ineffective. The force required really to _move_ an ileum (save in
joint disease or in children) is tremendous and not to be commanded by
the ordinary adjuster. The light jars applied as a routine procedure
by so many Chiropractors are in reality nothing more than single
percussion strokes which stimulate the sacral nerves.
Place patient in position B and apply the hands to a posterior ilium
as to a posterior sacrum, making contact with the most prominent
portion of crest or posterior border and driving in a direction which
would represent a part of the circumference of a circle of which the
transverse sacral axis of rotation touches the center, or the center
of fixation in the sacroiliac joint.
COCCYGEAL ADJUSTMENTS
Examination
Place patient on an angle table, i. e., one which rises in the center
and slopes away toward either end. Separate the thighs slightly,
patient lying face down, and insert the rubber-covered second finger,
palmar surface upward, very carefully into the rectum. The tip of the
coccyx may then be felt and its movability and position determined.
Unless it is immovably fixed in an abnormal position it should not be
molested; the movable coccyx responds to mere muscle tension by changes
of position and cannot act as a primary cause of nerve impingement.
Usually this examination will be rendered unnecessary by the external
palpation which may disclose the movability of the coccyx and at once
render further exploration superfluous.
When the coccyx is anteriorly subluxated and ankylosed in that position
it may be a factor in producing constipation, hemorrhoids, etc., but
its influence in other diseases, especially of the nervous system, has
been greatly overrated by those who have not yet fully accepted the
doctrine that nerve impingement is the primary cause of all disease.
[Illustration: Fig. 30. Edge contact with “Roll,” q. v. Attitude of
patient for coccygeal adjustment.]
Movement
When it has been decided that the coccyx must be moved, the position
and use of hand is the same as for the palpation. The finger hooks
under the tip of the coccyx, draws upon it until a tight contact is
secured and then jerks sharply backward upon it with a view to its
abrupt fracture. No mitigation of the jerk in the hope of previously
loosening or gradually replacing the bone is of value for _osseous
tissue_ must be broken before any movement may take place.
This movement is painful and the region of the newly fractured coccyx
may remain sore for a period ranging from a few days to several weeks.
It is wise to warn the patient of the facts before proceeding.
The fractured coccyx may be absorbed, or may be reankylosed in a proper
position or in a new abnormal position, or may remain loose and movable.
ADJUSTMENT OF CURVATURES
We have previously discussed in detail the nature and discovery of
curvatures. A few words should be said here about their correction.
If the sole object of the adjustment is to correct the curvature it is
best to select for adjustment those vertebrae which are most subluxated
in the direction of the curvature. According to the length of the
curvature a series of from two to six, separated by some distance, are
chosen. These are adjusted until they cease to be the most prominent
ones in the curvature and then others, then most prominent, are chosen
and adjusted until they in turn cease to be most prominent. In this
way the curvature may eventually be straightened, or nearly so. It is
doubtful if any curvature can be absolutely eradicated, although it may
be straightened until unnoticeable except by the expert.
To overcome a curvature it may be necessary to break every rule which
governs ordinary adjusting and to invent new ways of placing the hands
or of delivering force. No two require exactly the same measures and he
is most successful with curvatures who is most adaptable to changing
conditions.
One rule may be safely laid down. Do not alternate from day to day,
loosening at the same time many vertebrae, but choose the ones most in
need of adjustment and _follow your choice_ as long as it is indicated.
The chief vertebra is nearly always the one at the _angle_ or _point_
of the curvature.
The sharp, angular curve of Potts’ Disease, involving two or three
vertebrae, should warn against adjustment, usually, since in this
disease the vertebrae are fragile and easily fractured. If a case has
not progressed too far a cure may be effected, but great caution in
taking such cases must be exercised. Every Chiropractor should be well
informed on the diagnosis of Potts’ Disease, or spinal caries.
Many months are usually required for the straightening of a
curvature--how many can scarcely be estimated in advance of the
experiment with any case. Often the case which seems simplest requires
the longer time, while a very pronounced curvature, as in some cases of
rachitis, may yield in a few months.
PREFERABLE ADJUSTMENTS
The selection of the move with which to correct each subluxation
depends upon the adjuster’s concept of the _kind_ and _direction_ of
the subluxation and of the mechanics of the different corrective moves
in his repertoire. The move used should be one in which the application
of force is exactly along opposite lines to the lines of force which
originally produced the subluxation.
