In Defense of Metaphysics: A Kantian Approach to the Philosophy of Chiropractic

Abstract

Objective

At the extremes of interpretation within chiropractic’s philosophical landscape, one group of members adheres to historical doctrines of Innate Intelligence, whereas the other group borders on scientism. This article examines the metaphysical problems faced by each extreme and offers the methodology of Immanuel Kant as a means toward progress in understanding by offering a unifying application of philosophy.

Discussion

The philosophical and ideological extremes within chiropractic represent divergent epistemologies, with one group arguing for the necessity of deductive rationalism based on axiomatic principles and the other for the primacy of empirical or scientific knowledge. This division emerges from a basic misunderstanding of the aim of metaphysics and recapitulates fierce disagreements published throughout the Enlightenment in continental philosophy, culminating with Kant’s Critique of Pure Reason. Kant’s was an attempt to reconcile these disparate views by elevating metaphysics to the level of science. This article works backward chronologically from Daniel David Palmer to Kant and then from Kant to contemporary applications of metaphysics. By investigating Kant’s arguments and those that followed, it is observed that positivism, grounded in empirical science, as well as rationalism in and beyond chiropractic research, depends upon certain metaphysical ideas that cannot be dismissed.

Conclusion

This article proposes that empirical scientific research in the clinical setting is contingent upon basic assumptions that are inherently metaphysical. In order to further philosophical progress in chiropractic, metaphysics in chiropractic, as in Kant’s time, must embrace an academically rigorous form.

Introduction

Much of the contemporary literature pertaining to the philosophy of chiropractic reveals divergent epistemological approaches to the interpretation of historic chiropractic doctrines. Epistemology, as a branch of academic philosophy, is concerned with knowledge itself: what counts as real knowledge and how it might best be aquired.¹ One epistemology, rationalism, claims knowledge based upon the adoption of first principles and the application of deductive reasoning.² Rationalists generally contend that “…there are cases where the content of our concepts or knowledge outstrips the information that sense experience can provide” and that “…reason, in some form or other, provides that additional information about the external world.”² This approach may be loosely applied to those chiropractors who believe that proper interpretation of chiropractic’s historic teachings, and thus their application to chiropractic practice, should begin with the adoption of axioms or principles established by chiropractic’s founder Daniel David (D. D.) Palmer (1845-1913) and son Bartlett Joshua (B. J.) Palmer (1882-1961). Advantages of a rationalistic approach include the ability to establish true propositions beyond the reach of scientific experiment as is the case in matters of morality, art (aesthetics), and pure logic. Disadvantages of a purely rational epistemology, however, emerge as confirmation bias (interpreting all data as supportive of a preconceived notion) and dogma. Rationalism was interpreted by one author in the chiropractic literature as a form of epistemological error where “…the mere availability of ‘systematized knowledge’ and alternative organization of bio-clinical knowledge has been misconstrued as prima facie evidence of the profession’s legitimacy” leading to “…a static image of chiropractic science.”^3(pp2-3) Although Rationalism relies upon first principles as its ground; it does not preclude science or philosophy from employing empirical or scientific methods in the search for knowledge or the verification of these principles.

An example of the other epistemological extreme, positivism, “…holds that every rationally justifiable assertion can be scientifically verified or is capable of logical or mathematical proof and...therefore rejects metaphysics and theism.”⁴ Historically, positivism or “logical empiricism” was a movement in 20th century philosophy that endeavored to unite philosophy and the scientific method. The movement was driven by the departure of various disciplines such as physics, chemistry, and the social sciences away from philosophy during the 18th century as well as the lack of a discrete domain of information in philosophy, particularly metaphysics.⁵ The result was a radical reshaping of philosophy toward identifying statements that could, through mathematical or scientific verification, yield a set of established facts. The logical positivist enterprise in analytic philosophy largely failed upon its own premises, however, when it was shown that the very principle of verification upon which all true propositions were to rest was itself an unverifiable statement.⁶ A positivist epistemology within chiropractic may, through rigorous verification, at best, spur scientific progress and thus improve aspects of patient care. At worst, however, a solely positivist approach could descend into its own form of dogma as scientism. Scientism reduces all problems (and thus all of nature) to what can be verified by the scientific method, dismissing outright any idea that extends beyond the reach of the lab including “…the nature of human feelings, behavior and social discourse.”^7(p286)

Arguments from these epistemological extremes have intensified, with some insisting that traditional (deductive) chiropractic philosophy amounts to dogma, is divisive, and is thus detrimental to progress in chiropractic, “hastening the descent of the profession into irrelevancy.”^8(p2),9(p5) Others, however, find value in grounding their understanding of chiropractic on first principles and deductive arguments such as those offered by Ralph Stephenson and David Koch, extrapolating from these, insights into the clinical application of chiropractic.^{10(ppxxx-xxxiii),11(p77),12(p111)}

Building on prior work, this article attempts to show that both of these divergent epistemic approaches face problems in claiming clinical knowledge as well as problems interpreting and applying metaphysics to the acquisition of that knowledge.¹³ These divergent groups and their epistemic problems recapitulate similar disagreements observed as early as those between Aristotle and Plato extending to those who, by 18th century philosopher Immanuel Kant’s (1724-1804) time, supported an empirical or scientific approach and those who alternatively championed rationalism as the sole path toward knowledge. I will argue, similar to Kant, that metaphysics is an indispensable aspect of any investigation into the nature and extent of human knowledge. It will be shown that a Kantian application of metaphysics establishes clear boundaries for empiricism and thus reframes the idea of knowledge both within a purely scientific as well as clinical setting.

