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"Since I've been driving a truck for twelve years with no chance of doing much better, my uncle promised to pay my way to your college if I would do it. I wasn't too good of a student in high school, but I like to read a lot, and I read a little about chiropractic, and it really seems to be the coming thing."
The above is an excerpt from a letter written to one of the nation's leading chiropractic colleges by a person seeking admission. The college replied asking for a letter of recommendation and a transcript of high school credits, and enclosing two examinations for the prospective student to take. It received the examinations back from the student; they showed a tenth-grade level of achievement. The letter of recommendation, from a person in a trucking company, said, "Although I find him quite dependable, in all honesty I cannot say that he utilizes a great deal of imagination in his work. However, this lack of imagination should not be taken as a rebuke, but merely as an evaluation of his qualities."
From the prospective student himself the college received an eloquent letter explaining why he was unable to provide a copy of his high school transcript.
I went downtown to the main offices of the Board of education, and boy did I get the run-around. I never saw so much red tape in all my life. But after much running around and-being battered from piller to post, I finally got to see the guy who is suppose to be in charge of high school credits. After he took a lot of time looking all over the place for my credits, he finally said that he was sorry, but somehow my records got misplaced, and he just didn't know what to do now, because I guess they lost all my records. I hope this don't interfere with my being accepted.
The college wrote a letter to the Board of Education in the applicant's city, and received a reply stating that it had no record of such a person ever having graduated from the city's schools. The college then wrote to the applicant suggesting that he take a GED (General Educational Development) test. The applicant replied asking for conditional acceptance. The college replied in the affirmative; the applicant was enrolled in the fall class. (He subsequently received a letter from a female student at the college who was to be his "big sister," inviting him to see her if be needed any help; she signed it "Chiropractically yours.")
Actually, the prospective student did not exist-and neither did the trucking company that wrote his letter of recommendation, for that matter. The letter was one of seven different semiliterate letters written to seven of the nation's best-known colleges of chiropractic, in which the applicant sought admission but could not produce a high school diploma. Five of the schools accepted and enrolled the applicant.
Another of the letters was supposedly from a single girl in her thirties named Bonnie, who had been running a massage parlor in Chicago for five years. "We work on both men and women and do pretty good,, she wrote to one of the schools. "I never went to high school." The college to which it was addressed sent her an application. Bonnie filled it out, listing a nonexistent grade school and affirming that she had had no high school. The college replied, suggesting that she take a GED test. "Is it really necessary for me to take a bunch of tests to get into your school?" Bonnie replied. "I am sure that I would make a good chiropractor and I bet that I could do just as good in school as some of these young kids who went to high school." The college replied, offering her conditional acceptance and permitting her to take the GED sometime during her first year. Bonnie wrote back that that would be fine, "As I am going to be very busy in trying to wind up all my affairs here in Chicago. before coming to ________. I don't think that I'M going to get a chance to take these GED tests here in Chicago,"
A third letter was from an applicant who had been in the army but had not received an honorable discharge. "I have just been generally discharged from the Army after serving 10 years in the Army Medical Corp.," the applicant wrote. While I was in the Army I got real interested in helping sickpeople become well again. But since I am not a highschool graduate I won't be able to go to medical school. Besides, some of those medical doctors are real butchers anyway." The college granted him conditional acceptance.
As we have already seen in the chapter describing the origins of chiropractic, the schooling of chiropractors in the early days was brief, and there were no admission requirements to the schools other than the ability to pay for the course. Nowadays chiropractic colleges offer four-year courses. Based on available information, however, their admission standards appear to remain low, their faculties offer limited commonly recognized academic credentials, their equipment and facilities are meager, and their students have little if any opportunity either for research or for clinical work in hospitals.
According to the HEW Report there are twelve schools of chiropractic in the United States. None of, them is accredited by any recognized educational accrediting body. The American Chiropractic Association (mixers) recognizes eight of them and the International Chiropractors Association (straights) recognizes three. [*A list of the colleges and the associations that recognize them is contained in Appendix B.]
