust in vaccine practices continues to nourish the pseudo-scientific notion that vaccines are by their very nature sacramental. This paradigm is reinforced by pecuniary interests and research control by the drug manufacturers as reviewed by Rock, 1996.15 At the "Risk Communication and Vaccination" workshop this year, a consumer advocate summarized the faith crises mushrooming today. "Vaccine manufacturers, providers, and policy makers knew that there were risks associated with vaccine use when vaccines were first marketed but did not adequately communicate those risks to the public. Nor was it communicated that there was some uncertainty and disagreement about what was known. This failure to communicate what medical science does and does not know about vaccine risks was quite simply perceived as a fundamental betrayal of trust by those who were being asked to take the risks. When government and industry's media campaigns to achieve a high vaccination rate downplayed vaccine risks, there was further erosion of trust."16 Sage advise was offered by Jonas Salk regarding the preparation and use of the polio vaccine, which should apply to the preparation and use of all vaccines. "The objective in the preparation and use of a poliomyelitis vaccine cannot include the knowing or willful acceptance of a risk that is tangible, or measurable to any degree. Any risk that is involved, so long as it is recognized, must be corrected, whatever may be its cause." 17
Lack of trust also precludes consumers from adhering to the opposing "faith-based fundamentalism" which supports the chiropractic adjustment as the magic bullet for maintaining health and eliminating disease, thereby negating any need for vaccines or antibiotics. The fruit born of anti-science and pseudo-science education and practice is sour and spoiled. Another pin in the bubble of public trust directed to the science and practice of allopathic medicine erupts with the realization that 20th century medicine has accomplished little toward preventing and curing cancer and cardiovascular disease.
Although consumers have been fairly well insulated from the unsettling questions plaguing vaccine use, the microbial antibiotic resistance crises looms precariously close to home. Popular awareness of antibiotics losing their esteemed "magic bullet" status has catalyzed a fear and paranoia where individuals visualize themselves or loved ones entering the hospital for a simple procedure only to succumb to a fulminating, drug resistant staph infection. Science has taught us that, "antibiotic use, while contributing to the immediate demise of bacteria, serves to 'educate' microbes by establishing selective pressure that favors the 'smarter' bacteria, i.e., those that can resist the antibiotic."18 Mitchell Cohen predicts that "unless currently effective antimicrobial agents can be successfully preserved and the transmission of drug-resistant organisms curtailed, the post-antimicrobial era may be rapidly approaching in which infectious disease wards housing untreatable conditions will again be seen."19 This prophecy has been realized with the emergence of vancomycin resistant staphylococci and rifampin-isoniazid resistant tubercle bacilli. The continued nonjudicious use of antibiotics, often at the insistence of patients, renders Cohen's prediction of the 21st century a reality.
Furthermore, there are the documented risks of autoimmunity, allergy, immunosuppression, as well as nutritional imbalances, endocrinopathies, etc., following antibiotic use.20 Michael Schmidt, et al., provide an excellent review of the literature documenting the antibiotic crises as well as supplying holistic suggestions for restoring balance to a beleaguered immune system.21 Studies such as those compiled by Beach et al. delineate in animal systems the immunosuppressive effects, through three successive generations, of an initial immunosuppressive event.22 A harrowing implication of these studies unfolds with the realization that close to a hundred years may be necessary to reverse the immunosuppressive missiles launched at our kids this century.
In recapping the events of the 20th century, we can share with our kids the fact that although some battles against infectious disease were won with antibiotics and perhaps some vaccines, we lost the war. The magic bullet fantasy has played out. The adversarial notion of microorganisms threatening our health needs reexamination. Perhaps now we can incorporate the holistic view of the immune system serving to keep us in harmony with our environment. Liberating ourselves from a pugnacious, immunosuppressive, either/or mentality and restoring some semblance of balance with a cooperative, both/and approach must be the lesson learned and immediately taught. The time is right for chiropractic to acknowledge the disservice and destructive ends emanating from the conflict between "faith-based fundamentalists" and the "science-based intellectuals." Denying the strengths of both sides, as Stern and Black so eloquently express, leaves chiropractic to wallow in the mire of mediocrity. The kids will surely benefit and appreciate cessation of hostilities and "healing the division of the vision."23 Coupling a hundred years of vitalism with the scientific advances supporting the vitalistic paradigm, chiropractic can naturally spearhead the march into 21st century education and health care.
- Phillips RB. Division of the vision. Dynamic Chiropractic, July 14, 1997, p.26-27, 45.
- Cassidy CM. Unraveling the ball of string: reality, paradigms, and the study of alternative medicine. Advance: The Journal of Mind-Body Health Winter 1994, vol.10, #1, p.5-32.
- Gerber R. Vibrational Medicine. Bear and Company, New Mexico, 1988.
- Anderson R. Chiropractors for and against vaccines. Medical Anthropology 1990, vol. 12, p.169-186.
- Ader R, Felten DL, Cohen N. Psychoneuroimmunology. Academic Press, New York, 1991.
- Talaro K, Talaro A. Foundations in Microbiology. Wm. C. Brown, Dubuque, Iowa, 1993, p.417.
- Jaret P. Our immune system: the wars within. National Geographic June 1986, vol. 169, no. 6, p.702-736.
- Nossal JV, et al. Life, death and the immune system. Scientific American September 1993, vol. 269, no. 3, p.52-136.
- Moyers B. Healing and the Mind. Doubleday, New York, 1993, p.231.
- Johnson RB, et al. Vaccine Safety Forum, Institute of Medicine, National Academy Press, Washington D.C., 1997, p.3-4.
- Ibid, p.5-6.
- Ibid, p.5.
- Stratton KR, et al. (eds). Adverse Events Associated With Childhood Vaccines -- Evidence Bearing on Causality. National Academy Press, Washington D.C., 1994.
- Howson CP, et al. (eds). Adverse Effects of Pertussis and Rubella Vaccines. National Academy Press, Washington, D.C., 1991.
- Rock A. The lethal danger of the billion dollar vaccine business. Money, 11-12/96, p.148-164.
- Evans G, et al. (eds). Risk Communication and Vaccination. Institute of Medicine National Academy Press, Washington D.C., 1997, p.14.
- Salk JE. Considerations in the preparation and use of poliomyelitis virus vaccine. J. of the American Med. Assoc. 1955, 158, p.1239-1248.
- Welch GH. Antibiotic resistance: a new kind of epidemic. Postgraduate Medicine, 1984, 76:6.
- Cohen ML. Epidemiology of drug resistance: implications for a post-antimicrobial era. Science 1992, 257, p.1050-1055.
- Witkin SS. Infections in Medicine May/June 1985, p.129-132.
- Schmidt MA, et al. Beyond Antibiotics. North Atlantic Books, Berkeley, CA, 1994.
- Beach R, et al. Persistent immunological consequences of gestational zinc deprivation. Am. J. Clin. Nutrition 1982; 35, p.579-90.
- Stern N, Black D. Healing the division of the vision, part 1. Dynamic Chiropractic, Sept. 8, 1997, vol. 15, no. 19, p. 10.
Stephen C. Marini, MS, DC, PhD
King of Prussia, Pennsylvania