Chiropractic: The NCA versus the ICA (1963)

Samuel Homola, D.C.

Chapter 11:
Chiropractic “Technique Wars”
The N.C.A. versus the I.C.A.

Although the “Palmer Method” represents only the Palmer School of Chiropractic in technique, the Palmer School, advocating pure and straight chiropractic, represents, in philosophy and purpose, the International Chiropractic Association. The National Chiropractic Association, on the other hand, advocating chiropractic with the use of ‘Physiotherapy and other measures, is the direct antithesis of all that is proposed by Palmer and the I.C.A. Leading the International Chiropractic Association, the Palmer School is constantly at odds with the National Association.

The National Association was formed in 1930 by the amalgamation of the Universal Chiropractors Association and the American Chiropractic Association. In attempting to raise the educational standards of the chiropractic profession, the newly-formed N.C.A. approved only those non-profit schools that met certain minimum standards. Schools below those standards — the Palmer School among them — were not approved. A short time later, B.J. Palmer started a new organization called the “Chiropractic Health Bureau,” which was later named the International Chiropractic Association. This organization approved many of those schools that were not approved by the N.C.A. We remember that it was not until 1950 that the Palmer School adopted the four-year course of education for all of its students. The National Chiropractic Association started its four-year education program in 1939.

B.J. Palmer, who owned and operated the Palmer School of Chiropractic, and who was head of the International Chiropractic Association, recently stated of the “non-profit” schools approved by the National Association: “The N.C.A. accredited only those schools which were non-profit. Today they ARE non-profit, which is one or two main reasons why they are folding up.”

Needless to say, the National Chiropractic Association, in favoring higher educational standards and more liberal practice, is probably superior to the International Chiropractic Association. The Palmer group is strong in numbers and organization, however, and more than once has been influential in establishing professional standards, in certain states, in the definition and legislation of chiropractic. It seems, for the most part, that the definition of the practice of chiropractic in a particular state might well depend upon the predominate school of thought. In those states, for example, where there are more I.C.A. chiropractors than N.C.A. chiropractors, the use of physiotherapy may be stricken from the law by the chiropractor if state statutes have not already defined the practice to that effect. (About half of the states licensing chiropractors do not permit them to use physiotherapy.)

In his book Shall Chiropractic Survive?, B.J. Palmer (with these titles listed after his name: “D.C., Ph.C. — philosopher, scientist, artist, builder, hobbyist, musician, author, lecturer, publisher, art connoisseur — the bit of a mortal being whom Innate Intelligence developed”) said in favor of limiting the practice of chiropractic to “straight chiropractic”:

Most all patients of chiropractors are medical chronic failures, therefore these patients need what we have if they want to get sick people well. We do not need what medical men have unless we want to continue failing as they have done thru the centuries. . . . Millions of people are sick. Medical men manufacture business for us. As long as there is one medical man in business, there is need for one Chiropractor to follow his footsteps [1].

Although Palmer wanted equal rights in treating the sick, he was opposed to legislative control of the chiropractic profession. The book from which the quotation above was taken was, according to Palmer, A Declaration Opposing Legislative Domination — A Declaration for Chiropractic Professional Independence. It seems that he preferred such circumstances as would permit his followers to do as he taught them without the interference of law and educational standards. The teachings of B.J. Palmer (and D.D. Palmer) continue to be popular among chiropractors. Palmer gave them the faith and courage to believe that they were qualified and competent physicians. Banded together, persecution became strength and cause.

“We were prosecuted and persecuted,” said Palmer, “but that tested our sincerity and convictions, brot out stuff we were made of. The principle was grand, great. The practice might have been crude, but the percentage of sick people who got well was much higher than any other profession. Graduates of those days were filled to overflowing with a super-abundance of confidence in a highly essenced Innate knowledge, with a deep and sound understanding of the righteousness of their cause. They went forth with heads high, chests out, looking people eye-to-eye, and preached the gospel. Their cup of Chiropractic was filled to over-flowing and running over.” [1]

