Sren Shepherd

Professor Fisher
Power and Imagination
20 April 2015
The History of Chiropractic
Medicine that reaches far outside what is considered conventional in our society today has been around
since the beginning of time: from natural remedial practices by early humans, to things like homeopathic
or naturopathic approaches used today. These different disciplines in medicine can take many forms and
may be referred to in a multitude of ways, some such being: complementary, alternative, unorthodox or
unconventional. Although alternative medicine has been around a very long time, only in the past half
century has it really begun to take flight. However, with the growth of alternative medicine there has
come a rise of disapproval and skepticism regarding the approaches to medicine that all these different
disciplines have. Unconventional approaches have even been dubbed as quackery throughout the latter
half of the 20th century, and although the perception of unconventional medicine is beginning to change
there is still a very prevalent negative stigma surrounding it.
During my senior year of high school, my father and a group of other chiropractors were in a battle with
the school districts because they were trying to take away their ability to administer physicals to school
students of all ages, and reserve the right solely for medical doctors. The weirdest thing to me was the fact
that my father also owned a drug testing and screening company in which he gave DMV physicals all day
long, and they now were trying to take away his right to administer the physicals to children? Growing up
with my father as a chiropractor, it was the only practice of medicine I ever knew, or that my family and I
ever needed. On the forms I always filled out, wherever it said family physician I got to write my
fathers name down. It was not until the latter years of my youth that I ever felt any of the effects of the
reality that the chiropractic profession was a touchy subject in the medical world, and it took a decent
amount of research and a couple of interesting documentaries for me to fully grasp the scope of it. Ever
since its founding in the late 19th century, chiropractic has endured heavy oppression and discrimination

from the medical world. It has done a great deal to overcome these trials, but as can be seen from my
personal experience it is clear that these trials are not over. The goal here is to examine the history of
oppression the Chiropractic profession endured and the struggles it faced in order to become a legitimate
contributor to healthcare today.
The disparity between conventional and unconventional medicinal practices in the United States was
established in the 19th century, during a period of time in which homeopathy, osteopathy, naturopathy,
mesmerism, hydrotherapy, and the newfound chiropractic profession were all practiced in addition to
allopathic (conventional) medicine. The American Medical Association was established in 1847 by
conventional physicians to protect their hold on the medical market. Although at this point in time their
claims were false, these allopathic practitioners began to claim that their discipline was the only branch of
medicine that was actually rooted in science. Even though their practices were no more scientific than the
other branches, their claim as the sole scientific medical profession allowed them to seek the support and
protection of the state over their work (Winnick 40). The persuasion of the state by the allopathic
profession and the AMA to act in the public interest and to [limit] the funding of medical education to
regular schools, and [pass] licensing laws restricting irregular practice then allowed them to establish a
monopoly over the entire field of medicine by the early 1900s, one that would last until the mid 1960s
(Winnick 40).
The father of chiropractic, Daniel David Palmer, believed that impinged nerves in the intervertebral
foramen(Gevitz 291) were the primary cause of disease, and in 1895 subsequently created Chiropractic.
Palmer didnt believe in the use of drugs or surgery as he saw them as unnatural invasions of the body
and believed the most important aspect of health was the maintenance of the nervous system (Meeker
217). Chiropractic focuses on the musculoskeletal system, with the belief that if it is properly cared for
the nervous system will in turn remain healthy. The primary form of care comes in the form of a hands-on
spinal manipulation (or chiropractic adjustment), although they perform manipulation on many other
body parts too. Chiropractic also believes in the bodys innate ability to heal itself, and thus takes a more
holistic approach to medicine, often including exercise and diet counseling in treatments. Because

