The twelve in one table

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The twelve in one table

The whole of Part two on one page, with the rule beneath it

Table 2 — The twelve messengers, their number, their errand and their treatment Seated × 3

And before every one of them, (15) Medulla. And every one of them three times, ninety seconds apart.

These are the tables the student will come back to for years. They are set out region by region, exactly as they are given, and they are the reference half of this article: Part two tells you what a nerve is; these tables tell you every complaint that has been assigned to it. Do not read them straight through the first time. Read the heading of each, note what kind of complaint it collects, and come back when a patient puts one of those complaints in front of you.

Three rules govern every row in every one of them, and they are not repeated inside the tables: (Figure 37.8)

(15) Medulla first, before any cranial-nerve Medulla treatment.

Three treatments, at an interval of one and a half minutes. × 3

Where a row is starred, it is (10) Left Medulla only. Left ▲ Take care

The nose and the breathing

Two rungs of one complaint — the ninth nerve and the eleventh

Table 3 — Problems of the nose and breathing, and their Medulla treatments

All the above treatments are to be given three times at an interval of one and a half minutes — that is, (5) Medulla × 3 treatments, (7) Medulla × 3 treatments, and so on. × 3

Read the fifth and sixth rows together and you have a small clinical staircase. Breathlessness because oxygen is short is a chemical problem and the ninth nerve carries the sensor that detects it. Breathlessness so extreme that the neck muscles are recruited is a mechanical problem, and the eleventh nerve owns those muscles. Two different rungs of the same complaint, two different numbers.

The eyes

Six muscles, three nerves, and the finding that chooses the number

The eye is moved by six small muscles, and three different cranial nerves share them. Which is why three different Medulla numbers appear in the next table, and why the number you need is chosen not by the word squint but by which way the eye is actually pointing. Watch the patient's eyes before you decide.

Table 4 — The six muscles of the eye and their Medulla treatments

Table 5 — Other problems of the eyes and their Medulla treatments

Three rows of that table say double vision and each gives a different number. That is not a contradiction; it is a diagnostic instrument. Look at where the eye is sitting. Dilated pupil — (3). Crooked up and outward — (6). Down and outward — (4). The complaint the patient gives you is the same word every time; the finding is different every time, and the finding chooses.

The ear

Five numbers for one organ, and the row that is the safety net

Table 6 — Ear problems and their Medulla treatments

Five different numbers appear in a table about one organ. That is not untidiness; it is the ear's actual wiring. The outside of the ear is felt by the fifth and by the tenth. The middle ear belongs to the seventh and the ninth. The inner ear — hearing and balance, the two things people mean when they say "my ear" — is the eighth. And the row that says for all problems of the ear, (8) Medulla is the safety net beneath the rest: when you cannot tell which part of the ear is at fault, that is the row you use.

The brain and the forehead

The longest reference table: from migraine to the RAS in coma

Table 7 — Brain and forehead problems and their Medulla treatments

Three notes are printed beneath that table and belong with it:

For the maintenance of posture and balance, impulses of cranial nerve #2 from the eyes, along with impulses from the semicircular canals of the ears carried by cranial nerve #8, are necessary. That is why two numbers stand in the balance rows, and why you give both.

Control of equilibrium is a combined function of portions of the cerebellum and the reticular substance of the medulla, pons and mesencephalon.

And the discovery already met in Part two: (2) Medulla × 6 treatments stimulates the retinal neurons' GABA, acetylcholine, dopamine and several other neurotransmitters.

The neck and the shoulders

Seven ordinary complaints, sorted into two heaps by the polarity rule

This is the short table, and it is the most instructive one in the article, because it is the polarity rule written out as seven ordinary shoulder complaints.

Table 8 — Neck and shoulder problems, and the side that is given Left Right

Sort those seven rows into two heaps and the rule falls out of them.

The face and the mouth

Eight doors into one list: what the face feels, and what the face does

The longest table in the formulary runs across four pages. It is set out here in eight groups, so that a therapist can find a row in the time a patient takes to describe a complaint. Nothing has been left out and nothing has been combined; the groups are only doors into one list.

Table 9 — Swallowing Seated × 3

Two instructions decide between the two commonest rows of that group, and they are worth learning as a pair, because they are a diagnosis made from one extra question:

Table 11 — The face

Notice what that table does with one face. Everything that the face feels is the fifth. Everything the face does is the seventh. Sensation and movement, two nerves, side by side over the same cheek. When a patient's face droops but she can still feel your finger on it, you are looking at the seventh; when she feels nothing but the face moves normally, you are looking at the fifth.

Table 12 — The jaw, the teeth and the gums

Table 13 — The tongue, the mouth and taste

Table 14 — Saliva

Ptyalin is found in greater quantity in the saliva of the parotid glands. And it is the 9th cranial nerve that stimulates the parotid glands, not the seventh. That sentence is printed as a footnote, and it is a correction — the kind of small, exact self-correction that tells you somebody checked.

Table 15 — The pharynx and the tonsils

Table 16 — The blood pressure and the carotid sensors

Two marks travel with the face-and-mouth list and must be carried wherever a row from it is copied onto a card:

The coughs

Nine kinds of cough identified across a mat, with no instrument at all

For almost every kind of cough, (5) Medulla has proved useful. Then nine kinds are distinguished, and the descriptions are worth learning because they are how a cough is identified across a mat without any instrument at all.

Table 17 — The coughs, and their treatment

Perhaps for such a cough (10) Medulla will also be beneficial, because it looks after the laryngeal nerve.

That perhaps is not an editor's softening. It is written as a perhaps, and it stays one. So does the line that closes the whole cough section, printed by itself under a rule: in the detailed knowledge of the functions of (6) Medulla and (10) Medulla, some further discovery remains to be made.

This is the most unusual page in the whole formulary, and a student should be told what it is before reading a line of it. Every row below prefixed with a question mark is not an instruction. It is a hypothesis — a piece of reasoning forward from the anatomy just set out, saying this ought to follow; somebody should look.

Table 18 — Proposals for further research, exactly as they stand

And then the line that governs the table:

The last observations

Hiccups twice over, incontinence, and a thought about reading glasses

Eight further notes close the formulary. Four of them have already been given in their places above — the Pondicherry child with cerebral palsy, the Chennai throat, (6) Medulla with Raman in infertility, and Shri Pankit Shah's hiccups on the 1st of December 2006. Four remain.

For hiccups, benefit may also be had from (15) Left Medulla (6) Lt. Swt × 3 treatments. Two different answers to one complaint, both written down: the ninth nerve, which owns the epiglottis; and the polarity pair, which opens what is in spasm. Neither cancels the other. A therapist meeting a patient with intractable hiccups has two things to try and an order to try them in.

No control over urine. As age increases, it happens to some people that with a sneeze, or with laughing hard, urine comes away by itself. This is found especially in middle-aged women, because by that age the muscles below their navel have become loose. The material puts it beside a second thing, which is the observation that makes the treatment obvious: this problem is just like the passing of urine in children while lying in bed. It is called incontinence, and it happens in women too.

The whole index in reverse — number by number

Sorted by the count, so you can look up what a treatment covers

Everything above sorted the other way round: by the Medulla number, so that you can look up what a treatment covers before you give it. This is the table to photocopy.

Table 19 — Each Medulla number and the territory the index gives it