Today, the Palmer School has an enrollment of only one-third of what it was in “those days.” Only 68 years old, younger than the life span of its founder, the chiropractic profession itself, after a brief phenomenal growth, has already begun to shrink in size — even while still in its infancy. Since it sometimes requires a considerable length of time for the development of a profession — or the death of a cult — it seems entirely possible (if the present trend in chiropractic continues) that the chiropractic profession might deteriorate before it gets the time-consuming opportunity to make the changes necessary for its survival. Although time may find chiropractors licensed in every state as competitors of the medical physician (in the treatment of disease), it seems logical to assume that no activity, separated from the mainstream of science, could continue to offer spinal manipulation as a superior treatment for disease while the progress of medical science continues to present evidence to the contrary. Some of the most recent laws regulating the practice of chiropractic (defining the practice as a method of treating disease by hands only, i.e., spinal manipulation) will ultimately seal the doom of the profession in states where such laws are in effect — unless, of course, the practice is properly limited in reciprocity with medical practice. The mere suggestion of such a solution, however, presents fighting words to chiropractors who consider their treatment methods to be superior to those used by a medical physician.

The solution to the problem of a dying profession is, according to B.J. Palmer, simply that of increasing the number of its practitioners. In appealing to licensed chiropractors to send more students to the schools of the International Chiropractic Association, two-thirds of whom usually end up in the Palmer School, Palmer advised:

Send hundreds, yea thousands of students to ICA schools and colleges where they will get ten-fingered, pure, unadulterated Chiropractic; become wholesome, responsible, reliable Chiropractors who go forth, carry our message into the world and get millions of sick people well. If each [chiroprac]tor sent one student, what an army that would be. If each Chiropractor added one new member to the ICA, think of the sinews of war that would make [it] possible to save Chiropractic [2].

In Palmer’s efforts to “save” chiropractic, it is interesting to note that, in circular letters mailed to chiropractors in every state, attention is brought to the fact that the chiropractic profession is “growing weaker every day in numbers, economically and politically.” The letters advised that the only solution to the problem would be found in getting more students for the chiropractic schools. Copies of advertising mats, describing the “Palmer School of Chiropractic, Davenport, Iowa … the Chiropractic Fountain Head — where Chiropractic was discovered and developed,” were enclosed with the suggestion that they be run in the local newspapers in order to “attract students for chiropractic” and to “keep your name before the public constantly.” No mention was made of the other schools approved by the International Chiropractic Association.

B.J. Palmer, in commenting on the rival N.C.A. group’s attempt to elevate the standards of the chiropractic profession and make the changes they feel are necessary for the survival of that profession, stated that:

The NCA wants our profession to be looked up to, respected, so our people can take a social standing in society, going the way osteopathy has gone. They want legal respectability. They ask legislators for licenses. They got them. For 30 years, when we were growing, the only respect we wanted, needed, was support and respectability we gained from the public who had been sick, tried everything in medicine, went to a Chiropractor, took adjustments, and got well. What more did we need then, and what more do we have a right to have now? Today we are on the legislative greased toboggan, down-grade, because we couldn’t be satisfied with public support by doing the one thing medical men could not do — get sick people well [1].

How Palmer proposed to maintain the existence of chiropractic without legislation and legal licensure, I do not know. He apparently did realize, however, that progressive legislation, depending much upon the guide of contemporary science, will not continue to tolerate the fundamental philosophy of chiropractic; and it is this fundamental philosophy that supports the chiropractic profession as a group independent of all other healing arts.

Those who are members of the National Chiropractic Association will say that the opinions of B.J. Palmer and the I.C.A. do not represent their own opinions. It seems, however, that the difference between the two groups, when it comes to competing with the medical physician in the treatment of disease, is only one of degree. The Palmer School teaches chiropractic, in philosophy, as it was propounded in the beginning (as still taught in the majority of chiropractic schools today), holding on to the originality that permitted of those approved by the National Association, have simply added other measures to the practice.

The National Chiropractic Association says of the International Chiropractic Association:

The ICA . . . is dictatorially controlled by its perennial private school president. The Board always bows to his wishes and desires. He simply dictates policy and calls all the shots, so to speak, and there have been plenty of them, through the years, as you all well know — witness the Steele case in California, the Boston case in Iowa, and currently the Grayson case in Wisconsin. The ICA has only about 1,600 to 1,800 bonafide members and a small cash reserve. Further, while they have a number of outstanding chiropractors as members, it is unfortunately true that they also have in their membership many unlicensed chiropractors who would be ineligible for membership in the NCA-NCIC [National Chiropractic Insurance Company] because of lack of qualifications — they would be, indeed, poor and hazardous risks from an insurance standpoint because of their cultist attitude and insistence on the use of specific adjusting technique and nothing else in the care of the patient, regardless of the illness involved [3].

