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Chiropractic (1924)

H.L. Mencken

This preposterous quackery flourishes lushIy in the back reaches of the Republic, and begins to conquer the less civilized folk of the big cities. As the old-time family doctor dies out in the country towns, with no competent successor willing to take over his dismal business, he is followed by some hearty blacksmith or ice-wagon driver, turned into a chiropractor in six months, often by correspondence. In Los Angeles the Damned, there are probably more chiropractors than actual physicians, and they are far more generally esteemed. Proceeding from the Ambassador Hotel to the heart of the town, along Wilshire boulevard, one passes scores of their gaudy signs; there are even chiropractic "hospitals." The Mormons who pour in from the prairies and deserts, most of them ailing, patronize these "hospitals" copiously, and give to the chiropractic pathology the same high respect that they accord to the theology of the town sorcerers. That pathology is grounded upon the doctrine that all human ills are caused by pressure of misplaced vertebrae upon the nerves which come out of the spinal cord -- in other words, that every disease is the result of a pinch. This, plainly enough, is buncombe. The chiropractic therapeutics rest upon the doctrine that the way to get rid of such pinches is to climb upon a table and submit to a heroic pummeling by a retired piano-mover. This, obviously, is buncombe doubly damned.

Both doctrines were launched upon the world by an old quack named Andrew T. Still, the father of osteopathy. For years the osteopaths merchanted them, and made money at the trade. But as they grew opulent they grew ambitious, i.e., they began to study anatomy and physiology. The result was a gradual abandonment of Papa Still's ideas. The high-toned osteopath of today is a sort of eclectic. He tries anything that promises to work, from tonsillectomy to the x-rays. With four years' training behind him, he probably knows more anatomy than the average graduate of the Johns Hopkins Medical School, or at all events, more osteology. Thus enlightened, he seldom has much to say about pinched nerves in the back. But as he abandoned the Still revelation it was seized by the chiropractors, led by another quack, one Palmer. This Palmer grabbed the pinched nerve nonsense and began teaching it to ambitious farm-hands and out-at-elbow Baptist preachers in a few easy lessons. Today the backwoods swarm with chiropractors, and in most States they have been able to exert enough pressure on the rural politicians to get themselves licensed. [It is not altogether a matter of pressure. Large numbers of rustic legislators are themselves believers in chiropractic. So are many members of Congress.] Any lout with strong hands and arms is perfectly equipped to become a chiropractor. No education beyond the elements is necessary. The takings are often high, and so the profession has attracted thousands of recruits -- retired baseball players, work-weary plumbers, truck-drivers, longshoremen, bogus dentists, dubious preachers, cashiered school superintendents. Now and then a quack of some other school -- say homeopathy -- plunges into it. Hundreds of promising students come from the intellectual ranks of hospital orderlies.

Such quackeries suck in the botched, and help them on to bliss eternal. When these botched fall into the hands of competent medical men they are very likely to be patched up and turned loose upon the world, to beget their kind. But massaged along the backbone to cure their lues [syphylis], they quickly pass into the last stages, and so their pathogenic heritage perishes with them. What is too often forgotten is that nature obviously intends the botched to die, and that every interference with that benign process is full of dangers. That the labors of quacks tend to propagate epidemics and so menace the lives of all of us, as is alleged by their medical opponents -- this I doubt. The fact is that most infectious diseases of any seriousness throw out such alarming symptoms and so quickly that no sane chiropractor is likely to monkey with them. Seeing his patient breaking out in pustules, or choking, or falling into a stupor, he takes to the woods at once, and leaves the business to the nearest medical man. His trade is mainly with ambulant patients; they must come to his studio for treatment. Most of them have lingering diseases; they tour all the neighborhood doctors before they reach him. His treatment, being nonsensical, is in accord with the divine plan. It is seldom, perhaps, that he actually kills a patient, but at all events he keeps any a worthy soul from getting well.

