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ILEOCAECAL SYNDROME

Jacquie Strudwick - Wednesday, June 13, 2012

Welcome to our winter edition write-up of the Bloodless Surgery, CMRT and TS line work.  As stated in our last issue, we are doing the digestive in 2012 and are thus going T10, L1, L2 and L4.  We have suggested that you will need your seminar notes; a reflex chart and preferably DeJarnette’s 1966 CMRT manual (the latter two items are available from Averil; go to the website).  This series of articles on the organ work has, in the main, been a presentation of the writings of Dr. M.L. Rees, that first appeared in the SORSI Despatcher, in the 1970s.



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A warning you will find in your Lumbar 1 ileo-caecal seminar notes is:  An incompetent or over competent I.C. valve may simulate appendicitis.  The thing to do is establish the differences and we turn to Dr. Bennett’s chapter, Ileocaecal spasm v. Appendicitis, from a long-forgotten volume from the 1970s (The same Dr. Bennett of Bennett reflex points that have been preserved by Dr. Goodheart in the Applied Kinesiology notes).

Bennett states:  “If the case is an acute abdomen, and everything is sore, you cannot determine anything.  First you want the white blood cell count.  You check several hours later, or the next day, and it is not too acute.  Then you find that the condition has localised itself in the area of McBurneys point, where there is point tenderness.

Spasms of ileocaecal valves will present the same symptom complex as appendicitis, sometimes; vague chest, abdomen and back pains.  The difference with the ileo-caecal is that there is little or no fever nor will there be an increase in the white cell count.”  DeJarnette’s observations about the signs and symptoms may be of help in that your frozen shoulder will be present with an I.C. valve, not so with L2 syndrome, generally.

Return to Dr. Bennett’s observations, he further states:  “In appendicitis, the point tenderness is at McBurneys point and there is spasm across the entire lower portion of the right rectus muscle.  Where it is splinted, it shortens.  The classic symptom is that the person cannot extend the thigh because when they do it pulls on this sore muscle.  In order to seek relief they flex the thigh.

In the instance of the ileocaecal valve, the splinting is not across the belly of the muscle.  It is the outer margin of the right rectus muscle only.  The middle portion of the muscle is perfectly free.  In ileocaecal conditions you  have a rope like tension of the outer border of the right rectus muscle.  The mechanical pull of the shortening of the outer border would be just as painful if the extend the thigh, so that is no criterion.

As a practising SOT chiropractor you have one thing in your favour with the chronic lumbar one case and that is that you are not going to see one!  These are past the point of no return types who will have already been hospitalised, given up as incurable degenerative disease cases who are ‘made comfortable’ only.  In the last stages these cases are riddled with cancer.  Gruesome.

You are going to come across the acute and the sub chronic aplenty.  If you find an L1 in the early stages, you have a good chance to help them recover.  If you are unfortunate to come up with a sub chronic lumbar one patient, then you have a long haul ‘vale of tears’ in reversing this ‘morbific’ destructive syndrome and can only hope to save a partially destroyed patient, whom you must care for on a maintenance basis for the rest of their lives.

When you look at the T-S reflex points charts, you will see a zone called ‘toxic’.  Often this is active and tender along with the T-S L1 palpatory tender area.  Remember, a patient with an incompetent ileo-caecal valve is a fast ageing patient where all of the vital organs are wearing out fast fighting poisons.

The ileo-caecal patient will complain of a pain like a broken rib on the right anterior rib cage at the tips of the 11th and 12th ribs.  But the one to look out for is that condition that is printed in capital letters in your seminar notes:  FROZEN RIGHT SHOULDER.  Be suspicious of inflammation of the ileo-caecal valve if your patient complains of a right shoulder problem that resembles a rotator cuff tear.

Dr. Rees suggested another condition to observe which was a pseudo-gouty arthritis in both big toes.  In your seminar notes are two diagrams of pain and signs and symptoms of the ileocaecal syndrome.  Of note are the head and neck indicators that we need to bring to your attention.  These are the areas around the side of the head, the cheeks and the ears.

What will occur is that your L1 patient will lie prone on your table and feel an undue pressure from the headpiece.  The other thing that occurs is violent headache spasms coming from subluxation of the atlanto-occipital articulations often with vertebral artery occlusion.  This sets up the tinnitus aurium and vertigo symptoms of the eighth cranial nerve by circulation starvation.  Tinnitus is considered a condition with multiple and sometimes unknown cause.  As SOT, CMRT and Cranial trained practitioners, we have the basic cranial procedures in our armamentarium.  There is no better place to start than with the Basic One and Basic Two procedures.

Before going to procedure, we will list out the clinical picture of the ileo-caecal valve in the stages you are going to see, namely; a) the acute attack and; b) the sub chronic.

