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A Profession Seeking Clinical Competency: TheRole of the Gonstead Chiropractic Technique

MATTHEW J. AMMAN, D.C*

The Palmer School of Chiropractic was in a clinical conundrum after the death of its icono-clastic leader B.J. Palmer. The school had left full-spine chiropractic in the 1930s when Palm-er perpetuated his upper-cervical specific Hole-In-One Technique. In 1961, the Gonstead Chi-ropractic Technique resurrected full-spine chiropractic at the fiagship school and became thecornerstone of the school's technique curriculum. This paper reviews the history of this name-brand chiropractic technique to add to our understanding of early chiropractic education.

Introduction

A major effort of the chiropractic profession inits first one hundred years was gaining jjolitical le-gitimacy (1). It required enormous time and energyfrom chiropractic's political and educational leader-ship. To provide itself with the necessary frameworkto legalize, the reasons of why and how chiropracticwas different from medicine dominated chiropracticconsciousness ([2], [3], [4], [5]). Professional politicshas always united chiropractors; however, the prac-tice of chiropractic is entirely a different matter. Thetechnique wars of the 1950s that chiropractic criticSamuel Homola, D.C, noted in his 1963 analysis ofchiropractic affairs revealed a healing art strugglingto define itself clinically (6). This lack of focus onchiropractic art among chiropractic leadership withinnational associations and educational institutions per-mitted such schisms. Regardless, healthcare historyhas shown that inconsistent therapeutic effectivenesscan remain independent of professional development,but it will remain a barrier to professional maturation([7], [8], [9]).

The discussion about chiropractic technique iscomplicated and argued from many different anglesand justifications. The larger and historical argumenthas been between uni-modal (straight) and multi-modal (mixer) chiropractors. This may be a moreideological in nature than anything more. The otherfundamental argument is the difference between uni-modal procedures. In both situations, attempts to uni-fy practice procedures by either political or scientificmeans have failed.

© 2008 Association for the History of Chiropractic.

* Address correspondence to Matthew J. Amman, D.C, 9217 West Center Street, Milwaukee, WI53222, matthewamman@yahoo.coin

However, the advent and role of the chiropractic-scientist has recently changed the technique-war de-bate. The persuasion and rhetoric by this new type ofchiropractor, based on science, has not only led to therestructuring of academic departments by changinghiring and tenure procedures, but a new generationof graduates with an evidence-based practice mind-set ([10], [11], [12]). As expected, they are markedlyprogressive by using hard and soft techniques, vari-ous technologies and by hiring of massage therapists.While the success of this new type of intellectual chi-ropractor is highly debatable, the structure and ori-entation of this model is significant in many ways.Many of these explorations are beyond the scope oftis paper, but this paper will highlight the importantones:

First, the chiropractic-scientist is likely to de-velop and contribute to the corpus/knowledgebase important to developing chiropractic'sprofessionalism and rise to power. In contrast,numerous educational institutions have beencognizant of marketplace needs and createdspecific technicians (field-experts) whoseinformation coincides with chiropractors:biomechanicál engineers, exercise physiolo-gists, occupational health nursesj doctors ofphysical therapy, physical aides, massagetherapists trained in specific soft-tissue pro-cedures, etc;

Second, the chiropractor-scientist is perhapsafforded a fast-track route to the institutionsthat currently hold power: hospitals, integra-tive health clinics, group-doctor practices,etc;

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Third, the chiropractic-scientist is preparedto embrace new technologies and proceduresdirectly or indirectly complementary to chi-ropractic's social fact of being neuro-muscu-lar-skeletal specialists. The growth of sportschiropractic is a good example.

Although the chiropractic-scientist model mayhave significant advantages, it ignores the pragmaticquestion of does the patient get better because of thisnew orientation. Putting the cart ahead of the horse iscommon in the profession; and while the chiroprac-tic-scientist model on the surface seems to employthe most scientific forms of chiropractic, the evidencehardly supports the position. The Journal of Manipu-lative and Physiological Therapeutics, chiropractic'spremier research journal, clearly points out that atthis time only a few advocates of specific techniquesare interested in scholarly publishing (13). Rather,the emphasis by chiropractic's small scientific eliteis towards the broader questions of chiropractic inthe marketplace (chiropractic care effectiveness fortreating low-back pain, etc.) instead of optimizingpractice procedures and comparative studies betweentechniques.

As a result, chiropractic's periodicals have po-lemics on both sides of the issue advocating either thecontinued support for the old techniques, rich withhistory and years of observational proof, or supportfor the new techniques with arguments based on mar-ketplace needs and/or the limited science. Keating,Cooperstein, and Gleberzon among others have pro-vided various contemporary observations to explainthis debate ([14], [15]).

An archaeology of chiropractic practice revealsan inter-connection between the dilemma of today'schiropractic-scientist and that of the old chiropractic-field-practitioner to reveal the paradox of chiroprac-tic education. Ever since the formal development ofmanipulation in the late nineteenth century by oste-opathy and chiropractic, multitudes of strategies havedeveloped. The gaze of these diverse hand-healers re-veals a progressive understanding, but the democraticnature of chiropractic led to clinical frustration amongthe proletariat field-practitioner creating a plethora ofname-brand techniques. It was not until the revolt atthe Palmer School of Chiropractic (PSC), chiroprac-tic's flagship college, that things changed. This paperrevisits this period revealing the unique role GonsteadChiropractic Technique (GCT) played in chiroprac-tic's professional maturation.

