Professional Papers

Chiropractic of Today

Editor's note: The following statement was pre­ All systematic endeavors to restore and main­ pared in 1966 by five distinguished educators in tain health constitute the healing arts. Their main the chiropractic profession with the intent of con­ branches in this country are medicine, osteopathy, cisely setting forth the basic tenets of chiropractic and chiropractic. as a healing art, a clinical science, a concept of therapeutics, an educational discipline, and an A few decades ago the terms "healing art" and organized profession as they view it. Certainly this "medicine" were synonymous. With the advent of paper merits careful study by every member of the the age of chemistry and the importance given to profession. The authors welcome any comments the germ theory, a large segment of the healing regarding the contents of this statement. Corres­ profession concentrated more and more upon pondence should be addressed directly to one or chemotherapy, forgetting the heritage of manipula­ more of the authors. tion dating from the time of Hippocrates, and los­ ing sight of the structural concept in health and By: HELMUT BITTNER, D. C. disease, thus separating itself into what today is 118 Eastwood Circle called "medicine". As a result it remained for Spartanburg South Carolina 39302 early osteopathy and, subsequently, chiropractic, with its unique methods of structural analysis and WILLIAM D. HARPER, D. c. adjusting, to revive the lost art and place it on a Texas Chiropractic College 5912 Spencer Highway scientific basis. Pasadena, Texas 77505 Chiropractic, in contrast with medicine and the A. EARL HOMEWOOD, D. C. osteopathy of today, does not employ drugs or sur­ Los Angeles Chiropractic College gery. In its approach it endeavors to establish and 920 E. Broadway Glendale, California 91205 maintain optimal physiological activity by correct­ ing abnormal structural relationships. Its goal is JosEPH JANSE, D. C. to organize the body in such a manner as to enable National College of Chiropractic it to utilize its own biological resources for a return 200 East Roosevelt Road Lombard, Illinois 60148 to normal function. Its focal point of concern is with the integrity of the nervous system, because C. w. WEIANT, D. c. the nervous system integrates and coordinates all 809 Terrace Place Peekskill, New York 10566 function in the body in response to internal and external environmental change. Any mechanical, THE ACA JOURNAL OF CHIROPRACTIC, NOVEMBER 1973 Vol. VII, s-Bl chemical, and/or psychological irritation of the early, strictly empirical phases. One recalls, for neurological component is capable of producing example, the futile efforts in the medical profession dysfunction and thus initiating disease in the sus­ during the early days of bacteriology to discover a ceptible individual. bacterial cause for almost all disease. The vast Traditionally, chiropractic is associated with the catalogue of discarded drugs is another example of detection and correction of disrelated segments of the unavoidable resort to empiricism. Currently, the skeletal system, especially those of the spinal one may point to the propensity among the general column and pelvis. The successful application of practitioners of medicine to prescribe antibiotics such procedure by Daniel David Palmer constitut­ routinely and indiscriminately and to employ the ed the discovery of chiropractic. As the profession corticosteroids without fully understanding the evolved, it became increasingly evident that dis­ nature of their action and their iatrogenic threat. related structures, particularly subluxated verte­ It is, therefore, understandable that in the early brae, are a prime source of disturbance to the period of chiropractic, overly enthusiastic claims neurological bed and constitute a threat to health were made and naive, far-flung hypotheses were not to be ignored. Further study and clinical ex­ propounded which in the light of new facts have perience demonstrates that the spinal factor itself had to be modified or discarded. Another typical has its origin in the complexities of gravitational occurrence in those days was the predilection for and occupational strain, structural asymmetries, loosely applied terminology and poorly understood and reflex action initiated by noxious stimuli in expressions. Many misconceptions stem from the both the internal and the external environment. emphasis given to one meaning of a word, to the The practitioner of chiropractic advises and pre­ neglect of others more often used and generally scribes relative to such habits and environmental accepted. Perhaps the most conspicuous examples factors as may tend to generate these adverse were the confounding of "philosophy" with prin­ influences. ciple, and "principle" with theory, and the coining The chiropractor is concerned with the integrity of new words for conventional meaning. At this of the entire body, the spinal column remaining his