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A Programmed
Instruction Course
About
CHIROPRACTIC
PREPARED BY
WILLIAM T. JARVI S DEPARTMENT OF HEALTH EDUCATION
UNIVERSITY OF OREGON 1973
50
© 1973 t-Jilliam T. Jarvis All Rights Reserved
, 1 1 1 i 1 ~
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PREFACE
This is a self-instructional course about the healing art of chiropractic. It covers the aspects of chiropractic that are of concern to the scientific community, including its "discovery", its theory of the cause of disease, its basic mode of treatment, chiropractic education and training, its status legally and scientifically, its possible future, and how health education possibly ought to relate to it.
You have been provided with a packet of the significant materials about chiropractic; some of them have been prepared by chiropractors and those favorable to chiropractic; others represent the case against chiropractic.
It is the purpose of this programmed instructional course to guide you through these materials emphasizing the important basic issues in the chiropractic controversy.
This programmed instructional course should enable you to becom_e well-infonned and well-read on this subject in a relatively short period of time.
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TABLE 0 F CONTENTS
Reference Abbreviations Used in Reference Frames
Symbols Used in Answering
Instructions to the Student
Part ! .... History of Chiropractic
Part !! .•. Chiropractic Theory
Part 111 •• Chiropractic Practice
Part IV ••• Chiropractic Education
Part V •••• Recognition of Chiropractic
Part vr ... Chiropractic Research
Part VII •• Chiropractic and the Federal Government
Part VIII.Chiropractic and the Hospital
Part IX ••• Chiropractic's Future
Part X •••• Chiropractic in the Health Education Class
Appendix A ••• Selected References
Appendix B ••• Bibliography
i
ii
iii
1
5
17
28
34
42
45
57
60
67
70
78
REFERENCE ABBREVIATIONS USED IN REFERENCE FRAMES**
7 1 1 7 l 1 l
Abbreviated references and symbols will be used in the reference frames because of the space limitations. Following are the abbreviated forms and what they represent:**
Answers Pamphlet
Appendix A, Item 0
Biedermann, p.O
Dintenfass, p.O
Health for Life
HEW Report
Ibid.
ICA Reprint
Quebec Brief
Smith, AYOR, p.O
The 3\"x8\" yellow-red pamphlet, "Answers to Your Questions About Chiropractic."
The section in the back of this booklet starting on page 68; items are numbered.
Booklet by Freimut Biedermann, M.D., Fundamentals of Chiropractic from the Standpoint of a Medical Doctor. Translated from German by L.C.J. Iekeler, D.C.
Chiro 6ractic: A Modern Waa to Health, a paper ack book widely use in this course. 7 Vol.4, No.2, of this publication is pro-vided. References may be to pages or to l'· designated articles.
Booklet entitled, "Independent Practioners Under Medicare". A Report to Congress by 7·•. the Department of Health, Education and Welfare, Wilbur J. Cohen, Secretary, 1968.
Refer to the same reference source cited in the previous frame.
1 International Review of Chiropractic reprint 7· entitled, "Questions and Answers Regarding Chiropractic. 0 April, 1971 issue.
Report of the College of Physicians and Surgeons of the Province of Quebec submitted in 1963 to the Royal Commission on Chiropractic. A reprint entitled, "The Scientific Brief Against Chiropractic."
l l
At Your Own Risk: The Case Against Chiropr- 7 actic, a paperback book by Ralph Lee Smith widely used in this course. NOTE: other articles by Smith from Today's 1·
Health are also cited. Be sure you are following the correct reference.
**Other references given are not abbreviated. l l , - i -
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REFERENCE ABBREVIATIONS, CONTINUED.
Si-Nel Pamphlet(s) Several pamphlets obtained from the Life Foundation, a chiropractic promotional organization representing "straight" ideology, are provided. They may be referred to collectively or singly.
"White Paper", p.O A publication entitled, Chiropractic's "White Paper" on Health, Education and Welfare Secretary's Report "Independent Practioners Under Medicare". A joint presentation of the American Chiropractic Association, Inc., the International Chiropractic Association, and the Council of State Chiropractic Examining Boards, May, 1969.
Weiant, M&C, p.O A booklet entitled, Medicine and Chiropractic (Thumbnail Edition), by C.W. Weiant and S. Goldschmidt.
Weiant, WMRTAC, p.O What Medicine Really Thinks About Chiropractic, a more recent book by the same.
SYMBOLS USED IN ANSWERING:
ANSWERS
f _.1_ p. 2
1 4 C:
a)
c) F
2
NR 5
0 3 p
i n
T i 0 n
The correct answers to the questions are found by turning back the next page as you progress through the booklet.
Frames 1 and 4 are identified here.
In frame 1 both choices a) and _£1 are correct.
In frame 4 the correct response is false.
In frame 2 you are not means "no response".
required to respond, NR
In frame 5 there is no correct response, but your opinion is called for.
In frame 3 the correct response is true.
- ii -
INSTRUCTIONS TO TH~ STUDENT
In a progranuned instruction course, the information is broken down into small units called "frames", each of which requires you to make an active response to the material presented. After you have responded, you may compare the answer you wrote with the correct response.
In order to maximize your learning, you should go to the reference given in the reference frame and look up the information under discussion. This will enable you to become familiar with the contents of these very significant articles and publications about chiropractic which represent the select literature on the subject. An appendix which begins on page 68 contains exerpts from other materials not contained in the materials packets that will document many of the responses. Here is a sample frame:
1
A frame is made up of:
a question or statement only. a single question or statement and a single correct response. a single question or statement
REFERENCES to be used in answering are printed in this frame.
and ONE OR MORE correct responses.
Turn page back for answer to this sample question.
In taking a programmed instruction course, it is essential that you do what each frame asks. If the frame asks for your OPINION on something, you should thoughtfully respond and write in the space provided.
You should look at the correct response only after you have made your response. It should not be necessary to refer back to previous frames unless specifically directed to do so.
- iii -
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PART I. HISTORY OF CHIROPRACTIC
1
DISCOVERY OF CHIROPRACTIC
Accounts of the discovery of chiropractic do not differ in detail by its proponents or its critics. The acceptance of its legitimacy is questioned by its critics.
The following sequence of frames deals with the account of the discovery of chiropractic as viewed by those who believe in chiropractic and by those who do not.
2
Who was the "discoverer" of chiropractic?
a) Anton Mesmer b)- William Simms c)- Daniel D. Palmer d)= Willard Carver
3
How was the alleged discovery made?
a)_
b)_
c)_
a man who had been deaf for seventeen years was immediately cured by the movement of a displaced vertebra. a miracle similar to those described in the Bible occurred and it was learned how to repeat it. a chemical solution was accidently poured into a container of acid which caused an immediately recognizable positive reaction on a heretofore incurable disease.
HEW Report, p.21-2
Dintenfass, p.34-6
Smith,~' p.1-3
HEW Report, p.21
Dintenfass, p.36-7
Smith, AYOR, p.3-4
- 1 -Turn page back for answers to pages iii and 1.
P.iii P.l
1
NR
sample 2
1
c)
c)
3
a)
4
On what grounds has the discovery of chiropractic been questioned?
5
a)_ the poor laboratory conditions b)_ location of the auditory nerve c)_ the unlikelihood of miracles
What evidence is offered to support the validity of the discovery?
6
a)_
b)_
c)_
the reported replication of the event in Denmark. an anatomical explanation of how it possibly could have occurred. none at all
JOINT MANIPULATION IN ANCIENT CULTURES
Dintenfass, p.37
Smith, AYOR, p.3
Dintenfass, p.37-8
Those who believe in chiropractic point to the use of manipulation, "bone-setting", etc., by ancient cultures as evidence of its established practical value.
Opponents would point out the limitations of the science of ancient cultures and the great amount of error in their systems.
The next sequence of frames deals with these aspects of chiropractic history.
7
Place a mark (x) by the ancient cultures that have been reported to have used manipulation as part of their healing art.
a) China b)- Babylon c)= Egypt
d) Greece e)- Hebrew f)= Hindu
g)_ Aztec h) Caldean i)= Persian
- 2 -
Dintenfass, p.29
7 7 7 l l l 1 7 1 7 7 7 7 l 1 7 7 7 l
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8
Chiropractic historians trace spinal bone displacement as a causal factor in disease back to Hippocrates, "Father of Healing".
true false
9
What did the Hippocratic school regard as the nature of disease?
10
a) nerve impairment b)- imbalance of the four humors c)= demonic possession
Were all of the theories of Hippocrates regarding the nature of disease and the proper methods of treatment accurate in the light of modern science?
yes no
11
THE DEVELOPMENT OF CHIROPRACTIC
Ibid. p.29-30
Appendix A, Item 1
Ibid., Item 2
Certain persons played key roles in the development of chiropractic from one man's idea in 1895 to what it has become today.
The next sequence of frames identifies some of the significant personalities and events in chiropractic's development.
12
The term "chiropractic" means:
a) setter of bones b)- done by hand c)= cheerful hearts heal
- 3 -
Dintenfass, p.39
Smith, AYOR, p.4
Turn page back for answers to pages 2 and 3.
ANSWERS
E_4 P.3
4 8
b) T
9 5
a) b)
b)
10
6
NR no
7
a) b) c) d) f) g)
11
NR
12
b)
13
What three men are called the "trinity of giant~• in chiropractic history?
14
a) D.D. Palmer b)- Harvey Smith c)= Willard Carver
d) Anton Mermer e)- B.J. Palmer £)= H. Lillard
Who was B.J. Palmer?
15
a) the son of D.D. Palmer b)- the "Developer of Chiropractic". c)= the first licensed chiropractor.
B.J. Palmer was •••
16
a) well educated in science b)- largely self-educated c)= a very capable man
YOUR OPINION PLEASE:
Dintenfass, p.140
Ibid. p.137
Dintenfass, p.137-9
Smith,~, p.3-13
What are your impressions of B.J. Palmer after having read the accounts given of him by Dintenfass and Smith?
17
What is Willard Carver known for?
a)_
b)_
c)_
adding other modes of treatment to chiropractic. founding the "mixer'' approach in chiropractic. establishing an emphasis on good posture in chiropractic.
- 4 -
Dintenfass, p.83
Appendix A, Item 3
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18
In what field was Willard Carver's professional training and background?
19
a) law b)- medicine c)= science
What was the name of the first chiropractic college?
20
a)_ National Chiropractic College b) Palmer school of Chiropractic c)= Carver College
The first state to pass a law regulating the practice of chiropractic by licensure was:
a) Iowa b)- Minnesota c)- Kansas d)- Oregon -
PART II. CHIROPRACTIC THEORY
21
THE SUBLUXATION
Smith, AYOR, p.59
Dintenfass, p.139
Smith, AYOR, p.8 -Dintenfass, p.138
Dintenfass, p.142
The concept of vertebral subluxation is central and unique to chiropractic theory. While the subluxation concept is universal within chiropractic, the degree of importance placed upon it varies to some extent.
The next sequence of frames describes the subluxation and its rol~ in chiropractic theory.
- 5 -Turn page back for answers to pages 4 and S.
13 18
a) a) e)
c)
14 19
a) b)
15
b) c)
16
0 p i n i 0
b)
20
c)
n 21
17
a)
b)
c)
NR
22
Does the term "subluxation 11 have exactly the same meaning in medicine as it does in chiropractic?
_ yes no
23
What is meant be the term "subluxation" in chiropractic?
24
a) b)=
c)_
d)_
"under and unseen" partial displacement of avertebra a fixation of the joint within its normal range of movement, usually at the extremity of this range. a neurothliptic dyskinetic spondylosis.
According to chiropractic theory, how does a subluxation cause disease?
25
a)_ by interference with nerve function
b)_ by interference with the circulatory system
c)_ as a bacterial medium
What percentage of disease is caused by spinal subluxations according to Palmer's original theory?
a) 50% b)- 75% c)- 95% d)= all (100%)
- 6 -
Quebec Brief, p.3
Biedermann, p.27-8
Smith,~' p.4
Dintenfass, p.63-4
HEW Report, p.23
Answers pamphlet, p.3
Weiant, M&C, p.5
Dintenfass, p.64-5
Smith, AYOR, p.4
Health for Life, p.4
ICA Reprint, p.10
Smith, AYOR, p.4
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26
Do all chiropractors today state that subluxati~ns are the exclusive cause of disease.?
_ yes no
27
Do chiropractors reco~nize germs as a causal factor in infectious diseases?
_ yes no
28
If forced to choose, ~hich factor does chiropr~ctic cons1~er to be of grerter importance in the causation of infectious diseases?
a) germs b)= suhluxations
29
Does chiropractic generally favor the practice of imrnuni.zation?
_ yes no
30
What does chironractic offer in place of immunization to protect against infectious diseases?
ab))_ a normally functioning spine. nutritional sun .. rlementation
c)= water treatments
"White Paper", p.11
Dintenfass, p.65-6
Smith, AYOR, p.21
Smith, AYOR- p.80
HEW Report, p.33
Answers Pamphlet, p.12
HEW Report, p.25;33
Smith, AYOR- p.80
Smith, AYOR, p.82-3
Health for Life, p.4 "· .Miss WashinP-ton .. '
Health for Life, I bid.
- 7 -turn page back for answers ~o pages 6 and 7
P .6 P. 7 --22 26
no no
23 27
b) yes
c) 28
d)
24 b)
29 a)
no
25 30
a)
c)
31
What is the major purpose of chiropractic care?
32
a)_
b)_
c)_
to free the nervous system of interference with its normal function, thus removing a basic cause of disease. diagnosing specific diseases in specific organs. to aid the "Innate Intelligence" in its sending out and receiving messages in a correct manner.
What is meant by the term "Innate Intelligence" in chiropractic?
a)_ the force that commands the
b) body's vital functions. the soul, spirit or spark of life.
c)= an individual's IQ
33
THE SCOPE OF CHIROPRACTIC THEORY
Dintenfass, p.40;55
Answers Pamphlet, p.3
Dintenfass, p.40
HEW Report, p.23
It would be incoorect to state that all chiropractors individually believe chiropractic treatment to be the preferred one in as wide a scope as will be indicated in the next sequence of frames. However, the evidence is clear that chiropractors collectively treat a very wide range of diseases.
