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Bonesetting, Chiropractic, and Cultism

Chapter 2: Bonesetting, Chiropractic,
and Joint Manipulation

©1963, Samuel Homola, D.C.

We see but a part, and fancy that we have grasped the whole.

But the senses cannot lead to the truth;

thought and reflection must look at the thing on every side.

                          -- EMPEDOCLES THE PHYSICIAN, 495-430 B.C.

Many authorities, in referring to the use of joint manipulation in the treatment of disease, refer to what used to be the cult of osteopathy (rather than to chiropractic) for the simple reason that osteopathy was founded quite some time before the almost identical practice of chiropractic. In all fairness, however, we must state, as we will again do later, that osteopathy has considerably abandoned the doctrine of vertebral misalignment and is as far removed from the practice of pure bonesetting as is the practice of medicine.

In A. G. Timbrell Fisher's book, Treatment by Manipulation, the difference between manipulation as applied by the medical man and that usually applied by the bonesetter was very well put:

The osteopath, if a true disciple of Still, manipulates the spine, not primarily because it is itself the seat of symptoms, but in the misguided attempt to cure some disease -- for example, epilepsy, diabetes, or even cancer.

The orthopedic surgeon, on the other hand, if consulted by a patient complaining of pain and stiffness of the spine due to adhesions, manipulates the spine, breaks down the adhesions, and often cures the patient. If the osteopath manipulates the spine for similar conditions, he encroaches upon the domain of manipulative surgery. There is little evidence that the founder of osteopathy was ever concerned with the stiff or deranged joint per se, and the rational treatment of such by manipulation was well established long before Still raised the banner of osteopathy [1].

Although osteopathy has changed considerably in its methods and purpose, chiropractic, for the most part, has continued largely to bedefined as "a method which aims at restoring health by palpating the spinal column for subluxations or misplaced vertebrae and adjusting them by hand without other aids or adjuncts," or simply "a theory of treating human disease by manipulating the spinal column." Chiropractic has changed but little in its fundamental concepts, although certain factions do include the use of other "drugless" methods of healing in addition to spinal manipulation.

As we shall show in the following pages, that which is good in manipulation has been and is being taken up by medical specialties and put on a scientific basis, while the chiropractic profession, to a great extent, continues to struggle under the stigma of cultism on one hand and severe limitations on the other. Since the medical profession has not yet offered sufficient facilities and services in the field of joint manipulation, many intelligent Americans, who feel the need for manipulative treatment in certain conditions, are forced to exercise their own judgment in the selection of a competent practitioner offering such services outside the field of medicine -- a judgment made exceedingly difficult and precarious considering the prevalence of cultism among those who practice spinal manipulation in the treatment of disease. In addition, it is quite impossible for the intelligent and discriminate layman to accurately decide for himself what is a case for manipulative therapy and what is not -- thus leaving him quite at the mercy of chance that he might select a competent practitioner who will not administer unnecessary or harmful treatment.

Ordinarily, it would seem, the general public would be completely dependent upon the opinions of those authorities who spend their entire lives studying a subject of which the average layman knows little or nothing. Probably the majority of people do depend upon their authorities for guidance, but there are a number of persons who actively dispute authoritative opinions, while at the same time, possessing comparatively little or no knowledge as would be necessary to support their own contentions. Obviously, anyone in contradiction with authority must possess equivalent knowledge and additional fact in order to sustain his argument. A basis for judgment and selection is complicated by the fact that a layman is quite often unable to determine who is the accredited authority and who is not. Not every medical practitioner, for example, is able to determine what is good or bad in manipulative therapy, and not every chiropractor recognizes his own limitations. There are, however, specific authorities who are able to differentiate known falsehoods from known truths in their particular fields and still leave a margin for the probable or possible.

In the final analysis, there is no such thing as two opposing authorities who base their opinions on a double standard of truth. Truth, in science, is always based first on what is known in fact; and fact is a universal and common truth, forming a basis for agreement between any two qualified authorities.

