Vitalism

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This article is about the non-mechanist philosophy. For other uses, see vital.

Vitalism, as defined by the Merriam-Webster dictionary, <ref>Merriam-Webster definition</ref> is

  1. a doctrine that the functions of a living organism are due to a vital principle distinct from physicochemical forces
  2. a doctrine that the processes of life are not explicable by the laws of physics and chemistry alone and that life is in some part self-determining

Where vitalism explicitly invokes a vital principle, that element is often referred to as the "vital spark," "energy" or "élan vital," which some equate with the "soul."

Vitalism has a long history in medical philosophies: most traditional healing practices posited that disease was the result of some imbalance in the vital energies which distinguish living from non-living matter. In the Western tradition, associated with Hippocrates, these vital forces were identified as the humours; eastern traditions posited similar forces such as qi, prana, etc. More recently, vitalistic thinking has been identified in the naive biological notions of children. <ref>Inagaki K, Hatano G (2004) Vitalistic causality in young children's naive biology. Trends Cogn Sci 2004 8:356-62 PMID 15335462</ref>

Contents

[edit] Development of vitalism

Image:Sanzio 01 Plato Aristotle.jpg
Plato (left) and Aristotle (right), a detail of The School of Athens, a fresco by Raphael. Aristotle gestures to the earth, representing his belief in knowledge through empirical observation and experience, whilst Plato points up to the heavens showing his belief in the ultimate truth.

The notion that bodily functions are due to a vitalistic principle existing in all living creatures has roots going back to at least 384-322 BC. While vitalist ideas have been commonplace in traditional medicine,<ref> e.g. Zarrilli PB. (1989) Three bodies of practice in a traditional South Indian martial art. Soc Sci Med 28:1289-309. PMID 2660283, Noll R (1989) What has really been learned about shamanism? J Psychoactive Drugs 21:47-50 PMID 2656952 and Merchant J. (2006) The developmental/emergent model of archetype, its implications and its application to shamanism. J Anal Psychol51:125-44 PMID 16451325 </ref> attempts to construct workable scientific models date from the 1600s, when it was argued that matter existed in two radically different forms, observable by their behavior with regard to heat. These two forms of matter were termed organic and inorganic. Inorganic matter could be melted, but could also be restored to its former condition by removing the heat. Organic compounds "cooked" when heated, transforming into new forms that could not be restored to the original. It was argued that the essential difference between the two forms of matter was the "vital force", present only in organic material.

Aided by the invention of the microscope in the 16th century, the germ theory of disease challenged the role of vitalism in Western medicine, and the roles of the organs of the human anatomy in the maintenance of life became better understood, reducing the need to explain things in terms of mystical "vital forces". Nevertheless, vitalist ideas were still thought necessary by many scientists to explain how organisms maintained life.

The phlogiston theory, developed by J. J. Becher and Georg Stahl late in the 17th century held that all flammable materials contain phlogiston, a substance without color, odor, taste, or weight that is liberated in burning. Once burned, the "dephlogisticated" substance was held to be in its "true" form, the calx. This vitalist theory led to the prediction that substances should lose weight after burning; the prediction was tested by an experimental demonstration that, when combustion took place in a closed, sealed system, no weight was lost or gained. While the prediction was not germane to determining the presence or absence of a weightless substance, the closed-system experiment made it impossible to observe "separation of phlogiston," which if present must have remained in the closed volume with the other products of combustion. Of course we now recognize that "weight" is inseparable from the concept of substance in a gravitational field, and that the very definition of phlogiston was contra-physical.

In the early 19th century, Jöns Jakob Berzelius, known as one of the "fathers" of modern chemistry, rejected mystical vitalism, but nevertheless argued that a regulative force must exist within living matter to maintain its functions. The geologist Carl Reichenbach, considered to be one of the top 1,000 scientists of all time, later developed the theory of Odic force, a form of life-energy that permeated living things; this concept never gained much support despite Reichenbach's prestige. Vitalism is now often used as a pejorative epithet. <ref>"Other writers (eg, Peterfreund, 1971) simply use the term vitalism as a pejorative label." in Galatzer-Levy,RM (1976) Psychic Energy, A Historical Perspective Ann Psychoanal 4:41-61 [1]</ref> By contrast, Ernst Mayr, co-founder of the modern evolutionary synthesis and a critic of both vitalism and reductionism, writing in 2002 after the mathematical development of theories underlying emergent behavior, stated:

