DD Palmer References

D.D. Palmer references are a vital source of information about early chiropractic theory. The chiropractic profession developed from his chiropractic paradigm.

The science behind D.D. Palmer’s theories was advanced for his time. This is important because some chiropractors are still unclear about D.D. Palmer’s knowledge of anatomy, physiology, pathology, and surgery.*

This post focuses on D.D. Palmer references rather than the articles, interviews, and public presentations that misrepresent the history of ideas in chiropractic.

DD Palmer’s Medical Library

Twenty-three years ago, a landmark paper was published on D.D. Palmer references. The article was subtitled, “The Founder was Into the Literature.”

The authors document D.D. Palmer references in an amazing way. They were able to demonstrate that the founder of chiropractic was current on the latest textbooks in his field.

D.D. Palmer references were compared to the books that medical schools required during that time. In his 1910 book, D.D. Palmer referenced the latest texts alongside previous editions. He even gave some historical citations going back almost 100 years in the literature. 

D.D. Palmer was a self-taught expert on anatomy, physiology, and pathology. 

No More Excuses

Leaders of the chiropractic profession should demonstrate a mastery of chiropractic’s history of ideas. In the past, there simply wasn’t a great deal of information. Most authors did the best they could with the resources they had. Today we know much more about D.D. Palmer and we have access to virtually all of his writings.

Also, we now have access to most of his references!

Chiropractic educators should demonstrate a solid understanding of chiropractic’s history of ideas. This goes for speakers at conferences, authors, faculty, and administrators. Mastery of chiropractic’s history of ideas should be a professional standard.

Here are two example of how D.D. Palmer used the literature to develop his theory of vertebral subluxation.**

D.D. Palmer on Subluxation as a Partial Displacement of Articular Surfaces

One of the best examples of D.D. Palmer’s integration of the literature comes from his article Chiropractic Rays of Light. It was first published in The Chiropractor, in the June 1905 issue. The article was then republished as a chapter in The Science of Chiropractic (1906) and again as a chapter in The Science, Art, and Philosophy of Chiropractic (1910).

In the article, he provides 27 quotations to support the following statement,

“It is interesting and instructive to notice the various opinions of medical writers, in regard to luxations of the vertebral column, and how near they were onto that which is now known as Chiropractic. Below are given extracts from standard anatomies and orthopedical books.

A Chiropractic luxation is where the articular surfaces of any of the 51 spinal joints have been partially displaced, and not usually accompanied with fracture. The replacing of these sub-luxated vertebrae are readily accomplished by a Chiropractor. When we refer to Chiropractic luxations of the spinal column, we speak of those which have been only partially displaced in the articular processes.”

Most D.D. Palmer references are now digitized and available online. It is very easy for us to check his references.

Here are a few:

Regional Anatomy in its Relations to Medicine and Surgery Vol. 2

George McClellan (1894)

A Text-Book of Anatomy by American Authors

Edited by Frederic Henry Gerrish (1902)

The Science and Art of Surgery

John Eric Erichsen (1884)

D.D. Palmer on Nerve Tension and Nerve Stretching

D.D. Palmer referred to the stretching of nerves in relation to displaced vertebra as early as 1899. By 1910, D.D. cited Landois to support the latest development of his theories. He quotes Landois description of nerve stretching and then says,

“Nerve tension, nerve stretching, acts as an irritant, causes too much functionating, too much action, a waste of energy. Extreme tension causes paralysis. Bones of the body framework give to nerves a proper and normal tension, known as tone. If they are displaced, they will cause either more tension or relaxation. If so, why not replace the displaced bone which is causing tension or relaxation?”***

He also referenced Landois, Gould, and Lippincott to support his theories on the effects of nerve irritation. He proposed that the irritation of the nerve is related to the atomic activity of the nerve. He referred to this as his “thermal-nerve theory.” Life processes were viewed as vibratory. Subluxation causes too much or not enough function due to increased vibration or decreased vibration. This leads to increased or decreased tonicity of the organs or tissues. Thus, chiropractic is based on tone.

