Trying to Prove a Fairy Tale

Trying to Prove a Fairy Tale

Many pseudo-medicinal interventions have an origin story. Ear acupuncture was discovered when it was noted that a patient had relief of back pain with a burn to the ear. Iridology was based on the changes in the iris noted in an owl with a broken wing. And there is being bitten by a radioactive spider or too much gamma radiation. Wait. Those last two are from comic books, not that you can tell from the content.

Perhaps the most famous origin story is that of DD Palmer and chiropractic

 

The founder of chiropractic, Daniel David Palmer, constructed a model of causation of disease based on his seminal experience with a patient, Harvey Lillard, who lost his hearing at the instant of injuring his upper back, but had his hearing restored suddenly 17 years later after receiving spinal manipulation.

The problems is that spine is far removed from the 8th nerve and the anatomy and physiology of hearing and no amount of spinal manipulation could plausibly effect hearing. Well, if you injure the vertebral arteries badly enough with a neck crack you will change hearing, but not in a salubrious direction.

However, just because the origin story of chiropractic is a ludicrous fantasy doesn’t prevent someone from trying to prove that it really could have happened.

It would be easy enough to dismiss the case of Harvey Lillard if there were not a number of other reports of similar cases – patients losing their hearing as a result of a spinal injury, or having their hearing restored by spinal manipulation; see, for example [4],[5]. Thus, the phenomenon itself seems real enough; what is lacking is a plausible mechanism.

Perhaps, they suggested, that stimulation of paraspinous nerves would effect hearing, explaining the experience of D.D. Palmer with science. I flash back to Mickey Rooney and Judy Garland. "Hey, everyone, I know, lets put on a medical experiment."

And the results are in An audiometric study of the effects of paraspinal stimulation on hearing acuity in human subjects – understanding the Harvey Lillard phenomenon.

They stimulated the thoracic (T4/T5) spine with a TENS unit and measured hearing to see if one would affect the other. And what a surprise, there was no effect on hearing.

Of course they had reasons why it may have failed: wrong placement of electrodes, wrong stimulation, and too weak a stimulation. They did not consider that perhaps the origin story of chiropractic is nonsense.

The Ignoble awards

are intended to celebrate the unusual, honor the imaginative, and spur people's interest in science.

I do not think tooth fairy science such as this qualifies. At least they didn't injure birds or traumatize ears.

I always wonder how pseudo-medical therapies sneak though ethically. At least by the Helsinki Declaration,

Medical research involving human subjects must conform to generally accepted scientific principles, be based on a thorough knowledge of the scientific literature, other relevant sources of information, and adequate laboratory and, as appropriate, animal experimentation.

and as the IRB Guidebook notes:

But if a research study is so methodologically flawed that little or no reliable information will result, it is unethical to put subjects at risk or even to inconvenience them through participation in such a study.

Pseudo-medical research should fail IRB approval since it is not based on science and will not provide reliable information. So why was it approved? Ah. The study was approved by the IRB of the Chiropractic College where the authors work. No conflicts there.

Points of Interest 11/25/2014
Points of Interest 11/24/2014

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