Chiropractic History Volume 32, No.1 59 Chiropractic and Type O (Organic) Disorders: Historical Development and Current Thought STEVE TROYANOVICH, DC* AND JENNIFER TROYANOVICH, BA# The chiropractic profession originated at a time when the healing arts were comprised of a medley of capricious theories, practitioners, and prac- tices. Early chiropractors claimed to treat and cure a wide spectrum of ail- ments; however, in this era, the diagnosis and treatment of disease was, by definition, the practice of medicine or osteopathy. To avoid conflict with the law and differentiate chiropractic from medical practice, the profession abandoned medical terminology and chiropractic as a disease-specific inter- vention in favor of a distinct lexicon and a doctrine of chiropractic as a non- ‘therapeutic’ philosophy, science and art. This allowed for the possibility that analysis, detection and correction of the chiropractic lesion could indi- rectly cure or improve a wide range of clinical conditions – both muscu- loskeletal and organic (Type O) – without infringing upon the practice of licensed healthcare providers. On the surface, improvement or cure of organic disorders by manual treatment methods seems to be " . a fantastic and totally unacceptable claim.” Is improvement or cure by manual treatment methods of non- musculoskeletal conditions possible? Or are such notions implausible and unlikely? The evolution of the profession's claims, management, clinical success or failure with Type O disorders is generally discussed in the his- torical context of the healing arts and scientific evidence. Introduction by manual treatment methods will be ex- The genesis of the chiropractic profes- plored in the historical context of the heal- sion occurred when a self taught healer of ing arts. Additionally, manual treatment of the late nineteenth century, Daniel David Type O disorders will be broadly discussed Palmer, manually manipulated the upper in light of a government investigation and dorsal spine of a partially deaf janitor, re- the scientific literature. storing his sense of hearing.1 Today, this claim would be met with skepticism or dis- The Healthcare Landscape and counted as outright quackery; however, Medical Education circa 1800-1900 during the 19th century, people would find During the early nineteenth century, this claim acceptable, if not likely. healthcare was a hodgepodge of capricious In this treatise, the origination of the chi- theories, practitioners and practices: ap- ropractic profession and claims of improve- proaches included allopathy, herbalism, ment or cure in cases of Type O disorders Thomsonism, homeopathy, Grahamism, hydropathy, Seventh-day Adventism, phre- *Private practice of chiropractic, 322 Susan Drive, Suite B, Normal, IL 61761 nology, Fletcherism, Christian Science, [email protected] #President and Executive Director, Central Illinois Neuroscience Foundation, magnetic healing, osteopathy, patent medi- 1015 S. Mercer Ave., Bloomington, IL 61701 www.cinf.org cines, Mesmerism, electro-medicine, divine Reprinted by permission of the Association for the History of Chiropractic Chiropractic History Volume 32, No.1 60 healing and physical culture,2 among oth- from sixteen to twenty weeks; ers. More was known about human anat- D) Laboratories and libraries were all omy than ever before, yet the healing arts but non-existent in most institutions; still reflected local customs, traditions and E) The primary method of instruction spiritual influences in ridding the body of was lecture with little personal contact physical ailments. between student and professor, or be- Although allopathic medicine is the pri- tween student and patient; mary method of care in today's society, at F) At many schools, students could fail the turn of the twentieth century, a visit to several courses and still obtain a medical an allopath was often a last resort. Allo- degree; and, pathic physicians believed that the harsh- G) 120 of the more than 150 medical ness of the remedy should be proportional schools in operation should be closed. to the severity of the disease, meaning the Flexner’s report also suggested that the sickest patients often received the most in- quality of medical education, with variable vasive treatments.2 "Heroic therapy," in- curricula and training, was further diluted cluding regimens of bloodletting, purga- by insufficient funding for facilities and the tives and emetics, was often more harmful faculty necessary to effect a scientifically than the disease itself.3 Ludmerer notes, “It rigorous course of study.6 When the Johns was estimated that a patient in 1900 stood Hopkins School of Medicine was opened in only a fifty-fifty chance of benefiting from 1893, the school Flexner held up as ideal,7,8 an encounter with a random physician.”4 American theological schools had endow- Thus, it is not surprising that alternatives to ments of approximately eighteen million "orthodox" allopathic medicine existed at dollars, whereas medical school endow- this time as patients were commonly