point it should be emphasized that to achieve primary interest. His armamentarium may include maximum clarity in defining the position of chiro­ measures other than manual adjustment, provided practic today, we shall avoid in the following dis­ that these are drugless and nonsurgical in char­ cussions the pitfalls to which we have called atten­ acter. tion, by committing ourselves to the usage of the term theory to apply to the explanation of chiro­ Retrospect practic. In view of the fact that the profession of chiro­ Moreover, in our formulation of theory, we shall practic is now seventy years old; has benefited mil­ be governed by the requirements of science. We lions of ailing people throughout the world; and are fnlly aware that in all human attempts to re­ ranks second numerically in the healing arts, it is store and maintain health there are intangible appropriate that its development be reviewed and factors which defy scientific investigation and ex­ critically evaluated. planation, but until this obstacle has been over­ Its inception dates from the initial experiment come (and it may well be that it will never be in 1895 of Daniel David Palmer of Davenport, overcome), we must leave these matters to philoso­ Iowa, who ingeniously saw a relationship between phy. vertebral subluxation and ensuing pathology. His However, chiropractic is also a true science in subsequent provocative announcements attracted its own right in that it utilizes in the most meticu­ widespread attention. Among the many who lous way the scientific achievements provided by sought instruction in this new therapeutic approach all relevant sciences to explain the phenomena of were numerous medical and osteopathic practi­ health and disease. It also uses a scientific method­ tioners. ology to pursue further investigation in this field. It was ouly natural, as is the case in all new pro­ Chiropractic As Science fessional efforts, that the pioneers of chiropractic had to seek their way by trial and error. Lacking The question may now be asked, what is science the guideposts of precedent and an adequate body and when is an effort scientific? Traditionally, of scientific data, they had to forge new procedures science has been regarded as classified or system­ and grope for satisfying interpretations of the as­ atized knowledge. The intent of science is the yet-unexplained phenomenon of their clinical suc­ acquisition of truth. Science would question both cess. Consequently, there was the tendency both to theory and dogma when left empirical. It deals I. oversimplify the rationale and to miss the fnll bio­ with facts and propositions verifiable by standard­ logical implications of the measures employed. ized objective evidence. These trends have their parallels in the history of In a broader sense, however, science is more than the other schools of healing, especially during their classified knowledge. It is an attitude of objective Vol. VII, 8-82 THE ACA JOURNAL OF CHIROPRACTIC, NOVEMBER 1973 inquiry, a method of investigation, and a process of to discover the unique manipulative measure most reasoning which guides the inquiry and controls efficient or best adapted to certain conditions and the interpretation. It organizes isolated facts into types of patients. Special experinlents have check­ meaningful relation with each other and arrives at ed the immediate effect of the adjustment upon a synthesis within the largest possible frame of heart rate, blood count, blood pressure, and other reference. This indeed is the supreme goal of physiological phenomena. Other experiments have science. Nothing better illustrates this process measured the extent to which a correction at one than the various factors out of which has develop. spinal level alters the status at another level; ed the science of chiropractic. 3. Statistics: A far-reaching program of statis­ First of all, it is a body of classified knowledge. tical research is in progress under the auspices of The essentials of the basic sciences from the nu­ the Department of Research and Statistics of the cleus of chiropractic education. From these, the American Chiropractic Association, to evaluate the basic sciences, come the data which support the results of chiropractic therapy in specific types of theory of chiropractic and shape the practice. Such cases. knowledge is supplemented by additional knowl­ Finally, chiropractic is stringently bound by the edge garnered from chiropractic centers in various rules of logic. It reasons by induction and deduc­ parts of the world. tion, applies the methods of establishing causal Second, chiropractic represents the typical atti­ relationships, and follows accepted procedures in tude characteristic of science. There is within formulating hypotheses and theories. chiropractic an insatiable curiosity concerning the The general theory of chiropractic, which fol­ phenomena with which its practitioners deal. There lows, represents the culmination of all these efforts