Divergent beam: A history of the use of x-rays in chiropractic

The use of diagnostic x-ray is controversial in chiropractic, due to different groups in the profession holding conflicting opinions on its main utility. This thesis is a historical study of the effects the x-ray has had on the practice of chiropractic from its introduction in 1910 until the present day. It examines the influence of the founders of the profession, other prominent chiropractors, medical and chiropractic professional associations, as well as the role of the state in defining the paradigms for diagnostic imaging. The study adopts a biomedical perspective which prioritises the use of historical evidence in contextualising epistemologies of healthcare methods. In doing so it questions traditional chiropractic depictions of health and disease, which have not changed significantly since the profession’s inception. Historically, chiropractic has been divided along traditional/biomedical lines, and the exacerbating effect of the adoption of x-ray technology on the schism in the profession is examined here for the first time. Several themes became apparent during the research, including legitimation, professionalisation, and the concept of boundary work. The thesis investigates the emergence of novel practice techniques centred on the use of x-ray for traditional, chiropractic-specific purposes, as well as the beliefs surrounding those techniques. The contrasting views and innovations of biomedically-oriented chiropractors on the use of x-ray are explored as well. These include the creation of structures parallel to those in medicine, like speciality certification exams in diagnostic imaging, the development of speciality professional associations, and organs of information dissemination such as books, journal articles, and conferences. Included is an in-depth look at a particularly illustrative example, the legislative battle for chiropractic to be included in the American Medicare system, which ultimately focused on the use of x-rays. It showed that the involved parties had a deeper concern for ideology than for patient benefit. This thesis argues that in adopting the x-ray, chiropractic both shaped its use for chiropractic purposes and was simultaneously shaped by it, with profound, unique, and lasting effects on intra- as well as interprofessional relationships