THE ROLE OF FEVER IN AN INFECTION Those that have a strong philosophical understanding of chiropractic do not need to have it proved scientifically but it always makes us feel good when the scientific community discovers something we have been saying for years. Some time ago an article appeared in the American Journal of Physiology concerning research into fevers. The experiments done by Harry A. Bernheim and Matthew J. Kluger of the Department of Physiology, University of Michigan Medical School in Ann Arbor reveal some interesting facts concerning the body's response to infection. Drs. Bernheim and Kluger performed the experimentation on the lizard Dipsosaurus dorsalis. For the uninitiated, that is a desert iguana, those ugly looking little creatures that are used for Japanese science-fiction movies. The doctors simulated the environment of the iguana. Heat lamps were strategically placed so that during the days the temperature would range from 30 to 50 C. At night ambient temperature was kept constant at 12 + or - 1 degrees C. The humidity and light intensity as well as the temperature mimicked a March day in the southwestern desert of the United States. Two experiments were done: one with dead bacteria and one with live bacteria. In both experiments a gram negative organism, Aeromonas hydrophila, was used. The iguana has no mechanism within his body which automatically raises his body's temperature in response to infection as we humans do. They must rely upon their ability to navigate to a warmer environment to raise their body temperature. In both experiments the lizards sought areas under the heat lamps that were the warmest in an effort to raise their body temperature. Those lizards infected with live bacteria developed a fever which averaged 2.3 + or - .5 degrees above their average daytime temperature. The fever began 4-5 hours after inoculation, reached its peak the day after the lizard was infected, and lasted 5 days. By the sixth day the lizards' body temperatures had returned to normal. Of course there were control animals which were also kept in the experimental chamber. These animals did not seek the warmest areas of the chamber and hence a fever was not developed. Of the 13 animals injected with live bacteria, one did not develop a fever and eventually died on the 3rd day of the experiment. Another lizard that did develop a fever died on the 7th day. Both of these can be attributed to limitations of matter. In the first lizard, its innate fever regulating mechanism was not functioning properly. In the second, the one with the fever, it appears that despite its ability to elevate the temperature it still was not strong enough to fight off the infection. Nevertheless, the survival rate of lizards developing a fever was 92% [11 of 12]. A further experiment was done in which the lizards inoculated with live bacteria were also injected with sodium salicylate, an antipyretic. Of the 12 lizards injected, five developed a fever within 48 hours despite the sodium salicylate and all of those survived. The seven lizards that did not develop a fever died. As a control, eight lizards were injected with the sodium salicylate alone and only one died indicating that the dosage was not toxic. They could not explain why five of the lizards infected with the drug still became febrile. Obviously the innate intelligence of the lizard's body had the ability to create a fever despite the educated efforts to reduce it. But then we see that happen constantly in children, a fever develops despite dosages of aspirin. Dr. Kluger published some conclusions from his experimentation in a Review of the Hungarian Academy of Science, entitled [are you ready for this?]: Survival Value of Fever! How's that for a chiropractic term. In this pamphlet Dr. Kluger points out that the role of fever in disease has fallen into two general approaches: 1. The effect of temperature on host defense mechanisms. Among the noted occurrences due to elevated temperature are: a. considerable evidence of mobility of some types of leukocytes. b. some evidence of phagocytic activity of leukocytes at febrile temperatures. c. increased bactericidal activity. Not only do they engulf pathogenic microorganisms better but they also kill more effectively. d. lymphocytes undergo proliferation and transformation and as a result they are capable of participating in the immune response. e. increased Leukocyte Inhibition Factor [LIF] which could account for decreased dissemination of bacteria. f. Liposome Stability - intracellular particles containing large amounts of hydrolytic enzymes are thought to be released at elevated temperature. g. some evidence that antibody production is enhanced at higher temperatures. h. evidence, although not conclusive, that elevated temperature increases the production of interferon. 2. Direct effect of temperature on viability of microorganisms. There is indication that elevation of body temperature may result in the direct killing or the attenuation of pathogenic microorganisms. While it is nice to see the scientific community beginning to recognize chiropractic philosophical tenets, it should be understood that the idea of fever as a beneficial host mechanism did not originate with the chiropractic profession. Ancient physicians such as Rufus of Ephesus actually advocated a form of fever therapy. This article is not meant to be a definitive work on the subject but to merely acquaint you with the fact that scientific research is continually reinforcing the chiropractic philosophy. The research at the University of Michigan also has involved similar experiments with rabbits and birds with equally interesting results. Anyone interested in an in-depth report of this work should write the Department of Physiology. Anyone interested in a more in-depth paper on the chiropractic philosophical basis for the fever regulating mechanism should contact the Foundation for the Advancement of Chiropractic Education.
