May 1976 er Reports consum t from A reprin CHIROPRACTORS HEALERS OR QUACKS? PART1: THE 80-YEAR WAR WITH SCIENCE PART2: HOW CHIROPRACTORS CAN HELP-OR HARM Copyright 1975 by Consumers Union of United States, Inc., Mount Vernon, NY 10550. Reprinted by permission from CONSUMER REPORTS, September/October 1975. Pennsylvania Medicine, May 1976 45 CHIROPRACTORS HEALERS OR QUACKS? Can the chiropractor serve some of your health­ care needs? Pointing to the more than 5,000,000 persons who visit .chiropractors in the United States and Canada each year, the chiropractic profession insists it offers an important health ser­ vice. Its critics in medicine and science think other­ wise, however, and assert that chiropractic is a danger to patients. In this first of a two-part series, CU explores the reasons for that controversy and examines some of the theories and practices of chiropractic, a system of therapy that claims to / restore or maintain health by spinal manipulation. PART 1: THE 80-YEAR WAR WITH SCIENCE In a voice charged with emotion. Dr. Joseph Janse, presi­ fostered by agencies like the NIH. In turn, medical and gov­ dent of the National College of Chiropractic, was addressing ernment officials have generally branded chiropractic as "an the hushed audience in the conference room. unscientific cult " or "a significant hazard to the public." "For me to stand here and exclaim or explain that I and This time, however, the planning commission for the meet­ my people, or those who preceded me, have never indulged ing-which was held in response to a Congressional mandate in mishap or overclaim ... would be dishonest. -included three chiropractors among its eight members. " ... I am not, and we are not, necessarily proud of those The arrival of chiropractic in such a prestigious strong­ that we are responsible for, and have to live with. But I do hold of science marked the latest in a series of developments hope ... this workshop will not deny the people of my pro­ that would appear to lend support to the chiropractor's de­ fession the privilege of progress and ethics." mand for general recognition as a legitimate practitioner of As on many previous occasions, Dr.Janse was responding the healing arts. to a challenge to chiropractic. But this occasion last Febru­ Despite opposition from organized medicine and the U.S. ary was different from the rest. Public Health Service, chiropractors in 1973 won the right The conference, a "Workshop on the Research Status of to render some services under both Medicare and Medicaid. Spinal Manipulative Therapy," was taking place in Be­ Soon after, they achieved licensure in Louisiana and Mis­ thesda, Md., at the National Institutes of Health (NIH). sissippi, the last two holdouts among the 50 states. (The period saw similar chiropractic gains in Canada.) Never before had chiropractors participated in an inter­ same national scientific conference in the United States, much The crowning triumph for American chiropractors came less at the NIH. one of the world's foremost medical and in August 1974, when the U.S. Commissioner of Education biological research organizations. recognized an accrediting agency for chiropractic colleges. Throughout its 80-year history, in fact, chiropractic has Now colleges accredited by the Council on Chiropractic Ed­ largely rejected or ignored advances in medical science ucation have official national standing. Previously, degrees 46 Pennsylvania Medicine, May 1976 conferred by such institutions-such as the "Doctor of who specializes in medical and environmental reporting. Chiropractic" degree (D.C.)-were listed as "spurious" by The investigation included an extensive review of chiro­ the U.S. Office of Education. Recognition also meant that practic and medical literature, as well as the findings of accredited chiropractic schools would be eligible for finan­ pertinent national, state, and provincial government studies cial assistance under a variety of Federal funding programs. conducted in the U.S. and Canada over the last decade. CU Chiropractic, in short, has made undeniable progress in visited three chiropractic colleges-Palmer, National, and professional status and access to government-funded pro­ Canadian Memorial-and also interviewed officials of the grams. Whether those gains mean equivalent progress for principal chiropractic associations, whose memberships in­ health care, however, is another question. In CU's view, the clude virtually all of the 15,000 U.S. chiropractors in active answer depends on whether chiropractic is a valid method practice and some 1400 chiropractors in Canada. CU also of treatment or, as its critics contend, a form of quackery. conducted interviews with American Medical Association To explore that question, CU studied the current claims representatives and with medical practitioners in ortho­ and practices of the profession to determine what chiroprac­ pedics, physical medicine, neurosurgery, radiology, and tic is and what potential benefits or harm a patient might other specialties. In the interest of objectivity, the assistance experience. Our report is