Explanation of CCSI Scale Scores

Click on a scale for an explanation:

    1: Poor Superficial Circulation
    2: Cold Hepatic Circulation
    3: Gastric Hypoacidity
    4: Gastric Hyperacidity
    5: Systemic Hyperacidity
    6: Torpid (Sluggish) Liver
    7: Sensory System Dysfunction
    8: Kidney Dysfunction
    9: Systemic Toxicity
    10: Low Calcium
    11: Lack of Coagulation
    12: High Urea
    13: Stomach Position
    14: Intestinal Permeability
    15: Hypothyroid
    16: Voluntary/Involuntary Incoordination
    17: Lacteal Duct Adhesions
    18: Psychological
    19: Hypoadrenal
    20: High Hepatic Circulation
    21: Anemia
    22: After Effects of Intestinal Flu
    23: Gallbladder Dysfunction
    24: Respiratory System Dysfunction
    25: Brain Dysfunction
    26: Abnormal Heart Action
    27: Pancreatic Exocrine (Digestive) Dysfunction
    28: High Blood Sugar
    29: Spleen Dysfunction
    30: Reproductive System

The CCSI Workbook and Manual contains more extensive documentation for each scale.

Scale 1: Poor Superficial Circulation
    The superficial circulation is carried by blood vessels relatively near the surface of the body as distinguished from the deep circulation (also called the "hepatic circulation") associated with the organs of the abdomen.  Poor superficial circulation usually indicates an imbalance between the blood flow to the surface and extremities and the deep circulation to the organs within the body cavity.  Poor superficial circulation may result from pressure on nerve centers which regulate blood flow throughout the body.  Manual therapy (spinal manipulation and massage) may be helpful to improve nervous system functioning in such cases.  Fume baths, moderate exercise, and mild electrotherapy also tend to improve superficial circulation.

Scale 2: Cold Hepatic Circulation
    The hepatic circulation is the flow of blood and lymph through the liver and organs of the digestive, urinary, pulmonary and cardiovascular system.  The primary hepatic circulation is between the liver and kidneys which are important organs of elimination.  The hepatic circulation also includes other vital organs such as the intestines (hepatic portal), pancreas, spleen, gallbladder, lungs, and heart.  When the circulation through these organs is slowed or low in volume, it is said to be "cold."
    Cold hepatic circulation may result from poor eliminations (especially the colon).  The system becoming extremely toxic overloads the liver and kidneys (two primary organs of elimination).  In an exhausted or overwhelmed state, the hepatic circulation becomes slow or sluggish.  Decreased secretions from the liver contribute to intestinal problems (such as constipation) which further exacerbates the deficient hepatic functioning.  Internal cleansing through hydrotherapy and diet are common therapeutic interventions for this pathological pattern.  Nerve pressures on the centers governing the hepatic circulation is another primary etiological factor in cold hepatic circulation.  Manual therapy to relieve the nerve pressure is a common treatment for cold hepatic circulation resulting from somatic dysfunction.  Moderate exercise, a basic diet consisting mainly of fruits and vegetables, and mild electrotherapy (such as the violet ray appliance) may stimulate a sluggish hepatic circulation.

Scale 3: Gastric Hypoacidity
    Gastric hypoacidity is usually indicative of insufficient hydrochloric acid in the stomach.  Naturally, this often leads to indigestion and nausea.  Poor digestion will make assimilation of nutrients difficult decreasing vitality resulting in general weakness and lack of energy.  A less recognized symptom of gastric hypoacidity is headache.  Gastric hypoacidity can be produced by numerous factors, including pressure on the nerve centers which regulate gastric secretions.  Manual therapy (spinal manipulations) may be helpful in such cases to improve nervous system functioning and remove the cause of the gastric hypoacidity.  Various digestive aids containing hydrochloric acid are available at most health food stores.  A balanced diet with plenty of vegetables may also help this condition.  For individuals suffering from general debilitation resulting from poor digestion and assimilation, body building foods which increase vitality may be helpful (e.g., beef juice, eggnog, malts, etc.).
    Options for further assessment include:
  •  Heidelberg pH capsule system (Heidelberg International, Inc.)

