Historical Review Of Manipulative Therapy

A Historical Review of Manipulative Therapy By Franklin Schoenholtz, D.C. Faculty Member of The Los Angeles College of Chiropractic More than thirty-two centuries ago, chiropractic was known to the Greeks and also the ancient Egyptians, Chinese and Hindus who, in their respective manuscripts and other documents, left concise but clear descriptions of this art. The ancient Hindu, the Chinese or the man of Tibet, the Babylonian, the modern Kurd, the Egyptian and the Arabian fellah, the man of Iran, the aboriginal man of Ceylon or of the Brazilian Matto-Grosso, the highly specialized Incas an Aztecs, or other American Indians, and all the rest of mankind have in some way used their hands for curative purposes. There is, in fact, no person living or dead who has not at some time practiced manipulation and chiropractic of some form. However the systematic and intelligent teaching of chiropractic in ancient Greece was no doubt originally taught by the mythical semi-gods and heroes of Greece and particularly the Thesalians, Chiron, the Centaur, and Aesculapius. The were, so to say, the first instructors in the arts of Grecian classical medicine and through them and their descendants the different therapeutic methods have been transmitted to all civilized mankind.

The principles embodied in modern chiropractic long have been known to man, and particularly to the Greeks. Much authentic information indicative of the existence of applied spinal and body mechanics in ancient writings has reached us today. Such knowledge, coming from indisputable masters teaches us that in classical times of Greece, body mechanics spinal balancing and vertebral adjusting were thoroughly investigated, understood and applied long before the Hippocratean epoch. The relationship of the vertebral column to the nervous system and to the human frame, as well as to the different diseases of the living organism, were adequately recognized and sufficiently investigated an also demonstrated by them. Furthermore, they have, so to say, providentially included most of such valuable observations and conclusions in their many notable writings. From these works it becomes evident that every possible aspect in regard to spinal function and derangement has been well investigated, exploited and treated at great length by them. Deliberately or otherwise, the Greeks efficiently detected not only the various malformations and displacements, curvatures and other distortions of the human frame, particularly the spinal column; but, much to our amazement, they even discovered the slightest misalignments of the different vertebrae which are often displaced or slightly luxated or rather subluxated. This fact, however, was for long time disputed or ignored by the regular medical school. In recorded history there are many outstanding instances and occasions which clearly indicate that surgery, dentistry and their allied systems and sciences were tabooed and criticized by orthodox medicine which, under no circumstances, authorized their use. All of the aforementioned arts were ignored and excluded from ethical practice for many centuries. Not so long ago, these systems were considered unscientific and their followers and administrators were persecuted and bluntly condemned and branded as quacks and charlatans of the most degraded sort. The time, however, came when these systems and sciences were finally accepted in medicine, being since advanced to new standards of efficiency and scientific development. The same has happened in other branches of medical sciences and arts. Among those of recent recognition: opthalmology, midwifery, psychopathy, psychiatry and osteopathy. Their origin, however, is very old and can be traced to older epochs. The Chinese, the Hindus, the Egyptians and the Greeks had a clear conception of them. Their principles had been known and applied for many centuries. Veterinary surgery, too, endocrinology, and diet were long ago practiced. Now podiatry, optometry and chiropractic assert their rights, fast pushing their claims toward recognition. They would have been accepted long ago were it not for the reason that they were considered to be innovations. Inadequate information and ignorance made them appear as cults, heresies in medicine, or foreign to ethical practice. The same can be said for dentistry. In olden times the filling of a decayed tooth was not only a habit of good hygiene, but even of good aesthetics. Gold and cement or porcelain fillings have been found in many ancient mummies and skeletons. The objections which have been raised from time to time in regard to therapeutic systems or methods, often were met with in the past, and in some instances, were properly settled.

