The following article was submitted to the Journal of Chiropractic Humanities in August 2017. But they wanted me to make so many changes I decided to withdraw it.
What's In A Word
Commentary by William Conder, D.C.
Presented is a discussion of chiropractic in the context of the history of the greater American culture of the late 19th and early 20th century. Using a non-linear style of narrative writing, science-based evidence, and reports from well-respected observers, we explore various factors that formed the perceptions of D.D. and B.J. Palmer and other doctors of the period, and we compare these to factors that have driven the medicalization movement in the profession. In this discussion, we find significant differences between the sensibilities of traditional chiropractors and modern mainstream spine specialists. What we find in the profession, obscured by the lines of typographic programming, is the presence of a re-emerging oral culture traceable to the roots of the Palmers' chiropractic.
...it is important to realize that great changes in the ways of ordinary human speaking and acting are bound up with the adoption of new instruments. 1
throw the dog a bone
A May 22, 2017 Palmer News report happily announced, “Chiropractic Garners Positive Mainstream Media Coverage”. The article refers to several recent publications in medical journals that seem to support chiropractic “spinal manipulation” as being at least as effective and safe as medical procedures performed by doctors. 2
One article in particular to which Palmer News refers appears in The Upshot section of the May 1 New York Times online, written by Aaron Carroll, M.D. The title of the article is “For Bad Backs, It May Be Time to Rethink Biases About Chiropractors”. 3
The title of the article alone contains important talking points: the word “chiropractor” in print in a New York Times article, without derogatory or demeaning reference, is a big step; and the open admission of bias toward chiropractors on the part of a member of the medical establishment is astonishing. Reading this article, a chiropractor might think, as declared by Palmer News, that this “mainstream media coverage” about chiropractic was “positive”. But that would be a mistake.
Aside from the persistent use of the phrase “spinal manipulation”, offensive to the sensibility of some in the chiropractic profession, as in “[P]hysicians are traditionally wary of spinal manipulation (applying pressure on bones and joints) because the practitioners are often not doctors...”; and Carroll's kind-of definition, “...applying pressure on bones and joints...”; and wariness about the procedure as it may not be performed by real doctors; and Carroll's ignorance about what chiropractors do and his arrogance about it because he is a real doctor and he knows. Aside from these chronic annoyances, or possibly central to the issue, is Carroll's incorrect use of the word “traditional”.
As mentioned above, Carroll says “[P]hysicians are traditionally wary of spinal manipulation....” His use of the word “traditionally” is inaccurate at best. It betrays his ignorance concerning what tradition is. Elsewhere in the article, Carroll says, “And spinal manipulation – along with other less traditional therapies – like heat, meditation, and acupuncture - ...” What he seems to be saying here is that his profession, conventional medicine, is the traditional form.
Tradition is specific to oral cultures' method of passing skills, beliefs, and values from generation to generation by word-of-mouth, for example, from father to son. The intention is to maintain the culture's skills, beliefs, and values, and to provide a kind of education in the ways of the culture for the coming generation. According to this proper definition, Carroll obviously does not participate in a traditional culture. Carroll practices conventional medicine.
...the war is in words... James Joyce, Finnegan's Wake.
Conventional medicine practitioners “convene” on a regular basis, yearly, for example, to discuss new discoveries, and reformulate protocols based on these discoveries. The intention here is to improve medical practice in the belief that new research, when implemented, will bring about “progress” in medical care, even though the notion of progress in conventional medicine is one of genuine debate. For example, see David W. Light's 2014 “New Prescription Drugs: A Major Health Risk with Few Offsetting Advantages”. 4
In general, the idea of progress implies that society can become increasingly better in political, economic, scientific, and technological areas. In this regard it is believed, especially in science and technology, that advances assure social progress and modernization and result in an improvement in the “human condition”. But modern conventional and traditional cultural forms are very different kinds of social organization.
The so-called Progressive Era in American culture is identified as coming into dominance in the late 19th through the early 20th century, a period which coincides with the Carnegie Institute's Flexner Report 5 and the introduction of scientific medicine. In this same period, philanthropy was a force behind progressivism, especially on the part of Carnegie and Rockefeller foundations and Johns Hopkins. However, some observers have proposed that philanthropy and progressive reforms were intended to empower American industrialism, which would destroy rural agrarian culture, and to promote standardized education. Industrialism, and American industrialism in particular, are effects of print literacy and typography.
