by clicking the arrows at the side of the page, or by using the toolbar.
by clicking anywhere on the page.
by dragging the page around when zoomed in.
by clicking anywhere on the page when zoomed in.
web sites or send emails by clicking on hyperlinks.
Email this page to a friend
Search this issue
Index - jump to page or section
Archive - view past issues
Chiropractic Journal of Australia : CJA June 2012
Chiropractic Journal of Australia Volume 42 Number 2 June 2012 47 and cost-effectivenes; etc.). It was nevertheless somewhat debatable. Questionnaires were established by experts who had specifc scientifc and cultural backgrounds. It was therefore doubtful whether ensuing interpretations actually refected patients’ points of view or were biased by a priori assumptions of experts and public authorities. More generally, public authorities were anxious to secure control over citizens’ lives, for their own good. This control, that started in the 19th century, can resort to powerful technical and administrative tools. In order to compensate for risk factors, importance was given to individual behaviours whereas environmental factors were regarded as not really decisive, at least in offcial studies. Health and prevention were individuals’ own responsibility. This leads to further comments. Philosopher Georges Canguilhem observed in the 1960s that the subtle transition from normalcy to pathology could not be determined by scientifc and objective criteria. It rested with each individual to decide when the threshold of tolerable suffering had been reached.15 Circumstances have changed. Widely available medical knowledge; compliance with official recommendations (regular check-ups, screening campaigns, vaccinations, etc.); preventive procedures; evaluation of family history and of multifactorial etiologies; developing predictive medicine were now leading to a complex appreciation of health and disease that individuals could no longer determine by themselves. Healthy individuals were under intense scrutiny and became patients. Health professionals were involved in this evolution: they participated in normalisation of health care and of individual behaviours, as well as in over-medicalisation of lifestyles. An ambiguous outgrowth of 18th-century medical science of man! Paradoxically, a sophisticated understanding of physiological mechanisms resulted in uncertainty, anxiety, and in multiple constraints. HOLISM IN CHIROPRACTIC Chiropractic principles were two-sided. D.D. Palmer retained the tradition of esotericism and the principle of interactions between elements of the macrocosm - “Universal Intelligence” and “Universe” - and of the human being as a microcosm - “spirit” and “body.” As “a part of Universal Intelligence, individualized and personified,” innate intelligence was to adapt universal forces so that spirit and all parts of the body had co-ordinated action.16 Simultaneously, attention given to the nervous system paralleled scientifc knowledge of the turn of the century. Health was maintained as long as innate intelligence could fow from the brain to the various organs of the body “through the nervous system.” 17 B.J. Palmer underscored that innate intelligence was “always present, always normal.” 18 One of the first adjustments “cured” deafness. This encouraged D.D. and early chiropractors to “treat” a large variety of conditions, as they were diagnosed in their time: heart troubles, asthma, vision loss, melancholia, pneumonia, infantile paralysis, respiratory and gastro-intestinal disorders, etc.19 B.J. confrmed: “Application of chiropractic is far- reaching to conditions to which names are applied by diagnosticians.” 20 Investigative chiropractors took great interest in many clinical felds: pregnancy and childbirth, child’s care, ageing population, mental health, public health, sports and work related injuries, etc. Thus established on principles that pertained to several domains of refexion – macrocosm and microcosm, spirit- body interactions, neurology -- chiropractic had characteristics of holism, both in its defnition of the person and as a method of health care. Elaboration and Commentaries Elaboration of chiropractic principles was evolutional and multiple. While it was infuenced by cultural backgrounds, it was concurrently fashioned by orientations of colleges, universities, and academic agencies (e.g. with respect to scope of practice and to status of basic and clinical sciences). Generations of chiropractic students became familiar with the writings of D.D. and B.J. Chiropractic principles were illustrated by the “triune of life” consisting in three necessary united elements - intelligence, force and matter. The somewhat different “chiropractic triangle” was characterized by three poles of chiropractic analysis and effcacy - physical, chemical and mental. Chiropractic was patient-centred; it proposed a fairly encompassing approach that enhanced naturism and prevention. Eventually, chiropractors made personal choices as to principles, methods, diagnostic procedures, styles of practitioner-patient relationship, and scope of practice (correction of subluxations, relief of various conditions, maintenance care, etc.). Commentaries on holism by chiropractors and friends of chiropractic contributed to elaboration of chiropractic principles and to various styles of practice. Here are a few of them. Ralph Stephenson stated that universal intelligence “created” matter: “Universal Intelligence is in all matter and continually gives to it all its properties and actions.” 21 He echoed B.J. and wrote further that “Innate Intelligence is always normal and its function is always normal.” Interferences with transmission of innate intelligence might be due to “limitations of matter.” 22 Similarly, Joseph Maynard stated that all forms of life were “the expression of Universal Intelligence.” Life within the body was denominated innate intelligence but defed defnitions.23 Decades later Joseph Janse stressed that “interrelationship of body action is the symphony that maintains the harmony of health.” 24 He considered, like Georges Canguilhem, that disease is the cumulative sequence of dysfunctions and prodromal signs: “There are earlier phases of disturbed function which lead up, perhaps very slowly, to those gross conditions which affict the average person before he has been taught to deem it necessary to seek the ministrations of a doctor.” 25 Chiropractors, observed sociologist Walter Wardwell, “agree that chiropractic adjustments are limited in the range of conditions they are appropriate for,” however, this does not prevent them from confdently using “alternative paradigms” such as holism.26 Researcher Ian Coulter noted the diffculties raised by references to holism in the principles and practice of chiropractic, namely the mere signifcance of the notion and the specifc skills required from practitioners. He recognized nonetheless that “the philosophy of chiropractic has ensured that the worse reductionist excesses of biomedicine in ignoring the person have been avoided by chiropractic.” 1 HOLISM IN HEALTH CARE JOLLIOT
CJA March 2012
CJA September 2012