Each association has set up an accrediting body of its own, which has accredited the colleges that its association recognizes. These two accrediting groups do not enjoy recognition by the U.S. Office of Education or the recognized academic accrediting bodies. [The three recognized educational bodies that accredit institutions of higher education in the United States are the Federation of Regional Accrediting Commissions of Higher Education, the National Commission on Accrediting, and the Office of Education of the Federal Government. The Federation of Regional Accrediting Commissions of Higher Education accredits colleges and universities through its member regional associations. The National Commission on Accrediting and the Office of Education list approved accrediting agencies for the professions. Chiropractic schools are not recognized or listed by any of these accrediting organizations.]
The educational purpose of chiropractic colleges has to a great extent been molded by state chiropractic licensing acts passed by most states. The most important provision in the licensing laws is that aspiring chiropractors must pass a series of "basic science examinations" in anatomy, bacteriology, chemistry, diagnosis, hygiene, pathology, physiology, and public health. The same requirement is made of aspiring medical doctors.
These requirements were enacted with good intention, but their actual impact has hardly been beneficial. The passage of such written examinations does not qualify one to treat the sick. As a matter of practice, medical students take and pass the exams at an early stage of their medical education, and spend years of additional study, internship, and research before they are licensed to practice. By contrast, almost the entire thrust of chiropractic education is aimed at getting the students past these examinations, which constitute the principal hurdle they must surmount to enter their profession.
In five states the same basic science exams are given to students of chiropractic and students of medicine, and the exams are graded by the same board on a uniform standard. A set of statistics covering a period of several years in these states showed that an average of 81.4 percent of all medical students passed the exams on their first try. An average of 84.5 percent of chiropractic students failed.
Chiropractors are exerting strenuous efforts to prevent such information from being compiled. The American Chiropractic Association is pushing to prohibit exam applicants from having to list the college from which they are applying; this would make it difficult to tell how chiropractic students as a group fared on the exams. The International Chiropractors Association is working to prevent medical and chiropractic students from having their exams graded by the same board. The value to chiropractors of the latter procedure has been well demonstrated. In states in which medical students' exams are graded by a board of M.D.'s, and chiropractic students' exams are graded by a board of chiropractors, the showing of the chiropractic students improves tremendously.
In chiropractic colleges it is common lore among the students that some states have "easy" exam standards and other states are "tough." Some students establish residency in "easy" states in order to take the exams there; they can then achieve licensure through reciprocity in other states where reciprocal licensing arrangements have been established. Thus, for example, a Palmer student front Tennessee told a reporter that he planned to take his basic science exams in Alabama and then obtain reciprocity in Tennessee, because Alabama's examinations were known to be easier.
The relatively poor performance of chiropractic students in these examinations reflects not only the colleges' low admission standards but the educational backgrounds of their instructors.
The September 19, 1966 issue of the Journal of the American Medical Association (JAMA) carried a report entitled "Educational Background of Chiropractic School Faculties." The report was based on a review of the catalogues of eleven U.S. chiropractic colleges, plus one in Canada, and a check of the academic backgrounds of the listed faculty members.
The JAMA report says that, in contrast to the procedure of accredited colleges and universities, three of the twelve catalogs do not list the school's faculties. Three others that list the faculty members and their degrees neglect to indicate what institutions granted the degrees, again in contrast to the practice of accredited institutions, It was thus possible to check the academic credentials of the faculties of only seven of the colleges.
Most members of the faculties of these colleges are listed as holding the degree of D.C.-Doctor of Chiropractic. This, as we have seen, is not an accredited or recognized academic degree.
Turning to actual recognized degrees from accredited institutions that are held by faculty members of the seven chiropractic colleges, JAMA's report states that less than 50 percent list even bachelor's degrees from accredited colleges or universities. In the public school system of most states today a bachelor's degree is required even to teach kindergarten. Where academic degrees are listed they are often in subjects bearing little or no relationship to the subjects the faculty members are teaching.
