Prognosis is the determining, in advance of the fact, of the probable course, duration, or outcome of a disease. A Chiropractic prognosis is a prediction as to the changes which will take place in a case during and after Chiropractic adjustments.

General Prognosis is an opinion expressed of a disease without reference to any particular case. It is based upon the experience of the profession and the average result obtained with the disease. It furnishes only a basis for consideration of the special prognosis of an individual case. This latter must be based upon the general prognosis of the disease and upon study of every modifying factor present in the case, as general vitality, living habits, facility of adjustment, apparent response to early adjustments, and especially an estimate of the amount and kind of damage done to tissue and the probability of its repair.

Only general prognosis can be set down as a guide to others. To state even this with certainty and safety many precautions must be observed. All cases included as a basis of conclusions must be handled under standard test conditions (see index) as far as may be; in accepting the observations of others one must be sure that they are sufficiently trained and sufficiently careful and veracious to render their statements reliable.

In order to introduce the subject to the literature of the profession and to invite comment and discussion looking toward the ultimate development of a complete Chiropractic prognosis we shall set down, without further preliminary, the general prognosis of those commonly described diseases concerning which we feel qualified to speak. No statement is made without the gathering of reliable evidence.

GENERAL PROGNOSIS

Abscesses.—Those abscesses which would tend to discharge externally may be adjusted for with success and will rapidly develop, point, and discharge, with quick recovery. Those which might break internally absolutely forbid adjustment because of the almost certain occurrence of peritonitis, pyaemia, or other grave condition.

Acne.—Good, but usually slow.

Addison’s Disease.—Few cases reported, and these slow cures.

Adenoids of Pharynx.—Prognosis so good as to contraindicate operation in every case. The lymphoid growths gradually and slowly absorb under adjustment.

Adiposis Dolorosa.—Only one case seen, the Derkum case. This reduced in six months of adjustment from 360 to 280 lbs. in weight, and was improved in every particular. No final report received.

Alcoholism.—Adjustments greatly aid a cure if alcohol be discontinued at once, or if the daily consumption is gradually and steadily decreased. No permanent cure can be secured without the aid of the patient. Acute alcoholic intoxication may be lessened at once by the aid of a single adjustment.

Amenorrhoea.—Prognosis excellent. One to several months required. Conservative amenorrhoea, as in tuberculosis or other wasting disease, disappears only with the occasion.

Anaemia.—If primary, yields slowly but surely. Secondary anaemia depends upon some disease process and its prognosis is that of the disease which produces it.

Angina Pectoris.—A case for careful diagnosis. False angina recovers with general building of nervous system. True angina, usually associated with arteriosclerosis, is frequently fatal and death may occur during any adjustment. If this does not happen most cases recover, though slowly. Let me repeat, there is great danger in handling true angina pectoris.

Anidrosis.—Usually responds to adjustments for the kidneys.

Ankylosis.—Almost any ankylosis, except that in which there is gross deformity of the bones, would yield to repeated applications of force along right lines. Only vertebral ankyloses are amenable to Chiropractic adjustment and those are usually broken in time.

Anterior Poliomyelitis.—Chiropractic experience with “infantile paralysis” has been very extensive and gratifying. During the febrile stage the disease may be aborted by one or several adjustments with only slight and transient paralyses resulting. The chronic paralysis which follows an unadjusted case is curable, but restoration of the motor function and trophic tone of the paralyzed members is delayed while the ventral horn cells are regenerated, the axons rebuilt, and the atrophied muscles redeveloped. Often no apparent results will be obtained for one or several months, after which gradual improvement progresses to a complete cure.

Aphonia.—Prognosis excellent. No failures reported.

Apoplexy.—The occasional case in which a premonitory partial paralysis precedes real hemorrhage responds remarkably to adjustment so that with care the hemorrhage may be averted. After hemorrhage the absorption of the clot is slow and tedious, but about 50 per cent recover.

