Osteopathy Complete
Elmer D. Barber, D. O.
1898
  
             
DISEASES OF THE KIDNEYS
 
 
THE KIDNEYS
 
    The kidneys are two in number, situated in the back part of the abdomen, and are for the purpose of separating from the blood materials which, when dissolved in a quantity of water, also separated by the kidneys from the blood, constitute the urine.
    They are situated one on each side of the vertebral column, behind the peritoneum, surrounded by a mass of fat and loose areolar tissue.
    Their upper extremity is on a level with the upper border of the last dorsal vertebra, and their lower extremity is on a level with the third lumbar.  The right kidney is usually a little lower than the left, probably on account of the vicinity of the liver.
    The kidney is flattened, and presents, at one part of its circumference, a hollow.  It is larger at its upper than at its lower extremity.
    Each kidney is about four inches in length, two to two and a half in breadth, and a little more than one inch in thickness.  The right is somewhat shorter, though some what broader, than the left.
    The weight of the kidney in the adult male varies from four and a half to six ounces.  In the adult female, from four to five and a half ounces.
    Relations. - Their posterior surface is in relation with the crus of the diaphragm, the eleventh and twelfth ribs, and the quadratus lumborum and psoas magnus muscles.  The right is covered in front by the right lobe of the liver, the descending portion of the duodenum, and the beginning of the transverse colon.  The left lies behind the fundus of the stomach, the tail of the pancreas, and the upper part of the descending colon.
    At the hilium of the kidney the relative position of the main structures passing into and out of the organ is as follows: The vein is in front, the artery in the middle, and the duct or urethra behind and toward the lower part. (By a knowledge of these relations a student may distinguish between the right and left kidneys.)
    Blood Vessels. - Considering the size of the kidney, it is most abundantly supplied with blood.  The renal artery, arising from the abdominal aorta, divides into four or five branches, which pass into the kidney at the hilum.  These branches, surrounded by connective tissue continuous with that of the capsule, continue to divide, and pass between the papillae to reach the bases of the pyramid on the limit between the cortical and boundary zones, where they form incomplete arches.  From these horizontal trunks, the interlobular or radiate arteries run vertically and singly into the cortex, between each two medullary rays, and in their course they give off on all sides the short undivided vasa afferentia, each of which enters a Malpighian capsule at the opposite pole from which the urinary tubule is given off.
    Nerves. - The nerves of the kidney, although small, are about 15 in number.  They have small ganglia developed upon them and are derived from the renal plexus, which is formed by branches from the solar plexus, and lower and outer part of the semilunar ganglion, and aortic plexus, and from the lesser and smaller splanchnic nerves.  They communicate with the spermatic plexus, a circumstance which may explain the occurrence of pain in the testicle in diseases of the kidneys.  They accompany the renal artery and its branches, but their exact mode of termination is not known.
    Nerve Influence on the Kidneys. - With regard to the influence exerted by the nervous system on the renal secretion, there can be little doubt that here, as in other glands, the process is under the control of the nerves.  Many of the conditions which cause increased secretion have no effect upon the general blood-pressure, so that if the increased flow be brought about by the vaso-motor mechanism, it must be by means of nervous channels altering the blood-flow in the special arteries of the glands.  In some emotional conditions, such as hysteria, an unaccountably great amount of urine of very low specific gravity is evacuated.
    The principal renal vaso-motor fibers leave the spinal cord by the anterior roots of the tenth, eleventh, and twelfth dorsal nerves.
    In regard to the effects of the vaso-motor nerves, we know that section of all the nervous twigs going to the kidneys causes great congestion and an immense increase in the secretion.  This undoubtedly depends upon the sudden rise in pressure in the glomeruli owing to the dilatation of the arteries.
    If the great splanchnics, in which also are renal vasomotor fibers, be cut, in addition to the lesser and smallest splanchnics, a great quantity of urine is produced from the vaso-motor paralysis, but, on account of the large area of vessels injured, the general blood-pressure falls; and the effect, therefore, is not so marked.  If, on the contrary, the lesser and smallest splanchnic nerves be stimulated, the secretion is diminished, Owing to the contraction of the renal arteries.  Section also of the spinal cord at the seventh cervical vertebra stops the flow, because it reduces the general blood-pressure below that necessary for the secretion of urine.
 
