International Journal of Complementary & Alternative Medicine The Vulcan Nerve Pinch - Cultural Iconography Anchors the Proposal of a Novel Manual Approach, the Bow-String Technique Clinical Paper Abstract The Vulcan Nerve Pinch has a memorable and unique place in the cultural Volume 5 Issue 5 - 2017 to anchor the proposal of a novel technique preliminarily described here. The techniqueiconography may of possess Star Trek. both The diagnostic proposed and Bow-string therapeutic technique implications uses forthis somatic image University of Otago, Dunedin, New Zealand dysfunction in the cervical region. It is based upon the established viscoelastic properties of collagen, in particular time-dependent stress-relaxation. The *Corresponding author: M. C. McGrath, University of Otago, technique is reliant upon a high level of patient-centred engagement and Dunedin, Country Practice Ltd. East Taieri, Mosgiel 9024 New Zealand, Email: co-operative and runs for 2-4 minutes. It theoretically engenders significant intervenes at the contralateral side to a patient’s active muscle effort. It is gentle, Received: October 26, 2016 | Published: February 21, collaginous material change (lengthening) through the stress-relaxation 2017 characteristic of collagen associated with the imposition of a fixed mechanical strain. It is anticipated that the technique may possess a considerably greater persistence of effect when compared with shorter duration, repetitive passive stretch techniques, reliant on patient relaxation. Introduction human and animal testing, it is unlikely that the VNP will ever be formally tested and future ethical approval in either case seems According to a variety of sources the Vulcan Nerve Pinch (VNP) unlikely given that the procedure has been described to cause the is a rapidly immobilising manual procedure usually performed by it is nevertheless generally well known. It may therefore serve a horsedeleterious (equus ‘rupture ferus caballus) of nerve has fibers’. been recordedNevertheless, [4]. In a this pragmatic equine a Vulcan [1,2]. While considered the province of science fiction useful purpose as an iconographic aide memoir, anchoring a novel example,example oftwo the keyVNP differencestechnique applied emerge to when an animal, compared specifically to the a manual technique that may have potential for both diagnostic and application of the VNP technique upon humanoids. First, the VNP therapeutic utility. technique was applied to the horse at a different location, namely The VNP is embodied by the application of manual force to the dorsal caudal aspect of the equine cranium at its junction through digital pressure at a region located lateral to the junction of the head and neck of the target subject. While a similar location humanoids there appeared a rapid loss of consciousness, in the is replicated in the proposed and novel Bow-string technique, casewith ofthe the most horse cephalad the animal point slowly of theadopted neck. a Second,recumbent whereas position in observation of the VNP suggests that the successful application of and did not appear to lose consciousness [4]. Empirical observation of the multiple applications of the hand-neck relationship [3]. In this way and in contradistinction VNP technique under varying conditions provides substantive the technique does not appear to be reliant upon a highly specific to the VNP the novel Bow-string technique will be shown to be generic information [2], indicating widespread agreement that the junction of the base of the neck with the ipsilateral shoulder is a designated general point of application. However, the precise reliantThere on isspecified a paucity anatomical of data placement.regarding the formal testing of the both manual procedures. In the case of the VNP, empirical anatomical location of the VNP remains elusive. This has led observation suggests that when the technique is applied by Vulcans it appears to lead to dependable and effective immobilisation anatomical structures likely to be implicated. Furthermore, [3]. In contrast, the delivery of the VNP by non-Vulcans suggests whetherto persisting such uncertaintyanatomical considerationregarding the isspecific indeed underlyingnecessary considerably diminished reliability and effectiveness [1]. Formal remains moot as it has been alleged that the putative effect may in vivo testing of the VNP procedure by Vulcans on humans seems be entirely psionic [7]. Indeed, it seems established that humans either unknown or undocumented. Whether data exists for in vivo testing between Vulcans also appears unknown as no formal record capability to attempt the procedure with any realistic expectation ofmay reliable not only success lack sufficient [7]. manual strength but adequate psionic is identified