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VOL. 5, NO.6 BULK RATE U .S. POSTAGE

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Chiropractic-and other healing arts

Q A

Difference between

chiropractors, osteopaths,

and physicians

Dr. Robert Mendelsohn

This month, the cover of Dr. Mendelsohn's new book "Male Practice: How Doctors Manipulate Women" shares this first page with its author's photo. Available through Contemporary Books (Chicago : $10.95), "Male Practice" has already made it to the list of best­sellers. We hope yo~ share our modest wish that it remain on those lists for as long as doctors continue to overmedicate, overtreat, overbear, and underestimate their women patients.--Vera Chatz, Associate Editor.

What is the difference between a chiropractor, an osteopath a nd a phy­sician? I've had back trouble for years, and a friend sugges ted I go to a chiropractor or an osteopath. My doctor got quite upset whe n I mentioned this to him. vfuat should I do?--P.T.

As a medical doctor, I can't give an objective answer to your ques tion because the kind of healing which medical doctors practice, known as allopathy, is only one branch of the healing arts. Other branches include homeopathy, acupuncture, osteopathy and chiropractic.

According to the dictionary, any form of allopathy trea ts disease by using r emedies that produce effects different from those of the diseas e itself. Chiropractic holds that disease results from l ack of normal nerve function, and its prac titioners emplo y manipula tion and adjustment of body structures such as the spinal column. Osteopathy , on the other hand, is based on the theory that diseases are caused by loss of structural integrity and can be healed by manipula tion of the parts, supplemented by therapeutic measures suc h as medicine a n d sur gery .

The healing a rts are united by one thing--mutual cont emp t among members of the different disciplines.

Since practically no M.D. has gone to chiropractic school, h e is hardly in a position to g ive you accurate information a bout chiroprac­tic, except that he will, with rare exception, re fe r t o it as "quackery ." (In fact, the American Hedical Association's code of e thics states that an M.D. should not associate with a cultist--which includes the other forms of healing arts.)

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Conversely , chiropractors don't go t o medical school, and they have their own negative vocabulary with which t o r efer t o M. D.' s . And while some osteopa ths have come very close t o organized medicine in recent years , many still maintain a respec t able d istance .

Al l this is meant to sugges t tha t yo u probabl y should refrain from asking one gro up about any of the others. You must seek informa tion for yourself by reading about these var ious groups, t a lking with fr iends who ' ve had experience wi th one or more bra nches of the h ealing a rts, and by doing some compa rison shopping .

My sincere congratulations o n the way you a nswered a reader ' s question about consul ting a chiroprac t or or osteopa th. Your r esponse was the most objective, sensible and unbiased I've read or h eard from a nyon e . I especially appreciate yo ur words, "the healing Arts a r e unit ed by one thing--mu tual contempt ."

I hope I am among the newer, more optimistic and forwa rd-thinking members of the healing arts who believe tha t we should cooperate fo r the benefit of the patient.

If yo u or your readers would care to learn something abou t chiro­practic, may I suggest that one of the best sources of informa tion is a college of chir opractic. Thank yo u, doctor. --L . D. H., D. C., San Francisco

Your ar ticle about different t ypes of healer s seems to me to be most honest and objective. For the sake of public health, it is unfortunate that there has not been g r ea ter dialogue between the professions . Each discipline claims its share of success , yet none offers a panacea for all the ill s of our nation's c itizens.

One can but wonder what the effec t would be if each profession co u ld overcome its prejudices and freq uently join in a team approach where - the bes t of each could be directed towards the goals of public health.-­R. C . S ., D. C., Director of Public Affairs, American Chiropractic Assn.

In the mid- 1970 ' s , I served first as a member and l a ter as chairman of the Illinois Medical Licensure Board . The fact that my fellow board members included a n osteopath, a chiropractor and a consumer represent a ­tive made me r eal iz e that coexistence is not only possible, but beneficial to the public .

I remember a column you wro t e several years ago in which you remind ed a fellow medical doctor that he has a responsibility to serve and pro­tect his patients . I applauded you for tha t answer.

In a nother column you once wrote, yo u mentioned an article by Joseph B. Kirsner, M. D., in which it sounded as though he were confirm­ing the wise admonition of Dr . Boyd in the preface of his Textbook of Pathology , "If we continually interfere with nature, we must pay the penal t y . " Keep up your good work! It is a pleasure to read the writings of a thinking man.

I would like yo u to investiga te the ideas of Applied Kinesiology , and I am enclosing seve r a l brief brochures .-- J . V.C., D.C.

