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At Your Own Risk:
The Case Against Chiropractic

Chapter 3: I Get the Treatment
© 1969, Ralph Lee Smith

"OOF!"

I was kneeling with my head on a little headrest that reminded me of a chopping block. The student chiropractor in the Palmer College of Chiropractic Clinic, a young blond Hercules, stood over me with his hands planted, one over the other, firmly at a midpoint in my unsupported back. Suddenly he pushed down with all his strength and weight. "There must be a better way to get this information,' I thought to myself as Hercules moved his hands a little farther down my spine. But I didn't say it out loud. Instead, I said "Ouch!" as he did it again.

Actually, although I was left with a sore back for a couple of weeks, there probably was no better way to find out the things I wanted to know. I visited the clinics associated with the Palmer College of Chiropractic, Davenport, Iowa, and the National College of Chiropractic, Lombard, Illinois. These are regarded with pride in the chiropractic world as offering excellent treatment and care. At both I said that I was experiencing symptoms that are usually associated with the presence of serious conditions. The clinics' response made me wonder if I were Alice and had fallen down the rabbit hole.

First of all, I wanted to see for myself if today's chiropractors are really taught to treat disease according to the theories and techniques expounded almost severe five years ago by Daniel David Palmer.

Second, I was interested in the host of questions arising, from that theory, some of which were touched on in the previous chapter. Is it true that the chiropractor is taught not to diagnose the symptoms that his patients present but simply to adjust the spine? If a patient went to a chiropractor with symptoms of a serious condition, would the chiropractor recognize the symptoms as indicating the possible presence of that condition? Would he try to discover whether or not the patient had that illness? It need hardly be said that, for innumerable persons who seek health care from chiropractors, the answer to this question involves the difference between sickness health, between recovery and disability, and even between life and death.

I also wanted to know how chiropractors would react to a spine in which recognized medical specialists and roentgenologists could find no significant abnormality. Would chiropractors find subluxations in such a spine that they regarded as being serious enough to cause illness? The clinics of the Palmer and National colleges seemed good places to make the test. In both, the actual work is done by senior students or recent graduates, and their methods would therefore reflect present-day teaching at leading colleges of chiropractic. At the same time each case handled at these clinics is reviewed and supervised by chiropractors on the faculties of the colleges and the staffs of the clinics, who are recognized as skilled leaders of the profession. The analysis of my condition and the treatment I would receive, therefore, would bear the stamp of approval of prominent and experienced chiropractors.

Since Palmer and its clinic are affiliated with "straights,' and National and its clinic are affiliated with the "mixers," I would have an opportunity to try both types of treatment and discover if the differences in theory which have split the chiropractic world down the middle reveal themselves in the therapies that the two groups offer.

Because Palmer is a "straight' college, and its students devote their attention largely or exclusively to the spine as the cause of disease, I decided to present at the Palmer clinic the symptoms of a straightforward back problem -a disc lesion, or, in laymen's language, a slipped, compressed, or damaged disc.

At National Clinic, I decided to present the symptoms of angina pectoris-coronary artery disease. I not only wanted to see if they would recognize the symptoms of this lethal condition, but I wanted to see how the "mixer' philosophy would react to a malady that could not conceivably originate in the spine.

As recent experiences with human heart transplants have shown, this organ can function perfectly without the help of the nervous system. "The origin of the heartbeat is in the muscle and the heart will beat in the absence of any nervous connection,' says Hyman S. Mayerson, Ph.D., professor of physiology and chairman of the department of physiology at Tulane University Medical School. Furthermore, heart trouble is primarily heart muscle trouble, whether the cause is disease of the muscle fibers or faulty coronary artery circulation. Heart trouble, therefore, could not possibly be treated by "relieving spinal nerve pressure' even if such pressure really existed.

First, I went to one of the nation's best urban hospitals and had the most exhaustive physical examination that I have ever undergone. It included fourteen different laboratory tests, an electrocardiogram, and an especially detailed study of my spine, based on a series of X-ray Plates taken from every angle.

