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GENERAL EXAMINATION, ETIOLOGY, SYMPTOMATOLOGY AND PERVERSIONS Students of Neuropathy were not only taught the unique method of examination peculiar to it, but were also taught all known forms and methods of examination. This was for a twofold, purpose, (1) In order to fill out certificates and testify in Courts of Law if necessary, in terms used by the Medical profession, and understood by the laity; (2) So that Neuropath could have the benefit of both methods. From the viewpoint of the Medical profession, the invasion and effect of bacteria on the tissues dominated the theory of causation and pathology. The Neuropathic theory of disease on the other hand is due primarily to perversions or aberrations in the nervous systems. There was always a battle going on, as to which of the two methods was the most accurate. Our answer has always been, that a synthesis of the two would lead to a better diagnosis. The use of the stethoscope, sphygmomanometer and all kinds of laboratory
tests with the X-ray techniques were taught by practical class work.
SUGGESTED EXAMINATION PROCEDURE The steps in this plan of examination may be very familiar to thee older practitioner and may have but review value, but to the beginner, it should be very suggestive and helpful in making his own plan of procedure. The first visit of a prospective patient is vital, the manner of managing
it will largely decide whether the patient will have confidence enough
to go on with the doctor. Salesmanship and propaganda are not the first
approach to the patient, but a friendliness and an eagerness to serve the
needs of the ill one. Dr. Russell Conwell based his lectures “Acres of
Diamonds” on the preface: “Supply the need and you will succeed.”
PERSONAL EXAMINATION The first step in the personal history examination is for thee physician to carefully, patiently and sympathetically listen to the patient tell his or her symptoms. This will give the physician an idea whether his patient is physically ill, or psychosomatic. After the physician has finished his conversation, he can have his patient fill in the blank spaces in the following form, or one of his own making: Name:
Date:
Personal History: Have night sweats?
Drink water?
Appetite?
OBSERVATION OF THE PATIENT While the above form is being filled out, the physician can observe carefully The physical and emotional features. The face can tell some things to the observing physician: Facies cardiac - An anxious expression, seen in the early stages of chronica valvular disease. A purple or bluish appearance of the face, especially the eyes, temples and ears, with veins showing on the nose and sometimes on the cheek, caused by high blood pressure. Hepatic Face - An early appearance of jaundice. Ovarian Face - Features emaciated and sunken, an anxious expression, forehead furrowed, eyes hollowed, nostrils distended and sharply drawn. Lips full and compressed, angles of the mouth are drawn and wrinkled; puckered but protruding. Gastric Face in Children - A white line around the mouth, extending up the side of the nose shows irritation and improper feeding. Add to this sign pungent breath and vomiting and the child has Gastritis. Gastric Face in Adults - Chronic irritation of the stomach in adults is indicated by a dragging down of the corners of the mouth. Add to this drooling or driveling of saliva and the indication is of starch poisoning, and if there is a broad, pallid tongue evidence is strong of the eating of too much starchy foods. Hysteria - Is marked by staring and an ecstatic expression. Lypothmia - Great mental depression from grief. A lypomaniac has sadness written in his face. In general, patient is composed and satisfied. The inebriate has trembling lips and wandering expression. Stupid Expression in Children - Enlarged tonsils and adenoid growths, mouth open, lips hanging and nose is expressionless. Mitral Face - Excessively heavy drinker, excessively red nose, enlarged veins, bluish lips, cyanosed cheek and puffiness of face. Pallor - Intense pallor develops when the vital parts are diseased. In Bright’s Disease the face is swollen and white. Signs of Croup - These are well known, but the type of disease is not so easily told. There are fits of coughing and suffocating when a foreign body is in the air passages. Respiratory Disturbance - Is marked by a flushed face, (puffed and bluish), the eyes are suffused and the veins stand out. There is shortness of breath. Consumptive Appearance - Is that of emaciation, protruding, flushed cheeks, pinched nose, flaring nostrils, short, quick and jerky breathing; faulty speech and more or less suppressed voice. Face of Peritonitis, Intestinal Obstruction, Renal and Hepatic Colic - Face looks smaller and shrunken. Nose is thin, long and drawn. The bones of the face are prominent. The skin pale and covered with cold sweat and when drawn and pinched the cold sweat remains for some time. While the patient is walking toward treating room, physician can observe contour and body posture and other features; a few are: Rickets - Shortening of the stature, causing the head to appear large. Spine is incurved. Pelvis deformed, limbs are curved and project forward. When muscles are atrophied they cause general deformity. Alterations of heart and lungs cause deformities of the chest. The bowels are often too large and distended from gas, fat or ascites in fevers from tympanitis and inflammation. Enlargement - Of the liver or spleen causes a large abdomen in the upper regions. In the lower abdomen enlargement may come from tumor, distended bladder or uterus. Deformity - Of the third joint of the fingers (Nodes of Heberden) means arthritis deformens. Joint Distortion - Indicates gout, rheumatism or injury. Not infrequently they mean all three of these. Frequently injury is complicated by rheumatism. Skin - A straw-yellow hue is found in cancer and cachexia. Paleness may be from anemia, dypsnea, leukemia, amyloid, degeneration or Bright’s Disease. Articular Rheumatism is marked by paleness of skin and profuse sweats with strong acid odor. Anger, fear, jealousy also cause paleness which is due to vascular spasms. Bulge in Abdomen - May be a sign of ptosis. The posture is noted which, if wrong, places a strain on all the viscera. But no conclusion is made until all the factors of a complete examination are finished. If the patient shows any symptoms of being psychosomatic, the physician is referred to that form of examination, page 90, in my book, “The Fundamentals of Applied Psychiatry.” if signs of respiratory irregularity are present the physician will find a special form of examination in my book, page 41, “Endo-Nasal, Aural and Allied Techniques.” For the male who requires an examination of the genitalia, a method is found in my book, “Treatment of the Prostate by Physical and Manipulative Therapy,” page 41. Some simple forms of chemical examinations are now extant, which can be used in the office to determine whether more extensive laboratory tests are required. First, there is the Litmaisin pH indicators for Gastric, Vaginal and Nasal Secretions. Also the pH of urine, skin (blood), basal metabolism, feces, saliva, tears, and cervix. The Galatest for sugar and thee Endo-albumin test, along with the hemoglobin
index. All can be finished in a few minutes and a decision made if more
extensive laboratory tests are required. X-rays can be made when necessary.