"It would be ahistorical to ridicule vitalists. When one reads the writings of one of the leading vitalists like Driesch one is forced to agree with him that many of the basic problems of biology simply cannot be solved by a philosophy as that of Descartes, in which the organism is simply considered a machine…..The logic of the critique of the vitalists was impeccable. But all their efforts to find a scientific answer to all the so-called vitalistic phenomena were failures.… rejecting the philosophy of reductionism is not an attack on analysis. No complex system can be understood except through careful analysis. However the interactions of the components must be considered as much as the properties of the isolated components." <ref>Mayr E (2002) The Walter Arndt Lecture: The Autonomy of Biology, adapted for the internet, on [2]</ref>

[edit] Mesmerism

A popular vitalist theory of the eighteenth century was "animal magnetism", in the theories of Franz Anton Mesmer (1734–1815). So popular did Mesmer's ideas become that King Louis XVI of France appointed two commissions to investigate mesmerism; one was led by Joseph-Ignace Guillotin, the other, led by Benjamin Franklin, included Bailly and Lavoisier. The commissioners learned about Mesmeric theory, and saw its patients fall into fits and trances. In Franklin’s garden, a patient was led to each of five trees, one of which had been "mesmerized"; he hugged each in turn to receive the "vital fluid", but fainted at the foot of a 'wrong' one. At Lavoisier’s house, four normal cups of water were held before a "sensitive" woman; the fourth produced convulsions, but she calmly swallowed the mesmerized contents of a fifth, believing it to be plain water. The commissioners concluded that "the fluid without imagination is powerless, whereas imagination without the fluid can produce the effects of the fluid." This was an important example of the power of reason and controlled experiment to falsify theories. <ref>(Best M, Neuhauser D, Slavin L (2003) Evaluating Mesmerism, Paris, 1784: the controversy over the blinded placebo controlled trials has not stopped. Qual Saf Health Care 12:232-3 PMID 12792017 [3]</ref> It is sometimes claimed<ref name="Becthel_Richardson">Vitalism. Bechtel W, Richardson RC (1998). Routledge Encyclopedia of Philosophy. E. Craig (Ed.), London: Routledge.</ref> that vitalist ideas are unscientific because they are not testable; here at least is an example of a vitalist theory that was not merely testable but actually falsified.

[edit] Vitalism in the foundations of chemistry

In the history of chemistry, vitalism played a pivotal role, giving rise to the basic distinction between organic and inorganic subtances, following Aristotle's distinction between the mineral kingdom and the animal and vegetative kingdoms. <ref>see Schummerr J (2003) The notion of nature in chemistry. Stud Hist Phil Sci 34:705-736 for this account within an extensive review on vitalist notions in the foundations of chemistry [4]</ref> The basic premise of these vitalist notions was that organic materials differed from inorganic materials in possessing a "vital force", accordingly, vitalist theory predicted that organic materials could not be synthesized from inorganic components. However, as chemical techniques advanced, Friedrich Wöhler synthesised urea from inorganic components in 1828. <ref>Vitalism and Synthesis of Urea</ref> Wohler subsequently wrote to Berzelius, saying that he had witnessed "The great tragedy of science, the slaying of a beautiful hypothesis by an ugly fact." The "beautiful hypothesis" was vitalism; the ugly fact was a dish of urea crystals. <ref> cited by Schummerr J, op cit, [5]</ref>

According to the conventional view of the subsequent progress of chemistry, further discoveries pushed aside the "vital force" explanation, as more and more life processes came to be described in chemical or physical terms. However, contemporary accounts do not support the claim that vitalism died when Wöhler made urea. The Wöhler Myth, as it was called by historian of science Peter J. Ramberg , originates from a popular history of chemistry published in 1931 which, "Ignoring all pretense of historical accuracy, turned Wöhler into a crusader who made attempt after attempt to synthesize a natural product that would refute vitalism and lift the veil of ignorance, until 'one afternoon the miracle happened'." <ref>The Real Death of Vitalism: Implications of the Wöhler Myth</ref>

Image:Tableau Louis Pasteur.jpg
Louis Pasteur in his laboratory, painting by A. Edelfeldt in 1885.