Appendicitis.—In the early stages of the acute form, and in nearly all chronic cases, recovery is almost certain under adjustments. Signs of suppuration indicate immediate operative interference and drainage, and failure to read the signs may lead to rupture, peritonitis, and death. Acute cases yield very quickly as a rule.

Arthritis Deformans.—In well developed cases some almost complete cures have been effected in periods varying from two to four years. Prognosis good as to relief, but poor as to complete recovery.

Ascites.—Fair prognosis, depending upon the nature of the portal obstruction. Cirrhotic ascites does not yield well.

Asthma.—Spasmodic bronchial asthma is almost always curable except in the very aged, but the usual posterior curvature in lower cervicals and upper dorsals requires time and persistent heavy adjustments for its correction. The asthmatic paroxysm may be relieved instantaneously, but will recur at intervals for a long period before the cure is fully established. The cardiac form of asthma depends upon restoration of compensation for a leaking valve, and yields by irregularly progressive diminution.

Blindness.—As a condition, without qualifying terms, blindness offers a bad prognosis. Most cases fail to develop sight under adjustments. Yet some individual cures in optic atrophy, in detached retina, and in other conditions, attest the possibility. Cataract blindness perhaps yields best.

Bradycardia.—If symptomatic, yields as does the disease. If primary, a few adjustments are usually sufficient. In one case the first adjustment increased to 90 a pulse which had been at 60 for fifteen years. In twenty-four hours, without further adjustment, the rate had settled at 69 and there remained.

Bright’s Disease.—Prognosis good, but some cases terminate abruptly with intercurrent disease, such as pneumonia. There is danger until the albuminuria has ceased and the strength of the patient markedly improved. Probably the diseased kidney area is simply walled off from the healthy tissue, which then hypertrophies and takes on the work of the entire organ, or pair of organs. If too much damage has been done, the case will terminate fatally in time, even though its progress is checked by adjustments.

Bronchitis.—Acute bronchitis is quickly checked as a rule. Chronic bronchitis may prove intractable, or may require many months for a cure. There are exceptional quick cures of the most chronic cases.

Caked Breast—Mammary Inflammations.—Rapid and positive cure follows proper adjustments.

Cerebral Softening.—Prognosis bad.

Cerebrospinal Meningitis.—Serious always, but no fatalities reported in adjusted cases. Failure to modify fever and cervical retraction within two or three hours, and with one to ten adjustments, is alarming.

Chickenpox.—Like smallpox and the other exanthemata, chickenpox should be modified at once by adjustment and all cases should be light, eruption hastened, and fever quickly broken. Sometimes the rash may be strongly marked and the disease run its usual course in all particulars except fever and prostration, being a febrile with absence of all the consequences of fever.

Cholangitis.—Recovers quickly under adjustment.

Cholecystitis.—Prognosis excellent.

Chorea.—Prognosis excellent in acute and subacute cases, less favorable in chronic. No figures are available, but many chronic cases fail to respond at all.

Cirrhosis of Liver.—Doubtful. No statistics have been compiled, but it seems probable that most cases are unmodified by adjustment.

Congestion of Liver.—Prognosis good.

Conjunctivitis.—Readily curable, unless part of a more general infection.

Constipation.—Prognosis usually good, but some cases which have paralyzed the intestines with drugs, or in which atony of the intestinal muscles exists from any cause, are very stubborn. One is led to believe that any case of chronic constipation would respond to proper adjustments in time, but sometimes the time is prolonged more than seems reasonable.

Coryza.—Some cases respond instantly, others persist and run their usual course. Chronic nasal catarrh recovers in favorable climates, and in unfavorable tends to become permanent, though less severe and annoying under adjustment.

Croup.—Always dangerous, but no fatalities reported under adjustments, which are powerfully effective. Croup requires constant attention until all symptoms subside, usually within an hour or two.

Cystitis.—Usually curable, but some chronic cases prove intractable for an unknown reason. There is no way of recognizing the curability of a case before the attempt.

Deafness.—Variable outlook. Deafness due to catarrhal occlusion of the Eustachian tubes is usually curable. That due to middle ear disease sometimes yields. That due to nerve disease is possibly—though not certainly—incurable.