34
What diseases does chiropractic theory claim can occur as the result of interference with nerve flow?
a) arteriosclerosis b)= appendicitis c) coronary occlusion d)- tonsillitis e)- thyroid conditions f)- mental disorders g)- kidney disease h)- migraine headache i)- chronic back pain j)- hypertension
k) arthritis 1)- asthma m)- gonorrhea n)- acne o)- diabetes p)- allergies q)- mumps r)- epilepsy s)- sciatica t)= cancer
- 8 -
Dintenfass, p.97; 104-10;115
HEW Report, p.25-8; 35
Health for Life, p.4
Smith, AYOR, p.4
Si-Nel Pamphlets
Answers Pamphlet, -p.7;12
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35
Are these claims accepted by the medical profession?
_ yes no
36
What evidence is offered by chiropractors that they are successfully treating such a wide variety of diseases?
37
c)_
none at all results of a survey of chiropractors made by the American Chiropractic Association. chiropractic reports of clinical cases.
d)_ personal testimonials of patients.
Do chiropractors believe ·in the use of personal testimonials to promote chiropractic?
_ yes no
38
On what grounds is the validity of a personal testimonial challenged?
a)_
b)_
c)_
d)_
e)_
f)_
the competency of a p2tient to accurately judge the value of any therapeutic tr~atment. the susceptibility of people to sug~estion and persuasion. the phenomenon of spontaneous remission in many diseases. the factor that most diseases are self-limiting due to the healing power of the body. it is not possible to tell whether or not the claims are authentic. the question of the accuracy··of· the original diagnosis.
Dintenfass, Chap 17
Quebec Brief, p.10
HEW Report, p.25-6
Dintenfass, p.90-8
Health for Life, p.1-7
Smith,~ p.123-5
Health for Life, Ibid.
Smith,~ p.124-8
- 9 - ~ turn page back for answers to pages 8 and 9
..... ..., ........ ...
31
a)
c)
32
a)
b)
33
NR
34
35
no
36
b)
c)
d)
37
yes
38
a)
b)
c)
a) k) d) b) 1) c) m) d) n) e) e) o) f) p) f) g) q) h) r) i) s) j) t)
39
YOUR OPINION PLEASE:
How much credence should be placed on a personal testimonial by a patient who testifies of a cure of a disease that is generally thought of as not curable by either a chiropractor or a medical doctor?
40
a)_ believe the medical doctor's patient, but not the chiropractor's
b) believe the chiropractor's patient but not the M.D.'s. c)= be suspicious of either.
CHALLENGES TO CHIROPRACTIC THEORY
It has already been pointed out that the medical profession, which represents the scientific community at large, does not accept chiropractic's theory that there is a cause-effect relationship between interference with nerve flow and the diseases chiropractors claim can result.
The next sequence of frames will deal specifically with criticisms of chiropractic theory. References will be made to the "Scientific Brief Against Chiropractic" prepared for the Province of Quebec in 1963 and reported in The New Physician in September, 1966. This reference is chosen because it represents the most complete scientific criticism of chiropractic available in a single article.
41
What reasons does the Quebec Brief give for not accepting chiropractic theory?
a)_
b)_
c)_
d)_
the lack of verification by research outside of the field of chiropractic. the lack of research within the chiropractic field. the failure of chiropractic to define qualitatively or quantitatively what is meant by the perturbation of a nerve impulse. the lack of experimental proof of a causative relationship between disturbances of nervous flow and the development of illnesses.
- 10 -
Quebec Brief, p.2
Smith, AYOR, p.147-8
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42 '· . ·(. . .
What evidence does the brief offer to refute chiropractic's claim that the nervous system is of primary importance in combating disease? Ibid. p.8-9
43
a)_ people with paralysis are not afflicted with illnesses as a result of their impaired nerve flow.
b)_ Orthopedists observe no improvement of disease conditions as the result of the removal of vertebral obstructions.
c)_ an explanation of the disease conditions known to respond well to spinal manipulation.
d)_ the function of intracellular mechanisms on the molecular level which operate independent of the nervous system.
What does the brief state happens to a nervous impulse when it encounters a zone of partial blockage?
44
a)_
b)_
c)_
it is transmitted more slowly as it passes through the zone. it resumes all its characteristics as soon as it reaches normal nerve tissue. it becomes impaired and remains so for the remainder of its course.
According to the brief, what changes can be measured in a nerve impulse by modern technology?
a) number b)- amplitude c)= frequency
d) wave pattern e)- degree f)= speed of pro
pagation
Ibid. p.7
Ibid. p.2
Turn page back for answers to pages 10 and 11.
- 11 -
ANSWt;RS
P.10 L.ll,------------------1----------39 42
0 p i n i 0 n
40
NR
41
a)
b)
c)
d)
43
a)
b)
a) 44
b)
c) a) b) c)
d) d) f)
45
Has chiropractic identified any of these characteristics of a nervous impulse as relating to a specific disease?
_ yes no
46
Does chiropractic admit that its theory is not totally verified by the scientific method?
yes no
47
Does chiropractic claim that its theory has been established to a degree by scientific principles?
_ yes no
48
What evidence does chiropractic offer as scientific validation of its principles?
Ibid. p.2
"White Paper", p.8-9
Weiant, M&C, p.11;12
Weiant, ~, p.12
Dintenfass, p.51-2
a) the relationship between structure Dintenfass, p.42-55 - and function in any organism.
b)_ the accepted concept of homeosta-. sis and its possible connection
with chiropractic theory. c)_ the operation of the feedback
mechanisms and their possible connection with chiropractic theory.
d)_ the importance of the central nervous system to normal body control.
e)_ the function of the autonomic nervous system and its possible connection with chiropractic theory.
- 12 -
7 7 l 7 l 7
J
7 l l 7 l 7 l l 7 l l l l
49
What eviden c e of verif i cation by persons ou t side of chiropract i c is offered as support?
50
a) _
b)_
c) _
Dr. Ussher, M.D. and his paper "The Viscerospina l Syndrome. " the work of a gr oup of German physicia ns called Die arztliche Fo r schu ngsund Arbeitsgemeinschaft fur Chiropractik.* stateme n ts by several M.D.'s ackn owl edgi ng the value of chiroprac tic treat ment.
Accordin g to the Quebe c brief, who must chiropractic convince of the val idity of its theory to make all of its troubles vanish?
51
a) b) c) -
d)=
the general public the Americ Dn Medical Association the Scientific world the wor ld of scholars
THE DIFFU·d:. NCES v.ITHL . C..dlROFl-1.Al TIC
Di nte nf ass , p.80 -1; 160 - 7 .
lr.ieiant, M&C p. 10
Bi edermann' s book
Weiant , WMRTAC, p. 10 - 13 1,NOTE : See a l so
Append i x A, It em 22
ruebec Brief, p .2
Smith, AYOR. p.148
Important ideological differences exist within the chiropractic profess ion . The next se quence of frames dea 1 E, with those dif f -erences.
52
A sing l e the ory of chiropractic is uniform l y held through out the prof ess ion today.
true false
Smith , AYOR. p.28 - 9
- 13 -Turn pa ge back for answers to pages 12 and 13 .
M ~ WJ!..l\.)
P'~12 p.13
45 49
no a)
b)
46
c)
yes
50
47
yes c) d)
48
51
a) NR
b)
c)
52
d)
e) F
! f I
I f
I l I
I
! I I
l I I
53
What does the term "straight" mean in chiropractic?
54
a)_
b)_
the belief that the spine should have no curvatures. the devotion of attention largely or exclusively to the spine as the cause of disease.
What does the term "mixer" mean in chiropractic?
55
a)_
b)_
a dynamic action of the spinal column resembling a mixing action. the inclusion of therapeutic techniques in addition to spinal manjpulation.
which of the following best describes the relationship that exists between the '' straights" and the "mixers" in chiropractic?
56
a) friendly and cordial b)- cooperative c)= divisive and antagonistic
Smith, AYOR, p.29
Carlova, "I Visited A Chiropractic Coll· ege", Medical Econo· mies, July, 1968, p:T
Carlova, Ibid.
Ibid.
It is important that one understand that the variation in chiropractic theory and practice cannot be adequately described by the sirnr-le dichotomizing of "straights" and "mixers". The descriptiv€ continuum shown below is much more representative.
S T R A I G H T S
Radical Religious
conservative
- 14 -
M I X E R S
moderate li eral
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57
The description by Weiant of those in chiropractic who still cling to what they refer to as "the philosophy of chiropractic" applies to which group on the continuum?
a) b)c)-
d)=
radical religious straights conservative straights moderate mixers liberal mixers
58
There are two national chiropractic organizations, one for the "straights" and one for the "mixers" . Identify which represents each group by assigning Sand M to the proper organization.
a) American Chiropractic Ass ociation b)= International Chiropractic Asso
ciation
59
What do "straights" g ive as their major reason for tenaciously holding to their position?
60
a)_
b)_
c)_
a dedication to the memory of D.D. Palmer . a fear that mixing will eventually result in chiropractic losing its unqueness . a disbelief in any other type of treatment for disease besides spinal manipulation .
Which of the two national organizations for chiropractic is th e largest?
a) American Chiropractic Ass'n b)= International Chiropractic Ass'n
Weiant, M&C, p.4
HEW Report. p.18
Smith, AYOR, p.18-20
HEW Report, p.18-9
- 1 5 -.Turn page back for answers to pag es 14 and 15.
ANSWERS
f..:.li P .15 ------------------------------
53 57
b). a)
54 58
b)
a) M b) S
55
59
c) b)
56 c)
NR 60
a)
61
What reason does Ralph Lee Smith give for the failure of the "straights" and the "mixers" to be able to patch up their differences?
a)_ the refusal of certain personalities in leadership to relinguish power.
62
b)_
c)_
the inability to resolve the differences by recourse to science. geographical inconviences that would result.
What reasons do "mixers" state for remaining separate?
a)_ they do not identify chiropractic with any particular philosophy.
63
b)_
c)_
they are willing to accept new scientific data. they do not dream of a dav when chiropractic shall have displaced medicine.
A degree held by many "mixers" in addition to Doctor of Chiropractic is:
a). Doctor of Osteopathy b)- Doctor of Naturcpathy c)= Doctor of Chiropooy
64
Doctor of Naturopathy is a fully recognized scientific degree.
true false
- 16 -
Smith, Ibid. p.19
Weiant, Ibid. p.5
Appendix A, item 4
See also: ~estern States Chiropractic College Bulletin, p.29-30.
Smith, Ibid. p.76
9 j
l 7 7 l l 7 7 7 7 l 7 l 7 l 7 7 7 l
65
Which of the following statements best describes the philosophy of Naturopathy?
a)
b)_
c)
drugs are nature's most powerful forces and therefore constitute the most powerful natural cure. nature's forces of air, light, water, heat, massage, vibration, electricity, and dietetics should be employed as treatments rather than drugs or surgery. health and disease are both equally natural conditions.
PART III. CHIROPRACTIC PRACTICE
66
Appendix A, Item 5
SOME QUESTIONABLE ASPECTS OF CHIROPRACTIC PRACTICE
Because of the wide variance of chiropractic ideologies represented by the continuum in frame 56, further compounded by individual competence and morality, private chiropractic practices are extremely heterogeneous.
The next sequence of frames deals with some of the questionable aspects of chiropractic practice . Some of these practices are widespread in chiropractic, others are limited to only a few individual practioners.
67
What criticisms have been levelled at chiropractic practice by outside observers?
a)_
b)_
c)_
d)_
chiropractic's past contains many cases of blatant medical quackery. some of chiropractic's luminaries and educators have been proven frauds. chiropractic has not instituted a strict uniform code of ethics with the self-policing necessary to protect the public. the highly questionable nature of many chiropractic promotional techniques.
Smith, AYOR, Prologuep.vii-xi; 60;chapter 4
- 17 -Turn page back for answers to pages 16 and 17.
ANSWERS
. P~"i6_ P .1:7 .--------~---------------------61 65
b)
b)
62 66
a) NR
b)
c)
63
b)
64
F
67
a)
b)
c)
d)
68
How do responsible leaders of chiropractic respond to these charges?
69
a)_ they deny them b)_ they totally ignore them c)_ they admit to them, but point
to a larger group of more responsible chiropractors which has come to exert a controlling influence over the profession.
Weiant, M&C, p.4-5
Dintenfass, p.136
CHIROPRACTIC'S USE OF DIAGNOSTIC MACHINES AND DEVICES
A significant earmark of modern medical quackery that has been noted by every writer on the subject is the employment of machines and devices which are supposed to "scientifically"· locate, diagnose or cure disease. Observers question chiropractic's rather extensive background of using devices which have been found to be worthless by federal investigators.
The next sequence of frames deals with some of these devices.
70
The Los Angeles chiropractor and chiropractic educator who became well-known through the use of phony gadgetry for the diagnosing and treating of disease was: Smith, AYOR, p.53-
61
71
a) Ruth B. Drown b)~ Marvin Phillips c)_ Harriet C. Larson
Machines used in chiropractic that have been siezed by federal agents as fraudulent devices are:
a) Neurocalorneter b)- Sonus Filrn-O-Sonic 105 c)- Micro-Dynameter d)- Visual Nerve Tracing Instrument e)- Detoxacolon f)= Radioclast
- 18 -
Ibid. p.62-_7
7 7 l l 7 l 7 7 7 7 7 7 7 l 7 l l l l
72
To what extent are diagnostic machines used by chiropractors today?
a) extensively b)- to some degree c)= not at all
73
Appendix A, Item 6 Stanford Study
The Stanford study revealed that chiropractic practioners use some 57 differe nt types of diagnostic and therapeutic equipment. Most of these are the same ones used by other types of health care pract-ioners. Several are not. Ibid.
What is th e most commonly used device used by chiropractors which i s unique to chiropractic?
74
a) b)c)-
d)=
x-ray diathermy neurocalometer ultrasound
What were the findings of the Sta nford study group who tested the Neurocalometer?
a)_
b)_
c)_
d)_
e)_
it is a machine which measures differences in skin temperature. the machine was incapable of measurin g anything. the readin gs obt a in ed co uld be greatly influenced by the technique us ed in holding the thermocouples ag ainst t he body. it is just a simple skin galvanometer. the device properly han dled could measure temperature differences within O.lC accuracy, but that the interpretati on and sig nificance of the findings were beyond the scope of th eir report.