Omitting involved explanations as to the elements of each displacement
and the manner of change in bone, muscle, ligament, cartilage, etc.,
and presupposing a comprehension of the principles of each adjustment
named, there follows here a list of possible subluxations of each
vertebra in turn, from Atlas down, with a simple statement of the RIGHT
MOVE for that subluxation.
In each instance there are other moves than the one listed which would
_move_ the vertebra and some which would partially correct it, but none
which would quite so definitely tend to _correct the displacement_.
Unfortunately it is not a fact that every movement of a vertebra is an
adjustment. If this were true subluxations would not exist, because
they could never have been produced. Too often the adjuster uses a
move because it is easy, because its use has become habitual with him,
rather than because it is indicated by the conditions of the case--then
blames Chiropractic because his results are negative or bad.
The move which is suited to a certain kind of subluxation of one
vertebra may be quite out of place with another, in a different part of
the spine. Thus the Recoil is quite proper for a posterior Lumbar and
is contraindicated with a posterior middle Dorsal.
If all vertebrae were shaped exactly alike, if all were equal in size,
if subluxation were possible only in one direction, then one method of
adjustment would be quite sufficient. Diversity of technic is demanded,
but a discriminating diversity, with a good reason for every move used.
First Cervical
_Subluxation._ _Adjustment._
Right--R. Break, or straight lateral.
Right, posterior--R. P. Rotary lateral.
Right, anterior--R. A. Morikubo.
Right, superior--R. S. Break.
Right, inferior--R. I. Break.
Right, posterior, superior--R. P. S. Rotary lateral.
Right, posterior, inferior--R. P. I. Rotary lateral.
Right, anterior, superior--R. A. S. Morikubo.
Right, anterior, inferior--R. A. I. Morikubo.
Left--L. Break.
Left, posterior--L. P. Rotary lateral.
Left, anterior--L. A. Morikubo.
Left, superior--L. S. Break.
Left, inferior--L. I. Break.
Left, posterior, superior--L. P. S. Rotary lateral.
Left, posterior, inferior--L. P. I. Rotary lateral.
Left, anterior, superior--L. A. S. Morikubo.
Left, anterior, inferior--L. A. I. Morikubo.
Anterior (entire Atlas)--A. Morikubo (both sides).
Posterior (entire Atlas)--P. Rotary lateral (both sides).
NOTE.--All right subluxations adjusted from right side, all left
from left side.
Second Cervical
Posterior--P. Posterior Cervical move.
Posterior, right--P. R. Double contact on right side.
Posterior, left--P. L. Double contact on left side.
Posterior, right, inferior--P. R. L. Double contact on right.
Posterior, right, superior--P. R. S. Double contact on right.
Posterior, left, inferior--P. L. I. Double contact on left side.
Posterior, left, superior--P. L. S. Double contact on left side.
Right (lateral)--R. Break (Same if R. I. or R. S.)
Right (rotary)--R. Rotary (Same if R. I. or
R. S.)
Left (lateral)--L. Break (Same if L. I. or L. S.)
Left (rotary)--L. Rotary (Same if L. I. or
L. S.)
Superior--S. Posterior Cervical move.
Inferior--I. Posterior Cervical move.
Anterior (entire Vertebra)--A. Ventral transverse contact on
most anterior side.
Anterior, right (lateral)--A. R. Second metacarpal contact from
right.
Anterior, right (rotary)--A. R. Pisiform Ant. Cerv. contact on
right.
Anterior, left (lateral)--A. L. Second metacarpal contact from
left.
Anterior, left (rotary)--A. L. Pisiform Ant. Cerv. contact
on left.
Third Cervical
Same as second.
Fourth Cervical
Same as second.
Fifth Cervical
Same as second.
Sixth Cervical
Posterior--P. The Recoil, hands reversed.
Posterior, right--P. R. Recoil, hands reversed.
Posterior, left--P. L. Recoil, hands reversed.
Posterior, right, superior--P. R. S. Recoil, hands reversed.
Posterior, right, inferior--P. R. I. Recoil, hands reversed.
Posterior, left, superior--P. L. S. Recoil, hands reversed.
Posterior, left, inferior--P. L. I. Recoil, hands reversed.
Right (lateral)--R. Break (Same if R. I. or R. S.)
Right (rotary)--R. Rotary (Same if R. I. or
R. S.)
Left (lateral)--L. Break, from left (Same if
L. I. or L. S.)
Left (rotary)--L. Rotary (Same if L. I. or
L. S.)
Superior--S. Edge contact move.
