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- When confronted with two courses of action I jot down on a piece of paper all the arguments in favor of each one -- then on the opposite side I write the arguments against each one. Then by weighing the arguments pro and con and canceling them out, one against the other, I take the course indicated by what remains.
- BENJAMIN FRANKLIN
While the scope of manipulation, as recommended by Dr. Mennell and others, is, of course, limited to specific indications of joint dysfunction, or to conditions with no pathological contraindications, most chiropractors, on the other hand, continue to exercise their legal rights as "physicians" with a limited treatment method. Defending this rather unusual stand, a California chiropractor gave these answers on a 1958 Hollywood program "Greet the People":
(1) Question: It has been said to me that there are many members of the medical profession who resent the chiropractor having the title doctor. What is your answer to this?
Answer: My answer to this is that the chiropractor has every right to the title of doctor. He has been legally recognized as a doctor, a doctor of chiropractic. He has completed the course of study required for a doctor of chiropractic. The medical profession has no prior or exclusive right to the title of doctor. There are many professions who have this title in recognition of their achievement.
(2) Question: What type of cases do chiropractors diagnose and treat, basically?
Answer: I'm glad you asked that question, because there is a confusion in the minds of the public. They believe that chiropractic is limited to the treatment of a stiff neck, or backache. But actually, chiropractic treats many of the organic diseases, many of the internal conditions, and these conditions respond very well to chiropractic.
(3) Question: Well, how do they differ from those of the medical profession?
Answer: They don't differ. These people have the same ailments as they do for the medical profession. But the point is that there are other avenues, other ways of treating these people. I might make this point, too, that chiropractic has often succeeded, and the great majority of the early patients of chiropractors were the unsuccessful cases of the medical profession. They were the ones who had the nerve, in the early years of chiropractic, and who not only had the nerve, but were so desperate that they sought chiropractic help. And this is the manner in which chiropractic began to grow.
(4) Question: What kind of cases do you as a chiropractor feel you are capable of treating that you are not allowed to by law?
Answer: There are no cases we are not allowed to treat. There are many cases I wouldn't treat, because of the limitations of chiropractic.
(5) Question: What are the limitations?
Answer: If there were irreversible pathology -- if I felt that the patient was in need of surgery -- I would be very ready to refer the patient to a surgeon. But, as I say, there is a wide area of treatment, a wide area of diseases which do respond to chiropractic.
(6) Question: There are innumerable stories of people who 90 to a chiropractor, and the chiropractor bends them, cracks their spine. They say they save themselves a lot of money, supposedly, by not going to a doctor. Why and how do they start these stories?
Answer: I am not sure what your question implies, But there are many people, millions of people, who have found chiropractic the answer to their health problems. I have many patients who come to me, not because they are sick, but because chiropractic makes them feel well. It stimulates them, relaxes them, and they have a feeling of well-being as a result of it.
(7) Question: Wouldn't you say that one basic reason there has been confusion about chiropractic is that there are people whom we call quacks in this business?
Answer: There are quacks in every profession. There are quack lawyers. There are quack M.D.'s. There are quack osteopaths. There are quack psychiatrists, and there are quack psychologists. We regret that these people are in the profession. There are standards set up to control these people. But, I don't feel at all defensive that the chiropractic profession is the major one in which there are quacks. This is not so.
(8) Question: How much education does a chiropractor have to have to get his doctor's degree today?
Answer: In most states these qualifications are four years of chiropractic college. In many states there is a two-year prechiropractic college requirement. And the course of study closely parallels the medical course of study.
Deeper answers to most of the questions above are found throughout the pages of this book. I have already been exceedingly repetitious on certain points; rather than repeat further, I invited you to turn the pages and select the answers for yourself. However, on some of the answers given above we might elaborate a little.
Question 6 asks why people claim to save a lot of money by going to a chiropractor rather than to a medical doctor. Part of the explanation underlying such claims is found in the fact that many of these people, in addition to experiencing a sense of well-being following such treatment, have been led to believe that misaligned vertebrae cause most disease and, as a result, feel rather obliged to get regular adjustments in order to "keep the vertebrae in place" and prevent the development of disease. By doing this they feel that they not only make medical and hospital care unnecessary but have, in chiropractic, a cheaper and superior method of removing or treating the "cause" of disease. In view of what chiropractors teach, this is a natural attitude for lay-indoctrinated persons to take when they have been "sold" on the superiority of chiropractic as a treatment for disease. In fact, many such patients become psychologically addicted to chiropractic treatment, taking regular and excessive treatments for as long as they live. Some will tolerate unusually rough treatment in order to "prevent disease later." When serious disease does occur, however, the need for proper medical care may become even more expensive, or futile, as a result of an unnecessary delay in receiving the proper treatment.
