Alva Emery Gregory, M.D.
CHAPTER 1: EQUILIBRIUM OF FUNCTION
Normally there exists perfect equilibrium of the amount and efficiency
of the nerve impulses and the consequent vital energy generated by and
originating within the various nerve centers contained in the brain and
Under normal conditions there is no interference with the generation
of vital energy in the nerve centers, or with the transmission of vital
impulses by motor nerves, from the brain and spinal centers where they
originate, outward to the various viscera or parts which these transmitting
nerves ramify and supply.
Vital phenomena and essential functional activity are constantly maintained,
under normal physical conditions, in the various parts of the organism
as a result of the efficient generation of vital energy or impulses within
or by the nerve centers, and of the perfect transmission of the vital impulses
by the efferent spinal nerves, to the ganglia of the sympathetic system
and to the various parts of the body which they ramify.
Such normal conditions will produce the fundamental requirements of
perfect health and efficient auto-protection, which will maintain health
during the continuation of these normal physiological conditions.
Franck, in the "Dictionnaire Encyclopedique des Sciences Medicales"
observes, that when one considers the normal functions of the nervous system,
he finds that there exists a necessary equilibrium between the different
parts of this system.
This observation is true of the normal physiological condition which
must be present, and continue, to maintain normal functional phenomena
which constitutes perfect health.
It is the existence and continuation of the equilibrium, and of perfect
co-ordination and reflex action, which maintain perfect health, and it
is the existence of some variation and loss of the perfect equilibrium
of nerve action which engenders derangement of function, and the resulting
in co-ordination or consequences, which is disease.
DISTURBANCE OF EQUILIBRIUM
The existence of the normal equilibrium of nerve impulses may be disturbed,
and it is always altered or destroyed in case of any temporary or continuous
derangement of function, associated with disease.
The abnormal functional activity or the consequent organic alterations
in the different organs or parts of the body may be due to an excessive
action or to a diminished function in the generation and discharge of vital
impulses by the spinal centers or to derangement in the transfer of afferent
impulses to efferent nerves.
The derangement of function in the different organs or parts of the
organism may be due to an interference with nerves causing a depression
and consequent failure in transmission of the vital impulses to generate
the normal amount of vital energy.
A condition of over excitability of the transmitting nerves, especially
if associated with an over excitable state of their centers of origin or
reflex, will produce and maintain an over action, even from normal stimulation.
The deviation from the normal equilibrium of function associated with
disease, in the organs or parts applied, may be due to a depressed condition,
or to an over excitability and action of the reflex centers, which will
cause an altered and ab-normal reflex phenomena, which is due to the fact
that the normal or automatic stimulus will fail to produce the normal reflex
functional response, due to the altered excitability of the reflex centers.
RESULTS OF FAILURE OF EQUILIBRIUM
The prominent or excessive over action of certain centers in the spinal
cord or in the brain, seem to divert, and to contribute to their own use,
an excessive amount of vital energy, and in this way there is caused a
diminished activity of the other spinal centers in the generation of impulses.
The excessive use or waste of nerve energy, which is necessary to overcome
refractive errors of the eyes, and pathological conditions of the orifices
of the body, as of the rectum or genitalia, may and do materially affect
the integrity of the brain and nervous system, and consequently the different
viscera and parts of the body.
There is generated normally within our bodies, by the nervous mechanism
from the nourishment we take, sufficient vital energy to maintain the integrity
of the vital phenomena in all parts of the organism and an excessive consumption
of nerve energy, to overcome refractive errors of the eyes or overcome
the results of orificial lesions, will rob other parts of the organism
of their due portion of nerve energy and consequently the weaker portions
All the different functions of nerves may be influenced by disturbance
or alteration of the normal equilibrium of the activity of the different
nerve centers, as for example the functions of mentality, thermogenic action,
trophic supply, inhibition, excretion, secretion, and muscular action,
in short, all forms of derangement of function may ensue, and infections
and contagious disease may successfully invade, owing to deficient auto-protection
in certain zones.
FUNCTION OF NERVE CENTERS VARY
The function of the nerve centers in the brain and spinal cord differ
very materially in the vital phenomena which they excite, and in the functions
which they, maintain in the organs and parts they supply.
There are certain centers in the spinal cord which exert special or
specific influences upon the different organs and parts, and there are
other centers which exert counter influences, and these various centers
are situated in the different portions of the spinal cord.