The N.C.A. further contends that the I.C.A. is engaged in an attempt to bring the entire chiropractic profession back to “straight chiropractic” (as Palmer puts it, anything else is medicine, “whether you like it or not”).

It is interesting to note that, while the N.C.A. advocates “mixed” chiropractic (including the use of physiotherapy) , only three of the eight N.C.A. approved schools include the instruction of physiotherapy in their regular course of studies. Likewise, while the I.C.A. fights for strictly “straight” chiropractic, two or three of the I.C.A. approved schools include physiotherapy courses in their curriculum! Thus, when the National Chiropractic Association refers to the “cultist attitude” of the International Chiropractic Association (for using a single treatment, “regardless of the illness involved”), and when the I.C.A. refers to the “stealing of medical methods by the NCA,” the accusations each group levels at the other seem to pretty well sum up the situation: one group “persisting in a cultist attitude” in order to hold ground gained, and the other group “plagiarizing medical methods” in order to insure its future on new grounds.

Although fewer than half of the N.C.A. schools actually teach physiotherapy in their regular curriculum (with fewer I.C.A. schools teaching the subject), the N.C.A. often maintains that 86 percent of licensed chiropractors practice “rational chiropractic,” which includes the use of other measures in addition to the spinal adjustment [3]. Yet, according to testimony by the Director of Education of the National Chiropractic Association, before a Senate Committee in Missouri in 1959, only 22 states allow the chiropractor to use conservative physiotherapy, “by one means or another, out of forty-eight jurisdictions.” Apparently, many chiropractors, not trained to do so, are employing physiotherapeutic methods in only a few states. Since the Palmer School professes to have graduated more than half of all the chiropractors in the field today, we have to assume that large numbers of Palmer graduates, instructed against the use of physiotherapy, are actually employing such methods.

Since I quoted, earlier, from published material of the National Chiropractic Association, concerning the size and the “cultist” attitude of the International Chiropractic Association, I present, from the other side, defensive statements from the writings of B.J. Palmer of the International Chiropractic Association:

The NCA, from time to time or place to place, claims a membership of 8,000. We have their membership list and it is liberally about 4,000. It has been stated that about 50 per cent of this is, or was, in California. Within the past few months, the California Chiropractic Association has seceded from that affiliation. This would reduce 4, 000 to 2,000. It is reported that that list contains names of men and women retired, and some dead and buried — how many is questionable. It has been told by California Chiropractors that this loss has withdrawn about 28 percent of their income. It is believed that there are about 5,000 real and false Chiropractors in California, yet when the NCA held their National Convention in Los Angeles, reports we received were that they had about 200 at their meetings. . . . The ICA prints a directory and it is not padded. It lists over 2,000 and has had a substantial and healthy growth each year since its birth [1].

Under the NCA statements now made, it is obvious they designedly, intentionally, and maliciously desire to reverse the chiropractic “one cause — one cure” for the outside medical 18,000 causes and 18,000 outside cures; go from the chiropractic “one cause — one cure” to 18,000 medical “causes,” 18,000 “cures”; tried, tested, proved failures one by one, year by year, ad infinitum, ad nauseum; none for which medical men or the NCA seek have they yet found. What fools NCA mortals be! [4]

In considering Palmer’s preference for “one cause — one cure” (over medical science’s “18,000 causes and cures”), it is interesting to note that the National Chiropractic Association, in trying to establish the definition of chiropractic to include other treatment methods, has, on occasion, distributed literature to the effect that, if chiropractic is to survive, the “one cause — one cure” concept, such as that promoted by the Palmer School and the International Chiropractic Association, “must go.” This resulted in a “back to chiropractic” crusade by Palmer, which, as a result, began a progressive promotion of ‘.straight chiropractic” laws and policies in a good many states. A few states, influenced by Palmer, terminated their Class A affiliation with the National Chiropractic Association. Literature distributed by the International Chiropractic Association, portraying the fate of homeopathy and osteopathy (“absorbed by medicine”) after these groups began to employ medical treatment methods, seems to have been quite effective in convincing many chiropractors that the safest and most workable course for a chiropractor to follow would be in close adherence to straight chiropractic as formulated by its founder. To go along with the N.C.A. plan of adding other treatment methods, Palmer argued, would be to start down the same road taken by homeopathy, naturopathy, and osteopathy.