Apart from the fact that I have, and have had for many years, several small, benign sebaceous cysts, this examination failed to reveal any deviation from normal health. The physician supervising the examination wrote to me:

The physical examination was entirely within normal limits and there were no significant abnormal findings except for several fibrous or cystic subcutaneous nodules on your face, your back, and your right thigh. The large battery of biochemical tests which were made the following day failed to disclose any abnormality. Your electrocardiogram is normal; the X-ray of your chest demonstrated your heart and lungs to be normal in size and contour. You were particularly interested in the condition of your back and for that reason, X rays of the entire spinal column were made and these films failed to show any significant abnormality.

My first stop was the Palmer College in Davenport. The college occupies three city blocks on an attractive site at the top of a hill overlooking the Mississippi River. Across the street are the modern transmitting facilities of stations WOC and WOC-TV. One of the transmission towers is mounted atop the D. D. Palmer Memorial Building, a classroom facility on campus.

After browsing around the campus and viewing the two marble monuments to D. D. and B. J. Palmer, I entered the clinic building (a slogan on the steps said 'Keep Smiling) and told the receptionist that I would like to see someone about a "back problem."

A student in a white coat promptly appeared, whom we will call Dr. Tom Blake (students working in the clinic wore nametags identifying them as 'Dr.' so-and-so). We shook bands and Dr. Blake led me into the clinic, a large open area divided up into some thirty treatment cubicles. The place was busy. There were patients in a number of the cubicles, and student chiropractors were scurrying around everywhere. Dr. Blake told me that last year the clinic handled some 28,000 patient-visits.

We entered a treatment cubicle and sat down. I asked him if his work in the clinic was supervised, or if he was "on his own." He replied that his findings, recommendations, and plans for treatment in every case he handled were reviewed and approved by chiropractors on the faculty of the college and/or the staff of the clinic.

I then described my "symptoms" to him. I had, I said, an off-and-on back pain. Sometimes this pain was accompanied by pain extending through my hip, down the back of my right leg, past my knee, and almost as far as my ankle. The pain, I said, never entered my other leg, and never extended upward in my back.

This set of symptoms, I had been told by several physicians, would suggest the possible presence of a slipped or damaged disc in my back. Such symptoms should be carefully checked because the condition is serious. The usual treatment is bed rest on a hard bed, sometimes accompanied by traction. Disc lesions can rarely or never be helped by manipulation of the spine by hand. In fact, manipulation is usually contraindicated, since pushing and jerking the spine is likely to aggravate existing damage.

Dr. Blake took my medical history. I then removed my shirt and undershirt and sat with my back to him. He ran his fingers slowly and evenly down my back, then began to feel the vertebrae of my lower spine. 'Finding anything?, I asked. "Yes,' he said. "There are subluxations in there [pressing my lower spine] and there [touching a spot in my mid-back, just below where I told him that the pain stopped]." He then felt my neck, turned my bead to the left and right, and stated that there was a third subluxation in my atlas, at the top of the spine where it joins the bead.

I lay down on the chiropractic adjustment table in the cubicle and Dr. Blake went back over my lower spine. "There's edema [swelling] there.' he told me. I got up from the table and we arranged for me to have X rays taken at 6:45 that evening. We then conversed for a while. I evinced great interest in chiropractic theory, and he obligingly explained it to me. Subluxations, he said, "cause the nerve impulses to go either too fast or too slow," causing the organs served by these haywire nerves to function incorrectly. This, be said, was the cause of disease.

I asked if chiropractic treatment was good for things other than back conditions. "Oh, yes," he replied. "One of our big problems is to dispel the public's belief that chiropractic treatment is for back troubles only." For example, he said, chiropractic adjustments can cure ulcers. They can also cure gallstones.

"What about a heart condition?' I asked.

"Yes," he replied, 'if it's caught in time.

