An Eyewitness View of Chiropractic (1968)
Ralph Lee Smith
In his excellent paper Science and Chiropractic, Dr. Hugh Hussey has discussed chiropractic's claim to be a scientific healing art. I would like to supplement his presentation by telling you about some of my experiences in connection with a book I am writing on the subject of chiropractic. I first posed as a chiropractor and enrolled in a seminar for chiropractors held under the auspices of the Parker Chiropractic Research Foundation in Fort Worth, Texas. Then I posed as a patient having the symptoms of certain maladies, and submitted myself for treatment at the clinics of the Palmer College of Chiropractic and the National College of Chiropractic, two of the leading chiropractic educational institutions in the U.S. I will begin by telling you about my three days as a chiropractor. In case you don't think that I am a chiropractor, here is my graduate certificate from the Parker Chiropractic Research Foundation, designating me by the title "Doctor," and showing that I have "completed the prescribed course of study."
Chiropractors attending the Parker Seminar receive this handsome document, which they can hang on their walls for all their patients to see. The patients have no way of knowing from the certificate that the "course of study" lasts only three days, that no attendance is taken so that the Foundation really has no way of knowing whether you "completed" the course or not, and that the scientific subject studied at the seminar is—how to make money.
I am, of course, not a chiropractor or any other kind of doctor. I simply sent in my $250 fee for the seminar, calling myself "Dr. Lee Smith, Chiropractor," My money was accepted without hesitation and my credentials were never questioned.
The Parker Chiropractic Research Foundation is the creation of a chiropractor named James W. Parker. Founder of a chain of 18 chiropractic clinics in Texas, he has grossed millions of dollars while spending over half a million on advertising and public relations. Having made one fortune from his practice, he now appears to be making another from his fellow chiropractors, by selling them courses on how it is done.
When I checked in at the seminar registration desk in the Hotel Texas in Fort Worth, an attractive girl smiled and handed me a handsome split cowhide briefcase with "Dr. Lee Smith" stamped on the side in gold. Inside was a ream of literature including a 336-page multigraphed softcover book called Textbook of Office Procedure and Practice Building for the Chiropractic Profession. The seminar—I soon learned—is built around this remarkable book.
More than 200 chiropractors and their assistants were in attendance when Parker, wearing a badge that said simply Dr. Jim, stepped to the rostrum to begin the first session at one p.m. "At these sessions," he said, "1 intend to teach you all the gimmicks, gadgets, and gizmos that can be used to get new patients. . . . Thinking, feeling, acting determine the amount of money you will· take to the bank . . . Remember, enthusiasm is the yeast that raises the dough."
It turned out that, when it comes to love, the hippies have nothing on Dr. Jim. To succeed, the Textbook says, the chiropractor must "Lather Love Lavishly," "When you meet a new patient,'' Parker explained, "You can push a button. You can push the LLL [Lather Love Lavishly] button, the love button. It's like a light bulb that you switch on, When you meet a new patient, LLL him in. When you do this, you disarm a patient who has developed sales resistance."
Perhaps the most important of the many subjects covered at the seminar was the procedure for getting the patient to agree to chiropractic treatment, The Textbook kicks off the subject with a detailed discussion of telephone technique, including many sample conversations. "If possible," it says, "the assistant should handle calls since she can refuse requests for prices and can praise the doctor and chiropractic with an emphasis not possible for the doctor himself."
When the chiropractor does get on the line, his job is to get the prospect in. The bait on the hook is a "free consultation." If he is asked about his charges, the chiropractor is told to reply, "There is no charge . . . (pause) . . . for the consultation of the first visit. This is to determine the cause of your trouble and what should be done about it," Actually, the Textbook explains, the patient will not learn the cause of his trouble and what should be done about it in the free consultation. Its purpose is to get the caller into the office so that the chiropractor can make a complete selling pitch in person, "The consultation is without cost," says the book, "but the examination will cost them money."