But a cautionary remark should be recorded now.First, skewed by its generic nature and commonnessin practice, previous chiropractic scholars and orga-nizations often categorize the GCT as separate andunique or under the label of Palmer Package or Di-

versified ([16], [17], [18]). Second, this author mustdefine clinically competent. The assumption is thatchiropractic has the purpose of correcting a sublux-ation with pain being the most obvious symptom.The chiropractor, by definition, employs the high-velocity-low amplitude (HVLA) adjustment to cor-rect a subluxation. The field-practitioner confrontsvarious types of pain; the most obvious type of painconducive to chiropractic adjustment is neuro-mus-culo-skeletal (NMS) pain. An example for sake ofargument is the sacroiliac subluxation, a commonNMS malady. According to the training at PSC be-tween 1930 and the early 1960s, the Palmer graduatewould be incapable of alleviating this type of pain, asevidence will demonstrate later. The works of Gillet,Gonstead, Logan and others were capable of correct-ing this subluxation, but only by remaining outsidethe theoretical framework of B.J. Palmer and his HIOtechnique. That is, a full-spine chiropractic approachoffered chiropractic a better strategy for power withGCT being the provisional model (Diversified tech-nique would subsequently replace it). The followingkey components made GCT attractive:

1) GCT has successful outcomes;2) GCT is full-spine;2) GCT adjustments are HVLA;3) GCT hypotheses on spinal

biomechanics seemed plausible at thetime; and

4) GCT uses chiropractic machines.

The final aspect of this author's archaeologydepends on the definition of chiropractic practice.Chiropractic's success is dynamic because of its non-uniform styles of practice. To state that chiropractic'sprimary success is because of the HVLA adjustment isboth true and false. The professional fact is that somechiropractors adjust, while others do not. Because ad-justing is an art that requires skill to master, some areadept enough to become more proficient than others.This irregularity is inherent in all manual care (i.e.,chiropractic, dentistry, massage therapy, surgery). Toaid the practicing chiropractor, various strategies forcreating patient dependency exist, often with the as-sistance of chiropractic business consultants. Thesestrategies include patient-doctor rhetoric (enneagramprofiling, hyperbolic language, use of similes andmetaphors ([19], [20])) and ancillary therapies (e.g.,nutrition, soft-tissue techniques, physiotherapy equip-ment). As a whole, these can optimize the outcomeindependent of a chiropractic HVLA adjustment. Atits farthest point, the incapable but psychologicallyastute chiropractor practices across the street from themaster adjustor.

In other words, we must establish the fact that

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Clarence S. Gonstead, D.C, was a master adjustor.Experts in any field, including chiropractic, mustmeet three requirements that demonstrate their exper-tise: first, the outcome of an expert needs to be con-sistently superior to that of his/her peers; second, theresults need to produce concrete results like havingsuccessful outcomes and third, expertise needs to bereplicable and measured (21). Gonstead meets theserequirements:

1. His practice, the largest single-doctorchiropractic office in the world, attrac-ed patients from al! over the UnitedStates and numerous other countries aswell. The foundation of that success wasclinical competency—helping patientswith aches and pains from toe to skull.Meanwhile B.J. Palmer's HIO techniqueworked well for subluxations in thecervical spine. Furthermore, Gonstead'sskill garnered respect from those in theacademic world. Joseph Janse, D.C,president of National College of Chiro-practic, firmly believed in Gonstead'swork. He recognized that Gonsteadrepresented success built upon skill andeffectiveness, not verbosities ormarketing (22). Even upper-cervicalspecific chiropractor and Life Collegeof Chiropractic founder Sid Williams,D.C, wrote, "He (Gonstead) was not acommercial chiropractor. He was, rather,first and totally concerned with theadjustment (23);"

2. Gonstead's method of care alleviated thepatient's pain;

3. The growth and success of Gonsteadseminar-trained and eventually PSCPalmer Package trained chiropractors.

Gonstead Seminars of Chiropractic

Ted Markham, D.C, receives credit for promot-ing the GCT. While attending Lincoln ChiropracticCollege (1948-1950), he met a fellow student whowas a patient of Dr. Clarence S. Gonstead. This wom-an, whom Markham would later marry, convincedhim to visit Gonstead and observe his unique methodof practice. Finally conceding to her wishes, he vis-ited Gonstead. After witnessing Gonstead's uniqueside-posture adjustments, the use of a chair to adjustthe cervical spine, and the role of the neurocalome-ter and x-ray analysis in clinical decisions, Markhamwas in disbelief. It was very different from what hewas learning in school. When he finally graduated in

1950, he set up his own clinic in Beaver Dam, Wis-consin. With his free time, Markham researched thebiomechanics that Gonstead proposed using a dryskeleton and x-ray machine mainly out of an effort todisprove him ([24], [25]). Yet, he became convincedthat Gonstead was onto something, especially whenconfronted with his own professional situation: Hefound himself clinically incompetent to treat the ma-jority of his patients.

