The chiropractic profession traces its roots to the American Midwest at end of the nineteenth century. Daniel David Palmer, a man in many ways characteristic of his times, wove together the threads of his era’s metaphysical and scientific thought to create a philosophy, science, and art of healing that has now entered its second century. Palmer’s varied health-related interests ranged from what was known in his day as magnetism and magnetic healing to his signature contribution—identifying a fundamental relationship between functional skeletal abnormality and the potential for adverse effects on the nervous system.
Attention to the human skeleton did not begin with Palmer. As described in Chapter 1, “Forerunners of the Chiropractic Adjustment,” throughout history countless people have been acknowledged for their talent in caring for various components of the skeletal system. Such manually applied skills, in one form or another, have been found in all cultures on all continents.
What was it that made Palmer’s contribution sufficiently noteworthy to form the basis of a profession that, a century later, spans the globe? Similar to his contemporary, Andrew Taylor Still, the founder of osteopathy, Palmer did not view the spine, or even the full skeleton, as an isolated body part to be tended solely at the site where symptoms arose. Rather, each person articulated a paradigm of human health in which the spine played a central role. A.T. Still related the integrity of the spine and skeleton to the proper functioning of the circulatory system and theorized a broad impact on health and well being as a consequence of alterations of that relationship. Palmer, on the other hand, emphasized the relationship between the skeleton (especially the spine) and the nervous system and theorized a system-wide interdependence, in which a person’s state of health depends on proper integration between skeletal structures and the function of the nervous system.
Perhaps Palmer’s greatest contribution was not the delivery of a spinal adjustment but rather his concentrated focus on the effects of spinal dynamics on nerve function, as well as the development of a body of knowledge and clinical skills to address the clinical manifestations of these effects. Palmer was not the first to discover that the human body is capable of self-regulation and healing, nor was he the first healer to use manual techniques. Palmer was, however, the originator of an approach to healing that incorporated specific manual techniques into a paradigm that accorded supremacy to the role of the nervous system (rather than the circulatory system) in physiologic regulation and healing.
HEALTH CARE AND PHILOSOPHIC LANDSCAPE IN D.D. PALMER’S ERA
To understand how Palmer arrived at his unique synthesis, it is essential to understand the state of late nineteenth century health care in the United States. Allopathic doctors of the time did not yet enjoy the status they now possess and did not have to meet the same rigorous educational and licensing standards as today. Much of medical practice emphasized using so-called heroic therapies, such as leeching, cupping, and bleeding. Because the public often perceived these methods as worse than the ailments they sought to cure, Americans were hungry for alternative approaches to their health problems. 1
Several more natural healing systems, less invasive than allopathic medicine, gained popularity during the nineteenth century. Among these systems were2:
1. Homeopathy, founded by the German physician Samuel Hahnemann, which used as its medicines highly diluted quantities of various substances, primarily from plant and mineral sources
2. Thomsonianism, a system of healing founded by the American herbalist Samuel Thomson, in which overexposure to cold was considered a central cause of disease
3. Hydrotherapy, which emphasized the internal and external therapeutic uses of water
4. Nature Cure, which used a vegetarian diet, along with light and air
5. Hygienic System, which amalgamated the hydrotherapy and Nature Cure movements
6. Osteopathy, founded by Andrew Taylor Still, which used manual therapy for correcting osseous lesions (referred to as the osteopathic lesion) proposed to exert a negative effect on circulation and thereby on overall health
These approaches to healing shared a preference for conservative, minimally invasive interventions that were believed to allow the body to heal itself. (See Appendix II regarding the relative invasiveness of various health interventions.)
Health care practitioners in this era ranged from those trained in formal university settings to villagers who apprenticed under local doctors and at some point were themselves recognized as doctors. Health education and practice-related legislation were minimal. Many systems of health and healing were freely espoused throughout the United States, each proclaiming its own superiority and the failings of its competitors. Numerous health fads gained adherents and then lost them, only to be supplanted by newer approaches.
Gevitz, a historian of osteopathy, outlined a life cycle for these developments, noting that “movements such as osteopathy, homeopathy, and eclecticism, generally have a natural life cycle. They are conceived by a crisis in medical care; their youth is marked by a broadening of their ideas; and their decline occurs whenever whatever distinctive notions they have as to patient management are allowed to wither. At this point, no longer having a compelling reason for existence, they die.”3 To survive for many generations, a healing art must provide a unique and valuable service, as allopathic medicine, dentistry, chiropractic, and other professions have done. Similarly, its practitioners must not lose sight of its basic purpose: to restore patients when ill and to aid them in their daily quest for health.