at the Vulcan Academy of Science [5,6]. In the case of Submit Manuscript | http://medcraveonline.com Int J Complement Alt Med 2017, 5(5): 00162 The Vulcan Nerve Pinch - Cultural Iconography Anchors the Proposal of a Novel Manual Copyright: 2/8 Approach, the Bow-String Technique ©2017 McGrath Irrespective of the precise location or of the alleged effect of nevertheless be drawn to its broad application and position ofthe application VNP technique and inthe science relevant fiction human iconography, anatomy attention of potential may association with cultural iconography to introduce a novel manual technique,clinical significance. referred to The as theaim Bow-string of this commentary technique. is to employ an Regional Anatomical Considerations - A Tale of Two Points Anatomical consideration of the region highlights its underlying complexity. The posterior triangle of the neck is formed embryonically from the division of a single large muscle mass into two muscles, the sternocleidomastoid and trapezius muscles. The posterior triangle is notionally formed within the anterior border of the middle portion of the trapezius muscle, the posterior border the sternocleidomastoid, and has as its base the middle third of the clavicle [8,9]. The posterior triangle is three boundaries are formed by the inner margins of the anterior Figure 1A: superficial to and encompasses the deeper scalene triangle whose rib. Original depiction of .. the location of Erb’s Point and middle scalene muscles, and the superior border of the first Ranney [10] highlighted this region when anatomically relevanceredefining liethe within‘thoracic the outlet’ boundaries as the ‘cervico-axillary of the posterior canal’. triangle, Two described landmarks or ‘points’ of key anatomical and clinical is the observation that the latter point, the Punctum Nervosum doesnamely not Erb’s appear Point coincident and the Punctum with the Nervosum. general application Of iconic interest of the approximated by it. Neither though could be associated with any VNP, though the former point, Erb’s Point, may more closely be attributionErb’s point of the alleged instantaneous ‘effect’. German neurologist Wilhelm Heinrich Erb, who described it in his Figure 1B: Erb Point: brachial plexus anatomy schematic. 1883Erb’s text Point of electrotherapeutics [11] is an eponymous as, ‘a circumscribedpoint named by point, the eminentabout 2- 3 cm above the clavicle, somewhat outside of the posterior border provides electro- accessibility of C5 and C6 roots, suprascapular of the sternomastoid and immediately in front of the transverse The most superficial location of a portion of the brachial plexus nerve and nerve to subclavius. SupraS: suprascapular; Subcl: nerve to subclavius; SUP: superior trunk brachial plexus; MID: middle trunk withprocess the of cervical the sixth plexus) cervical [10],vertebra’ corresponding Figure 1A, [12]. to the The superior location dorsalbrachial rami. plexus; DS: dorsal scapular nerve; P: phrenic nerve; LT: long trunkof Erb’s of Point the brachial at the upper plexus cervical (derived outlet from (nb. the not C5 toand be C6 confused roots), thoracic nerve; LC: nerve to longus colli; S: nerve to scalenes; DR: together with the suprascapular nerve and nerve to subclavius, and the bifurcation of the trunk into the posterior and lateral Punctum nervosum cords. This structural conglomeration may be visualised in Figure 1B. Erb termed this point of neurological electro-accessibility, Over time, confusion appears to have arisen between the in contraction of the ‘deltoid, biceps, brachialis anticus, and more superiorly, referred to in Latin as the Punctum Nervosum the ‘supraclavicular point’, in which electro-stimulation resulted location of Erb’s Point and another point located significantly Point provides utility for electro-diagnostic motor conduction studiessupinator of longusthe C5 muscles’.and C6 roots The superficialpotentially accessibilityinvolving the of lateral Erb’s ramior ‘nerve of C2- point’ C4 and [13,14]. critically This possesslatter point close is spatial associated relations with withfour cord (musculocutaneous nerve - biceps, brachialis), the posterior primecutaneous moving nerves muscles that are and the fasciasuperficial of the branches region. ofA theschematic ventral cord (radial nerve - brachioradialis and axillary nerve - deltoid), depiction of the location of the Punctum Nervosum and posterior and the suprascapular nerve and nerve to subclavius. cervical triangle is portrayed in Figure 2. Citation: Technique. Int J Complement Alt Med 5(5): 00162. DOI: 10.15406/ijcam.2017.05.00162 McGrath MC (2017) The Vulcan Nerve Pinch - Cultural Iconography Anchors the Proposal of a Novel Manual Approach, the Bow-String The Vulcan Nerve Pinch