In answer 5 the chiropractor states that if a patient with irreversible pathology needed surgery he would send him to a surgeon, but adding, however, that "a wide area of diseases do respond to chiropractic," after stating earlier that chiropractic patients "have the same ailments as they do for the medical profession." Thus, in treating most disease chiropractically, it would appear that many chiropractic cases, not treated medically in the beginning, would very likely advance to a stage requiring surgical intervention. Practically all cases of "irreversible pathology" (tumors, tissue destruction, etc.) are cases in which there has either been a delay in the proper treatment or in the diagnosis.
On the other hand, we should not forget that cases properly selected for manipulation will often save one from a fruitless trial of a very long line of treatment methods, sometimes even from surgery. But this is not to say that the "I'm through with medical doctors" attitude so often found among chiropractic patients has the slightest justification. In fact, any well-qualified manipulator who recognizes both the value and the limitations of his treatment would be dutybound to encourage medical examination and medical treatment in cases not presenting specific indications for manipulative therapy. Although there are some physicians who send selected cases to certain osteopaths and chiropractors for manipulative treatment, reciprocity with the chiropractic profession as a whole has been necessarily refused because of that profession's lower standards in competing with medical practice in the treatment of disease.
In the answer to question 3, we learn that the cases treated by the chiropractor do not differ from those treated by the medical man, that chiropractors simply have "other ways" of treating the same ailments treated by the medical profession. We also learn that a chiropractic course of study "closely parallels the medical course of study." It does not seem likely, however, that chiropractic and medical training could even be remotely similar, since the graduates of both schools came out with a basically different approach in treating the same diseases. Only chiropractors believe that vertebral misalignment is the common denominator underlying the cause and cure of disease. With standards in accordance with this theory, only one school (Western States College of Chiropractic) presently enforces a standard requiring two years of preprofessional training, in spite of the fact that every state (but five) actually permits chiropractors to treat contagious and infectious diseases. Furthermore, about half of all the states require that chiropractic licensees have some preprofessional training.
In noting the failure of some chiropractors to admit the obvious shortcomings of some of those they represent, while they look askance upon intimations that they treat only "stiff necks and backaches," we are left with the impression that there are many who would prefer a corps of third-class physicians to a smaller number of first-class specialists, for there seems to be little doubt that a chiropractic "physician" who treats disease in a general practice not only falls short in his training but also falls short in his treatment method. If all chiropractors were specializing in the treatment of "stiff necks and backaches," conditions which are more serious, complicated, and prevalent than the disparaging remarks of some chiropractors would indicate (as evidenced by increasing volumes of orthopedic literature on the subject), firmer ground might be found outside obviously unqualified attempts to compete equally with the medical physician.
"Whose bread I eat, his song I sing."
In observing demonstrations of spinal manipulation and hearing the "crack" of the spinal joints, it has been said by some that the manipulations are so difficult that the physical therapist or the general physician could not perform such movements without great length of training. This is far from the truth. Any technician with a knowledge of the anatomy and mechanics of the body's joints -- and normal coordination -- could, in a few months, learn the basic procedures of joint manipulation. As far as spinal manipulation goes, there are several general technics that might be employed to cover treatment of the spine and pelvis, with the remaining technics being only variations of these basic movements.
Dr. John Mennell, in his book Back Pain, advises:
Perhaps the greatest difficulty in explaining the subject of manipulation in writing is that manipulative therapy is an art. The techniques of an art can only be taught with any certainty by practical demonstration. It is my experience that it takes six months for a well-trained physician in preceptorship training on patients and practicing on the normal subject after hours to master the science of diagnosis and the art of therapy, using manipulative methods. Thus, to learn this subject is a formidable undertaking for an active practitioner .