There are some in the field of chiropractic who disagree with medical authorities (who are more qualified academically than chiropractors) on the grounds that those who have not practiced and studied chiropractic could not possibly know enough about the practice to condemn it. It should be remembered, however, that chiropractors do not possess knowledge of new laws in physiology, neurology, and other biological sciences, and that they must depend entirely upon the textbooks of accredited authorities in acquiring a working knowledge of these sciences. While these same authorities have not recognized the wide claims of many chiropractors, they most certainly would recognize possibilities substantiated sufficiently in fact. Any further recognition by these authorities would then, of course, depend upon proper limitations being placed upon these possibilities. Although much of what chiropractors do has been recognized by medical science, the chiropractors themselves have not yet been recognized because of their failure, thus far, to properly qualify and limit their efforts as a group.

Strangely enough, chiropractic educators, in teaching from books by medical authors, may draw altogether different conclusions from those of the medical author, and apply what they learn in a manner entirely different from that recommended by the author. The Director of Education of the National Chiropractic Association, for example, stated that chiropractors do not undertake the actual practice of medicine, and that the chiropractic conception of therapy differs from that of the medical profession, "Because we have different conceptions of physiology, pathology and what is the cause of pathological conditions." [2]

While manipulation in the field of medical science (and under the direction of those guided by medical science) is applied primarily according to what is known in fact -- or in accordance with related facts -- the fundamental chiropractor's manipulations are performed with an element of mysterious theory. It is this theory, in defiance of medical science and in competition with medical practice, that determines the overall status of chiropractic.

A medical orthopedic authority, who employs the use of manipulation, states of manipulation and those practitioners outside the field of medical practice who employ the treatment:

Manipulation is no mystery to anyone who understands the pathological changes in these tissues. Manipulative surgery has, to a considerable degree, fallen into the hands of unqualified practitioners because the public assumes that the irregular practitioner has some hidden knowledge, divine gift and peculiar skill. He has the additional unrestricted power to publicize and advertise his successes, but most of his mistakes and failures are concealed by his disillusioned victims or even buried with them. There is no God-given skill conferred on any group of practitioners [3].

Another medical manipulative specialist comments:

It is sometimes asserted that the medical profession is opposed to osteopathy from jealous and selfish motives. This is untrue. Medical men are willing and even eager to accept any method of treatment, whatever its origin, which contains possibilities of alleviating human suffering. It should never be forgotten, however, that it is the duty of the profession to safeguard the public against any method of treatment which is potentially dangerous. Secondly, if any cult or method of treatment boldly asserts that orthodox medicine is based upon false pathological principles, and that all the great pioneers of medicine were in error, such a cult must be prepared to substantiate its revolutionary claims by evidence that will stand careful and impartial scientific investigation. Can any educated member of the public, or even an osteopath, logically object to such conditions? [1]

There is, of course, a great deal of value in joint manipulation when such treatment is indicated. Orthopedic authorities do not denounce the value of manipulation as such. Medical science has readily incorporated the use of scientific manipulative therapy into a department of medicine called physical medicine; no argument there. Further, many hitherto unknown values of manipulation, all in accord with the laws of physiology, neurology, psychology, and anatomy, are being progressively recognized and sifted by medical science. Many of these values have long been conveyed by a good number of competent and conscientious osteopaths and chiropractors. Many chiropractors, however, continue to apply manipulation indiscriminately and promiscuously to the whole gamut of human disorder, most specifically as a treatment for disease.