Diabetes Insipidus.—Prognosis excellent. Few cases fail of cure, and no fatalities are reported.

Diabetes Mellitus.—Always necessitating grave and careful consideration, this metabolic disease is marvellously controlled by Chiropractic adjustment. Probably 90 per cent of all cases are curable, and only those presenting impossible problems of adjustment, or those in the very last stages, are hopeless.

Diarrhoea.—Prognosis depends largely upon secondary causes. Adjustments sometimes produce diarrhoea to cleanse the intestinal tract of waste or poisons. Such a diarrhoea, if instituted by Nature without aid, does not cease with adjustments until its purpose is accomplished. Nervous and infective diarrhoeas usually respond well.

Dilatation of Heart.—Compensatory hypertrophy and strengthening of the muscle usually follows adjustment.

Diphtheria.—Under adjustment the false membrane tends to exfoliate and to be coughed out entire within a few hours, with rapid recovery. In children, watch for possible strangulation from loosened membrane. Constant bedside attention is imperative until fever and membrane have disappeared. Convalescence, unless antitoxin has been used, is very rapid, and physicians watching the clinical course of diphtheria under adjustment customarily doubt the diagnosis unless culture is made. Antitoxin modifies the prognosis toward gravity, and in spite of adjustments persistent sequelae often follow its use.

Dropsy.—Cardiac or renal dropsy disappears with improvement in the diseased organ.

Dysentery.—In temperate climates death is extremely unlikely. Recovery is often quick and easy, but some cases persist. The tropical amoebic dysentery seems hardest to master and may not improve at all.

Dyspepsia.—Prognosis good.

Endocarditis.—If primary, recovery is the rule. Occurring in the course of some other disease, as rheumatic fever, it renders the prognosis less certain and may terminate fatally. Likely to leave chronic valve weakness or contraction.

Enteritis.—Prognosis generally fair. No figures available.

Enuresis.—The majority recover within a few weeks or months, with occasional exceptions. Failure to get results within a few weeks suggests a change of adjustment.

Epilepsy.—Doubtful. Less than half of all cases recover, and no case can be pronounced cured until all symptoms have been absent for a year. Cases with anterior cervicals offer the poorest chance. It is usually possible to restore consciousness and muscular control by an adjustment during the grande mal, in the instant between the tonic and clonic spasms, but such immediate response does not—unfortunately—always mean that a cure will eventually be effected.

Epistaxis.—Nose-bleed usually stops at once following proper adjustment.

Erysipelas.—Cases adjusted early show little spreading of the eruption with but slight constitutional symptoms. After eruption is fully developed it is more difficult to keep down the fever and recovery is slower, but none the less certain unless cardiac or other grave weakness is present.

Exophthalmic Goitre.—Like other forms of goitre this may be reduced, and with its reduction all other symptoms disappear. Many cures are on record.

Friedrich’s Ataxia.—In hereditary cerebellar ataxia (which is probably congenital, rather) cures are limited to 40 per cent or less. History of instrumental delivery, with marked upper cervical subluxation, argue for the natal origin of the disease and increase the probability of cure.

Gallstones.—Prognosis excellent. The calculi absorb under adjustment by a reversal of the chemical process by which their deposit was induced. When small they may pass through the ducts and escape, with slight pain. Adjustment during the painful passage of a gallstone may act upon the duct so as to lessen greatly the pain and hasten the passage.

Gastralgia.—Like other gastric neuroses, is easily curable but may sometimes require correction of a neurotic diathesis, which means time.

Gastric Ulcer.—Usually recovers, but occasionally leaves a fibrous cicatrix which cannot be affected by adjustment and which, if located at the pylorus, may produce stenosis, with consequent incurable dilatation of the stomach. Operation is required for such a condition, but the diagnosis is difficult, and it may be best to test with adjustments for some time.

Gastritis.—Prognosis good. To prevent recurrence adjustments should continue after symptoms subside.