 
EXPLANATORY
 
    We desire to call the attention of the reader particularly to the large blood-supply of the kidneys, and the important duty which these organs are called upon to perform in separating the urine from the blood.  With poor circulation, and the blood in a stagnant, diseased condition, it is obvious that the kidneys are laboring under a disadvantage, and must in time feel the effects of this extra effort; hence, in all kidney diseases, the first duty of the osteopath is to free the entire circulation; neither can we hope to have healthy kidneys for any length of time if the liver is in an abnormal condition; it is, therefore, advisable to look well to that organ, giving such treatment, if it is found diseased, as conditions would indicate.  The nerves, also, play an important part, and we have no reason to hope for healthy kidneys if certain regions in the spinal column are in a sensitive or a congested condition.
    So many complications are liable to arise in diseases of the kidneys that the results obtained from osteopathic treatment will depend largely upon the good judgment of the operator in making a correct diagnosis, and applying, in all cases, such accessory treatments for complications arising in individual cases as the conditions indicate.
 


 
ANURY, ANURIA, ANURESIS, OR RENAL INADEQUACY
(Deficiency of the urine; of low specific gravity, containing but little urea, and neither
albumin nor casts.)

TREATMENT
    1.  Place the patient upon the face; beginning at the eighth dorsal vertebra, with one thumb on each side of the spine, between the eighth and ninth vertebra, press strongly a few seconds; with the thumbs between the ninth and tenth, repeat the operation; work in this manner between each successive vertebra, until the first lumbar is reached.
    2.  Place the patient on the back, with the knees slightly flexed, thus lessening the tension on the abdominal muscles; place the hands over the kidneys, the patient being required to make several strong expirations; with each succeeding expiration we come closer to the kidneys, until at last they art, easily felt.  The patient will now make thoracic respiration, that the manipulation of the kidneys may not be interfered with.  Knead the kidneys gently but thoroughly, from without inward and slightly from above downward, that the pressure may be applied in the direction of the venous circulation and large number of renal canals.  This treatment should be given in a very thorough manner, as it assists largely in exciting the kidneys to renewed action.
    3.  Place the hand over the kidney, and vibrate gently for two minutes over each kidney.
While the above treatment is very beneficial in stimulating the kidneys to greater activity, it is very often necessary to give General Treatment or such part thereof as may, in the judgment of the operator, be deemed essential.
    Treatment should occupy about fifteen or twenty minutes, and be given every other day.
 



 
ALBUMINURIA
(Albumin in the urine, generally from defective action of the secretary tubes of the kidneys;
detected by heating.)

TREATMENT
    Acute and Productive Nephritis.
 



 
CHYLURIA
(A discharge of milky urine, without apparent derangement of the kidneys or bladder, there being chyle in the urine, from communication between the lymphatic system and the genito-urinary tract; detected by microscope.)

TREATMENT
    Not treated successfully by Osteopathy.
 



 
HEMATURIA
(Hemorrhages from the mucous membrane of the urinary passages.  Blood in the urine.  Small quantity and uniform admixture with the urine points to renal hemorrhages.  Pure blood or clots mixed with the urine at the beginning or close of urination points to bladder or urethral hemorrhage.)