The fact that the greatest majority of chiropractors have had no training in treatment methods other than pure chiropractic may have had a great deal to do with the success of Palmer’s drive. There is no doubt that a feeling of inadequacy and insecurity would invade the small world of a straight chiropractic practitioner if a necessity for additional treatment methods were demonstrated — by chiropractors — to that portion of the public patronizing the chiropractic “physician.” It would, of course, probably be quite difficult to convince a practitioner (chiropractic) that he needed to employ measures he had not been trained and instructed to use — especially if his livelihood had been founded and developed on procedures and doctrines excluding the use of such measures. Furthermore, the tendency to add additional treatment methods, under the chiropractic theory, would throw the door open for progressive addition of such methods — as in the case of the osteopath, thus creating a method of practice much too complicated in the viewpoint of large numbers of chiropractors who are presently using a single and simple treatment method.

Right or wrong, any expansion of the chiropractor’s treatment method would probably have to begin almost entirely in the classroom. Ironically enough, considering the arguments of the N.C.A. and the I.C.A., the solutions offered for survival of chiropractic are not even exercised in all of the approved chiropractic schools. The paradox displayed in the schools and policies of these two opposing organizations is probably quite typical of the problems besetting the profession. One workable solution to the chiropractors’ problems might be found in the amalgamation of several chiropractic schools to form one large school. Considering the diversity of methods and policies taught in chiropractic schools, however, it does not seem likely that a “teaming-up” would be possible.

In referring to the withdrawal of the California Association from the National Association, it is interesting to note, considering the usual arguments between “straight” and “mixed” chiropractors, that, according to testimony given by Dr. J.J. Nugent, Director of Education of the National Chiropractic Association, before the Senate Committee on Public Health and Welfare in Jefferson City, Missouri, February, 1959, about 1200 chiropractors terminated their membership with the N.C.A. (independent of the efforts of the I.C.A. to limit the treatment methods of chiropractic, and the efforts of the N.C.A. to broaden them). We take the following quotation from the Fountain Head News, May 1, 1959, as stated, in part, by Dr. Nugent:

We have a group in California . . . but California is a land of many freakish things. We have freakish medical doctors, we have freakish lawyers, we have freakish chiropractors and we have a group out there who want to practice medicine . . . and, Sir, rather than agree with them we let 1200 members go in California from the National Chiropractic Association.

In noting the withdrawal of the California Association from the National Association (which advocates “mixed” chiropractic), because of “a group out there who want to practice medicine,” it is interesting to recall that the attempts of the N.C.A. to include the use of physiotherapy, minor surgery, and other such medical procedures in the practice of chiropractic is an attempt to change chiropractic from what it basically is (as promoted by the I.C.A.). Thus, we have three groups of chiropractors: those who practice pure chiropractic; those who practice a modified form of chiropractic; and those who literally want to practice medicine! Considering the theory of chiropractic, however, it seems that the inclusion of any form of treatment, in addition to the spinal adjustment, is the inclusion of the practice of medicine.

Probably, in the three groups mentioned above, we find stages of chiropractic evolution leading either to change or extinction. The proposed need for any change in the manner of practice now followed by the majority of chiropractors might possibly be considered to be an indication of the ineffectiveness of the chiropractic adjustment. Certainly the inclusion of other forms of therapy in the chiropractor’s practice would seem to invalidate a theory that contends that “95 percent of diseases are caused by displaced vertebrae; the remainder by luxations of other joints.” In any event, the stand of the California chiropractors “who want to practice medicine” is, perhaps, one of the first positive indications of the possibility of the development of a Class C medical practice.

B.J. Palmer, in noting the efforts of the National Chiropractic Association to make a change in the practice of chiropractic, stated:

The NCA is fully cognizant of what they do. They know they are destroying everything Chiropractic except its name. They laud D.D. Palmer on Chiropractic Day and destroy everything he believed, practiced, and fought for, the other 364 days in the year, year after year.

