Observation of the patient with a view to determining any signs of disease should begin with the moment the patient steps into the office. It should continue during your conversation and during the Vertebral Palpation and Nerve Tracing which follow. The mind of the examiner should be constantly on the alert to note any sign on any exposed part of the patient’s body, or any motion which may betray the nature of the disease or diseases with which he suffers. Before preparing the patient for palpation observe temperament, position and carriage of head, body, and limbs, and facies. Ask male patients to strip to the waist and female patients to remove all clothing down to the waist except a loose gown or kimono, which is worn reversed so that it opens behind and exposes the spine to direct examination. No greater error can be committed than to attempt examination of the vertebral column through clothing or other covering. Examine with patient seated on a bench or stool with feet evenly placed upon the floor. If the patient is for any reason unable to assume this position the examination may be varied somewhat. While in this position continue observation of points mentioned above and observe also condition of skin, whether abnormal in color, moisture or nutrition, or whether there is flushing, cyanosis, or pallor, roughness, eruption, etc.; the condition of bones and joints other than vertebral; general emaciation or obesity, local malnutrition or hypertrophy; evidences of operation, scars etc.; and action of muscles more in detail than is indicated under position and carriage of parts. Having observed these things discontinue general observation and all other considerations for the time in favor of Vertebral Palpation. Vertebral Palpation The primary object of Vertebral Palpation is the location of subluxations, or partial displacements, and the determination of the relative degree and direction of those found. Next comes the recording of subluxations in such a manner that a perusal of your record will enable you to reconstruct at any time a mental picture of the spine, as far as possible. (See Record.) With the making of the record the proper form of adjustment for the correction of each subluxation is decided. Finally, by _failing_ to find subluxation in certain segments you may safely eliminate those segments from consideration and confine your further attention to the remainder. (See Spino-Organic Connection.) It must be borne in mind that while the finding of a subluxation is not always positive evidence of the necessity for adjustment there, the _absence_ of subluxation of any spinal segment is proof positive that no disease exists in the corresponding somatic segment. Differential diagnosis is thus often greatly aided by palpation. Nerve Tracing