TREATMENT
    1.  Place the patient on the face; with the thumbs of the operator upon each side of the spine, beginning at the eighth dorsal, pressing hard with the thumbs, move the muscles upward and outward; move the thumbs down to the next dorsal, and repeat until the second sacral vertebra is reached.
    2.  Place the patient upon a stool; the thumbs of the operator upon the angles of the second ribs, an assistant standing in front, raising, the arms slowly, strongly, high above the head; press hard with the thumbs while the arms are lowered with a backward motion.  Treat in this manner until the eighth ribs are reached.
    3.  Place the patient upon the back; one operator grasping the shoulders, another the feet, give thorough extension of spine.
    4.  Place the hand lightly over the kidney, and give thorough vibration three or four minutes.  Treat the opposite kidney in a similar manner.
    In case of other complications, see General Treatment, applying such portions thereof as will meet the conditions.
 



 
HEMOGLOBINURIA
(Hemoglobin in the urine.  Urine dark-red or chocolate brown, high specific gravity, contains albumin, and few or no blood-cells.)

TREATMENT
    See Hematuria.
 



 
LIPURIA
(Fat in the urine.  May occur in health after excessive ingestion of fatty food; detected by adding potassium hydrate and shaking with ether.)

TREATMENT
    1.  Place the patient on the side; beginning at the upper cervicals, move the muscles upward and outward very deeply the entire length of the spinal column, being very thorough over the splanchnic nerves, as it is here we will find conditions which are causing an obstruction to the nerve wave, thereby interfering with their control of the digestive mechanism of the stomach. pancreas, and liver.   Thorough treatment of these nerves stimulates them to greater activity.
    2.  Place the patient on the back; with one hand under the chin, draw the head backward and to the side; with the disengaged hand manipulate the muscles thoroughly and deeply over the pneumogastric, thus freeing and stimulating this nerve to great activity.
    3.  Place the hands over the stomach, vibrating gently two minutes.  Vibrate the pancreas, liver, and kidneys in a similar manner.
    This treatment will occupy about fifteen or twenty minutes, and should be given every other day.
    During the course of this treatment, the patient should be confined strictly to a fruit and vegetable diet.
 



 
PYURIA
(Pus in the urine.  From suppuration in any portion of the genito-urinary tract; detected by microscope.)

TREATMENT
    1.  Place the patient on the face; beginning at the last dorsal vertebra, with the thumbs on each side and close to the spinal column, move the muscles upward and outward gently but very deep, being particular to treat thoroughly between the last lumbar and first sacral vertebra.
    2.  Place the patient upon the back, with one hip and limb off the edge of the table; place one hand upon the knee, the other under the great trochanter, pressing downward strongly upon the knee, at the same instant lifting upon the great trochanter.  This treatment stretches the muscles through which passes a large portion of the urinary tract, thereby freeing the circulation in this immediate region.  Treat the opposite side in a similar manner.
    3.  The kidneys and the entire urinary tract should be manipulated in a very thorough and careful manner.
    Treatment will occupy about fifteen minutes, and should be given every other day.
 



 
OXALURIA
(Calcium oxalate in the urine.  From insufficient activity of the stage which should change
oxalic acid into carbonic.)

SYMPTOMS
    Dull pain in the loins; boils or carbuncles; specific gravity of urine increased, and contains an excess of urea and oxalates.

TREATMENT
    1.  Place the patient upon the back; grasping both knees, flex the limbs slowly but very strongly against the abdomen; with the knees in this position, press as hard as the patient can stand without too much pain, at the same time moving the limbs gently from side to side.
    2.  Flex one limb strongly upon the chest, giving it strong abduction, and extending with a light jerk.  Treat the opposite limb in a similar manner.
    3.  Knead the kidneys carefully and thoroughly.
    4.  Place the hand over the liver, vibrating gently three or four minutes; also vibrate over the kidneys.
    Treatment should occupy about ten or fifteen minutes, and be given every other day.
 



 
UREMIA
(Toxic condition of the blood from accumulation of urea.  Due to retention of poisonous materials
which should be eliminated by the kidneys.)

SYMPTOMS
    Headache; nausea; vertigo; vomiting; dilatation of the pupils; delirium; convulsions; and coma.

