Osteopathy Complete
Elmer D. Barber, D. O.

    The spleen is the largest and most important ductless gland.  It is undoubtedly related to the vascular system, yet its anatomical relations to the stomach and physiological relations to the liver may allow it to be described as an accessory to the digestive tract.  It is placed deep in the left hypochondrium, between the fundus of the stomach and the diaphragm, above the descending colon.  There is usually but one spleen, yet observation shows it may be congenitally lacking, or may be multiple, as many as twenty-three having been found in one body.  These are called accessory or supernumerary spleens, and are probably occasioned by the deep notching of the anterior margin and separation of the included parts.  They may be connected with the mother organ by thin bridges of splenic tissue, or only by a portion of capsule.  They are usually wholly isolated, and situated in the gastro-splenic omentum, great omentum, transverse mesocolon, or in the pancreas on a branch of the splenic artery; frequently one or two are in the region of the hilus. They are the size of a hazel-nut, red, to almost black, in color, and of a rounded form.  The spleen varies more in volume than any other organ, being relatively well developed in children, and atrophied in old age.  It varies with the same individual, with sex, degree of fullness of the portal vein. state of health, or disease, and with the influence of certain drugs.  It is hypertrophied in all infectious diseases.  It may be so large as to reach the pelvis, and weigh many pounds.
    The spleen is situated, under cover of the ribs, on the left side, being separated from them by the diaphragm, and above by a small portion of the lower margin of the left lung.  Its position corresponds to the ninth, tenth, and eleventh ribs.
    Blood Vessels. - The splenic artery arises from the celiac axis, and is large and tortuous,._ dividing at the hilum into five or six branches, each supplying a segment of the organ, and terminating either in the venous radicles or in the lacunar spaces.
    The splenic vein arises by radicles, partly from the capillary, partly from the lacunar spaces, and empties into the portal vein.
    Nerves. - The splenic nerves are derived from the semilunar ganglion of the solar plexus and the right pneumogastric, forming the splenic plexus.
    Function. - Leading authorities regard the spleen as a prominent source of white blood corpuscles, which seems to be proven by the enormous number of them found in the blood in cases of leucocythemia as well as by the fact that they are more numerous in the region of the spleen than in any other part of the body.  It is a very vascular organ, capable of very great distension, and becomes, in a passive way, a sort of safety-valve in relieving the portal system.  It is also regarded as an organ in which many of the red blood corpuscles undergo degeneration when their usefulness is impaired.

(Inflammation of the spleen.)

    Nausea; vomiting; aggravated respiration; elevation of temperature: pain and tenderness in the left hvpochondrium.

    1.  Place the patient on the side; beginning at the upper dorsal, move the muscles upward and outward, gently but very deep, the entire length of the dorsal region. being very thorough where any tenderness or abnormal temperature is discovered.  Treat the opposite side in a similar manner.
    2.  Place the patient on a stool; the thumb of the right hand on the angle of the eighth rib, with the left hand draw the left arm slowly but very strongly above the head, pressing hard upon the angle of the rib as the arm is lowered with a backward motion; place the thumb upon the angle of the next lower rib; raise the arm; and repeat, until the eleventh rib has been treated in a similar manner (cut 27).  This portion of the treatment usually gives immediate relief.
    3.  Place the patient on the back; with the hand resting lightly over the spleen, vibrate gently three or four minutes.
    4.  Place the hands on the sides of the neck, fingers almost meeting over the upper cervicals; press gently three or four minutes upon the vaso-motor to reduce the fever.
    This treatment will occupy about fifteen minutes, and should be given each day.

(Enlargement of the spleen.  May occur as the result of blood diseases.)

    Fever; weakness; diarrhea; disposition to hemorrhages; pain in the splenic region, which may extend to the left shoulder.

    1.  See Splenitis.
    2.  Flex the limb strongly against the abdomen, adducting the knee strongly as it is extended with a light jerk; repeat two or three times; treat the opposite limb in a similar manner.  This treatment stretches the abductor muscles of the thigh, and thereby starts the circulation to the limb.
    3.  Place one hand under the chin, the other under the occipital, and give thorough extension of the neck; also manipulate the front and sides of the neck thoroughly, thus freeing the circulation to the head.
    4.  Place the patient upon a stool; bend strongly backwards over the operator's knee, the knee being placed against the spine just below the last rib; hold in this position a moment and repeat.  This last treatment will almost invariably check the diarrhea in a very few days.
    This treatment will occupy from twenty to twenty-five minutes, and should be given every other day until recovery.

(Tumor of the spleen.)

    When large enough to permit palpation, fluctuation may be detected, and characteristic cystic fluid may be withdrawn by aspiration.

    1.  Place the patient upon the right side; place the fingers of the right hand as far as possible under the ribs immediately over the spleen; with the left hand draw patient's left arm above the head, at the same instant, with the right hand raising the ribs as much as possible from the spleen. This treatment usually gives immediate relief.
    2.  Place the hand lightly over the spleen, and vibrate four or five minutes.  Treatment should be given every other day.

(Mobility of the organ, due to relaxation of its attachments.)

    The absence of the organ from its usual position.  The presence of a solid body in an unusual position.

    1.  A thorough Treatment to Equalize the Circulation will nourish and strengthen the attachments of the spleen, thereby enabling them to hold the organ in place.
    After each treatment for the circulation, the operator should endeavor, by any manipulation which seems most suitable to the case, to move the organ toward its normal position.
    Treatment should be given every other day.