CAN YOU TRUST A CHIROPRACTOR WITH YOUR HEALTH?
WHAT A HEALTHY MAN LEARNED FROM SIX CHIROPRACTORS
Maclean's sent a man to six chiropractors to complain of pains in the leg. Here’s what they said was wrong with him:
1 left leg shorter than right 2 right leg shorter than left
3 simple sprain 4 right hip rotated 5 pressure ridge on spine 6 inflammation. Treatments: spinal manipulation, deep heat, electric pads and vibrators.
ONE OF THE GREAT twentieth century anomalies in the science and art of treating human illness is the continued existence and prosperity of a group known as chiropractors. There are about 25,000 chiropractors in North America, of whom 1,200 practise in Canada, thus making them the second largest healing profession, next to medical doctors. The term chiropractic is derived from the Greek, meaning, literally, “done by hand.” The chiropractor believes that a faulty spinal column is the source of most human ailments. In this view ill health is caused by a dislocated or misaligned vertebra— known as a subluxation—pressing on one nerve or another leading to the body’s organs and tissues. To restore the patient to normal health, the chiropractors advocate removing the pressure on the nerve by manually adjusting and manipulating the spine. Chiropractors look upon themselves as skilled body mechanics who are able to bring about a perfect adjustment between the body’s bone and nerve structures.
Official medical bodies denounce chiropractic theory and practise as utter poppycock and nonsense. They frequently brand chiropractors as impostors, fakers and “gadgeteers.” When the American Medical Association and the Food and Drug Administration held the first Congress on Quackery in Washington last fall, chiropractors were lumped with a motley assortment of health quacks and charlatans. In a report on the costs of medical care, published by the University of Chicago Press, Dr. Louis Reed concluded that “all chiropractic schools hold open to carpenters, baggage handlers, pick wielders and the like, the alluring prospect of making easy money and becoming a doctor.”
DOCTORS: CHIROPRACTORS ARE QUACKS
This unflattering view is shared by our own official provincial medical bodies. “Chiropractic is a danger to the public health and the well-being of every Nova Scotian,” says the Medical Society of Nova Scotia. The Quebec College of Physicians and Surgeons states flatly, “Chiropractic does not rest on a scientific basis. How can chiropractors diagnose and treat without a proper medical education?” A spokesman for the Newfoundland Medical Board told me, “We no longer have chiropractors here, nor do
we want them. The last one was chased out a few years ago. These quacks have treated cancer patients for lengthy periods without being aware of their condition.”
CHIROPRACTORS: DOCTORS ARE GREEDY
Yet chiropractors are thriving as never before. An estimated two million Canadians, including a sizable number of teachers, ministers, nurses, dentists and business executives, have received chiropractic treatment. Each spring chiropractors graduate practitioners after a fouryear course from their own school in Toronto, the Canadian Memorial Chiropractic College. In every province except Quebec. Nova Scotia, P.E.I. and Newfoundland, they enjoy a legal status that permits them to diagnose and treat patients. The only things chiropractors are not permitted to do is perform surgery, prescribe drugs, administer anesthetics and deliver babies. Over 500 insurance companies in North America make payments to chiropractors on behalf of their policy holders. The Ontario Workmen's Compensation Board—like similar bodies elsewhere — makes use of their services. So do athletic teams like the Saskatchewan Roughriders football club. In most communities — particularly the smaller ones — the chiropractor enjoys considerable status and income. A beginner can expect to make about $4,000 a year; a $20-$30,000 annual income for an established chiropractor is not uncommon.
Chiropractors don’t suffer doctors’ criticism in silence. Medical opposition, they claim, is motivated by greed, jealousy and ignorance. In a recent year, 12,000 doctors in Canada received payment of $186,200,000 for their services while 1,200 chiropractors earned $13,200,000. “Monopolistic medicine sees us as a growing economic threat,” a prominent chiropractor told me. Joseph McCarthy, a busy Toronto chiropractor, says, “Doctors don’t want to admit that their profession has failed to solve many patients' problems.”
Paradoxically, while official medicine condemns chiropractors, many medical practitioners make use of them. A leading Toronto orthopedic surgeon told me, “I refer patients with certain back conditions to chiropractors for manipulation. They’re very helpful — as long as they stick to their business.” Walter 1. Wardwell, in a study of chiropractors for Harvard Uni-
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A DAY ON CAMPUS AT CHIROPRACTIC COLLEGE
CAN YOU TRUST A CHIROPRACTOR WITH YOUR HEALTH? continued from page 22
“It’s our business to manufacture chiropractors, We teach them an idea and just how to sell it”
versity in 1951, concluded that some chiropractic theory and technique has found its way into highly respected medical periodicals and textbooks. “However,” he observes, “it’s imported sub rosa and is usually disguised as 'independent medical findings in neural disturbances’ or 'recent experiments with manipulative therapy’ and so on.”