Kant’s philosophy, called transcendental idealism, attempted to reconcile disparate epistemological views and, in so doing, launched a 25-year span of inquiry in continental philosophy that would change the trajectory of Western thought, influencing countless thinkers including (if only indirectly) the founder of the chiropractic profession, D. D. Palmer.¹⁴ Empiricism, as much in Kant’s day as the present, argues that the facts of reality are given to the human mind by observation and experimentation, the extreme of which is a naïve realism that suggests that what is observed is all that actually exists.^2,15(p3637) Kant coined the term “realism” and a voluminous corpus of work has grown up around questions regarding the basic facts of what can be known of the world beyond sense experience.¹⁶ Rationalism, on the other hand, “[claims] that there are significant ways in which our concepts and knowledge are gained independently of sense experience.”²

It will be argued that D. D. Palmer’s philosophy, although influenced by a variety of sources, was a product of post-Kantian Idealism. Kant’s idealism began with the premise that all that can be known of reality must be filtered through the structure (defined as categories) of the human mind. He attempted to arrive at truth by first dividing knowledge into 3 domains: science, morals, and aesthetics, each detailed in Kant’s 3 critiques (Critique of Pure Reason, Critique of Practical Reason, and Critique of Judgement, respectively).¹⁷ Although essential to Kant’s mode of understanding, this division of knowledge posed a threat to the completeness and unity of knowledge, which later thinkers (including D. D. Palmer) would attempt to reconcile.

One of the early students of Kant’s philosophy, the German philosopher Friedrich Wilhelm Joseph Schelling (1775-1854), for instance, proposed a detailed explanation of reality that built upon Kant’s transcendental idealism by reconciling Kant’s divisions of knowledge^18(p39) He achieved this by proposing the universe itself to be the source of all knowledge in a self-creating and evolutionary fashion.^{19(pp376-378)} Schelling’s thought represented a critique of the rational, modern views of the Enlightenment, which claimed a clockwork, mechanistic universe—a universe that could be entirely known by the investigations of human reason insisting rather on the validation of reason by experience.^20(p131)

The impact of Schelling’s philosophy on later thinkers was profound and it has been argued that “Schelling’s philosophy not only shared many common ideas with D. D. Palmer’s philosophy, but it can be viewed as one of the cultural forces that helped shape Palmer’s philosophy and worldview.”^18(p51) The basic tenets of D. D. Palmer’s philosophy will be briefly reviewed and discussed against progress made in the philosophy of chiropractic since the profession’s founding in 1895. The historical methodology employed throughout this article will be to work backward chronologically from D. D. Palmer to Kant, then from Kant to contemporary applications of metaphysics to contemporary clinical science and philosophy. Critical to understanding philosophy, either within or beyond chiropractic, is the role of metaphysics, which, defined in its academic form, is a subdiscipline within philosophy that questions the kind of things that exist in the world and the nature of reality.^21(p99),22 A clearer understanding of metaphysics will thus allow a reinterpretation of ontology (those objects that come to be and exist in reality) within the philosophy and science of chiropractic.^23,24(p6) This article will discuss how metaphysics, for instance, seeks to establish the conditions upon which scientific and rational thought is based. In so doing it will be shown that the science, art, and philosophy of chiropractic cannot logically dismiss metaphysics, but must instead appreciate the subtleties of metaphysical investigations and arguments. It can only effectively do this by both seriously considering and also moving beyond the speculative assumptions of the profession’s founders. It will be concluded that metaphysical investigations within the philosophy of chiropractic clarify appropriate research designs and establish rational principles of chiropractic practice.

Chiropractic Philosophy and German Idealism

Generally, “chiropractic philosophy” is connotated with the set of writings and beliefs held by the Palmers, and those later thinkers aligned with their view.^{25(p50),26(p42)} Chiropractic philosophy is often narrowly interpreted, however, with many authors failing to acknowledge the long history of ideas that led to D. D. Palmer’s postrational, postconventional understanding of the relation of humanity to nature and spirit exemplified in his philosophy.^18(p39) “Chiropractic philosophy” can be held in contradistinction to the “philosophy of chiropractic,” which is a growing academic subdiscipline that raises philosophical questions about chiropractic as a health care practice. Distinguishing between chiropractic philosophy and the philosophy of chiropractic is key and has been approached by several authors as part of the discussion around professional identity and education.^{27,28,29(p15),30(p21),31,32(p35),33(p33)}

Chiropractic philosophy began in the mind of D. D. Palmer as a culmination of various influences popular during the mid-19th century in the United States.^{34(pp68-69),35(p24)} These included elements of the metaphysical religious culture of the time that espoused spiritualism, vitalism, magnetic healing, and theosophy.^{18(p41),34(pp38-65)} It can be said that the diversity of thought that eventually gave rise to D. D. Palmer’s philosophy of chiropractic, can be traced to Kant’s reaction to the Enlightenment and to the German Idealist philosophers that followed in Kant’s wake. A complete description of Palmer’s various influences is beyond the scope of this work, but these influences have been thoroughly investigated elsewhere.^18,24,35, 36, 37, 38, 39, 40, 41 Many of D. D. Palmer’s primary influences shared an acknowledgement of spiritual realties that transcended the bounds of scientific investigation, and yet, “chiropractic from the outset aspired to public recognition on the grounds of scientific, not scriptural, authority.”^34(p79) Thus, the early philosophy of chiropractic was never intended to be taken on faith, but rather as a science based on principles.^42(p8)