TREATING TABLE EXAMINATION Thee patient in dorsal position. The physician makes a brief examination of the heart with the stethoscope, with one hand on wrist to see how the pulse synchronizes. Then he puts his hand along the aorta to note any undue pulsations that may have a great bearing on his diagnosis. If the heart is excited and rapid he will have the patient sit up and lightly concuss over the 7th cervical vertebra to quiet it down. (See "Concussion.") If the rapidity is due to excitement of the first visit, it will quiet down and remain so for the duration of the visit, if not, then other causes are investigated, as given under examination of the heart. The physician examines the finger nails. Pressing the tip of one finger of the patient between the thumb and forefinger at the very tip. Note the ring formed just above the lunula. If it is purple, cyanosis and anemia are present. If the ring is pink and rises to , say, one-quarter inch, the heart action can be said to be good, then attention may be given to the large toe nails, which are not found stained as frequently as the finger nails. The same technique of pinching the toe is used, except the physician’s thumb is back of the lunula and thee forefinger is underneath. On pinching, the body of the nail will take on various colors. Butler contends that when the hemoglobin is less than 50 per cent, as in cases of aortic regurgitations, chlorosis and severe hemorrhage, pressure on the nail completely exsanguinates it. In other conditions in which the peripheral arteries are quickly filled and emptied a sublingual pulse may be present, and in these disturbances, slight pressure will produce alternate reddening and blanching." "The presence of a transverse groove is indicative of a recent acute illness, unless the groove is a result of traumatism. Gouty individuals and cases of arthritis may have hard, brittle and longitudinal striated nails." "Arrest in nail growth on one side of the body is indicative of hemiplegia and brain tumors on the opposite side." "More about hemiplegia and tumors later."" "The presence of white spots in the nails may be an indication of mild trauma or may be due to small pockets of air accumulating between nail and its matrix. It may also be a sign of exhausting diseases, dissipation, sexual excesses, overwork and worry." "By practical experience with this technique, we have been able to add an outline that can be followed with a great deal of accuracy by the examiner. We have found the following colors significant: Pink, Purple and the following three shades of White -- Chalky White, Pale Dull White and Transparent White. Pink is the color of health. Purple is the color indicating cyanotic, anemic and anoxemic conditions. Purple is seen either in spots, lines or angles in simple anemia, pernicious anemia, or any cyanotic conditions due to any dietary or inorganic deficiencies as oxygen starvation, an excess of dioxides in the blood caused by any interference with the entrance of air in the respiratory tract. Also purple lines are seen in overdoses of certain drugs or metallic substances or stenosis of the pulmonary orifice, from an imperfect ventricular septum. Purple signs or lines are seen in all cardiac dilations, respiratory conditions, lesions of the vagus nerve and the medulla. Chalky white spots with longitudinal white lines are seen in gouty, rheumatic and arthritic conditions. Pale dull white with tinges of purple that may cover the best part of the nail body are seen in people who have congenital cold feet. These may not have much clinical significance, unless the diagnosis has some complication. Transparent white spots that do not disappear on pressure are indicative of some degenerative process. On looking at the toe nail you may see many white transparent spots. If on pressure they disappear, they are but gas spots between the body of the nail and its matrix and have no clinical significance, but if they persist, then serious search should be made to find the cause for so many organs and tissues showing signs of degenerative process. Butler says: "It may be a sign of dissipation, sexual excess, overwork and worry." if transparent white spots should keep on enlarging, that person is heading for a breakdown. The greatest emphasis is placed on prognosis. There are all kinds of methods of arriving at a rather accurate diagnosis; after that has been made, then a confirming of it can be made by a very serious study of the toe nail. If, after treatment, pink is coming through more clearly, the patient is improving, but if any other color is getting larger, the patient is not improving. The growth of transparent white presents a very serious problem. In a case showing mixed colors, you have a complication. There is a large or slight degeneration, much or little anemia, and rheumatic or arthritic condition in various degrees. Your effort then is toward eradicating the most serious to life, and probably the cause of the others. For illustration. If purple is predominant, then the effort must be toward building up the blood stream to normal, in content and free circulation. The nervous system stabilized, and all obstructions removed that prevent a proper function of all parts of the respiratory tract. Thus a state of equilibrium may be established which will bring about the regeneration of the tissues that are in a pathological condition, and the transparent white spots will disappear. The nail can be divided into three parts. Its minute size makes zoning in detail too great a task. Experience has taught this method to be uniformly correct as to the location pathology or lesions or other conditions. [Fig 3: LUNULA]
ANATOMICAL ZONING Zone 1 --- Begins at the end of the free margin of the toe and reaches up to a line drawn across the body from the superior crest of one ilium to the other. Zone 2 --- Begins at the crest of iliums to a line drawn across the body from the superior crest of shoulder to the other one. Zone 3 --- Is from the shoulders to top of head.