Scale 4: Gastric Hyperacidity
    Gastric hyperacidity refers to a chemical imbalance in the stomach characterized by excessive acidity.  Beyond the obvious pathophysiological effects such as ulcer and acid reflux, more systemic effects may be apparent.  For example, poor digestion in the stomach (from hyperacidity) compromises the assimilation process throughout the rest of the gastrointestinal system.  When the partially digested food leaves the lower portion of the stomach in a hyperacid state, the uppermost section of small intestine (duodenum) can become irritated.  Unless the hyperacidity is neutralized quickly, assimilation throughout the rest of the gut is decreased.  Constipation in the lower bowel is one common result of poor digestion and assimilation.
    Gastric hyperacidity can be produced by a variety of factors, including a highly acidic diet, improper food combining, negative emotions while eating, and pressures on nerve centers which regulate gastric secretions.  The following treatments may be helpful for gastric hyperacidity: alkaline-reacting diet, proper food combining, positive attitudes and emotions, manual therapy, and digestive supplements that decrease gastric acidity.
    Options for further assessment include:
  • Heidelberg pH capsule system (Heidelberg International, Inc.)

Scale 5: Systemic Hyperacidity
    Systemic hyperacidity refers to a tendency for widespread effects of acid/alkaline imbalance in which excessive acidity is noted.  Maintaining a proper acid-alkaline (pH) balance is important.  In particular, high systemic acidity either causes or contributes to many health problems.  It may be helpful to monitor urine and saliva pH to ensure a slight tendency for alkalinity.
High systemic acidity is often caused by eating a diet containing too much acid-producing foods such as sweets and meats.  Stress is another factor which can increase acidity.  Improper food combinations (such as eating grains and citrus at the same meal) can result in high acidity.  Poor elimination of wastes can increase systemic acidity.
    Improved diet (more alkaline-reacting foods and proper food combining), reduced stress, and improved eliminations (hydrotherapy) are suggested to address systemic acidity.  Specific alkalizing supplements such as Glyco-thymoline and baking soda taken in small quantities may decrease systemic acidity.
    Options for further assessment include:
  • Ph testing of urine
  • Biological Terrain testing (Biological Technologies International, Inc.)

Scale 6: Torpid (Sluggish) Liver
    A torpid liver is underactive or sluggish producing poor eliminations and diverse systemic symptoms.  Torpid liver is an effect produced by a variety of causal factors, especially impaired nerve impulse due to lesion or subluxation of the spinal centers (especially the 8th and 9th thoracic) associated with this organ.  Anxiety and distress can be contributing factors.  Systemic toxicity and digestive system dysfunction are also sometimes factors in cases of torpid liver.
    There is an intimate relation between liver and kidney functioning.  When one of these organs suffers from torpidity, the other is likely to be affected.  Thus, in cases of torpid liver, kidney functioning is also sometimes pathological as a compensation for the sluggish liver.
    Typical therapies for torpid liver include manual therapy (spinal manipulation), hydrotherapy, castor oil packs, electrotherapy (violet ray appliance), herbal remedies, and a basic diet consisting primarily of alkaline-reacting fruits and vegetables.
    Options for further assessment include:
  • Comprehensive Detoxification Profile (Great Smokies Diagnostic Laboratory)

Scale 7: Sensory System Dysfunction
    When speaking of sensory system dysfunction focuses on the organs of sight, hearing, smell, and taste.   Apart from the obvious dysfunction that can result from direct injury or disease of a sensory organ, systemic problems which can cause or contribute to sensory system dysfunction.  In this sense, the sensory system can be regarded as a unit.  Systemic dysfunction can thus affect the sensory system as a whole.
    Hepatic systemic dysfunction (particularly of the liver or kidneys) is sometimes involved in sensory system problems.  Torpid liver, low (cold) or high hepatic circulation, or kidney disease can contribute to impaired vision, hearing, taste or smell.  Sometimes systemic toxicity is the link between hepatic system problems and sensory system dysfunction.  Nervous system dysfunction (particularly to the cervical and upper thoracic nerve centers) is another common etiological pattern of sensory system dysfunction.  The sensory system can thus become deficient in its functioning.  Or, sometimes nerve pressure on these nerve centers can cause the sensory system to become "supersensitive" to environmental stimuli including interpersonal actions.  The senses are easily stressed (or distressed) and a feeling of being easily overwhelmed may ensue.  Circulatory imbalances (which may be related to the two previous pathophysiological patterns) are also sometimes involved sensory system dysfunction.  Both blood and lymph circulation is important.  A feeling of fullness in the throat or face is one indication of circulatory imbalance.
    Therapeutic options for sensory system dysfunction include manual therapy (with special attention to the cervical and upper thoracic nerve centers), electrotherapy (radial appliance or violet ray appliance), and internal cleansing (diet, hydrotherapy, and castor oil packs).  Local attention to the sensory organs may be appropriate for symptomatic relief (e.g., packs, massage, etc.).
    Options for further assessment include:
  • Thorough manual therapy assessment with special attention to the cervical and upper thoracic vertebra.

