Subluxation

“ Correction of the subluxation afforded a cure. Such instances might be cited in great numbers. No person without the necessary subluxation ever contracts a germ disease and the necessary subluxation can be exactly located for the vast majority of such diseases. Unfortunately it is impossible to find a person who has not some subluxations and is not, therefore, subject to some form of contagion or infection. ”

“ Upon ascertaining that a certain vertebra is in normal alignment we may say with absolute certainty that the organs innervated by the nerves passing through its foramina are not and cannot be the site of any pernicious germ activities. To go further, it has been demonstrated in a number of cases that the subluxation existed before the contagion or infection developed. A man has been known to have a second Lumbar subluxation for many years without effects other than a tendency to constipation and on the appearance of a typhoid epidemic to contract the disease. ”

“ Whereas, in palpation of the spine every real subluxation gives evidence of disease, or tendency to disease, while every normally aligned pair of vertebrae furnish proof that no disease can exist in the area of distribution of the nerve emerging between them, nerve-tracing is much less reliable. If the tender nerve be traceable to a vertebral subluxation it may be taken as additional evidence that the effect of that68 subluxation is disease, rather than tendency to disease, truly an important distinction, but scarcely broad enough to support a diagnosis without aid. ”

“ The two facts that not all subluxations impinge nerves and not all nerve impingements cause demonstrable disease explain why we do not, in practice, find a disease to correspond with each subluxation discovered by palpation. It must be remembered that there may be latent weakness following a subluxation and of importance because it renders the patient susceptible to infection or to the action of other secondary causes. ”

“ Every possible means must be used to make an accurate palpation. If there is a subluxation in the cervical region there will very likely be symptoms which will indicate it. Subluxations are not as commonly found in the cervical region as in the other regions of the spine.
In making an analysis of the infant the importance of the sacrum must not be overlooked. It will be remembered that the segments of the child’s sacrum are separated with cartilage and are subject to being subluxated. These segments coalesce later in adolescence and form the sacrum into one solid bone. ”

“ To adjust such a vertebra many successive movements are required. An apparently full and free movement of a subluxation meets the elastic resistance of the solidly packed210 tissues and the pull of the modified intervertebral disk—strains at these tissues—and rebounds so as to settle almost, but not quite, in its old abnormal position. The amount gained in a single adjustment can rarely be appreciated by palpation. ”

“ The absence of tenderness from nerves does not negative a disease in any instance, whereas the absence of subluxation does. Like all other expedients for the selection of vertebrae for adjustment without admitting the necessity for first acquiring much skill by much labor, nerve-tracing has a great weakness. Only irritated nerves are tender and the effects of subluxation may be either irritation or paralysis. ”

“ The vertebral subluxation is the primary cause of all truly pathological conditions. Through its existence the action of a large number of secondary causes becomes possible. Upon no other hypothesis can we explain the remarkable percentage of cures of all known classes of disease through the specific vertebral adjustment. ”

“ The other bones of the human body sometimes undergo subluxation, and sometimes complete luxation, but the articulations at the hip and the shoulder are subject only to complete luxation, more especially the hip-joint, because it has a deep and round cavity which is further strengthened by a strong brim. The limb, then, being subject to displacement from its cavity by some great violence, many differences arise according to the greater or less degree of the dislocation. ”

“ General thinning of intervertebral substance through a condition of disturbed metabolism itself produced through the agency of some one serious subluxation, may narrow all the foramina and increase impingement of nerves at any point where a slight subluxation previously existed. An irritated nerve may become swollen and the nerve impinged at the foramen. ”

“ We have learned how to discover a subluxation, how to adjust it, and how that adjustment permits a natural cure of its abnormal effects. We must now learn exactly where to218 apply adjustment for any given organ in the body or for any disease. It must be understood in interpreting this statement and all those which follow in this section that it is never proper to adjust a vertebra merely because it is stated to be the cause of a disease believed to exist in a patient. No vertebra should be moved unless palpation determines it to be subluxated. ”

“ Luxation of the Bones of the Leg.—separation of them from the end of the femur—seldom occurs. It can be the effect only of great violence and great laceration. Most frequently fracture is concomitant, perhaps with wound; and such accidents require amputation, either primarily or secondarily. Subluxation, from laceration of the internal lateral ligament, is not so unfrequent. It is most common in females, the natural conformation of their thigh-bones disposing them to bend inwards; and from falling awkwardly, particularly if carrying a weight, the ligament is apt to give way. ”

“ Once produced, however, a subluxation may not cause noticeable effect until it has been increased in degree by the reaction of forces within the body such as poisons, general fever, etc. Thus germs, dietetic errors, exposure to sudden temperature changes, waste of energy through abnormal mental activities, as hate, fear, worry, etc., or through78 physical excess—in fact, all the secondary causes of disease may appear to have produced a subluxation. ”

“ The move which is suited to a certain kind of subluxation156 of one vertebra may be quite out of place with another, in a different part of the spine. Thus the Recoil is quite proper for a posterior Lumbar and is contraindicated with a posterior middle Dorsal.
If all vertebrae were shaped exactly alike, if all were equal in size, if subluxation were possible only in one direction, then one method of adjustment would be quite sufficient. Diversity of technic is demanded, but a discriminating diversity, with a good reason for every move used. ”

“ A subluxation occurs which weakens tissue and permits germ invasion; toxins enter the circulation from the germ action and motor reaction increases the original subluxation and causes local inflammation; germ activity is favored by the increasing degree of abnormality and toxins from rapid tissue destruction are added to those already present. ”