ANALYSIS OF TOE NAIL A white line or spots down the center indicates degeneration of spinal cord. In case of advanced locomotor ataxia look for it in Zone 1 near thee top border of Zone 2. A purple line in center with projecting lines is indicative that those spinal centers are constricted and anemic and reflexes to organic areas of those nerve centers. An angle or triangle or purple or white lines means a near chronic, or complete chronic condition. A white or purple line drawn between two white or purple spots is indicative of complication or an envolvement. [sic] Let us take a case of advanced Nephritis in which there has been some degeneration of the kidney uriniferous tubules, there is also a cardiac envolvement.[sic] There is a white spot on the outer size border near the middle of Zone 2, then there is a purple or white line leading to a white spot in the heart area of the upper part of Zone 2. In a case of hemiplegia, with paralysis on one side of body from a tumor on the other side of the brain. You will find that the nail on the paralyzed side is dirty white and shriveled, and an arrest of growth has taken place, but in Zone 3 near the top you will find a rather large spot corresponding to the location of tumor, and usually a purple line or lines running to the opposite paralyzed side. It is a method whereby a physician can watch the progress of his patient toward health or death, for example, when the inorganic condition passes to the organic or pathological state. We have observed this in people who were aged, and who passed from inorganic disturbances, into the period preceding their death, and from that time on the transparent white spreads rapidly covering nearly the whole toe nail before they passed on. This happens to all toe nails as death nears. When the examination of the toe nail is in progress, the patient is apt to ask questions. The physician need but say that it is but a part of the whole examination which will help him to a conclusion when all the parts are put together. It is never wise to mention to a patient the prognostic value of this method. There are too many factors involved, and no one factor is ever conclusive
in making a certain prognosis. This technique is not offered to the profession
with the idea that it is the only step in arriving at a prognosis. But
with accurate analysis of the colors in conjunction with an accurate diagnosis
seldom can a mistake be made. But to tell the laymen without a thorough
explanation of the whole art would lead to useless confusion. But rest
assured it has prognostic value for after taking into account all the circumstances
of an incurable disease and watching the spreading of transparent white
over the nail that does not disappear on pressure, then a calculation of
how long the patient has to live by the size of the transparent white line
toward either the lunula and the end of the nail, or vice versa.
OBSERVATION OF PHYSICAL TYPES UNDER EXAMINATION There are generally two types, with some exceptions, the leptic and the pyknic. The leptic type has an acute costal angle, wide intercostal spaces, long thorax, narrow waist, and tenth ribs which are frequently loose. The distance between the xiphoid and the umbilicus is much greater than the distance between the midline and the flank just above the level of the navel. Long vertical viscera are encountered in the leptic type. The stomach is of the vertical fishhook type, the greater curvature extending into the pelvis in the upright posture. The lower pole of the kidney, and liver are easily examined. In this type there are higher incidences of certain clinical manifestations. Pulmonary tuberculosis is frequent. Anemia, nervousness are frequent, and if psychosis is present, they fall usually in the praecox classification. Usually is an introvert. The opposite build are the pyknic type. One with broad head, thick shoulders, large chest, short neck and rounded body and is usually an extravert. The stomach occupies a position high under the diaphragm, the pylorus being the lowermost part. In this type organic abdominal disease is frequent. Gallbladder disease is common. Cancers and ulcers are not infrequent. Nervousness is seldom found among them until the involutionary stage of life. This is sufficient to illustrate the importance of making a careful observation in aiding in making a diagnosis. Reference: Page 73, "The Fundamentals of Applied Psychiatry" by the author. In considering the diagnosis of a ptosis, the two types mentioned must
be taken into consideration. In the leptic type peptic ulcer is more common,
but abdominal complaints are usually dependent on ptosis, constipation,
irritable colon, mucous colitis, duodenal ileus or functional nervous disturbances.