is a willingness to modify any theory when more to date. tenable explanations are advanced and to abandon The Nature of Disease error when error is shown to exist. "The ideas and theories of our predecessors must be preserved only All living cells possess irritability, the capacity to insofar as they represent the present state of respond to external or internal environmental science.'" There is a definite disposition also to changes by performing specialized functions to demonstrate the efficacy of chiropractic by sub­ secure adaptation and survival. jecting it to comparative evaluation, using other In the multicellular organism, a control system, therapies as controls. the nervous system, coordinates cellular activities Third, the methods of obtaining data in chiro­ for adaptation to external or internal environ­ practic are the methods of science. These include: mental change. Through it an innate and genetical­ ly determined "organism consciousness" or "intelli­ 1. Observation and description: No other profes­ gence", attempting to assure health, directs the sion has made such elaborate, detailed, and exact specialized functions of cells in the never-ending description of the facts of anatomical disrelation. process of adjustment to external and internal In daily practice the doctor of chiropractic occupies conditions. himself with the details of body mechanics and Disease is abnormal function. Abnormal function makes careful record of his findings. He has devel­ is function out of time and phase with environc oped new precision methods in radiography in order mental need. Disease does not involve any new to render his findings objective, measurable, and function; it is only the consequence of change in subject to the scrutiny of others. He has utilized quality, frequency, and/or chamleling of nerve photography and mechanical devices for the study impulses. of posture. He has employed the standard technics Disease, whether of the heart, kidney or brain, of diagnosis in gathering data on which to base his is disturbed funCtion, not merely disordered conclusions relative to the applicability of chiro­ structure~ For pathology in the modem sense is practic to specific conditions. He has also design­ physiology gone wrong and not just the morpho­ ed and produced technical equipment for the study logical changes called lesions.2 of the statics and the dynamics of the human body, Disease is not an entity, but a process, an ab­ particularly of the vertebral column and the sacro­ normal functional performance and alteration of iliac mechanisms. morphology. Environmental agencies and condi­ 2. Experimentation: It will be recalled that chi­ tions which irritate the nervous system and to ropractic began with an experiment. Now chiro­ which the body cannot successfully adapt, produce practic research uses experimental methods to fluctuation in the frequency of nerve impulses determine and explain the relation of particular deviating from the norm. Thus originate the func­ kinds and degrees of anatomical disrelation to tional aberrations and structural alterations known specific pathological processes and symptoms and as disease. has acquired an immense body of data in this way. Disease ensues when mechanical, chemical, and/ Experiments have varied the technic of adjusting or psychic environmental disturbances irritate the THE ACA JOURNAL OF CHIROFRACT!C, NOVEMBER 1973 Vol. VII, 5-83 nervous system. There can be no disease without The Problem of Infectious Disease irritation of the neurological component of the It is a widespread misconception that "chiro­ organs and parta involved. "Disease is a reaction practors do not believe in germs." Nothing can be to, rather than an effect of noxious forces."' It is further from the truth, since it is the chiropractic not the result of what something does to the body, concept that environmental factors (and "germs" but what the body does about it, because existing constitute an inescapable component of environ­ mechanical, chemical, and/or psychic irritation of ment) determine health and disease. Furthermore, the nervous system prevents adaptation. this is not a matter of belief or disbelief but a Mechanical irritants include, primarily, trauma, realistic scientific appraisal of the germ theory. gravitational and occupational stress, postural de­ The following statements, representative of the fects and faults, developmental asymmetries, un­ most authoritative contemporary medical opinion, balanced work and play, and deforming changes in are highly pertinent to this appraisal: the articular beds. Man is a variable host living in a constant en­ vironment of microorganisms and we may find Chemical irritants include the endo. and that the host is more important than the micro­ exotoxins of pathogenic microorganisms, drugs and organism.