TREATMENT
    1.  Place the patient upon the side; beginning at the eighth dorsal, move the muscles upward and outward to the last lumbar vertebra, being very particular over the lesser splanchnic nerves to manipulate deeply, as it is here we are very apt to discover conditions which are the real cause of the failure of the kidneys to properly perform their duties.
    2.  Place the patient on the back; and knead the kidneys careful] and thoroughly; also give vibrations.
    It is often advisable in this disease, in addition to the above treatment, to give a thorough Treatment to Equalize the Circulation.
    Treatment will occupy about twenty or twenty-five minutes, and should be given each day.
 



 
RENAL CONGESTION
(Excess of blood in the kidneys.)

SYMPTOMS
    Amount of urine diminished, and of high specific gravity, 1020 to 1030, dark, and only small amounts passed at frequent intervals; uric acid increased, small amount of albumin, hyaline casts, and few red blood-cells.

TREATMENT
    1.  Place the patient on the side; beginning at the eighth dorsal, move the muscles upward and outward, very deep, to the end of the sacrum, thus freeing and stimulating the nerves which assist in controlling the kidneys.  Treat the opposite side in a similar manner.
    2.  Place the patient face downward; the operator pressing very hard upon the sacrum, as an assistant raises the limbs, slowly, as high as the patient can bear without great inconvenience, holding them in this position a moment, also moving them gently from side to side; lower the limbs; and repeat, this time, if possible, raising the limbs a little higher.
    3.  Place the hand lightly over the kidney, and vibrate gently two or three minutes.  Treat the opposite side in a similar manner.
    Treatment will occupy about fifteen minutes, and should be given each day, until recovery.
 



 
ACUTE EXUDATIVE AND PRODUCTIVE NEPHRITIS, OR ACUTE BRIGHT'S DISEASE
(Inflammation of the kidneys, with exudation of plasma, red and white blood-cells; excessive growth of capsule-cells in the glomeruli; and overgrowth of connective tissue.)

SYMPTOMS
    May commence with a chill, followed by fever; pain in the loins; headache; eyelids puffy; extremities dropsical; diminished excretion; micturition frequent; urine smoky and reddish, specific gravity high, deficient in urea, contains albumin, hyaline, and blood-casts.

TREATMENT
    1.  Patient lying face downward; beginning at the tipper cervicals, with the thumbs on each side of and close to the spinous processes, pressing rather hard, move the muscles upward and outward the entire length of the spinal column, being very thorough in the lower dorsal and lumbar regions.
    2.  Place the patient on the back; the operator grasping the patient's shoulders, while an assistant, grasping the ankles, assists in giving thorough and strong extension, which should be continued one minute.
    3.  Place the patient close to the edge of the table, the limb and hip lying over the side; place one hand upon the knee, the other under the trochanter; while lifting strongly upon the trochanter with one hand, with the other press the limb as far downward as possible, holding it a few seconds in this position.  Treat the opposite limb in a similar manner.
    4.  Place the hand lightly over the kidney, and vibrate gently two minutes.  Treat the opposite
kidney in a similar manner.
    5.  Flex the limb strongly against the chest, while in this position moving it slowly from side to side; give the knee strong abduction, extending with a light jerk.  Treat the opposite limb in a similar manner.
    6.  Place one hand on each side of the thigh, and move all the flesh gently but very deep from side to side the entire length of the limb.  This and the above treatment frees the circulation to the limb, and will immediately relieve its dropsical condition.
    7.  Knead and manipulate the bowels carefully but deeply.
    Treat twenty minutes each day, till a cure is effected.
 



 
CHRONIC EXUDATIVE AND PRODUCTIVE NEPHRITIS, OR CHRONIC BRIGHT'S DISEASE
(May follow acute attacks.  And develop in the course of syphilis, endorcarditis, tuberculosis,
or bone diseases.)