Goitre.—Prognosis good. One large goitre under the author’s observation was reduced in one week so that the neck measurement decreased one inch. Most cases require several months for complete reduction.

Gonorrhoeal Rheumatism.—More stubborn than other forms of rheumatism and sometimes defies adjustment. No percentages are available. It is probable that nothing but a general cleansing of the system will prevent recurrence.

Hay Fever.—Perhaps one-half of all adjusted cases recover fully, some at once and some after several months. By recovery is meant failure of the annual appearance of the attack with no symptoms at any time. No case can be pronounced cured in less than a year. The remaining half are modified little or not at all.

Headache.—Nervous, bilious, ocular, and reflex headaches yield well. Toxic headaches, or those accompanying systemic infections, give way slowly with the cleansing of the system.

Hemorrhoids.—Excellent, except when lower lumbars are anterior and defy adjustment.

Hernia.—In all sites and forms of hernia, excepting strangulated hernia, prognosis is good. Strangulation requires immediate surgical interference. Prognosis is better if a truss be used.

Hodgkins’ Disease.—Prognosis theoretically good, but the few cases under adjustment, while benefited, seem to have died of intercurrent disease, so that it is well to suspend judgment.

Hydrocele.—Theoretically hydrocele should respond well, but in practice the author has seen several failures, and no cures.

Hydrocephalus.—If due to cervical twisting at birth, the prognosis is fair; otherwise bad.

Hypertrophy.—Adaptative hypertrophies, those due to overstrain upon an organ, do not and should not disappear until the strain has been relieved. Hypertrophy is sometimes accelerated by adjustment, as in the case of defective heart valves, when thickening of the wall restores and maintains compensation. Other hypertrophies tend to disappear under adjustment.

Hysteria.—Good, but slow. Some extreme cases refuse to respond. Instant recovery from hysterical coma is the rule following adjustment, but the coma tends to recur.

Immunity.—There is no doubt that adjustments often confer immunity from infection and contagion, but it is so difficult to strengthen every part of the body against every possible infection or contagion, and so uncertain that immunity really exists in a given case, that it is best always to assume the possibility of contagion and act accordingly. Adjustments following exposure to known contagion are always wise, but one may never know, if they succeed, that the patient might not have escaped without them.

Impotence.—Variable outlook, according to secondary causes and pathology. Previous venereal disease renders the prognosis most doubtful. Nervous or vascular impotence is likely to respond well. If due to cord disease, the prognosis is to be made on the original disease.

Influenza.—Mortality not more than 2 per cent, and that in the very aged and infirm. Duration varies greatly. May yield at once, first adjustment being followed by disappearance of fever, profuse perspiration, and completed convalescence in from twenty-four to forty-eight hours; or may require several adjustments at frequent intervals to break fever.

Insanity.—No accurate tabulation of results in different forms of insanity has been made. Numerous successes, interspersed with fewer failures, have been reported. The author has both succeeded and failed with acute dementia, but the failure was a twenty-four-hour trial only, and included but three adjustments.

Intestinal Obstruction.—The prognosis of intestinal obstruction from intussusception or strangulated hernia is, under Chiropractic, bad. Such cases are almost surely fatal unless operated. Faecal obstructions or masses of worms, also volvulus, respond quickly and prognosis is good. Careful diagnosis is required before taking a case of apparent complete obstruction.

Irritable Heart.—If purely nervous, recovery is quick and easy. If there is a drug diathesis or organic disease, slow and doubtful.

Jaundice.—Yields readily, but if of the obstructive form the obstruction must first be reduced or removed by adjustments.

Laryngitis.—A few adjustments suffice for simple acute cases. Specific laryngeal infections are more difficult. Laryngitis with ulceration, which is either syphilitic or tubercular, may not recover or may recover after a protracted struggle. Chronic laryngitis of other forms is curable, but requires more time than acute.

Leucorrhoea.—Fair prognosis only.

Lumbago.—Good, unless pain prevents proper adjustment. True lumbago is quick to respond.