Appendix A, Item 23 Stanford Study
- 19 - Turn page back for answers to pages 18 and 19.
.ANSWERS
P.18 P.19 ......... __________________ ..,_ _______ _
68 72
b) c)
73
69
NR
c)
70 74
a) a)
71
b) c) d) e) f)
c)
e)
75
What is the attitude of chiropractic ·leadership today concerning the government siezures of the machines listed in frame 71?
76
a)_
b)_
c)_
they make no statement on the subject. they feel it was government harassment. they say that it represents another area that chiropractic is working to control in order to gain acceptance by the scientific community.
CHIROPRACTIC l'ROMOTION AND ADVERTISii~G
According to Eric Jameson, the author of The Natural History of Quackeri, "It is the principle of self-advertisement that reafly defines quackery". The origin of the term quackery is derived from "quacksalver". ''(uack'', means to boast and "salver", means to cure--literally to boast of a cure.
Other writers on the subject of quackery state that•in the art and science of healing the legitimate practioners h'.ve aonscentrated on the scientific aspects of disease and the quucks have conscentrated on the art, i.e. the handlin~ of the patient psychologically, the selling of himself as a.healer, etc.
Critics accuse chiropractic of indulging in these practices which have always been primary indicators for quackery. The next sequence of frames examines some of these charges.
77
Who is James w. Parker?
a) b)-c)=
a chiropractor a supersalesman a person who runs a school that teaches other chiropractors how to succeed by developing the art of handling patients.
- 20 -
Smith, AYOR. chapter four. -
l l 7 l l 7 7 l l 7 7 7 7 l l l l l l
78
What are some specific psycholo g ical techniques t ha t Parker teaches which are designed to cause the patient t o submit to tr eat ment, acco rdi ng to Ralph Lee Smith's rep ort?
79
a) b) c)d)-e)=
l at her love l avis hly offering money-back guara ntees the "y e t" dise as e g immick su ggest pos si bility of tumor make no ch a r ge for f ir s t con sultation .
What pro motional tech n iaues are included in the Parker School of Profes s ion a l Success?
80
a) b) -c)-d)=
e)_
ho w to adverti se for pat ient s ho ~ to ~vo id rayin8 taxes tel epho ne tech n iques building up t he pract i ce by dig g ing f or chr onicity. P?lient managem ent techniaues th at utilize th e power of sug g estion.
What does William s say i s th e answer to the sky ro cket in g costs of medica l care?
81
a) socialized medi c ine b)= free en t erp ris e for pr ofes si ona l
c) _ men. he ~l th pr~ction er s should adve rt~ is e .
Does the America n Chiropract i c Associa tion endorse advertisi r,g as an ethica l pract i ce for its members?
yes no
Smi th, AYOR p.42-5
( a more extensive repor t of this situat ion can be found in Tod ay's health, J un e 1968, ''A Golden Tauer for Chiropractors" .)
Smith, AYOR. p.39 - 50
willi ams, " Eth ical Codes vs Hea lth Freedom." Hea 1th for Li fe, p.2 .
Aprend ix A, Item 8
ACA code of ethics, Part 2, a rt.I, sec. 3
- 21 -Turn pa ge back for answers to pages 20 and 21.
ANSWERS
P .20 p .21 --~------------------..----------
75
a)
76
NR
77
a) b) c)
78
a) b) c) d) e)
79
a)
c) d)
e)
80
b)
c)
81
no
82
What is the ICA position on advertising by an individual chiropractor?
83
a) b)-c)=
they do not permit it they recommend it they neither condemn nor condone it which leaves it up to the individual chiropractor.
CHIROPRACTIC Is us~ Or' X-RAY
The Department of Health, Education and Welfare has Fublished numerous materials concerning the possible hazards of radiation exposure <iue to the us~ of x-ray machines. They recommend that all possible ?recautions be taken to reduce patient exposure, P~neciAll~ with regard to pregnancy and gonadal areas.
Chiropractic has been criticized for its practice of using a full body x-ray which increases gonadal and total exposure from 10 to 1000 times greEter than that of a regular chest x-ray according to some sources.
84
Very few chirorractors use x-ray, and all of them are "mixers".
true false
85
How does chiropractic respond to the criticism of their use of the full body x-ray?
a)_
b) c)=
d)_
some deny the danger of x-ray exposure. they are discontinuing it they limit its use to a very small percentage of their patients they are working on safer techniques.
- 22 -
HEW Report, p.31
Health for Life, testimonials, p-2-6
Smith, AYOR, C~ap.8
Pamphlet: "X-Ray: Meeace or Miracle?"
Smith, AYOR. p.102
Dintenfass, p.72-3
Appendix A, Item 7
7 ;
7 7 7 l l l 1
l 7 7 7 l 7 7 l l 7 1
86
What are recognized as potential dan gers of x-ray ex ro sure by HEW?
a)_ possible dama ee to a developing fetus poss ible dama ge t o gonads possible undesirable gen etic mutations
87
Did the study by J.W. Howe, D.C. with Levine and Rolofson of the Public Health Service Bureau of Radiological Health determine that some commonly used chiropractic x-ray techniques give excess radiation exposure?
_ yes no
88
What safety pre cautions are r ecommended by HEW for pro t ection aga inst poss i ble hazards of x-ray exposu re?
89
a) the use of go nada l shie lds b)- the us e of beam re s trictors c)= the use 0f filters
CHIROPRACTIC ADJUSTMENT
Appendix A, Item 9
HEW x-ray document
Appendix A, Item 7
Appe nd ix A, I tern 9
HEw x-ray doc ument
Manipul at ion is utili zed as a tre a tment procedure by a number of health ca re rracti on ers bes ides chi ropractors. 2xamp les are os teo pa ths, physical the rapi sts, and orthopedists. The exact natur e of the manipul at ive technique s vary in accordance with the desired pu r pose of the man i r ulation. The chi ropractic adjustment is described by ch ir oprac ti c sources as " • .. a carefully pla nned and sk ill fu lly execut ed thrust with t he hands to restore mobil i ty to the joints and to all ow the vert e bra to assume its normal position."
Certain questions have been raised concerning the actual adjustment itsel f . Th e next sequenc e of frames examines some of those que s ti ons.
- 23 - Turn page back for answe rs to pa ge s 22 and 23.
ANSW~RS p.22 p •. 23 _______________________________ __
82
a) a)
b) c)
83 87
NR
84
F
85
a)
d)
yes
88
a) b) c)
89
NR
· 90
What criticisms have been directed at spinal manipulation as a method of treatment?
91
a)_ none by any practioner who ever utilizes it.
b)_ it has only limited use in the overall treatment of human disahility and disease.
c)_ manipulation of the spinal cord is potentially dangerous in certain conditions.
d)_ manipulation of the neck is particularly hazardous
Does chiropractic recognize any danger in connection with spinal adjustment?
_ yes no
92
What specific diseases are mentioned in the references for which manipulation could be extremely hazardous?
93
a) ruptured disc b)- muscular backache c)- infectious lesion of the spine d)- tumor of the spine e)~ localized stiffness of the spine
In the cases documented by Ralph Lee Smith where spinal manipulations resulted in death, the cause of the fatal injury was due to:
a)_ manipulation of a diseased spine b)_ a failure to render proper treat
ment to a unrecognized condition which resulted in death, rather than any factor related to the manirulation itself.
c)_ injury inflicted on the spinal meninges and the cerebral cortex by the manipulation itself.
- 24 -
Smith,~. p.112; p.113.
Quebec Brief, section entitled, "Readjustment of the Vertebrae", p.4.
Answers Pamphlet, p.13.
Quebec Brief, p.9
Smith, AYOR, p.117
Smith, AYOR, p.117; p.118-20.--
l 7 7 7 7 l l 1 l 7 l 7 l l 7 7 l 7 1
94
A three-year study by an orthopedist in private practice found that 172 of his patients had received chiropractic treatment. How many of them were injured by the chiropractic treatment?
95
a) none (0.0%) b)- six ( 3. So/o) c)- twelve (7.0%) d)= seventeen (10.0%)
Do the treatments rendered by medical doctors ever result in harm to their patients?
_ yes no
96
What term is used to describe a disease which results from medical treatment?
97
a) b)-c)-d)=
prognostic disease assymptomatic disease iatrogenic disease diagnostic disease
What does some of the data show concerning patient's satisfaction with chiropractic treatment?
The Roebuck-Hunter study found: a) Chiropractors: __ % effective; b) % ineffective or harmful. c) Medical Doctors: % effective; d) % ineffectivecrr"""°harmful.
The chiropractic survey found: e) __ % of patients are satisfied; f) __ % "definitely dissatisfied".
Appendix A, Item 10
Report for Journal of Clinical Orthopaedics, Nov-Dec '71
Dintenfass, p.18
I bid.
Appendix A, Item 11
I bid. I tern 12
Turn page back for answers to pages 24 and 25
- 25 -
ANSWERS. . .
P.24 P.25~------------------------------1 90
b) ..
c)
d)
91
yes
92
a)
c)
94
c)
95
yes
96
c)
d) 97
93
c)
a)24.1 b)13.4 c)86.5 d) 1.9
e)70 f)26
98
YOUR OPINION PLEASE
Recognizing that all health practioners make errors of practice which result in problems or tragedy, should chiropractic's errors be criticized any more severely than those of regular medicine's?
_ yes no
Please explain briefly why you answered as you did:
99
CHIROPRACTIC AND DIAGNOSIS
There seems to be no question as to the value of manipulation as a mode of treatment for certain conditions. There also is agreement that spinal manipulation can be harmful for some conditions. The harm might come either directly or indirectly. For example: direct injury may be done to the joint, soft tissue, spinal cord, nerve, vascular tissue, basilar arterial flow in the neck 1 region under certain conditions, bony injury, fracture or dislocation, especially in the presence of infection, malignancy or osteoporosis.
Indirect injury can result by ommission. That would be where manipulation cannot benefit the condition and only postpones the proper treatment.
The most important question to be asked on this wise is whether or not chiropractic education and training adequately prepares a chiropractor to readily diagnose conditions which chiropractic treatment would cause direct or indirect harm to the patient.
The next sequence of frames deals with questions that have been raised concerning chiropractic diagnosis and "analysis".
- 26 -
l l l l l l 7 l l l 7 l l 7 7 l 7 l 7
100
What approach to d i agnosis is described by the ACA- ICA vocationa l gu idance manual entitled, Opportun i ties in a Chiropractic Career, as quoted i n the HEW Report?
a) _
b) _
c) _
d) _
101
for the chiropractor, diagnosis does not constitute what it does for a medical doctor. spinal analysis must first deter mine whether or not disease in a certain organ exists. disturbances of the nervous system are among the most important factors of disease etiology. spinal analysis alone is all that is needed to make a correct diagnosis.
Which does chiropractic consider to be of greater importance in the determination of disease?
a) di ag nosis b) = analysis
102
What conclusion did the HEW Report reach concerning the ability of chiropractors to perform adeguate di ag noses of diseases?
a) _.
b) _
c)_
they concluded that chiropractors compare d favorably to M.D. general pr ac ti oners. they concluded that chiropractors were less qualified than medical doctors, but ad equate to do their job. . they did not be l ieve the scope and quality of chiropractic education to be sufficien t to prep a re the practioner to make an adequate diagnosis.
HEW Report, p.30-5
see p.30
see p.31
see p.32
see p.31 & 32
Dintenfass, p.76
ICA Reprint, p.10
HEW Report, p.52 "Conclusions and
Recommendations".
- 27 -Turn page back for answers to pages 26 and 27.
ANSWERS . .
l!1! ~ P.27 ti----------------------...---------98 100
0 p i n i 0 n ..
a)
b)
c)
103
How does chiropractic respond to the questions raised concerning the ability Dintenfass, p.75-6 of a chiropractor to adequately diagnose diseases? "White Paper", p.9
a) they say diagnosis isn't necessary ICA Reprint, p.10 - in chiropractic care.
b)_ they point out that diagnosis is a part of chiropractic education.
c)_ they say that chiropractors do more than simply diagnose by also making a chiropractic "analysis".
PART IV. CHIROPRACTIC EDUCATION
99 101 ' 104
NR
b)
102
c)
QUALITY OF CHIROPRACTIC EDUCATION
Central to the issue of chiropractors' ability to adequately diagnose disease is the quality of chiropractic education and training. The next sequence of frames deals with factors concerning that phase of chiropractic.
105
How many chiropractic colleges are there in the United States?
a) 12 HEW Report, p.36 b)-. 20 c)- 27 d)= 41
106
How are chiropractic educational institutions financed?
a)_ privately b)_ by federal funding c)_ by state funding locally d)_ by philanthropic foundations
- 28 -
Dintenfass, p.121
7 l l 7 7 l 7 7 7 l l l 7 7 l 7 l l l
107
The largest chiropractic college is:
a) b)c)-
d)=
108
National College of Chiropractic. Cleveland Chiropractic College Palmer College of Ch iropractic Lincoln Chiropr act ic College
I
All chiropractic colleges offer a fouryear course which lead s to the Doctor of Chiropractic degree.
true false
109
Place a mark(X) by the subjects listed below th a t a re taught in chiropractic colleges that are a ls o taught in medical colleges.
a) b)c)d)e) -
f)=
110
anatomy biochemistry physi ology microbiology pathology public health
I
g) obstetrics h)- psych iatry i)- .. radiolo gy j )- surgery k) - pediatrics l)= pharmacology
What kind s of textbook s are used in the coursewo r k at chiropra ctic colle ges?
a) exclusively chiropractic texts. b)- stand &rd medic2l textbooks c) = chiropractic textbooks
HEW Report, p.36
HEW Report, p.36
"White Paper", p.7
Dintenf ass , p . 124-7
HEW Repo rt, p.37-8
- 29 -
Turn page back for answers to pa g es 28 an d 29.
~ P.29 .---""!""" _____________ ..,._ ____ _,__-.
