certain death because of their importance in the general economy of
the body, but it is also true that section of the nerves leading
to these organs just as certainly causes death by the cessation of
their functions. There is no organ in the body aside from the nerves
themselves which does not immediately cease to act upon withdrawal of
its nerve force and at once begin a process of degeneration or atrophy.
Pathologic changes in the Nerve System invariably are followed by
pathologic changes in the organs controlled by the diseased segment but
the converse is not true. Excitation or inhibition of nerve activity
produces corresponding and responsive change in the activity of the
organs innervated, but excitation of an organ does not necessarily
produce similar changes in the Nerve System. That system possesses the
power of inhibiting or permitting responsive action, in other words,
the power of _choice_.
Research in Comparative Anatomy develops the fact that the differences
in power of complex action possessed by different organisms are
entirely measurable by differences in the structure and complexity of
their nerve mechanisms.
Further, by studying the effects of removal or extirpation, or of
pathologic changes in various parts of the nerve system it has been
demonstrated that the Brain is the center for those higher forms of
activity known as psychic, for the power of accelerating or inhibiting
the responses of the lower centers of the nerve system to stimulation
from without, and for the conveyance of authority to act to all the
lower centers. The Nerve System is the morphologic, physiologic, and
dynamic center of the organism and the Brain the center of the Nerve
System. We may, then, logically expect to find in the Brain, or in the
channels by which power is distributed from the Brain to lower centers
or organs, the initial step in the disease process, which is our
present quest.
One Nerve System
All nerve tissue in the body is organized and linked together in
a complicated aggregation of individual units, communicating by
_contact_, and forming one great Nerve System having its directing
center in the Brain. It is said by some writers to consist of two
distinct systems--cerebro-spinal and sympathetic--but would better be
described as consisting of central organs--brain and spinal cord--and
peripheral organs--cranial, spinal, and sympathetic peripheral axons
connecting with cells in the central axis and linked together in a
net-work improperly separable into separate or distinct divisions,
the fibres of different parts being bound together in such a way as
to establish an intricate intercommunication, closest on the one hand
between the cranial and sympathetic and on the other between the spinal
and sympathetic. The sympathetic system may be regarded as nothing more
than a medium for proper distribution of impulses originating in the
cerebro-spinal system, and a series of reflex centers deriving their
power to act from the central axis. The proper action of sympathetic
ganglia has been demonstrated to depend upon the integrity of the
spinal nerve fibres, or rami communicantes, which pass to and terminate
in the ganglia with their telodendria (terminal arborizations) in
contact with the dendrites (cellulipetal processes) of the ganglion
cells.
It will appear that interference with one division or part of the
nerve system may be followed by effects partly manifested through a
distant part; that excitation or inhibition of a spinal nerve may
correspondingly excite or inhibit sympathetic fibres.
Chiropractic Hypothesis
Chiropractic has accepted, as a convenient working hypothesis
amply justified by years of clinical experiment and anatomical and
physiological research, the proposition that all disease in the human
body is primarily made possible by injury to (stimulation or inhibition
of) some part of the nervous mechanism.
Injury to other tissues, unless the injury also involves nerve tissue,
is quickly repaired and the body goes on without disease. Or the injury
is sufficient at once to render the body untenable and death ensues.
Few pathological changes follow trauma unless nerve tissue be injured.
This theory to be logical must and does include the entire nerve
system. Also, since it is noted that each nerve cell presides over the
nutrition of its own processes and possesses its own power of repair,
it follows that unless an injury be of fatal nature or of permanent
duration, even injuries to nerves tend toward automatic cure. We must
seek a permanently operating interference with nerve tissue.
The brain, enclosed within the comparatively solid cranium, is so
well protected that nothing except fracture of the skull, violent
concussion, or shutting off of its blood supply from without, will
produce permanent change there. Also, unless there be pressure by
foreign substance against the brain, an injury will be repaired in
time and the body resume its normal functional activity. It has been
demonstrated that comparatively few diseases occur in this way. Such as
do are called traumatic; i. e., caused by wound or injury.
In the broadest sense all disease is caused by trauma, as we shall
presently show.
The upper or cephalic peripheral nerves, called cranial, leave
the skull by foramina in its base (except the auditory) and are
so protected by the immobility of the bones of the skull as to be
comparatively free from direct injury. Peripheral injuries occur to
cranial nerves but are repairable; even section of the trigeminal for
neuralgia is usually followed after an interval by a reunion of the
severed parts. As will be shown later, the special end organs of the
cranial nerves are not free from the effects of spinal subluxation and
their nuclei (deep origins) often share in morbid changes in the brain
tissue due to nutritional disturbances.