A.  Inflammation of the Ileo-caecal Valve (Acute)

1)        These people will have migraine headaches that are sub-occipital starting at the pain reflex line just below the occipital three and extending over the ear on the temporal bone through T-S D4 and D5 with extreme posterior eye pain and upper teeth pain.  They will be nauseated and when they vomit, bile will be present resembling a bilious attack.  Many of these people will have been through the barrage of tests and scans and may even have been hospitalised.  They are coming to see you with headaches for which they are often taking multiple pain killing drugs.

2)         They will have tinnitus aurium as the petrous portion of the temporal bone is pulled into distortion.

3)         They will have higher level low back pain around the level of the first lumbar and check for the palpatory pain at the transverse processes.  This is often the pain that drives them in to see you.

4)         They will have pain resembling broken ribs at the tip of the 11th and 12th ribs on the anterior rib cage.

5)         In these acute cases, the area on your wall chart – the temporal sphenoidal tonic area (slightly medial and anterior to the L1 and actually on the zygomatic) may not yet be painful.

6)           Another observation that didn’t appear in the 1966 CMRT notes is that the metatarsal-phalangeal joints of the big toes will be painful to pressure palpation as inflammatory material is being deposited.

B.  The Incompetent Sub Chronic Ileo-Caecal Valve

1)         They will have painful but hardened tissue at the right anterior humeral head which will be felt in the rotator cuff musculature. This is the frozen shoulder type patient.  Note in your seminar notes, under signs and symptoms that frozen right shoulder is in capital letters.  This is the frozen shoulder that does not have ‘rotator cuff tear’ or ‘supraspinatus problem’ reports from the radiologist.  In advanced cases you will note that the patient cannot raise the right arm and keep the neck straight.  Your true indicators for this type of frozen shoulder is occipital line 2 area 3 is active; TS L1 and the hardened feel of the shoulder.

2)         As previously mentioned, the metatarsal phalangeal joints of the big toes have become like a toxic dumping ground.  The pain will resemble gouty arthritis.  Hallux valgus develops.

3)         The 10th rib costal tip on the right side becomes acutely painful.  A chest x-ray  will show a calcified costo-chondral cartilage.

Background Thoughts and Rees’ Marking

Two factors in correction of the ileo-caecal incompetency are of note.  First, you must think in terms of mesentery correction.  The apron-like folds of the mesocaecum must be lifted back to normal position and all lace adhesions that restrict the freedom of ileo-caecal movement must be broken up.

A second factor is that you must think in terms of the entire digestive tract with ileo-caecal fault.  One common cause of this syndrome is back pressure of colon gas causing the valve to open the wrong way.  Trace it back to the person’s stomach not producing enough stomach acid.  Remember with insufficient acid there is difficulty digesting proteins and iron.

With this background information covered let’s now look at information on the Rees’ marking system and then we will cover the Dr. Rees procedure for correction.  Once again, for those who may be reading this article separately from others in the series, the Rees procedure was developed from his 1950s study of the De Jarnette Bloodless surgery notes combined with the 1965 Temporal Sphenoidal Research.  We have found that reviewing DeJarnette’s early work as presented by Dr. Rees has helped us understand the reasoning behind the 1966 work that is presented yearly in the seminar series along with providing some additional, effective procedure.

Rees’ Marking points


  1. The basic receptor block area for the ileo-caecal syndrome is located 5cm inferior of McBurneys point.  This area is quite tender to pressure palpation.
  2. Find an mark the tender area on the right shoulder.
  3. Find and mark the tender area found at the fifth level interspace (this is an area marked in your seminar notes that you probably wondered about.  It is a tender area that vanishes with L1 CMRT procedure.)
  4. Find and mark the 11th and 12th rib anterior rib cage.  These will be quite painful and are easily located.
  5. Find and mark the tender metatarsal phalangeal joints.
  6. Find and mark the TS lumbar one points and the tonic point.
  7. Now palpate the neck motor unit at cervical 5 and 6 which is your Lovett brother relationship.
  8. Another indicator not included in the 1966 CMRT notes is the temporal sphenoidal meningeal irritation area.  If this area on the interior of the T-S line is palpatorily painful, then you also have a disc problem at lumbar one level which must be corrected with annular ligament technique before the work will be effective.
  9. If sacral one is painful to palpation, then you have a dural port closure at lumbar one and a need for the fibre neutralisation work.

Technique

In modern times (from 1966 on) CMRT lumbar one technique has consisted of a) neutralisation of sacral one and occipital fibre, b) receptor reflex area and shoulder contacts, c) postganglionic.  In going over Dr. Rees’ procedure you can see some inclusions and exclusions of the work of DeJarnette.  This is the case in all of the thoracic and lumbar syndromes and L1 is no different.  Here now is the bloodless surgery technique for a lumbar one major, by the number.