The ICA, by contrast, is an organization composed of Chiropractors, whose programs, speakers, legislative and legal intentions are to preserve, protect, defend and make possible everything pro-chiropractic and nothing pro-medical [1].

In order to widen the scope of therapeutic measures used by the chiropractor, the National Chiropractic Association adopted a “rational definition and scope of accepted practice which will enable all doctors of chiropractic to work, side by side, for the sound advancement of their profession.” This definition stated: “Chiropractic is a science of healing based on the premise that disease often is caused by the abnormal functioning of the human nervous system.”

In observing changes in the N.C.A. definition of chiropractic (over a period of many years), it is interesting to note that the original definition — that disease is the result of misaligned vertebrae — has been changed to say that disease is “often” caused by “abnormal functioning of the nervous system” (with no mention made of vertebral misalignment), and further changed to say that “Chiropractic is a branch of the healing arts devoted to the promotion of the public health and welfare” (with no mention of nervous interference or vertebral misalignment).

In the pamphlet “Industry and Chiropractic,” prepared by the National Chiropractic Association, the definition of chiropractic given states that disease is “often” caused by abnormal functioning of the nervous system, yet the pamphlet goes on say:

The field of chiropractic is broad and applicable to a wide variety of diseases and ailments — almost any type of disorder your workers may acquire. Chiropractic’s underlying theory is that the nervous system controls all other systems and all physiological functions of the body — that interference with this control impairs the various functions and induces disease [5].

Thus, it seems that the word “often” in the definition of chiropractic has little meaning. Furthermore, reference in chiropractic definitions to the “use of all diagnostic procedures recognized by the various schools of the healing arts” does not mean that chiropractors, working entirely within the confines of their offices, routinely employ all the diagnostic measures commonly used in medical hospitals and laboratories. Countless diagnostic procedures, such as biopsy, surgical exploration, electroencephalography, myelography (injection of dye into the spinal canal or subarachnoid space for visualization of the spinal canal), visualization of internal organs and the circulatory system with dyes, spinal tap, gastric analysis, bacterial cultures, and so on, could not possibly be used by a chiropractor who is forbidden to take blood from the arm, admit a patient to a hospital, or refer a patient to a clinical laboratory for examination. Even if chiropractors were in a position to employ “all the diagnostic procedures recognized by the various schools of the healing arts” (which they have not been trained to use), it would, of course, be quite impossible for them to select which “diagnosed” diseases were “often” caused by nerve interference at the spinal column and which ones were not, if the chiropractic theory is used as a guide.

In any event, diagnosis of a disease is one thing, but the cause and proper treatment of that disease is another. If the definition of chiropractic were altered from the contention that “all” disease is caused by nerve interference at the skeletal joints, to the conjecture that disease is “often” caused by such interference (in order to permit the use of other therapeutic measures), there is no method or reason, in the chiropractic theory, for eliminating a disease process that is not caused by such means, any more than there is a reason for believing that most disease is caused by misaligned vertebrae. Regardless, the chiropractor, as a “drugless healer,” is extremely limited in his methods of diagnosis and treatment, yet he is still allowed to treat a “wide variety of diseases and ailments.” Even if all methods of diagnosis were available to the chiropractor, he would be compelled to continue the use of spinal manipulation, as a primary treatment for disease, according to the theory of chiropractic-in spite of the fact that the sole purpose of diagnosis, in the medical sense, lies in the detection of the nature and the cause of the disease so that treatment may be selected accordingly. Diet, psychotherapy, and physiotherapy are actually auxiliary methods of treatment-though valuable they are-that are common to all accredited healing arts (even nursing), and are not often of primary value in the treatment of most serious illnesses as they occur today.