Pedestals, Authority, and Paradigms

Chiropractors who criticize the use of D.D. Palmer’s theories in modern practice should be wary of their argument style. A critical approach is essential especially when taking a dismissive stance.  An academic discussion about the history of ideas in chiropractic should include historical facts and evidence using appropriate references. Otherwise it is just rhetoric.

For example, it is too easy to assume various things like; just because the term “subluxation” is being used that it is the same definition that was used a century ago. A simple look at the literature and textbooks on subluxation will demonstrate the fallacy of that position.

Then there is the mistaken assumption that those who invoke D.D. Palmer’s ideas or B.J. Palmer’s are automatically putting them up on pedestals, appealing to authority, or the strangest claim; making chiropractic into a religion. It is true that chiropractors in the past have exalted the Palmers. And some chiropractors may still do that today. And yet, most do not. That is an important distinction that gets glossed over or perhaps is just not commonly understood.

There is a big difference between appealing to authority and learning from the past. The fact of the matter is that D.D. Palmer developed a new paradigm, the chiropractic paradigm. In the Kuhnian definition of the term, a paradigm must include a new radical viewpoint with a practice that enacts it. D.D. Palmer’s paradigm was that irritation of the nervous system due to impinged or stretched nerves (usually of the spine) led to abnormal function of the nerves. This could be a primary or secondary contributor to pathophysiology. The practice of chiropractic is to adjust the spine to release the irritation and normalize intelligent function.

Critics should examine D.D. Palmer references along with his clinical observations and then re-frame the critiques so that they are evidence-based. Are D.D. Palmer’s ideas being correctly described? How EXACTLY has his paradigm been debunked in the literature? Has it? The task for a critic is to determine how his work is being applied in relation to today’s practice, which should include objective assessment not assumptions.

 

*The surgery literature of the time included detailed explanations of the spine and nervous system.

**According to Faulkner’s book, he first used the term a few months after O.G. Smith, in 1902.

***His term “functionating” was in use at the time.

Chiropractic Insider

Have you ever wondered what really divides the chiropractic profession? For decades the story was that it was the straights vs. the mixers. The straights adhered to the adjustment of the vertebral subluxation only and the mixers added other modalities to chiropractic. The wars between these two factions marked a unique epic in 20th century American history as a conflict between several worldviews.

That story evolved and split over the years. For a time it revolved around educational standards and scope of practice issues. Eventually this schism grew into a spectrum between therapeutic vs. non-therapeutic approaches. Across the middle of the spectrum is where most chiropractors practice.

There is no simple dichotomy anymore, although for many the line ultimately gets drawn at the inclusion of drugs and surgery into chiropractic.(1,2, 3)

And yet, as I have pointed out in other blog posts,[4, 5] the split really comes down to perspectives. There are many ways to discuss this fact such as orienting frameworks, levels of complexity of thinking, values, morals, the list goes on.

For this month’s post, I want to emphasize the importance of distinguishing between the inside and the outside perspectives, especially in relation to the organism. I view this as the heart of the conflicting perspectives within the profession and also a place of common-ground.

This distinction, that the organism may be viewed from the inside and the outside is relatively new in philosophy.[6, 7, 8] American philosopher Ken Wilber has recently codified these two perspectives into his 8 Zone methodology.[9] The zones are created by taking an inside and outside perspective on the four primary domains of reality; subjective (“I”), intersubjective (“we”), objective (“it”), and interobjective (“its”). (I explore how this applies to chiropractic practice, research, and principles in the eight-hour online continuing education course and also in a recent article.)[10, 11]

By acknowledging the inside and outside views of “it,” or the objective observation of the organism, Wilber incorporates the latest insights of neurophysiology and anatomy, as well as systems theory and the new biology. For example, anatomy and physiology are the outside view of the body. These can be measured through visual observation and various tests. The inside view of the organism looks to homeostasis, dynamic equilibrium, autopoiesis, and of course, innate intelligence as it relates directly to these processes of life. The processes may be measured in terms of how well the body expresses its organization and how well it adapts.

