In the previous three columns, I have discussed recognizing the symptoms that suggest a patient requires a dietary modification. Briefly, we should immediately recognize the following:

*** any form of indigestion, including bloating and gas pain;

*** abnormal bowel function (constipation or diarrhea);

*** restlessness, irritability, or insomnia;

*** inability to tolerate stress, anxiety or depression, road rage; and

*** stiff, sore joints.

It's true that many of these symptoms respond to manipulation but, unfortunately, not on consistent basis. Because of this, we should take more time to determine the cause of the problem. Is it somato-visceral or viscero-somatic? When we have explained how and why the symptoms are produced, we should also have knowledge of the therapeutic approach necessary to treat the condition.

Any symptom is caused by abnormal function of a tissue, organ, or joint. Thus, the symptom itself indicates the organ or structure in which normal function is increased or decreased and is out of time with need. Remember, in disease there are no new functions. The question is, how can we determine what is the cause of the symptom?

Fortunately, there is a scientifically sound and uniquely chiropractic methodology for making that determination. An objective test is needed to determine the exact area of involvement, other than by going by the symptomatology of the patient reporting pain or tenderness. This objective test, with a high degree of interexaminer reliability, is palpation.

First, recall that the neurological connections between each organ/tissue and the brain are established between 16 and 21 days of fetal life. As the spinal cord develops, it establishes linkages to the ectodermal, mesodermal, and endodermal tissues via the spinal nerves. Between the years 1898 and 1917, it was discovered that anytime a visceral organ was sending sensory signals of distress to the brain, the motor response came back not only to the organ but also to the associated skin and muscles that shared the same innervation.

For example, any form of indigestion indicates inadequate function of the digestive organs. That means there will be an associated muscle contraction in the abdomen associated with the affected viscera, and there will also be a contraction of the spinal muscles associated with the spinal innervation.

Next, listen to the patient's chief complaint. Is the discomfort being caused by receptors in the skin, muscles, or viscera? Put your hands on the area of complaint-can you feel the muscle contraction? Examine the area, looking for evidence of local muscle contraction. Consult a dermatome chart and determine the spinal level where muscle contraction will be found in the paravertebral muscles. Palpate the spinal muscles and determine the spinal root involvement.

Examine for joint dysfunction and muscle contraction. Remember, the muscles which move a joint are supplied with motor fibers from the same segment that receives sensory fibers from the ligaments of the joint (Hilton's Law). If joint dysfunction (range of motion) does not exist, review the case history for symptoms of visceral dysfunction that could be associated with the irritation and palpate that area to confirm.

The connective tissues that support the viscera are supplied by somatic afferent fibers from the level at which they develop embryologically. Also, consider whether the symptom pattern fits a sympathetic dominance or a parasympathetic pattern. In other words, if the symptom is one of sympathetic dominance (parasympathetic weakness), the muscle contraction will be in the upper cervical or lumbosacral area.

Determine the areas of spinal segmental dysfunction (subluxation). Adjust the segment to restore normal motion and relieve the muscle contraction. Temporary alleviation of the symptom may accompany adjustment of the appropriate area of the spine. However, if the problem is caused by visceral dysfunction, then the postural and spinal dysfunctions will recur very soon.

Re-examine the reflex muscle contraction on the anterior of the body. If the patient's symptom was caused by a somato-visceral problem, then the reflex or referred muscle contraction will not be present following the spinal adjustment. However, if the problem is viscero-somatic, the reflex muscle contraction will still be present and the exact cause of the stress must be determined. A large percentage of the recurring symptoms experienced by your patients will be found to be viscero-somatic.

It has long been my contention that spinal subluxations are present in every body dysfunction regardless of whether the cause of the dysfunction results from an emotional, mechanical, or biochemical (nutritional) cause. Spinal subluxations may occasionally be the primary cause of the symptoms, but they are always produced by any body dysfunction.

Once we know how and why the symptoms are produced, we have the explanation of the therapeutic approach necessary to treat the condition.