Epigenetics is defined as the study of

• Changes in gene expression which occur in organisms with differentiated cells, and the mitotic inheritance of given patterns of gene expression, and
• Nuclear inheritance which is not based on changes in DNA sequence

Epigenetic factors that can influence the behavior of genes include:

1. Chromatin structure – how DNA is packed
2. DNA methylation – turning genes off
3. Small RNAs – made from DNA and can influence gene behavior in many ways

Our genetic code, the actual sequential structure of our DNA, can pretty much shrug off the influence of any external environmental factors, short of massive radiation. However, the expression of individual genes within that sequence can be permanently altered by such seemingly innocuous influences as diet, exercise, sensory input, lifestyle or how others treat us (socialization). Once triggered, a group of molecules called a methyl group attaches itself to the control centre of a gene, permanently switching on or off the manufacture of proteins that are essential to the workings of every cell in our body. In most tumors, this DNA methylation pattern has been knocked awry, leading to a gene being completely deactivated or triggered to abnormally high activity.

Now, scientific evidence is emerging that these externally driven changes in the behavior of our genes might be passed down through the generations. For example, recent research has demonstrated that the sons of men who began smoking before puberty were more prone to obesity.

All of a sudden, we're staring personal responsibility in the face. Not only can our bad habits or noble attempts at clean living permanently change the way our genes act within us, they could very well have a significant impact on the quality of our children's lives. If DNA is the hardware of inheritance, the epigenetic operating system is the software, controlling the 30,000 genes that carry instructions for the proteins that make up our bodies and keep them running.

If left alone, the epigenetic changes that bad or good behaviors (sensory input) causes in research animals not only lasted a lifetime but was inherited.

The traditional idea that we are the passive carriers of our genes is being challenged by the notion that we are their custodians. Our lifestyles — what we eat, what drugs we ingest, how we utilize chiropractic care, how much we exercise, whether we smoke — plays a role in a chemical switching system that activates or deactivates our genes. There are signs that our behavior may program sections of our children's DNA, and that how we live may even affect our grandchildren's genes.

Synergistic Neurophysiological Efficiency: Over time, all neural processing moves to the most energy efficient state. Neuroplasticity is driven by long term efficiency of the information processing NOT the long term survival needs of the individual.

Neuronal communication and computation are efficient when considered in the dual (synergistic) context of energy and information rather the either context alone.

Primary Neurocomputational Principle: Innate Intelligence maximizes the computational information developed by the neuron and its inputs to no more than the limit imposed by the information capacity of the axon whose capacity is set by optimizing the energy efficiency of its ability to signal other neurons (transmit the developing information).

Energy Use by the Brain: Organisms in the natural environment are highly efficient in their use of their available energy, and sometimes even more important, their cooling resources. That is, the use of food and water by organisms is often associated with processes that become sensible when we suppose one or both of these resources are scarce. And scarce they are at the margins, the place where evolution/ natural selection occurs fastest. It is at the interfacial niches of marginal survival that competition is most severe and mutations would be most beneficial, thus leading to higher rates of evolution. Clearly at such places of marginal survivability, energy efficiency will be very important. So we have good reason to expect that organisms are made up of and use energy efficient processes.

In this context of energy , neural processing is rather expensive. The adult human the brain accounts for20% or more of our total energy use and it consumes on the order of 20-25 watts. In young children, whose brains are nearly as large as an adults, the energy use by this organ can account for nearly 50% of the caloric intake.

Current research implies that more than 85% of the energy used by brain goes toward restoring the ion fluxes across neuronal membranes that are the biophysical basis of computation and communication in the neocortex. Thus neural informational processing although perhaps five to six orders of magnitude more energy efficient than man-made computation, is a considerable expense for the organism.

Because of such energy costs, natural selection (or intelligent design for maximal survival) has optimized energy use as well as information processing in constructing the way neurons compute, process, develop, filter, integrate and communicate.

In all of its functions, the brain seeks optimum efficiency, or the path of least resistance. If one particular function is not accessible, the brain will automatically go on to the next most efficient process for doing that particular task. If the second task is not available, it will go on to the third or the fourth most efficient way. Because each alternative process is less efficient, it becomes more stressful and energy expensive

The brain will keep searching for an appropriate processing method, until eventually the activity may become so subconsciously stressful (energy greedy) that the person will choose to give up trying to do the task altogether. If it is a conscious activity, the individual will give up the fatiguing activity. If the process is unconscious, the individual will decrease the energy partitioning to that process, making this unconscious activity minimized, nonfunctional or detrimental to the whole, depending on where the process is located in the physiological hierarchy.

Thalamic Integration and Filtering: The thalamus does not passively relay information from the sensory system to the cortex. Rather, via feedback from the cortex and the brain stem, the thalamus controls the type and amount of information that reaches the cortex. Recent scientific findings prove the thalamus plays a role in how the cortex functions. Cortico-cortical communication depends heavily on how messages are integrated, filtered and modified through the thalamus.

The complex cell and circuit properties of the thalamus leave little doubt that the relay of sensory information to the cortex is an active, adjustable and modifiable process. Thus, the full impact of the thalamus recent research has shown is much more than simply controlling flow of information from the periphery and from other parts of the brain to the cortex: it is the most active partner in all cortical computations.

Integration in the thalamus is the sum of different driver inputs (highly prioritized afferents) to produce an output that differs qualitatively from that of any of the inputs. Filtering in the thalamus is the summing of different driver inputs (highly prioritized afferents) to produce an output that differs quantitatively from that of any of the inputs. So if the thalamus is intact, symptoms and dysfunction are the sum (integration and filtering) of different inputs into the thalamus. Symptoms, dysfunction and dis-ease are dependent on thalamic firing. Thus if the chiropractor can change input into the intact thalamus to move the CNS to produce a healthier functional status, the output will be health. The “nerve interference” is on the afferent side.

Thursday, October 24, 2002 - 12:00 a.m. Pacific

Drug firms control medical studies

By Linda A. Johnson

The Associated Press

Drug companies that pay for major testing of most new medicines give participating university researchers little or no say in how studies are designed and how findings are handled, a survey found. The survey of 108 medical schools, published in today's New England Journal of Medicine, is the latest sign of growing concern about conflicts of interest between those doing scientific research and pharmaceutical companies sponsoring it.

"What the institutions have told us is they feel almost powerless in these contracts," said Dr. Kevin Schulman, a Duke University Medical Center professor who led the survey.

While federal agencies sponsor much early research, large-scale studies of drugs' safety and effectiveness usually are funded by manufacturers. Typically, companies hire medical-school faculty members to carry out studies.

But some scientists worry their lack of control could threaten the integrity of research and the safety of participants. Among other things, pharmaceutical companies have sponsored research that found a drug didn't work or was dangerous, then suppressed the results.

Concerned about the problem, the International Committee of Medical Journal Editors in 2001 published guidelines for research contracts between medical schools and the pharmaceutical industry. Researchers at Duke University interviewed officials at U.S. medical schools last winter and reviewed some of their research contracts to determine how many complied with the new guidelines. Only a minority did.

Schulman said researchers have less and less control over patient trials as more and more studies include dozens of medical centers, a strategy meant to bring results faster.

Among the study's findings:

. Researchers rarely were allowed a say in the design of clinical trials,

with only 10 percent of contracts covering how data is collected and

monitored and only 5 percent covering how data is analyzed and interpreted.

. Fewer than 1 percent of contracts guaranteed that results would be

published and that an independent committee would have control over that.

But 40 percent of contracts addressed editorial control of manuscripts.

. Only 1 percent of contracts required an independent board to monitor

patient safety. Such boards can stop a study early if the treatment is found

to be harmful.

Financial ties between academic researchers and industry sponsors already are under scrutiny for apparent conflicts of interest, as when researchers receive stock in a company testing an experimental drug.

The Pharmaceutical Research and Manufacturers of America last summer established voluntary guidelines for clinical research, but they are "basically toothless," said Dr. Jeffrey M. Drazen, editor of the New England

Journal. "The system would be better served if there were universally accepted contractual language," he wrote

“Power to corrupt, and absolute power corrupts absolutely.”

• The Entire Chiropractic Profession has only 70 full time researchers

· The drug company Pfizer has 12,000 full time researchers

• Less than 5% of full time DC Faculty at chiropractic institutions are involved in chiropractic research
• The total budget (for Everything) for all our chiropractic institutions is a mere $224 million
• Of that $224 million of the total budget, our chiropractic institutions spend only $4 million on research programs
• Harvard University receives $739 million a year from the NIH alone just to do research
• In the entire 100+ year history of the chiropractic profession, chiropractic has received less than $10 million from the federal government to do research
• The top 25 medical schools received $6 Billion from just the NIH in 2000 alone

What are the results?

When one begins comparisons with medical / allopathic procedures, the statistics really begin to spin one’s head. Using a baseline figure of one per one million as an estimate of stroke incidence attributed to cervical manipulations (not just chiropractic, but all such procedures), one finds a:

· Two Times greater risk of dying from transfusing one unit of blood

· 100 Times greater risk of dying from general anesthesia

· 160-400 Times greater risk of dying from the use of NSAIDS

· 700 times greater risk of dying from lumbar spinal surgery

· 1000-10,000 times greater risk from traditional gall bladder surgery

· 10,000 times greater risk of serious harm from medical mistakes in hospitals

The 225,000 deaths per year attributed to medical iatrogenesis (allopathy) have propelled it to the third leading cause of death, after heart disease and cancer.

Absolute, testosterone charged, black and white statements by heroic allopathic physicians will have to give way to the gray world of reality and hard numbers brought to us by evidence and real science – rather than Eminence based medicine and allopathic-religious superstitions.

The human brain is an expensive tissue whose evolution, development and function have been shaped by available metabolic energy within and without neurons. The human nervous system is innately tuned towards survival of the organism. This survival tendency manifests itself as the development and continuance of efficient use of energy for all its processes.

This survival tendency, or drive, is for the conservation of energy and efficient use of that energy towards expression of optimal potential in life. These processes and pathways are directed on the input (sensory) side of the system. Chiropractic should address conservation of energy and the efficient use of that energy towards expression of optimal potential in life. Chiropractic should not ignore the 6 million year history of the evolution and development of the human brain. Working in synergy with this reality leads to incredible clinical results.

The purpose of human life goes far beyond survival; it is the expression of our abundant potential. This potential is reached by the efficient relationship between self (innate) and our internal and external environment. It is my hope that functional analysis technique and the functional approach to a patient’s health pathology may lead to a more rational, common sense advance that weighs the evidence of biology and science over superstition and blind faith (current allopathy).

The essential purpose of chiropractic is to unlock and unleash this potential.

Sensory Exercise and Clinical Decision Making

The purpose of any rehabilitation exercise, sensory therapy or regime should be to make the nervous system more efficient. When taking a functional approach the processing within the CNS becomes the primary consideration.

How mechanistic, reductionistic and allopathic thought has infected vitalistic chiropractic theory is a subject for another book and not this seminar manual, but we can look at a few clinical decision making scenarios to flesh out a few keys.

Lets us look at a right sided upper extremity contracture from a left sided CVA. The right elbow becomes flexed and the wrist flexes due to the stroke. In traditional North American physical therapy and chiropractic, the therapists will stretch out the contracture, of course, to return the joint to normal. Many hours will be spent jumping on a chronically contracted biceps. But this increases somato-sensory representation of the biceps. Is this what we want to do with an already over-contracted (over represented in the somato-sensory cortex) biceps? No thought as to the true process of the disorder.

Muscles can only contract. The biceps in our scenario above is not dysfunctional; it is contracting efficiently and vigorously, doing what it is suppose to do. The problem is lack of inhibition from the triceps. The afferentation processing from the antagonist, triceps, is damaged from the CVA. By stimulating the triceps, increasing somato-sensory representation of the triceps, magically the elbow contracture improves immediately. The biceps (elbow flexion) should be hands off unless you are stimulating the triceps while at the same time trying to reduce the biceps contracture.

Again, looking at all components of the symphony above (upper extremity movement), one would have to assess that the biceps is working and the triceps is not. The CVA has damaged the amount of “triceps” afferentation that gets to the cortex. By increasing the amount of input from the antagonist (if the program for normal upper extremity movement still exists in the CNS) the biceps contracture improves. When the program is non-existent, then the challenge is to place the program into the CNS. A subject for another manual.

Let’s look at an acute situation. The running back in a football game starts running and pulls up screaming in pain, grabbing his left hamstring. The trainer runs onto the field, grabs the hobbled elite athlete and begins to stretch out the tight ‘pulled’ hamstring.

Question: Does this increase or decrease somato-sensory representation of the spasmed hamstring? By stimulating the quadriceps (tapping, contracting), the hamstring tone is decreased. This is observed immediately.

By looking at each component/module of dynamic equilibrium, the coordination within each module of dynamic equilibrium, a global plan for rehabilitation can be attained.

One needs to look just not at antagonist and agonist relationships, but the timing of when a module or muscle group should be activated and de-activated and the proprioceptive and vestibular component. Functional processing of all the incoming information, always being weighted by efficiency, should drive all our rehabilitative (exercise therapy and sensory integrative exercises) efforts.

Traditional allopathic medicine has defined health as merely the absence of disease. This foundational definition has limited allopathy to limit its goals as the eradication of pathogens or the attainment of certain lab values. Present evidence has accumulated to show that the health state involves more than the lack of detectable pathogens in the body or attainment of certain lab value ranges. In the face of this information, the basic position of traditional allopathic medicine concerning the achievement of health has not changed. Medical schools and managed care organizations, with their emphasis on a diagnosis and rationed care, promulgate this traditional orientation by teaching that diagnosis and treatment of the named “disease” is the major pathway to health.

Synergistic Neurophysiological Efficiency: Over time, all neural processing moves to the most energy efficient state. Neuroplasticity is driven by long term efficiency of the information processing NOT the long term survival needs of the individual.

Neuronal communication and computation are efficient when considered in the dual (synergistic) context of energy and information rather the either context alone.

Neurophysiological Partitioning: since the CNS controls and regulates all physiological process of the human body, these optimizations must occur at the microscopic cellular level in the nervous system first.

All these changes can be explained by considering the process of energy efficiency of neural communication and neural processing. Energy (available ATP) is finite. It is reasonable to assume that the limiting factor for this energy efficiency optimization process is the use of available ATP. Thus, to optimize neurological programs, the CNS will shunt and mobilize ATP to the areas of greatest physiological need in the CNS.

Thalamic Integration and Filtering: The thalamus does not passively relay information from the sensory system to the cortex. Rather, via feedback from the cortex and the brain stem, the thalamus controls the type and amount of information that reaches the cortex. Recent scientific findings prove the thalamus plays a role in how the cortex functions. Cortico-cortical communication depends heavily on how messages are integrated, filtered and modified through the thalamus.

The complex cell and circuit properties of the thalamus leave little doubt that the relay of sensory information to the cortex is an active, adjustable and modifiable process. Thus, the full impact of the thalamus recent research has shown is much more than simply controlling flow of information from the periphery and from other parts of the brain to the cortex: it is the most active partner in all cortical computations.

Integration in the thalamus is the sum of different driver inputs (highly prioritized afferents) to produce an output that differs qualitatively from that of any of the inputs. Filtering in the thalamus is the summing of different driver inputs (highly prioritized afferents) to produce an output that differs quantitatively from that of any of the inputs. So if the thalamus is intact, symptoms and dysfunction are the sum (integration and filtering) of different inputs into the thalamus. Symptoms, dysfunction and dis-ease are dependent on thalamic firing. Thus if the chiropractor can change input into the intact thalamus to move the CNS to produce a healthier functional status, the output will be health. The “nerve interference” is on the afferent side.

Chiropractic is concerned with the enhancement, promotion, preservation and restoration of health and focuses particular attention on the subluxation. A chiropractic vertebral subluxation complex (VSC) is a complex of functional and/ or structural and/or pathological articular changes that compromise neural integrity and may influence the homeostasis of multiple organ systems and the body as a whole. The chiropractic vertebral subluxation complex can only be evaluated by chiropractors utilizing profession specific procedures based on the best available rational, scientific, empirical evidence. Over 100 years of chiropractic care for children has shown in the scientific literature to be the safest interventional health care modality available to the public.

The role of the chiropractor, though trained and educated in the function of disease labeling and therapy, is to identify and correct vertebral subluxation complexes that have a profound negative impact on the physiological development of the child. Health promotion through well child maintenance care as well as VSC corrective care is an invaluable contribution the chiropractor can make to the health and well being of the child. Since human function and innate homeostasis is neurologically integrated, Doctors of Chiropractic evaluate and facilitate biomechanical and neuro-biological function though the appropriate application of the chiropractic adjustment and diagnostic procedures. When the pediatric patient’s homeostasis is overwhelmed and produces an identifiable disease, the pediatric patient moved from wellness into the interventionist medical paradigm, the chiropractic focus on the location and adjustment of the VSC remains unchanged. This dedicated therapeutic focus does not exempt the chiropractor from the responsibilities of practicing the art and science of whole body diagnosis.

Even in the most severe disease states, chiropractic has a critical role to play in the management of the pediatric patient who clearly belongs within the allopathic interventionist model. Disease is a struggle to maintain homeostatic balance of the body despite tissue damage and chiropractic adjustments move the child closer to wellness and away from pathologic dysfunction of tissues and organ systems. By contrast, allopathy has little role to play in the management of the patient who fits within the chiropractic wellness paradigm because of the lack of an identifiable pathology. Even preventive measures such as prophylaxis for asthma are dependent for their implementation upon the manifestation of the disease in the first place. Chiropractic care has been proven effective in positively effecting children with various “named” disease manifestations and empirically has blamed for the increased general health status of chiropractically treated children versus the general allopathic population.

Therefore, direct access and widespread utilization of chiropractic care is an integral part of the pediatric patient’s healthy development. Chiropractic should be included first in the health care planning of every child.

Pediatrics. 2007 Jan;119(1):e275-83.

Adverse events associated with pediatric spinal manipulation: a systematic review.

BACKGROUND: Spinal manipulation is a noninvasive manual procedure applied to specific body tissues with therapeutic intent. Although spinal manipulation is commonly used in children, there is limited understanding of the pediatric risk estimates. OBJECTIVE: Our goal was to systematically identify and synthesize available data on adverse events associated with pediatric spinal manipulation. METHODS: A comprehensive search was performed of 8 major electronic databases (eg, Medline, AMED, MANTIS) from inception to June 2004 irrespective of language. Reports were included if they (1) were a primary investigation of spinal manipulation (eg, observation studies, controlled trials, surveys), (2) included a study population of children who were aged 18 years or younger, and (3) reported data on adverse events. Data were summarized to demonstrate the nature and severity of adverse events that may result rather than their incidence. RESULTS: Thirteen studies (2 randomized trials, 11 observational reports) were identified for inclusion. We identified 14 cases of direct adverse events involving neurologic or musculoskeletal events. Nine cases involved serious adverse events (eg, subarachnoidal hemorrhage, paraplegia), 2 involved moderately adverse events that required medical attention (eg, severe headache), and 3 involved minor adverse events (eg, midback soreness). Another 20 cases of indirect adverse events involved delayed diagnosis (eg, diabetes, neuroblastoma) and/or inappropriate provision of spinal manipulation for serious medical conditions (ie, meningitis, rhabdomyosarcoma). CONCLUSIONS: Serious adverse events may be associated with pediatric spinal manipulation; neither causation nor incidence rates can be inferred from observational data. Conduct of a prospective population-based active surveillance study is required to properly assess the possibility of rare, yet serious, adverse events as a result of spinal manipulation on pediatric patients.

9 Serious chiropractic injuries in the history of medicine versus thousands of deaths EVERY YEAR from allopathy?

The Driving Force of Function:

A Tonal Chiropractic Manifesto

For years chiropractors have stated collectively that structure equals function. The structure of the spinal column gives the chiropractor a standard into which to establish clinical guidelines for therapy. This presumes that there is a structural component to the spine that is perfectly adapted for the individual organism’s immediate and long term needs that can be imposed by outside standards. Current chiropractic theories state that small asymmetries are pathological, ineffective, cause disease, decrease normal physiology of the human. These negative traits of small rotary asymmetries in the vertebra (the classical chiropractic subluxation) would naturally decrease evolutionary fitness. But to state this is also to affirm that those small rotary asymmetries at the local level in the spine were not adapted for and selected against. These comments presuppose that the spine (after 400 million years of development) has not selected for species fitness and success as a biological line. How could these small asymmetries exist for 400 million years if they did not increase fitness?

Basic evolutionary fitness is the probability that the line of descent from an individual with a specific trait will not eventually die out. Perhaps those small rotations may be small adaptations to the many degrees of freedom (cultivated over 300,000 generations of vertebrate existence) allowed by the hominid spine. These small asymmetries may be pathological in the short term or long term or these small asymmetries may be the best physiological adaptation for the individual to preserve resources in the short or long term. Perhaps these asymmetries may contain both traits?

An understanding of proper function and the analysis those patients with small rotary asymmetries in the spine reveal that many of these patients have lived to ripe old ages and reproduced effectively. If this is documented fact this leads one to deduce that these asymmetries are at least not fatal to those individuals. To state that small asymmetries are always pathological would deny the fitness of 6.2 million years of human natural selection and generational adaptation. If these slight rotations were always a source of inefficiencies and decreased evolutionary fitness these rotations would have been de-selected for and they would not have survived to the present.

The original chiropractic theory of vertebral subluxation (functional anomalies) -the exertion of pressure on a spinal nerve which by interfering with the planned expression of Innate Intelligence produces pathology-is an incomplete statement. This is an incomplete when we recognize the vertebral column has been evolving for over 400 million years of vertebrate evolution to support the body and protect the central nervous system in many millions of vertebrate species.

Traditional chiropractic (segmental and postural technique classifications) evaluates abnormal function as a result of labeled abnormal structures. These labels are self-developed and described in isolation in the chiropractor’s practice or technique. Tonal Chiropractic, a subset of chiropractic technique and theory, has attempted to answer these inconsistencies by looking at the input side of structure. That abnormal structure can lead to abnormal function that continuously feeds the CNS with aberrant input. Or that aberrant structure is the individual’s best attempt to adapt and save resources given the current immediate demands of the internal and external environment. Tonal chiropractic techniques explain that symptoms that we see in our clinics are a result of neuron-physiological partitioning. Since the CNS controls and regulates all physiological process of the human body, these optimizations must occur at the microscopic cellular level in the nervous system first. All these changes can be explained by considering the process of energy efficiency of neural communication and neural processing. Energy (available ATP) is finite. It is reasonable to assume that the limiting factor for this energy resource/metabolic) efficiency optimization process is the use of available ATP. Thus, to optimize neurological programs, the CNS will shunt and mobilize ATP to the areas of greatest physiological need in the CNS. Tonal chiropractic relies on observable biological standards.

History has proven, especially recently, that our science’s understanding of certain human physiology traits is not only incomplete but can be plain wrong. The recent revolutions in the areas of CNS neuroplasticity, the existence of widespread adult CNS stem cells, the ‘discovery’ of the bidirectional communication of the CNS and the immune system; these are areas of science that have changed 180 degrees from their original dogmas. This limitation of human understanding proves our generation’s descriptive limitation and the evaluation of normative function. But physiological proper function must be historical if human existence is a product of 400 million years of vertebrate adaptation and positive modifications. .

Ruth Garrett Millikan (born 1933) is a well-known American philosopher of biology, psychology, and language described the term “proper function” in the late 1980’s. Proper functions are the sorts of functions that biologists assign to the organs of animals and the sorts of function that human artifacts have. The notion in the context of the philosophy of biology is introduced that proper functions are what things are for whilst other functions of the design are not. It is possible to distinguish having the function X from merely functioning as X. Both these linguistic distinctions can be used to mark a rough boundary for the class proper functions.

Function is any activity that can be produced by a structural entity. Proper functions differ from other functions in that they can be cited to explain the reason for the structures existence. The presence of the heart can be partially explained by its capacity to circulate blood and move oxygen into tissues. These functions enter into an evolutionary and natural selection explanation of the presence of the heart. But the presence of the heart cannot be explained by its ability to cause severe pain during a myocardial infarction event. The ability to cause pain is a function of the heart (pathological abet a function) but not its proper function that leads to greater evolutionary fitness. The normative (fitness) function could be said to be its proper function. But it would not be evaluative because of course normative definitions change with better understanding of biological functions. By definition proper function is defined historically over evolution. For example, science used to understand that CNS glia cells were simple supportive structures, we now know that glia cells are the most important cells in the CNS for intercellular communication and neuroplasticity. Some glia cells are not supportive at all, but are in fact adult stem cells. The proper functions of a trait are those effects of a trait which ancestral evolution has determined have fitness components. These functions of a trait are advantageous and are those selected over time. The effects are a positive adaptation. To explain a trait by alluring to its proper function is to explain it as the result of natural selection, in the way with which we are all familiar.

When addressing the functions of the spine one must specifically separate and define the proper functions and foundational functions. Proper spinal functions are functions that can best fit its place in the evolutionary fitness picture. The foundation functions of the spine must first fit in the overriding natural selection process. Function X or Y as described as a spinal function must first agree with evolutionary biology.

If spinal function X or Y, although describable, deny the natural selection process and evolutionary biology for all vertebrates, then the description of the observation must be incomplete.

The incomplete description of spinal function X or Y can not be a proper function. If the function of the spine is to maintain perfect alignment with complete axial symmetry but this “model spine” can not be found in living or deceased humans (or any vertebrates for that matter) and more over that perfect symmetry may not have evolutionary value, then perfect axial symmetry may not be a normative function, or be the foundational function function. There can be no statistical outliers to foundational function. If a few specimens with small rotary asymmetries are observable examples of maximum human performance and presumed evolutionary fitness (biological and athletic rock stars) then the principle of traditional chiropractic that small asymmetries led to depressed function is visibly incomplete. Although ‘perfect axial ‘symmetry may exist theoretically as a spinal function, it does not supersede evolutionary drive and proper foundational function. The described proper structure of the spine (as described by traditional chiropractic paradigms and colleges) can not override examples of super normative function and faultless evolutionary fitness. How can an individual have perfect adaptation traits and outstanding biological function and have small rotary asymmetries if these small rotary vertebral asymmetries have a deleterious effect on individual function and fitness? For example, how can we have patients that are athletics superstars, have a large socially stable families and have small rotary asymmetries if these asymmetries are always deleterious?

