…But wait! There’s more!
[originally published in KCN, February 2000]
Today it is becoming more and more accepted by the health care community and public at large that chiropractors are great back doctors. I would agree. The scientific literature certainly supports our primary method of treatment for back pain, and more insurance companies are covering our services for it. Considering our history of long uphill battles to gain “acceptance” as a viable health care profession, it is understandable that we might be drawn to settle into this “comfortable chair” of being labeled as back pain specialists. But to do so would really be undermining the true potential that the art, science, and philosophy of chiropractic has to offer.
It surprises a lot of people, but the first chiropractic patient didn’t come to D.D. Palmer’s office on September 18, 1895, complaining of back pain, but rather deafness! His patient, Mr. Harvey Lillard, explained that for the past 17 years he had been unable to hear after an incident in which he exerted himself while working in a cramped, stooping position, when something gave way in his back — immediately bringing on the deafness. Palmer writes that Mr. Lillard was so deaf that he couldn’t hear the ticking of a watch or the racket of a wagon on the street. Upon examining the gentleman’s spine, Dr. Palmer found what appeared to be a misaligned vertebra in the midback region. Hypothesizing that this misalignment could be the cause of the hearing problem, he persuaded his patient to allow him to realign it. And align it he did! Almost immediately following the adjustment, Mr. Lillard could hear again! While this treatment of Dr. Palmer’s has been questioned by skeptical anatomists and neurologists, chiropractic historian Walter Wardwell, PhD, notes in his chiropractic history book that similar accounts have been reported in the medical literature. He also quotes a medical doctor skilled in the art of spinal manipulation who stated that he has noted “dramatic and lasting relief of…deafness…after treatment of the thoracic joint,” and further remarked that Palmer’s claim “may not be quite as fantastic as it sounds.”
Nevertheless, before D.D. Palmer had a chance to open up a chain of deaf clinics, he encountered a patient with heart trouble which was not improving. Palmer writes, “I examined the spine and found a displaced vertebra pressing against the nerves which innervate the heart. I adjusted the vertebra and gave immediate relief….” Palmer continues, “Then I began to reason if two diseases, so dissimilar as deafness and heart trouble, came from impingement, a pressure on nerves, were not other diseases due to similar cause?” He embarked upon a “systematic investigation” and found that individuals with all kinds of health problems (asthma, skin conditions, digestive problems, headaches, epilepsy, sciatica, etc…) were responding to his “hand treatments”, which he later coined, with the help of a patient, “chiropractic.”
Since that day in 1895, chiropractors have been helping patients with all kinds of conditions besides the back pains that most people associate us with. Many exciting patient testimonials and case reports abound. This is not to say, however, that chiropractic is an actual treatment for these conditions, but rather a treatment of the person as a whole, which emphasizes optimal spinal and nervous system function. Because every function of the human body is under the control and coordination of the brain and nervous system, chiropractors are able to empower the body’s self-healing and self-regulating properties by adjusting the spine, and thus can have an effect on the body’s overall health — sometimes dramatically, as in Mr. Lillard’s case.
And while the majority of medical doctors and others unfamiliar with chiropractic and spinal adjusting might scoff at the idea that chiropractic can help patients beyond the back pain realm, some digging in the medical and chiropractic literature tends to make this doubtful viewpoint a little harder to support. As a matter of fact, some very intriguing research was conducted, by a medical doctor nonetheless, back in 1921, by the name of Henry Winsor. Dr. Winsor wondered how chiropractors could claim such good results with conditions such as stomach troubles, ulcers, menstrual cramps, thyroid conditions, kidney disease, constipation, heart disease, lung disease, etc. “We M.D.’s criticize them, but what if they really have discovered a new, drugless way to treat disease?”
Inspired by this question, Dr. Winsor conducted an experiment at the University of Pennsylvania, in which he dissected 50 human cadavers. His objective was to see if there was a relationship between any diseased internal organs discovered on autopsy and the vertebrae associated with the nerves that went to these organs. During his dissections he found a total of 139 diseased organs ranging from lung disease to bladder disease. In short, he described these diseases as “the ordinary diseases of adult life.” Further study of these dissections revealed that 128 of these diseased organs had “vertebral curvatures” (ie. structural misalignments) at the exact segmental levels to where the nerves branched off of the spine to supply these organs! Another 10 had curvatures in adjacent segments; which isn’t surprising, as nerves can sometimes travel up or down a few segments before exiting or entering the spine. The remaining one diseased organ was described as having only a slight pathology and a faint vertebral curve. Dr. Winsor’s findings were published in the respected medical journal, The Medical Times, and although it appeared some 78 years ago, can be found with some persistent searching in the archives of our nation’s medical libraries. [As a side note: my two plus month search finally uncovered a copy of his manuscript at the University of Illinois’ Library of Health Science].
As with Winsor’s experiment, over the next several decades other researchers would conduct studies that would lend further credence to chiropractic’s theories and effectiveness with conditions such as high blood pressure, asthma, colic, menstrual cramps, ulcers, and bed wetting, as well as many other conditions not immediately associated with the spine. More recently, neurological research, conducted by Akio Sato, MD, PhD, out of Japan, and Ralph Schmidt, MD, PhD, out of Germany, has now established a clear anatomical basis for chiropractic’s claims of influencing organ disorders and general health through correction of spinal subluxations, via special nerve pathways known as somato-autonomic/somato-visceral reflexes. A recent article in The Chiropractic Report, quotes Brian Budgell, DC, MSc, who has worked closely with Dr. Sato for the past three years in his research endeavors, as saying, “A close examination of the basic scientific studies shows that many of the clinical observations of chiropractic are eminently sensible and deserving of further investigation….There is growing evidence to support the hypothesis that dysfunction at particular levels of the spine may preferentially, provoke symptoms in specific organs.”