The chiropractor claims: "Of all the causes of disease, there is one which is more universally present than any other, and that is subluxation of vertebrae. Probably in all abnormal states there is a demonstrable spinal lesion." [4]

The medical orthopedist replies:

Occasionally the lateral articulations of the vertebrae are caught in an unusual position and held by muscle spasm. This occurs most often in the mid-cervical or lumbosacral region. Such a "slip" may be reduced by manipulation and the reduction may be accompanied by an audible or palpable snap or crack. Manipulation has been much abused in such conditions, however, and displacement of the vertebrae has been made a diagnostic and treatment cult by certain practitioners of the healing art. Manipulation of the spine has been done by such practitioners in cases of tuberculosis, cancer, fracture or actual dislocation of the spine, with serious and occasionally fatal results. Continued manipulation without other treatment does nothing constructive to result in permanent cure or improvement in the patient's local condition, even though it may temporarily relieve the symptoms. Valuable time may be lost in continuing such treatment while proper treatment is neglected [5].

There is probably not a single orthopedic book on the shelf, that deals with manipulation, that does not point out the dangers of unqualified manipulation when applied, as many chiropractors apply it, as a general treatment for disease -- often "without other aids or adjuncts."

"There is no doubt that some 'manipulators' are very skillful," admits one well-known orthopedic specialist, "but everyone gets the same general type of treatment, which cannot always be correct." [3]

Chiropractic, in fundamental definition, has always been, and still is, a system of treating human disease according to the theory that manipulation of the spine (and other joints) will remove "nerve interference," thus removing the "primary cause of disease." The fact that chiropractors have, of necessity, been barred from reciprocity with medical organizations creates an unusual situation, as far as the existence of an antithetical method of healing goes.

Obviously, the chiropractor could not always make a proper selection of cases that would always benefit from manipulative procedures, as opposed to those cases in which the treatment would be contraindicated or actually harmful, without recourse or submission to all the diagnostic procedures available to every hospital and physician unless, of course, he was working under the prescription of an unlimited medical specialist or in close cooperation with those who are able to make a complete diagnosis. Any such attempted cooperation, however, would provide grounds for violent disagreement in the selection of cases suitable for manipulation, since the chiropractor, preeminently, would attempt to manipulate the greatest majority of the cases.

Essentially, the fundamental chiropractor would manipulate for an entirely different reason than would a medical specialist. Any voluntary limitation of the chiropractor's practice, however, would go hand-in-hand with further recognition of benefits found in medical practice and, consequently, an attempt toward better cooperation with medical practice. Although there are increasing numbers of chiropractors specializing their practice in the treatment of back and spinal conditions, the majority of chiropractors still exercise a "general practice" in competition with the medical physician.

"Chiropraktik" is Germany

In West Germany at the present time, a group of about 200 German physicians are attempting to separate and properly apply the practical and theoretical value of spinal manipulation as indicated. The group is called Antliche Forschungs und Arbeits Gerneinschaft für Chiropraktik (MedicaI Research and Work Group for Chiropractic). There, where chiropractic is relatively unknown, manipulative procedures have retained the title of "chiropraktik." German physicians are quick to designate, however, that such manipulative procedures should be selected and prescribed by the physician -- in carefully selected cases.

The practice of chiropractic in West Germany, when compared to the practice of chiropractic in America, is difficult to evaluate. A clue to the situation is, perhaps, found in this statement by a chiropractor who visited Germany:

What I did not know, until I had talked with people in Switzerland, Austria, and Germany itself, was that this new ferment in German medicine has its roots in matters purely economic. There are, it is said, 60,000 too many doctors in West Germany. Two factors have contributed to this situation. First of all, during the war years, the medical schools were the only departments of German universities which remained open. Thus, many students who would normally have entered other professions chose medicine. Incidentally, they thereby escaped immediate military service. The second factor has been the constant migration of doctors from the East to West Germany. By devious methods they have managed to escape the rule of the Soviets. The resulting surplus of doctors has greatly sharpened competition among them. The greatest hope of avoiding starvation is the acquisition of some new therapeutic technic which will differentiate a man from his nearest competitor and enable him to stand out as capable of rendering some sensational service which the next man cannot do. One of the unfortunate ones I met in Geneva. Unable to make a living in Germany, he had migrated to Switzerland, where he works as a journalist attached to a leading newspaper. And this man has been trained as a specialist in neurology! [6]

Personal correspondence with Dr. Gutmann, of the West German Medical Association, revealed, in part, that:

In Germany we are learning and doing "chiropractic" or manipulations of the spine in a scientific manner, irrespective of what chiropractors believe of their doctrine. Doing so, we have been surprised by the real effect of "chiropractic" indeed. We are sure that "chiropractic" will have a future as practiced under medical responsibility and by well trained technicians.