“ Force applied to any body segment tends to subluxate the segmentally associated vertebra. This subluxation tends to produce disease throughout the area of distribution of the subjacent pair of spinal nerves. ”

“ The accident may also result from forcible abduction of the extremity, particularly when the power is applied near the extremity of the limb. There is laceration, to a greater or less extent, of the capsule, and of the muscles immediately investing the fibrous tissue round the articulating cavity. Without disruption, complete luxation cannot exist—the articulating surfaces cannot be separated, nor can the head of the humerus be altered in position; subluxation, or, in other words, a sprain, may occur in such circumstances, but true luxation cannot. ”

“ But those who are neglected, and are not in the practice of putting their foot to the ground, but keep the limb up, have the bones more atrophied than those who use the limb; and, at the articulations, the limb is more maimed in the direct line than in the other forms of dislocation.
Part LXI In a word, luxations and subluxations take place in different degrees, being sometimes greater and sometimes less; and those cases in which the bone has slipped or been displaced to a much greater extent, are in general more difficult to rectify than otherwise ”

“ If a man falls so that he strikes first on the point of his shoulder the force will be transmitted almost directly across225 the line of the spine, at right angles, and may subluxate the sixth or seventh Cervical or first Dorsal. If subluxation occurs it is because the law of gravity causes the remainder of the body to keep moving downward after the shoulder strikes and until it too comes to rest. ”

“ Older subluxations must be dealt with differently because they present a different condition. Adaptative changes have taken place in the shape of the vertebra itself and of every surrounding tissue as they prepare to make the best of their situation. ”

“ Slight subluxations may exist, because of the adaptation of surrounding parts and the slight play within the intervertebral foramen, without producing noticeable effect. They always, however, evidence a tendency to disease. ”

“ Lateral luxations, that is, luxations at the sides have been divided into complete, when the two articular ranges of the arm and fore-arm, have lost their connexion entirely, and incomplete, when only one bone or one part of a bone has been separated from its natural connexion with the humerus. But what cause can act with sufficient force to produce the first kind of luxation, namely, that which is complete? In such an accident so great would be the extent of the wreck and ruin of the part, that without doubt amputation would be the only resource. ”

“ When the luxation is of long standing, it is always attended with more or less difficulty, occasioned by the adhesions of the surrounding soft parts to the articulating surfaces, by the thickening of the capsule, which diminishes the size of its opening, by the rigidity contracted by the whole part, &c. It is, in such cases, useful to employ emollient applications for some time previously to attempting the reduction, in order to produce such a relaxation, and diminution of the congestion, as may favour the efforts of the surgeon. ”

“ The mechanism of a primitive luxation inwards, differs a little from the preceding. The elbow, being at once separated from the trunk, and carried backward, the person falls: the weight of the body rests on the humerus; the capsule is lacerated in its fore-part; and a displacement in the same direction supervenes.
22. In a luxation outwards, the elbow is carried forward, towards the opposite shoulder; the capsule being stretched outwardly, gives way in that part, provided the humerus be acted on by a sufficient power. ”

“ When the reduction is finished, the articulating surfaces have sometimes a great tendency to be displaced, by the different movements of the fore-arm, a tendency of which we may easily form an idea, if we observe, that in a state of pronation, the head of the ulna presses against the back part of the strained capsule, and consequently against its opening, when the luxation has been forward: a contrary state of things occurs in a luxation backward. Whence it is always prudent to avoid, for some time, the motions of pronation and supination, according to the direction of the displacement. ”

“ But where luxation of phalanges accompanies sprain, reposition and immobilization are necessary—that is if cases are thought likely to benefit by any treatment.
Luxations—Dislocations.
Luxation or dislocation is a condition where the normal relation between articular ends of bones has been deranged to the extent that partial or complete loss of function results. When a bone is luxated (out of joint) , there has occurred a partial or complete rupture of certain ligaments or tendons; or a bone may be luxated when an abnormal or unusual elasticity of inhibitory ligaments or tendons obtains. ”

“ Luxation of the Patella is spoken of by some as common. Others of much experience have not met with a single instance of it. I have never seen this accident. The bone, it is said, may be displaced outwards, inwards, or upwards. The first form of luxation is the most frequent, and is caused by a severe fall, with the foot twisted outwards and the knee inwards. Displacement inwards is produced by direct violence applied to the outer part of the bone, or by the foot being turned inwards in a fall. ”

“ If the Luxation be on the sides, the Hand is turn'd to one side; so that the Extension must be made, and the Hand turn'd on the side opposite to the Luxation. But the Fingers are usually drawn one after another, to the end that the Tendons may be set again in their Place.
The eight Bones of the Carpus may be in like manner dislocated both on the inside and without; and to set 'em right, the Hand is to be laid upon a Table, and the Extension to be made, so as to press the Protuberances on the inside, if the Luxation be internal, and on the outside if it be external. ”

“ It is oftentimes only at the moment of reduction, that it is practicable to ascertain to which kind of luxation the accident belongs. Indeed, as in most cases, the reduction takes place of itself when the extensions are well executed, if the head be consecutively drawn inward, it is seen to descend along the internal part of the scapula, till it arrives near to the inferior part of that bone, and then to reascend towards the rupture in the capsule through which it passes into its natural situation. ”

“ A dislocation or luxation is a persistent displacement of the opposing ends of the bones forming a joint. We are here concerned only with such dislocations as immediately follow upon injury. Those that are congenital or that result from disease will be studied later.
Causes.—The majority of dislocations are the result of indirect violence, the more movable bone acting as a lever, on a fulcrum furnished by the natural check to movement in the form of ligament, bone, or muscle. It is in this way that most dislocations of the shoulder, hip, and elbow are produced. ”