Technic and Practice of Chiropractic

by Joy Maxwell Loban

PISIFORM DOUBLE TRANSVERSE No. 1

An adjustment to be used only in the Dorsals from fourth to ninth inclusive, for posterior or postero-rotary subluxations. It is probably best to use this movement only for straight posterior subluxations and to apply either the Pisiform Single Transverse or the Two Finger Double Transverse to the rotary displacements in this region.

Contact

Both pisiform bones, each upon a transverse process and both upon the same vertebra.

With patient in position B and the adjuster standing upon his left the contact should be made by the following exact method. Palpate with right hand, which comes to rest upon the spinous process of the subluxated vertebra. Note if it be P. R. or P. L., because this fact will govern the next movement. Let the first finger of palpating hand reach outward about one inch and upward to a point opposite the tip of the next superior spinous process, which point will approximate the position of the transverse. This first upon the side of the posterior transverse, which will be the right with a left subluxation or the left with a right one. Let second and third fingers, now abandoning the spinous, follow the first and rest over the assumed position of the transverse.

Now palpate with a deep, limited, massage movement until the club-shaped extremity of the transverse is felt under the middle finger. Hold this point with the middle finger, drawing away the other two, and guide the free hand to an exact contact upon the transverse. Thus if standing on the left, as predicated, the left hand will be first to make contact and with the most posterior transverse, with which most exact contact is necessary.

With pisiform placed, let the fingers extend away from your body; if on the side of the spine opposite you, let them extend downward so as to follow the curve of the rib and to be anchored upon the rib connected with the transverse of contact; if on the same side, let fingers extend downward parallel with the column.

Fig. 24. Pisiform double transverse adjustment as it should be given, elbows locked.

Now—still using the original palpating hand—palpate on the other side from the first contact until the other transverse is discovered. Mark its tip with a quick, deep pressure and a sharp withdrawal of the fingers, so that a spot of anaemia appears momentarily. Carefully place the pisiform of the palpating hand in contact, guided by the anaemic spot. If this second contact is on the side on which you stand the fingers will be toward the head; if on the opposite side, they will follow the rib curve outward and downward.

Re-read the above directions carefully. It will be seen that the technic is quite free from unnecessary movements.

The two hands are now placed almost exactly at right angles to each other, arched fingers anchored to prevent slipping.

If you stand on the patient’s right the use of hands is, of course, exactly reversed, the left hand being palpating hand, and making the first contact.

Completing Position

When hands are in position and adjuster standing so as to face directly across the spine, the arms are rotated outward until the elbows “lock.” The adjuster leans over so as to have shoulders directly over the spine, draws the body back from the shoulder girdle to secure freest play in the shoulder joints, and drops head loosely between the shoulders so as to relax the trapezius and prevent any checking of the force.

Movement

Directly downward from the shoulders through straight, stiff arms. The force is delivered separately with the two arms and yet simultaneously. If the vertebra is straight posterior, equal force must be applied on the two sides; if it is posterior and slightly rotated (P. R. or P. L.), most force must be applied to the more posterior transverse.

Considerable practice and looseness of shoulder are required to use this movement properly. It is a regrettable fact that few adjusters do use it correctly, most of them giving a thrust instead of a transmitted shock.