It’s little wonder that the frequent and fiery public exchanges between members otiba-'Wedical and chiropractic professions leave all but dyed-in-the-wool partisans confused. Does chiropractic have anything to offer in healing disease and promoting health? Is it safe to entrust yourself to the care of a chiropractor? Is there a scientific basis for chiropractic? Have the doctors acted fairly in their total rejection of chiropractic? The most logical place to begin giving the answers is the origin of chiropractic.
The founder of chiropractic was a Canadian, Daniel David Palmer, born in Port Perry, near Toronto. As a young man he moved to Davenport, Iowa. Critics refer to him as "an uneducated fish peddler”; chiropractors say he was “a grocer and magnetic healer.” Palmer himself said his interest in manipulative therapy was sparked by a study of the healing methods of the Greeks and other ancient peoples. Critics say he lifted his techniques from Andrew Taylor Still, the founder of osteopathy, who had been manipulating bones for several years before Palmer came on the scene.
In 1895, Harvey Lillard. a janitor who claimed he had been deaf for seventeen years, presented himself to Palmer for treatment. Palmer later wrote, “An examination showed that a vertebra had been racked from its normal position. I reasoned that if the vertebra was replaced the man’s hearing would be restored.” Palmer adjusted a vertebra in the neck region and Harvey Dillard's hearing returned. That was the first chiropractic adjustment and Palmer adds modestly, “There was nothing crude about it. No chiropractor has ever equaled it." Shortly after. Palmer claims he treated a heart case successfully by adjusting a vertebra which was pressing against the nerves leading to the patient’s heart. From these two early cases, and others. Palmer evolved his definition of chiropractic—irritation or impingement of the nerves due to faulty spinal structure causes illness and pain, and normal health can be restored by adjusting and manipulating the spine to remove the impingement. Farly in the century. Palmer opened the Palmer School of Chiropractic in Iowa where he taught his method in a two-week course. Later, under the direction of his son. B. .1. Palmer, the school became a flourishing commercial venture, with B.J.’s income reaching an estimated million dollars a year. In a moment of frankness, he once said, “Our school is established on a business, not a professional basis. It is our business to manufacture chiropractors. We teach them an idea; then we show them how to sell it.”
Chiropractors I spoke to were quick to emphasize that their profession has changed a great deal since the hurly-burly days of Daniel David Palmer. Chiropractic, they say. no longer claims it can cure every human affliction. Diseases or injuries directly due to cuts, burns, bacteria and viruses arc not within their sphere. “Our men will refer such cases to a medical doctor,” an official of the Canadian Chiropractic Association told me. This still leaves a pretty broad field open to chiropractors. They claim to treat ailments of
the back and neck, successfully, nine times out of ten. They claim good results with patients suffering from stomach, liver, intestinal and heart disorders, as well as in the treatment of circulatory and glandular disorders. They make other claims that are hard to take seriously. Herman S. Schwartz, of the National Chiropractic Association, published a study which purports to show that ninety-five percent of 400 nervous and mental patients given adjustments “showed some reduction in manifest. mental pathology.” Another chiropractor I spoke to said that he cured sixty percent of all migraine headaches. Still another said he was able to ease the pain of menstruation by manipulation. The same man adjusted the spine of a young housewife who had been trying, in vain, to have a child for two years. After a few treatments, he said, she became pregnant.
There are about twelve accredited chiropractic schools in North America, including the Canadian Memorial Chiropractic College in Toronto. The colleges, the chiropractors say. are a far cry from Palmer’s original two-week course or the oneor two-year courses still offered by several “renegade” chiropractic schools. To enter Toronto's college, students have to be high school graduates and “of good moral character.” During a four-year course they spend more than 4,000 hours studying, under chiropractors, such subjects as anatomy. chemistry, histology and pathology as well as learning chiropractic philosophy and technique. They also serve an “internship" in the college clinic where members of the public come for treatment. Before graduates can get a license to practise in
Ontario, they must pass an exam set by the Ontario Board of Chiropractic — five chiropractors appointed by the Minister of Health. The board may suspend or cancel the license of any chiropractor who violates the regulations of the Drugless Practitioners Act. Similar controls exist in the six provinces and forty-six American states where chiropractic is legal.