In some cases the faculty members list degrees that have no recognized status in the academic community. According to the JAMA report, other faculty members list degrees that must politely be called "unconfirmed" In some of these instances no record can be found that the listed college ever existed. In others, the college exists, but it stated, when queried, that it has no record that the faculty member ever went there. Again, in some instances, the colleges stated that the person in question attended but never graduated.
With 1,100 students, the Palmer College of Chiropractic remains the largest of the chiropractic colleges from the standpoint of enrollment. Its 1965-1966 catalog lists twenty-nine faculty members, of whom only eight list recognized four-year degrees, and only three list any recognized degree beyond the bachelor's degree.
The dean of the faculty, the chairman of the X-ray department, and the director of education and professor of anatomy, all holding the rank of full professor, do not list a single recognized academic degree among them, even at the bachelors level.
The person designated as dean of basic sciences and professor of anatomy and diagnosis lists no recognized four-year degree. Neither do an assistant professor of chemistry and bacteriology, an assistant professor of anatomy and pathology, or the two instructors in X ray. Among the faculty members who do have degrees, an associate professor of physiology and pathology has a bachelor's degree in animal husbandry. An associate professor of chemistry and diagnosis has a B.S. degree in business administration. He is also director of athletics.
Two schools with larger faculties are the Los Angeles College of Chiropractic, listing forty-four faculty members in its 1964-1965 catalog, and the Chiropractic Institute of New York, listing thirty-one members in its 1965-1966 catalog.
The president of the Los Angeles College of Chiropractic lists a Ph.D. degree, but does not indicate where it came from. The administrative dean, the dean of instruction, the dean of the graduate school, the dean of students, the director of research, the director of clinics, and the dean emeritus do not list a bachelor's degree among them.
The chairman of the anatomy department, who lists himself as a "certified pathologist," holds a bachelor's degree in education. The acting chairman and sole member of the department of obstetrics and gynecology lists no recognized academic degree.
On the "clinic staff," the heads of the departments of roentgenology, EENT, cardiology, neurology, and orthopedics list no academic degrees. One member of the department of chemistry and nutrition actually does list no less than three recognized academic degrees-a B.S. in electrical engineering, an M.A. in education, and an O.D. in optometry.
Another faculty member lists a "D.P.M." degree from the "Los Angeles College of Drugless Physicians." It is not known what the letters stand for. Another member lists an "O.C.R." degree. The letters apparently stand for "Order of Christ the King."
The 1965-1966 bulletin of the Chiropractic Institute of New York (the school of which Clarence W. Weiant is dean emeritus) lists the faculty but does not say who teaches what. The president and vice-president of the school list no academic degrees.
The faculty listings of the various colleges are often followed by unrecognized or meaningless academic initials. The president of one chiropractic college lists himself as an "N.D."-doctor of naturopathy-without indicating what institution granted the degree. The N.D. degree from any institution is unrecognized by modern science. In at least some instances, the overall facilities of chiropractic schools have been as inferior as the backgrounds of their faculties. In 1960, Stanford Research Institute, under a grant from the John Randolph Haynes and Dora Haynes Foundation, prepared and published a study of the programs and facilities of three chiropractic colleges in California-the Los Angeles College of Chiropractic, the Cleveland College of Chiropractic, and the Hollywood College of Chiropractic. The Hollywood College of Chiropractic refused to cooperate with Stanford Institute in the project, and would not permit institute teams to visit its facilities. [This college, originally called the Pasadena College of Chiropractic, became the Drown College of Chiropractic (see Chapter Five) in 1948. In 1949 its name was again changed, to Hollywood College of Chiropractic. It was later absorbed into the Los Angeles College of Chiropractic.] Institute teams made a number of visits to the other two schools during a six month period in 1958-1959, and compiled statistical and other information on all three colleges.
The study of the faculties of the two cooperating colleges produced a familiar story. Of twenty-nine faculty members, only ten claimed to have bachelor's degrees, and in four of these cases the college from which the faculty member claimed to have a degree denied that such a degree had been granted.
