Letters to the editor - Europe PMC

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issue ofJune 1982. If I may add a further comment on this situation, I have ... to become a teacher, he then must pass a three-hour writ- ten examination, and anĀ ...

* Letters to the editor

The manipulators To the Editor: Thank you for publishing my remarks on Cyriax in your issue of June 1982. If I may add a further comment on this situation, I have recently had the opportunity of attending one of the Cyriax seminars at Rochester, N.Y. There were 100 registrants there, plus his teaching staff of about 15 physiotherapists, most of whom were trained by him in England. This organization should be fully understood by the chiropractic profession. Here's how it works: A registrant may attend the three levels of instructional courses, after which he is placed upon an international register for the purpose of referrals. If an individual wishes to become a teacher, he then must pass a three-hour written examination, and an oral. At the seminars, Cyriax introduces each topic himself, ranting on at length about the incompetence of chiropractors, and the dangers of their methods. (He says that every case in the literature of brain stem infarction following manipulation has been at the hands of a chiropractor.) The audience then divides into small study groups in which the Cyriax approach is taught absolutely verbatim from his text. There are now 9000 people in the world who have attended the three basic courses and been put on the referral list. I have had a running battle with Cyriax in the Journals, over the past ten years, although I have never met him personally. I have a personal letter from him, suggesting that I buy his textbook, and give up my wicked ways. I might have been tempted to meet him in Rochester, but, on the third day, after seeing what he did to the cervical spine, I checked out and went home. A nineteen-year-old man was presented, with a mildly stiff neck of about three months duration, and having slight radiation of pain over the left deltoid region. Now Cyriax lays down a series of manipulations to be followed in each region, re-checking the -range of movement after each one. First is traction. He grasped the chin and occiput of the patient, braced his feet under the table, and applied all the traction he could muster, while an assistant pulled footward on the shoulders. He then re-tested the area, and there was no change. On to step two. He grasped the head as before and forcefully rotated the head as far as possible to the left, again with traction. He re-tested, and again there was no change. The manceuver was then repeated to the right. Note that at no time was there any contact other than on the occiput and mandible - no contact at any time at the level of pathology, probably C4-5. Now this is safe, and what we do is dangerous. Every chiropractor I know could have managed this case in about ten seconds, with a comfortable move, and probably in one visit. The young man then left the stage, with a puzzled look on his face, with Cyriax reassuring all that he was now cured. It is tragic that this frustrated elderly man is allowed to The Journal of the CCA/Volume 26 No. 4/December 1982

continue his libelous assault on the chiropractors. It is equally tragic that the chiropractors seem to have slid past home plate and are running off in all directions, perhaps without realizing just how good they are. The empire builders in the field of manipulation totally ignore one another, and force the interested party to separate wheat from chaff. This has been a problem in chiropractic, but seldom in medicine, and makes the whole thing a bit of a joke. The best situated and most impartial observer is Scott Haldeman. Cyriax admits in his book that neither the orthopadic world nor the physiotherapists have endorsed him during his life, and to that extent he has failed. His bitterness toward the success of the 'laymen' has to be seen to be believed. The simple truth of the matter is that nowhere in medicine is there a facility in this society able to render this service as quickly and as conveniently as the chiropractor, and I hope that my remarks will aid in establishing this obvious fact, and that better interprofessional liaison will result, to the good of all. G. E. Potter, MB, BS, DC Vancouver, B.C.

Four-quadrant weight scale To The Editor: Although the four-quadrant weight scale has been promoted as a significant part of a chiropractic postural analysis by a small minority of clinicians, it is hardly "used routinely in chiropractic practice", as suggested by Drs. Mrozek and Wiles, nor has it generally "formed a significant part of the chiropractic postural analysis", as suggested by Dr. Vernon (JCCA, Sept. 1982). In fact, outside of CMCC and a couple of offices in the Toronto area, this questionable method of postural analysis is largely unheard of. Moreover, there have been few published reports on the usefulness of this device (other than the testimonial reports of its originator and a second-hand account of the same'), and no experimental documentation of its clinical usefulness. Furthermore, Dr. Vernon's study has shown a 15% range of error in each quadrant with repeated measurements, and Drs. Mrozek and Wiles have shown that four-quadrant measurements are, at best, a static snapshot of a fluid postural state. Therefore, it would seem that this device is probably insensitive to anything other than gross postural changes occuring within a static time frame in an unnaturally fixed posture. Perhaps the proponents of this device would do well to consider these findings before promoting this method of postural analysis to students and field practitioners. J. David Cassidy, DC, BSc, FCCS, Graduate Studies and Research Department of Orthopaedics University of Saskatchewan, Saskatoon, Saskatchewan 1. Janse, J.: The concepts and research of Dr. Fred W. Illi. National College of Chiropractic 1956 June; 28: 10-34.