Chiropractic at the Turn of the Century
By Joseph Keating Jr., PhDTemper of the Times
1901: It was the dawn of a new century, wondrous and mysterious and compelling in its promise. Victory in the Spanish-American War was still fresh in the American mind, but Theodore Roosevelt would not assume the presidency until the assassination of William McKinley in September.The Wright brothers were still experimenting with gliders to work out the aerodynamic details of flight control surfaces. Marconi was dabbling with wireless telegraphy, that would eventually become radio and television, and Einstein had not yet issued his first theory of relativity. The Oldsmobile Company was only four years old, and Sigmund Freud, MD, had only recently (1898) released his seminal work, in psychoanalysis, An Interpretation of Dreams. The hydraulic concepts inherent in the Viennese physicians's volcanic psychodynamics were in synchrony with the world views of the age of machines and the industrial revolution.
A half-century after their abolition, the re-introduction of medical practice acts was well underway (see Table 1). The American Medical Association (AMA) was increasingly successful in eliminating or absorbing eclectic and homeopathic medical schools, and was determined to contain and eliminate midwifery. However, new challenges to allopathy's authority were multiplying. Members of the osteopathic profession had endured prosecutions for unlicensed practice since 1893, but by 1901 some 14 states had authorized licensure for DOs (Gevitz, 1982, pp. 40-2), and osteopathic education had already spread as far as California (Booth, 1924, p. 89). Patent medicine vendors flourished, as yet unfettered by the Pure Food & Drug Act of 1906, and traveling medicine shows were very popular. Practitioners of electrical medicine were likewise gaining ground, especially in the AMA's backyard: Chicago.
In New York City, Dr. Benedict Lust had only recently begun operations of his American School of Naturopathy. The cause of natural healing and methods of naturopathy would be broadcast nationwide by means of Lust's journal, the Herald of Health. The Big Apple was also home to Bernarr Macfadden the health and body building movement, which was growing rapidly, promoted by means of his magazine, Physical Culture, and several books (Ernst, 1991).
Meanwhile, in the business district of Davenport, Iowa, the father of chiropractic, a magnetic practitioner transformed by the clinical results he had obtained with manual therapy, was occupied in the care of patients in his thriving, 40-bed facility on the fourth floor of the Ryan building. Canadian born Dr. Daniel David Palmer (1845-1913), a self-titled doctor, was also training a few individuals in the new healing art of chiropractic (see Table 2), although never more than three at a time (Palmer, 1910, p. 159). Incorporated as the Palmer School of Magnetic Cure in the summer of 1896 (Wiese, 1986), the institution came to be known as "Dr. Palmer's Chiropractic School & Cure" (Palmer, 1901).
The "magnetic manipulator's" (Palmer, 1897) formal qualifications to operate a school for doctors were limited. Palmer had made his living as a teacher in the public grade schools of rural Iowa and Illinois in the 1870s and 1880s, and was listed as a member of the faculty of the Independent Medical College of Chicago during 1897-98 (Cramp, 1921, pp. 777-8). A Palmer-autographed copy of L.A. Stimson, M.D.'s 1900 volume, A Practical Treatise on Fractures and Dislocations, was signed by Palmer in 1901, which suggests that Old Dad Chiro had begun the self-education in the clinical and biological sciences that would serve him well in years to come. (The book is in the possession of the president of Southern California University of Health Sciences).
At the turn of the century, the chiropractic course in Davenport cost $500 (a sum which approximated the tuition at the best medical schools), but involved as few as two or three months training. Oakley G. Smith, an 1899 graduate of the Palmer school and subsequently the founder of the rival profession of naprapathy (Beideman, 1994), recalled his chiropractic training as barely an apprenticeship (Smith, 1932, pp. 5-6). Historian Russell Gibbons (1980) also describes the rudimentary character of early chiropractic education. However, to place this in interprofessional context, many medical schools in America in that day and age were also rather primitive, and most would be condemned by Abraham Flexner, PhD, in his historic report to the Carnegie Foundation on medical education in the United States and Canada (Flexner, 1910).
The Initial Conflict
In 1901, Palmer was still teaching the first of the several theories of chiropractic he eventually offered (Keating, 1991, 1992, 1993). This initial set of hypotheses and assumptions comprised a decidedly mechanistic view. Palmer likened the human body to a fine watch and identified himself as a "human mechanic" (Palmer, 1897). This first chiropractic theory, a derivative of his nine years of practice as a magnetic, proposed that inflammation (which Palmer saw as the essential characteristic of dis-ease) arose in the body due to friction between displaced anatomical parts.
From these ideas would eventually emerge his notion of "tone," which D.D. considered the centerpiece of his final chiropractic theories (Palmer, 1910, 1914). However, in 1901, not yet exclusively concerned with bones-pinching-nerves (Keating, 1995), Old Dad Chiro would manipulate to adjust any displaced anatomy he found, including arteries, veins, nerves, muscles, bones, ligaments and joints. The range of patient conditions Palmer accepted for treatment (his terminology at the time) was as broad as A.T. Still's osteopathy, although the theoretical bases for these two manipulative arts were distinct. Palmer's theory had most closely resembled osteopathic concepts when he described his treatment for cancer in the January 1897 issue of his advertiser:
Having found the cause of cancer, it is an easy thing to relieve the pressure upon the blood vessels and nerves. Arranging the body in a natural condition so that the circulation of blood is free and the pressure is removed from the nerves, the secretion and excretion becomes perfect, and the patient cannot help getting well. In other words, if all the different parts of the machinery of the human body were just right, secretion and excretion would be perfect and all the impurities would be thrown out the back door, instead of finding an outlet elsewhere (Palmer, 1897, p. 2).