So what is the proper function of the spinal column. Perhaps protection of the CNS and spinal cord, Intersegmental flexibility that allows for great range of movement and mobility. Greater mobility adds to species fitness (evolutionary survival ability). But again there must be an underlying principle that is true in every case when applied to all spinal functions. These functions of the spine are not the foundation function, which ids of course, evolutionary fitness. The first and primary proper function of any biological structure is energy efficiency. The proper functions must first and foremost satisfy the evolutionary fitness requirement before another function can be assessed. Does your chiropractic technique evaluate (in real time) the patient’s proper physiological function that would increase evolutionary drive? High priority physiological functions like breathing and circulation should be evaluated pre and post chiropractic interventions. Can a chiropractic or allopathic intervention be positive for the individual if it does not increase real physiological function despite its nociceptive effect?

Increasing the body’s main physiological traits (e.g. breathing, circulation, and heat regulation) should be our prime motivation for intervention. The body after 6.2 million years will shift resources to maintaining basic abilities. If we assist the body in prime physiological functions, the body’s innate ability developed over 400 million years will utilize the freed up resources to improve fitness and heal local injuries/disease.

This brief article was designed to begin conversations within the chiropractic community as to what is the best physiological function to analyze that guides our adjusting techniques. Is it okay to have a chiropractic intervention (or an allopathic one for sake of conversation) that may decrease pain but maintains or assists in degraded physiological function? Do we assess global physiological functions biology and science have always proven effect every cell(breathing, circulation) or do we assess physiological functions on a small local level (segmental biomechanical function, muscle spasms and swelling) and presume they have global effects? The patient’s leg length may be even but does that correspond to an immediate positive change in prime physiological functions like breathing, circulation, heat regulation, nutrient absorption, CNS informational processing energy efficiency, or overall health? Is L5 right rotated a pathological structural malposition or is it the best adaptation 400 million years of winning can produce to maintain efficiency and drive towards fuller expansion of our human potential? Do we evaluate physiological and pathological asymmetries? Is it always best to adjust that swollen, painful high spot or is their a bigger game we should consider? Do we really trust that after 400 million years the human body knows how to adapt efficiently in the short term? Or for those of other religious flavors; do we think we are divine junk?

Very Selected References:

Andre Ariew (Editor) (2002). Functions: New Essays in the Philosophy of Psychology and Biology

Bowler, Peter J. (2003). Evolution:The History of an Idea. University of California Press. ISBN 0-52023693-9.

Clary, Frederick. (2006). Functional Analysis Seminar Manual

Futuyma, Douglas J. (2005). Evolution. Sunderland, Massachusetts: Sinauer Associates, Inc. ISBN 0-87893-187-2.

David H. Peterson (Author), Thomas F. Bergmann (Author) (2002). Chiropractic Technique

Dr. Clary has been practicing in Roseville, MN since 1992. His practice focuses on neurologically challenged patients and neurological conditions like cerebral palsy, Dystonia, Parkinson’s, head trauma, mental health conditions. He is the original of Functional Analysis Chiropractic Technique. His book can be obtained at http://www.drclarydc.com/index.html

The periphery and CNS function as an integrated whole, each influencing the other by constant physical and chemical communications and modulations. These rhythmic neuronal activities are involved in the control of the respiratory apparatus, which includes the lungs, diaphragm, pelvic musculature, thorax, intercostal muscles, etc. When this internal driving force, based on CNS drive, activates the peripheral neuromuscular elements to consummate the act of breathing, these same elements, when activated by chiropractic adjustments, also stimulate the same neural circuitry controlling respiration which thus can be influenced in an afferent and efferent “dance”. The synchronization and efficiency of this dance is the diagnostic window that the functional chiropractor addresses.

How important is functional leg length compared to the mechanics of breathing? How important is the coupling of L4-L5 motion in right lateral flexion compared to the mechanics of breathing?

Chiropractic traditionally uses static structure to diagnose dynamic functional loss. Segmental and Postural Chiropractic techniques presuppose that structural correction (by our imposed standards) will lead to functional improvement. The overriding belief is poor structure leads to poor function. Yet everyday we see cases that defy this underlying belief. Clinical cases were dysfunction and pain are not questioned but the structure is grossly normal. Also everyday we see cases were structure, as verified by MR and other objective tests, is grossly abnormal yet the functional performance of the individual is above what would be considered normal for normal structure.

Does structure determine function or does function determine structure, or does each determine the other, and if the latter, how can it be? The answers to these questions seem to be matters of definition, personal paradigm and recognition of the driving purpose of the natural order.

In the inorganic world structure may be regarded merely as a mechanical collocation of parts in a whole. But in the biological world, structure is a mechanical collocation of parts adapted to an end.

One cannot argue that “structure leads to function” is a popular belief yet when evolutionary forces are considered one is drawn to concepts such as Wolff’s Law: Function precedes structure. A look at biology gives clinician a unique understanding. That understanding is that efficient function and behavior in the external environment leads to adaptable structure. Saving and economic use of resources drives the individual and the species. Efficient function with available finite resources determines the survival of an individual. With enough time and offspring, structure adapts to save resources and energy. What can be said definitively is that structure and function are interdependent with the biologic drive of survival being efficient utilization of available resources.

Efficiency is the driving force, not convenience for the organism. The subluxation can only be rightly called a subluxation if it negatively affects the body’s most important systems and leads to inefficiency in the system. The chiropractor must be removing afferent information from the system that leads to inefficient processing.

In fact ineffective processing can not only be learned (efficiency driven) depressed functions but other physiological states labeled asthma, atopic diseases, mental health conditions. Evidence at the molecular, cellular, systems, behavioral, and the analytical computational levels is converging to suggest a view that addiction represents a pathological usurpation of the neural mechanisms of learning and memory that under normal circumstances serve to shape survival behaviors related to the pursuit of rewards and the cues that predict them.

These addictive behavior patterns and pre-frontal executive functions become efficient at the level of the CNS. Chiropractic has long discussed the role of the vertebral subluxation in mental health. Because of flawed afferent input, an aberrant output begins.

This model of the VSC, with the subluxation altering afferent input that leads to inefficiency of processing and thus physiopathology, has larger ramifications. The chiropractor should consider that humans have the ability to alter development, physiology, growth, and behavior in response to different internal or external environmental conditions. These responses represent critical assessments of both external and internal environment.

Tonal and Functional Approach

A tonal chiropractic technique approach looks at the controlling systems of the body. Even traditional segmental and postural concerns like subluxation degeneration (also called osteoarthritis) are now being targeted as a functional (tonal) issue.

Although there are many risk factors (such as age, family history, and obesity) associated with the development of osteoarthritis (OA), only trauma is known to cause OA. The neuromuscular system, through CNS-controlled afferent-efferent programs, controls the amount and kind of movement occurring at a joint, so it is this system that is ultimately responsible for ensuring that joint tissues are not damaged to the point of developing OA during normal day-to-day activities. Tonal chiropractic techniques concern themselves with influencing the controlling systems of the body.

Most of the current research shows that a neuromuscular protective model based on central pattern generators (CPGs) can explain this clinical reality. CPGs are subconscious motor programs that run during dynamic equilibrium and movements. They control balance, static posture, and background tone in all joints and movements. These programs are developed, then remembered (recalled) as needed. These afferent/efferent programs are driven by instantaneous energy efficiency. Understanding the role of CPGs can best reconcile much heretofore ambiguous information pertaining to the development and progression of OA (subluxation degeneration) in stable and unstable joints. These CPGs (programs) can explain the continuance and maintenance of the pain in patients. Tonal chiropractic techniques concern themselves with influencing the controlling systems of the body.

The vertebral motion unit is rich in proprioceptors and nociceptors. Biomechanical alterations, from trauma or from inefficient movement patterns (chronic), may result in an alteration of normal nociception and mechanoreception. Thus, aberrant afferent input into the CNS leads to dysponesis.

Dysponesis is defined by Dorland's Medical Dictionary as follows:
A reversible physiopathologic state consisting of unnoticed, misdirected neurophysiologic reactions to various agents (environmental events, bodily sensations, emotions, and thoughts) and the repercussions of these reactions throughout the organism. These errors in energy expenditure, which are capable of producing functional disorders, consist mainly of covert errors in action-potential output from the motor and pre-motor areas of the cortex and the consequences of that output.
Dysponesis does not mechanistically describe a specific allopathic (ICD-9 labeled) condition but rather relates to human homeostasis and dis-ease. It relates to human health as a function of the whole. It is philosophically and scientifically suitable for a tonal technique chiropractor to detect a patient with dysponesis (errors in energy expenditure) secondary to vertebral subluxation complex or causing a ‘perceived misalignment’. All that is necessary are the tools for the chiropractic assessment / analysis that evaluates CNS processing and efficiency at all levels (local, regional, global) of physiology and the understanding of that processing.

D.D. Palmer emphasized the importance of “tone” in the dynamics of health and disease. Dr. Palmer in his text, The Chiropractic Adjuster, stated in 1910, “ Life is an expression of tone. Tone is the normal degree of nerve tension. Tone is expressed in function by normal elasticity, strength, and excitability...the cause of disease is any variation in tone.”

DCs must find a strategy, which is effective in disclosing these covert errors in energy expenditure caused by inefficient input and correcting them. Tonal chiropractic techniques concern themselves with influencing the controlling systems of the body that manage energy expenditure are one answer to the search for assisting the CNS in handling afferentation.

Inappropriate afferent input can lead to aberrant efferent output leading, and in the long term, to a state of dis-ease or abnormal energy expenditure. This inefficient energy expenditure leads to depressed function of other body systems as the finite energy is partitioned or mobilized to other parts of the CNS. The appropriate chiropractic adjustment adds positive physiological input into the CNS that allows resources to be saved and thus the surplus resources are able to utilized.

If this depressed functioning remains for any length of time, neuroplasticity takes over and the brain will “prune” connections to allow for a more efficient firing and ATP utilization of this depressed functional state. This pruning and efficiency is based on ATP and neurological resource utilization not on the long term effects it will have on the organism. The CNS and natural selection do not make ‘moral or rational ‘decisions on the long term consequences of increasing efficiency of deleterious programs. The drive is to save resources in the immediate short term. One ‘learns” to be sick efficiently.

These disadvantaged functional states could be a simple decreased filtering of nociception as it travels through the thalamus for filtering, integration and modification. Resources (ATP, neurotransmitters, etc are being utilized for other greater prioritized programs) rather than filtering an achy knee. Or they could be inefficient biomechanics of the sacrum and pelvis. They could indicate inefficient filtering of extraneous sensory information (auditory, kinetic, visual) and abnormal descending pre-frontal inhibition into the thalamus (or other areas) and thus lead to ADD-like symptoms.

These depressive functional states could lead to neurophysiological partitioning and mobilization of energy resources and lead to an efferent program called dysautonomia. All these outputs can be termed dis-ease or will eventually develop into an ICD-9 AMA-labeled diagnosis.

Breathing Pattern Retraining and Exercise in Persons with Chronic Obstructive Pulmonary Disease

"Smaller breaths conserve energy in the short term but contribute to respiratory muscle fatigue and hyperinflation as the work of exercise increases or is prolonged."

"A properly designed breathing retraining program in which patients with COPD learn to control their pattern of breathing under the stress of performing different modes of exercise at increasing intensity and duration may markedly decrease dyspnea and improve gas exchange."

AACN Clinical Issues -Volume 12, number 2, pp 202-209 (c) 2001 AACN

"It is surprising that this simple measurement has not gained more importance as a general health assessment tool," he noted. Schunemann HJ, Dorn J, Grant BJB, Winkelstein W, Jr., Trevisan M. Pulmonary Function Is a Long-term Predictor of Mortality in the General Population 29-Year Follow-up of the Buffalo Health Study. Chest 2000;118(3)656-664.

The Framingham study focused on the long-term predictive power of vital capacity and forced exhalation volume as the primary markers for life span.
"This pulmonary function measurement appears to be an indicator of general health and vigor and literally a measure of living capacity". Wm B. Kannel and Helen Hubert.

Longevity and Breathing

One of my favorite birthday cards shows a picture of a “seeker” coming to the “top of the mountain” to ask the great sage and seer of all knowingness, “Oh great baba, what is the secret of long life?”

Inside the card, baba reveals, “Keep breathing as long as you can.”

On a slightly more serious note, studies show that there is a strong relationship between better breathing, fullness of life and longevity. In a study by a thoracic surgeon and psychologist Phil Neurenberger, all 152 heart attack victims had a serious breathing irregularity. Breathing in a less than optimal way can result in shortening of life span and or illness ranging from chronic nervousness to a slowly agonizing death.

Article concerning content of a National Institute of Aging meeting from Science News, vol.120, 1981 p.74

"Findings resulting from a 5,200 clinical study group observed over a 30 year span showed that pulmonary function measurement is an indicator of general health and vigor and literally the primary measure of potential life span.

The vital capacity falls with age – 9 percent to 27 percent each decade depending on sex and age at the time the test is given. the decline is clear both in cross-sectional data, comparing persons of different ages, and in cohort data, following a group of people as they grow older. The long term predictive power of vital capacity is what makes it a good candidate as a marker of aging.

Long before a person becomes terminally ill, vital capacity can predict life span. A person whose vital capacity is low is not going to do as well as someone whose is always high. It can pick out people who are going to die 10, 20, 30 years from now."

The National Institute of Aging is using rodents and primates for longevity studies. Because they are omnivorous mammals, showing aging patterns similar to human but about 30 times faster. Neither one of which has a similar enough lung structure to benefit from the same Optimal Breathing™ techniques available to humans.

I suggest you take more interest in your biological age instead of your chronological age. A physically active 45 years old can have the biological age of a 35 year old and an inactive 45 year old can have the biological age of a 55 -75 year old. Your breathing volume is a key factor in your biological age.

“At least ninety percent of our metabolic energy should come from our breathing.” – Dr. Gabriel Cousens

We can breathe, + or - due to lung and body size, approximately eight pounds of oxygen daily, eat four pounds of food and drink two pounds of water. The earth breathes; it expands and contracts about two feet. The body contains billions of cells. They need to breathe too. Sadly, most people breathe a fraction of full capability, and so do their cells.

If you do nothing to preserve even average breathing, you will by age 70 lose over 70% of what you had at age 20.(Framingham Study) You breathe 7,000 to 30,000 times a day. Dr. Gay Hendricks states that “a five percent increase in breathe-ability can work wonders”.

HEART CONDITIONS AND “EASY” BREATHING
The less oxygen you take in the harder your heart has to work to gather oxygen for the body. When breathing becomes easier, the heart does not have to work as hard. When you try to breathe too quickly, as in a race or when you are frightened, you excite the nervous system and this excitation locks up the expansion potential of the muscles holding the rib cage together. This reduces the ability for the chest to easily expand and the lungs to take in extra oxygen easily.

EASY BREATH OFTEN OVERLOOKED
When you “take a deep breath” you may well relax a little but you are actually stimulating your nervous system to restrict your breathing from its optimal potential. Most schools of exercise and breathing overlook the “ease” factor.

Much of longevity comes from "grace", from being in the flow. There is a naturally calming, breathing reflex that becomes eroded by forcing the breath too much or too often. Even world class athletes and woodwind players can develop asthma and other forms of restricted breathing. The “erosion” manifests in locked up breathing muscles and creates blocks in full and easy breathing. Difficulty breathing makes day to day living harder. Easier breathing makes everything in life richer and easier; including living longer.

GERM-KILLING OXYGEN
Germs, viruses and bacteria are anaerobic; they cannot survive in a high oxygen environment. The stress of unbalanced breathing can break down the body’s resistance to disease by using up valuable oxygen needed for healthy metabolism as well as cause the vital organ system to overwork and become vulnerable to disease.

ASTHMA AND COPD
There are many hidden degrees of restricted breathing or what I call latent shortness of breath. Asthma and emphysema are easy to spot. But asthma and emphysema don’t just suddenly enter your body. They often take years to develop. Some of the signs of restricted breathing are headaches, heart conditions, dizziness, hyperventilation, sighing, memory loss, yawning, chronic depression, apathy, tension or restriction felt across chest or abdomen, slouched posture, hoarseness, low and or mid back pain, raspiness, and a thin or weak voice. There are many more.

BREATH IS LIFE
Breathing has much more to do with life than taking in oxygen. Much of the nervous system responds to the way the breath is taken in. If you breathe a lot in your belly you stimulate a more relaxed response to everything you see hear and feel. If you breathe into the high chest you stimulate the organs and muscles of action. Balance is indispensable. Many breathe in an unbalanced and labored manner. To not breathe easy is to overstimulate the organs and muscles of action. Like keeping your foot on the accelerator day in and day out, and one foot on the brake. Your engine is constantly at a higher rev than needed. Type “A” personalities are good examples but many non types “A’s” have less obvious but still harmful or restricted breathing patterns.

The Bobath Concept is an important approach to rehabilitation in the care of patients with injuries to the brain or spinal cord. It is named after its inventors, Berta Bobath, a physiotherapist, and her husband Karel, a neurophysiologist.

It is based on the brain's ability to reorganize (Neuroplasticity), which means that healthy parts of the brain learn and take on the functions which were previously carried out by the damaged regions of the brain. The prerequisite for this is, however, a consequent support and stimulation of the patient on the part of the patient's caretakers. The concept has achieved good successes in rehabilitation, in particular in the case of people paralysed on one side (hemiplegic) after a stroke.

Hemiplegics often tend to neglect their paralysed side, and therefore their limitations, in order to compensate with their less affected side. Such single-sided movements, however, only help the patient in a basic way, since the affected side is not given the ability to receive and work with new information. The brain therefore does not have the opportunity to restructure itself. Instead because of the asymmetric movements, there is still the danger of developing painful spasms.

The main principle of the Bobath Concept is, on the other hand, to support the affected side of the body as much as is necessary to bring its movements into accord with the less affected side of the body.

In the United States the Bobath Concept is usually referred to as Neuro-Developmental Treatment.

: Spine. 2007 Oct 1;32(21):2375-8; discussion 2379.
Links
Safety of chiropractic manipulation of the cervical spine: a prospective national survey.
Thiel HW, Bolton JE, Docherty S, Portlock JC.
Department of Research and Professional Development, Anglo-European College of Chiropractic, Bournemouth, United Kingdom. hthiel@aecc.ac.uk
STUDY DESIGN: Prospective national survey. OBJECTIVE: To estimate the risk of serious and relatively minor adverse events following chiropractic manipulation of the cervical spine by a sample of U.K. chiropractors. SUMMARY OF BACKGROUND DATA: The risk of a serious adverse event following chiropractic manipulation of the cervical spine is largely unknown. Estimates range from 1 in 200,000 to 1 in several million cervical spine manipulations. METHODS: We studied treatment outcomes obtained from 19,722 patients. Manipulation was defined as the application of a high-velocity/low-amplitude or mechanically assisted thrust to the cervical spine. Serious adverse events, defined as "referred to hospital A&E and/or severe onset/worsening of symptoms immediately after treatment and/or resulted in persistent or significant disability/incapacity," and minor adverse events reported by patients as a worsening of presenting symptoms or onset of new symptoms, were recorded immediately, and up to 7 days, after treatment. RESULTS: Data were obtained from 28,807 treatment consultations and 50,276 cervical spine manipulations. There were no reports of serious adverse events. This translates to an estimated risk of a serious adverse event of, at worse approximately 1 per 10,000 treatment consultations immediately after cervical spine manipulation, approximately 2 per 10,000 treatment consultations up to 7 days after treatment and approximately 6 per 100,000 cervical spine manipulations. Minor side effects with a possible neurologic involvement were more common. The highest risk immediately after treatment was fainting/dizziness/light-headedness in, at worse approximately 16 per 1000 treatment consultations. Up to 7 days after treatment, these risks were headache in, at worse approximately 4 per 100, numbness/tingling in upper limbs in, at worse approximately 15 per 1000 and fainting/dizziness/light-headedness in, at worse approximately 13 per 1000 treatment consultations. CONCLUSION: Although minor side effects following cervical spine manipulation were relatively common, the risk of a serious adverse event, immediately or up to 7 days after treatment, was low to very low.

Efficient Inhalation
Normal Physiological Breathing Wave
· Initiates at coccyx – sacrum
· Moves inferior to superior

Initiation

Initiation of breathing mechanics is the most important sensory-motor program in the CNS. An inefficient program here can lead to partitioning (sapping off) of CNS resources to maintain a breathing program. Again, since energy is a limited resource and evolutionary adaptive processes drive neuroplasticity towards efficiency, the breathing mechanics take priority in energy and significance in the thalamus.

The Chiropractor observes which region moves FIRST on inhalation. Be careful not to be misled by regions that have the most movement. It is the region that moves first that is the location of Initiation.

IT MUST BE UNDERSTOOD THAT LABELS (NAMED DISEASES) CAN BE PRESENT WITH ANY ABERRANT BREATHING PATTERN.

Aberrant Initiation in the thoracics or a cycle that initiates in the lumbars can reveal:

· Brain Stem Issues

· Chemical Dependencies

· Hormonal Imbalances

· SIDS Potential

· Bipolar Disorder

· Depression

· Chronic Pain

Aberrant Initiation that is focused more superiorly than the pelvis:

· Loss of initiation of pelvic movement will cause a degree of visceral circulatory stasis and pelvic diaphragm weakness will develop, as will an imbalance between increasingly weakening abdominal muscles versus hypertonic spinal stabilizers.

· The upper ribs will be fixated superiorly on the chronic motion palpation and there will be dysafferentation costal cartilage tension on palpation.

· The thoracic spine will have intersegmental glide fixations caused by lack of normal motion of the articulation with the ribs.

· Thoracic breathing wastes large amounts of energy. In this form of paradoxical respiration, the chest and abdominals function oppose each other.

· Normal effort produces inadequate tidal volume; more energy (ATP) and increased cervical and thoracic thalamic/cortical representation must be accessed to maintain a minimal tidal volume.

· Accessory respiration muscles of the upper chest must come into play, including scalenes, upper trapezius and levator scapula. The muscles overwork to exchange sufficient air. Accessory muscle hypertonia will be palpable and observable. Hypertonic scalenes can entrap lymphatic structures mechanically, which has been shown to reflexively suppress lymphatic duct peristaltic contraction in the affected extremity.

· Fibrosis (regional myofascial pain) will occur in these overworked muscles.

· Trigger points in the pectoralis, subscapularis, teres major and latissimus dorsi caused by thoracic breathing patterns negatively influence lymphatic drainage.

· The neurological overload (increased thalamic integration and priority given to secondary respiratory muscles) changes the thalamic relays to give priority to respiratory function. Other visceral afferents are simply filtered. Thus the connection to other visceral afferents is “lost.”

· Cardiovascular dysfunction and high blood pressure can result as the CNS fights for a minimal functional tidal volume.

Aberrant Initiation that is focused in the lumbars is a common presentation as the first sign of interference and inefficiency in the CNS.

1) Lack of proper proprioception leads to aberrant local and global movement patterns (dysponesis) including inefficient breathing mechanics.

a) Improper sensory integration leads to inefficient/ imbalanced efferent yield, local/global efferent dysfunction, disability, disease states, symptoms and loss of human potential.

b) Aberrant local and global movement patterns habituate (pathological neuroplasticity) unless adjusted, attenuated and eliminated from the input side. Physiological filtering and integration through the thalamus.

2) The top two dominant reflexes in the hierarchy of adult human survival are the Breathing Reflex and the Righting Reflex (Dynamic Equilibrium).

a) The two most important reflexes that can be observed (for function) and corrected are the Breathing Reflex and the Righting Reflex.

b) If the Breathing Reflex or the Righting Reflex are not corrected properly, all other input/output system adjustments (chiropractic adjustments, physical rehabilitation, diet therapy, psychological therapy) become less effective at best and iatrogenic at worst.

Inefficient breathing patterns shift the nervous system to a negative state of utilizing all conserved energy for appropriate oxygen exchange. The Breathing Reflex is the driving reflex of all physiological processes. It is the first step and the controlling factor to all physiological processes.

Physiopathology – clinicians have long been aware of structural pathology and the ability of these anatomical or biochemical abnormalities to produce malfunction. Malfunctions produced in this manner are termed pathophysiology by the health care community. Malfunction resulting from processing or signaling errors within the circuitry of nervous system is termed physiopathology. Because of the presence of both inborn and acquired neuronal interconnections (acquired because of efficiency driven neuroplasticity), processing and signaling errors can be produced and maintained.

Signals traveling along sensory afferent pathways and entering various neuronal circuits within the CNS or signals in from the PNS but entering the CNS will affect individuals differently. They can also affect the same individual differently on different occasions. In the presence of one set of variables, a migraine headache develops. With another set of variables, gastrointestinal or cardiac malfunction of one form occurs. In the presence of still another set of variables, the individual becomes chronically fatigued or clinically depressed. Acute or chronic anxiety, mental illness and amplified pain are a common result. Alterations in endocrine function can also occur. All of these consequences result from sub-cortical processing errors (signaling malfunction) that affect physiological mechanisms in a manner detrimental to the organism. In this paradigm, inappropriate emotions or amplified bodily pain or a diagnosable disease is just a symptom from processing and signaling errors and is not the primary diagnosis. Physiopathology causes Dysponesis. The dis-ease is a result not the cause.

Physiopathology (Nervous System processing errors) can accompany structural pathology and it can also exist alone and be the sole cause of a given patient’s symptoms.

For optimal patient care it is essential to examine and estimate the extent to which Pathophysiology and Physiopathology is contributing to the patient’s illness.

In the Chronically Subluxated patient the brain is not processing or organizing the flow of sensory impulses in a manner that gives the individual good, precise information about himself and his world.

