Part 52

These questions are hard to meet truthfully and convincingly, for the truth is that every Chiropractor fails sometimes and is unable to predict that failure in advance and that no one wise enough to predict the length of time which will be required for the cure of any given case has yet arisen. And these truths do not sound reassuring or convincing.

Explain to the patient that nature alone is the curative agent and that the cure depends not alone upon the skill of the adjuster but upon the exact condition of the vertebrae, the exact amount or degree of damage to tissue, the patient’s habits of living, etc. Any accidental interjection of other factors into the case may have an important bearing. You may assure him of the excellent results you have obtained in other cases similar to his, or even cite individual cases if to do so does not violate a professional confidence. But you had best avoid a promise to cure or an exact statement of the time which will be needed. State your belief or opinion but do not bind yourself to a promise. Offer your best skill and closest attention; you can do no more.

The patient should rely upon the skill of the Chiropractor as upon the skill of his lawyer or his physician. Neither can honestly promise that he will succeed in his efforts, even though all indications point that way.

Re-Tracing of Disease

From the original concussion of forces which produces a nerve-impigning subluxation to the stage of chronic disease with which the patient usually approaches the Chiropractor for relief, disease develops by a series of gradual steps. Successive changes take place from time to time in the degree of subluxation as it is augmented by further jars, strains, etc., or by the reaction of secondary causes upon it and with these changes come corresponding changes in the development of the disease.

Perhaps the first effect of the bad subluxation is irritation of a nerve and acute functional disturbance such as pain, fever, etc. The later effect may be paralysis and its attendant train of evils.

When the Chiropractor begins adjustment he does not at once return the long-displaced and misshapen vertebra to its normal position. He merely tends to do so, his adjustments making slight and gradual changes from the abnormal back to normal.

Thus it is that the subluxation passes back in reverse order through the successive stages of its development, following a process which may be called the involution of the subluxation. At the same time the morbid process resulting from the subluxation tends to retrace its steps, passing in reverse order through the stages by which it developed. Pains which have not been felt for years may unaccountably return under the reawakening of the long dormant nerves. Headache, long absent but once a prominent feature of the disease, may again make its appearance. The patient feels worse.

These changes, however, take place much more rapidly during the correction than during the development of the disease. To a certain extent they are probably always present, although in many cases they occur so rapidly or are modified so much by changed environment as to be unrecognizable. In many cases it is possible by securing an accurate history and by careful observation of the patient’s progress to observe a definite reappearance, in reverse order, of every important event in the history of the disease. For instance, if the patient has at one time had a severe fever, perhaps lasting many weeks, and has later developed a chronic weakness marking the increase in degree of subluxation, the fever may reappear during adjustments, last a day or two, and disappear forever, having been corrected beyond that stage.

If explained in advance to patients with chronic diseases, the facts of retracing may not cause the patient to become discouraged as he would if he failed to understand them. If he knows before your work is commenced that he may expect such phenomena but may possibly escape them he meets them as necessary parts of the process of cure. If they are not explained in advance he is likely to feel that you are doing him injury and to discontinue your service just at the time he most needs them. In fact, it occasionally happens that if adjustments are stopped at some irritant stage of the cure that condition will remain and do great damage.

This theory of retracing has been much abused. Chiropractors have used it to cover a multitude of errors in practice. With some it becomes a habit to call all unfavorable events which occur during adjustments retracing, thus shifting the blame from their own shoulders to Nature’s. This is a pernicious practice because it deceives the patient and also because too frequent repetition of this explanation finally deludes the practitioner into the belief that all such events really are retracing. This view withdraws his attention from his own technic and he ceases to discover his own mistakes by ceasing to look for them.

It is best in the face of any painful or apparently unfavorable development always to examine our own work thoroughly to detect any possible error in diagnosis, palpation, or selection of move for correction. It is always possible for us to err and our cases should be observed at every stage with the most minute care to insure accuracy in detail.

Limitations of Chiropractic

There are many things which can be done better by others than by a Chiropractor. There are others for which the Chiropractor’s training does not fit him at all and to which his methods do not in any sense apply. Knowledge of these limitations is just as essential as acquaintance with the powers of the vertebral adjustment.

Bony dislocations other than vertebral, fractures, wounds causing, or likely to cause, hemorrhage or severe internal injury, should at sight be diverted into the hands of a surgeon. The Chiropractor receives no training in handling such cases and has neither legal nor moral right to attend them. In obstetrics likewise no practical training is given which would prepare the practitioner for delivery and he is unprepared to use necessary asceptic or antiseptic measures.