There are centers of nerve origin which initiate nerve impulses of constriction,
which are transmitted by the efferent nerves to the parts which they supply;
there are centers which cause dilation; there are centers which produce
inhibition or depression, and also centers which excite an acceleration
and stimulation, of the vital functions in the parts which they supply.
For every variety of function produced in the different nerve centers
of the spinal cord and brain, there is produced a counter function in some
other center thereof.
We may stimulate a spinal center, and excite the impulses of contraction
or constriction of a certain organ or zone, by concussion or by the application
of the sinusoidal current, but we will find it necessary to apply stimulation
to an entirely different center, to excite the counter reflex or impulse
From the results which we obtain, by spinal stimulation, we learn that
the different spinal centers exert different and opposing influences upon
the different organs or parts supplied, and practitioners of spinal therapy
should understand this subject.
REFLEX ACTION VARIES
Owing to a deficiency of the nutritive elements, or to an interference
with the circulation of the vital fluid within the spinal centers, there
may be a diminished or an increased excitability and action of the spinal
The integrity of the excitability of the spinal reflexes, and of the
sympathetic reflexes or automatic action, is very essential, since all
the commerce of the body, as salivation of food, deglutition, digestion,
peristalsis of the intestines, and all the eliminative processes are directly
maintained and controlled by the automatic reflex nerve phenomena.
By a general concussion and stimulation, along all or most all of the
spinal column, we will stimulate impulses and also counter impulses, which
may nullify each other, and for this reason we may fail to secure specific
Spinal concussion, or stimulation of the spinal centers by any other
means, should not be used by anyone who has not a competent knowledge of
the specific influence of the impulses which may be excited in each spinal
center upon each and every organ which they supply or in any way influence.
Every practitioner of spinal concussion, or of any other method of spinal
stimulation, should be competent in physical diagnosis, so that they may
be able to discern what is advisable and desirable to be accomplished by
the spinal stimulation, otherwise they may produce ill effects and discomfort
to the patient.
To stimulate the subsidiary centers of vaso-constriction, in a case
where there is vaso-motor competency, would excite headache and distress,
and such an unprofessional mistake is apt to be made when concussion is
It is the object of this booklet to make the subject plain, concise
and comprehensive, and to give you a competent knowledge of this subject,
and to assist all who may read, understand and avail themselves of these
most potent auxiliary methods of rational therapy.
Those who read, understand and profit by this our humble contribution
and effort to make this matter plain and comprehensive, and those who put
these methods into intelligent use will certainly profit greatly thereby,
while those who for any reason doubt and fail to profit thereby, must bear
the misfortune of dealing with less competent methods in the treatment
of many forms of disease or functional derangement.
We beg to call to the reader's attention some very important considerations
in the use of spinal therapy, and some self-evident truth of material worth.
No one method of treatment embraces all that is beneficial, either in
the line of medical or in surgical methods, nor can any one method of treatment
preempt the entire field of therapeutic art to the exclusion of all others.
Spinal concussion, nerve pressure, sinusoidal stimulation and freezing
over or near the spinal exit of tender nerves, are by no means the only
beneficial methods of spondylotherapy. Some of the best and most
efficient methods are not used by those who depend wholly upon the above
These measures of spinal treatment, freezing excepted, are administered
to stimulate the spinal centers of the origin of nerves, and to increase
the nerve impulses and consequently the functional phenomena produced in
the parts supplied, and to overcome any failure of the normal equilibrium
of the energy which is being generated in the spinal centers, or of the
vital function which is being produced in the different organs or parts
WHY CONCUSSION IS NEEDED
The need of this concussion stimulation and increase of function in
the parts supplied, is due to a diminished functional activity of the spinal
center of nerve origin, which we find it necessary to stimulate to greater
activity, or to some interference with the transmission of the nerve energy
from the spinal center to the zone which is supplied.
This is a self-evident fact since normal, vital impulses amply generated
and perfectly transmitted, will maintain normal functional activity in
the organs and parts supplied. This is axiomatic.
