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Bonesetting, Chiropractic, and Cultism

Chapter 11:
Chiropractic "Technique Wars"
A New Chiropractic Hypothesis

©1963, Samuel Homola, D.C.

The April 1958 issue of the Journal of the National Chiropractic Association contained the third of a series of articles discussing another new theory and method of chiropractic practice. The articles were apparently designed, by the author, to dispute the "nerve pressure" doctrine so long supported by chiropractors -- a doctrine that presently forms the foundation of all chiropractic practice, according to all legal definitions, teachings, and "proven data."

The article presented an "hypothesis" to explain why all methods of chiropractic, from Palmer to Logan, get results "equally well." After all these years of argument by chiropractors that the cause of disease is nerve pressure at the intervertebral foramina, one comes forth quoting, in part, obvious fact, and advances a new theory of the cause of disease that seems to be quite as untenable as the theory he disproves. The "new hypothesis" even seems to go so far as to dispute the actual existence of vertebral subluxation and nerve irritation as recognized by medical science. Every orthopedic surgeon is familiar with the pain syndrome of a subluxated vertebra, as well as with the referred symptoms of an irritated or compressed nerve trunk. Cases of brachial neuralgia, intercostal neuralgia, and various forms of neuritis are sometimes attributed to pressure or irritation at the intervertebral foramina. Except in rare instances, however, such symptoms are not produced by a vertebra being "out of place," but by existing pathology such as the spurring of arthritis, the protrusion of a herniated disc, muscle spasm, tumors, infections, and so forth -- and sometimes by poor body mechanics. As a general rule, subluxated vertebrae are one thing and nerve pressure or nerve irritation another. One can occur without the other. Displacement of a single healthy vertebra, with few exceptions, severe enough to exert pressure upon an intervertebral nerve trunk would, of necessity, be quite painful in itself, but not necessarily a cause of disease. When bodily or vague aches and pains are present that have no obvious cause, the joints should, of course, be thoroughly inspected. In the treatment of chronic disease, no obvious joint disturbance or nervous irritation should be left uncorrected.

In presenting a "new chiropractic hypothesis," the author quotes a few well-known facts of neurology that have been used for years as evidence against the chiropractic doctrine. Being contrary to the philosophy of chiropractic, however, these facts are usually ignored or denied by chiropractic practitioners and authorities.

The author of the "New Chiropractic Hypothesis" states:

As emphasized before in this series, actual nerve (or cord) pressures undoubtedly can and do occur-but only in rare instances. Offhand, I cannot recall in thirty-five years of practice more than a dozen or so cases that could qualify as nerve or cord pressure. The percentage, therefore, is almost nothing. In nearly all of our cases, we cannot possibly be dealing with "pressure" at the intervertebral foramina or anywhere else. Every provable fact denies the "nerve pressure" dogma. And I challenge anybody to cite a single, established anatomical or physiological fact to support it.

A patient comes to a chiropractor and complains of pain, let us say, somewhere in the distribution of the sciatic nerve. The components of this large trunk are typical nerves, the upper two of which emerge between movable bones, the lower three through sacral foramina. What is true of them is true of any other spinal nerve. Most chiropractors would look to the lower lumbars, adjust accordingly, and relieve the pain. The HIO 'Palmer' man would look to the atlas, adjust, and relieve the pain. The BT [Logan] man would think of neither, but would go clear down below all sciatic connections, apply his contact to the skin there-and relieve the pain. So what? Nerve pressure? Cord pressure? Or neither? Take your choice.

Since pain drives people to doctors, and is therefore one of the commonest symptoms we see, let us use that in testing the validity of the nerve pressure dogma. According to that assumption, every disease or symptom is caused by vertebrae slipping from normal position and exerting pressure on spinal nerves or on the spinal cord -- depending on which sect you were trained to believe in [1].

The article goes on to present evidence against the doctrine of vertebral misalignment. What is known in fact seems to have been taken from the book Physiology of the Nervous System, published by Oxford University Press. It seems quite fantastic, however, that the author of the "new hypothesis" would assume that any one of the chiropractic methods he mentioned could provide relief in the case of sciatic pain, and that nerve pressure is not likely to be a factor in the causation of such pain. Of all the forms of pain experienced in the human body, sciatic pain is, perhaps, one of the few syndromes commonly caused by direct pressure on a nerve trunk. As we brought out in an earlier chapter, the 5th lumbar intervertebral foramen, giving off a branch of the sciatic nerve, unlike other foramina in the spine, fits snugly about the nerve trunk. Thus, strains, inequality of leg length, and other minor disturbances often result in direct bony pressure upon the 5th lumbar nerve. Traction, applied to separate the vertebral joints slightly, and maintained long enough to permit subsidence of swelling in the nerve trunk, is usually the most effective form of treatment. Manipulation causing excessive movement in this joint could very well aggravate the symptoms in such a case. Occasionally, pressure or irritation of a branch of the sciatic nerve, persisting unrelieved for a long period of time, will result in death of the irritated fibers, causing a loss of certain functions in the extremity -- such as an inability to lift the toes when walking, or a loss of sensory perception over certain portions of the skin. All of this, however, is common knowledge in the field of orthopedics and is unrelated to the chiropractic doctrine (that vertebral misalignment is the cause of most disease).