At 6:45 that evening I met Dr. Blake at the clinic and we went to the X-ray department in another building. He took two 14-by-36 inch "full spine" X-rays, one from the front and one from the side. This is standard chiropractic practice. However, as we shall learn in Chapter Eight, it is unusual for medical roentgenologists to take such plates to analyze conditions in a specified area of the spine. A smaller plate carefully focused on the afflicted area not only yields far clearer and more detailed information, but exposes the patient to much less radiation.

When I returned to the clinic at 1 p.m. the next day Dr. Blake said that the X-rays bad been developed, and they confirmed his discovery of three subluxations. One was the fifth lumbar vertebra, the second was the ninth dorsal vertebra, and the third, as he had already stated, was the atlas.

We went into another treatment cubicle where, under the supervision of a senior student, we buckled down to the nitty-gritty.

For my first adjustment I lay down on a bard, flat couch, on my left side. Dr. Blake drew up my right leg, clasped it between his knees, bent over me, and placed his left band in the small of my back and his right hand on my chest just below my right shoulder. Suddenly, he gave a sharp thrust into my spine with his left hand and arm, using his right to keep me from slipping. There was some pain, but even more predominant was the sensation of shock-a swift and ruthless taking of the body by surprise, before it can marshal its defenses. I wondered what such a thrust would have done to a damaged disc if I had had one.

 

The next adjustments were the ones described at the beginning of this chapter. They consisted of three heavy downward thrusts, one to adjust the supposed subluxation in my mid-back at the ninth dorsal, and two to adjust the fifth lumbar in the small of my back. It was at this latter spot that I experienced for about two weeks thereafter the soreness that one usually feels with a slightly pulled or strained back.

Dr. Blake then adjusted my atlas. I sat on a chair, and, standing behind me, he took my head in his hands and felt the area behind my ears carefully, pushing his fingers in firmly. He then rolled my head to the right and gave it a sudden jerk. This apparently did not produce the desired effect. The supervising student took Dr. Blake's place behind me and repeated the process, also apparently without success. My atlas, they agreed, was "very tight" on the right side.

Dr. Blake then resumed his place behind me, rotated my head to the left, and jerked it. I felt and beard a snap in ray neck. This was apparently what they were seeking-they pronounced the left-side adjustment successful.

Back in our own treatment cubicle, Dr. Blake explained soberly that a subluxated atlas such as I had could pinch 'the whole cord' and cause just about any kind of trouble, I asked him what disease or condition I was suffering from. He replied that chiropractors do not seek to diagnose or identify illnesses; rather, they locate and remove the cause in the spine.

I asked him what types of conditions were treated at the clinic, assuming that they had been diagnosed and identified elsewhere. "They run the gamut," he said. "You name it." He confided to me that they included patients who really had nothing wrong with them at all. The backs of these patients are adjusted, along with all the rest. "You don't often come across a back that doesn't have a subluxation," he said. As for actual illnesses, one of his current patients has sinus trouble. Other ailments that he had seen treated at the clinic included bursitis, ulcers, a malady that involved "spitting blood," headache, sciatica, and heart conditions.

As we parted Dr. Blake told me that subluxations are rarely or never put permanently back into place by a single adjustment, and that I should therefore continue treatment with a chiropractor back home. This, of course, meant that, if the subluxations existed, I would still have them when I visited the National College clinic.

The next day I presented myself at the National College clinic in Lombard, Illinois. However, they were booked solid for the rest of the day and could not take me. I made an appointment for 11:00 the following morning.

When I arrived for my appointment I was met by a young chiropractor-we'll call him Dr. John May. At National College, I found, the clinic work is done by recently graduated students, who work at the clinic for fifteen to eighteen weeks before beginning their practice. As is the case at Palmer, their work is supervised by chiropractors on the college faculty and on the staff of the clinic.

National College's buildings and clinic are somewhat more modern than Palmer's. Instead of the one large gymnasium-like room sectioned off into cubicles by dividers, in which the Palmer clinic is housed, the National clinic has individual patient treatment rooms. We entered one, and I described my "symptoms."