TECHNIQUES, TECHNIQUES, TECHNIQUES
It is amazing the number of technique packages and seminars that are around today. Everybody and his brother within this profession seems to be selling a technique that is guaranteed to give you better results or improve your practice and increase your income. There is nothing inherently wrong with many different techniques, in fact, it is healthy for the profession. But the fact that there is such a great market out there, that is, great numbers of young and not so young practitioners interested in different techniques, indicates an under lying problem. It appears that a good percentage of chiropractic college graduates are not satisfied with the techniques that they were taught in chiropractic school. That can only lead to two conclusions. Either the techniques taught in chiropractic colleges are inferior or the graduates do not feel proficient and therefore confident in utilizing them. I hardly feel that we can indict the instructors in chiropractic colleges by accusing them of teaching archaic, outmoded techniques. For the most part they are competent teachers utilizing modern techniques. In fact they themselves are teaching these techniques at seminars to graduates of other colleges! The latter conclusion remains, that the graduate is not confident in the technique he has been taught as a student. I believe a good deal of the problem is that the student has not really learned the technique he was taught in college. He has taken the course and gotten a passing grade but really not learned the technique. You do not learn a technique only by knowing the position, the contact, the line of drive, etc. You learn by one means only repetition. Any art form is learned by repetition. In fact any thing is best learned by repetition. Contrary to the old saying, experience is not the best teacher, repetition is. Doing something hour after hour, day after day, week after week is the only way you become proficient. Van Cliburn became a great pianist and Willie Mays a great ballplayer because of one thing practice, practice, practice. They had natural abilities and good teachers but there are probably thousands of men and women with the same natural ability who have not developed that ability and become skilled. To be a skilled adjustor, adjusting must become as normal and natural an activity as breathing. The hands of a competent chiropractor should be able to accomplish their objective of locating, analyzing, and correcting subluxations as easily as Van Cliburn's fingers move over the keys of a Steinway. That does not occur by having five hours of technique class per week and adjusting five patients a week in clinical experience. It occurs by spending five hours a day in class learning and practicing the technique and seeing fifty patients a day in clinical experience. Adjusting five patients per week in a clinical experience constitutes at best 30 minutes a week of practice. How good would Van Cliburn have been had he practiced the piano 30 minutes a week? Obviously, if this is the problem then the solution can only come from an evaluation and subsequent change in the curriculum of chiropractic colleges in order to allow for the increased amount of time needed to turn out competent chiropractors with the necessary technical skills to correct vertebral subluxations.
LET'S GET TECHNICAL
Everyone involved in a profession has a technical vocabulary. It is one of the distinctives of a profession. Anyone with less than three years of Latin has felt the frustration of dealing with the legal profession. Even the automobile mechanic has a technical vocabulary. You have to admire the medical profession for over the years it has refused to compromise its vocabulary. People complain that the medical doctors speak four-syllable words that they do not understand, but the doctors keep right on doing it. People have gotten so tired of being in the dark that they have begun to learn those terms. As a result, people are becoming more sophisticated today when it comes to technical terms and that is good! Now it seems that we chiropractors are trying to take an intelligent public in the other direction. We either talk to them in one and two syllable words and insult their intelligence or we try to conform chiropractic to fit the medical vocabulary with which they are already acquainted. It is time we wiped the slate clean and began to teach people our technical terms. Chiropractic is a simple principle, easily understood. There is no reason why any patient cannot understand our technical vocabulary. How many patients have even heard, let alone know the meaning of, the following chiropractic terms: adaptation, analysis, coordination, dis-ease, educated brain, innate intelligence, mental impulse, subluxation, survival value, or universal intelligence. What will be the results of beginning to use a technical vocabulary? 1. It will give the patient more respect for you as a professional and you are a professional. Talk like one. 2. It will make you a better chiropractor. Human beings tend to rise to the level of their thinking. You can only think within the confines of your vocabulary. Limited vocabulary - limited thinking; more highly technical vocabulary - more highly technical thinking - a more highly technical chiropractor.
3. It will make the patient a better and more knowledgeable patient. After all, isn't that what chiropractic is all about, getting people to understand the Big Idea?
