Elizabeth Anderson-Peacock, DC, DICCP

Objective: This article offers a description of two women

who presented with varying complaints to a family-based

chiropractic practice. In each case one of the complaints was

infertility.

Clinical Features: In both case histories, the women had

been deemed medically infertile and artificial insemination

was being considered. Upon presentation, complete

chiropractic evaluations were performed which detected

spinal subluxations.

Chiropractic Care and Outcome: Torque Release

Technique Protocols were utilized for both evaluation and

application of care. Adjustments were performed with an

instrument, the Integrator, to improve spinal-neural integrity.

During the course of chiropractic care both women were able

to conceive.

Conclusion: Although chiropractic care is not a treatment

for infertility, it is postulated that improvement of spinal

neural integrity through specific chiropractic adjustments

may have contributed to improved homeostasis and

physiological adaptation thus allowing the body to express a

greater level of health as an outcome. Various effects via the

reduction of the vertebral subluxation complex are

postulated.

Key words: Chiropractic, Infertility, Torque Release technique,

Infertility is a condition of the reproductive system whereby

there is either an inability to conceive or an inability to carry a

pregnancy to term after one year of unprotected intercourse.

Approximately 40 percent of the time infertility is due to

problems with the female, 40 percent of the time due to problems

with the male and approximately 20 percent of the time it

is due to problems in both partners or remains unexplained.

Anecdotal evidence has been presented on cases of infertility

within chiropractic such that when the reduction of the subluxation

has occurred or when improvement of function has

occurred the bodies response changes. 1,2,3

The purpose of chiropractic is to optimize health. Chiropractic

utilizes the principle that the ìbodyís innate recuperative

power is affected by and integrates through the nervous systemî.

Chiropractic practice focuses on the ìrelationship between

structure (primarily of the spine) and function (as coordinated

by the nervous system) and how that relationship affects the

preservation and restoration of health. 4 Traditionally, causes of

interference or dysfunction can be grouped into three main categories:

trauma (macro and micro), toxicity (chemical changes)

and autosuggestion (thoughts/stress).5

Chiropractors recognize that there may be long reaching effects

within the function of the body as a bi-product of restoration

of biomechanical and neurological integrity.

Chiropractors have traditionally restored homeostasis within

the body by the detection and reduction of the vertebral subluxation.

A subluxation as defined by the Association of Chiropractic

Colleges is a ìcomplex of functional and/or structural and/or

pathological articular changes that compromise neural integrity

and may influence organ system function and general

healthî. In addition a subluxation is ìevaluated, diagnosed, and

managed through the use of chiropractic procedures based on

the best available rational and empirical evidenceî.4

This paper cites two examples of outcomes in infertile women

who while undergoing chiropractic care, became pregnant and

sustained their pregnancy, one with a 6 week premature infant

and the other to term.

In case study one, a 35 year old Caucasian female presented

with a chief complaint of chronic recurrent low back pain of

five years duration. It was described as moderate to severe pain

with varying character ranging from ache to sharp to throbbing Dr. Elizabeth Anderson-Peacock, Private Practice

300 Lakeshore Drive, Suite 202, Barrie, ON, Canada L4N 0B4

J. Vertebral Subluxation Res., July 19, 2003 2 Torque Release Technique with Changes in Fertility

located at the sacrum to the lower lumbar spine midline. Occasional

paresthesia was noted into the left postero-lateral leg and

this had extended to the ankle.

Aggravating factors were gardening, carrying anything heavy

and stress. The patient gave the example that shoveling snow

for 15 minutes would cause her to be bent over in extreme pain.

During exacerbations, a heaviness was noted in both legs. Nothing

improved the pain once exacerbated and she tried to avoid

aggravating factors.

The initial onset of low back pain was subsequent to a fall

whereby she landed on a rock and fractured her sacrum. She

was hospitalized for this injury. The intensity of this trauma

subsided and reached a plateau approximately three years prior.