In looking over the historical development of medicine, we find that manipulations of the spine had been practiced in every period of mankind and may no longer be regarded as an invention of D.D. Palmer in 1894.

We think that we are now able to fix definite limitations on chiropractic value [7].

Dr. Gutmann, author of much German literature on chiropractic, feels that, thus far, the physician has neglected the spinal area to a great extent, and that in America the Medical Association has been "choked by the philosophic pretensions of the chiropractors." Although this is unfortunately true to a great extent, a check of recent American publications in the field of physical medicine and orthopedics does reveal that much experimental work and procedure has been recorded and adopted in the realm of manipulation, particularly in the area of the spine. The doctrine, however, has been left to the chiropractor. Thus, in these times, as always, many unorthodox and irregular practices contribute to the continuous progress of medical science while, at the same time, "the cult with the creed slowly dies."

Although the late D.D. Palmer, the founder of chiropractic, admits in his book, The Science, Art and Philosophy of Chiropractic (1910), that he was "not the first person to replace subluxated vertebrae, for this art has been practiced for thousands of years," he does claim to be the first to state that "95 percent of diseases are caused by displaced vertebrae; the remainder by luxations of other joints." B. J. Palmer, son of D. D. Palmer, states that:

D.D. Palmer was the first person in history to intentionally and successfully discover, develop, locate, find, present, Prove and teach where, when, how and why to intentionally adjust a vertebral subluxation by hand only, to intentionally correct it as the cause of all disease in man as well as animals of the vertebrata to get them well, of disease in them [sic].

I doubt whether anyone will argue that D.D. Palmer was not the first man to adjust subluxated vertebrae as a cure for all disease; for, probably, outside Andrew Taylor Still, the founder of osteopathy, and Palmer, the founder of chiropractic, no one ever has or ever will officially claim that spinal manipulation is a cure for all disease. Regardless, there is some evidence that bonesetters before the time of Still and Palmer did attempt to cure all disease by manipulation, although they had no theory or explanation for their claims.

D.D. Palmer, in claiming the distinction of being the first to say that 95 percent of all disease is caused by spinal subluxation (and the other 5 percent by luxations of other joints), claims origin of a present-day cult that is still supported by many of his followers. Those in osteopathy who know that Andrew Taylor Still first made such claims will, no doubt, gladly concede these claims to chiropractors in order to clean their own linen. As we shall see later, there is some question as to whether D.D. Palmer originated the chiropractic doctrine or whether he simply patterned it after the old doctrine of osteopathy (founded by Still some twenty years earlier). Osteopathy has since abandoned the claim that spinal subluxation is the cause of all disease, and the contention now belongs almost exclusively to certain chiropractic factions. There are, however, other factions in chiropractic that have withdrawn considerably from the original teaching of chiropractic by including other forms of therapy in their procedures. Thus, reference to chiropractic manipulation is not always synonymous with ancient bonesetting or with scientific joint manipulation.

In looking over literature purported to affirm the antiquity of the chiropractic theory (that subluxations in the spine interfere with nerve flow and cause most disease), we note a confusing tendency of some authors to assume that old and new medical theories stressing the importance of the nervous system are simply "reaffirmations of the chiropractic theory." In K.A. Ligase' book, How Ancient Healing Governs Modern Therapeutics (1937), for example, we note reference to Hippocrates' dictum "Look well to the spine for the cause of disease," followed by "reaffirmation" of Hippocrates' beliefs by mention of the theories of such long ago famous men as Herophelus, Erasistratus, and Descartes who emphasized the importance of the nervous system in health and in disease. There have been and still are many qualified medical authorities (such as Pottenger of America, and Speranksy of Russia) who stress the importance of the nervous system in the diagnosis and treatment of disease, but none of these men have expressed opinions that are necessarily related or conducive to the chiropractic contention that most disease is caused by nerve interference at the spinal joints.

