Essentials of Complementary and Alternative Medicine (June 1999)

Table 14.4. Comparison of Badmaev Formula 28 Therapeutic Results with Those of Synthetic Pharmaceutical Drugs in Improving PVD

THE FUTURE
Based on past and recent history, the development of botanic treatments derived from Tibetan medicine will continue and complement the development of synthetic 
drugs. As illustrated in 
Figure 14.3
, both developmental processes from the different pharmacological concepts are complementary in that they provide different 
approaches for research and improvement of pharmacological treatments.
F
IGURE
 14.3. Coexistence of the development of natural and synthetic drugs.
Integration of Tibetan medicine with Western medical practice can improve existing health care systems considerably. But it is not only a matter of advanced 
technology that allows people to become and feel healthier. Despite tremendous advancement in medical technology, we, as a modern society, are still plagued with 
chronic disease. We need, therefore, to learn more, and in different ways. To learn and understand more, we may have to set aside preconceptions and follow the 
advice of the European philosopher and Tibetan scholar, Cyrill von Korvin-Krasinski: “... theoretical medical science cannot be separated from its practical application, 
nor the teaching from life in community, nor the finished doctrine be acquired without personal experience of its truth.” To experience and perceive Tibetan medicine 
firsthand is the best way to understand it.
DEDICATIONS
To the work of my predecessors, my wife Eulalia Badmaev, MD, and son Michael.
ACKNOWLEDGMENTS
Thanks and appreciation go to Dr. Muhammed Majeed, Todd Norton, Thomas & Dee Mower, William S. Coury, Curtis Jacquot, Dr. Maja Nowakowski, Dr. Henry M. 
Wisniewski, Dr. Georgia Schuller-Levis, Dr. Peter B. Kozlowski, Dr. George Weissmann, Ms. Janette Carlucci, Ms. Jackie Woottan, and Dr. Herbert Schwabl.
C
HAPTER
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EFERENCES
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Tenzin Wangyal. Wonders of the natural mind. The essence of Dzogchen in the native bon tradition of Tibet. Tarrytown, NY: Station Hill Press, 1993:218.
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Olschak BC. The art of healing in ancient Tibet. CIBA Symposium 1973;12:129–134.
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Berthenson LB. Uber russische Buddistah und die sogenannte tibetanische Medzin. Med Wochenschr 1906;24:248–257.
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Kowalewski K. Wladimir Badmajeff, Tibetan doctor in Europe. J Res Indian Med 1973;8:101–109.
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Rockwood M. Tibetan cure. OMNI 1985;6:24, 148.
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Ross M. Tibet: ancient remedies gain new acceptance as research explore “mysterious” medicines. The Medical Post (Canada) 1990;July 10:14.
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Winder M. Introduction. In: Kunzang J, ed. Tibetan medicine. Berkeley and Los Angeles: University of California Press, 1973:1–7.
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Badmaev PA. O sistemie vrachebnoi nauki Tibeta (On the Tibetan medical system). Contains translation and commentaries on the first two books of the yGyud-Bzhi, St. Petersburg:1898:234.
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Csoma de Koros A. Tibetan studies (a reprint of the articles contributed to the Journal of the Asiatic Society of Bengal). J Asiatic Soc Beng 1911;7:1–172.
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Badmajew P, Badmajew V, Park L. Healing herbs. Berkeley: Lotus Press, 1982:80.
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Glatfelter RE. Peter Badmaev. In: Wieczynski JL, ed. The modern encyclopedia of Russian and Soviet history. Vol. 2. London: Academic International Press, 1976:234–237.
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Grekova T. Tibetska Medicina vy Rossii (Tibetan medicine in Russia). Nauka Religia 1988;August 8;10–15.
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1995;1(3):44–49.
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CHAPTER 15. C
HIROPRACTIC
 M
EDICINE
Essentials of Complementary and Alternative Medicine
CHAPTER 15. C
HIROPRACTIC
 M
EDICINE
Dana J. Lawrence
Background
 