There is a long history of this line of thinking in chiropractic. B.J. Palmer originally wrote about how health comes from above downward and from inside outward as the essence of the philosophy of chiropractic.[12] At the heart of this approach is an emphasis on the body’s ability to self-heal and self-organize. This view of the body is shared by most chiropractors.

B.J. contrasted this to the outside inward and below upward approach characteristic of Western medicine. Relying on this view includes an emphasis on materialist and mechanistic paradigms.

By acknowledging the importance of inside and outside views of biology, we can more consciously bridge the divides within the profession by embracing a more holistic framework. This is easy because we already share such a framework.

The outside view is simple enough. It relates to any focus on the structures of the organism; brain, spine, muscles, signs and symptoms, pathological processes, and even vertebral subluxation as a clinical and definable entity. The inside view includes the body’s natural ability to self-organize, self-heal, effectively adapt, and create its own parts. Traditional philosophy of chiropractic refers to this as innate intelligence.

This common ground within the chiropractic profession is a starting place for unity of definition. It is apart from scope of practice questions and definitions of primary care, which are at the heart of the current controversies in chiropractic accreditation standards.[3, 13]

Chiropractic is based not only on an outside view of the body but also on an inside view. This insider view is one defining characteristic of the profession. It sets chiropractic apart from other paradigms of health care.

We should always remember however, in order for chiropractic to rightly be defined as its own paradigm, it must have a defining set of practices, not just its own unique viewpoint. One argument in the profession suggests that the defining praxis is the chiropractic adjustment of the vertebral subluxation.[14, 15] To me, this makes the most sense as it is congruent with the characteristic insider view of the body and consistent with the most common practice of chiropractic, the adjustment.

What if we could all agree that the two most defining characteristics of the chiropractic profession were the two most common aspects to chiropractic worldwide; the insider view of biology and the chiropractic adjustment?

Of course state laws and educational standards will often include more than just the adjustment in terms of scope of practice. Chiropractors love to include other professions within their daily practices from nutrition to acupuncture to physical therapy. But the key to unity is to find where we have common ground. The insider view is the best place to start.

 

1.    Painter, F. Is “Expanded Practice” our Pandora’s Box? September, 13, 2011.

2.    Edwards, J. Drugs and Chiropractic: Exposing the red herring and the Trojan horse. Dynamic Chiropractic, 2011. 29(20).

3.    Kent, C. The profession formerly known as chiropractic. Dynamic Chiropractic, 2011. 29(10).

4.    Senzon, S. Chiropractic Honesty, in Chiropraction. August 27, 2012.

5.    Senzon, S. Chiropractic Evolution, in Chiropraction. June 21, 2012.

6.    Maturana, H. and F. Varela. Autopoiesis and cognition: The realization of the living. 1980, Dordrecth: D. Reidel Pub. CO.

7.    Piaget, J. Biology and knowledge: an essay on the relations between organic regulations and cognitive processes. 1971, Chicago: University of Chicago Press.

8.    Thompson, E. Mind in Life: Biology, Phenomenology, and the Sciences of Mind. 2007: Harvard University Press.

9.    Wilber, K. The ways we are in this together: Intersubjectivity and interobjectivity. Ken Wilber Online, 2003.

10.    Senzon, S. Constructing a philosophy of chiropractic: Integral Map. Online Continuing Education. 2011-present.

11.    Senzon, S. Constructing a philosophy of chiropractic I: an Integral map of the territory. J Chiropr Human, 2010. 17(17): p. 6-21.

12.    Palmer, B. The known man or an explanation of the “phenomenon of life”; Volume 19. 1936: Davenport, IA: Palmer College.

13.    Edwards, J. Primary Care: Be careful what you wish for.  Dynamic Chiropractic, 2012. 30(8).

14.    Rutherford, L. The role of chiropractic. 1989, Eugene, OR: Health Education Pub. Corp.

15.    Gelardi, T. The science of identifying professions as applied to chiropractic. J Chiropr Hum, 1996: p. 11-17.

 

 

Chiropractic Honesty

I was recently made aware of a blog post written by Stephen Perle,[1] a well-known voice in the chiropractic profession and a professor at a chiropractic college. Interestingly, the subtitle of Perle’s blog is, “A forum for intellectual honesty.” In my view, intellectual honesty requires that we include as many perspectives as possible, not only one, because it is bound to be limited, narrow in focus, and prone to errors.