Inferior--I. Edge contact move.
Anterior (entire vertebra)--A. Pisiform Ant. Cerv. contact on
most anterior side.
Anterior, right (lateral)--A. R. Second metacarpal contact from
right.
Anterior, right (rotary)--A. R. Pisiform Ant. Cerv. contact on
right.
Anterior, left (lateral)--A. L. Second metacarpal contact from
left.
Anterior, left (rotary)--A. L. Pisiform Ant. Cerv. contact on
left.
Seventh Cervical
Same as sixth Cervical, except that T. M. may be used on right or
left rotary subluxations.
First Dorsal
Posterior--P. Recoil, hands reversed.
Posterior, right--P. R. Recoil, hands reversed.
Posterior, right, superior--P. R. S. Recoil, hands reversed.
Posterior, right, inferior--P. R. I. Recoil, hands reversed.
Posterior, left--P. L. Recoil, hands reversed.
Posterior, left, superior--P. L. S. Recoil, hands reversed.
Posterior, left, inferior--P. L. I. Recoil, hands reversed.
Posterior, superior--P. S. Heel contact.
Posterior, inferior--P. I. Edge contact.
Superior--S. Heel contact.
Inferior--I. Edge contact.
Right--R. T. M. (Same if R. S. or R. I.)
Left--L. T. M. (Same if L. S. or L. I.)
Anterior--A. No correction.
Second Dorsal
Posterior--P. Heel contact.
Posterior, superior--P. S. Heel contact.
Posterior, inferior--P. I. Edge contact.
Posterior, right--P. R. Recoil.
Posterior, right, superior--P. R. S. Recoil.
Posterior, right, inferior--P. R. I. Recoil.
Posterior, left--P. L. Recoil.
Posterior, left, superior--P. L. S. Recoil.
Posterior, left, inferior--P. L. I. Recoil.
Left--L. T. M. (Same if L. S. or L. I.)
Right--R. T. M. (Same if R. S. or R. I.)
Anterior--A. No correction.
Third Dorsal
Posterior--P. Heel contact.
Posterior, superior--P. S. Heel contact.
Posterior, inferior--P. I. Edge contact.
Posterior, right--P. R. Recoil.
Posterior, right, superior--P. R. S. Recoil.
Posterior, right, inferior--P. R. I. Recoil.
Posterior, left--P. L. Recoil.
Posterior, left, superior--P. L. S. Recoil.
Posterior, left, inferior--P. L. I. Recoil.
Right--R. Pisiform single transverse (on
left) (Same if R. S. or
R. I.)
Left--L. Pisiform single transverse (on
right) (Same if L. S. or
L. I.)
Anterior--A. No correction.
Fourth Dorsal
Same as third Dorsal.
NOTE.--While the Recoil is here, the preferred move for posterior
and postero-lateral subluxations, the pisiform double transverse or
the two finger double transverse may be used if both transverses
are palpable.
Fifth Dorsal
Posterior--P. Double transverse move.
Posterior, superior--P. S. Heel contact.
Posterior, inferior--P. I. Double transverse.
Posterior, right--P. R. Double transverse.
Posterior, right, superior--P. R. S. Double transverse.
Posterior, right, inferior--P. R. I. Double transverse.
Posterior, left--P. L. Double transverse.
NOTE.--The pisiform double transverse and the two-finger double
transverse, apply force in exactly similar directions and may
therefore be used interchangeably. The latter is preferable for
children.
Posterior, left, superior--P. L. S. Double transverse.
Posterior, left, inferior--P. L. I. Double transverse.
Right--R. Pisiform single transverse
(Same if R. S. or R. I.)
Left--L. Pisiform single transverse.
(Same if L. S. or L. I.)
Anterior--A. No correction.
Sixth Dorsal
Same as Fifth Dorsal.
Seventh Dorsal
Same as Fifth Dorsal.
Eighth Dorsal
Same as Fifth Dorsal.
Ninth Dorsal
Same as Fifth Dorsal.
Tenth Dorsal
Posterior--P. Heel contact.
Posterior, superior--P. S. Edge contact.
Posterior, inferior--P. I. Edge contact.
Posterior, right--P. R. Recoil.
Posterior, right, superior--P. R. S. Recoil.
Posterior, right, inferior--P. R. I. Recoil.
Posterior, left--P. L. Recoil.
Posterior, left, superior--P. L. S. Recoil.
Posterior, left, inferior--P. L. I. Recoil.