Some of the greatest scientific minds of the time continued to investigate these vital properties. Louis Pasteur, shortly after his famous rebuttal of spontaneous generation, made several experiments that he felt supported the vital concepts of life. According to Bechtel, Pasteur "fitted fermentation into a more general programme describing special reactions that only occur in living organisms. These are irreducibly vital phenomena." In 1858, Pasteur showed that fermentation only occurs when living cells are present and, that fermentation only occurs in the absence of oxygen; he was thus led to describe fermentation as ‘life without air’. He found no support for the claims of Berzelius, Liebig, Traube and others that fermentation resulted from chemical agents or catalysts within cells, and so he concluded that fermentation was a "vital action".<ref name="Becthel_Richardson"/>

[edit] Vitalism in psychology

Perhaps more than any other area of science, psychology has been rich in vitalist concepts, particularly through the ideas of Sigmund Freud and Carl Jung. Freud was a student of the notable anti-vitalist Herman von Helmhotz, and initially struggled to express his concepts in strictly neurological terms. Abandoning this effort as fruitless, he became famous for his theory that behaviour is determined by an unconscious mind, of which the waking mind is unaware. In 1923, in The Ego and the Id, he developed the concept of "psychic energy" as the energy by which the work of the personality is performed.

Although Freud and Jung remain hugely influential, psychology has made a determined effort to rid itself of the most mystical of these concepts in an attempt to appear more like the "hard" sciences of chemistry and physics. <ref> see Warren HC (1918) Mechanism Versus Vitalism, in the Domain of Psychology Phil Rev27:597-615 [6] and Elkus SA (1911) Mechanism and Vitalism J Phil Psych Sci Meth 8: 355-8 [7] for examples of this debate within psychology</ref> However, concepts for instance of mind, or of intelligence, and of motivational states such as anger, fear, anxiety and stress, remain essentially higher level constructs, with observable correlates, but with no adequate low-level description of underlying mechanisms or processes.

The neuroscientist Roger Sperry, in his Nobel prize lecture in 1981, described modern scientific concepts of the nature of consciousness and its relation to brain processing as follows:

"The events of inner experience, as emergent properties of brain processes, become themselves explanatory causal constructs in their own right, interacting at their own level with their own laws and dynamics. The whole world of inner experience (the world of the humanities) long rejected by 20th century scientific materialism, thus becomes recognized and included within the domain of science." <ref>Some Effects of Disconnecting the Cerebral Hemispheres, Roger W. Sperry, Nobel Lecture, 8 December 1981]</ref>

Anti-reductionism has been identified as a problem in psychology. Thomas (2001) states that "It is now generally considered that biology had to rid itself of vitalism to enable significant progress to occur. It is suggested that psychology will develop as a science only after it rids itself of anti-reductionistic, 'emergentism'." <ref>Hazards of “Emergentism” in Psychology, Roger K. Thomas, Ph.D.</ref>

[edit] Vitalism in developmental biology

Caspar Friedrich Wolff (1733-1794) is considered to be the father of epigenetic descriptive embryology. In his Theoria Generationis (1759), he tried to explain the emergence of the organism by the actions of a "vis essentialis", an organizing, formative force, and declared that "All believers in epigenesis are Vitalists." However, even early vitalists were aware that the vital forces that they proposed were to be understood metaphorically, not literally. For example, Johann Friedrich Blumenbach, established epigenesis as the model of thought in the life sciences in 1781, with his publication of Über den Bildungstrieb and das Zeugungsgeschäfte. Blumenbach cut up freshwater polyps and established that the removed parts would regenerate; he inferred the presence of a "formative drive". an organic force, which he called "Bildungstrieb". He pointed out that this, "like names applied to every other kind of vital power, of itself, explains nothing: it serves merely to designate a peculiar power formed by the combination of the mechanical principle with that which is susceptible of modification."

Vitalism was also important in the thinking of later teleologists such as Hans Driesch (1867-1941) <ref name="DevBio">[8]</ref> In 1894, Driesch wrote a theoretical essay entitled Analytische Theorie der organischen Entwicklung where he declared that

"Development starts with a few ordered manifoldnesses; but the manifoldnesses create, by interactions, new manifoldnesses, and these are able, by acting back on the original ones, to provoke new differences, and so on. With each new response, a new cause is immediately provided, and a new specific reactivity for further specific responses. We derive a complex structure from a simple one given in the egg."