The rest of the institute's study presents a rare inside look at the type of program and curriculum that has turned out many of today's D.C.'s. "In their curricula, chiropractic schools use course titles and textbooks similar to those used in medical and osteopathic schools," the institute's report says. "However, their teaching approach is centered almost entirely on classroom lectures and practical work in out-patient clinics. No hospital in-patient training is available.
"Although a number of laboratory courses are listed in school catalogs," the report continues, "there was no evidence that the chemistry laboratories were in use at any time during the Institute project team visits. . . . Similarly, the libraries were found to be seldom used. . . . The laboratories were not equipped and the libraries not staffed to serve the purposes for which they were intended. These conditions suggest that libraries and laboratories do not play an important part in the education of a chiropractor."
Total fixed assets of the Los Angeles College, including the three two-story brick buildings in which the college was housed, were valued at $186,069. "However," says the report, "during the course of many visits by Institute personnel in the period June, 1958, to February, 1959, the chemistry laboratory was found to contain no more in the way of equipment than chemistry benches. NO reagent bottles or chemicals were in view, and the laboratory was odorless. The benches, which were newly painted in the summer of 1958, were free of the chemical stains and bottle marks commonly seen in a laboratory which is used. . . . The chemical stockroom was also odorless: it contained several prepared solutions, stored in dusty cartons, and a five-gallon tin of acetone and isopropyl alcohol."
The school's library contained about four thousand books, and the periodical racks carried about forty magazines and journals. There was seating capacity for exactly four students. The library was often closed during the hours that it was scheduled to be open; there was dust on the tabletops. "In general," says the report, "the library facilities are meager and appear to be seldom used."
At the Cleveland college, a smaller school, all activities, says the report, "are carried on in two single-family dwellings which have been made over to fit the needs of the college." The college estimated the value of its properties at $75,000 to $80,000, and its equipment at $15,000 to $20,000.
"The CCC [Cleveland College of Chiropractic buildings contain four lecture rooms, the largest of which has a capacity of about fifty students, " the report states. "The other lecture rooms hold no more than about thirty students each. Laboratory space in the college has been converted from the kitchen and dining room areas of one of the residences."
The laboratory facilities were so meager, the Stanford teams found, that the college could not even offer lab work to compare with that given in the public schools."
"Equipment observed in the laboratory by Institute personnel during visits to the college included twelve test tubes, one or two flasks, and a variety of dusty bottles, all stored in a small room adjoining the laboratory. . . . There were no chemicals stored on the grounds and no odor of chemicals in the laboratory, the laboratory storeroom, or elsewhere on CCC property. Storage space under the work benches was empty except for a few discarded cartons, a roll of paper towels, and several similar items. In view of the quantity and type of equipment in evidence, laboratory use would necessarily be limited to only the most rudimentary experiments. "
The library was also rudimentary; it was housed in a single room seven feet three inches wide and twelve feet eight inches long. "There are between 1,500 and 2,000 volumes in the stacks. Seating space for reading is provided in a classroom located next to the library rather than in the library itself." Less than 1 percent of the books in the library, the researchers found, had been written in the last ten years, and there were no periodicals. When a member of the school's staff was asked about the antiquity of the library's holdings, the staff member replied that "things are happening so fast in chiropractic that it would cost too much to buy new books all the time."
Conditions in the California colleges, and in other chiropractic colleges, may have improved in some respects since 1960. However, the general picture of chiropractic education remains seriously inadequate. Its shortcomings, says the HEW Report, "raise serious doubts as to the qualifications of chiropractors generally to make an adequate diagnosis and effectively treat patients."
In their classroom work, chiropractic students use both standard medical works and texts written by chiropractors. One wonders how the students-or the professors-reconcile the two kinds of information that they find in these books.
According to HEW's 1968 Report, the most commonly used textbook is The Neurodynamics of the Vertebral Subluxation, by A. E. Homewood, D.C., N.D. (n.p.; published by the author, 1962). Homewood is described in the Report as dean emeritus of the Canadian Memorial Chiropractic College and a member of the American Chiropractic Association's Commission on Standardization of Chiropractic Principles. The Report quotes Homewood's book as saying,
While it is not the purpose of the writer to derogate practitioners of other forms of healing, it is of the utmost concern to awaken an appreciation in the minds of doctors of chiropractic for the heritage left by D. D. Palmer, which provides the basis for the most complete understanding of the patient as a unit of structure and function yet to be devised by man to this date.
