Unsubstantiated claims in patient brochures from the largest state, provincial, and national chiropractic associations and research agencies.

OBJECTIVE: To determine the presence or absence of claims for the clinical art of chiropractic that are not currently justified by available scientific evidence or are intrinsically untestable. DESIGN: A survey of patient education and promotional material produced by national, state, and provincial societies and research agencies in Canada and the United States. METHOD: Patient brochures were solicited from the 3 largest provincial, 3 largest state, and the 3 largest national professional associations in the United States and Canada. Similar requests were made of 2 research agencies supported by the national associations. Brochures were reviewed for the presence or absence of unsubstantiated claims. RESULTS: Of the 11 organizations sampled, 9 distribute patient brochures. Of these 9 organizations, all distribute patient brochures that make claims for chiropractic services that have not been scientifically validated. CONCLUSION: The largest professional associations in the United States and Canada distribute patient brochures that make claims for the clinical art of chiropractic that are not currently justified by available scientific evidence or that are intrinsically untestable. These assertions are self-defeating because they reinforce an image of the chiropractic profession as functioning outside the boundaries of scientific behavior.

Laid to uneasy rest: D.D. Palmer, 1913.

A study of the documentary records related to D.D. Palmer's death in Los Angeles in 1913 provided several surprises and a number of unanswered questions. How tall was D.D. Palmer? Why were the Founder's attending physicians persuaded to change their opinions about the primary cause of death? Was there a private autopsy, and what of the reported abscess in Palmer's side? What role did D.D.'s widow play in the patricide controversy? There is more to the documentary trail to explore.

C. Sterling Cooley, D.C., F.I.C.C.: politician, innate fundamentalist and Palmer historian.

From the day he graduated from the Palmer-Gregory Chiropractic College in 1908 until his death in 1965, C. Sterling Cooley considered himself a student of D.D. Palmer. Friend to three generations of the Palmers, he nonetheless found his own path through the stormy politics of his era. Appointed to the first Board of Chiropractic Examiners in Oklahoma in 1921, he served for many years as president and secretary and, later, as a member of the state's basic science board. Cooley helped establish the International Chiropractic Congress in 1928 and was elected the third president of the broad-scope National Chiropractic Association (NCA) in 1935. The first serious steps in the NCA's educational reform efforts took place during his term on the society's executive board (1936-41). Concerned that both the NCA and the International Chiropractor's Association were ignoring the principles of chiropractic as set forth by Old Dad Chiro, Cooley devoted his final two decades to studying, speaking and writing about the life and teachings of the founder. His career epitomizes that segment of the profession which held that authority in defining and practicing chiropractic must derive from the principles of the "Old Master."

Interexaminer reliability of activator methods' relative leg-length evaluation in the prone extended position.

OBJECTIVE: To investigate the interexaminer reliability of the prone extended relative leg-length check as described by Activator Methods, Inc. SUBJECTS: Thirty-four subjects were selected from a pool of 52 consecutive patients visiting a private chiropractic office. METHODS: Exclusion criteria included congenital or acquired conditions known to affect lower extremity length and inability to lie prone for a 10-minute period. Two experienced chiropractors who specialize in Activator Methods and are "advanced-proficiency rated" by Activator Methods, Inc. assessed each patient in random order for leg length inequality. Findings were recorded as left short leg, equal leg length, or right short leg. RESULTS: The data for 34 subjects were organized in a 3 x 3 contingency table. Total agreement was 85%. A simple, unweighted kappa value yielded kappa = 0.66. A disproportionately greater number of right short leg findings than left short leg findings were observed by both examiners. In only 2 instances were equal leg lengths observed, and both were detected by the same examiner. Because examiners found only 2 of 34 subjects with equal leg lengths, several secondary analyses involving data reductions were conducted. The resulting kappa values were similar to the 3 x 3 analysis. CONCLUSION: There was good reproducibility between 2 examiners by using the Activator Method to detect leg length inequality in the prone extended position. This study does not address the validity or clinical significance of the measurement method. Future studies should include larger numbers, a wider variety of subjects, and a diversity of examiners.

A descriptive analysis of the Journal of Manipulative and Physiological Therapeutics, 1989-1996.