Markham had two things going for him. First, hesaw that he was like most mid-twentieth century chi-ropractors—clinically incompetent. It was not that hedid not try to help his patients; the root of his problemwas his application of chiropractic. When Markhamexamined and adjusted a patient, more often thannot, the patient did not get any better. His system ofanalysis and program of care was ineffective. Second,when he and his wife traveled to Mount Horeb, Wis-consin, to observe Gonstead practice and to interviewhis patients, he saw something very different hap-pening. Most of Gonstead's patients were reportingfeeling completely fixed—results Markham was notachieving (26).

Since Lincoln was a very small chiropracticschool, its graduates, like Markham, represented onlya fraction of the overall doctor population. If prob-lems with competency existed, the public could havehad the opportunity to visit a graduate of anotherschool—one with superior training. However, thiswas not the case. PSC as the dominate chiropracticinstitution was actually a much larger problem withthousands of PSC graduates under the HIO regimewho were equally incompetent. To compensate, manyPSC graduates, and Lincoln graduates as well, at-tended post-graduate seminars on chiropractic tech-nique or were self-taught to become full-spine ori-ented ([27], [28], [29], [30], [31], [32]). In one case,second-generation chiropractor John Darrow (1950PSC) had to learn full-spine evaluation and adjustingfrom his father, a 1914 PSC graduate (33). Curt Gon-stead (1956 PSC) did the same thing with his fatherMerton (1927 PSC) (34). The technique wars of the1950s were likely a result of chiropractic's education-al deficiency. As for Markham, he had the vision tosee that there was a market for educating others in thetechnique. If chiropractic schools were not going toproduce competent chiropractors, then he would withGonstead's unique method.

In April 1954, Ted Markham organized the first"class" in the basement of Gonstead's clinic. It wasa small success with seven attendees paying Gon-stead six hundred dollars—reimbursement for miss-ing one day's work. With the help of his wife Phyl-lis Markham, D.C, these classes became a platformfor a traveling seminar program. In the beginning,Markham invited his classmates and colleagues from

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his alma mater, Lincoln Chiropractic School, to hosta Gonstead seminar at their clinics. One of the first tooblige was Marv Klaes, D.C, a chiropractor in Indi-ana who later became one of the first seminar instruc-tors (35).

With strong growth in seminar attendance in agreater number of host cities, Markham had a hardtime taking care of his own chiropractic office. In1962, Gonstead agreed to hire Markham as the semi-nar director. In the process, Gonstead also hiredMarkham's good friend Lee Vogel to be the seminar'sbusiness manager.

As the seminar business captured the attention ofthe profession by hosting events all over the coun-try, a problem of intemal cohesiveness developed. Ina disagreement regarding economic compensation,Markham and Vogel resigned from their positions inOctober 1965 (36). To fill the vacancies, Gonsteadhired Drs. Alex and, later, Doug Cox, two brotherswho worked at the Gonstead Clinic and taught theseminars.

Managing Gonstead Seminars of Chiropracticand later acquiring and operating the Gonstead Clinicof Chiropractic were monumental tasks. Together theCox brothers brought a new academic model of edu-cation to the seminars. The seminars offered a tieredset of classes ranging from the specific needs of thefirst time attendee to those of the well-versed seminarattendee. They also sought to clarify the discrepan-cies that existed in the material. For example, therewere technical problems with Gonstead's protocolfor taking full-spine x-rays. Other problems existedin Gonstead's interpretation of leg-length inequalityand his methods of adjusting extremities ([37], [38],[39]). One reason for much of the confusion was Gon-stead himself. Being the kinesethic type, it was ofteneasier for him to show people how to do rather thanto tell them. The other problem was his enormous pri-vate practice. Gonstead refused to give up his practiceto teach others; he preferred to adjust patients, oftentimes adjusting three hundred patients a day, six daysa week. As a result, it took years for others to under-stand his approach, let alone teach it (40).

The Role of Palmer School of Chiropractic

The seminar business fiourished under theMarkham and Vogel's leadership. In doing so an im-portant event occurred to cause flashover and legiti-mize the technique—PSC's adopting a full-spine cur-riculum. One marker of professional acceptance andlegitimacy is the adoption of a procedure or techniqueby a profession's educational institutions. While theseminars met a basic market need, no matter howhard Markham and Vogel worked, at best they couldonly capture chiropractors who were electively seek-

ing higher education. The next level was acceptanceof the work by a chiropractic school, not as an elec-tive but as a core class. This was not a conscious de-cision on the part of the Gonstead Seminars, but anopportunity afforded them by chance. Ironically, hadGonstead not been an alumnus of PSC, he might havebeen degraded as another technique guru instead of anexpert. Another point worth making is that Gonstead'swork was not the first to offer a full-spine techniquesystem; but as luck would have it, presented itselfwhen PSC had a renewed need for one.