D. D. Palmer was, by virtue of time and place, a product of the Modern era and an avid reader of the Spiritualists and Transcendentalists.^24,35,37 Palmer was also a product of “counter-Enlightenment,” a movement begun by thinkers and artists pushing against the pervasive reductionism of the Enlightenment era.^{35(p35),43,44} The various metaphysical religious movements that emerged during this period were heavily influenced by the writings of Swedish Christian theologian, scientist, philosopher, and mystic Immanuel Swedenborg (1688-1772) and the father of “Mesmerism” and “magnetic healing” Anton Mesmer (1734-1815).^34(p53),45 Although there is no direct evidence that Palmer read the self-authored works of either Mesmer or Swedenborg, these particular influences bear out in Palmer’s interpretation of soul and spirit as well as his taking up magnetic healing as a profession.^34(pp68-74)

In his earliest philosophy, Palmer’s primary intellectual pursuit centered on healing the fracturing of nature wrought by philosophical reductionism between mind, body, and spirit or what, in a deeper sense was described by English mathematician and philosopher Alfred North Whitehead (1861-1947) as a “bifurcation of nature” that divorced qualitative experiences of sense and feeling from the natural world.^46,47(p176) At the core of Palmer’s philosophy was the idea of a Universal Intelligence (UI) through which he reconciles man and nature and provides the genesis of human physiology and thus of mind. It is worth quoting Palmer at length:

Universal, is the sum total of the conscious intelligent element or factor manifested in the universe. Individualized spirit is the segmented portion embodied in each individual. The body, as an entity, is the organized substance which we recognize as a human being. The mind is the intellectual part, that which is conscious, that which understands, reasons, wills and thinks. The soul is intelligent life—life guided by intelligence. It resides thruout [sic] the body wherever life is manifested… Now one step more. Life is the sum total of functions. It is that which distinguishes a living, organized animal from a dead animal and inorganic bodies. Intelligent life maintains the performance of functions. All vital activities are guided by intelligent life. Animal existence is dependent upon the soul—intelligent life. Intelligent life—the soul—is the bond of union which holds spirit and body together as one. Mind is the product of soul and body—of a living body. Thru the mind Innate (spirit) conducts the functions which control the body, and looks after its external welfare.^42(pp56-57)

This author’s interpretation is that, for Palmer, UI was a panentheistic world-soul that he referred to as God.^42(p446) The inner spirit of humans was, for Palmer, a segmented portion of UI that he called Innate Intelligence (II). Personified in humans, II thus controlled “…the vital functions, and thru them, indirectly, the control of the intellectual functions.”^42(p362) Palmer asserts, “Innate is not the mind. Innate is the intelligence back of and controller of the mind as well as of every thought.”^42(p362) This direct connection of nature to mind represents Palmer’s understanding of the inherent creativity and evolution of nature manifesting in human consciousness within nature’s progressive unfolding.^42(p446)

Interpreting nature as inherently generative and guided by a divine intelligence or pure reason, parallels conclusions drawn by Schelling’s philosophy of a “world-soul.”^{38(p27),48(p66),49(p527)} Schelling’s view, illustrated in his naturphilosophie, was, contrary to the subjective individualistic approaches of his contemporaries, a means of seeking out what nature itself must be for human consciousness to emerge.^19(p374),50 Additionally, Schelling granted freedom to both God and man in a cocreative process that seems echoed in Palmer’s view that humanity can choose against its own well-being, that is, the choice of the mind or educated intelligence (EI) over the needs of the II.^51(p94)

Palmer includes contemplative or meditative practice alongside the injunction of the adjustment whereby the action of UI and II reconcile mind, body, and spirit.^18(p53) It is important to note that Schelling also posited an injunction whereby nature (through human consciousness) comes to know itself as the subject (perceiver) and object (perceived) in a form of “intellectual intuition.”⁵² It has been noted that Schelling may have viewed intellectual intuition as a meditative practice or an experiential insight into the “‘unprethinkable’ productivity of nature.”^50(p132) Schelling’s view was a radical departure from the modern, Enlightenment era views of those who thought of nature as lifeless matter unconnected from the being of the divine. By resituating human consciousness within nature, as a product of nature, Schelling reconciles mind, body, and spirit in an ongoing creative process of becoming. Palmer reconciled mind and body in a similar fashion through the concept of spirit or II.