Scale 8: Kidney Dysfunction
    The kidneys maintain an intimate relation to the liver in keeping a balance in the body and eliminating wastes.  Problems with the liver are often reflected in the kidneys and vice versa.  The other organs of the hepatic system (pancreas, spleen, and gallbladder) are also closely linked to kidney functioning. Thus the kidney can be regarded as the focus of the lower hepatic circulation while the liver regulates the upper hepatic circulation.  When the liver is torpid or sluggish, the kidneys are called upon to work harder to eliminate wastes.  If the kidneys are unable to compensate, systemic toxicity can manifest in varied symptoms such as eye problems and rheumatism as well as local problems with the urinary tract.  The kidneys are also responsible to a significant degree for maintaining proper acid-alkaline balance in the body.  Thus systemic acidity is often reflected in kidney functioning.  The kidneys may attempt to throw off excess acidity producing bladder and urinary symptoms.
    Kidney dysfunction can sometimes be traced to pressure on nerves which provide impulse to the kidneys.  Spinal manipulations to improve nerve functioning may be helpful for kidney dysfunction.  A diet that is primarily alkaline-reacting (mostly fruits and vegetables) may help decrease systemic acidity which may be associated with kidney dysfunction.  Local therapies including hot packs (Epsom salts, castor oil, Glyco-Thymoline, mullein, or turpentine) over the kidneys or bladder area may also provide symptomatic relief for pain associated with kidney and bladder problems.   Massaging the back at the location of the kidneys with a compound containing mutton tallow, spirits of camphor, and spirits of turpentine may provide symptomatic relief for aches and pains associated with urinary tract problems.  Watermelon seed tea, Coca Cola syrup (uncarbonated), lithia water, Jerusalem artichoke, and sweet spirits of nitre may be helpful to cleanse and stimulate the kidneys.

Scale 9: Systemic Toxicity
    Systemic toxicity is a common etiological factor which may be described as "poor eliminations." Of the four primary processes of elimination (defecation, urination, respiration, and perspiration), about 85% of the toxins are normally eliminated through the bowel.  When the bowel becomes deficient in this activity (i.e., constipation), the other channels of elimination must increase their activity to cleanse the body of toxins.  Failure of any of the other eliminating processes will lead to some degree of systemic toxicity.
    Manual therapy (spinal manipulation and massage), hydrotherapy and packs, and a cleansing diet are primary therapeutic options for systemic toxicity.
    Options for further assessment include:
  • Comprehensive Detoxification Profile (Great Smokies Diagnostic Laboratory)

Scale 10: Low Calcium
    Calcium is an essential element important for maintaining the structural integrity of the body.  Deficiencies in calcium result in bone problems, especially with the teeth and nails.  Calcium deficiency may also be linked to circulatory problems (low blood pressure and poor superficial circulation), fatigue, lowered resistance to disease, and anxiety.
    Therapeutic options for low calcium focus on diet and supplements.  A calcium rich diet may be helpful.  Calcium rich foods include: Spinach, steel cut oats, whole grain cereals, cheese, onions, garlic, rhubarb, milk, raw cabbage, turnips, turnip greens, beets, celery, carrots, water cress, lettuce, citrus fruits, parsnips and oyster plant.  A dietary supplement called Calcios may also be helpful for low calcium.
    Options for further assessment include:
  • Elemental Analysis of Hair (Great Smokies Diagnostic Laboratory)

Scale 11: Lack of Coagulation
    From a traditional medical perspective, coagulation refers to blood clotting with respect to wound healing.  Lack of coagulation results in excessive bleeding (hemophilia is the most extreme example) and poor wound healing.  However, coagulation (while including blood clotting and wound healing) may be regarded in a more expansive way by considering the systemic aspects of this process.  For example, coagulation is an essential step in the immune response.  Infectious forces and pathological processes (such as virus, bacteria, cancer) are surrounded and "separated" from the body.  The formation of  cysts and tumors are the result.  Thus the lymphatic system (i.e., white blood cells - leukocytes - "warriors" of the immune system) are activated in the body's attempt to fight off invading forces.
    Apart from pathology, coagulation is an important component in the maintenance of health.  At a microscopic level, the body is constantly eliminating wastes and rebuilding tissue.  Coagulation is the process by which the body "encases" wastes and toxic substances for elimination from the body.  Furthermore, there is a constant wear and tear on the organs of the body from normal processes that takes place at a cellular level.  Coagulation provides a protective "coating" to worn tissues within the body so that rebuilding, replenishing, and rejuvenation can take place.  Maintenance of the walls of the blood vessels is an example of this type of coagulation.
    Of course, if the internal damage is severe (from an accident or surgery), coagulation is more extensive and notable in the formation of adhesions and scar tissue during the initial stages of healing.  Monitoring and improving the coagulative factor (when necessary) helps to ensure that recovery from surgery will be optimal.
    The primary therapy for poor coagulation is diet.  An alkaline diet emphasizing fruits and vegetables may be helpful.  Yellow fruits and vegetables (e.g., squash, corn, peaches) are especially recommended while avoiding vegetables of a bulb nature (e.g., potatoes, carrots, beets, turnips).  Vegetable and citrus juices are helpful as are whole grains.  However, do not eat grains and citrus at the same meal.  For persons who are debilitated and lacking in vitality, blood and body building foods may be helpful.  These include: gelatin, tripe, pig's feet, liver, beef juice, cod liver oil, fish, fowl or lamb.  Meats are to be broiled, roasted or baked (never fried).   Dietary supplementation can also be helpful.  Vitamins A, D, and B (especially B-1) are emphasized.  Iron and calcium supplementation may be helpful if the body is deficient in these elements.  When supplementation is necessary, it is best to take the supplements in cycles with rest periods so that the body does not become addicted and lose its natural ability to assimilate vitamins and minerals from food.  Other therapeutic options include electrotherapy (animated ash with ultra-violet light), hydrotherapy, manual therapy, and stress management.