It is obvious that Dr. Perle thinks his approach is historically accurate. Unfortunately, such assumptions are at the core of chiropractic’s internal conflicts. When we don’t consider our own perspectives and how they shade our point of view, we are prone to think that we must be correct. Add to that a hand full of references that come from the same perspective and a self-perpetuating false authority gets established. In my first blog post I compared this to the telephone game.[2]

More than anything, I seek to build bridges in the chiropractic profession. Doing so makes it vitally important to point out faulty arguments and bad scholarship so that we may all move forward together. There is hardly anything more important in a profession than good scientific research, accurate historical accounting, and solid philosophical reasoning. When these three methodological approaches are utilized from the widest possible perspectives, we are likely to find large areas of agreement.

Since the post in question was written in 2009, I would have ignored it at this point if not for the fact that it was recently sent to all of the members of a state association. And, it does represent some of the most basic mistakes being made in historical interpretations of the philosophy of chiropractic, so here we go…

Perle begins the article by pointing out the important research of the late Joe Keating. One of Keating’s main contributions to the history and philosophy of chiropractic was establishing how D.D. Palmer’s ideas evolved during his final decade of life.[3]

Palmer’s use of the term vertebral subluxation was only written down after the 1907 Morikubo trial, and after it was widely used in Smith, Langworthy, and Paxson’s textbook.[4]  There is no written evidence of Palmer’s use of the term subluxation before. The term is generally attributed to Langworthy and made important to the profession based on the Morikubo case.

So, I don’t really take issue with the fact, that Perle would equate all of D.D.’s previous theories with his final theory. That is common pluralistic thinking in academia. But to suggest that D.D.’s final writings on chiropractic DID NOT set the tone for decades of the profession’s core focus on vertebral subluxation is bizarre.

In fact, Perle goes so far as to suggest that embracing the vertebral subluxation as chiropractic’s core identity is an “attempt to revise the history of chiropractic.” Does this seem Orwellian to you? Just look at the facts.

The vertebral subluxation as a clinical entity is considered by several researchers and scholars in the profession as its reason for being.[5-7] Furthermore, our understanding of the biological mechanisms of vertebral subluxation is constantly evolving, and not rooted in one model.

Historically, it wasn’t just B.J. Palmer and his school that took up the mantle of vertebral subluxation although the Palmer School certainly carried the torch. Many schools and associations have focused on vertebral subluxation going all the way back to the earliest days. Even the leaders of National College of Chiropractic embraced the scientific research of vertebral subluxation since its earliest days; Howard incorporated it into his encyclopedic system, Forster wrote about it extensively, and Janse developed his own theories about vertebral subluxation.[8-12] Not to mention the fact that vertebral subluxation terminology is codified in state law, federal law, Medicare, as well as chiropractic’s main trade organizations. And, 88% of chiropractors want to retain the term.[13]

I will be the first to agree that the traditional use of the term was embedded in other philosophical concepts that made it difficult to consider it solely in terms of objective physiology, but that is another discussion.

The historical and scientific veracity of vertebral subluxation is hardly the main issue at hand. The issue is really philosophical honesty while understanding the importance of perspectives. I will discuss this issue based on three other historical inaccuracies and omissions from the Perle blog post. All three can be viewed in terms of the philosophical perspectives that the Palmer’s attempted to imbue into the profession and a lack of understanding of the role perspectives play in human thinking.

The next problem comes from Perle’s referencing of Gaucher-Peslherbe’s research.[14, 15] He points out the important fact that D.D. Palmer was indeed better read in anatomy, physiology, and surgery than most medical doctors of his day (Perle doesn’t go that far, but Gaucher-Peslherbe does). Perle then uses this fact along with D.D.’s revisions of his ideas to suggest that chiropractors today should be able to rethink chiropractic.

If that were it, I would say, sure whatever, that seems to be what has been happening anyway if you read the literature on vertebral subluxation research, and keep up with technique development in the profession. The problem is that Perle completely omits Gaucher’s main conclusions about D.D. Palmer’s theories and the important role they played in the history of physiology.