Her symptoms for the past two years were constantly present at

a low grade level plus additional episodes of acute exacerbations.

She described her low back symptoms as getting neither

better or worse for the past three years.

She noted that she had been trying to conceive for two years

and was considering artificial insemination. She had a son who

was three at the time of her presentation to this office.

Secondary complaints were that of recurrent neck pain and

stiffness aggravated by stress for which she described having

for years. Occasional paresthesia into the left hand was noted

without pattern. She noted chronic insomnia with resultant fatigue,

irritability and reduced concentration. Additional complaints

were chronic constipation. She had a past history of

smoking for which she quit and occasional intake of alcohol.

She tried to exercise about four times per week. She had explained

she was under a great deal of stress with her husband

traveling out of country much of the time.

Medication had just begun with Paxil. No family history was

available as she was adopted. Previous surgeries involved a

fusion of her fourth and fifth digits of the right foot when she

was about 15 years old. She felt she compensated her gait due

to pain in the fourth and fifth metatarsal region.

The examination noted a height at 5í6î and weight of 137

pounds. Postural examination revealed unleveling in the PA

posture with the right occiput, shoulder girdle and pelvis held

superior when compared to the left.

Six directions in ranges of motion (ROM) were performed

in the cervical, thoracic and lumbar spine (Flexion, extension,

lateral bending left and right and rotation left and right). Gross

passive ROMís were diminished with cervical flexion by 10%

and left rotation by 5%. Thoracic-lumbar ROMís were reduced

in extension by 20% with pain elicited from L2-L5 midline

which extended bilateral to the erector spinae (left greater than

the right). Cervical and Lumbar axial compression test and compression

with extension and rotation test (Kemps) were within

normal limits. Resisted muscle testing in the upper and lower

limbs were within normal limits. Deep tendon reflexes and sensation

to pinwheel in the upper and lower limb were within

normal limits. Orthopedic tests of straight leg raising, knee to

chest and Fabre Patrick were unremarkable.

Sensitivity was noted beneath the right fourth and fifth metatarsal

heads. Segmental palpation of the vertebral areas noted a

loss of the normal joint play at C2-3 and C5 on the right, T3-4

on the left, T8-9 bilateral, L3-4 on the right and L5- sacrum

bilateral.

Initial Tonal evidence of spinal stress was noted with a prone

leg length check according to TRT protocol as a positive left

cervical syndrome and negative right Derifield. While prone

bilateral Achilles were graded as moderately hypertonic. Computerized

Thermography and Surface Electromyography was

performed according to the protocols of the Insight 7000 Subluxation

Station with abnormal heat generated in the Thermography

at the levels of C6, T9 and T12. Surface EMG noted on a

50uv scale increased tone in the paraspinal musculature throughout

the spine at multiple levels with asymmetry maximized at

the cervico-thoracic and thoraco-lumbar regions.

X-rays were performed with views of an AP full spine, Lateral

cervical and lumbar spine. On the AP a mild translation

from T6 left to T9 right was noted. A right open disc wedge was

noted at T9-10 with T9 vertebral body superior on the right.

The lateral cervical spine noted an anterior head carriage with

the dens 21 mm anterior to the C7 body. An interruption in

Georges line was noted at C2-3 and C3-4. A cervical kyphosis

was noted from C3-6 and the atlas angle at 1 degree. The lateral

lumbar noted a slight anterior gravity line from L3 through the

sacral base. A healed fracture was noted in the distal half of the

sacrum giving the sacrum an irregular contour from S3-S5. Her

films were graded as a phase I for subluxation-degeneration.

Vertebral subluxation complex was noted. Kinesiopathology was

noted to be moderate, neuropathophysiology was noted to be

moderate, myopathology was noted to be moderate and histopathology

was noted to be mild.

