Chiropractic “Technique Wars”
By now the reader’s intellectual curiosity (having been made familiar with some of the definitions and activities of the practice of chiropractic, and the competitive situation of chiropractic and medical science) should be stimulated to the point that much interest has arisen as to how the chiropractor actually attempts to treat disease or “remove nerve interference” — what mechanical procedure he follows. In the preceding chapters, we occasionally referred to the use of “any one of several opposing methods” employed by various chiropractors who treat disease in a general practice. This chapter discusses several of these methods [each on a separate Web page].
In referring to an “adjustment,” I include all the various methods employed by chiropractors to “move” or “realign” the spinal joints or to “remove nerve interference,” some of which do not involve direct movement of a joint. Generally, force or leverage is applied directly to the indicated or supposedly involved joint. The most prevalent and popular method of “adjusting the vertebrae,” for example, is carried out by applying pressure with the “heel” of the hand — or some other part of the hand — to the transverse processes of the vertebrae (elongations on each side of the vertebra), and using leverage at these points to “rack the vertebra or vertebrae back into place.” As we shall see, however, some forms of chiropractic treatment employ “reflex” methods as a means of adjusting the vertebrae or treating disease. This implies that a desired effect is obtained by using a form of stimulation (or inhibition) remote from the joint or the disease. The “chiropractic adjustment” is performed in many varying and opposite ways, each method as a treatment for the same disease processes — generally speaking.
An article in a 1958 issue of the Journal of the International Chiropractic Association provides us with an explanation for the bulk of material found in this chapter:
Our present day text book on philosophy states . . . that, “the cause of disease is interference with transmission of mental impulses; and, interference with transmission causes disease by preventing Innate Intelligence from producing adaptation in the tissue cell; hence it becomes unsound and not at ease.”
This always has been and always will be our only claim to distinction as a separate and different health science. It is the continued search for this cause factor within the dis-eased individual that has led us into our technique “wars.” 
Thus, searching for what seems to be an elusive “cause,” the chiropractic technique wars go on, with “new” techniques coming and going as frequently as women’s fashions. Although considerable competition exists between chiropractic practitioners employing different techniques, all usually agree that all forms of chiropractic treatment, as opposed to medical treatment, are superior methods of treating disease.
With regard to specific chiropractic treatment for a specific disease process, it is interesting to note that no two treatments are quite the same. Two individuals might “adjust” entirely different vertebrae as a cure for the same disease, and two different schools might use entirely different and opposite methods of treatment for the same diseases. One chiropractic authority might state for a fact, for example, that a certain disease process does not occur without subluxation of a certain vertebra, while another chiropractic authority might also state for a fact that the same disease does not occur without subluxation of different vertebrae in another part of the spine. A good example of opposing chiropractic “facts” is provided in the very beginning of chiropractic history. Willard Carver, one of the original founders of chiropractic, was supposedly cured of tuberculosis by D.D. Palmer, the discoverer of chiropractic. Yet, in the writings of Carver, a method of treatment different from that used by Palmer is recommended for the cure of tuberculosis. This led to no small amount of disagreement between Palmer and Carver.
“Consumption, or tuberculosis of the lungs, as the process exists today,” contended Carver, “is caused specifically by occlusion of the first, second, third, and fourth dorsal, and sometimes the eighth, seventh, and sixth nerves.”
“My adjusting of one vertebra for the relief of consumption in the case of Willard Carver he thinks ‘very crude,'” retaliated Palmer, “but the adjusting of three pairs of cervical and four pairs of dorsal nerves is considered by him to be precise, definite and specific. This is the specific, scientific analysis of Chiropractic by Carver. “In order to give specific adjustments, we must possess a knowledge of the disease in question and be able to trace it to its origin; not to seven pairs of nerves, nor to one pair, but to the one single nerve trunk impinged upon, and sometimes even to that of one filament of a nerve.” 
Thus, while some chiropractic references might be very specific in listing which vertebrae to adjust for a certain disease, others might be quite general. To provide another example, the book Chiropractic Principles and Technique states: “When a subluxation is produced in the lower dorsal or upper lumbar region of the vertebral column, no untoward effects may follow at once. But years later, perhaps, the individual develops typhoid fever . But the book Chiropractic Diagnosis states that adjustment should be made in the “middle dorsal, lower dorsal, and upper lumbar area of the spine for typhoid fever.” 
While the references given above list lower vertebrae as points of irritation causing typhoid fever, one popular school of chiropractic thought contends that the one spinal subluxation causing the most disease is found in the area of the uppermost cervical vertebrae.
There are many types of diseases — supposedly caused by misaligned vertebrae — that decrease or increase in different areas of the country according to the social climate and other factors, regardless of the percentage of the population receiving spinal adjustments. There are some states in America that have relatively few licensed chiropractors, but the disease incidence in these states is no greater than in those states where large numbers of chiropractors practice. Outside the United States, there are many countries with no chiropractors at all. Yet, many diseases (mostly of the chronic variety), supposedly best treated by chiropractic, are more prevalent in America than in countries where chiropractic is unheard of. America is by no means the healthiest country in the world. This is a fact that speaks sorely for a civilization as far advanced as ours. There are many Americans who do not conscientiously follow the recommendations made by the various departments of medical science — a situation no doubt aggravated by the retrogressive activity of large numbers of religious and healing cults that seem to prosper in this country.
