Reading the Reports

The question asked of every report, every time

Does this report change what I am going to do — or does it not?

Two honest answers, both said out loud and written on the card.

1. It changed the plan — and you say what changed in the same breath: a point withheld, a point substituted, the hand used instead of the foot, the patient sent to a doctor before the mat.

2. It changed nothing — said plainly, without apology, and written in those words with the date of the report.

There is no third answer. A report you have not decided about is a report you have not read. One that will matter later changes nothing today: write repeat due in three months.

It does not ask what the disease is called — this therapy does not treat a name — but whether your hands will do something different at ten o'clock because of a piece of paper. Usually they will not, and saying so is the mark of a therapist (The Hand That Heals). (Figure 12.1)

Where this therapy stands towards modern investigation

Neurotherapy has its own distinctive methods of disease-identification and diagnosis; and along with that, it keeps in coordination with the knowledge obtained from modern investigation — such as the testing of blood, or a picture taken by X-ray, and so on.

Its own methods — the pain points, the grading, the bowel, the tongue, the undigested food, the history — are the diagnosis, and are sufficient for it. Coordination is not obedience and not competition, and it runs both ways.

Five things every report is, and one thing no report is

1. It is a picture of one moment.

Some values swing through a single day — sugar most of all, and any value taken during fever, infection or fright.

2. It answers only the question it was ordered for. "They checked everything" means "they took a lot of blood".

3. Its range is a range of the healthy, not a target. Neither inside nor outside means cured or doomed.

4. A value inside the normal range is a normal value. Not "borderline"; not "low normal, which is really low". If a therapist may move the line where the laboratory drew it, the line means nothing — and neither does anything else that therapist says.

5. It is read to inform a treatment — never to make a diagnosis, never to award a name, never to contradict the person who ordered it.

And no report is an instruction to your hands. The instruction comes from what you find; the report tells you which findings to be careful with.

Investigation is expensive too — one blood panel can be a week of somebody's wages — and a report is never ordered to show a patient that you are thorough.

What a thyroid report is saying

The thyroid sets the speed of the body — the master craftsman, without whose order the other workmen do not get on. All the functions of the digestive tract depend on the thyroid gland.

When the thyroid works less, T₃ and T₄ come out in less than the right quantity; after years of it the quantity in the blood is far below normal and it is called hypothyroidism, and one chief indicator is that the quantity of TSH also rises — because TSH is the order sent to the thyroid from the pituitary. A high TSH is the sound of the body shouting at a gland that is not answering.

And the part that belongs to this therapy: the thyroid gland's basic chemical is tyrosine, an amino acid, which is made in the intestine during digestion. If digestion is not right it will not be made; so T₃ and T₄ will not be made either, and TSH will rise in the blood. If digestion were right, thyroid function would remain right, and we would not fall ill.

What a low haemoglobin changes

The pace you expect, said at the start rather than explained in week four. Where the work goes: the red cell is made on an order — erythropoietin — from the kidney, so in chronic diseases Mu° is given to make erythropoietin, which will stimulate the bone marrow to make red blood cells, and the liver point is given in kidney failure and other chronic diseases to stimulate erythropoietin so the red cell count does not fall too low. And what is asked about: the periods, the stool, the gums, the piles — blood from anywhere, even once, even a little, goes to a doctor this week ▲ Take care , as does a very low figure with breathlessness at rest (When the Hand Must Stop).

The two directions of calcium

The quantity of calcium in the plasma should ordinarily be from 9.00 to 11.00 mg/dl.

Below 9 mg/dl: the muscles cannot work properly — and the glands cannot send out their secretion unless the muscles beside them work, so a low calcium slows glands with nothing wrong with them. If there is an extreme deficiency, even the heart can fail. To prevent it, PTH — parathormone, from the parathyroid gland — tells the osteoclasts to take calcium out of the bones and put it into the plasma.

Above 11 mg/dl: from the thyroid gland calcitonin comes out, which tells the osteoblasts to put that excess calcium into the bones, and the parathyroid stops the intestine and the osteoclasts from taking up any more, and lets calcium go out through the urine.

Calcium is absorbed by way of the hormone 1,25 DCC, and for that the presence of PTH is essential (Correcting the Two Kingdoms); if the kidneys become spoiled, 1,25 DCC will not be made, and those patients can get osteoporosis, in which the bones become so hollow that they cannot bear even a little pressure.

If there is osteoporosis, there will be deficiency of calcium in the blood too — because calcium is not being absorbed. However many calcium tablets one eats, that deficiency will not be made up: if the intestine is not working properly, calcium will not be absorbed and will not reach the blood. Correct the intestine and even a disease like osteoporosis can be cured. In the other direction, if calcium in the bones becomes excessive, we stimulate the parathyroid gland, which draws calcium out of the bones into the blood; along with it we give Heparin, which increases blood circulation, and by that increase the calcium raised in the blood is properly broken down and passes out of the body — by which relief comes in such diseases as ankylosing spondylitis or kidney stone. (Figure 12.2)

Why a low B₁₂ is a report about the stomach

For the absorption of vitamin B₁₂ it is necessary that intrinsic factor be made in the stomach; only then, on reaching the ileum, will vitamin B₁₂ be stored in the liver. Otherwise the enzymes of the stomach and the intestine will digest it — that is, finish it off.

The stock of vitamin B₁₂ in the liver lasts five to six years, so if someone has symptoms of vitamin B₁₂ deficiency, it means that for several years it has not been getting stored in his body — and for intrinsic factor to be made properly the blood circulation in the stomach must be proper, for which we give Gas Only.

A man who eats well and shows a low B₁₂ has not been eating badly for five years. His stomach has not been taking it in. These are reports about absorption, not intake.