A 36 year old, 5í6î 143 pound Caucasian female presented

with the chief concern of infertility. Her history involved a fully

blocked left fallopian tube and a partially blocked and damaged

right fallopian tube. She noted a 9 year history for high

prolactin levels.

She had five years of dysmenorrhea which was worsening

with a menstrual cycle which disappeared on the 3rd day and

reemerged with bright red blood by the end of the fourth day.

Stress caused this pattern to increase. She had been on Inserol

for four months. She stated she had been under gynecological

care for a number of years. Additional complaints were low

back pain midline limited to the lumbar and sacral spine without

radiation into the legs, abdominal discomfort with bloating

and a constant ìstitchî across the right inguinal region. Her

past history involved a motor vehicle accident 12 years prior

while she was the driver, wearing a seatbelt when she was hit

from the front left side and sustained left knee damage which

required surgery.

Postural observation noted unleveling of the right shoulder

girdle with scapular flaring, an increase in the thoracic kyphotic

contour and a left laterally translated occiput.

Gross passive ROMís were limited in cervical extension by

10 percent with pain elicited to the right of C7. Cervical flexion

caused a pull from C6-T2. Left lateral flexion showed a loss of

motion from T5-10 with an overall reduction by 10 percent.

Left Lumbar Kemps test caused pain at L4 on the left. All other

active and passive spinal ranges of motion were within normal

limits.

J. Vertebral Subluxation Res., July 19, 2003 3 Torque Release Technique with Changes in Fertility

Deep tendon reflexes were within normal limits. Sensation

to pinwheel in the upper and lower limbs were unremarkable.

Resisted muscle strength tests were unremarkable in the upper

limbs. Mild right psoas weakness was noted upon testing the

legs. Right straight leg raising was limited at 80 degrees with a

hypertonic hamstring. Knee to chest was stiff on the left and

reduced by 10 percent on the right. Fabre Patrick test was reduced

30 and 20 percent on the left and right respectively.

Initial examination revealed evidence of Tonal changes with

a negative left Derifield and positive right Cervical syndrome.

Muscular hypertonicities were noted in the gluteals and trapezius

bilaterally.

Increased resistance and tone was noted bilaterally along the

full spinal length of the paraspinal muscles.

Tenderness was noted with palpation to each side of the pubic

symphasis and the right ASIS. The right inguinal ligament

was also tender to palpation.

Thermography and Surface EMG were performed according

to the protocol of use by the Insight 7000 subluxation station.

Mild increase in tone was noted with asymmetry at the

right cervico-thoracic region and left lower thoracic region.

Asymmetry was mildly increased in the right lumbar region.

Thermography noted multiple levels of mild involvement

(within one standard deviation) in the upper cervical mid thoracic

and upper to mid lumbar region.

Segmental palpation noted aberrant joint play at the left occiput,

atlas and axis, bilateral C7, T5, T11-L3, sacrum, and right

coccyx. Additionally sensitivity and tenderness was noted with

palpation at L2-3 on the right.

X-rays were taken in the weight bearing position of an AP

full spine, Lateral cervical and Lateral lumbar.

The AP noted a mild 7-degree convex right curve from T10-

L3 with the apex at L1. As a result L1-L4 vertebral bodies were

superior to the left and T9-12 were superior on the right. A 5-

degree translation was noted from C4 on the left to T4 on the

right.

Spinous process rotation to the right was noted at C4-5 and

T2-3. Innominate length was 213 on the left and 215 mm on the

right. Early lipping and spurring was noted bilateral at L3-4

endplates. The lateral cervical demonstrated a general reduction

in lordosis. The occiput was PS relative to atlas. Early osteophytic

growth was noted at the endplates of C5-6 both anterior

and posterior. Lateral lumbar noted lipping and osteophytic

growth at L2-4 anterior. Mild lipping and osteophytic growth

was noted anterior and posterior at L4-5 and to a greater extent

at L5-sacrum. A reduced disc height was noted at L5-sacrum.