Energy Use by the Brain: Organisms in the natural environment are highly efficient in their use of their available energy, and sometimes even more important, their cooling resources. That is, the use of food and water by organisms is often associated with processes that become sensible when we suppose one or both of these resources are scarce. And scarce they are at the margins, the place where evolution/ natural selection occurs fastest. It is at the interfacial niches of marginal survival that competition is most severe and mutations would be most beneficial, thus leading to higher rates of evolution. Clearly at such places of marginal survivability, energy efficiency will be very important. So we have good reason to expect that organisms are made up of and use energy efficient processes.

In this context of energy , neural processing is rather expensive. The adult human the brain accounts for20% or more of our total energy use and it consumes on the order of 20-25 watts. In young children, whose brains are nearly as large as an adults, the energy use by this organ can account for nearly 50% of the caloric intake.

Current research implies that more than 85% of the energy used by brain goes toward restoring the ion fluxes across neuronal membranes that are the biophysical basis of computation and communication in the neocortex. Thus neural informational processing although perhaps five to six orders of magnitude more energy efficient than man-made computation, is a considerable expense for the organism.

Because of such energy costs, natural selection (or intelligent design for maximal survival) has optimized energy use as well as information processing in constructing the way neurons compute, process, develop, filter, integrate and communicate.

In all of its functions, the brain seeks optimum efficiency, or the path of least resistance. If one particular function is not accessible, the brain will automatically go on to the next most efficient process for doing that particular task. If the second task is not available, it will go on to the third or the fourth most efficient way. Because each alternative process is less efficient, it becomes more stressful and energy expensive

The brain will keep searching for an appropriate processing method, until eventually the activity may become so subconsciously stressful (energy greedy) that the person will choose to give up trying to do the task altogether. If it is a conscious activity, the individual will give up the fatiguing activity. If the process is unconscious, the individual will decrease the energy partitioning to that process, making this unconscious activity minimized, nonfunctional or detrimental to the whole, depending on where the process is located in the physiological hierarchy.

Thalamic Integration and Filtering: The thalamus does not passively relay information from the sensory system to the cortex. Rather, via feedback from the cortex and the brain stem, the thalamus controls the type and amount of information that reaches the cortex. Recent scientific findings prove the thalamus plays a role in how the cortex functions. Cortico-cortical communication depends heavily on how messages are integrated, filtered and modified through the thalamus.

The complex cell and circuit properties of the thalamus leave little doubt that the relay of sensory information to the cortex is an active, adjustable and modifiable process. Thus, the full impact of the thalamus recent research has shown is much more than simply controlling flow of information from the periphery and from other parts of the brain to the cortex: it is the most active partner in all cortical computations.

Integration in the thalamus is the sum of different driver inputs (highly prioritized afferents) to produce an output that differs qualitatively from that of any of the inputs. Filtering in the thalamus is the summing of different driver inputs (highly prioritized afferents) to produce an output that differs quantitatively from that of any of the inputs. So if the thalamus is intact, symptoms and dysfunction are the sum (integration and filtering) of different inputs into the thalamus. Symptoms, dysfunction and dis-ease are dependent on thalamic firing. Thus if the chiropractor can change input into the intact thalamus to move the CNS to produce a healthier functional status, the output will be health. The “nerve interference” is on the afferent side.

Neuroplasticity (variously referred to as brain plasticity or cortical plasticity) refers to the changes that occur in the organization of the brain, and in particular changes that occur to the location of specific information processing functions, as a result of the effect of experience during development and as mature animals. A common and surprising consequence of brain plasticity is that the location of a given function can "move" from one location to another in the brain due to repeated learning or brain trauma.

The concept of plasticity can be applied to molecular as well as to environmental events. The phenomenon itself is complex and can involve many levels of organization. To some extent the term itself has lost its explanatory value because almost any changes in brain activity can be attributed to some sort of "plasticity". For example, the term is used prevalently in studies of axon guidance during development, short-term visual adaptation to motion or contours, maturation of cortical maps, recovery after amputation or stroke, and changes that occur in normal learning in the adult. Some authors separate forms into adaptations that have positive or negative consequences for the animal.

For example, if an organism, after a stroke, can recover to normal levels of performance, that adaptiveness could be considered an example of "positive plasticity". An excessive level of neuronal growth leading to spasticity or tonic paralysis, or an excessive release of neurotransmitters in response to injury which could kill nerve cells, would have to be considered perhaps as a "negative or maladaptive" plasticity.

The main thing to know is that even the adult brain is not "hard-wired" with fixed and immutable neuronal circuits. Many people have been taught to believe that once a brain injury occurs, there is little to do to repair the damage. This is simply not the case and there is no fixed period of time after which "plasticity" is blocked or lost. We simply do not know all of the conditions that can enhance neuronal plasticity in the intact and damaged brain, but new discoveries are being made all of the time. There are many instances of cortical and subcortical (thalamic!) rewiring of neuronal circuits in response to training as well as in response to injury.

There is solid evidence that neurogenesis, the formation of new nerve cells, occurs in the adult, mammalian brain--and such changes can persist well into old age. The evidence for neurogenesis is restricted to the hippocampus and olfactory bulb. In the rest of the brain, neurons can die, but they cannot be created.

To review, plasticity is the selective elimination of axons, dendrites, axon and dendrite branches, and synapses, without loss of the parent neurons, which occurs during normal development of the nervous system, as well as in response to injury or disease. The widespread developmental phenomena of exuberant axonal projections and synaptic connections require both small-scale and large-scale axon pruning to generate precise efficient connectivity. This pruning provides a mechanism for neural plasticity in the developing and adult nervous system, as well as a mechanism to evolve differences between species in a projection system.

Such pruning is also required to remove damaged axonal connections or those that are perceived by local mechanisms as not being efficient for the required circuit, to stabilize the affected neural circuits, and to initiate their maturation or repair. Pruning occurs through retraction, degeneration or functional degradation.

To maintain energy efficiency (whether the program is physiological or not), the CNS, through innate intelligence, will actually change the cells themselves!

Neurophysiological Partitioning:
since the CNS controls and regulates all physiological process of the human body, these optimizations must occur at the microscopic cellular level in the nervous system first.

All these changes can be explained by considering the process of energy efficiency of neural communication and neural processing. Energy (available ATP) is finite. It is reasonable to assume that the limiting factor for this energy efficiency optimization process is the use of available ATP. Thus, to optimize neurological programs, the CNS will shunt and mobilize ATP to the areas of greatest physiological need in the CNS.

Synergistic Neurophysiological Efficency:
Over time, all neural processing moves to the most energy efficient state. Neuroplasticity is driven by long term efficiency of the information processing NOT the long term survival needs of the individual.

Neuronal communication and computation are efficient when considered in the dual (synergistic) context of energy and information rather the either context alone.

Successful problem solving depends on a brain that efficiently lessens its workload rather than laboring harder, a new study finds. Individuals may thus prefer less effortful problem-solving strategies not only for their simplicity but for their superior results, contend neuroscientist Erik D. Reichle of Carnegie Mellon University in Pittsburgh and his colleagues.

Reichle's group administered tests of visual-spatial ability and verbal ability to five men and seven women. Next, functional magnetic resonance imaging scans assessed volunteers' brain activity--as indicated by the blood flow rising and falling--as they determined whether a series of sentences that they read corresponded to images that followed each sentence. On some trials, participants were told to form a mental image of each sentence to compare with the pictures; on other trials, they were told to focus on verbal meanings of sentences.

Volunteers made few errors on this task. The imagery strategy yielded more activation in brain regions linked to visual and spatial skills. However, individuals who scored highest on visual-spatial ability exhibited markedly lower blood-flow boosts in those areas, the scientists report in the June COGNITIVE PSYCHOLOGY. The verbal strategy produced activity hikes in language-related locations. Those increases were lowest for volunteers with the best verbal skills, Reichle's group says.

Physiopathology – clinicians have long been aware of structural pathology and the ability of these anatomical or biochemical abnormalities to produce malfunction. Malfunctions produced in this manner are termed pathophysiology by the health care community. Malfunction resulting from processing or signaling errors within the circuitry of nervous system is termed physiopathology. Because of the presence of both inborn and acquired neuronal interconnections (acquired because of efficiency driven neuroplasticity), processing and signaling errors can be produced and maintained.

Signals traveling along sensory afferent pathways and entering various neuronal circuits within the CNS or signals in from the PNS but entering the CNS will affect individuals differently. They can also affect the same individual differently on different occasions. In the presence of one set of variables, a migraine headache develops. With another set of variables, gastrointestinal or cardiac malfunction of one form occurs. In the presence of still another set of variables, the individual becomes chronically fatigued or clinically depressed. Acute or chronic anxiety, mental illness and amplified pain are a common result. Alterations in endocrine function can also occur. All of these consequences result from sub-cortical processing errors (signaling malfunction) that affect physiological mechanisms in a manner detrimental to the organism. In this paradigm, inappropriate emotions or amplified bodily pain or a diagnosable disease is just a symptom from processing and signaling errors and is not the primary diagnosis. The dis-ease is a result not the cause.

Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study.

Bakris G,
Dickholtz M,
Meyer PM,
Kravitz G,
Avery E,
Miller M,
Brown J,
Woodfield C,
Bell B.

1Department of Preventive Medicine, Rush University Hypertension Center, Chicago, IL, USA.

Anatomical abnormalities of the cervical spine at the level of the Atlas vertebra are associated with relative ischaemia of the brainstem circulation and increased blood pressure (BP). Manual correction of this mal-alignment has been associated with reduced arterial pressure. This pilot study tests the hypothesis that correcting mal-alignment of the Atlas vertebra reduces and maintains a lower BP. Using a double blind, placebo-controlled design at a single center, 50 drug naive (n=26) or washed out (n=24) patients with Stage 1 hypertension were randomized to receive a National Upper Cervical Chiropractic (NUCCA) procedure or a sham procedure. Patients received no antihypertensive meds during the 8-week study duration. The primary end point was changed in systolic and diastolic BP comparing baseline and week 8, with a 90% power to detect an 8/5 mm Hg difference at week 8 over the placebo group. The study cohort had a mean age 52.7+/-9.6 years, consisted of 70% males. At week 8, there were differences in systolic BP (-17+/-9 mm Hg, NUCCA versus -3+/-11 mm Hg, placebo; P<0.0001) and diastolic BP (-10+/-11 mm Hg, NUCCA versus -2+/-7 mm Hg; P=0.002). Lateral displacement of Atlas vertebra (1.0, baseline versus 0.04 degrees week 8, NUCCA versus 0.6, baseline versus 0.5 degrees , placebo; P=0.002). Heart rate was not reduced in the NUCCA group (-0.3 beats per minute, NUCCA, versus 0.5 beats per minute, placebo). No adverse effects were recorded.

We conclude that restoration of Atlas alignment is associated with marked and sustained reductions in BP similar to the use of two-drug combination therapy.

Journal of Human Hypertension advance online publication, 25 January 2007; doi:10.1038/sj.jhh.1002133.

Hyperventilation Syndrome: A Diagnosis Begging for Recognition


GREGORY J. MAGARIAN MD; DEBORAH A. MIDDAUGH MD, and DOUGLAS H. LINZ MD, Portland
Topics in Primary Care Medicine


"Topics in Primary Care Medicine" presents articles on common diagnostic or therapeutic problems encountered in primary care practice. Physicians interested in contributing to the series are encouraged to contact the series' editors. --BERNARD LO, MD, STEPHEN J. McPHEE, MD Series' Editors


Refer to: Magarian G J, Middaugh DA, Linz DH: Hyperventilation syndrome: A diagnosis begging for recognition (Topics in Primary Care Medicine). West J Med 1983 May; 138:733-736. From Ambulatory Care and Medical Services, Veterans Administration Medical Center, and the Division of General Medicine, Department of Medicine, Oregon Health Sciences University, Portland. Supported in part by HEW grant No. 1-028-PE10051-02. Reprint requests to Gregory J. Magarian, MD, Ambulatory Care Service (llC), Veterans Administration Medical Center, Portland, OR 97207.



Beginning with the American Civil War, military physicians seeing soldiers under the stress of combat have described a syndrome characterized by breathlessness, lightheadedness or dizziness, pronounced fatigue and exercise intolerance, numbness and paresthesias and chest pain. Rarely have organic diseases been found to account for the symptoms in such cases, yet despite reassurance, symptoms commonly persist for prolonged periods despite removal from the apparent stress setting. This syndrome has been given many names including irritable heart, soldier's heart, Da Costa's syndrome, effort syndrome, neurocirculatory asthenia and, more recently, hyperventilation syndrome.

Since the original descriptions in soldiers, it is now recognized that hyperventilation occurs in many persons under stresses of daily living. It is manifest not only in those overtly stressed, anxious and depressed but also in those who appear outwardly calm as they "bottle up" their feelings, often because of undeveloped or lack of acceptable emotional outlets. Physicians and lay persons alike readily recognize acute hyperventilatory attacks occurring under acute stress. However, chronic or recurrent hyperventilation problems often are unrecognized probably for a variety of reasons, including the frequent lack of obvious overbreathing, a tendency to focus on one or two complaints that alone are not particularly suggestive of hyperventilation, minimal discussion of the topic in medical school and cursory coverage in medical textbooks.

Physiology of Hyperventilation Although precise delineation of the relationship between physiologic responses and symptoms of hyperventilation is lacking, an understanding of known physiologic mechanisms does provide insight (Table 1). Hypocapnea and respiratory alkalosis develop rapidly upon onset of hyperventilation and can easily be maintained indefinitely, by nearly imperceptible hyperventilation, such as by taking an occasional deep breath while maintaining a normal respiratory rate. Without knowing this, physicians may directly observe the subtle, chronic form of hyperventilation without recognizing it or, upon considering the diagnosis, inappropriately reject it because the anticipated hyperventilatory respiratory pattern is not present.

TABLE 1.--Physiologic Responses Associated With HyperventilationHypocapnic, respiratory alkalosisHyperadrenergic state Increased oxygen binding to hemoglobin (Bohr effect) Hypophosphatemia Initial vasodilatory, later vasoconstrictive cardiovascular responses Reduced cerebral perfusion Possible coronary vasospasm

Stress is often associated with a hyperadrenergic state that is known to provoke hyperventilatory responses in humans. Beta-blocking drugs may reduce not only stress levels but also ventilatory responses to catecholamine stimulation and have recently been shown to improve performance levels in stressful situations.

Respiratory alkalosis increases the avidity of oxygen binding to hemoglobin such that oxygen becomes less readily released to tissues (the Bohr effect). Hypophosphatemia develops rapidly and persists for the duration of respiratory alkalosis, probably related to intracellular shifts of phosphorus. With persistent hyperventitation, hypophosphatemia would impair generation of 2,3-diphosphoglycerate (2,3- DPG), further reducing oxygen availability for tissue utilization.
It is estimated that a 2 percent reduction in cerebral blood flow occurs for every decline of 1 mm of mercury in arterial carbon dioxide tension. This, along with the Bohr effect, leads to reduced cerebral oxygenation. Cerebral hypoxia, however, produces a vasodilatory response that may compensate for the initial reduction in cerebral perfusion.

Cardiovascular responses are variable and seem to be in large part related to the duration of hyperventilation. The initial response is a reduction in systemic vascular resistance and blood pressure with an increase in heart rate and cardiac output. Within four to seven minutes of sustained hyperventilation, however, this response diminishes or disappears.

Finally, several investigators have shown coronary vasoconstriction induced by hyperventilation in some patients with Prinzmetal's angina and others with fixed coronary occlusive disease.
PathogenesisHow does the hyperventilation syndrome develop? Although hyperventilation may have organic or physiologic causes, the syndrome of hyperventilation is usually associated with emotional triggers and thoracic breathing tendency. Indeed, many persons who are anxiety-laden, stressed or depressed have hyperventilatory breathing patterns and complain of their inability to obtain satisfying deep breaths. Anxiety, anger and other emotions produce increases in both rate and depth of respirations probably mediated by a hyperadrenergic state. Once hyperventilation is initiated, persisting stresses of everyday living or the stresses of new bothersome symptoms from hyperventilation create the potential for a self- perpetuating cycle of chronic hyperventilation (Figure 1 ). Persons who hyperventilate more commonly exhibit obsessional behavior, excessive body consciousness, phobias, feelings of inadequacy and maladjustments in many stages of life. Lum believes that an exaggerated tendency to breathe using thoracic musculature is an important factor allowing for the development and, once developed, the persistence of the hyperventilatien syndrome.

Symptoms and Signs of Hyperventilation SyndromeAmong the most difficult and frustrating. patients for physicians are those with multiple complaints involving many organ systems who, despite seeing numerous physicians, fail to obtain a satisfactory explanation or relief from their symptoms. They often have a "positive review of systems." After numerous physicians have been seen and multiple diagnostic tests have been done, which have excluded organic disorders, such patients are often dismissed as having nothing wrong with them or having a severe neurosis, anxiety, depression, hypochondriasis or hysteria, despite the persistence of symptoms that may be disabling in their work and other aspects of everyday living. Unfortunately, this scenario continues to be a common occurrence and is the frequent setting in which the hyperventilation syndrome is recognized, months or years after its onset. Previous studies have shown that 5 percent to 10 percent of patients seeking care from primary care physicians have at least some complaints related to hyperventilation.

TABLE 2.--Signs and Symptoms of Hyperventilation SyndromeGENERAL Weakness, fatigue, sleep disturbances, blurred vision

PSYCHIATRIC Anxiety, depression, phobias, feeling far away, sensations of unreality
NEUROLOGIC Paresthesias in extremities or periorally, lightheadedness, dizziness, disorientation, impaired thinking, seizures, syncope, headaches
CARDIOLOGIC Palpitations, chest pain
RESPIRATORY Dyspnea often without provocation characterized as being unable to take a satisfying deep inspiration, exaggerated thoracic breathing, sighing, yawning
GASTROINTESTINAL Dry mouth, bloating, belching, flatulence
MUSCULAR Cramping, spasm, musculoskeletal chest wall pain (chest wall syndrome)

The hyperventilation syndrome may be associated with a myriad of symptoms (Table 2), affecting both men and women equally. The most frequent complaints for which medical attention is sought are lightheadedness or dizziness, dyspnea and chest pain. Substantial weakness, exercise intolerance, fatigue and peripheral or perioral numbness and tingling, occurring in isolation or in concert with other hyperventilatory symptoms, are almost always present. Many patients have multiple other complaints. When symptoms are taken in isolation, the syndrome is often not considered. However, when taken together, the entire symptom complex often makes the diagnosis rather obvious.

The dizziness of hyperventilation may be described as lightheadedness or an unsteady, giddy feeling, similar to drunkenness or vertigo. In one review of 104 patients who presented to a specialty clinic for the evaluation of dizziness, 23 percent had hyperventilation as the sole or prominent contributing factor. There may also be some degree of disorientation and mental impairment.
Breathlessness is a common complaint and is usually described as the inability to inhale a satisfyingly deep breath. It may be manifested by periodic, predominantly thoracic deep breaths, sighing and yawning. Sighing dyspnea is not a manifestation of cardiac failure. Although the hyperventilation syndrome rarely is associated with an obvious increase in respiratory rate, astute observers usually will note an increase in thoracic respiratory efforts. Paradoxically, whereas many people take deep breaths in an effort to relax, they may be provoking the very state they wish to avoid. The dyspnea of the syndrome may arise from fatigued respiratory muscles, overworked from chronic, excessive respiratory efforts. Since this type of dyspnea rarely occurs in the absence of other related symptoms, it is important that other manifestations of the hyperventilation syndrome be sought in all cases of otherwise unexplained dyspnea.

Gastrointestinal manifestations include dry mouth, bloating, belching and flatulence, related to aerophagia associated with overbreathing. Depression with attendant anorexia and weight loss may mimic systemic disease.

Cardiovascular symptoms of the syndrome are primarily palpitations and chest pain, which may mimic angma. Continuous ambulatory electrocardiographic monitoring of hyperventilators has shown frequent sinus tachycardia and supraventricular arrhythmias, even during sleep. Hyperventilatory symptoms without apparent provocation may occur during these times.
The chest pain of hyperventilation is variably described. It may be sharp and stabbing, thought to be related to pressure on the diaphragm from gastric distention or diaphragmatic hypertonicity related to a generalized hypertonic muscular contractile state. Other types of chest pain have features that may strongly suggest angina including location and radiation patterns. The pain may be described as dull, gnawing, burning or constricting and localized to the precordial or retrosternal area but is often rather diffuse and of greater duration than is typical of angina pectoris. It is not predictably associated with events that usually provoke angina, frequently occurring at rest or after exertion, and is not reliably relieved by nitroglycerin. Occasionally, "pseudoischemic" electrocardiographic patterns may be seen in patients with chest pain from hyperventilation. It currently remains uncertain whether hyperventilation- induced coronary vasospasm and myocardial ischemia contribute to the chest pain associated with the hyperventilation syndrome. Unfortunately, a diagnosis of noncardiac chest pain, while initially gratifying, usually does not result in a significant reduction in outpatient clinic or emergency room visits as symptoms often persist. Therefore, in evaluating chest pain, the historical data base should include questions directed toward the possibility of hyperventilation lest the etiologic basis of the chest pain be dismissed as noncardiac, yet unrecognized as hyperventilatory.

Other symptoms of hyperventilation are usually present but rarely offered voluntarily. Apart from other disorders the patient may have, the physical examination is often normal. Patients often do not appear overtly anxious though they are frequently depressed. Obvious hyperventilation is usually lacking although occasional deep breaths, sighing or yawning and palpable chest wall tenderness may be noted. The diagnosis of chest wall syndrome requires exclusion of the hyperventilation syndrome which may be its basis.
It is critical to recognize that the presence of the syndrome does not exclude the presence of an organic disease. In fact, reaction to the symptoms of an organic disease may be a prime factor provoking hyperventilation.

Management of Hyperventilation SyndromeAs many patients with the syndrome have had symptoms for months or years and have seen other physicians without appreciating the cause of their symptoms, it is important that the patient be confronted with the cause-and-effect relationship between hyperventilation and their symptoms. A hyperventilatory trial is crucial for therapeutic success. This can be accomplished by having the patient breathe deeply at a rate of 30 to 40 times per minute. Most patients with the hyperventilation syndrome will recognize at least some of their symptoms within several minutes and often in seconds. This recognition and subsequent explanation of hyperventilation greatly enhances the potential for improvement. An explanation and reassurance without the patient actually experiencing the cause-and- effect relationship of overbreathing at the time is often without therapeutic benefit.
After provocation of symptoms .during a hyperventilatory trial, breathing into a lunch bag-sized brown paper bag will result in resolution of those symptoms that are directly related to hypocapnea. Dyspnea and chest pain, however, may persist in that they are not caused by hypocapnea, but more likely by the excessive use of thoracic musculature.

Because many patients have experienced substantial adverse effects on their employment and social interactions it is beneficial for a spouse or a friend to be present during a hyperventilation trial. Family and friends may be highly skeptical that something as simple as overbreathing can be having such devastating effects on the patient and indirectly upon them as well. Convincing both the patient and others provides support for the patient as he or she attempts to regain control.

Although some believe bag rebreathing is of little value, we have found it to be useful, allowing patients an escape from symptoms. Initially, we encourage patients to attempt bag rebreathing, relax and get away from the situation that may have triggered the response. As a result, patients appreciate a newfound control. This greatly reduces the anxiety and stress that fuel the hyperventilation cycle.

Long-term control may be achieved by relaxation therapy and retraining patients to become diaphragmatic rather than thoracic breathers. Referral to behavior modification experts may be of value in particularly difficult patients with long-standing symptoms. In anxious and depressed persons with chronic hyperventilation we have rarely seen substantial benefit from the use of anxiolytic or antidepressant medications when the hyperventilatory component was unrecognized or being inadequately addressed. in conjunction with therapeutic measures directed toward the hyperventilatory tendency these drugs may be of additional benefit though we often find them unnecessary.

GENERAL REFERENCES Evans DW, Lure LC: Hyperventilation: An important cause of pseudoangina. Lancet 1977; 1: 155-157
Heistad DD, Wheeler RC, Mark AL, et al: Effects of adrenergic stimulation on ventilation in man. J Clin Invest 1972; 51:1469-1475
Lary D, Goldschlager N: Electrocardiographic changes during hyperventilation resembling myocardial ischemia in patients with normal coronary arteriograms. Am Heart J 1974; 87:383-390
Lurm LC: Hyperventilation: The tip of the iceberg. J Psychosom Res 1975; 19:375-383
Magarian GJ: Hyperventilation. syndromes: Infrequently recognized common expressions of anxiety and stress. Medicine 1982; 61:219-236
Pfeiffer JM: The aetiology of the hyperventilation syndrome. Psychother Psychosom 1978; 30:47-55

As previously stated, in the subluxated patient, the brain is not processing or organizing the flow of sensory impulses in a manner that gives the individual good, precise information about himself or his world. Thus any efferent output will be inefficient and lead to eventual dysfunction and limitation.

The chiropractic subluxation is any afferent-based program that leads to long-term pathology and inefficiency. The interference in the nervous system is on the afferent side NOT the efferent side. It just may not be the area of pain, or motor unit fixation, or wedge on X ray, or the loss of a lateral curve that, if corrected, will give the CNS the best information about its internal and external environment and allow it to produce the most efficient output. It just may be the wedge on X ray or the listing just may change from day to day.

Critical Thinking: Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action. In its exemplary form, it is based on universal intellectual values that transcend subject matter divisions: clarity, accuracy, precision, consistency, relevance, sound evidence, good reasons, depth, breadth, and fairness. It entails the examination of those structures or elements of thought implicit in all reasoning: purpose, problem, or question-at-issue; assumptions; concepts; empirical grounding; reasoning leading to conclusions; implications and consequences; objections from alternative viewpoints; and frame of reference.