Socially, the typographic extension of man brought in nationalism, industrialism, mass markets, and universal literacy and education... print presented an image of repeatable precision that inspired totally new forms of extending social energies. 6
“Progress” seems always to have a positive connotation, but some say there is a downside. Daniel O'Leary describes the “progress trap” as “the condition in which we find ourselves when innovation creates more problems than it can solve, often inadvertently”. 7 According to historian Sidney Pollack, progress is “...the assumption that a pattern of change exists in the history of mankind... that it consists of irreversible changes in one direction only, and that this direction is towards improvement.” 8
...the continuing pursuit of human advancement...
Chiropractic is a traditional health care system. Little has changed about its activity and purpose since D.D. and B.J. Palmer. Even the Palmer family's somewhat clumsy passage of the system through several generations bears evidence of a tradition. For the most part, students still attend chiropractic colleges to learn to adjust subluxations. Superficially, however, much has changed. The smothering of chiropractic's holistic, vitalistic ideology by its acceptance of the reductionist belief that “life is chemical” and that chiropractic is “neck and spine care” has corrupted chiropractic education and its identity.
So-called scientific medicine, associated with the Flexner Report and the introduction of standardized European-style education in medical schools in America in the early 20th century, ultimately led to chiropractic college accreditation. The process, which begins at the federal level, is run and overseen by people who know little or nothing about chiropractic, yet we assume that these standards improve the quality of education and the quality of chiropractic college graduates. In any case, grants and student aid are available only to students who attend accredited schools. This is the same kind of coercion that the American Medical Association (AMA) and the Carnegie Institute via the Flexner Report imposed on dozens of medical schools in the early 20th century. Privately owned, proprietary medical schools were offered “grants” if they adopted the Johns Hopkins medical school model. Schools that did not accept the offer found that they could not compete and eventually went out of business.
tail wags the dog
In 2010 the American Chiropractic Association and the Council on Chiropractic Guidelines and Practice Parameters “engaged in a multidisciplinary consensus process to address the terminology related to 'levels of care.'” A “consensus language” was developed “[T]o ensure equitable inclusion in the health care arena.” The ultimate purpose of adopting the consensus language, as stated, is to “facilitate better integration of chiropractic care within the health care mainstream.” 9
We are Borg. You will be assimilated. Resistance is futile.
The language of mainstream medicine is defined, analytical, and pedantic and is an effect of print literacy programming. The language of traditional chiropractic is metaphoric and based in the rural, oral culture of late 19th century America. The argument presented by some is that the vernacular of chiropractic should be modernized and mainstreamed to make chiropractic more acceptable to consumers and insurance companies. But because American culture, and Western culture in general, has transformed from the modern, mechanical, print-literacy sensibility to an electric, new oral sensibility, the old-timey chiropractic metaphors may resonate with consumers better than the mechanical officialese of conventional medicine, even as insurance payments for chiropractors dry up.
It helps to know that civilization is entirely the product of phonetic literacy, and as it dissolves with the electronic revolution we rediscover a tribal, integral awareness that manifests itself in a complete shift in our sensory lives. 10
he who defines the terms wins the argument
Since we identify the so-called electric age as having begun with the telegraph in the mid 19th century, we might begin to see D.D. Palmer as a kind of prophet of what has come to be called “energy medicine”. “Biofield science” as discussed by Rubik and others in “Biofield Science and Healing: History, Terminology, and Concepts” 11 is an “emerging field of study that aims to provide a scientific foundation for understanding the complex homeodynamic regulation of living systems”. The beneficial effects of the chiropractic adjustment are included in this “emerging field of study”.
It took less than 20 years after Samuel Morse installed his telegraph line from Washington D.C. to Baltimore in 1844 for a telegraph cable to be laid under the Atlantic Ocean and then strung across America. Morse's' first message in 1844 was “What hath God wrought?” Though its importance was overshadowed by the railroad in this early period, it soon proved to be critical in coordinating railroad schedules and routing. Ironically, as it was customary for telegraph lines to be strung alongside of rail lines, this marked the beginning of the end of the railroad as a dominant technology.