There must exist some interference with nerves, either in the generation
or transmission of vital energy, or else there would be efficient nerve
supply and a perfect equilibrium of the vital phenomena produced in the
CAUSE OF NERVE INTERFERENCE
Nerves are usually interfered with, by pressure upon the nerve sheaths,
where they make their exit, or pass between the pedicles of the vertebrae,
from the neural canal in the spinal column on their way to the zone which
The nerve sheaths, containing the spinal nerves, where they extend or
pass through these spinal foramina, between the pedicles of the adjacent
vertebrae, are surrounded by bone tissue, which is hard and resistant,
much more so than nerve sheaths and the nerve fibers, and if any contraction
of the spinal musculature occurs, causing an approximation of the vertebrae,
there will occur physical, structural interference with the spinal nerve
sheaths, and the nerves which they contain.
These spinal nerve sheaths, extending through intervertebral foramina,
contain arteries passing to spinal cord, veins which drain the neural canal,
lymphatic vessels supplying nutrition to the nerve centers, besides the
spinal and sympathetic nerve fibers.
If the musculature of the spinal articulations contracts, and becomes
permanently contractured, causing approximation of the vertebrae, the nerves
become impinged or the vessels of circulation occluded, and either will
interfere with the integrity of the function of the nerves or nerve centers
involved, and consequently of the parts supplied.
Occlusion of the arteries will cause anemia of the spinal centers which
they supply, and this will retard or destroy their excitability and diminish
the generation of nerve impulses, and will also derange or destroy the
reflex transfer action in the spinal centers.
Obstruction of the lymphatic supply, to the spinal centers, will cut
off the nutrient supply to them and thus interfere with their histological
or structural integrity and their functional activity.
Obstruction of the veins will cause a congestion to occur in the corresponding
spinal centers, and this will cause an alteration of the generative power
and reflex action in the centers involved.
A decided contraction of the spinal musculature will cause a closer
approximation of the vertebrae, which may impinge the nerve trunk where
it passes between the pedicles, and this will cause pain of a greater or
less degree, according to the amount and severity of the impingement.
This pain is not felt at the spinal intervertebral foramen, where it
is caused, but it is referred to the terminal endings of the nerve which
is impinged, and is felt in the organs of its terminal ramification.
A SELF-EVIDENT TRUTH
We must concede that there is some interference with the integrity of
the nerve supply, causing deranged conditions, before we can contend for
the necessity of concussion or any other means to stimulate, to alter or
increase the function of nerve centers or to correct derangement of function,
or to create a balance of equilibrium of nerve impulse generated by the
different nerves or spinal centers.
Which is the more rational, to stimulate the action of depressed nerves,
or to remove the interference which preventing their normal action?
Spinal adjustment will relieve contractured conditions of the spinal musculature
and overcome interference with spinal nerves.
We fully believe that both methods, spinal adjustment and spinal concussion,
are excellent, but that a combination of the two methods is the most rational
and efficient procedure, and experience has convinced us of this fact,
since many cases recover from the use of both methods, which have failed
to respond to either of these methods alone.
For the latest, best, and most efficient, and least painful methods
of spinal adjustment, to relieve interference with nerves, the reader is
referred to "Spinal Treatment, Science and Technique" (Gregory), which
work is well illustrated and is clear, concise and comprehensive.
We fully believe that those who advocate, exclusively, the use of the
methods of stimulation of the spinal centers to greater activity, have
failed to give the subject of spinal treatment intelligent and unprejudiced
consideration, or they could readily appreciate the rationality and necessity
of measures to remove the interference, which mitigates or in any way alters
the function of the nerves or nerve centers.
RATE AND FORCE OF CONCUSSION
It has required a great amount of empirical work, and no doubt much
more will be necessary, to determine the proper rate of the speed and the
amount of the force of the spinal concussion blows, necessary to accomplish
the most in obtaining the desired results.
There is a very different result obtained by using rapid percussion
blows or the rapid sine, than what is obtained by the use of the slow rate
of concussion and the slow alternations or breaks of the sinusoidal current.
There is a different effect produced by nerve pressure which is applied
for a brief space of time than that which is produced by continuous nerve
pressure for a considerable length of time, and it is necessary for us
to understand the rate, the force and the time of the continuation of our
treatment in order to obtain the best results by the use of stimulating
or depressing methods of spinal therapy.
In this connection, there is one very important consideration or matter
to which I would call the special attention of the reader, and that is
the difference in the force of the concussion stroke, and amount of stimulation
which is required when giving treatments after giving spinal adjustment
as compared with the amount of concussion stimulation which is necessary
to be administered when we do not first remove all interference with the
nerves by spinal stretching or by spinal adjustment.