Thank yo u for the information on Kinesiology. Since chiropractors are reading Boyd ' s Textbook of Pa thology, M. D.' s migh t do well to familiar ­i ze themselves wi th some chiropractic literature. All members of the healing arts sho uld be conversant with other major con troversial issues

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Q A Defining

an osteopath

Q

Q

of our time, which include acupuncture, chelation therapy, macrobiotics, laetril e and me gavi tamin therapy. Only by critically reviewing al l aspec ts of these issues, rather tha n reje c ting them out of hand, can we wisely counsel our pati ents on these types of tre atment.

Would yo u please explain what an osteopath is, how much education he receives, a nd whether or not he is a qualified doctor?

So many women seem t o be using osteopa ths instead of obs t etricians since osteopaths a r e in favor of home births and seem to be good at " popping " pregnant women ~ s backs . Is this "popping" s afe for the baby and the mother?--Mrs. C.S.

While a dic tiona r y definition may not help you very much, it is a gJod place to s tart. Hy dictionary defines osteopathy as " A s ys tem of med i­cal practice base d on a theory tha t diseases are due chiefly to loss of structur al integrity which can be restored by manipulation o f the parts suppl ement ed by therapeutic mea sures (as use of medicine or surgery)." But I has t e n to add that there is proba bly just as much disag reement among osteopathic physicia ns in de f ining their field as there is among c hiropracto rs and members of other bra nches of the healing professions in definin g the ir own fields.

Bo th ordinar y M.D. physic i ans and osteopathic phys i c i ans a re ''qual­ified" in the sens e that they pass examinations requir e d for their degrees a nd their licensure. To complica te matters, some physicians possess both M.D. and D.O. degrees .

Since I have had no formal training in os t eopa thy, I asked Dr. Irwin Tischler, De partment of Oncology a nd Hematology, Chicago College of Os t eo ­pathic Medicine, to comment. He felt that the "popping " of pregnant women ' s backs refers t o the cus t omary adj ustment that osteopaths prac­tic ing obstetrics us e on many pregnant women wh o have back problems. In his opinion, suc h adjus t men t is both effec tive and safe.

I hop e that someday an independent study conducted by a group with no bias or conflict of interest will compare the merits of childbir th practices of M.D. physicians , chiropractors, os t eopa ths, nurse-midwives, l ay mi dwives, and others who se r ve as " accoucheurs" (a fancy Fren ch word for whoever is in at t en dance at a bir th). Until this kind of study is done, pregnant women, toge ther with their husbands, will have t o exercise a larg e degree of commonsense judgment .

You seem t o advocate chiropractic only because most physicians oppose it. If physic i ans themselves were dosing 90 per cent of their clients with frequent sho ts of broad-field, high-dose x-rays which caused strokes (s ee Medical Wo rld News , March 17, 1980 ) and broke backs because of ir­rational joint popping, you ' d be screaming your head off . How can you even discuss the problems of x-rays without critic izing the worst abusers of a ll-- chiroprac tors--who often use "free x-rays " t o lure people into their offices?-- K. B.

Ar en 't there any good, qualified chirop racto rs who could examine and adjust the sp ine without using x-rays? It seems that a doctor wh o has knowledge of the human skeleton should be able to us e sight and touch to determine the alignment of the spine (which, after a ll, is on the sur­fac e of the back) .

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A Chiropractors

and abuse of

x-rays

Changing views on

chiropractic

Chiropractors are said to reason that x-rays "just bounce off the bone" and are "very fast," and they mus t use them as a "precaution." That just seems to be an excuse for using a method that is expensive and dangerous for the pa tient just for the convenience and safety of the doctor. It is strange indeed to see "holistic" and "x-ray" both adver­tised by the same doctor.

Do you have any hope that things will change in the fu ture ?--N . G.

Regardless of who points the x-ray beam in your direction (M . D.' s, chiropractors , dentists, or in previous decades, shoe salesmen), a high degree of suspicion is appropriate. Therefore, chiropractors, just like M.D . physicians (and all other members of the "healing professions") should be closely questioned, as you suggest, t o determine if the y really need those x-rays for proper diagnosis and treatment. While some chiro­practors (like their M.D. c ounterparts) obviously will not concur, my experience over the last few years from speaking with chiropractors and chiropractic students at meetings convinces me that many do agree with me .