According to Myron Brown's “Old Dad Chiro: his thoughts, words, and deeds”,12 Ralph Waldo Emerson was one of D.D. Palmer's favorite sources. In the article Brown quotes Simon Senzon as saying that Emerson was one of Palmer's “inspirations”.
Ralph Waldo Emerson was a 19th century American writer, poet, and orator. He is identified as America's leading proponent of Transcendentalism, which has been associated with Romanticism, Hinduism, and the philosophy of Emanuel Swedenborg. (According to Walter Ong in Orality and Literacy, “[T]he Romantic Movement marks the beginning of the end of the old orality-grounded rhetoric” 13.) Transcendentalism, Romanticism, and the New Thought movement are considered to have grown out of the same frustration artists, writers, and spiritual leaders had with over-intellectualism, industrialism, and the perceived loss of individuality of that period. New Thought, a quasi-religious organization, exists today with many of its same original principles, including the presence of an infinite, universal intelligence that dwells in every person. Emerson was one of the first to introduce Eastern religion concepts to the American public.
Leaving a position as pastor of a church in Boston, Emerson first engaged a lecture tour in Europe and then participated in the Lyceum movement in America. Though he was called a writer and poet, Emerson wrote his material to be presented orally in lecture format. He gave over a thousand oral presentations in the Lyceum circuit.
Lyceum was a lecture circuit popular in the Midwest in the late 19th century. Educators, entertainers, and politicians toured with the Lyceum movement in the interest of improving the education of local people and encouraging public debate. Lyceum was an important part of oral culture adult education.
In Ancient Greece, the Lyceum was a temple dedicated to the god Apollo where Aristotle later founded his Peripatetic school. Peripatetics walked about and talked about various philosophical matters.
Palmer College's Lyceum Hall is a vestige of the Lyceum movement, and it remains an indication of the Palmers' preference for the oral mode. Today, however, it is difficult to find a reference for lyceum except as a synonym for a couple of chiropractic college's homecoming events. A search in chiro.org yields no results for “lyceum”, even though the website contains a significant amount of chiropractic historian Joseph Keating's research.
innate vs. educated
The late Dr. Joseph Keating, Jr., was a clinical psychologist who made his way into chiropractic as a research and history professor. He was beloved and respected by many in the chiropractic profession, but in some ways he was chiropractic's Trojan Horse. His history of the formative years of the profession was linear and analytical, as one would expect of a university-trained Ph.D., and without due respect for D.D. and B.J.'s oral sensibility and common sense. Further, his history of chiropractic was abstracted from the greater social context, and it ignored the wave of change underway in the culture at large. Unfortunately, many chiropractors have accepted Keating's literal point-of-view as the official word of chiropractic history.
magic and bullets
In the early 20th century German physician Paul Ehrlich conceived the “magic bullet” idea, a chemical treatment of an infected or diseased patient that would kill the offending microorganism without harming the rest of the patient's body. His first medicine based on this concept was an arsenic compound for the treatment of syphilis. It was moderately successful at killing the spirochete but too toxic to patients, causing convulsions and other neurological side effects, and death. Though the magic bullet concept drives pharmaceutical research to this day even the miracle drug penicillin could not live up to that ideal.
The “germ theory” of the late 19th century is another concept introduced with scientific medicine. Both concepts, the magic bullet medicine and the germ theory of disease, are examples of a propensity of the visually biased for abstracting a figure from its ground, of taking text out of context, of not seeing the forest for the trees.
The magic bullet and germ theory ideas became dominant in the early days of American scientific medicine, but other points-of-view expressed by prominent medical doctors were popular, too. For example, William Osler, M.D., one of the four founders of Johns Hopkins Hospital famously said, “The person who takes medicine must recover twice. Once from the disease and once from the medicine.” And, “One of the first duties of the physician is to educate the masses not to take medicines.” Harvard-trained Richard Cabot, M.D., in the early 20th century, said, “Every educated physician knows that most diseases are not appreciably helped by medicine.”
