Failure to Diagnose or Refer, Problem?

[Guest guest]

Could we say that:

Anti-war Democrats don't develop a cervical curve as they don't need one to

keep their heads in the sand?

or

Pro-war Republicans don't develop one as they don't need one to look down

all day and count their money!

Brought to you by an equal opportunity offender!

--

E. Abrahamson, D.C.

Chiropractic physician

Lake Oswego Chiropractic Clinic

601 First Street

Lake Oswego, OR 97034

503-635-6246

> From: " Underhill, DC " <drmikeu@...>

> Date: Tue, 21 Jan 2003 13:00:37 -0800

> dcdocbrian@...

> Cc:

> Subject: Re: " Failure to Diagnose or Refer, Problem? "

>

> Dr. Seitz:

>

> Just wanted to offer some " new " information regarding the myth of a child

> being born with a continual kyphotic curve. I was taught this as well as

> many others but it turns out this is not true. A cervical lordosis

> actually develops in the womb. For more info on this, check out Dr.

> 's Portland seminar in two weeks.

>

> Mike Underhill, DC

>

>

> " Think of a newborn; one continual kyphotic curve. As the child raises

> their head to see the world a cervical lordotic curve develops. "

>

>

> OregonDCs rules:

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> removed.

>>

>>

[Guest guest]

Thank you Mike for your detailed replies:

I think we agree on all important points, except perhaps one: Spinal structure dictates all body function.

You probably don’t mean to say that health is restored solely by

adjustment, although this is a broad interpretation of your premise. Hopefully,

we do not have to disprove the idea that all you need to do for healthcare is

adjust the spine and everything else will take care of itself.

I think we can agree that health is not possible in the presence

of subluxation. Still this does not mean that structure dictates function. It

simply means that structure and function are inextricably related.

Now we can enter the most likely area of debate. That is, should

a chiropractor attend to the entire function of the body in order to correct

spinal subluxation?

The most valid application of the spinal structure and body function

concept allows that spinal subluxation prevents normal function throughout the

body. Still abnormal states exist within the body that will not respond to

spinal correction efforts, namely, iron deficiency from metrorrhagia, breast

cancer, etc. These are evidence that frequently there are states of illness

that are beyond the reach of spinal adjustment alone. Can these states exist

when the spine presents with globally normal structure? Probably we would agree

that the answer would be no. Restated as a theory: normal body function is intertwined with normal spinal structure.

Thus, in the presence of dysfunction the spine cannot be in a normal structural

state.

It is reasonable to consider that, in an ideal world, to

structurally correct the spine it would be required to also correct body

function. So, in the cases where body function is disturbed by other

dysfunctions in addition to spinal subluxation BOTH must be corrected to

achieve correction of the subluxation(s). In these instances the theory that Spinal

structure dictates body function is invalid. In addition, the premise that Subluxation

Correction = Health is also false in the sense that, in these instances again,

if all subluxations are corrected by manual means only, health could not be

restored.

Herein rests the legal point we have been dissecting all along.

If the

chiropractor does not look beyond the spine in the assessment, the patient does

not receive adequate care to correct a subluxation. In addition, the patient is

subject to harm in the form of missed diagnoses that could be associated with

preventable mortality and/or morbidity.

In my household where 7 children were born at home, no vaccines,

no drugs, straight A’s etc. we live in virtual absence of medical intervention.

How many chiropractors live in a similar environment I do not know. I can say

first hand that I have cared for every form of spinal subluxation on association

with every acute life-threatening systemic illness with nothing more than

spinal adjustment, a few supplements, relaxation training, exercise, and faith

in God’s design. Why any chiropractor would restrict their practice to spinal

adjustment only is obviously one formed for logical business or legal

objectives.

It is my observation that the body heals itself or it doesn’t.

The chiropractor who can know when chiropractic will work and when the body

will fail must rely upon information gathered from outside of the spine in

addition to spinal evaluation for subluxation. We absolutely must adjust

the subluxations, but we must also

recognize that functional loss can alter structure in a way that structural

correction alone will not reverse. Therefore, it is important that we agree as chiropractors

of all stripes that structure and function is a bi-directional relationship.

