The tubercular ridge formed by the rudimentary spinous process in the median line of the posterior surface of the sacrum is of very little value in palpating the segments of the sacrum. It is best to palpate the articular crest on each side of the tubercular ridge. In this way it is possible to determine if one segment is more prominent on one side than on the other. This should be done very carefully and if a subluxation is found it should be adjusted on the side that is most prominent. The contact is on the articular ridge and the thumb may be used for nail point the same as in the dorsal region; or if the child is large enough nail point one may be used.
Whenever possible a spinograph should be made of the child. This may not always be possible with the small child and with the very young infant it may be very difficult. In many acute incoördinations it is impracticable to try to get a spinograph, not because the spinograph would not be of value, but because it is difficult to get to the office to take it. In the chronic cases a spinograph should by all means be taken. Every possible means should be used to verify the palpation.
CHAPTER IV
ADJUSTING INFANTS
CHAPTER IV
ADJUSTING INFANTS
The recoil is used in adjusting a child the same as in adjusting an adult. The young infant can be placed upon the knees of the mother or nurse instead of being placed on an adjusting table. The ordinary adjusting table will be too large for the real small infant. Care must be used that the child is placed in the correct position for the adjustment and that the neck and head are properly supported. Placing the child on a pillow on the lap of an adult is not satisfactory because the pillow is too soft and makes it more difficult to move the vertebrae. If the child is adjusted on the mother’s lap care must be exercised that the mother’s skirt is not drawn tightly for it is best to leave the infant’s abdomen unsupported or at least not to have too solid a support.
When the mother holds the babe on her lap there is a tendency for her to raise her heel off the floor so as to make the knee supporting the child’s head higher than the other. When the adjustment is given the knee will not be sufficiently solid to support the child and the vertebra will not move. For this reason the chiropractor must see that the mother’s heels are both placed squarely on the floor. It is a good plan after the contact has been taken and the chiropractor is ready to give the adjustment to ask if both heels are on the floor. Nine times out of ten one heel will be lifted and the toe will be supporting the weight of the child.
In adjusting small infants in the dorsal and lumbar regions the side of the thumb may be used for nail point. In getting the contact one should palpate in the usual manner, find the vertebra that is to be adjusted, remove all fingers except the pointer finger, turn the hand so the finger is parallel with the child’s spine, then instead of placing the pisiform bone of the nail hand, place the side of the thumb in exactly the same manner as if it was nail point one. This being done, remove the pointer finger. Then instead of placing the hammer hand on the nail hand as in using the pisiform bone for nail point, grasp the thumb that is being used for nail point between the thumb and finger of the hammer hand and press the tissues tightly to make the side of the nail thumb firm. The thrust is given with a recoil just the same as in the usual manner.
It is best not to use too much force until it is determined just the amount required to move the vertebra. One will be surprised, however, at the amount of force required to move the vertebrae of a very small infant. It should be remembered that the vertebrae must move if we expect to get results. It must also be remembered that the child is small and that it is necessary to adapt the amount of force used to the size of the patient. It is not possible to injure a child with a chiropractic adjustment, but it is possible to apply an awkward force, supposed to be a corrective force, in such a way that subluxations may be produced.
This method will be used only with the smallest infants. When the child is a few months old the pisiform bone may be used in exactly the same manner as with the adult. The only difference is that the amount of force will be suited to the size of the patient. In case a straight posterior subluxation and a double transverse adjustment is given on a single vertebra the adjuster may use his two fingers, the first and second, to get contact on the transverse processes. The nail hand is then placed across the two fingers and the adjustment is given with the recoil. It will require very little force to move a vertebra of an infant on the transverse processes.