There is a very material difference in the amount of the force of the
blow and in the continuation of treatment, or in other words in the amount
of stimulation, which is required in giving efficient treatment following
proper spinal adjustment, compared to what is necessary when giving treatment
by spinal concussion when spinal adjustment bas not been previously given.
There is a very material difference in the amount of the impulses, stimulated
by concussion, which are conducted by an afferent or motor nerve which
is free from interference, than by one which is interfered with so that
its conducting power is diminished.
The reasons for all these facts are self-evident and obvious to even
a casual observer or a superficial reasoner, and this question should be
considered intelligently by all physicians who would use spinal concussion,
sinusoidal stimulation, or nerve pressure as methods for spinal therapy.
If the spinal nerves are free from any interference, and if the nerve
sheaths are free from impingement and if the vessels of the circulation,
supplying nourishment to the spinal centers and furnishing open channels
of drainage are normal in size, then spinal concussion, or other modes
of stimulation of nerve centers will not be needed or indicated, except
in cases where the interference has been recently removed, and an extra
amount of work is to be done, in the part supplied, by the nerves in question.
If there is retention from failure of proper elimination and structural
alteration occurring during the existence of the nerve interference, we
may restore the normal nerve supply, by removing the spinal nerve interference,
and still need more than the normal nerve supply of nerve energy to restore
the normal condition.
We may by spinal concussion applied to a nerve center, after that center
and the nerve originating therefrom are freed from all interference, cause
the veneration and transmission of double the amount of normal energy which
is a most efficient and expedient healing agency.
If, because of interference with the nerve in the transmission of the
impulses, or if because of interference with the spinal center of origin
of that nerve, we have a long continued, diminished and inefficient amount
of nerve energy, to maintain health in the part supplied, then will concussion
and other methods of spinal stimulation be indicated to augment or hasten
recovery, and spinal treatment, to overcome the spinal interference with
the nerve or of its center of origin, will be first indicated to obtain
the best results.
For example, let us suppose that because of interference with a nerve
or with its center of origin, only one-half of the normal amount of nerve
impulses are generated and transmitted to the parts supplied. We
will then have but 50 per cent of the normal vital energy and functional
phenomena performed in the zone supplied.
Stimulation of the center of origin of this nerve may readily double
the amount of impulses which are generated by its center of origin, and
this will raise the vital energy in the parts supplied to 100 per cent
instead of 50 per cent.
Now if we first remove interference with a nerve or with its center
of origin, which has been furnishing only 50 per cent of the normal amount
of energy, then it will, because of the removal of interference, furnish
100 per cent of the normal amount of energy.
If we now, when the nerve is furnishing 100 per cent of vital energy,
stimulate its center of origin as above we will cause it to produce 200
per cent of energy, which will be conducted to the part supplied.
We will then have double the amount of the normal energy which is a most
potent and efficient agency for the hasty restoration of the normal condition,
and normal functional activity which is health.
We can look at this matter from another angle. If we apply spinal
concussion to a spinal center of nerve origin, from which the nerve is
transmitting but 50 per cent of the nerve energy generated, it will require
a great deal more stimulation and more vigorous concussion to increase
sufficiently the nerve energy supplied to the diseased zone, than if the
nerve conducted 100 per cent or all of the nerve energy, which is excited
in its center of origin by the concussion or other stimulation.
We obtain results by adjusting the spine and overcoming contractions,
and by removing interference with nerves, because by so doing we restore
their conducting power to 100 per cent or to a normal amount, and we may
obtain better and quicker results by using spinal concussion also to furnish
a still greater amount of energy, which will more quickly rejuvenate and
reconstruct the histological or structural alterations, which have occurred
as a result of long continued functional derangement.
Continuation of Effects
The permanency of the effects, obtained by the stimulation of any part
of the nervous system, is an important item for our consideration.
The natural and almost universal rule, concerning the continuation of
the effects of stimulation, is that the increased action, which is excited,
is transient, and that it is only manifest for a short time after the application
of the stimulus, and it is generally true that a corresponding period and
amount of depression follows the use of temporary stimulation.
It appears to the causal observer that the effect of spinal concussion,
which is excitation or stimulation, would prove but transient in effect,
and of no great permanent efficiency, but this does not prove to be the
case in clinical practice or has not done so in the experience of the author.