103 ~07
b)'
c)
104
NR
105
a)
106
a)
c)
108
T
109
a)g) b)h) c)i) d) e)k) f)
110
b) c)
111
If the chiropractic curriculum is much like that of medicine, and many of the same textbooks are used in chiropractic coursework, what reasons are there for considering chiropractic education and training inadequate1
a)_
b)_
c)_
d)_
112
the quality of chiropractic students is low doe to the admission requirements of colleges. the qualification of chiropractic faculties is generally quite poor. chiropractic college facilities are substandard and inadequate. the achievement of chiropractic graduate is poor when compared to medical graduates.
Does chiropractic recognize the importance of a faculty of competent, stimul~ ating teachers who are masters in their individual fields?
_ yes no
113
Have chiropractic colleges fulfilled the requirements for selection of chiropractic faculties as outlined by the Council of Education of the ACA as outlined by Dr. Dintenfass?
_ yes no
114
What year was the Council of Education of the American Chiropractic Association formed?
a) 1928 b)- 1935 c)= 1947
- 30 -
Smith, AYOR, chapter six -
Carlova, "I Visited a Chiropractic College." Medical Economics, 1968 p.o
Dintenfass, p.121
Compare Dintenfass, p.121 with Smith, AYOR, p.74-6
Dintenfass, p.121
1 J
7 7
J
7 l 7 7 7 7 7 l 7 7 l 7 7 l l 1
115
What dificiencies are noted in chiropractic school faculties?
a)_
b)_
c)_
d)_
116
very few hold recognized academic degrees of any kind. persons appear to be teaching in areas that demand high academic qualifications without the credentials necessary. some teachers that do have degrees do not have them in scientific fields, but are teaching highly technical scientific subjects. some degrees listed by those on the faculties cannot be confirmed as being authentic .
What facilities are listed by Dintenfass as required by chiropractic colleges?
a) b)c)d)-e)=
117
laboratories hospital units libraries general clinics classroom demonstration aids
Smith, AYOR, p.74-6
Dintenfass, p.121-2
Did the chiropractic colleges studied by the Stanford Research Institute comply with the standards referred to by Dinten-fass of the chiropractic Council of Ed- Smith, AYOR, p.76-9 ucation?
_ yes no
118
Even though the laboratory facilities of the Colleges studied by the Stanford group were substandard, they showed evidence of extensive use.
true false
Ibid.
- 31 - Turn page back for answers to pages 30 and 31.
P.30 P1.311-------------~------+----- ...... -----,
111 115
a)'·
b)
c)
d)
112
yes
113
no
·114
c)
a)
b)
c)
d)
116
a)
c) d) e)
117
no
118
F
119
Many chiropractic colleges require an applicant to have at least two-years of work in an accredited liberal arts college before acceptance into the chiropractic training program.
true false
120
When was the two-year college requirement for admission to chiropractic training first instituted?
a) · May, 1925 b)- April, 1939 c)- Au~ust, 1950 d)= September, 1968
121
Because of the above date, is it likely that the majority of chiropractors currently in practice have had to fulfill that requirement?
_ yes no
122
How ~trictly were the published requirements of needing a high school diploma adhered to in the summer of 1963 when the Depcrtment of Investigation of the A.M.A. undertook its study to determine the requirements for admission to schools of chiropractic?
a) very strictly by all schools. b)- most schools followed the guide
- _lines of the ACA and ICA. c) A minority of schools followed
- the stated guidelines of the ACA and ICA.
- 32 -
HEW Report, p.40
HEW Report, p.40
Special Report: "Admission to Schools
of Chiropractic." JAMA, 190:8, Nov 23, TioZ..
7 7
J
7 l l 7 7 l 7 l l 7 l 7 l 7 7 7 7
123
Whi ch of the following were used to describe the four categories Carlova believed chiropractic s tudents could be placed in ?
a) t he misled b)- the cur iou s c)- the disc i p le s d) = the snake-oil
e) the desperate f)- the dedicated g) - the studious
pitcnmen
124
In the survey made in five of the 26 states requiring chiropractic students to pass the same basic science examinations a s medica l students, how did the chiropractic students perform when compared to the medical students?
a) b) c)-d)=
125
bet t er about as wel l a little poorer extremely badly
The fairness of co mpari ng chiropractic with medicine has been questioned by
Carlova, "I Visited A Chiro-
practic College," Medical Economics, July 22, 1968, p.4-5
Carlov a, Ibid. p.6
Smit h, AYOR, p.73
some chiropractors. ~hat reasons are given in the HEW Report for jud g ing chiroprac tic education by the same standards a s schools of medicin e and osteop a thy? HEW Report, p.38
a) _
b)_
becau s e the title "doctor" is bestowed upon completion of the coursewor] , . because of the 2vidence of th e use of re gu l ar medical textbooks and th e listing of the same basic sci~nces as the other healing arts indicates that chiror,ractic stud en ts are being trainee to function as prim ary sources of patien t ca re.
- 33 -
Turn page back for answers to pages 32 and 33 .
LE. P.33
119 123
a)e) T ..
c) d).
120
124
d)
121 d)
125
no
122
b)
c)
I
126
A comparison of the libraries of chiro-practic schools with those of medical .schools revealed which of the following?
a) chiropractic libraries were as - well supplied in number of books
HEW Report, p.38
Smith,~, p.78-9 b)_
and periodicals. chiropractic libraries were not
Carlova, Ibid. p.2 as well supplied quantitatively, but they were found to be of very
c)_ high quality. chiropractic libraries were extr-emely deficient and considered inadequate for a quality profess-ional preparation program.
127
Is chiropractic doing anything to improve the quality of chiropractic education?
Carlova, Ibid. p.2-3
Dintenfass, Chapter _ yes no 14 -
PART V. RECOGNITION OF CHIROPRACTIC
128
OFFICIAL AMBIVALENCE TOWARD CHIROPRACTIC
The term "recognition" has many different meanings ranging from simple acknowledgement to complete endorsement. When studying the recognition extended to chiropractic by various agencies, one must always discriminate between the many uses of the term as the ambivalence toward chiropractic is most apparent when viewing it from the perspective of recognition. The next sequence of frames deals with the enigma of chiropractic recognition throughout American officialdom.
129
Do any of the three recognized educational bodies that accredit schools of higher education recognize any chiropractic college?
_ yes no
- 34 -
Smith, AYOR, p.72 footnoten-
l 7 7 7 7 l 7 7 7 l 7 7 l 7 7 7 7 l l
I 130
What classification is g iven to the Doctor of Chiropractic degree by the Office of Education of the U.S. Dept. of Hea lth, Education and ~elf a re?
a) b)-c)-d)=
131
regular recognized spurious classified
How is the c l ass i fication "spurious" defined by the U.S. Office of Education?
c) _
132
a non - existent degree one purporting to be a Jegi timate degree, duplic a ting those g iven by le g itimate institutions, but Granted by diploma mills. a degree that has no clear ly defined standard by which it can be judged.
All chiropractic colleges list some sort of accreditation. If none of them are recognized by either of the three recognized accrediting bodies, who accredits
Append ix A, Item 13
from "Educational Backgrounds of Chiror-ra c tic ..• Faculties." JAMA, 9/19/66, p.169.
Appendix A, Ibid.
them? HEW Report, p.81-2
a)_ the individual states licensing chiropractors.
b) they accredit themselves . Appendix A, Item 21 c)= The Council on Chiropractic
Education
13 3
Does any recognized accredi .tin g agency r eco gnize any chiropractic school anywhere in the United States?
yes no Appendix A, Item 14
let t er from NY
- 35 -Turn page back for answers to pages 34 and 35.
P. 34 P .35 ------------------...------------.
126 130
c)
c) 131
127 b)
yes
128 132
NR
c)
133
129
yes
no
134
How many of the fifty states license chiropractic practioners?
a) 21 b)- 30 c)- 48 d)= 50
l 35
State licensure of chiropractic constitutes recognition of chiropractic theory.
true false
136
The main rurpose of state licensure is for:
a) tax revenue source b)- recognition of validity by st2te. c)- regulation of practice d)= r,rotection of the public
Which of the following are chiropractors licensed to perform in Oregon?
a). obstetrics b)- minor surgery c)= prescribe drugs d) rhysiotherapy e)= treatment of auto accident injurief:
138
Oregon is unique in that it is the only state which permits chiropractors to perform:
a)_ minor surgery b) obstetrics c)= physiotherapy
- 36 -
HEW Report, p.50
HEW Report, p.50 "Positions on Chiro
practic".
Maisel, ''Should Chiropractors be Paid .• " R~ader's Digest.p.3-4 Dintenfass, p.142
HEW Report, p.50
Smith, AYCR, p.159
Answers Pamphlet, p.6
HEW Report, p.51
l l l l l l 7 l 7 7 7 1 l 7 7 7 l 7 1
fl I
r r r r r r r L
r r r r r r r r r r r
139
Has state lieensure of chiropractic served to regulate its practices and thus protect the public as originally intended?
_ yes no
140
What does the 1967 Health Manrower Report recommend ~e done in regard with the basic assumption of the licensure of chiropract1.c?
a) it should remain unchanged b)- it should be reexamined c)= it should be eliminated
141
v:hat reasons did the College of i:.·hysicians and Surgeons of the Province of Quebec give for refusing to endorse the licensure of chiropractic in that prov-ince in 1963.
a)_
b)_
c)_
142
a feeling of responsibility to r--r.otect the peorle of Quebec. a fear of the judgement before the tribunal of history. no reason was given, just vague references to the absence of an established need for more prattioners in Quebec.
YOUk OfljlON ~LEA~~:
Appendix A, Item 15
from Report of the Health Manpower Conunission, p.360
Appendix A, Ibid.
Quebec Brief, p.10
What de you believe should be done abouc chiropractic licensure?
- 37 -Turn page back for answers to pages 36 and 37.
p. 36 p. 37 t------------------- ......... ---------1 134 139
c)
135
F
136
c) d)
137
a) b)
d) e)
138
a)
no
140
b)
141
a)
b)
142
0 p i n i 0
n
143
Place a mark (X) by the organizations which recognize chiropractic in the following list:
a) GI Bill of Rights b)- U.S. Immigrations Service c)- U.S. Office of Education d)- most State Workmen's Cornpensa.tion
- Acts. e)_ U.S. Emr.loyees Compensation
Bureau. £)_ the armed forces by giving comm
issions as to medical doctors. g) Internal Revenue Service h)= many state Medicaid Programs
144
Have the organizations abcve who recognize chiropractic done so on che basis of having judged chiropractic theory to be valid?
_ yes no
145
The number of private insurance companies that recognize chiropractic for indemnification is about:
a) 50 b)- 100 c)- 300 d)= 600
146
Why have so many insurance companies recognized chiropractic care?
a)_
b)_
c)_
they accept chiropractic's theory of disease causation. chiropractic care is considerably less expensive than medical care, which costs them less money. there is less time lost from work with chiropractic care.
- 38 -
HEW Report, p.50 ''Positions on Chiro
practic."
HEr Report, Ibid.
Answers Pamphlet, p. 18.
"r.·h · " 15 7 w 1te Paper, p. -
7 I
7 l l l l l l l l 7 1 l l 1 l l l l
147
Why is chiropractic care less expensive than medical care?
a)_
b)_
c)_
148
chiropractic care doesn't involve hospitalization. chiropractors charge less for an office call and other services. chiropractic doesn't involve the prescribing of expensive drugs.
YOUR OFINION PLEASE
11White Paper", p.13-15
Would you say that the ability of chiropractic to perform well enough to qualify f or indemnification by over 600 private insurance - companies is evidence of the effectiveness of chiropractic care?
yes no
Why? ______ -,- _____________________ _
149
The American Medical Association gives full reco gnition to chiropractic as a le git imate healin g art.
true false
150
The American Medical Ass ociation permits their members to openly refer patients to chiropractors when they feel their conditions mi ght be helped by manipulation.
tru e false
Dintenfass, chapter 17
Appendix A, Item 16
Turn page back for answers to pages 38 and 39.
- 39 -
~ P.39 -------------------,---------~ 143 147
a) b)
d)'
g) h)
144
no
145
d)
146
b)
c)
a)
c)
148
0 p 1 n 1 0 n
149
F
150
F
151
Chiropractors openly refer patients to medical doctors.
true false
152
What reasons does the A.M.A. give for not permitting the referral of patients to chiropractors by their members?
a)_
b)_
153
it is the position of the A.M.A. that chiropractic is an unscientific cult, and its code of ethics prohibits all volunatry associated activities with cultists. the A.M.A. only permits its members to refer patients to other A.M.A. members ~nd chiropractors aren't permitted to join.
The A.M.A. 's "honorable" intentions have been questioned by persons outside of the health field as to the motivation behind their constant attack on chiropractic.
true false
154
What reason does Rayack give as the possible real motivation behind the A.M.A.'s attacks on chiropractic?
a)_ the competition of 25,000 chiropractors with medicine.
b)_ the refusal of chiropractic to merge with the A.M.A.
c)_ the refusal of chiropractors to recognize the A.M.A. as the primary spokesman for health care in America.
- 40 -
"White Paper", p.10
Weiant, M&C, p.5
Appendix A, Item 16
Appendix A, Item 17
Ibid.
l l 7 7 l 7 7 l 7 7 l 1 7 7 7 l l l l
15 5
What does Wei ant say regarding t he poss i ble complaint that chi r op ract ors constitute a signif i can t form of financ i a l compe tit io n to medic a l docto r s?
a) _
b)_
c) _
156
the i s evidence that in a reas where ther e are many chiropractic practio ner s medical doctors are not as busy. in are a s where there are ma ny chir0prac t ~c rractione r s, doctors are busi er th nn ordinary. t he i s no evidence presente d that physici ans are less busy in local i tie s where chiropractors are numer ous.
Wha t reasons does Wil lia ms give for t he A.M.A. opposition to ch i ropract i c?
a) _
b)_
c) _
157
financial compet iti on a s Rayack sug ge s t s . refu s a l of chiropractic t o merge with t he A.M.A. A.~ .A. ' s thir st for power over all docto r s .
