One of the very best general indicators of the nutritional state of the patient, and also of stress in the cervical spine, is the condition of the mucous membranes of the head, eyes, and nasopharynx. Vitamins A and C as well as calcium are often associated immediately in the clinician's mind when this area is mentioned.

However, symptomology in these areas is often ignored because supplementation has been tried previously and found to be ineffective in abating the symptoms. Chronic symptoms involving the mucous membranes of the head are often ignored if they are not the chief complaint.

In the November 1995 issue of The Chiropractic Journal, I spoke of homeostasis and the concept of the internal environment and the necessity of maintaining it relatively constant as being the most important idea to be kept in mind while attempting to understand a patient's symptom patterns.

While maintaining equilibrium in the extracellular fluids involves many factors, for this month's column it is important to recall that just as there is an antagonistic relationship between H+ (acid) and OH- (alkali), there is also an antagonism between Ca++ and K+. Symptoms can be understood based on whether the cell is accumulating Ca++ and H+ on the one hand, or K+ and OH- on the other.

Many symptoms are based on the mandatory shifting of electrolytes in and out of the cell to maintain extracellular concentrations. When acid-base balance of the ECF is stressed there is an alteration of the normal concentrations of H+ and OH-. When continued, this stress -- either toward acidity or increased alkalinity -- may cause an abnormal shifting of electrolytes (especially Ca++ and K+) between the ECF and the cells.

When there is a relative intracellular decrease in calcium compared to potassium, the patient manifests symptoms of parasympathetic dominance. Parasympathetic innervation from the seventh cranial nerve increases the secretions of the lacrimal glands, salivary glands, and mucous membranes of the head.

The mucosa becomes congested and swollen and the glands become overactive producing an excessive secretion of thin, watery, mucus. Common chronic complaints include the following:

*** Frequent head colds, runny nose and/or watery eyes.

*** Bruise easily and/or slow healing of cuts, etc.

*** Sore or bleeding gums, gingivitis.

*** Headaches associated with eye strain or pain when moving the eyes.

Chiropractic adjustments in the cervical spine will stimulate the VII cranial nerve and aggravate the condition. But, adjustments directed at the first and second thoracic segments will stimulate sympathetic innervation and relieve the symptoms. However, it will all go for naught if the electrolyte imbalance is not addressed.

Vitamin C and A supplementation can only be helpful if it comes from a whole food source and is combined with a readily ionized form of calcium. But, even this will fail if enzymes are not used to specifically address the acid-base imbalance and the assimilation problems it has caused.

When there is a relative intracellular decrease in potassium compared to calcium, the patient manifests symptoms of sympathetic dominance. Sympathetic visceral branches from the upper thoracic nerves produce vasoconstriction and decrease the secretion from the mucous membranes of the head and the lacrimal glands of the eye. They also dilate the pupil of the eye. Common chronic complaints include the following:

*** Increased matting of the eyes

*** Thick mucous secretions in the nasal passages

*** Thick saliva

*** Pale and dry mucous membranes of the head

*** History of chronic sinus problems

*** Difficulty breathing through the nose

*** Frequent nosebleeds caused by cracking of the dry epithelial tissues

Most of these symptoms will have an upper cervical involvement. In other words, symptoms of sympathetic dominance respond well to adjusting procedures directed at the vagus nerve (C1 to C3). All this is well known in our profession. Perhaps what has not been appreciated is the nutritional deficiency associated in such cases, accounting for adjustments that "don't hold" until the nutritional imbalance is addressed.

Nutritional supplementation should include Potassium and its natural synergists, in combination with vitamins A and C. This can be achieved by using whole food sources and herbs. However, it will not be effective unless the associated assimilation problem is also corrected. This requires the use of enzymes as a delivery system past an incomplete digestive system that is related to the acid-base imbalance.

Sympathetic-parasympathetic imbalances have been addressed by our profession for years, but always with an eye toward stimulation and inhibition of various parts of the autonomic nervous system to affect symptoms -- seldom toward maintaining homeostasis.

Nutritional supplementation has been used for years by our profession, but never with an eye toward delivering nutrients to maintain homeostasis -- only directed at controlling symptoms.

Neither system has been effective. The secret to success in this area may be to combine the two, but direct your efforts at maintaining homeostasis and the symptoms will take care of themselves.