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Chiropractic Principles & Their Evolution Through History

Lecture 1
Paul Wanlass, D.C. Assistant Professor Lead Instructor for CP 4, CP 7, and Chiropractic Theories & Principles
2011

TheChiropracticParadigm
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DefinitionofParadigm
O A philosophical or theoretical framework of

Assoc.ofChiropractic CollegesParadigm
O 1996- The A.C.C. published a position paper

any kind

describing the nature of Chiropractic and its professional attributes. O Adopted by the ACA, ICA, and World Federation of Chiropractic. O Professional organizations can pursue common goals and objectives.

http://www.merriam-webster.com/dictionary/paradigm

ACCsDefinitionof Subluxation
A subluxation is a complex of functional, structural, and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health.

TheACCContinuedtoSay...
O A subluxation is evaluated, diagnosed and

managed through the use of chiropractic procedures based on the best available rational and empirical evidence. O The preservation and restoration of health is enhanced through the correction of the subluxation.

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VitalisticApproach
O Suggests that a life force, innate

VitalisticApproach
O A fundamental Chiropractic Principle the

recuperative power, or innate intelligence is in all living things. O Also used as a legal defense for Chiropractors in the early years

body is a self-regulating and self-healing organism O The adjustment corrects the Subluxation, thereby restoring the flow of life force through the nervous system O D.D. Palmer attempted to merge science and metaphysics* which became the foundation for vitalism in 1890
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* A branch of philosophy dealing with theories of existence and knowledge.

ThePalmers
O The Palmers are both considered

ThePalmers(2)
O This segmental orientation is epitomized by

segmentalists O They believed that individual joints of the spine subluxate independently of one another. O D.D. insisted that he only adjusted a single joint in a patient during any given treatment session.
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the Meric charts that relate individual spinal segments to specific organs of the body. O D.D. proposed that there were three causes of subluxations: toxins, physical trauma and auto-suggestion

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ThePalmers(3)
O B.J. Palmer later claimed that the

NeurocalometerHistory
O Invented in 1924 by Dossa D. Evans, D.C.

Neurocalometer (1924) he marketed to the profession was the only valid means of identifying these subluxated spinal joints.

and developed by Otto Schiernbeck, a consulting engineer on the staff of Palmer College of Chiropractic O Original Neurocalometer (NCM):

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NeurocalometerHistory
O A later wireless version:

NeurocalometerHistory
O Further advanced to the Nervo-Scope:

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HowTheyWork
O D.D. Palmer used the back of his hand to

HowTheyWork
O Based on the theory that a subluxated

locate "hot boxes" along the spinal column in an effort to detect differences in surface temperature from one side to the other O This device had two heat-detecting probes (thermocouples) connected to a meter that registered whether points on either side of the spine had different temperatures.
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vertebrae causes pressures on a nerve or group of nerves as they pass through or emit from spinal column O This pressure causes a resistance to the flow of nerve energy. O The resistance produces heat which can be measured before and after an adjustment using the NCM
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HoleInOne
O In the mid-1930s, B.J. further proposed that

MechanisticApproach
O It implies that life can be explained in strictly

the only adjustment-worthy subluxations occurred in the upper cervical spine, and heavily promoted his Hole-In-One (HIO) method of upper cervical adjusting. O B.J. also developed the neurocalograph (a NCM with a strip chart) to monitor patterns of subluxations before and after HIO interventions.

physical terms.

O In Chiropractic it refers to: O Reducing nerve compression O Increasing joint R.O.M. O Affecting aberrant spinal reflexes O Improving a patients activities of daily living (ADLs)

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TheMericSystem
O Developed by B.J. Palmer and James

TheMericSystem
O Meric analysis or Neuromeric analysis says

Wishart in 1910

(Gatterman, Foundations of Chiropractic: Subluxation (2nd ed.) 2005. pg. 218)

that levels of spinal subluxation are connected to various organ systems according to the innervation of the autonomic and peripheral nerves. O The area found by tracing the nerve from the level of subluxation to the end organ was known as a Mere, or Vertemere. O For example, adjusting T4 would help the Gallbladder.
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MericChart

BoneoutofPlace
O The Palmers developed the concept that the

adjustment repositioned displaced vertebrae and, therefore, treated disease by relieving pressure on the nerves. O Both D.D. and B.J. Palmer emphasized that a subluxation was a static malposition of the vertebral body.

