X-ray and Chiropractic
( Originally Published 1957 )
As has been pointed out, chiropractic was discovered in 1895, the same year that Prof. Wilhelm Roentgen of Wurzburg, Germany, discovered the X-ray, which was destined to play an important role in the growth and development of the science of chiropractic.
X-rays were so named by Prof. Roentgen because they were then rays of unknown origin which, al-though' they could not be seen, could penetrate the human body and many other substances. X-rays have become invaluable in the healing arts, in industry, and in scientific research.
Since the study of anatomical disrelation, particularly of the bones of the spinal column, is the special province of the chiropractors, it was natural that they should have been among the first professionals to use the X-ray for spinal studies. Even before World War I, in 1910, at a time when glass plates served the purpose for which photographic film is now used, courses in X-ray were given at The Palmer School of Chiropractic in Davenport, Iowa.
During World War I, rapid progress was made in the development of X-ray equipment and . techniques.
All the resources of the United States government were directed toward improvements resulting from the discoveries that grew out of the demands made during the European conflict. Films gradually replaced the glass plates that had been used for many years. Film sizes increased, and improved X-ray tubes that could accommodate increased voltage were also produced. Contrast safety films, processed in improved chemicals, all contributed to a better finished product.
By 1918, the Universal College of Chiropractic in Pittsburgh, Pennsylvania, had produced the first X-ray views of the spine taken in the upright position in order to observe the effects of unequal leg lengths, pelvic distortion, and body stress under the influence of gravity. In 1932, Dr. Warren L. Sausser, a chiropractor of New York, produced the first full-length single-exposure X-ray view of the entire spine on a 14 x 36 inch film. This remarkable development enabled an engineering analysis for body distortion in the up-right position. It was reported in the Journal of Radiography and Clinical Photography, published by the Eastman Kodak Company of Rochester, New York, in the August, 1937 issue (Vol. 13, No. 2).
After considerable experimentation, Dr. Warren Sausser, in 1934, for the first time successfully made , a full-body X-ray picture showing the entire skeletal system of an adult human. The Eastman Kodak Company cooperated fully on this project, making a special 20 x 70 inch film. The entire technique for the full-skeleton exposure was described in the February, 1935 issue of the National Chiropractic Journal.
In 1940, Dr. Theodore Vladeff, a chiropractor of Detroit, Michigan, invented new apparatus relating to X-ray processes and improved the means for taking spinal X-ray pictures and for recording the conditions under which such pictures were taken. The process and apparatus were filed with the U.S. Patent Office on April 16, 1940, and the patent was granted August 18, 1942 (U.S. Patent No. 2,293,324). In March, 1953, Dr. Vladeff patented a screen for the control of X-ray exposures. (U.S. Patent No. 2,630,536.) This was filed on November 16, 1949.
Dr. Ernest A. Fox, a chiropractor of Battle Creek, Michigan, filed a patent on June 26, 1953, for anapparatus which would X-ray the spinal column laterally (from the side) and was subsequently granted his patent on December 18, 1956 (U.S. Patent No. 2,774,884).
Stereoscopic X-ray studies of the upper cervical region, developed at The Palmer School of Chiropractic, and X-ray research of the human pelvis by Dr. F. W Illi, a chiropractor of Geneva, Switzerland, have ex-cited the admiration of European medical researchers, particularly in Switzerland, England, and Germany. Dr. Albert Cramer, a Hamburg physician, and Professor Zuckschwerdt, state in two books on this subject that these studies by Dr. Illi surpass in refinement and precision anything to be found in the entire literature of medicine.
For more than half a century, instruction in the taking of X-ray pictures of the spine and their interpretation has been a standard part of the chiropractic curriculum in every school of chiropractic, and this instruction today consists of 300 class hours and is both theoretical and practical. The subject matter is regarded as an integral part of chiropractic, and research in this field continues to be-active among chiropractors on both sides of the Atlantic.
Despite the demonstrated fact that members of the chiropractic profession have been the pioneers of spinal roentgenology, organized medicine continues to attack the competency of doctors of chiropractic in the use of X-ray for diagnostic purposes.
But the scientists and the courts have decided other-wise. There is an erroneous impression that only a licensed medical doctor may be competent to testify as to the taking of X-rays and their interpretation.
Our courts have generally held to the contrary. The mere licensing of a physician does not in itself give him the necessary qualifications. He must first show experience in the taking of X-rays and in their interpretation. The courts have likewise held that it is not necessary that the witness be a member of the medical profession in order to qualify in the interpretation of X-ray plates. The witness must show knowledge of the human anatomy and experience in taking X-ray plates. This problem arose in the case of Ladlie v. American Glycerine Co., 115 Kan. 507, where testimony as to the nature of the X-ray plates was given by a chiropractor. The court overruled the objection to his testimony and held :
". . . surely a man who had made a professional study of the human spine, and who had worked with an X-ray for eighteen months, and who had taken 500 or 600 X-ray pictures of parts of the human skeleton, could not be totally disqualified to testify; and any want of thoroughness of his information would only lessen the convincing force of his testimony: it would not bar its consideration altogether."
The amount of experience the witness has may affect the weight of his testimony, but would not be any basis for excluding it.
The court, in Whipple v. Grandchamp, 261 Mass. 40, likewise noted that a person, not licensed as a doctor of medicine, who otherwise is experienced in taking and interpreting X-rays, is permitted to testify:
"It is plain that knowledge of the human anatomy may be acquired to a high degree by a student of that subject, although such a person is neither licensed nor registered as a doctor of medicine, and it is equally clear, as a matter of common knowledge, that, in many professions other than medicine, the use of the X-ray is familiar, and that it is read in connection with the human anatomy."
As the courts throughout the country have observed, the X-ray is a scientific and mechanical appliance which may be used by any person schooled in the art and having the requisite scientific knowledge of its properties, and "there would seem to be no reason why its application to the human body may not be explained by any person who understands it," Henslin v. Wheaton, 91 Minn. 219.
The X-ray plays an important part in the practice of chiropractic. It determines the condition of the bones of the human framework and the exact position of the spinal misalignment or subluxation. This knowledge is important in that it provides information that will lead to corrective measures.
Surveys made by radiation physicists throughout the country, indicate that radiation hazards in chiropractic offices are kept to a minimum in accord with generally accepted radiographic standards. Professor Edgar N. Grisewood, Director of the Department of Physics, New York University, made such a survey in New York - State and reported that in chiropractic offices examined by him at random he found that the doctors of chiropractic employ all the accepted safeguards necessary to minimize exposure.
In 1956, exaggerated fears were raised in the public's mind by blowing up a scare smoke screen about "atomic radiation" with reference to the taking of X-rays for health purposes. In 1961, a sober reappraisal of the situation began, according to William C. Stronach, Executive Secretary of the American College of Radiology. This has been brought about by an educational program for all who use X-ray equipment. The chiropractic profession has been in the forefront in this program with the establishment of "Radiation Commissions" created by its national organizations.
It is now recognized that X-rays are essential in the diagnosis of a wide range of disorders, and that a patient who refuses to be X-rayed because of fear of radiation would not be protecting his health but jeopardizing it.