Medical doctors Elmer Lee, Henry Lindlahr, and John Tilden, considered to have been originators of natural and alternative medicine in the early 20th century, expressed views about medicine similar to those of A.S. Still and D.D. Palmer, as well as those of Osler and Cabot. The following is from John Tilden, M.D., who developed the idea that poor diet, poor hygiene, and too much stress caused toxemia, which he identified as the cause of disease:
What hope is there for medical science to ever become a true science when the entire structure of medical knowledge is built around the idea that there is an entity called disease which can be expelled when the right drug is found? 14
Tilden was a so-called “eclectic” doctor. Eclectics were a primary target of the AMA and the Flexner Report. The last Eclectic medical school closed in 1939. Although these targets of the AMA seem to have been shot down by the mid-20th century, by the 1990's they returned with other modalities as Complementary and Alternative Medicine (CAM). 15
the universal tolerates no alternatives
The Catholic Church is an important cornerstone in the foundation of Western culture. Comparing the Church to today's conventional medical establishment may yield some interesting insights.
The etymology of “catholic” is “universal” from Greek and Latin vocabularies. The Roman Church was decreed The Catholic Church by Constantine in the 4th century. It wasn't until the Reformation and Martin Luther that Christian worshipers could consider a different way of approaching their Christianity. It calls itself “the one true church”. As such, it acknowledges no alternative to its teaching.
Marcia Angell, M.D., former editor of the New England Journal of Medicine, known for her criticism of pharmaceutical industry ties to the FDA, also has been critical of “alternative medicine”. In a 1998 NEJM editorial she wrote “What sets alternative medicine apart... is that it has not been scientifically tested and its advocates largely deny the need for such testing.” 16 The kind of testing she refers to is the kind required by the FDA, the results of which are published in medical journals. She says, “It's time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine – conventional and alternative. There is only one medicine....” Elsewhere, however, she's been critical of clinical trials and the FDA's response to them. 17 Angell is a science crusader.
A June 28, 2017 Medpagetoday.com F. Perry Wilson, M.D. interview with Steven Novella, M.D., featured the title “What Used to be Fraud is Now Alternative Medicine”.18 Fraud is a criminal act of intentionally deceiving another for monetary or personal gain. According to findlaw.com, “Fraud offenses always include some sort of false statement, misrepresentation, or deceitful conduct.”19 Perry and Novella, in their discussion of “science-based medicine”, mention homeopathy, acupuncture, and naturopathy. In the interview, the doctors lament that patients seek health care at the hands of these practitioners. They don't specify that these modalities are fraudulent, but the damage is done in the title. And, in fact, Medpagetoday, in posting that title, may be the party committing a fraudulent or defamatory act. Chiropractic was not mentioned during the interview but it didn't have to be: conventionally, chiropractic is included in the category “alternative medicine”. Implicit in the words of these doctors is their belief that conventional medicine, whether it is evidence-based or science-based, is “the one true medicine” - rigorous, rigid, infallible, mechanical, catholic, universal.
The sense of touch had been anesthetized in the mechanical age... 10
Conventional medicine doctors and traditional chiropractic doctors operate from different perceptions of life and health. We are reluctant to recognize this difference, however, because as programmed literates we assume we can know and understand all things and that we see the world from a superior point-of-view. To us, the oral sensibility is inferior. In fact, our typographic literacy disturbs the natural sensory balance that all people enjoy prior to acquiring phonetic alphabet literacy. Our sense of hearing is the common sense, but after literacy training and repeated reading of print, we suffer a visual bias, trading an “eye for an ear”, as James Joyce so adroitly observed.
Prolonged mimesis of the alphabet and its fragmenting properties produced a new dominant mode of perception and then of culture. 20
In Laws of Media, McLuhan defines “visual space” as a human artifact, a technology, “created and perceived by the eyes when they are abstracted or separated from the activity of the other senses.” Further, he cites studies indicating that American English literacy is a most analytic, left cortical hemisphere function.
