THE ROLE OF CHIROPRACTIC Some time back an article appeared in one of the chiropractic publications comparing the allopathic approach and the chiropractic approach. "The allopaths look upon the musculoskeletal system as a porter or low motor system of the organs. They place their emphasis on the organs. They see men as organs first and foremost, carried around by the skeleton and muscles." The article goes on to say that chiropractors see or should see the body from the opposite point of view. We should view the musculoskeletal system as supreme and that our organs are important because they support that system. The article's point is that we should emphasize and develop the preeminence of the musculoskeletal system because that is where our own entering into the health care delivery system occurs. The argument of which is more important (the musculoskeletal system or the organ system) is more than a "which came first, the chicken or the egg?" discussion. It is of vital importance to the self esteem of many chiropractors. It allows them to maintain the same status as the physician. After all, if the lumbo-sacral complex is as important as the heart, are we not as important as a cardiologist? But, the fact is, this entire line of reasoning misses the whole point of chiropractic. Chiropractic came into existence because of one fundamental error in the practice of medicine. Medicine views the human organism as unrelated parts without any organizing, intelligent principle. That is why medicine has failed, not because their techniques were wrong but because their fundamental principle was incorrect. Hence, the reason for chiropractic to come into existence in 1895. If we as chiropractors fall into the trap of "promoting" one organ system or part of the body over another we are doomed to the same failure that medicine has experienced. We may reach the same level of respectability and acceptance as medicine but we will never make an impact on the health of humanity. Chiropractic does not divide the body up into parts and we definitely do not place degrees of importance on the various parts. True, we address our attention to one particular area commonly called the vertebral column, but only as it relates to the nervous system and only as the nervous system relates to health. Treating diseases is medical thinking. Treating parts is medical thinking also and is not the role of the chiropractor. We cannot allow the desire for recognition or for a "paradigm", to make us assume the role as specialists of the musculoskeletal system, nervous system, or any system. We cannot allow the insurance companies to coerce us into making the vertebral subluxation a musculoskeletal disorder. If we do, chiropractic will cease to be what it was intended, a health care system, and will sink to the level of a second-rate orthopedics. If we must "glorify" something let us not make it a system of the body as the medics do, let us see man as "first and foremost" an expression of the innate intelligence without which every system of the body will quickly become dust.
NAPOLEON'S GLANDS
Almost every chiropractor has read B.J.'s short paragraph... AFTERTHOT
"A slip on the snowy sidewalk, in the winter, is a small thing, it happens to millions. A fall from a ladder, in summer, is a small thing, that also happens to millions. The slip or fall produces a subluxation, the subluxation is a small thing. The subluxation produces pressure on a nerve, that pressure is a small thing. The pressure cuts off the flow of mental impulses, that decreased flowing is a small thing. That decreased flowing produces a dis-eased body and brain, that is a big thing to that man. Multiply that sick man by a thousand, and you control the physical and mental welfare of a city. Multiply that sick man by a million, and you shape the physical and mental destiny of a state. Multiply that man by two hundred million, and you forecast and can prophesy the physical and mental status of a nation. So the slip or fall, the subluxation, pressure, flow of mental impulses, and disease are big enough to control the thots and actions of a nation..." We have either thought it was a bit far fetched or merely an interesting idea. But, recently there has been a synthesis of the fields of science and history which indicate that B.J.'s idea has a lot of merit. Not only does it have merit with regard to "two hundred million", but it even relates to individuals in history. This new field called "Biohistory" relates the physiological and pathological problems and functions of individuals, nations, and mankind, to events that have shaped history. It is not difficult to see how the plagues of the Middle Ages, the genius of Alexander the Great, or the insanity of Adolph Hitler have affected history. But, they are remote examples and difficult with which to relate. However, the fact that a flare-up of hemorrhoids may have cost Napoleon the Battle of Waterloo is something with which many people can identify! In his book, Napoleon's Glands and Other Ventures in Biohistory, Arno Karlen cited numerous examples of how physiological dysfunction in many individuals is thought to have changed history.
