"Who are your
By: John A. Amaro D.C. FIAMA, Dipl.Ac.
Recently I conducted
an educational symposium when a doctor came up to me at the break expounding
on how I had been a significant part of his life and practice. Even though
we had never met, he was an avid reader of my articles in "Dynamic
Chiropractic" and proudly exclaimed that he had clipped every one
of the 120 articles I had written over the last 12 years. Here was a man
who held me in high esteem and credited me with helping numerous of his
patients as well as his practice growth through my articles. To say I
was humbled would be an understatement. As he walked away, he said, "Dr.
Amaro you're my hero". WOW! I never thought about me being someone's
hero, I know who my hero's are in the profession, but I guess I never
considered the fact I could be someone's hero.
In the days of my
early development of Chiropractic, (early 70's) the profession was filled
with charismatic, knowledgeable and dynamic leaders. The ones who I was
personally awe struck were the college presidents who I had become close
to and to me were the epitome of professionalism, dedication and dignity.
They were people who I wanted to mimic in their actions and deeds, little
did I realize, these individuals, really were 10 feet tall, and to this
day, I still feel several feet below any of their levels of academic achievement.
Coggins of Logan, Harper of Texas, Cleveland of Cleveland College, my
alma mater, and of course my two greatest hero's namely Dr. Ernest Napolitano
of New York Chiropractic College, and the incomparable Dr. Joseph Janse
It was Dr. Napolitano
of New York Chiropractic College who launched the first acupuncture certification
program in the nation at what was then Columbia Institute of Chiropractic
in 1972. This was the same year President Richard Nixon developed diplomatic
relations with the People's Republic of China. While New York Chiropractic
College was teaching acupuncture certification through its postgraduate
program, National College was conducting serious research into its clinical,
practical and academic applications. Literally thousands of doctors both
medical and chiropractic learned the fine art of Meridian Five Element
Acupuncture, which was the first style of acupuncture introduced into
the United States. Acupuncture as a profession, was at its earliest, still
a full decade away.
As Chiropractic, acupuncture
and Alternative Medicine are all seeking to define who and what they are.
As acupuncturist are laying claim that acupuncture is theirs and theirs
alone and no other profession should utilize it. That they and they alone
are the only ones qualified to perform its application. Allow me to share
with you an official statement, declared by the President of National
College of Chiropractic, Dr. Joseph Janse in 1974 regarding the role of
acupuncture and Chiropractic.
It is so unfortunate,
that there are literally thousands of Doctors of Chiropractic who never
had the chance to sit mesmerized while Dr. Janse spoke. Anyone who ever
heard Dr. Janse speak will never forget his eloquent style and use of
the English vocabulary. For those of you who were blessed to have known
Dr. Janse, read his words and hear his voice, for those of you who never
knew him, bear in mind there has never been anyone quite like him. He
along with Dr. Napolitano were definitely "my hero's"!
"The Rationale of a Premise and a Position Declared"
By Dr. Joseph Janse
President National College of Chiropractic
The Western World
of Medicine (the word "medicine" being used in the generic sense
as relating of all forms of disciplined and organized methods of healing)
is agog with interest, curiosity and concern about acupuncture in all
its variations of interpretation and application. This ancient and commandingly
challenging concept and clinical thrust has brought the Western Clinical
World into confrontation. Certainly it has exploded the sophistication
of exclusiveness in concept, hypothesis and so-called clinical "know
how". It has challenged the knowledge and the self-styled infallibility
of Western clinical methodology and research. In so many ways, it has
been a humbling experience for Western Medicine, because the "ivory
towers" of self-declared scientific and clinical acumen, have encountered
an inexplicable phenomenon. It is for certain, therefore, that every segment
of the clinical world has been compelled to reflect upon its own incompleteness
and that probably there is still a great deal to research, to study, to
deliberate and to conjugate.
of the self-protectiveness of intellectual egocentricity there are those
who belittle and denounce; there are those who declare it as purely psychosomatic
or somatopsychic phenomenon as if the psychological process in the human
organism were not a significant physiological process. There are those
who belittle and declare the process as only being palliative to the neurotic
and the hypochondriac, but certainly the question might be asked, "Aren't
these patient types elements of the human clinical problem, and has Western
medicine competently solved this concern"?
Without any attempt
at being conclusive, instructive or clinically paragonical, let us seek
to present and evaluate some of the facts of the issue:
1. The chiropractic profession has, in many respects, stood in
the vanguard of the "wholistic" concept in therapeutics, especially
as it relates to the neurological element. Ever since its inception, segments
of the chiropractic profession have asserted the fact that the somatic
tissues (skin, fascias, tendons, muscles and articular ligaments) and
their possessed receptors comprise the great sensorium of the body and
that in many instances mirrors the status of visceral function and by
virtue of synaptic inter-relationship we now know that somatic (body outer
tissue) applications by means of contacts, percussion's, tapotements,
electro-therapeurtic pulsatings or needlings may so stimulate the large
A fibers of the somatic sensorium that a diluting, a shunting or an inhibiting
of the pain sensation flow is accomplished.
a. The exact relating neurological mechanism as yet has not been
explained by anyone. The Melzack-Wall Gate Control Theory is a favorite
attempt at explanation. The Hypothalamic-Limbic Inhibitory Effect of the
physiological stimulation of spinothalmic-cortical pathways, as explained
by Rodahl, is another attempt
at explanation. The original concepts of Dogiel and Sherrington, as well
as Head in relation to synaptic overlap and sensorial "overwhelm"
are very much still valid.