Neuronal Fatigue

Not only does neurophysiological partitioning siphon off available ATP to other more important circuits within the CNS, dysponetic processing secondary to subluxation can also reduce intracellular energy reserves of neurons, with a consequent decrement in neuronal performance, such as a reduction in action potential amplitude or a reduction in maximum frequency of activation. When a neuron transmits more frequently or more continuously than appropriate to its physical design, and is required to repolarize its membrane and resynthesize transmitter more rapidly than its capacity, fatigue may occur as it does at any cell. The possible sites of this fatigue lie within the mechanisms for polarizing the membrane and for synthesizing transmitter substance.

Continued activation of circuits in the neocortex, limbic system, thalamus, hypothalamus or reticular activating system as a consequence of dysponetic processing (secondary to subluxation) can generate fatigue of neurons in any CNS area. Any circumstances that diminish or impair restorative processes within the organism, such as sleep deficits, debilitating active dis-ease, injury or drugs, facilitate the development of neuronal fatigue.

When energy reserves (ATP) within a neuron are reduced sufficiently, the energy available for repolarizing the membrane after each transmission of an action potential is reduced, with resultant impairment of the repolarization process. Impaired and inefficient neuronal performance results. A lengthened repolarization time reduces the maximum frequency of transmission of action potentials and an incompletely repolarized membrane would reduce the magnitude of the action potential.

Declining ATP resources within a neuron also reduces the energy at hand for synthesizing neurotransmitters and receptor function. The result is a reduction in the excitatory or inhibitory effect of the neuron.

The central theory of biology is evolution through natural selection. Frankly, if we assume a stationary environment, natural selection improves the ability of an average organism to reproduce fertile offspring. Consequently we arrive at the notion of evolution as an energy efficiency optimization process. These plastic changes have to happen at the microscopic cellular level (DNA expression).

Since the CNS controls and regulates all physiological process of the human body, these optimizations must occur at the microscopic cellular level in the nervous system first.

All these changes can be explained by considering the process of energy efficiency of neural communication and neural processing. Energy (available ATP) is finite. It is reasonable to assume that the limiting factor for this energy efficiency optimization process is the use of available ATP. Thus, to optimize neurological programs, the CNS will shunt and mobilize ATP to the areas of greatest physiological need in the CNS. This is neurophysiological partitioning.

Immediate energy-efficient processing of information can explain seemingly independent physiological processes. In the context of energy, neural processing is rather expensive. The adult human brain accounts for 20 percent or more of our total energy use. In young children, whose brains are nearly as large as an adult, the energy use by this organ can account for nearly 50 percent of the ATP use. Recent studies have shown that 85 percent of the energy used by the brain goes toward restoring the ion fluxes across neuronal membranes that are the biophysical basis of computation and communication in the neocortex. Thus information processing, although perhaps five or six orders of magnitude more energy efficient than man-made computation, is a considerable expense for the organism. Our survival and dominance as a species is dependent on the energy efficiency of CNS processing.

This is chiropractic’s greatest challenge and opportunity for increasing human potential. Increasing the efficiency of CNS processing is the chiropractor’s true goal.

Long ago I stopped blaming my computer for all the errors it produced. If the hardware and software were in working order, the machine would simply produce from the input loaded into it. Similarly, the thalamus (as the integrator and filter of all sensory information, except smell) is the primary focus of the functionally based chiropractor. L5 cannot even misalign chronically without cortical firing. Sensory cortical firing originates with thalamic firing into the sensory cortex. Our perceived and unperceived reality begins and stops at the thalamus.

Paradigm: A set of assumptions, concepts, values, and practices that constitutes a way of viewing reality for the community that shares them, especially in an intellectual discipline.

A philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations and the experiments performed in support of them are formulated; broadly : a philosophical or theoretical framework of any kind.

Since the late 1960s, the word paradigm has referred to a thought pattern in any scientific discipline or other epistemological context.

Philosopher of science Thomas Kuhn gave this word its contemporary meaning when he adopted it to refer to the set of practices that define a scientific discipline during a particular period of time. Kuhn himself came to prefer the terms exemplar and normal science, which have more exact philosophical meanings. However, in his book The Structure of Scientific Revolutions Kuhn defines a scientific paradigm as:

• what is to be observed and scrutinized,
• the kind of questions that are supposed to be asked and probed for answers in relation to this subject,
• how these questions are to be structured,
• how the results of scientific investigations should be interpreted.

Paradigm Shift : When anomalies or inconsistencies arise within a given paradigm and present problems that we are unable to solve within a given paradigm, our view of reality must change, as must the way we perceive, think, and value the world. We must take on new assumptions and expectations that will transform our theories, traditions, rules, and standards of practice. We must create a new paradigm in which we are able to solve the insolvable problems of the old paradigm.

Evidence or Eminence Based Medicine?

“Power to corrupt, and absolute power corrupts absolutely.”

• The Entire Chiropractic Profession has only 70 full time researchers

· The drug company Pfizer has 12,000 full time researchers

• Less than 5% of full time DC Faculty at chiropractic institutions are involved in chiropractic research
• The total budget (for Everything) for all our chiropractic institutions is a mere $224 million
• Of that $224 million of the total budget, our chiropractic institutions spend only $4 million on research programs
• Harvard University receives $739 million a year from the NIH alone just to do research
• In the entire 100+ year history of the chiropractic profession, chiropractic has received less than $10 million from the federal government to do research
• The top 25 medical schools received $6 Billion from just the NIH in 2000 alone

What are the results?

When one begins comparisons with medical / allopathic procedures, the statistics really begin to spin one’s head. Using a baseline figure of one per one million as an estimate of stroke incidence attributed to cervical manipulations (not just chiropractic, but all such procedures), one finds a:

· Two Times greater risk of dying from transfusing one unit of blood

· 100 Times greater risk of dying from general anesthesia

· 160-400 Times greater risk of dying from the use of NSAIDS

· 700 times greater risk of dying from lumbar spinal surgery

· 1000-10,000 times greater risk from traditional gall bladder surgery

· 10,000 times greater risk of serious harm from medical mistakes in hospitals

The 225,000 deaths per year attributed to medical iatrogenesis (allopathy) have propelled it to the third leading cause of death, after heart disease and cancer.

Absolute, testosterone charged, black and white statements by heroic allopathic physicians will have to give way to the gray world of reality and hard numbers brought to us by evidence and real science – rather than Eminence based medicine and allopathic-religious superstitions.

Dysponesis: Chiropractic in a word

by Christopher Kent, D.C., FCCI and Patrick Gentempo, Jr., D.C.

Medical practitioners seem to be obsessed with the diagnosing and naming of specific "conditions," while often overlooking the underlying cause. This has resulted in a myopic assessment of patients which could be partially responsible for medical malpractice being the third leading cause of preventable death in this country [1].

Dysponesis does not mechanistically describe a specific "condition," but rather relates to human homeostasis and dis-ease. It relates to human health as a functional whole, rather than a sum of independent parts. It is philosophically and scientifically appropriate for a chiropractor to diagnose a patient with dysponesis secondary to vertebral subluxation complex. All that is necessary are the tools and the understanding.

Dysponesis is defined by Doreland's Medical Dictionary as follows:

A reversible physiopathologic state consisting of unnoticed, misdirected neurophysiologic reactions to various agents (environmental events, bodily sensations, emotions, and thoughts) and the repercussions of these reactions throughout the organism. These errors in energy expenditure, which are capable of producing functional disorders, consist mainly of covert errors in action-potential output from the motor and premotor areas of the cortex and the consequences of that output.

Physicians Whatmore and Kohli, who first described dysponesis, observed that "Most diseases consist of physiologic reactions that lead to organ dysfunction. These physiologic reactions constitute the response of the organism to some noxious agent, whether microbial, chemical, or mechanical." [2]

D.D. Palmer emphasized the importance of "tone" in the dynamics of health and disease. "Life is an expression of tone. Tone is the normal degree of nerve tension. Tone is expressed in function by normal elasticity, strength, and excitability...the cause of disease is any variation in tone." [2] B.J. Palmer acknowledged the role of muscular function in maintaining life. "Life is motion; motion is life. The absence of motion is death...in human beings, motion is produced by muscles...that which moves muscles is nerve force." [3]

Traditionally, the vertebral subluxation consists of a loss of juxtaposition of a vertebra with the one above, the one below, or both, to an extent less than a luxation. Furthermore, there is occlusion of opening, impingement of nerves, and interference with the transmission of mental impulses. [5] A contemporary definition of the vertebral subluxation complex proposes five components: spinal kinesiopathology, neuropathology, myopathology, biochemical changes, and pathology. [6] It is significant that both definitions incorporate both structural and physiological factors.

The term "dysponesis" is derived from "dys" meaning faulty, and "ponos" meaning effort, work, or energy. It is important to remember that motor dysfunction results from nerve interference. Neurological dysfunction is, by definition, an element of the vertebral subluxation described in chiropractic. According to D.D. Palmer, vertebral subluxations may be caused by trauma, poisons, or autosuggestion. Whatmore and Kohli note that "The agent to which the organism is reacting can be an environmental event, a bodily sensation, an emotion, or a thought." Dysponesis effectively expresses, in contemporary terms, the essential elements of the vertebral subluxation complex.

A clinical challenge to the chiropractor is determining the presence and correction of vertebral subluxations. Many D.C.s feel uncertain about their analytical strategies for determining if a patient is subluxated, and if the subluxation was corrected following an attempt at adjustment. Fortunately, technology exists to objectively assess muscular activity as it relates to subluxation.

A clinical challenge to the chiropractor is determining the presence and correction of vertebral subluxations. Many D.C.s feel uncertain about their analytical strategies for determining if a patient is subluxated, and whether the subluxation was corrected following an attempt at adjustment. Fortunately, technology exists to objectively assess muscular activity as it relates to subluxation.

Dysponesis defined

Dysponesis is a reversible pathophysiologic state. It is composed of neurophysiologic reactions to various agents, and the repercussions of these reactions throughout the organism. The neurophysiologic reactions consist mainly of covert errors in energy expenditure. [2] To the chiropractor, it is essential to develop clinical strategies which are effective in disclosing these covert errors in energy expenditure and correcting them.

Whatmore and Kohli describe the factors which determine the specific effects that dysponesis will have in a given person:

1. The inherited constitutional characteristics of the individual.

2. Acquired characteristics of the individual, resulting from the person's total past experience.

3. Activity going on within the neuronal networks of the nervous system at the time he or she is subjected to dysponetic influences.

4. The duration, magnitude, and distribution of the particular dysponesis present at that time.

These authors developed diagnostic strategies for the assessment of dysponesis using multi-channel surface electrode electromyography. Today, better technology makes assessment of dysponesis practical in the clinical setting. Modern surface EMG equipment is capable of performing static surface EMG measurements, as well as graphing the real time action of muscle groups being assessed.

Surface EMG techniques have the ability to disclose "covert errors in energy expenditure" in asymptomatic patients, permitting the chiropractor to intervene with appropriate adjustments before pain or pathology become evident. Protocols for SEMG in chiropractic practice have been published in peer reviewed scientific journals. [7,8] Furthermore, there are over 300 scientific papers in the indexed scientific literature on surface EMG.

Dysponesis embodies the tenets of traditional chiropractic philosophy and the technology of the 21st century. Acknowledging the devastating effects of the vertebral subluxation upon human health, the chiropractor now has the clinical and intellectual tools to effectively lead humanity into a healthful and fulfilling 21st century.

References

1. Dye M: "Silent danger of medical malpractice: third leading cause of preventable death in U.S." Public Citizen May/June 1994, p. 10.

2. Whatmore GB, Kohli DR: "Dysponesis: a neurophysiologic factor in functional disorders." Behavioral Science 13:102, 1968.

3. Palmer DD: "The Chiropractor's Adjustor." Portland Publishing House. Portland, OR. 1910.

4. Palmer BJ: "The Law of Life." Audio tape of lecture delivered at the Palmer School of Chiropractic. Davenport, IA.

5. Stephenson RW: "Chiropractic Text-Book." The Palmer School of Chiropractic. Davenport, IA. 1927.

6. Flesia J: "Renaissance--A Psychoepistemological Basis for the New Renaissance Intellectual." Renaissance International. Colorado Springs, CO. 1982.

7. Kent C, Gentempo P: "Protocols and normative data for paraspinal EMG scanning in chiropractic practice." Journal of Chiropractic Research and Clinical Investigation. October 1990.

8. Kent C, Gentempo P: "Dynamic paraspinal SEMG: a chiropractic protocol." Chiropractic Research Journal Volume 2, Number 4, 1993.

(CHRISTOPHER KENT, D.C., a 1973 graduate of Palmer College of Chiropractic (PCC), and the ICA's 1991 "Researcher of the Year," was a principal investigator in the PCC research department, assistant professor of diagnosis and X-ray, and president of the faculty senate. A member of the editorial review board for the Chiropractic Research Journal, he has published more than 50 articles in various chiropractic publications, including popular and peer-reviewed journals. He served as an item consultant and reviewer for the National Board of Chiropractic Examiners and as a consultant to the FDA panel on review of neurological devices. Dr. Kent, a Diplomate of the Academy of Chiropractic Radiology, serves as chairman of the ICA College of Chiropractic Imaging. A former associate professor at Palmer College of Chiropractic-West, he has conducted postgraduate programs for PCC, PCC-W, Cleveland, Life-West and Texas Chiropractic Colleges.

PATRICK GENTEMPO, Jr. D.C., a 1983 Life Chiropractic College graduate, is president and co-founder of the seminar group Paradigm Partners, Inc., and chairman of E.M.G. Consultants, Inc. Dr. Gentempo has authored or co-authored more than 30 papers in popular and peer-reviewed journals on a variety of subjects. He is on the post-graduate faculties of leading chiropractic colleges and gives over 40 seminars a year both nationally and internationally. His unique and well-attended presentations combine educational, motivational and inspirational elements, blending the science and philosophy of chiropractic in objective and rational terms.)

What is more important, the L5 disc wedge on the right, or the efficiency of the breathing reflex?

What is more important, the intersegmental glide between C3 and C4 or the body’s ability to dampen the shock force of normal walking?

Case report: The effect of a chiropractic spinal adjustment on toddler sleep pattern and behavior. Rome PL. Chiropractic Journal of Australia 1996 (Mar); 26 (1): 11-14

• Author's abstract: The interaction of the cervical spine with the nervous system, and the effectiveness of spinal adjustment in the management of the poor sleeping patterns of a 12- month-old male are discussed. The history of an often irritable, unsettled infant, is also presented with a brief, but relevant, research review. Since birth, this 12 month old boy would wake up 7-8 times a night. Medication (Panadol TM ) had been given without success. Following the first adjustment (C 1/2 and T 8/ 9) the child slept for seven hours. A second case is briefly discussed of a 4-month-old boy with depressed appetite who slept only 30 minutes at a time. After one adjustment, he slept for 11 hours. Four months later he had a fall and his poor sleeping habit returned. After one adjustment the sleeping returned to normal, in addition he had a normal appetite.

What Makes People Different?

Nerve cells are the same in all humans. It is clear that the merging of our parents’ genes, shaped by experience and culture, ultimately molds each one of us into a distinct individual. But though each one of us has an identifiable set of traits, outcomes & behavior can be variable – sometimes predictable, sometimes erratic. This is because the brain is not unchanging and rigidly logical like a computer, but ever evolving in response to life’s demands. Unlike a digital device, the brain operates more like an orchestra which is complex and interactive. To reach an understanding of illness and treatment, we need knowledge of neuroanatomy and physiology, which are the study of the parts of the nervous system, their functions and how they interact to generate behavior. Although there is still much to be learned, a growing body of scientific evidence has laid the foundation for a true understanding of the biology of illness.

The Causes of Depression

What Causes Depression?

There is a long history of uncertainty in the field of mental health about whether mental illness, especially depression, is psychogenic or biogenic, that is, whether the cause is psychological or biological. Today, mental health professionals agree that, for most mental illnesses, it is difficult to pinpoint any one cause and that multiple factors play a role. But for severe cases of depression, it is agreed that a strong biological component is involved, and that the illness can be brought on with little or no apparent precipitating environmental stressor.

According to integrated models of disease,² the symptoms/signs, severity and duration, and outcome of any disease are the product of complex interactions among multiple factors: biological (inherited vulnerability, malfunctioning bodily organs or systems or disease agents such as viruses), psychological (level of stress, learned coping skills, negative thinking habits, unpleasant or traumatic experiences), and sociocultural (social support, family environment, cultural stigmas towards a disease). In fact, a sickness of any kind, even a physical ailment, is the result of social and psychological factors, to some degree. For example, exposure to a virus isn’t necessarily enough to make one sick. One’s predisposition to illness is influenced not only by genetic makeup but also the status of one’s immune system, which can be affected by stress. The level of stress in a person’s life will be influenced by social circumstances, such as the presence or absence of love and support from family and friends, or stigma towards people with a particular illness, such as depression or AIDS. Individuals coping with chronic illness are particularly vulnerable to the impact of these social stresses.

Cross-cultural research provides some interesting insight into how important love and support from others can be for the prevention of depression even under circumstances we might assume would inevitably bring on a depressive episode. In Western society, it is widely believed that the death of a loved one is such a traumatic event that depression, even if transient, would be a normal consequence for the bereaved. But among the Kaluli tribe in New Guinea, anthropologists found this did not happen. The tribe would offer a member who lost a loved one such strong social support that depression did not occur.

Physiology is also a factor in depression and other mental disorders. Abnormal levels of the neurotransmitters norepinephrine and serotonin and other chemicals that play an important role in pleasure and moods are closely linked with depression.³ Research indicates that depression may also be associated with abnormalities in some structures of the brain.⁴ How the brain’s neurotransmitters and brain structures respond to stress and depression is not fully understood. It is still unclear if changes in brain chemistry and structure are what cause mental disorders, or if those changes are simply a reaction to environmental factors.

In the end, it is probably safe to say that the cause of a depressive disorder in any person is a unique combination of a person’s genetics, health status (especially of the brain), history of relationships, repertoire of learned coping skills, and the psychosocial and cultural environment. What science does understand about brain function and depression makes it possible to influence neurotransmitter activity in the brain with medication and thus bring relief for many cases of depression.

Genetic Factors in Depression

Research shows us that there is a strong familial component to depression, or as some might say, it seems to “run in the family.” That is, children of parents with depressive disorders are more likely to develop depression than are children whose parents who are not depressed. Some of this effect can be explained by the fact that depressed parents behave in ways that “teach” their children to become vulnerable to depression, but studies of identical twins demonstrate that genetics plays an important role. When the influence of learning from depressed parents is removed, as with identical twins who were separated at birth and reared by different sets of parents, the twins whose natural parents were depressed were more likely to develop depression than are those whose natural parents were not depressed. Identical twins reared apart, who share the same genes but different experiences, will develop depression at a similar rate. If one twin develops depression, the other does also 40% to 80% of the time (rates vary according to researchers’ differing diagnostic criteria).

The fact that the rate is not 100% shows that life experiences, i.e. learning, are also determinants of depression. Remember the diathesis-stress and integrative models of illness? Both theoretical frameworks take into account possible differences between identical twins such as learned coping skills, family environment or other factors that may either protect against depression or precipitate it, regardless of genetic makeup.


Neurotransmitter Malfunction: A Biological Cause of Depression?

Every thought, image, or perception that humans experience is mediated by the brain. Each mental event has a biochemical counterpart in the brain; the mind can’t exist without the brain. No matter what events may have led up to it, a depressive episode will always have a neurobiological component. There will be disruptions of neurons and neurotransmitters (especially serotonin [5HT] and norepinephrine [NE], based on our current understanding), which are the chemical substances that send electrical signals between neurons.^3,6

This abnormality in brain function is not entirely understood by neuroscientists, and there are many theories about what actually malfunctions on the cellular level when someone experiences depression. We know that some of the neurotransmitters that seem to be involved in depression are also responsible for important functions known to be impaired by depression, such as sleep, appetite, attention, concentration and emotion.^3,6,7,8 We also know that, while some individuals may be more innately vulnerable to abnormal brain function, most anyone can develop such problems given a sufficient combination of unfortunate circumstances.

The most convincing evidence we now have for the biological cause of depression comes from research into the functions of serotonin and norepinephrine, both of which are in a class of neurotransmitters known as the monoamines. Studies during the 1950s that tested drug treatments for high blood pressure and tuberculosis tipped off scientists that these two neurotransmitters might play a role in regulation of mood. One study tested the drug reserpine (known to deplete monoamine levels in the brain) for treatment of high blood pressure. Fifteen percent of the patients on the drug developed severe depression. In another study, doctors found that treating tuberculosis with a drug that slowed the breakdown of monoamines also improved moods in some patients. From these two studies, it was concluded that low levels of monoamines were the cause of depression. This led to the introduction of the first pharmaceutical drugs to treat depression, monoamine oxidase inhibitors, which work by maintaining normal brain levels of monoamines.

The theory that abnormally low levels of monoamine neurotransmitters, specifi cally serotonin and norepinephrine, are the underlying cause of depressed mood is supported by the fact that depression can be controlled by medications that increase the availability of serotonin and norepinephrine. Also consistent with this model are observations that the illicit drugs cocaine and amphetamine raise norepinephrine and serotonin levels and that both these substances produce shortterm, mood-elevating and stimulating effects.

Scientists are still piecing together the evidence to fully understand how monoamine-elevating substances affect mood. In the case of the illicit drugs, the effects on mood are immediate but short-term and can have permanently damaging effects, whereas the pharmaceuticals work much more gradually. Antidepressant medications do restore monoamine neurotransmitters levels to normal within hours, but it generally takes several weeks before positive changes in mood are evident. One of many possible explanations is that the medications work by increasing the number of monoamine receptors to a level that mood is improved. This increase in monoamine receptors takes time, typically several weeks. These types of uncertainties in the biochemical imbalance model point out the complexity of the systems involved and how much more research is needed.

It may be that individuals with depression don’t all suffer from the same kind of neurotransmitter dysfunction. One person may have a problem with a serotonin defi cit; another may have a problem with a norepinephrine defi cit. According to a leading theory, dysregulation of mood may result from more than a simple defi cit of a neurotransmitter, but a malfunction of the entire system that maintains the synthesis and release of neurotransmitters and the neural pathways that transmit them.^7,10 As changes occur in the brain, including those induced by stress, the neurotransmitters fail to adequately respond. As a result, imbalances occur, either in the level of serotonin and/or norepinephrine.

The differences in neurotransmitters involved in depression for different individuals would explain why people behave differently when depressed. A serotonin defi cit would be more likely to cause sleep and appetite changes, since the areas of the brain that regulate sleep and appetite are known to be more affected by serotonin. Similarly, a norepinephrine defi cit may result in fatigue, since areas of the brain regions regulating energy level are affected by norepinephrine.

The brain has ways of trying to resolve the problems due to neurotransmitter deficits. For example, neurobiologists have detected an increase in the number of receptor sites in the brain, when serotonin is abnormally low. It appears that the brain is trying to do what it can to pick up all the serotonin available to it.

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Brain Structures Involved in Depression

Researchers have identified these areas of the brain that are particularly dependent on serotonin and therefore may play a role in the triggering of a depressive mood when serotonin is low:

Amygdala^11,12 – an almond-shaped structure deep within the brain, which is believed to be involved in depression because it has a role in regulating rage, aggression and sexual behavior, all of which can be affected by depression.

Hypothalamus – is believed to also play a role in depression because it uses serotonin and regulates appetite, sleep, libido (sexual interest), the fight-flight response, and the capacity to experience pleasure – all of which are often reduced in someone who is depressed. The hypothalamus also regulates hormone secretions within the body, so if serotonin in the hypothalamus is depleted, hormone levels could also be affected. Abnormal hormone levels originating in the hypothalamus are not uncommon for women who have just given birth or for individuals under extreme stress. (See the section on stress and the hypothalamicpituitary-adrenal axis).

Imaging technology such as MRI (magnetic resonance imaging) and PET (positron emission tomography) make it possible to study changes in brain structure and funtion in relation to emotional response. According to this type of research, other areas of the brain that may be implicated in depression are:

Hippocampus – a critical structure for memory that is reduced in size in some individuals who are depressed.¹³

Cingulate cortex, the temporal lobe and the left prefrontal area – all play an important role in the regulation of positive emotions, awareness of mood state, and in memory and concentration.^11,14,15,16

Raphe nucleus and locus coeruleus (parts of the brain stem) – sites for the manufacture of serotonin and norepinephrine, respectively.^3,17

Depression and Stress^17,18

As we will see in Lesson Four, there is a strong connection between stress and depression through the body’s steroid hormone system, the Hypothalamic-Pituitary-Adrenal (HPA) axis, which is involved in the fight-flight response to stress. Stress and depression are believed to be related because they have common elements (some of the same neurotransmitters, brain areas, and symptoms).

Although it is known that a malfunctioning HPA axis is associated with depression, it isn’t clear which causes the other or if both are a result of some other process. Because it is affected by the HPA axis, serotonin, one of the primary neurotransmitters involved with regulation of pleasure and mood, is also implicated in stress and depression.

When the HPA axis works normally, stress causes the fight-flight response to be evoked throughout the body via the sympathetic nervous system. Many bodily changes occur. The adrenal glands, which sit atop the kidneys, secrete norepinephrine. As a result, heart rate goes up, blood vessels dilate, and blood pressure increases, preparing a person for fight or flight. The hypothalamus releases corticotropin releasing factor (CRF), which causes the pituitary gland to release adrenocorticotrophic hormone (ACTH) into the bloodstream. The ACTH travels to the adrenal glands, triggering the release of cortisol. Cortisol, a steroid with powerful effects, is necessary at moderate levels for a variety of bodily functions. However, elevated cortisol over time can be damaging. To keep this from happening, the hypothalamus, by a process called a feedback loop, ordinarily monitors the cortisol level in the blood. If it is too high, it will decrease the release of CRF until the cortisol level returns to normal.

Problems arise when chronic levels of high stress cause the HPA axis to “work overtime,” causing the hypothalamus to habituate to elevated cortisol. The feedback loop stops doing its job so that cortisol remains at an abnormally high and unhealthy level. When this happens, a person may become vulnerable to depression.