The triad. Innate—Soul—Body. Innate—Intelligent Life—Body. Immaterial—Vital—Material. The life directed by intelligence is the soul (the life) of the body. The Soul (the life) is the symphysis which unites Spirit and Body. Without the connecting link, the Spiritual and Physical are separate and distinct from each other. Man is a part of Creation. Innate is a part of the Creator. Innate is the Creator of man before as well as after birth. Mother Innate builds before birth—the individualized, personified Innate after birth. Innate is a part of The All Wise. Innate (Spirit) is a part of Universal Intelligence, individualized and personified.^42(p691)

Palmer’s use of a triadic representation in the synthesis of being (Innate-Soul-Body) is essential to understanding his “…theory, practice, and moral viewpoint” as well as his unique paradigm that “…underpins the philosophy of chiropractic and the evolution of the use of the triune in chiropractic literature.”^53(pp52-53) In many respects, this parallels the triadic dialectical method utilized by Kant and the thinkers that followed him, most notably Johann Gottlieb Fichte (1762-1814) and Georg Wilhelm Friedrich Hegel (1770-1831).^{54(pp234-328)} Dialectic here refers to the reconciliation of apparently opposing ideas (thesis and antithesis) into a synthesis, or new idea under which the earlier propositions are subsumed. Hegel particularly employed this triadic dialectic as a mode through which “Absolute knowledge” was achieved.^55(p454) This he related to the “Absolute,” which represented a “…recourse to ancient nous-metaphysics” where “…intellect, and its principle, the logical idea…are the totality of all determinations.”^56(p217) The Absolute, on Hegel’s understanding, seeks an evolutionary ascent through the historic turns of philosophy. D. D. Palmer describes a similar desire for UI,

The Universal Intelligence, collectively or individualized, desires to express itself in the best manner possible. It has been struggling for countless ages to improve upon itself to express itself intellectually and physically higher in the scale of evolution. Man’s aspirations should be to advance to a superior level, to make himself better, physically, mentally, and spiritually. This marvelous existence of many systems, harmoniously associated and controlled by the I AM, [sic] constitutes the duality of man. The spirit was a living intelligence before it was united with the body. It will continue a living, intelligent entity after it is separated from it.^42(p691)

This author interprets the struggle of UI to improve upon itself as a dialectical tension between the perfect will of the spirit and the agency of an imperfectly perceiving body mediating an evolutionary advancement of UI. The tension between these 2 poles of being are also recapitulated in Schelling’s exploration of “…the exact relation between nature and human freedom.”^57(p250) Although well-read for his time, there is no evidence among the 14 books comprising D. D. Palmer’s personal collection or “traveling library” that he read the works of the German Idealist philosophers.^{24(ppxv-xvii),58} Similarly there are no direct references to Kant, Fichte, Schelling, or Hegel in his Text-book of the Science, Art and Philosophy of Chiropractic (ca 1910).⁴² Yet, the similarities between the tenets of early chiropractic philosophy and German Idealism are apparent. Palmer integrated into his system of thought concepts that focus on ethics, aesthetics, logic, and epistemology, yet, the core concepts of his philosophy, embodied in UI, II, and EI, rely most heavily on metaphysics.

Palmer’s use of metaphysics has drawn ire from contemporary scholars who have raised to the fore the distinction between metaphysics qua philosophy and metaphysics qua doctrine.59, 60, 61, 62 Metaphysics in chiropractic has been equivocated as a term denoting Aristotelian philosophy without acknowledgement of the metaphysical form of religiosity popular during Palmer’s time.^{24(pp4-12),63(p6)} The confusion regarding the appropriate application of metaphysical inquiry has driven much of the philosophical and ideological debate within the philosophy of chiropractic. It was the need for an appropriate and rigorous metaphysics qua philosophy that likewise compelled the Idealist movement in Germany beginning with Kant. In order to understand how Kant achieved a more robust metaphysics, and how we may apply his lessons to our own epistemic challenge, we must further explore Kant’s work.

Ancient Metaphysics and the Kantian Revolution

Metaphysics, as it applies to academic philosophy, denotes a branch of study that was established by the Greek philosopher Aristotle, although the name Metaphysics is one that Aristotle never used and would not have recognized.⁶⁴ As distinct from its modern connotation with the “New Age” section of many bookstores whose works elaborate on ideas popular during D. D. Palmer’s time, Metaphysics is rather a collective title for the fourteen books that follow Aristotle’s Physics (Φυσικὴ ἀκρόασις) or “lectures on nature” and thus was named “Ta meta ta phusika” or “after the physics.”^23,38(p14) Traditionally, the focus of metaphysics related to issues such as: “reality as such,” that which is unchanging in the universe, and the first causes of things.^23,65(p1) It was not until the 17th century that metaphysics became a kind of catch-all for questions that did not neatly fit into other established disciplines such as logic, ethics, and epistemology.²³ Questions of this kind investigated the relation of the mind to the body and the preservation of identity across time.²³

Despite this changing application of the discipline, metaphysics lagged considerably behind advances made through empirical science and mathematics that, by the time of Kant, had provided the world Newton’s laws of motion and universal gravitation as well as vast improvements in diverse fields including optics, medicine, and chemistry.⁶⁶ The work of modern thinkers such as Descartes, Locke, and Newton had ushered a period of rapid technological and scientific growth dubbed the Enlightenment and with it an optimism that human reason alone would soon uncover the secrets of nature fulfilling Durant’s interpretation of Sir Francis Bacon’s (1561-1626) charge that “we must ‘put nature on the rack and compel her to bear witness’ even against herself, so that we may control her to our ends.’”^67(p103) Bacon’s Novum Organum had codified inductive reason as an invaluable epistemic method against what he thought of as the abuses wrought upon human knowledge by mere deduction and skepticism. Bacon is clear on his position against these “dogmas,”

Those who have taken it on themselves to lay down the law of nature as something that has already been discovered and understood, whether they have spoken in simple confidence or in a spirit of professional posturing, have done great harm to philosophy and the sciences. As well as succeeding in producing beliefs in people, they have been effective in squashing and stopping inquiry; and the harm they have done by spoiling and putting an end to other men’s efforts outweighs any good their own efforts have brought.^68(p1)

Bacon’s method eventually blossomed into the scientific method of modern research, and yet, there were questions regarding the veracity of our sense observations. The most famous of these came from a contemporary of Bacon’s, the French philosopher and mathematician René Descartes (1596-1650), who attempted to ground the primacy of human consciousness and, with it, existence itself.