  1. As soon as the patient is turned from prone to supine, you apply the following temporal sphenoidal pain control.  Dr. Rees found the combination of the TS work at the start of the procedure and the use of the preganglionic to ‘switch on the motors’ again to be a successful action in many of the syndromes (not all).  Note, with L1 there is a warning about when and when not to perform preganglionic technique.

The left hand holds light contact over the most painful T.S, L1 area as the right hand finger tips hold light contact over the ileo-caecal receptor block area.  Hold these contacts for two minutes with no motion.  The ileo-caecal patient will have a very alive occipital area 3 and the valve area may just be screamingly tender to the touch.  So, your two minute TS contact is for pain control to first calm down the abnormal pain oscillations in the reflex arc between the hollow viscus and the spinal cord pathways before you can successfully do the deep tissue work.  In two minutes this reflex arc pain oscillation will be neutralised so that you have anaesthetised your patient, locally, or blocked his pain interpretation pathway from the hollow viscus, so now you can go deep into the soft tissue without discomfort.  If you wish to make sure the pain pathways are blocked you can re-palpate your marked areas and you will find them absent or with only a faint remnant of pain.  Be sure and remember this is not a correction.  You have only anaesthetised the warning signs.  This is a regional visceral receptor block anaesthesia that will last about ten minutes.  This gives you sufficient time to painlessly accomplish your bloodless surgery to the involved hollow viscus.

  1. The receptor area and right shoulder work.  Your left hand is over the right humeral head; your right two fingers contact the ileocaecal area.  Your work both areas.  This procedure is continued until you can feel the tension resistance at the ileocaecal release.
  2. Using a double hand reinforced contact just below McBurneys point, you have the patient flex their leg.  The patient moves their flexed leg medial then lateral eight times.
  3. In the same position, with both hands you squeeze an expanse of abdominal tissue into a mound.  You lift this soft tissue ceiling-ward like you were going to raise the patient off the table.  Carry this tissue headwards then away from you then towards you.  Repeat this complete manoeuvre eight times.  This puts normal motion back into the ileocaecal valve.
  4. Now adjust the metatarsal – phalangeal joints of both big toes.  This is done by traction and then a quick thrust.
  5. In subsequent visits when the pain rib areas are not present; when the right shoulder pain, the 5th rib intercostal pain and the other indicators of L1 toxicity do not return, you can be rest assured that you have removed this patient from his tendency towards carcinoma.
  6. If there were 8th cranial nerve indicators, you clear this with your upper cervical work and with Cranial Technique Basic One and Basic Two.  The 2nd or 3rd office visit after the initial L1 is a good time to do this.
  7. You do not do preganglionic technique until you are ready to have this patient on maintenance visits.

As a final word, there is a right / left brain dysfunction as a key problem in many of these patients.  There are often resultant immune related problems such as sinusitis, influenza and colds.  L1 has the associated C5 which is part of the neurological rod of the phrenic nerve to the diaphragm.  These people are very sick and the liver pump and hiatal technique will also be of help.

With the Expression newsletter every three months, we hope that this allows you time to study and incorporate the TS, bloodless surgery and CMRT work.  Remember as SOTO Australasia members you also have access to the Rose Ertler memorial library which has a very large selection of DeJarnette’s works including the 1965 Temporal Sphenoidal research project notes.

Until spring, we remain

John S Kyneur                                                                Peter J Kyneur

Haberfield, Sydney                                                         Toronto, Lake Macquarie

New South Wales                                                           New South Wales

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D10 Intestinal Syndrome

Jacquie Strudwick - Thursday, March 22, 2012
We have been progressing through the Bloodless Surgery and CMRT work from the viewpoint of Dr. M. L. Rees, a good friend of Major’s and a keen student of SOT, from his (Rees’) college days in the 1950s and his attendance at the annual Omaha Homecoming seminars.

We will cover the third and fourth units of digestion in this year’s four Expression articles and thusly will write about D10, L1, L2 and L4, so consider 2012 the ‘year of digestion’.  The first unit of digestion is the mouth, throat and oesophagus.  Have you ever wondered about reflex work for this zone?  The second unit of digestion is the stomach with gall bladder, pancreas, liver and bile duct.  When you are performing your TS, CMRT and Bloodless Surgery work with these areas you are normalising function and often freeing up the spider web and lace adhesions that have developed.  The third area of digestion is the small intestine and ileo-caecal valve covered in the next two issues.  The fourth unit of digestion is the caecum and large intestine and this with its two articles will see out the year.