Some researchers believe that excessive cortisol, which builds up in the body, may be toxic to cells that produce serotonin or use it for nerve signal transmission.^19,20 If serotonin-dependent brain tissue becomes damaged, brain structures that regulate mood don’t work as well. This may be why a person under chronically high stress is prone to depression. Some antidepressants can help normalize the hypothalamus’ feedback loop by lowering the amount of cortisol that is released from the adrenal gland.

Psychological Factors in Depression

The way we perceive process and react to daily events significantly affects our moods and even physiological reactions.²¹ From childhood, we gradually develop habitual attitudes or ways of thinking about ourselves, other people, and the world, which psychologists call “explanatory styles.” Research has found that most people who are depressed have a pessimistic explanatory style.²² Because these unhealthy patterns of thinking are so ingrained, they are almost automatic and instantaneous. This makes it hard to recognize negative thought patterns or see their connection to bad moods.

Cognitive psychologist Martin E. P. Seligman, PhD, who with his colleagues developed the concept of explanatory style²³, identified its three dimensions:

■ Personalization – Internal-External: Do things happen to you because of things within you (intelligence, hard work) or outside of you (luck, other people interfering with you)?

■ Permanence – Temporary-Permanent: Are things the way they are only temporarily and can be changed, or are they not capable of being changed, no matter what?

■ Pervasiveness – Specific-Universal: When something happens, is it always this way, or only just in this one instance?

The most pessimistic explanatory style is one that attributes positive events to external, temporary and specific causes, and negative events to internal, permanent, and universal causes. For example, a pessimist might see a perfect test score as a one-time fl uke, or dumb luck or an easy test, rather than proof of one’s own abilities. On the other hand, the pessimist might react to a bad grade by thinking: “I blew it on the test because I am stupid. I’ll always fail because I am stupid! It won’t change!! Everything I do is wrong!!!” In contrast, the optimist minimizes the significance of a specific negative event and might blame a bad grade on someone or something else, rather than oneself:

“The teacher gave a really hard test” or “I was sick that day.” Failure does not spell doom for the future but is just an isolated incident. In other words, an optimist compartmentalizes life’s upsets, whereas a pessimist reacts by generalizing a single disappointment into the future and all areas of one’s life. It is the “I never do anything right” syndrome, or catastrophic thinking – a kind of negative thought pattern known as a cognitive distortion.

There is some disagreement among mental health researchers about what role cognitive distortions actually play in the development of depression. Some researchers contend that distorted cognitions are what cause depression. Others point to evidence that seems to support the idea that, at least in cases of severe depression, the disruption in mood is first and the cognitive distortions arise from that. Whatever their origin, it is apparent that distorted, pessimistic types of thinking are closely associated with depression. Current research shows that a type of psychotherapy called cognitive behavioral therapy (CBT) can successfully treat most types of depression without the use of drugs.^24,25,26 With CBT, depressed persons learn to replace excessively negative thoughts with more realistic and positive ways of thinking about themselves, the world, and others.

So how does a non-medication treatment help resolve depression, if neurochemistry is the basis for the disorder? It isn’t clear. We have a good idea how antidepressant medications change neurochemistry, thereby resolving depression, but we don’t really understand how this type of psychotherapy works. Apparently, something about the cognitive therapy, which teaches patients to modify pessimistic thought patterns, somehow changes the brain’s neurochemistry in a way similar to antidepressant medication. Perhaps practice at thinking accurately and positively about life helps prune away those old neural circuits, promoting the growth and development of neural circuits that are more adaptive. Or, maybe the psychotherapy helps improve the person’s ability to deal successfully with stress, thus lowering the person’s vulnerability to depression. Quality research over time will help us to better understand how it all works.

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Environmental/Social Factors in Depression

Stress of any type can make us more vulnerable to developing negative moods. Over time, if the stress becomes too great or stays with us for long periods, we may become depressed. It doesn’t matter what the stressor is. It could be stress encountered on the job, in school, or in family relationships. The stress could be due to financial problems, lack of social support or living in poverty or in a noisy or crime-ridden area. Research has clearly shown that living in a stressful environment can eventually led to a depressive episode^{18, 27} even without an apparent triggering event.

There is much scientific evidence to indicate that stress can also directly affect one’s physical health. For example, stress can weaken one’s immune function. In one well-known study, medical students had blood drawn before taking an exam and afterwards to measure levels of immune-response cells to assess immune system function.²⁸ The post-exam measures were significantly lower, apparently due to the stress of taking the exam. This may explain why we sometimes get sick after a period of high stress: Our body’s ability to fight off infections has been compromised by the stress. Thus, stress can have many harmful consequences, both psychologically and physically.

Society, Culture and Mental Health²⁹

With relative ease, most adolescents can describe how society or elements of their culture can contribute to stress in their lives. From the messages and influences in popular media (movies, TV, radio, and print), parents and family history, to peer cliques at school, church, and employment, society and culture profoundly shape how we feel and think about ourselves. Many research studies indicate that the impact of society and culture can contribute to our resistance or vulnerability to stress, depression and other mental disorders. Understanding how societal and cultural forces can make one susceptible to stress and mental illness is the focus of specialized research within sociology and psychology. Sociology is defined as the scientific study of society, social institutions, and social relationships and how these social structures affect individual behavior.

The prevalence of mental illness (i.e. how often it occurs in a population) is affected by certain so-called “social structures” such as race, ethnicity, religion, and social class, which in turn define our culture. Culture refers to patterns of thought, behavior, values and feelings that are characteristic of a social, racial or ethnic group (e.g., children who play on a sports team, a women’s civic organization, members of a religion, an Amish community, African-Americans, or Hispanics) within a larger society.

Attitudes, beliefs, values and standards for normal behavior (called “norms”) within a society are aspects of culture. All of these cultural aspects play a role in an individual’s self identity, which in turn, can either be a determinant of psychological well-being or distress. Whether we recognize it or not, each of us is affected to some degree by many cultural factors by which we are defined, in most cases not by our own choosing. For instance, discuss with students which of the following characteristics play a role in their identity and mental well-being.

- Age
- Marital status
- Body type
- Minority/majority group status
- Disability status
- Family structure
- National origin
- Gender
- Political affiliation/ideology
- Race
- Generational status
- Ethnicity
- Geographic origin
- Religion/spirituality
- Immigration status
- Socioeconomic status
- Language & cultural barriers
- Sexual orientation
- Residence: urban or rural

Using race as an example, national and international epidemiological studies have revealed that the prevalence of all mental disorders is similar between minorities and whites, yet there may be differences when considering specific illnesses such as depression. For example, recent survey research has shown that African Americans may be less likely to suffer from depression than non-Hispanic whites. Race significantly impacts mental well being through differences in health care between whites and racial minorities. The body of current research indicates that racial minority groups are less likely to use mental health services and they receive poorer quality mental health care when they do access services. This contributes to a higher level of unmet mental health needs in minority communities.²⁹

One’s culture can even influence how the symptoms of a mental disorder like depression are expressed, as well as how likely a depressed person would recognize the problem, seek help, and what types of help they might seek. The “Mental Health: Culture, Race, and Ethnicity” Supplement to the Surgeon General’s Report on Mental Health details much of the research that supports a causative relationship between society, culture and depression.

“Cultural and social context weigh more heavily in causation of depression. In the same international studies cited above, prevalence rates for major depression varied from 2 to 19 percent across countries. Family and molecular biology studies also indicate less heritability for major depression than for bipolar disorder and schizophrenia. Taken together, the evidence points to social and cultural factors, including exposure to poverty and violence, playing a greater role in the onset of major depression. In this context, it is important to note that poverty, violence, and other stressful social environments are not unique to any part of the globe, nor are the symptoms and manifestations they produce. However, factors often linked to race or ethnicity, such as socioeconomic status or country of origin, can increase the likelihood of exposure to these types of stressors.”²⁹

More than a decade of research has also demonstrated that certain cultural factors can act as protective factors for persons at risk of depression or other mental health problems. For instance, having a strong religious faith or spirituality has been linked to an improved sense of well being and life satisfaction. Additional protective factors related to social structures or culture include an individual’s sense of social competence and connectedness to others, commitment to schools/ education, and the availability of health and social services. All of these factors are associated with mental health promotion and illness prevention. While the body of research is still evolving and more study is needed, other examples abound that suggest connections between social and/or cultural subgroups and various mental health issues. Students who choose to research the effects of social and cultural differences on mental health, especially in light of the tremendous cultural diversity in the United States, will be at the cutting edge of the mental health field for the next generation.

Social stratification refers to unequal access to resources, power, autonomy, and status across social groups.³⁰ In the United States, the most widely recognized systems of social inequality are based on race/ethnicity, social class and gender. According to current social science research, stratification can have a bearing on the mental well being of individuals through the effects of poverty, segregation and isolation, prejudice and stigma, and limited opportunity. Social scientists have identified two ways that the effects of inequality can heighten vulnerability of stress in the individual of lower economic status. Inability to meet basic material needs simply makes life distressing and harder to endure, especially if poverty is chronic. Social evaluation, or how persons of differing economic classes perceive inequalities, can also be a source of stress and diminished psychological well being by negative self comparisons to others. ³⁰ A sense of failure can take the form of aggression towards others or self-blame.

Although individuals living in poverty are more at risk for developing mental illness, stresses directly related to our consumer-driven, profit-oriented society affect people on all levels of society to some degree. Acquisition of material things in pursuit of the American Dream has resulted in Americans working more than they did 20 or 30 years ago, according to Harvard University economist Julia Schor.³¹ In most families, both parents work, and in some, teenagers hold down jobs to contribute to the family income. Still, the gap between rich and poor in the United States continues to widen, and 38 percent of all children 27 million children – live in low-income families (family earnings at 200% of the federal poverty line or below).³²

Researchers have found that poverty threatens psychological health of children because they are more likely to experience the following stresses²⁹:

■ Parents with unstable employment (especially true of women and non-whites)
■ Living or working in a noxious or hazardous environment
■ Marital problems
■ Parent-child conflicts
■ Parental incarceration
■ Poor nutrition and inadequate stimulation (affecting neurological development and school performance)
■ Poorer general health
■ Lack of culturally meaningful experiences and resources
■ Lack of positive social networks and other means for coping with life’s difficulties

The segregation and isolation related to living in a economically deprived, dangerous neighborhood have been found to be significantly associated with increased mental illness (most notably Post-Traumatic Stress Disorder, PTSD) and relationship problems for children and adolescents. Researchers theorize that risk factors such as a lack of social cohesion, or connectedness, among persons living in unsafe areas feeds a sense of suspicion and mistrust and the belief that events are outside one’s control, which can give rise to futility, self-doubt and depression.³⁰ In areas of high adult unemployment and isolation from the mainstream culture, a collective sense of helplessness can be pervasive. Some sociologists have used the term “culture of poverty” to describe this type of pervasive phenomenon. Culture of poverty can be defined as a self-perpetuating complex of escapism, impulse gratification, despair, and resignation – an adaptation and reaction of the poor to the marginal position in a class-stratified, highly individuated, capitalistic society. For a young person growing up in that kind of negative environment, “success stories” of optimistic cognitive styles and positive lifestyles may be few.

The effects of poverty and race on mental health also vary with urban or rural living. Poor whites who live in rural areas have been found to have poorer mental health than urban whites, whereas poor blacks in rural areas fare better than urban blacks.³⁰ Researchers attribute these differences to how segregation and isolation, tough life conditions, and prejudice impose greater stresses for the urban black and the rural white. In general, the prevalence of mental illness for ethnic minorities rises with decreasing proportion in a community population (the fewer there are of one’s cultural/ethnic group, the more likely one will become mentally ill). However, as this section has shown, depression is due to many interrelated factors including the over-representation of minorities in high-risk populations that have unmet mental health needs.³¹

Prejudice and stigma refer to practices, beliefs or attitudes that discriminate against members of a particular status group. While these concepts will be explored fully in Lesson Eight, it is important to note that researchers have found that experiences of racial discrimination or sexist prejudice are stressors that can contribute to mental health problems or mental illness, but all of that depends on the capacity to resist on the part of the targeted individual. That is, if an individual or family possesses certain protective factors such as high intelligence, social connectedness, a supportive relationship with parents, or, as mentioned earlier, a strong sense of faith or spirituality, these factors may mitigate the degree of illness or problems.

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Interaction of Multiple Factors in Depression

Remember the bidirectionality and integrative models from Lesson Two? What these theoretical frameworks tell us is that biological and psychological, social and cultural factors can have an impact on each other. There is a growing body of scientific evidence validating the idea that the developing brain is somewhat “plastic” and subject to environmental influences.

Research has found that neural circuits in an infant’s brain are either impaired or nurtured by the quality of his or her home life.^6,8,33,34 The brain of a baby raised in an abusive, chronically stressful home will be saturated by excess neurotransmitters associated with the stress response. This can affect the infant’s brain development and make the baby much more vulnerable to stress, anxiety and other negative mood states than one with the same genes and health status, but is reared in a peaceful, loving and stable home. These changes during early neurological development can have lasting effects, leading to behavioral problems and greater susceptibility to stress and anxiety-related problems.

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30. McLeod JD, Nonnemaker JM. Social stratification and inequality. In: Aneshensel CS, Phelan JC, eds. Handbook of the Sociology of Mental Health. New York, NY: Kluwer Academic/Plenum Publishers; 1999.

31. Schor J. The Over-Worked American. New York, NY: Basic Books; 1992.

32. Lu, H-H. Low Income Children in the United States. National Center for Children in Poverty, Columbia University Mailman School of Public Health; 2003. Available at http://www.nccp.org/pub_cpf03.html. Accessed September 29, 2003.

33. Perry BD, Marcellus JE. The Impact of Abuse and Neglect on the Developing Brain. Colleagues for Children. Missouri Chapter of the National Committee to Prevent Child Abuse. 1997;7:1-4.

34. Perry BD, Pollard R. Homeostasis, stress, trauma, and adaptation: a neuro-developmental view of childhood trauma. Child and Adolescent Psychiatric Clinics of North America. 1998:7(1):33-5

Help with brain integration

When you are in a state of depression, your non-dominant hemisphere is 75-85 percent shut down. When you are no longer depressed, there are higher levels of electrical activity on both sides of the brain, and your brain is, what we call in Functional Analysis Chiropractic , integrated.

I am not a big fan of EEG biofeedback therapy because it can inadvertently raise certain brain waves - like theta brain waves - too high. Most people with depression have too much theta and/or too much high beta.

The safest and most effective way I have found to improve brain integration is with a system of mind-body fitness called Functional Analysis Chiropractic and Sensory Integration Exercises. I have one fmany patients whom have had a spontaneous remission of life-long manic depression after doing just a couple Functional Analysis Chiropractic Adjustments. Although these techniques were originally developed to help people with Musculoskeletal Issues, they are radically and surprisingly helpful not only for integrating the brain but for uncovering and reversing the psychological self-sabotage programs that lock many people in a state of depression.

Common Misconception about Chiropractic: "It is quite simple: chiropractic is not limited to the musculoskeletal system."

The Adverse Effects of Chemical Treatment of Depression in Children

The intent of this article is to present to the field doctor the story of growing usage and adverse effects of newer types of antidepressants (selective serotonin reuptake inhibitors, or SSRIs) among children and adults. This is not an attempt to discourage entirely the use of antidepressants by children, but rather, to provide the family chiropractor information that may shed light on the growing concerns held by many in other health care branches.

On January 3, 2003, the Bloomberg News reported that Eli Lilly had been given approval from the Food and Drug Administration (FDA) to release its antidepressant, Prozac (fluoxetine) for treating children and adolescents with depression (major depressive disorder) and obsessive-compulsive disorder (OCD). Prozac was approved for patients 7-17 years of age, although the manufacturer planned not to promote the pill for children. Prozac once was the world's top-selling depression treatment, with annual sales of more than $2 billion dollars.1

After many reports and hearings, on March 22, 2004, the FDA issued a Public Health Advisory regarding the new generation of antidepressants (Prozac, Zoloft, Celexa, Luvox, Paxil and Lexapro), including Wellbutrin, Effexor, Remeron and Serzone. The FDA warned that these antidepressants may contribute to suicide among children and adults for a small few; however, the warning came short of concluding that they were a cause of suicide.

What may not have received as much attention are the other known side-effects of these antidepressants, which include:

* agitation;

* anxiety;

* insomnia;

* panic attacks;

* irritability;

* hostility;

* impulsivity;

* mania;

* hypomania; and

* akathisia (severe restlessness).

It should be further noted that these antidepressants and their induced behaviors, listed above, are identical to those of methamphetamine, cocaine and PCP, all chemicals known to cause violence and aggression. Both the new antidepressants and old stimulants alter the neurotransmitter in the brain called serotonin.2-5 Another added concern to the usage of antidepressants is that the behavior of "mania" often escalates to violence when the person is aggravated. A manic individual can also go into a crash stage of depression or suicidal behavior.

On March 22, 2004, the FDA issued a caution to physicians, their patients and families, urging them to "closely monitor both adults and children with depression, especially at the beginning of treatment, or when the dosages are changed with either an increase or decrease of dose." The FDA also asked the manufacturers to change the labels of 10 drugs to include stronger cautions and warnings about monitoring patients for worsening of depression and the signs of suicidal behavior.6 The FDA has made the new label and cautions available on its Web site: www.fda. gov/cder/drug/antidepressants/ defaults.htm.

Peter Breggin, MD - a psychiatrist, medical expert and author - has been a watchdog regarding the underreporting of side-effects of antidepressants and Ritalin when used on children. His books, The Antidepressant Fact Book, Brain-Disabling Treatments in Psychiatry and Talking Back to Prozac, reveal his decade-long journey to uncover the hidden truths and often tragic outcomes involving children taking these prescription drugs.3-5

Dr. Breggin has recommended that the U.S. follow Great Britain in banning the use of most of these drugs by children. Regarding the new FDA committee suggestion of "black warning labeling" of all antidepressants, Dr. Breggin suggests that he would rather see that the specific drugs be labeled. His concern is that if all antidepressants receive the black label, this would water down the overall impact on the sales of SSRIs, which would positively benefit the drug industry.

Dr. Breggin further suggests that if the FDA is not willing to ban SSRIs drugs, then the FDA should label these drugs a "contraindication" in children. At least a contraindication would be an alert not to prescribe these medications to children. (To stay current with Dr. Breggin's articles and his public safety concerns, periodically check his Web site, www.breggin.com.)

Parents should also be cautious when removing their child too quickly from antidepressants. Withdrawal reactions may take days or weeks; a physician should closely monitor this process. A side-note to the reader is that many antidepressants are prescribed at medically supervised weight-loss clinics and are often used not only on the obese adult, but the adolescent.

Although the family chiropractor does not treat depression, many parents may want to discuss this concern and their child's struggle with this problem. Parents often do not know what direction to take or what alternative choices exist. Further, many parents lack all the information (previously stated side-effects) necessary to make such a critical decision regarding their child.

Dr. Breggin would suggest, "Those struggling with severe depression essentially are feeling profound hopelessness and despair that can be addressed by a variety of psychotherapeutic, educational, and spiritual or religious interventions."

Family chiropractors should keep themselves current regarding the trends of usage of antidepressants by children and the public safety concerns of these drugs, and direct parents to related Web sites, research studies, books and resources. Even developing a network of other health professionals who would approach the child in a noninvasive manner is suggested.

And last, but not least, never underestimate the powerful influence of an upper cervical adjustment. Although studies are warranted in this area, many who perform specific chiropractic adjustive techniques to the upper cervical spine hear of improvement in many of the children's behavioral issues.

This article is available online at www.chiroweb.com/columnist/ anrig. You may also leave a comment or ask a question at her "Talk Back" forum at the same location.

References

1. www.nytimes.com/ 2003/ 01/04/business/04PROZ.html?ex =1103950800&en=b2b5.

2. "The Proven Dangers of Antidepressants." www.breggin.com.

3. Breggin P. Brain-Disabling Treatments in Psychiatry. Springer Publishing, 1997.

4. Breggin P. The Antidepressant Fact Book. Preseus, 2002.

5. Breggin P and Breggin G. Talking Back to Prozac. St. Martin's Press, 1994.

6. www.fda.gov/bbs/topics/ ANSWERS/2004/ANS01283.html.

Some spinal problems can cause ADHD like symptoms because if the spine is not connected to the brain properly nerves from the spinal cord can give the brain all of signals at once making a child rambunctious and always on the go.

A Chiropractor is Doctor trained in the science, art and philosophy of manipulation (adjustment) of the human body. Chiropractic evaluation and treatment is directed at evaluating the cause of the problem through structural analysis of the musculo-skeletal systems of the body. Abnormal function of these systems can lead to abnormal function of the body's nervous system, which in turn may effect function of other systems in the body.

Chiropractic has also been a proven treatment for ADD/ADHD. Twenty-four children were tested in an independent research project conducted by the Psychoeducational & Guidance Service of Texas A&M University. Twelve children received chiropractic care and twelve received medical care.

The outcome proved children receiving chiropractic care improved more than children treated with drugs in areas such as verbal output, reading and comprehension, attitude and self-esteem, coordination and emotional maturity.

Functional Analysis bases its technique on gentle touch and light thrusting by hand or instrument. This low-force adjusting method allows the nervous system to better integrate and understand the new corrective information and to process it throughout the spinal cord and brain.
Functional Analysis utilizes your breathing patterns and how you walk and move to determine the most appropriate places to treat, not just pain. Reconnecting your body with your brain is one of our main goals.
Your spinal corrections do not stop once you get off the table. They continue as you breath and move. You may notice that you hear a click or popping sound in your spine later on the same day after the functional analysis adjustment. That’s your body realigning and correcting its own subluxations.
Functional Analysis teaches and empowers your body to make more corrections and healing with ongoing care.

The relationship between intensity of chiropractic care and the incidence of childhood diseases. Rose-Aymon S, Aymon M. Prochaska-Moss G, Moss R, Rebne R, Nielsen K. Journal of Chiropractic Research, 1989 (Spring): 70-77.

• From the abstract: A pilot study was undertaken to determine if a relationship existed between the incidence of childhood diseases and intensity of chiropractic care. The analysis of the data focused on non-vaccinated children who did not contract the disease in question. The results suggest that intensive chiropractic care (i.e. more than seven visits per year and more than one year of care) increased resistance to the common childhood diseases. Future research on a large scale is needed.

A comparative study of the health status of children raised under the health care models of chiropractic and allopathic medicine. Van Breda, WM and Van Breda JM Journal of Chiropractic Research Summer 1989.

• Lower antibiotic use and lower incidence of disease, especially ear infections, was reported in the chiropractic children. If the "chiropractic" children did get measles, rubella or mumps it was reported that the diseases were quite mild compared to those exhibited by their classmates.

Absence of T-cells, immune dysfunction, has colds all the time. International Chiropractic Pediatric Association Newsletter. November 1996

• Male child - Age 5 from a central American country. Prior diagnosis: malformation of cervical spine, severe scoliosis, occiput position severely anterior to cervical spine. Not vocalizing well. Absence of T-cells, immune dysfunction, has colds all the time. Surgery had been considered to correct skull positioning. In the first series of adjustments, we adjusted the lad in a sitting position utilizing the infant toggle headpiece. The Atlas was adjusted ASL. Child was reevaluated in native country and medical staff stated that everything was now normal. Child returned to U.S. for care 6 months later. Vocabulary was now normal. Head position -normal. No colds evident during these months. Scoliosis was greatly reduced.

References : Children and Chiropractic

• Leboyer, F. 1984. Birth without violence. New York: Alfred A. Knopf. pp.21,28.
  
  

• Van Breda, W.M. & van Breda, J.M. A comparative study of the health status of children raised under the health care models of chiropractic and allopathic medicine. Journal of Chiropractic Research, pp.101-103, Summer 1989.
  
  

• Giesen, J.M., Center, D.B., Leach, R.A. An evaluation of chiropractic manipulation as a treatment of hyperac-tivity in children. JMPT, October 1989; 12: 353-63.
  
  

• Walton, E.V. Chiropractic effectiveness with emotional, learning and behavioral impairments. International Review of Chiropractic, 29: 2-5, 21-22, September 1975.
  
  

• Gemmell HA, Jacobson BH. Chiropractic management of enuresis: Time series descriptive design. JMPT, 1989; 12: 386-389.
  
  

• Lewit K Functional disorders (fixations) of the spine in children. Manuelle Therapie, Barth, Leipzig, 1973, Chap. 2.7. pp. 50-54.

The value of a healthy attitude: how faith, anger, humor, and boredom can affect your health

Does your attitude affect your health? Does a positive, happy one keep you healthier? Or a negative, unhappy, even angry, one hurt you? The answer to all these questions is yes. The mind and body are snugly interwoven, and this connection affects you in more ways than you might be aware of.

It used to be thought that the mind and the immune system existed independently of each other. But research now shows that they may act as a single unit. Feeling stressed, for example, can make you more susceptible to whatever virus is going around. On the other hand, when you feel joyous and lighthearted, your immune system has a better chance of protecting you from it.

It's been shown that even pretending to feel something can affect you. In a study at the University of California at Los Angeles, researchers found that actors could influence their immune systems simply by the emotions they portrayed.

It's a good bet that expectation also plays an important role. If you expect to be healthy, you increase your chances of enjoying good health. If you expect to be ill, you increase your chances of that.

This doesn't have to do just with whether you come down with a cold or a bug. Attitude influences whether you get--and even die from--more serious illnesses. Heart disease is a good example.

Anger is an emotion that's directly related to illness. It has its place in life, and there are times when feeling angry is an appropriate response. But chronic anger or anger that's out of proportion to the situation at hand is another matter. A study in Boston gave a questionnaire to 1,300 men to measure their tendencies toward anger. The study concluded that those men who scored the highest were three times more likely to develop heart disease than the men who scored the lowest.

This knowledge is not brand-new. John Barefoot, Ph.D., a research professor at Duke University Medical Center in Durham, North Carolina, did a 25year follow-up study of a group of medical students. "These were students in the 1950s," he says, "and we followed them up through 1980, I believe." What he and his colleagues discovered was that the ones who were hostile initially were the ones who were more likely to have died by the time of the follow-up study.