Right--R. Recoil (Same if R. S. or
R. I.)[A]
Left--L. Recoil (Same if L. S. or
L. I.)[A]
Anterior--A. No correction.
[A] Note.--The use of this move is not quite mechanically correct,
but it is advised because of the possible danger of using the
transverse processes as levers.
Eleventh Dorsal
Same as Tenth Dorsal.
Twelfth Dorsal
Same as Tenth Dorsal.
First Lumbar
Posterior--P. Heel contact.
Posterior, superior--P. S. Heel contact.
Posterior, inferior--P. I. Heel contact.
Posterior, right, superior--P. R. S. Recoil.
Posterior, right, inferior--P. R. I. Recoil.
Posterior, left--P. L. Recoil.
Posterior, left, superior--P. L. S. Recoil.
Posterior, left, inferior--P. L. I. Recoil.
Right--R. Lumbar single transverse move,
if transverse is palpable,
otherwise Recoil. (Same if
R. S. or R. I.)
Left--L. Lumbar single transverse move,
if transverse is palpable,
otherwise Recoil. (Same if
L. S. or L. I.)
Anterior--A. No correction.
Second Lumbar
Same as First Lumbar.
Third Lumbar
Same as First Lumbar.
Fourth Lumbar
Posterior--P. Heel contact.
Posterior, superior--P. S. Heel contact.
Posterior, inferior--P. I. Heel contact.
Posterior, right--P. R. Recoil, hands reversed.
Posterior, right, superior--P. R. S. Recoil, hands reversed.
NOTE.--The Heel contact may be substituted for the Recoil above if
force be carefully directed in the proper direction in delivery.
Posterior, right, inferior--P. R. I. Recoil, hands reversed.
Posterior, left--P. L. Recoil, hands reversed.
Posterior, left, superior--P. L. S. Recoil, hands reversed.
Posterior, left, inferior--P. L. I. Recoil, hands reversed.
Right--R. Lumbar single transverse move,
if transverse is palpable,
otherwise Recoil. (Same if
R. S. or R. I.)
Left--L. Lumbar single transverse, if
transverse is palpable,
otherwise Recoil. (Same
if L. S. or L. I.)
Anterior--A. No correction.
Fifth Lumbar
Posterior--P. Heel contact.
Posterior, superior--P. S. Edge contact.
Posterior, inferior--P. I. Edge contact.
Posterior, right--P. R. Recoil.
Posterior, right, superior--P. R. S. Recoil.
Posterior, right, inferior--P. R. I. Recoil.
Posterior, left--P. L. Recoil.
Posterior, left, superior--P. L. S. Recoil.
Posterior, left, inferior--P. L. I. Recoil.
Right--R. Recoil (Same if R. S. or
R. I.)
Left--L. Recoil (Same if L. S. or
L. I.)
Anterior--A. “Bohemian” anterior fifth
Lumbar move. (Not always
advisable.)
Sacrum
Posterior base--B. of S.--P. Heel contact on base.
Posterior apex--A. of S.--P. Heel contact on apex.
Entire Sacrum posterior Sac. P. Heel contact between
sacroiliac articulations.
Coccyx
To be adjusted only when ankylosed in an abnormal position and then
by leverage of finger through rectum.
A FINAL WORD
Some useful information pertaining to adjustment will be found in
section entitled, “Practice,” q. v.
After a careful and painstaking study of the foregoing pages it will
still be found that the student is not by any means equipped for the
work. He must _practice_ these things to learn them. We learn to do by
_doing_. The chief use of this section will be as a reference and guide
during the practice of adjusting.
THE CAUSE OF DISEASE
Disease a Morbid Process
Disease has been variously regarded as an entity, a process, a
condition. It has been mentioned in terms which would almost
personalize it, such as, “attacked by pneumonia,” “seized with cramps,”
“in the clutches of tuberculosis.” Men have endeavored constantly
to discriminate between diseases and to learn the appearance and
peculiarity of each, and have resolved each into its peculiar elements
only to learn that the merging lines between two diseases or between
cases of the same disease are imperceptible. It is no more possible to
define any one disease within exact limits and to distinguish it from
all others than to consider one function of the human body without
studying its interdependence with others.
Disease is a _process_. It is a natural process. It follows certain
well-defined laws and consists in the abnormal performance of function
in some bodily organ or organs, or in the untimely performance of some
function which would be normal in its proper chronological relation
with other functions or at another period of the body’s development.
The balance of function of the body is destroyed--some function
intensified or diminished--that is all. Every disease, properly
studied, reveals its functional base.