-1 other chemicals; and metabolic wastes. Of these, All human beings are infected with a 'host' of the metabolic wastes of cellular activity probably viruses, bacteria, fungi, and parasites-which are potentially pathogenic, but usually remain latent tax the adaptability of the cell the most. or silent. The incidence of latent infections is Psychic irritants are principally the emotional likely to increase with chemotherapy, but a state and mental disturbances arising out of the effect of biological equilibrium can be upset by any change in the internal or external environment, of man upon man, and man upon himself. such as sudden change in weather, mental stress, Subluxation-A Clinical Entity overwork, nutritional deficiency, etc.2 Chiropractic wholeheartedly agrees with these The mechanical lesion referred to by chiroprac­ statements, but goes further and offers rational tors as a subluxation is an attending complication therapeutic approach to the problems posed-an of those mechanical, chemical, and/or psychic en­ approach which aims to strengthen the host, avoid vironmental irritations of the nervous system which or mitigate the disturbances, and thereby restore in the biped man produce muscle contraction suf­ and maintain health. ficient to cause articular dysfunction. Once pro­ duced, the lesion becomes a focus of sustained path­ Freedom from infectious disease is not depen­ ological irritation. It irritates proprioceptors in dent upon the absence of microorganisms (a condi. the articular capsules, ligaments, tendons, and mus­ tion never realizable because, as previously stated, cles of the involved segment. A barrage of im­ bacteria are ubiquitous), but upon maintenance of pulses streams into the spinal cord, where inter­ normal physiological activity despite their presence. nuncials receive them and relay them to motor The body protects itself against noxious micro­ pathways for conduction to muscles and glands, organisms by producing antibodies and certain initially in excessive amounts. The contraction types of blood and tissue cells which destroy them. which originated the subluxation is thereby re­ The production of antibodies and of the pertinent enforced, thus perpetuating both the subluxation cells is regulated by the nervous system. "The and the pathological process which it engenders. phagocytes and antibodies are not independent Not all the irritation originates in the proprio­ entities. Their function is governed by the nervous ceptors, however. The microtrauma attending the system."' Hence, the most fundamental therapeu­ vertebral subluxation sets off an inflammatory re­ tic approach is to assure undisturbed function of action with edema, which tends to encroach upon the nervous system. Auy environmental irritation the portion of the spinal nerve contained within of the nervous system can upset this symbiotic the intervertebral foramen; the process may even balance and permit microorganisms that are already terminate in foramina! adhesions. Still more exten. present to initiate the infectious process. sive encroachments occur upon the foramina! con­ The physiologic integrity of the host is more im­ tents (soft tissues, nerve trunk, and other neural portant than the microorganism that invades, be­ elements) in the presence of developmental de­ cause infection results from the morbid change in fects, congenital anomalies, osseous asymmetries, the natural defense mechanism due to environ­ and degenerative and proliferative changes. With mental irritation of the nervous system. Infection the contributory factor of the subluxation, such represents the change from an uneasy truce into a complications may trigger a full-fledged syndrome state of open warfare between microorganism and of severe root compression, or irritation. The fact host when a lowered resistance arises primarily I that a substantial majority of the spinal nerves out of a morbid irritation of the nervous system. 5 pass through movable foramina makes such con­ The role of chiropractic therapy is to relieve the tingencies by no means rare. irritation of the nervous system that initiated this J Vol. VII, S-vaccination is changing. The concepts postulated prudent to restrict immunization, on an individual THE ACA JOURNAL OF CHIROPRACTIC, NOVEMBER 1973 Vol. VII, S-85 basis, to those who have been or are likely to be decades of this century. Toward the end of this exposed to the disease, and, on a larger scale, to period, a decisive event took place which accelerat. segments of the population threatened with an ed the growth of didactic medicine in the most re­ epidemic. Moreover, on each instance, the in­ markable way. The mighty Andrew Carnegie dividual or his guardian should have the right to Foundation, disgruntled by the frightening lack of weigh the evidence and make his own decision, for quality of the medical schools, sternly commanded only then can he give "informed consent". This is them to improve their standards, threatening them one of his civil rights. It is regrettable that chiro­ with the withdrawal of financial support. Against practic has neither the personnel nor the facilities the