After Gonstead's 1923 graduation from PSC, B.J.Palmer stiñed chiropractic art by his development andabsolute adherence to upper cervical specific Hole-In-One (HIO) technique in 1934. This therapeutic ap-proach disregarded any spinal adjusting below cervi-cal bone number two (41). HIO would dominate thePSC curriculum, the largest chiropractic school inthe nation from 1934 to 1961, while the school wasfalling from its esteemed position. The HIO modelwas restrictive as a primary guide for the profession,specifying legal boundaries and creating norms fortheory construction, theory acceptability, conceptlegitimacy, and success criteria. Chiropractic sci-ence and art had fallen prey to extreme reductionism.Ultimately, it led to a revolt and the "Green Light"speech by Herbert M. Himes, D.C, chair of the tech-nique department at PSC On 4 January 1956, Himesoutlined to the student body and faculty that becauseHIO was "practiced exclusively by relatively few"and that "until such time as the Chiropractor becomesthe PRINCIPLE HEALER, legally and legislatively,we must have a circumscribed area of practice, andthat area must be the ENTIRE spine (42)." To appeasethe Palmerites—chiropractors with uncritical fidelitywho accepted B.J. as some sort of prophet—Himesclosed his speech by saying:

In case you have any ideas that we aresneaking this into school while B.J. is inFlorida, let me close this talk by reading twoquotations from recent correspondence withhim. FIRST QUOTE: "In granting this pro-gram, as outlined, with exceptions noted, wedo so knowing that if it is RIGHT, it will liveand grow in the minds of more people. If it isWRONG, it will die and anything we mightstubbornly refuse to yield on would be a dog-matic attitude in dealing with this program.Second, I do fully and most heartily concur ingetting on top of this program and the soonerthe better. We DO give YOU the greenestlight we know, to go ahead (43).

Over the next few years, the school would adopta quasi full-spine curriculum. The pioneer in this

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transition was B.J.'s friend and faculty member ClayThompson, D.C. An inventor of sorts, he first devel-oped the Palmer-Thompson drop headpiece adaptedin HIO work. Extending his ideas, he made a table in1957 with drop sections for the thoracic, lumbar andpelvic regions (44). However, without full coopera-tion of the school's faculty, it failed to be incorporatedinto the classroom and the student clinic. By matterof convenience, the momentum of HIO continued(45). Alan Zelm, a 1959 Palmer graduate, remembers"the student clinic at the time was a huge auditoriumwhere you had to use the NCM and establish an ab-normal pattern three times before you could adjust it.Once you verified the pattern with an instructor, youwent up on stage, in front of everyone, and toggledeither Cl orÇ2(46)."

Not until B.J. Palmer's death in June 1961 wouldthe institution attempt to rebuild through the progres-sive leadership of David D. Palmer. In the final yearsof B.J.'s administration, the school's reputation hadfallen to its lowest point. With declining enrollment,the school was in bad financial shape. To rebuild itsacademic reputation, gain financial solvency, and re-pair the deteriorating school buildings required mas-sive action as detailed in David's book Three Genera-tions:''A Brief History of Chiropractic (47).

.-" Among the' various educational 'reforms werenew faculty appointments. David Palmer hired JerryMcAndrews, D.C, in October 1961 as the new clinicdirector and later as chairperson of the chiropracticsciences division. In this capacity, McAndrews start-ed rewriting the curriculum; and for the first tinie inover a quarter of a century, the PCC faculty would be-gin teaching full-spine chiropractic again—measuresthat failed to happen with the Thompson ChiropracticTechnique. In the transition phase, McAndrews at-tended a few Gonstead seminars after hearing it wasa "rational, mechanical, and structural" full-spinesystem. When he saw "the logic of it," he made thetechnique the school's core curriculum (48). In time,Gonstead invited the Palmer faculty to attend semi-nars at no cost; and it became common to have facultyand students sitting side by side at seminars learningthe material. In 1963, McAndrews hired Doug Cox, aformer student of his and brother of Gonstead semi-nar instructor Alex Cox, D.C, to teach the techniqueat PCC (Table 1).

The transition under McAndrews was not with- 'out struggles. Prominent Palmerites such as Sid Wil-liams, D.C, Reggie Gold, D.C, and Bud Crowder,D.C. (president of Palmer Alumni Association), pre-ferred the esoteric upper cervical work and resistedthe changes. Despite their arguments, the curriculum •changed to full-spine science and art. David Palmer;with McAndrews' collaboration, recognized the po-litical limitation of the HlO model. At the time, the

school was fighting political battles for state licensurelaws in New York, Massachusetts, Mississippi, andLouisiana. Meanwhile, a federal accreditation effortby the Foundation for Accredited Chiropractic Edu-cation (FACE) was upgrading chiropractic education(49). The broader definition of chiropractic scienceand art as full-spine was politically necessary for theprofession to gain complete legal legitimacy (50).The years of rhetoric and persuasion by B.J. Palmerand the Palmerites that chiropractic was alternativehad collapsed. The social fact was that chiropractorswere spine doctors. The arguments for inclusion atthe state and, later, federal levels played on that factin order to win.