Chiropractors say their profession has become streamlined, and point to the wide assortment of treatments they now use. These include the use of X ray, massage, diet, deep heat, electric vibrators, water therapy and so on. I visited one chiropractor's office which was equipped with about $10,000 worth of electrical appliances. Chiropractors who offer such a grab-bag of therapy are in the majority and are known as “mixers.” They are held somewhat in contempt by the “straight” chiropractors—those who stick to manipulation.
The “straight” men believe that chiropractic started going downhill the day the first chiropractor used an X-ray machine in 1911. They refer to the X-ray machine as “the mixer’s first drink.” Don Sutherland of the Chiropractic Association defends the position of the “mixers.” “Manipulation still remains the heart and core of their treatment. They only use other forms of therapy to make the manipulation more effective.”
Whether they attend “straight” or “mixer” chiropractors, there are hundreds of educated, sophisticated people who speak glowingly of the help they’ve received. A woman advertising executive was invalided for a year. Her left leg was badly weaken-
ed and shorter than the right. A chiropractor fully restored the limb to use. An artist who had been plagued by crippling headaches for two years had a clear head after a single adjustment. The owner of a large business was incapacitated by a low back pain which his doctor could do nothing about. Now he visits his chiropractor once a month and is seldom bothered by his back.
Regardless of the number of enthusiastic testimonials from patients, the doctors remain adamant in their view that no sane person would entrust his health to a chiropractor. Their basic objection is that even a so-called “modern” chiropractor is not equipped to understand or diagnose disease. This argument was spelled out in a brief presented by the Nova Scotia Medical Society, opposing the granting of legal status to chiropractors in 1959. Dr. C. B. Stewart, dean of the medical school at Dalhousie University, wrote: “Chiropractic schools do not expose their students to scientific knowledge from other sources because they’re a cult, not a science . . . Physicians are well aware that a few diseases, but only a very few, are caused by pressure on nerves . . .” At the Chiropractic College, Stewart added, the entire teaching staff—with one exception—holds only degrees in chiropractic.
The chiropractor’s inability to diagnose and understand disease, says the Nova Scotia brief, can lead to serious consequences for the patient. Dr. Norman H. Gosse. Director of the Nova Scotia Tumor Clinic in Halifax, relates the following case history:
“A woman came to the clinic complaining of a lump in her breast. The lump was quite large and hard, suggesting to me that it had been neglected. I asked her how long she had known she had that lump, to which she replied, 'More than six months.’ She told me that during most of this time she had been taking treatments —electrical vibrations and massage. I informed her that was the worst possible thing to do to any such lump and learned from her that she had received the treatment from a local chiropractor.”
Another case history is offered by Dr. Rayfield Wood of Lunenberg, N.S. “1 first examined Mrs. T.K., age thirty-four, in January 1956. She had symptoms which suggested a spinal cord lesion and I advised further investigation and treatments at the Victoria General Neurological Centre in Halifax. However, unknowm to me, she sought the advice of a chiropractor and was told she could be helped. She was treated for six months and was then told to return to her doctor as nothing more could be done. I saw her again in August 1956. Her condition had so deteriorated that she could not walk without the support of two persons.
“Again I impressed on her the necessity of neurological treatments and this time my advice was taken and she was admitted to hospital. A spinal cord tumor was removed. Patient is now a paraplegic w-ith paresis of the bladder. If this case had been recognized by the chiropractor and honestly informed that chiropractic was of no avail when she was first seen, the cord tumor could have been removed and the patient not left to live as a paraplegic for the rest of her life.”
Nobody will ever know just how many preventable health tragedies occur because people place their faith in chiropractors. In the past few months, I have noticed three such cases in the daily press. A nineteen-year-old suburban Toronto housewife had been diabetic since childhood.
Doctors had prescribed ninety units of insulin daily. From February until September 1961 she had been under the care of a chiropractor who persuaded her to reduce her insulin dosage to sixty units. She went into a coma and died at the end of September. According to medical testimony the reduced insulin dose had aggravated a long-standing kidney condition which was a side effect of the diabetes. At the trial which ensued the chiropractor pleaded guilty and was fined $50. In March of this year, a Buffalo chiropractor was charged with second-degree murder in connection with the death of a seventecnyear-old high school student. He had been treating the boy for seven weeks. Death was due to pneumonia and a lung abcess following a ruptured appendix. At about the same time a Los Angeles grand jury indicted a chiropractor for the murder of an eight-year-old girl. Doctors had sent her to hospital to have her cancer-infected left eye removed. The chiropractor had persuaded her parents to remove the child from hospital and treated her with iodine drops and vitamin and mineral pills. She died shortly after.
