Read Marketplace of the Marvelous Online
Authors: Erika Janik
At first, Palmer kept his system to himself, fearful of potential competitors and imitators. But a brush with death in a train accident in 1897 compelled him to share his system so that his great discovery did not die with him. He took on an apprentice and taught him enough
of the basics of chiropractic technique that he could heal Palmer's injuries from the accident. This informal apprenticeship system was quickly replaced with a formal school, the Palmer Chiropractic School and Cure in 1897. Like osteopathy, chiropractic adjustments were not easy to explain in words but better learned through observation and experience. That first year, the school graduated its first student, who also happened to be a homeopath. Enrollment tripled the next year and had increased to five by 1901. In 1902, Palmer's own son B. J. enrolled. Many of these early students were regular doctors looking to add a new element to their practice. Women were also welcome, and many of the women who matriculated did so with their husbands, as Palmer offered a tuition break for spouses. Mae Parsons entered chiropractic with her husband not “seriously intending to practice,” but once she learned more, she “became greatly interested.”
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One of the first women to graduate was Minora Paxson, who went on to coauthor the first chiropractic textbook. Another, Julia C. Bowman, set up a “Chiropractic Cure” on Hennepin Avenue in Minneapolis in 1899. Palmer's liberality only extended so far, however. Despite the importance of Henry Lillard, a black man, to the foundation of chiropractic, African Americans were not welcome at the Palmer School, or at most of the other chiropractic schools that soon opened, until the mid-twentieth century.
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And there were many more schools. The American School of Chiropractic was opened in Cedar Rapids, Iowa, in 1902 by two Palmer graduates. Schools also opened in Minnesota and Oklahoma, and in 1903, Palmer himself founded a school in Oregon. By the 1910s, schools conferring the degree of DC, doctor of chiropractic, had opened around the country, with particularly heavy concentrations in the Midwest and on the West Coast. Many were short-lived, closing after a few years or even a few months. Chiropractic's leaders regularly acknowledged the poor quality of many of these schools. At a lecture in Oklahoma City, Palmer lamented that “I teach the science to one person and that person teaches it to another . . . until chiropractic is in the hands of the third or fourth person [and] is hardly recognizable as chiropractic.”
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Even Palmer's own school was not safe from criticism. Oakley Smith recalled that the “first thing I learned was that there was no instruction to be given. There were no blackboards, no text books, no notes, not a single lecture. For six days I witnessed the giving of a number of treatments. That was the sum total of information
that was transferred in exchange for tuition paid.” At the end of the week, Smith was told he had learned all that he needed and that he “should do the treating thereafter.”
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Rather than ignore or deny the problems, though, chiropractors took steps to eliminate the abuses at their educational institutions, particularly diploma mills that issued degrees to anyone who could pay.
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Smith's negative review did little to hinder the growth of the Palmer School in Davenport, Iowa. The institution prospered under the charismatic and egotistical leadership of Palmer's son B. J., who had purchased the struggling school from his father in 1906. B. J. paid off his father's debts and purchased more land and buildings for the school. He then proceeded to shut his father out, even allegedly hitting his father with an automobile after Palmer refused to leave during the school's 1913 homecoming parade. B. J. announced himself as the “Developer” of chiropractic and his Palmer school as the “Fountain Head” of the field. He also shifted the system's focus from the divine to the more practical task of relieving daily pain through adjustments. Though he did not abandon the spiritual aspects completely, B. J.'s emphasis on the brain as the real seat of the body's power rather than Innate Intelligence in the nerves angered and embittered Palmer, who accused his son of robbing him of credit and financial reward for chiropractic.
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Short of stature and filled with the same impetuous self-confidence as his father, B. J. possessed an administrative and business-oriented mind that allowed him to ably recruit both staff and students to the school and to expand the entire chiropractic field. Students learned not only the skills and theories of chiropractic but also how to be good businessmen, a skill B. J. believed essential to success and prosperity in medicine. It was a prescient move, as today more than sixty regular medical schools offer combined degree programs in medicine and business for much the same reason. At a chiropractic convention in Butte, Montana, B. J. explained that his school operated “on a business and not a professional basis. It is a business where we manufacture chiropractors. They have got to work just like machinery. A course of salesmanship goes along with their training. We teach them the idea and then we show them how to sell it,” B. J. proclaimed.