We firmly believe that settling of the spine, or contraction of the
musculature from direct or reflex causes, does engender the necessity of
spinal stimulation by concussion and that the immediate cause of their
diminished functional phenomena should be corrected in order to accomplish
We can conceive how the musculature may be affected favorably by concussion,
provided the application is vigorous and severe, for then will it certainly
affect the musculature and cause some relaxation which is indispensably
necessary to the continuation of the result of the stimulation caused by
It is also necessary for the concussion to be given with sufficient
force to adjust the musculature which is a more disagreeable method of
relaxing the spinal musculature than are methods of spinal adjustment or
RATE OF APPLICATION
As a general rule the rapid sine or the rapid and interrupted concussion
strokes or brief applications of nerve pressure, are more excitable or
more stimulating than continuous and excessive applications, and will produce
the most decided constriction or contraction of the viscera.
The slow sine and the slow but interrupted concussion strokes are sedative
in their influence and act as well or better than rapid treatment, when
applied to spinal centers for the purpose of inducing dilation or inhibition
of function or action of glandular viscera.
The slow sinusoidal interruptions are more efficient in stimulating
and in exercising and strengthening the muscular tissue.
Nerve pressure applied for a brief space of time, consisting of about
30 seconds, acts as a decided stimulus, but long continued pressure acts
as a depressant and a sedative, and inhibits the action of the nerve to
which it is applied.
Concussion applied interruptedly for a short time, from three to seven
or ten minutes, is exciting or stimulating in its effects, while long continued
concussion or concussion without interruption will soon produce a sedation
and temporary paralytic condition of the center which is treated.
The most effective time for applying spinal stimulation by concussion,
for the purpose of excitation of the centers of nerve origin, is to apply
the concussion after the spinal adjustment to remove all interference with
the nerves or with their spinal centers.
The most efficient manner of stimulation is to apply the rapid concussion
strokes, from ten to twenty per second, for 30 seconds and then rest for
30 seconds, and then again use the concussion and periods of rest for 30
seconds each and continue in this manner for from five to ten minutes at
each daily seance.
If two or more different centers are to be concussed, we may them easily
secure the necessary interruptions by concussing first one segment and
then the other segment, and by this rotation and alteration secure the
If from over use, the stimulating action of concussion is exhausted,
the sinusoidal current may be substituted, and the excitation may thus
be continued and the results increased and continued.
Definition - A spinal center, or segment of the spinal cord,
is a certain portion thereof which gives rise to a certain pair of spinal
nerves, and it is the reflex center of sensory impulses and the source
of origin of the central impulses of that pair of nerves.
The spinal centers or segments are not clearly defined or differentiated
from each other, for the reason that there is a close relation and a more
or less intermingling of the grey cells of the adjacent segments or centers
of the spinal cord.
There are thirty-one pairs of spinal nerves which ,are given off from
the spinal cord, and there are therefore thirty-one nerve centers or segments
contained within the spinal cord. The different pairs of spinal nerves
which are given off from the spinal cord, are given off from different
regions or divisions as follows:
8 pairs of nerves
Thoracic region 12
pairs of nerves
5 pairs of nerves
5 pairs of nerves
Coccygeal region 1 nerve only
By way of comparison, we note quite a difference in the location of
the spinal centers of origin of nerves, and the spinal exit of the nerves.
The center of origin or the reflex center of a pair of nerves is always
situated above the point or level of the exit of the nerves, and variation
in the distance in which the nerve passes downward in the neural canal,
to where it makes its exit, increases from above downward.
In the cervical region the nerves pass out from the neural canal but
a very short distance below the location of their centers of origin.
In the thoracic region there is a greater variation between the level of
the site of the origin of the nerve, and of the point of its exit, which
is below, and this variation increases as you pass from the upper to the
lower portion of the thoracic division.
There are centers of origin of the spinal nerves contained in the different
divisions of the spinal column, as follows:
10 centers of nerve origin
Thoracic Division 20
centers of nerve origin
1 center of nerve origin
We have therefore the centers of origin of all of the cervical nerves
and of the upper two thoracic nerves in the neural arches of the cervical
division of the spinal column.
