By Chris Dalrymple, D.C., F.I.C.C
As Texas entered the Gilded Age, a term coined by Mark Twain to describe the time from 1870s to about 1900. It was the time when the science of chiropractic was founded and developed. In 1878, a man named Harvey Lillard lost hearing in his left ear after lifting a heavy weight while in a stooped and cramped position. He would later become the first “chiropractic patient” on September 18, 1895, when D. D. Palmer successfully adjusted his spine. By the late fall of that year Palmer had developed four methods of adjusting the vertebrae of the spine. In the summer of 1896 he also trained a few individuals in the new-school healing art of chiropractic. Chiropractic students of D. D. Palmer in 1898 included Texan Andrew P. Davis, MD, DO, DC, who may very well be the first practicing chiropractic doctor in Texas.
In early 1906 a chiropractic licensing bill was written and introduced in Minnesota. The bill passed but was vetoed the the governor. It was the very first chiropractic licensing law introduced in any state. That same year, not being eligible to become licensed as a medical practitioner under the sanctions introduced by organized medicine, both D. D. and B. J. Palmer were indicted on charges of violating the Iowa Medical Practice Act. Convicted of the charge, D.D. Palmer relinquished interest in the Palmer School of Chiropractic and moved to Medford, Oklahoma where he practiced chiropractic in his spare time.
By 1907 the Texas Legislature required that applicants for medical licensure must have attended a “reputable” medical school whose course of instruction should total 4,000 hours during four college years. In August of 1908 the Carver-Denny Kiropractic College in Oklahoma City became the Carver Chiropractic College, the first substantial competitor to the Palmer Chiropractic School. These two schools would be the source for most of the chiropractic doctors drifting southward into Texas from the early 1900s to the 1920s.
J. N. Stone D.C., a graduate of the Carver-Denny Kiropractic College, was on friendly terms with both B.J. Palmer and Willard Carver. In September, 1908, a San Antonio newspaper ran a short article on chiropractic and Harvey Lillard’s recovery, and Dr. J. N. Stone founded the Chiropractic College of San Antonio, presiding there until 1913. He and his wife, Ida C. Stone, practiced in San Antonio as “Kiro-Practic Spinal Masseurs" and "Nerve Specialists.”
In 1909 the Carnegie Foundation commissioned Abraham Flexner to visit medical schools and write a report on the status of medical education in the United States and Canada. The report found that many of the schools were substandard. The Rockefeller Foundation helped bring about implementation of the report’s recommendations through the funding of additional grants, giving rise to the strongest professional monopoly in the United States – Organized Medicine.
With the creation of a strong monopoly there was no effective opposition to the implementation of the reforms recommended in the Flexner Report. Consequently, not only was Organized Medicine able to “clean up” and improve their own schools, they were also able to shut down their competition by closing schools of the other healing arts — which included the chiropractic schools. They now held the cards for governing all health professions. They strenuously fought every effort by chiropractors to obtain separate licensure. Consequently, chiropractic in most states came to be considered practicing medicine without a license — a crime punishable by fine or imprisonment. Chiropractors were arrested and often jailed for practicing chiropractic. While most chiropractors simply paid their fines, many decided that simply paying their fines was in essence a plea of guilt and instead chose to stand up for their belief in their profession. Go to jail for chiropractic became a popular slogan amongst the chiropractic community.
In 1911 it was reported by the San Antonio Light that the first chiropractic college in Texas was chartered by the state in April 1910. The 1911 Texas State Journal of Medicinereports that the Texas College was opened with about forty enrolling. "Dr. J. N. Stone, a San Antonio chiropractor and one of the oldest workers in this field, is president of the new institution." The medical journal continued: “the course of study embraces 36 subjects, and two and one half years of study without a vacation period will be required of the students before the degree of doctor of chiropractic will be conferred. This is equivalent to four years with the usual vacation.”
D. D. Palmer died October 21, 1913, and his official death certificate listed his occupation as “Chiropractic Physician.” From before 1913 when the first chiropractic licensure act was passed (but vetoed), to the last act being passed in Louisiana in 1974, doctors of chiropractic have struggled against organized medicine. State chiropractic licensing laws were established in Arkansas, Kansas and North Dakota in 1915. The Kansas statute was the first one passed and North Dakota was second, but the Arkansas law went into effect first. North Dakota, however, had the privilege of issuing the first chiropractic license in the world in April 1915. Though chiropractors now enjoy licensure in all 50 states, not all parts of the world can say the same. Arrest and jailings of chiropractors for “practicing medicine without a license” continues today in various countries.
