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Chiropractic Journal of Australia : CJA December 2013
132 Chiropractic Journal of Australia Volume 43 Number 4 December 2013 cites a variety of ages of child patients as well as referencing a range of medical colleagues in doing so. Among other conditions, he mentions headaches -- some of which were "formerly thought to be of psychological origin." 17 While the term cervicogenic headache has now been adopted in orthodox medical literature, this does not seem to have changed the orthodox practice approach towards the management of headaches of cervical origin -- or perhaps even their clinical recognition. Despite this syndrome being well published in recognised journals, the pharmaceutical approach to managing this common ailment seems to have prevailed. The term cervicogenic headache frst appeared in Pubmed as recently as 198318 -- and by chiropractors since at least 1910.19,20 However headaches of cervical origin was noted by Braaf and Rosner in 197021-22 The Braaf and Rosner fnding was reported in the media by Professor Stuart Butler that "90% of recurring headaches can be traced to injury induced mechanical derangements in the neck." 23 VISCERAL CONDITIONS While there is some controversy as to the role of a vertebrogenic or spine-related factor in visceral dysfunction, there is published medical evidence available supporting this concept and the neurophysiological rationale underpinning it. Biedermann's medical text devotes a whole chapter by Theiler on the manipulative management of Attention Defcit Disorder (ADD).24 This was one of the conditions mentioned controversially on the Catalyst program.5 There is also a specifc section in that book on colic,25 as well as discussions on mechanical dyspnea syndrome and asthma.26 These were also mentioned on the Catalyst program. In a similar vein on medical spinal manipulation, Lewit has a section on vertebrovisceral correlations, where he discusses various published medical papers on numerous 'visceral' conditions. His dissertation covers conditions involving the tonsils, heart, lungs and pleura, stomach and duodenum, liver and gall bladder, kidneys, as well as gynaecological disorders.7 In his text on spinal manipulative management under the heading of functional disturbances, the once head of the physical medicine department of a Paris hospital - Maigne, lists such conditions as constipation, certain digestive pains, asthma, facial pain, Basedow's disease, mastodynia, palpitations and pseudo-ulcers, as conditions that have responded to spinal manipulation.8 Apart from these independent supportive medical citations, there is ongoing evidence of somatovisceral pathophysiology published in medical journals by both medical doctors and chiropractors. Members of both professions also publish in chiropractic journals. Such studies cover a wide range of evidential levels, including research formats focussing on complex neurophysiological research, as well as randomised controlled trials and case studies. Historically, there was pioneering research involving animal models dating back many years. The Cleveland Chiropractic College conducted experiments using rabbits in the 1960's.27 Burns and colleagues conducted extensive osteopathic animal and clinical studies in the 1940's and 50's.28 There has also been considerable neurophysiological and manipulation research involving animal studies published by osteopathic and chiropractic practitioners.29-31 Both these professions have associated research bodies and their educational institutions conduct active research programs. Indeed, animal manipulation also known as animal chiropractic has become an established part of veterinary care.32-33 These observations involving apparent neurovertebral factors as noted by these recognised authorities in the cited cases tend to support the possibility of a role for manipulative management in particular conditions. THE PHYSIOLOGICAL RATIONALE To imply that chiropractic hypotheses are not supported by the scientifc literature ignores the published evidence. It is simply false in fact and is inconsistent with readily available refereed journal papers, many of which are in medical journals. Perhaps one of the most signifcant texts on this subject is a medical one by Sato et al., entitled, The Impact Of Somatosensory Input On Autonomic Functions.34 This text originated from eminent neurophysiological research laboratories in Japan. It explores the body's reactions to somatosensory input (somato-autonomic refexes) to primary organs and systems in the body. It makes special mention of spinal manipulation: "In contrast to the impressive body of knowledge concerning the effects of visceral afferent activity on autonomic functions, there is, generally speaking, much less information available on the refex regulation of visceral organs by somatic afferent activity from skin, the skeletal muscle and their tendons, and from joints and other deep tissues. The elucidation of the neural mechanisms of somatically induced autonomic refex CONTRADICTIONS ROME Table 1. BIOLOGICAL SYSTEMS UNDER WHICH CONDITIONS ARE LISTED* AS INVOLVING MANAGEMENT BY MEDICAL SPINAL MANIPULATION. 10 Cardiovascular ENT Gastrointestinal Gynaecological Immune System Neurological - Headache Neurological - Vertigo Paediatric Respiratory Thyroid Psychology Vision This includes some 150 refereed medical papers, plus some 20 on paediatric manipulative care.
CJA September 2013