昨日Simon Singhを訴えるBritish Chiropractic Associationの話を取り上げた。

そのついでに、2年前に始まったChiropractic Stroke Victims Awareness Group(カイロプラクティック脳卒中犠牲者周知グループ)の広告をめぐるGBTA(ブリッジポート交通局)とWorld Chiropractic Allianceの裁判について、Stephen Barrett, M.D.主宰のQuackwatchのカイロプラクティック専用サイトであるStephen Barrett, MD, and Samuel Homola, DCが管理するChiroBase記事を見てみることにしよう:
[Stephen Barrett, M.D. : "Chiropractors Angry about Bus Ad" (2006/05/27) on ChiroBase]

The World Chiropractic Alliance (WCA), an organization dedicated to "preserving and strengthening subluxation-based chiropractic around the world," is upset about a conspicuous ad appearing on the outside of a bus in Bridgeport and Waterbury, Connecticut. On May 8th, a lawyer acting on its behalf notified the Greater Bridgeport Transit Authority (GBTA) that if the ad ws not immediately removed, the WCA and several local chiropractors would file suit and ask state and federal authorities to investigate [1]. The ad was placed by the Chiropractic Stroke Victims Awareness Group.

世界の関節ベースのカイロプラクティックの維持強化を目的とする機関である"World Chiropracic Alliance(WCA)"は、コネチカット州BridgeportとWaterburyの1台のバスの外側に目に付くように描かれた広告に、WCAは怒っている。5月8日にその代理人として働く弁護士はGreater Bridgeport Transit Authority (GBTA)[ブリッジポート交通局]に対して、この宣伝がただちに除去されなければ、WCAと当該地域のカイロプラクターが訴訟を起こし、州政府および連邦当局に調査を要求するだろうと通告した。その広告はChiropractic Stroke Victims Awareness Group(カイロプラクティック脳卒中犠牲者周知グループ)によるものだった。


It appears to me that the GBTA has done nothing wrong and will not be intimidated. Its official position is that:

The advertising space on our fleet of buses is considered “public forum” as is any advertising billboard, therefore protected by the first amendment of the US Constitution of “free speech.” This amendment therefore limits advertisers that can be rejected regardless of the concerns of any one body in the community. The GBTA could not and will not engage in any form whatsoever that could be construed as prejudicial or bias. GBTA does not condone or support any of our advertiser’s claims. The advertisement in question defames no one; it merely sets forth a rhetorical question common in lawyer and professional mass media advertising, which asks whether the reader was injured by a chiropractor. We thank you for your correspondence.

Because the ad points to the Neck911 Web site, many chiropractors assume the Chiropractic Stroke Victims Awareness Group owns the site. That is not true, however. Neck911 is a network of professionals who provide consultations on complications due to neck manipulation [2]. Its Web site is operated by John W. Kinsinger, M.D., an anesthesiologist who has investigated many chiropractors [3]. Dr. Kinsinger told me that neither he nor Neck911 had anything to do with the content or placing of the ads.

広告にはNeck 911のサイトのアドレスが書かれているので、多くのカイロプラクターはNeck 911がChiropractic Stroke Victims Awareness Group(カイロプラクティック脳卒中犠牲者周知グループ)によるサイトだと考えた。しかし、これは間違いだ。Neck911は首のマニピュレーションによる合併症についてコンサルテーションを行っている専門家のネットワークである。

Last year, the Chiropractic Stroke Victims Awareness Group placed other ads that angered chiropractors. One used the billboard pictured to the right. The other advertised in the Hartford Courant that:

昨年、Chiropractic Stroke Victims Awareness Group(カイロプラクティック脳卒中犠牲者周知グループ)は他の広告でもカイロプラクターたちを起こらせた。そのひとつは以下の写真のようなものだった。また他にも、次のようなHartford Courantの広告があった:
Our mission is to warn people of the risks involved with chiropractic adjustments and to help victims, like us, their families try to get back some degree of normalcy in their lives. Unfortunately, chiropractic adjustments are not completely safe and without risk. We are the proof. If you or a loved one have been affected, We Want to Hear from You."


The Connecticut Chiropractic Association complained to the billboard company and the newspaper and published a newspaper counter-ad which claimed that chiropractors' "proven safety record" and "focus on education and patient improvement, as research now shows, are important factors in the success of chiropractic management. . . " [4]


Stroke from chiropractic neck manipulation occurs when an artery to the brain ruptures or becomes blocked as a result of being stretched. Speculations exist that the odds of a serious complication due to neck manipulation are somewhere between one in 5,000 and one in 10 million manipulations. No one really knows, however, because there has been little systematic study of its frequency [5]. Neck911 has summed up the situation this way:

The chiropractic profession has attempted to ignore, or minimize the realities of this devastating consequence. They often state that it occurs in only one out of a million cervical manipulations, or that a person is more likely to be struck by lightning. Recently an administrator at a prominent chiropractic college in the midwest was asked about stroke following chiropractic upper cervical manipulation. He responded that this phenomenon has NEVER happened. Of course this is totally false as prestigious medical journals from around the world have documented these cases for the past sixty years.