The sympathetic portion of the nervous system might be classed with
the cranial as regards infrequency of permanent interference were it
not for the proximity of the great gangliated cord to the transverse
processes and bodies of the vertebrae. This proximity renders it liable
to sustain permanent impingement in vertebral subluxation.
Trauma Affects Spinal Nerves
With the exception of the first pair of Cervical nerves and the Sacral
and Coccygeal, all spinal nerves pass through foramina of exit which
are composed each of two movable vertebrae. The Chiropractic hypothesis
is based upon the discovery that in addition to the part these
vertebrae may take in general movements of the spine it is possible
that their relation to each other may be changed by the application of
force from without, and that this change once produced tends to remain
permanently. These permanent vertebral subluxations occur with great
frequency, a fact clinically demonstrable by palpation and by the X-Ray.
The discovery of this fact led to the ascertaining of two more, namely,
_No disease is ever found without accompanying subluxation._
Since each organ or tissue is connected with some definite and special
vertebra, subluxations accompanying disease bear a relation to disease
which is controlled by a general law, operative alike on all human
organisms.
The latter fact required one other for its complete demonstration;
namely, that the removal of the subluxation is always followed by the
complete disappearance of the disease. Given more perfect methods of
correcting subluxations it would follow that proof of the Chiropractic
theory would be so complete and overwhelming as to meet at once with
general acceptance. The difficulty lies in the fact that with our
present methods much time is often required for complete correction of
the vertebral displacement and much skill is needed even for successful
investigation of the results obtainable. The theory is too often judged
by unskilled or imperfect applications of it.
Every school of Chiropractic accepts the presence of the subluxation
and has spent much thought and time in the effort to deduce the law
governing its connection with disease. Diverse conclusions have been
reached owing to the difficulty experienced in completely eradicating
the subluxation. When it _is_ accomplished the results are absolutely
conclusive. When it is partially or relatively accomplished the results
are so good in a great per cent of cases as to lead sometimes to the
erroneous belief that the subluxation did not cause the disease since
mere partial correction of the subluxation suffices to bring about
the apparent total removal of the disease. In every case of thorough
experiment the results warrant the recommendation of the subluxation
theory as at least a proper working hypothesis.
Without attempting here to review all the various conclusions reached
or the methods by which they have been attained, we would simply state
our own conclusion, which we believe is the only one compatible with
demonstrable facts. It is briefly this: Since every portion of the body
is connected through the nervous system with the spinal nerves and
since it has been proven that this connection is reasonably constant
and anatomically demonstrable; since the removal or correction of a
subluxation leads in all cases to the complete disappearance of disease
from the organs or tissues innervated from the subluxated portion of
the spinal column, we conclude that the subluxation is the _primary
cause_ of disease.
The final test of the correctness of any theory is the result of its
application. Since Chiropractic secures a larger percentage of results
than any other known system of healing it is safe to assume, at least,
that it has discovered the way to remove the primary cause of disease.
That the Chiropractic theory, or more properly the subluxation theory,
does not include all of the etiology of disease is evidenced by the
facts of contagion and infection, by the effect upon the organism of
the introduction of poison, by the consequences of worry, anger, and
other abnormal mental states and conditions. These facts do not in the
least invalidate the theory. They merely require explanation which will
make clear their relation to the subluxation. That such explanation is
abundantly at hand strengthens the position of Chiropractic more than
would negation of all other causes save the one we concentrate upon.
The Mentalist who holds that all diseases exist in and are but figments
of the mind is as far afield as the Physicist who holds that special
nerve energy is nonexistent. The Chiropractor views Man as a complex
psycho-physical unit, self-operating and internally self-healing until
environmental forces disturb the nice adjustment of the machinery.
Disease is produced by, and is, a series of events, chief and most
permanent of which is the subluxation. We may consider its etiology
according to the order in which the events take place thus:
Direct Chain
Concussion of Forces.
Subluxation of Vertebra.
Impingement of Nerve.
Excitation or Inhibition.
Disease--Abnormal Function.
Accessory Chains
Between the last two steps above, or following the last, are often
introduced one or more of the following accessory chains which modify
or increase the final effect and are themselves made possible by the
first four steps in the direct chain.
Pathogenic germ.
Poisonous excretions from germs.
Tissue destruction by chemical action of such toxins.
Reflex muscular tension tending to increase subluxation and thus
augment nerve impingement and its effects.
Or
Dietetic error.
Abnormal chemical action.
Tissue destruction or nerve irritation by chemical poisons.
Reflex motor disturbances which further limit digestive power.
Or
Abnormal mental condition.
Waste of nerve energy with production of toxins.
General metabolic disturbance.
Increased disease wherever disease previously existed.
These are offered merely as illustrations. There are many accessory
chains which aid in the production or development of disease and act as
_secondary causes_.
