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Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
October, 2009, Vol. 9, Issue 10
Red, White and Black Reaction
By Leon Chaitow, ND, DO
In the current edition of my book, Palpation & Assessment Skills, there are 12 "special topic" sections, where subjects that don't quite fit into the regular chapters, have been placed. The special topic I want to bring to your attention is the so-called "red and white" reaction - the name of which has been expanded to "red, white and black" reaction. Mysterious? Not really - but it's a catchy name for a simple but useful assessment method that dates back well over 100 years. The name refers to superficial responses that take the form of red, white and sometimes blue-black lines following skin-friction, applied by a finger or probe, usually running down each side of the spine.
In the early days of osteopathy in the 19th century, the assessment method was already in use. Carl McConnell, one of the original osteopathic pioneers wrote this in 1899: "I begin at the first dorsal and examine the spinal column down to the sacrum by placing my middle fingers over the spinous processes and standing directly in back of the patient, draw the flat surfaces of these two fingers over the spinous processes from the upper dorsal to the sacrum in such a manner that the spines of the vertebrae pass tightly between the two fingers; thus leaving a red streak where the cutaneous vessels press upon the spines of the vertebrae. In this manner slight deviations of the vertebrae laterally can be told with the greatest accuracy by observing the red line. When a vertebra or section of vertebrae are too posterior, a heavy red streak is noticed and when a vertebra or section of vertebrae are too anterior, the streak is not so noticeable."6
Much more recently, another osteopathic physician, Marshall Hoag, discussed the same phenomenon: "With firm but moderate pressure the pads of the fingers are repeatedly rubbed over the surface of the skin, preferably with extensive longitudinal strokes along the paraspinal area. The blunt end of an instrument or of a pen may be used to apply friction, since the purpose is simply to detect color change, but care must be taken to avoid abrading the skin. The appearance of less intense and rapidly fading color in certain areas as compared with the general reaction is ascribed to increased vasoconstriction in that area, indicating a disturbance in autonomic reflex activity."3
On the same theme, Upledger and Vredevoogd wrote: "Skin texture changes produced by a facilitated segment [localised areas of hyper-irritability in the soft tissues involving neural sensitisation to long-term stress] are palpable as you lightly drag your fingers over the nearby paravertebral area of the back. I usually do skin drag evaluation moving from the top of the neck to the sacral area in one motion. Where your fingertips drag on the skin you will probably find a facilitated segment. After several repetitions, with increased force, the affected area will appear redder than nearby areas. This is the 'red reflex.' Muscles and connective tissues at this level will:
De Jarnette, the chiropractor who developed the sacrooccipital technique (SOT), wrote extensively on the subject of the red reaction, suggesting some complex interpretations.2 He used such assessments as part of a process of evaluating the particular category of patient he was treating. In one variation he describes the process as follows: "Making a firm pressure, draw fingers down the spine, with a fairly slow motion. You should be able to count to 15 while drawing the fingers from the seventh cervical to the coccyx, by counting steadily. With a good light on the back, the results should show a line which becomes red, some portions brighter and some very faintly colored. Now watch the lines fade. The area which shows the whitest is marked as the major [lesion] for this is the most anaemic spinal muscle area. It will be paler than any portion of skin on the patient's body."
Eminent physiologist Irvin Korr described how this red reflex corresponded well with areas of lowered electrical resistance, which themselves correspond accurately to regions of lowered pain threshold and areas of cutaneous and deep tenderness (termed "segmentally related sympatheticotonia").5 He cautioned: "You must not look for perfect correspondence between the skin resistance (or the red reflex) and the distribution of deeper pathologic disturbance, because an area of skin which is segmentally related to a particular muscle does not necessarily overlie that muscle. With the latissimus dorsi, for example, the myofascial disturbance might be over the hip but the reflex manifestations would be in much higher dermatomes because this muscle has its innervation from the cervical part of the cord."
By use of a mechanical instrument that quantified the pressure applied at a constant speed, followed by measurement of the duration of the redness resulting from the action of the frictional stimulator on the skin, Korr could detect areas of intense vasoconstriction which corresponded well with dysfunction elicited by manual examination.
But was the opportunity to feel the tissues being ignored during all these strokes? Marsh Morrison discussed this: "Run your fingers longitudinally down alongside the dorsal and lumbar vertebrae (anywhere from the spinous processes extending laterally up to two inches [5 cm]) and stop at any spot of tissue which seems 'harder' or different from normal tissue. These thickened areas, stringy ligaments, bunched muscle bands, all represent indurated tissue; they are usually protective and indicate irritation and dysfunction. Once these indurated areas are palpated press down and almost always they will be sensitive, indicating a need for treatment."7
Osteopathic researchers Cox, et al., wrote: "'Red reflex' cutaneous stimulation was applied digitally in both paraspinal areas [T4 and T9-11] simultaneously briskly stroking the skin in a caudad direction. Patients were divided arbitrarily into three groups.
Hruby, et al. describe the thinking regarding this phenomenon. "Perform the red reflex test by firmly, but with light pressure, stroking two fingers on the skin over the paraspinal tissues in a cephalad to a caudad direction. The stroked areas briefly become erythematous and almost immediately return to their usual color. If the skin remains erythematous longer than a few seconds, it may indicate an acute somatic dysfunction in the area. As the dysfunction acquires chronic tissue changes, the tissues blanch rapidly after stroking and are dry and cool to palpation."4
Newman-Turner described the research of osteopath/naturopath, Keith Lamont, who first described the "black line" phenomenon: "It is a common observation of osteopaths...that pressure on either side of the spine with a hemispherical probe of approximately 0.5 cm diameter, will, in some patients, elicit a dark blue or black line. Local engorgement of the capillary bed with de-oxygenated venous blood causes the appearance of the line which slowly fades as the circulation returns."8
I hope these glimpses onto different interpretations of the red reflex will stimulate you to explore the concepts described, remembering that what you feel and see is not the basis for a diagnosis; only an indication of dysfunction that may be local or reflex, chronic or acute, or significant or not.
Click here for more information about Leon Chaitow, ND, DO.
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