The real concern should not focus on the frequency of this occurrence but rather on risk/benefit ratio. No matter how infrequent the complication, if there is little or no benefit to the procedure, then a complication as severe as death can not be risked. This is the case with regard to chiropractic manipulation of the highest part of the neck. It is a procedure that is used to treat everything from ear infections in babies to high blood pressure and epilepsy in adults. There is no evidence of any benefit for the majority of the ailments that this procedure is utilized for [6].

On May 24, WTNH-TV aired a program about the bus ad which described the Chiropractic Stroke Victims Awareness Group as "victims, family members and friends who have been traumatized" by chiropractic treatment and "whose lives have been destroyed." [7] Two members appeared on the program. The first, identified as "Britt," said she had reached an out-of-court settlement after having a stroke about three years ago in her chiropractor's office. Britt continues to receive physical therapy and requires a feeding tube because she' has lost the ability to swallow. The other member is Linda Solsbury, a former nurse who won a jury award after suffering a stroke during an adjustment 20 years ago. She is partially paralyzed, can't speak, and must use a keyboard to communicate. The book Chiropractic: The Greatest Hoax of the Century? has a chapter about her case [8].

2006年5月24日にWTNH-TVは「Chiropractic Stroke Victims Awareness Groupをカイロプラクティック治療によってトラウマになり、生活を破壊された犠牲者とその家族と友人たちの集まりだという」バスの広告について取り上げた番組を放映した。2名の会員が番組に出演した。まず、Brittという名の女性は、カイロプラクティック治療所での3年前の脳卒中について、法廷外の解決に到達したと述べた。Brittはその後も理学療法を受け続け、食物を飲み込めなくなったためにチューブを挿入されている。もう一人の会員はLinda Solsburyで、20年前の治療で脳卒中になったあと、陪審で勝利した元看護婦である。彼女は部分麻痺であり、話すことができず、会話のためにキーボードが必要である。"Chiropractic: The Greatest Hoax of the Century?"(カイロプラクティック:世紀最大の詐欺?)という本のひとつの章で、彼女の症例が取り上げられている。


Negrete CF. Letter to Vincent J. Biondi and Ronald Kilcoyne, May 8, 2006.
About Neck911. Neck911 Web page, accessed May 19, 2006.
Kinsinger JW. My experiences with nine chiropractors. Chirobase, Dec 25, 2003.
Connecticut State News. Dynamic Chiropractic Web site, accessed May 20, 2006.
Barrett S. Chiropractic's dirty secret: Neck manipulation and strokes. Quackwatch, Jan 27, 2004.
What chiropractors are saying. Neck911 Web site, accessed May 20, 2006.
Injured by a chiropractor? WTNH-TV, May 24, 2006.
The crippling of Linda Solsbury. In Chotkowski LA. Chiropractic: The Greatest Hoax of the Century? Kensington, CT: New England Books, 2005.
BridgeportはMetro NorthのNew Have Line沿線の街で、ManhattanのGrand Centralから1時間半ほどの北東に進んだところにある。New YorkのMTAやNew JerseyのNJ Transitと似たような組織と思われるGBTA(Greater Bridgeport Transit Authority)がバスを運行している。このGBTAの回答「問題となっている広告は、誰も誹謗していません。読者がカイロプラクターで被害を受けたかを問うているだけの、弁護士やプロのマスメディアの広告によくある修辞的質問です。」は、いいボケで、World Chiropractic Allianceをあしらった形になっている。

それはさておき、カイロプラクティックによる脳卒中被害は深刻な問題である。日本では厚生労働省の通達(1991年6月28日 医事58号)で、「頚椎に対する急激な回転伸展操作を加えるスラスト法は、患者の身体に損傷を加える危険が大きいため、こうした危険の高い行為は禁止する必要があること」などを述べている:
[医業類似行為に対する取扱いについて (平成三年六月二八日) (医事第五八号)]

2 いわゆるカイロプラクティック療法に対する取扱いについて



(1) 禁忌対象疾患の認識


(2) 一部の危険な手技の禁止


(3) 適切な医療受療の遅延防止


(4) 誇大広告の規制


WCAとGBTAの対決やBCAとSimon Singhの対決はさておいても、カイロプラクティックと脳卒中の問題は気にかけておく必要があるかもしれない。

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