SYMPTOMS
    Development slow.  Dropsy; skin pasty in color; sclerotics very white; headache; insomnia; dyspnea; nausea; vomiting; urine deficient in urea and specific gravity; excess of albumin; casts abundant, both epithelial, fatty, and granular; few red blood-cells.
    More common in males.

TREATMENT
    1.  See Exudative and Productive Nephritis.
    2.  Manipulate and vibrate (see Acute Lithemia, 7, 8, and 9) the liver in a very thorough manner.
    3.  Place the patient upon a stool; the knee of the operator between the scapula of the patient, grasp the wrists and draw the arms slowly but strongly above the head as the patient inhales (cut 5), pressing hard with the knee as the arms are lowered with a backward motion.
    Treatment should be given every other day, and occupy about twenty or twenty-five minutes.
    Patients suffering with this disease are very often benefited and occasionally cured by the above treatment.
 



 
DIABETES INSIPIDUS, OR POLYURIA
(Excessive quantity of urine of low specific gravity.)

SYMPTOMS
    Urine pale and of low specific gravity, 1001 to 1005.  Patient usually well nourished.  Generally secondary to some disease of the brain or abdomen.  More common in young males.

TREATMENT
    1.  Place the patient upon the side; beginning at the first cervical, move the muscles upward and outward, carefully but very deep, the entire length of the spinal column.  Be very thorough from the ninth dorsal vertebra to the second lumbar.  Treat the opposite side in a similar manner.
    2.  Place the left hand upon the sacrum, just below the last lumbar; with the right beneath the knees of the patient, the limbs should now be drawn toward the operator, upon a level with the table, after which they should be raised as far as the patient can stand without too much inconvenience, the operator pressing, at the same instant, very hard upon the sacrum; move the limbs until they are on a line with the body, and lower to the table (cut 31).  Repeat this operation two or three times, raising the limbs a little higher with each succeeding operation.
    3.  Place the hand over the kidney, and vibrate for two minutes.
    The above treatment acts directly upon the nerves and, if given correctly, will immediately check the excessive flow of urine.
    In case the disease is secondary to brain or abdominal troubles, it, of course, will be necessary to give such accessory treatment as the conditions indicate.
 



 
DIABETES MELLITUS, OR GLYCOSURIA
(Excessive quantity of urine containing sugar.)

SYMPTOMS
    Urine pale, of high specific gravity, 1025 to 1045, acid reaction, and contains sugar; hunger; emaciation; muscular weakness; and loss of sexual power.
 
TREATMENT
    See Diabetes Insipidus.
    This disease is very often benefited by the above treatment, using such other accessory treatment as the condition of the patient and judgment of the operator would indicate.

PAROXYMAL HEMOGLOBINURIA
(Hemoglobin in the urine, accompanied by paroxysms.)

SYMPTOMS
    Languor; fatigue; feeling of chilliness; fingers, toes, and ears become numb, cold, and cyanotic.      More common in young adult males.

TREATMENT
    In the treatment of this disease it is necessary to stimulate the nerves controlling the entire digestive tract) particularly the nerves of nutrition, which can be stimulated by thorough treatment in the upper dorsal region.  It is also essential to expand the chest, thus stimulating the lungs to greater activity, and also freeing the circulation to these organs.  The liver, pancreas, and kidneys must also be treated, with a view of equalizing and stimulating their action.
    1.  Place the patient upon the side; beginning at the upper cervicals) move the muscles upward and outward very deeply the entire length of the spinal column, being very thorough in all regions which appear at all sensitive to the touch, or in which the temperature is abnormal.  Treat the opposite side in a similar manner.
    2.  Place the hand under the chin, drawing the head backward and to the side; with the disengaged hand manipulate the muscles immediately over the pneumogastric nerve.  Treat the opposite side of the neck in a similar manner.
    3.  Vibrate one minute over each of the following organs: the lungs, stomach, liver, pancreas, and kidneys.
    4.  Place the patient upon a stool; the knee of the operator between the scapula at about the second dorsal, draw the patient's arms strongly above the head, as the lungs are filled to their fullest capacity (cut 5); press hard with the knee as the arms are lowered with a backward motion.
    This treatment will occupy about fifteen or twenty minutes, and should be given every other day.
 