When the patient comes in, the chiropractor's assistant first secures basic information including name and address. "Check the patient s address for Income status," the Textbook says. Later on, the chiropractor is also told to learn the family breadwinner's occupation by evincing interest in the family. "This should be done subtly," the book states. The patient is then ushered into the august presence, where the chiropractor deals with him in a 13-step procedure that leaves nothing to chance. As the patient enters, the chiropractor pushes the love button and lathers him lavishly, He is told to establish a common bond through such links as fraternal jewelry, similar religious affiliations, and talk about children.
"What would you like me to do for you?" he then asks. His moves now, according to the Textbook, are : "(1) Eye contact; (2) Lean forward ; (3) Hands on desk, or one hand on edge of desk and other at side; (4) When patient begins to answer, you can lean back in chair and listen attentively with arms and legs uncrossed.''
Now comes what the book called the "Yet Disease." "If the patient has a pain in his left shoulder," Dr. Parker said, in explaining it to the seminar, "ask, 'has the pain started in your right shoulder yet?' Use it when you must instill a sufficient amount of fear to get the patient to take chiropractic."
The next step is to perform an operation called "digging for chronicity." The chiropractor puts a series of questions to the patient which suggest or imply that his complaint or condition is a chronic one. "The course," says the Textbook, "is designed to make you a 'D.C.'—'Doctor of Chronics' rather than a Doctor of Acutes." "You'll make a lot more money," Dr. Parker explained in covering this point at the seminar.
With the chronicity of the patient's condition established, the chiropractor is then told to tell the patient that the problem stems from spinal subluxations. The chiropractor is then instructed to take a prudent step. In the Textbook's words, he is to "restate information (or acquire additional information) which may prove useful later on to explain limited results, or to excuse you from getting results expected." After that, the chiropractor is told to turn on the lather again and give the patient a final dose. At this point, says the text, "most patients are ready to proceed." If the patient, however, is still dragging his feet, the chiropractor offers what the book calls a "preliminary examination." Beginning where the patient feels pain, he touches the afflicted parts, then says something like "There doesn't seem to be anything wrong with the arm itself. . . let's trace the nerves back to the spine and check there." Not too surprisingly the chiropractor finds that the real trouble is in the spine. "Oh, here it is," Dr. Parker suggested that the chiropractor can say. "why didn't we look here, first? I'm glad we found the trouble here, because this is my specialty."
If the patient still doesn't see what is good for him, he gets both barrels between the eyes. '"Build fear of more serious trouble, if necessary," the book says. It suggests such comments as, "Do you feel there could be a tumor or perhaps cancer causing these nerves to act up?" Having raised such specters, the chiropractor is told to sit back and let the patient's fear do the rest. "Put the problem of making decisions on the patient's shoulders," the book says. No human extremity is beyond the pale of the sales pitch. "In terminal cases," the chiropractor is told, "mention 'a miracle of nature' has often occurred."
While tightening all these screws, the chiropractor keeps a sharp eye peeled for the green light. Sooner or later, the book says calmly, it comes.
When the patient has agreed to proceed, he is examined and x-rayed. "If in doubt about the payment or the return of the patient," the Textbook suggests, "take only the smaller x-rays on the first visit but ostensibly x-ray fully."
When the examination is completed the doctor is told to collect for it on the spot. "That will be $27. 50 for today," he is told to say. "Will that be cash or check'?" "Begin writing receipt," the book continues, "Don't look up."
On the patient's next visit, the chiropractor, who has relaxed and is back to lathering, hands the patient a document entitled Confidential Report of Chiropractic Examination and Recommendations, which consists of six sheets and a blue cover." "Our examination has now been completed," the multigraphed text says. "In your particular case, we have found definite misalignments in your SPINE resulting in a disturbed nervous system. Therefore, you are a case for chiropractic." For the patient's enlightenment, the Report explains the chiropractic theory of disease, and says, "the nervous system is the master system which controls all other systems of the entire body, including the glandular, reproductive, digestive, eliminative, respiratory, and circulatory." "They couldn't possibly have a condition not covered here," Dr. Parker said to the seminar.