In chiropractic literature, recommendations are made for almost every condition afflicting mankind. Some chiropractors simply follow a chart giving “the vertebrae which will be found subluxated in disordered states of the structures named.” [3[ This means that when a particular organ or structure is disturbed in any way, the practitioner will simply adjust the vertebrae corresponding to the diseased tissues. In suspecting that a “subluxation” will be found at this point, the chiropractor usually does find a vertebra that is “out of place.” That they are probably imaginary, however, is indicated by the fact that no two chiropractors will make an identical listing of the vertebrae — even with a chart for guidance. Yet, chiropractic literature states that, “A diagnosis of cardiac disturbances, gastric disorders, etc., may be made and confirmed by examining the spine and locating these subluxations.” 
For further example of the relative simplicity of the chiropractic method of diagnosis and treatment, we take the following statements from the book Chiropractic Principles and Technique:
And it is a clinical fact that in nearly all affections involving the structures of the head and face, such as the ear, eye, nose, and throat, subluxations exist, and that, moreover, adjustment of subluxated vertebrae is followed by a cure or improvement of such disease. . . . The tenth dorsal vertebra is found subluxated in all cases of kidney diseases the second lumbar vertebra virtually always is found subluxated in constipation. . . . A subluxation in the fifth and sixth cervical segments, however, markedly alters the normal conditions of the tonsils, and they then become a favorable medium for the entrance of this specific infection [rheumatic fever]. This same principle applies to all infectious and contagious diseases .
Primarily, it seems, the varying and opposing “clinical facts” recorded by different chiropractic authorities are the personal findings of the individual (in examination of the spine during the course of a particular disease). As we shall bring out, if one followed the chiropractor’s method of palpating and measuring the vertebrae, few vertebrae could be examined without being designated as subluxated. What the practitioner finds may also be suggestively influenced by the findings of others. Furthermore, it would seem that it would be irresistibly tempting for chiropractic practitioners to depend upon fundamental and simple chiropractic guides rather than upon the more difficult and complicated procedures of scientific medical practice.
In analyzing the spine for the purpose of diagnosing human illnesses, the chiropractor may be forced to admit that the nature of a disease process in a particular organ cannot be determined, although he may continue to maintain that the organ affected can be readily selected and treated through the spinal column. Under such circumstances, it would seem that a specific diagnosis would be quite unnecessary, since the treatment would be quite the same regardless — that of adjusting the “subluxated vertebrae” corresponding to the diseased organ.
Regardless of the proposed simplicity of the chiropractic method of diagnosis, it is important to remember that spinal nerves, emanating from segments of the spine, primarily supply the mechanical structures of the body (such as the muscles) and not the body’s internal organs (such as the liver or kidneys). While the spinal nerves do contribute fibers to an independent autonomic nervous system whose job it is to control the body’s internal functions, there is so much overlapping and such a wide distribution of nerve fibers to various organs that it would often be quite impossible to associate subluxation of one specific vertebra with one specific organ. Correlation of “subluxated” vertebrae and organic diseases for the purpose of providing a guide for chiropractors seems very much to be simply the product of one individual’s observation — or another, depending upon which guide is used. The fact that no two of these guides are exactly alike presents good evidence that the theories underlying their construction — or fabrication — are not uniformly grounded in scientific facts.
- As a guide in diagnosis and treatment, the chiropractor might rely upon a chart like the one given below, which uses the abbreviations “C” for cervical (neck), “D” for dorsal (upper back), and “L” for lumbar (low back):
- Large Intestine
- Small Intestine
- Suprarenal Capsule
- 1 to 4C, 6 and 10D.
- 1 to 4C, upper and 10D.
- 1 to 4C, upper and 10D.
- 1 to 4C, upper D.
- 1 to 4C, 5 and 10D, 1 or 2L.
- 1 to 4C, upper D.
- 1 to 4C, 1-4D.
- Upper and lower C 1-4D.
- Upper and lower E, 1-4D.
- 1 to 4C, 2-4D.
- 1 to 4C, 1-4D.
- 3 or 4C, 14D.
- 3 to 4C, 14D.
- 6C, 2-41).
- 6 or 7C, 2 to 6D.
- 1 to 4C, 2D.
- 1 to 4C, 3D.
- 1 or 2D.
- 11 or 12D, 1 or 2L.
- 3 to 5C, middle D.
- 4 and 8D.
- 6 and 9D.
- 8 or 9D.
- 1 to 4C, 5 to 7D, 11D.
- 1 or 2L.
- 11 or 12D.
- 4 or 5L.
- 1 and 4L.
- 1 and 4L.
- 2 and 4L.