On the relationship of chiropractic treatment to heart attacks, the Report gives the following quotation from the book:
Experience has established the fact that the administration of chiropractic adjusting is efficacious in handling both the acute and chronic cases of coronary occlusion but no button has been located, either theoretically or clinically, that may be pushed in every patient to make the correction.
On the germ theory of disease, the Report quotes Homewood's book as saying,
The doctor of chiropractic is well aware of the presence of bacteria and concedes that these minute organisms play a role in many diseases. He would, however, emphatically deny that microorganisms are THE cause of the diseases with which they are associated [HEW Report, pp. 153, 154, 160, 167, 174]
The second most widely used chiropractic text, says HEW's Report, is Chiropractic Principles and Technic for Use by Students and Practitioners, by Joseph Janse D.C., R. H. Houser, D.C., and B. F. Wells, D.O., D.C., copyright 1947 by the National College of Chiropractic. Among the authors, the most distinguished appears to be Joseph Janse. He is president of the National College of Chiropractic, a leading "mixer" school and has recently (1966) been chairman of both the Committee on Public Health and the Committee on Chiropractic Standardization of the American Chiropractic Association,
As a basic text on a medical subject, Chiropractic Principles is perhaps unique. The 660-page work contains no bibliography, no bibliographic references, and not a single footnote. In the entire text I was able to find only two references to other medical works, each one sentence long. In neither instance is the publisher, date, or page number of the reference cited.
The only medical person whose opinion on any subject is cited at length is a Dr. Alfred Walton, whose three-paragraph endorsement of chiropractic appears in the text. Dr. Walton was one of a small group of M.D's who became converts to chiropractic, and who actually became chiropractors, during the infancy of the cult. [For further information on these MD-chiropractors, see Chapter Ten. A testimonial by Dr. Walton is among those used in the Parker Chiropractic Research Foundation's leaflet "M.D.'s Comment on Chiropractic," discussed in that chapter.] He published a monograph endorsing chiropractic ideas in 1908, and died in 1920.
"Vertebral subluxations," readers of Chiropractic Principles are told, "are the cause of the production and continuance of disease.... Probably in all abnormal states there is a demonstrable spinal lesion."
Many maladies are discussed. Some examples are:
The authors concede that germs have something to do with human disease. But this need not worry the chiropractor. Germs can do their dirty work only when the body has been weakened by subluxations. When the subluxations are adjusted, the germs fold up their tents and steal away. The book cites typhoid fever as an illustration, The direct cause of the disease, it says, is the typhoid bacillus.
"This bacillus is not, however, the primary cause: for by this cause one must understand that state or condition of certain parts which makes the action of the typhoid bacillus possible. This primary cause is subluxation of vertebrae, which by producing a disturbed nerve supply, and thereby diminishing the typhoid the resistance of those parts for which bacillus has a selective action, make possible their activity in those parts. Therefore the subluxations are the primary, indirect and predisposing cause of typhoid fever, and the typhoid bacillus is the secondary, exciting and direct cause."
Faced even with foes such as the typhoid bacillus the chiropractor, therefore, can simply adjust the sufferer's spine. "It is found that the fever subsides rapidly when these subluxations are corrected," the text says. The same principle, it adds, applies "to all infectious and contagious diseases."
Immunization is strongly opposed by many leaders of chiropractic, and is condemned in a number of chiropractic texts. One of the enemies of immunization is C. W. Weiant, dean emeritus of the Chiropractic Institute of New York. His book Rational Bacteriology, written with R. J. Watkins and J. R. Verner, is used as a text in many chiropractic colleges. "Diphtheria antitoxin and toxoid," says this book, "are both not only worthless in practically every case, but also virulent and injurious in all cases." Rabies serum is "utterly worthless." Typhoid vaccine has been "completely exposed" as "worthless." In cases of tetanus, "there is not the slightest excuse for the toxin-antitoxin," By contrast, "drugless healers have been highly successful in handling diphtheria without serums," and diseases such as gonorrhea and cerebrospinal meningitis "respond readily to non-medical methods." Verner is also the author of a work called Vaccination: A Fraud.