We should note here that the development of osteopathy as a general medical practice -- although providing an excellent opportunity for well-trained osteopaths to combine selected manipulative procedures with modern medical care -- leaves an opening for the development of chiropractic as a practice specialized in the treatment of certain back and spinal disorders. This opportunity may soon diminish, however, if chiropractors continue to treat most human disease in competition with the medical physician, or if a department of medical practice, such as physical medicine, continues to develop the services of manipulation for the ready disposal of the physician.

In West Germany, where a small number of medical physicians are adopting the use of manipulation in their private practices, chiropractors have not been given any official status as a profession, primarily because physicians there, as in this country, recognize the use of manipulation as a procedure that can be used safely only in cooperation or conjunction with other medical procedures. Chiropractors, however, continue to use their art as a treatment for disease in competition with medical practice, thus excluding the use of many diagnostic and treatment methods found in more discriminate medical practice.

One chiropractic authority, in noting the failure of German physicians to replace standard medical procedures with newly-adopted chiropractic manipulations, advised his colleagues:

From time to time someone ventures the idea that the solution might be found in collaborating with the medical profession. Let us not be deceived; equality is never attained through collaboration. Subjugation, and loss of professional identity and self respect is all that we will ever gain through collaboration. It is and always will be the philosophy of medicine that all schools of healing should be and eventually must be under its control and authority. My observations lead me to voice the opinion that German medicine itself does not fully know what it wishes to do with chiropractic as a science and clinical subject. I did not find any definite decision on their part to include it in the curricula of their colleges, or to. afford it the full inclusion in their therapeutic program. Certainly there is a noticeable ambivalence in their attitudes which we of the chiropractic profession might well utilize to our advantage in precipitating our own program of progress [8].

Another chiropractic authority stated of the German situation:

For a number of years now, the medical journals of Germany have been referring to the existence of a crisis in German medicine. There has been a definite mood of self examination and self criticism expressed in pleas for a more fundamental understanding of the disease process and its causes. Speransky's researches on the overall importance of the nervous system in every type of pathology have been the subject of frequent discussion. New books have appeared dealing with such unorthodox matters as zone therapy, acupuncture, and iridiagnosis. A special technical journal, devoted to empirical healing methods and wide open to nonconformist thinking in every department of therapy has been started and is evidently a publishing success [6].

Zone therapy (treatment of disease by stimulating certain areas of the body), acupuncture (an ancient practice of puncturing the tissues with long, fine needles for the relief of pain), and iridiagnosis (diagnosis of disease by examination of the iris of the eye) have been almost completely discarded in the United States in exchange for better methods. Obviously, the German Medical profession is considering all forms of empirical practice, cultism, and folk medicine, seeking some value in each one that might be used in conjunction with scientific medical practice. While such open-door and broad-minded investigation of all forms of healing practice is a necessary and commendable attitude for any scientific organization, recognition of value found in any one of these phases of healing does not, of course, validate the use of the treatment in competition with the entire field of medical practice. It is often the duty of medical science to extract methods of value from other healing arts without embracing the source, especially when the source is more bad than good.

Any one phase of healing, capable of standing alone in a specialized field (such as dentistry, optometry, or chiropody), would, of course, prefer to remain apart from the jurisdiction of other organizations. When opposition of one group to another does occur, it is important to first determine whether differences are based upon economic or upon scientific grounds before any worthwhile evaluations can be made. In the practice of optometry, for example, well-trained practitioners, graduated from many state universities following six years of training, are restricted to examination of the eyes for the correction of vision not disturbed by actual pathology. Any opposition to this practice by organized ophthalmology (an unlimited medical practice devoted to disturbances of the eye) would appear to be more economical than scientific ... especially since the practice of optometry is based primarily upon the same scientific principles governing the same procedure in the field of ophthalmology.