Regardless of what the N.C.A. or the I.C.A. has to say about it, there are a great many chiropractors who believe 100% in the chiropractic creed. They want to keep chiropractic as it was developed by its founder. This type of chiropractic was simple, uncomplicated, and without any relation to methods and subjects of medical practice, As such, it was in direct competition with medical practice; its difference justified its existence. This was the type of chiropractic that attracted so many students in the earlier days. It required little time to learn, for it did not depend upon medical methods of diagnosis and treatment. In order to prevent any change in chiropractic, chiropractors, under the direction of the Palmer School, organized in order to spread the gospel of “old fashion chiropractic” — “all chiropractic and no medical.” Many practitioners adopted the policies of “straight” chiropractic. B.J. Palmer encouraged them:

Chiropractors got sick people well when all boasted exaggerated gigantic medical educations of basic sciences failed. Chiropractors, so-called “ignorant” people with “ignorant fantasies,” were getting millions of sick people well, when all bragging medical education failed . . . their single simple vertebral adjustment accomplished more than all the vast aggregation of immense armamentarium of medicine. . . . I would rather be ignorant of everything taught in basic sciences and be able to give a simple single vertebral chiropractic principle and practice adjustment and get sick people well, than to know all basic sciences, pass their examinations, and then fail to find one single cause for one single disease, as medical men are aware [6].

B.J. Palmer was the son of D.D. Palmer, the founder of chiropractic. Large numbers of chiropractors listened to him, for he undoubtedly knew more about chiropractic — what it really was — than any living individual. He wanted to do away with extensive basic science studies, two-year pre-college requirements, and legislative control over chiropractic boards and chiropractic licensure. He wanted chiropractic limited to “straight” chiropractic in every state.

Chiropractors replied in agreement (1959):

We do not attempt to diagnose. We do check the patient with the Neurocalometer and Neurocalograph equipment for the determination of pressure-interference of the nervous system. If interference exists, we then take spinographs to find that part of the subluxation. . . . We have been doing this for 10-1/2 years, with 7,605 Patients. They have ranged in age from a baby 10 days old, to a 92 year old man…. Under this thinking, and the described technique, we have had to refuse care to 19 people. They had nervous system interference too, but spinographs showed bone conditions beyond safe limit of adjusting. No one has been refused, except two inebriated brothers [6].

Another said:

Any Medical man would shudder in absolute fear, if he were to make a house call with me to a raging fever case; see me check the patient with a Neurocalometer; adjust a vertebra; and after re-checking leave the case to its own care. All this without ascertaining what dis-ease it was that “caused” the fever. Yet the success of such practice has been satisfying to me, as a Chiropractor, for eleven years. . . . In every practice there is a failure percentage, as well as a success percentage. No amount of diagnosis before-hand will prevent this. Stiff necks may fail to respond at times, as well as more serious cases. Medically diagnosed, “Terminal Hodgkins,” (with University confirmation), recovered in spite of all opinion to the contrary. . . . It is our responsibility, as chiropractors, to apply Chiropractic with utmost skill. The outcome is governed by several factors, such as: Ability to properly adjust; amount of damage attained before hand; the patient’s co-operation, etc. Beyond these factors only Jesus could be a more confident Doctor; could be more certain of His results [6].

In considering the horrifying implications found in the quotations above, I hope the reader can correctly label such contentions on the basis of his own judgment.

In his efforts to take control of the chiropractic profession, B.J. Palmer published several proclamations defining the practice of chiropractic. The quotations just given were taken from one of them called Shall Chiropractic Survive?; in them is contained the evidence that chiropractic — in some quarters — is still the “panacea.” Large numbers of chiropractors are still treating “raging fevers” without even making a diagnosis; and many chiropractic schools are still teaching “straight” chiropractic in supporting such efforts.

The philosophy of the Palmer School is still largely supported among practitioners in the field, for, in one of its publications, we note that “over 6700 chiropractors” (the publication stated that there were 15,000 chiropractors in America) gathered at a 1959 Palmer “Lyceum” in order to “find ways to preserve chiropractic” [7]. And the fight between the N.C.A. and the I.C.A. goes on.

1. Palmer B.J. Shall Chiropractic Survive? 1st Edition. Davenport, IA: Palmer School of Chiropractic, 1958.
2. Fountain Head News. May 1, 1959, & June 15, 1959. Palmer School of Chiropractic, Davenport, Iowa.
3. National News. Volume 7, Number 1. National Chiropractic Association, Webster City, Iowa, undated.
4. Fountain Head News, January 1960.
5. Industry and chiropractic. Undated pamphlet. National Chiropractic Association, Webster City, Iowa.
6. Palmer B.J. Shall Chiropractic Survive? 2nd Edition. Davenport, IA: Palmer School of Chiropractic, March 1959.
7. Fountain Head News, May, 1960.

Next Section ||| Table of Contents