A History of Chiropractic Part 1

DD Palmer carried out the first Chiropractic treatment in Iowa on September 18th, 1895. Palmer was a “magnetic healer”. That is, he used magnets to heal people. He was also familiar with some of the medical literature of the time. Plus he knew the methods of the “bone setters”. Bone setting is the name given to spinal and other manipulation which seems to exist in most if not all cultures.

Often bone setting is a family business and skills in manipulation can be handed on from generation to generation. Bone setters are mentioned in the records of St. Bartholomew’s Hospital in London as early as the seventeenth century and as late as 1866. One bone setter mentioned there was even knighted.

It is unclear if DD Palmer was acquainted with the newly developed Osteopathic Techniques. The founder of Osteopathy is Dr. Andrew T Still (1828-1917). The best guess is that, probably, he was – Palmer was based in Iowa and Still was in the neighbouring state of Missouri. According to Palmer, Chiropractic dealt with “subluxations” – reduced mobility and slight misplacement of a vertebra.

This was thought to put pressure on nerves. Palmer also placed more stress on the method of manipulation or adjustment. Palmer wrote: “I do claim…to be the first to replace displaced vertebrae by using the spinous or transverse processes as levers whereby to rack displaced  vertebrae into normal position, and from this basic fact, to create a science, which is destined to revolutionise the theory and practice of the healing art….”

Palmer’s Chiropractic had a strong philosophical base. Palmer founded Chiropractic on the twin pillars of science and vitalism, with strong emphasis on the mind-body relationship. The mechanical side was the manipulation of “subluxations”.

Vitalism gave Chiropractic an equally strong metaphysical and spiritual side. Palmer saw this as a “life force”, expressed in the individual as “innate intelligence” that controls and coordinates bodily activity and influences health and illness. It is the fundamental ability of the body to heal itself. Holism integrates body, mind and spirit. It considers that health depends on obeying certain natural laws and on lifestyle and that deviation can lead to illness.

The “innate intelligence was thought to give purpose, balance and direction to all biological function. The  naturopathic approach is the opposite of orthodox or allopathic medicine. The allopathic approach considers that disease is due to an external cause overcoming the body’s resistance e.g. germs cause infection. Orthodox medicine’s answer is to counter the external cause e.g. with antibiotics.

The naturopathic approach considers that illness is largely due to the person’s lowered resistance e.g. Only a few of those exposed to germs became infected. So, the answer is to strengthen the person, rather than attack the external cause. Healing was seen as depending on mobilising the innate recuperative powers within the patient.

The emphasis of Chiropractic is on natural remedies. It restores musculoskeletal integrity and neurophysiologic function. It stresses a proper diet, lifestyle and a healthy environment. It uses conservative safe treatments and avoids drugs and surgery. It helps the patient to understand that his or her illness is the result of the body’s failure to maintain a healthy state. Manipulation may stimulate healing but the patient also has to change and return to more healthy living.

It is a patient-centred, hands-on approach that depends on good communication between Chiropractor and patient. Touch and physical contact between Chiropractor and patient help to mobilise this internal healing power. It is wellness-oriented rather than sickness-oriented and is concerned with the person who is ill rather than the illness the person has.

Philosophy, of course, has its dangers and if carried to an extreme may become a dogma. The holistic and the mechanistic approaches must be balanced. “First, do no harm” Hippocrates.

Secondly, remember that “it ill behoves the skilled physician to mumble charms over ills that crave the knife” Sophocles. Modern Chiropractors may have a holistic approach but incorporate and use knowledge from the mechanistic, scientific approach. In practice of course, philosophy can be left behind. Many Chiropractors simply get on with treating their patient’s physical symptoms.

The origins of Chiropractic must be seen in the context of the time. In the late nineteenth century, Iowa was still a frontier state. This was the age of so-called “heroic” medicine. The primitive state of medical science meant that some of the new invasive treatments for disease did as much harm as good, leading to public outrage and a search for safer alternatives.

The medical reform movement in the US stressed the need for personal responsibility for health, lifestyle recommendations and professional alternatives to orthodox medicine. Chiropractic sought to preserve some of the ancient principles that orthodox medicine seemed to be abandoning.

This was the Bible Belt and the medical reform movement had strong evangelical overtones. That philosophic base has helped to sustain the professional identity of Chiropractic to this day.

This background also helps us to understand the reaction of orthodox medicine. Chiropractic was a direct competitor at the time orthodox medicine was struggling to establish its own professional status. Orthodox medicine met Chiropractic with outright hostility and persecution. From 1896 until as late as 1949, hundreds of Chiropractors went to jail in the US for giving “unlawful treatment” and for the unlawful practice of medicine.

Litigation between Chiropractic and the American Medical Association was not finally settled until 1987. Despite that, Chiropractic survived, supported by patients who continued to choose Chiropractors in preference to orthodox medicine.

Chiropractic also developed professional education with virtually no external funding. DD Palmer founded the first school of Chiropractic in 1896. Chiropractic has stayed completely independent and recognition as a health profession has been slow. The Anglo-European College of  Chiropractic did not open until 1965. In the UK, an Act of Parliament to register and regulate Chiropractors was not passed until 1994. Most Chiropractors even today practice completely independently from orthodox medicine.

Reference: The Back Pain Revolution by Gordon Waddell, Orthopaedic Surgeon. Published by Churchill Livingstone, 1st Edition, 1998. Second Edition, 2004.