Definition and Descriptions
 
History and Development
Principal Concepts
Provider-Patient Interaction
 
Patient Assessment Procedures
 
Differential Diagnosis
Therapy and Outcomes
 
Treatment Options
 
Description of Treatments
 
Treatment Evaluation
Use of the System for Treatment
 
Major Indications
 
Contraindications
 
Preventive Value
 
Scope of Practice
Organization
 
Training
 
Quality Assurance
 
Reimbursement Status
 
Relations with Conventional Medicine
Prospects for the Future
Chapter References
BACKGROUND
Definition and Descriptions
Chiropractic is one of the major branches of Western medicine. The major difference between chiropractic and other forms of Western medicine, such as osteopathy 
and allopathic medicine, is that chiropractic focuses on the spine as integrally involved in maintaining health, providing primacy to the nervous system as the primary 
coordinator for function, and thus health, in the body. The approach of chiropractic is the maintenance of optimal neurophysiological balance in the body, which is 
accomplished by correcting structural or biomechanical abnormalities or disrelationships. The primary method for accomplishing this balance is spinal manipulation, 
known as the chiropractic adjustment.
F
OUNDER AND
 K
EY
 F
IGURES
The following are the key figures from chiropractic's history:
Daniel David Palmer (1845–1913) was the founder of the profession. His interest in healing grew from his initial forays into spiritualism and magnetic healing. His 
adjustment of Harvey Lillard led to the creation of the chiropractic profession. He founded the first chiropractic school in 1898.
Bartlett Joshua Palmer (1882–1961) was the son of Daniel Palmer. Bartlett voraciously promoted the profession and helped keep its flame alive during years of trial 
and tribulations.
Solon Langworthy (dates unknown) was a student of David Palmer. He founded his own school and introduced the use of traction tables and naturopathic remedies 
to the fledgling profession.
Oakley Smith (1880–1967) was another early Palmer graduate. He felt that the true cause of interference to the nervous system came from cramping in the 
connective tissue, which he called a  ligatite. He later founded the naprapathic profession, and he was coauthor with Langworthy and Minor Paxon of the first 
chiropractic text, A Textbook of Modernized Chiropractic (
1
).
John A. Howard (1876–1954) was the founder of today's National College of Chiropractic (then the National School of Chiropractic). He had left Palmer's college with 
the blessing of David Palmer after disagreeing with the direction that Bartlett had chosen for the Palmer School. Howard emphasized a scientific approach to training 
chiropractors, referred to today as  rational chiropractic.
William Schulze (1870–1936) purchased the National School of Chiropractic from John Howard and maintained the emphasis on training in basic science.
Willard Carver (1866–1943) was a tremendously influential early chiropractor who developed a systems approach to subluxation that emphasized compensatory 
adaptations to preexisting subluxations elsewhere in the spine. He also influenced early legislative and licensing laws for the profession.
Tullius Ratledge (1881–1967) helped pass the first licensing regulation in the nation and went to jail rather than accept a license as a drugless healer. He founded 
Ratledge College, which is known today as Cleveland Chiropractic College in Los Angeles.
John Nugent (1891–1971) was to chiropractic education what Abraham Flexner was to medical education—the man who almost single-handedly revamped its 
educational system. Under his direction as Director of Education for the National Chiropractic Association (known today as the American Chiropractic Association), he 
led reforms to standardize the chiropractic curriculum and to move the chiropractic institutions to become nonprofit and professionally owned.
Leo Spears (1884–1956) was the founder of the first chiropractic hospital, the Spears Hospital and Free Clinic for Poor Children.
Joseph Janse (1909–1985) was a man of formidable intellect and perseverance who led the National College of Chiropractic for 38 years (
Fig. 15.1
). Under his 
stewardship, the college made a number of important advances for the profession. He helped found the Council on Chiropractic Education, the National Board of 
Chiropractic Examiners, the Federation of Chiropractic Licensing Boards, scientific councils, and the residency program in chiropractic radiology. His college was first 
to receive regional accreditation and the first to found a journal (the  Journal of Manipulative and Physiological Therapeutics) that became internationally indexed; it 
remains the only chiropractic journal indexed in  Index Medicus.

