This month I would like to discuss the clinical importance of the upper neck: the atlas‐axis region and the lower occiput. The importance of this area has been discovered by a number of medical "schools of thought" and may be important in neural therapy as well. I say "may be" as I am not aware of it receiving any special attention in German neural therapy (at least in the Dosch neural therapy books). Perhaps our Spanish speaking readers can enlighten us if their tradition has anything to add.
Students of anatomy know that the atlanto-axial and atlanto-occipital joints are unique in the spine. They allow more mobility than at any other spinal level. In addition, a host of muscles control motion, and according to Abrahams, these muscles contain 40 times as many proprioceptors per unit volume as does a gastrocnemius muscle. And just above these joints is situated the brain stem, the autonomic nervous system's main regulatory centre. It is clear that both the musculoskeletal and nervous systems are heavily invested in this area.
Practitioners of spinal manipulation quickly learn that somatic dysfunction of the atlanto-occipital and atlanto-axial joints can not only cause headache, but also disturb function in many other parts of the body. For example it is not unusual to find that treating this area is key to correcting pelvic ring somatic dysfunction and curing low back pain.
B.J Palmer, (the son of the founder of chiropractic), beginning in the 1930's, taught that the upper two cervical vertebrae are the only two vertebrae that can "subluxate".His method, which he called "Upper cervical specific chiropractic" came to be the only method taught at the Palmer School of Chiropractic at that time.
This method, also called "Hole‐in‐one upper cervical chiropractic" is practiced by some chiropractors to this day. It is claimed to be effective for a wide variety of ailments from diabetes, to PMS to Lou Gehrig disease. Using this method, diagnosis is made by physical examination and precisely directed Xrays, from which measurements are taken of the relative positions of occiput, atlas and axis. Treatment is directed at these segments only.
One branch of osteopathic medicine, cranial osteopathy pays particular attention to this area as well, but for much different reasons. BJ Sutherland DO, was the first to notice that the human skull is not only innately mobile, but also that its parts move in a complex, rhythmic and highly precise manner. He called this motion the primary respiratory impulse and saw it as a pumping mechanism for cerebrospinal fluid throughout the brain and the spinal cord. Techniques of correcting abnormalities of motion were developed including one called the CV4. This technique targeted the inferior occiput (partly overlying the brain stem)and was known to be a powerful technique for "priming the pump".
The DOs in the readership might be interested to hear that in the early 1980s I met an elderly osteopathic physician from Florida named Charlie Knau. He told me that he spent a great deal of his time with Dr Sutherland in the last year of his life and that during that time Dr. Sutherland treated his patients almost exclusively with the CV4 technique.
Another medical "school" that pays particular attention to the upper cervical region is Dr. Oswaldo Font's system of electroneuromedullar therapy.He treats what he calls the "master switch" by inserting an acupuncture needle deep into the upper cervical region down to the dura mater. When the needle rests on the dura he applies a pulsed electrical impulse to the needle.
So why is the upper neck important in neural therapy? I have come to believe that it is important because the brain stem itself can be an interference field, even with no somatic dysfunction of the upper cervical vertebrae. This can be detected using autonomic response testing and treatment of the area can have profound effects. I have been using the Tenscam to treat them, but procaine quaddles into the scalp over the atlanto‐occipital area probably have the same effect.
When should we look for brain stem interference fields? The brain stem is unlikely to be affected by direct trauma, but can be subject to neurological "overload", just as are autonomic ganglia.In other words, just as autonomic ganglia can become interference fields when the neurological traffic to and from the areas that they control becomes too intense, so also can the brain stem develop an interference field when peripheral interference fields anywhere in the body are especially active.
A brain stem interference field should be looked for when other interference fields have been treated, but the patient is still not regulating; ‐ or when the patient is blocked and no reason can be found. When a brain stem interference field is found, reasons for the blocking can be searched for by introducing substances into the patient's magnetic field with one finger on the brain stem. If the autonomic response reverses, the substance can be assumed to be the cause of the patient's blocking.
Treatment should not be expected to result in the relief of specific symptoms; rather it should be looked upon as a method of resetting the autonomic nervous system's responsiveness. Sometimes the patient goes into a yin state. At other times, the patient simply feels more relaxed and is found to be regulating. This is usually a sign that treatment is complete (at least for this session).
What should we call this interference field? Dr. Font's name for this location: "The Master Switch" seems appropriate and is the name that I am now using.
Robert F. Kidd, MD, CM