The GCT led to a significant reorientation ofchiropractic art at PCC. The school began teachingGonstead's evaluation procedures (visualization, in-strumentation, static and motion palpation, and full-spine x-ray analysis) followed by specific segmentaladjusting.̂ Since its acceptance, the school had under-gone various curriculum changes; but patient evalua-tion and adjusting as taught in the classroom and stu-dent clinics remains structured around the GCT. Toaccommodate a more academic neutral position, PCCdecided to label its heavily weighted GCT classes un-der the disguise of Palmer Package. In doing so, itaccommodated the inclusion of the Derifeld-Leg Testand certain Thompson Technique procedures ([51],[52]) (Table 4).

Other Factors

Beyond the reach of PCC, other efforts worthmentioning facilitated proliferation. On his death in1978, Gonstead's estate created two trusts. The Gon-stead Chiropractic Teaching Trust sought to providechiropractic colleges the necessary means to teach thework: a paid educational chair, the necessary equip-ment (neurocalometers, full-spine x-ray film cas-settes, complete Gonstead adjusting sets consisting ofa knee-chest table, cervical chair, and pelvic bench)and numerous copies of the Gonstead Technique text-book. Only four chiropractic schools received themoney: PalmerCollegeofChiropractic($198,230.00);Cleveland College of Chiropractic ($78,750.93); Lo-gan College of Chiropractic ($37,503.00), and West-em States College of Chiropractic ($37,689.21). Thesecond trust. The Gonstead Educational Trust, pro-vided full-ride educational scholarships for ninety-one students. Besides covering the cost of school, itallowed students to attend Gonstead seminars free.Beginning in 1980, the two trusts awarded a total of$1,143,662.40 until its termination in 1997 (53).

The second force was the efforts of individualGonstead practitioners to affiliate themselves withchiropractic school faculties. Richard Cranwell,

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D.C, graduated from Logan College of Chiropracticin 1976 feeling confused on how chiropractic worked,much as Markham had years before. Four monthslater, Cranwell attended his first Gonstead Seminarwhere the Gonstead Seminar staff announced theywere looking for a new intern. He applied for, got thejob, and stayed at the Gonstead Clinic of Chiropracticuntil 1979. He then retumed to St. Louis, Missouri, tostart a private practice. In 1980, he joined the facultyof Logan, teaching the GCT as a recipient of the Gon-stead Teaching Trust. He continues to be on facultywhile maintaining his private practice ([54], [55]).The author has observed parallel efforts by LindaMullins at Life University and John Quitoriano atPalmer West.

Another medium for dissemination was studentstudy groups and internship programs. For exampleJohn Thatcher, D.C, in St. Paul, Minnesota recog-nized the need to promote the work at other chiroprac-tic schools. In the 1970s, he developed a relationshipwith Northwestern College of Chiropractic (NWCC)President John Wolfe, D.C, to work on getting theGCT into the curriculum. At Thatcher's suggestion,NWCC hired GCT-oriented and PSC graduate GaryPennebaker, D.C. As a co-instructor, Pennebakertaught GCT with the school technique department. Atthe same time, the committee members of the Gon-stead Trusts invited NWCC to apply for funds, butthe college decided to withdraw any interest in theFducational Trust on the grounds of academic inde-pendence. However, NWCC did promote the Gon-stead scholarship program to its student body. Manyreceived the scholarship. Frustrated with the school'sresistance to embrace a proprietary technique in itscurriculum, Thatcher offered to teach a class dedi-cated entirely to GCT in 1980. The school grantedThatcher permission to teach a voluntary class overthe lunch period for one trimester. The school appoint-ed part-time faculty member Gary Pennebaker, D.C,to oversee the class. However, when the class started,Thatcher's notorious personal habit of running hourslate forced Pennebaker to take the lead in assistingstudents to leam the material. Despite interest fromstudents, without administrative support, the optionallunchtime program lasted one trimester (56).

Nevertheless, Pennebaker would remain a Gon-stead aficionado and assist Thatcher in teachingNorthwestem's students the material off-campus inthe basement of Thatcher's private practice clinic.These informal, unofficial student gatherings con-tinue to this day, although at a different location (57).Furthermore both Thatcher and Pennebaker began ac-cepting student intems at their clinics to leam GCT.A similar situation occurred with Larry Troxell, D.C,starting an intemship program for students at PCC

The creation of Gonstead clubs in chiropractic

schools and among field-practitioners was a thirdforce. The Gonstead Clinical Studies Society (GCSS),started in 1979, was the field organization of the Gon-stead enterprise. The Society sought to recognize andcertify doctors who claim to use the method and toinitiate further scientific investigation of the GCT.For the most part, it has been successful. Currently,it has 447 members in all fifty states with internation-al members in Australia, Canada, Germany, Israel,Netherlands, New Zealand, Norway, Switzerland,and United Kingdom (58). It has also assisted in thecreation of two full-referenced textbooks: Textbookof Clinical Chiropractic: A Specific BiomechanicálApproach and Pédiatrie Chiropractic. As for on-campus student Gonstead clubs, they likely startedbecause of student initiative sometime after 1980([59], [60], [61]). These clubs, especially at schoolswith Diversified programs such as NWCC, providestudents with opportunities to explore and specializein specific name technique protocols (e.g., Gonstead,AK, Activator, Motion Palpation, SOT).