Concerning cases like these, Don Sutherland, of the Canadian Chiropractic Association, says, “Certain chiropractors, on occasion, have been a source of embarrassment to the profession. Like all other professions, ours includes human beings with weaknesses.” There are undoubtedly many chiropractors with diagnostic skill who promptly refer patients to regular physicians. I know, because I visited some of them. Their records show frequent referrals to gynecologists, orthopedic surgeons, cancerologists and other medical specialists. Dr. John O. Godden, associate editor of the Canadian Medical Association Journal, feels that ninety percent of the people attending chiropractors will suffer no harm. They’re people with minor complaints where manipulation may, or may not, help. “However,” he says, “it’s the other ten percent we’re concerned about. These may be people with serious conditions which the chiropractor doesn't recognize. Delay in treatment may have serious consequences. We can’t take that risk with human life.”
The average person who wants a chiropractor would consult the yellow pages of the telephone book and choose a practitioner near his home or job. What standard of care would he receive? To answer this question, a Maclean’s researcher recently visited six chiropractors in Toronto chosen at random from the yellow pages. He’s a young man of twenty-four, given a clean bill of health by a prominent Toronto diagnostician. This is a summary of his six visits:
First: The waiting room was small, shabbily furnished; it also acted as the entrance to a watch repair shop. A sign read, “If you do not enjoy good health, see your chiropractor first.” Religious music poured from a loudspeaker. The literature on the table consisted of magazines of the Christian Businessmen’s Committee and Billy Graham publications. The chiropractor asked me for my name and address and my complaint. (Only one of the six chiropractors elicited a general health history. It’s impossible to make an intelligent diagnosis without this information.) I told him I had a pain in my left leg. He examined my spine and my legs. “The left leg is shorter than the right, causing pressure and pain,” he said. I lay face down on the adjusting table. He rubbed the base of my spine, then worked his way up, cracking bones as he went, by making a human bow of me and bending my back. He gave my leg a deep heat treatment and told me to come back the next day for another treatment. I asked why my doctor couldn’t help me with my
leg. “Because he’s not a specialist in body structure,” he said. Doctors, he added, refuse to send him patients because they are bigots. 1 paid $7 and left.
Second: I switched legs, informing this man that my right leg hurt. He examined me and announced that the trouble was due to the fact that my right leg was shorter than my left. He suggested a spinal X ray at a cost of $20 in order to “pinpoint the trouble.” On the subject of doctors, he said, "MDs have a God complex. The concept of an MD as a witch doctor who can cure everything is fading.” Asked if he referred patients to doctors he said, "No . . . there’s practically no disease a chiropractor can’t cure.” Cost of the examination: $4.
Third: His office was on the ground floor of his house. I told him my right leg hurt. After an examination, he announced that both legs were the same length and that the pain was probably due to a sprain. Deep heat treatments and massage would relieve the discomfort. He was dressed in an old pair of slacks, in his shirt sleeves and smoked cigarettes throughout the interview. I told him many people don't believe in chiropractors. “The fellows that came into chiropractic after the second war have given us a bad name,” he said. “They’re chasing the fast buck.” (1 had been told earlier that the establishment of the Chiropractic College in Toronto in 1945 had enhanced the reputation of the profession.) He told me of one chiropractor treating a sixty-five-year-old hunchback, another a bedridden cardiac case who was beyond help. He placed some of the blame on a promotion organization which traveled around, showing chiropractors how to “talk up” minor ailments into a serious condition requiring lengthy treatment.
Fourth: The office was small and clean and smelled like a gymnasium. 1 told him my right leg was in pain. He ran his hands up and down my spine and said that the right hip had rotated, causing a muscle spasm. He adjusted my spine. The charge was $5 and he said, “Two more treatments will fix you up fine.”
