Chiropractic “Technique Wars”
The Palmer Method
The Palmer School of Chiropractic is one of the first schools of chiropractic and is, today, the largest. The school, founded by the founder of chiropractic, teaches a system of spinal adjustment called the H.I.O. (“hole in one”),” whereby the atlas (the first vertebra at the top of the spine) is adjusted in different directions, depending upon measurements made on an X-ray film. (The neologism “Hole-In-One” was originally coined to imply that a perfect adjustment in the upper cervical region of the neck would cause everything else to “fall into place.”)
Palmer maintained that only the atlas could misalign itself, or cause misalignment below that point, thus putting pressure on the spinal cord or spinal nerves and causing disease. This new theory was considered by many to be a “dirty trick” on the thousands of chiropractors graduated by Palmer in years past and who had been completely convinced that vertebrae out-of-place at different points in the spine caused certain diseases — that it was necessary to adjust those specific vertebrae in order to cure these diseases. The introduction of B.J. Palmer’s new theory that misalignment of the atlas was the primary factor in the production of disease, and that such disease could not be cured unless the atlas was corrected, meant that all chiropractors were giving the wrong treatment unless they took additional training in the “latest findings of chiropractic.” Needless to say, the “new theory” brought back many postgraduate students and attracted many new students to the Palmer School.
One of the strange contradictions surrounding the behavior of many chiropractors who claim miraculous cures and unbending faith in their particular treatment method lies in the apparent willingness of these practitioners to switch their treatment methods and adopt new theories. While chiropractors claim that the growth of chiropractic in its early days took place simply because chiropractors cured those patients medical science failed to cure, we learn, years later, from the “Fountain Head of Chiropractic” (the Palmer School) that, until practitioners adopted the Palmer method of correcting the atlas, no chiropractor could remove the primary cause of disease. Up until that time, chiropractors had simply followed the “meric system” of adjusting (a system designating a certain vertebra for a certain organ or disease, similar to the chart given earlier). This contradiction in behavior and claims is also evident in the activities of many present-day chiropractors who eagerly enroll in one technique course after the other and who claim supreme healing powers for each new technique they employ. It is difficult to determine whether such practitioners are naively sincere or whether they are simply gullible. Undoubtedly, disappointment is an element underlying the readiness of many chiropractic practitioners to change treatment methods, notwithstanding statements to the contrary. There are probably many chiropractors who find it financially beneficial (and professionally “face-saving”) to adopt new theories and techniques when the old ones have failed to cure their patients.
Needless to say, the special technique taught at the Palmer School for correcting misalignment of the atlas, and the introduction of patented devices designed to locate misaligned vertebrae and nerve interference, proved to be a boon for the Palmer School. Still promoting the H.I.O. theory in 1959, B.J. Palmer proclaimed:
The primary, causative vertebral subluxation can be only where there are no intervertebral osseous locks, viz., between occiput, atlas, and axis, except for the odontoid which prevents one direction only. The only place a causative vertebral subluxation can be adjusted is in that area.
The statement needs some modification. That primary superior subluxation can and often does produce some vertebral traumatism or pathology of vertebrae inferior to that area. Such conditions can and do occasionally occlude foramina, produce pressure upon nerves, and create a secondary traumatic or pathological interference, which temporarily needs correction until such time as the superior primary factor is corrected and restores health to the lower and inferior pathologies .
This theory is expressed in a technique whereby the chiropractor places the heel of his hand immediately beneath the patient’s ear on one side and, gripping the wrist of that hand with the other hand, applies a sudden thrust against the side of the neck. The patient is positioned on his side with his head supported on an elevated headpiece. The atlas, being partially protected from outside pressure by bony portions of the skull (the styloid and mastoid portions of the temporal bone project down just behind the ear on each side, virtually covering the lateral aspect of the atlas), is almost inaccessible to direct pressure applied through overlying tissues. Although there are other methods of “adjusting the atlas,” such as rotating the skull on the atlas, or rotating the atlas by rotating the neck, most of which are quite safe when they are properly performed, attempts to “push” the atlas one way or another with the heel of the hand (the pisiform bone) are still very common in chiropractic offices. Since the atlas is so deeply situated beneath the skull and overlying tissues, attempts to thrust against the atlas with the patient’s head backed up by a supporting headpiece could very well result in a mechanical transfer of force to lower, more flexible vertebral joints.