What he calls hostility, he says, is "an attitude of cynical beliefs and lack of trust in other people.... If you believe people are mean-spirited and bad and untrustworthy, that leads to a negative world outlook.

"That was one of the first studies," he adds, "but there have been several other studies, larger studies, that have also confirmed that."

In a study conducted at the University of Chicago, on the effect of attitude on health, 200 telecommunication executives were observed as their companies were downsized. The health of the executives who saw change as an opportunity for growth fared much better than those who saw it as a threat. Fewer than a third of the executives who had a positive attitude contracted a serious illness during or soon after the downsizing. But executives who saw downsizing as a personal threat had mare than a 90 percent likelihood of becoming severely ill.

Feeling stressed is something everyone can relate to. What's stressful, though, is an individual matter. A situation that stresses one person may feel exhilarating to someone else and go entirely unnoticed by another.

Boredom has negative effects on your health, also, because of its lack of challenge and mental stimulation. Fatalism has a negative effect too. According to an article published recently in the Washington Post, researchers "stumbled onto a striking finding: Women who believed they were prone to heart disease were nearly four times as likely to die as women with similar risk factors who didn't hold such fatalistic views.

"The high risk of death, in other words, had nothing to do with the usual heart disease culprits--age, blood pressure, cholesterol, weight," the article states. "Instead, it tracked closely with belief. Think sick, be sick."

If we convince ourselves that we're going to develop a particular illness or that we're going to die, we increase our chances of doing exactly that. The article further points out that surgeons are wary of patients who are convinced they're going to die, because almost 100 percent of them actually do.

It may seem that your health is at the mercy of your feelings, but the fact is that you have greater control over them than you might suppose--and there are definite ways you can exercise that control. One is to spend as much time as possible around positive, happy people. Another is to spend as little time as possible around negative, anxious, or angry people.

Support groups can make an enormous difference in your life too. And there are a variety of them around that deal with various problems and illnesses. In a study at Stanford University researchers found that cancer patients who were in support groups stayed in remission longer and lived longer.

When you feel overwhelmed by anxiety, anger, depression, or lack of interest in what's going on around you, it helps to know that you can talk to someone who will listen, someone who may be able to point you in a better direction--a friend, a member of the clergy, or a doctor or therapist. Sometimes what you need most is simply to know that you've been heard, that someone cares, and that you are not alone with your problems.

Religious faith has an enormous effect on your attitude. It can make you more generous and openhearted toward others and toward yourself, too. It helps to look for what's good and uplifting so that you focus more on the positive.

Regular exercise works wonders too. It defuses stress and strengthens your cardiovascular and immune systems while it makes you feel better about yourself.

Prayer, meditation, or simply relaxing while listening to soothing music helps. So does pursuing a hobby--gardening, painting, or cooking, for example. Hobbies give you something else to concentrate on, something to enjoy that shows positive results. And that gives your spirit a much-needed respite.

It's important to develop an attitude of optimism. Even when a situation or circumstance looks bleak, sad, or painful, there will be at least some small thing? the situation that can offer hope or something to smile about. By practicing looking for what's uplifting, you will find it more often.

And then there is humor--one of the most important weapons in a person's attitude arsenal. Humor impacts your health in a number of ways, says Steven M. Sultanoff Ph.D., a clinical psychologist in Irvine, California, and past president of the Association of Applied and Therapeutic Humor.

"Humor stimulates laugher. And we know that physiological stimulation through laughter leads to a number of health benefits. It appears to reduce stress; it tends to boost immunoglobulin A (an antibody that fights upper respiratory disease); and it tends to boost killer T-cells, which are antibodies that fight infection.

"Through laughter we get a physiological stimulation. Humor also stimulates us through what I call mirth. which is an emotional experience," Sultanoff adds. There's an enormous amount of research showing that people who have chronically distressing emotions, such as anger, depression, or anxiety, suffer a negative health impact from them. "The research, particularly on heart disease, is very dramatic," Sultanoff says. "People who are chronically angry and hostile are four to five times more likely to have a heart attack than people who are not.

"There's dramatic research that shows that the distressing emotions lead to bad health, and the experience of humor replaces distressing emotions. So, for example, you may have had a time in your life when you were really angry with someone, and they did something to make you laugh. In that moment you said, `Don't make me laugh. I want to be angry.' The experience of humor displaces the distressing emotion."

Humor also has a positive effect on health in the way that it affects your attitude. There's research showing that the way people believe and the way their attitude is adjusted are directly related to health. People who have a negative or pessimistic attitude about life are actually more susceptible to common everyday illnesses, such as colds or stomach pains.

"Humor changes attitude through what I call wit," Sultanoff continues. "There's a particular element of perspective that's provided by humor that relieves us of a potential health distress. So instead of seeing everything as negative, all of a sudden you see it in perspective."

Something worth cultivating is the ability to see humor in even small everyday things. One of Sultanoff's favorite examples is a sign on the freeway on the way into San Diego. "It says `Cruise Ships Use Airport Exit.' So how many cruise ships do you think there are on the freeway?" he asks. "And why would they use the airport exit?"

Sultanoff concludes, "Another important thing people can do is to learn one humorous thing--a story in their life, or a joke, or anything funny--that they can share with others. There is something in the sharing of humor that rekindles one's own experience. The complement to that is to have a humor buddy--someone who can share something funny with you every day or so."

Considering how important humor and laughter are to the state of health, they are both worth cultivating. So are faith, love, friendship, and pleasure in the small things of everyday life. All of these are within our reach. And all pay big health dividends.

LIFE IS 10% WHAT HAPPENS TO ME, AND 90% HOW I REACT

The Dynamics of Growth and Change

a) The only way life gets better for you is when you get better! Better is not something you wish for; better is something you become
b) If you are not changing your responses to the situations and circumstances that make up your life, you’re not being flexible and thus you’re throwing away your greatest asset as an individual human being
c) By not being prepared, you make the choice of getting caught in some of life’s unpleasant circumstances, such as a rainy day. Make the decision to carry an umbrella. You’ve got to take personal responsibility you’ve got to be self-reliant
d) Learn all you can. Make all the friends you can. Read as many books as you can. Develop as many skills as you can. See and do as much as possible.

• The universe functions according to a set of ordered laws
• Living organisms function as self-regulating systems
• The nervous system plays a significant role in the coordination of function
• Interference with the nervous system's communcation abilities decreases an individual’s capacity for physical, mental and social well-being
• Vertebral subluxations interfere with nervous system function
• Vertebral subluxations are identifiable and correctable
• A human being without vertebral subluxations is in an enhanced state of physiology

Chiropractic Philosophy


Chiropractic is the only health care profession that not only bases its care on clinical research & basic science but also critical thinking and a philosophical approach that matches the reality around us.

80 years ago one chiropractic wrote down some basic tenets that can be proved by quantum physics and sciences of today.

In 1927 Dr. Ralph Stevenson wrote:

The 33 Chiropractic Principles

1. The Major Premise - A Universal Intelligence is in all matter and continually gives to it all its properties and actions, thus maintaining it in existence.

2. The Chiropractic Meaning of Life - The expression of this intelligence through matter is the Chiropractic meaning of life.

3. The Union of Intelligence and Matter - Life is necessarily the union of intelligence and matter.

4. The Triune of Life - Life is a triunity having three necessary united factors, namely: Intelligence, Force and Matter.

5. The Perfection of the Triune - In order to have 100% Life, there must be 100% Intelligence, 100% Force, 100% Matter.

6. The Principle of Time - There is no process that does not require time.

7. The Amount of Intelligence in Matter - The amount of intelligence for any given amount of matter is 100%, and is always proportional to its requirements.

8. The Function of Intelligence - The function of intelligence is to create force.

9. The Amount of Force Created by Intelligence - The amount of force created by intelligence is always 100%.

10. The Function of Force - The function of force is to unite intelligence and matter.

11. The Character of Universal Forces - The forces of Universal Intelligence are manifested by physical laws; are unswerving and unadapted, and have no solicitude for the structures in which they work.

12. Interference with Transmission of Universal Forces - There can be interference with transmission of universal forces.

13. The Function of Matter - The function of matter is to express force.

14. Universal Life - Force is manifested by motion in matter; all matter has motion, therefore there is universal life in all matter.

15. No Motion without the Effort of Force - Matter can have no motion without the application of force by intelligence.

16. Intelligence in both Organic and Inorganic Matter - Universal Intelligence gives force to both organic and inorganic matter.

17. Cause and Effect - Every effect has a cause and every cause has effects.

18. Evidence of Life - The signs of life are evidence of the intelligence of life.

19. Organic Matter - The material of the body of a "living thing" is organized matter.

20. Innate Intelligence - A "living thing" has an inborn intelligence within its body, called Innate Intelligence.

21. The Mission of Innate Intelligence - The mission of Innate Intelligence is to maintain the material of the body of a "living thing" in active organization.

22. The Amount of Innate intelligence - There is 100% of Innate Intelligence in every "living thing," the requisite amount, proportional to its organization.

23. The Function of Innate Intelligence - The function of Innate Intelligence is to adapt universal forces and matter for use in the body, so that all parts of the body will have co-ordinated action for mutual benefit.

24. The Limits of Adaptation - Innate Intelligence adapts forces and matter for the body as long as it can do so without breaking a universal law, or Innate Intelligence is limited by the limitations of matter.

25. The Character of Innate Forces - The forces of Innate Intelligence never injure or destroy the structures in which they work.

26. Comparison of Universal and Innate Forces - In order to carry on the universal cycle of life, Universal forces are destructive, and Innate forces constructive, as regards structural matter.

27. The Normality of Innate Intelligence - Innate Intelligence is always normal and its function is always normal.

28. The Conductors of Innate Forces - The forces of Innate Intelligence operate through or over the nervous system in animal bodies.

29. Interference with Transmission of Innate Forces - There can be interference with the transmission of Innate forces.

30. The Causes of Dis-ease - Interference with the transmission of Innate forces causes incoordination of dis-ease.

31. Subluxations - Interference with transmission in the body is always directly or indirectly due to subluxations in the spinal column.

32. The Principle of Coordination - Coordination is the principle of harmonious action of all the parts of an organism, in fulfilling their offices and purposes.

33. The Law of Demand and Supply - The Law of Demand and Supply is existent in the body in its ideal state; wherein the "clearing house," is the brain, Innate the virtuous "banker," brain cells "clerks," and nerve cells "messengers."

In Sensory Integration Dysfunction, the brain is not processing, or organizing, the flow of sensory impulses in a manner that gives the individual good, precise information about himself or his world.

When the brain is not processing sensory input well, it often means it is also not directing actions or behavior effectively or efficiently. Without good sensory integration, learning is difficult, the brain makes inefficient and inaccurate responses to there internal and external environment.

Acta Neurol Belg. 2005 Mar;105(1):23-9.



Clinical neurophysiology of dystonia.

It took decades to accept that dystonia, a bizarre condition which often produces abnormal movements exclusively during specific activities like writing, was due to brain disease. Clinical neurophysiology certainly added to this evolution of thinking. Recent neurophysiological observations demonstrate that dystonia is not only due to an isolated brain motor dysfunction, but also to sensory and sensorimotor integration disturbances. We hope that new treatment strategies will arise thanks to our better understanding of dystonia pathophysiology.

J Neurol. 2005 Oct;252 Suppl 4:IV13-IV16.




Basal ganglia encompass four to five distinct loops to allow parallel processing of information. Among them, the most intensively studied is the motor loop, which includes two distinct direct and indirect pathways. The direct pathway exerts facilitatory influence upon the motor cortex, whereas the indirect pathway exerts an inhibitory effect. Overall, this dual system provides a center(excitatory)-surround-(inhibitory) mechanism to focus its effect on selected cortical neurons, and several lines of evidence suggest that this center-surround mechanism is used to focus the output on a specific group of muscles required for performing a specific task. This operation is made possible through opening the sensory channel for the expected sensory feed-back afferents during movement. Thus, one of the important functions of basal ganglia seems to be the gating of sensory input for motor control. Dystonia may be caused by a mismatch between sensory input versus motor output, and parkinsonism may be viewed as a disorder of gain control of this sensorimotor integration.

Mild head injuries and chiropractic


Zielinski, Robert J


Count to 15. When you reach 15, another person in the United States will have sustained a head injury. Each year, an estimated 2 million people will suffer a head injury and about 500,000 to 750,000 will be severe enough to be hospitalized. These accident victims will be classified as having a moderate to severe brain injury. However, approximately 85 percent of accident victims will sustain a "mild head injury" or concussion and will not be hospitalized. These accident patients will typically seek treatment for the physical consequences of their accidents in the offices of chiropractors, neurologists, and/or orthopedic doctors. Although these patients generally seek relief from physical pain, i.e., neck, back, and muscle, they may also be suffering the consequences of a closed head injury. An accident victim who has sustained a mild closed head injury may show no noticeable signs of physical damage to the head area, but he or she may be suffering from a traumatic brain injury. It is also necessary to realize that the term "mild brain injury" is a misnomer since any insult to the brain can have significant and devastating effects on cognitive functioning.


An accident victim may have had an automobile accident, a fall, a sports accident, or any other serious event. This can cause trauma to the muscles, bones, ligaments, blood vessels, nerves in the neck, back, and head, and to the brain. A traumatic brain injury can be defined as:

* direct impact of the brain upon the skull caused by an object striking the skull (such as a baseball bat striking the skull)
* the skull striking an object ( such as the head hitting the windshield in a car) the brain undergoing movement in the skull without direct impact to the head (such as a whiplash).
If the brain is damaged at the point of contact, it is considered a coup injury. If the damage is on the opposite side of the brain, it is known as a contrecoup injury.

The mild head injury without visible signs is often overlooked by physicians because the patient looks and acts "normal." In reality, a mild closed head injury may not show structural brain damage on a CAT scan or MRI and the accident patient may or may not have lost consciousness, or only report feeling "dazed" after the accident.

In a mild head injury, there may be no direct blow to the head. Instead, the head may be violently shaken back and forth, as in a rear-end collision. An injury may result to the brain because the brain ricochets inside the skull during the impact of the accident. The bouncing of the brain first against one part of the skull, and then against another, can produce bruises and/or swelling in different parts of the brain. Additionally, a shearing or tearing may occur, especially in the temporal and frontal areas of the brain, because of the skull's bony structure. The shearing and tearing happen on a microscopic level and, for the most part, are not apparent on common medical tests, such as an MRI or CAT scans. It should be noted that even if an MRI or CAT scan is negative, this does not mean that the brain is not compromised. These tests do not assess how the brain processes incoming and outgoing information. They assess only brain structure. In other words, these medical tests do not assess the "brain in action"-cognitive tasks that involve thought, memory, reading, and so on.

When a patient who has been in an accident comes to your office because of neck/back pain, you must be aware that in any accident, the brain may also be compromised. The patient may show only subtle signs of compromised brain functioning, and without an alert recognition of possible problems, the patient is shortchanged in terms of a treatment plan.

By the time the accident victim shows up in your office, he or she may have the following cognitive and personality consequences (beyond the physical problems for which the patient is seeking relief):

Cognitive Deficits
short attention span
short-term memory problems
problem-solving deficits
difficulty in understanding abstract concepts
inability to perform one- or two-step commands simultaneously
problems in reading comprehension or in performing math problems
mispronouncing words
word-finding difficulties
Personality Changes
depression
emotional instability
apathy and lessened motivation
lowered Frustration tolerance
fatigue
increased aggression

If these symptoms do not improve from one to three months after the head trauma, they may become permanent. An appropriate referral to a psychologist, neuropsychologist, or neurologist is absolutely necessary.

Behaviorally, an accident victim with a mild head injury can get confused about performing simple daily tasks, such as remembering telephone numbers, names, and faces, and in carrying out the common tasks of daily life. While pre-injury learning and memory typically remain unaffected, learning new material and procedures can be devastating since so much mental energy is needed to cognitively function that the tasks become overwhelming.

Additionally, in a mild head injury, it is typical that mental confusion occurs in over-stimulating environments, such as grocery stores, malls, restaurants, or large crowds. Learning new material is exhausting for this patient. Performing several tasks at the same time is equally taxing--such as cooking a meal. Concentrating on doing paper work is daunting. This exhaustion occurs because of the necessary additional effort on the part of the patient to pay attention to the task at hand; additionally, it usually becomes worse as the day wears on. The exhaustion is not only mental but also physical. Usually, a rest period is needed in late afternoon or early evening to help the patient recharge his or her "batteries." Along with the mental and physical exhaustion come emotional stress and a reduced ability to control the temper. Thus, the patient may become extremely frustrated, angry, and depressed and experience significant self doubt.
These deficits become even more devastating if the patient has been told that the MRI or CAT scan was negative. Patients wonder if they are "going crazy 11 since they think they should feel normal if their test results come up negative. These accident victims are "put into a box," i.e., victims know that "something is wrong," but they are told that they should not be experiencing cognitive consequences from their accident. Many times patients suffer in silence, afraid to pit their own experiences against their medical tests. The typical result is a depression in which patients doubt their own cognitive weakness experiences. This self-doubt is overwhelming in terms of emotional functioning.

Patients with a mad head injury tend to deny their cognitive problems and try to cover up their weaknesses. Few patients want to admit memory lapses, cognitive confusion, reading comprehension problems, or other related cognitive tasks. They want to avoid losing a job. Or they want to appear "normal" in daily life.

For the treating chiropractor, careful observation and active listening to the patient's verbalizations are necessary to detect if subtle consequences of the mild head trauma are present. For instance, does the patient forget simple instructions during your treatment, ask you to repeat what you have said, have problems verbally expressing thoughts, stumble over words, need to be directed over and over to perform a task, have difficulty discriminating left from right, or seem to be depressed or unduly anxious?
Questions can be directed to the patient, such as:

How is your memory?
Do you have problems remembering what you read?
Do you get distracted easily?
Is your thinking confused?
Do you forget what has been told to you?
Do you have trouble performing daily tasks?
Do you have problems following directions?
Has there been a change in your personality since the accident?

These, among other variables, can suggest that the patient is suffering from the consequences of a mad head injury. Since many patients, however, will try to deny "problems," each response will need to be validated by behavior observed by the treating physician. Other methods of inquiry could include questionnaires relating to the consequences of a mad head injury, as well as computerized screening assessments of the patient.

The first tragedy of an accident victim may be a mild traumatic brain injury. The second tragedy is if a treating physician does not recognize the devastating cognitive and emotional consequences of a brain injury, which may mean that a proper referral to those professionals with expertise in working with head-injured patients is not made.

The author would like to state that this article is not intended to be an exhaustive examination of mild traumatic head injuries. It is merely a starting point for those who are interested in the topic.

Reference and Reading List
1. Filskov S & BoIl T. (Eds.) Handbook ofClinical Neuropsychology. 1981. New York: Wiley and Sons.
2. Levin H, Eidenberg H, e3 Benton A. (Eads.) Mild Head Injury.1989. New York: Oxford University Pres.
3. Levin H., Benton A, e3 Grossman R (Eds.) Neurobehavioral Consequences of Closed Head Injury. 1982. New York: Oxford University Pres.
4 Lezak L. Neuropsychological Assessment.1995; New York: Oxford University Press.
5: Long C & Ross L. (Eds.) Handbook of Head Trauma: Acute Care to Recovery 1992. New York: Plenum Press.
6. Parker R Traumatic Brain Injury and Neuropsychological Impairment. 1990. New York: Springer- Verlag.
7. Taylor R. Distinguishing Psychological from Organic Disorders. 1981. New York: Springer Publishing.
8. Szymanski H & Linn R. "A review of the post concussion syndrome. "International J. Psychiatry in Medicine. Vol. 22 (4), pp. 357-375:1992.
9. Reitan R & Wolfson D. Traumatic Brain Injury. Pol e3 Vol. 2. 1986. Tucson: Neuropsychological Press.

Chiropractic treatments for whiplash

Introduction to whiplash
Chiropractors are specialists in treating non-surgical spine injuries and commonly treat whiplash injuries from car accidents. The job of the chiropractor in helping his or her patients overcome the pain and disability associated with whiplash is to:

• Diagnose the source of the pain from the whiplash injury

• Treat the most important dysfunctions

• Teach the patient to return to a more normal lifestyle

The process of rehabilitation from a whiplash injury requires a concerted effort between the chiropractor, the patient and any other professional assisting in the case. The likelihood of success of recovering from whiplash is enhanced by a continued focus on restoring normal function with the help of the chiropractor.

After a whiplash injury, chiropractors take a systematic approach to establishing a diagnosis (1), including:

1. Patient history
2. Chiropractic examination
3. Working diagnosis
4. Chiropractic treatment plan

Chiropractors’ evaluation of patient history for a whiplash injury
The chiropractor will review specific information regarding the car accident, such as:

• What was the vector of the crash (i.e., rear-end collision, head on collision, side impact collision, etc)?

• Was the patient wearing a seatbelt?

• Did the patient or the vehicle strike any other objects after the crash?

• Was the patient aware of the impending impact?

• How was the patient's head positioned at time of impact?

• What was the collision speed and damage amount?

The chiropractor will also ask questions about the whiplash injury:

• Where is the exact location of the patient’s pain?

• What is the quality and character of the patient’s neck pain or back pain?

• What movements, positions or activities either increase or decrease the patient’s neck pain or back pain?

Finally, the chiropractor will ask about any other symptoms that may be related to the pain, such as numbness, tingling, weakness, dizziness, or blurred or double vision.

Chiropractor’s examination of a whiplash injury
Next, the chiropractor will examine the patient to assess, in the immediate stage, whether serious whiplash injury is present that may require hospital and/or surgical referral, and to identify specific tissues that have been injured.

• The chiropractor will conduct a neurological examination which involves a cranial nerve examination, sensory, motor and reflex examination of the extremities, and tests for injury in the brain.

• Maneuvers will be carried out by the chiropractor that stresses certain tissues to see if they have been injured by the whiplash.

• The chiropractor will perform motion palpation, designed to assess the mobility and pain reactions in the joints of the spine.

• The muscles of the spine will be examined by the chiropractor for areas of congestion called myofascial trigger points, which are common sources of pain after whiplash.

Chiropractor’s working diagnosis of a whiplash injury
From the history and examination, the chiropractor will establish as a "working diagnosis" — a clinical impression of the most salient features of the whiplash injury.

Based on this diagnosis of the whiplash injury, the chiropractor will then determine whether any additional tests (such as x-rays, MRI, EMG or blood tests) are required. The chiropractor will obtain reports from any tests that were done through the emergency room or at previous consultations with spine specialists to avoid unnecessary duplicate testing at the chiropractic clinic.

Once all the necessary information has been gathered, the chiropractor will make a determination as to the best course of action required to bring about maximum recovery from the whiplash injury in the shortest time possible. This may mean referral by the chiropractor to another spine specialist or a chiropractic treatment plan.

Breathing is one of the most important and most “instant” of all the vital functions of the body and yet the understanding of it, let alone the correction and therapeutic use of it, in complementary medicine is far from sufficient. The aim of this article is to shed light on some of the confusing issues about respiration.
The very existence of our physical body in the environment requires several “interactions” and “exchanges”:
• exchange of oxygen and carbon dioxide between the atmosphere and the body through breathing;
• exchange of organic matters (eating, defecation) provided by the digestive system;
• exchange of heat (emitting, conserving or absorbing heat mainly through the skin) with the environment is provided by the thermoregulatory system;
• movement of the body is provided by the locomotor system (bones, joints and muscles);
• informational, emotional and spiritual exchange is provided by the central nervous system, (The Thalamus, Hypothalamus & Limibic Systems).
If any of these interactions goes wrong disease will ensue. However, in reality the sick person has many, or all, of these systems deranged, though in different degrees.

Infertility and Chiropractic

A new series of case studies was published and made the news in a big way. Madeline Behrendt, D.C., who has written several articles in the JVSR on infertility was interviewed, and they are including Chiropractic in their segment! This aired nationally on CBS.

Read about it here: http://www.chiro.org/research/FULL/Fighting_Infertility_At_The_Chiropractor.htm
View it here: http://wcbs.dayport.com/viewer/viewerpage.php?Art_ID=8777&tf=chtopsviewer.tpl

Read additional articles about chiropractic and infertility here:
http://www.jvsr.com/index.asp
http://www.chiro.org/research/ABSTRACTS/Infertility.shtml

The Resolution of Chronic Colitis with Chiropractic Care Leading to Increased Fertility Charles L. Blum, D.C Journal of Vertebral Subluxation Research 2003 (Aug 31): 1-5

• Introduction: A 32-year-old female presented at my office for chiropractic care of her chronic colitis and did not disclose her condition of infertility during the course of care at this office. There appears to be some relationship between chiropractic care and relief of some visceral conditions relating to the colon and female reproductive organs.
  
  

• Results: The patient had her chronic condition of colitis relieved and relatively simultaneously became pregnant after giving up on allopathic fertility treatments for 7 years.
  
  

• Conclusion: As with all single subject case studies it is difficult to extrapolate finding from one result to treatment to the populous at large, however due to the success in this case further studies appear to be indicated.

Insult, Interference and Infertility: An Overview of Chiropractic Research Madeline Behrendt, D.C. Journal of Vertebral Subluxation Research 2003 (May 2): Special Infertility Issue

• The application of chiropractic care and subsequent successful outcomes on reproductive integrity, regardless of factors including age, history and medical intervention, are described through a diversity of chiropractic arts. Future studies that may evaluate more formally and on a larger scale, the effectiveness, safety and cost benefits of chiropractic care on both well-being and physiological function are suggested, as well as pursuit of appropriate funding.

The restoration of female fertility in response to chiropractic treatment. Proceedings Of The National Conference On Chiropractic And Pediatrics. 1994:55-64. McNabb B. Copies of the proceedings may be purchased through the ICA; call 1-800-423-4690.