BACKGROUND: Two previous reports have summarized the content, institutional affiliations, academic training and funding sources for articles published in the Journal of Manipulative and Physiological Therapeutics (JMPT) from 1978-1986 and 1987-1988. OBJECTIVES: (a) to quantitatively assess the types of articles published in the JMPT from 1989-1996; (b) to identify the affiliations of contributors to the JMPT during this period; (c) to identify the academic backgrounds of contributors to the JMPT from 1989-1996; (d) to identify funding sources for scholarly works published in the JMPT during this period; (e) to identify the proportionate contributions of female authors; (f) to assess the proportion of articles contributed, i.e., foreign vs. domestic sources; and (g) to compare findings for the JMPT from 1989-1996 with similar data for 1978-1988. STUDY DESIGN: Survey of the contents of the JMPT from 1989-1996. METHODS: The contents of the 69 issues of the JMPT from 1989-1996 were reviewed by all authors. Characteristics extracted included category of the article, academic backgrounds of authors, institutional affiliations of authors, funding sources, gender of authors and nation(s) of origin of articles. RESULTS: The annual rate of published contributions to the Journal has more than doubled compared with its first 11 yr of publication, and the proportion of original data reports has grown slightly. Controlled and quasicontrolled clinical trials were 7 times more numerous (n = 28 articles) during the past 8 yr. Chiropractic colleges were the most frequently mentioned affiliation of authors, followed by private practice and nonchiropractic colleges. Collaborative articles submitted by authors at two or more chiropractic colleges grew from only 4 articles from 1978-1988 to 31 articles from 1989-1996. As in previous years, the National College of Chiropractic continued to be the most frequently mentioned academic affiliation of authors. The numbers of articles contributed by those holding scientific (e.g., PhD) and medical degrees have grown substantially. The number of articles mentioning financial support grew from 78 from 1978-1988 to 179 from 1989-1996, and 58 new funding sources were identified. The Foundation for Chiropractic Education and Research continues to be the most frequently mentioned source of funding. Of all articles published in the JMPT from 1989-1996, 21% were authored or coauthored by women. Of 1050 articles, 286 (27%) were authored or coauthored by individuals residing outside the United States of America. CONCLUSIONS: Substantial increases in scholarly activities within the chiropractic profession are suggested by the growth in scholarly products published in the discipline's most distinguished periodical. Increases in controlled outcome studies, collaboration among chiropractic institutions, contributions from nonchiropractors, contributions from nonchiropractic institutions and funding for research suggest a degree of professional maturation and growing interest in the content of the discipline.

James F. McGinnis, D.C., N.D., C.P. (1873-1947): spinographer, educator, marketer and bloodless surgeon.

Perhaps best remembered for his contributions to B.J. Palmer's earliest developments in spinography, James F. McGinnis also pioneered in marketing methods while a straight chiropractic practitioner in Iowa. His advertising brought him to the attention of organized medicine, which sought his prosecution. Relocating to California in the early 1920s, he broadened his scope of practice and earned a naturopathic doctorate. In the 1930s he became one of the best known of several chiropractic bloodless surgeons and traveled around the nation to teach his methods. Although initially a passionate member of the Universal Chiropractors Association and receptive to Palmer's introduction of the neurocalometer, McGinnis eventually changed his political allegiance and became an active member of the National Chiropractic Association. He died in 1947 while on a teaching tour of Claifornia's San Joaquin Valley.

Ted L. Shrader, D.C., F.I.C.C.: a gentle force for improvement in chiropractic. 1998 Lee-Homewood Chiropractic Heritage Award recipient.

Long before technology assessment and continuous quality improvement were in vogue in chiropractic, Ted L. Shrader, D.C., F.I.C.C., was working toward these goals in the profession. Convinced that chiropractic must change from within for the benefit of society, Dr. Shrader has made a career-long commitment to evaluating chiropractic procedures and establishing consensus statements regarding chiropractic principle. Determined in mind, moral by nature, and unobtrusive in manner, Dr. Shrader has been decidedly effective in his endeavors. He has encouraged in chiropractic a mind for critical thinking. The fruits of his labor can be seen today in chiropractic publication, among chiropractic scholars, within the American Chiropractic Association Council on Technique, in conference proceedings, and in our institutions.

Early Canadian chiropractic colleges.