As with all of the articles of this series, we encourage you to review the relevant section of your seminar notes and the chapter in DeJarnette’s 1966 CMRT manual.  If you haven’t got a copy of the latter, visit our online shop on our website (www.soto.net.au) or contact Averil at SOTO Australasia headquarters, 07 5442 3322 email sotoa@bigpond.com, to secure your very own manual which you will refer to many times in your chiropractic career.


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A review of the above two references (seminar notes, 1966 manual) informs you that D10 syndrome includes gall bladder and modified liver procedure.  DeJarnette’s view, from the 1943-44 Bloodless Surgery compendium, is applicable.  He states:  ‘No one can be sick and have a healthy liver and gall bladder’.

As we have done in previous articles we will present DeJarnette’s CMRT work with reference to Dr. Rees’ variation so you can see the two at work.  Dr. Rees always started with a TS contact and included some of the earlier procedures of DeJarnette Bloodless Surgery that may not have made their way into the 1966 manual.

DeJarnette’s procedure is:

1.    Occipital fibre neutralisation
2.    Umbilical box procedure
3.    Gall Bladder reflex
4.    Modified liver pump; and
5.    Post-ganglionic.

Dr. Rees starts with the TS contact and umbilical box hold which acts as a good manoeuvre for patients who are ‘tender to the touch’ with the occipital fibre neutralisation.  Contacting these points and reflex areas often serves as a good calming, starting point preliminary to the procedures to be performed.
Step Two is the umbilical contact.  You palpate in a circular area about two and a half inches around the umbilicus.  You are particularly interested in 2 O’clock, 4 O’clock and 10 O’clock as being tender to palpation.  Note that if all three are tender then your patient has intestinal parasites and you need to recommend elimination.  There are several vermifuges (worm eliminators) available from your local health food shop.

Rees, also noted that the intestinal syndrome patient with the worms, will have a painful angle of the jaw.  This needs correction but first comes the use of the post-ganglionic work.
Step 3:  Hold the over the shoulder contact with your left hand on the patient’s right shoulder.  Your right hand works the most tender area of the umbilical box.  As we mentioned previously you may find all three clock face areas in the 2, 4, 10 pattern.  In this case it is beneficial to work each of these for thirty seconds as a variation.

Step 4:  Now to the forgotten painful angle of the jaw.  You make a saddle contact under the patient’s chin as your other hand is flat hand contact over the umbilicus for a minute.
Step 5:  Rees used neck extension to free up the vagus nerve.  So he would stretch the cervical column with the chin contact from the previous step while at the same time making a mound of the other hand-held tissue in the umbilical box and moving this mound headwards three times.  Very useful.
In addition, a gem of a technique for vagus stimulation is to be found in the old DeJarnette Bloodless Surgery compendiums and we have extracted the description from the 1943 Bloodless Surgery Abdominal Technic notes.

“Stimulation of the vagus nerve does the following things in the order given:

1.    Closes the cardiac orifice of the stomach
2.    Opens the pyloric orifice of the stomach
3.    Opens the ampulla of vater
4.    Contracts the gall bladder
5.    Produces peristalsis of gall ducts
6.    Opens ileo caecal valve
7.    Slows the heart beat”

Centres of Vagus Stimulation:
Mechanical Centre:  Medial border sternocleidomastoid muscle opposite angle of the right jaw.  To gain this contact, turn the patient’s face to the left until SCM muscle becomes fully visible on right side of neck.  Place left thumb in medial border of this muscle at angle of right jaw.  Support left thumb contact with left index finger which is on lateral border of SCM muscle.  Pinch tissues between thumb and index finger.

Physiological Stimulation Centre: 
This is the ampulla of Vater reflex spot.  Go one and a half inches (3.75cm) right of the umbilicus and inferior for three quarters of an inch (2cm).  Place a contact on this located area and press posterior and you will have located the ampulla of vater reflex which is the physiological centre for vagus stimulation.

Application of the Reflex:
Place index and middle fingers of right hand on the ampulla of vater centre which you have just located.
Place left thumb and index finger on the SCM points described above.  Now, you rotate the ampulla of vater contact clockwise and simultaneously rotate the neck contact anti-clockwise.  You do this procedure for two seconds then reverse the direction.  So second time through you rotate the ampulla contact anti-clockwise with neck contact clockwise for two seconds.  A total of five times through is an extremely useful ten second procedure for maximally affecting the liver, gall bladder and duodenum.
And so, a couple of ‘new – old’ procedures have been discussed which we know you will find most useful.
See you next issue.

John S. Kyneur        Peter J. Kyneur
Sydney, NSW           Newcastle, NSW


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