For about a year, I said, I had been having dull, cramplike pains in my chest. I had them sometimes two or three times a day, sometimes only once a week. They tended to come when I had been exerting myself heavily, or when I was angry or under strong emotional stress. The pains, I continued, would cause me to breathe deeply. They lasted for periods of time ranging from a few seconds to a few minutes. When they came, I said, they would go away if I simply stopped what I was doing, if they came when I was angry, they would go away if I just took it easy, sat back, and relaxed. I added that these pains would sometimes go up from my chest into my left shoulder and arm.

These symptoms, physicians told me, clearly suggest the possible presence of a coronary heart condition. I even helped Dr. May along by saying pointedly that the pains were never in my back, thus making it unlikely that my condition was arthritis.

Dr. May asked me no questions about my symptoms, and showed not the slightest sign of recognizing their possible significance. He took a brief medical history. As he finished it, Dr. Eugene V. Hoffmann, Jr., a chiropractor who is an assistant director of the clinic, came in. Dr. May told him that I had "dull chest pains, going up into his left shoulder and arm." Dr. Hoffmann was apparently as impervious to the possible meaning of the symptoms as Dr. May. He asked me no questions.

I took my shirt off and Dr. Hoffmann, the assistant clinic director, felt my upper left shoulder and my spine. He told me that the musculature of my left side was more developed than that of my right, and that that might well be causing my trouble. I told him that I was right-handed. He replied that perhaps my left-side musculature had nevertheless become overdeveloped by such activities as lifting.

He then felt my neck, pushing his fingers in firmly and asking me if it were tender. I said no. Dr. Hoffmann then turned things over to Dr. May, and left the room. Dr. May took me in front of a mirror to show me that my left shoulder was higher than my right. In the mirror, it was clearly not so. "It shows when you sit down," he said.

We then went to another room, where I lay face down on a chiropractic adjustment table. Dr. May put a hot compress on my back to relax my spine, and left me there for about ten minutes. In the next room I heard a man gasping in pain as be was adjusted.

Dr. May re-entered the room, removed the compress, felt my neck and back, and settled his hands upon the area just below my shoulder blades. 'Finding anything?" I asked. "Yes," he said, "you have a subluxation there," "Where is it?" I asked. "At the fifth dorsal," he replied. He found nothing at the ninth dorsal or the fifth lumbar, where the Palmer clinic had told me I bad subluxations. Conversely, Palmer bad found nothing at the fifth dorsal.

Dr. May gave a sharp thrust at the fifth dorsal, and my spine popped audibly. Next he moved to the bottom of my spine. 'One down there?' I asked. "Your hips are slightly out of line," he replied, and gave me a wingding adjustment, He then took my head and jerked it left and right, getting a good sharp pop each time. That concluded the treatment. I sat up and asked him if the subluxation at the fifth dorsal might be causing my chest pains. He replied that nerves lead from the fifth dorsal to 'organs all around the chest area," and the subluxation there might well be causing my pain.

As was the case at Palmer, be told me that a series of adjustments would be necessary to get my subluxated- vertebra permanently back into place. I asked him if X-ray of my spine would be advisable to establish that it was indeed subluxated. He said that it was not necessary. I had intended to continue my research by offering myself as a guinea pig in the office of individual chiropractors. But as I left the clinic and got into my car I felt a sharp twinge from my lower-back adjustments at

Palmer. I couldn't help remembering the comment made by by Dr. Edward T. Wentworth, past president of the Medical Society of the State of New York: 'Only a strong, healthy person can afford to indulge in chiropractic treatment." My back had been healthy before I began the project, and I decided there was no point in taking further risk. Another consideration prevented me from making further tests-the frequent use of X-ray by many chiropractors. Although the National Clinic had not X-rayed me, I felt that I would be fortunate to escape from the office of the average chiropractor in private practice without getting a heavy dose of radiation, no matter what symptoms I presented. That was one of the many things I had learned when, posing as a chiropractor, I attended a three-day seminar in practice-building given by the Parker Chiropractic Research Foundation in the fall of 1967.

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