As with any health profession, chiropractic has had its fair share of trials and tribulations. We have been unfairly called names ranging from “quacks” and “scam artists” to “mad dogs” and “killers”. And in our efforts to become recognized and accepted by the mainstream of medicine and the insurance industry, much of our claims and efforts in helping patients with non-spinal related symptoms have fallen into the background. The Chiropractic Report makes reference that, “The issue whether chiropractors have a role in the management of patients with visceral [organ] disorders is so sensitive politically, and open to exploitation by others saying this is evidence of unscientific practice, that some have questioned whether or not it might be better for the general advancement of the profession to jettison all claims in this area.” The article continues stating that, “Unfortunately this debate is taking place in the absence of substantial scientific evidence for or against either side and, in the the rush to establish chiropractic’s place among what are perceived as scientific health practices, there is great danger of throwing out the baby with the bath water.”
You see, even though we have many thought provoking research studies to establish a link between chiropractic and its effect on conditions other than back pain, it is still, in scientific circles, not conclusively proven. On the other hand, it’s not disproven either. Historically research has been a difficult area for chiropractic for a plethora of reasons, but namely it has been one of finances. Fortunately, we have had the gracious opportunity to bask in the laborious research efforts performed by professions other than our own on chiropractic-related topics; but if we want to steer the direction of future research efforts, we, as the chiropractic profession, realize we have to step up to the plate and take on a lot of the leg work ourselves. Without the deep pockets of the pharmaceutical industry funding our research, we have had to make strategic decisions in the allocation of our modest research monies and consequently have devoted the bulk of our resources into the category of patients we most often see — namely those with back pain.
Times are changing, however. Today our role in effectively managing mechanical low back pain is relatively established. Consequently, our ability to focus our research in other areas, such as our effectiveness in influencing the health of non-spinal related conditions, is much more feasible. This past century has brought with it some very convincing ground work that will allow for further in-depth, quality studies to take place.
Back in 1979, the New Zealand Commission, which has investigated through judicial inquiry and medical cross examination many of the “hard to believe” case results that chiropractors have achieved, stated, “…our view is that chiropractors are not unreasonable or unscientific in believing that their method of treatment may sometimes have a beneficial effect on a patient’s visceral and/or organic disorder….There ought to be intensified research into why spinal manual therapy sometimes has the effect it appears to produce. It is no answer to accuse chiropractors of being ‘quacks’, to try to explain away their results, or to try to sweep their results under the carpet on the ground that they have not been verified by scientific method.” The Commission called for “open-minded” medical doctors and chiropractors to join forces, working together in research and in practice, to produce an answer. Some twenty years later, we are slowly making headway. But research, good research, can take a long time and a lot of money.
It is unfortunate, that some patients will never know of the possible benefits that chiropractic might offer them and their state of health because of a technical necessity to scientifically “prove” something beyond a shadow of a doubt. I’m not claiming that chiropractic is a panacea for “anything that ails you.” I am stating that chiropractic has a lot to offer, and that the spine should be taken into consideration when trying to promote the health of the body — especially if someone has a condition that is not improving with traditional medical means.
As an “underdog” health profession, chiropractors are held to a higher standard than those who “make the rules.” It has been reported in the British Medical Journal and the New England Journal of Medicine that only about 15% of the standard, orthodox medical procedures these days have any solid scientific backing for their effectiveness. Surely a double standard exists. And as one chiropractic journalist so aptly asked, “Are we expected to deny the clinical possibilities of structure affecting function because we can’t prove the mechanics of this hypothesis through research?” I don’t think so. It certainly hasn’t stopped medicine. We chiropractors will persist in our research efforts, however, and the evidence will eventually come in. Until then, chiropractors across the world will silently continue to help those in need.
Sources used for this article:
Chapman-Smith, D. The spine and the nervous system: new knowledge on somato-visceral reflexes supports chiropractic theory. The Chiropractic Report. May 1997.
Kent, C. Research on purpose: spinal abnormalities and visceral disease. The Chiropractic Journal 13(10). July 1999.
Koren, T. Chiropractic: bringing out the best in you! Koren Publications. 1995.
Koren, T. The winsor autopsies. (brochure). Koren Publications. 1991.
Levinson, D. The truth about chiropractic. Max Publications. 1992.
Maurer, E. Is there fairness in scientific evaluation? ACA Today. March 1999.
Plews, L. Health watch. Natural Healing through chiropractic. BodyWise. Bainbridge HMC. Spring 1998.
RHT. In the meantime. Dynamic Chiropractic. December 20, 1999.
Wardwell, W. Chiropractic: history and evolution of a new profession. Mosby. St. Louis. 1992.
Winsor, H. Sympathetic segmental disturbances-II. The evidence of the association of dissected cadavers of visceral disease with deformities of the same sympathetic segments. The Medical Times. November 1921.
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