F
IGURE
 15.1. Joseph Janse (courtesy of the National College of Chiropractic).
Carl Cleveland (1896–1982) led two chiropractic colleges for 60 years. His sons, Carl, Jr., and Carl III, also led chiropractic colleges. Carl III is currently the president 
of Cleveland Chiropractic College.
There are many significant historical figures not mentioned in this list. A more comprehensive list would also include Sylvia Ashworth, Homer Beatty, William Budden, 
Andrew Davis, James Drain, James Firth, Arthur Forster, Henri Gillet, Almeda Haldeman, George Hariman, George Haynes, Arthur Hendricks, A. Earl Homewood, 
Fred Illi, Craig Kightlinger, Lyndon Lee, Joy Loban, Hugh and Vinton Logan, Ernest Napolitano, Earl Rich, Leo Steinbach, Harry Vedder, Claude Watkins, and 
Clarence Weiant as just some of those who played a significant role in chiropractic's historical development. Even a comprehensive list does not account for many of 
the “movers and shakers” helping the profession in modern times.
K
EY
 P
UBLISHED
 W
ORKS AND
 R
EFERENCES
Important texts of the early and middle period of chiropractic are listed in 
Table 15.1
 (
1
, 
2
, 
3
, 
4
, 
5
, 
6
, 
7
, 
8
, 
9
, 
10
 and 
11
). Also, one of the most complete lists of early 
chiropractic texts can be found in the reference list to Gaucher-Peslherbe's text  Chiropractic: Early Concepts in Their Historical Setting (
12
).
Table 15.1. Import Texts of the Early and Middle Chiropractic Era
The modern era of chiropractic texts was ushered in by the 1975 publication of  The Research Status of Spinal Manipulative Therapy (
13
), edited by Murray Goldstein. 
This text grew out of a critically important workshop held under the auspices of the National Institute of Neurological and Communicative Disease and Stroke. Since 
then, a large number of texts have been published. In part, this growth of texts is due to market forces; there are more students in chiropractic college, and more 
practitioners scattered around the country, so there is an obvious market waiting to be tapped. Also, many chiropractic texts have been published because of the 
growth of chiropractic research and education; more faculty and researchers means a greater critical mass of potential writers. Some of the best texts of the past two 
decades are listed in 
Table 15.2
, although this list should not slight any of the many other texts or authors who made important contributions to the chiropractic 
biomedical literature during the past 20 years.
Table 15.2. Important Texts of the Modern Chiropractic Era
History and Development
Although manipulation has been used as a medical therapy since ancient times, the chiropractic profession itself only celebrated its centennial in 1995. The 
profession was founded when Daniel David Palmer (
Fig. 15.2
), an itinerant scholar, grocer, and magnetic healer, was able to restore the hearing of Harvey Lillard, 
who had suffered from deafness for some time. Lillard had noted that his hearing loss began after he felt something “snap” in his neck. Palmer palpated for the 
spinous process, found it abnormally positioned, and reasoned that this abnormal position, or  subluxation, could be involved in the etiology of the hearing loss. Palmer 
thus was involved in two “firsts”—the use of the spinous process as a lever for manual adjusting of the spine, and the application of then current medical knowledge to 
create a new approach to healing, based on his contention that illness is effectively functional and becomes organic only as an end process (
22
).