For Descartes, there was no assurance that the world perceived by the mind was exhaustive of the world beyond the senses. Upon this doubt, Descartes employed a radical form of questioning that ended only with the single undeniable fact that, whatever else he may be, he must be a thinking thing, and that the fact of his thinking grounded his existence. Thus, “cogito ergo sum”—“I think, therefore, I am.”^69(p28)

In proving his own existence, Descartes also established a substance dualism where the mind (res cogitans) exists apart from the body (res extensa). Implicitly, however, he left no clear method for establishing the reality of other human minds.^70(p27) Despite this challenge, it was clear that the human mind, in some inescapable fashion, is brought to bear upon the world of sense objects. The other Rationalists who followed after Descartes, including Baruch Spinoza (1632-1677) and Gottfried Wilhelm Leibniz (1646-1716), would, in starkly different ways, attempt to reconcile Descartes’ substances of mind and matter while maintaining that mind is the generator of experience.⁷¹ Rationalism, as mentioned earlier, aimed at acquiring truth by the application of reason questioning how the world appeared to the mind.

The Empiricists, on the other hand, inspired by Bacon and no doubt enthused by advances in political theory, technology, and science, during the Enlightenment, hurried along a divergent path indifferent to the questions of metaphysics in the understanding of the nature of existence. The most important of these thinkers to Kant’s project was the Scottish philosopher David Hume (1711-1776) who, in the footsteps of fellow Empiricist John Locke (1632-1704), took the world itself to be the source of mental representations.^72(p3) Locke, for instance, understood the mind to be a tabula rasa or “blank slate” upon which the senses furnished the facts given to it by experience.^73(p58) For his part, Hume pointed out that, since the facts of the world are merely given to experience, one cannot definitively ascertain any underlying causality between corresponding events. That is, according to Hume,

The mind can never possibly find the effect in the supposed cause, by the most accurate scrutiny and examination. For the effect is totally different from the cause, and consequently can never be discovered in it. Motion in the second Billiard-ball is a quite distinct event from motion in the first; nor is there anything in the one to suggest the smallest hint of the other... In a word, then, every effect is a distinct event from its cause. It could not, therefore, be discovered in the cause, and the first invention or conception of it, a priori, must be entirely arbitrary.^74(p154)

What Hume calls into question is the very coherence of cause and effect. Hume’s thesis is that causation, as we intuitively understand it, is nothing more than a habit of the mind. The typical way in which objects interact gives to the mind an impression of causation; yet, effects, on Hume’s view, can never be known entirely from prior causes. The implications for this interpretation of causation are immense in terms of any underlying order of the world. Lacking any foundational or rational principle of causality, the action of the world seems utterly arbitrary, reducing knowledge to mere skepticism. If one is inclined, for instance, to think of nature as operating according to identifiable laws or principles, one must acknowledge Hume’s argument and admit that no a priori principle seems given apart from experience.

We might compare this view to the clockwork universe given by Newton’s laws. Newton’s description of the world depended on a clear and certain causation, and yet, the description of motion in Newton’s mechanics is intelligible only by observation a posteriori, that is, after the fact representing a kind of customary action of moving bodies. Alternatively, if one is to understand Newton’s laws as fully explanatory and adopt the materialist claim that human beings are nothing more than a composite of particles, then humanity becomes stripped by blind necessity of any free will and thus of morality. On this view, humans are nothing more than complex collections of atoms in a void, operating by pure cause and effect with no agency or choice. Despite these inherent problems, Hume derides the stagnation of metaphysics. In his An Inquiry Concerning Human Understanding, he goes so far as to state:

Here indeed lies the justest and most plausible objection against a considerable part of metaphysics, that they are not properly a science; but arise either from the fruitless efforts of human vanity, which would penetrate into subjects utterly inaccessible to the understanding, or from the craft of popular superstitions, which, being unable to defend themselves on fair ground, raise these intangling brambles to cover and protect their weakness… Accurate and just reasoning is the only catholic remedy, fitted for all persons and all dispositions; and is alone able to subvert that abstruse philosophy and metaphysical jargon, which, being mixed up with popular superstition, renders it in a manner impenetrable to careless reasoners, and gives it the air of science and wisdom.^74(p146)

Kant himself admits that “…the remembrance of David Hume was the very thing that many years ago first interrupted my dogmatic slumber and gave a completely different direction to my researches in the field of speculative philosophy.”^75,76(p10) The importance of this moment for Kant would echo throughout the remainder of his work and go on to profoundly impact his reputation and legacy. So important is this turn in the history of ideas, in fact, that “…nearly every major philosophical movement that emerged after the publication of the Critique of Pure Reason…was forced to grapple with the issues Kant posed in the work that would mark the turning point in the history of philosophy and serve as the catalyst for its future development.”^57(p29)

Kant and the New Metaphysics

Kant agreed with Hume that metaphysics had degenerated into a dogmatism that was “‘capricious’, unscientific and closed to rational scrutiny.”^57(p32) Yet, Kant also regarded Hume’s skepticism, along with the hard empiricism of Locke, as dangerous to the cause of reason.^57(p32) Hume’s arguments had deftly showed, after all, that there is no true science and “…that our minds are but our ideas in procession and association; and our certainties but probabilities in perpetual danger of violation.”^67(p201) If this is true, there could never be any certainty whatsoever of knowledge.