Reflections

The GCT has followed a natural history. The evo-lution of school trained versus seminar trained Gon-stead chiropractors has shifted the locus of control. Asa result, the need for Gonstead post-graduate seminarshas decreased. It has also led to the diminishing pres-ence of the Gonstead Clinic of Chiropractic in MountHoreb, Wisconsin. From 1960 to 1990, the clinic staffstarted recognizing that it was beginning to competewith other Gonstead chiropractors. Former membersof their staff, seminar attendees, and PCC gradu-ates (after 1961) were practicing in the area .(Table3). As more chiropractors were trained according tothe principles of the GCT, a new generation of clini-cally competent chiropractors emerged; and arguably,the typical Palmer Package chiropractor became pro-ficient through his/her education at PCC or at otherschools teaching the Diversified approach/technique.The net result was, for the most part, a competent pro-fession.

As a stand-alone technique, a number of issueshas fragmented the Gonstead enterprise, many ofwhich are outside the scope of this paper (e.g., use ofphysiotherapy, soft-tissue techniques). The first andmost significant was the schism between GonsteadSeminars of Chiropractic and Gonstead AdvancedTechnique (GAT). This second seminar group forlong-time devoted Gonstead seminar attendees start-ed shortly before Gonstead's death. Initially approvedby Gonstead Seminars of Chiropractic staff (the Coxbrothers), it allowed Gonstead to spend more timewith seasoned field-doctors and answer their morecomplicated questions. However, when Gonstead

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died, instead of GAT disbanding, it developed into arival seminar business, Gonstead Methodology Insti-tute (GMI), under the direction of Larry Troxell, D.C.Many years later, a third and inconsequential semi-nar group, Thornton Consultant Services RelicensureSeminar, formed (Table 5). It is not a new phenom-enon. The same happened when technique guru JohnF. Grostic, Sr., D.C., died in 1964 with his originalseminar company breaking into multiple factions([62], [63]).

Further splitting occurred when Gonstead Semi-nars of Chiropractic (now Gonstead Seminars, Inc.)under the ownership of W. John Cox, D.C, decidedto separate from GCSS in 2000. Both sides have re-mained closed-lipped about why. This lack of auton-omy has caused duplication in efforts. One exampleis that both groups compete for the right to "certify"Gonstead chiropractors. Gonstead Seminars, Inc.chose to develop an allegiance with the Palmer Insti-tute of Professional Advancement. Interested doctorsmust follow a four-part process to achieve the title of"Ambassador." GCSS, on the other hand, has a Col-lege of Fellows that grants certification based on apractical and written exam. Regardless, neither sys-tem carries any legal merit and is nothing more thanan acceptance by one's peers.

In summary, David Palmer as president of PCCwas critical to GCT's proliferation. David was man ofa new generation with an admiration for technologyand respect for formal education (64). His backgroundoffered him a new view of the chiropractic landscape,which revealed numerous discrepancies that neededresolution for chiropractic progress. Technology, spe-cifically the x-ray machine and Nervo-Scope®, andfull-spine chiropractic would become part of his ver-bal armament that chiropractic is both scientific andsuccessful in the healthcare marketplace (65). To em-phasize that GCT's role in this context was no morethan a political strategy ignores the practical outcomeof David's decision because subsequent graduates notonly entered a more favorable marketplace free ofprosecution, but were clinically competent as well.

Moving forward, the GCT at PCC facilitated chi-ropractic's discourse in the original intellectual andphysical space created by D.D. Palmer. Until the mostsignificant school in chiropractic adopted the realityof field-practitioners, the profession remained educa-tional and clinically divisive. Diversified ChiropracticTechnique, in many ways, reflects the combination ofthe profession's rich and successful techniques andthe flexibility to change its ways that science demandsof it.

REFERENCES:

1. Walter L. Wardwell, Chiropractic: History and Evolu-tion of a New Profession. (St. Louis: Mosby-Yearbook, Inc. 1992)p. 178.

2. J. Stuart Moore, Chiropractic In America: The Historyof a Medical Alternative. (Baltimore: Johns Hopkins UniversityPress, 1993)pp.73-92.

3. Joseph Keating, B.J. of Davenport: The Early Years ofChiropractic. (Davenport: IA. Association for the History of Chi-ropractic, 1997) pp. 107-137.

4. , Toward a Philosophy of the Science ofChiropractic: A Primer for Clinicians. (Stockton, California:Stockton Foundation for Chiropractic Research, 1992) pp.44-5,313-314.

5. David Palmer, Three Generations: A Brief History ofChiropractic. (Davenport: Palmer College of Chiropractic, 1967)pp.31-33.

6. Samuel Homola, Bonesetting, Chiropractic, and Cult-ism. Panama City, Florida: Critique Books, 1963) Chapter 11.

7. Margaret Pelling, "Unofficial and Unorthodox Medi-cine," in The Oxford Illustrated History of Western Medicine. Ir-vine Loudon (Oxford: Oxford tJniversity Press, 1997) p.27O.

8. Paul Starr, The Social Transformation of AmericanMedicine: The Rise of a Sovereign Profession and the Making ofa Vast Industry. (New York: Basic Books, Inc, 1982) p. 16.