Gaucher-Peslherbe was a medical historian who completed his Ph.D. at Ecole des Hautes Etudes en Sciences Sociales (French for School for Advanced Studies in the Social Sciences). His dissertation was published by National (at the urging of Louis Sportelli) as a book entitled, Chiropractic: Early Concepts in Their Historical Settings. D.D. Palmer’s theories are explored in the context of a history of such theories in the medical literature. Gaucher concluded that Palmer was way ahead of his time and contributed to the physiological literature in a significant way. Gaucher Peslherbe writes,

“D.D. Palmer was undoubtedly a visionary…It was because of this vision that he was able to formulate a scientific definition of the concept of subluxation that was in many ways far superior to anything that medicine and chiropractic were able to produce subsequently.” [15](p.166)

He even went so far as to compare Palmer’s wider philosophical approach in terms of subluxation and “what causes disharmony in man,” to philosophers from the last century such as Bergson, Freud, Merleau Ponty, and Heidegger.

A few other glaring mistakes in the Perle “history” should be pointed out:

Perle offers up a picture of the Rehabilitation Laboratory that was part of the B.J. Palmer Research Clinic in the 1940s. Perle points out that B.J. Palmer’s signature (what we might call a logo today) was on the rugs, thus Perle writes, “What this shows is that even BJ Palmer wasn’t so pure and straight as he “mixed” using rehab.” The logic itself is appalling but to so misrepresent B.J. Palmer’s approach and philosophy is a mistake. Perhaps the mistake is because the Lab was called Rehabilitation Lab? I’m not sure but it certainly shows a lack of knowledge.*

The intent of the Rehab Lab was congruent with Palmer’s Innate philosophy. The premise of the lab was  that the internal self-organizing functions of the organism should be allowed to assimilate the energetic changes set in motion by the adjustment through self-guided movements. Thus the whole concept of rehabilitation was turned on its head. I would add, this was because it originated from a perspective that focused on the inherent autopoietic aspects of the organism. It was an inside-out approach to assist the organism to more fully integrate and express the innate intelligence.

The photo itself is from a magazine from 1945 about the Palmer research clinic. In the magazine it clearly states, “At no time, in no way, do we use any therapeutic apparatus on any case.” The Rehab Lab was really for research purposes and also for a place for patients to “digest” the energy now freely moving to paralyzed parts after the adjustment. Patients were not directed to use the equipment and there were no electrical devices besides a riding horse, “which was seldom used.”

Yet another mistake in the blog post is the erroneous claim that the term “innate intelligence” was coined in the book Modernized Chiropractic and used by Palmer after the Morikubo case like subluxation. Not true. Palmer’s first documented use of Innate comes from an article in 1906.[16, 17] In addition, Modernized Chiropractic does not even mention Innate Intelligence!

Finally, Perle refers to the philosophy of chiropractic as a pseudo-religion. I have dealt with this elsewhere and this blog post is way too long.[18]**

As I see it, the core issue (besides mistakes) is a misunderstanding of the role of perspectives in chiropractic. This is a common problem in chiropractic and in most professions.

As adults develop, the research shows that they can increase in the complexity of their thinking and be able to take on more and more perspectives. The level of thinking that most adults are assured to reach is the objective, rational, third-person point of view. Research shows, somewhere around 40% of our culture are at this level.[19, 20] It used to be thought that this was the height of human development, the rational scientific thinker. This is the person who can comfortably deal in 3rd person perspectives. That is, he or she can take the role of another and even view themselves as an “it” or an “object.” Children have not developed this ability yet, and teens are new to this perspective.

Here is the problem, not only may people develop to even more complex ways of viewing the world, such as 4th person perspectives, 5th person perspectives, etc…, but those of us who spend our days relying on 3rd person perspectives might miss that! We don’t even know those other perspectives exist. And, we may generally confuse all other perspectives as less objective than ours, because anything that is not 3rd person perspective tends to look the same to us; probably 2nd person, or at least dogmatic or fundamentalist.