Is the A.M.A. the only hea l th organi Eat i on to of f ic i a ll y oppose chiropractic?
yes no
158
Have 2 ny of t he se org a n ization s issued public statements co ndemn in 3 chiropractic?
yes no
Weiant, M&C, p . 15
1,: ill iams, "E thica l Ccx:le s Vs Hea lth Freedo m." Hea l th for Life . p . 2
Wilbur, ' 'What t he Heal th Ca re Consume r Should Know About Chiroprac t ic ". ~"!A1vJA Feb 22 , 1971.
What They Sa y fi.~ Chirotractic, P~mph et by A.M. A.
- 41 -Turn pa ge bF-ck tor ans wers to pages 40 and 4 1.
P.40 P.41 ------------------- ....... ----------1 151 155
T
152
c) a)
156
153
c)
T 157
154
no
a) 158
yes
159
Place a mark (X) by the organizations in the listed presented below which have made official statements condemning chiropractic.
a) Dept. of Health, Education and - Welfare.
b) National Advisory Commission on - Health Manpower.
c) American Public Health Association d)- American School Health Association e)- AFL-CIO £)- Consumer Federation of America h)- National Council of Senior Citjzens i)- Aff1erican Ca.1cer Society j)- Amerjcan Rheumatism Association k)= American College of Sports Medic-
ine. 1) American College of Radiology rn)= Nat.icnal Association of Letter
carriers
160
What test of performance were chiropractic representatives unable to pass which resulted in the action taken by the National Association of Letter Carriers to delete chiropractic from their medical rlan?
a)_ the inability to detect subluxation· which· had been analyzed as existing on x-n1ys tal--.. en by other
.--. chiropractors. b)_ the failure to successfully treat
sever.:il ''testi. 1 cases. · c)_ the inability to keer chiropractic
care within tr.e financial scope of the as~ociation's resources.
PART VI. CHIROPRACTIC RESEARCH
- 42 -
Wilbur, Ibid. p.1308-9
What They Say Abou,t. Chiropractic, Pamphlet by the AMA
Deely, copy form p.53A of refort by the National Association of Letter C2.rriers.
l l l l 7 l l l l 7 7 l l l 7 7 7 l 1
----- - ----- ---·----- --- ----------------, 161
CHIROPRACTIC RtSEARCH
In a era of rapidly inc re as in g knowled ge suc h as has characterized the twentieth century the importance of re search has become well established. Crit i cisms of chiropractic's failure to establish its theory scientifically have been noted pr evi ously in the Quebec br i ef.
The next sequence of f r ames deals with the subject of re sear ch in chiropract i c.
162
Does chiropr a ctic recognize the importance of research? Dintenfass , p.12 9
_ yes no
163
Has ch iropr 2.ctic rese a rch compared well with tl ,e ot he r ::ealin g arts?
yes no
164
~ha t r eas ons are off ere d for chiropractic ' s l ack o f a t :e nti cn to research ?
a ) b)=
c)_
d)_
in sufficient f in ancial resources. l ~c~ of intere s t by t he government in ch ir opr a ctic rese a rch . a ge neral dis bel i ef among chiropr a ctors in t ~e value of scien tific research. a l a c~ of qualific a tion to do r e s e&rch among chiropr actic faculties.
Dintenfass, p.1 29
HE\r! Report, p. 41
Dinte nfass, p . 129
HEt,_; Report, p. 41
Turn pa ge back for answers to pages 42 and 43.
- 43 -
p .42. P .43 --------------------,...----------1 159 161
a)
b)
c)
e) f) g) h) i) j) k)
1) m)
160
a)
NR
162
yes
163
no
164
a) b)
d)
165
Has any significant scientific information resulted from chiropractic research? Dintenfass, p.129-30
_ yes no
166
Who has contributed what is described by Dintenfass as "probably the most outstanding recent work performed by an individual in the professio~'?
a) Dr. Earl Rich, D.C. b)- Dr. F.W. Illi, D.C. c)- Dr. D.D. Palmer, D.C. d)= Dr. George Campbell, O.C.
167
What is t:·1e nature of thE:: research mentioned above?
a)_
b)_
c)_
168
the establishment of a cause-effect relations~·:ip between vertebral subluxations and specific diseases. x-ray analysis of the human spine in motion and in various positions. measurement of the effect of structural changes on nerve transmission
Has any research been submitted by ci1iropractic Liat demonstr2.tes a specific cause-effect relationship between a vertebral subluxation and a particular disease
Dintenfass, p.129-35
Dintenfass, p.130
as hypotl:esized by chiroptactic tbeory? Quebec Brief, p.2
_ yes no
- 44 -
~
7 l l l l l l 1 l l 7 7 7 7 7 l l l 1
PART VII. CHIROPRACTIC AND THE FEDERAL GOVERNMENT
169
CHIROPRACTIC AND THE 1968 HEW REPORT
The report to congress entitled, "Independent Practioners Under Medicare'', by t he Department of Hea lth, Education and Welfare represents what has probab l y been the most damaging inquiry ever conducted into chiropractic. Bec ause of its importance, chiropr actic responded with its "White Paper". You have become fami li ar with both of these as you have progressed through this programmed study gu i de.
The next sequence of fra mes deals with the report itself and some of the issues chiropractic has raised abo ut it.
170
What did the HEW Report conclude about chiropractic and the body 0£ basic knowledge re la tins to hea 1t h, disease .md hea 1th care t i1a t has beet. widely accepted HEW Report, p. 51-2 by t he scientific community?
a)_
b)_
c)_
171
chiropractic theory and practice are not based upon this body of basic knowled ge. chiropractic operates well withi n t h is body of basic knowled ~e. chircpractic practioners i gnore or t ak e exceot i on to much of this know l edg t despite the fact they have not undertaken adequate sc i entific re s earch.
Beca use of t :,e lack of valid evidence es t abl ishing a cause-effect relationship betwe en subluxation (if it exists) and disease, wl1at did th e report conclude about chiropractic's sr-inal analys is and adjustment?
a) _
b) _
c)_
they mi ght be wor thw hi le under certain circums ta nces. because many r,eople seem to benefit from. t hese procedures, they should be continued. their use is not justified.
HEW Report, p.51
- 45 - Turn pa ge back for answers to pages 44 and 45.
r..Jt!t. P.45------------------r-----------. 165 169
NR
yes
166
b) 170
167
a)
c) b)
168 171
no
c)
172
What further reasons did the HEW report give for questioning the value of chiropractic care?
a) the relative financial costs for - chiropractic care compared with
medical care. b) the inadequacies of chiropractic
- education to prepare a chiropractor to make adequate diagnosis and know the appropriate treatment.
c)_ the failure of chiropractic to use drugs in its treatments.
173
what did the report state concerning manipulation as a tre~tment procedure?
a)_ research in this area is inadequate.
b) manipul~tion is of no value in - the tre .. tment of any known dis
ease condition. c) chiropractic manipul~tion is of
- no value, but other forms may be.
174
l,~·as chiropractic care r, . .:commended for inclusion by the 1968 H~W Report?
yes no
HEW Report, p.52
Ibid.
Itid.
1-------·------------------1--------------◄
175
What complaints have been voiced by the "White Paper", p.5-6 chiropractic profession about the 1968 H~\rJ Report?
a) they say it was a "fixed" report. b)- the report dealt with "false issues'
- rather than the ones Congress had specified in law.
c)_ the report ignores or misstates the facts.
- 46 -
l l 7 l l 7 l 7 l l 7 l l l l l l 7 l
176
On what basis does chiropractic state that the HEW Report was "fixed"?
a)_ someone a ltered the initial reports contents before it was pre se nted to Congress.
b)_ the committees appo inted to do the report had an overwhelming built-in profes sio nal and institutional bias.
c)_ no chiropractic repre se ntatives were included on the committees.
177
What issues does chiropractic state were the "false issues" the HEv~ Report dealt with?
a) chiropractic education b)= chiropractic's close connection
with medical qu~ckery over the
C) d)-e)=
f)
g )
178
yec.rs. chiropractic philosophy chiropractic dibgnosis chiropractic's failure to estoblish a cause-effect relationship betw ee n subluxations and specific diseaset through research. the danger of manipul ution in certain disease cond itions . chiropractic's theory of the cause of disease.
In their attempt to establish the quality of chiropractic educati on what criterion -
Ibid. p.6
Ibid. p.7-11.
is offered? Ibid. p.7
a)_
b)
C )
a comparison of the performance of the product of ch iropra ctic education with that of medicine's. an analysis of chiropractic education prepared by an independent group of researchers.
a quantitative comparison of the hours spent in ce rtain courses by medical ~nd chiropractic s tudents.
- 47 - Turn page back for ans. p.4b-7
P.46 fill--------------------------172 176
b) ..
173
a)
174
no
175
a) b)
c)
b)
c)
177
a)
c) d)
g)
178
c)
179
what does this type of a comparison fail to take into account?
a) the quality of students being - taught since more intelligent
students learn faster. b)_ the quality of instruction being
given since chiropractic faculties have been found to often be deficient in qualification.
c) the quality of facilities and equ-- ipment at the various schools since
chiropractic schools are known to be substandard in comparison to the medical schools.
d)_ the nature of the information being transmitted within the school since chiropractic theory is felt to be erroneous by the scientific community at large.
180
¼hat issue does chiropractic take with the Ht~ Report concerning chiropractic "philosophy"?
a) cuotations ~re out of context. b)= quotations ccnfuse the hypothesis
for chiropractic with clinical findings.
c )_ the hy;:othesis stated by the report aE chiropractic are not those of chiropractic at all.
181
Does chiropractic admit that the hypotheses that are found under the heading of "Chiropractic Principles or Philosophy" in chiropractic literature are the same aE tho~e cited by the HEW Report?
_ yes no
- 48 -
"White Paper," p.8
Ibid. p.8, II. False Issue No.2
l l l 7 7 l 7 7 7 1 l l 7 l 7 1 7 1 1
182
Does chiropractic attempt to make a case for the validity of chiropractic hypotheses in this White Paper?
_ yes no
183
The White Pap er complains that while the HBW Report attacks chiropr~ctic's concern with s ubluxations, it admits that specia lists in physical medicine and rehabilitation agree t hat subluxations ex ist.
Wh~t justification is offered for this situation?
c)_
184
nor: e th 0 ''subluxations" of chiropractic terrr.inology are not the same as those of classical medical terms. no connection is made between sutluxations and diseases by those specialists menLioned as i s done in chiropractic theory.
Since chiropractic makes no attempt to establish its hypothesis in the . defense set forth in this section of the White Paper, upon what premise does it attempt to establish its validity?
a)_
b)_
the meeting of the patients needs clinically by chiropractic care. the statement that Congress wanted to know alout ne eds and costs and whether chiropractic care is a valid hectlth service for the e lderly, rather than a review of chiropractic's hypothesis.
Ibid. p.8
Ibid. p.9
( uebec Brief, p.3
Biedermann, p.27-8
"White Paper," p.9
Turn page bac k for answe rs to pages 48 and 49.
- 49 -
~ Llt2.1-----------------------. 179 182
a) no
b)
183
c)
d)
b)
180 c)
a) b) 184
c)
181
yes
a)
b)
185
Do you fee] that the committees that assembled the 1968 HEW Report overstepped their bounds when they went into the hypothesis underlying chiropractic in their attempt to establish whether or not chiropractic is a valid health service ·for the elderly?
_ yes no
Please explain briefly why you answered as you did: _____ _
186
The third so-called "false-issue" of the ~hite Paper concerns diagnosis. because this issue has been de~lt with to some degree previously, let us deal only with certain main points made here.
Whbt evidence does chiropractic offer as ''objective indications of the substautiali ty" of the adequacy of chiropractic tr·a ining in diagnosis?
a)_ the amount of time spent in classwork.
b) the pro~ortion of the required - textbooks that deal with diagnosis.
c}_ several practical demonstrations
187
of performance documented by independent testing agencies.
Wh~t evidence is offered as to the qualifications of a chiropractor to perform in the highly critical area of diagnosis?
a) recognition by the scientific community at large.
b)_ recognition by the other healing arts
c}_ only chiropractic's o~~ word on the matter.
- 50 -
"White Paper," p. 9-10
l l l l 7 l l 7 7 7 7 7 7 l 7 7 l 7 1
188
'I'he fourt}-1 r➔ nd fina l so-called llfalse fssue" dea l t with by the White Paper states that the HEW Report claims that ch i ropract i c regards subluxation as the sole cause of disease. Is this statement accurate?
yes no
189
¼hat exact ly does the H6W Report state that chiropractors beli eve in regord to subluxation and disea s e ?
a) "sutluxotion i s the so l e cause - of dis ease ." b ) " suLluxation i s the most signif-- icant causal fa cto r in disease." C ) "subluxation is a minor contrib-- utin g factor only in disease ." d) " sub lu xc:.tion pl a ys no role in - the cau sat i on of disease. "
190
I bid. p. 11
HEW Report, p.25
Is th e H~W st&temeht referred to in the Review frames 23&24 foregoin g fram e accuraL e and consistant with ch iropra ctic lit erat ur e on the matter?
yes no
191
What a r e the "true issu es " identified by chiropractic's ~hite Paper?
a) b)=
c)_
d)_
the need for chiropractic. the cost of chiropractic under medicare. the effectivenes s of chirop ractic se rvice s. states ri ghts and freedom of cho ice.
ICA Reprint, p.12
"White Paper," p.11- 17
Turn pa ge back for ans wers to pages 50 and 51.
- 51 -
p. 50 p. 51 1-----------------------..---------, 185 188
0 p i n i 0 n
186
a)
b)
187
c)
no
1-89
b)
190
yes
191
a) b)
c)
d}
192
What does chiropractic cite as evidence of the need for chiropractic?
a) the demand for such services by - the American people.
b) the recognition of chiropractic - services by a number of federal
agencie·s. c) the recognition of chiropractic
- services by state governments. d) the recognition of chiropractic
- services by several private and commercial progr~ms.
193
According to data available from the U.S. Public Health Service, what percent of the civilian non-institutional population consulted~ chiropractor in the 1963-5 time period?
a) less than one-percent. )
- <f' b 2 .J,. C )- 6. c~--d )= over ten- ercent
194
hCcording to the same source as cited in frame 193, what percentage of elderly patients in the California medicaid program ~vailed themselves of chiropractic care?