L4 was mildly posterior relative to L5. A moderate reduction in

the IVF was noted at L5-sacrum and mild IVF reduction at L4-

5. Her films were graded as a late phase I - early phase II for

subluxation-degeneration. Vertebral subluxation complex was

noted. Kinesiopathology, neuropathophysiology and

myopathology components were felt to be moderate. Histopathology

components at mild.

A report of findings was delivered and consent was given

for care. The patient was placed on a course of chiropractic

care of 3 visits per week for 4 weeks with the plan to reassess

after 12 visits. The protocol for Torque Release Technique was

utilized with the delivery of the adjustment made by the Integrator.

On each visit, the patient was evaluated from the prone

position and adjusted according to the TRT protocol (see figures

1 and 2). Segments noted as adjusted throughout the course

of the initial twelve visits but not on each visit were: C0, C1,

C2, right sacrum, T2, T3, T4, L3, L5 left and right innominate,

C5, and T8.

The patient was irregular with her frequency of care. As her

insomnia was occurring, her medical physician gave her a prescription

for sleeping pills which she did not fill.

She also had surgery for breast adhesion release after her

11th visit. She was re-evaluated at the 12th visit. An increase in

her thermal readings and surface EMG tone was noted but palpation

findings were improving for tissue compliance, less resistance

and improved vertebral segmental motion.

At this time her chiropractic care was reduced to twice per

week for six weeks. Her attendance for adjustments was irregular

with a full month interruption in chiropractic care. TRT protocols

indicated adjustments at similar levels with the addition of

PALPATION: includes scanning superficially for changes in skin drag,

heat, tension, turgor, resistance, imbalance or asymmetry; static segmental

and motion palpation assessment; changes in tissue tone or congestion

in tissue on palpation.

FUNCTIONAL LEG LENGTH INEQUALITY (LLI):

ABDUCTOR TENDENCY / ADDUCTOR RESISTANCE:

FOOT FLARE: EVERSION / INVERSION

FOOT PRONATION / SUPINATION

HEEL CORD TENSION / ACHILLES TENSION

ABNORMAL BREATHING PATTERNS: compartmentalized breathing,

noting where breathing is limited or restricted

INAPPROPRIATE SUSTAINED PATTERNS OF PARASPINAL

MUSCLE CONTRACTIONS/POSITIVE JUMP SIGN/

MYOIRRITABILITY / EMG CHANGES

EVIDENCE OF CONGESTIVE TISSUE TONE:

POSTURAL FAULTS (STANDING/SITTING/PRONE): The inability

to maintain or adapt to space and gravity in an appropriate posture

CERVICAL SYNDROME TEST:

BILATERAL CERVICAL SYNDROME TEST:

DERIFIELD TEST:

ABNORMAL HEAT / ENERGY RADIATION FROM THE BODY (example:

thermography, thermograph, neurocalometer, tissue humidity

changes)

J. Vertebral Subluxation Res., July 19, 2003 4 Torque Release Technique with Changes in Fertility

one visit an adjustment was indicated at T12 and on another at

L2.

Two weeks prior to the second re-assessment she had an

influenza vaccination. Subsequently, she had symptoms of vertigo,

a right-sided torticollis and tonsillitis for which she was

given penicillin.

At this assessment her gross passive cervical, thoracic and

lumbar spinal ROMís were within normal limits. However, lumbar

spinal extension was tender at end range in the lower lumbar

spine and right lateral bending demonstrated reduction in

lower thoracic motion.

Postural changes noted a shift to a left superior occiput and

shoulder. The pelvis was level. Testing of muscle strength noted

mild weakness with pain in the right deltoid where the inoculation

was administered. Sensation to pinwheel noted increased

sensitivity along the full right side upper and lower limb.

Muscular hypertonicity was noted in the trapezius, supraspinatus

and levator scapular bilateral. Thermography noted

an increase in the signal at the upper cervical spine and L5. The

surface EMG noted improvement in symmetry and reduction

(calming) in signal throughout.

