Organic Problems and Chiropractic
By Alfred L. Logan, DCOrgan-muscle relationships are controversial, therefore before discussing the specific organ-muscle relationships, it is necessary to relate the author's opinion of the history and theory as well as our methods used to prove or disprove them clinically.
The earliest signs of organ-muscle relationships recorded were in drawings of therapeutic yoga exercises in India. The positions used in therapeutic yoga applied pressure to or stretched specific muscles for each organic problem. A comparison shows the muscles being affected by the exercises similar to the ones related to the same organ as introduced by George Goodheart, D.C., in the 1960s.
With the introduction of muscle testing, the author, utilizing two other theories, set out to prove or disprove the organ muscle theory clinically. To our knowledge, no studies have been done to prove or disprove the organ-muscle theory, the fixation-organ theory or Bennett's neurovascular dynamics (NVD) theories.
An explanation of the author's interpretation of each of the theories is necessary to follow the methods used.
For many years organic "places" have been taught as areas of fixation found by doctors of chiropractic to accompany organic problems.
Reports of success in treatment of organic problems have been reported by various authors by adjusting the areas indicated. Dr. D.D. Palmer reported that by adjusting, he restored the hearing of a deaf person, the first patient of chiropractic. So, the relationship of an organ to a "place" started from the beginning of chiropractic in 1895.
Many technique proponents have related various areas of the spine as organic "places" including Biron, Welles, and Houser's Chiropractic Principles and Technic, published in 1939 which refers to the "centers" and organic "places" in use by many chiropractors at that time. The most prominent chiropractic "system" to propose organic places has been the Meric system.
The fixation level for an organ may vary from author to author, yet are usually no more than one vertebra apart. The variations of patient anatomy and methods of palpation used by the authors may account for the differences.
The following are the levels of fixation and the organs related to them as used by the author:
Even though there are areas of overlapping in the list above, persistent fixation in the area should alert the practitioner to investigate the possibility of organic problems associated with the area. Further investigation may be necessary to prove that the fixation is from organic causes and not a structural fault missed during the examination.
All methods of palpation is fraught with the variables of patient reaction and the examiner's experience and ability which probably accounts for the variables in the areas of fixation recorded by the different authors. The author prefers palpation of the thoracic and lumbar spine in the supine, non-weight bearing position for greater accuracy. The distortion and stresses of the prone position for static palpation and the weight bearing problems in motion palpation interfered with the accuracy.
Neuro-Vascular Dynamic Points
Terrence Bennett, D.C. established reflex areas which he felt related to each organ of the body and claimed success in some organic problems by using the reflexes as treatment points.
On the front (fig. a), the reflex points are either over the location of the organ, or what Dr. Bennett claimed was a reflex from the organ (or valve). The reflex point on the back (fig. b) is felt as a tight muscle and is usually sensitive to the patient when palpitated. Some of the posterior points coincide with the "fixation" places.
If nothing else had ever come from his work, the location of the reflex points alone would be helpful in diagnosing possible organic problems.
Treatment consists of passive contacts of the two reflexes. With the patient supine, use the right hand and palpate the abdominal area (fig. a) corresponding with the organ that is associated with the area of persistent fixation. With the left hand, contact the area related to the organ (fig. b), and simply hold. In the author's opinion, this technique helps greatly in decongesting the organ or relax the sphincter. The author has helped many patients with known organic problems with the use of NVD as an adjunct to adjustive procedures. All reflex techniques should be used only after an adjustment when possible.
Along with the organic "place," NVD should be taught as an integral part of diagnosis.
Dr. Chapman, an osteopath, found that patients with organic problems usually had sensitive areas related to them, one adjacent to the spine and one on the anterior part of the body (generally different areas than the NVD areas). Dr. Chapman claimed success in treating organic problems by stimulation of the reflexes.
George C. Goodheart, D.C., introduced to the profession the importance of muscle balance and function as a part of diagnosis and treatment. He found that patients with known organic problems also had specific muscles that tested weak. He also found that stimulation of the reflex areas located by Chapman for the same organ many times resulted in an increased response in muscle strength. Thus, the organ-muscle relationship.
Dr. Goodheart, with further testing found that in the presence of organic problems, the reflexes would be present and the muscle would be inhibited from normal function. However, if the muscle was injured, organic function was not affected. He theorized that the common denominator is that the reflex, when stimulated, improves the lymphatic drainage in both the organ and the muscle. Thus, the name used in applied kinesiology, neuro-lymphatic reflexes.
NOTE: Above is the author's interpretation of the work of Bennett, Chapman and Goodheart, and does not necessarily reflect the theories as usually presented nor are they complete. Our intention is to acquaint the reader that has not studied them with the basic theories as we see them. In the attempt to prove or disprove the organ-muscle theory, the neuro-lymphatic reflexes were not considered, only the muscle weakness, the fixation, and NVD.
To prove or disprove the organ-muscle relationship it was necessary also to prove or disprove the fixation and NVD theories. Several things had to be considered:
Several methods were used to find the answers:
1. Several post-graduate classes were instructed to dine on spicy Mexican or Italian food for lunch. Upon returning, all of the muscles related to digestion were tested, and retested for three remaining hours following the meal.
This was by no means a scientific study, with both the patient and examiner aware of the test. However, each time this method was used, the majority of the muscles that presented weak corresponded with the organ required to function at that time during digestion. As the three hours passed, and the food passed, the muscles associated with the stomach returned to normal and those associated with the pancreas, small intestine, etc., progressively weakened and returned to normal.
It would seem reasonable that if the muscle is inhibited when the organ is working, that it should be affected during any dysfunction.