The osteopaths, I fear, are finding this new competition serious and unpleasant. As I have said, it was their Hippocrates, the late Dr. Still, who invented all of the thrusts, lunges, yanks, hooks and bounces that the lowly chiropractors now employ with such vast effect, and for years the osteopaths had a monopoly of them. But when they began to grow scientific and ambitious their course of training was lengthened until it took in all sorts of tricks and dodges borrowed from the regular doctors, or resurrection men, including the plucking of tonsils, adenoids and appendices, the use of the stomach-pump, and even some of the legerdemain of psychiatry. They now harry their students furiously, and turn them out ready for anything from growing hair on a bald head to frying a patient with the x-rays. All this new striving, of course, quickly brought its inevitable penalties. The osteopathic graduate, having sweated so long, was no longer willing to take a case of delirium tremens for $2, and in consequence he lost patients. Worse, very few aspirants could make the long grade. The essence of osteopathy itself could be grasped by any lively farmhand or night watchman in a few weeks, but the borrowed magic baffled him. Confronted by the phenomenon of gastrulation, or by the curious behavior of heart muscle, or by any of the current theories of immunity, he commonly took refuge, like his brother of the orthodox faculty, in a gulp of laboratory alcohol, or fled the premises altogether. Thus he was lost to osteopathic science, and the chiropractors took him in; nay, they welcomed him. He was their meat. Borrowing that primitive part of osteopathy which was comprehensible to the meanest understanding, they threw the rest overboard, at the same time denouncing it as a sorcery invented by the Medical Trust. Thus they gathered in the garage mechanics, ash-men and decayed welterweights, and the land began to fill with their graduates. Now there is a chiropractor at every crossroads.

I repeat that it eases and soothes me to see them so prosperous, for they counteract the evil work of the so-called science of public hygiene, which now seeks to make imbeciles immortal. If a man, being ill of a pus appendix, resorts to a shaved and fumigated longshoreman to have it disposed of, and submits willingly to a treatment involving balancing him on McBurney's spot and playing on his vertebra as on a concertina, then I am willing, for one, to believe that he is badly wanted in Heaven. And if that same man, having achieved lawfully a lovely babe, hires a blacksmith to cure its diphtheria by pulling its neck, then I do not resist the divine will that there shall be one less radio fan later on. In such matters, I am convinced, the laws of nature are far better guides than the fiats and machinations of medical busybodies. If the latter gentlemen had their way, death, save at the hands of hangmen, policemen and other such legalized assassins, would be abolished altogether, and the present differential in favor of the enlightened would disappear. I can't convince myself that would work any good to the world. On the contrary, it seems to me that the current coddling of the half-witted should be stopped before it goes too far if, indeed, it has not gone too far already. To that end nothing operates more cheaply and effectively than the prosperity of quacks. Every time a bottle of cancer oil goes through the mails Homo americanus is improved to that extent. And every time a chiropractor spits on his hands and proceeds to treat a gastric ulcer by stretching the backbone the same high end is achieved.

But chiropractic, of course, is not perfect. It has superb potentialities, but only too often they are not converted into concrete cadavers. The hygienists rescue many of its foreordained customers, and, turning them over to agents of the Medical Trust, maintained at the public expense, get them cured. Moreover, chiropractic itself is not certainly fatal: even an Iowan with diabetes may survive its embraces. Yet worse, I have a suspicion that it sometimes actually cures. For all I know (or any orthodox pathologist seems to know) it may be true that certain malaises are caused by the pressure of vagrant vertebra upon the spinal nerves. And it may be true that a hearty ex-boilermaker, by a vigorous yanking and kneading, may be able to relieve that pressure. What is needed is a scientific inquiry into the matter, under rigid test conditions, by a committee of men learned in the architecture and plumbing of the body, and of a high and incorruptible sagacity. Let a thousand patients be selected, let a gang of selected chiropractors examine their backbones and determine what is the matter with them, and then let these diagnoses be checked up by the exact methods of scientific medicine. Then let the same chiropractors essay to cure the patients whose maladies have been determined. My guess is that the chiropractors' errors in diagnosis will run to at least 95% and that their failures in treatment will push 99%. But I am willing to be convinced.

Where is there is such a committee to be found? I undertake to nominate it at ten minutes' notice. The land swarms with men competent in anatomy and pathology, and yet not engaged as doctors. There are thousands of hospitals, with endless clinical material. I offer to supply the committee with cigars and music during the test. I offer, further, to supply both the committee and the chiropractors with sound wet goods. I offer, finally, to give a bawdy banquet to the whole Medical Trust at the conclusion of the proceedings.

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Henry Louis Mencken (1880-1956) was a controversial American journalist, essayist and literary critic. During the 1920s, he became famous for his vitriolic attacks on what he considered to be the hypocrisy, stupidity, and bigotry of much of American life. For obvious reasons, his critics considered him highly skilled at satire but intolerant and often crude. This essay was published in the Baltimore Evening Sun in December 1924. Although the medical knowledge of his day was still quite primitive, Mencken knew enough to realize that chiropractic theory was preposterous.