What Is A General Osteopathic Treatment?
Definitions By One Of The Older Members Of The Profession
James Clarke Rule, D.O.
The Osteopathic Profession
WHAT is a general osteopathic treatment and who is in need of
When a student has finished a course in a college
of Osteopathy and procured his diploma and license to practice,
he has received his credentials as an engineer of the human body,
an engineer who knows the anatomy, physiology and pathology, the
structure and chemistry of the body he is to supervise.
Also he has served his apprenticeship as a master mechanics theoretically
schooled and trained in the methods of correcting all pathological
To become an osteopathic physician in the truest
and best sense of the term he must believe that the correction
of structural abnormalities is the most potent therapeutic agent
known to science and that most pathologies are amenable to this
same mechanical treatment. If this graduate believes what
he his been taught and applies osteopathic treatment in every
case where indicated it is only a matter of time until he will
know that what he was taught to believe is right.
When he has given his first thousand treatments
he will not be a finished master mechanics but if he has given
intelligent thought to what he is trying to do in every treatment
he will have a good start toward efficiency. This statement
should discourage no beginner. I have given a hundred thousand
treatments and am still far from perfection. I make an effort
every day to come nearer that goal.
Efficiency in Osteopathy
This question of efficiency is most important not
only to the public but to the welfare and even to the very life
of our profession. That we should hope for near-perfection
in every D.O. may be too high a standard to expect. On the other
hand, the fact that we have allowed many to go out into the field
credentialed as engineers and master mechanics but with a minimum
of ability is greatly to be deplored.
Let me illustrate. Thirty-four years ago this
month I was a young man just out of school and in Pasadena with
a private patient. I had never known through personal experience
what sickness was and had never received an osteopathic treatment.
One day I was chilled and aching from head to foot.
I decided to seek an osteopathic physician and get a treatment.
In the directory I found the name of a graduate of the same school
where I had studied. I went to his office and told him how
I felt, and he said that maybe I needed a general osteopathic
treatment. This he proceeded to give me. Four or five minutes
later I left his office the most disgusted person in California.
The treatment he had given me was literally nothing. As
I went home I said to myself, "Is it possible that this is what
I have been spending my time and money to learn?" Of course
I knew better, but I was more sick over that poor demonstration
of Osteopathy than I was over my aches and mounting fever.
At six o'clock the boy who was my patient came to
my room to get me to go down to dinner. I was under the
covers and said, "No dinner for me tonight." In about two minutes
the boy's mother was in to see what was the trouble. A few
questions, and her hand was on my hot forehead and she said I
must have a doctor. I said I did not want a doctor, and
told her of my afternoon experience. She said, "Well, you
pick another osteopath or I'll have an M.D. come in." I said I
had seen the sign of Dr. J. Strothard White out on East Colorado
Street and that Bruce might phone him if she wished. That
evening Dr. White came in and gave me a general treatment, with
one the next day and a third on the day following, and that ended
my attack of influenza. The contrast in the work of those
two doctors was almost unbelievable.
Another illustration. A few years ago, being
in one of the largest cities of our State with a little extra
time on my hands, I decided to call on Dr. Blank who was an old
friend. I found him in and not busy, so after a short visit
asked him if he would give me a little general treatment.
was little, all right and it was terrible.
In contrast, one day while I was driving from Los
Angeles to Stockton I decided to go a few miles out of my way
to Porterville to say hello to one of my old patrons and to Dr.
Reed. Reed not being busy, I told him I had not had an osteopathic
treatment for several years and asked if he would mind stretching
out the old back. In twenty minutes he gave me the best
osteopathic treatment I had ever had. The point is that
there is altogether too wide a difference in the ability of our
What Is A General Treatment?
What is a general treatment? It may be very
different in different cases.
Three years ago a distraught mother came to my office
to consult me about her eight-months-old baby. She gave
a history of a normal birth and apparently normal health and development
up to five months of age. Then the child began to suffer
from indigestion and malnutrition. During this time the
baby was under the care of medical specialists, but got steadily
worse until they said it could not live. They advised removal
to the county hospital. After ten days they told the mother
that the bowels had ceased functioning, the kidneys were excreting
free blood and pus, and that the baby could not last another forty-eight
Of course the mother wanted me to say I could save
her baby. As an osteopathic physician I had no access to
the county hospital, but the mother had the privilege of taking
her baby home. The doctor told her, however, if she took
the baby home for me to examine it she could not bring it back
again. Naturally I envisioned a distressed mother bringing
her baby home only to see it die, and therefore I did not encourage
her though I did admit that there might be a possibility that
Osteopathy might succeed where drugs had failed.
That evening on the dining-room table I examined
a baby that had an ivory-colored skin stretched over a framework
showing the outline of every bone and marked with prominent blue
veins, the belly protruding upward like a young mountain.