Scale 12: High Urea
    Urea is a substance produced by the liver and transported to the kidneys to be excreted from the body in the urine.   When urea levels become excessive, the body suffer from a condition called uremia.  In such cases, kidney functioning is often impaired.  Therapeutically, a variety of natural treatments may be helpful for this condition, inlcuding: a basic diet consisting primarily of fruits and vegetables, manual therapy to improve eliminations, hydrotherapy, and hot packs over the abdomen or back.
    Options for further assessment include:
  • Blood Urea Nitrogen (BUN) test

Scale 13: Stomach Position
    Abnormal stomach position can be a contributing factor to serious systemic imbalances.   In general, two patterns of abnormality are possible: 1)  The stomach position may allow food to pass through too quickly without allowing proper digestion.  The stomach is too vertical with the upper portion (cardiac) too high or the lower end (pyloric to low).  2)  The stomach position may hold foods too long producing to much fermentation.  The upper end (cardiac) is dropped or the lower end (pyloric) is raised.
    Abnormal stomach position causes or contributes to poor digestion and assimilation; poor eliminations as poorly digested food is passed into the intestinal system; disturbed circulation; abnormal acid/alkaline balance; abdominal symptoms including stomach pain, feelings of heaviness after eating, etc.; unbalancing of hepatic system functioning, primarily the liver, resulting in systemic toxicity and related problems.  Abnormal stomach position can be produced by injury to the abdomen or to the mid-thoracic spinal nerves which regulate nerve impulse to the muscles holding the stomach in position.
    Therapeutic options for abnormal stomach position include manual therapy (especially spinal manipulation to the mid-thoracic vertebrae), supporting belts around the abdomen, specific exercises to coax the stomach back into proper position, digestive aids to improve digestion, hydrotherapy to cleanse the system of toxins produced in the system due to poor digestion, and a well-balanced diet.
    Options for further assessment include:
  • Abnormal stomach position may be assessed by careful palpation of the abdomen.
  • Imaging techniques (such as barium swallow and ultrasound) may be helpful in assessing for this problem.
  • History of stomach injury (such as a blow to the stomach) or spinal injury to the second to sixth thoracic vertebrae may be significant.
  • Physical examination of the spine with special attention to the second to sixth thoracic vertebrae may also be useful in locating somatic dysfunction associated with abnormal stomach position.

Scale 14: Intestinal Permeability
    Intestinal permeability refers to a condition involving a thinning of the walls of the bowel.  This condition is sometimes known as "leaky gut syndrome" or excessive "bowel permeability."  With the walls of the intestine compromised, toxins that would normally be eliminated by defecation are absorbed through the gut wall and picked by the circulatory system (especially the lymphatic circulation) to be distributed throughout the body.  If the toxins cannot be eliminated through the other channels of elimination (such as urination or respiration), the skin becomes the last outlet of elimination (perspiration).  Thus, skin disorders (such as psoriasis) may result from excessive intestinal permeability and poor eliminations.
    Several factors can contribute to excessive intestinal permeability.  Pressures on nerve centers (especially in the mid thoracic region) which innervate the intestines may contribute to increased intestinal permeability.  Depleted nerve energy to the intestines weakens the lining of the gut allowing toxins to leak through.  Hyperacidity in the bowel can also contribute to excessive intestinal permeability.
    Therapeutic options for excessive intestinal permeability include: a basic alkaline-reacting diet (primarily fruits and vegetables), dietary supplements (especially yellow saffron tea, slippery elm bark, and olive oil taken in small doses throughout the day), manual therapy (with special attention to the mid-thoracic vertebra), and hydrotherapy (to improve eliminations).
    Options for further assessment include:
  • Intestinal Permeability Test (Great Smokies Diagnostic Laboratory)