Yo u b o th may be interes t e d in knowing tha t a recent report issued by the Toronto (Canada) Health Department advocates that routine x-rays required of job applicants or of those seeking landed immigrant sta tus should be stopped. The report states, "X-rays used by dentists and chiropractors in screening programs, and for a third party (such a s a n employ er) must all be a ble to demonstra te a health benefit to the rec ip­ient in order to be considered appropriate ." One of the contributors to the report also urged the revision of provincia l and federal (Cana dian) legislation which now requires x-rays for day- care workers, food hand­lers, hospit a l workers and immi gration candida tes .

Even my own organization, the Amer ican Academy of Pediatrics, is finall y b eg inning to catch up. Just a few months a go, they recommended a gainst the routine chest x - rays done for deca des on children before surgery, and also for attendance at school, college a nd summer c amp .

In November 1980, I addressed 3,000 chiroprac tors a nd the ir families a t the Parker Chiropractic Resea rch Seminar. I reported tha t:

1. I was taught in medical school never to " consort " with chiro­practors, but later was allowed to associate with them. Last y e a r, as a r e sult of the pressure of a l awsuit by the chiropra ctors, the Ameri­c an Medica l Association allowed its doctors to consult with chiropractors . I predict tha t at this rat e , within a few y ears, M.D.'s will be permitted to ma rry chiropractors .

2 . Hy wife fina lly go t rid o f her ba ck pa in at the ha nds o f a chiro­pract o r af ter repeated f a ilure o f orthopedic sur geons .

3. When the AMA (in its l awsuit) holle r e d a bout "unproven reme dies ," "ex tra vagant claims" and "uns c ientific methods, " I thought they we re referring , not to chiro prac tors, but to their own H.D. members.

4 . In s ome states, chiroprac tors are d e live ring babies--a prac tic e I r ega r d a s quite safe, sinc e by law they a re p rohibited from u s ing dru gs o r surgery .

5 . I a dvise anyone f ac ing b ac k sur gery to first c onsider a chiro­prac tic consultation, just as a nyone f a cing co r onary by pass should l ook a t Natha n Pritikin, and anyone thre atened with e le c tive Caesa rean s ec t ion s hould first c onsult a home birth practitioner.

I had a chance a few days l a ter to repea t and elaborate on the s e idea s during testimony in a l egal a ction brought by f i ve c hiroprac tors aga inst the American Hedical Assoc iation, the Ameri can Ho spit a l Associa -

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tion, and a number of doctors' etc.--and individual doctors. in violation of the anti-trust profession of chiropractic.

groups--radiologists, orthopedic surgeons, The suit charged that the AMA et al were laws in their attempts to eliminate the

One of the key documents favoring chiropractic is the authoritative New Zealand Government Report, 1979 (available through chiropractic colleges and chiropractors' offices) which, in addition to being the best and most up-to-date reference on the subject, confirms my long­standing view that Modern Medicine is a religion. The Dean of the University of Auckland Medical School, Dr. D. S. Cole, was asked if he would teach chiropractic students. His answer was, "You might equally ask a Church of England clergyman to teach a black magic man counselling. He won't do it if they have different beliefs."

Will M.D.'s ever move from religion to science?

Acupuncture Since I often am asked about the rather unorthodox and controversial nondrug pain control method known as acupuncture, I am pleased to pass along the following advice which appears in the decidedly orthodox Journal of the American Medical Association (February 20, 1981). After explaining the techniques of both traditional and modern acupuncture, George A. Ulett, M.D ., PhD, of St. Louis, Missouri, concludes:

Midwifery on

trial

"The evidence now available ... is sufficient to place this age-old Chinese healing art, modernized to U.S. standards, on a solid scientific base. There seems little doubt but that a more physiologically deter­mined acupuncture-type stimulation can and will play an increasingly important role in the relief of pain.

"In the hands of competent physicians, acupuncture is a method free from discomfort or side effects that can, in many cases, bring some relief from suffering of chronic pain. ~~en patients with such conditions ask about acupuncture, the answer can now be, with good justification, 'It may well be worth a try.'"

In view of this ringing endorsement, I wonder why acupuncture is being taught in chiropractic colleges, but not in medical schools.

In November 1980, I participated in the trial of midwife Rosalie Tarpening of Madera, California. Ms. Tarpening was accused of murder when she finally lost a baby after conducting hundreds of successful home deliveries.

Mind you, it was not the parents of the dead infant who complained, but a posse of doctors who were out to "get" that midwife in what re­sembled a frontier-style lynching party. But justice intervened when 80-year-old Edith Potter, M.D ., world renowned expert in pediatric pathology, emerged from retirement in Fort Meyers, Florida to testify on behalf of the defendant.