In 1915, the process of forming a Texas State Chiropractic Association begin with eight charter members who were quickly joined by 19 more. The Texas State Chiropractic Association (now the Texas Chiropractic Association) was formed in 1916. The first chiropractic licensing bill in Texas was offered in 1917. It promptly passed the house, but failed to overcome resistance in the Senate.
In 1918 an influenza epidemic swept silently across the world. It was estimated that 400,000 deaths resulted from influenza during 1918. Chiropractors got fantastic results from influenza patients where many under traditional medical care died. One Texas chiropractor serving in the Medical Reserve Corps in France set up a makeshift influenza ward in the Base Hospital No. 84 in Southwestern France. The medical officer in charge sent all influenza patients in for chiropractic adjustments for the several months the epidemic raged in that area. In Wichita Falls, another chiropractor was pressed into service by the County Health Officer and authorized to write prescriptions for the duration of the epidemic there, but he never wrote any, getting better results without medication. Nevertheless, in 1918 there were at least 54 indictments for unlicensed medical practice across the state.
The first state-wide public relations program for chiropractic in Texas came about when the Texas State Chiropractic Association decided in 1921 to ethically advertise for the profession. Chiropractic doctors were signed up to donate a small percentage of their monthly gross to an advertising fund. Even though 1921 was a deep depression year most Texas chiropractors supported the program and enough money was raised to place regular ads in 38 newspapers across Texas.
Beginning in 1922, however, the medical doctors also began an aggressive public relations program, a series of ads in newspapers, warning the people about “quacks” being a menace to the “Public Health.” Newspaper articles and radio programs proposed an “Injunction Law” whereby one found guilty of practicing medicine without a license was enjoined permanently from continuing to practice. Practicing healthcare without a license issued by the state became a jailable offense. In 1923 Attorney General Dan Moody met with the Texas Medical Association and promised them that he would, “run all the chiropractors in Texas into the Gulf of Mexico.” The Injunction Law was passed in 1923.
The Texas State Chiropractic Association again sought to introduce a chiropractic licensing bill in 1923. Chiropractors had one favorable vote committed in the Senate and the support of Governor Pat Neff. The bill got a lot of attention in the media, but was promptly stifled in the public health committee of the Texas Legislature. The medical monopoly continued to strengthen its hold over the public. In Texas, the AMA’s state medical association's Council on Education and Public Instruction passed a resolution calling for a publicity campaign of its own and called for voluntary contributions from each Texas Medical Association member to pay for the campaign. By February 1924, about one-fourth of the membership had responded with their donations and the assault against chiropractic continued.
The Wall Street crash of 1929 brought about the beginning of the Great Depression, but during the 1930s the unrelenting attack of the medical community continued. One chiropractic doctor was so enraged that he sued the Texas Medical Association for malicious prosecution. The suit was dismissed, but he carried the constitutionality of the Medical Practice Act of Texas to the U.S. Supreme Court for a test, after being convicted under its provisions in 1933. The U.S. Supreme Court declined to act on his suit, and organized medicine continued to disparage those new-school practitioners that were not of its membership. By the 1940s the requirements to become a DC were four years of nine months each. Doctors of chiropractic continued to seek professional licensure and bills were generally submitted with each session of the legislature.
Finally, in 1943 the first Chiropractic Act of Texas passed.
As the law was conceived and submitted by the combined Texas State Chiropractic Association and Texas Chiropractic Research Society it was not controversial. But the Texas Medical Association persuaded the Senate to attach amendments designed to cripple the chiropractors in years to come. The bill passed, however, and was signed into law. But the 1943 law had a fatal defect in its constitutionality in that it did not restrict chiropractors to a portion of the human body, instead of its entirety. The law was soon found to be unconstitutional and was overturned in 1944.