The deficiency has a face you see before any report: fatigue; blackness between the joints of the fingers; numbness of the feet on sitting a long time; anaemia; mouth ulcers; weakness of the nerves, the ear or the eye. Folic acid has its own family — megaloblastic anaemia, the neural tube defects, cleft lip and cleft palate, and pain at the folic acid point in a hole in the heart: ASD, VSD, PDA — with the rule that if in pregnancy the mother has a deficiency of folic acid, these defects can occur in the child (Vitamin and Gene Formulas).

A small child cannot answer; the mother can

Small children, if their pain points are checked, will not be able to say whether it hurts or not — but their mother can speak about her own pain points, can she not? And during pregnancy, whichever vitamin the mother is deficient in, the child too will certainly have a deficiency of those same things.

So in children's diseases, before deciding the treatment, always check the mother's B₁₂ and folic acid pain points, and if during pregnancy the mother had a deficiency of vitamin B₁₂ or folic acid, treat the child for that same thing — and only then will there be great progress in the child's treatment.

What creatinine and urea are

They are waste, made all day by an ordinary working body and removed by the kidneys, which filter the blood as a sieve holds back what should not pass. When the flow of blood inside the kidneys is less than is needed, the kidneys will not be able to filter the blood properly, and there will be an accumulation in the blood of unwanted things like urea and creatinine, from which harm will come to the body.

A raised creatinine is not a disease of creatinine. It is a report that the sieve is not clearing — and the body's own answer to it, which helps to maintain the GFR, the flow of blood inside the kidneys, is taught in Water and Salt, "Water and Salt".

The coma case — a value that removed one station from a formula

A patient lay unconscious, and the treatment given was (8) Pan · (1) Gal · (2) Acid · (4) Lt. Ch. Only — in which Gal was given and Mu° was not given, because both his kidneys were spoiled, on account of which his creatinine was greatly raised. Given twice, the blood's pH changed from 7.32 to 7.4 and he came out of the coma. (Ordinarily a patient goes into coma at pH 7.1, and on its becoming pH 6.8 death occurs.)

The lesson is not the pH. It is the clause in the middle: Mu° was not given, because the creatinine was greatly raised — and the formula still worked.

The incidental finding on a spine X-ray in a person of sixty

A man of sixty brings a film of his lower back. The report names narrowing between two bones, roughening at the edges, a little bone grown where there was none. Every word is accurate. Almost none of it is news — that is what a sixty-year-old spine looks like, in people with pain and in people with none.

A finding present in bodies with the complaint and equally present in bodies without it does not explain the complaint. So: changed nothing — unless the film names a level your fingers had already found, which is two independent instruments agreeing (one instrument round the room twice is worth nothing — The History That Cannot Mislead You); or unless it names a thing on the caution lists, since spur and bamboo spine have come from increased calcium, and points that raise calcium into bone are therefore withheld. ▲ Take care

The same holds for an old report of a complaint that has gone, a report ordered for somebody else's question, and a value a hair outside the range in a person who feels well.

One exception teaches the rule. A knee hot to the hand, red and swollen, but with no pain at Mu°, whose film may read "OA of the knee": within one or two treatments both the heat and the swelling are reduced by G. Heparin — but this treatment is not to be given to those patients who have heart disease ▲ Take care . What chose it was not the X-ray.

A scan is read the same way, and occasionally names a thing you cannot feel. A prolapse of the uterus seen on sonography decides a treatment after which (6) WD is necessary — otherwise that woman will have still more trouble ▲ Take care (Treating Women); a blockage in the Ampoulla of Vater, which congeals the bile, can be detected by having an ultrasound done (Setting the Stomach); a hole in the heart, with its size in millimetres, gives something measurable to watch — in one child, after five to six months the sonography showed the hole reduced from 9 mm to 4 mm (Vitamin and Gene Formulas). And keep the old films: in a spina bifida patient treated for months, in the X-ray something faint began to appear at the place of L5–S1.

Never tell a patient that a normal report is secretly abnormal

A normal report is normal.

Not "technically normal", not "they say normal but I can see it is not".

It is untrue — the value was inside the range, and you have no instrument that measures it better. It is unkind — you are taking away the one piece of good news the patient has and replacing it with an anxiety only you can relieve.

And it is unnecessary, which is what students miss: your finding does not need the report to be wrong, because you are not reading the same thing. The laboratory asked: is this value outside the range found in healthy people? You asked: which organ is short of blood this morning? Two questions, two instruments, two answers, and no contradiction between them at all.

We call those patients RA patients in whose blood test report these words are written — RA Antigen Positive or Rheumatoid Factor – Positive. (The factor is also positive in hepatitis, syphilis, liver cirrhosis, SLE, scleroderma and in acute bacterial or viral infection — so positive does not by itself name the disease.) After seeing the report we write on our card the date of the report and, in front of it, RA positive — or ANA positive, where that is what it says.

"RA positive" and "RA hai" — a rule about what may be written

Remember that on that patient's card, RA positive is not to be written. ▲ Take care

Whether there is a report or not, the treatment of both is one and the same.

That convention holds the ethic of the article: the therapist has a real finding, records it, treats — and does not write down a laboratory result the laboratory did not give. It is the model for what you say: not "your report is wrong", but "Your report is negative, and that is true and it is good news. What I found is a tenderness in one joint of both hands, which tells me which treatment will help you. It does not argue with your blood test."

The same shape covers the back. There are patients with pain on both sides of the waist in whose X-ray report of the back it is written NAD — No abnormality detected. They are not imagining the pain, the film is not lying, and the treatment for them — the Pure Folic Black formula — was arrived at from the pain points, not from the picture.