Malaria.—Tenacity varies according to climatic conditions. Malarial cachexia always yields slowly, sometimes defies adjustment altogether. No reports are to be had on pernicious malaria. Other forms recover though paroxysms tend to recur several times before checked, but of shorter duration than if no adjustment is given.

Mastoiditis.—Good results in the few cases observed.

Measles.—Excellent. Recovers quickly. Eruption hastened by early adjustment, runs very mild course with little or no fever, catarrhal symptoms disappear early. No sequelae.

Meniere’s Disease.—Labyrinthine disease of this character has been cured, without reported failures, but data is meagre, not more than three or four cases having come under the author’s notice.

Menorrhagia—Metrorrhagia.—Results excellent, and usually quick. One fifty-two-hour intermenstrual hemorrhage from uterus was stopped in one hour by adjustment, with no recurrence.

Migraine.—Migraine, or hemicrania, gives a fair prognosis only. Most cases require a long course of adjustments.

Movable Kidney.—Prognosis good, but change of position and complete fixation slow. No treatment required—merely adjustment.

Myelitis.—Transverse myelitis, if adjusted in the acute stage, may be checked as any other inflammation, and the damage and resulting paralysis will be greatly lessened or altogether prevented. The paralyses which follow myelitis require time for the rebuilding of the degenerated axons whose course is interrupted at the diseased area, but tend to recover.

Myocarditis.—Reports conflict. It is well to consider this a grave condition and one open to investigation.

Myxoedema.—Only one case known to have been under adjustment, and this after several years was markedly improved, but not yet quite cured.

Nephritis.—Prognosis good. Acute cases show rapid, chronic cases slow, improvement.

Neuralgia.—Prognosis excellent in any form. Trophic neuralgias, such as herpes zoster, are slowest as a rule, but occasional cases of tic doloureux will require several months. One may always expect a cure unless the patient, in long cases, becomes discouraged and stops adjustments.

Neurasthenia.—Good, but will be slow unless mental aid be given in the form of freedom from worry or strain.

Neuritis.—Good, but very uncertain as to time; some cases show quick disappearance of all pain and some drag interminably.

Optic Atrophy.—Complete atrophy with total blindness is rarely cured, though occasional partial or complete cures have been reported. Partial atrophy may slowly recover, or recovery may cease at some point short of completion and case remain stationary thereafter.

Ovaritis.—Good, except in suppurative forms. When adhesions have been formed, results are doubtful.

Pancreatitis.—Obscure, hard to recognize, and hard to cure. Prognosis probably bad.

Paralysis Agitans.—Probably in the earliest stages this is curable. Cure of a fully developed case is exceedingly doubtful and the writer has yet to see marked benefit in such a case.

Paralyses.—Prognosis decidedly variable. Apoplectic hemorrhage recovers in about 50 per cent of all cases. Paralyses from central lesions require much more time than peripheral palsies because of the necessity for rebuilding degenerated nerve cells as well as fibres. The paralyses following anterior poliomyelitis are almost certain to be cured if sufficient time is allowed. Most peripheral palsies, except in the very aged, are curable. Any other paralysis but a purely functional one recovers slowly, but this form may yield almost in a day.

Parotitis.—Mumps respond immediately and may be checked at any stage.

Pericarditis.—Usually recovers. Effusions are stubborn and may become purulent, in which case the prognosis is grave.

Peritonitis.—Prognosis grave, but some cases have been reported as cured under adjustment. These are probably localized rather than diffuse inflammations, usually pelvic.

Pertussis, or Whooping-Cough.—Tends to run its course despite adjustments, though some aborted cases are reported. All cases mild under adjustment, with small liability of complications. A nervous cough is likely to persist for months after the infection has passed. Adjustments seem seldom to prevent contagion.

Pharyngitis.—Acute form yields readily. Chronic pharyngitis is more stubborn, but usually curable.

Pleurisy.—Pleurisy, unless purulent or tubercular, yields well in varying periods. Purulent and tubercular pleurisy are stubborn and may not recover.