Kant was likewise dissatisfied with the rationalism of Leibniz and others who argued that the best way to acquire knowledge was through the strict application of reason itself. Leibniz, and other rationalist thinkers claimed, in various ways, knowledge of nature to be immutable, if not mathematical. Against this rationalist metaphysics, Kant contended that reasoning has strict limits. Reason cannot, for instance, give us knowledge of God or a world beyond the senses and “…reasoning itself falls into contradiction and confusion if it does not respect these boundaries.”⁷⁷

It was Kant’s intent to reconcile these views that were each, in their own way, dogmatic, one-sided, and based upon false assumptions. He achieved this reconciliation through his Critique of Pure Reason (1781), a critical analysis that does not attack or criticize “pure reason” but rather shows reason’s limitations and exalts it above the imprecise knowledge that comes to us through the distorted channels of our senses.^67(p201) Kant aimed to show, by the application of principles (rationalism), how the mind transforms the real data of the senses (empiricism) into an intelligible perception or appearance. He attempted this project with the following goals in mind: first, to limit the scope of traditional, dogmatic metaphysics and in so doing, demonstrate its ineffectiveness in questions of knowledge; second, to develop a truly systematic metaphysics serving as a refutation of skepticism, thus maintaining the possibility of knowledge and morality; and third, to defend the possibility of universal and necessary knowledge, which he called a priori knowledge, against the attacks of empiricism.^57(p32) One might also add that Kant sought in his metaphysical project to provide a justifiable foundation for science.

Kant’s approach to these objectives has been widely considered a kind of “Copernican revolution” insofar as he shifted the epistemic locus from that of a world given to the mind by the senses to a world crafted and made intelligible by the senses. In other words, just as the astronomer Nicolaus Copernicus (1473-1543) completely changed the picture of the then known universe, by putting the sun in the center of the solar system and placing us and our observations on the surface of an orbiting planet Earth to resolve strange planetary behavior, Kant shook the very foundation of epistemology by granting to the mind an active role in structuring our experience and knowledge.^57(p32)

Kant’s great insight was that, out of the morass of potential sensory data, the mind provides a priori structures, or “categories of the pure understanding,” that constitute our experience of quantity (the number and kinds of things there are), quality (the unique character of objects), relation (the manner in which things interact), and modality (the nature of objects and their possibility of existence).^14(p19),78 Even the most fundamental aspects of human intuition, namely, dimensionality (space) and time (duration), are, according to Kant, structured a priori in the mind. What this means, in a practical sense, is that, for Kant, all that we know and experience of reality is filtered through the unique structures (categories and intuitions) of our minds. This underscores the reason for labeling Kant’s philosophy a “transcendental idealism”—“transcendental” in that it describes all that can be known by the mind as well as that which cannot be known and “idealism” in that it is the mind alone that allows for the possibility of experience and knowledge.

In their introduction to The Critique of Pure Reason, translators Guyer and Wood make clear that “Kant argues that our capacities for intuition and conceptualization each have their own characteristic forms, principles, or laws, which can be known by us and which constitute the basis of metaphysical cognition.”^79(p36) For humans to have any cognition at all, much less any reliable scientific understanding, the mind must construct reality according to the aforementioned categories and intuitions that constitute the metaphysical basis of all knowledge, including, of course, empirical scientific knowledge. Put succinctly, if all that can be truly known of reality is a product of the mind’s unique structure, then all of science must, likewise, be the result of the mind’s action. On this view, science ceases to be a purely empirical representation of the world and reduces instead to a product of the mind.

On this latter point, in order to establish a metaphysics that would effectively justify the necessary preconditions of scientific thought, Kant began by delineating 2 kinds of ideas: those that, as Bykova identifies, “…are either innate (rigorous rationalism) or given to the mind by objects acting upon it, … (rigorous empiricism).”^57(p32) The first Kant calls analytic, that is, known prior to (a priori) any sense experience, and true simply by definition (eg, all bachelors are unmarried men). One need not have ever met a bachelor, for instance, to know that the word means “unmarried man.” The second type of ideas he called synthetic, that is, gathered from experience (a posteriori) and brought together (synthesized) in order to assert something about the objects of the world (eg, the words printed in this article are readable). Case in point, one must have read the very words on this page to know, a posteriori, that they are indeed readable. Purely analytic ideas are known definitionally; most synthetic ideas are known only through experience.

Having made this distinction, Kant then argues that there must be a third type, which he classified a priori, synthetic ideas. These are ideas known prior to experience that presuppose the very possibility of experience. In other words, synthetic a priori ideas are those that make experience possible in the first place. A priori synthetic propositions, as demonstrated in human intuition of space and time as well as the categories of pure understanding, show the necessity of metaphysics in understanding anything at all about the world, much less empirical science.