In 1947-48 chiropractic in Texas was again seeking a licensure law and had a constitutional lawyer draft the next bill so it would be satisfactory to both the chiropractic and legal professions. The revised bill was introduced into the 1947 session of the Texas State Legislature but failed to gain enough support to pass. Its constitutionality was a major issue. About this time a judge stepped down from the State Supreme Court bench after a 21 year career and was soon employed by the Texas State Chiropractic Association to write Section 1 of the Chiropractic Act in a constitutional manner. Ultimately an effective Chiropractic Act was passed by the 1949 legislature. That same year the basic science law passed and added two years of college outside of chiropractic college and specified required basic science subjects. The chiropractic profession was included by the legislature in the Workmen’s Compensation Act of 1951.
The AMA’s plan to undermine chiropractic became even more zealous. In 1963. The American Medical Association (AMA) formed the committee on Quackery, its primary mission: to contain and eliminate the profession of chiropractic. In 1976, Chester Wilk and four other chiropractors sued the AMA and others for violations of the Sherman Antitrust Act. The plaintiffs lost at the first trial in 1981, but obtained a new trial on appeal in 1983 and prevailed.
As a result of the antitrust lawsuit, in 1977 the AMA reluctantly made three major policy changes. The first would allow the referral of patients between chiropractors and medical doctors; secondly they would allow specialists within both professions to consult with each other concerning a particular patient; and the third they would allow medical doctors to engage in any teaching for which they are qualified, meaning they could be employed as teachers in chiropractic colleges.
By 2001 the Texas Chiropractic Association was actively included and consulted in legislative negotiations regarding the Texas Workers’ Compensation Commission overhaul, but in 2002, the University Interscholastic League (UIL) prohibited chiropractic doctors from performing and signing school physicals. TCA filed a lawsuit in that year against both the UIL the Texas Workers’ Compensation Commission for discriminatory regulations against the chiropractic profession regarding their use of designated doctors.
In 2003 the TCA’s MGCT study demonstrated cost effectiveness of chiropractic care within the Texas Workers’ Compensation System. A law including chiropractic doctors as those who may be protected from liability when performing voluntary school physical examinations was passed. The UIL reversed its discriminatory policy against chiropractic doctors and chiropractors were again allowed to sign school physical examination forms.
But organized medicine has been ever ready to seek to oppress those it deemed to be lesser than they. In 2006 the AMA announced an industry consortium known as the “Scope of Practice Partnership” (SOPP) that included as one of its founding members the Texas Medical Association (TMA). That same year the TMA sued the Texas Board of Chiropractic Examiners (TBCE) asserting a violation of the Texas Constitution in an infringement of the “rights” of the Texas Board of Medical Examiners (TBME). TMA challenged the right of chiropractic doctors to “diagnose” stating that ONLY medical doctors have that right. In 2014 the Texas Association of Acupuncture and Oriental Medicine (TAAOM) sued the Texas Board of Chiropractic Examiners in district court. Reiterating the arguments of the Texas Medical Association in their previous lawsuits. It still seems that organized medicine is of the belief that a state license is a government issued monopoly rather than a permit to practice as the government has defined.
In 2016 the TCA celebrated its centennial year. The Texas Chiropractic Association’s main purpose is to protect the chiropractic profession through advocacy and through the courts. It’s a 52-week, 365-day job, although it commands the most attention during years in which the Texas Legislature meets, such as 2017, when a record four pro-chiropractic bills were signed into law. Around 600 DCs, staff, students, faculty and patients met at the Capitol to advocate for chiropractic in 2017 and again in 2019.
It’s no secret that some in the medical profession have long sought to curtail chiropractic as an important branch of healthcare. Those representing the state medical association have virtually sought to eliminate the profession choosing to view chiropractic as unwelcome competition for healthcare dollars. In turning back the medical lobby’s assault on chiropractic, Texas legislators have given overwhelming support to preserving and protecting the rights of our profession. It has become obvious to many just how one-sided and discriminatory the medical opposition to chiropractic had been. But the battle is not over. While chiropractors’ right to diagnose is preserved, the TMA continues to challenge the right of chiropractors to evaluate and treat neurological conditions (including subluxations). So the primary battlefield shifts from primarily the statehouse to both the statehouse ANDthe courtroom.
For well over 110 years the new-school of medicine, chiropractic, has had to struggle for its very existence. Thankfully, the men and women of the chiropractic profession refuse to let it be defeated by the misunderstanding majority.
