SOTO-USA POSITION STATEMENT

Chiropractic Manipulative Reflex Technique (CMRT).

Charles L. Blum, DC, CSCP1

Originally called “Bloodless Surgery,” Chiropractic DeJarnette continued to teach and practice bloodless
manipulative reflex technique (CMRT) surgery through the 1940s and began its
encompasses the relationship between modification to use more reflex applications and
somatovisceral and viscerosomatic reflexes and referred pain indicators as a method of affecting
therefore between the somatic and autonomic organ symtomatology. In the 1950s he furthered his
nervous systems. R. J. Last in his book "Anatomy: investigations into reflexes and their affect on the
Regional and Applied" points out: viscera and related vertebra. By the early 1960s
DeJarnette modified the nature of sacro occipital
"There is only one nervous system. It technique’s method of bloodless surgery from its
supplies the body wall and limbs 1939 procedures, which might take 2-4 hours of
(somatic) and viscera (autonomic). preparation and treatment, to procedures that could
Its plan is simple. It consists of be practiced in a span of 15 minutes.5,6 For multiple
afferent (sensory) and efferent reasons he decided to change the name of his
(motor) pathways, with association method of affecting referred pain pathways,
and commissural pathways to connect viscerosomatic / somatovisceral reflexes, and direct
and coordinate the two. There is no organ manipulation to chiropractic manipulative
more than this, in spite of the many reflex technique (CMRT).
pages devoted to its study." 1
CMRT is used as a method of treating the spine or
Bloodless Surgery was historically used in vertebral visceral syndromes associated with
chiropractic as a term describing soft tissue viscerosomatic or somatovisceral reflexes,7-9
treatment affecting an organ and its related vertebral dysafferentation at the spinal joint complex,10 and
relationship or viscerosomatic and somatovisceral visceral mimicry type somatic relationships 11.
reflexes. 2,3 Bloodless surgery was also used to Treatment involves location and analysis of an
describe methods of manipulating joints and soft affected vertebra in a reflex arc by way of occipital
tissue without related to the viscera. 4 fiber muscular palpation, similar to trigger point
analysis or Dvorak and Dvorak's spondylogenic
James F. McGinnis was a chiropractor that reflex syndromes 12. Once specific vertebra reflex
relocated to California in the early 1920s, where he arcs are located, corroborated with referred pain
earned a naturopathic doctorate. In the 1930s he pathways, and clinical symtomatology, then the
became one of the best known of several specific vertebra to be treated is isolated by pain
chiropractic bloodless surgeons and traveled around provocation, muscle tension, and vasomotor
the nation to teach his methods.2 Around this time symtomatology. Often times if a vertebral
Major Bertrand DeJarnette, DO, DC, developer of dysfunction is chronic or unresponsive to
sacro occipital technique, was also practicing and chiropractic spinal manipulation then a
teaching extensive methods of bloodless surgery. viscerosomatic or somatovisceral component is
DeJarnette published a comprehensive book on the evaluated.13 Treatment of the viscerosomatic or
topic entitled, “Technic and Practice of Bloodless somatovisceral component is performed using soft
Surgery” in 1939, which remains the most complete tissue manipulation, myofascial release techniques
discussion on the topic to date.3 and reflex balancing methods.6