In 1965 chiropractic educators and textbook writers had an opportunity to air their beliefs at a trial in Louisiana. Louisiana is one of two states in the Union (the other is Mississippi) that have resisted the pressures of the chiropractic lobby, and refuse to license chiropractors or to legalize their practice. A chiropractor named Jerry R. England, on behalf of himself and a number of other chiropractors, brought an unsuccessful suit against the Louisiana Board of Medical Examiners, to try to force the board to permit them to practice chiropractic in the state. In the trial, a number of luminaries of the chiropractic world journeyed to Louisiana to testify.
One was Joseph Janse. Here are excerpts from his testimony under cross-examination:
Q: What specific centers would you adjust for tetanus?
A: To normalize the vasomotor extension, of course, you would adjust in the lower lumbar spine.
Q: What is the chiropractic treatment for polio?
A: Chiropractic treatment for polio in the initial stages of polio, in the prodroma, is the adjustment primarily.
Q: (by the Court): What would you do with a patient while you are making up your mind as to whether he has meningitis?
A: I would, in this patient-I would give this patient a careful chiropractic adjustment.
Another witness was William D. Harper, former dean and now president of the Texas Chiropractic College, a member of the American Chiropractic Association's Commission on Standardization of Chiropractic Principles and also the author of a book on chiropractic entitled Anything Can Cause Anything (San Antonio, Texas: published by the author, 1964):
Q: In your book, Dr. Harper, I get the impression from reading it that at one point you say that some workings of the individual psychic thought could cause a subluxation?
A: Yes, because psychic irritation of the nervous system can through irritation of the cord and into the anterior horn cause muscle contraction and in turn produce a subluxation in which case the subluxation becomes one of the symptoms of the complex and not the cause of the phenomena as long as the original irritation, be it clinical or psychic, remains.
Q: In other words, I could think myself into a subluxation?
A: You could. Now, pardon me, may I say one thing. That is one of the, as a perfect example, I have suffered today from the irritation of being up on this stand. This is my first experience. I am demonstrating the fact today.
Q: You mean you think I am giving you a subluxation?
Q: Could you tell us what vertebra is affected by cross-examination?
A: All of them.
Q: So that the gamut of diseases is possible as a result of being a witness?
A: Chronic irritation of the nervous system.
Q: You could get polio?
A: It's possible.
Perhaps one reason that chiropractic students find such teachers and teachings acceptable is that they are completely insulated from an experience that is a central part of the education of medical students. No hospital accredited by the Joint Commission on Hospital Accreditation permits chiropractors or chiropractic students to make use of its facilities either for seeing patients or for intern training. The chiropractic student, therefore, graduates, becomes a "doctor," and treats human illness without ever having had any experience with hospitalized patients.
For chiropractic students, however, there is at least one consolation. They get better grades than students in medical school. The Stanford Institute found that, of all grades awarded by Cleveland Chiropractic College to its students during a five-month period in 1958, 60 percent were As. Of the rest, 30 percent were Bs, 6 percent were Cs, 3 percent were Ds, and 1 Percent were Fs. Of all grades granted by the Los Angeles College over several comparable periods, 78 percent were As and Bs.
The laws of all states except North Carolina also prohibit chiropractors from having access to hospitals. North Carolina's law, dating back to 1919, permits chiropractors access to hospitals. This state's health officials, however, were surprised to learn of this provision of the law when it was called to their attention in 1967, and no official could recall any instance in which the right had been exercised.
And, as for hospital facilities, if they have none in their training, they can at least refer their more serious cases to Spears Chiropractic Sanitarium and Hospital in Denver, Colorado, after they begin their practice.
It is to this unique institution that we must next turn our attention.
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