This comment came from his experiments on sea urchin eggs. Driesch, already a famous biologist, became a vitalist, but his reputation as a biologist deteriorated in later life <ref name="DevBio"/>. He moved to Heidelberg and became a Professor of Natural Philosophy, seeing his vitalism an extension of Immanual Kant's notion that the organism develops as if it had a purposeful intelligence.

[edit] Vitalism in the foundations of complementary medicine

Complementary and Alternative Medicine (CAM) encompasses many fields of medicine including; acupuncture, chiropractic, homeopathy, dietary and nutritional therapies, Western herbalism, bioenergetic medicines and more <ref>Muehsam, Patricia M.D. 1997, What is Complementary and Alternative Medicine?, Carol Ann Schwartz Cancer Education Fund, viewed 26 November, 2006, <http://www.rosenthal.hs.columbia.edu/cancer/info/whatis.html></ref>. The field that continues to be most intimately associated with vitalism is that of bioenergetic medicines. This field can be further divided into bioelectromagnetic medicines (BEM)and biofield therapies (BT). Compared with bioenergetic medicines, biofield therapies have a stronger identity with vitalism. Examples of biofield therapies include therapeutic touch, Reiki, external qi, chakra healing, and SHEN therapy.<ref name="Rubik">Rubik, Bioenergetic Medicines, American Medical Student Association Foundation, viewed 28 November, 2006, <http://www.amsa.org/ICAM/C6.doc></ref>

Biofield therapies are medical treatments in which the "subtle energy" field of a patient is manipulated by a biofield practitioner. The subtle energy is thought to exist beyond the elctromagnetic(EM) energy that is produced by the heart and brain. Beverly Rubik describes the biofield as a "complex, dynamic, extremely weak EM field within and around the human body..."<ref name="Rubik"/>

Acupuncture and chiropractic emphasize a holistic approach to the cause and treatment of disease (see main articles on these subjects). They retain some concepts that were originally vitalist concepts, although they now largely use these metaphorically rather than literally implying an animate essence. For example, "Innate Intelligence" in chiropractic is used to represent an internal guiding force, and it is also used to represent the physiological mechanisms of self-repair, including in particular the regulation of the immune system by the nervous system. <ref name="keating_innate">"The Meanings of Innate," Joseph C. Keating, Jr., PhD, J Can Chiropr Assoc 2002; 46(1)</ref>

The founder of homeopathy, Hahnemann, promoted an immaterial, vitalistic view of disease: "...they are solely spirit-like (dynamic) derangements of the spirit-like power (the vital principle) that animates the human body." However, as practised today, homeopathy simply rests on the premise of treating sick persons with extremely diluted agents that - in undiluted doses - are deemed to produce similar symptoms in a healthy individual. Thus modern expressions of homeopathy have largely excluded early vitalistic concepts, though whether they have gained any credibility as a result is debatable (see main article Homeopathy)

[edit] Vitalism in "New Age" mysticism

Vitalism is also an aspect of many "New Age" theories. Examples include Rupert Sheldrake's concept of "morphic resonance" - the idea of telepathy-type interconnections between organisms and of collective memories within species[9], and revivals of Reichenbach's Odic force, which is sometimes used to explain colored auras.<ref> See United States Patent 6016450, "Method and apparatus for stimulating the healing of living tissue using aura therapy" [10]</ref> Anthroposophy, founded by Rudolf Steiner, is a quasi-religious cult whose teachings, in Steiner's words, lead "from the spirit in the human being to the spirit in the universe." <ref>The Anthroposophical Society in America; website [11]</ref> An early form of sustainable agriculture, biodynamic agriculture, was fostered by this movement.

[edit] Relation to emergentism

In terms of the biology of the cell, a variation of vitalism can be recognized in contemporary molecular biology, for example in the proposal that some "high level features" of organisms, perhaps including even life itself, are examples of emergent processes which cannot be accurately described simply by understanding each of the chemical processes which occur in the cell in isolation from all the others <ref> see Berg EL, Kunkel EJ, Hytopoulos E. (2005) Biological complexity and drug discovery: a practical systems biology approach. Syst Biol 152:201-6 PMID 16986261 and see Schultz SG. (1998) A century of (epithelial) transport physiology: from vitalism to molecular cloning. Am J Physiol. 274:C13-23. PMID 9458708 This also contains the following account, relating to the pejorative nature of vitalism as an epithet.