In the practice of chiropractic, however, we find a dual system of healing opposed by medical science on grounds that the chiropractor's principles are not scientific and that his education could not possibly be adequate for the treatment of disease. Unlike any one of the specialties mentioned above, chiropractic is a general practice engaged in the treatment of disease while, at the same time, having no affiliation or common bond with any other healing group or educational institution.

That there is some value to be found in chiropractic manipulations will be brought out as we go along. The German medical profession is simply taking what is good in the field of manipulation, calling it chiropractic, and using it where it will do the most good. This is a far cry from the practice of many American chiropractors who are in competition with medical practice.

Personal correspondence with Dr. Roken, representative of the West Germany Medical Association, revealed that: "The German medical profession has a postiv [sic] opinion of the practice of chiropractic as long as it is exercised by physicians. We are, however, unable to form an opinion of chiropractic in America." [9]

Chiropractic in America

Chiropractors in America seem to have no intention of subordinating themselves to become a branch of healing under medical practice. Moreover, as practitioners competitive with medical practitioners, they have no intention of working under the direction of any medical or orthopedic authority since, obviously, the chiropractic theory is incompatible with any phase of medical practice. "Its proponents are not interested in having it [chiropractic] defined as a limited or separate branch of medicine. Their goal is clear-cut; the declaration of chiropractic as a distinct science. "To this end," said B. J. Palmer, "there is to be no compromise with present legislation classing chiropractic as anything but chiropractic. There are to be no side issues. All effort is to be directed from now on toward this one outstanding objective." [10]

Dr. C. W. Weiant, a foremost chiropractic authority, echoes Palmer's sentiments:

We have no desire to be considered a branch of orthodox medicine. Ours is a mechanical therapy, a separate profession actually competitive with conservative medicine [10]

It would be quite impossible for the chiropractor to reconcile his beliefs with those of medical practice and continue to compete with them.

The determination of the chiropractor to remain an active competitor of the medical physician is further exemplified in these recent excerpts from a chiropractic journal:

There has never been a time in the history of the chiropractic profession when it has been so important that a chiropractor carefully appraise his attitude toward and relationship with the local medical doctor as today. For whereas in the past the chiropractic profession was threatened with being outlawed by the medical profession, it is now faced by a new threat -- absorption by the medical profession....

The chiropractor's obligation to the public and to his medical colleagues is to make it clearly understood that chiropractic and medicine are two distinctly different healing arts -- two distinctly different methods of treating the sick, based on principles diametrically opposed to each other, and for that reason the methods of one may not be adopted by the practitioners of the other....

Rather, a chiropractor, because he is privileged to practice the greatest of the healing arts, should be fortified by that fact and know that he can afford to be friendly toward any man whose purpose in life is to heal the sick. A chiropractor who would understand his medical brother should not overlook the fact that for a man who has dedicated his life to healing the sick, struggling along with a system which treats effects rather than cause must be a frustrating experience indeed [11].

Here we have a typical example of the chiropractor's belief that chiropractic is a greater healing art than medicine. The statement above to the effect that chiropractic is an entirely opposite and different method of treatment from that of medicine, making it unnecessary for chiropractors to adopt methods used by "frustrated" medical practitioners, commits the chiropractor to the doctrine of D.D. Palmer, limiting the treatment of disease to manipulation of the joints. Medicine, on the other hand, concerned with any effective method of treating disease, is unlimited in its methods of treatment.