A thorough knowledge of the human anatomy is, of course, essential, but this knowledge is acquired in the basic courses of both the physical therapist and the physician. Probably the most important requirement for the use of manipulation is that of qualified diagnosis and selection. This is why manipulation should be subordinated to the "check-list" of the diagnostician. Although a general physician might be able to learn manipulative procedures in the course of his training, as does the osteopath, it seems likely that a physician specializing in diseases of the bones and joints could offer more qualified recommendations for the use of such treatment. A general physician might offer general manipulative services in much the same manner that he does in reducing dislocations, setting bones, and performing other minor orthopedic tasks. Ideally speaking, manipulation could best be performed by orthopedic or physical medicine specialists, or by well-trained technicians under their guidance.
As we have stated, one of the most essential requirements for manipulating a joint is to know that it is safe and of value to perform such treatment. The knowledge required to make such a decision should represent -- by far -- the greatest part of any qualified manipulator's training when the manipulator does not work under the supervision of a physician. Considering the limitations Placed upon a practitioner who treats disease by manipulation, it does not seem likely that such a practitioner could possess a knowledge fundamental to the decisions of a physician.
By now it should be obvious to the reader that how and for what manipulation is used depends a great deal upon the circumstances and the school of thought surrounding its use. It is to be expected, for example, that an isolated minority group, limited to the use of manipulation according to a creed suggesting the one cause-one cure idea, would conform to the tenets of its teaching in order to survive, especially if it is not legally allowed to step beyond that scope professionally. In addition, it is not likely that many chiropractors would dispute the basic thought underlying their only claim to professional independence, at least not until sufficient change had taken place to permit their support on another level. Thus, when training has been inadequate, the less-qualified practitioner is compelled to practice according to the only guide he knows, refusing to recognize the need for measures he cannot or does not employ, or to recognize shortcomings that would undermine his very existence. A broadly-trained practitioner, on the other hand, may completely and competently select and utilize treatment and diagnostic measures as they are indicated, and not be forced to rationalize the improper use of the only method that is available to him. Many chiropractors, for example, for lack of choice and by virtue of their training, support their own methods above all others, regardless of the disease being treated, while the osteopath, being trained in all phases of medical practice, is more inclined and qualified to employ manipulation only when it is indicated. In any event, it becomes clear that any form of treatment, including manipulation, should be selected under conditions permitting due consideration of all forms of treatment, so that selection may be a matter of choice rather than a matter of creed. For this reason, treatment by manipulation, whether done by the osteopath, the chiropractor, the physical therapist, or the physician, should be performed in close cooperation with medical practice, or subordinated to such medical specialties as orthopedics.
There is no secret surrounding the technics of joint manipulation. In fact, anyone with a thorough knowledge of the anatomy and physiology of joint movement could devise manipulations for the joints. We recall that Hippocrates, approximately 400 years before the birth of Christ, employed methods of setting bones that have changed but little in modern medical practice. Without the benefit of X-ray, he devised corrective joint manipulations simply by "comparing the sound joint with the unsound."
"Manipulation is no mystery to anyone who understands the pathological changes in these tissues," explains Dr. Philip Lewin in his book, The Back and Its Disk Syndromes . . . "Sir Robert Jones emphasized the fact that there is nothing in the science of manipulation which cannot be safely undertaken by a surgeon who possesses a knowledge of the pathological changes and anatomy of bones and joints, but he must become familiar with methods of manipulation which are safe and thorough." 
For the most part, manipulation of a joint is simply a matter of moving the joint over its course of normal movement, up to and through the range of disturbed function, after adequate examination has revealed the absence of disease or bony blocks. Not every one, however, has the basic coordination to apply controlled movements, by hand, to another person's joints. Essentially, manipulations are performed by "taking up the slack" in directions of normal joint movement and then applying a slight "thrust" in order to move the joint a little further than the patient himself could move it. In order to prevent excessive movement in the joint, short, snappy thrusts are applied within a determined range, followed by an immediate release of the force. There are many laymen, utilizing the practice as an art, who are able to "pop" the joints of others. As we noted earlier in the history of bonesetting, the art of manipulation has, in fact, been perpetuated almost entirely by laymen, although the practice was originally a medical practice. In recalling the art into the armamentarium of medicine, German physicians were astonished to learn that the practice was still being used by laymen in remote sections of Germany. In observing the frequency with which "bonesetting" has and still is being used by medically untrained persons all over the world, it is not logical to assume that the art is unusually difficult -- at least not so difficult as to be ignored by more competent and scientifically trained persons.