We have the origin of all of the thoracic spinal nerves except the first
two, and of the lumbar and sacral nerves, situated in the neural arches
of the thoracic division of the spinal column.
In the lumbar region, and within the arch of the first lumbar vertebra,
we have the center of origin of the coccygeal nerve. There are no
centers of origin of spinal nerves situated below the neural arch of the
first lumbar vertebra.
For your convenience, we publish a table showing approximately the relation
of the location existing between the spinal centers of the nerve
origin, or reflex centers, and the spinous processes of the vertebrae.
As a summary of the relative locations of the exits of the spinal nerves,
and of their centers of origin in the spinal cord, we give you the following
The first four or upper pairs of cervical nerves originate in the spinal
cord in that portion of the neural canal formed by the neural arches of
the first and second cervical vertebrae, and just above the level of the
top of the neural arch of the third cervical vertebra.
The lower four cervical pairs of nerves have their origin in that portion
of the spinal cord, situated within the neural arches of the third, fourth,
fifth and sixth cervical vertebrae and above the upper plane or within
the arch of the sixth cervical vertebra.
The upper or first six pairs of thoracic nerves originate within that
portion of the spinal column situated in the neural arches of the seventh
cervical and the first, second, third and fourth thoracic vertebrae.
The lower thoracic pairs of nerves, from the seventh to the twelfth
inclusive, originate in the spinal centers or segments of the spinal cord
located in the neural arches of the fifth to the eighth thoracic vertebrae,
The five lumbar pairs of nerves have their centers of origin in that
portion of the spinal cord contained within the neural arches of the tenth
and eleventh thoracic vertebrae.
The five sacral pairs of nerves leave their centers of origin in that
portion of the spinal cord located within the neural arch of the twelfth
thoracic vertebra principally, the lowermost portion extends into the first
lumbar neural arch.
The coccygeal nerve has its spinal center of origin within the neural
arch of the first lumbar vertebra and this nerve also receives fibers from
the arachnoidal and myelin sheath of the spinal cord, which coverings are
a continuation and an enlargement of the nerve fibers originating both
in the pineal glands and the pituitary bodies, at the base of the brain.
The coccygeal ganglion, which is situated within the rectal sphincters,
contain the terminal endings and the commissural fibers of the downward
stream of the white rami communicantes, and also the gray rami communicantes
of the gangliated cords of the sympathetic system which are contained within
the terminal portion and commissural union of the gangliated cords of the
sympathetic system or in the coccygeal ganglion.
Now that you may be able to locate easily each spinous process, and
in this way locate the different spinal centers, we will give you some
special tables of directions for locating them readily and with certainty.
Approximate Relation of Spinal Centers of Nerve Origin to the Spinous
Center of Nerve Origin
Arch of Atlas
1st Cervical Origin
2nd Cervical Origin
2nd Cervical Spine
3rd Cervical Origin
4th Cervical Origin
3rd Cervical Spine
5th Cervical Origin
4th Cervical Spine
6th Cervical Origin
5th Cervical Spine
7th Cervical Origin
8th Cervical Origin
6th Cervical Spine
1st Thoracic Origin
2nd Thoracic Origin
7th Cervical Spine
3rd Thoracic Origin
1st Thoracic Spine
4th Thoracic Origin
2nd Thoracic Spine
5th Thoracic Origin
3rd Thoracic Spine
6th Thoracic Origin
4th Thoracic Spine
7th Thoracic Origin
5th Thoracic Spine
8th Thoracic Origin
9th Thoracic Origin
6th Thoracic Spine
10th Thoracic Origin
7th Thoracic Spine
11th Thoracic Origin
8th Thoracic Spine
12th Thoracic Origin
9th Thoracic Spine
1st Lumbar Origin
2nd Lumbar Origin
3rd Lumbar Origin
11th Thoracic Spine
4th Lumbar Origin
5th Lumbar Origin
12th Thoracic Spine
1st Sacral Origin
2nd Sacral Origin
3rd Sacral Origin
4th Sacral Origin
5th Sacral Origin
1st Lumbar Spine
Coccygeal Segment Origin
In the above table we have, in the left-hand column, named the spinous
processes, and in the right-hand column, we have named the spinal center
that is situated directly under each spinous process.
HOW TO DETERMINE THE LOCATION OF THE SPINOUS PROCESS OF ANY VERTEBRA
First Cervical or Atlas
The first cervical vertebra or the atlas has no spinous process.