Although Iowa had passed a medical practice act in 1886, the law had rarely been enforced, perhaps owing to the public's continuing reluctance to accept the exclusive authority of any one branch of the healing arts. Orthodox medicine was only beginning to establish its scientific authority; the first randomized, controlled clinical trials of pharmaceuticals were still nearly four decades in the future. In many respects, Palmer's vituperative commentaries on medical practice were mirrored in the public consciousness. The father of chiropractic made some allowance for MDs:
Medicines and medical doctors are necessary; we cannot get along without them (Palmer, 1896).
But he neglected to specify when he thought medication might be appropriate. Palmer minced no words in condemning what he thought were primitive and hazardous methods. Among the rhetoric that must have infuriated his medical competitors was:
MEDICINE A SCIENCE (?)
Palmer's strong words were met with equally intemperate discourse from a local allopathic doctor, Heinrich Matthey, MD, who had committed himself to sweeping all unlicensed healers from his community. Matthey opined in the Davenport Republican on 17 September 1899:
It is a pitiful sight that presents itself at this time - at a time of departure of this glorious century in our great republic: on the one hand, the most wonderful enlightenment in all sciences, and the accompanying benefits to the human race - and on the other, the brazen array of swindlers who are not ashamed to carry on their fraudulent manipulations - even at the bedside of the suffering - in a place where one would least suspect such frauds. We are all aware of this evil but are at present practically helpless...
Enraged, Palmer devoted nearly half of the 1899 edition of his advertiser, The Chiropractic, to a systematic rebuttal of Matthey's charges. Their public feud would continue for several years. Historian Cyrus Lerner suggested that the enrollment at Palmer's school of a young man from Chicago, H.H. Reiring, may have been a plant by Matthey. Reiring paid his $500 tuition in March 1900, and soon began to brand Palmer a fraud. Old Dad Chiro ordered him off of school property, and when Reiring refused to leave unless his tuition was refunded, Palmer called the police. Although Reiring was arrested, Palmer failed to file a written complaint, and thereby left himself open to "a liability for a suit for false arrest" (Lerner, 1954, pp. 260-4). Historian Vern Gielow indicates that Reiring sued Palmer for misrepresenting the content of his educational offering (Gielow, 1981, p. 96).
Reiring's lawsuit was dismissed on 15 January 1901 (Gielow, 1981, p. 96), but the threat of prosecution and civil suits apparently hung over the father of chiropractic. In June of 1902, he relocated to Southern California, ostensibly to locate and help his friend and former pupil, Thomas H. Storey, DC, who was suffering from a mental disorder. But the real reasons for his departure probably had more to do with his legal and financial difficulties in Iowa. And soon he would run into legal difficulties in California (Zarbuck, 1989; Zarbuck & Hayes, 1990).
In the Aftermath
Left in charge of the debt-ridden Palmer School & Infirmary was young Bartlett Joshua Palmer, son of the founder, who had earned his chiropractic diploma from his father only a few months earlier. His days of major glory and grief were yet to come (Keating, 1997), but even in the short-term there were signs of special ability. The young Dr. Palmer (not yet 21 years of age) was a product not only of apprenticeship to his father, but was also a protâgâ of Professor Herbert Flint, who operated a traveling "vaudeville hypnotism show" (Lerner, 1954, pp. 265-6, 309). B.J. grasped the reins as "manager" of his absent father's facility, garnered a loan for the business (Gielow, 1981, p. 130), and in the next few years returned the institution to profitability.
One century ago the legal war between the "chiropractics" (not yet identified as "chiropractors") and the medical doctors was already underway, at least on a small scale. Although the entire "profession" at this point numbered fewer than two dozen Palmer graduates (plus whatever other alternative healers had assumed the designation "chiropractic"), Old Dad Chiro's aggressive tone, widespread testimonial advertising and strenuous resistance to the local allopathic onslaught had already created a microcosm of the profession's impending interprofessional fate.
Not yet in evidence was the intraprofessional strife that has since colored so much of the chiropractic century. Not until 1902 did the onset of disagreements over scope of practice ("mixing") and the earliest competition among schools of chiropractic come into view (Zarbuck, 1988). Not until 1903 would the first major change in D.D. Palmer's chiropractic theory appear (Keating, 1995). "Innate intelligence" would not make it's public debut until 1904 (Donahue, 1986, 1987). As the new century dawned, the consecration of "chiropractic philosophy" still awaited the first acquittal (in 1907) of a DC charged with unlicensed practice (Rehm, 1986) and the award of the first PhC ("Philosopher of Chiropractic") degree in 1908 (Keating, 1997, pp. 65-6).
Chiropractic at the turn of the century was still in gestation.
Joseph Keating Jr., PhD
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