Chiropractic Manipulative Reflex Technique (CMRT).
Charles L. Blum, DC, CSCP
Originally called "Bloodless Surgery," Chiropractic manipulative reflex technique (CMRT) encompasses the relationship between
somatovisceral and viscerosomatic reflexes and therefore between the somatic and autonomic nervous systems. R. J. Last in his book "Anatomy: Regional and Applied" points out:" supplies the body wall and limbs (somatic) and viscera (autonomic). Its plan is simple. It consists of afferent (sensory) and efferent (motor) pathways, with association and commissural pathways to connect and coordinate the two. There is no more than this, in spite of the many pages devoted to its study. Bloodless Surgery was historically used in chiropractic as a term describing soft tissue treatment affecting an organ and its related vertebral relationship or viscerosomatic and somatovisceral reflexes. describe methods of manipulating joints and soft tissue without related to the viscera. 2,3 Bloodless surgery was also used to4 James F. McGinnis was a chiropractor that relocated to California in the early 1920s, where he earned a naturopathic doctorate. In the 1930s he became one of the best known of several chiropractic bloodless surgeons and traveled around the nation to teach his methods. Major Bertrand DeJarnette, DO, DC, developer of sacro occipital technique, was also practicing and teaching extensive methods of bloodless surgery. DeJarnette published a comprehensive book on the topic entitled, "Technic and Practice of Bloodless Surgery" in 1939, which remains the most complete discussion on the topic to date. 2 Around this time3 DeJarnette continued to teach and practice bloodless surgery through the 1940s and began its modification to use more reflex applications and referred pain indicators as a method of affecting organ symtomatology. In the 1950s he furthered his investigations into reflexes and their affect on the viscera and related vertebra. By the early 1960s DeJarnette modified the nature of sacro occipital technique's method of bloodless surgery from its 1939 procedures, which might take 2-4 hours of preparation and treatment, to procedures that could be practiced in a span of 15 minutes. reasons he decided to change the name of his method of affecting referred pain pathways, viscerosomatic / somatovisceral reflexes, and direct organ manipulation to chiropractic manipulative reflex technique (CMRT). CMRT is used as a method of treating the spine or vertebral visceral syndromes associated with viscerosomatic or somatovisceral reflexes, 5,6 For multiple7-9 dysafferentation at the spinal joint complex, visceral mimicry type somatic relationships Treatment involves location and analysis of an affected vertebra in a reflex arc by way of occipital fiber muscular palpation, similar to trigger point analysis or Dvorak and Dvorak's spondylogenic reflex syndromes arcs are located, corroborated with referred pain pathways, and clinical symtomatology, then the specific vertebra to be treated is isolated by pain provocation, muscle tension, and vasomotor symtomatology. Often times if a vertebral dysfunction is chronic or unresponsive to chiropractic spinal manipulation then a viscerosomatic or somatovisceral component is evaluated. somatovisceral component is performed using soft tissue manipulation, myofascial release techniques and reflex balancing methods. 10 and11.12. Once specific vertebra reflex13 Treatment of the viscerosomatic or6 Page 2
SOTO-USA POSITION STATEMENT
Chiropractic Manipulative Reflex Technique © Sacro Occipital Technique Organization- USA • 2008 Bloodless surgery, was used and taught by SOT chiropractors since 1939 and was practiced extensively in the 1930s and 40s. Since 1960 it has been called CMRT, and focuses predominately on the vertebra and iscerosomatic/somatovisceral reflex relationships. CMRT is listed as a chiropractic technique throughout the chiropractic literature. CMRT for years, are publishing their methods in the literature, helping to develop an evidence base for this method of care. 14-8 SOT clinicians using these methods of19-27 CMRT, just like all of chiropractic and manual healthcare warrants further clinical study. Until chiropractic has the sufficient funds and tools to perform all the necessary research to help substantiate everything we do in our clinical practice we must be careful not to throw out or impugn aspects of chiropractic that support its position as being complementary or alternative." When only 1-2% of the research is in on most innovative forms of manual medicine, even those practices for decades, we must be careful not to throw out the baby with the bathwater as we attempt to strictly define what is "evidenced based" and what is not.
1. Last RJ,
Sixth Edition, Churchill Livingstone: New
2. Keating JC James F.
C.P. (1873-1947): Spinographer,
Educator, Marketer and Bloodless
3. DeJarnette MB,
Nebraska City, NB, 1939.
4. Taylor H,
Setter and Early Advocate of "Bloodless
5. DeJarnette MB,
Manipulative Reflex Technique
Published, Nebraska City, NB, 1964.
6. Blum CL, Monk R,
Manipulative Reflex Technique
Occipital Technique Organization - USA,
Winston-Salem, NC, 2004.
7. Budgell BS.,
the autonomic nervous system.
Manipulative Physiol Ther.
8. Budgell BS,
and Visceral Disorder.
Journal of Australia.
Anatomy: Regional and Applied,McGinnis, D.C., N.D.,Chiropractic History , 1998; 18(2):Technique and practice of, Privately Published,Sir Herbert Barker: Bone-Journal of the American1995 Jul; 32(7):Chiropractic, PrivatelyChiropractic, SacroReflex effects of subluxation:J2000Spinal Manipulative TherapyChiropractic1999 Dec; 29(4):
9. Sato A
nerve stimulation on visceral function
The reflex effects of spinal somatic.
J Manipulative Physiol Ther.
10. Seaman DR, Winterstein JF,
Dysafferentation: A Novel Term to
Describe the Neuropathophysiological
Effects of Joint Complex Dysfunction. A
Look at Likely Mechanisms of Symptom
11. Szlazak M, Seaman DR, Nansel D,
Dysfunction and the Phenomenon of
Visceral Disease Simulation: A Probable
Explanation for the Apparent
Effectiveness of Somatic Therapy in
Patients Presumed to be Suffering from
True Visceral Disease,
12. Dvorak J, Dvorak V,
from German) George Theime Verlag,
Stuttgart, Germany, 1988: 326-33
Journal of Manipulative and. 1998 May;SomaticJ Manip Physiol. 1997 Mar;20(3) : 218-24Manual Medicine:, 3rd Edition, (Translated Page 3
Chiropractic Manipulative Reflex Technique © Sacro Occipital Technique Organization- USA • 2008
1 There is only one nervous system. It" 1