If we take Hume’s example mentioned earlier of billiard balls moving in relation to one another, we must admit that Hume is correct in stating that the effect cannot be known prior to some sense experience of the event. What must also be admitted, however, is that this event happens for us in space and in time. Knowing that there are no direct human senses for either space or time, we must assume that the mind itself organizes the sense data given to it in such a way as to derive intelligible spatiotemporal movement of the balls. What Kant has shown, therefore, is that to answer how science is even possible, metaphysics must be brought to bear on the fundamental processes of human understanding in the form of assumptions that stand as a background to all experience and, thus, science.

In order to justify this conclusion, Kant had to put a hard limit on what can be known by the mind, namely, that which can be furnished by both the categories of pure understanding and that which appears in space and time. To this knowledge he gave the name phenomena. To the world as it may be in itself, beyond the senses, he named noumena. This limitation of knowledge also provided a means of establishing free will beyond the reach of determinism.⁸⁰ Kant states, in the preface to the second edition of his Critique of Pure Reason, that he had to “…deny knowledge in order to make room for faith.”^79(p117) Kant would publish his critiques in 3 parts: The Critique of Pure Reason (1781), which established the conditions of possible experience; The Critique of Practical Reason (1788), which attempted to establish an a priori and universal moral law; and The Critique of Judgement (1790), which took on disparate subjects including aesthetics and the special case of living organisms within the framework of his broader metaphysical system.¹⁷

What Kant has shown, at last, is the manner in which reason can be brought to bear upon experience. Having stripped bare from experience the contents of its various subjects (sensations and perceptions), he has shown the light of reason upon the thinking apparatus itself giving, within his metaphysics, a new foundation for science built from the very structure of thought. Kant has in this way, given to philosophy and science the conditions for knowledge that reconcile empiricism with rationalism in such a fashion that we can apply these conditions to epistemic extremes as they present themselves in the philosophy of chiropractic that is, between adherence to principles on one side and positivism the other. There is perhaps no better topic for which to turn in this regard than to the role that life (as a “natural purpose”) plays in Kant’s system and its meaning within contemporary clinical science.

Toward a Kantian View of Contemporary Epistemology

Organisms, for Kant, are the living or what he refers to as “natural purposes.”^81(p33) They take on a special significance for him in that they represent objects of the world (noumena), subject to natural laws, that display a purposiveness in nature above and beyond the raw material of reality and thus, not explainable by natural mechanisms.^14(p138) Plants, for instance, do not obtain the faculties of reason afforded to human minds, and yet, the parts of the plant come together in its development in just such a way as to generate a self-determining and self-perpetuating whole. It is as if the whole or final form of the plant is given before germination. The same, of course, is true for human and animal development. The whole seems to exist (as an idea or pre-established plan) prior to the construction and organization of the parts. A telos or pre-established end, as well as an underlying creativity to nature, was acknowledged by Kant that set life apart as exceptional within the natural world and made impossible the hope of determining, with Newtonian precision, any underlying or entailing law of nature—an idea that has force to this day.^82,83 This is to say, whatever organisms are in themselves, there must be a teleological end at play in their organization such that the whole exists for and by means of the parts and the parts for and by means of the whole. Kant concludes,

Hence an organized being is not a mere machine. For a machine has only motive force. But an organized being has within it formative force, and a formative force that this being imparts to the kinds of matter that lack it (thereby organizing them). This force is therefore a formative force that propagates itself-a force that a mere ability [of one thing] to move [another] (i.e., mechanism) cannot explain.^81(p253)

Kant takes the inscrutable purposiveness of nature, expressed in organized beings, further setting within science a teleology that must be acknowledged,

It is these beings [organisms], therefore, which first give objective reality to the concept of a purpose that is a purpose of nature rather than a practical one, and which hence give natural science the basis for a teleology, i.e., for judging its objects in terms of a special principle that otherwise we simply would not be justified in introducing into natural science (since we have no a priori insight whatever into the possibility of such a causality).^81(p255)

Kant’s description of natural purposes, that is, a nonmechanistic understanding of the living, is echoed in D. D. Palmer’s description of the body. Palmer repeatedly rebukes those who would reduce man to machine. He asserts “There is no resemblance or likeness between a machine and the human body. A machine is an unimpassioned, automatic contrivance, composed of mechanical elements. The body is a self-conscious, appreciative, animated being.”^42(p128) In several places in his 1910 text, Palmer iterates a Kantian purposiveness of II independent of mind or EI, as given in the example of bone development and remodeling asserting that “…the processus dentatus is elongated for a purpose, with an aim in view.” This is not metaphorical for Palmer, but rather an acknowledgement of the purposiveness of life manifested in the human body.^42(p500) Both the purposiveness of life and the inability of science to apprehend this innate, formative purpose remain an active area of investigation in life sciences and philosophy and, furthermore, demand a clinical approach to life far different than one we may adopt in approaching nonlife.84, 85, 86

Applying Kant’s View to Chiropractic Epistemologies

Applying Kantian metaphysics to chiropractic epistemology requires that we take a metacognitive perspective on the ideas and hypotheses assumed in the design of clinical research and the application of findings in evidence-based practice (EBP). In other words, we must apply rigorous metaphysics to the structure of clinical science as well as to the rational assumptions that underlie our understanding of science itself. This begins by acknowledging the role of metaphysics as the limit condition of science, revealing the “…tacit assumptions, unquestioned principles, hidden implications, overreaching simplifications. And other forms of delimitations that cannot themselves be the subject of a physical experiment but rather figure invisibly as its conditions of possibility.”^87(p12) Metaphysics is simply that which is taken for granted at the very start of the scientific enterprise representing all that must be assumed for scientific investigation to begin.