Scale 15: Hypothyroid
    The thyroid is an important endocrine gland involved in a wide range of systemic processes.  Hypothyroid (underactive thyroid) can thus manifest in a broad array of symptoms.  Hypothyroid tendencies may be caused by hereditary predisposition, nerve dysfunction associated with the nerve centers which influence the thyroid, diet, and stress.
    Medicines such as Atomidine (an iodine supplement) and thyroid extract may be helpful for underactive thyroid but should only be taken under the supervision of a physician.  Balanced diet, mild electrotherapy, and manual therapy may also be helpful for hypothyroid.
    Options for further assessment include:
  • A complete thyroid panel including TRH (thyrotrophin-releasing hormone) test (Meridian Valley Clinical Laboratory)

Scale 16: Voluntary/Involuntary Incoordination
    Voluntary/involuntary incoordination refers to a lack of harmony between two primary nervous system divisions - the central nervous system (nerves with cell bodies within the brain or spinal cord) and sympathetic (nerves with cell bodies outside brain and spinal cord).  Some people have roughly translated this distinction as the modern designation of central and autonomic nervous systems, although is probably an over-simplication of the physiology involved.
    Voluntary (conscious) activities are associated with the central nervous system and involuntary (unconscious) activities with the sympathetic system.  Sometimes, a form of nervous system incoordination is present in which the voluntary activities had become involuntary and vice versa.  It was as if the two great divisions of the nervous system get their wires crossed.  The result is an obvious neurological dysfunction in which the individuals become impaired in even simple daily activities.
    Manual therapy and mild electrotherapy (wet cell battery or radial appliance) may be helpful to assist the nervous systems to become better coordinated.

Scale 17: Lacteal Duct Adhesions
    Lacteals are small lymph capillaries which absorb lipids (fats) from the small intestine.  Lacteals join together to form ducts which are especially associated with the Peyer's patches (lymphatic nodes) along the right side of the abdomen in conjunction with the ileum portion of the small intestine. Adhesion refers to holding together by new tissue [e.g., scar tissue], produced by inflammation or injury, of two structures which are normally separate.   Adhesions may interfere with circulation of blood and lymph and nervous system activity and impulse.  Poor assimilations and nervous system incoordination (such as seizure disorders) may result from such adhesions.
    Lacteal duct adhesions can be produced by several factors, including: injury to the right side of the abdomen or to the umbilicus during birthing; high fever or cold and congestion affecting the lymphatics of the intestinal tract; nerve reflexes (especially from the lower spine - 4th lumbar and coccyx).
    Hot abdominal castor oil packs and massage may be helpful to break up the adhesions.  If spinal somatic dysfunction is a causative factor, manual therapy (spinal manipulation) may be helpful to remove pressures on spinal centers.
    Options for further assessment include:
  • Thorough manual therapy assessment with special attention to palpation of the right side of the abdomen (for tenderness, adhesion and temperature) and examination of the lower spine including the coccyx.
  • Thermographic photography may provide visual documentation of coolness along the right side of the abdomen when compared to the full abdomen.

Scale 18: Psychological
    Although psychological symptoms can be related to mental illness, more often this scale is referring to "psychosomatic" factors.  In other words, attitudes and emotions are intricately interwoven into the fabric of our beings: physically, mentally, and spiritually.  Thus, thoughts and feelings affect our physiology.  The biology of the body produces psychological effects.  In a metaphysical sense, psychology takes on a broader meaning than modern systems of thought which strongly emphasize the material aspects of our being.  "Psyche" means soul - "ology" means "knowledge of."  Literally, psychology means soul knowledge.  From this enlarged perspective, psychology includes concepts such as reincarnation.  Therefore "karma" is regarded as a psychological factor often manifesting through thoughts and feelings.
    Karma is an ancient concept which refers to the "law of cause and effect."  This panoramic view of the human condition parallels the Eastern religions (particularly Hinduism, Buddhism, and Taoism).  From this perspective humans are regarded as immortal beings evolving toward unity with the divine source of being.  This view includes reincarnation and the ability of each individual to choose certain key probabilities concerning a particular lifetime.  Naturally, genetics play an important role because heredity provides a relatively stable and predictable means of having the necessary life experiences to encounter one's personal karma.
    If psychological or "karmic" patterns are contributing to illness, the mental and spiritual aspects of healing are emphasized.  "Soul development" may be considered as the purpose for illness and healing.  Prayer, meditation, service to others, hypnosis and suggestive therapeutics, and attention to ideals may be helpful in addressing psychological issues.
    Options for further assessment include:
  • Brief Symptom Inventory (National Computer Systems)