chiropractic treatment requires multiple visits, another key aspect is the development of a patient-provider
relationship, the lack of which is a common complaint in regards to conventional medicine. Manipulation
has been practiced since the beginning of time, but during this era it was mostly being practiced by
osteopaths. However, by the 1920s manipulation was more often associated with chiropractic than it was
with Osteopathy (Gevitz 217).
As the early parts of the 20th century wore on, some fields of medicine fell out of practice entirely while
some such as osteopathy and homeopathy merged with conventional medicine, which now allowed them
to be included and recognized by the American Medical Association. The chiropractic profession - by
now the most popular and accepted unconventional medicine - however, stayed independent of the AMA
and continued to thrive from about 1920-1960, during an era in which there was a very prominent
allopathic monopoly present in the medical world. But by the 1970s Chiropractic had thoroughly
concreted itself as a legitimate establishment with its own education, licensing, and government funded
health insurance (Winnick 40). The profession managed to do this despite the fact that throughout the
20th century it was in an underground war with the American Medical Association.
The American Medical Association was singlehandedly responsible for the majority of the
oppression that Chiropractic has endured and is still enduring today. Known as the Medical Mussolini,
Morris Fishbein was the editor of the Journal of the American Medical Association and was one of the
most influential individuals in terms of the oppression the chiropractic profession has faced. From 19241949 he used his power to thoroughly promote the anti chiropractic movement; mainly with various forms
of anti chiropractic literature. However, by the 1960s the ground that chiropractic had gained as far as
insurance and other legalities was enough to thoroughly frustrate the AMA (Gevitz 292). In 1962 the
AMA got behind the Iowa Plan whose overall goal was to contain and eventually eliminate the cult of
chiropractic as a health hazard in the United States (Simpson 4). A year later in 1963 the AMA created
the Committee on Quackery with the same purpose as the Iowa Plan. Normally occurring practices of the
committees were producing and distributing anti chiropractic literature, communicating with medical
boards and other medical associations, fighting chiropractic-sponsored legislation, and seeking to

discourage colleges, universities, and faculty members from cooperating with chiropractic schools
(Gevitz 292).
The reason the AMA was able to gain such a significant amount of political and social power can
be better comprehended when connecting it with Zerubavels The Fine Line and Millers Domination
and Subordination. Zerubavel explains that our brains understand things by carving out mental chunks
and then treating them as if they were totally detached from their surroundings (Zerubavel 5).
Allopathic medicines claim to science created in the minds of people, and in the mind of society, a
mental division that now gave meaning to the differences between various medicinal practices. Humans
tend to think in a black and white manner, and the establishment of allopathic medicine as the only right
and scientific method of medicine, it dubbed anything contrary to that as just the opposite. Zerubavel
goes on to explain how we regard all cluster members as similar and [ignore] all differences which
often results in stereotypes (Zerubavel 17). The stereotypes that the AMA indirectly placed on
chiropractic medicine, and all alternative medicines would prove to have a strong negative influence on
the perception of these other branches of medicine.
This reality then plays into Millers discussion of the Dominate and the Subordinate and the relationship
between the two. Miller explains that once a group is labeled inferior the superiors tend to label it as
defective or substandard and that these labels acrete rapidly (Miller 88). Since chiropractic was
dubbed inferior to allopathic medicine so early, the criticisms of the profession surfaced rapidly and
abundantly, just like Miller explains. They quickly got labeled as liars, thieves, and overall unethical
people because the dominant group [tends] to be destructive of the subordinates (Miller 88). Miller also
explains that dominant groups usually impede the development of subordinates and block their freedom
of expression and action, which can clearly be seen in the actions that the AMA took against
chiropractic. The most relevant observation however is the point that Miller makes in that the dominant
groups inevitably have the greatest influence in determining a cultures overall outlook - its philosophy,
morality, social theory, and even its science (Miller 89). The realization that these dominant groups in
our society have the ability to shape our culture is a scary reality. A lot of these organizations have

