CHAPTER I - THE BACKGROUND

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Backache is pain of spinal origin, plus its radiations. Low backache has been unduly emphasized. It is only one-sixth of the problem, because similar pains, with analagous radiations, occur in every part of the spine.

The four following quotations, extracted from a great deal in the same vein in medical literature, are worthy of thoughtful consideration. They illuminate the position of the doctor and the patient in the ailment most frequently seen-even if rarely recognized-by doctors.

An editorial in The Practitioner (1957) stated:

Backache is the bane of the general practitioner's life. The unfortunate victim cannot understand why the doctor can do nothing to put it right, whereas every hoarding and most popular journals contain myriad remedies guaranteed to produce that result so devoutly desired by the patient.

D.G. Wilson in The Lancet (1962) wrote:

It is clear that very many patients still have recourse to irregular practitioners (of manipulation) and this is a constant reflection upon the skill and competence of the profession, on the general practitioner in particular.

J.R. Armstrong in Lumbar Disc Lesions (1958) stated:

There is not even a street in this country, (England, which has many small streets) in which there are not one or two individuals who have been martyrs to lumbago or sciatica for the major part of their lifetime. They have run the whole gamut of treatment and have come to accept their affliction and do not trouble to seek further medical advice.

In a sentence that is particularly appropriate to this situation Hippocrates said:

It is disgraceful in every art, and more especially in medicine after much trouble, much display, and much talk, to do no good at all.

In spite of all this, the profession has been dimly aware of the approach for twenty-five hundred years. In ancient Greece Hippocrates practiced manipulation of the spine, as did Cato the Wise in Rome and Galen [of Pergamum] in various places in Asia Minor and in Rome.