Biohistorians are able to ascertain numerous maladies that affected Napoleon Bonaparte and could have contributed to his failures. Looking at his accomplishments in battle, leadership, and government administration one has to wonder what he could have accomplished had he been healthy. Napoleon claimed to have caught scabies during the siege of Toubon in 1793. He also suffered neurodermatitis off and on throughout his life which was worse when he was under stress. He once said "I live only by my skin" and was known to scratch himself so hard that he bled and his soldiers thought he had been wounded. His attacks of hemorrhoids seemed to occur before and during battles from his late twenties. He had an especially severe attack on the road to Waterloo. Can you imagine riding a horse with hemorrhoids? Karlen says "The French won an advantage at Ligny on June 17." Normally Napoleon would have capitalized on it speedily. Instead he lay awake much of the night in pain and finally arose, exhausted and sluggish, at eight o'clock. To his general's frustration, he issued no orders for several hours; meanwhile, the opposing Allies repositioned themselves, and the French advantage was gone. Throughout the day Napoleon seemed foggy, erratic, indecisive; some of his actions still puzzle historians. At one point he dismounted and stood clutching a fence post, his face white with pain and for an hour he straddled a chair by the road to Brussels. Wellington later said "Waterloo was one of the narrowest victories he had seen." Napoleon's fatigue, pain, and limited mobility, could have made the difference. Napoleon also suffered from gastrointestinal problems. Autopsy results indicated he died of stomach cancer. He was often seen with his coat unbuttoned and his hand slipped in holding his painful abdominal area. In Chapter 2 Karlen discusses Francisco Goya, the great artist of the Romantic era, who suffered a mysterious illness that affected his nervous system. It caused "dizziness, impaired balance, mental confusion, impaired hearing and speech, and partial blindness." It drastically affected his art. The author brings out research by a Dr. Niederland that indicates the neurological disorder was brought about by lead poisoning from the lead in Goya's paints. Whatever the etiology, there is clear indication that the painter's work, life, and historical fame was a direct result of a physical change in his body.
A chapter deals with Edgar Allan Poe and the physical problems that shaped his personality and his writing. Karlen also devotes a chapter to the effects of various plagues and diseases on the course of history. While that aspect of biohistory does not relate directly to the philosophical concept espoused by B.J., it has always intrigued chiropractors not that the Black Plague killed off one-third of Europe, but as in the case of any epidemic, why two-thirds were able to live through it. Some of the book deals with biohistory as it relates to social and psychological development of the human organism and how it relates to evolution. Some of Karlen's book deals with subject matter outside the interest of the chiropractor. Some of it is written from a distinctly medical viewpoint and of course he writes with no knowledge of chiropractic. The theoretical ramifications of history are fantastic in thinking about the idea of a Napoleon or Julius Caesar or Poe or Alexander of Macedon or any other important figure in history being under chiropractic care. But more relevant to us today is a new awareness of the importance of what we are doing every day in our offices. We may not be having any future Goyas or Napoleons walking into our offices but every chiropractor is most assuredly adjusting the present and future leaders in business, industry, and government. To quote B.J. again "We never know how far reaching something we may think, say, or do today will affect the lives of millions tomorrow."
FLEXIBILITY-INFLEXIBILITY It is absolutely essential for the perpetuation of the profession that chiropractors begin to show flexibility in their attitudes toward certain things. On the other hand, it is important that we maintain an inflexibility in other areas. Unfortunately our profession tends to be inflexible in the non-essentials and flexible in the essentials. Technique is a "non-essential." Oh, it's not unimportant, but your technique is not essential to the perpetuation of chiropractic. Techniques have come and gone for the last 90 years and there are more techniques now than there have ever been. Good technique is important, but which technique you practice is not important. Hence it is non-essential. Yet we read in a national publication proponents of two different techniques arguing that the other is not scientific or valid. It is simply not an essential aspect of chiropractic that deserves an inflexible attitude. We should respect the right of every chiropractor to practice the means of correcting vertebral subluxations that he or she feels is most effective. Another example of inflexibility in the nonessentials was brought home to me recently. I referred a patient who had been under regular care for 10 years to a young chiropractor who had opened closer to where she lived. He never examined her, but informed her over the phone that he would not take care of her without x-rays. She only wanted maintenance care but he was inflexible in a non-essential. (This same chiropractor six months before as an unlicensed student was probably adjusting his wife, friends, people who he met at cocktail parties or in a local bar without an x-ray, case history, or anything else.) It always amazes me how x-rays are not essential when you are a learning student, but are essential after you become a licensed competent chiropractor. This is another example of an inflexible attitude in something that is not an essential. Fee systems are also a non-essential that demand a flexible attitude. Yet most of our profession is inflexible with regard to the fees that they charge patients. The day of the "flexible fee system" appears to be over. Those few that still ,ÿ3 have a flexible fee system are looked down upon by those who are inflexible. On the other side of the coin are the essentials: those areas in which we should remain inflexible. The most important, of course, is the definition and scope of chiropractic. We should be inflexible as to what chiropractic is. Yet most of our profession is saying that every chiropractor should practice as broad a scope of practice as he or she desires. The scope of chiropractic is an essential. For the survival of chiropractic we must maintain an inflexible attitude. Filling our insurance forms involves terminology, terminology involves vocabulary, vocabulary involves thinking, thinking involves principles, principles are an essential. There should be no flexibility with regard to filling out insurance forms. Yet most chiropractors are totally flexible when it comes to insurance forms and will write anything in order to get paid. It really comes down to this: the principles, tenets, terminology, and philosophy of chiropractic are essentials. With regard to these we must remain inflexible. There can be no flexibility and no compromise with regard to them. The application of the principles, tenets, and philosophy are non-essentials and with regard to them we must learn to be flexible.