Research Director – SOTO-USA

1752 Ocean Park Boulevard, Santa Monica, CA 90405

Chiropractic Manipulative Reflex Technique © Sacro Occipital Technique Organization- USA • 2008
 Bloodless surgery, was used and taught by SOT 5. DeJarnette MB, Chiropractic
chiropractors since 1939 and was practiced Manipulative Reflex Technique, Privately
extensively in the 1930s and 40s. Since 1960 it has Published, Nebraska City, NB, 1964.
been called CMRT, and focuses predominately on
the vertebra and viscerosomatic/somatovisceral 6. Blum CL, Monk R, Chiropractic
reflex relationships. CMRT is listed as a Manipulative Reflex Technique, Sacro
chiropractic technique throughout the chiropractic Occipital Technique Organization – USA,
literature.14-8 SOT clinicians using these methods of Winston-Salem, NC, 2004.
CMRT for years, are publishing their methods in
the literature, helping to develop an evidence base 7. Budgell BS., Reflex effects of subluxation:
for this method of care.19-27 the autonomic nervous system. J
Manipulative Physiol Ther. 2000
CMRT, just like all of chiropractic and manual Feb;23(2):104-6
healthcare warrants further clinical study.
Until chiropractic has the sufficient funds and tools 8. Budgell BS, Spinal Manipulative Therapy
to perform all the necessary research to help and Visceral Disorder. Chiropractic
substantiate everything we do in our clinical Journal of Australia. 1999 Dec; 29(4):
practice we must be careful not to throw out or 123-8
impugn aspects of chiropractic that support its
position as being “complementary or alternative.” 9. Sato A The reflex effects of spinal somatic
When only 1-2% of the research is in on most nerve stimulation on visceral function.
innovative forms of manual medicine, even those J Manipulative Physiol Ther. 1992
practices for decades, we must be careful not to Jan;15(1):57-61.
throw out the baby with the bathwater as we attempt
to strictly define what is “evidenced based” and 10. Seaman DR, Winterstein JF,
what is not. Dysafferentation: A Novel Term to
Describe the Neuropathophysiological
Effects of Joint Complex Dysfunction. A
REFERENCES Look at Likely Mechanisms of Symptom
Generation. Journal of Manipulative and
1. Last RJ, Anatomy: Regional and Applied, Physiological Therapeutics. 1998 May;
Sixth Edition, Churchill Livingstone: New 21(4): 267-80
York, 1978:20.
11. Szlazak M, Seaman DR, Nansel D, Somatic
2. Keating JC James F. McGinnis, D.C., N.D., Dysfunction and the Phenomenon of
C.P. (1873-1947): Spinographer, Visceral Disease Simulation: A Probable
Educator, Marketer and Bloodless Explanation for the Apparent
Surgeon Chiropractic History , 1998; 18(2): Effectiveness of Somatic Therapy in
63-79. Patients Presumed to be Suffering from
True Visceral Disease, J Manip Physiol
3. DeJarnette MB, Technique and practice of Therp. 1997 Mar;20(3) : 218-24
bloodless surgery, Privately Published,
Nebraska City, NB, 1939. 12. Dvorak J, Dvorak V, Manual Medicine:
Diagnostics, 3rd Edition, (Translated
4. Taylor H, Sir Herbert Barker: Bone- from German) George Theime Verlag,
Setter and Early Advocate of "Bloodless Stuttgart, Germany, 1988: 326-33
Surgery." Journal of the American
Chiropractic Association. 1995 Jul; 32(7):
27-32.

Chiropractic Manipulative Reflex Technique © Sacro Occipital Technique Organization- USA • 2008 Page 2
 13. Heese N, Viscerosomatic Pre- and Post- 23. Blum CL, Normalization of Blood and
Ganglionic Technique, Am Chiro, 1988 Urine Measures Following Reduction of
Mar :16-22. Vertebral Subluxations in a Patient
Diagnosed with Early Onset Diabetes
14. Peterson DH, Bergman TF, Chiropractic Mellitus: A Case Study. Journal of
Technique: Principles and Procedures. Vertebral Subluxation Research, Dec. 7,
(Second Edition) Mosby: St. Louis, MO, 2006:1-6.
2002: 493, 497
24. Blum CL, Resolution of gallbladder
15. Gleberzon BJ, Chiropractic 'name visceral or mimicry pain, subsequent to
techniques': a review of the literature. surgical intervention, International
European Journal of Chiropractic. 2002; Research and Philosophy Symposium.
49: 242-3. Sherman College of Chiropractic,
Spartanburg, SC, Oct 9-19, 2004: 10-11.
16. Gleberzon BJ, Chiropractic "Name
Techniques": A Review of the Literature 25. Holbeck M, Tomson A, Blum, CL, Monk R,
J Can Chiropr Assoc. 2000;45(2): 86-99. The Effects of the Sacro-Occipital
Technique on the Quality of Life in Lung
17. Bergmann TF, Various Forms of Cancer Patients Undergoing
Chiropractic Technique ,Chiropractic Chemotherapy and Radiation Treatment,
Technique. May 1993; 5(2):53-5. Proceedings of the Integration of
Complementary and Alternative Medicine
18. Cooperstein R, Gleberzon BJ, Technique into Clinical Practice: Evidence-Based
Systems in Chiropractic . Churchill Medicine, John Hopkins University:
Livingstone: New York, NY April 2004: Baltimore, MD, June 8-10, 2005.
209, 211, 214, 217.
26. Blum CL, Globe G, Angina visceral
19. Courtis G, Young M, Chiropractic mimicry syndrome: A proposed
management of idiopathic secondary collaborative integrative treatment model.
amenorrhœa: a review of two cases. Journal of Chiropractic Education, Spr
British Journal of Chiropractic. Apr 1998; 2006;20(1): 51-2.
2(1):12-4.
27. Blum CL, Visceral Mimicry Syndrome
20. Cook K, Rasmussen S, " Visceral and Cholecystectomy: A Chiropractic
Manipulation and the Treatment of Case Study, FCER’s Conference on
Uterine Fibroids: A Case Report ", ACA Chiropractic Research, Sep 15-16, 2006 -
Journal of Chiropracti.c Dec 1992; 29(12): Chicago, Illinois.
39-41.

21. Blum, CL, Role of Chiropractic and Sacro

Occipital Technique in Asthma.
Chiropractic Technique, Nov 1999; 10(4):
174-180.

22. Blum CL, The resolution of chronic colitis

with chiropractic care leading to
increased fertility.
Journal of Vertebral
Subluxation Research, Aug 2003:1-5.

Chiropractic Manipulative Reflex Technique © Sacro Occipital Technique Organization- USA • 2008 Page 3