This becomes a real problem in a profession like chiropractic because evidence shows that D.D. Palmer was one of the first post-conventional thinkers of our era and may have attempted to establish the first 4th person perspectival profession.[21] And get this, his son may have even developed to 5th person perspectives or higher in his later years.[22]

Let’s just all take a step back and acknowledge that we might not have the entire truth even though it sure feels like we do. In fact, we might each have partial truths that could in some way blend together and make for a much stronger profession.

Instead of dismissing “everyone” you disagree with as dogmatists, which has become a very tired and philosophically shallow approach in the profession,[23, 24] let’s see if we can determine what else might be going on that other scientific researchers, perhaps in the social sciences, might shed light upon that we are just missing. Honesty comes from facing things you did not even know were there and accepting them.

References

1. Perle, S. 2009. Foundation for Anachronistic Chiropractic Pseudo-Religion, in Perles of Wisdom: A forum for intellectual honesty.

2. Senzon, S. 2012. Chiropractic games & distortions of truth, in Chiropraction.

3. Keating, J. 1992. The evolution of Palmer’s metaphors and hypotheses. Philosophical Constructs for the Chiropractic Profession, 2(1): p. 9-19.

4. Smith, Oakley G., Solon. M. Langworthy, and Minora C. Paxson. 1906. Modernized chiropractic. Cedar Rapids, Iowa: S.M. Langworthy.

5. Haavik-Taylor, H., K. Holt, and B. Murphy. 2010. Exploring the Neuromodulatory effects of vertebral subluxation. Chiropr J Aust. 40: p. 37-44.

6. Gatterman, M. 2005. Foundations of Chiropractic Subluxation: 2nd Ed. St. Louis: Mosby. [Description @ googlebooks]

7. Boone, W. and G. Dobson. 1997. A proposed vertebral subluxation model reflecting traditional concepts and recent advances in health and science: Part I. 1(1). [Abstract]

8. Beideman, R. 1996. The role of the encyclopedic Howard System in the professionalization of Chiropractic National College, 1906-1981. Chiropr Hist. 16(2): p. 29-41.

9. Phillips, R. 2006. Joseph Janse: The apostle of chiropractic education. Los Angeles: R. Phillips.

10. Janse, J. 1975. History of the development of chiropractic concepts: Chiropractic terminology, in The research status of spinal manipulative therapy: A workshop held at the National Institutes of Health, February 2-4, 1975. M. Goldstein, Editor. U.S. Department of Health, Education, and Welfare: Bethesda. p. 25-42.

11. Forster, A. The White Mark: An editorial history of chiropractic. 1921. Chicago: National Publishing Association.

12. Forster, A. 1923. Principles and practice of chiropractic. Chicago: The National Publishing Association.

13. McDonald, W., K. Durkin, and M. Pfefer, How chiropractors think and practice: The survey of North American Chiropractors. Seminars in Integrative Medicine, 2004. 2(3): p. 92-98. [ABSTRACT]

14. Gaucher-Peslherbe, P. G. Wiese, and J. Donahue. 1995. Daniel David Palmer’s Medical Library: The Founder was “Into the Literature.”. Chiropr Hist. 15(2): p. 63-69.

15. Gaucher, P. 1993. Chiropractic: Early concepts in their historical setting. Chicago: National College of Chiropractic.

16. Zarbuck, M. 1988. Innate Intelligence (Part 1). Illinois Prairie State Chiropractors Association Journal of Chiropractic, 1987. 8(4): p. 12-13.

17. Zarbuck, M. 1988. Innate Intelligence (Part 2). Illinois Prairie State Chiropractors Association Journal of Chiropractic, 1988. 9(1): p. 11,16.

18. Senzon, S. 2011. Constructing a philosophy of chiropractic: When worldviews evolve and Premodern roots. J Chiropr Humanit, 18(1);10-23.

19. Cook-Greuter S. 2007. Ego development: Nine levels of increasing embrace. Wayland, MA: Cook-Greuter & Associates.

20. Kegan, R. and L. Lahey, The immunity to change: How to overcome it and unlock the potential in yourself and your organization2009, Cambridge (MA): Harvard University Press. [Preview @ Google Books]

21.  Senzon, S., Constructing a philosophy of chiropractic: When worldviews evolve and postmodern core. J Chiropr Humanit, 18(1);39-63.