Fifth: The chiropractor wore a white smock and looked like a doctor. I told him that my doctor couldn't tell me why my right leg hurt so much. “That doesn’t mean anything,” he said. “A woman came in the other day after being told by a doctor that she was in perfect health. I X-rayed her and found the beginning of arthritis at the top of her neck.” He applied heat to my spine, an electric vibrator to my right leg. Only after these two treatments did he examine me. “I’ve found the trouble,” he said, tapping my spine
about three quarters of the way down. "You've got a pressure ridge here. If you don’t do something about it while you're young, you'll get arthritis.” I expressed skepticism. He became very serious, telling me about other people who had disregarded his advice. "One man came back five years later, loaded with arthritis. He had to be carried into my office.” (The causes of arthritis are complex and not wholh known to science.) He cracked bones in my spine, paying particular attention to my neck. 1 had a stiff neck for the next three days. He gave me two electrodes to hold, turned on the power and took readings from a dial. "This shows you’re under terrific pressure.” he said. If I didn’t return for further treatments. 1 would "crack up.” Evidently he had forgotten about my leg. The fee was $5.
Sixth: His office was in the basement of his home. His examination consisted of feeling my leg through my trousers. “1 can feel the inflammation when 1 touch your leg." he said. He applied electric pads to m\ thigh which gave me a mild shock. "This machine can cure almost anything.” he said. "It was built to my specifications by an American firm.” He charged me $4. He looked insulted when 1 asked him for a receipt, and didn't give me one.
It would not be entirely fair, however, to use a series of visits to individual practitioners as the basis for passing final judgment on chiropractic theory and technique. Undoubtedly, some people feel better after a visit to a chiropractor. Much of the improvement can probably be explained psychologically. "The chiropractor’s treatment.” writes Dr. Louis Reed, "has a large element of suggestion. The patient is told, with evangelical fervor, that his troubles are due to just one thing: a subluxated vertebra. The chiropractor sets out to adjust the vertebra, using great force and perhaps causing bones to crack. He assures the patient the nerve .is no longer impinged and that his troubles are over. The patient is quite likely to believe him and. if there is nothing seriously wrong with him. he’ll be 'cured' by this belief.”
The power of suggestion aside, there’s a considerable amount of evidence from the doctors themselves that chiropractic manipulation—-even though it sometimes masquerades under euphemisms in medical literature—can play a valuable part in treatment. “Manipulation is an art as old as medicine,” write Dis. W. B. Parsons and .1. D. A. Gumming of Red Deer, Alberta, in the Canadian Medical Association Journal. "That manipulation can bring comfort to mankind there can be no doubt." The authors describe how they have successfully applied techniques used by chiropractors for various forms of back pain. But they emphasize that a thorough knowledge of organic diseases is necessary to ensure that manipulation will not be improperly used.
There is a final and important question: how valid is the chiropractic over-all theory that nerve impingement is the common cause of a wide variety of human ailments?
Lack of research makes it impossible to answer this question authoritatively. However. Walter 1. Wardwell of Harvard, after an exhaustive survey of medical research literature, said : “The basic theory of the chiropractors, although grossly overapplied by them, is now acknowledged to be of value in certain cases.” Dr. A. D. Speransky, a physiologist with the Institute of Experimental Medicine. Leningrad, after wide animal experimentation, postulates that “irritation of the nerve is a primary factor in disease.” Up until now, medical research has been strongly oriented to the investigation of the body’s biochemistry. The body’s mechanical structure — the bones, muscles and nervous system—has
been relatively neglected. Speransky urges medical researchers to broaden their field of investigation. “The medicine of Virchow. Pasteur and Ehrlich is approaching exhaustion and cannot cope with the contradictions which have arisen,” he says.
To me. these reports by reputable medical scientists—and there are many others like them—suggest that there's something of value in chiropractic theory and technique. At the same time, there seems little doubt that chiropractic is often grossly— and sometimes dangerously—overapplied. The present-day tragedy is that the possi-
ble benefit of chiropractic is being withheld from thousands of people it might help because of the wide and hostile chasm separating medicine and chiropractic.
Without serious investigation, doctors— particularly their organizations — continue to brand chiropractic as unscientific quackery. "This is the party line of the American Medical Association,” says Walter Wardwell. the Harvard sociologist. "Chiropractors respond by becoming more ingrown and cu It ist ic. obsessed by the idea that they're being persecuted by monopolistic medicine, jealously guarding its eco-
nomic interests.” Wardwell. as well as other informed and dispassionate observers, strongly urges the doctors to co-operate with chiropractors. Joint research would bring to light new knowledge about the structure of the body and improved manipulative techniques. Doctors and chiropractors could also develop new regulatory legislation which would safeguard the health of people who want chiropractic treatment. And, ultimately, the chiropractor would fit into the medical scene, as has been the case of the dentist, chiropodist and optometrist. +