Pneumonia.—The author has had a wide and gratifying experience with pneumonia. At every stage it seems amenable to adjustment, and the usual effect of the first adjustment is a drop of from one to two degrees in the temperature with immediate softening of the consolidated area. Specific adjustments get best and quickest results. Pneumonia should always recover, unless it occurs as an intercurrent event in some chronic and wasting disease, as Bright’s Disease.

Potts’ Disease.—Tubercular caries of the bodies of the vertebrae is curable, within limits. Occasional cases are seen in which Nature has stopped the spread of the disease by walling off the morbid area with exostosis. Such cases should not be adjusted, and the disease may remain latent through a long life. When active the disease proves fatal unless checked, which is possible in the earlier stages, and becomes impossible when the vertebral bodies are too fragile to stand strong adjustments. Discernment in case-taking will avoid any fatalities under adjustment, but by no means all cases of Potts’ Disease are curable.

Pregnancy.—We may correct by adjustment any pathological conditions arising during pregnancy which would be amenable to adjustment under other conditions. A course of adjustments during a normal pregnancy will render delivery easier and lessen, but not abolish, the pains. Great care must be exercised in the manner of adjustment.

Prostatic Enlargement.—Varies according to age and recuperative power. Prognosis is bad in the very aged and infirm, but in more vigorous subjects quite good for steady reduction of the hypertrophied gland, with subsidence of attendant symptoms. Venereal history is unfavorable.

Pulmonary Tuberculosis.—In the early stages, where little damage has been done to lung tissue, recovery is rapid and quite certain. In fully developed cases, with characteristic symptoms and marked damage to tissue, prognosis is very grave, and it is usually wisest to advise a trip to the Southwest in preference to adjustments. Tubercular cases should be studied with a view to estimating the exact condition and recuperative power of the patient before taking.

Rachitis.—Prognosis excellent. In a period varying from six months in the best to five to seven years in the slowest cases, all show complete or nearly complete cures. All deformity may be checked in a short time and proper bone nourishment established. Correction of deformities existing prior to adjustment is a growth process. Too many cases become discouraged at the slowness of the work and stop adjustments.

Retinal Hemorrhage.—Prognosis fair. Undoubted cures have been recorded, as well as a few failures. At least one case of hemorrhages followed by partially detached retina has been cured, or nearly so, by adjustments.

Rheumatic Fever.—Hard to adjust because of its painful nature. Results of proper adjustment usually, but not always, good.

Rheumatism.—Muscular rheumatism yields more rapidly than articular. Acute tends to quick recovery, chronic to more or less lengthened and slow improvement. Rheumatic diathesis may require many months of careful adjustment.

Rubella.—Simply and easily checked. Rash slight, and no prostration at all.

Scarlet Fever.—Data on quarantinable cases is meagre, but scarlet fever, or scarlatina, seems to be quickly modified by adjustment. One may expect a drop of from one to two degrees in temperature after first adjustment, followed by steady rise, which will again be checked by the next adjustment. Rash appears early, and all symptoms are mild, but several days are often required to put the patient at ease. Occasional sequelae, such as endocarditis, otitis media, or other inflammations, occur unless case be watched with great care. No fatal terminations under adjustment except in cases which were at first misdiagnosed.

Seminal Emissions.—Prognosis excellent in cases uncomplicated by masturbation or excessive venery; in such cases bad until habits are changed.

Simple Continued Fever.—Always recovers. Usually drops one to two degrees shortly following correct adjustment, with amelioration of all symptoms.

Smallpox.—Infections vary in virulence. In temperate climates all phases are hastened by adjustment and tend to recover without sequelae. The milder smallpox due to infection by vaccination is also amenable to adjustment, and prompt handling will often prevent serious poisoning.

Splanchnoptosis.—Partial or marked relief is usual—and slow. Complete natural replacement of all viscera is the exception rather than the rule.

Splenic Enlargement.—Variable prognosis according to cause. Secondary enlargements due to systematic infection yield with the disappearance of the infection. Primary enlargements yield more readily as a rule, with exceptions. Malarial spleen is slow to reduce.