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MotionRestriction/ JointFixationModel
O Solon Langworthy, D.C. presented his theory

NerveTracing
O An early manual diagnostic procedure used

that a subluxation was a vertebra that had a restricted field of motion.

by of palpating a tender nerve from its spinal origin to an inflamed area, or from a tender area back to the spinal column. O Used by D.D. Palmer

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Thermography
O Pioneered by B.J. Palmer as a method of

TheGreenBooks
O A series of books written by B.J. Palmer

detecting vertebral subluxation in 1924

discussing his view of innate intelligence and philosophy in Chiropractic.

Spinography
O Weight bearing radiographs used by B.J.

O He believed that innate intelligence is

spiritual. AboveDownInsideOut (1949)

Palmer between 1908 and 1922.

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Stephensons33Principles
O A set of beliefs about the human body and

the natural order of the universe.

O #1. (The Major Premise): There exists a

Universal Intelligence which brings organization to all matter, and maintains its existence O Chiropractic is a philosophy, science and an art.
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ImportantPeople

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Hippocrates(460377B.C.)
O The first physician to clearly describe spinal

Hieronymus(1746)
O He identified a lessened motion of the

manipulation in the western world O He authored the book On Joints O Used gravity traction and rachiotherapy (spinal therapy) O His famous quote Look well to the spine for the cause of disease

joints by slight change in position of the articulating bones and pain

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DanielDavidPalmer,D.C.
(18451913)

D.D.Palmer
O Farmer, beekeeper, and school teacher

O A.K.A. D.D. Palmer or Old Dad Chiro O Known as the founder of Chiropractic in

1895

until the early 1880s

O Practiced as a magnetic healer (1886) O Moved to Davenport, Iowa in 1887 O Advertised widely that he could cure

disease without medicine

O Distributed newspaper flyers known as

The Educator & The Magnetic Cure

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D.D.PalmersTheory
O Thought that inflammation was caused by

D.D.PalmersTheory
O Claimed that the principles of his theory were

displaced anatomic parts:

O Arteries, veins, nerves O Muscle & ligament O Bone & joint

revealed to him by spiritual sources inflammation

O Used his fingers to palpate for the site of O Cooled the hot, inflamed tissue by pouring his

personal, excess, vital magnetic force into the lesion

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D.D.PalmersTheory
O His theory evolved to focus on nerve

D.D.Palmer
O Acknowledged that he studied osteopathy

impingement due to subluxation of spinal joints as the source of illness (~1904) O Further development included nerve stretching and slackening as the critical factor (~1910)
O Insisted that a subluxated joint (including

but denied he ever visited A.T. Still

O Origins of his development of segment-

specific manipulations are not truly known

extraspinal) could alter the tension in nerves and thereby modify their effective message to end organs
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1st PatientTestimonial
O Testimonial in the January 1897 issue of

1st PatientTestimonial
Last January Dr. Palmer told me that my deafness came from an injury in my spine. This was new to me; but it is a fact that my back was injured at the time I went deaf. Dr. Palmer treated me on the spine; in two treatments I could hear quite well. That was eight months ago. My hearing remains good.

The Chiropractic by Harvey Lillard, janitor in the building where D.D. Palmer practiced:
I was deaf 17 years and I expected to always remain so, for I had doctored a great deal without any benefit. I had long ago made up my mind to not take any more ear treatments, for it did me no good.

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D.D.Palmer
Left Iowa for California in 1902 Spent time in Pasadena where he was indicted for

D.D.Palmer
O After his release, he left for Oklahoma and

practicing medicine without a license after one of his patients died; suit was dropped due to technicalities Spent time in Santa Barbara where he taught and practiced

Returned to Davenport in 1904 Was put on trial for practicing medicine without a

then Oregon opened up several chiropractic schools O His son, Bartlett Joshua Palmer managed the Palmer School of Chiropractic in D.D.s absence

license

Chose to go to jail rather than pay the fine this was

the first time a chiropractor was incarcerated for practicing medicine without a license

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BartlettJoshuaPalmer,D.C.
(1881 1961)

B.J.Palmer
O 1906 founded a protective society that

O A.K.A. B.J. Palmer O Known as the developer of Chiropractic, HIO,

vitalism, and the Neurocalometer O Co founder of the Meric System O Author of the Green Books

provided legal services to member DCs charged with practicing medicine without a license

O Strongly promoted the emerging chiropractic

philosophy, which helped defend chiropractors against unlicensed practice suits

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B.J.Palmer
His Chiropractic philosophy included the notions of
O Universal intelligence O Innate intelligence O Educated intelligence

B.J.Palmer
O B.J.s focus was on finding and correcting

subluxations to free obstructed nerves and allow Innate Intelligence to direct healing messages from the brain through the nerves to the end organs.

