July 2006

The significance of Pottenger's Saucer

by Dr. Howard Loomis

Structure (anatomy) and function (physiology) cannot be separated. A deviation from normal in one has consequences in the other. Beginning with my October 2005 column, I have been describing a five‑minute "Source of Stress" examination that can be done in your office any time you need to determine the exact cause of a patient's symptoms. Neither expensive equipment nor changes in your office procedure are required. Regardless of how busy you may be, there are always times when a patient is not responding as he or she or you would like. It simply makes sense to run a special exam to reassure the patient and yourself that you're on the right track.

This month, I begin a series devoted to a one‑minute procedure that is actually a small, but incredibly important, part of the entire examination I began in the October column. This one‑minute interlude in your busy schedule will identify those patients who are not physically able to respond adequately to the stress in their lives. Therefore, you can quickly determine those who cannot respond to your therapy regardless of your time, talent, and compassion. One minute well‑spent is always worth the effort when you consider that the vast majority of symptomatic patients don't have positive clinical test results.

How then are you to identify the true cause of symptoms such as: stiff, sore joints; constipation or diarrhea; headaches; restlessness or irritability; heartburn; anxiety; indigestion; depression; gas and bloating; and insomnia?

Pottenger's Saucer

I ended last month's column with a brief description of Pottenger's Saucer. Arguably, this is one of the most important physical findings in the practice of health care. The presence of a "saucer in the mid‑thoracic spine" was first described by Francis Pottenger, MD. The phenomenon has been referred to by chiropractors as the anterior dorsal syndrome. Interestingly, this is not a chronic osseous problem. It is a transitory problem, caused by muscle contractions, and has a viscero‑somatic origin. In Belgian Chiropractic research notes, Henri Gillet describes the occurrence of a dorsal saucer after the consumption of three‑to‑five cups of coffee per day. Imagine having a normal dorsal kyphosis when you wake up and producing a "saucer" near the apex of the kyphosis by mid‑morning.

My clinical experience has taught me that patients presenting with Pottenger's Saucer have a low blood sugar level at the time. Low blood sugar levels have two primary causes:

1. Inability to digest protein (functional hypoglycemia): Hydrochloric acid deficiency; biliary dysfunction; low protein levels in the blood; low calcium levels; iron deficiency.

2. Inability to digest carbohydrate (reactive hypoglycemia): Low blood glucose levels; inability to release glycogen from the liver; adrenal insufficiency; an alcoholic "hangover."

Also of enormous importance is the observation that patients suffering with muscle tension headaches present this loss of kyphosis and are relieved by its adjustment (more about this phenomenon when I talk about stress in future columns). Most acute attacks of heartburn or gastritis can be relieved immediately with an anterior dorsal adjustment and the appropriate upper cervical adjustment. These phenomena are important clinical observations and should never be overlooked.

Palpation of the Saucer

Sit the patient on the adjusting table with his or her legs extended on the table. Have him or her bend the head forward and slide your fingers down the spinous processes. When the saucer is encountered, press headward on each of the spinous processes. They will be painful and there will usually be at least three vertebral segments involved. Once the saucer is identified, all you need to do is determine the cause of the low blood sugar. This will be the subject of my next column or two but, for now, do two things.

First, ask the patient what he or she ate last and when. Then simple abdominal palpation will point you in the right direction. While case history and dietary analysis are important, they have no place in a one‑minute screening procedure.

Second, palpate across the "shawl area" of the shoulders. Painful muscle contractions or stress points in the upper trapezius and supraspinatus muscles may be associated with Pottenger's Saucer and responsible for many symptoms beyond headaches and shoulder problems.

Understanding the relationship of these two structural areas to functional disturbances such as poor digestion, low blood sugar, and inability to cope with stress will change your patients' lives and your practice.

(Dr. Loomis welcomes input on the subjects covered in this column. To make a comment or ask a question, write to him at 6421 Enterprise Lane, Madison, WI 53719. Visit http://www.loomisenzymes.com online or call 800‑662‑2630 for information on upcoming Loomis Institute seminars.)