2. As early
as 1914, the curriculum of the National College of Chiropractic included
a course, with clinical application, in physiological therapeutics, i.e.,
the clinical application of light, heat, water, traction, exercises, manipulation
and pressure point therapy as well as diet nutrition, fasting and psychotherapy.
Later, the term "physiological therapeutics" was abbreviated
to the word "physiotherapy". Certainly, it cannot be denied
that within the chiropractic profession "physiotherapy" found
its primary initial emphasis and clinical phylogenesis.
3. Beginning at the 1974 summer trimester (May 7) and under the
auspices of the Clinical Sciences Division and as a component in the courses
on physiological therapeutics, a three clock hours a week course in "Triggerpoint
and Acupressure and Acutpotement Therapy" will be taught both at
an undergraduate and postgraduate level.
a. It is the considered opinion of the College Administration that
it is the responsibility of the college to introduce developments in the
clinical sciences that are relevant to the basic tenets of the profession,
and that have evidenced clinical merit.
b. It is also the considered opinion of the college Staff that
"trigger-point" therapy, acupressure, acutapotement and even
acupuncture therapy, within containment, are intimately related to the
basic premise of chiropractic, namely, "that in man, the biped, the
musculoskeletal system maintains an intimate conditioning, controlling
and regulating relationship with both the somatic and visceral neurological
c. It is further the considered opinion of the College Administration
that these measures could well be, and should be, included under the generic
designation "physiological therapeutics: and should be included in
the relating clinical profile of application.
4. So characteristic
of the totalitarian posture of organized medicine, the "voice of
the AMA" has declared that acupuncture should not be practiced by
doctors of chiropractic and that "needling" is a form of surgery
and hence should only be performed by an allopathic physician and surgeon.
In counter argument to this assertion, the following deliberations are
a. Western Medicine (allopathy) can in no way lay claim to having
sponsored the genesis, development and dissemination of any form of acupuncture.
Hence clinically, professionally and control-wise, they do not possess
any copyright, or legal authority over its practice.
b. "Needling" as one form of acupuncture, is not a surgical
procedure. The insertion of the fine caliber needle does not induce noticeable
traumatic dissolution of the histological continuity of tissue. "Needling"
does not cause hemorrhage or inflammatory reaction, nor does it necessitate
c. Incisive or operative surgery is that process that disrupts
the integrity of the continuity of tissue, necessitating procedures and
processes of repair both by the surgeon and the restorative processes
inherent within the tissue. Incisive or operative surgery may also be
attended by the extirpation of gross amounts of offending tissue and may
also involve the repair of gross faults in tissue continuity subsequent
to traumatic mishap. "Needling acupuncture in no instance falls in
any such category of clinical procedure.
5. It is certainly the considered opinion that the agencies and
organizations of the profession, both state and national, address themselves
to this imperative and concern. Because of the fact that the legal, legislative,
scope of practice and professional ideological affectivity, as well as
the political influences, vary noticeably in the states throughout the
country, solution is not going to be accomplished in one fell swoop. Every
situation will have to be individually evaluated and conclusions designed.
Simply on a basis of suggestion, the following possibilities and progressive
steps could well be deliberated:
a. Decision by the State Association to sponsor the inclusion of
acupuncture (used in broad generic sense) in the practice of chiropractic
in a limited or complete variety manner.
b. Decision by State Boards of Chiropractic Examiners or Composite
Boards to sponsor Board ruling to this effect.
c. Decision to present the rationale to the State Attorney General
for purpose of obtaining a favorable ruling.
d. Decision to open the "Chiropractic Act or Law" by
sponsoring legislation that would stipulate it's inclusion within the
defined scope of practice.
e. Decision by the Council on Chiropractic Education to recommend
that acupuncture (generally used) in the prescribed contained manner be
taught at both undergraduate and postgraduate levels as a branch of physiological
f. Decision to encourage the NCMIC to include the practice of acupuncture
(generic interpretation) in the malpractice insurance policy as soon as
proper legal privilege has been effected.
6. The foregoing posture and position commands a deliberate organized
approach to a clinical sensationalism that will explode if not properly
contained. Every clinical science must remain "open ended" to
repudiate when necessary and to include when imperative to the benefit
of rendering a more effective service.
7. The Charter of the National College of Chiropractic as an educational
institution for clinical and research purposes did permit the college
to conduct, for over a year, a careful controlled clinical study of all
aspects of acupuncture involving a reputable number of documented cases
and the foregoing deliberations and conclusions are based upon this investigation.
Staff members of the college, but primarily Dr.Andries M. Kleynhans, Chairman
of the Division of Clinical Sciences, have conducted extensive studies,
both in the Orient as well here in the States, to include seminars conducted
by Medical Centers.
In case you were ever
wondering, acupuncture has been a part of the chiropractic profession
officially declared for over a quarter of a century.
Here's to the best
in 2001, may it be a phenomenal year.
John A. Amaro D.C.,