Concussion of Forces
Man was so created, so provided with means for repair, growth, etc.,
that the body tends to maintain its own functional balance--perfect
harmony among all its parts--unless interfered with by some outside
agency. There are certain natural laws such as the law of gravitation
and the law of momentum and inertia which operate without regard for
man or man’s welfare. If man, wittingly or unwittingly, allows himself
to come into violent conflict with one of these laws by falling to the
ground or in meeting sudden and unexpected opposing force or mass while
in motion, that which may be termed a concussion is produced by the
meeting of the outside force and the internal bodily resistance.
Many such concussions may occur without serious damage. Some produce
wounds or injuries which it is possible for the body to heal without
causing serious disturbance of function. Other concussions are so
violent as to produce displacement of structure which tends to
remain permanently. Under Spino-Organic Connection will be found an
explanation of the manner in which force applied to various parts of
the body tends to affect the spine.
Now the displacement of a bone cannot be corrected by the body without
outside aid. No method is provided for such correction. Produced by
outside force affecting the body, it can only be reduced by outside
force. It is this failure of Nature to make man adaptable to _every
untoward circumstance_ which renders him susceptible to disease.
Subluxation
As has been previously stated by no means all concussions of forces
produce subluxation. (All subluxations, however, are produced by
concussion of forces.) It may be added that not all subluxations
impinge nerves and that when they do not so encroach upon nerve tissue
they produce no noticeable effect after the first temporary soreness
has disappeared.
Every subluxation, however, evidences a _tendency_ to disease. Once
moved from its normal position and the poise and symmetry of the body
disturbed, there are influences which tend more readily to affect the
same vertebra. The subluxated vertebra is more easily disturbed by
jars, strains, etc., than the normal one because such jars are less
regularly distributed to all its parts. A reflex muscular tension due
to other and more pronounced subluxations and their disease effects
may in turn increase the slight deviations throughout the spine,
rendering them in their turn capable of producing disease. When the
spine or any part of it has lost its perfect regularity disease is made
_possible_, if not a fact at once. The average number of subluxations
in each individual is about nine and one-third. Of this number probably
not more than one-third (though no accurate figures are available)
are actually productive of conditions nameable as disease at any
given time. Discrimination between those which do, and those which do
not, produce discoverable symptoms in a given case is a matter which
requires a nice technical skill and perfect judgment.
Impingement of Nerves
When a vertebra has lost its normal articular relations with its
fellows and occupies an abnormal position as a consequence in regard
to _all_ surrounding or adjacent tissues it may impinge nerve tissue
in two ways, by _tension_ or by _constriction_. By the displacement of
one vertebra of a pair the size and shape of the intervertebral foramen
may be altered (occlusion) constricting the nerve which passes through
the opening. That this change in the size and shape of the foramina
does frequently occur is shown by the frequency with which alterations
in the shape of vertebrae appear in dry spines, by post-mortems which
have demonstrated the altered foramina in the cadaver and by permanent
occlusion of the foramina in ankylosed spines so that the occlusion may
be preserved. Adding cartilage changes in the intervertebral disks to
alterations in bone shape and position, especially the latter, we find
full and sufficient reason for all the pathological phenomena which
follow the subluxation. Explain it as you will, these morbid results
_do_ follow subluxation and can be experimentally produced in animals.
Moreover, the disease may be directed to a desired organ or region by
selection of the particular vertebra to be displaced.
The suboccipital, sacral, and coccygeal nerves cannot be constricted
as they pass through the foramina because they do not emerge through
complete rings formed of separate and movable bones. But these
nerves may be _pressed upon_ or stretched by displaced bone, as may
also the great gangliated cord of the sympathetic, especially the
Cervical portion of it. _Tension_ of the Cervical sympathetic cord by
subluxation of vertebrae is a very common occurrence.
Whether the impingement be by constriction or by tension the effect
is much the same depending upon the degree to which the molecular
continuity of the nerve substance is impaired--interference with the
function of the organ connected with the nerve and sometimes swelling
and pain in the nerve itself followed by degeneration. The effects are
chiefly noticeable in peripheral tissues. S. Weir Mitchell says (1872),
“A continuous pressure upon a nerve results in the degeneration of the
nerve and a disturbance of function of the parts innervated by that
nerve.” No clearer statement can be made.
It must not be understood that all nerve impingement is due directly
to subluxation of a vertebra. A dislocated shoulder would produce a
similar effect of nerve tension. But dislocated shoulders are seldom
met with as permanent conditions. Likewise there may be secondary
impingement from new growths, themselves due to some primary
subluxation. Aneurism of the thoracic aorta often produces hoarseness
by impingement of the recurrent laryngeal.
Not all impingement is sufficient to produce noticeable disease.