The Report sets forth the chiropractor's analysis of the patient's condition, together with a recommended number of adjustments, a price for the series, and an offer of a discount for full payment in advance. The Textbook adds some comments intended for the chiropractor's eyes only. "You might suggest only as many adjustments as the patient can pay for," it says. ". . . One adjustment for each year of age of the chronic patient over 20 years of age is a rough thumbnail guide of what people will willingly accept and pay for."
I talked to many chiropractors during the three days of the seminar. Their response to the course was overwhelmingly enthusiastic. Over half those in attendance wore blue badges showing that they had attended previous seminars and had come back for more. A chiropractor from Ohio told me that he had been attending the seminars since 1959; by applying Parker's methods he had built his practice. rom $25,000 to $100,000 a year. Another said that this was his 18th seminar. "After the first one my income went up from $2,000 to $4,000 a month," he said. He is also now near the $100,000 mark. A third didn't give figures but summarized his situation with graphic simplicity. "We have gone, he said, "from rags to riches."
The. seminars are given five or six times a year, and six thousand chiropractors and their assistants have attended one or more of them. Parker's project seems to be nothing less than turning the entire chiropractic profession into an army of smooth-talking merchants.
What kind of merchandise do these merchants dispense? To find out first hand, I posed as a patient and went to the clinics associated with the Palmer College of Chiropractic, Davenport, Iowa, and the National College of Chiropractic, Lombard, Illinois. These are regarded with pride in the chiropractic world as offering the best in chiropractic care. At both I said that I was experiencing symptoms which are often or usually associated with the presence of certain serious conditions. I wanted to see, first, if they would recognize the possible presence of these conditions, and second, what kind of treatment they would give.
I chose Palmer and National for several reasons. Almost from its inception, the chiropractic fraternity has been split into two groups, the "straights" and the "mixers." "Straights" stick to spinal manipulation as the almost exclusive treatment of human disease. "Mixers," the majority group, supplement spinal manipulation with such treatments as giving vitamins and minerals, and sometimes with treatments such as "colonic irrigation" (in layman's language, an enema with the water under pressure, and other methods long ago discarded by medical science. Palmer College—named for and founded by Daniel David Palmer, the inventorof chiropractic—is the headquarters of the "straight" approach, and National is the banner school of the' "mixers," With a combined enrollment of more than 1300 students, the two colleges currently provide half of all new persons entering the field.
Before visiting the clinics, I went to one of the nation's leading hospitals and submitted myself to a thorough physical examination. It included extensive laboratory work, and an especially careful examination of my spine, based on a detailed series of x-ray plates taken from every angle. The examination showed me to have no illness and showed that my spine had no medically significant defects that could be detected by the finest facilities and equipment of modern science.
My first stop was the Palmer College of Chiropractic in Davenport. It occupies three city blocks on an attractive site at. the top of a hill overlooking the Mississippi River. Across the street are the modern transmitting facilities of stations WOC ("Wonders of Chiropractic") and WOC-TV, founded by B.J. Palmer, son of Daniel David Palmer and longtime president of Palmer College, Since B.J.'s death in 1961, incidentally, the College has been run by David Daniel Palmer, B,J,'s son. The Palmer family also owns the radio and TV stations, along with other broadcasting interests. One of the woe transmission towers is atop the D, D, Palmer Memorial Building, a classroom facility on campus,
I mounted the steps to the clinic building and told the receptionist that I would like to see someone about a "back problem," A student in a white coat appeared, whom we will call Dr. Tom Blake, We shook hands and Doctor Blake led me into the clinic, a large open area divided up into some 30 treatment cubicles, The place was busy, There were patients in a number of the cubicles, and student chiropractors were scurrying around everywhere, Dr, Blake told me that last year the clinic had handled some 28,000 patient-visits.
We entered a treatment cubicle and sat down. I asked him if his work in the clinic was supervised, or if he was "on his own," He replied that his findings, recommendations, and plans for treatment in every case he handled were reviewed and approved by chiropractors on the college faculty or the clinic staff.