afraid ments totaled five hundred thousand dol- of accepted techniques. lars.9 Funding for medical education was In the late 1800s, however, medical edu- as lacking as the scientific discoveries cation in the United States was primarily needed to advance appropriate care and by apprenticeship with no formalized aca- treatment. demic standards for the training of physi- While medicine was practiced haphaz- cians.2 Consequently, most allopathic phy- ardly in the late 1800s, there were also few sicians were no better off in terms of the reliable treatments available. For example, foundation of their methodologies than penicillin would not be discovered until their "unorthodox" counterparts. It was not 1928 and would not be mass produced until until 1910, with the publication of the Flex- 1943.9 The most common cause of death in ner Report describing medical education as the era of the founding of the chiropractic a shambles, that the orthodox medical es- profession was infectious disease, namely tablishment made sweeping changes to im- pneumonia and tuberculosis.8 Mankind prove the quality of medical education. In was involved in a death match against his his landmark report,5 Abraham Flexner ex- own filth and the bacteria and viruses that posed the following: thrived in the relatively poor sanitation of A) Most medical schools required only a the period. high school diploma as eligibility for It was in this environment that rival enrollment; methods to allopathic medicine found fer- B) Few schools assigned grades or gave tile soil in which to grow and flourish. examinations; These rivals found equal footing with allo- C) A standard course of study lasted pathic medicine for the relief of human suf- Reprinted by permission of the Association for the History of Chiropractic Chiropractic History Volume 32, No.1 61 fering, claiming to have solutions to all Figure 1 is a reproduction of the adver- manner of ailments. In this milieu, it is not tisement for the Palmer School and Infir- surprising that D.D. Palmer, practicing his mary. newly established healing art of chiroprac- tic in the Ryan Building in downtown Dav- Chiropractic and the Law enport, Iowa, claimed improvement or cure Prior to chiropractic licensing laws, chi- of a wide variety of disease entities pre- ropractors were routinely arrested, indicted senting to his clinic. A full-page advertise- and convicted on charges of practicing ment from a local broadside contains the medicine or osteopathy without a license.12 following Palmer proclamation: D.D. Palmer himself was convicted on 28 I treat all diseases, but it might be well to March 1906 of practicing without a license mention here a number of diseases in the and was sentenced to a fine of $350, or 105 treatment of which medical doctors rarely meet with success, whereas Chiropractics days in the Scott County jail. Palmer re- seldom fail. fused to pay the fine and was incarcer- 13 Diptheria--People say: "We can readily ated. Palmer's early writings and broad- understand how your treatment will cure side advertisements provide evidence that rheumatism or diseases of the joints, but you the language he used to describe his meth- certainly do not claim to cure diphtheria." I ods included the diagnosis and treatment of do claim to cure diptheria in its most ma- 11 lignant forms. disease. By definition, diagnosing and Bowel Troubles--Diarrhoea, flux, consti- treating disease was the practice of medi- pation, and, in fact all diseases of the stom- cine or osteopathy. ache, intestines and peritoneum are re- The first acquittal of a chiropractor ar- lieved by restoring harmony to the vital forces. rested on the charges of unlicensed practice Insanity--Has in many cases yielded to was secured, in part, due to the legal strat- chiropractic treatment. Many cases are egy employed by defense counsel Tom caused by mechanical injury. Morris. As described by Troyanovich and Fevers--By taking off the pressure upon Keating,13 and Rehm,14 the saga concerning nerves and controlling the caliber of small arteries. Japanese immigrant and Palmer School of Smallpox being cured by one or two Chiropractic graduate Shegetaro Morikubo treatments. on the charges of the unlicensed practice of Female Diseases--Are very successfully osteopathy in La Crosse, Wisconsin in treated. Local treatment is not necessary. 1907, was strategically devised to legally Goitre--Is always caused by pressure upon the nerves, and we know how to take differentiate chiropractic from the practice off the pressure. of medicine. The story is revisited here to Asthma--Medical men will tell you that provide context as to why medical termi- only a change of climate will bring relief. nology was abandoned in favor of a vo- The trouble is, they don't know the cause. cabulary and practice philosophy different Asthma has been cured by Chiropractic treat- ment in one treatment. Irritation of nerves from that espoused by either allopathic or causes the spasmodic contraction, and re- osteopathic medicine: moval of the irritation cures the disease.