 
PYELITIS
(Inflammation of the pelvis of the kidney.)

SYMPTOMS
    Pain in the lumbar region; urine acid reaction; sediment, principally pus, but may contain blood.

TREATMENT
    1.  Place the patient on his side; beginning at the last dorsal, move the muscles upward and outward, gently but very deep, the entire length of the lumbar and upper sacral region.  Treat the opposite side in a similar manner.  This treatment, if correctly applied, will remove almost immediately the pain in the lumbar region.
    2.  Manipulate the kidneys and entire urinary tract gently, but as thoroughly as possible.
    3.  With the patient lying upon the side, place one hand against the sacrum, with the other grasping the knee; draw the limb strongly backward, pressing hard at the same instant upon the sacrum.
    4.  Place the hand lightly over the kidney, vibrating one minute.  Treat the opposite kidney in a similar manner.
    Treatment should be given each day, and occupy about ten minutes.
 



 
RENAL CALCULUS, OR NEPHROLITHIASIS
(Stone in the pelvis of the kidney.)

SYMPTOMS
    Constant dull pain in the lumbar region; following paroxysms, urine may contain blood; if calculus enters ureter, there is excruciating pain in its course; numbness of the thigh; nausea and vomiting.

TREATMENT
    1.  Place the patient on the back, the operator's hands immediately over the kidneys; the patient will now be required to exhale several times very deeply; with each exhalation the hands are brought nearer the kidneys, until at last they can be felt very distinctly; patient will now make thoracic respiration, that the process of kneading the kidneys may not be interfered with.
    In manipulating the kidney, great care must be exercised in endeavoring to move the stone towards its natural point of exit.
    2.  Place the hand over the kidney, and vibrate gently two or three minutes.
    3.  Place the patient on the face; the operator's thumbs upon each side and close to the spine, beginning at the ninth dorsal vertebra, move the muscles upward and outward, gently but very deeply, to the first sacral, being very thorough the entire length of the lumbar region.
    Treatment should be given at short intervals, until the desired results are obtained.
 



 
HYDRONEPHROSIS
(Dropsy of the kidneys, due to obstruction.)

SYMPTOMS
    Dull pain, with sense of fullness; periodical discharges of large quantities of urine, as the obstruction is temporarily removed; rigor; sweat; and emaciation.

TREATMENT
    1.  Place the patient on the side; beginning at the upper dorsal vertebra, move the muscles upward and outward the entire length of the spinal column, being very thorough in the splanchnic and lumbar region.
    Treat the opposite side in a similar manner.
    2.  Place the patient on the face; operator placing one hand upon the sacrum, the other beneath the knees, raise the limbs strongly, pressing at the same instant very hard upon the sacrum.
    3.  Place the hand lightly over the kidneys, vibrating each kidney two minutes.
    4.  Place the patient upon a stool; the operator places his thumbs upon the angles of the second ribs, an assistant raising the arms strongly above the head as the patient inhales; press hard with the thumbs as the arms are lowered with a backward motion; place the thumbs on the angles of the third ribs; raise the arms as before, and repeat until the lower borders of the scapulae are reached.
    This treatment will occupy about fifteen minutes, and should be given each day.
 



 
CHRONIC INTERSTITIAL NEPHRITIS
(Overgrowth of connective tissue, with atrophy of the epithelium and tubules.  Due to lead poison, gout, or alcoholism.)

SYMPTOMS
    Urine increased and of low specific gravity; frequent micturition; diarrhea; shortness of breath; arterial tension high; and hypertrophy of the heart.
    No care in Osteopathy.
 



 
RENAL AMYLOID DEGENERATION
(Starch-like degeneration of the renal capillaries.)