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Students developed their business acumen in a one-month “Salesmanship” course that intensively studied the topics of “Personal Magnetism,” “Business Relations,” “Advertising,” “Selling the Patient,” and “Keeping Yourself
Sold.” To promote chiropractic, B. J. taught, lectured, and published constantly. He also saw the potential of commercial radio far in advance of other businessmen. In 1910, he established Davenport station WOC, whose call letters stood for “Wonders of Chiropractic,” one of the first and most powerful radio stations in the country. B. J. used the station, listened to by more than a million people, to promote the benefits of chiropractic care and to “establish Good Will for Chiropractic.” The station was not solely the marketing mouthpiece for chiropractors; it also broadcast news, sports, music, and farm reports. In the 1930s, the station hired a promising young Illinois sportscaster named Ronald Reagan. Under B. J.'s leadership, the Palmer School grew from twenty-one students in 1906 to more than two thousand in 1920. It was the largest medical school of any system of healing, regular or irregular, anywhere in the world.
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The osteopathic education system grew rapidly as well. The last five years of the nineteenth century saw schools opening in Anaheim, Minneapolis, Denver, San Francisco, Milwaukee, Boston, Des Moines, and Chicago. Graduates set up practices throughout the United States as well as abroad in Canada, Mexico, Britain, Ireland, and China. Not all of these schools were of the highest quality, as the rapid expansion of the field drew entrepreneurs out to make a buck from various educational schemes.
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Serious osteopaths worried about the damage these incompetent osteopaths might cause the fledgling field. Still was frequently moved to tears by stories of osteopathic charlatans preying on innocent patients or claiming osteopathic expertise. “They are drunken scoundrels, the very trash of your town,” raged Still, who “are no more fit [to practice] than a donkey is to go in a jewelry-shop.”
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And then there were, of course, the biggest imitators of them all, the chiropractors, who sullied the good name of manual manipulation. Regulars seized on osteopathy's inferior schools as evidence of the profession's mercenary rather than selfless motives to heal. They published articles ridiculing the incompetency of osteopaths and their education system. The fact that regular medicine had its fair share of diploma mills and poorly run schools did not seem to temper their criticism. Rather than refute these accusations, osteopathy's leaders, like those in chiropractic, worked to upgrade and correct abuses.
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Many of the people who enrolled in osteopathic and chiropractic schools came from the lower classes. Too poor to afford regular
medical school, which raised tuition in the late nineteenth century, many working-class Americans came to Palmer and Still seeking the promise of the American Dream, social mobility and economic independence. Osteopathic schools had historically maintained lower admission standards than regular medical schools, in part as a means of remaining accessible to poor students. In the 1920s, George Laughlin, president of the Kirksville College of Osteopathy, argued “that requiring two years of prior college work was hurting the underprivileged since they could least afford the additional schooling.”
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This commitment to accessibility had the unintended effect of creating an impression of osteopathy today as somewhat of a “back door” into medicine, a way for people who could not get into regular medical schools to become doctors.
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Both osteopathy and chiropractic also recruited practitioners from the ranks of satisfied patients, which Still and Palmer touted as the ultimate validation of their systems. Relief from what was for many a pain-filled life often prompted a powerful and dramatic conversion experience to a new way of life, just as it had for many of the founders and followers of other irregular health systems. Chiropractic, in particular, drew converts from those discontented with medicine or simply the course of their lives. Many had no medical experience save for a positive encounter with chiropractic adjustment. In other cases, teachers, lawyers, and ministers came to chiropractic seeking the fulfillment lacking in their current jobs. The maturity of these early chiropractors may have helped them withstand the persecution that a chiropractic career, particularly in the initial years, often entailed.
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Professional journals and associations followed the educational expansion of chiropractic and osteopathy. The
Journal of Osteopathy
began in 1894, and three years later, in 1897, the American Osteopathic Association (AOA) organized in Kirksville with the intention of improving educational standards, imposing sanctions on incompetent osteopaths, and raising the profile of osteopathy as a profession.