Reid had clearly and, to the best of my knowledge, for the first time unambiguously demonstrated and recognized "active transport" by an in vitro preparation; that is, the flow of matter in the absence of an external (conjugate) driving force that was dependent upon a source of metabolic energy!
...However, what should have been a clarion call heralding a major conceptual breakthrough in epithelial biology turned out to be barely a whimper. ...

Why? Could it be because he used the phrase "vital force" to describe his observations, a phrase that was perhaps the naughtiest in the naturalist's lexicon during that era? </ref>; When individual chemical processes form interconnected feedback cycles which produce products perpetuating these cycles rather than unconnected products, they can form systems with properties that the reactions, taken individually, lack <ref>e.g. see Gilbert SF, Sarkar S. (2000) Embracing complexity: organicism for the 21st century. Dev Dyn 219:1-9 for explicit discussion of relationship to vitalism. PMID 10974666 </ref>.

Whether emergent system properties should be characterized with traditional vitalist concepts is a matter of semantic controversy.<ref> see "Emergent Properties" in the Stanford Encyclopedia of Philosophy. online at [12] for explicit discussion; briefly, some philosophers see emergentism as midway between traditional spiritual vitalism and mechanistic reductionism; others argue that, structurally, emergentism is equivalent to vitalism. See also Emmeche C (2001) Does a robot have an Umwelt? Semiotica 134: 653-693 [13]</ref> In a light-hearted, millennial vein Kirshner and Michison call research into integrated cell and organismal physiology “molecular vitalism.” <ref> Kirschner M, Gerhart J, Mitchison T (2000) Molecular "vitalism" Cell 100:79-88 PMID 10647933 </ref>

According to Emmeche et al (1997) "On the one hand, many scientists and philosophers regard emergence as having only a pseudo-scientific status. On the other hand, new developments in physics, biology, psychology, and crossdisciplinary fields such as cognitive science, artificial life, and the study of non-linear dynamical systems have focused strongly on the high level 'collective behaviour' of complex systems which is often said to be truly emergent, and the term is increasingly used to characterize such systems."<ref name ="Emmeche 1997">Emmeche C (1997) EXPLAINING EMERGENCE:towards an ontology of levels. Journal for General Philosophy of Science available online</ref> Emmeche et al (1998) state that "there is a very important difference between the vitalists and the emergentists: the vitalist's creative forces were relevant only in organic substances, not in inorganic matter. Emergence hence is creation of new properties regardless of the substance involved." "The assumption of an extra-physical vitalis (vital force, entelechy, élan vital, etc.), as formulated in most forms (old or new) of vitalism, is usually without any genuine explanatory power. It has served altogether too often as an intellectual tran-quilizer or verbal sedative—stifling scientific inquiry rather than encouraging it to proceed in new direc-tions" [14].

[edit] Critical opinions of vitalism

Bechtel and Richardson<ref name="Becthel_Richardson"/> state that "vitalism now has no credibility" because it is often viewed as unfalsifiable, and "therefore a pernicious metaphysical doctrine". Many vitalistic theories were in fact falsified, notably Mesmerism and the phlogiston theory (see above), but the pseudoscientific retention of these falsified theories continues to this day in a fashion that ignores the testability criterion of the scientific method.

For many scientists, "vitalist" theories are unsatisfactory "holding positions" on the pathway to mechanistic understanding. In 1967, Francis Crick, the co-discoverer of the structure of DNA, stated “And so to those of you who may be vitalists I would make this prophecy: what everyone believed yesterday, and you believe today, only cranks will believe tomorrow.”<ref name="Crick"> Crick F (1967) Of Molecules and Men; Great Minds Series Prometheus Books 2004, reviewed in [15]. Crick's remark is cited and discussed in: Hein H (2004) Molecular biology vs. organicism: The enduring dispute between mechanism and vitalism. Synthese 20:238-253, who describes Crick's remark as "raising spectral red herrings."</ref>

