Technic and Practice of Chiropractic. Joy Maxwell Loban
forward and rest elbows on knees, evenly, to facilitate Lumbar palpation. Patient’s head may be erect or flexed forward or backward but should never be rotated or laterally flexed during Cervical palpation except for the purpose of locating some particular transverse process.
(B) In emergency cases, where haste is urgent or patient is unable to assume a sitting posture, or as a means of re-verifying previous palpation, place the patient on adjusting table prone, face down. (See Fig. 2.) Remember that with the head lying upon its side the upper dorsal vertebrae will assume a curve with its convexity away from the face. Palpation in position (B) should precede every adjustment and, to guard against error, should be considered as a necessary preliminary to the movement of any vertebra.
(C) For palpation preparatory to using the Rotary, the Break, and other moves, have patient lying on his back with his head projecting beyond upper end of bench and resting on the hands and wrists of the palpater, or have the patient’s head rest on the bench, a less accessible position.
General Observation
Each spinal examination should begin with a general survey by which curvatures, marked prominences, etc., may be appreciated. Frequently some very important fact may be noted which would escape attention upon minute examination.
THE RECORD
The record of spinal palpation, when completed, should be an accurate history of the irregularities found in the spine and an accurate guide to adjustment. It must be brief and concise as well as readily comprehensible. One should be able to see at a glance any desired point on the record, so that it may be used during the adjustment without undue loss of time or attention. Obviously the introduction of any useless mark or sign, such as the inclusion of a number and blank space for each vertebra of the spine, or all possible subluxations with indications as to which do or do not exist in the given case, is a mistake.
The record should contain three parallel columns. In the first column place the number of the vertebra chosen for adjustment. In the second, place the direction of subluxation. In the third, place the word or sign which stands for the indicated movement for correction.
Number of Vertebra
The letter C is used to indicate Cervical, D Dorsal, L Lumbar, and S Sacrum in the record. Immediately following the letter which designates the region, place the number which shows the position in that region occupied by the vertebra in question, the relation of that vertebra to its fellows. For instance, the third Cervical vertebra is C 3, the eleventh Dorsal D 11. To the S for Sacrum append B or A to indicate that the Base or Apex is described as to position. This locates the subluxation. For a record of full spine palpation it is unnecessary to use the letters C, D, or L more than once, as subluxations are recorded in the order of their occurrence from above downward. A dash should always follow the number of the vertebra to separate it from the letters in the second column for convenience in reading.
Direction of Subluxation
The directions considered in palpating or recording subluxations are six in number, namely:
| Name | Abbreviation | Meaning |
| Posterior | P | Toward the rear (Dorsad) |
| Anterior | A | Toward the front (Ventrad) |
| Right | R | Toward the right hand |
| Left | L | Toward the left hand |
| Superior | S | Toward the head (Cephalad) |
| Inferior | I | Toward the feet (Caudad) |
As the fingers glide down the spine the posterior vertebra is the one which interposes itself in the path of the fingers, forcing them to describe an outward curve. It is the hill on the automobile road which forces the surmounting of a curved departure from the evenness of the road. It is relatively posterior to its fellows above and below.
The anterior vertebra, to the gliding fingers, means a depression, a valley. It causes the fingers to dip inward from the level of their course.
The right or the left subluxation is appreciated by running the tips of the fingers down the sides of the spinous processes. It really indicates rotation of the whole vertebra more often than any other malposition.
We say that a vertebra is superior when its spinous process is nearer the one above than the one below. It requires a measuring of relative distances. The degree to which a vertebra is superior is measured, not by its actual closeness to its fellow, but by the relation between the space above and the space below.
Likewise a vertebra is inferior when it is closer to its fellow below than to its fellow above.
Anterior subluxations are rarely recorded as such, except of the Cervicals or the last Lumbar, because no means of properly adjusting them is known to Chiropractic.
Order of Letters
In the second column, that devoted to direction of subluxation, the letter P or A should appear, if at all, as this antero-posterior relation is the first thing to be determined concerning any individual subluxation chosen except the Atlas. With the Atlas the first letter will be R or L. Next the laterality or rotation is indicated by R or L in every case except Atlas subluxation. Finally the S or I indicates the last point to be determined, the approximation of the vertebra to its fellows. This last letter usually shows thinning of intervertebral fibrocartilage, which will be discussed elsewhere.
If you desire to emphasize any direction as being more important than another, underscore the letter which stands for that direction with a single line. If two directions are to be emphasized, one more than another, underscore the one with two lines and the other with one. For example, if a vertebra is found to be quite decidedly posterior, more plainly to the right, and slightly superior, the record will show it thus: P R S.
Movement for Correction
This is indicated in the third column, separated from the second by a dash, by means of some brief word or words which describe a certain movement used in adjusting. The descriptive words and terms used in this work are all given and explained under Technic of Adjusting. (See p. 89.) Each word or term stands for a definite method of procedure. The best movement for the correction of any subluxation of any vertebra may be found by reference to the section on Preferable Adjustments, p. 155. If other terms are more familiar to the student, or in time replace those which are now common usage in the profession, they will be brief and clear and may be easily substituted for those given.
Palpation, fixing in the mind of the palpater the manner and direction of the subluxation, should also suggest as the obvious correction a movement calculated to reverse the procedure by which the subluxation was first produced. In other words, a certain kind of subluxation stands as the effect of a certain application of force along definite lines determinable by examination. Its correction should be made in a reverse direction along the same