9. Moore, Chiropractic in America (n.2) p. 144.

10. Michael Haneline, Evidence-Based Chiropractic Prac-tice. (Sudbury, MA: Jones and Bartlett Publishers, 2007).

11. Claire Johnson, "Highlights of the Basic Componentsof Evidence-Based Practice," Journal of Manipulative and Physi-ological Therapeutics, 2008, 31:91-92.

12. Matthew Davis and Geoffrey Bove, "The ChiropracticHealer," Journal of Manipulative and Physiological Therapeu-íící, 2008, 31:323-327.

13. Joseph Keating, letter to the editor. Journal of Manipu-lative and Physiological Therapeutics, 2004, 27(l):74-75.

14. , "Several Pathways to the Evolution ofChiropractic Manipulation," Journal of Manipulative and Physi-ological Therapeutics, 2003, 26(5):300-321.

15. Robert Cooperstein and Brian Gleberzon, TechniqueSystems in Chiropractic. (St. Louis, Missouri: Elsevier Limited,2004).

The Role of The Gonstead Chiropractic Technique - Amman88

16. Herbert J. Vear, H.J. Introduction to Chiropractic Sci-ence. (Portland, Oregon: Westem States Chiropractic College,1981)p.l69. ' •

17. Cooperstein, Technique Systems in Chiropractic (n.l5).

32. James Loftus, D.C, interview with author, 11 March2008.

33. James Darrow, D.C, interview with author, 6 March2008.

18. Reed Phillips, "We Need to Bring Order to Our Tech-niques," Dynamic Chiropractic, 2002, 20(01):Table 2.

19. Larry Markson, Dennis Perlman and Bob Hoffman. TheMasters Guide for the 21st Century Chiropractor. (Lake Success,New York: The Masters Circle, 2001) pp.227, 232-273.

20. Parker System of Professional Service for the Doctorof Chiropractic, first edition (Fort Worth, Texas: The Parker Chi-ropractic Resource Foundation, 1993) pp.309-310, 408, 417-432,443-445.

21. K. Anders Ericsson, etal., "The Making of an Expert,"Harvard Business Review, July/August 2007:15-21.

22. Joseph Janse, "A Great Distinguished Clinician andTeacher is Called Home," Digest of Chiropractic Economics, No-vember/December 1978:28.

23. Sid Williams, "Lyceum Clarence S. Gonstead: A Manfor All Seasons," Today's Chiropractic, October/November1978:6.

24. Mary Goble, The Master's Touch. (Mt. Horeb, Wiscon-sin: GCSS Publication, 1990) p.3.

25. Phyllis Markham, D.C, interview with author, 20 Sep-tember 2005.

26. _, "Gonstead Chiropractic" in Chiro-practic Ethics and Economics, vol 9, no 4, ed/pub L.E. Cheal,D.C, (Leitchfield, Kentucky: Golden Rule Publishing Co., 1962)pp. 5-7.

34. Curt Gonstead, D.C, interview with author, 10 October2005!

35. Marvin Klaes, D.C, interviews with author, 11 April2005 and 30 November 2005.

36. Lee Vogel, interview with author, 15 April 2007.

37. Alex Cox, D.C, interviews with author, I April 2005and 7 April 2005.

38. John Rosser, D.C, interview with author, 7 May 2005.

39. Harvey Storm, D.C, interview with author, 15 March,2005.

40. Cox, interview (n.37)

41. B.J. Palmer, D.C, The Subluxation Specific—The Ad-justment Specific (Davenport: Palmer School of Chiropractic,1934).

42. Herbert M. Himes, "Green Light" speech to studentbody at Palmer Chiropractic College, 4 January 1956, from per-sonal collection of Victor Strang.

43. _, "Green Light," (n.42).

44. Wayne Zemelka, D.C, interview with author, 25 Janu-ary 2006.

45. Jerry McAndrews, D.C, interview with author, 1 Feb-ruary 2006.

27. Richard Gilliland, D.C, interview with author, 6 March2008.

46. Alan Zelm, D.C, interview with author, 19 January2006.

28. Clifford Price, D.C, interview with author, 6 March2008.

29. Kenneth Kling, D.C, interview with author, 6 March2008.

30. James Greenwald, D.C, interview with author, 6 March2008.

31. Gene Rohloff, D.C, interview with author, 7 March2008.

47. Palmer, Three Generations (n.5), pp.38, 51 -52.

48. McAndrews, interview (n.45).

49. Keating, Toward A Philosophy (n.4) p.66.

50. McAndrews, interview (n.45).

51. , interview (n.45).

52. Richard Bums, D.C, Meeting of the Minds II, Gon-stead Gathering, Palmer College of Chiropractic, Florida campus,October 2005 and interview 4 April 2006.

Chiropractic HistoryVolume 28, No. 2 - 2008

89

53. Probate Court Records, Madision, Wisconsin; GonsteadEstate and Will; M&I Bank Trust Records, Madison, Wisconsin,courtesy Diane Cody.