Dr. Mennell, in Back Pain, expressed the opinion that "in the foreseeable future manipulation will be, and should be, as readily forthcoming from the family physician as a diathermy treatment (which at best can only be comforting and palliative) or a pain pill (which may be deluding)." In hopes that his work "will draw attention to a wide gap in medical knowledge," Dr. Mennell concluded his treatise on manipulative treatment of back conditions with this advice for the physician:
Meanwhile, if you can satisfy yourself that a patient's symptoms are arising from joint dysfunction, then I think you are justified in asking a well-trained manipulator, whoever he may be, to treat your patient for that specific complaint, just as you would ask a radiographer to take an X-ray picture, or a laboratory technician to do a blood examination, or a pharmacist to make up a prescription.
But you must make the diagnosis yourself and be prepared to take the responsibility for the treatment you prescribe .
A great many symptoms of disease are caused by abnormal nerve impulses that originate in a variety of ways. An internal disease, for example, might refer reflex symptoms to a peripheral portion of the body, or disturb the function of some other organ that is not actually diseased, Excessive irritation of a sympathetic or parasympathetic nerve ganglion might simulate or cause a disease process, while pain referred over the course of an irritated spinal nerve might create the subjective symptoms of an acute organic disturbance. This is not to say, however, that, using the spine as a switchboard, the good and bad nerve currents can be cut on and off simply by moving the vertebrae one way or the other.
Ordinarily, stimulation or inhibition of nerves for clinical purposes is accomplished electrically or by injection of substances similar to those produced by the nerves themselves. Various types of stimulation applied to the skin are known to produce temporary reflex effects upon the visceral organs. Hot or cold packs, for example, applied to certain portions of the body will cause an increase or decrease in the blood circulation of certain deeper-lying organs. Most therapy of this type, however, is used to relieve symptoms temporarily or to speed natural healing. Many forms of stimulation applied to the skin, or through the mental faculties, have been the basis for many illusions of cure in the use of various sectarian healing methods.
There is much room for imagination and theorizing in the complex workings of the nervous system, but, of course, such theorizing is the prerogative of those who are properly able to separate fact from fantasy. A fact is worth little unless it can be applied in its proper perspective, and only those with enough knowledge to see where a fact fits in can competently utilize a theory. "When you meet with a fact opposed to a prevailing theory," Claude Bernard wrote, "you should adhere to the fact and abandon the theory, even when the latter is supported by great authorities and generally accepted."
Many practitioners who employ chiropractic "reflex technics" attempt to base indications for such treatment upon well-known neurological symptoms which, occurring as a result of a physiological disturbance, are primarily of diagnostic importance. It is well known, for example, that disturbed organs often send impulses back through connector fibers in the sympathetic and parasympathetic ganglia to the spinal nerves where they are referred as symptoms to other structures. Since these symptoms are the result and not the cause of the primary disturbance, it would be quite futile to apply treatment to the symptomatic areas.
Abnormal nerve impulses as a cause of disease originate almost entirely in the nerve centers (brain, ganglia) where mental, hormonal, chemical, and nervous disturbances are capable of pathologically disturbing outgoing nervous impulses.
Although prolonged irritation of a nerve ganglion might cause organic disease or functional disturbances over a wide area, mechanical irritation of a spinal nerve at the intervertebral foramen (labeled by most chiropractors as the cause of most disease) can cause symptoms to radiate into a given structure but has little or nothing to do with visceral function and innervation. The muscles used in voluntary functions (such as walking) receive their nerve supply over the spinal nerves from the central nervous system -- i.e., the brain and spinal cord -- while the involuntary functions (such as digestion, respiration, circulation, and so forth) receive their nerve supply primarily from a more or less independent vegetative nervous system located outside the spinal column, being little affected by the alignment of the vertebrae. The nerves connecting these two systems are known primarily as "connector fibers" and are not an integral part of the vegetative (involuntary) nervous system. Thus, it does not seem that pressure upon a spinal nerve could be imagined to pathologically curb the function of a visceral organ, especially since impulses capable of seriously disturbing an organ would probably have to originate in the nerve centers supplying the organ.
"The independence of the vegetative system has been shown by Langley, who severed the spinal connector neurons between the central nervous system and the motor ganglia; and by Cannon, who removed the gangliated cord of the entire sympathetic system and still the animals lived and carried on the functions necessary to life."  Dr. Walter Alvarez recently reported in Geriatrics that he removed a section of muscle from the intestinal tract of a young criminal who had been hanged in a state prison, placed it in an ordinary refrigerator, and found that it continued to contract regularly and rhythmically.