Have patient of either type stand up and notice if a bulge forms into a
football shape below the umbilicus. That is an indication of ptosis.
DIAGNOSIS BY VIBRATIONS. SKIN COLOR, TEMPERATURE AND HYDROLOGY This is done by slowly and lightly rubbing the hand and fingers over
the tissues and is based on the following principles:
In order to facilitate a quick comprehension of this method of diagnosis, we group diseases under five headings: Bacterial Invasion.
Then, under each of the foregoing headings, we have five general manifestations expressed by: Five general muscle tones.
CLASSIFICATION BY SYMPTOMS Bacterial Invasion: -- By bacterial invasion we refer to the bacterial infections which are responsible for infections and contagious diseases. General symptoms are weakness, mental weariness, prostration, initial chills, skin eruptions, nervous excitement, complete anorexia and quickened pulse. Finger Tip Diagnosis: The muscle tone is tense and drawn, denoting high nerve tension and there is pain due to the inflamed condition of the sensory nerves pulsating against the bacterial congested viscera tissue systematic or lymphatic systems. In contagious or infectious diseases, the vibrations are what is known as the "Thrill", a sensation likened to that received when placing the hand on the back of a purring cat. The pulse is dicrotic or double sounding. Muscle temperature is hot and stinging against the finger tips. Muscle color is deep red or flesh countenance appearance. Hydrological manifestations are dry and slippery. Now, using the Niveau method to localize the infection, we find that the muscles over the seat of the infection will have a thrill of greater tensity, the temperature somewhat elevated, the color more exaggerated and the muscle tone more tense and painful. For example, this greater tensity of muscle tone, color, temperature and pain in Typhoid Fever would be found on the muscles over Peyer’s Patches, while in Diphtheria or Scarlet Fever on the muscles back of the ears and on both sides of the throat. Enervation: -- We mean by the enervation that condition in which there is a lack of nerve force, with the following general symptoms. A lack of vital resistance or auto-protection. It is an interference with the nerve functions that opens the way for bacterial invasion or retention. Enervation is of two types or stages. The symptoms of the first stage of enervation are weak pulse, flabby muscles, perspiring feet, mucous exudation, local congestion all-gone feeling, tendency to bad colds, and coldness of extremities. These people are usually well built, some are fat, and many think there is nothing wring with them. Finger Tip Diagnosis: In the first stage we have the following finger tip reactions: The muscle tone is relaxed, soft, spongy, with no resistance to pressure, denoting anemia of nerves and spinal centers. On pressure, the muscles are indented without any resiliency. The vibrations are dull, denoting lack of ambition. Pulse is regular but weak. Muscle temperature is cool. Muscle color is bending slightly toward the white - gray. Hydrology is like putting hand on cool, damp moss. The second stage of enervation. This is the state where the person has experienced the first stage and having found that the realities of life demand attention, exerted all the will power of the Cerebro brain cells, all his instinctive and subconscious will power to force life to go on. This is often spoken of as "living on his nerve." The symptoms of this stage are emaciation, excitable actions such as eating and drinking too fast, talking rapidly and jerkingly, sometimes there are hallucinations and neurasthenia. There is itching and continual pain, not localized but general. Clothing, atmospheric pressure or another person’s touch make the patient conscious of it. Movement is often jerky or jumpy. There are susceptible to great excitement on sudden appearance of friends or of noises. The muscle tone is sensitive. It is a combination of the tense and stringy muscle. Bellies of the muscles are string-like and atrophied. This type of muscle denotes a chronic anemia of the spinal centers controlling the vaso-motor dilators giving off reflexes of irritation to the cranial centers. The vibrations are of the tympanic variety, bell-like with discordant notes, with a slight contraction of the muscles on the touch of the doctor’s fingers. The doctor feels also a sensation of intermittent stinging. Muscle temperature is hot and cool, alternating, according to what may be said or happen at the particular moment. Muscle color is pale yellow generally, but at intervals of jumpy temper or excitement the patient will break out in red patches here and there over the face and body. Hydrological manifestations are very dry and like very fine sand paper. Retention: -- retention is the prime pathological condition in the majority of all acute diseases as a sequence of toxic elements accumulating in the tissues. It is the result of interference with the vasomotor dilator or constrictor nerves. The interference is brought about by impingement of nerves, or too much or wrong types of nutrition, or failure of proper metabolism and elimination, or all combined which permits bacterial invasion and enervation to a large degree. The symptoms of retention, pure and simple, are very easily distinguished from any other condition. We have a condition of toxemia and failure of proper elimination, associated with both acute and chronic disease. We feel that we should have a clear understanding of these symptoms. For convenience, we classify the symptoms of retention under five headings: 1. Eyes watering
The symptoms we have enumerated are due to the mucous membranes and kidneys trying to eliminate from the system the toxic elements that are retained due to the failure of the action of the emunctories. Symptoms of the circulation are manifested as follows:
The symptoms we have enumerated are due to the mucous membranes and kidneys trying to eliminate from the system the toxic elements that are retained due to the failure of the action of the emunctories. Symptoms of the circulation are manifested as follows: 1. Full head.