22. Senzon, S., B.J. Palmer: An integral biography. Journal of Integral Theory and Practice, 2010. 5(3): p. 118-136.

23. Keating, J., et al. 2005. Subluxation: dogma or science. Chiropractic & Osteopathy, 13(17).

24. Simpson, J. 2011. The five eras of chiropractic & the future of chiropractic as seen through the eyes of a participant observer. Chiropractic & Manual Therapies. 20(1).

*Please click here to explore photos and quotes about the BJPCC Rehabilitation Lab.

**These themes are explored in greater detail in my online courses.

 

 

Future of Chiropractic Curriculum

Have you ever wondered where the chiropractic curriculum developed from? It is quite an amazing story of intrigue, bootstrapping, and warfare. I won’t fill you with too many of the details today (as I am working on a two-hour online course on the history of the CCE…),1 but I would like to share a bit of my vision of what is possible with you.

The first real attempt at an integrated curriculum was pioneered at Palmer College of Chiropractic in the 1920s. The chiropractic greenbooks integrated the philosophy of innate intelligence and the central importance of the vertebral subluxation in human health and dis-ease throughout every course from chemistry to symptomatology, physiology to anatomy. I recently summarized the quotes about innate intelligence from many of these texts written by B.J .Palmer’s staff. The quotes show extraordinary evidence that the philosophy of chiropractic was on its way to becoming the first systems science of human health, rooted in a deep philosophy that explained human physiology as part of an intricate pattern of intelligence expressing through matter itself. 2

Alas, this approach was short lived due to historical circumstance, economics, philosophical and political disputes, and eventually political agendas, which would soon take over the accreditation process in all American chiropractic colleges. B.J. Palmer was voted out of his leadership role of the Universal Chiropractors’ Association (UCA) in 1926. He then started the Chiropractic Health Bureau, which became the International Chiropractors Association (ICA). According to one of chiropractic’s most revered historians, the break within the “straight” chiropractic movement in the 1920s, “had an impact that was significant enough to change the whole course of the chiropractic education and politics for the rest of the century.”3 The remainder of Palmer’s UCA joined with the newly formed ACA (1922), to become the NCA in 1935, which became the modern-day ACA in 1963. The direction of chiropractic education took a decidedly “medical” turn because of these events.

Chiropractic suffered the fate of most of the pioneering approaches to biology in the first half of the twentieth century. Chiropractic’s systems orientation was often overshadowed by a more molecular/medical approach. The brilliant ideas of emergence, holism, organismic biology, and systems theory, which all emerged around the same time as the Palmer greenbooks, were to take a backseat to the developments in molecular biology inspired by Watson and Crick’s discovery of DNA in 1952. The mechanistic approach to biological systems would gain dominance for the rest of the century.4

Chiropractic curriculum reform was undertaken by John Nugent starting in the 1930s, a Palmer graduate from the 1920s. As the NCA Director of Education, Nugent took on the task of reforming the chiropractic schools by modeling Flexner’s approach to reorganizing America’s medical schools. Not only did Nugent encourage many schools to close and merge, go from profit to nonprofit, from no pre-reqs to pre-reqs, from 18 month programs to 36 month programs, but he also led the charge on a standardized curriculum (based on the molecular/medical school curricula) and wrote the first manuals of accreditation.  In 1943, the first handbook of the NCA’s accrediting agency, Nugent wrote, “The chiropractor is a physician -a particular kind of physician, and as such is engaged in the treatment and prevention of disease…” Chiropractors from the philosophical side of the profession were outraged at being referred to as physicians. The new standardized curriculum was modeled after the medical schools. The only significant change was that drug and surgery courses were replaced by chiropractic courses. Nugent was hated by both sides of the profession. In fact, B.J. Palmer referred to Nugent as the anti-Christ. Nugent was also viewed as one of the great reformers of chiropractic education. The CCE of today can be attributed to Nugent’s efforts. 5

Calls for curriculum reform are louder than ever in chiropractic (especially with the recent controversy over the CCE’s lack of accountability to the profession, which resulted in CCE’s being required to comply with 43 violations within a year). Calls for curriculum reform span the profession, from the extreme medical fringe of the profession suggesting we fire all philosophy faculty,6 to a more balanced look at innovative approaches to pedagogy and contemporary content,7 to more visionary approaches.8,9,10  It is time we totally revamp our medical chiropractic education.