recalcitrant opposition of the medical teaching to put its modern, rational concepts into practice institutions, Abraham Flexner, a total stranger to on a mass scale. Therefore, it recommends modera. medical education, but a highly competent educa­ tion in the use of the present precarious methods. tor, was assigned to investigate the medical schools, In other aspects of public health this profession forcing them to upgrade their education or close offers its specialized knowledge and service, as for At that time chiropractic was still too young example in the following: and obscure to attract attention of the great found­ 1. Assessment of physical fitness. ations, and, consequently, was bypassed and left 2. The planning and direction of programs for alone and unassisted to grapple with the herculean improving physical fitness. task of upgrading and improving its educational system. This struggle continues today in spite of 3. Structural and postural correction to raise the the significant differences between the financial level of health and resistance, especially of youth. means and facilities for teaching and research of 4. The accumulated experience of the profession the two professions. I in nutritional counseling, dietetic management, and Medicine not only has at its disposal the seem­ natural hygiene. ingly inexhaustible resources of industry and the 5. The application of chiropractic to geriatric foundations, but also enjoys the generous support problems. of federal and state agencies. Chiropractic, on the 6. Research on the effects of school seats on the other hand, being a drugless profession, can expect spines of children for correlation with health, nothing from the pharmaceutical industry, and as absenteeism, and academic performance (modest for state or federal aid to chiropractic education, beginnings already have been made). the subsidizing of the chiropractic education of 7. Extensive research on vehicular seats in rela­ veterans of the armed services by the federal gov­ tion to the rising incidence of accidents resulting ernment has been the one and only form in which from fatigue, the slowing of reflexes, and even such aid has been forthcoming. cardiac involvements. The reason for the striking disparity between the 8. Prevention of industrial accidents by applica­ financial support available to medical education tion of knowledge of body mechanics. and that available to chiropractic education is four. Many other relationships between structural fold: stress and human functions point up urgent need First, the comparative youth of chiropractic as for research and corrective measures. The spiraling an organized branch of the healing arts. incidence of mental disease presents a public health Second, the vociferous denouncement through­ challenge still unanswered. Chiropractic acknowl­ out the years of the chiropractic profession, its edges without hesitation the importance of psy­ achievements, contributions, efforts, and values by chosomatics but emphasizes the neglected somato­ incessant propagandistic attacks by organized psychic side of the equation. Cooperative effort medicine and its public relations. should do much, in the light of experience, to miti­ Third, the influencing of most media and related gate the problem. Chiropractic does not derogate personnel of printed, broadcast and televised com­ the efforts of others but is eager to contribute the munication by representatives of organized medi­ wisdom of its discipline in the furtherance of pub­ cine, for the purpose of systematically and delib­ lic health. This is possible only by cooperative erately suppressing or distorting any news relevant interprofessional relations, the sharing of public to chiropractic. and philanthropic funds, redistribution of research Fourth, the monopolistic control held by the emphasis beyond the confines of microbiology, and medical profession over federal and state agencies above all, by termination of unwarranted hostility. that deals with matters of individual and public To this end is chiropractic committed in the inter­ health. est of humanity. Lamentable as these conditions are, they go un­ The Question of Education resisted and unopposed by the public; no tax dol. Chiropractic and medical education had a some. Iars have been contributed to the growth, expan­ what parallel development for about the first two sion, or upgrading of chiropractic. The chiropractic Vol. VII, S-86 THE ACA JOURNAL OF CHIROPRACTIC, NOVEMBER 1973 educator has learned to adapt himself to these ad­ chiropractic profession has accepted without reser­ verse and hostile circumstances. Despite his isolat. vation in anticipation that the axiom of law, "Every ed position and the dearth of outside help, he re­ duty is balanced by a corresponding privilege," mains undeterred in his struggle for educational will one day apply. excellence. Thus chiropractic schools have reached The years of stringent educational discipline their present academic