As we have noted, it is the opinion of many chiropractors that subordination of their practice to medical science would mean subjecting themselves to a "dictatorship" with the ultimate destruction of chiropractic by the "professional jealousy" of the medical profession. They believe that this would take place in spite of the fact that they often claim that medical science now recognizes the value of their treatment, that attempts are being made by the medical profession to absorb their art. It seems, however, that medical practice might be absorbing only a part of what chiropractors are doing (what has, actually, always been a part of medical practice) and that supervision of chiropractic by medical science would destroy chiropractic as the majority of chiropractors believe and practice it. If this is the case, it may merely be expedient for chiropractors to contend that medical practice is absorbing their art, so that they may more effectively "precipitate their own program of progress." Thus, when medical textbooks demonstrate technics of joint manipulation, for use in specific joint conditions, there are some chiropractors who might infer that "medical science has finally recognized the chiropractic treatment for disease." The completely opposite natures of the chiropractic and medical professions ("two distinctly different methods of treating the sick, based on principles diametrically opposed to each other"), however, creates an incompatibility that makes it quite impossible for the medical profession to absorb chiropractic as chiropractors practice it. Thus, the cry of many chiropractors that medical practice is stealing their science seems to be without any significant basis.

Interestingly enough, there are those in chiropractic, guided by the fundamental teachings of the chiropractic doctrine, who claim that chiropractors are engaged in an attempt to "steal" medical methods. "Note that there is a great hullabaloo about what medical men are doing stealing chiropractic," said B. J. Palmer of the Palmer School of Chiropractic, "but you see and hear only whispers about how chiropractors are stealing medicine aided and abetted by the N.C.A. [National Chiropractic Association,] and N.C.A. journals." [12]

According to the chiropractor's philosophy of the cause and cure of disease, it may very well be said that the chiropractor "borrows" medical therapy when he employs treatment methods other than spinal manipulation, since the chiropractic theory does not make provisions for the use of any treatment other than manipulation. In the practice of medicine, however, manipulation, physiotherapy, and other forms of treatment have always been legitimate branches of medical science, and the practice of medicine is forever open to improvements or the use of new methods of treatment. It shall always be the prerogative of medical science to incorporate ideas and methods of value, irrespective of their source. The cult, on the other hand, is bound by its creed to the specific limitations of that creed, for it is the creed that makes the cult.

Many chiropractors who adhere to the contention that chiropractic is a practice superior to the practice of medicine maintain a great portion of their practice by treating -- and continuing to treat -- a large number of patients who do not really need such treatment but who are "sold on chiropractic" in preference to medical treatment. Some of these patients are convinced that they are "through with medical doctors" -- until a serious illness arises to change their minds. It would be difficult to recommend manipulation for a joint condition at a source where a patient might possibly be educated against lifesaving medical procedures, and it might be more difficult to select a competent chiropractor who is not alienated from the practice of medicine. In the meantime, most physicians are actively opposed to the practice of chiropractic.

"Medical men are opposed to chiropractic because it is baseless and disproved," said a pamphlet distributed by the Louisiana State Medical Society. "Medical men are opposed to chiropractors because chiropractors are false prophets, practicing a false art.

"Scientific medicine has accepted, approved and recommended only a part of what chiropractors do, and did so, in fact, before chiropractic was 'invented.' That part is physical therapy." [13]

A publication of the New York Medical Society, in attempting to explain the testimony of those who claim miraculous cures under chiropractic treatment, said, in part:

Here one enters the realm of human psychology and the well known idea of the laying on of hands. . . . And the technique works for those type of illness which have ramifications in the field of what is now called psychosomatic medicine; where physical ills stem from problems of the mind.... Thus when a chiropractor tries to treat pneumonia by manipulations of the spine he is relying on this power of the body to make the patient recover eventually. The chiropractor, in this case, is using the methods of medicine of 1880 or before, but he does have a minor chance of success. The insidious danger, however, is that the patient may very well die because he did not see a physician who could give him modern chemotherapeutic treatment [14].