agendas that purely serve their own self-interests, and it is important to be aware of the influence they
have over society as a whole.
Despite the American Medical Associations bold efforts to contain the chiropractic profession
throughout the 20 years from 1960-1980, it still gained significant ground during this period. The
committee on quackery was shut down in 1975, and was considered a success by the AMA, who felt that
chiropractic would have grown significantly larger without its services (Burkart). The next year Medicare
fully recognized chiropractors as competent health care providers, and Louisiana gave licensure to
chiropractic, making the profession now legal in all 50 states (Meeker 216). The most important factor
that contributed to the AMAs backtracking and the advancement of chiropractic came from the
realization that the courts could recognize their actions to contain chiropractic as an attempt to establish
an economic boycott, which in turn could be absolutely detrimental to their organization in a legal sense
(Gevitz 294). Over the next 15 years the increasing legitimation of chiropractic forced the AMA to
perform a complete overhaul of their policies and restrictions on chiropractic. The AMA rewrote their
Principles of Medical Ethics, including the revision of a clause that had previously stated that "A
physician should practice a method of healing founded on a scientific basis; and he should not voluntarily
professionally associate with anyone who violates this principle" (Burkhart). The revision now allowed
physicians associate with any other practitioner of medicine that they saw fit. In addition to that, various
other policies were changed; hospitals could have chiropractors on staff, physicians could teach at
chiropractic seminars or colleges, and could also accept patients from a chiropractor or refer patients to a
chiropractor, all without fear of losing their accreditation from the AMA.
Wilk v. American Medical Association was another occurrence that continued to spur the uprising of
Chiropractic. In 1976 Chester Wilk and four other chiropractors sued the AMA, and a variety of other
national healthcare associations for conspiring to prevent chiropractors from practicing in the United
States, which was a violation of the first and second sections of the Sherman Antitrust Act. Although the
plaintiffs lost the first trial in 1981, an appeals court reversed the decision and in 1983 the plaintiffs
received a new trial. The second time around, the plaintiffs stopped seeking for monetary damages, and

nationwide fundraisers paid for their legal expenses. In 1987 the judge ruled the AMA and its co
defendants guilty for fostering a culture of anti chiropractic in medicinal politics. The judge made it very
clear however, that this ruling didnt in any way endorse chiropractic as scientific practice or further
legitimize it in any way (Doctored).
As much ground as Chiropractic has gained in the medical world, there still remains plenty of
negative perceptions, longstanding biases, and continued hostility between chiropractic and conventional
medicine. Although there are various factors that contribute to this reality, the majority of them are a
direct result of the AMAs efforts against the profession. The most frequent criticism of Chiropractic that
Allopathic medicine makes is the lack of scientific based evidence that supports the spinal manipulation
therapy that chiropractic uses. Over the past 30 years however, inquiries and research into the efficacy of
chiropractic has been conducted. The findings of these inquiries have not been overwhelmingly in favor
of chiropractic, but they do much more to support the therapy than to invalidate it. The cases of low back
and neck pain are especially supportive of the adequacy of chiropractic. According to the Journal of
American Medical Association a report on a study of chiropractic efficacy dealing with low back pain
stated chiropractic almost certainly confers worthwhile, long term benefit in comparison with hospital
outpatient management. The benefit is seen mainly in those with chronic or severe pain (Kaptchuk). The
article also gives an insight into the results of neck pain as well, and of the 6 trials it reports on all but one
showed benefits from chiropractic treatment, with 2 cases even showing results superior to that of
conventional medicine (Kaptchuk).
With the increase of research and evidence that supports the treatment of chiropractic, the
profession will continue to gain more and more cultural status. In addition, patient perception of
chiropractic seems to becoming more and more positive. The Journal of the AMA refers to chronic back
pain as the Achilles heel of biomedicine and is a symptom all too popular among the population
(Kaptchuk). Because of the prevalence of this ailment, alternative approaches to treating it have become
highly sought after; thats where chiropractic care comes in, as over 65% of patients that visit
chiropractors have some sort of back pain (Kaptchuk). In another study 30 out of 43 trials showed that

