英国カイロプラクティック協会が、"Trick or Treatment"のSimon Singhを訴える

2008年4月19日に英国The GuardianがSimon Singh執筆の以下の記事を掲載した(現在は削除されている)。
Beware the spinal trap

Some practitioners claim it is a cure-all but research suggests chiropractic therapy can be lethal


Simon Singh
The Guardian, Saturday April 19 2008

This is Chiropractic Awareness Week. So let's be aware. How about some awareness that may prevent harm and help you make truly informed choices? First, you might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that, "99% of all diseases are caused by displaced vertebrae". In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

今週はカイロプラクティックを知る週間である。なので知ることにしよう。被害を回避し、真に知った上での判断ができるように知るというのはどうかな? まずは、カイロプラクティックの創設者Daniel David Palmerは「99%の病気は脊骨のズレによって起きる」と書いているのは驚きだろう。1860年代に、Palmerは、脊髄神経は脳と体をつないでいるので、あらゆる病気は背骨に関係するという自身の理論を発展させ始めた。従って、背骨のいかなるズレも体の離れた部分に問題を起こしうるのだという理論を。

In fact, Palmer's first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.


You might think that modern chiropractors restrict themselves to treating back problems, but in fact they still possess some quite wacky ideas. The fundamentalists argue that they can cure anything. And even the more moderate chiropractors have ideas above their station. The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.


I can confidently label these treatments as bogus because I have co-authored a book about alternative medicine with the world's first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

私は自信を以ってこれらの治療法がボーガスだと言える。というのは、世界初の補完医療の教授Edzard Ernstと共著で代替医療についての本を書いたからだ。Edzard Ernst教授は自らもカイロプラクティックを学び、治療者として使った。これは、何らかの批判的な評価の必要性を認識したときから始まった。多くのプロジェクトから、背骨と無関係なカイロプラクティックの治療効果について探求すべく、Edzard Ernst教授は70の治療例を調査した。そして、カイロプラクティックがこれらの症例を治療できたことを示す証拠をまったく見出せなかった。

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

しかし、背骨についてのカイロプラクティックの治療の効果はどうだろうか? 背骨をマニピュレートすることで、幾らかの症例を治療できるが、結果は色々だ。フェアに行くなら、理学療法のような通常のアプローチも、同様に背骨の問題に対応している。しかし、通常の治療法を選択する理由がある。それはカイロプラクティックに伴う危険性があるからだ。

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.


More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.


Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.


Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: "Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck."

20歳のカナダ人ウェイトレスLaurie Mathiasonが腰背痛の緩和のために1997年から1998年に21回にわたりカイロプラクターを訪れた。直前の訪問で、彼女は首のこわばりがあると言った。その夜、彼女はレストランで皿を落とすようになった。なので、彼女はカイロプラクターを再訪した。カイロプラクターが彼女の首をマニピュレートすると、彼女は叫び始め、彼女の目が回り始め、口から泡を吹き、彼女の体は痙攣し始めた。彼女は病院にかつぎこまれ、昏睡状態に陥り、3日後に死亡した。検死のとき、検死官は「Laurie Mathiasonは、カイロプラクティックの首のマニピュレーションに伴って起きた椎骨動脈の破裂により死亡した。」と述べた。

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Professor Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

この症例は唯一の例ではない。カナダだけでも他に数名の女性がカイロプラクティック療法を受けた後で死亡しており、Edzard Ernst教授は医学文献の中から、700の合併症の例を特定した。これは医療当局にとって重大な懸念たるべきで、報告されていない例も考えれば、このような症例の実数は、はるかに多い。

Bearing all of this in mind, I will leave you with one message for Chiropractic Awareness Week - if spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.


Simon Singh is the co-author of Trick or Treatment? Alternative Medicine on Trial

[Original Page, Cache]
なお、この記事は、Simon Singh and Edzard Ernst: "Trick or Treatment"の第4章 "The Truth About Chiropractic Therapy"の要約である。第4章には、Guardianの記事では名前が挙げられていない「他に数名の女性」の名前 Dora Labonte, Lana Dale Lewis, Pierrette Parisienも記載されている。また、椎骨動脈の損傷リスクは、首のマニピュレーション10万回に1回と推計されているとの記載もある。
Other surveys have suggested higher risks, and perhaps the most significant study was published by Canadian researches in 2001, concluding that the risk of artery damage is one incident per 100,000 individuals receiving chiropractic nek manupilation. They compared patients under forty-five years of age who had suffered torn arteries were five times more likely to have visited a chiropractor in the week prior to the damage being recognized than healthy inidividuals of a similar age. This implies that chiropractic treatment can increase the risk of damaged arteries by a factor five.

[Simon Singh and Edzard Ernst: "Trick or Treatment", p.177]
これに対して、英国カイロプラクティック協会は、対抗措置として、2008年8月に、掲載したThe Guardianではなく執筆者であるSimon Singhを訴えた。
Simon Singh expected to arouse controversy when he claimed that chiropracters knowingly promoted bogus treatments for illnesses including asthma and ear infections. The bestselling author and Bafta-winning broadcaster did not, however, expect to have a High Court writ issued against him.

カイロプラクターたちは気管支喘息や耳の感染症をふくむ病気についてのボーガスな治療法を宣伝していると主張して、Simon Singhは論争を起こそうとした。ベストセラーの著者であり、英国映画・テレビ芸術協会賞受賞のブロードキャスターであるSimon Singhは、自らが裁判に訴えられるとは思っていなかっただろう。

Mandrake can disclose that the presenter of the Channel Four series The Code Book is being sued for libel by the British Chiropractic Association.

Channel FourのThe Code Bookのプレゼンターが、英国カイロプラクティック協会に

"It wasn't a decision taken lightly," says Dr Antoni Jakubowski, a member of the association's governing council. "I know that a lot of thought went into this."

協会の評議員であるDr Antoni Jakubowskiは「軽々しい決定ではない。ここに至るまでに熟慮した」と述べた。

Dr Jakubowski, whose patients have included the golfers Nick Faldo, Ian Woosnam and Justin Rose, adds: "It's a terrible shame he made those comments and he has been given a full opportunity to take them back. However, he hasn't."

患者にはゴルファーNick FaldoやIan WoosnamやJustin RoseがいるDr Antoni Jakubowskiは「彼のコメントはまったく恥知らずなもので、撤回する機会を与えたにもかかわらず、撤回しなかった」と付け加えた。

The association has taken the unusual step of suing Singh himself rather than the newspaper that published his claims, The Guardian.

協会は、記事を掲載した新聞であるThe Guardianではなく、Singh自身を訴えるという異例な手段をとった。


[Richard Eden: "Doctors take Simon Singh to court" (2008/08/16) on Telegraph]
The Guardianを訴えなかったのは、英国カイロプラクティック協会(British Chiropractic Association
)がSimon Singh自身を黙らせることを目指しているからのようである。

また、British Chiropractic AssociationのページにはSimon Singhや裁判についての言及はない。協会自身も黙ることにしているようだ。

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