According to Dr. Potter, it was not the delivery of the baby that caused his death, but the resuscitation improperly carried out by the physicians at the local hospit a l. Those over-enthusiastic doctors, faced with a baby who was brought there because he had some trouble getting started breathing, were so heavy-handed that, in their clumsy efforts at artificial breathing, they blew out the lungs, creating what is known to physicians as "tension pneumothorax." This condition made it impossible for the baby to breathe at all. Edith Potter's evidence, practically unchallenged on cross-examination, pointed to the guilty parties.

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The local pathologists, including San Francisco's coroner, had conducted such a sloppy autopsy that Potter gave them a grade of 25. I subsequently called for investigation of all these local physicians by the Ca lifornia state licensure authorities.

In 1950, I had been a student of Dr. Edith Potter at the University of Chicago Medical School, and I had not seen her in the intervening 30 years. When I phoned her, after reviewing the c ase and noting the poor quality of the autopsy report, I asked only two questions: First, are you willing to examine the case and give an honest opinion? Second, are you willing to stand up publicly in court and sta te your opinion? She answered in the same direct, simple and understanding manner in which she presented that series of unforgettable lectures three decades ago. Her affirmative answer to those two questions was a refreshing change from the usual evasions of prominent physicians asked to g ive expert testimony.

~~at, yo u may ask, will happen next? Well, the condition of Cal­ifornia justice will determine the fate of the doctors. But, in any event, Rosalie Tarpening is back at work again. The sharp contrast between the safety of midwifery and the danger of obstetric-ped iatric interference has again been highlighted. And, finally, the nobility and courage of Dr. Edith Potter marks this trial as one of medicine's r a re finest hours.

According to American Medical News (February 6, 1981), the New Jersey Board of Medical Examiners has revised its previous policy on nurse­midwifery and is now permitting teenagers and older women to receive care from nurse-midwives in hospitals and clinics which have full-time physicians on the premises. The board earlier had enacted regula tions which prohibited midwifery care for women who were considered "high risk" because of age, illness, obesity or other problems.

While this may look like an advance, it is no more than a lateral pass. And there will be no real forward motion on this issue until nurse-midwives are allowed to practice in homes as well as in hospitals .

Homeopathy (The following is taken from the introduction I wrote to the book "Homeopathic Medicine at Home" by Maesimund B. Panos, M. D., and Jane Heimlich [J. P. Ta rcher, $10.95] .)

Would you like to know how to use inexpensive, effective, natural remedies that have no side effects? As overwhelming numbers of Ameri­cans lose faith in modern medicine, this is the right era for us to learn about homeopathy , a time-honored method of healing, whose prepara­tions are obtained from animal, vege table, and mineral sources. As the image of penicillin is tarnished by the reality of allergic reac tions, why not examine Belladonna (a homeopathic--and, th e refore safe remed y --pre­pared from deadly nightshade) as an appropriate treatment for strep throat. As concerned parents reject phenobarbital for their co licky infants, why not try Bryonia. As obstetrics and pediatrics are rocked by the scandals of thalidomide and its descendants, why not reduce morning sic kness with Colchichum. As the evidence of dangers such as gastrointestinal bleeding

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Q

A Problems

after coronary

bypass

mounts, why not use Gelsemium to ge t rid of your tension headache. And, rather than rely on habit-forming laxatives, why not use Nux to break the habit.

In my medical education, the total field of homeopathy was presented in less than ten minutes. The attitude was condescending at best and more accurately , deroga tory. Because I have learned precious little about homeopathy in the intervening years, I was delighted when Jane Heimlich asked me to write a foreword to this important book. I wish that all doctors--and especially medical students--would read it; those who do will certainly have a head start on their colleagues for the 1980's. However, since most will not, we must be grateful to Maesimund Panos and Jane Heimlich for giving every responsible a nd c oncerned person a spendid opportunity to learn, easily and usefully, about this valuable alternative healing method.

If you are interested in helping an epilepsy researcher, Jim Davies of Nor thwestern University is attemp ting to learn more about that illness by understanding non-tradi tional approaches . Davies asks that, if you are a person with epilepsy who does not depend solely on medications to cope with seizures, you should please write him a t 2040 Sheridan Road, Northwes t ern University, Evanston, Illinois 60201.

Since my coronary bypass surgery four years ago, I have had difficulty emptying my bladder, the stream is not as forceful, my ejaculation is not as copious, and my erections aren't as firm as they were before . I had a brief per i od of impotence and lack of sexual desire when I first recovered from the bypass, but I now have no trouble getting or main­taining an erection.