As the underlying joint function was improving, the patient

was given low back stabilizing exercises and cervico-thoracic

stretching to be performed daily. Her care was scheduled at two

times per week but the patient only attended weekly.

Four weeks after her comparative examination, the patient

noted she was six weeks pregnant. Her care continued throughout

the pregnancy with a complication of vaginal spotting between

8 through to 11 weeks gestation. She was medically

monitored, felt to be stable and not treated.

An exacerbation of low back pain and a worsening of insomnia

was mentioned by the patient after traveling for six

weeks. Upon return, she commented on a correlation between

missing her chiropractic appointments and a worsening of her

inability to sleep and back pain. Spinal palpation and TRT findings

noted increased spinal stress so she was recommended a

temporary increase in her frequency of care to three times per

week which she maintained for two weeks. Her subsequent frequency

of care she undertook was approximately once per week.

A report of findings was given to the patient with a course of

care recommended. Consent was given to begin and chiropractic

care was delivered at a frequency of twice per week for six

weeks utilizing the protocol for Torque Release Technique with

the delivery of the adjustment made by the Integrator. On each

visit, the patient was evaluated from the prone position and

adjusted with the TRT protocol using the Integrator (see figures

1 and 2).

Over the course of the initial twelve visits the following segments

were indicated to adjust on varying visits: C0, C1, C2,

C5, T2, L2, L3, L4, S2, S3, coccyx and sphenoid.

She had a progress reassessment at the 12th visit. SEMG

noted a calming in her muscle tone with less asymmetry. Her

Thermography noted calming in her cervical spine, a similar

pattern in her thoracic spine and an increase in signal at the

sacrum. A low back program of exercises was instigated at this

time with a continuation in the frequency of two visits per week

for a further two weeks, then she was reduced to weekly appointments.

Two weeks later she became pregnant. Her care continued

for a further 5 weeks then the patient self-discharged. On follow-

up she had a normal pregnancy which was taken to term

with delivery.

Infertility medical management may involve treatments at

many levels. This may range from medications such as hormonal

treatments and ovulation stimulation to surgeries involving

parts of the reproductive system such as reconstructive surgeries.

Other technologies may be utilized such as intrauterine

insemination, in vitro fertilization, egg/sperm donation and surrogacy.

If infertility was recognized as an end-stage outcome, as a

result of aberrant function in the interplay of one or many variables,

the causes of infertility may be simplistically broken down

into three main groups. Utilizing the classic 3Tís (trauma, toxicity

and thoughts) as a reference, infertility may be an end result

from numerous risk factors such as any condition which

may change the bodies structure and thus function. Examples

of effects from trauma causing structural and functional changes

might be pelvic organ position/alignment, inflammatory diseases

with scarring, other physical obstruction of any part of

the reproductive tract, congenital anomalies, weight and changes

in neurological function.

The order of adjustment was made dependent on the highest priority

indicator present at the time of the visit presentation.

Once an indicator was found, the corresponding spinal segment was

checked to note if a pressure test caused a physiological response. This

pressure check was performed manually with the distal phalanx of the

index finder contacting a spinal segment.

Prior to each adjustment, the indicator used in determining the segment

to adjust was re-visited to observe if a physiological response was made

towards normal. If a partial response was made, the procedure was repeated

at other segments until the appropriate balance of the indicator

occurred or another indicator was viewed as higher priority and the

corresponding segments checked.

Fine tuning was performed to note the contact point on the vertebrae

(spinous process, lateral mass, articular pillar for the appropriate vector

and if indicated the need for torque as indicated.

Once the indicator, segment, vector(s) and torque were found, the Integrator

was set to deliver the adjustment.

Once the adjustment was delivered, the indicator was re-visited to note

its amelioration.