195
Does chiropractic claim to be able to offer the elderly any type of care that is superior to that of traditional care?
_ yes no
- 52 -
Ibid. p.11-13
Ibid. p.12
Ibid.
Ibid. p. 12-13
l l l 7 7 l 7 l l l 7 7 7 l 7 7 7 7 1
196
What particular type of conditions does chiropractic cite as proble ms of the e lderl y that they can offer aid to.
a) heart dise a ses b)- malignant neoplasms c)- diabetes mell it us d)= mu sc ul o-skeletal impairment
197
Does the ;.merica.n Rheumat i sm nssociat i on se ction of the /-'.rthri tis Foundation recognize chi rop ra · tic care are effective or valuable in the d i~eases that they are concerned with as a voluntary health organiz&tion?
_ yes no
198
Wh~t evidence is offered that chiro practic has effect iv e cbr e to render to those suffering from musculo - sk eletal impairm ent .
a)
b)_
c )_
d)_
199
the fa c t th&t ffi~ny people utilize chiropractic ca.re for the f e proble ms . resec:1r ch conducted by r ecognized independent sources . chiropr&ct ics own word on the mat te r. indemnificat i on by insurance compan ies, workmen ' s compe n sat ion, etc .
Does chir opr act i c beli eve th at the addition of chiropractic s ervices would increas e the costs of Lhe medicare program?
yes no
Ibid . p.12-13
~ha t They Say About Chi r oprac tic, Pamphl et by the A:tv1A
"White Paper , " p.11-13
I b id. p. 13
- 53 -Turm page back for answers to pag es 52 and 53,
p .52 p .53 ~-----------------,----------,
192 196 200
a)
b)
. d) c)
d)
193
b)
194
c)
195
yes
197
no
198
a)
b)
c)
d)
199
no
I
What evidence does chiropractic offer to support this belief?
a) official government data from - british Columbia's government
~perated health service program. b) Workmen's Compensation data c)- the fact that chiropractors do
201
- not use expensive hospitalization, drugs or surgery.
The third so-called "true issue" concerned chiropractic's effectiveness. What evidence is offered to substantiate chiropractic claims of effectiveness?
Ibid. p.13-15
Also, review frames 145-147
a)_ only chiropractic's own word. b)_ a 19b0 study of the Florida In- Ibid. p.15-17
dustrial Commission showed that work time lost was fully two-thirds less under cbiropractic care.
c)_ no evidencP ;~ offered by chiropracti r •
202
YOUh uPI~ION PL.l!.fi~~
c·an you think of any logical explanations for the findings of the Flo~id~ study in regard to less time lost under chiropractic care than under medical care?
(answer here) _______________________ _
203
v~hcit t,,·-) issues are raised under so-called "'frue Issue No. 4"?
a)_ iree enterprise b)_ st~tes rights c)_ p~tients freedom of choice
- 54 -
"White Paper," p.17
7 7 7 7 7 7 7 7 1 7 7 7 1 1 7
J
7 7 1
204
Do eithe r of the s e i ssue s ha ve anythin g to do wit h th e value or effic a cy of chir opract i c ca r e, the sci entific valid a t i on of chiro pra ctic th eor y, or any i ss ue in volvin g th e we l fa r e of the pat i ent ?
_ yes no
205
Wha t is t he nat ur e of these i ssues?
a ) s ci en t i fic b )- mo:-a l c )= po l it i cal
206
THE I SSUE OF HEALTH FREEDOM
The law of cavea t emptor is called the law of the ma r ke t pl ace . I t s inte r pre t at i on is, "let the tuyer be wa r e ". I t is bc:1sed on the concept that both the buyer and the se ll er ha ve eq ua l exp ertise about the produ ct being tr~ded . The art of hor s e -tr ad in g represents th e most clo. s sical tr aditional exc1mple.
The is s ue of how great a role governn,ent s hou l d pl ay in consume r a ffairs is e~ sent i a l to the en tir e free enterpr i se con cept . The extent to whi ch free ente rprise ~nd freedom of choice shoul d be carried in hea l th services is central to the health f r ee dom iss ue .
The next seq uence of frames asks for yo ur op 1n1 on on se ver al questions whl ch are important to the questio n of hea l t h fr ee dom.
207
Since medicare money is taken from the people i n t he fo rm of Social Secuc l ty taxes, s houldn ' t t he taxpayers ha ve a ri ght to spend that hea lth cbre money as they woul o spend thei r own if it hadn ' t been tak en by the gove r nment i n the f ir st pl ac e?
_ yes no
- 55 -
Turn page back for answers to page s 54 an d 55.
IU'h) VV .c,ni:> , ~ ~ ------------------------~- J
200 204
a)
b) c)
201
no
205
c)
b) 206
202
0 p i n i 0 n
NR
207
203 0 p i l'
i
b) c)
0 n
208
Because some people who also pay taxes utilize Christian Science, astrology, faith healing, phrenology, or feeling the soles of one's feet as forms of health services, should these also come under the umbrella of health freedom and be covered by medicare?
_ yes no
209
7 7 l 7
Where does one draw the line between the various types of ser- 7~ vices that should be covered by medicare or other tax-supported programs?
a)_ there should te no limitations placed upon which services 7· are covered.
b)_ any person who is licensed by the state to deliver any kind of health services should be covered. (Examples: 1• .. audioloeists, occupational· therapists, clinical psycholo~ists, social workers, naturopaths, chiropractors, optometrists, corrective therapists, etc.) 1·.,
c)_ only persons delivering health services that are recog-nized as representative of scientifically valid procedures
210
On Octoter 30, 1972, President Nixon signed into law a bill, H.R.1, which included coverage for certain chiropractic services under Medicare. On ~hat date will this coverage begin?
a) Janua.ry 1 , 1973 b )- ;,pril 1 5, 1973 c)~ July 1, 1973
211
~re all chiropractic services covered under the provisions of the new law?
_ yes no
- 56 -
7 7 l
Appendix A, Item 18
Letter from HEW Off- 1 ice of Public Affairs
Ibid.
7 l 7
j
7 l l
212
What chiropractic services are covered under the new law?
a)_ all services performed by a licensed chiropractor. Ibid.
b) manual manipulation of the spine c)- only manual manipulation of the
- spine to correct a subluxation that is verified by a satisfactory x-ray.
PART VIII. CHIROPRACTIC AND THE HOSPITAL
213
CHIROPRACTIC AND HOSPITAL PRIVILEDGES
An issue that has been raised on the local level in some areas concerns the right of a chiropractor and his patients to utilize publicly-owned or tax-supported hospital facilities. The reasons chiropractors give for wanting to use hospital facilities are for access to certain modes of therapy and the ability to closely supervise a patient under treatment.
Medical doctors refuse to work in a hospital which grants priviledges to chiropractors because it is a violation of medical ethics to voluntarily associate with cultists. Webster defines a cultist as 11one who has a devoted attachment to a principle, which seems to apply to chiropractic .
An important function of the hospital for medicine is that it serves as an open arena where a practioner must perform before the critical eyes of his peers. It has been pointed out that it i$ nearly imrossible to monitor the activities of any practioner in the seclusion of his private office practice. There are those who believe that permitting chiropractors to use the hospitals would serve as a means of detecting incompetent practioners. Critics believe it would simply serve as another apparent stamp of approval on chiropractic which would seem to further legitimize a scientifically invalid system of care.
214
YOUR OPINION PLEASE
Do you think chiropractors should be given hospital privil.edges?
_ yes no
- 57 - Answers to pages 56 and 57➔
ANSWERS
P .56 .:..P.:...::.5~7...-----------------+------------t
208 212
0 p i n i 0 n c)
209
0 p i n i 0 n
210
c)
211
no
213
NR
2 14
0 p . 1 n i 0
n
215
Is hospital training part of present-day chiropractic education?
_ yes no
216
For what reason is it not included?
a) chiropractors don't want to use - hospitals
b} chiropractors are not permitted - to use these facilities
217
Are there now, or have there ever been any chiropractic hosoitals?
_ yes no
218
What is the nbme of the chiropractic hospital visited and reported on by Ralph Lee Smith?
a} Palmer 1~~emorial Hospital b)- Carver Sanitarium and Hospital c)= Spears Chiropractic Hospital
219
where is the hospital identified in frame 218 locuted?
a) Davenport, Iowa b}- Denver, Colorado c)- Kansas City, Kansas d)= Los Angeles, California
- 58 -
"White Paper," p.7
Refer to frame 213
Smith, AYOR, chapter seven.
Ibid. p.87
Ibid.
7 J
7 j
1 7 7 l 7 7 7 7 l 7 7 l 7 l 7 1 1
220
According to publications of the Spea rs Chiropractic Hospital the cause of cere bral palsy is:
a) b)-c )=
22 1
brain injury subluxations bony structure of abnormally shaped skull s pre ssing on tender brain tissue.
How does the Spea rs r ese arch on the cause of cerebral palsy compare to what is known about the condition at t he United Cerebr a l Palsy Research and Educctio nal Foundc.1tion.
a) b )=
c)_
222
it is ir compl et e harmony with it. the Found atio n den i es that i t has bn y va lid ity. it i s simi l ar, but var i es u little in detc.1il.
~hat dis ea se did t he Spea rs Chir opractic Hospita l make its big gest name on?
a) cancer b)- a rthri t is c) - cerebr&l pa lsy d )= heart disease
223
Has the ~pe~rs treatment for cancer es tablished any cre dibil ity in the scien tific com.rnuni ty?
_ yes no
Smith, AYCR, p. 91
Ibid. p. 92
Ibid. p.93
Ibid. p.92
Turn page ba ck for answers to pages 58 and 59 .
- 59 -
p .58 ~ 1-------------------------------""t
215 220
no
c) 216
221
b)
217
b)
yes
218 222
a)
c)
219 223
b) no
224
What did the state of Colorado do to stop the cancer treatments at the Spears Chiropractic Hospital?
a) they passed a law prohibiting - chiropractors from treating cancer.
b) they closed the hospital. c)- they put on a public information
- campaign warning the people away from the hospital.
225
What was the latest field the Spears Chiropractic Hospital was opening up according to Ralph Lee Smith's report?
a) arthritis cures b)= weight reduction clinics c) mental and emotional illness d)= diseases of the aged
226 PART IX.
CHIROPRAC'l'IC'S FUTURE
Ibid. p.96
Ibid.
With the ever increasing participation of government in the health care delivery system coupled with a growing consumer awareness, more and more public inquiry into chiropractic can be expected. It appears as if the scientific age has caught up with chiropractic. The question seems to be, can chiropractic catch up with the scientific age!
As fo·r what the future holds for chiropractic one can only try to guess, but no such guesses will be attempted here. The next sequence of frames deals with a variety of factors relating to chiropractic's possible future.
227
Is any effort being made by chiropractic to validate itself scientifically?
yes no
- 60 -
ICA Reprint, p.11
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228
Will the increased research into the value of manipulation as a mode of treatment called for by the conclusions of the HEW Report be a boon to chiropractic? HEW Report, p.52
a) yes, for a certainty b)- perhaps, but not necessarily c)= no, not likely
229
The reason for the conjecture in frame 228 is due to the find ings of Dr. Livingstone of Canada who has written quite a bit on the subject of manipulation as a mode of tre dtmen t.
While fully rE=cognizin g and even promotmanipulation as a mode of therapy, what does Dr. Livin gsto n conclude about chiropractic tr ea tment?
c)_
230
he values it hi ghly he cites several case histories of injury as the result of chiropractic manipul at ion. he says complications would be avoided by re asona ble manipulative care in wiser hands than those of a chiropractors.
The entire thrust of ~e iant's booklet, Jv1edicine and Chi ropractic, is toward the resolution of the problems between chiropractic and medicine.
Which of the following statements best summarize \veiant's hop ef ul solution?
a) _
b)_
c)_
Chiropractic must work to displace traditional medic ine eventually. chiropractic must continue to exist as a n all-inclusive alte rnativ e side by si de with medicine. chiropractic must establish its place within th e scientific community perfo rmin g its scientifically validated tre&tments in full cooperation with the medic a l fraternity.
Appendix A, Item 19
Livingston , "Spinal Manipulation in Medical Practice: A Century of Ignorance." The Medical Journal of Australia, p.553 Sept.8, 1968.
Also, review frame 94
Weiant, M&C
- 61 - Answers to pages 60 and 61~
AN5W~~ 7 p.60 P.61
224 228 231 7 According to Weiant in his more recent
7 hublication, what response has his opeful solution referred to in frame
a) 230 received from organized medicine?
Weiant, WMRTAC, 7 a) it has been taken under advise- p.19-20 b) - ment by the AMA.
b) it has fallen on deaf ears.
7 c)- it has been well-received by - most medical doctors.
229 7 225 232
Does Weiant seem to hold out hope that 7 medicine will accept chiropractic on the terms he hoped for in Medicine and
1 Chiropractic eventually? Ibid. p.15
_ yes no - ' 7 c)
233
7 b) What does Weiant see as the future of 226 chiropractic if what he describes as
c) the "new strategy for America" becomes 7 successful?
NR Ibid. p.15-16 a)_ chiropractors will be deinied 7 licensure. b) - physiotherapy will be expanded
as fast as possible to fill
7 chiropractic's place. 230 c)_;_ chiropractic will be merged with
medicine and chirohractors will work as equals wit medical l doctors.
d) _ manipulation will only be per-formed by medical prescription.
1 227
7 yes
c) l
- 62 - l l
234
What ethical violations does Weiant say·would result if medicine takes manipulation from chiropractors and utilizes it as one of its modes of therapy?
a)_
b)_
c)_
235
deprivation of an entire profession of its livelihood. deprivation of chiropractic of 70 years of exhaustive study, diagnostic inventiveness, technical skill and painstaking clinical research. it would breach medical ethics on the point of association with cultists.
What does Weiant consider would be the most grevious aspect if medical doctors attempt to perform manipulation as a mode of treatment?
a)_
b)_
c)_
236
they would probably stop using many drugs and other useful therapies. they would endanger the unsuspecting public by trying to
·perform manipulation without proper skill and training. chiropractic as a profession would disappear.