level, solely because of chi­ must be rewarded by universal recognition which ropractic enthusiasm, chiropractic devotion, and equates the degree, Doctor of Chiropractic, with continuing chiropractic sacrifice. the doctorates in other branches of healing, with These qualities exhibited by an ever-struggling equal deference and prestige for all physicians. profession augur well for deserved support and The propriety accorded by legislative recogni­ future success of its institutions, which at the tion with autonomous regulation of practice present time offer curricula that enable the gradu­ privileges has been earned, but not fully secured. ates to qualify for licensure, even where the state The duty and right of the chiropractic physician board examinations are prepared, administered, and to utilize his diagnostic skill and knowledge in the corrected by medical examiners. interest of his patients must be recognized and From humble, erratic beginnings, both medicine protected by statute and courts. and chiropractic, as different as they are, have The constitutional right of the individual to achieved academic proficiency which reflects scien­ care for his own body by the method of his choice tific accomplishments and satisfies the demands of demands that reports and information vital to society. Neither can ever be equated with the accurate diagnosis from laboratory and diagnostic other because each has its own objectives. The services, especially those which are tax-supported, technics of medicine are not the technics of chiro. be made available to the doctors of chiropractic. practic. Material relevant to both needs to be studied with different emphasis. Hence, neither The same constitutional right dictates that pub­ can be used as the yardstick for the other. The licly owned and financed institutions be opened to best medical school is the one producing the best the doctor of choice to minister to those unfortun­ doctor of medicine, and the best chiropractic school ate citizens. No division of the healing arts should is the one producing the best doctor of chiropractic. be permitted monopolistic control over the life, To ask either of them to duplicate the work of the health, and treatment of the citizenry. other would be incongruous and unrealistic and Seventy years of proven efficacy make it both would reduce their respective effectiveness to fulfill wise and urgent to make available the services of their common goal: to help ailing mankind. chiropractic to the members of the armed forces Duties and Rights of a Profession and to civil servants. Service to flag and country should not abrogate free choice in matters of health. Membership in a learned profession has never before carried a greater burden of moral and legal As a tested profession within the healing arts, obligation. From the initial choice of a career in rendering service to a sizable segment of the popu­ chiropractic the candidate must complete the lation, chiropractic justifiably resents a second­ normal secondary school program leading to two class treatment of itself and patients. Both have years in the arts and sciences and four or more a right to anticipate favorable inclusion in legisla­ years in a professional institution. The profes­ tive enactments that provide for subsidized health sional program includes extensive training in the care. Furthermore, legislative action becomes im­ clinical application of diagnosis and chiropractic perative to guarantee equality of benefits for those therapeutics. insured by any insurance carrier offering financial, health, and accident protection. Proof of competency is required by a state­ A profession such as chiropractic, whose institu­ appointed board of examiners having the preroga­ tions of learning provide a depth of educational tive to examine in preclinical and/or clinical dis­ excellence that permits graduates to compete suc­ cipline prior to issuance of the license to practice. cessfully in examinations required of all aspiring The conduct of the professional man is subject to healers, merits financial support by governmental a host of board regulations and special municipal, agencies in ratio with medical institutions. That state, and federal laws. branch of the healing art which has contributed the The ethical code of the profession and the mores unparalleled concept that environmental irritation of society demand a superior behavioral pattern. of the nervous system is one of the fundamental The financial status of the patient demands a causes of disease and has made this concept the moral responsibility of self-restraint on the part of foundation of a special therapeutic approach (chi­ the doctor and imposes the duty of acting for the ropractic adjusting), should not be limited from patient's greatest benefit. applying it or any other drugless or nonoperative These obligations, duties, and responsibilities the surgical procedures by constraining legislation or THE ACA JOURNAL OF CHIROPRACTIC, NOVEMBER 