Basic Principles and Practice of Chiropractic
Basic Principles and Practice of Chiropractic
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 1 from RC’s best-selling book:
“Basic Chiropractic Procedural Manual”
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CHAPTER 1: BASIC PRINCIPLES AND PRACTICE OF CHIROPRACTIC
This introductory chapter describes the general causes and effects of the subluxation complex.
The role of subluxation as an etiologic or perpetuating factor in disease is determined by the extent of the neuropathologic and/or biomechanical processes involved and how they relate to the creation, maintenance, or progress of such disorders.
The study of pathology shows that disease is not a static state. It is a process, and as such it manifests in certain signs, symptoms, functional alterations, and morphologic changes. These occur as an action of the body to motor responses of a somatic, visceral motor, or vasomotor nature that begin by noxious sensory stimulation. Such initial sensory irritation arises from the environment, are of a varied and complex nature, and their effects depend on an inherent or conditioned resistance of the organism at a given time. It can therefore be said that disease states essentially depend on irritations from the environment overcoming constitutional resistance and response mechanisms and reserves, with the nervous system acting as the mediating factor between. As life is a stimulus-response phenomenon in its normal homeostatic functions, disease can be considered an abnormal response to stimuli that is beyond the capacities of the organism to adapt.
THE CAUSES OF DISEASE: AN OVERVIEW
The general etiology of disease has been traditionally considered an irritation brought about by trauma, poison, or autosuggestion. Today, we might say physical injury; chemical, thermal, and/or pathogenic irritation; and psychologic overstress. Current pathology categorizes causes in somewhat different areas such as environmental or constitutional factors.
The four major environmental factors are
- physical trauma;
- various parasitic, bacterial, viral, rickettsial, or fungal infections;
- harmful inanimate substances such as foreign bodies or chemical toxins; and
- nutritional abnormalities from
(a.) deficiency and/or in excess in various ingested food substances or
(b.) tissue deficiency from impaired absorption, metabolism, or blood supply.
The two major constitutional factors are
(1) the inheritance of genetic abnormalities and
(2) nongenetic factors that may lower a person’s resistance to disease by impairing his constitutional health, particularly as a by-product of previous disease states.
Because of the general environmental and constitutional factors involved, the proper treatment of disease would thus be to remove these irritations from an individual’s environment and enhance resistance to disease by improving constitutional health.
THE “CHIROPRACTIC” SUBLUXATION
The processes described above, however, are complicated by one’s nervous system that reacts to irritations uniquely, according to conditioned or genetic constitutional factors, that may establish certain neurologic patterns of response. There may then be created a habituation (self-perpetuating) of certain neurologic responses and, therefore, the establishment of physiologic and structural alterations acting as an intrinsic source of neurologic irritability that persist after the initiating stimulation has decreased. This internal source of sensory stimulation may produce motor responses giving rise to clinical symptoms and signs.
The physical changes secondarily created by these reactions or primarily by structural injury, disease, anomaly, etc, may act as a physical source of neuropathologic reflexes and may be called a “chiropractic” subluxation. That is, a structural state characterized by an abnormal physical relationship between adjacent anatomic structures whose contiguous tissues elicit neurologic responses that may clinically be manifested as symptoms, signs, functional changes, and morphologic alterations of a disease state but less than that of complete structural disruption.
It can therefore be readily acknowledged that to discuss the “chiropractic” subluxation in general terms is difficult. Thus, to clarify the issue in a cause and effect manner, the remainder of this chapter will describe primary neural and homeostatic mechanisms, fixation-related articular therapy, the foundation of chiropractic clinical rationaler, the major causes of joint fixation development, and potential contributory causes of joint fixation development. These topics will be followed by a summary review of subluxation-fixation effects on, in, or near the intervertebral foramen (IVF).
PRIMARY NEURAL AND HOMEOSTATIC MECHANISMS
Each moment the nervous system receives thousands of signals from a variety of sensory organs, integrates the data, prepares necessary responses, and initiates responses through a multitude of motor and/or autonomic mechanisms. A specialized network of nerve fibers permeates the body to do this in a manner that some fibers receive and respond to stimuli from the external and/or internal environments, some transmit signals to and from integrating and coordinating centers, and some conduct messages from centers peripherally to the complex of muscles, vessels, and glands to produce an action.
This explanation describes normal neural function, but it does not explain what happens if some process or mechanism fails. In more instances than not, that is the concern of the doctor of chiropractic. Healthy homeostatic mechanisms are the ideal for which all DCs strive. This is especially true in family practice where much more than orthopedic and trauma-related disorders are seen. Working as partners in distinctive roles, the nervous system and the endocrine system provide almost all functional control for body processes.
The basic function of the nervous system is to control rapid activities of the body such as muscle contraction, swift visceral events, and the rate of endocrine secretion, states Guyton, the renowned physiologist. The endocrine system, in contrast to the nervous system, principally regulates the slower metabolic functions of the body to prolonged physiologic activities.
The general design of the body is an organic matrix of synchronized master tissues and vegetative systems. The quick-acting master tissues specialize in receiving messages from the external and internal environments and reacting to them (eg, nerve and muscle tissue). Specialized peripheral receptors (eg, the telereceptors and contact receptors) become impressed by stimuli from the external environment, while deep proprioceptors in muscles and joints and the interoceptors and chemoreceptors of the viscera are sensitive to stimuli arising within the internal environment. In this context, the slower-acting vegetative systems (eg, digestive, respiratory, circulatory, excretory systems) provide the basic utilities of life necessary for cellular nutrition, growth, or repair and the removal of waste products.
Vegetative systems are directed and regulated primarily by the sympathetic and parasympathetic divisions of the autonomic nervous system (ANS), whose activities are modified, harmonized, coordinated, and integrated by centers within the central nervous system (CNS) to meet the constantly changing needs of the body relative to its internal and external environment. It is this way that homeostasis is maintained.
FIXATION-RELATED ARTICULAR THERAPY
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