What if we start fresh and envision a chiropractic curriculum for the twenty-first century, one that keeps the important elements of the old system of education and develops something totally new? What could that look like?

Well, for starters, all students should have a clear and honest exploration of the history and philosophy of this amazing profession. These courses should be standardized and free from politics and disrespect. All future chiropractors should understand the story that is theirs, the good, the bad, the ugly, as well as the leading edge and at least some of what was left behind.

We should also study chiropractic within the context of the paradigms that it helped to bring forth such as systems theory, holism, complexity theory, autopoiesis, non-linear thermodynamics…all of the important biological models of the 20th century. Students should not just study the linear molecular level of biology but also the 40,000 foot view. How do the systems fit together? What are the latest ideas in theoretical biology? Are those ideas consistent with the philosophy of the body as an intelligent and self-organizing system? If so, why aren’t they being taught? (As an offshoot to these additions, we should include the latest research and theory on subtle energy systems and energy medicine!)11

Of course, central to such a curriculum would be the latest science of vertebral subluxation, the leading models of spinal and neural integrity, chiropractic adjusting, instrumentation, alongside the best techniques of the past, ones that have been honed and refined for decades and mastered by the great artists of this profession.

Most importantly we need an integral model that can tie things together; chiropractic philosophy and science, practice and theory, while also developing systems where people feel nurtured and can grow within a community. The chiropractic campus could become a place where humans develop themselves while studying this great profession and feeling included in a worldwide community. Any future curriculum should model the latest ideas of Integral Education.12

Imagine if students could have all of their courses integrated each quarter, with practical hours that were relevant? Imagine if chiropractic school prepared future chiropractors with the practical and business skills needed for their future? Imagine if social networking were integrated into the curriculum not only for each class or each school, but between all chiropractic students worldwide? (I am sure there are many practicing chiropractors that would love to act as mentors through such a system.) Imagine if chiropractic education was a model for doctoral level training that centered on assisting human beings to be their best, serve at the highest, and live a flourishing life?

There is so much more to be added and subtracted to an ideal curriculum. The future of chiropractic education is bright. We are the profession. We get to set the standard if we can share a vision and move forward together.

*(previously published in LifeWest student newspaper – March 2012)

  1. Online Chiropractic Philosophy and History CE Course
  2. Third Wave of Chiropractic Philosophy
  3. Senzon S. 2003. What is Life? JVSR.
  4. Gibbons, R. 1980. The Rise of the Chiropractic Educational Establishment. In: Who’s who in Chiropractic. P. 346
  5. Gibbons R. 1985. Chiropractic’s Abraham Flexner: the lonely journey of John J. Nugent, 1935-1963. Chiropractic History 5:44-51. *Reprinted by permission of the Association for the History of Chiropractic
  6. Murphy, D, Schneider M, Seaman D, Perle S, Nelson C. How can Chiropractic become a respected mainstream profession? Chiropractic and Osteopathy 2008, 16.10.
  7. Johnson C., Green B. 2010. 100 Years after the Flexner Report: Reflections on its influence on chiropractic education. J Chiro Ed. 24(2).
  8. Kent, C. 2010. A new direction for CCE? Dynamic Chiropractic 28(24).
  9. http://mcqi.org/vitalistic-curriculum/introduction
  10. Senzon, S. 2007. What I Wish I Learned in Chiropractic College. Today’s Chiropractic Lifestyles.
  11. Senzon, S. 2008. Chiropractic and Energy Medicine: A Shared History. J Chiro Hum 15.
  12. http://nextstepintegral.org/resources/integral-education-resources
© 2018 The Institute Chiropractic - Senzon Learning, Inc.