When Hippocrates reasoned with his contemporaries that in healing, the most famous and renowned practitioners of their day did not treat disease with medication and drugs alone, he pronounced a great truth which remains, even today. Again, when he says all reputedly successful physicians use diet and other effective means, which one cannot deny belong to healing, he simply voices a universally acknowledged fact. Obviously, he sought to demonstrate to the medical practitioner, whom he wished to convince, that medicine, and particularly healing, cannot be restricted or limited within the narrow boundaries of the pharmacopoeia. The sick, in consulting the doctor, seldom know or care from which school system he graduates, but visit him with the ultimate purpose of getting well; and anyone who treats them successfully and helps dispel their troubles quickly becomes, in their estimation, a worthy doctor. Sir William Osler, in his introduction to the book The Life of Pasteur, makes the following admission: “Great advances have been made in the treatment of disease. We learned to trust nature more and drugs less; we got rid (in part) of treatment by theory and we ceased to have a drug for every symptom.” Hippocrates gives remarkable accounts of such diseases as puerperal convulsions, epilepsy, fevers, etc. He admonishes the physician to examine the patient carefully and especially in all acute diseases to note the sick, make his comparison with those in health, and to observe the changes which take place in condition. Alarming symptoms are hollow eyes; collapsed temples; cold and contracted eyes, with lobes turned out; skin about the forehead rough or distended; color of the face dusky; whether the stool was loose or hard and not its color and odor; inspect the urine and observe color and sediments. No one today can deny the wisdom of these truths which have their place today as well as at all times. Hippocrates brought about careful examination of the legs, of the pelvic bones and more especially correction of any existing deficiency in the legs. He urged recognition of abnormalities of the bony frame of the pelvis, the base upon which the spinal column and the whole weight of the body rely. Hippocrates described the spinal column and mentioned its parts. He gave a present day scientific and complete anatomical and osteological description of it, calling the attention of the doctor to the peculiarities and probable anomalies of the vertebrae and their spinal processes which to the uninstructed might appear as luxations. He evidently studied very closely the mechanism of the spinal column and understood thoroughly its importance and significance. He appears to have known well its relation and application to and effects upon the nervous system, and also its influence upon the whole organism. He insisted that the practitioner should become well acquainted with all these facts and learn the mechanical relation of the spinal column to the nervous system and of the latter to the organism, so as to be ever ready to make proper correction in case of such skeletal and spinal displacements and malformations or similar derangements by means of reduction, extension, counter-extension, etc. We can almost still hear him teaching that, “one should practice most often and continuously train himself and his hands, endeavoring to do his work well, elegantly, quickly, without trouble, neatly and promptly.” Aristotle explained his idea on blood circulation and motion in his book, De Animale, clearly stating that the blood in all animals palpitates within their veins.

Further on in his De Respiratione he asserted that the pulse sends the blood simultaneously to all parts of the body; that all the veins by successive strokes pulsate together; that all the blood vessels are dependent upon the heart; and, that the successive strokes of the pulse keep the blood always beating together by successive movements. Likewise, Harvey's discovery of the circulation of the blood met with the opposition of those who were unable to understand what he put forth. Harvey's contemporaries vehemently opposed his explanation of the circulation of the blood. It is appropriate to mention here that there are still those who reject and oppose the statement made years ago by D. D. Palmer, relative to the partial luxations of the vertebral segments of the spinal column and the consequent nerve impingement, which fact was common knowledge in antiquity particularly during the Grecian period. It is wise then to pay due attention to the teachings of the past and heed their warnings, instead of trying to imitate the examples set by the medical profession which, because of its influence in other fields, has totally neglected the great truths which so many other celebrated men in healing advanced. Nevertheless, the healing art, once placed in mortal hands, had to undergo many necessary changes until it finally reached its complete development. From the time when man received from the immortals the gift of healing, he turned to Mother Nature, seeking to gain from her additional knowledge, and thus complete the imperfect and restricted art which he had received from divinity. What the gods withheld from man he had to seek himself, to learn by intensive pursuit of knowledge. If medicine had not neglected the studies of ancient medicine and had given due consideration to the findings of the ancient healers, the scientific world today, as well as suffering humanity, would have greatly profited in the form of advanced methods of diagnosis and treatment. Had not the wholesome and scientific teachings of Hippocrates been forgotten or neglected on the shelves of the libraries, the progress thus far made in medicine and general therapeutics would have been greater, more substantial and much sooner realized. Careful, comparative study of the ancient scientific findings would have convinced the modern medical investigator that the old masters still were worthy of the keenest attention. To imitate them is a compliment and not a disgrace. Both Hippocrates and Galen wrote extensively and taught body and spinal mechanics, and taught them so wisely that they should command the admiration and respect of all contemporary scientific minds. As spinal mechanics were well investigated and understood by the ancients, their admonitions to the practicing physician to make a special study of the anatomical and physiological structure of the spinal column became inevitable. Nor were they made in vain. An important part of the art of medicine is making a correct diagnosis of the nature of the diseases. This should include the proper understanding of spinal and body mechanics. Hippocrates, in his treatise on articulations, repeatedly states that, “It is necessary to know well the nature of the spine, what it is, as such knowledge is requisite in many diseases.” Considering all this past evidence, it is not a fair question to ask why then is chiropractic not accepted