Does Weiant feel that physiotherapists could competently perform the manipulation now performed by chiropractors?
_ yes no
237
Does Weiant offer any evidence of the danger of manipulation performed by medical doctors?
yes no
Ibid. p.16-17
Ibid. p.17
Ibid.
Ibid. p.17-19
- 63 - Answers to pages 62 ana 63~
ANSWERS
P.62 P.63 --------------------------------...
231
b)
232
no
233
a)
b)
d)
234
a)
b)
235
b)
c)
236
no
237
yes
238
How does the International Chiropractic Association view the role of the chiropractor in the final section of their reprint from the International Review of Chiropractic, entitled, "Questions and Answers Regarding Chiropractic''• Reference cited, p.13
a) chiropractic is an all-inclusive - alternative to medicine which
should exist side by side with, but in opposition to medicine.
b) the model presented desires to - place chiropractic withing the
scientific community, but parallel with medicine, not below it.
c)_ chiropractic is confined to the spine and its immediate articulations as the dentist is to the mouth; (according to chiropractic's hypothesis of subluxations and disease this could include a wide variety of diseases ••• which is precisely where chiropractic is currently!)
239
According to data from HE~ on health manpower, is chiropractic a growing profession?
a) yes, and very rapidly b)= no, it is losing steadily c)_ yes, it is apparently registering
a slow but steady increase in the actual number of practioners.
240
Is chiropractic making any effort to recruit students for chiropractic careers?
_ yes no
- 64 -
hppndix A, Item 20
Carlova, "I Visited A Chiro
practic College," Medical Economics, p.2
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241
Is there a demand for ch iropra ct ic Practioners in the health care marketplace?
_ yes no
242
Where does chiropractic rank in tota l numbers of practioners compared to all types of health care?
a) fourth b )- third c )= second
243
How does Dr. J. A. Sabatier Jr., Chairman of the A.M.A. Committee on Quackery describe the situation of chiroprac t ic?
a )_
b)_
as a pol itical problem, not a scientific probl em. as a moral issue, not a l egal one.
c) a s a scientific problem. d)= a s a professional conflict problem.
244
Who does Ral ph Lee Smith say the blame belongs to for permittin g chiropractic to achieve " •.. its status as th e only legally reco gnized and licensed medical superstition in the United States"?
a) b )c)-d)=
the academic community the public's apathy organiz ed medicine's monopoly. the l eg i s latur es
Dintenfass, p.128
Weiant, WMRTAC, p.7
Carlova, "I Visited a Chiropract ic Coll ege" ~ed ical Economics, July, 1968, p. 7
Smith, AYOR, p.157-158
Turn page ba ck for answers to pages 64 and 65.
- 65 -
,u,uvu:,nu
p. 64n p. 65 .,_-------------------.....-----------.. --238 241 245
Why do legislatures vote in favor of chiropractic so often if the A.M.A. is as powerful as critics say, and chiro-
yes practic is so small?
242
b)
c) c)
243
a) 239
c) 244
a) chiropractic's strong and well- staffed lobbists.
b) chiropractic's strong voter supp- ort.
c)_ apparent corruption· is involved.
246
What does Smith say is the correct way to deal with treatment methods which cannot or will not submit to the judgement of scientific research?
a) limit their use b)- prohibit the by law c)- control their use by some sort
of government inspection
247
Which of the following does Smith recommend be done with chiropractic?
a)_ chiropractors should be imrrediately prohibited from further use of x-ray
b)_ an inspector should be appointed in each state to control the kinds of
Ibid. p.165
Ibid.
diseases chiropractors treat. Ibid. p.166 c)_· each state should create an orderly
240
yes d)
program for withdrawing all chirop-ractic licenses.
d)_ state licensure of chiropractic should be placed under control of persons other than chiropractors.
e)_ a chiropractor's "GI Bill"--for the reschooling and retraining in any other field they might wish to enter should be instituted.
- 66 -
7 7 l 7 7 7 7 7 7 l l 7 7 7 7 7 l 7
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7
248
What solution did chiropractors Fisher, Crogdale and Shimer employ after having personally acknowledged chiropractic's shortcomings and its "gl oomy" future?
a) b)=
c)_
249
they went into physical therapy they went into training in the field of physical rehabilitation they entered training as M.D. 1 s Assistants
Why do some peop le object to chiroprac tic's use of the title "doctor"?
a) _
b) _
c)_
they don't feel a chiroprRctic education involves eno11gh tota l years to merit the title. they fee l that the public is apt to pl ace too much confidence in anyon e who is lega lly gra nted a title of that stct tus. a state's "d octor 's" lic ense permits its holder too much unregulated freedom of action, which constitutes a publ ic danger in the hands of a chiropractor.
250 PART X.
CHIROPRACTIC IN HEALTH EDUCATION tLkSSES
Reprint from: American Medical News, November 15, TI7I
Smith, AYOR, p.158-9 --
Until recently, health textto oks haven't conta i ned any inform ation on chiropractic . Even now, only a few do bnd the inform ation they contain is quite limited. Thi s may be because of the reason that son,e pe rs on s who believe rather st ron g ly in chiro practic (or who a re strongly anti -e stbblishment and choose to side with anything that the A.M.A. is agctinst) oft en react or are offended by a ny stdtements which question its vali dity. It is becoming incre a sin ely apparent that health educators are go ing to h~ve to be at least well enough info rmed about chiropractic to answer questicns concerning it in the classroom .
Studies show that the primary group of family bnd clos e friends is most often the source of information about different types of healers. The professional group consisting of doctors, phar macists, teachers, etc., is second. The he a lth teacher faces
- 6 7 -
con t inued on next page
Turn page back for answers t o pages 66 and 67,
P.66 P.67 -----------------------------
.245 248
c)
246 249
b) b)
c)
247
a) 250
c) NR
e)
251, continued
a gre&t responsibility in the giving of health information, because in many cases the health teacher represents the only well-informed person a student may ever be exposed to regarding matters of health and health care.
The final sequence of frames deals with somA of the factors concerning teaching about chiropractic in the classroom. There will be no references of answers provided in this last sequence because it is your opinion that is sought in all of them.
252
Do you believe consumer health teaching units should include substantial information about chiropractic?
_ yes no
253
Would you include chiropractic as a desirable career choice if you were teaching a unit on health careers?
_ yes no
254
What approach should a health educator take when presenting information on chiropractic?
a) unfavorable, since the bulk of the data is negative ~ toward chiropractic.
b) favorable, to avoid offending anyone who might strongly - believe in chiropractic. ,
c) be as objective as possible, well-supplied with inform- ation and not highly opinionated.
255
Would you be reluctant to teach about chiropractic because it might cause controversy in the classroom?
- yes
- 68 -
no
There are no more answers beyond this point.
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256
With whom should health education align itself in the chiropractic controversy?
a) with the A.M.A. because it not only is the recognized - spokesman for scientific medicine, but a great deal of
the information dispensed by health educators comes either directly er indirectly from that source.
b) with the law of the land. If the state licenses chiro-- practic a health educator should present it as a legiti
mate alternative health care system emphasizing its legal recognition and favorable assets.
c)_ with the people and their right to freely choose any type of health care they wish. Health education should take a strong stand for the concept of health freedom.
d)_ with the scientific method and its objective search for truth. As representatives of the scholarly world, health education must place the search for truth above all other considerations cind report the facts they observe. They should align themselves with NO ONE!
257
What price would health education have to pay if it should align itself with any organization rather than fulfill its role as representative of the academic community and stand for the scientific method and its objective search for truth?
a)_ it would lose credibility by grouping itself with any organization which could be accused of having a vested interest.
b)_ if it gives up its objectivity, it is apt not to be aware of new information or significant changes that are occuring in the status quo.
c)_ it would give up its right to arbitrate issues as an interested but unbiased third party.
258
Do you feel that as a result of having taken this programmed learning course you now intend to keep up with changes in the chiropractic situation?
_ yes no
- 69 -
APPENDIX A
SELECTED REFERENCES
1. Garrison, History of Medicine, Philadelphia: W.B. Saun-ders Company, 1929, page 99.
" ••• the Hippocratic ••• school ••• treatment was centered upon assisting the patient ••• against the disease, which was regarded as an imbalance of the four humors."
l l l l 1
2. Bender, Great Moments in Medicine, Parke, Davis & Company, 7 1958. "Hippocrates: Medicine &ecomes A Science."
" ••• most Greek physicians, unlike their contemporaries in some other nations, were not priests, but craftsmen. Thus were combined empirical knowledge of craftsmen and speculative theories of philosophers.
Best known of these pseudoscientific principles was the humoral theory. The human body was thought to consist basically of four humors: blood, yellow bile, black bile, and phlegm. In a state of health these four humors were balanced. Unbalance in their proportion resulted in disease, and nature made efforts to restore this balance by throwing off matter. It was the physician's job to assist nature in these efforts."
l l l l
NOTE: This is the theory that led to blood-letting and other errors that made life in the hands of the ancient phy- l'--. sicians a rather precarious matter at times.
Guthrie, A Historz of Medicine, Sons LTD, 19 6. p.55.
London: Thomas Nelson and
"Hippocrates knew little of anatomy or physiology, and he possessed neither clinical thermometer nor stethoscope •••• But although he had no scientific apparatus, he had scientific method, and his writings were full of sound observation and logical reasoning."
3. Smith, "Chiropractic: Science or Swindle?" Today's Health, May, 1965, p.59.
"The two approaches to chiropractic have continued to this day. Adherents to the Palmer approach are called "straights" and followers of Carver are called "mixers". Feuding between the two groups has often been bitter. Chiropractic colleges in the United States align themselves with one of the two schools of thought, and the two groups even have separate associations."
- 70 -
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4. Annual Catalog 1971-1972 of Western States Chiropractic
5.
College, Portland, Oregon. p.29-30.
Out of fifteen listed faculty members, nine have both the Doctor of Naturopathic degree and the Doctor of Chiropractic.
u. s. Public Health Service. Health Resources Statistics. Rockville, Md.: Department of HEW, 1971, p.57-8.
"NATUROPATHS Naturopathy is a school of healing employing a combination of nature's forces such as air, light, water, vibration, heat, electricity, dietetics, and massage. It does not include the use of drugs, surgery, and x-ray or radiation (except for diagnostic purposes). Many naturopaths are former chiropractors and use chiropractic treatment.
The National Association of Naturopathic Physic.ians ( 170 members) is composed of naturopaths, naturopa~b~chiropractors and chiropractors."
6. Stanford Research Institute, Chiropractic in California, Los Angeles: The Haynes Foundation, 1960, p.71.
"Other than the type of x-ray machine common to the healing arts in general, the most commonly used device is the neurocalometer, which was found in the offices of some 12 percent of the chiropractors surveyed. Eight percent of the chiropractors used inhalation apparatus. An analysis was made of ••• the ozone generator. Still another device in frequent use is the radionic machine, which was found in more than 4 percent of the offices surveyed."
NOTE: The conclusions of the test of the Radionic machine by the Stanford group stated: "The machine is incapable of detecting or measuring radiation. In fact, it can detect no physical phenomenon of any kind."(p.74)
7. Levine, Howe, and Rolofson. "Radiation Exposure to a Phantom Patient During Sirpulated Chiropractic Spinal Radiography," .Radiological Health Data and Reports, 12:245-51, May,'71.
Mr. Levine is public health advisor, Division of Medical Radiation Exposure, Bureau of Radiological Health, Public Health Service, Rockville, Maryland 20852. Dr. Howe is radiological health consultant to the American Chiropractic Association, Tallmadge, Ohio 44278. Mr. Rolofson is health physicist, Division of Biological Effects, Bureau of Radiological Health, Public Health Service.
"Radiographic exposures to various organs of a simulated patient were determined for 31 techniques of spinal radiography used by doctors of chiropractic •••• It is clear that some of the commonly used techniques ••• do give excess radiation factors as well as excessive film density which yields less than optimum film quality. There is considerable need for further studies and efforts toward obtaining optimum quality radiographs with less patient exposure." This report is followed by practical suggestions on techniques to reduce exposure.
- 71 -
8. "Duties of Chiropractors to the Profession and to Each Other." Part 2, Article I. "Duties to the Profession." Section 3. Code of Ethics. The American Chiropractic Association, Inc.
"The individual chiropractic physician, or doctor of chiropractic, or chiropractor, shall refrain from personal advertising in order to extend the sphere of respect, recognition and integrity of the profession. Personal advertising is defined as that which in substance deals with the particular abilities, features, or accomplishments of the individual. At no time will a doctor of chiropractic make known his superiority over that of another, verbal or written-this act shall be considered as a vtolation of this Code. An ACA member shall never employ a professional agent. Direct mail public relations to the patient shall contain material of education about chiropractic. At no time will mailed material be flamboyant or showy, make promise of cure, free examination or consultation, spec~al technics or methods, or imply superiority in any manner. Further, the material must not castigate other health sciences or make claims that cannot be substantiated by laboratory and diagnostic procedures. The material should never contaim statements of any kind that might be construed as false or misleading."
9. American College of Radiology Commission on Radiologic Units, Standards and Protection. X-Raa Examinations ••• A Guide to Good Practice. Rockville, M .: U.S. Public Health Service, 1971, p.4.
A. WHY BE CONCERNED ABOUT RADIATION EXPOSURE GENERALLY? 1. Possible genetic effects:
Sound theoretical considerations suggest that even small amounts of radiation exposure to the gonads can adversely affect the genetic inheritance of future generations. This has led to the widely acceipted principle that no amount of gonadal exposure is so small as to be dismissed as harmless •••
2. Possible effects on the patient: -Although no significant somatic change has been demon
strated in adults as a result of the low doses incurred in diagnostic radiology, there is laboratory evidence that even these levels of radiation may affect some cells; however, several epidemiological studies suggest that special consideration must be given to the relatively high radiosensitivity of the fetus in utero, particularly during the early phases
. of gestation.