Chiropractic education arrived in Canada, principally in Ontario, in 1909 with Robbins Chiropractic Institute, (RIC) in Sault Ste. Marie, Ontario. After the RIC's closure in 1913, the Canadian Chiropractic College (CCC) Hamilton, Ontario, held its first classes in 1914 under Dr. Ernest Du Val, 1911 Palmer School of Chiropractic graduate. It was during this period that the Hodgins Commission on Ontario Medical Education held public sessions with presentations from all health professions including chiropractic. It was the outcome of this Commissions Report that dealt a devastating blow to chiropractic. The CCC, which moved to Toronto in 1919, remained the only chiropractic college in Canada until 1920 with the opening of the Toronto Chiropractic College (TCC). The CCC closed in 1923; and the TCC, in 1926. Although all three colleges taught a "straight" program, the "mixers," largely from American schools, became the dominant political force in the province, particularly on the Board of Regents for the enforcement of the 1925 Drugless Practitioners Act, a mixed Board of chiropractors, osteopaths and drugless therapists.

Cleveland chiropractic: the early years, 1917-1933.

Although the Cleveland family is well known in the profession for the two colleges that carry its name, relatively few of the details of the early activities of these chiropractic pioneers are recalled. This paper traces the early lives and careers of Ruth Ashworth and Carl S. Cleveland, Sr. from their education and marriage at the Palmer School in 1917 through their college operations and national professional activities before the start of the National Chiropractic Association's educational reform initiatives in the mid-1930s. The pair was active in Missouri chiropractors' struggles for licensure in the 1920s and fought to prevent the enactment of basic science legislation later on. The Clevelands remained allied to B. J. Palmer and the Chiropractic Health Bureau (today's International Chiropractors' Association) after the introduction of the neurocalometer (NCM) in 1924. However, they followed a less strident and less extreme course within straight chiropractic than did their Davenport mentor. The Cleveland College perpetuated a full-spine approach to chiropractic technique and always included diagnostic instruction. In the late 1920s and early 1930s, Carl Cleveland's more moderate stance found favor within the unification efforts centered in the International Chiropractic Congress, and he served during 1931-1933 as president of the Congress' division of school leaders. The Cleveland Chiropractic College's battle for economic survival during the lean days of the nation's economic depression is a testimony to its founders' vision and commitment to chiropractic education.

The short life & enduring influence of the American Chiropractic Association, 1922-1930.

The American Chiropractic Association (ACA) of the 1920s is an ancestor of today's ACA. Established in 1922 as an alternative to B.J. Palmer's protective society, the Universal Chiropractors' Association (UCA), the ACA floundered under its first administration, but found its way when Frank R. Margetts, D.D., LL.D., D.C. was elected its second president in 1923. A skilled orator, Margetts toured the nation to rally support for the new society's policies and programs: independence from any school, higher educational standards, opposition to basic science legislation, national publicity, a clinical research program, and malpractice insurance and legal aid for its members. The ACA accepted straight and mixing chiropractors, but rejected applicants with only correspondence school diplomas. The ranks of the ACA grew after Palmer's 1924 introduction of the neurocalometer and the consequent decline in UCA membership. Following BJ's ouster from the UCA, the two societies commenced the lengthy negotiations for amalgamation which produced the National Chiropractic Association (NCA) in 1930. The NCA became today's ACA in 1963; the enduring influences of the 1920s ACA upon the present day ACA are considered.

"Heat by nerves and not by blood": the first major reduction in chiropractic theory, 1903.

Recalled as the demarcation between D.D. Palmer's magnetic healing and chiropractic, the Harvey Lillard case holds a special place in the history of the profession and its healing art. Less familiar to chiropractors today, but of considerable significance in the subsequent development of chiropractic theories, was Old Dad Chiro's 1903 "discovery" that thermoregulation was a neural rather than a circulatory phenomenon. This Santa Barbara incident established the first major alteration in D.D. Palmer's chiropractic concepts, and would set the stage for the earliest known acquittal of a DC for unlicensed practice four years later, which in turn created strong incentive for subsequent differentiation between "neural supremacy" and the osteopathic "rule of the artery." The nature of the 1903 insight and some of the reasons why it is not more widely remembered among chiropractors today are discussed.