Scale 19: Hypoadrenal
    The adrenals are major endocrine glands located above the kidneys.  Consisting of a medulla (sympathetic) and cortex (endocrine), the adrenal glands are active in a wide variety of systemic processes involving metabolism, anti-inflammatory agents, emotional states, etc. Hypoadrenal (underactive adrenal) is sometimes linked to chronic fatigue, depression, impaired cognitive functioning, and digestive problems.
    Therapeutic options for hypoadrenal include Atomidine (an iodine supplement), manual therapy, Jerusalem artichoke, and fume baths with witchhazel oil.
    Options for further assessment include:
  • Adrenocortex Stress Profile (Great Smokies Diagnostic Laboratory)

Scale 20: High Hepatic Circulation
    The hepatic circulation is the flow of blood and lymph through the liver and organs of the digestive, urinary, pulmonary and cardiovascular system.  The primary hepatic circulation is between the liver and kidneys, which are important organs of elimination.  The hepatic circulation also includes other vital organs such as the intestines (hepatic portal), pancreas, spleen, gallbladder, lungs, and heart.  When the circulation through these organs is increased or high in volume, it is said to be a "high hepatic circulation."
    High hepatic circulation is often associated with increased systemic toxicity.  In other words, the increased circulation is often a form of detoxification whereby the liver, kidneys and lungs throw off toxins.  High hepatic circulation can also be the body's response to infectious agents such as virus or bacteria.   A third pattern of high hepatic circulation may be produced by nerve reflexes which increase the internal (deep) circulation for no adaptive reason - simply a form of nervous system incoordination.
    Therapeutic options for high hepatic circulation include manual therapy (spinal manipulation and massage), hydrotherapy (such as colonic irrigation), the a basic cleansing diet (mostly fruits and vegetables), and mild electrotherapy (violet ray appliance).

Scale 21: Anemia
    Anemia is not itself a disease, rather it is a set of signs and symptoms which represent some other pathology.  Primary causes of anemia are genetic predisposition, infection, or poor assimilation of nutrients.  Thus, anemia can result from a variety of pathological patterns, including excessive blood loss, deficient production of red blood cells, excessive destruction of red blood cells.
    Some common therapies for persons with anemia include: blood building diet and medicines (including herbal tonics and nutritional supplements), mild electrotherapy (radial appliance and violet ray appliance), and internal cleansing (colonic irrigation, fume baths, and castor oil packs).
    Options for further assessment include:
  • Complete Blood Count (CBC)

Scale 22: After Effects of Intestinal Flu
    Flu virus can produce chronic, residual effects.  The essential pattern is one of infectious agents settling in the system, especially in the intestinal tract.  Colitis (now called irritable bowel syndrome or inflammatory bowel disease) is the result.   A tonic consisting of ginseng root, ginger root, stillingia, and lactated pepsin may be helpful for this pattern.  Abdominal packs and hydrotherapy may also be helpful.

Scale 23: Gallbladder Dysfunction
    Gallbladder dysfunction usually refers to the presence of gallstones or inflammation of the gallbladder.  Gallstones are pieces of solid material that form in the gallbladder.  Gallstones form when substances in the bile, primarily cholesterol and bile pigments, form hard, crystal-like particles. The formation of gallstones is called cholelithiasis.  Gallstones may be as small as "tiny specks" or as large as the gallbladder itself.  Edgar Cayce sometimes referred to the tiny specks as "sand," "gravel," or "sediment."  These tiny particles can sometimes be almost as disturbing as the larger forms.  Gallstones may make their way out of the gallbladder and into the cystic duct, the channel through which bile travels from the gallbladder to the small intestine. If stones become lodged in the cystic duct and block the flow of bile, they can cause cholecystitis, an inflammation of the gallbladder.  Blockage of the cystic duct is a common complication caused by gallstones.
    Poor dietary habits and underactive (torpid) liver are primary contributing factors in gall bladder dysfunction.  Therapeutic options for gallbladder dysfunction include: improved diet, internal cleansing (via colonic irrigation, laxatives, and castor oil packs), manual therapy (including osteopathic drainage of the gall duct), mild electrotherapy, and medicines to improve digestion and cleanse the gall bladder.  Surgery may be indicated for acute cases of cholecystitis involving high fever and inflammation.

