The Logic of the Specific: Upper Cervical Foundations of Chiropractic

The Logic of the Specific: Upper Cervical Foundations of Chiropractic

A Contemporary Study of B. J. Palmer's The Subluxation Specific—The Adjustment Specific (1934)

Jiro Yamahata, BCSc., DOMP · PCC PRESS · Chiropractic Clinical Reasoning Series

"Today, the less we do, if done right, the more results we get." — B. J. Palmer, 1934

In 1934 B. J. Palmer published the eighteenth of the Palmer School's Green Books, The Subluxation Specific—The Adjustment Specific. It made one of the boldest arguments in the history of chiropractic: the practitioner needs only one place to correct and one way to correct it. Palmer narrowed the whole spine to the atlas and axis. He found "the specific" with spinographs and heat readings, adjusted it once with a toggle-recoil thrust, and then left it alone. His listings, rules and case galleries shaped upper cervical practice for the next century.

This book reads Palmer's text from beginning to end, in his own words. It then examines each claim against the modern anatomy of the craniovertebral junction, neurophysiology, the reliability of radiographic measurement and the clinical evidence. Some of Palmer's ideas have stood up well: the discipline of precise examination, written records, restraint, rest after adjustment, and re-examination before doing anything more. Others survive in reformed form, such as his attention to the richly innervated suboccipital region. Some must be set aside, with reasons: the claim that ordinary misalignment presses on the spinal cord, the idea of a single cause of all disease, and the use of uncontrolled case series as proof.

Inside you will find:

• 34 chapters in six parts, following Palmer's text: the search for the specific, the nervous system and the upper cervical region, analysis, the adjustment specific, Palmer's listings, and evidence and practice
• In every chapter: learning objectives, Palmer's argument with page references to the 1934 edition, contemporary understanding, a "From 1934 to Today" comparison table, clinical reasoning for the manual clinician, a case for discussion, key points, review questions and further reading
• A clear explanation of Palmer's spinous-based listings (PLI, PRI and the rest) and how they differ from the body-based listings of Gonstead and Diversified practice, drawn from both the 1920 Palmer Technique of Chiropractic and the 1934 text, so that readers trained in any system can read Palmer correctly
• Safety guidance for upper cervical care: screening, red flags, cervical arterial dysfunction, atlantoaxial instability and referral
• An appendix restating each of Palmer's atlas and axis listings and rules with a contemporary reading, a glossary of his vocabulary, a bibliography and an index
• Original schematic figures of the listings, plane lines, toggle-recoil and the craniovertebral junction

Throughout, the book keeps to the series position: clinicians do not treat or cure disease. They find and reduce interference so that the body's own capacity for regulation and repair can work.

Part of the Chiropractic Clinical Reasoning Series, for students and practitioners of chiropractic and manual therapy. Companion titles: From Source to Periphery, More Than Machinery, The Body Itself, A Little World Within and The Roots of Clinical Reasoning.