SYMPTOMS
    Albuminuria; edema; diarrhea; waxy complexion; urine pale, and specific gravity 1008 to 1014, containing hyaline casts and white blood-cells.
    No cure in Osteopathy.
 



 
RENAL TUBERCULOSIS
(Consumption of the kidney, with specific bacillus.)

SYMPTOMS
    As a rule, other organs of the body are involved.  Urine generally contains pus and waste matter and tubercle bacilli; emaciation; and exhaustive perspiration.
    No cure in Osteopathy.
 



 
RENAL CARCINOMA
(Cancer of the kidney.)

SYMPTOMS
    Hematuria and development of tumor; dull exacerbating pain in the lumbar region; anorexia; emaciation; anorexia; and edema of the lower extremities.
    No cure in Osteopathy.
 



 
RENAL  HYDATID CYST
(Tumor of the kidney.)

SYMPTOMS
    Fluctuating tumor in the loin or lateral region.  Peculiar thrill on percussion.

TREATMENT
    1.  Place patient on the back; flexing the limb corresponding to the diseased kidney slowly, gently, gradually increasing the force used, as far as possible upon the abdomen; abduct the knee strongly as the limb is extended.
    2.  Place the patient in such position that the limb will hang over the edge of the table; placing one hand under the trochanter, with the other press the limb gently downward, being very careful not to cause much pain; raise the limb carefully, and again press it downward, this time a little further, if possible, than before.
    Place the hand over the tumor, and vibrate two minutes.
    Treatment will occupy about ten minutes, and should be given every other day.
 



 
RENAL ABSCESS
(Abscess of the kidney.  May be due to general pyemia, or to traumatism.)

SYMPTOMS
    Rigors; sweat; emaciation; urine may contain pus, albumin, tube casts, and blood-corpuscles; pain and tenderness in the renal region.

TREATMENT
    1.  Place patient on the back; manipulate very carefully over the abscess, working gradually deeper, until the kidney has been manipulated as thoroughly as possible.
    2.  Place the hand over the abscess, and vibrate two minutes.
    3.  Place the patient on the face; while pressing hard upon the sacrum with one hand, draw the limb corresponding to the diseased kidney backward slowly, but as far as possible.  This operation should be repeated, the second time drawing the leg a little further backward.
    Great care must be exercised in giving this treatment to cause no unnecessary pain.  If given very gently, patient relaxing all muscles, quite a thorough treatment can be given even the first time.
    Treatment will occupy, about fifteen minutes, and should be given every day.
 



 
PERIRENAL ABSCESS
(Suppuration in the perirenal connective tissue.)

SYMPTOMS
    Fluctuating tumor in the lumbar region; chills; fever; sweat; emaciation.

TREATMENT
    See Renal Abscess.
 



 
FLOATING KIDNEY
(Mobility of the organ.  Generally the right.)
 
SYMPTOMS
    A void in its usual position; sense of weight and dragging in the abdomen, with dull pain; sometimes nausea and vomiting.  More common in females.

TREATMENT
    In treating this disease it is necessary to free the circulation and nerve-wave to the muscles and ligaments holding these organs in position.
    1.  Place the patient on the face; with the thumbs on each side of and close to the spine, move the muscles upward and outward the entire length of the spinal column, being very thorough in the lumbar region, which will be found in a very sensitive condition.
    2.  Place the patient on the back; one operator grasping the shoulders, the other the feet, give very thorough extension, using as much strength as the patient can stand without too much inconvenience.
    3.  The operator should now endeavor, by any manipulation which seems most applicable to the case, to work the kidney back to its normal position.
    Treatment will occupy about fifteen minutes, and should be given every other day.
 



 
ADDISON'S DISEASE
(Disease of the suprarenal capsule.)

SYMPTOMS
    Skin discolored; appetite impaired; heart action feeble; pulse soft and slow; nausea and vomiting. Supposed to be tuberculous.
    No cure in Osteopathy.