The metaphysics of science is the basis and necessity of destabilizing what French physician and philosopher Georges Canguilhem (1904-1995) calls, “…a savoir, a system of knowledge that has proclaimed itself to be the only font of truth and that has had the power to label its scientific and political opponents’ ‘errors’ as disingenuous dwellings in fallacy and delusion.”^88(p6) Similar to Kant’s rejection of Locke’s hard empiricism, such savoirs represent the inherent danger of scientism, that is, an overreliance on empiricist or positivist epistemologies within chiropractic and the sciences more broadly that lead to an overconfidence in what science can explain, elevating scientific knowledge to the only legitimate form of knowing and thus rendering useless any other epistemic approach. The counter danger, of course, is an overreliance on unverified rationalist epistemologies that reduce to bare assumption. As an example of the application of Kant’s metaphysics, Canguilhem’s work shows “that the very activity of asking questions about life is indicative of the fact that the questioners themselves are always already part of life. There is, in this sense, an intrinsic tie between life and rationality, or, to put it in a philosophically more tractable way: there is an intrinsic tie between life and logic.”^89(p125)

In a Kantian fashion, Canguilhem rejected staunch positivist and Hegelian stances on truth and knowledge on the grounds that the sciences “…tend to be self-enclosed and tend to produce norms of their own, in order to formulate, validate, and defend what they perceive as their own ‘truths.’”^88(p6) This has been the case in the hard sciences as well, including physics, where it has been observed that, “…physics is so deeply, historically, and metaphysically dedicated to maintaining theoretical unification that the objective of research is to find evidence for what the framework predicts, in a logic that appears curiously circular.”^87(p5) In the discourse surrounding philosophy in chiropractic, we must avoid the temptation of reifying what Canguilhem calls “scientific ideologies” into new scientific dogmas in much the same way that we must not rely too much on accepted principles or axioms. This is particularly true of EBP, which, despite its popularity within chiropractic and medicine, suffers from a variety of disparate interpretations and notable challenges in terms of structural limitation (eg, difficulty in quantifying quality of life outcomes, measurement errors, limitations of data, etc.), bias (internal and external), and the latency of implementation against the emergence of new data.^{90(p26),91(p66),92} One of the pioneers of clinical epidemiology, Alan Feinstein, offered the following warning regarding EBP as early as 1997,

The laudable goal of making clinical decisions based on evidence can be impaired by the restricted quality and scope of what is collected as "best available evidence." The authoritative aura given to the collection, however, may lead to major abuses that produce inappropriate guidelines or doctrinaire dogmas for clinical practice.⁹³

This is not to minimize the utility of evidence or the efficacy of EBP, but rather to show that metaphysics has a profound role to play in maintaining an open, creative, and self-evaluative science. We may well learn from D. D. Palmer, who began chiropractic with a “science of principles” so long as these principles (both empirical and rational) be evaluated against a rigorous and robust metaphysics that allows for critical evaluation as demonstrated by Kant.^42(p8)

Limitations

This article reflects a sole author’s interpretation of the historical writings surrounding German Idealism and the philosophy of chiropractic. The author is a licensed chiropractor and professor of philosophy. The approach taken to the work is entirely their own and is based upon the interpretation of readings in Western philosophical tradition as these apply to the practice and teaching of chiropractic. Additionally, the article is limited by the number of philosophical approaches (such as postmodernism) that could relate to the topic. The article is also limited in that it fails to include others who have addressed this topic in other health care professions. These limits may represent a potentially biased view. Additional research is needed to assess the usefulness and utility of the ideas presented.

Conclusion

The path toward reconciling chiropractic’s epistemic extremes begins with the application of a rigorous, more robust metaphysics within the philosophy and clinical science of chiropractic. Beyond the fundamental necessity of metaphysics, where philosophy, particularly the idealist project, finds relevance in contemporary chiropractic is that, like the Palmers, we seek a model of health (and mode of health care) that reconciles the patient (which Kant would insist is an end unto itself) and the empirical world of nature. The Palmers attempted an interesting approach by taking force to be a connecting link between an immaterial UI (comparable to the Hegelian notion of the Absolute) and matter which was observed by D. D. Palmer as passive or directed by force.^42(p106) In D. D. Palmer’s approach, we find elements of Schelling’s generative nature and Hegel’s triadic dialectic illustrating UI as moving/evolving ever closer to perfection. Palmer’s concepts were clearly influenced, if only indirectly, by the idealist themes popular in the generation before him. Palmer’s ideas were forward thinking representing the zeitgeist of his era and offer an insight into the forward movement of research in metaphysics both as a historical religious movement in the United States and as applied academic philosophy.

This article has shown that work in metaphysics offers necessary investigation into the very possibility of science, including the clinical sciences, and thus cannot be dismissed in the pursuit of evidence or particular health care approaches such as EBP. Finally, the example of Immanuel Kant was used to illustrate how the profession may integrate a more rigorous and robust form of metaphysics within its philosophy that both provides structure to the design and interpretation of empirical data while also providing a framework wherein its underlying principles may be critically assessed. We can conclude, therefore, that metaphysics in the philosophical and clinical research of chiropractic is not only necessary for correcting its epistemic extremes but also essential.