The location of the posterior arch of the atlas is approximately midway
between the lower portion of the occipital bone and the first or uppermost
spinous process or marked prominence, which is the spine of the axis.
Second Cervical Spine
The spine of the second cervical vertebra or atlas is large, thick,
strong and prominent, to which are attached many important muscles.
This large or prominent spine is easily recognized and located as it is
the first spinous process palpated below the occipital bone.
Third Cervical Spine
The spine of the third cervical vertebra is difficult to palpate when
the head is in the normal position. This is because this spine is
covered under the large heavy prominent spine of the axis. To palpate
the third cervical spine, flex the head and neck sharply by dropping the
bead forward with the chin upon the breast.
Fourth Cervical Spine
This spinous process is the second one which is palpated below the occipital
bone when the neck is in a normal position. This spine is the first
one palpated below the second cervical spine except when the head is flexed
forward so as to enable the palpator to detect the third cervical spine,
then the fourth becomes the third cervical spine which is palpated.
Fifth Cervical Spine
This spine is the second spinous process below the fourth cervical spine
and it is the third spinous process above the first thoracic spine or the
second above the spine of the seventh cervical, when counting from below.
Sixth Cervical Spine
This spine is the second spinous process below the spine of the fourth
cervical vertebral and it is the first one above the spine of the seventh
cervical or the second spine above that of the first thoracic. It
is located on a level with the upper commencement of the esophagus and
opposite the cricoid cartilage.
Seventh Cervical Spine
(Vertebra Prominens.) This spine is distinguished by its prominence
and by its length, and it serves as a guide for counting the processes
which are immediately above and below it. Sometimes the sixth cervical
spine is also quite prominent and may be difficult to differentiate, for
this reason, from the seventh cervical spine. The seventh cervical
spine is on a level with the apexes of the lungs.
First Thoracic Spine
This spinous process is on a level with the superior portion of the
spine of the scapulae and it may be detected and located by placing the
thumbs in a line with the fingers when they are placed above the spines
of the scapulae on both sides.
Second Thoracic Spine
This spinous process may be most easily determined by first locating
the first thoracic spine and then by finding the one immediately below
this spine which is the second thoracic spine.
Third Thoracic Spine
The location of the spinous process of the third thoracic vertebra corresponds
to the level of the inner edge of the spines of the scapulae and it is
the second process palpated below the first thoracic spinous process.
Fourth Thoracic Spine
This spinous process is best located by first differentiating and then
counting from the first thoracic process above, or by first locating and
counting from the seventh thoracic spinous process below.
Fifth Thoracic Spine
The fifth thoracic spinous process is best located by first differentiating
and counting from the seventh thoracic spinous process below, or it may
be located by counting from the first thoracic spinous process above.
Sixth Thoracic Spine
The sixth thoracic spinous process is best located by first determining
the location and counting from the seventh thoracic process below.
Seventh Thoracic Spine
The seventh thoracic spinous process is on a line with the inferior
angles or points of the scapulae when the patient is standing, and this
spine is a fingers breath below a straight line connecting the lower points
of the scapulae when the patient lies prone upon a treatment table with
the arms hanging down. This spine is easily located by placing the
forefingers of the two bands immediately below and against the lower angles
of the scapulae on both sides, with the thumbs on a line between and they
will then fall upon the seventh thoracic spine.
Eighth Thoracic Spine
The spinous process of the eighth thoracic vertebra is most easily located
by first determining the seventh thoracic spine. The eighth thoracic
spine is directly opposite the lower level or border of the heart and of
the central tendon of the diaphragm.
Ninth Thoracic Spine
The spinous process of the ninth thoracic vertebra is most readily determined
by first locating and counting from the seventh thoracic spinous process.
The ninth thoracic spine is situated on a level with the cardiac opening
of the stomach.
Tenth Thoracic Spine
The spinous process of the tenth thoracic vertebra is about a finger's
breadth below the attachments of the last two ribs, and it may be determined
by the prominence of the tenth pair of ribs in the axillary line by following
them to the spine. The tenth spine may be located by counting downward
from the seventh thoracic spine. The tenth thoracic spine is on a
level with the lower border of the lungs.