Scale 24: Respiratory System Dysfunction
    The respiratory system includes the throat, larynx, and lungs.  Problems with the respiratory system range from the simple acute infections (such as cold) to chronic and life-threatening illnesses (such as asthma or pneumonia).  Respiratory system dysfunction may result from various causal factors, including: infection, injury, systemic toxicity, environmental toxicity, and psychological factors.  Respiratory problems can sometimes be linked to pressure on nerves associated with the thoracic vertebra.  These nerves provide impulse to the lungs.  Aberrant nerve impulses predispose the respiratory system to illness via other factors such as infection and allergic reactions.
    Systemic toxicity can also be a predisposing factor which makes the lungs more vulnerable to more specific causes.  The respiratory system is one of the four main channels of elimination (defecation, urination, respiration, and perspiration) by which waste are removed from the body.  One common pattern of dysfunction is for the liver (that great detoxifier of the body) to react to systemic toxicity by increasing the amounts of poisons to be eliminated through the breath.  This is sometimes referred to as the "upper hepatic circulation" which cycles between the liver, heart, and lungs.  Poor digestion and assimilation are sources of systemic toxicity which can be directed to the upper hepatic circulation for elimination.  If the lungs are weakened, illness such as asthma may result.  Thus, the hepatic system is a link between the respiratory and digestive systems.  Digestive problems (including food sensitivities) may be a contributing factor to respiratory dysfunction.
    Consistent with the above causal factors, therapeutic options for respiratory dysfunction focus on decreasing toxicity and improving nerve functioning.  Manual therapy with special attention to the thoracic vertebra is important.  A cleansing diet consisting primarily of fruits and vegetables is encouraged.  Inhalants to combat infectious forces may be helpful.  A medicine called Calcidin (calcium iodate) may also provide symptomatic relief for acute episodes of respiratory dysfunction such as asthma.
    Options for further assessment include:
  • Thorough manual therapy assessment of the spine, with particular attention to the thoracic vertebra.

Scale 25: Brain Dysfunction
    Brain dysfunction covers a broad range of pathology from relatively minor functional disorders (such as occasional lapse of memory or poor concentration) to the most severe neurological diseases (such as cerebral palsy or stroke).  However, even in the most serious conditions involving brain degeneration (such as dementia), the body as a whole should be taken into consideration.  In other words, brain dysfunction may linked to other physiological processes such as circulation of blood and lymph and elimination of wastes.  Thus, therapeutic options for brain dysfunction often include treatments to the peripheral nervous system and vital organs of the body to improve systemic functioning.
    The mental and spiritual aspects of healing are typically emphasized in such cases.  Suggestive therapeutics (a form of naturalistic hypnosis) may be helpful.  Prayer and spiritual application are also key elements in the healing of serious brain disease.  Other therapeutic options include: electrotherapy (such as the wet cell battery), manual therapy (massage and spinal manipulation), suggestion, and patience.
    Options for further assessment include:
  • neurological or psychoneurological testing for organic or functional disease.

Scale 26: Abnormal Heart Action
    The heart is a muscular pump divided into four chambers - two atria located on the top and two ventricles located on the bottom.  Normally each heartbeat starts in the right atrium. Here, a specialized group of cells called the sinus node, or natural pacemaker, sends an electrical signal. The signal spreads throughout the atria to the area between the atria called the atrioventricular (AV) node.  The AV node connects to a group of special pathways that conduct the signal to the ventricles below. As the signal travels through the heart, the heart contracts. First the atria contract, pumping blood into the ventricles. A fraction of a second later, the ventricles contract, sending blood throughout the body.  Usually the whole heart contracts between 60 and 100 times per minute. Each contraction equals one heartbeat.
    Systemic toxicity and aberrant nerve impulses from centers along spine to the heart are two common causal factors associated with abnormal heart action.  Therapeutically, consider spinal manipulations to relieve pressures on nerve centers which influence heart action.  Colonic irrigation may be helpful in decreasing systemic toxicity which may contribute to functional abnormality of the heart's action.  A basic diet (consisting primarily of fruits and vegetables) will assist with internal cleansing may assist in improving the heart's action.
    Options for further assessment include:
  • Electrocardiogram,
  • Echocardiograph,
  • Chest x-ray.

Scale 27: Pancreatic Exocrine (Digestive) Dysfunction
    The pancreas is a large gland behind the stomach and close to the duodenum (first section of the small intestine). The pancreas, as an exocrine gland, secretes powerful digestive enzymes that enter the small intestine through a duct. These enzymes help digest fats, proteins, and carbohydrates.  In its endocrine function, the pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones play an important part in metabolizing sugar.
    Pancreatic exocrine dysfunction may be helped by spinal manipulation focusing on the 8th and 9th thoracic centers that provide impulse to the pancreas.
    Options for further assessment include:
  • Comprehensive Digestive Stool Analysis for pancreatic exocrine insufficiency (Great Smokies Diagnostic Laboratory).