I then described my "symptoms" to him. I had, I said, an off-and-on back pain. Sometimes this pain was accompanied by pain extending through my hip, down the back of my right leg, past my knee, and almost as far as my ankle. The pain, I said, never entered my other leg, and never extended upward in my back.
This set of symptoms, I had been told by several prominent physicians, would suggest the possible presence of a "disc lesion"—a damaged disc in my back. Such symptoms should be carefully checked because the condition is serious. The usual treatment is bed rest on a hard bed, sometimes accompanied by traction. Damaged discs rarely or never can be helped by hand manipulation of the spine. In fact, manipulation is usually contraindicated, since pushing and jerking the spine is likely to aggravate existing damage.
Doctor Blake took my medical history. I then removed my shirt and undershirt and sat with my back to him. He ran his fingers slowly and evenly down my back, then began to feel the vertebrae of my lower spine. "Finding anything?" I asked, "Yes," he said. "There are subluxations in there (pressing my lower spine) and there (touching a spot in my midback, just below where.' I told him that the pain stopped). He then felt my neck, turned my head to the left and right, and said that I had a third subluxation in my atlas, at the top of the spine where it joins the head.
In less than a minute he had "found," by hand, pathologies that could not be detected by the most advanced scientific equipment and medical specialists.
I lay down on the chiropractic adjustment table and Dr. Blake went back over my lower spine. "There's edema there," he told me.
I got up from the table and we arranged for me to hove x-rays taken. They were taken that evening—two 14x36-inch "full spine x-rays," one from the front and one from the side. Medical specialists rarely take such plates to analyze conditions in a specified area of the spine. A smaller plate carefully focused on the afflicted area not only yields clearer and more detailed information but exposes the patient to far less radiation. By contrast, the taking of these immense x-ray pictures is standard practice with chiropractor, and they x-ray nearly every patient who walks in the door.
When I returned to the clinic the next day, Dr. Blake said that the x-rays had been developed, and they confirmed his manual discovery of three subluxations. One was the fifth lumbar vertebra, the second was the ninth dorsal vertebra, and the third was the atlas.
We went into another treatment cubicle where, under the supervision of a senior student, he gave me a series of adjustments. It was a little bit like a wrestling match in which I wasn't allowed to fight back. The adjustments I really didn't like were three heavy 'thrusts straight down into my unsupported back, which were given to me stiff-arm style while I knelt on my hands and knees with my head on a cushioned stool. Someday I'd like to get that fellow into the same position and do it to him. In between saying "Oof," I wondered what such swift, heavy thrusts would do to a damaged disc if I really had one. At no time did my student chiropractor give any sign that he recognized what my symptoms might possibly mean.
Back in our treatment cubicle I put on my shirt and asked him what disease or condition I was suffering from. He replied that chiropractors do not seek to diagnose or identify illnesses; instead, they simply locate and remove the cause in the spine. I asked what kinds of conditions were treated at the Clinic, assuming that they had been diagnosed and identified elsewhere. "They run the gamut," he said. "You name it." Conditions that he had treated, or seen treated, included bursitis, ulcers, headache, sciatica, a malady that involved "spitting blood," headache, gallstones, and heart conditions.
I was especially interested in his mention of heart conditions. I planned to present symptoms of angina pectoris—coronary disease—at my next stop, the National College of Chiropractic clinic. As recent experiments with human heart transplants have shown, this organ can function perfectly without the help of the nervous system. "The origin of the heartbeat is in the muscle and the heart will beat in the absence of any nervous connection," says Hyman S. Mayerson, Ph.D., professor of physiology and chairman of the Department of Physiology at Tulane University Medical School. Furthermore, heart trouble primarily heart muscle trouble, whether the cause is disease of the muscle fibers or faulty coronary artery circulation. Heart trouble, therefore, could not possibly be treated by "relieving spinal nerve pressure, even if such pressure really existed.