1973 Vol. VII, S-87 alien meddlesome restraint which the medical pro­ mechanical, chemical, and/or psychic factors, it is fession so often seeks to impose. apparent that any measure that will help to relieve The chiropractic profession makes no claim to a such irritation, regardless of its nature, constitutes panacea, nor does it seek to encroach upon the indicated therapy. At times the source of nerve specialized methods of others. It does claim the irritation is very obvious, simple, and accessible, exclusive prerogative to determine the limitations making the therapeutic approach easy. Then again of its own methods and scope of practice and it the irritating factors are complex, obscure, mani­ seeks the professional courtesy of cooperation, con­ fold, and inaccessible, posing a more complicated sultation, and referral privileges from members of therapeutic problem. the other healing arts and ancillary groups. Having No single therapy offers a panacea. However, met the demands and standards of society, the pro­ one may be better suited to the problem than an­ fession is entitled to the right to sign certificates other, or a combined effort might be advisable. The of health, disability, and death, having the same axioms, "Primo Non Nocere" (The First Principle legal status as those issued by other professions. Is-Do No Harm) and "Salus Aegroti Suprema Chiropractic willingly shoulders its moral, ethical, Lex" (The Welfare Of The Ailing Is The Supreme and legal responsibilities and therefore is determin­ Law) places an enormous responsibility upon every ed to acquire the rights and privileges that permit physician, since he has to decide which therapy or a profession to minister adequately and efficiently therapies are indicated for the individual patient. to the populace, with dignity, self-respect, and There might be cases in which the patient's con­ right to pursue additional knowledge and to con­ dition may be cared for by the therapeutic com­ tribute to the solution of the problem of disease. petency of one specific school of healing and other Titles instances where the skill and wisdom of more dis­ Practitioners of the healing art, regardless of ciplines of the healing art are required. The above­ their branch have been called physicians since time quoted principles oblige the physician to discern immemorial. When in the course of the centuries according to his best ability which path of treat­ formal education became increasingly important, ment should be followed. It should be emphasized specially qualified physicians were honored with that the existence of this obligation presents the the title "doctor of medicine". This doctorate was most difficult task confronting the practitioners of not the first in the development of academic titles all the healing arts. In the final analysis it will be and it was not and will not be the last. With the the ethical tenets upon which a healing profession introduction of new sciences into the academic rests that will guide the individual practitioner in community, further doctorates became a logical the right direction. necessity. In some countries, e.g., England and The doctors of chiropractic have pledged, as Germany, a medical physician is not yet required other physicians have done, complete adherence to to possess the academic title "doctor of medicine". those avowed principles. However, it was only natural that in popular American usage "physician" and the nonspecific Bibliography designation "doctor" became synonymous for the 1. Hoff, Hebble E. et al: "Claude Bernard on Experimental practitioner of the healing arts. Medicine," Perspectives in Biology and Medicine~ vol. III, In the light of these undeniable facts, competi­ no. 1, Chicago, Illinois, University of Chicago Press, 1964. tive tactics which attempt to impugn the rights of 2. Boyd, William: A Textbook of Pathology, Philadelphia, Pa., Lea and Febiger, 1961. graduates of chiropractic colleges to participate in 3. Wolf, Stewart: "Disease A Way of Life", Perspective in all privileges which members of the healing arts Biolo~ and Medicine, vol. IV, Chicago, Illinois, University should enjoy become very dubious. Our graduates of Chtcago Press, 1961. have completed secondary school and have received 4. Dubas, Rene: Mirage of Health, New York, Harper Brothers both preprofessional college training and four Publishers, 1959. academic years of education in a professional 5. Fridland, L.: The Achievement of Soviet Medicine, New discipline. York, New York, Twayne Publishers, Inc., 1961. 6. Lasagna, Louis: "The Diseases Drugs Cause," Perspectives in The Highest Obligation Biology and Medicine, vol. VII, no. 4, Chicago, Illinois, Uni. versity of Chicago Press, 1964. Inasmuch as one of the basic causes of disease is 7. Moser, Robert H.: Diseases of Medical Progress, Springfield, environmental irritation of the nervous system by Illinois, C. C. Thomas Publisher, 1959.

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