As per TRT protocols, the legs were pumped three times and the above

procedure was repeated as indicated. This was performed usually two

to three times in a visit.

As per TRT protocol, care was taken to maintain the non-linear nature

of the technique by avoiding adjusting the same segments in the same

manner (vector, contact and order) greater than three times in a row.

J. Vertebral Subluxation Res., July 19, 2003 5 Torque Release Technique with Changes in Fertility

Examples of effects by changing the bodies toxicity or chemistry

might be from any change in the hormonal balance of the

body, inadequate diet, concomitant diseases such as autoimmune

diseases and pro-inflammatory states, presence of sexually

transmitted diseases, pelvic inflammatory disease, endometriosis,

fibroids, lifestyle habits such as smoking, alcohol,

use of certain drugs, chemical exposure and age.

Examples of thoughts would best be represented by the cumulative

effects on the body, in particular on the nervous system

by the general adaptive response as discussed by Hans

Selye.12

Chiropractic as a vitalistic profession would recognize the

interplay between the three as an impact in one may dynamically

alter or change the effect in another system as all systems

are interdependent. LeBouef-Yde noted changes reported upon

improved non-musculoskeletal symptoms subsequent to chiropractic

care.7

Masarsky reviewed the impact of chiropractic care via

somatovisceral effects.8

Sato has noted the impact of somatosensory input on autonomic

functions.9

Burns reported the effects of subluxations induced in the

cervical and lumbar spine upon the course of pregnancy as noted

in rats, rabbits, guinea pigs and cats. It was noted, ìfetal development

is subject to the influence of practically every factor

which effects maternal physiology, although in most instances

it is not possible to trace the relation between cause and effectî.

In this paper, it was noted that animals who were experimentally

subluxated, could not conceive, were unable to maintain a

viable pregnancy or had congenital abnormalities when compared

to non-subluxated mammals.10

This suggests that there is a profound relationship between

aberrant spinal function with functional implications.

These two cases are of interest as other anecdotal cases are

present in the chiropractic literature.1.2.3 It is postulated that by

improving the biomechanical integrity of the spine and changing

the facilitation of the nervous system, a restoration of homeostasis

can occur.

Both cases are interesting in that one presented with the chief

complaint of low back pain while the other presented with the

concern of infertility and during questioning it was revealed

that she had a history of low back pain. Both had aberrant spinal

function detected at various levels of their spine. Both had

experienced a history of trauma. Both women were 35 or over.

Both had been trying to conceive for greater than one year. Both

were adjusted using TRT protocols with the Integrator.

The first case was a challenge as the patient was experiencing

severe levels of family stress which would have impacted

her response to care. In addition, her situation necessitated travel

which interfered with her schedule of care. Even so, this case

demonstrated improvements within the parameters of seeing

positive physiological changes at her visits.

Both cases had evidence of changes in Tone as defined by

DD Palmer for which the tone of the tissue is reflected in the

state of health of the tissue. ìLife is the expression of tone. In

that sentence is the basic principle of chiropractic. Tone is the

normal degree of nerve tension. Tone is expressed in functions

by normal elasticity, activity, strength and excitability of the

various organs, as observed in a state of health.

Consequently, the cause of disease is any variation in tone.î11

As interpreted by this author, poor adaptation of a person to

their environment due to an inability or loss in the ability to

comprehend and respond to their surroundings would be a consequence

of altered ìToneî. This change in ìToneî could manifest

in many ways, but ultimately it alters the ability to selfregulate

and express.

It is postulated that the changes observed with each patientís

re-assessement and the improvement in spinal and neural integrity

caused changes to occur in far reaching ways. It is important

to note that this chiropractic care was not based as a

treatment for the symptoms such as low back pain or infertility

but to improve the spinal-neurological function and health

through the reduction of subluxations.

Coincidentally, these cases are clinically relevant as both

women were referred to chiropractic care by a friend who heard

of results with becoming pregnant through chiropractic care.