- Unless a practicing chiropractor (who uses no medical treatment methods and only a few medical diagnostic instruments) adopts the guiding doctrine of one school of thought or the other, he has little guide or choice in methods of treating his patients, for he obviously must go according to the recommendations made in his particular school or adopt those of another. Faced with a wide variety of chiropractic theories and techniques, it is extremely difficult for many chiropractors to determine how and for how long to treat a patient for a particular condition.
The first split in chiropractic thought came, perhaps, as far back as 1906 when some of the chiropractic schools began to teach methods of physiotherapy in addition to the chiropractic adjustment. Since then, many other splits have occurred, some widening and others breaking up into dozens of factions. Today, there are practically as many theories and methods of practice as there are chiropractors, with proof of the validity of any one of them as elusive as the “philosopher’s stone.” As we approach our discussion of some of the various chiropractic methods of treatment, we should remember that the “chiropractic physician” is a competitor of the medical physician, and that he is a “specialist” only in his method of treatment-not in any particular field of disease. Chiropractic has always been defined as a “method of treating disease by manipulating the spinal column.” The fundamental chiropractor assumes, of course, that interference with nerve supply is the most common cause of disease, and that “adjustment” of the joints “releases nerve supply” which “is followed by a cure or improvement of such disease.” It has always been my experience, however, that “cracking” one’s back for something like a cold has no more effect than cracking one’s knuckles — other than psychological. Manipulation or massage of the spine, if done gently, may, however, make one feel better temporarily, but this does not validate the treatment as a cure for most human disease. There is a great deal of value to be found in manipulation when it is properly limited, prescribed, and subordinated to medical science, but I could not promote this value until its associated falsehoods were uprooted in the process.
Probably, if one looked up material on the “subluxated vertebra” and spinal manipulation, he would find a larger number of medical books referring to the subject than chiropractic books. There seem to be considerably more orthopedic books dealing with manipulation, coming from medical book publishers, than one could find in the library of a chiropractic school. The difference in the description of the spinal subluxation — as given in orthopedic and chiropractic books — lies in the fact that the orthopedic subluxation is an obvious and detectable entity (presenting obvious local symptoms), while the chiropractic subluxation is a theoretical, elusive, and primarily imaginary process to which the chiropractor has attached the primary cause of disease.
Dr. James Mennell, a medical manipulation expert who is often quoted by chiropractors, stated in his book Joint Manipulation that:
There still exists a widespread misrepresentation of the scope of treatment by manipulation, and its true aim and object are obscured by a fog of mysticism and misunderstanding. . . . For example, the words, “joint lesion,” when used by medical practitioners, appear to infuriate some of the members of the Osteopathic fraternity to an extent that would seem to be almost incredible, and this applies even to a greater extent among those who practice chiropraxis. Members of these two professions seem to claim a sort of copyright in “joint lesion.” 
In another volume of his book, Dr. Mennell stated: “It has always been recognized by medical practitioners that a condition of partial dislocation known as subluxation, and distinct from luxation or complete dislocation, can and does occur.” 
Both volumes of Mennell’s books on joint manipulation deal primarily with the correction of actual joint disturbances, including subluxations, which all present obvious pain or disturbance of function in the involved joints. in noting that pain may be referred over a nerve trunk from a disturbed joint (often simulating organic disease), and that certain reflex symptoms may be transmitted to the abdominal viscera from badly disturbed joints, Dr. Mennell was careful to state that “to claim because this is so, that therefore all sorts and conditions of abnormal symptoms should be curable by manipulation, is, to my mind, a claim that approaches the ridiculous.” 
When Mennell published his book Joint Manipulation, he had had 40 years of experience in the “constant practice of joint manipulation” in hospitals and medical practice. Under such ideal circumstances, in the prescription, practice, and observation of the effects of joint manipulation, it does not seem likely that Mennell would have overlooked any unusual values in the use of manipulation as a treatment for disease. The fact that he did thoroughly consider all aspects of the use of manipulation is revealed in his writings.
Probably, there is no better way to demonstrate the futility of chiropractic manipulation in the treatment of disease than to review the methods and theories of practicing chiropractors. We should bear in mind that promoters of all forms of chiropractic contend that chiropractic is a science employing “proven” methods in treating the sick. In reviewing the conglomeration of theories and techniques of the chiropractor, however, we feel somewhat inclined to fall back upon medical science for a final differentiation.
- 1. International Review of Chiropractic, February 1958.
- 2. Palmer BJ. Shall Chiropractic Survive? 1st Edition. Davenport, IA: Palmer School of Chiropractic, 1958.
- 3. Janse JJ and others. Chiropractic Principles and Technic, 2nd Edition. Chicago: National School of Chiropractic, 1947
- 4. Firth, James N., D.C. Chiropractic Diagnosis. Lincoln Chiropractic College, Indianapolis, Indiana, 1948.
- 5. Mennell JM. The Science and Art of Joint Manipulation. Volume 2, The Spinal Column. New York: Blakiston Company, 1952.
- 6. Mennell JM. The Science and Art of Joint Manipulation. Volume 1, The Extremities. New York: Blakiston Company, 1949