Researching the importance of the right cerebral cortex in language function, psychiatrists Mitchell and Crow identified an important distinction between it and the left cerebral cortex. Right hemisphere language function “includes discourse planning/comprehension, understanding humor, sarcasm, metaphors and indirect requests, and the generation/comprehension of emotional prosody.” (“Right hemisphere language functions and schizophrenia: the forgotten hemisphere?” 21
Behavioral evidence indicates that patients with typical schizophrenic illnesses perform poorly on tests of these functions, and aspects of these functions are disturbed in schizo-affective and affective psychoses. The higher order language functions mediated by the right hemisphere are essential to an accurate understanding of someone's communicative intent... we now know that the left hemisphere is not sufficient to mediate normal levels of discourse comprehension... and temporal lobe activity is right lateralized when participants listen to stories... (Mitchell and Crow.)
When we override right cortex language function and intensively program the left cortex with print literacy are we not creating a schizoid effect in the mind and affect in the world? Is not conventional, scientific medicine, as it is presented to us, rigorously analytic and literal, cortically left-lateralized? Does not chiropractic's roots reach into the fertile ground of the American oral, rural culture of the late 19th century? Is not the conventional medical model, which dominates the health care industry and to which some chiropractors aspire, a kind of pathological adaptation to unbalanced cortical hemisphere function? Does not the natural, vitalistic, holistic perception of chiropractic doctors represent whole brain mental functioning? Is not the latter at least as valid as the former?
...the electric principle everywhere dissolves the mechanical technique of visual separation and analysis of functions. 6
One way to understand the polarization in the chiropractic profession is to recognize that some of us are more left-brain oriented and some of us are more right-brain oriented. This simplified view, possibly, can be traced to a habit for preferring one form of sensory input and output over another. Some of us believe that the only way to respectability in health care is to do the research, drop the old words and ideas for medicalized ones, and become specialists in the conventional medical system. Others of us prefer to stick with the “principles”, attend uplifting seminars, revivals, and “Jams”, and adjust subluxations to liberate Innate. We suggest that the former position, though apparently firmly entrenched, will be recognized increasingly as old, stodgy, and out-of-touch, while the latter moves into prominence as the front-line energy medicine that – since D.D. Palmer – it always has been.
Tactility is the integral sense, the one that brings all others into relation. 10
The shift from mechanical to electric, which has been underway for many years in the greater culture, is not something that can be changed or stopped. It is an effect of the form of the culture's dominant communications medium, which now is electric/electronic. For 500 years the mechanical printing press and print literacy programmed perception and established “visual space” as the only realm where truth could be determined. Today the electric media overwhelms the mechanical and, as an extension of the human nervous system, obsolesces the old sensibility and retrieves the whole world, and the whole body, at once. It increases our appreciation for the tactile, haptic, feeling, auditory sensibilities, and revives the roots of chiropractic.
What's In A Word References
1. Young, J.Z. Doubt and Certainty in Science. Oxford: Oxford University Press, 1961.
6. McLuhan, M. Understanding Media: The Extensions of Man. New York: New American Library, 1964.
7. O'Leary, D. Escaping the Progress Trap. Westmount, QC: Geozone Communications, 1991.
8. Wright, R. A Short History of Progress. New York: Avalon, 2004.
9. Dehen, M.D., Whalen, W.M., Farabaugh, R.J., Hawk, C. Consensus terminology for stages of care: acute, chronic, recurrent and wellness. J Manipulative Physiol Ther, 2010 July-August;33(6):458-463.
10. McLuhan, M. War and Peace in the Global Village. New York: Bantam Books, 1968.
11. Rubik, B, et. al. Biofield science and healing: history, terminology, and concepts. Global Adv Health Med. 2015;4(suppl):8-14.
12. Brown, M.D. Old dad chiro: his thoughts, words, and deeds. Journal of Chiropractic Humanities (2009) 16, 57–75.
13. Ong, W. Orality and Literacy. New York: Routledge, 2002.
14. Tilden, J. H. Toxemia Explained. Denver: John H. Tilden, M.D., 1935.
16. Angell, M., Kasirer, J. Alternative medicine: the risks of untested and unregulated remedies. NEJM, September 17, 1998 – volume 339, number 12.
20. McLuhan, M. Laws of Media: The New Science. Toronto: University of Toronto Press, 1988.
21. Mitchell, R., Crow, T. Right hemisphere language functions and schizophrenia: the forgotten hemisphere? Brain (2005), 128, 963–978.