Alan Sokal published an analysis of efforts within the field of nursing to describe vitalistic beliefs as "new science" (Pseudoscience and Postmodernism: Antagonists or Fellow-Travelers?).<ref name="Sokal">Pseudoscience and Postmodernism: Antagonists or Fellow-Travelers?</ref> Pseudoscientific accounts within the field of nursing of practices such as therapeutic touch were reviewed by Sokal and he concluded, “nearly all the pseudoscientific systems to be examined in this essay are based philosophically on vitalism”. Sokal also noted that, "Mainstream science has rejected vitalism since at least the 1930s, for a plethora of good reasons that have only become stronger with time.”<ref name="Sokal"/>

In his book "Kinds of Minds", philosopher Daniel Dennett wrote, "Dualism...and Vitalism (the view that living things contain some special physical but equally mysterious stuff -élan vital- have been relegated to the trash heap of history...." (Chapter 2).<ref name="Dennett">Dennett, Daniel C., 1996, Kinds of Minds: Toward an Understanding of Consciousness, BasicBooks.</ref>

Joseph C. Keating, Jr., PhD, <ref>Joseph C. Keating, Jr., PhD: Biographical sketch</ref> discusses vitalism's past and present roles in chiropractic and calls vitalism "a form of bio-theology." He further explains that:

"Vitalism is that rejected tradition in biology which proposes that life is sustained and explained by an unmeasurable, intelligent force or energy. The supposed effects of vitalism are the manifestations of life itself, which in turn are the basis for inferring the concept in the first place. This circular reasoning offers pseudo-explanation, and may deceive us into believing we have explained some aspect of biology when in fact we have only labeled our ignorance. 'Explaining an unknown (life) with an unknowable (Innate),' suggests philosopher Joseph Donahue, D.C., 'is absurd'."<ref name="keating_innate">"The Meanings of Innate," Joseph C. Keating, Jr., PhD, J Can Chiropr Assoc 2002; 46(1)</ref>

He clearly views vitalism as incompatible with scientific thinking:

"Chiropractors are not unique in recognizing a tendency and capacity for self-repair and auto-regulation of human physiology. But we surely stick out like a sore thumb among professions which claim to be scientifically based by our unrelenting commitment to vitalism. So long as we propound the 'One cause, one cure' rhetoric of Innate, we should expect to be met by ridicule from the wider health science community. Chiropractors can’t have it both ways. Our theories cannot be both dogmatically held vitalistic constructs and be scientific at the same time. The purposiveness, consciousness and rigidity of the Palmers’ Innate should be rejected."<ref name="keating_innate"/>

He also mentions Skinner's viewpoint:

"Vitalism has many faces and has sprung up in many areas of scientific inquiry. Psychologist B.F. Skinner, for example, pointed out the irrationality of attributing behavior to mental states and traits. Such 'mental way stations,' he argued, amount to excess theoretical baggage which fails to advance cause-and-effect explanations by substituting an unfathomable psychology of 'mind'."<ref name="keating_innate"/>

According to Williams <ref name="Williams">Williams.W. (2000) The Encyclopedia of Pseudoscience. From Alien Abductions to Zone Therapy. Facts on File inc. Contributors: Drs D.Conway, L.Dalton, R.Dolby, R.Duval, H.Farrell, J.Frazier, J.McMillan, J.Melton, T.O'Niell, R.Shepherd, S.Utley, W.Williams. isbn 081603351x </ref> "today, vitalism is one of the ideas that form the basis for many pseudoscientific health systems that claim that illnesses are caused by a disturbance or imbalance of the body's vital force." "Vitalists claim to be scientific, but in fact they reject the scientific method with its basic postulates of cause and effect and of provability. They often regard subjective experience to be more valid than objective material reality."

Stenger<ref>Victor J. Stenger's site</ref> states that "This term is applied in biochemistry to refer to the readily measurable exchanges of energy within organisms, and between organisms and the environment, which occur by normal physical and chemical processes. This is not, however, what the new vitalists have in mind. They imagine the bioenergetic field as a holistic living force that goes beyond reductionist physics and chemistry."<ref name="Stenger">Stenger.V.J., (1999) The Physics of 'Alternative Medicine': Bioenergetic Fields. The Scientific Review of Alternative Medicine, Spring/Summer 1999 Volume 3 ~ Number 1</ref>

[edit] References

<references/>

[edit] See also

[edit] External links

  • The Meanings of Innate - Joseph C. Keating, Jr., Ph.D., Litt.D.(hon). Article examining the role of vitalism in chiropractic.

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