Not every cell in the human body has a nerve supply (each cell an independent living unit) but carries on its functions in a chemical environment, as shown by experiments designed to keep cells and organs living in nutritive solutions for an indefinite period of time, The organs themselves possess nerve centers in their tissues that are influenced by stimulating and inhibiting forces which are balanced in good health. The sympathetic ganglia supplying these organs receive fibers from the central nervous system and distribute them over a wide area in coordinating their functions.
The fact that a good state of mind is essential to good health has been demonstrated by Selye's experiments. Dr. Hans Selye maintains that "stress," the mental wear and tear of everyday living, is the cause of much human disease. "Doctor Selye has caused heart, blood vessel, and kidney diseases in animals by giving hormone injections, indicating that the diseases were caused by stress which unbalanced the adrenal glands, and he has checked the same diseases by restoring hormone balance. The great alerters and defenders of the body against stress appear to be the pituitary and adrenal glands, particularly the cortical adrenal hormones, which have dramatic medical uses in management of arthritis and inflammatory diseases."  Inasmuch as the chemical balance in the body is governed primarily by the pituitary and adrenal glands, Dr. Selye's experiments indicated that abnormal stresses caused an imbalance in the hormone production of these glands, resulting in a chemical imbalance sufficient to cause disease. "The apparent cause of illness," said Selye, "is often an infection, an intoxication, nervous exhaustion or merely old age. But actually a breakdown of the hormonal-adaptation mechanism appears to be the most common ultimate cause of death."  If Selye's observations prove to be correct, ways might be found to control or alter the chemical and hormonal balance of the body so that disease can be controlled or prevented, the wearing out of organs postponed, and the life span lengthened to 150 years or so. Old age itself, as we know it, might then be considered just another disease that can be studied and conquered.
Even though the chiropractic theory (that subluxated vertebrae interfering with the nerve supply causes most disease) is not even remotely connected with Selye's theory of stress and hyperactivity in the cause of disease, many chiropractors leaned toward Selye's theory as evidence supporting the chiropractic hypothesis. Offering an almost magical way of restoring health and curing disease, these chiropractors argued that they could control and normalize internal secretions -- through the nervous system -- by manipulating the spinal column. Obviously, however, stress must be removed or controlled at its source. No amount of manipulation could change impulses originating in the brain. Any influence on such by manipulating the spine would, of necessity, be almost entirely psychological.
Although we do not wish to detract from the supremacy of the nervous system in man as an intelligent animal, it seems certain that the nervous system alone is not always the primary factor in the cause of disease. As we have shown, experiments have been done in which all the nerves leading to an organ have been severed, yet the organ was still able to carry on its functions. It seems that the nerve centers in the organs themselves -- nourished by the surrounding tissue fluids, the electrolytes -- are capable of maintaining the organ's functions. For the most part, the nerve fibers leading to the organs are primarily coordinators. Cutting one set of nerve fibers -- the inhibiting fibers, for example -- to an organ that has dual control, and leaving the stimulating fibers intact, may alter the function of the organ. However, physiological adaptation might restore the organ to its original condition (assuming that the nerve fibers were cut in order to normalize its function) if the primary disturbance is mental or chemical, as it often is.
The myogenic theory of organ function maintains that function can be carried on by certain cells and organs independently of nerves. While such cells can function without nerves, however, nerves cannot act without nourishment from the same electrolytic fluids that bathe the organ and its nerve cells. It is easy to see how mental stress, causing an excessive production of certain chemical and hormonal products, could detrimentally affect the entire body and its nervous system. Yet, many chiropractors claim to be able to exert control over every cell in the body -- through the nervous system -- simply by manipulating the spinal column.
For the most part, there is little or no evidence at all supporting the theory that vertebral pressure upon spinal nerves, or, as D. D. Palmer put it, upon "one filament of a nerve," is the cause of most disease. In fact, should one volunteer his spine after the guilty nerve was selected by a chiropractic physician who is guided by this theory (in treating a patient with actual organic disease), I have little doubt that rhizotomy (cutting of the selected nerve trunk) would have little or no effect upon the diseased organ, although cutting the nerve would deprive corresponding physical structures of certain sensory and motor functions. A certain area of the skin, for example, or a particular skeletal muscle, might receive its nerve supply from a single nerve trunk, the severance of which, though resulting in a loss of function in these structures, does not result in disease of the supplied tissue, much less in the viscera.