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WillardCarver,D.C.,LLB
O Willard Carver held a

WillardCarver,D.C.,LLB
O Presided over 4 schools in Oklahoma City,

Bachelor of Law degree O Known as the Constructor of Chiropractic and made Chiropractic legal in Oklahoma in 1921 O Authored 18 books

Washington D.C., New York, and Denver chiropractic in 1907 (in Oklahoma). Finalized in 1921.

O Introduced the first bill to legalize

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O Author of the 33 principles, philosophy

R.W.Stephenson,D.C., Ph.C.
teacher at Palmer, author of Chiropractic Textbook 1927

AndrewTaylorStill,D.O.
(18281917)

O Opened the American School of Osteopathy

in Missouri in 1892

O There are now 25 osteopathic medical O Curriculum included surgery (for

colleges & D.O.s practice in all 50 states emergencies) but not pharmaceuticals blood flow

O Early concepts included the supremacy of

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AndrewTaylorStill
O Worked as a hospital orderly in the Civil War O May have been a battlefield surgeon O Rose to the rank of Major O Following the war, lost several children to

AndrewTaylorStill
O Practiced as a magnetic healer in 1875 O Developed osteopathy in 1889 O Known as a lightning bonesetter O Believed that the brain manufactured the

typhoid or spinal meningitis O Wanted to find an alternative to heroic interventions used on his children

bodys own healing substances

O Health could be maintained by keeping

channels (arteries, veins, nerves, lymph) from the brain to the end organs free of obstructions.
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SolonLangworthy,D.C.
O Published the first textbook on Chiropractic

JohnHoward,D.C.
O Founded the National School of

in 1906 (along with Minora Paxson and Oakley Smith) O Organized the first American Chiropractic Association O Founded the American School of Chiropractic (Cedar Rapids, Iowa) - first school to provide competition to the Palmer school
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Chiropractic in 1906 in Davenport, IA

O National relocated to Chicago in 1908 O Offered physiological therapeutics

courses by 1914

O Diversified in its teaching approach, in

contrast to the Palmer school

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TulliusRatledge
O Moved his Ratledge College of Chiropractic

SylvaAshworth
O Graduated from Palmer in 1910 O Served on the first chiropractic board in

from Kansas to California in 1911 O Sold the school to Carl Cleveland, Sr., in 1951 O Spent 75 days in jail for practicing medicine without a license rather than pay the fine O Active in bringing the 1922 referendum to California voters to legalize chiropractic
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Nebraska

O Daughter Ruth and son-in-law Carl Cleveland

started the Central College of Chiropractic in Kansas City

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SylvaAshworth
College in 1924 Renamed the Ratledge College O Then the Cleveland Chiropractic College of Los Angeles in 1955 O Matriarch of the first 5-generation family of chiropractors
O O Which became the Cleveland Chiropractic

ImportantDefinitions

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SubluxationSyndrome
O An aggregate of signs and symptoms that

VertebralSubluxation Complex(VSC)
O A theoretical model of motion segment

relates to the pathophysiology or dysfunction of spinal and pelvic motion segments or to the peripheral joints. This is what you will see with the patient.

dysfunction (subluxation) that incorporates the complex interaction of pathologic changes in nerve, muscle, ligamentous, vascular, and connective tissue. What is used in education and in talking with other doctors.
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~Leach and Haldeman

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VertebralSubluxation Complex(VSC)
O We will discuss the vertebral subluxation

complex in more detail in a future lecture.