BOTH must be a part of chiropractic practice.

Respectfully,

Willard

-----Original

Message-----

From: Mike Riemhofer D.C.

[mailto:drmike@...]

Sent: Tuesday, January 21, 2003

8:49 AM

Dr. Willard Bertrand, D.C.

Subject: Re:

" Failure to Diagnose or Refer, Problem? "

Certainly, the nervous

system drives the function of the body, but the relationship between

posture-the spine and the nervous system is so inextricably linked such

that structure exerts a considerable influence on function and, of

course, vice versa.

From an " Overview

of Chiropractic Biophysics " :

" The premise of CBP

technique is that global subluxation presenting as abnormal posture and spinal

displacements affects normal biological functions of the body, disrupting

homeostasis and leading to pathological disorders. Therefore, reduction

of these structural abnormalities allows the body to resume a state of normal

functioning. "

Certainly we do not ignore

the other factors that influence the nervous system and certain

pathological disorders are beyond the scope of subluxation

correction.

But the fact remains, that

once subluxation has been established mechanically, it continues to exert a

negative influence on body function and its correction must not be

ignored.

Additional

responses below...

For clarification, are you

using the words " structure " and " alignment "

interchangeably?

I have added

" alignment " in a few places to clarify my meaning.

-----

Original Message -----

From: Dr. Willard

Bertrand, D.C.

Oregon

DC List

Sent: Thursday, January 16,

2003 5:44 PM

Subject: RE:

" Failure to Diagnose or Refer, Problem? "

Structure and function are

one of the important models for healthcare. There are others. I think that

there is much more to function that simply ideal spinal structure (I agree, but

it's an important part, perhaps no more, but certainly no less important

than other factors, especially in long standing cases of subluxation from

normal alignment, where adaptive soft and hard tissue changes have occurred). Anatomical Structure is a

physical expression of physical chemistry. To stop at spinal structure-alignment as the final point of

analysis for “normal” (I didn't mean to imply that it was

" the final point " ) ignores the obvious fact that there is much more at

play here than alignment. Spinal structure-alignment is very much a reflection

of neural function, which is a reflection of the vast physiochemical milieu

from gravitation to nuclear particle physics to metabolic biochemistry to

structural biophysics to cellular physiology and on up to spinal alignment and

beyond. This is not simply a linear relationship, but a dynamic reduplicative

hierarchy. Yes, that means you may be able to tell all about a person from any

angle. From the DNA, from the cellular function of the liver, from the light

absorbing properties of the retina, from the EEG, and yes from spinal

alignment. But, the reverse principle that spinal structure determines function

has no logical basis. (Spinal structure-alignment does not

influence neural and consequently physiological function?) This would be no more true

than saying that the perfect liver will create the perfect spine, or that the

perfect brainwave pattern will correct a malformed heart valve.

Biophysics is an important

part of chiropractic, but it is not sufficient to represent all of the science

necessary to care for patients (agree, I didn't mean to imply that it was

" all " ). That seems to be the crux of this discussion. Is it

sufficient to analyze the spine, or is a complete diagnosis necessary?.

W=m * 9.8 m/s or F-ma or

E=mC2 are important concepts, yes but the much appreciated normal on

models of biophysics are not sufficient evidence to justify the concept that

spinal structure-alignment dictates the function of

the human body (Not in any way?!). I am certain you did not

mean this and I would enjoy further clarification of how you apply this

structure dictate function concept

in practice. Nonetheless, I would continue to stand by my points that diagnosis

beyond the spine is necessary to care for and adjust patients and point to the

fact that the spine is subject to the nervous system which is inextricably

dependant upon proper environment, exercise, diet, relaxation, as well as

spinal alignment. Agreed.

And I stand by

my point that there is not an adequate emphasis on neuro-spinal

biomechanics in chiropractic education and clinical practice as a component of

total health.