NOTE: Recommendations in the guide intended to minimize the radiation hazards to the patient include the following:
Filters; to filter out useless rays from the tube. Beam Restrictors; to limit the beam to just what will fall on the film. Gonadal Shields; to shield the gonads of patients who
- 72 -
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are potentially procreative when the gonads cannot be excluded by collimation. Gonadal shields are not used when their presence would obscure important areas or otherwise interfere with the examination.
10. Livingston, "Spinal Manipulation Causing Injury: A Three-year Study." Clinical Orthopaedics and Related Research, 81: 82-6, Nov-Dec, 1971, p.82;85-6.
"The purpose of this paper is to record the frequency of injury associated with spinal manipulation in cases seen during 3 years of a general medical practice •••• SUMMARY Spinal manipulation is a common procedure in North America. Injury associated with spinal manipulation appears more frequent than the present North American medical literature suggests. Six hundred seventy-six patients with pains, possibly of spinal origin, were examined in 3 years. One hundred seventy-two of these had visited a chiropractor at some time, and 12 of these received an injury. Injury from manipulation may also occur from medical or paramedical personnel. Injury could be avoided if those practicing spinal manipulation were adequately trained.
11. Roebuck and Hunter. ''The Awareness of Health-Care Quackery As Deviant Behavior." Journal of Health & Social Behavior, June 13, 1972, p.164.
TABLE 2. RESPONDENTS' RATINGS OF THE EFFECTIVENESS OF FIVE TYPES OF HEALERS
Types of healers
Medical Chiro- Osteo- Natur-Rating doctor praetor path opath
Effective N 90 25 14 • • • • % 86.5 24.1 13.4 . . . .
Sometimes effective N 12 31 18 3 % 11.5 29.8 17.3 2.8
Ineffective harmful N 2 14 14 14 % 1.9 13.4 13.4 13.4
No opinion N .... 34 58 87 no knowledge % •••• 32.6 55.7 83.6
Homeo .. path
1 0.9 3 2.8 7 6.7 93 89.4
12. "A Professional Survey Report Shelved For 18 Years Comes To Light." New England Journal of Chiropractic, 6:2 9-22, Spring, 1972, p.11.
"Only 70% of chiropractic patients are satisfied with the results they get from chiropractors; 26% are definitely dissatisfied; and 4% give qualified answers •••• a 26 to 30% level of dissatisfaction is too high and can be very damaging. The stud-
- 73 -
ies show that the attitudes of these dissatisfied patients are the most adverse to chiropractic. They could do a lot of damage, and something should be done toward reducing their percentage in relation to the total number.
13. "Educational Background of Chiropractic School Faculties." JAMA, 197:12 999-1005,- September 19, 1966, p.999.
"For the purpose of this study, a definition of "spurious" degrees was obtained from the Office of Education of the US Department of Health, Education, and Welfare. In "Academic Degrees," a publication of that Department, more than 2,400 academic degrees are listed. The Doctor of Chiror.ractic (DC) degree is listed under the heading "spurious." A 'spurious" degree is defined by the Office of Education as one purporting to be a legitimate degree, duplicating those given by legitimate institutions, but granted by ''diploma mills," or a degree not granted or offered by a legitimate institution, but unique to the granting institution."
14. Letter from The University of the State of New York, The State Education Department, State Board for Chiropractic, Philip R. Johnson, Acting Executive Secretary, Dated November 20, 1972.
"Under New York State professional licensing laws which are administered by the Board of Regents and the State Education Department, only graduates of approved educational programs may be admitted to the examination. Wherever national accrediting bodies for a given profession exist and are recognized by the National Commission on Accreditation, we automatically accept the schools they approve. Since chiropractic accrediting bodies are not so recognized, we can conduct our own accrediting process. This is the action which we took in relation to the National College of Chiropractic in Lombard, Illinois. Thus, that school is approved for purposes of admission of its graduates to the professional licensing examination in chiropractic in New York State."
15. "Report of the National Advisory Commission on Health Manpower," Vol.II, November, 1967, p.326-46. Section C. Chiropractors and Other Cultists.
"Medical authorities unanimously agree that chiropractic has no validity. The cult's theories have never been supported by objective evidence, and they have been thoroughly refuted by medical science. Besides considerable economic consequences, the dangers inherent in this· healing cult are two-fold. First, chiropractic treatment frequently delays proper and effective medical care until it is too late. Second, chiropractic treatment often produces actual physical damage to patients. Ideally, therefore, the statutes should be repealed to remove the cult's shield of legitimacy ••••• The basic assumption of licensure of chiropractors-that licensure facilitates regulation-should be reexamined."
- 74 .:.
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16. Judicial Council Opinions and Reports. Chicago: American Medical Association, 1969, page VI "Principles of Medical Ethics," Section 3 (expanded on pages 13-17).
0 A physician should practice a method of healing founded on a scientific basis; and he should not voluntarily associate professionally with anyone who violates this principle. 1. STANDARDS, USEFULNESS, NON-SECTARIANISM
••••• A sectarian or cultist as applied to medicine is one who alleges to follow or in his practice follows a dogma, tenet or principle based on the authority of its promulgator to the exclusion of demonstration and scientific experience. All voluntary associated activities with cultists are unethical."
17. Rayack, Professional Power & American Medicine. Cleveland: The World Publishing Company, 1967. p.255-6.
"Although the A.M.A. has made considerable concessions to the osteopathic profession in recent years, there does not seem to be any prospect for a similar modification in its attitude toward chiropractic as a "dangerous cult." Only recently (October 1966), the A.M.A. sponsored a day and a half National Congress on Medical Quackery; although the congress covered such topics as health food fads, obesity treatment, flouridation, and cancer quackery, fully one-third of the time was devoted to an "educational session on chiropractic." While I am not prepared to evaluate the scientific case made by organized medicine against chiropractic, there is enough evidence to strongly suggest that the A.M.A. may in this area of its activities be less interested in propagating the truth than in destroying the medical profession's most substantial competition-the nation's 25,000 chiropractors. The basic question at issue is whether chiropractors are performing a useful social service in the provision of health care; legislative and widespread public acceptance indicate that they are."
18. Exerpt from a letter to Robert O. Beatty, Assistant Secretary for Public Affairs, Department of Health, Education and Welfare, from Russell R. Jalbert of the Social Security Administration dated November 15, 1972.
"Some professional _groups seem to believe that H.R.1 as enacted provides for Medicare coverage of the services of chiropractors on the same basis as payment is made for the services of physicians or as covered under Medicaid up till now. Others are under the impression that what was enacted was the Senate Finance Committee provision. Actually, what came out of the Conference Conunittee and was enacted was much more limited. Beginning July 1, 1973, Medicare can pay for the services of licensed chiropractors, but only (1) if the chiropractors meet uniform minimum standards to be set by the Secretary; and only (2) with respect to manual manipulation of the spine; and the9 only (3) if that manipulation is for correction of a subluxation; and still further, only (4) if that subluxation is verified by a satisfactory x-ray."
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19. Livingston, ''Spinal Manipulation in Medical Practice: A Ceritury of Ignorance." The Medical Journal of Australia, 2: 552-5, September 28, 1968.
"The link between quackery and manipulation has repelled physicians. J.·McM. Mennell (1966) has noted: "They associate manipulation with cultism and religious nuts, when, in fact, it offers them another dimension of diagnosis and treatment.".... · The anatomical concept and rationale behind manipulation are uncertain. CAN SPINAL MANIPULATION CAUSE HARM1 In the United States, over 25,000 manipulators of varying abilities are each manipulating a minimum of 10 patients daily. There are few reported injuries to show for possibly 75,000,000 yearly,.manipulations. Complications arise chiefly from the following causes: (i) vascular-the cerebellar syndrome; (ii) bony-especially from carcinoma, tuberculosis, osteoporosis, fracture or dislocation; (iii) disc fragments; (iv) spinal cord tumours; (v) ~iscellaneous. These complications are aided by improprer diagnosis or incorrect technique applied by untrained persons (Hirschfield, 1965) •••• Among my last 280 consecutive patients ••• 51 stated that they had visited a chiropractor ••• Four of these 51 had some injury from chiropractic treatment.
Case 22.-A man, aged 31 years, with sciatica from a lumbar disc syndrome, suffered two weeks of severe back pain after a chiropractor has stood on a stool and jumped on his back with both kne s.
Case 170.-A young alcoholic visited five chiropractors in eight days for irrelevant treatment. His back pain increased with this treatment.
Case 189.-A woman, aged 45 years, with a cervical disc syndrome confirmed by x-ray examination, had lost consciousness after chiropractic neck "adjustment" 15 years previously, and required three days of hospital treatment.
Case 240.-Rough treatment caused a fracture of the body of the third lumbar vertebra in a man, aged 82 years. While it is likely that this injury rate is higher than usual, it suggests that many c~iropractic injuries are unreported in the medical literature. The great majority of these complications would be avoided by reasonable manipulative care in wiser hands."
20. U.S. Public Health Service. Health Resources Statistics. Rockville, Md.: Department of HEW, 1971, p.57.
"About 20,000 chiropractors were licensed at the end of 1970 in the United States according to estimates provided by the American Chiropractic Association. This represents a slight increase over estimates made for previous years ••• Perhaps 15,000 to 17,000 of these chiropractors are activiely engaged in practice. The 1950 and 1960 Censuses of Population reported 13,091 and 14,360 chiropractors, respectively, in the civilian labor force.
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At the time of the publication of the 1968 HEW Report? either the American Chiropractic Association or the International Chiropractic Association accredited the various chiropractic colleges. As of 1970 the American Chiropractic Association discontinued accreditation turning the authority over to The Council on Chiropractic Education. The Council on Chiropractic Education is not recognized by the U.S. Office of Education of HEW, or any of the other major educational bodies who accredit -higher education in the United States, but this recent change is an important part of chiropractic's current attempt to gain such official recognition by these agencies. Standards for accreditation by the council are published in the following:
Fineberg, Henry I., "Chiropractic Education," Science, June 3, 1966. v. 152, pp. 1329-1330.
ttWeiant 7.- says: '.Foreign medical literature of the last 10 years, especially in Germany, is replete with references to chiropractic-contributions to its theory, reports of clinical trials, and enthusiastic appraisals of its usefulness.' The fact~, according to a recent letter from the secretary of the German Medical Association, are as follows: •~e may express that there are physicians here which make use among other therapeutic methods of a certain manual therapy of the vertebral column and the extremities. Those methods are also taught in special courses for doctors (not chiropractors). Those physicians--most of them are specialists for orthopaedy--use such methods besides other m~thods of curing. They are by no means com-parable with an American "chiropractor".' In the United States, doctors of physical medicine and other physicians utilize manipulative therapy in their practice, but this does not mean that they are practicing chiropractic or using chiropractic procedures. Manipulative maneuvers are not and never have been synonymous with chiropractic •••• ".
*Reference to: Weiant, C. W., "Chiropractic and Osteopathy,'' Science, March 11, 1966. v. 151.
Stanford Research Institute, Chiropractic in California, Los Angeles: The Haynes Foundation, 1990, p.71-2.
"THE PAL~R NEUROCALOMETJ::R •••• It is intended to be used for diagnostic rather than therapeutic purposes. Conclusion The instrument tested wa~ well made and operate·d on sound physical principles. It could measure the temperature difference of the skin at the two thermocouple locations to within O.lC, provided that equal pressures and contact areas were used. Faulty technique could result in erroneous readings. The: interpretation and significance of the measured temperature differences are beyond the scope of this report."
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Ballantine, H. T. Jr. ''Will The Delivery of He3lth Care Be Improved By The Use of Chiropractic Services?'' New England Journal of Medicine, 286: 237-42, Feb. ~1972.
Barrett:, s. "Mass X-Ray Screening". JAMA, 220: 1363, June 5, 1972.
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Caster 1 ine, R. L. ''Un sc ient if ic Cult ism~ T")angerous to Your He a 1th" , JAMA , 21 9 : 10 0 9-10 , Ma re h 13 , 197 2 •
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18. Health for Life, Volume 4, number 2.
19. Hunter and Roebuck, "The Awareness of Health-Care Quackery As Deviant Behavior". Journa 1 of Heal th and Socia 1 Beh-avior. June 13, 1972.
20. · "In The Wisdom of Congress", JAMA, : 1002-3, Feb. 9, 1970.
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Klar, R. M., Neuhauser, D. and Ballantine, H. T. Jr. "Chiropractic and Health Care''. New England Journal 6£ Medicine. 286: 951-2, April 27, 1972.
Kuch, Richard. "America's Health Delivery System is Everyone's Concern." Healthways, May, 1972.
Levine, J. I., Howe, J. w., Rolofson, J. W. "Radiation Exposure to a Phantom Patient During Simulated Chiropractic Spinal Radiogra.phy." Radiological Health Data Reports, 12: 245-51, May, 1971.
Livingston, M.C., "Spinal Manipulation Causing Injury. A Three-year Study." Clinical Orthopedics, 81: 82-6 Nov-Dec., 1971.
Livingston, M.C. "Spinal Manipulation in Medical Practice: A Century of Ignorance," The Medical Journal of Australia, 2: 552-5, September 28, 1968.
Maisel, Albert Q. "Should Chiropractors Be Paid With Your Tax Dollars?" Reader's Digest, July, 1971.
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Weiant, C. W. Medicine and Chiropractic (Thumbnail Edition), Des Moines: American Chiropractic Association, 1958.
Weiant, C. W. and Goldschmidt, s. What Medicine Reallt Thinks About Chiro ractic ••• A Stud in Con£ lict, A Pub! cation o t e American C iropract c Assoc at on, 1966.
Williams, Sid. "Force or Form", Life DE Meeting News Letter, Vol. 5, No.3, October 29-29, 1972.
Williams, Sid. "Spinelines: Ethical Codes vs Health Freedom," Health for Life, Vol. 4, No.2. p.2.
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47. Wolfe, Robert. Unpublished letter dated July 10, 1972 entitled, l "A Plea To All D.E. Members To Become Members Of The Scientific Research &nd Civil Rights Foundation.'-' From the Scientific Research and Civil Rights Foundation, P.O. 7 Box 1793, Altadena, California, 91001.
48. Wilbur, Richard S. "What the Health Care Consumer Should 7 Knew About Chiropractic," JAVu\, 215:8"1~07-9, Feb 22, 1971. --
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