This condition is due to the obstruction in the circulation, which is usually the result of crystals formed from the toxic elements which are thrown to the peripheral capillaries where they lodge because they are usually larger than the lumen of the capillary vessels. Thus is the circulation obstructed and the train of symptoms we have just mentioned are manifested as the result of extra work thrown upon the heart in maintaining the normal circulation. This peripheral obstruction accounts for the sluggishness of the capillary circulation. It also accounts for the soft and weakened condition of the pulse. As a natural result of the capillary obstruction to the surface of the body, the skin presents a certain train of symptoms as follows: 1. Doughy skin.
A careful study of the symptoms we have given above should enable one to always detect the symptom producing causes existing in the system. We should be able to judge whether or not: a. There is an invasion,
By a casual examination, we should be able to determine what condition leads to either of the classes of symptoms mentioned above. We can determine the symptom producing cause without asking a question and then proceed to enumerate all the different symptoms the patient feels. In connection with retention, we may find some of the following signs: 1. Shivering.
There are also certain symptoms which are more or less subjective and which may be enumerated as follows: 1. Pain.
These symptoms and signs are strictly due to the condition of retention of toxic elements such as crystals of urates in the muscles and mucous membranes and also in the peripheral portions of the body. Finger tip Diagnosis: Muscle tone - the muscles are doughy and lumpy, a feeling of dough before kneading. This type of muscle shows a passive and neurotonic congestion of the vasodilators, lymph stasis of the viscera. The vibrations are of a slurring character. The sensory nerves are fighting for release, pushing the waste matter back and forth. It feels like a backwash of heavy fluid. Pericellular and perivascular spaces are well filled. The pulse is excited but weak. Muscle temperature is warm, unless complicated by bacterial invasion, then it is hot. Muscle color is bluish-white. Muscle temperature is warm, unless complicated by bacterial invasion, then it is hot. Muscle hydrology is warm and moist unless there is a bacterial invasion, then it becomes hot and dry. Traumatism: -- Traumatism are the diseases which follow blows, injuries or mental shock. The general symptoms of external blows or falls are dislocations, fractures, lacerations, abrasions and inflammations. The evidence of these is so plain we will not dwell on them here. The symptoms of internal trauma are swellings, vomiting, hemorrhages, lesions and adhesions. Internal trauma may come from a blow outside the body or it may come from irritation on the inside by the amount of fluids and foods taken in. Abscesses are the result of injury to the lining of the organs. Finger tip Diagnosis (of Internal Trauma): The muscle tone is ropy and ridged, just as the name implies. This type of muscle pulls heavy on the spine, causing a "weak back." It denotes a sub-acute congestion of spinal segments and a degeneration of one or more of the viscera. The vibrations are a heavy pulsation, much in the nature of the tide going out. The pulse is slow and heavy. Muscle temperature is cold. Muscle color, except at the seat of irritation, is light grayish-brown, but over the seat of irritation may be light red and gray. "Neural Shock" or "Trauma" occurs when one is frightened by a sudden approach of some frightful apparition or possibility, to the extent that the subconscious mind has been affected. Finger Tip Diagnosis (of Neural Trauma): The muscle tone is stringy, drawn tight, no lumps or ropiness are noticed. The vibrations are strong, rhythmic, much as you feel on a dog ready to run when you let it go. This is due to other nerves trying to compensate for the traumatic one. Pulse rate is accelerated. Muscle color is pale white. Muscle hydrology is sweaty. Poisoning: -- We mean here the poisoning that is produced by foods, cooking utensils and occupations involving metals and paints. These present what are known as lead, aluminum, and drug poisoning; each has its own peculiar manifestations with the exception of lead and aluminum, which are both alike and present to the Endonasalist on examination the following: Finger Tip Diagnosis: The muscle tone is tense and rough. The vibrations are excited as if the nerves are battling to supply sufficient blood to the parts. The muscle temperature is alternately cool and warm. The muscle temperature is alternately cool and warm. The muscle color is a dirty white-gray. Muscle hydrology is much like that in enervation, cool and dry. Neuropathic Spinal Examination and Analysis. The common spinal nerve, as it exists from the intervertebral foramen, divides into an anterior primary division and a posterior primary division. The posterior primary division supplies the skin and structures of the back, and reflects to those structures the condition of activity of the segments of the spinal cord from which it arises. By virtue of this fact the neuropath is able to make a complete analysis of the spinal cord, and to determine the exact condition of each segment thereof. The degree of activity existing in any segment of the cord can be determined by testing the reflexes. These reflexes (vaso, viscero and myo motor are true indicators of segmental activity, thus making possible a diagnosis of condition of parts supplied by the anterior divisions of the spinal nerve. The patient first lies face down on the table, then all subluxations are noted and tabulated, also all abnormal curvatures. Then the patient is turned on his side. The physician stands in front of the patient, and palpates lightly with his finger tips in the gutter of the spine. There are nine types of spines that designate certain normal or abnormal conditions. The types of spines are classified as follows: 1. Healthy.