Mike

Willard

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve members

will be tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However,

it is against the rules of the listserve to copy, print, forward, or otherwise

distribute correspondence written by another member without his or her consent,

unless all personal identifiers have been removed.

Your use of

is subject to the

Terms of Service.

[Guest guest]

Willard,

That was beautiful and Thank You! You have just explained the very core issue most of us have with chiropractors that say they are subluxation based and do not diagnosis. If your going to be a Doctor of Chiropractic, you must be able to tell when a patient is best served by a timely referral.

You must know when to adjust and when not to!

Thanks Again,

DR. COBY L. HANES991 NE THIRD STREETPRINEVILLE, OR 97754voice: 541.447.7230fax: 541.447.5775dochanes@...

Re: "Failure to Diagnose or Refer, Problem?"

Certainly, the nervous system drives the function of the body, but the relationship between posture-the spine and the nervous system is so inextricably linked such that structure exerts a considerable influence on function and, of course, vice versa.

From an "Overview of Chiropractic Biophysics":

"The premise of CBP technique is that global subluxation presenting as abnormal posture and spinal displacements affects normal biological functions of the body, disrupting homeostasis and leading to pathological disorders. Therefore, reduction of these structural abnormalities allows the body to resume a state of normal functioning."

Certainly we do not ignore the other factors that influence the nervous system and certain pathological disorders are beyond the scope of subluxation correction.

But the fact remains, that once subluxation has been established mechanically, it continues to exert a negative influence on body function and its correction must not be ignored.

Additional responses below...

For clarification, are you using the words "structure" and "alignment" interchangeably?

I have added "alignment" in a few places to clarify my meaning.

RE: "Failure to Diagnose or Refer, Problem?"

Structure and function are one of the important models for healthcare. There are others. I think that there is much more to function that simply ideal spinal structure (I agree, but it's an important part, perhaps no more, but certainly no less important than other factors, especially in long standing cases of subluxation from normal alignment, where adaptive soft and hard tissue changes have occurred). Anatomical Structure is a physical expression of physical chemistry. To stop at spinal structure-alignment as the final point of analysis for “normal” (I didn't mean to imply that it was "the final point") ignores the obvious fact that there is much more at play here than alignment. Spinal structure-alignment is very much a reflection of neural function, which is a reflection of the vast physiochemical milieu from gravitation to nuclear particle physics to metabolic biochemistry to structural biophysics to cellular physiology and on up to spinal alignment and beyond. This is not simply a linear relationship, but a dynamic reduplicative hierarchy. Yes, that means you may be able to tell all about a person from any angle. From the DNA, from the cellular function of the liver, from the light absorbing properties of the retina, from the EEG, and yes from spinal alignment. But, the reverse principle that spinal structure determines function has no logical basis. (Spinal structure-alignment does not influence neural and consequently physiological function?) This would be no more true than saying that the perfect liver will create the perfect spine, or that the perfect brainwave pattern will correct a malformed heart valve.

Biophysics is an important part of chiropractic, but it is not sufficient to represent all of the science necessary to care for patients (agree, I didn't mean to imply that it was "all"). That seems to be the crux of this discussion. Is it sufficient to analyze the spine, or is a complete diagnosis necessary?.

W=m * 9.8 m/s or F-ma or E=mC2 are important concepts, yes but the much appreciated normal on models of biophysics are not sufficient evidence to justify the concept that spinal structure-alignment dictates the function of the human body (Not in any way?!). I am certain you did not mean this and I would enjoy further clarification of how you apply this structure dictate function concept in practice. Nonetheless, I would continue to stand by my points that diagnosis beyond the spine is necessary to care for and adjust patients and point to the fact that the spine is subject to the nervous system which is inextricably dependant upon proper environment, exercise, diet, relaxation, as well as spinal alignment. Agreed.

And I stand by my point that there is not an adequate emphasis on neuro-spinal biomechanics in chiropractic education and clinical practice as a component of total health.

Mike

Willard

OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.