Scale 28: High Blood Sugar
    Hyperglycemia is the technical term for high blood sugar. High blood sugar happens when the body has insufficient insulin, or when the body can't use insulin properly.  To understand the role of insulin in high blood sugar, it is necessary to understand certain aspects of pancreas physiology.
    As an endocrine gland, the pancreas is intimately involved in regulating blood sugar levels. The pancreas functions as an endocrine gland by releasing the hormones insulin and glucagon directly into the bloodstream. These hormones play an important part in metabolizing sugar.  Most food is broken down by the digestive juices into a simple sugar called glucose. Glucose is the main source of fuel for the body.  After digestion, the glucose passes into the bloodstream where it is available for body cells to use for growth and energy. For the glucose to get into the cells, insulin must be present.  The pancreas is supposed to automatically produce the right amount of insulin to move the glucose from the blood into the cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the body cells do not respond to the insulin that is produced.  As a result, glucose builds up in the blood and overflows into the urine.
    A number of factors can cause or contribute to hyperglycemia. For example, if you have type I (insulin-dependent) diabetes, you may not have given yourself enough insulin. If you have type II (non-insulin-dependent) diabetes, your body may have enough insulin, but is not as effective as it should be.  The problem could be that you ate more than planned, or exercised less than planned.  The stress of an illness, such as a cold or flu, or an infection, can also contribute to high blood sugar.  Other stresses, such as family conflicts, work, social or financial problems, can trigger high blood sugar in persons predisposed to this imbalance.  Somatic dysfunction can contribute to abnormal pancreatic functioning.  Thus, spinal manipulation of the 5th through 9th thoracic centers may be helpful in cases involving high blood sugar.  Dietary supplementation with Jerusalem artichoke may also be helpful.  The Jerusalem artichoke is a source of inulin (not insulin), a chemical that is known to influence sugar metabolism in a manner similar to insulin.  A basic diet consisting primarily of fruits and vegetables may also be helpful.
    Options for further assessment include:
  • Blood Glucose Test,
  • Insulin Glucose Tolerance Test for blood/sugar imbalances.

Scale 29: Spleen Dysfunction
    The spleen is a small organ about the size of the fist, located on the left of the abdomen below the diaphragm.  The spleen consists of two distinct areas, the red pulp and the white pulp, the latter occupying the larger portion of the spleen. The white pulp acts like a large lymph node, being involved in immunological functions, such as the production of antibodies and the maturation of B- and T-lymphocytes, and Macrophages.  The red pulp's function is as a blood filter to remove waste, including damaged red blood cells and bacteria, through phagocytosis by macrophages and neutrophils. In addition, the red pulp is able to remove foreign bodies from within red blood cells without damaging the cell. As a consequence of its filtration function, the red pulp also acts as a reservoir for various other white blood cells and platelets.
    In addition to these generally recognized features of spleen functioning, Edgar Cayce also often linked splenic activity to organs of the digestive system (especially the pancreas and liver).  Thus, spleen dysfunction can lead to poor digestion and assimilation, particularly with regard to the duodenum (uppermost portion of the small intestine).
    The Cayce readings on the spleen also directly link spleen functioning to brain processes involving cognition and imagination.  These readings make the point that a person experiencing spleen problems may have mal-adaptive flights of imagination in which the person seems to be out of touch with reality (not necessarily psychotic, but more impractical or excessively fanciful).  Or, the individual may become highly suggestible to outside influences (such as suggestions from other people).  Spleen dysfunction may be linked to mood swings or emotional upsets.  The expression "venting one's spleen" comes to mind in this regard.  Repressed emotions may be a factor in spleen dysfunction.
    Therapeutic options include spinal manipulation to relieve pressures on nerve centers which influence spleen function.  The 4th - 6th thoracic nerve centers are particularly important for persons experiencing spleen dysfunction.  Abdominal castor oil packs covering the liver and spleen may be helpful to stimulate circulation through these organs of the hepatic system.  A basic diet (primarily fruits and vegetables) will assist with internal cleansing may assist in improving spleen functioning.  Avoidance or meat may be helpful.  The Jerusalem artichoke may also be helpful as a dietary supplement, particularly if the pancreas is also involved.
    Options for further assessment include:
  • Manual palpation of spleen,
  • CT scan.

Scale 30: Reproductive System Dysfunction
    Naturally, reproductive dysfunction covers a vast number and variety of problems depending upon the age and sex of the individual.  Reproductive problems are sometimes linked to somatic dysfunction such as pressure on the spinal nerves (10-12 thoracic, lumbar, sacral, and coccyx).  Thus spinal manipulation to the lower spine should be considered in all cases involving reproductive system dysfunction.
    Options for further assessment include:
  • Manual palpation of the lower spine and lower abdomen,
  • X-ray or other imaging techniques for structural problems.
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