To a certain extent the power of adaptation inherent in the body
can overcome its deleterious effects and suppress all signs of its
existence until an overtax upon bodily energy lessens this adaptative
power. Then disease appears and we say that the overtax caused it.
Excitation or Inhibition
A slight impingement serves as a mechanical irritant to increase the
action of the nerve and the functions of the attached peripheral
organs. Such stimulation beyond the normal is always followed by a
reaction, or fall to subnormal action.
Heavy impingement, especially the impingement due to marked occlusion
of foramina, partly or wholly paralyzes the affected nerves. Often the
impingement produces only a latent weakness in some organ, a weakness
which may be brought to light only through the introduction of some
secondary cause which takes advantage of the susceptibility of the
organ to produce some definite disease. As an instance of this we may
mention typhoid fever. No typhoid case is found without subluxation
in the region of the second Lumbar; yet the latent weakness produced
by that subluxation may not have been observed until the typhoid germ
found a fertile feeding and breeding ground in the weakened tissue and
proceeded to multiply there and develop its toxins.
Effect Upon Single Cell
Each nerve cell is trophic to its processes and to the tissue cells to
which these processes are distributed. The growth, nutrition and repair
of each cell of the body is dependent upon the integrity of the axon
which supplies it. The effect of nerve impingement upon the single cell
is a weakening of cell structure and a disturbance, slight or great,
of the special function possessed by that cell. Dunglisson says of
diseases, “All ... are dependent upon modified cell-action.”
Effect Upon Organs
Each organ is but an aggregation of cells of some special type or kind.
Nerve Impingement usually involves either a whole nerve trunk or many
of its fibres and thus weakens either the entire organ or many of its
cells and increases or diminishes its special function. Some organs are
innervated by more than one nerve and may be injured only in part by a
localized impingement.
Alteration of the action of one organ often tends to affect the entire
body, as in subluxation of the fourth Dorsal interfering with the nerve
supply to the liver the secretion of bile becomes altered in character
or quantity and the entire system suffers, through deranged digestion,
from this alteration in a necessary secretion. Every disease presents
symptoms only indirectly referable to the organ which is primarily
affected and the problem of the diagnostician is to so discriminate
between direct and indirect symptoms as to be able to _locate_ disease.
Simple Subluxation Disease
We have considered a chain of events by which disease is produced
without the intervention of any secondary cause. Such a condition may
be called, for convenience, a simple subluxation disease. Its existence
depends directly upon the subluxation which is the first change
manifest in the individual and upon which all the other changes depend.
The two facts that not all subluxations impinge nerves and not all
nerve impingements cause demonstrable disease explain why we do not, in
practice, find a disease to correspond with each subluxation discovered
by palpation. It must be remembered that there may be latent weakness
following a subluxation and of importance because it renders the
patient susceptible to infection or to the action of other secondary
causes.
SECONDARY CAUSES
Among the secondary causes of disease may be mentioned the pathogenic
germ, poisons, dietetic errors, abnormal mental states, bodily
excesses, exposure to sudden temperature changes, and inhalation of
non-poisonous but irritating substances as the most common. Many others
might be included but these will suffice for complete illustration
of the principle. It will be our endeavor to show how each of these
secondary causes operates by virtue of a previous susceptibility, or
breaking down of the normal resisting power of the organism caused
by subluxation, and how each in turn _may_ bring about increase in
subluxation and thus, both directly and indirectly, increase disease.
Bear in mind these two all-important facts. _None of these secondary
causes can operate without previous subluxation. A subluxation may
produce disease without the aid of any secondary cause._
GERM DISEASES
These comprise a large portion of the febrile affections. Most germ
diseases are characterized by fever and the presence of circulating
toxins with resulting disturbance of the metabolic processes of the
body.
It is generally agreed among pathologists that the greater number of
varieties of micro-organisms found at times in man are not pathogenic.
Some aid in the decomposition of food in the alimentary canal; others
have various beneficial functions to perform. But some, under proper
conditions, feed upon and destroy living tissue. These are the
so-called pathogenic germs.
The pathogenic germs are many. They enter the body by various routes,
in the air we breathe, the food we eat, the water we drink; sometimes
they are communicated by direct contact with other persons or with
objects infected with them. The term “contagious” is applied to those
diseases whose germs may be carried through the air from one to
another; “infectious” refers to those communicable only by contact.
In every healthy individual are found multitudes of germs of both
the pathogenic and harmless varieties. We are constantly exposed to
the influence of the former yet by no means all bodies into which
pathogenic germs find entrance contract disease. This fact has caused
much study and among pathologists and bacteriologists generally the
conclusion has been reached that the development of colonies of
micro-organisms sufficiently to produce disease depends upon what is
known as “susceptibility” of the organism. There must be a latent
weakness of which the micro-organisms take advantage.