Two days later I sat in a cubicle in the National College Clinic, describing my "symptoms" to a recent graduate of the school whom we will call Dr. John May. For about a year, I said, I had been having dull, cramp-like pains in my chest. I had them sometimes two or three times a day, sometimes only once a week. They tended to come when I had been exerting myself heavily, or when I was angry or under strong emotional stress. The pains, I continued, would cause me to breathe deeply. They lasted for periods of time ranging from a few seconds to a few minutes. When they came, I said, they would go away if I simply stopped what I was doing—or, if they came when I was angry, they would go away if I just took it easy, sat back, and relaxed. I added that these pains would sometimes go up from my chest into my left shoulder and arm.
As I have already indicated, physicians had told me that these symptoms clearly suggest the possible presence of a coronary heart condition. I even helped Dr. May along by saying pointedly that the pains were never in my back, thus making it unlikely that my condition was arthritis.
Dr. May asked me no questions about my symptoms, and showed not the slightest sign of recognizing their possible significance. He took a brief medical history. As he finished it, a chiropractor who is the assistant director of the clinic came in. Dr. May told him that I had "dull chest pains" going up into my left shoulder and arm. The assistant director was apparently as impervious to the possible meaning of my symptoms as Dr. May. He asked me no questions.
I took my shirt off and the assistant clinic director felt my left shoulder and spine. He told me that the musculature of my left side was more developed than that of my right, and that that might well be causing my trouble. I told him that I was right-handed, not left-handed. He replied that perhaps my left-side musculature had nevertheless become overdeveloped by such activities as lifting.
The assistant clinic director left the room, and Dr. May took me in front of a mirror to show me that my left shoulder was higher than my right. In the mirror, it was clearly not so. "It shows when you sit down," he said.
We then went to another room I where I lay face down on a chiropractic adjustment table. Dr. May put a hot compress on my back and left me there for about ten minutes. In the next room I heard a man gasping as he was adjusted. I resolved that, if l escaped alive from this project, I would quit journalism and go into a sane profession. Like all good resolutions, this one faded within 24 hours.
Doctor May ·re-entered the room, removed the compress, felt my neck and back, and settled his hands upon the area just below my shoulder blades, "Finding anything?" I asked, "Yes," he said, "you have a subluxation there," "where is it?" I asked. "At the fifth dorsal," he replied, He found nothing at the ninth dorsal or the fifth lumbar, where the Palmer Clinic had told me that I had subluxations, and where I had been further informed that it would take a number of adjustments, in addition to those I had received at Palmer, to eliminate the subluxations. Conversely, Palmer had found nothing at the fifth dorsal.
Doctor May gave a sharp thrust at the fifth dorsal, and my spine popped audibly. Next he moved to the bottom of my spine. "One down there?" I asked, "Your hips are slightly out of line," he replied, and gave me a wingding adjustment, He then took my head and jerked it left and right, getting n good, sharp pop each time.
That concluded my treatment. I sat up and asked him if the subluxation at the fifth dorsal might be causing my chest pains, He replied that nerves lead from the fifth dorsal to· "organs all
around the chest area," and the subluxation there might well be causing my pain. had been dropped. As was the case at adjustments would be necessary to get into place. Apparently the "overmusculature" theory Palmer, he told me that a series of my subluxated vertebra permanently back into place.
I had intended to continue my research by offering myself as a guinea pig in the office of individual chiropractors. But as I left the clinic and got into my car, I felt a sharp twinge in my back from the straight-arm lower back adjustments at Palmer. Enough, l decided, was enough, I wondered how many people each year go to chiropractors to have such ailments as damaged discs and coronary heart disease treated by vertebral piano-playing. As I drove away into the warm sunshine I counted my blessings.
Now, I am not a doctor or a scientist, but these experiences I have been describing make it clear that, in my encounters with chiropractic, I did not find myself dealing with a scientific discipline. It should be noted that the public cannot be blamed for not realizing that chiropractic has no scientific foundation. People should be able to assume, and obviously do assume, that a state-licensed health practitioner using the title "doctor" is practicing a valid healing art, It is time to place ultimate responsibility for both the problem and its solution where it properly belongs—on the doorsteps of the state legislatures.