Palmer’s interests extended beyond the purely physical aspects of health and healing as he explored the energetics of the body, as well as paranormal phenomena. During the nineteenth century, the American religious landscape included various forms of spiritualist and metaphysical speculation, and Palmer’s curiosity was piqued by these influences. Anton Mesmer’s concept of animal magnetism was used by many individual practitioners such as Palmer and adapted by Mary Baker Eddy for use in her Christian Science, although Benjamin Franklin had dealt the concept a nearly fatal blow in a famous experiment in the royal court of France early in the nineteenth century. In this early example of a blinded clinical trial, Franklin demonstrated that healing effects occurred when patients believed they were being mesmerized, although no healing effects were noted if patients were ignorant of Mesmer’s magnetic passes.4
Mesmer used magnetic healing methods to treat a wide range of disorders, including hysterical blindness, paralysis, headaches, and joint pains. Magnetic healing primarily involved “laying on of hands” to transmit healing energy and may also have included vigorous rubbing, manipulation, or both. (See Chapter 1 for greater detail.) In his work with magnetic healing, D.D. Palmer believed that he was able to attain a higher degree of specificity than other magnetics. 5
During this same era, spiritualism, the belief that consciousness survives beyond death and that it is possible to contact the spirits of those who have died, also gained in popularity. Mediums purporting to facilitate this contact traveled the country, and séances were held in the parlors of many well-respected members of society. D.D. Palmer was part of the metaphysical movement of his day, attending spiritualist meetings then common in the Midwest. Other major philosophic influences in that era were the transcendentalist philosophers Henry David Thoreau and Ralph Waldo Emerson, whose love of nature and fierce independence of thought and action resonated with the individualistic spirit of many Americans and provided a supportive milieu for the pioneers of new healing methods. 6
D.D. PALMER’S CORE CHIROPRACTIC CONCEPTS
Though the individual components of Palmer’s chiropractic philosophy did not originate with him, he was able to blend recognized spiritual and metaphysical concepts together with the then-current scientific principles to create a unique ethos for the chiropractic healing art. The relationship between the structure and function of the body formed the essence of chiropractic’s approach to health care. Chiropractors sought to influence the body’s capacity to heal itself through the nervous system by applying specific forces to the spine. According to Palmer, function of the nervous system can be altered by a subtle change in position of a vertebral segment. Once function of the nervous system was altered, the entire organism can become predisposed to incoordination (dis-ease) and, ultimately, disease.
Stated in a current conceptual framework, “a structural problem within the spine contributes to diminished neurologic ability to cope with the environment, and the ability of the body to heal itself is decreased. Palmer believed the cause of most disease is displaced vertebrae; the disease is an effect of that displacement.”7
Although few contemporary chiropractors would now endorse a one cause–one cure explanation of human health and illness (with subluxation being the cause and adjustment being the cure), the interdependence of structure of the spine and function of the nervous system remains a cornerstone of the philosophy and practice of chiropractic today.
D.D. Palmer conceived of nerve function in the context of vibration and tone, common explanations for his time. Disease, he claimed, resulted from fluctuations in nerve tone, “nerves too tense or too slack.”8 Palmer asserted that either “too much or not enough energy is disease.”8 and that disease, rather than being something external that invades the body, is instead the result of internal imbalances involving hyperfunction or hypofunction of organs and systems. From this perspective, the resistance of the host is more significant than the power of the pathogen. Chiropractors are not now, nor were they in Palmer’s time, the only health care practitioners to place primary emphasis on strengthening the internal resistive forces of the body. The uniqueness of chiropractic lies in its assertion that the spine provides a key to affecting the nervous system, the controlling and coordinating system of the body. Thus according to Palmer, the mechanical process of spinal adjustment was employed for vitalistic purposes.
Vitalism is an explanatory model that suggests the body requires something greater than physical and chemical processes to function. In its more extreme forms, this something greater is given theologic significance. 9 Chiropractors have generally looked at the physiologic processes of the body as expressive of intelligence, or a wisdom of the body. Some early chiropractors philosophized about the source of that intelligence; however, many chiropractors have been content to acknowledge that the functions of the body are not wholly explicable by mere physical and chemical laws and that the nervous system seems to function largely to express the body’s integrative capability.
Palmer noted that the physical structure of the body is challenged through the activities of daily living and theorized that these challenges, or stressors, take three primary forms, the three Ts—trauma, toxins, and thoughts. Current discussions of the philosophy of chiropractic continue to include these three challenges (often expressed as physical, chemical, and emotional) and their adverse influence on tone or function of the nervous system, as well as in the causation of subluxation and illness.
REINTERPRETING PALMER’S ORIGINAL CONCEPTS
Palmer may have crystallized an idea and defined a philosophic context within which to employ it, but he was unable to constrain others, including his son, from modifying and reinterpreting chiropractic and its clinical application.
Similar to many sons, Bartlett Joshua, or B.J., followed in the footsteps of his father; and similar to many sons, he did not see eye to eye with his father. A nearly legendary level of disagreement, rivalry, and antagonism arose between the two. These disagreements did not end at the family dinner table but reverberated throughout the chiropractic profession.
D.D. envisioned chiropractic as a way to treat the full skeleton and also saw it integrated with matters of thought, trauma, and toxicity. D.D. theorized that the three Ts lead to skeletal manifestations, which continue to compromise the body’s capacity for well being. B.J. focused much more specifically on the mechanics of the spine, with correction of vertebral malposition and attendant neural compromise, together known as subluxation, assuming a primary role in helping sick people get well.
Although many chiropractors, then and now, have maintained that spinal or vertebral subluxations have more profound effects on health than subluxations of the extremities, B.J. Palmer went further. He simply stopped correcting subluxations beyond the spine, as a matter of both practice and philosophy, declaring such nonspinal subluxations to be of little significance to the chiropractor. Eventually, B.J. asserted that the only area of the spine capable of true subluxation was the upper cervical spine, the occipito-atlanto-axial region. For decades, between the early to mid-1930s and mid-1950s, the Palmer School’s technique department taught only upper cervical methods (H.M. Himes, unpublished notes, 1956).
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