Both cases had a history of trauma. Both had evidence of

subluxations for which chiropractic care was instituted. Upon

reduction of the vertebral subluxation there was an improvement

in spinal-neural function which appeared to have an im-

Adjustment causing changes in nociceptor and mechanoreceptor activity along the spine.8,9,12-16

Effects muscular tone

of associated motor unit and

compensatory muscles

Changes in breathing

Altered tension/distortion of the cord

Favorable changes in hormonal &/or immune

system activity especially the pituitary-ovarian axis

Alternation of posture

and locomotion

Change in somatoautonomic

reflexes

Changes in pelvic content alignment

(broad/round ligament tension,

sacrum/Innominate function).

Altered stress response

(improved sense of well-being)

J. Vertebral Subluxation Res., July 19, 2003 6 Torque Release Technique with Changes in Fertility

pact on the reproductive system through various postulated

mechanisms.

Anecdotally, this author notes discussions within the profession

by colleagues at seminars who have noted similar results

in clinical practice. There is a paucity of published research

in this area. Further research needs to be performed to

validate the outcome on chiropractic care through the reduction

of vertebral subluxations and improvement in bodily function

on end stage dis-ease and overall health status.

1. McNabb B. The Restoration of Female fertility in Response to Chiropractic

Treatment. Proceedings of the national Conference on Chiropractic and

Pediatrics. ICA 1110 N Glebe Rd. Arlington, VA 22201. 1994:55-64

2. Webster LL. Inability to conceive. Two case histories from the files of

Larry Webster. International Chiropractic Pediatric Association Newsletter.

Nov. 1995

3. Vilan, R. The Role of Chiropractic Care in the Resolution of Chronic

Migraine Headaches and Infertility: A Case Study. Original Paper

Presentation. Annual Conference on Chiropractic and Pediatrics. ICA 1110

N Glebe Rd. Arlington, VA 22201. November 22-24, 2002

4. Association of Chiropractic Colleges: Issues in chiropractic. Position

Statement #1. The ACC Chiropractic Paradigm, Chicago, July 1996,

Association of Chiropractic Colleges.

5. Palmer DD, The Science, Art and Philosophy of Chiropractic, 1910 : 364

6. Holder. JM. Torque Release Technique Seminar Notes. Miami FL 1997

7. LeBouef-Yde, Axen I, et al. The types and frequencies of improved nonmusculoskeletal

Symptoms reported after chiropractic spinal manipulative

therapy. JMPT 1999;22:559-64

8. Masarsky CS and Todres-Masarsky. Somato-visceral aspects of

Chiropractic: An evidence-based approach. Philadelphia,PA: Churchill

Livingstone, 2001:1-5, 37-49,109-138

9. Sato A, Sato y, Schmidt RF. The impact of somatosensory input on

autonomic functions. Reviews of Physiology, Biochemistry and

Pharmacology. Vol 130. Berlin: Springer-Verlag;1997.

10. Burns L. Vertebral Lesions and the Course of Pregnancy in Animals. JAOA,

1923;Vol23(3)

11. Palmer DD, The Science, Art and Philosophy of Chiropractic, Portland

Oregon. Portland Printing House Co.:1910 :7

12. Selye H. Stress without Distress. Penguin Books of Canada Ltd. 1981

13. Korr IM. Sustained sympatheticotonia as a factor in disease. In Korr IM

editor: The neurobiologic mechanisms in manipulative therapy, NY:

Plenum Press, 1977

14. Breig A. Adverse mechanical cord tension in the central nervous system.

New York. John Wiley and Sons, 1978:

15. Kent C. Models of Vertebral Subluxation: A review: JVSR. August

1996;1(1):11-17

16. Boone, WR, Dobson GJ. A proposed Vertebral Subluxation Model

Reflecting Traditional Concepts and Recent Advances in Health and

Science. JVSR August 1996;1(1):19-30