54. Richard Cranwell, D.C, interview with author, 22 Feb-ruary 2005.

55. Jeanne Taylor, interview with Richard Cranwell, M.S.,D.C, D.A.B.C.N., in The Scope - News and Information from thecess, February 2008.

56. Gary Pennebaker, D.C, interviews with author, 13 Feb-ruary 2008 and 29 February 2008.

57. Author's personal experience while student at North-western College of Chiropractic, 1998-2001.

58. 2008 Gonstead Clinical Studies Society MembershipDirectory: www.gonstead.com

60. Steven Tanaka, D.C, email to author, 14 February2008.

61. Richard Bums, D.C, email to author, 15 February2008.

62. Kirk Eriksen, D.C, "The Development and Protocolof the Grostic/Orthospinology Procedure," Today's Chiropractic,January/February 2002.

63. www.aucco.org/history.html

64. Palmer, Three Generations (n.5) p.55.

65. Steven Martin, "The Only Truly Scientific Method ofHealing: Chiropractic and American Science, 1895-1990," IStS,June 1994: pp.207-227.

59. Claudia Anrig, D.C, email to author, 20 February2008.

Table 1: Overview Gonstead Technique Instruction at PCC Davenport Campus(Collaboration of Amman and Burns, 2008).

1961-1963

1963-1967

1965-1971

1967-1972

1973-1977

1973-present

1974-present

1974-2007

1972-present

1991 -present

1991-present

1989-1994

1994-2005

2005-present

Instructor

Jerry McAndrew

Doug Cox

Jim Stoenner

Larry Troxell

Homer Adams

J. Richard Bums

Michael Bovee

Don Specht

Marjorie Johnson

Pam Gindl

Joe Peterson

James Morley

Don Gran

Roger Hynes

Class Orientation

Gonstead Concepts

X-ray analysis, Gonstead Concepts

X-ray analysis, Gonstead concepts

X-ray analysis, Gonstead concepts

Gonstead analysis and adjusting

Gonstead analysis and adjusting

Co-instructor

Co-instructor

Co-instructor

Co-Instructor

Co-instructor

Co-instructor

Co-instructor

Co-instructor

Number of Classes

1

l t o 3

3-4

3-4

3-4

5

The Role of The Gonstead Chiropractic Technique - Amman90

Table 2: Adoption of Gonstead Technique in Various College Curricula.

Palmer College of Chiropractic -Davenport

Canadian Memorial (CMCC)

Logan College of Chiropractic

Northwestern (NWCC)

Life College of Chiropractic -Atlanta

1961

1971

1980

1980

1994

Table 3: Gonstead Clinic of Chiropractic Doctors (While under ownership of CSG or Cox).

Doctor

Lyle Stewart

Alex Cox

Doug Cox

Albert Grove

Gaylord Culp

Sandra Chilson

Lester Cheal

John Rosser

Gary Hooks

Harvey Storm

Ray Clinton

James Stoenner

William Droessler

Year

1948-1948

1964-retired

1967-present

1963-1966

1964-1966

1964-retired

1965-1966

1966-1969

1966-1970

1968-1970

1971-present

1975-present

1977-1979

Destination

Middleton, WI

Mount Horeb, WI

Lake Geneva, WI

Leitchfield, KY

Elgin, IL

Sauk Prairie, WI

Madison, WI

Madison, WI

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Table 4: TECHNIQUE DEPARTMENT COURSES PCC 2008 DAVENPORT CAMPUS(Collaboration of Amman and Burns, February 2008).

Instructors

Herrity

Wild

Strazewski, Bhogal

Johnson, Gindl

DeVocht

Bovee, Lipes

TrimesterT3

T4

T4

T5

T5

T6

T6

Class NamePalpation

Instrumentation

Palmer UpperCervical Specific

Cervical Technique

Biomechanics

ThoracolumbarTechnique

Pelvic Technique

OrientationStatic & Motion

Nervoscope & Tytron

HIO, Grostic

Gonstead analytics,Gonstead x-ray analysisGonstead & Diversified Adj

Mathematical Models

Gonstead analyticsGonstead x-ray analysisGonstead & Diversified AdjHylo & Knee-Chest table work

Gonstead analytics

T7

T7

Peterson, PetterssonDiversified & Thompson analyticsGonstead, Diversifed, & Thompson

Adj

Technique Principles Palmer Package Overview& Practice

Extremity Adjusting Gonstead analytics & Adj

Burns, Hynes

Sorgenfrey, Paustian, Gindl

Table 5: Fragmentation of GCT Instruction.

1960s

1970s

1980s

2000s

2008

Gonstead Seminars

Gonstead SeminarsGonstead Advanced Technique (GAT)

Gonstead SeminarsGonstead Methodology Institute (GMI)

Gonstead SeminarsGMIThorton SeminarsFrom Start to Freedom

Gonstead SeminarsGMIThorton Seminars

Clarence Gonstead

Clarence Gonstead, Alex & Doug CoxClarence Gonstead, Larry Troxell, others

Alex & Doug CoxLarry Troxell

John Cox (Alex's son)Larry TroxellRichard ThortonJose Lara, James Warlick, Mike Rozenblum

John CoxDavid GearyRichard Thornton