The nerve supply received by an internal organ may come from a wide distribution of nerves that are interconnected with a great many other nerves, many of which find their origin in nerve centers outside the spinal column. This fact has caused many chiropractors to deny the existence of the more or less independent sympathetic nervous system, since it obviously cannot be "pinched" by "subluxated" vertebrae.
Maintaining that the nervous system described in the anatomies of present-day authorities is a "neurological superstition," these chiropractors contend that the "Brain System," as proposed by the founder of chiropractic (whereby all functions are determined by the flow of "Innate Intelligence" from the brain, over the spinal nerves, and out through the spinal column where interruption of such is the cause of all disease), is the correct interpretation of neurology. "In the study of Chiropractic," said the chiropractic author of Healing Hands, "there is possibly no one point upon which we so radically differ, from all preceding schools, as in eliminating the so-called sympathetic nervous system. We shall endeavor, by quoting authorities, to show how much they are in the dark as regards the origin of 'involuntary functions,' and by so doing supplant it with a superior teaching of Chiropractic." 
The author of Healing Hands goes on to say that the cranial nerves, long described as passing through solid bony openings in the skull to supply structures of the head, have been falsely charted by misguided medical authorities who conducted their studies on "dead bodies" rather than upon living human subjects:
Referring to 'Cranial Nerves' we take serious exception to the correctness of what has been previously supposed to be reliable authority," he went on to say. "We do object to the nerves that are now known by the various names being so called because they do not convey, coming or going, those impulses which terminate into those functions. . . . We have yet to find a single nerve involving any function to which these fibers have received the various names, leave the base of the skull but on the contrary have traced them all to some intervertebral foramina .
Thus, by "nerve tracing" in the sick patient, some chiropractors Claim to have knowledge of nerves that are not known to medical authorities. Contending that all functions can be disturbed or diseased by vertebral subluxation, these chiropractors maintain that disease anywhere in the body can be corrected by adjusting the vertebrae.
To provide an example of a structure supplied by nerves enclosed within the skull: It is well known among medical men that the eyeball receives its nerve supply from the optic nerve which passes directly from the brain, through the bony structure of the skull, to the eye. "From its mode of development, and from its structure," advises Gray's Anatomy, "the optic nerve must be regarded as a prolongation of the brain substance, rather than as an ordinary cerebrospinal nerve." In spite of this indisputable fact, many chiropractors contend:
In disease of the eye, where sight is involved, the physician cannot do a thing to stop the progress of any given disease of this organ. He can relieve conditions with medicines and oculists can operate and opticians can apply glasses and the conditions gradually get worse regardless of what treatments are applied. The Chiropractor adjusts the cervical subluxation and the patient gets well, sight is restored and other functions therein restored to normal .
Offering an explanation for such claims, chiropractors claim to be able to trace sensitive nerves from the eye ball, back over the scalp, to a cervical subluxation, thus "tracing out a nerve that no anatomy gives." More recent chiropractic theories now claim to be able to exert controlling influence over sympathetic ganglia by removing vertebral subluxations that impinge tiny fibers connecting the ganglia with the spinal nerves (such as the explanation offered in an earlier chapter of how D. D. Palmer restored the hearing of his first patient by adjusting his spine).
Much pseudoscientific literature presented by chiropractic authorities in supporting the chiropractic cause plunges the profession deeper into an abyss from which there is little hope of ever returning. (The book Healing Hands was edited by Dr. B. J. Palmer, who was, until his death in 1961, the "foremost authority in chiropractic.")
For the most part, chiropractic manipulation in the treatment of disease seems to be primarily a theoretical formula that has been handed down through the ages. "In comparison with medicine," said Dr. Fred W. Illi, one of chiropractic's most scientific and productive authorities, "chiropractic does not rest on a firm scientific basis and if it did, chiropractors do not know them as yet. . . . The application of chiropractic is a manual skill, to which there has been attached a theory which has remained broadly the same for 60 years and which still has no underlying basis." 
"The reason why we have to restrict the area of validity for this theory," said another well-known chiropractor, "is that there is an abundance of room for the nerve in the intervertebral foramen . . . so that at any rate a subluxation cannot be imagined to compress the nerve." 
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