Although the Palmer School still teaches the H.I.O. system, and continues to support the largest enrollment of chiropractic students, impressions are occasionally presented to indicate that the school is again returning to examination of the entire spine in searching for “primary, causative vertebral subluxations.” In a 1958 issue of the International Review of Chiropractic, for example, a Palmer School instructor in technique reported that, in the Palmer School:
Probably the most significant change within the last two years has been that of attitude. This is reflected throughout the faculty, student body, and field. It can be said, without fear of contradiction, that our faculty is more united than ever in a dual cause; first, that of searching out and correcting all interference, and second, that of training the PSC student to do likewise.” 
This statement is particularly interesting when we recall the more recent statement made by B.J. Palmer himself to the effect that the only place a “primary, causative vertebral subluxation” can exist is in the area of the atlas. Thus, when the Palmer School proposes to “adjust where and when we find provable pressure, and how it shall be done most effectively,” this apparently does not necessarily mean a withdrawal from Palmer’s H.I.O. doctrine. Emphasizing a “change of attitude,” the Palmer instructor went on to say that the school’s renewed efforts to remove nerve interference where it is found — by the most effective method possible — is not a return to the “practice of Meric Chiropractic as it was practiced in the ’20s.”
Regardless of any changes in treatment methods that might have taken place at the Palmer School over the years, the fundamental philosophy of chiropractic has remained the same. An early catalogue of the school, for example, stated as follows:
We do not waste valuable time in observing healthy and morbid tissue under the microscope, we do not bother with the compounding of chemicals or the analysis of secretions and excretions. Palmer School of Chiropractic students save time and money by omitting these useless studies. The chiropractor does not take the temperature, the sputum is not examined, he never taps the chest or stethoscopically listens as in auscultation — he never looks at the tongue — in fact, he makes no diagnosis or examination .
Needless to say, the attraction of such an “easy practice” found the approval of large numbers of would-be doctors in the early 1900’s. Not until October 1950 did the Palmer School raise its course of education from eighteen months to four years. For some time prior to that date, one could take an 18-month course or a four-year course, depending upon the requirements of the law in the particular state in which the chiropractor those to practice. In 1950, the four-year course became mandatory, primarily because all but a few states required that licensed chiropractors have at least four years of training.
In making claims just as sensational as those made in early catalogues, a 1958 catalogue stated:
Although a sick person would come to the clinic incapable of reciting symptoms, the staff could establish medically what conditions of disease the patient suffered from; could prove chiropractically what was the cause of that condition of disease and could, without having once talked with the patient, chiropractically, restore the sick person to health and establish scientifically how the restoration to health had been accomplished. . . .
The precision instruments, especially built for the clinic to detect pressure and measure nerve energy flow, were designed to rule out any human tendency to err .
In showing an improvement for the better, however, a 1962-63 catalogue of the Palmer School left out the statements above, and listed the inclusion of certain liberal arts courses in the Palmer curriculum, thus departing somewhat from the contentions of B.J. Palmer, who consistently maintained that “These unnecessary subjects never were necessary in olden days; neither are they helpful today.” 
Dr. B.J. Palmer died of cancer on May 27, 1961; he was 79 years old. Today, the Department of Chiropractic Philosophy at Palmer College “stresses the teachings of this man who was, until his death, the foremost authority in chiropractic.” His son, Dr. David Palmer, moved up to assume responsibilities for leadership of the Palmer School.
B.J. Palmer apparently stuck to a previously expressed contention that “a simple mind” is the best field for cultivating a chiropractor. To hear the arguments of Palmer, one would think the better-educated man is worse off for his education, and that all educated men are “brain-washed” — none able to think for themselves and intelligently apply the principles of a broad education. The fact that education changes the chiropractor has already been made evident in some of our earlier discussions.
The entire problem was one of survival in the mind of B.J. Palmer-a preservation of the ideas and principles promoted by his father. Chiropractic must remain chiropractic in order to survive as a “separate and original healing art,” and the only thing original in chiropractic is the doctrine of vertebral misalignment as a universal cause of disease — the cure of such disease being effected only by spinal manipulation.
In routine manipulation of the “atlas, axis, and occiput,” many H.I.O. specialists, as well as chiropractors who work in other areas, measure mechanical distortions of perfectly normal and freely movable spinal joints and then “adjust” them in order to “remove the cause” of the patient’s disease. Occasionally, joints of the spine, especially those in the neck, do become fixed, subluxated, dislocated, diseased, or injured, but these conditions are obvious to any orthopedic Specialist and are not often a cause of a remote disease process. The symptoms associated with such obvious and often acute joint disturbances are sometimes so painful that the patient is driven to a physician for relief of the pain. In the absence of actual disease, the routine use of heat, traction, and rest (and sometimes support) will usually correct the disturbance. If, as many chiropractors maintain, people go to chiropractors only as a last resort, it seems likely that a chiropractor rarely gets an opportunity to manipulate a truly subluxated joint.