If we go by the "new hypothesis" we are presently discussing, it would seem that the chiropractor does not even recognize nerve pressure when it does occur. If the Palmer chiropractor should attempt to treat sciatica by adjusting the atlas, and the Logan practitioner by placing a contact upon the skin, as suggested in the quotation, there seems to be little doubt that any recovery from this condition would not be the result of such treatment. Yet, this "new hypothesis" goes on to suggest that all forms of chiropractic treatment can relieve the pain of sciatica -- not because of correction of misaligned vertebrae but because of a mechanism not known by chiropractors (and explained in this new theory). Perhaps if any type of practitioner treated sciatica long enough, with any form of treatment, relief from pain, resulting from a degeneration of the irritated nerve fibers, might be erroneously attributed to the treatment.

Although sciatic pain may indeed be caused by the position of the vertebrae, the new chiropractic theory, based more or less on the correct observation that disease could hardly be caused by misplaced vertebrae "pinching nerves," goes on to state emphatically:

Slipped vertebrae "pinching" nerve trunks? No. But superstitions die hard. So in spite of the fact that modern knowledge supplies positive proof to the contrary, there are still people who believe that the earth is flat, and the ground hog rules the weather! [1]

Disputing the validity of the typical chiropractic explanation of the cause of disease, the author of the new theory offers an explanation of why the whole conglomeration of chiropractic techniques all get results equally well. His theory, in essence, suggests that chiropractic adjustments be abandoned and simple pressure applied to "trigger areas" in the Para-spinal tissues where he believes all tension and nerve irritation get started. Expressing much consternation over the fact that many chiropractors still believe that "every disease or symptom is caused by vertebrae slipping from normal position and exerting pressure on spinal nerves or on the spinal cord," he, nevertheless, does not dispute the fundamental chiropractic assumption that all disease is caused by nerve irritation or interference. In fact, he proposes that all chiropractors get results for reasons they are not aware of. The "new hypothesis" explains how to specifically accomplish what all chiropractors are doing inadvertently and haphazardly:

Therefore, anything that will remove the cause of such peripheral irritation will stop the whole chain of events producing abnormal tissue functions which we call disease. And unless irreversible changes have occurred in the cells of the affected area, the cure will be complete. . . . It will resolve a presently hopeless tangle of apparent contradictions into an orderly system in which we can see how all these procedures lead to the same result by doing (in different ways) the same identical thing: releasing abnormal tensions in paraspinal tissues [1].

One can obviously see that the chiropractor is not practicing a "proven" system in the treatment of disease, and that, according to the promulgator of this new theory, not one single chiropractor who treats disease knows what he is doing.

Some time during the course of the appearance of these articles in the National Chiropractic Journal ("A New Hypothesis for Consideration"), another chiropractic group was touring the country and giving courses in a theory and method of reflex therapy very much like that being presented in the journal. The charge for the course was $150 per student. The Receptor, a circular-type publication of this itinerant school of instruction, gave this reason for the promotion of its particular treatment method:

The steady decline of chiropractic can be stopped by placing in the hands of the chiropractor a supremely efficient tool which will enable him to meet the modern demand for the quick and dramatic, and at the same time give him a therapeutic power with a universality and consistency never before achieved in the history of the healing arts [2].

Needless to say, the failure of so many chiropractors to personally experience or interpret the "miraculous cures" so often attributed to their type of treatment renders them quite susceptible to the "passing fads." As I have already noted, the extremes and varieties of chiropractic treatments go so far, in some cases, as to fail to recognize the real though limited value of scientific manipulation. In concentrating upon the use of manipulation outside these values, the success of many chiropractors depends upon a somewhat religious type of faith and conviction that will hold them above their failures -- failures that, if viewed scientifically and objectively, could destroy the faith of anyone called upon to again follow the same course of action. Thus, those who succeed so completely in all forms of chiropractic treatment either believe in the efficacy of their particular treatment method, or, unhindered by doubt and confusion, deliberately apply, with a pretentious attitude, a form of treatment they actually know to have little value other than psychological.

It is probably convenient for some chiropractors to attend the wide variety of "Chiropractic Research Seminars," for many of them continue to offer hope or cure for conditions that cannot possibly be cured by physical treatment. By acquiring the "latest technique" and the "newest knowledge," the practitioner can again treat a patient who was not cured by the last method of treatment.

References

1. Hayes,S. A new hypothesis for consideration." Journal of the National Chiropractic Association, April 1958.
2. Nimmo RL. The Receptor, Volume 1, Numbers 2 & 3, 1958.

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