2. All patients with known (or at least diagnosed) organic symptoms were checked for fixation, NVD reflexes and muscle weakness.
Fixations were found in the majority of the cases with proven (ultra sound, x-ray, CT scan, etc.) organ problems. In several cases where fixations were not present, or were persistent elsewhere, investigation proved the original diagnosis to be incorrect with the new diagnosis later confirmed by surgery.
The NVD reflexes were present in most proven organic cases. One exception is the presence of stones in the gall bladder. The reflex was not always present in the absence of symptoms. A reasonable explanation is that where stones are present and are not blocking the duct, the reflex would not be triggered. (Gall stones are present in many individuals that have never experienced symptoms and are an incidental finding of another investigation or surgery.)
The muscles were affected in almost all of the proven organ problems.
In the majority of the proven organic cases, the fixation, NVD reflex, and the muscle inhibition were all present.
3. Patients who presented with persistent fixations in an area related to an organ were investigated as thoroughly as possible for other structural faults and if still persistent were investigated for organic problems.
The number of clinical and sub-clinical problems found were great enough to justify the use of persistent fixation as a major sign of organic disease. Some patients, without obvious signs and symptoms, limited our investigation. The patients could not ethically be referred for investigation without justification. Of course, some persistent fixations could have, and probably were compensatory for problems not found in our examination.
4. One procedure used on several occasions with classes of both students and doctors of chiropractic in workshop. Without explanation, each class was instructed to:
a. Examine each other in the erect posture to include flexion-hyperextension of the knees.
b. Examine in the supine posture with the legs relaxed and suspended by the heels for those hyperextended without weight bearing.
c. Those with bilateral hyperextention were eliminated from the test.
Using only those with unilateral hyperextended knees (27), they were instructed to:
d. Test the popliteus muscles bilaterally. Ninety-six percent (all but one) of the hyperextended knees tested weak compared to the opposite knee with the majority on the left knee.
e. Careful palpation in the supine position found fixations at thoracic 4-5 in all cases.
f. In two groups the author adjusted each patient in the supine position and two groups the patients were adjusted by the examiners, both with similar results.
Seventy-seven percent (21) of those adjusted revealed upon examination, both the weakness and the hyperextension was eliminated. Of the remainder, six responded when NVD was used. One patient failed to respond fully. He reported that he had recently experienced an injury to the knee.
One can only conclude that if the gall bladder is under stress:
By adjusting the thoracic 4-5 fixation a response may be expected by the weak popliteus muscle (no direct neurological explanation) most of the time.
Use of the NVD reflex (passive) after all else fails may produce improved function of the popliteus muscle (no neurological explanation) and possibly help gall bladder function.
The value of the above testing is proven time and time again, when during an examination a hyperextended knee is observed, a tight, sensitive area is palpated under the right rib cage and a persistent thoracic 4-5 fixation is present. Inquiry into symptoms of gall bladder dysfunction many times surprises the patient, as they usually do not believe that a relationship exists between the gall bladder symptoms and their structural problems. With the use of organ-muscle relationships followed by investigation into the organ problems, the treatment program must be improved.
Nothing is absolute. Each reflex, fixation muscle test requires judgment on the examiners part to determine the reflex, the degree of fixation and/or the loss of normal strength. Accuracy again depends on the amount of experience and ability of the examiner. To further cloud the issue, patient reaction varies from individual to individual.
Most signs and symptoms accepted by the medical community also require judgment of the examiner and patient reaction.
One study in Australia (socialized medicine where one would expect less needless surgeries) showed that only 57 percent of the appendices removed from female patients were pathological. Other studies in California showed even a lower percentage of accuracy.
The accepted signs and symptoms of nausea, elevated temperature, rebound over McBurnies point and elevated white cell count were the criteria used to determine the necessity for surgery.
If the area of fixation (thoracic 12, lumbar 1) had been checked; if the NVD points had been palpated and found sensitive; and if the quadratus lumborum muscle had been tested and found lacking in its normal strength, could needles surgery have been prevented? Would the percentage of pathological appendices be higher?
No one can answer those questions after the fact, however if the examiner has the advantage of the additional signs and symptoms provided by the fixation, NVD and organ-muscle relationships the diagnosis must certainly be more accurate.
There definitely is validity to the existence of an organic "place" and should be taught in palpation, examination and as a part of diagnosis in addition to accepted medical diagnostic signs and symptoms.
Neuro-vascular-dynamic reflexes are valuable in the diagnosis and treatment of organic problems and should be taught as a part of diagnosis as well as technique. The organ-muscle relationship is sufficiently correct to include as one of the signs and symptoms of organic disease and as part of structural analysis.
Using the three theories as a cross-check, most of the muscles proposed by Dr. Goodheart to be associated with organ problems proved clinically correct. Most of the NVD points coincided with the affected muscles and fixations. The fixations were found consistently correct in known, proven organic problems.
None of the above is intended to endorse applied kinesiology, nor to discredit it. The neuro-lymphatic reflexes were not used as a part of the tests as our intention was to cross-check NVD and the fixation theories. Therefore, the validity of treatment through use of the NL reflexes was not a consideration.
A knowledge of normal muscle function is necessary to enable the examiner to detect malfunction and/or distortion. To determine the cause requires investigation and should include orthopedic testing, neurological testing, palpation for fixations, muscle testing and all of the reflexes known to be helpful in arriving at a correct diagnosis.
The use of organ-muscle relationships, fixation and NVD reflexes help in determining that an organic problem exists, pinpointing the organ involved and adding to existing accepted medical diagnosis signs and symptoms. Their use can only enhance the diagnostic ability of our profession.
Alfred L. Logan, D.C.