by orthodox medicine today if we are aware of medical history? Well, perhaps because the times dictated the attitude. Then let us further examine those times, as well as the birth or perhaps the rebirth of the manipulative science we now identify as chiropractic. Bask in 1895 Daniel David Palmer of Davenport, Iowa, was fifty-years-old and well recognized as an unusual man of parts. Born in 1845 in the little Ontario town of Port Perry, he had become interested in healing the sick while still a young man, and had immigrated to the United States where he practiced several of the numerous methods of healing then in vogue. D. D. Palmer was an omnivorous reader and a diligent investigator of everything available that dealt with healing. He felt that far too many attempts to heal were conducted on a “by-guess-and-by-gosh” basis. If they appeared to work, well and good; if they didn't, try something else. Long after the Civil War, practitioners gained medical knowledge by serving a term of apprenticeship with some local M.D. Many gained knowledge of medicine while sweeping out offices, cleaning the M.D.'s stalls, currying his horses, or driving the M.D. Around the countryside on his house calls. In most academic institutions in these years, attendance was required for a limited time. Only in rare instances was the period longer than one year. It was not until the late 1880's that laws were written stating that licensees in medicine must have graduated from a recognized medical college before obtaining admission to practice in a state. Many early medical doctors were of the itinerant-type who traveled from town to town and peddled cure-alls or allegedly superior Indian herb cures. Some noted surgeons of the past were graduates of terms of a shorter duration than one year. Palmer felt that the healing arts up to this time were characterized by a singular unwillingness to search for a basic, underlying cause of disease. He set down his impressions in a penetrating analysis. “One question was always uppermost in my mind in my search for the cause of disease. I desired to know why one person was ailing and his associate, eating at the same table, working in the same shop, was not. Why? What difference was there in the two that caused one to have pneumonia, typhoid, or rheumatism, while his partner similarly situated, escaped. Why? That is a question that has intrigued many throughout the ages.” Palmer attempted to answer this question of “why” in order to serve his fellow human being. Because of its great efficiency in making sick people well, there has been a temptation to take chiropractic for granted. But the success of chiropractic is due to the fact that it has made several important contributions to modern science. They are as follows: 1. Anatomical disrelation can create function disturbances in the body. This great discovery blazed a trail for the need of the study of structural anatomy as relating to posture and body mechanics in the problems of health and disease. 2. Disturbances of the nervous system are primary factors in the development of many disease conditions. This concept was laid down in 1895, long before the scientific world was aware of the great significance of the nervous system in causing disease. 3. Spinal subluxations are a specific cause of nerve irritation or interference. It was the chiropractic profession that centered attention upon the human spine and pelvis as a significant factor in disease processes.

4. The viscero-spinal principle: Nerve irritation at the spine may lead to a disturbance in the function of one or more internal organs of the body. Today this concept has been confirmed by extensive neurological research. The threads that are woven in the fabric of the healing arts historically originated in man's relentless struggle to help his fellow human being. Chiropractic, like other forms of healing, was built with facts and findings of the biological sciences to which chiropractic investigators, researchers and clinicians in the field are constantly adding. The concept of “why” disease happens, “how” to prevent its recurrence is an endless struggle that chiropractic traditionally has waged. So the “battle” is for health rather than against disease. It is to that absolute from which chiropractic derives its existence and to which it is accountable. That is perhaps why this honorable profession has set themselves an almost unattainable goal.

All Content Copyright Dr Franklin Shoenholtz 2009. All Rights Reserved. Copyright California Chiropractic Association Archives 1977, Volume 4, Number 2