Some individual cases of disease usually curable will have advanced so far as to require surgical interference. Abscesses or suppurative diseases internally located or having any liability to discharge internally must be avoided. Gangrene, cancer, the advanced stages of tuberculosis (usually) are incurable.

Quarantinable diseases as a class yield readily to adjustment unless some serum treatment has been administered, when the chances of recovery are greatly lessened. But such cases must be reported in conformity with the laws of the state and will probably then be taken out of the hands of the Chiropractor--unfortunately. The laws of the various states should be modified to permit Chiropractors, with precautions required of physicians to safeguard the public health, to pass quarantine. Every effort should be put forth to secure such legislation but until it is secured in any state and the Chiropractor’s work is brought under the supervision of the authorities, the laws must be respected strictly.

Syphilis and gonorrhoea, communicable diseases, should be recognized and refused in practice. The former in the primary and secondary stages (not tertiary) and the latter in all stages is corrective by adjustment but the liability of transmission of the disease warns against contact with it unless all precautions known to science be used to avoid possible transmission.

Congenital anomalies of structure do not yield to Chiropractic and are best let alone although no harm is likely to arise through any attempt to correct them by vertebral adjustment.

Relation of Chiropractic to Other Methods

There are certain other methods which present a superficial resemblance to Chropractic which leads many to believe them closely related. Such methods are Spondylotherapy, Osteopathy, etc. There is a system called Napravit or Naprapathy which may be dismissed with the statement that it is Chiropractic, renamed.

Spondylotherapy, on the other hand, is a system of treating disease which takes no account of the vertebral subluxation as its primary cause and seeks to cure disease by stimulating or inhibiting nerve action through the use of mechanical, thermic, or electrical means. Its resemblance is due solely to the fact that most of the treatment is applied to the spine. As well might we say that serum injection for meningitis is Chiropractic because the serum is introduced by lumbar puncture into the spinal canal.

Osteopathy, since the profession has become aware of the superior results obtainable by vertebral adjustment, is rapidly adopting many Chiropractic methods and counterfeiting it as far as possible. Perusal of their literature of various periods clearly shows that this is a new growth and that they have never adopted in theory what they sometimes use in practice. In fact both the above methods treat disease, following the theory of medicine with the use of different remedies only, while Chiropractic adjusts the cause of disease and avoids treatment of any kind. Chiropractic is not a branch of medicine, never can be a branch of medicine because it is inherently and fundamentally antagonistic to the very basic principles of medicine, and no statute can change the fact of such antagonism. But unless we adhere strictly to the fundamental principles of our own practice and limit ourselves to the methods which grow from those principles Chiropractic may become a part of medicine. Which brings us to

The Use of Adjuncts

There are many methods of treating disease which are more or less beneficial to the patient just as there are some which are always injurious. Shall we employ such of these methods as are beneficial as adjuncts to the practice of Chiropractic? Or shall we adhere to the principle that the treatment of disease is erroneous and the adjustment of its cause the only logical method of procedure? There is much to be said on both sides of this question which has so long agitated the profession.

In the class of beneficial adjuncts may be placed massage, hydrotherapy, spondylotherapy, dietetics, osteopathy, Christian Science, suggestive therapeutics, mechano-therapy, and many others. Each of these has its field of usefulness; each taken alone is productive of some good in some cases at least. Each might possibly augment the results of Chiropractic, or hasten them in some cases, if judiciously used. By judiciously used we mean the avoidance of any method which would in the least interfere with proper vertebral adjustment or its results or which might carelessly cause subluxation. Osteopathy and mechano-therapy frequently cause subluxation because of the ignorance on the part of their users; they need not do so.

Among the pernicious adjuncts, or those which are harmful if combined with adjustments or harmful whenever and however used, may be mentioned drug medicine, serum therapy, and electricity. The first two may sometimes prove the lesser evil if used alone. With Chiropractic they are always unnecessary and always tend to lessen the good effect of adjustments. The latter alone is beneficial but in combination with Chiropractic proves a double stimulant to the nerves and should be avoided. The effect of these methods when used with Chiropractic can never be accurately predicted. One can only be certain that some unfortunate effect will follow.

As a secondary consideration the Chiropractor has neither legal nor moral right to practice medicine unless he has received a state license to do so.