When I went to my urologist with my complaints, he said, "Well, what do you expect of a ma n your a ge?" In other words, ever y thing is normal. Yet I didn't have these symptoms before my surgery .

When I told my cardiologist about the other doctor ' s remarks, he said, "Just wait till he's your age; he won't think it's s o norma l." I couldn't ge t him to commit himself a ny further.

I seem to be in pretty good health except for the complaints I mentioned. Is all this normal for a 64- year- old man, or is there some­thing that can be done?--N.O.

In a recent study at the University of North Carolina School of Medicine, 57 per cent of the 30 bypass patients studie d were impotent tvm years after the surgery. So the sur gery definitely brings about changes, regardless of the age of the patient.

Since both of your doctors are speaking in riddles, it mi ght be a good idea to sit them down to gether in the same room to discuss whether you were given full disclosure after surgery as well as whether you ar e being given full information now.

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by Marian Tompson President, La Leche League

International

It's not just alternative methods of treatment like acupuncture and chiropractic that are making waves in the health care system today. Look at the controversy about alternative approaches to childbirth which include out-of-hospi t a l deliveries and the use of midwives as well asphy­sicians as birth attendants. Physicians who provide alternative maternity care have trouble getting insurance coverage and retaining hospital priv­ileges . But even worse, a real battle has broken out between the practi­tioners and those who practice hospital-based medicine. The casualties are those doctors whose licenses a re being revoked and suspended. Just providing prenatal care for a couple planning a home birth can be grounds for probation or censure by a hospital board. Midwives, with excellent records of care, are being harassed and often denied the right to practice an art at which they have traditionally excelled.

Of course, the real victims in this fight are the mothers and the babies, for it is no longer a secret that hospitals have become hazardous places in which to give birth. Obstetric interference with the normal course of labor too often transforms what should have been a happy birth into a drugged, painful, unhappy event. So it's not surprising that many parents who never would have dreamed of having a baby anywhere but in a hospital a few years ago now are seriously considering a home birth, are going to a birth center , or are engaging a midwife to ensure the safest and most satisfying outcome.

Scientific documentation t o support this thinking can be found in a comprehensive 484-page report, "The Five Standards for Safe Childbearing" by David Stewart, PhD. ($9.50 from NAPSAC International, P. 0. Box 267, Marble Hill, Missouri 64764). After a careful review of the data, Dr. Stewart, a medical statistic ian, conc ludes not only that it is safer for a midwife to deliver a baby, but also tha t many babies are harmed by hospital-based care. A study done in California, covering the same popu­lation and circumstances, shows the death rates for babies delivered by certified obstetrician/gynecologists were three times greater than those for midwives, while the mortalities of babies delivered by family physi­cians were two times greater. The r eport makes the startling accusation tha t "between 1940 and 1980 at least a million babies have died in Ameri­can hospitals who would have lived were it no t for the doctor-dominated maternity system that dicta tes standards for American childbirth. At least 1.5 million babies were seve rely brain-damaged because of obstetri­cal pro cedures. On the average, at least one baby dies every 29 minutes in an American hospital, bab ies that would be born healthy and alive under the care of properly trained midwives."

Why should this be? Dr. Stewart gives three fundamental rea sons: (1) Most doctors use too much intervention; (2) Most doctors do not attend a woman in labor; and (3) }1ost doctors do not develop the support­ive rapport wi th a laboring woman to f ac ilitate her ability to give birth safely and naturally by her own efforts.

Last April, more than 2,000 parents and practitioners came to ge ther in Pasadena, California and formed the Alternative Birth Crisis Coalit i on to protect the parents' rights to choose, and practitioners' rights to provide, safe al ternatives in childbirth and to enforce high quality standards of maternity care .

The board of directors and founders of the Coalition are Gregory White, M.D., Robert Mendelsohn , M.D., William Hatviuw, M.D., Hai Abdul, M.D., and his wife, }fary, David and Lee Stewart, Jay and Margie Hathaway, attorney Gail Fraties, and me. If you 'd like to join in this effort or want more information about membership, write ABCC, P.O.Box 48371, Chicago, IL 60648 or phone 312-625-4054. The children of tomorrow need your help today!

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The People's Doctor Newsletter P.O . Box 982 Evanston, Illinois 60204

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Published monthly. Subscription rate: $18.00 annually .

RobertS . Mendelsohn, MD, Editor Vera Chatz, Associate Editor