ThePersecutionof Chiropractors & TheGrowthofChiropractic Schools

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PersecutionofChiropractors
O By 1930, an estimated 15,000

GrowthofChiropractic Schools
O Between 1903 and 1914, 23 chiropractic

chiropractors had been charged with practicing medicine without a license

schools opened their doors, including

O Parker School of Chiropractic (1905)

O National School of Chiropractic (1906)

O Chiropractors prevailed in about 75% of the

O Texas Chiropractic College (1908) O Los Angeles College of Chiropractic (1911) O Canadian Chiropractic College (1914)

cases

O It was also during this time that the rift

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between straights and mixers developed

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GrowthofChiropractic Schools
O The list doesnt include correspondence

GrowthofChiropractic Schools
O The biggest surge in enrollment came

schools that were essentially mail-order diploma mills O All schools at this time were for-profit ventures O The original Palmer curriculum was 3 months duration O Until the 1950s, it remained an 18month course of study

following WW I and WW II
vocational training
students

O The Veterans Bureau provided funds for

O Enrollment at Palmer in 1922 was over 3,000

O 1974: Council on Chiropractic Education was

recognized by the US Office of Education

guaranteed student loans

O Students could now be eligible for federally

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ComplementaryandAlternative (C.A.M.)HealthCare
The Big 5 disciplines are: O Acupuncture O Chiropractic O Herbal medicine O Homeopathy O Osteopathy O Most organized and regulated professions that: O Have an individual diagnostic approach O Have a research base

MajorEvents

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MajorEvents
O Struggles for licensure O 60-year effort O Kansas = first state (1913) O Louisiana = last state (1974) O Over 450 chiropractors went to jail in

MajorEvents(2)
O 1924: Introduction of the neurocalometer O Introduced in a speech by B.J.: The Hour

Has Struck

O Insisted that its use was necessary to

detect subluxations spine

California rather than pay the fine

O Coincided with B.J.s switch to HIO vs. full

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MajorEvents(3)
O 1930: National Chiropractic Association O 1941: International Chiropractic Assoc. O 1963: Committee on Quackery (originally

MajorEvents(4)
O 1972-3: Chiropractic coverage by Medicare

and other insurance plans

O 1975: National Institute for Neurological and

called the Committee on Chiropractic) (CCE) is the accrediting agency for chiropractic colleges

O 1971: Council on Chiropractic Education

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Communicative Diseases and Stroke Conference O Sponsored by Congress O Interdisciplinary discussion panel O Document: The Research Status of Spinal Manipulative Therapy concluded the following:

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TheResearchStatusofSpinal ManipulativeTherapyconcludedthe following:

O provides relief from pain, particularly

MajorEvents(5)
O 1976: Wilk Antitrust Suit O Chester Wilk & 4 other chiropractors sued

back pain, and sometimes cures, and may be dangerous, particularly if used by nonphysicians; there was a difference of opinion focusing on the issues of indications, contraindications, and the precise scientific basis for the results obtained.
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the AMA and 10 other medical organizations for engaging in a conspiracy to monopolize health care and restrain competition by making voluntary professional associations between MDs and DCs unethical.

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1976WilkAntitrustSuit
O Also asserted that the AMA had conspired

MajorEvents(6)
O 1996- The A.C.C. published a position paper

with insurance companies to exclude chiropractic coverage. O AMA was found guilty in 1978 of trying to destroy the chiropractic profession through boycott.

describing the nature of Chiropractic and its professional attributes. O Adopted by the ACA, ICA, and World Federation of Chiropractic.

(http://betterspines.com/2009/09/25/the-wilk-antitrust-lawsuit-etc/) 73 74

MajorEvents(7)
O 2002: Inclusion of chiropractic benefits

ProfessionalQuestfor Recognition
O A long and complicated struggle for the right

within the Department of Veterans Affairs

to exist

O Legitimacy and cultural authority are still

questioned due to: O Adversaries outside the profession O Disagreements within the profession about purposes and methods O Relative isolation from other health services and the scientific community

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AnyQuestions?

ReadingAssignment ThisWeek
O Order the required textbook A.S.A.P. You O Read Chap. 1 O Read the course syllabus O Read the article Chiropractic History by

dont want to get behind on the reading!

Keating (on my site under required reading)

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ReadingAssignment NextWeek
Remember to read BEFORE coming to each class. The quizzes are based on your required reading! O Read Chapter 6 O Read Accessing the LRC & the role of research within the profession (on my site)

ReferenceTexts:
O Chapters 1, 2, and 6 of the required text.

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ReferenceArticles:
O Keating, J., PhD., Chiropractic History, A Primer, 2004. Chiropractic

History: a Primer

O http://www.chirobase.org/06DD/nervoscope.html

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