4. Sensitive.
7. Ropy.
Definitions of the above types of spines: 1. Healthy. Presents a smooth, firm, velvety surface, with a slight elastic resistance on pressure. 2. Tense. Presents a tightness or a drawn condition with no elasticity. This spine denotes high nerve tension. The patient is irritable, easily excited, restless, and suffers from insomnia with frequent headaches; tenseness of the sphincture [sic] muscles and a passive congestion of the viscera. 3. Congested. Shows the muscles in the gutters slightly swollen and tender along the entire spine, or over certain segments of the spine. This spine denotes acute congestion of the viscera, corresponding to the inflamed area over the spinal segment from which the viscera receives its nerve supply. It also denotes or indicates the approaching of any disease long before the patient has developed any symptoms. 4. Doughy. Is soft and spongy, but is not relaxed or loose. The patient suffers no pain, is not fatigued easily as in the relaxed spine, but has an uncomfortable feeling and weight in the spine. This spine denotes passive congestion of the spinal centers, viscera, or a viscus, with lymphatic stasis (stasis: stagnation of blood.) 5. Ropy. Is ridged and ropy as the name implies. The patient suffers no pain, does not fatigue as easily is in doughy spine, but has great sense of tightness in spine. This spine denotes subacute congestion of the spinal centers to viscera or viscus and lymphatics. 6. Sensitive. Has a combination of the tense, ropy and congested spines. Painful to touch and movement, or atmospheric pressures and changes. Patient suffers pain continually, cannot bear to have anything touch spine, sometimes not even clothing. This spine denotes congestion of spinal centers as well as congestion of the viscera corresponding to the spinal segments involved, giving off reflexes to head and other parts of body. 7. Relaxed. Is loose, soft, spongy, with no resistance to pressure, having no tone, seemingly lifeless. Patient suffers no pain, but fatigues easily and has no ambition. This spine denotes anemia of the spinal centers with passive venous congestion of the viscera, or a viscus, and stored up waste in the tissues. 8. Stringy. Is drawn and tight, bellies of the muscles are atrophied and give a stringy appearance. The patient suffers no pain, but on pressure there is more or less numbness. Patient has more ambition than strength will permit, fatiguing easily but always restless. This spine denotes a chronic condition of long standing, found particularly in wasting diseases. The spinal centers are anemic with passive congestion of the viscera. 9. Lumpy. Presents appearance of knots tied in muscles
and are tender on pressure. The patient complains of no pain, except on
pressure, and does not fatigue easily. This spine denotes the breaking
up of an acute condition leading to a chronic condition. The spinal centers
are in a passive state with hyperemia of the viscera or viscus, and lymphatic
stasis.
HYPEREMIA AND INFLAMMATION Inflammation means "to burn up." The process which is commonly called
inflammation, is an attempt upon the part of the cells in the body to get
rid of an irritant. If an irritant is placed upon any part of the body,
it immediately affects the ingoing paths, particularly the arterio-motor
paths, and first arouses the reflex arterio-motor constrictors, which carry
a message into the arterio-motor nucleus, and produce reflexly, a constriction
of the blood vessels of the part involved. If the irritant continues its
presence, the reflex arterio-motor dilators are aroused and an active dilation
of the blood vessels is produced which is followed by pericellular infiltration
of the part. As the blood vessels dilate, more plasma is poured out, and
swelling occurs, due to the accumulation of plasma in the pericellular
spaces. At the same time, a great number of phagocytes are brought to the
part. The phagocytes wander out into the pericellular spaces and attempt
to remove the irritant, or destroy it. The presence of the poisonous products
irritates the ingoing paths and produces pain. The excessive amount of
pericellular fluid, the activity of the phagocytes and the active chemical
processes going on in the part, result in increased temperature or heat.
The pain and infiltration of the part produce a partial or complete loss
of function. If the phagocytes succeed in removing the irritant, and the
lymph vessels carry the excessive amount of fluid away, the redness disappears;
the blood vessels resume their normal caliber; the phagocytes are carried
into the lymph streams, the infiltrated fluid is adsorbed; the swelling,
the heat, and the pain and the redness disappear, and the normal functions
are restored. Sometimes the phagocytes are unable to remove the irritant,
because the germs are present is such great numbers, and their excretions
are so poisonous that the phagocytes are killed and pus forms. The parts
then remain swollen; the dead germs, dead phagocytes and dead cells accumulate,
forming an abbess cavity. Even at this stage, Nature may be capable of
removing this fluid containing the dead phagocytes, germs and cells. As
it accumulates, it destroys the surrounding parts and tends to follow the
path of least resistance. If the abbess is near the surface, the pus gradually
works upward, destroying cells on the way, and finally, nothing keeps the
pus inside but the thin upper layer of skin, and the pus can be seen through
the skin, which is finally broken and the pus escapes. The abscess empties,
connective tissue cells multiply rapidly in the skin and fill or cover
up the gap. A boil is the product of exactly the same process, but the
whole interior of the abbess cavity has not become liquefied into pus.