From its infancy the chiropractic profession has been politically precocious and politically successful. An important factor in chiropractic's present position is that it succeeded in getting licensure laws through 32 of the nation's 48 rurally dominated state legislatures by the year 1925, almost before the modern era of health care and health legislation began. They then conducted intensive campaigns to reduce the remaining legislatures one by one. By now Louisiana and Mississippi are the only states that do not license chiropractors, and the legislatures of these two states are under heavy chiropractic siege.
Chiropractic uses politics and licensing, not as a way for working with science, but as a protection against science. Essentially the same scenario has been enacted in legislatures throughout the land. A bill to license chiropractors is introduced and referred to committee. Hearings are held. Doctors, scientists, heads of medical schools, and leaders of medical research, appear before the committee and testify unanimously that the theory of chiropractic is false and its practice is a danger to public health. Typical was the joint statement by Dr. Frank W. McKee, associate dean of the University of Rochester School of Medicine and Dentistry, Dr. Charles H. Saunders, associate dean of Cornell University School of Medicine, Dr. Marcus D. Kogel, dean of the Albert Einstein College of Medicine·, and Dr. Ralph E. Snyder, president and dean of New York Medical College, made before the committee of the New York State legislature that was considering a chiropractic licensing bill in 1963. "It is an incredible anachronism," said the deans, "that in an age when this nation leads the world in many areas of scientific endeavor, New York State should be asked to place its seal of approval on a group of persons claiming to be practitioners who are largely ignorant of the accepted and proven science of health and disease."
After listening to reams of such testimony, without a single counter-balancing scientific voice supporting chiropractic, the legislators go into private session and report out the licensing bill favorably. The legislature passes it, and the governor signs it.
Whatever the difficulties involved, state legislatures can no longer ignore the abdication of their public obligation that such behavior on their part represents.
- First, legislation in scientific fields that pays no attention to science is bad law and is a deep failure on the part of legislators to fulfill their responsibility to their constituents.
- Second, in this country at this time, anyone claiming to have a valid treatment for human illness should be required to show its validity before the bar of science, ·before the state licenses him to use his methods on the sick.
- Third, the correct way to deal with treatment methods that cannot or will not submit to the judgment of science, is not to license and oversee them, but to prohibit them.
By abandoning all these precepts in the face of political pressures, the states have created a genuine Frankenstein—a state-supported medical hoax.
I believe that the time has come for each state to accept science instead of defying it, and to create an orderly program for withdrawing chiropractic licenses.
The theory of chiropractic is scientifically false, and its treatments bear no known relationship to the cause or cure of disease. Its practice should therefore be prohibited and its personnel should be retrained to enter other professions.
As part of this program, consultations should be held between state legislators and the scientific community to discover where needs exist for persons in physiotherapy, physical rehabilitation, and other fields that make use of paramedical personnel. People are badly needed in many of these fields. Chiropractors should then be consulted, and those wishing to remain in the field of health should be offered full retraining in order to pursue careers in one or another of these areas, where their work will be in accord with science· and will serve real needs. Chiropractors wishing to leave the field of health entirely should have available to them special assistance —a "chiropractor's GI Bill"—for reschooling and retraining in some other field that they may wish to enter.
Such a program is the least that the states can do in view of the central responsibility that they bear toward both chiropractors and the public for creating the current situation. It should not have happened in the first place; and, furthermore, when the legislatures passed the licensing laws, they did it with the full knowledge that chiropractic was and is without scientific foundation or support. When public servants, some misguided and some cynical, fail so completely in their most rudimentary responsibilities, there is always a price to pay. I think that it is time to get this whole matter straightened out, and I see no point in delay. It should be done, and it should be done now.
Ralph Lee Smith investigated and wrote about many quackery-related topics during the 1960s and 1970s. After that, he taught communications at Howard University and operated a writing and editing service. He also became interested in folk music and became a leading promoter and player of the Appalachian dulcimer. This report was originally presented at the Fourth National Congress on Health Quackery, October 1968, sponsored by the American Medical Association and the National Health Council. His investigations culminated in publication of the book At Your Own Risk: The Case against Chiropractic.
This article was posted on July 28, 2018.