Eleventh Thoracic Spine
The spinous process of the Eleventh thoracic vertebra may be located
by counting downward from the seventh spinous process above, or it is the
spine immediately below the tenth. The eleventh spinous process marks
the level of the lower border of the stomach and of the upper border of
the right kidney.
Twelfth Thoracic Spine
The spinous process of the twelfth thoracic vertebra may be located
in the same manner as the eleventh thoracic spine or it may be located
by counting from the fourth lumbar below.
First Lumbar Spine
The spinous process of the first lumbar vertebra is most easily located
by determining and counting from the fourth lumbar spinous process below.
The first lumbar spine is on a level with the renal vessels and pelvis
of the kidney.
Second Lumbar Spine
The spinous process of the second lumbar vertebra is easily and quickly
located by first determining and counting from the fourth lumbar spinous
process below. The second lumbar spine is situated directly opposite
the third portion of the duodenum and of the receptaculum chyli.
Third Lumbar Spine
The spinous process of the third lumbar vertebra is best and most quickly
located by counting from the fourth lumbar spinous process below.
It is situated on a level with a plane just above the umbilicus.
Fourth Lumbar Spine
The spinous process of the fourth lumber vertebra is on a straight line
between the highest points of the crest of the ilia, and this spine may
be located by first palpating the sacrum and the fifth lumbar immediately
below. Placing the thumbs on a straight line midway between
the fingers resting upon the crests of the ilia on both sides. This
fourth lumbar spine marks the level of the bifercation of the aorta and
of the rest of the ilia.
Fifth Lumbar Spine
The spinous process of the fifth lumbar vertebra is easily determined
by palpating the sacrum below or by first determining the first lumbar
spine immediately above. This spine is on a level with the points
of spinal exit of the fifth pair of lumbar nerves.
RELATION OF SPINES AND NERVES
The following directions are given to give the reader a definite idea
as to the level of the spinal origin or the spinal exit of the spinal nerves
from the neural canal as they pass out to the different parts, or organs
which they supply.
In the cervical region we have omitted any summary of the general relation
of the spinal exit of the nerves to the level of the spinous process of
the cervical vertebrae, for the reason that this is not so important and,
for the further reason, that the spinal exit of the nerves varies but little
from the same level of the location of the spinous process of the same
This table varies very materially from that table in which we give a
summary of the approximate relation of the location of the spinal centers
of origin to the location of the different spines. We believe, however,
that this table will be of considerable interest, especially to those who
are more rational in their views and believe in relieving that interference
with nerves which necessitates concussion and other stimulation and the
administration of these methods of the stimulation to the spinal centers.
The first thoracic or dorsal spine is on a level with a point
about midway between the points of spinal exit of the first and second
pairs of thoracic nerves.
The second thoracic spine is nearly on a level with, but a little
above, the points of exit of the third pair of thoracic nerves.
The third thoracic spine is situated on a level with the spinal
exits of the fourth pair of thoracic nerves.
The fourth thoracic spine is situated on a level with the spinal
exits of the fifth pair of thoracic nerves.
The fifth thoracic spine is situated on a level with the spinal
exits of the sixth pair of thoracic nerves.
The sixth thoracic spine is situated on a level with the spinal
exits of the seventh pair of thoracic nerves.
The seventh thoracic spine is situated on a level with the spinal
exits of the eighth pair of thoracic nerves.
The eighth thoracic spine is situated on a level with the spinal
exits of the ninth pair of thoracic nerves.
The ninth thoracic spine is situated on a level with the spinal
exits of the tenth pair of thoracic nerves.
The tenth thoracic spine is situated on a level with, or just
a little above, the spinal exits of the eleventh pair of thoracic nerves.
The eleventh thoracic spine is situated on a level with a plane
just between the level of the spinal exit of the eleventh and twelfth pairs
of thoracic nerves.
The twelfth thoracic spine is situated on a level just below
the level of the spinal exits of the twelfth pair of thoracic nerves.
The first lumbar spine is situated on a level with the spinal
exits of the first pair of lumbar nerves.
The second lumbar spine is situated on a level with the spinal
exits of the second pair of lumbar nerves.
The third lumbar spine is situated on a level with the spinal
exits of the third pair of lumbar nerves.
The fourth lumbar spine is situated on a level with the spinal
exits of the fourth pair of lumbar nerves.
The fifth lumbar spine is situated on a level with the spinal exits
of the fifth pair of lumbar nerves.