THE RECORD

The record of spinal palpation, when completed, should be an accurate history of the irregularities found in the spine and an accurate guide to adjustment. It must be brief and concise as well as readily comprehensible. One should be able to see at a glance any desired point on the record, so that it may be used during the adjustment without undue loss of time or attention. Obviously the introduction of any useless mark or sign, such as the inclusion of a number and blank space for each vertebra of the spine, or all possible subluxations with indications as to which do or do not exist in the given case, is a mistake.

The record should contain three parallel columns. In the first column place the number of the vertebra chosen for adjustment. In the second, place the direction of subluxation. In the third, place the word or sign which stands for the indicated movement for correction.

Number of Vertebra

The letter C is used to indicate Cervical, D Dorsal, L Lumbar, and S Sacrum in the record. Immediately following the letter which designates the region, place the number which shows the position in that region occupied by the vertebra in question, the relation of that vertebra to its fellows. For instance, the third Cervical vertebra is C 3, the eleventh Dorsal D 11. To the S for Sacrum append B or A to indicate that the Base or Apex is described as to position. This locates the subluxation. For a record of full spine palpation it is unnecessary to use the letters C, D, or L more than once, as subluxations are recorded in the order of their occurrence from above downward. A dash should always follow the number of the vertebra to separate it from the letters in the second column for convenience in reading.

Direction of Subluxation

The directions considered in palpating or recording subluxations are six in number, namely:

Name	Abbreviation	Meaning
Posterior	P	Toward the rear (Dorsad)
Anterior	A	Toward the front (Ventrad)
Right	R	Toward the right hand
Left	L	Toward the left hand
Superior	S	Toward the head (Cephalad)
Inferior	I	Toward the feet (Caudad)

As the fingers glide down the spine the posterior vertebra is the one which interposes itself in the path of the fingers, forcing them to describe an outward curve. It is the hill on the automobile road which forces the surmounting of a curved departure from the evenness of the road. It is relatively posterior to its fellows above and below.

The anterior vertebra, to the gliding fingers, means a depression, a valley. It causes the fingers to dip inward from the level of their course.

The right or the left subluxation is appreciated by running the tips of the fingers down the sides of the spinous processes. It really indicates rotation of the whole vertebra more often than any other malposition.

We say that a vertebra is superior when its spinous process is nearer the one above than the one below. It requires a measuring of relative distances. The degree to which a vertebra is superior is measured, not by its actual closeness to its fellow, but by the relation between the space above and the space below.

Likewise a vertebra is inferior when it is closer to its fellow below than to its fellow above.

Anterior subluxations are rarely recorded as such, except of the Cervicals or the last Lumbar, because no means of properly adjusting them is known to Chiropractic.

Order of Letters

In the second column, that devoted to direction of subluxation, the letter P or A should appear, if at all, as this antero-posterior relation is the first thing to be determined concerning any individual subluxation chosen except the Atlas. With the Atlas the first letter will be R or L. Next the laterality or rotation is indicated by R or L in every case except Atlas subluxation. Finally the S or I indicates the last point to be determined, the approximation of the vertebra to its fellows. This last letter usually shows thinning of intervertebral fibrocartilage, which will be discussed elsewhere.

If you desire to emphasize any direction as being more important than another, underscore the letter which stands for that direction with a single line. If two directions are to be emphasized, one more than another, underscore the one with two lines and the other with one. For example, if a vertebra is found to be quite decidedly posterior, more plainly to the right, and slightly superior, the record will show it thus: P R S.

Movement for Correction

This is indicated in the third column, separated from the second by a dash, by means of some brief word or words which describe a certain movement used in adjusting. The descriptive words and terms used in this work are all given and explained under Technic of Adjusting. (See [p. 89].) Each word or term stands for a definite method of procedure. The best movement for the correction of any subluxation of any vertebra may be found by reference to the section on [Preferable Adjustments], [p. 155]. If other terms are more familiar to the student, or in time replace those which are now common usage in the profession, they will be brief and clear and may be easily substituted for those given.

Palpation, fixing in the mind of the palpater the manner and direction of the subluxation, should also suggest as the obvious correction a movement calculated to reverse the procedure by which the subluxation was first produced. In other words, a certain kind of subluxation stands as the effect of a certain application of force along definite lines determinable by examination. Its correction should be made in a reverse direction along the same lines. By recording with the record of subluxation the desired correction, the adjuster may be reminded daily without new palpation of the movement best fitted to the case. If on trial it is decided that some other movement than the one first indicated will better overcome the abnormality, the record should be changed to correspond to the decision, and thereafter followed.

Complete Record

The completed record in three columns separated by dashes can be conveniently read. It contains no superfluous mark of any kind. It conveys all the necessary information leading to adjustment except diagnosis and case history. This palpation record should be a part of a more comprehensive record concerning the case in full and is best kept on a card, the reverse side of which carries case history. If kept in an indexed card file it may be referred to daily without loss of time and an accurate handling of each case be assured.

Have card perfectly blank on palpation record side. For convenience in reading draw a heavy line beneath the last Cervical subluxation recorded and another beneath the last Dorsal, thus dividing the record as the spine is divided, into three divisions.

Below follows a sample palpation record. It will be seen that here in a very small space may be recorded a great deal of information, for this record contains an accurate list of the primary causes of every disease, weakness, or tendency to disease with which the patient is afflicted, together with the methods for their removal.

Sample Record

C	1	R	Break
	4	P L S	Double Contact
	7	L I	Rotary
———————————————————
D	3	P R	Recoil
	7	L S	Pisiform Single Transverse
	10	P S	Heel Contact
———————————————————
L	1	P L I	Recoil
	4	R	Lumbar Single Transverse

Use of Record

The above record is made with patient sitting. It is to be used while patient is lying upon the adjusting bench. The most convenient way is to begin palpation in the Dorsal region after patient has been placed for adjustment, in this way. If first subluxation recorded is D 2—P R I, find the vertebra in the region of D 2 which appears P R I to the touch. To avoid error, let the fingers then glide downward to the next recorded subluxation. If this be found to agree in number and direction with the record, it is safe to assume that the first one found was correctly numbered in the palpater’s mind; if not, that an error was made. This can be quickly done. Before each adjustment the vertebra adjusted should be found to agree with the record; by doing this constant accuracy may be assured.