The only apparent reaction to everything I did was a slight flutter
of half-closed eyelids. That baby received an osteopathic
general treatment -- time ten minutes. Treatment was
continued daily for ten days, then less frequently for three months.
Case dismissed. Today he is a four-year-old boy, active
and normal. Some D.O.'s say that they do not believe in
general treatment. I do.
Let me give another illustration. Twenty-odd years
ago I received a telephone call in mid-afternoon. I did
not want to leave my office at that hour, but the parents were
very insistent as their medical doctor had told them their baby
would be dead in another hour. I found an inert infant three
months old in which I could distinguish no heart beat, no breath,
no reaction of any kind save a slight papillary reaction to light.
Two weeks earlier the case had been diagnosed as pneumonia.
This infant received an osteopathic treatment for two hours.
One week later the case was dismissed. When the family moved
from Stockton this baby had grown to be a fine eleven-year-old
Again, what is general treatment? I would
describe a typical general treatment for the case that comes to
the office as one that stretches all spinal soft structures and
puts every spinal articulation as nearly as possible through its
normal range of motion. This should be followed by an abdominal
manipulation, with the patient on knees and elbows, drawing abdominal
contents out of the pelvis and away from the spine, and freeing
the abdominal circulation.
I speak of a typical general treatment, yet I presume
every intelligently general treatment is atypical for this reason
-- that in every case there is some structural imperfection that
calls for specific corrective measures which became a part of
that particular general treatment.
An osteopathic treatment, whether specific or general,
is or should be a work of art. The osteopathic fingers and
intelligence must be trained to recognize the normal tissues,
the fibrotic, the atonic, the toxic and all other variations from
the normal. This takes time, practice and diligence.
A general treatment should be a corrective, curative
measure, but it may be and sometimes is a harmful, vicious thing.
We all know that when we have limited or no movement in one or
more spinal articulations due to lesion, fibrosis or ankylosis
we have increased movement in articulations above or below.
In such a case unintelligent, rough general treatment that merely
hauls, twists and pops the spine without definite control as to
movement and correction simply accentuates movement and creates
lesions in articulations already overfunctioning in one of Nature's
compensatory attempts while doing nothing to correct the primary
lesions. The victim of this kind of treatment eventually
quits Osteopathy full of just criticism for its failure, or changes
to an osteopathic physician who is an artist and knows his business.
Who Needs General Treatment?
Next, who needs general treatment? The person
who comes to one's office with altered curvatures due to bad postural
habits; the person with various secondary lesions following a
lower back primary lesion; the person with hypertension and the
one with hypotension; usually the person with digestive tract
disturbances; any person with chronic trouble where the contours
of the back are not normal; some acute conditions, such as the
baby cases described earlier in this paper; typhoid, etc.
However, a general treatment in many of these conditions may be
widely different from the definition I have given of a typical
One osteopathic physician whose work I respect highly
once told me he did not give a general treatment. Another
time he told me that in almost every office treatment he checked
up every spinal articulation and treated every one that was in
lesion. It is simply a matter of viewpoint and nomenclature.
I would say that he gave an ideal, intelligent and effective general
treatment in all such cases.
I have often heard another one of our best doctors
speak of the value of general treatment. All do not agree
on the necessity for general treatment. I have heard a D.O.
of some reputation and standing say on a national convention program
that be was treating from fifty to seventy-five patients a day
and his ambition was to pass the hundred mark. Five minutes
was his outside limit for a treatment, and he never gave a general
treatment. Take your choice. I know which one a patient
would choose if he could have a knowledge of both methods.
Of course there are many conditions that call for
short, specific treatment only, not general treatment. The
differentiation in diagnosis and prescription is where your engineering
ability comes in. The carrying out of your prescription
is where mechanics and art come in.
Again, who needs general treatment? I would
say every one past forty years of age and many others, including
I was walking along a golf fairway with Chester
Morris of Chicago one day. He told me that the then U. S.
amateur golf champion came to him once a week, the year around,
for a general treatment. Dr. Morris told me that this golfer
had the most perfect back he had ever seen. Why did he have
continued general treatment? To keep it that way.
A general treatment weekly for the person already in health is
the soundest insurance against ill health.
I would recommend that every osteopathic physician
arrange with a neighbor D.O. to exchange weekly general treatments.
A young, beginning D.O. could exchange with an older one, because
the older D.O. needs the treatment and the younger one has much
of value to learn from such a contact.
I have already said that there is a need for all
of us to improve our mechanical knowledge and ability. In
this connection I would advise that a group of three or more beginning
D.O.'s make arrangements with an experienced osteopathic physician
to hold a series of clinics among themselves for the purpose of
learning and perfecting their technic. I also know by experience
what pleasure and value this procedure can be to the oldster as
well as to the youngster.
In conclusion, let me express the opinion that what
Osteopathy needs is more and better master mechanics who believe
in what they are trying to do.