patients preferred manipulation over other forms of treatment for back pain. As of 2002, no trials had ever
found manipulation to be statistically or clinically less effective than any other form of treatment
(Meeker 221). Even the Journal of the AMA (although probably begrudgingly) admits, patients perceive
Chiropractic as a valuable component of their healthcare (Kuptchak). As chiropractic treatment
continues to produce these kinds of results, and more research is being initiated, Chiropractors cultural
authority will continue to rise, and the profession will gain more and more respect.
With the AMAs established monopoly over the medical world, the culture that they were able to foster
has had a great impact on society. Their political power and social influence allowed them to dictate what
form of medicine people in the United States use. In a sense the AMA took away some of the free agency
of people, by limiting their choices of medical treatment. While the scope of allopathic medicine is very
expansive, and many of their services are exclusive only to them, there are plenty of people that can
benefit from the services of different branches of medicine. As I mentioned before, Chiropractic has very
positive results and if not for the diffusion of the AMAs monopoly some people would never have the
chance to be exposed to alternative types of treatment. A diversified medical system in the United States
would be ideal, all different branches of medicine working together as a cohesive whole to provide
healthcare to people. But as long as different branches are working to establish a monopoly, or preaching
against other medical professions, it is a system that will never be established. This reality is very farfetched however, as many of the branches of medicine practice methods that are contradictory to one
another.
Chiropractic has come a long way in its 120 year lifetime. It has grown into a profession practiced by tens
of thousands of people across the United States, and plenty more in numerous other countries. Coverage
on insurance plans, recognition from the U.S. department of Education, inclusion in Medicare, are all
achievements that Chiropractic had to earn all by itself. All despite the fact that it was an outcast,
sentenced to death by one of the most powerful organizations in modern day America. For that I have the
utmost respect for the profession and everyone who practices it; the amount of dedication it took for

chiropractors in the United States to stick with their beliefs throughout times of persecution and
discrimination is admirable and brave.
During my sophomore year of high school my father moved us to Vietnam to pursue his latest business
venture, which was opening up a chiropractic clinic in the country; one of two in the entire country. One
day I walked home and found 6 cases of Dr. Thanhs tea stacked in our kitchen. My father explained that
a particular patient (the owner of the tea company) he had treated came back and was so overwhelmingly
grateful, my fathers treatment had been able to treat her pain that she previously could find no solace
from through any other treatment. She felt so inclined to gift my dad with a generous supply of tea. And
this was not an isolated incident, it became a regular occurrence for him to come home with various
different gifts from all sorts of people. It was amazing for me to see how this profession changed the lives
of so many people, and it is sad to me that for a long time in our country, people were trying to take that
away. It also made me realize how much we take for granted a diversified healthcare system in the United
States. We have options for different treatments and different methods that are not available to people all
over the world, and we should be grateful for that. While this profession may not have the cultural
authority that it desires, or the universal support of the medical world, but because of its dedicated
practitioners there is nowhere for this profession to go up, as it has been doing for the past 100 years.

Works Cited
Burkhart, Lori. "Wilk v. AMA." ACA. American Chiropractic Association, 1 Mar. 2012. Web.
21 Apr. 2015. <https://www.acatoday.org/content_css.cfm?CID=4767>.
Doctored. Jeff Hays Films, 2012. Film.
Gevitz, Norman. "The Chiropractors and the AMA: Reflections on the History of the Consultation
Clause." Perspectives in Biology and Medicine 32.2 (1989): 281-99. Print.
Kaptchuk TJ, Eisenberg DM. Chiropractic: Origins, Controversies, and Contributions.Arch Intern Med.
1998;158(20):2215-2224. doi:10.1001/archinte.158.20.2215.
Meeker, William, and Scott Haldeman. "Chiropractic: A Profession at the Crossroads of Mainstream
and Alternative Medicine." Annals of Internal Medicine 136.3 (2002): 216-27. Print.
Miller, Jean B. Domination and Subordination. Boston: Beacon, 1976. Print.
Simpson, J Keith. "The Five Eras of Chiropractic & the Future of Chiropractic as Seen through the
Eyes of a Participant Observer." Chiropractic & Manual Therapies 20.1 (2012). Print.
Winnick, Terri. "From Quackery to "Complementary" Medicine: The American Medical Profession
Confronts Alternative Therapies." Social Problems 52.1 (2005): 38-61. Print.
Zerubavel, Eviatar. The Fine Line: Making Distinctions in Everyday Life. New York: Free, 1991. Print.