I have seen chiropractic patients who have been repeatedly manipulated over normal joints so long and so frequently that strain, traumatic arthritis and other disturbances have developed as a result, with the patient continuing the treatment under the false belief that the treatments will keep the condition from getting too bad. The cervical (neck) region of the spine, being most accessible to manipulation, is perhaps the area most abused by excessive manipulation. “I have taught for many years that cervical manipulation was ‘dynamite,'” said one well-known present-day orthopedic specialist. “I was referring to the facets, foramina, and nerves. One must be especially cautious, because of the disks.” 
The Palmer School of Chiropractic, like the majority of chiropractic schools, does not teach the general use of physiotherapy but sticks primarily to the use of “treatment by hands only,” which, as ‘we noted earlier, is called “straight chiropractic.” None of the chiropractic schools teach medical and surgical methods.
“I would rather be a Chiropractor with one simple principle and practice which works, and gets sick people well, and be called ‘ignorant,'” said B.J. Palmer, “than a supra-educated medical man with millions of arbitrary and empiric theories, none of which work or get sick people well. . . . The dividing line is sharply drawn — anything given, applied to, or prescribed from outside-in, below-up, comes within the principle and practice of medicine. None of this does Chiropractic do! Our principle is opposite, antipodal, the reverse, for everything within the chiropractic philosophy, science and art works from above-down, inside-out. Anything and everything outside that scope is medicine, whether you like it or not.” 
Thus, as some chiropractors attempt to change or widen the definition of chiropractic they are continually and painfully reminded of what chiropractic really is by the one man who ought to know: the son of its founder.
I once witnessed a humorous demonstration that exemplifies the attitude of the “straight” chiropractor who relies solely on spinal manipulation as a treatment for disease. During an educational session of a large gathering of chiropractors, most of whom practiced “straight” chiropractic, one of the lecturers was so untactful as to extol the virtues of colonic irrigation (mechanical washing out of the lower portion of the large colon), whereupon a practitioner in the audience immediately raised his hand for permission to speak. “Doctor,” he asked, “is it possible to wash out a subluxation with a colonic irrigation?” Amidst loud laughter of agreement from the audience, the inquiring chiropractor triumphantly returned to his seat without waiting for an answer to his question.
Although it is quite impossible to attach any definite meaning to Palmer’s “philosophy,” considering the manner in which it is written, he is probably referring to “Innate Intelligence” when he defines the scope of chiropractic as being “from above-down, inside-out.” By definition, the term “innate” denotes natural or inborn powers, or the genetic constitution. In chiropractic discussion it seems to mean a “curative power” conveyed over the nervous system from the brain. This curative power is supposedly permitted full and free expression if all “nerve interference is removed.” Andrew Taylor Still, the founder of osteopathy, also built his system around the idea that the body could cure all of its own ills. Up to a point, of course, this philosophy is all right. It is the method employed by various healing cults to permit or stimulate this inborn healing mechanism that usually makes the cult. According to Palmer, as according to Still, interference with the body’s healing powers takes place at the spinal joints. While Still worked from the beginning with the entire spine, as did D.D. Palmer, B.J. Palmer eventually theorized that interference with the nerve supply (the amount of which determined the state of health or disease) took place primarily at the first joint of the spine, irritating the nerves or pressing against the spinal cord just beneath the brain, the source of “Innate Intelligence.” If the atlas and its joints were so displaceable as to commonly interfere with the function of the spinal cord, the human race would be a corps of invalids – – victims of an extinguishing measure of nature.
- 1. Palmer B.J. Shall Chiropractic Survive? 1st Edition. Davenport, IA: Palmer School of Chiropractic, 1958.
- 2. International Review of Chiropractic, February 1958.
- 3. Boyd CE. The Cult of Chiropractic. Louisiana State Medical Society, 1953.
- 4. Catalogue of the Palmer School of Chiropractic. Davenport, Iowa, 1958.
- 5. Lewin P. The Back and Its Disc Syndromes, 2nd Edition. Philadelphia, PA: Lea & Febiger, 1955.