• This is the case history of a 36-year-old woman who had been medically tested and examined for infertility for a year. No abnormalities were found in her or her husband's reproductive system. When she finally sought chiropractic care she also had pelvic pain (often interfering with sleep) low neck and upper back pain, headache of two weeks duration and tinnitis of several year's duration. Chiropractic care adjusted C1-2, T11-T12, and L-4-5. Care was three times a week for two weeks, twice a week for four weeks and once a week for 3 weeks. The pelvic, tinnitis lower neck and upper back pain were improved. Headaches became mild and rare. Patient became pregnant shortly thereafter and had an uncomplicated delivery. Below is the story of a California woman who was given a 5 percent chance of ever pregnant, even with in vitro procedures and who became pregnant after chiropractic adjustments to her lower spine released subluxations.

Inability to conceive. Two case histories from the files of Larry L. Webster,D.C. International Chiropractic Pediatric Association Newsletter. Nov. 1995.

• Female - Age 32 - Prior Care - Medical -fertility pills, shots - negative results. No menses for 12 years. After two months of chiropractic care, menses resumed. Patient complained of abdominal discomfort during cycle. It was my feeling that this would be natural occurrence following an absence of menses for 12 years. Her menses occurred on a regular cycle for four months when she conceived. She was referred back to her medical doctor for confirmation of pregnancy. Her doctor informed her it was impossible for her to be pregnant - after all, he had done everything medically possible "and besides, there were no nerves emitting from the spine to the reproductive organs." A few months later she delivered a healthy seven 1/2-lb. son. The major area of the spine adjusted in this case was the lumbar region.





• Female - Age 26 - Had been trying to get pregnant for past few years with negative results. She had taken the medical route with fertility pills, shots, etc. Had a severe scoliosis (Cobb's angle of 58°) and upon examination, I informed her that I felt we could not affect the Cobb's angle and that possibly the severity of the curve with the subluxations present could be the reason for the lack of her body's ability to conceive. At the end of six months, X-Rays revealed the Cobb's angle was reduced to 47°. Approximately one month later, she became pregnant and remained under care throughout the pregnancy and delivered a fine baby with no complications. The areas adjusted were sacrum, lumbar and cervical spine. No side posture moves were utilized in this case.

Case report: autism and chronic otitis media. Warner SP and Warner TM. Today's Chiropractic. May/June 1999.

• This is a case report of a 3 ½ year-old girl with autism. She was non-verbal, had compulsive disorders, daily rituals, head banging and violence. After chiropractic, care began within one month her parents and teacher noticed a 30% improvement socially. After one year of care, an 80% improvement was noticed. Head banging and other rituals diminished by 50% with less violent behavior. She had chronic serous otitis media and had been on antibiotics for one year. Within a one-week period after her first adjustment, antibiotic use stopped due to a 70% improvement in her otitis media.

2) Case Study - Autism. Rubinstein, HM, Chiropractic Pediatrics Vol. 1 No. 1, April 1994

• This is the case study of a seven year old female diagnosed with autism. The child has a history of sexual and physical abuse. The little girl would slowly turn in circles in place while singing an incomprehensible song with a glazed stare and blank expression. Spinal examination revealed a right posterior and superior C1 with a frequency of about twice a week. After ten months of care she was able to carry on conversations, carry out commands, dress and groom herself. Cognitivedevelopment progressed to where she was able to learn, read, and participate in public school.

3) The effects of chiropractic treatment on students with learning and behavioral impairments due to neurological dysfunction. Walton EV. Int Rev of Chiro 1975;29:4-5,24-26.

• In this study 24 learning impaired students, half received chiropractic care and the other half, who were either on medication or receiving no treatment at all, were used for comparison. The case histories that follow were obtained from the above paper.





• Case C-91: A high school student who was failing three subjects, with a history of failure, low morale, discipline problems, poor coordination, and a long history of clinical and medical treatment. After chiropractic care the student was passing all subjects, highly motivated, showing improved coordination and able to participate in athletics. All medications were dropped.





• Case C-92: Also a high school student on 20mg. Ritalin and on Dilantin. She was non-motivated, negative, passive, nonverbal, and failing in high school work despite placement in special classes. After chiropractic adjustments the student was taken off Ritalin, began talking and expressing herself, and showed improved reading comprehension and reading speed.<





• Case CE-92: An elementary student who was extremely hyperkinetic, irritable, and he had severe behavior problems at home and school. Grades were marginal to failing. Al-though the boy was only 8 years old, Ritalin had been increased from an initial 5mg. to a total of 70mg./day with steadily diminishing results. (70mg. approaches danger level as a dosage). At the conclusion of chiropractic care, the Ritalin had been entirely discontinued and coordination was improved to the extent that the student became an able Little League ball player. His attitude was excellent, grades were up an average of one letter grade, and the student was considered free of all limiting factors. Behavior at home and school was exemplary.





• Case CE-101: An elementary student. This student was marginally passing his courses. There was a four year history of marginal accomplishment in school. He was nervous, underweight and suffered from insomnia. Medication was briefly tried but the student's emotional control became poor and he frequently wept. The medication had to be discontinued. After chiropractic care there was a marked reduction in nervousness and great improvement in emotional stability. His mother reported that his appetite was now normal and he began enjoying school during the last month.





• Case C-93: A high school student. Initially on heavy dosages of medication, non-motivated with a long history of clinical evaluation and treatment. The girl was failing most school subjects, marginal in others, and withdrawn. After chiropractic adjustments, her self-confidence improved; she was passing all subjects. All medication was discontinued after four months of treatment. A vocational goal was established.





• Case CJ-95: A junior high school student. He was hyperkinetic almost from birth and had a traumatic early developmental history with suspected neurological problems. Although of above average intelligence he was passing only two subjects, both marginally. He was starting to become a discipline problem, making little or no effort in school. After chiropractic care, fine and gross motor coordination improved markedly. He began taking an interest in athletics and played Little League on a team that placed third in the state. Effort and motivation improved to the extent that plans to send him back to a lower grade were dropped and he was promoted. Reports at the third week of school indicated that his academic progress was excellent after a late summer remedial program.





• Case CE-102: An elementary student who had been diagnosed by numerous clinics as minimally brain damaged, retarded and/or suffering from neurological dysfunction. He also suffered from severe emotional problems. After chiropractic he showed great improvement in self-confidence. He began to take part in public speaking in school. Mental ability tests indicated that the student was at normal grade level except for deficiencies in reading.

4) Developmental Communication Disorder. Subluxation location and correction Stephen R. Goldman, D.C. Today's Chiropractic July/August 1995 p.70-74.

• "A 2-year old child had a medical diagnosis of 'developmental communication disorder.' He was non-responsive to any external stimuli, even to receiving an injection.did not respond to sound or touch.Chiropractic analysis revealed an axis subluxation. "On the third visit, when I walked into the room, he began to cry. That was the first time that he responded to anything happening around him. By the sixth adjustment, he started to follow certain commands and stopped making repeated hand motions. He started to talk after the 12th office visit. At present, he has an extensive vocabulary and is slightly hyperactive; he is probably making up for lost time."

5) Autism, Asthma, Irritable bowel syndrome (IBS), strabismus and illness susceptibility: a case study in chiropractic management. Amalu WC. Todays Chiropractic. September/October 1998. Pp. 32-47.

• A 5-year-old female with autism, asthma, allergies, irritable bowel syndrome and left-sided strabismus who was experiencing 25 violent temper episode per day, with each episode lasting up to 20 minutes was referred for care. She also exhibited three episodes each day of self-inflicted violent behavior, which included biting her arm, slapping her head and repeatedly banging her head against a full-length mirror. She also had at least one episode of violent behavior each day - hitting people, especially her mother. Speech was limited to a few words such as "mama, dada, milk and walk."





• Chiropractic Management consisted of correction of the atlanto-occipital subluxation with the patient adjusted in the knee-chest posture with contact to the posterior arch of atlas.





• First week of care: After the first adjustment, patient had her first good night's sleep since her mother could remember. Violent temper episodes had reduced to 15 per day with de-crease in intensity. Self-inflicted violent behavior was decreased in frequency. Her speech, vocabulary and sleep patterns had improved.





• Second week: one adjustment. Violent temper episodes at five per day. Right eye showed no more signs of strabismus. Patient began speaking in sentences for the first time. Mother reported a marked decrease in hyperactivity along with a desire to be touched and hugged.





• Third week: One adjustment. Violent temper episodes 2 per day with decreased intensity. Mother stated there was little hyperactivity. Self-directed or outward violent behavior have ceased. Irritable bowel syndrome was much improved.





• Fourth week: no adjustments. All temper episodes, hyperactivity, violent behavior have stopped. Sleeping through the night. Patient was evaluated by two therapists who declared the diagnosis of autism was "incorrect."





• Week 5- 8: a mild return of symptoms, an adjustment was given, and symptoms abated.
  
  

• Weeks 9-12: no adjustments. The IBS had almost completely resolved. Patient continued to improve over next 8 months; no more asthma attacks.

6) Subluxation location and correction by Stephen R. Goldman, D.C. Today's Chiropractic July/August 1995 p.70-74. Case Study No. 4:

• 31-year-old with Crohn's disease (since age 15). A portion of his intestine had been removed and he was on antibiotics and prednisone. Had not had a normal bowel movement since age 15 and constantly suffered from abdominal cramps. Chiropractic analysis: Subluxation of axis. By the 13 th visit, he started having normal bowel movements and all medication was stopped.

Additional Articles:

1) An analysis of 350 emotionally maladjusted individuals under chiropractic care. Hartmann GW, Schwartz HS. NCA Journal of Chiropractic, Nov. 1949.

• Classic review of 350 individuals helped under chiropractic care.

2) Relations of disturbances of cranio-sacral mechanisms to symptomatology of the newborn. Fryman V. JAOA. 1966;65:1059

• In a group of 1250 unselected babies examined five days post partum, a group of 211 'nervous' children were found suffering from vomiting, hyperactivity, tremors and sleeplessness. Release of 'strain' in the skull resulted in immediate quieting, cessation of crying, muscular relaxation and sleepiness.

3) Post-traumatic evaluation and treatment of the pediatric patient with head injury: a case report. Araghi HJ. Proceedings of the National Conference on Chiropractic and Pediatrics, 1992:1-8.

• From the abstract: a two-year-old boy suffering from vomiting and loss of energy following impact trauma to the head and found by neurological exam ant CT scan to have suffered a concussion with no evidence of brain or spinal cord pathology. Chiropractic adjustment of occiput resolved the patient's symptoms.

Autism

Peer Reviewed Journals:

1) Blocked atlantal nerve syndrome in infants and small children. Gutman G. ICA Review, 1990; July:37-42. Originally published in German Manuelle Medizin (1987) 25:5-10.

• From the abstract:

  Three case reports are reviewed to illustrate a syndrome that has so far received far too little attention, which is caused and perpetuated in babies and infants by blocked nerve impulses at the atlas. Included in the clinical picture are lowered resistance to infections, especially to ear-, nose-, and throat infections, two cases of insomnia, two cases of cranial bone asymmetry, and one case each of torticollis, retarded locomotor development, retarded linguistic development, conjunctivitis, tonsillitis, rhinitis, earache, extreme neck sensitivity, incipient scoliosis, delayed hip development, and seizures.
  
  
  

2) Learning difficulties of children viewed in the light of osteopathic concept. Frymann V (1988). In: Retalaff EW, Mitchell Fl Jr. (Eds). The cranium and its sutures, Springer, Berlin Heidelberg, NY, pp.27-47.


3) The relationship of craniosacral examination findings in grade school children with developmental problems. Upledger JE, J Am Osteopath Assoc. 1978 (Jun);77 (10):760-776


4) Osteopathic management of psychosomatic problems. Dunn, FE. JAOA, Vol. 48 No. 4 Neuropsychiatric Supplement Vol. 2 No. 1 Dec. 1948.

• There is a relationship between structure and mental states and patient management.

5) Osteopathic concepts in psychiatry. Dunn FE JAOA, March 1950.

• A table describing the lesion (subluxation) frequency in schizophrenia is included. Patient management is discussed.

6) A pilot study of applied kinesiology in helping children with learning disabilities. Mathews MO, Thomas E, British Osteopathic Journal Vol. X11 1993.

• IQ scores improved and learning disabilities lessened. The British Osteopaths used applied kinesiology and Neural Organization Technique (NOT) developed by Carl Ferrari, D.C.
  
  
  

7) The effect of chiropractic adjustments on the behavior of autistic children; a case review. Sandeful, R, Adams E. ACA Journal of Chiropractic, Dec 21:5, 1987.

The authors reported that 50% of all subjects under chiropractic care experienced reliable behavioral improvements, as recorded by independent observers. It is reported by those working with autistic children than any change in behavior in an autistic child is considered to be significant. Behavioral improvements were observed in such diverse areas as picking up toys, use of sign language, reduction of self-abuse and appropriate use of language.

National Press about theVaccine/ Autism Connection:

These recent articles in Washington Times reveal a very interesting hypothesis. Author, Dan Olmsted writes: "Since the Amish have been cut off for hundreds of years from American culture and scientific progress, the Amish may have had less exposure to some new factor triggering autism in the rest of population. The likely culprit: vaccines.

Traveling to the heart of Pennsylvania Dutch country in search of autistic Amish children, the reporter, based on national statistics, should have found as many as 200 children with autism in the community -- instead, he found only three, the oldest age 9 or 10.

The first autistic Amish child was a girl who had been brought over from China, adopted by one family only to be given up after becoming overwhelmed by her autism, and then re-adopted by an Amish Mennonite family. (China, India and Indonesia are among countries moving fast to mass-vaccination programs.)

The second autistic Amish child definitely had received a vaccination and developed autism shortly thereafter.

The reporter was unable to determine the vaccination status of the third child.

Read the articles here: http://www.washtimes.com/upi-breaking/20050321-115921-9566r.htm and here: http://washingtontimes.com/upi-breaking/20050417-052541-5549r.htm

The Medical Debate:
This link leads you to an informative letter from one MD to another about the connection between vaccines and autism. http://bbs.babycenter.com/board/baby/babyills/babyvaccine/11967/thread/2127794

Video on Autism:
The autism mailing group recently sent out this link: http://www.autism-recoveredchildren.com/
It is a one hour video from the DAN conference, about kids on the autistic spectrum who have recovered through the use of nutritional intervention. The interesting thing is that a lot of these kids became "autistic" after vaccination. Some really interesting footage. And a fantastic shot of the audience responding to Gov. Schwarzenager signing a bill to forbid the use of mercury in vaccinations. The speaker has all parents in the audience stand and wave their hands if they thought their child would not be autistic if not for their vaccination.

RFK, Jr on Autism:
Recent press has been focusing on an article written by RFK, Jr on the effects of thimerosal in vaccines and the vaccine connection.
Read the article here: http://www.commondreams.org/views05/0616-31.htm
Read his complete text on the subject here: http://www.robertfkennedyjr.com/docs/AutismHgPolitics_6_23.pdf

Increase in Autism Baffles Scientists

October 18, 2002 ~ Authors of California study say they cannot explain reasons for what they call epidemic of childhood autism in state; mysterious brain disorder affects person's ability to form relationships and to behave normally in everyday life; study discounts genetics, birth injuries and childhood immunizations as factors in tripling of autism cases from 1987 to 1998; Dr Catherine Lord, leading authority on autism, says it is unclear whether California findings apply to other states; federal Centers for Disease Control and Prevention is working in 13 states to look at apparent increase in autism cases; there is no reliable count nationwide so far, since criteria and reporting practices vary from state to state.The full article is available for a fee from the New York Times.

MMR/ Austism Link -- New Research

Ever since Andrew Wakefield's work on the MMR Vaccine and Autism came out there has been multiple papers, comments and disputes about its validity. Search for collection of previous studies

Now a new study adds additional reason to believe there is a a direct correlation between the two.

This news article sums it up well. New Research Suggests Autism Link to MMR

Here is Singh's abstract on: Abnormal Measles-Mumps-Rubella Antibodies and CNSAutoimmunity in Children with Autism Read the abstract in PubMed

“The Status of Research into Vaccine Safety and Autism"

Washington, D.C. - On June 19, 2002, at 11:00 a.m., in Room 2154 of the Rayburn House Office Building, the Committee on Government Reform, chaired by Congressman Dan Burton (R-IN), will conduct a hearing to evaluate the status of research concerning the possible relationship between vaccines and neurological disorders, including autism. Ten years ago, autism was estimated to affect 1 in 10,000 children. According to the National Institutes of Health, it is now anticipated to affect 1 in 250 children.Read the Report

New Study Supports Link Between MMR Vaccine and Autism

The newest research on the vaccine-autism relationship has just come out showing a link between mercury in vaccines and autism when there is genetic predisposition.The measles virus was detected in spinal fluid of children with autism, but not in controls.The findings challenge the results of several large studies on autism and bolster the fears of parents who have long believed their children were harmed by the vaccines.
http://www.latimes.com/news/science/la-sci-autism9jun09,1,5059086.story?coll=la-news-science

Prenatal Risk Factors for Infantile Autism

The following study, "Prenatal risk factors for infantile autism", poses an interesting correlation between infantile autism and intrauterine growth restriction. Reuter's article begins, "Intrauterine and neonatal factors related to restricted intrauterine growth or fetal distress may be associated with the development of autism, according to a report in the July issue of Epidemiology.
In a case-control study nested within a population-based cohort, Dr. Christina M. Hultman, of the Karolinska Institute, Stockholm, Sweden, and colleagues examined various maternal characteristics and pregnancy outcomes among 408 children diagnosed with infantile autism before 10 years of age and 2040 matched controls." And concludes with . "Although several of the reported associations could be a function of genetic risk in the fetus, several of the findings are consistent with nongenetic environmental mediation of risks." (Read the complete article)

The chiropractic correlation here comes in the conclusion drawn by the authors: "Our findings suggest that intrauterine and neonatal factors related to deviant intrauterine growth or fetal distress are important in the pathogenesis of autism."

Intrauterine constraint can lead to deviant growth and fetal distress. 1,2 This new study isjust one more reason why removing constraint to the woman's uterus throughout pregnancy leads to easier, safer births for both the mother and baby.

Specific chiropractic care balances pelvic muscles and ligaments and removes constraint to the woman's uterus. 3 When we understand the physiological relationship between the woman's uterus and the developing baby, it is clear to see that specific chiropractic adjustments throughout pregnancy can decrease the potential of deviant intrauterine growth and/ or fetal distress. 4

1.Hellstrom B, Sallmander U "Prevention of Spinal Cord Injury in Hyperextension of the Fetal Head" JAMA 1968; 204(12): 1041-4

2. Cunningham FG et al, "Dystocia Due to Pelvic Contraction", Williams Obstetrics, Nineteenth Ed 1989

3.Anrig C, Plaugher G; "Chiropractic Management of In-Utero Constraint" Pediatric Chiropractic, 1998: Chapter 5 page 102.

4.Chiropractic Care in Pregnancy for Safer, Easier Births

Umbilical Cord Clamping a Cause of Autism?

This particular study examines the potential relationship between early cord clamping, infant asphyxia and autism. It summarizes: Brain lesions are associated with autism and related disorders[1]. Hypoxic brain lesions in monkeys are associated with intelligence/memory defects similar to autism. [2] Immediate cord clamping causes newborn hypoxia. Placental oxygenation until the lungs are functioning prevents newborn hypoxia. Placental oxygenation until the lungs are functioning should prevent autism that is caused by hypoxic brain lesions.
Read the article at: http://www.redflagsweekly.com/features/Morley.html

Check out this compilation of additional resources on the subject by the same author:
www.cordclamp.com

Send your patients to: http://www.icpa4kids.org/pregnancy/umbilical.htm so they can download additional info and present documentation to their birth care providers.

http://bmj.com/cgi/eletters/323/7326/1389
http://www.birthlove.com/pages/health/cords.html

More Resources:

Research on Autism and Chiropractic

The Autism Page @ Chiro.Org

Additional Info on Vaccines

Autism Research Institute

Center for the Study of Autism

The Autism Autoimmunity Project

Families for Early Autism Treatment

Articles in Mothering Magazine

---

Vaccine-Autism Link

Over the past several years, parents have been hearing about the possible link between mercury in vaccines and its potential cause of autism. Studies have been published on either side of the fence , however the most recent published research is swaying the controversy back to the probable side.

Here is a highlighted timeline of this controversy::

1998:
Andrew Wakefield and the Autism Link:

In 1998, Dr. Andrew Wakefield first published a paper in the Lancet associating the MMR vaccine to autism.

2001:
Wakefield resigns:

Scorned and rebutted by his peers, Dr. Wakefield did not give up his search for truth and real science. Read about his struggles here: http://autism.about.com/cs/autisminprint/a/wakefieldfired.htm and http://news.bbc.co.uk/1/hi/health/3513365.stm and http://www.melaniephillips.com/articles/archives/000345.html

2002:
Wakefield disputes study in NEJM:

In November 2002, the New England Joural of Medicine published a study to rebut Wakefield's findings about the MMR Vaccine/ Autism link. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12421889&dopt=Abstract

Dr. Andrew Wakefield had this to say about their findings: http://www.freewebz.com/schafer/wakefield.htm

February 2004:
CDC Vaccine Data Leads Scientists to Shocking Discovery.

In February 2004 this headline hit the presses: CHILDREN 27-TIMES MORE LIKELY TO DEVELOP AUTISM WITH EXPOSURE TO MERCURY- CONTAINING VACCINES, FINDINGS REVIEWED AT TODAY'S IOM MEETING IN DC. Read article here: http://www.bioprobe.com/ReadNews.asp?article=76

Parents Show Increasing Concern about Autism and Vaccines

More parents refusing to get kids vaccinated. Physicians are increasingly confronting parents who are concerned about the safety of childhood immunizations.
http://www.ama-assn.org/amednews/2004/02/09/hlsd0209.htm

May 2004:
Immunization Safety Review: Vaccines and Autism

The committee concludes that the body of epidemiological evidence favors rejection of a causal relationship between the MMR vaccine and autism. The committee also concludes that the body of epidemiological evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism. The committee further finds that potential biological mechanisms for vaccine-induced autism that have been generated to date are theoretical only.
http://www.iom.edu/report.asp?id=20155

National Vaccine Information Center Comments on Review:

SAYS IOM PLAYED POLITICS IN REPORT ON AUTISM AND VACCINES. http://www.909shot.com/PressReleases/pr51804iom.htm

June 2004: New Study Supports Possible Link Between MMR Vaccine and Autism

The newest research on the vaccine-autism relationship has just come out showing a link between mercury in vaccines and autism when there is genetic predisposition.The measles virus was detected in spinal fluid of children with autism, but not in controls.The findings challenge the results of several large studies on autism and bolster the fears of parents who have long believed their children were harmed by the vaccines. http://www.sutterhealth.org/health/healthinfo/reutershome_top.cfm?fx=article&id=17345

For a recent TV News clip on the vaccine issue visit: http://www.cbsnews.com/stories/2004/05/18/health/main618142.shtml
Clips on the right hand side of the page

Resources on Mercury in Vaccines: http://www.909shot.com/Issues/mercury.htm

For additional articles on autism visit:
http://www.icpa4kids.org/research/children/autism.htm

For information on vaccines visit:
http://www.icpa4kids.org/research/children/vac_info.htm

For information on chiropractic and autism visit:
http://www.icpa4kids.org/research/chiropractic/autism.htm

Visit this site for clips from the Autism Conference:
http://www.lighthousestudios.info/autismone95.html

Dualism : contends you must have both of the two components in question, rather than one or the other. In contrast to dualism two other philosophical positions concerned with the number of substances: monism and pluralism. Monism is the view that there is one elemental whereas pluralism maintains that there are many things which constitute the world.

A major problem faced by dualists is the inability to resolve the rift created between the two opposing elements. Typically the motivation for resolving conflicts between these two realms is to make the world more understandable. For instance, how is the interaction between mind and body explained? Descartes, for example, claimed that the pineal gland is the point of contact between the bodily and spiritual realm. The inability to rectify these two realms has inclined some to adopt monism. Modern Allopathic/ Traditional/Orthodox Science, for example, offers a monistic account of reality (physicalism), which eliminates the mental altogether, removes any problems of relatedness between mind and body by eliminating the spiritual all together. Mental events are reduced to brain states, thus leaving only the bodily realm, thus monism.

Epiphenomenalism : The accepted extension of the allopathic, reductionist, mechanistic view of the mind/body concept. Epiphenomenalism contends there is only a one-way causal connection from the body to the mind, but none from the mind to the body. According to this idea, Consciousness is just a byproduct of the body, much like smoke from a steam engine train. Thus all value and attention is focused of the “chemical” physical processes of the body and thus; the mind, soul, spirit and “consciousness”, “Individual Human Awareness” of the patient is cheaped or minimized.

Pleomorphism : microbial genera and species are not fixed and rely on he host’s environment to determine it’s form and malevolence. A paradigm in which the host organism or patient was an active participant in infection and disease - in contrast to Koch and Pasteur and the monomorphists who held the microbe to be all-powerful, the host organism a passive victim. Pleomorphism means downgrading the microbe, since the host, by resisting the latter's onslaught, could alter its characteristics and make it return to a normal form as again. The patient has control over the bacteria, not the other way around. The microbes are the result, not the cause of disease

Monomorphism - a dogma meaning again that microbial genera and species are fixed and eternal, that the form of each microorganism associated with a specific disease always stays the same and always causes that same disease.

"Accepting Pleomorphism meant acknowledging the host organism's, the patient's capacity to defend itself (him or her) against, and dominate, the microbe.

Monomorphism, on the contrary, enhanced the role of the microbe in disease, and consequently that of the physician who combats the microbe. This is the principal reason for the instinctive hostility of the majority of physicians to Pleomorphism and Holistic/Alternative Medicine in general."( Divided Legacy, Harris Counter . pg. 39)

Pleomorphism was a great threat to this "control" factor. This control factor means;

"control of the disease with poisons that need monitored and controlled, controlling therefore, the patient and their pocket book."(Ibid, pg.39)

The phenomena of life are forced into categories (disciples; i.e., cardiology, oncology, EENT, etc.), which can be manipulated to make a living from the practice of allopathic medicine. The monomorphists have identified their doctrine with science itself, as science itself, that Monomorphism is a law of nature, which it is not. This viewpoint has, through the years, taken on such an aspect of truth that to question it now seems a scientific sacrilege.

