CHIROPRACTORS ‑- SCOPE OF PROFESSION

CHIROPRACTORS ‑- SCOPE OF PROFESSION

It is not within the scope of chiropractors' profession to prescribe or administer items such as vitamin pills, herbs, or other substances of like nature.

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                                                                 January 11, 1973

Honorable R. Frank Atwood
State Senator
Legislative Bldg.
Olympia, Washington 98504                                                                                                                 Cite as:  AGLO 1973 No. 7

Dear Sir:

            By recent letter you have requested our opinion on the following questions:

            (1) "Is it within the scope of chiropractor's profession to prescribe or administer items such as vitamin pills, herbs, or other substances of like nature?"

            (2) "If it is within the scope of chiropractor's profession to make such recommendations or prescriptions, is it within his scope to sell these items?"

            We answer question (1) in the negative thereby rendering any consideration of question (2) unnecessary.

                                                                     ANALYSIS

            The legislature recognized and required the licensing of chiropractors in this state in 1919 by its enactment of chapter 5, Laws of 1919 (now codified as chapter 18.25 RCW). It specifically declared in § 4 of this act (RCW 18.25.010) that it is unlawful for any person to practice chiropractic without a license.  By § 6, now codified as RCW 18.25.030, the legislature further provided that:

            "Any chiropractor who has complied with the provisions of this chapter may adjust by hand any articulation of the spine, but shall not prescribe for or administer to any person any medicine or drugs now or hereafter included in materia medica, nor practice obstetrics, nor practice osteopathy or surgery."

             [[Orig. Op. Page 2]]

            It is, of course, the prohibition contained in the second clause of this statute which is pertinent to your present inquiry.  Does this specific prohibition against prescribing or administering to any person ". . . any medicine or drugs now or hereafter included in materia medica . . ." cover vitamin pills, herbs, or other substances of a like nature?

            The first point to be determined in answering this question is the meaning of the term "drug."  InKelly v. Carroll, 36 Wn.2d 482, 219 P.2d 79 (1950), the Washington court stated that "A drug is a substance that is used as a medicine" and then went on to quote with approval from State v. Baker, 229 N.C. 73, 48 S.E.2d 61 (1948), as follows:

            "'A "drug" is any substance used as a medicine or in the composition of medicines for internal or external use, and a "medicine" is any substance or preparation used in treating disease.  [Citing cases and authorities.]  Hence, the term "drugs" embraces patent or proprietary remedies possessing or reputed to possess curative or remedial properties sold and used for medicines.  This is true irrespective of whether such remedies contain poisonous ingredients, or whether they may be purchased without any direction from a physician, or whether they can be obtained at retail stores generally.  Calling drugs domestic or family remedies does not rob them of their character as medicines. . . .  The lexicographers declare that a laxative is a medicine. . . .  The test is whether it is administered or employed as a medicine.'  (Italics ours.)"

            See also, the following dictionary definition of "drug" appearing in the Random House Dictionary (1969):

            "a chemical substance administered to a person or animal to prevent or cure disease or otherwise enhance the physical or mental welfare."

            Next to be considered is the phrase "in materia medica."  We note, initially, that this term was capitalized "Materia Medica" in the original, 1919, act ‑ thus suggesting a reference to some specific book or other publication.  However, although there appear to have been a number of publications in existence in 1919 covering the general field of drugs and medical substances, we have been unable to locate any such publication or treatise  [[Orig. Op. Page 3]] entitled "Materia Medica."  The closest title we have found is "American Materia Medica," 3rd Ed., 1919, F. Ellinswood, subtitled "Therapeutics and Pharmacognosy, With a Practical Consideration of the Principles of Pharmacy and Pharmacognosy."  However, the most "official" of the publications at that time was the "Dispensary of the United States," 19th Ed., published in 1907.  This publication had been published for a number of years in different editions, but the 19th edition was the first formally accepted by the federal government as the official publication.

            Accordingly, if the 1919 legislature in enacting the chiropractic act had intended to refer to a specific publication, it would seem more logical for it to have referred to that 1907 publication rather than using the term "materia medica."  Since it did not, we are inclined to the view that no specific publication was intended ‑ a view which finds further support in both the subsequent codifications of the statute and in decisional law.

            In both RCW 18.25.030 and in its long-time predecessor, RRS § 10101, the term "materia medica" is and has always been set forth in small case.  And, in State v. Wehinger, 182 Wash. 360, 47 P.2d 35 (1935), a criminal action for practicing chiropractic without a license, the Washington court resorted to a common dictionary definition rather than to any specific publication when it sought the meaning of this term.  At page 366, the court stated that:

            "'Materia medica' is defined by Webster's New International Dictionary as:

            "'Material or substance used in the composition of remedies;‑-a general term for all substances used as curative agencies in medicine.  2. That branch of medical science which treats of the nature and properties of all the substances employed for the cure of diseases.'"1/

             This leads us to the ultimate question of whether "vitamin pills, herbs or other substances of like nature" constitute drugs ". . . in materia medica . . .".  In answering we should first compare the earlier quoted definition of "drug" with the  [[Orig. Op. Page 4]] dictionary definition of "vitamin."  The Random House Dictionary, supra, defines a vitamin as:

            "any of a group of organic substances essential in small quantities to normal metabolism, found in minute amounts in natural foodstuffs or sometimes produced synthetically. . . ."

            The purpose of a vitamin pill is to supply to the body the quantity of the particular vitamin or vitamins necessary for normal metabolism and thereby either to correct or avoid a deficiency of the vitamin which can produce specific disorders of the body.  Thus, such pills are designed to "prevent or cure disease or otherwise enhance physical welfare."  We would therefore conclude that vitamin pills are drugs which are included ". . . in materia medica . . ." for the purposes of RCW 18.25.030, and, accordingly, that chiropractors are precluded by this statute from prescribing or administering such drugs.

            Similarly, we would conclude that herbs and other substances of like nature, if they are such as to fall within the preceding definition of drugs (i.e., a substance administered to a person to prevent or cure disease or otherwise enhance physical or mental welfare), may likewise not be prescribed or administered by a chiropractor under the provisions of the chiropractic act.

            Having thus answered your first question in the negative, there is no need to consider your second question, since it was asked only in the event that our answer to the first question was in the affirmative.