Disturbances of the functions of _growth_, _nutrition_, and _repair_
produce changes in structure, physical evidences of disease. It is
probable that every disease has a certain amount of structural change
connected with it; it is hard to conceive of functional derangement
without structural change, in a universe in which Nature is eternally
building, destroying, or modifying organic peculiarities to meet
changing functional demands. But in many instances this structural
change is so slight as to be undiscoverable; such diseases are called
“functional” to distinguish them from those in which structural
pathologic changes are directly discernible, called “organic.”
Beginning of the Process
Recognizing the fact that disease consists in a succession of steps
or a series of events, each depending upon the next preceding one and
making possible its successor, and desiring to arrest or check this
process and correct the damage done, in other words, “to cure disease,”
the question arises, “Where does this process begin?”
If we wish merely to check the process or to modify it, as does
medicine, the etiology of the disease is less important than the
present state. It is then more important that we understand the changes
which are taking place in the body at the time of our attempt, the
condition of each organ at that time, and the general recuperative or
resisting power of the individual.
But if we would correct all the damage done instead of merely
preventing further damage or building up internal resistance against a
still active destructive process; if we would so eliminate the effects
of the earlier steps as to make the resumption of the disease process
most improbable, we must know each step from the beginning to the
present, understand their sequence and relation, and go back to the
beginning with our correction, _removing the cause_.
The Cause of Disease
Since each event in the morbid process depends upon the preceding
one and makes possible those which follow, it is possible to stop at
any point in the chain of events and declare, “Here lies the Cause
of Disease.” This explains the various etiologies adhered to each
by a school of intelligent and scientific men, yet each apparently
disagreeing most flatly with the others. No matter which step we select
as our “ultimate cause” it truly is the cause, or one of the causes,
of succeeding steps, which succeeding steps may well stand in our
minds as the whole of the disease. Thus the physician, having found a
germ, is quite content to look forward from the invasion of the germ
and consider that as the primarily necessary requisite for disease
production. In retrospect he follows disease back within the body to
the time of entrance of the germ and then leaves the body to study
the life habits of the germ and its favorite mode of conveyance. He
has unwittingly left the direct line of investigation and followed a
spur-track.
So with the osteopath who discovers contractured muscles drawing a
member, or a bone, from its normal position. He proceeds to a study
of the effect of such contracture upon other tissues and strives to
relieve it by treatment--of the muscle.
The dietist discovers that certain food combinations cannot be properly
cared for by an individual and that if taken they tend to develop
toxins deleterious to the system. Whereupon he undertakes to discover
food combinations which the body _can_ care for and believes that he
has solved the question of etiology.
Now it is _most_ important that we find the _primary_ cause, the one
which makes possible the operation of all the rest and without which
all would be powerless to harm man. This we shall expect to find at
the point of entrance of disease into the human organism. The primary
cause must be the first step _which concerns man_, the first change
from normal to abnormal, on which all subsequent changes depend. It is
useless to pass outside of the consideration of man and those forces
which directly affect man, in our search for the cause of disease. We
are powerless to affect outside forces or to control or amend the laws
of nature through which disease exists.
Let us attempt then to resolve disease into its successive steps and
to find the first which concerns man. Correcting that, we shall have
corrected, fully and completely, the process which constitutes disease.
By striking at the root we may destroy the entire growth.
Vital Energy
_Irritability_ is the property of being susceptible to excitement
or stimulation. Stimulation is the process of increasing the
functional activity of any organ. Inhibition is the act of checking,
restraining, or holding back the functional activity of any organ.
These definitions, taken from Gould, are here introduced as a necessary
preface to an attempt to set forth, without unnecessary reference to,
or discussion of, any other theory as to the etiology of disease, the
Chiropractic explanation of its presence.
Chiropractic maintains that all the chemical and physical activities of
the human organism are controlled, directly or indirectly, through a
third form of energy transmitted through the Nerve System; that while
all three forms of energy are interdependent and closely related in
their ultimate expression, one of the three is the _primary_ and most
essential form, and especially indicative of life. We may call this
third form _Vital Energy_.
There are several good reasons for believing that this nerve force is
the primary form in which energy is expressed in man and for believing
that it controls and directs the others in greater degree than it is
controlled and directed by them.
Of the four forms of tissue of which the body is composed--connective,
epithelial, muscular, and nervous--the latter is the one damage to
which is followed by the greatest and most permanent consequences.