The followers of Koch proclaimed Monomorphism with 'religious fanaticism', stated Max Gruber in 1885. F. Loehnis stated in 1922 that the intransigence and verbal violence displayed by the various factions in this conflict resembled certain historic theological quarrels.

For all these reasons, Monomorphism was at first excessively rigid, even dogmatic. Rene Dubious states that Koch and Pasteur; "overestablished" the doctrine of the specificity of disease causes and that blind acceptance by several generations of bacteriologist of the dogma of constancy of cell forms and immutability of cultural characteristics discouraged for many years the study of the problems of morphology, inheritance, and variation in bacteria and viruses.

Biol Psychiatry. 1999 May 1;45(9):1085-98.

Morphometric evidence for neuronal and glial prefrontal cell pathology in major depression.

Rajkowska G, Miguel-Hidalgo JJ, Wei J, Dilley G, Pittman SD, Meltzer HY, Overholser JC, Roth BL, Stockmeier CA.

Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson 39216, USA.

BACKGROUND: This report provides histopathological evidence to support prior neuroimaging findings of decreased volume and altered metabolism in the frontal cortex in major depressive disorder. METHODS: Computer-assisted three-dimensional cell counting was used to reveal abnormal cytoarchitecture in left rostral and caudal orbitofrontal and dorsolateral prefrontal cortical regions in subjects with major depression as compared to psychiatrically normal controls. RESULTS: Depressed subjects had decreases in cortical thickness, neuronal sizes, and neuronal and glial densities in the upper (II-IV) cortical layers of the rostral orbitofrontal region. In the caudal orbitofrontal cortex in depressed subjects, there were prominent reductions in glial densities in the lower (V-VI) cortical layers that were accompanied by small but significant decreases in neuronal sizes. In the dorsolateral prefrontal cortex of depressed subjects marked reductions in the density and size of neurons and glial cells were found in both supra- and infragranular layers.

CONCLUSIONS: These results reveal that major depression can be distinguished by specific histopathology of both neurons and glial cells in the prefrontal cortex. Our data will contribute to the interpretation of neuroimaging findings and identification of dysfunctional neuronal circuits in major depression.

What People are saying about Dr. Fred Clary & His Seminars:

“ I drive 4 hours through that crazy Seattle traffic to hear Fred. I have taken his all Ped’s Modules three times and I can’t believe how much I learn every time. His classes have given me the confidence to help the toughest cases, take on the allopathic discrimination and battle the insurance companies.” Washington State Doc (20 years in practice)

“ I have know Dr. Fred Clary for Years and I refer many cases to him for care. His knowledge and commitment and professionalism are a mark in his chosen field” Former Chief of Orthopedics of a St. Paul, MN Hospital

“ I haven’t gone to a seminar in decades where someone so young had the scientific knowledge and intellectual confidence…and could explain it with such passion since I was at Palmer under BJ…” Washington State Doc (40+ years in practice)

“ The amount of current scientific articles presented at all Fred’s talks blows me away. I had no Idea that there is more science behind what we do than what the medics do…As I have learned at the talks, it isn’t even close…” MN Doc (20+ years in practice)

“ I am one of the last GP’s that still delivers babies in the Cities. I have seen many neurologically challenged kids in my practice. Fred’s comprehension and efficiency of therapy is amazing. He is knocking down walls. His clinic treats my whole family including my daughter who has spastic CP. We all love Dr. Fred.” St. Paul Osteopath

“ I though philosophy was all BJ and Green Books. I couldn’t figure out where the science fit in and if it did. I now realize that there is more basic science and biology behind chiropractic than any health care profession out there, why can’t this guy be at the [chiropractic] school”.

MN Doc (25 years in practice)

“ I will never write a narrative again…I learned more administrative and practice management tips during a break from Dr. Fred at his Rehab Seminar than all the thousands I spent over a decade at this guru or that program or that coach. I have never seen someone correct someone’s gait or posture in a few minutes like that. I spent thousands on diagnostic equipment and he just uses his hands and eyes. The neurology behind his analysis and rehab holds up to scientific scrutiny…many of the toys I have at my 4 offices , including X-Ray, do not hold up to scientific scrutiny …I got the confidence to go after CP, MS and those poor people the medical doctors push off to the dark corners of society…”

Michigan Doc (25+ years in practice)

“ I get all my CE’s from Dr. Fred. It’s the school of tough knocks chiropractic and the science and philosophy work in his busy practice.” MN Chiropractic Orthopedist (20+ years in practice, lecturing , defending chiropractors for their malpractice carriers)

“ I ‘ve known Freddy since school. He takes complex, impossible information and breaks it down so you can use it. There is always a line of chiropractors wanting a subluxation analysis after his talks. How he lectures for over eight hours without a pause is legendary. His focus on patient results is what whacks them. I’ve been trying to get him to lecture or practice here for years. If you can’t back up the” Big Idea” with science and neurology, just what the hell are we doing anyway…He doesn’t blow sunshine up your skirt, he crams science and results in your head… Reality not Rhetoric...” Michigan Chiropractor,

600+ patient visits a week in solo practice

Dr. Clary is the director of a multi-disciplinary clinic of chiropractors, medical doctors, physical therapists, psychologists, massage therapists and exercise physiologists. He lectures nationally to young physicians and promotes the value of a drug free natural lifestyle to the community at large.

Thalamic neuron theory: theoretical basis for the role played by the central nervous system (CNS) in the causes and cures of all diseases.


The Thalamic Neuron Theory (TNT) postulates that the central nervous system (CNS) is involved in all disease processes, as the CNS not only processes incoming physical and chemical information from the periphery, it also sends out physiological commands to the periphery in order to maintain homeostasis for the entire body. Inherent in its capacity to learn and adapt (i.e. to habituate) is the CNS' ability to learn to be sick (pathological habituation) by looking in certain deranged central neural circuitry, leading to chronic disease states. These pathologically habituated states can be reversed by dehabituation through manipulation or modulation of the abnormal neural circuits by physical means (physical neuromodulation) like functional analysis chiropractic technique or sensory integration training.

More research exploring the relationship of subluxation correction to brain function is needed. Yet, the dramatic changes that have been reported in children medically diagnosed with ADD/ADHD and adults with depression or psychosis following chiropractor care must not be ignored.

Every child with a vertebral subluxation or dysponesis needs chiropractor care, regardless of whether or not symptoms are present.

By correcting nerve interference(dysponesis & energy utilization inefficiencies)... Function is improved, with greater expression of human potential.

Many report terminating drug therapy, and seeing the personality, will, and soul of the child unfolding.

Maria Montessori wrote, "It is easy to substitute our will for that of the child by means of suggestion or coercion; but when we have done this we have robbed him of his greatest right, the right to construct his own personality."

Definitions of Health and Wellness

Traditional allopathic medicine has defined health as merely the absence of disease. This foundational definition has limited allopathy to limit its goals as the eradication of pathogens or the attainment of certain lab values. Present evidence has accumulated to show that the health state involves more than the lack of detectable pathogens in the body or attainment of certain lab value ranges. In the face of this information, the basic position of traditional allopathic medicine concerning the achievement of health has not changed. Medical schools and managed care organizations, with their emphasis on a diagnosis and rationed care, promulgate this traditional orientation by teaching that diagnosis and treatment of the named “disease” is the major pathway to health.

World Health Organization definition of health (1946): Health is a state of complete physical, mental, and social well-being and is not merely the absence of disease or infirmity.”

Halpert Dunn (1959) argued there were different levels of wellness. Some levels are depicted as states of passive adaptability to the environment and others, as a dynamic process in which the objective is the attainment of one’s optimal potential. High Level Wellness is an all-encompassing term focusing on a dynamic process toward optimal functioning of an individual, family or community.

Adaptation: Health depends on the ability to maintain a physiological, mental and social balance despite changes in the ever-changing external and internal environment through the use of regulatory mechanisms within oneself. The state of dynamic balance is called homeostasis.

All available history records suggest that many ideas of wellness and health developed long before the advent of modern allopathic medicine and chiropractic.

Health can thus be defined as a state of abtaptness which permits the person concerned to function as effectively as long as possible in the environment where chance and choice has placed him.

Holistic Health: holistic health is based on the idea that the “body-mind-spirit” trinity has the inherent capacity to heal and that the environment – air, food, water and space- have more influence on humans than anything else. The human being is an organized whole greater than the sum of its parts and the whole also determines the nature of its parts and the parts cannot be analyzed in isolation from the whole. They are dynamically interrelated and interdependent. The term “holism” also refers to the beliefs that all parts of a living organism work together to determine the health of the entire person.

Wellness : Wellness is a dynamic state, reflecting growth and change physically, emotionally, spiritually, intellectually, vocationally and socially. It is not a STATIC state. Wellness is an active process through which an individual makes choices and adaptations passively and actively which result in a more successful existence.

High-level wellness is a life-style-focused approach, which allows the individual to personally design a way to achieve optimal wellness within the limits of his or her own capacity. Life-style-focused approach to wellness is an integrated, ever changing state, which focuses on self-responsibility, accountability, nutritional awareness, physical fitness, stress management and environmental sensitivity as critical components of optimal wellness.


Vitalism : The doctrine of vitalism holds that life processes are guided by non material vital principle and are, thus, unable to be fully explained as physical and chemical phenomena. Most vitalistic practitioners today use natural methods which ALLOW the body to change itself.


Vitalism maintains that;
"the organism is reactive, at all times coping with, and attempting to overcome, the stresses which impinge upon it from outside. It behaves purposively, the nature and form of its reaction being determined by the specific environmental stress encountered. It responds to challenge, which no aggregate or assembly of non-living substances can ever do". (Divided Legacy, Harris Counter, pg. xvii.)

Quantum Vitalism : The testable hypothesis that life is a process intimately linked to the fundamental level of the universe; particular biological systems (cells, tissues, organisms) have a "unitary oneness" based on macroscopic quantum coherence; the flow of Innate Intelligence/ ch'i energy/information through tissues is related to sequences of emergence/collapse of quantum status in biomolecular systems.

Mechanism: The doctrine of mechanism holds that ALL natural phenomena can be explained by material causes and mechanical principles. Most mechanistic practitioner today use drugs and surgery. These methods FORCE the body to change.

Reductionism: is a view that asserts that entities of a given kind are collections or combinations of entities of a simpler or more basic kind or that expressions denoting such entities are definable in terms of expressions denoting the more basic entities. Thus, the ideas that physical bodies are collections of atoms or that thoughts are combinations of sense impressions are forms of reductionism.

The traditional reductionist view ( known as traditional / orthodox scientific view in the popular culture) and the traditional medical (allopathic) view sees a person as a machine. The 'parts' of this machine are prone to 'breakdown' and need time to repair or replacement with 'spare parts'. Medicine intervenes to correct dysfunction and restore 'normality'. Emphasis is on the physical, reducing a human being to a collection of systems. In accordance with this approach, Allopaths and their health care colleagues engage in acquiring a basic knowledge, of various subjects. Biology, psychology, pharmocology, sociology, epidemiology and others disciplines. Ultimately, of course the focus on the patient is neglected by the constant focus on the parts of the patient as if they were unconnected and interdependent.


Junk Science: is faulty scientific data and analysis used to further a special agenda.
As Australian philosopher Bernard Robertson-Dunn once wrote:
I am not a seeker after truth ... just evidence.
I will draw my own conclusions.
Cawadias (1953) has said that "the history of medicine has shown that, whenever medicine has strayed from clinical observation[ …read… Results…Fred], the result has been chaos, stagnation, and disaster."--British Medical Journal, Oct 8th, 1955, p.867 (Quoted in Clinical Medical Discoveries by Beddow Bayly)


Emergence: The vitalism/reductionism debate in the life sciences shows that the idea of emergence as something principally unexplainable will often be falsified by the development of science. Nevertheless, the concept of emergence keeps reappearing in various sciences, and cannot easily be dispensed with in an evolutionary world-view. We argue that what is needed is an ontological non-reductionist theory of levels of reality which includes a concept of emergence, and which can support an evolutionary account of the origin of levels.

Emergence is expressed as the concept that there are properties at a certain level of organization which can not be predicted from the properties found at lower levels. (Intelligent organization, coordination and adaptation towards full unlimited potential). Emergence does not exclude explanation, in some cases not even a deterministic one, and emergence is not an indeterministic process. Emergence in relation to levels can only be analyzed within the distinction between global/local perspective.
Dualism : contends you must have both of the two components in question, rather than one or the other. In contrast to dualism two other philosophical positions concerned with the number of substances: monism and pluralism. Monism is the view that there is one elemental whereas pluralism maintains that there are many things which constitute the world.
A major problem faced by dualists is the inability to resolve the rift created between the two opposing elements. Typically the motivation for resolving conflicts between these two realms is to make the world more understandable. For instance, how is the interaction between mind and body explained? Descartes, for example, claimed that the pineal gland is the point of contact between the bodily and spiritual realm. The inability to rectify these two realms has inclined some to adopt monism. Modern Allopathic/ Traditional/Orthodox Science, for example, offers a monistic account of reality (physicalism), which eliminates the mental altogether, removes any problems of relatedness between mind and body by eliminating the spiritual all together. Mental events are reduced to brain states, thus leaving only the bodily realm, thus monism.



Epiphenomenalism : The accepted extension of the allopathic, reductionist, mechanistic view of the mind/body concept. Epiphenomenalism contends there is only a one-way causal connection from the body to the mind, but none from the mind to the body. According to this idea, Consciousness is just a byproduct of the body, much like smoke from a steam engine train. Thus all value and attention is focused of the “chemical” physical processes of the body and thus; the mind, soul, spirit and “consciousness”, “Individual Human Awareness” of the patient is cheaped or minimized.

Pleomorphism : microbial genera and species are not fixed and rely on he host’s environment to determine it’s form and malevolence. A paradigm in which the host organism or patient was an active participant in infection and disease - in contrast to Koch and Pasteur and the monomorphists who held the microbe to be all-powerful, the host organism a passive victim.

Pleomorphism means downgrading the microbe, since the host, by resisting the latter's onslaught, could alter its characteristics and make it return to a normal form as again. The patient has control over the bacteria, not the other way around. The microbes are the result, not the cause of disease

Monomorphism - a dogma meaning again that microbial genera and species are fixed and eternal, that the form of each microorganism associated with a specific disease always stays the same and always causes that same disease.

"Accepting Pleomorphism meant acknowledging the host organism's, the patient's capacity to defend itself (him or her) against, and dominate, the microbe.
Monomorphism, on the contrary, enhanced the role of the microbe in disease, and consequently that of the physician who combats the microbe. This is the principal reason for the instinctive hostility of the majority of physicians to Pleomorphism and Holistic/Alternative Medicine in general."( Divided Legacy, Harris Counter . pg. 39)

Pleomorphism was a great threat to this "control" factor. This control factor means;
"control of the disease with poisons that need monitored and controlled, controlling therefore, the patient and their pocket book."(Ibid, pg.39)

The phenomena of life are forced into categories (disciples; i.e., cardiology, oncology, EENT, etc.), which can be manipulated to make a living from the practice of allopathic medicine. The monomorphists have identified their doctrine with science itself, as science itself, that Monomorphism is a law of nature, which it is not. This viewpoint has, through the years, taken on such an aspect of truth that to question it now seems a scientific sacrilege.

The followers of Koch proclaimed Monomorphism with 'religious fanaticism', stated Max Gruber in 1885. F. Loehnis stated in 1922 that the intransigence and verbal violence displayed by the various factions in this conflict resembled certain historic theological quarrels.


For all these reasons, Monomorphism was at first excessively rigid, even dogmatic. Rene Dubious states that Koch and Pasteur; "overestablished" the doctrine of the specificity of disease causes and that blind acceptance by several generations of bacteriologist of the dogma of constancy of cell forms and immutability of cultural characteristics discouraged for many years the study of the problems of morphology, inheritance, and variation in bacteria and viruses.
Ontology : is a (Platonic) description of essential reality, i.e., what actually is, as opposed to what one can see (observation, accident), or what one can know (epistemiology) . The term ontology was coined by two German philosophers, Göckel and Lorhard, in 1613, and first appeared in English in 1721. Ontology as the metaphysical commitments or presuppositions embodied in the different natural sciences. For example, the belief that a cancer can metastasize would be an ONTOLOGICAL COMMITMENT. In the philosophy and the practice of science, ontology goes under various names: essence, reality, Mind of God, nature, gold standard, or mathiverse What actually is, human potential and the multiple random events both positive and negative (ie. The Bid Idea. Formal otology deals with the interconnections of things with objects and properties, parts and wholes, relations and collectives.


Epistemology : (Greek episteme,”knowledge”; logos,”theory”), branch of philosophy that addresses the philosophical problems surrounding the theory of knowledge. Epistemology is concerned with the definition of knowledge and related concepts, the sources and criteria of knowledge, the kinds of knowledge possible and the degree to which each is certain, and the exact relation between the one who knows and the object known. A critical study of method, knowledge, validity and scope. What you can see and measure. Lab Tests, Orthopedic , Neurological Tests.

Inductive Reasoning (Inductive Logic): According to the philosopher John Stuart Mill, it's chief proponent, we are using inductive reasoning when we conclude "that what is true of certain individuals of a class, is true of the whole class, or what is true at a certain time will be true in similar circumstances at all times."

"Take the example of appendectomies. Medical doctors had studied this curious organ for a long time and had never found a useful purpose for it. They concluded therefore, that it had no useful purpose. When it became inflamed or otherwise troublesome, they remove it. It took years for the medical profession to admit that its reasoning was incorrect, and to seek other means of treating appendicitis.

Medical science still stand by most of its other conclusions, however, even though they were arrived at by the same reliance on inductive reasoning. Moreover, it adheres to the "rules" with a rigidity that often does not allow for individual differences. Scientists discovered that the average temperature for a human being is 98.6 Fahrenheit. I f you have a 99.3 temperature, you're said to be "running a fever" and you're given medications to bring the temperature back to "normal."

The problem with this type of reasoning is obvious. No one perfectly fits the profile of the "average" human being -- not in height, weight, or even body temperature. It is incorrect to conclude that the correct temperature for all members of the human race is the same as the "average" temperature of a sample of individual members."
(Terry Rhondberg D.C)



Deductive reasoning : starts with major premises and, based on those ideas, deduces the truth about each individual part of the whole.
Deductive reasoning works from the more general to the more specific. Sometimes this is informally called a "top-down" approach. We begin with a theory about our topic of interest. We then narrow that down into more specific hypotheses that we can test. We narrow down even further when we collect observations to address the hypotheses. This ultimately leads us to be able to test the hypotheses with specific data -- a confirmation (or not) of our original theories.


Critical Thinking: Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action. In its exemplary form, it is based on universal intellectual values that transcend subject matter divisions: clarity, accuracy, precision, consistency, relevance, sound evidence, good reasons, depth, breadth, and fairness. It entails the examination of those structures or elements of thought implicit in all reasoning: purpose, problem, or question-at-issue; assumptions; concepts; empirical grounding; reasoning leading to conclusions; implications and consequences; objections from alternative viewpoints; and frame of reference.

Critical thinking - in being responsive to variable subject matter, issues, and purposes - is incorporated in a family of interwoven modes of thinking, among them: scientific thinking, mathematical thinking, historical thinking, anthropological thinking, economic thinking, moral thinking, and philosophical thinking.

Critical thinking can be seen as having two components: 1) a set of information and belief generating and processing skills, and 2) the habit, based on intellectual commitment, of using those skills to guide behavior.
It is thus to be contrasted with: 1) the mere acquisition and retention of information alone, because it involves a particular way in which information is sought and treated; 2) the mere possession of a set of skills, because it involves the continual use of them; and 3) the mere use of those skills ("as an exercise") without acceptance of their results.

Critical thinking varies according to the motivation underlying it. When grounded in selfish motives, it is often manifested in the skillful manipulation of ideas in service of one's own, or one's groups', vested interest. As such it is typically intellectually flawed, however pragmatically successful it might be. When grounded in fair-mindedness and intellectual integrity, it is typically of a higher order intellectually, though subject to the charge of "idealism" by those habituated to its selfish use.

Critical thinking of any kind is never universal in any individual; everyone is subject to episodes of undisciplined or irrational thought. Its quality is therefore typically a matter of degree and dependent on , among other things, the quality and depth of experience in a given domain of thinking or with respect to a particular class of questions. No one is a critical thinker through-and-through, but only to such-and-such a degree, with such-and-such insights and blind spots, subject to such-and-such tendencies towards self-delusion. For this reason, the development of critical thinking skills and dispositions is a life-long endeavor.
Chiropractic Wellness: Health or EASE is the coordination of matter through innate intelligence through out the body. Coordination is the harmonious action of all the parts of an organism in fulfilling their function and physiology. Dis –Ease is a deficiency or lack of ease. Wellness is the process of functioning at highest level of coordination and the body, mind and spirit operating at maximum efficiency. This process of functioning at high levels of organization allows for the unfolding of full physical, mental and spiritual potential of the human.


Innate Intelligence: The localized or inborn intelligence of the body. Innate Intelligence’s function is to keep the matter in active organization. Chiropractic refers to the body’s organizational ability as its innate intelligence. Innate intelligence organized your body into a complicated, living, adapting, growing being – without it, the human body would be no more than a few dollars worth of chemicals.

There is Innate Intelligence within each of human body that is far superior to the intellect, which creates and recreates the body on a continual basis. In order for this process to occur, life force (mental impulse) must be flowing throughout the body to all cells and tissues. Its medium is the brain and nervous system. The Innate Intelligence directs this life force to every cell and tissue of the body.

"Chiropractors adjust subluxations, relieving pressure from the nerves so that they can perform their functions in a normal manner. The Innate can and will do the rest." -B.J. Palmer, D.C.
Coordination: is the principle of harmonious action of all the parts of an organism, in fulfilling their offices and purposes. "Coordinated function" supersedes the autonomy of a subsystem activity (The needs of the whole supercede the needs of the parts, i.e….as in scoliosis the nervous will sacrifice the spine in order to decrease dysponesis and correct gait and station, posture) . It can be accessible to examination by introducing coordination as an objective, tangible observation.


Mental Impulse: is a "thought" which may be expressed through a variety of neurobiological mechanisms. These mechanisms include synaptic and non-synaptic processes. But it is not synonymous with Innate Intelligence or the neurochemical action potential. Mental Impulse is the adaptive drive and communication for survival and maximum life potential. Mental Impulse is the initiation of the process that the Innate Intelligence uses for the Correct Coordination of the Organism.
Mental Impulse also encompasses the expanding science of the role of neuropeptidies in cellular communications for example there is bidirectional communication between the nervous system and immune system. Neuromodulators released by the nervous system influence immune function. Activated immune cells release an array of immunomodulators that influence the function of the nervous system. Thus, the nervous system and the immune system are not independent, but employ the common language of cytokines and neuroreceptors. The primary intend of a mental impulse is adaptive but the final outcome of a mental impulse depends on the complex inter-communication of the body systems and cells, tissues , their individual current physiological vs, pathological potentials and limitations of matter of the various cells, tissues and systems involved.


Tone: The harmonious synchronization of the body’s functions and potentials integrating all it’s systems, organs, tissues and cells. This harmonious synchronization is organized, controlled and maintained by the nervous system. There is a perceptible or theoretical “resonance” or tone caused by the harmonious interaction of all the body’s tissues. The goal of Coordination and coordinated function is normal tone.
“ Life is the expression of tone. In that sentence is the basic principle of chiropractic. Tone is the normal degree of nerve tension. Tone is expressed in functions by normal elasticity, activity, strength and excitability of various organs, as observed in a state of health. Consequently, the cause of disease is any variation of tone ”
D.D. Palmer


Dysponesis: Dysponesis is defined as a reversible physiological state consisting of unnoticed, misdirected neuro-physical reactions (e.g. abnormal muscle activity) to various agents (environmental events, bodily sensations, emotions, and thoughts) and the repercussions of these reactions throughout the organism. These errors in energy expenditure that are capable of producing functional disorders consist mainly of covert errors in action, potential output from the motor and pre-motor areas of the cortex, and consequences of that output.
The resulting aberrant muscle activity may be evaluated using surface electrode techniques. Typically, static SMEG with axial loading is used to evaluate innate responses to gravitational stress. Dysponesis may also be disclosed by postural analysis.
The early stages of the vertebral subluxation complex in children will exhibit dysponesis. This symptom-less states taxes energy from the body and cause abnormal muscle balance across motor units. This kinesopathology can lead to structure changes in the developing musculoskeltetal system and thus aberrant neurological input into the central nervous system. This aberrant input may lead to permanent changes in the developing central nervous system. (Sensory, Motor, Personality, Integration, Intellectual Processing)
Dysponesis clarifies the momentous consequences of prolonged VSC in children.
Disability: summarizes a great number of different functional limitations occurring in any population, in any country of the world. People may be disabled by physical, intellectual or sensory impairment, medical conditions or mental illness. Such impairments, conditions or illnesses may be permanent or transitory in nature. (United Nations Standard Rules on the equalization of Opportunities for Persons with Disabilities

Mental / Emotional Dysfunction

• You have your reasons when you think about it, given all of life's stresses and challenges over the last years, but gradually anxiety and depression have become more constant companions. You are taking medication, which controls them reasonably well, but heaven forbid that you should stop and see what happens.
  
  Additionally, you have been reading about the unknowns of long-term usage of these drugs and how they may be permanently rewiring your brain. What is the real root of your problem and what other options do you have?

• Your child has been struggling at school with poor grades, lack of focus and interest, and now you have been called aside regarding behavior concerns. You are being strongly encouraged to place your child on stimulant drugs like Ritalin for ADHD. You have heard strong cautions about the medication side effects even though they "work". You want to make sure you are addressing the causative issues and wonder if a different, more natural approach might help.