based on a six-month investigation of CU's medical consultants was sought only for clarifying by Joseph R. Botta, a Senior Editor of CONSUMER REPORTS medical terminology or practices. Chiropractic, which literally means been a common practice, in fact, to apply chanical disturbances of the nervous sys­ "done by hand," originates from the theo­ leeches, irritants, or even hot irons to tem are what impair the body's defenses. ries of Daniel David Palmer, a tradesman tender sites along the spine as a treatment According to this theory, minor "off-cen­ who operated a "magnetic healing" studio for various disorders. terings" of the vertebrae or pelvis might in Davenport, Iowa, late in the 19th By the end of the 19th century, how­ disturb nerve function and lower the century. According to Palmer's writings, ever, such practices had waned. The sci­ body's resistance to germs. Structural mis­ one of the passions of his life had been to entific revolution that would shatter the alignments, say chiropractors, may also discover the ultimate cause of disease boundaries of medicine in the 20th cen­ disturb nerve impulses to the visceral -why one person should be ill while tury had already begun. organs, allegedly causing or aggravating another, "eating at the same table, work­ Osteopathy, which emerged a few years such illnesses as heart disease, stomach ing in the same shop," was spared. "This before chiropractic, adapted to the change. ulcers, and diabetes. question," said Palmer, "had worried While retaining a separate identity-partly "While many factors impair man's thousands for centuries and was answered because of its use of manipulative therapy health, disturbances of the nervous system in September 1895." and its emphasis on the muscles and skel­ are among the most important," asserts the American Chiropractic Association. The answer occurred to him, wrote etal system--0steopathy gradually adop­ According to the association, almost any­ Palmer, after treating a janitor he claimed ted the concepts and practices of orthodox medical science as well. Osteopathic stu­ thing can cause a mechanical subluxation was deaf. Palmer alleged that he restored dents now receive training similar to that that might trigger nerve disturbances: the man's hearing by adjusting one of his of medical students and earn a Doctor of gravitational strains, asymmetrical activi­ vertebrae, the bony segments of the spine. Osteopathy (D.O.) degree. In contrast, ties and efforts, developmental defects, or Apparently unaware that the nerves of chiropractic maintained its allegiance to other mechanical, chemical, or psychic hearing are entirely in the skull, Palmer the 19th-century focus on the spine. irritations. "Once produced," claims the theorized that he had relieved pressure association, "the lesion becomes a focus on a spinal nerve that affected hearing. CHIROPRACTICTHEORY NOW of sustained pathological irritation." Adjusting the vertebrae, he decided, had Some chiropractors still cling strictly to removed interference with the nerve sup­ Palmer's theory that misalignments of THECHIROPRACTIC ADJUSTMENT ply and thereby allowed the body's "In­ the vertebrae--0r "subluxations"-are the While Palmer's theory of disease has nate Intelligence" to effect a cure. Innate principal cause of disease. Such practition­ been modified, the primary chiropractic Intelligence, according to Palmer, was the ers tend to advertise that chiropractic is treatment for all human illness remains "Soul, Spirit or Spark of Life," which he crucial to good health. One recent ad, for the same as in 1895: spinal adjustment. believed expressed itself through the instance, called vertebral subluxation "a Chiropractic adjustment is a specific nervous system to control the healing killer of millions of people yearly." form of spinal manipulation. The tech­ process. By supposedly impeding that ex­ In the main, however, chiropractic now nique, which is also used occasionally by pression, misaligned vertebrae were judged recognizes other factors in illness. It osteopaths, physical therapists, and some by Palmer as the cause of most disease. tends to assign bacteria and viruses a back medical doctors, is distinguished by the In 1895, Palmer's emphasis on the seat, but it no longer ignores their exis­ suddenness or speed of the maneuver, spine raised fewer eyebrows among med­ tence. Essentially, it has modified Palm­ which prevents any control by the patient. ical practitioners than it does today. Louis er's theories to accommodate some basic By comparison, a patient can voluntarily Pasteur had only recently demonstrated scientific realities. resist-and therefore control-a manipu­ the plausibility of the germ theory of For example, modern chiropractic lation when the therapist does it slowly or disease. And little more than a generation agrees with medicine that germs are fac­ rhythmically. If there is pain, for example, separated Palmer from many eminent tors in disease and that the body has in­ the patient can physically prevent further physicians who had viewed the spine as herent defense mechanisms against them.