F
IGURE
 15.2. D.D Palmer (courtesy of the National College of Chiropractic).
From this inauspicious beginning, within two years Palmer had founded his first Chiropractic School and Cure; at the same time, he expanded on the concept of the 
subluxation as a factor in creating, contributing to, or perpetuating disease. For his efforts, Daniel Palmer is now known as “The Founder.”
Daniel's son, Bartlett Joshua (
Fig. 15.3
), took over his father's college when he was only 25 years of age. Within 10 years, Bartlett had developed one of the nation's 
largest nonmedical institutions, and thus was later known as “The Developer” of chiropractic. A truly controversial figure, Bartlett's entrepreneurial spirit helped protect 
and expand the fledgling healing art. He was ideologically rigid when it came to his healing art, and it was under his stewardship that a schism that still exists within 
the chiropractic profession began. Bartlett was essentially a fundamentalist concerning chiropractic, practicing what came to be known as  straight chiropractic. It was 
Bartlett's unyielding beliefs that ultimately led John A. Howard to found the National School of Chiropractic, seen today as the leading institution following the  mixer 
approach to chiropractic. The split between Bartlett Palmer and John Howard started over the former's refusal to obtain cadavers for anatomical study, which Howard 
felt was essential for proper anatomical study. Howard, with the help of William Schulze, created a rational alternative to chiropractic practice and education (
23
).
F
IGURE
 15.3. B.J. Palmer (courtesy of the National College of Chiropractice).
Those early days of chiropractic were fraught with trouble, both with education and licensure (or lack thereof). Many chiropractors were sent to jail for practicing 
without a license, even after being offered the opportunity to pay a fine in lieu of jail (
24
). At the same time, the educational institutions had many of the same 
problems that beset their medical counterparts and which led to the famous Flexner Report (
25
). Some institutions were quite good, but many were poorly equipped 
and managed. The Flexner Report spurred the development of the modern day Council on Chiropractic Education, which was initiated under the early leader of John 
Nugent.
PRINCIPAL CONCEPTS
There are four general areas that chiropractic philosophy and practice emphasize:
1. Nervous system. In the human being, the nervous system is highly evolved and developed and influences all other body systems. It therefore plays important 
roles in health and disease.
2. Vis medicatrix naturae. The human body has an innate ability to heal itself and seeks to maintain that health via homeostatic mechanisms.
3. Effect of subluxation or joint dysfunction. When subluxation or joint dysfunction is present in the body, it may interfere with the ability of the neuromuscular 
system to act in an optimal fashion, and may therefore lead or contribute to the presence of disease.
4. Diagnosing and treating subluxation. One primary goal of chiropractic diagnosis and treatment is to identify, via appropriate medical and chiropractic 
procedures, subluxations and dysfunctions and to correct or eliminate them. This will then optimize the healing process in the human body.
Because an assessment of the spine is paramount in determining the presence of subluxation or joint dysfunction, the chiropractic physician relies more heavily on 
manual palpation of the body than other health care practitioners. This palpation and its associated procedures are performed alongside other standard medical 
diagnostic procedures.
Chiropractic is a holistic form of health care that recognizes that function cannot be separated from structure. This belief is not only from a macroscopic point of view 
but also from a cellular, microscopic view.
The National College of Chiropractic, in its “Profile of the Practice of Chiropractic” (
26
), provides a comprehensive statement regarding modern-day chiropractic 
practice. This statement admirably summarizes modern chiropractic practice and the principles on which that practice is based:
The National College of Chiropractic holds that the practice of the chiropractic physician embraces the whole person with emphasis upon conservative health care 
which facilitates the inherent potential of the human organism to develop and maintain a state of self-regulation and to invoke self-healing processes with minimal 
therapeutic risk at reasonable cost.Chiropractic practice embodies:
Recognition of a diversity of factors which impact upon human physiology, among which are biomechanical dysfunction, genetics, trauma, hygiene, 
microorganisms, nutritional status, exercise, motion, posture, environment, stress, emotion and human relationships.
Primary care of patients based upon diagnostic evaluation, including patient history, physical examination, clinical laboratory data, diagnostic imaging, and other 
special diagnostic measures, as well as those procedures which are unique to the chiropractic evaluation of human spinal and structural balance and integrity.
The application of a diversity of spinal and other adjustments and manipulations for the treatment, correction, and prevention of neurologic, skeletal or 
soft-tissue dysfunction and the production of beneficial neurologic effects.
The use of other conservative means including, but not limited to, nutritional counseling, physiologic therapeutics, meridian therapy/acupuncture, trigger point 
therapy, life-style counseling, emotional support and stress management.
The chiropractic doctor is a primary-care, first-contact physician who practices within the legal scope of licensure, emphasizes the importance of the 
doctor/patient relationship, recognizes the need for other kinds of treatment when indicated, and who, therefore, interacts fully with other members of the health 
care delivery team, always in the best interest of the patient (
26
).
There is a continuing intraprofessional debate about the role of modern chiropractic. One faction feels that chiropractic is a primary health care profession that should 
have full “gatekeeper” status for managing the health concerns of its patients, whereas the second faction feels that chiropractic should take pride in its ability to act 
as a strict musculoskeletal specialty, given that low back pain is ubiquitous and pervasive in modern culture. This debate is ongoing, and no consensus has yet 

developed, although it appears that the chiropractic colleges have for the most part hewed to the primary care approach.