Jacquie Strudwick - Sunday, November 13, 2011
Welcome to the Spring ‘Expression’ article on the bloodless surgery, CMRT and temporal sphenoidal work for the liver.
For those just joining us in this series of articles, we have been working through the work of Dr. Mel Rees. Dr. Rees learned the bloodless surgery work in 1952 while at Chiropractic College.
In 1965, he attended Dr. De Jarnette’s seminar on the Temporal Sphenoidal reflex points and incorporated the work into his practice. In 1966 Dr. De Jarnette standardised the bloodless surgery work and called it C.M.R.T. (Chiropractic Manipulative Reflex Technique).

The T8 T.S point is located on your wall chart, and on your patient on the lower line. If you haven’t got a wall chart, you need to make the small investment and have one of these in your clinic rooms – call Averil for prices (phone 07 5442 3322).

If you have located T8 and it ‘ouches’ to palpatory pressure, you have a patient with liver abnormalities. They will have an occipital line 2, area 6 heavy nodule. Dr. De Jarnette called the liver, ‘the great imitator’ in that it can mock just about any other organ of the body. The liver presents three
types of problems; metabolic, secretory and vascular.

The patients you see with a TS major will have metabolic liver problems. The secretory and vascular types will show up as a T4 and an L4 major, respectively.

The metabolic functions of the liver are by far the greatest concern to the C.M.R.T. and TS practitioner.

The liver is the gateway to the body and this amazing organ exercises tight control upon materials – food and poisonous substances – seeking entrance.

Materials absorbed from our intestines must first be carried to the liver by the portal circulatory system, inspected and stamped ‘good to use’ or ‘neutralise, poison’ before the needed nutrients are allowed to continue on to the billions of hungry cells clamouring for them. If there has been a lack
of ‘life force’ to the liver function for even a short time, we have a weakened liver unable to normally cope with these all important metabolic functions.

T8 Liver Physiology

The change in metabolic function you will see with these patients results from back pressure of the portal circulatory system. The portal circulation to the liver normally has about 8mm of pressure behind it. Liver dysfunction causes an increase in circulation pressure and this will produce the
symptoms these patients exhibit. Remember that the portal system has a large number of anastomoses with the general circulatory system – these are collateral circulatory pathways that are normally slightly travelled.

When the liver is in trouble, the portal pressure can increase to 20 and 30mm resulting in a spill-over into one or more of the collateral pathways. The weakest pathways will be the first affected and the symptoms appearing will depend upon the pathways to succumb.

The most common are:
  1. Probably the most common ballooning collateral is the back pressure through the haemorrhoidal circulation. The resulting symptoms, of course, are the very uncomfortable piles that occur overnight, many times.
  2. The second most common symptom you will find is the ‘oesophageal varicosity syndrome’ which in categories work and C.M.R.T. we know as reflux oesophagitis or pseudo-hiatal hernia. It can present as a sub-clinical version with the Category II patient. It can also present as a most terrifying affliction which the patients interprets as a ‘heart attack’. The distal oesophagus where it moves with respiration within the diaphragm balloons as an overworked collateral pathway.
  3. Two very serious symptoms can be caused by collateral ballooning in the splenic duct and/or in the pancreatic duct. This is where the liver major can resemble splenic problems or pancreatic problems and if not repaired can actually set the stage for future trouble in those areas.
  4. A ballooning of the collateral system through the peritoneum, omentum apron, that acts as a holding structure for pelvic and abdominal contents can result in kidney, GI tract and many pelvic symptoms. Female organ ptosis symptoms and prostate ptosis symptoms and kidney ptosis symptoms are what you will find in these liver major patients.
You may now understand why Dr. De Jarnette
called the liver the ‘great imitator’!
We will now present Dr. Rees’ procedure for the T8 work. As we have staged in previous writings in this series, it is a chance for you to review your C.M.R.T. notes from the seminar series and perhaps to re-read the 1966 C.M.R.T. manual appropriate pages.

Bloodless Surgery Technique for T8 Major

You are seated on the right of your supine patient throughout this procedure, which is outlined in ten steps:

  1. Dr. De Jarnette located two liver reflex areas on the anterior and posterior of the right shoulder girdle. It was Dr. Rees’ habit of marking these areas with a skin pencil for pre and post checking. The anterior is on the third right rib, about 5cm lateral of the sternal margin. The posterior is right straight through to the back side, thus just off the right transverse process of T3. The front area when painful means the front half of the liver is congested. The back area when painful means the back half of the liver is congested. Nearly always, both will be painful in a TS T8 major. When you do your bloodless surgery / C.M.R.T. procedures, these painful areas are gone and the portal back pressure can be normalised.
  2. This is an area of liver reflex you will have read about in your C.M.R.T. seminar notes and most probably overlooked. The front portion of the forearm, over the biceps muscle or lower one-third of the biceps muscle. This is a reflex area of soreness that is extremely consistent in its use as a progress monitor in the C.M.R.T. /TS work.
  3. Locate the most painful area, on the patient’s right from the liver down to McBurneys point. This is the receptor block area – the region you will use in the TS work and may wish to use with post ganglionic. In our current seminar notes we call this the ‘caecal area’!
  4. Here is the TS approach. You have previously located the painful temporal sphenoidal T8 indicator and you hold this with a left hand finger contact while you contact the receptor block area with your right hand finger tips. This is the ‘stop the reflex arc oscillation’ step of your technique which enables the steps to follow to take better. Essentially, if you hold the reflex arc oscillation contacts for two minutes you neutralise these areas and their neural volley input. Your temporal sphenoidal pain will no longer be present and the biceps’ indicator (as mentioned in step 2 above) will no longer be there. This results from your removing the receptor block that has kept the reflex arc in abnormal oscillation and with it removed the ‘pain interpreted’ reflex areas on the body.
  5. Now you are ready for your deep tissue technique which consists of the five steps:
    1. Third rib and posterior contact
    2. Third rib and McBurneys contact
    3. The anterior liver technic
    4. The posterior liver technic
    5. Pre – ganglionic work
    You know these from your C.M.R.T. seminar notes, but by repetition and stating these in a different context, this should give you more certainty to your approach. You hold the posterior marked third rib reflex area while you use a circular motion over the front third rib area for the count of ten, which is, about the length of time taken to achieve tissue relaxation.
  6. Now hold the anterior third rib marked area as you use your right hand to break up the adhesions at the caecal area. This area covers the area from the ampulla of vater down to the McBurneys point. It is less tender than it would have been if you didn’t do the TS contact, but nevertheless will still have loads of tension in it. You will feel this tension leave in about thirty seconds of gentle circular work. This step is most necessary to relax the bile duct so your liver congestion techniques, the anterior and posterior pumps that follow, can work.
  7. This step is the anterior liver technique which is a gem of a move and seems to have been overlooked in the modern notes. Dr. Mel Rees whilst a student at the small and now, defunct Kansas State Chiropractic College, learned this from his teacher, Dr. Brian Surtees. As to the importance of this step, Dr. Surtees used to say ‘you better do this move or you aint done nothing’. Here is the liver pump out technique or anterior liver technique to clear out the front portion of the liver. Your left hand is an ‘over the shoulder contact’ with your thumb landing on the anterior third marked area. Your right hand finger tips make a soft touch contact two inches under the right inferior costal arch and gradual increase pressure, superiorly and then floorward, like the tide going in and out, for one minute. In this action, remember your anatomy and the fact that you are squeezing out congestion on the front one half of the liver.
  8. This next step, you know from the C.M.R.T. seminar notes as ‘the liver pump’ which is described as – left hand over right liver area presses and pumps in a rotation motion while the right hand lifts and holds the caecal area. In more detail and with some variation, this technique in the old Bloodless Surgery notes was called the posterior liver technic. Following your last step, you move both hands down. Your left hand which was over shoulder now is moved down to the right inferior costal arch with heel of the hand over the lateral margins of T-7, T-8, T-9 and T-10 ribs. Your contact needs to be as far posterior as you can on your supine patient. Now follow these variation directions. Your right hand is placed on that caecal area, just below McBurneys point with the fingers pointing to the medial line. Your left hand holding contact lifts the rib cage ceilingward as your right flat hand contact turns in a torque manoeuvre until the fingers face the right shoulder and at the same time carry the soft tissue floorward always gaining as much tissue stretch as possible. Now your left hand rib cage contact squeezes the costal arch towards you as your right hand pushes for a count of five. This cycle is repeated five times to clear the most difficult portion, the posterior portion of the liver of congestion.
  9. Now palpate the sternal bone for tenderness. This is the pre-ganglionic, which you have come to know now from this series of articles, a component which had been forgotten. Remember, the idea here is to ‘start the motor’ again, that you ‘switched off’ with the TS and organ receptor area holding contact. You hold the liver area flat hand contact with your right hand while you give ten quick left finger circles on the mid-sternal area.
  10. Except for nutritional support, this concludes your bloodless surgery technic. Remember the liver needs a food source of manganese enzymes for the formation of urea from ammonium ions and for the glycolysis process. Also, the sick liver needs vitamin A but can’t tolerate oil sources. Thus, lettuce, carrot and/or beetroot juices need to be taken. There are several liver cleansers available on the market but the simplest measure of having the patient squeeze the juice of half a lemon and taking this in warm water twenty minutes before breakfast proves to be a very successful action.
A principle the C.M.R.T., bloodless surgery and TS practitioner must remember is that there are often
secondary organs involved. Thus, a liver ‘major’, may have a need for kidney raising and drainage and as we said before reflux oesophagitis and the Allen Flip technique are often indicated. Most likely you would have started these procedures when the patient presented as a Category II.

All the best with the work.
John S. Kyneur
Sydney, NSW

Peter J. Kyneur

Newcastle, NSW

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