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Chiropractors embarked on a similar professionalizing course. The first chiropractic journal, the appropriately named
Backbone
, debuted in 1903. The
Chiropractor
, a Palmer publication, began the following year. In 1905, the American Chiropractic Association organized in Cedar Rapids, Iowa, and the following year B. J. Palmer started the Universal Chiropractors' Association.
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These professionalizing tendencies differentiated chiropractic
and osteopathy markedly from the irregular systems that had arisen before. American medicine, not to mention American culture, had changed. Experts and expertise increasingly mattered as people in every field banded together into professional organizations. While the democratic impulse still animated Americans toward common sense and resentment of elite knowledge and power, American culture in the late nineteenth century increasingly deferred authority in some fields, particularly science, to specialists. Irregulars could not rely on the populist sentiment that had sustained them in the past.
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But even as they recognized the realities of the new medical marketplace, osteopathy and chiropractic were not without internal dissensions that could potentially damage their growth. Osteopaths wrestled over the scope of their practice, particularly in regard to the range of therapies they should employ and the types of diseases and conditions they should treat. Two groups vied for support and control: those loyal to Still and his manipulative theory, known as “straights,” and those who doubted that manipulation could really cure everything and blended osteopathy with regular and other irregular medical therapies, known as “mixers.” Surgery presented the first challenge. Those who believed in manipulation alone saw no reason to add surgery to the osteopathic curriculum. Andrew Taylor Still, while disgusted by regular medicine's overeagerness to reach for the knife, felt surgery had some place after all other options had been exhausted. It was the doctor, not the surgery, that was the problem, he reasoned.
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“We accept . . . surgery also as of great use and benefit to mankind,” wrote Still. “But when should the knife be used? Never, until all nerves, veins, and arteries have failed to restore a healthy condition of the body in all its parts and functions.”
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But if osteopathy was truly to compete with regular medicine and even other irregulars like homeopathy, the mixers argued, it had to provide the same range of services to patients. Still added surgery to the curriculum of his school in 1897, in part, out of hope that osteopathy could bring some reform to a field he thought too quick to send patients to the operating table. The conflict over inclusion of drugs was a far bigger and longer fight. Unlike surgery, Still saw no use for drugs, and he continued to attack them as an assault on the body's natural healing power and an insult to the wisdom of God. He managed to keep most of his followers, who greatly respected his leadership even as they sought modifications of his theory, in line during his life. But the struggle between
straights and mixers over drugs simmered beneath the surface and eventually transformed osteopathy into its modern form.
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Early chiropractors argued endlessly over adjustment techniques, equipment, and even aspects of Palmer's theory itself. Many chiropractors developed their own way of manipulating subluxations. Others introduced a broad range of therapies to supplement physical adjustment, such as massage, electrical stimulation, and water therapy. Those methods that involved mechanical devices struck some pure chiropractors as particularly egregious, violating the meaning of a science whose name meant “done by hand.” B. J. Palmer discovered this himself in 1923 when he attempted to introduce the Neurocalometer, a device that could supposedly find subluxations by detecting changes in nerve transmission along the spine. The device deeply divided chiropractors and further fractured the movement.
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Many of the chiropractic schools, associations, and journals that formed operated as organs of these various splinter groups. The first chiropractic textbook was not published by Palmer but by some of his students who had set up a competing school in Cedar Rapids, Iowa. The authors not only neglected to credit Palmer, they also claimed the brain, not the nerves alone, was the source of all nerve function in the body, a position that Palmer's son B. J. gradually adopted.
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B. J. himself also altered chiropractic theory and introduced new official chiropractic terms to maximize chiropractic's differences from osteopathy. Instead of a diagnosis, chiropractors made an “analysis”; an “adjustment” instead of treatment; and never “manipulation,” the word most osteopaths used to describe their therapy.
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Some chiropractors felt their techniques were so different from Palmer's as to be an entirely different medical system. One known as neuropathy blended chiropractic, osteopathy, and ophthalmology, while another called naprapathy was a form of manual medicine based on problems with the ligaments and connective tissues rather than nerves; both were started by Palmer graduates.
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