Splenitis.—Prognosis presumably good, but few authentic cases reported.

Spondylitis Deformans.—Prognosis favorable for slow, slight improvement, but not for complete cure.

Strabismus.—Excellent in young subjects, less than fair in patients over thirty.

Sunstroke.—Theoretically curable, but no experience.

Syphilis.—The primary sore frequently dries under adjustment without the development of any secondary or tertiary stage. If first adjusted during the secondary manifestations symptoms may readily disappear and no tertiary stage ever appear. There are some authenticated cures eight and ten years past without recurrence of any sign. In the tertiary stage the organic lesions do not respond. Prognosis is so hopeless in this stage that it seems useless to apply Chiropractic at all.

Tabes Dorsalis.—Posterior spinal sclerosis, commonly called from its chief symptom “locomotor ataxia,” recovers in 40 to 50 per cent of cases adjusted. No accurate pre-judgment can be formed as to the probabilities in any particular case without experiment, nor has any adequate explanation been offered as to why some cases recover and others do not. Those cases which improve at all are likely to recover fully. In any instance, time is required for the regeneration of the dorsal column axons, and while this is going on no improvement may be apparent at all.

Tachycardia.—If symptomatic, as of exophthalmic goitre, tachycardia yields as the disease does. If primary, a few adjustments usually establish a proper pulse rate.

Tetanus.—Only one undoubted case has been brought to the writer’s attention and this one a marvellous cure. Adjustments were given as often as every ten minutes for a time.

Thoracic Aneurism.—Cure exceedingly doubtful, and fatal termination possible at any time. Little information is at hand.

Tonsilitis—Quinsy.—Simple or follicular tonsilitis aborts under adjustment in from a few hours to two or three days. Quinsy, or suppurative tonsilitis, runs its regular course as to duration, but is frequently a febrile after the first day. Spontaneous rupture of the tonsil will usually occur and sometimes two or three such ruptures will lengthen the case slightly. Sequalae are wanting, but all forms of tonsilar inflammation tend to recur unless a long course of corrective adjustments is applied to the cervical region.

Torticollis.—Acute spastic or rheumatic torticollis in which permanent contractures have not yet set in may be cured almost invariably in a period varying from a few days to several weeks. Chronic cases with permanent contractures yield very slowly, but prognosis is good for a fairly accurate straightening of the neck. Such cases often leave slight abnormalities even in the most competent hands.

Tuberculosis, Pulmonary.—See Pulmonary Tuberculosis.

Tumors, Benign.—Unlike malignant growths, benign tumors, fatty, fibroid, etc., tend to gradual absorption under adjustment. Perhaps 75 per cent or more may be completely cured. Age is a factor, tumors in young subjects being more readily curable than in the aged or infirm.

Tumors, Malignant.—Prognosis bad. If cancer in any form can be cured proof has escaped the author’s diligent search. It is wisest to refuse all cancerous cases.

Typhoid Fever.—Prognosis excellent if adjustments are commenced during first week of fever, in which case the fever should be aborted at once, followed by one or two mild exacerbations, then permanently checked. Doubtful prognosis after first week, because of liability to perforation during adjustment. After second week of fever very grave prognosis under adjustment, and better with nursing alone.

Uteroversion—Prolapsus.—Uteroversions and prolapses are corrected, sometimes rapidly but more often slowly and gradually. Favoring circumstances are freedom from overwork or overlifting. Some extreme cases result in failure.

Valvular Diseases.—These may be grouped for prognosis. No percentages have been compiled, but it may be said that the prognosis is generally good as to relief and restoration of compensation, but poor as to rebuilding of the valves. Many cases of apparent permanent and complete recovery are probably simply cases of excellent compensation. Death occasionally occurs despite adjustments.

Varicocele.—Outlook good for a slow, certain recovery.

Varicose Veins.—Probability favors cure in subjects not beyond middle life, providing they are not greatly overweight or too much on their feet. Cure always slow.