The dead cells are glued together in a form of a "core’" and surrounding
this is the fluid pus. If the abscess be of large size, repair is not perfect
and a scar remains.
HOW GERMS AFFECT THE CELLS OF THE BODY Those parts of the body which are exposed to external conditions are the mucous membranes and the skin. The germs enter the body either through the mucous membranes or the skin; they either get into the circulation and are distributed to all parts of the body by the blood vessels, or they lodge in the mucous membranes or the skin, and produce their effects by the distribution of their toxins. The toxins are soluble and diffusible; they pass into the blood vessels and readily escape from the capillaries into the pericellular spaces. These toxins affect the different groups of cells with more or less virulency. The virulence of the same germs differ at different times, and the degree of perversion produced depends very largely upon the virulence of the germs. The diphtheria bacilli vary in their virulency, and, under certain conditions, they produce only a mild irritation of the part in which they lodge. At other times, the virulency of the bacilli is so great that they produce death. The mild forms of germs are capable of becoming virulent under certain conditions. Therefore, the perversions produced by germs depend to some extent upon their activity. The extent of the damage done to the cells varies with the virulency and the number of germs which are introduced, and with the location of the germs in the body. The cells of the body possess a certain degree of resistance, and they also vary in their degree of susceptibility to different kinds of toxins, and a large variety of perversions are produced by the different kinds of toxins. The toxins are carried through the lymph and the blood streams to the heart, from whence they are carried through the arteries to the kidneys and sweat glands, which excrete them from the body. The phagocytes destroy the germs and thus lessen or stop the formation of toxin. The toxin is also neutralized by the anti-toxins, which is produced by the cells of the body. If the germs are within the body, the only safe and efficient means by which the germs can be destroyed is to increase phagocytic activity. It is impossible for a cell to become perverted if it is supplied with the proper quality and quantity of plasma, and has its waste products properly removed, except as a result of a direct injury, including, in the proper quality and quantity of plasma, the temperature [sic]. Any cell in the body will become perverted if the above conditions are not normal. In considering perversions of the cells, we must in all cases, except where it is the result of direct injury, attribute the perversion primarily to some disturbance in the supply or removal of the pericellular fluid. This is an underlying law. These perverted conditions depend upon perversions of nutrition. The only changes that can take place are as follows: Alterations in the quantity of the plasma, which may be either decreased or increased, alterations in the quality of plasma, which may be due to the presence of abnormal substances, abnormal temperature, or abnormal quantities of normal substances. Neuropathy has always considered that the first effects of irritations has first been on the cerebro spinal nervous system, then on the circulations, then on the tissues and organs. A summary would be as follows. The origin of diseases has been studied from its secondary causes, and not from the primary causes, and not from the primary causes. The secondary cause of disease develops from a few hours to weeks after the primary cause. Health being a state in which the normally constructed body properly performs its functions, then disease is any variation from the normal standard and can be described as any condition in which the organism finds itself in abnormal relationship with its environment. The blood being the fluid that largely creates the healthy environment for the cells of the body, and nervous system regulating and controlling the blood supply as needed by the tissues, therefore the primary cause of disease is the result of loss of function of the nerve mechanism, and the blood supply to the involved diseased areas. Hyperemia is transitory change in function. Active hyperemia is rapidity of the flow of blood through the arteries and veins, and the color of the part is bright red. There is an arterial color in the small veins of the part and at the time they seem to pulsate. The capillaries are filled with arterial blood and are dilated; there is no edema as the vessels hold the fluid and no exudation takes place. There is an excessive warmth in the part affected as more warm blood from the interior of the body flows through it. The nerves concerned in these functional changes are the Vasoconstrictors and perivascular ganglia and this is the foundation of Neuropathy. Hyperemia of paralysis is paralysis of the vasoconstrictor nerve. This irritation may be so extensive as to withdraw blood from the greater part of the body, producing a similar condition which causes a temporary cessation of respiration, heart pulsation, and muscular action, from which condition is a speedy recovery. Hyperemia of irritation is caused by irritation of the vasodilator nerves. It is shorter and quicker in its action, and is accompanied often by other active nervous symptoms, such as pain, the flushing accompanying facial neuralgia and herpes zoster is supposed to be of this variety; also, reflex hyperemia belongs to this class. Hyperemia caused by paralysis of the perivascular ganglia is that form produced by purely local cause, such as pressure. This is seen after removing Esmarch bandage, or tapping the abdomen in acites, or suddenly emptying an over-distended bladder. Active hyperemia of whatever form, is a passing condition and when the condition has subsided, there is no appreciative change in the affected part. All these changes are caused by a stimulating or a depressing effect upon the nerve mechanisms controlling the blood supply to the involved area. If the nerve mechanisms cease to respond to nature’s bidding the hyperemic condition will not subside and a pathological change takes place in the ganglia controlling the nerve mechanisms to the affected part. This is the primary cause of all diseases. The pathological change that has taken place in the nerve center and its mechanisms, predispose the affected area to inflammatory changes. The resisting power of the