Dr. Howard W. Haggard, in his book Devils, Drugs, and Doctors, gave an interesting explanation of the success of chiropractic as a faith cure:

Chiropractic treatment is an old form of faith cure under a new name; its forerunner was osteopathy, and the forerunner of osteopathy was the bone manipulation practiced by "joint-adjusters" or "bone-setters." . . . Bone-setters have always made remarkable cures, but so did the relics from the Holy Land and so have a horde of healers of all cults. A statement frequently repeated in previous chapters is that 80 to 90 per cent of all patients get well under any treatment, or none, and that when one of these patients gets well his case is invariably attributed to the virtues of the "treatment." [15]

After everything has been said, however, it remains an indisputable fact that much value is conveyed in the manipulations of some chiropractors and osteopaths. Although these values are being recognized and adopted by certain specialties in the field of medical practice, many general practitioners, who are only aware of the cultism promoted by those who exploit manipulation, too often disparage manipulation under any circumstances. Thus, many physicians are not aware of the specific values of manipulative therapy as promoted by the physical medicine and orthopedic specialist. "The art of joint manipulation forms no part of the medical curriculum," stated Dr. James Mennell, a physical medicine specialist, "and the medical student is fortunate if he has any real conception of what is meant by that term as scientifically used." [16]

The ignorance of many medical practitioners of what is actually good in the use of manipulation, and the unfounded faith of those who employ the treatment exclusively, leaves the public pretty much at a loss as far as obtaining the use of such treatment when it is indicated. Facilities for manipulative service should be added to every major hospital, with physical medicine specialists or technicians working in close cooperation with the orthopedic specialist. Fortunately, such developments are taking place with increasing rapidity, and what is good or bad in the use of manipulation becomes more evident with each passing day.

"It behooves us, once and for all," wrote Dr. James Mennell in one volume of his book, Joint Manipulation, "to try to decide what is good in joint manipulation, what is bad, and whether or not there is a definite science underlying it and a definite art in the performance of the movements of joints by manipulation. . . .

"The fact that their treatment [chiropraxis] relies almost entirely on joint manipulation, and that their creeds are unacceptable to most medically trained minds, should not, of necessity, preclude medical men from trying to discover what can be proved to be good in the practice of joint manipulation and leave the bad -- the creeds especially -- alone." [16]

References

1. Fisher TAG. Treatment by Manipulation, 5th Edition, H. K. Lewis & Company, London, 1948.
2. Boyd CE. The Cult of Chiropractic. Louisiana State Medical Society, 1953.
3. Lewin Philip. The Back and Its Disc Syndromes. 2nd Edition, Lea & Febiger, Philadelphia, 1955.
4. Janse, J and others.. Chiropractic Principles and Technic. 2nd Edition, National School of Chiropractic, Chicago, 1947.
5. Howorth MB. A Textbook of Orthopedics. W. B. Saunders & Company, Philadelphia, 1953.
6. Weiant CW. Chiropractic and the crisis in German medicine." Journal of the National Chiropractic Association. Webster City, Iowa, September, 1955.
7. Gutmann G. Medical Research and Study Group for Chiropractic. Hamm, Germany. Personal Correspondence, Oct 15, 1958.
8. Janse J. Observations in Europe. Florida Chiropractor. Lakeland, Florida, 1955.
9. Roken MD. West German Medical Association, Stuttgart, Personal Correspondence, Sept 11, 1958
10. Doyle KC. Science vs chiropractic. Public Affairs Pamphlet No. 191, Public Affairs Committee, New York, 1953
11. Florida Chiropractor. Lakeland, Florida, June, 1959.
12. Palmer B.J. Shall Chiropractic Survive? 1st Edition. Palmer School of Chiropractic, Davenport, Iowa, 1958
13. Dear Doctor (A Report to the Medical Profession, Unlawful Practice of Medicine by Chiropractors). Committee on Public Policy, Louisiana State Medical Society, undated.
14. Potter, Robert D.: Should Chiropractors Be Licensed? Medical Society of the State of New York, Committee to Combat Cults, New York, undated.
15. Haggard HW. Devils, Drugs, and Doctors. Blue Ribbon Books, New York, 1929.
16. Mennell, James, M.D.: The Science and Art of Joint Manipulation. Volume 1, The Extremities. Blakiston Company, New York, 1949

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