tissue is diminished and the soil is made favorable to bacterial infection, and the bacterial infection is the secondary cause of disease. Passive hyperemia is due to partial or complete obstruction of the flow of blood through the veins. It is purely mechanical in structure or character. There is cyanosis of the part affected and its temperature is abnormal. If the small veins and capillaries are observed under the microscope, they are found to be distended with blood corpuscles which appear to be more or less fused together. The flow of blood ceases at certain points and extravasation of red blood corpuscles occur. There is at the same time an escape from the vessels of a certain amount of fluid, giving rise to oedema. This can be seen in varicose veins and hypostatic congestion. The passive congestion rarely or ever subsides to nature’s bidding due to the pathological lesion found in the nerve mechanism controlling the blood supply to the part, predisposing the affected area to inflammatory changes. Inflammation is a succession of changes taking place in a part due to a reaction of an irritant to the nerve mechanisms controlling the blood supply to the involved area, providing that reaction of an irritant is not sufficient to destroy the vitality of the part. The first change noticed in inflammation is active hyperemia of the blood vessels in the part. In the interior is noticed a marked change in the small veins and capillaries, the white corpuscles are seen arranged along the walls of the vessels increasing in number until the vessel wall seems to be lined with them. The vasoconstrictors are now being overpowered by the vaso-dilators through the irritation on the perivascular ganglia sending the afferent impulses to the nerve centers controlling the nerve mechanism to the involved area. The blood vessels become over extended or dilated, and the stomata of the capillaries no longer perform their normal physiological function, as now, they not only admit the flow of the blood serum, but the leukocytes in virtue of their ameboid movement pass through the stomata of the capillary and wander freely into the pericellular spaces. This exudation, due to diapedesis, spreads over a considerable area. Many of the leukocytes break up and liberate the substance necessary for the process of coagulation, which is essentially clotting with the formation of fibrin. Fibrin is formed by the action of Thrombokinase of the leukocyte upon the Prothrombin of the blood serum and forms thrombin, the thrombin joins with the calcium and fibrinogen of the blood serum, and forms fibrin; this is necessary for a clot. This process differs from hyperemia. The vessels have been damaged and leak, and the changes in their power to conduct the blood through them are marked. The rapidity of the flow of blood varies greatly in different parts of the inflamed area. On the periphery the velocity of the current is greatly increased, as is rapidly shown by an incision through which the small vessels force their blood with great vigor. The nearer we approach the central point of an actively congested area, the slower is the current; and at times when the lesion of the part has been greatly increased, there may be stasis or stoppage of the flow. There is great variability in the rapidity in the flow of blood, according to the local condition. The changes seen in the blood is simple inflammation are the increase in the number of white corpuscles, or leukocytes, being more characteristic of infective or more strictly speaking, suppurative inflammation. The changes seen in the tissues are those produced by the great increase in the cells of the part. The cells of connective tissues are known as the fixed and the wandering cells. The fixed cells are stellate or fusiform, and lie hidden between the fibers which constitute the principal portion of the intercellular substance. In addition to these are the small round cells containing one or more nuclei and a granular protoplasm. In all respects resembling the white corpuscle of the blood. These are the so-called wandering cells. When the nerve mechanisms are irritated the area to which it supplies becomes inflamed and these cells are found in large numbers. After the tissue has reached this stage of inflammation we find that the cells predominate over all other elements. The intercellular substance becomes less apparent, the fibers disappear, and a granular material takes their place. This tissue is considerably modified in its physical properties; it becomes rigid and less pliable, and at the same time loses its tough and flexible characteristics. A "Cake" forms which indicates the outline of the inflamed area. The tissue thus formed is known as "granulations tissue," for it is of tissue like this that the granulations seen upon the open surface of wounds are composed. When the inflammatory process begins to subside, these cells gradually disappear; some wander into the adjacent lymphatics and are taken back into the circulation again; others are broken down and absorbed. New intercellular substance makes its appearance, and, with the gradual process of repair, new tissue is found to replace any loss of substance which may have occurred during the inflammatory process. If these different stages follow one another without suppuration having taken place, the inflammation is said to have terminated by resolution. Resolution is nature’s way of returning a diseased part back to health by action of the nerve mechanisms on the blood supply to the involved area. That is, the vasoconstrictors begin to regain their strength as soon as the irritation has subsided upon the perivascular ganglia. The vasodilators are now no longer active and a normal compensation has taken place in the blood supply to the involved area through the nerve mechanism. The capillaries have contracted and there is a normal flow of plasma (blood serum) passing through the stomata into the intercellular spaces supplying nutrition to the cells. The lymphatic system has carried off the excessive exudation and the normal cell metabolism is taking place. If nature can not bring about this compensation in the blood supply to the part through the nerve mechanism, then we have the beginning of disease, the primary cause which is the loss of nerve function to the part. Exudation into surrounding tissues becomes so great that the phagocytes can no longer perform their function, and now we have a medium for the development of bacteria, the bacterial invasion is the secondary cause of disease. |