Osteopathy Complete
Elmer D. Barber, D. O.

    The heart is a hollow, muscular organ, of a conical form, placed between the lungs and enclosed in the cavity of the pericardium.  It is placed obliquely in the chest, the broad attached end, or base, upward, backward, and to the right, and corresponds to the interval between the fifth and eighth dorsal vertebra; the apex is directed downward, forward, and to the left, and corresponds to the space between the cartilages of the fifth and sixth ribs, three-quarters of an inch to the inner side, and an inch and a half below the left nipple.  The heart is placed behind the lower two-thirds of the sternum, and projects farther into the left than into the right cavity of the chest, extending from the median line about three inches in the former direction and only one and one-half inches in the latter.  In the adult it measures five inches in length, three inches and a half in the broadest part, and two inches and a half in thickness.  The average weight in the male varies from ten to twelve ounces, and in the female from eight to ten.  It continues to increase in weight, also in length, breadth, and thickness, up to an advanced period of life.  The heart of man and warm-blooded animals may be said to be made up of two muscular sacs, the Pulmonary and Systemic pumps, or, as they are commonly called, the right and left sides of the heart.  Between these no communication exists after birth.  Each of these sacs may be divided into two chambers.  One, acting as an ante-chamber, receives the blood from the veins; it has very thin walls, and is called the Auricle; the other, the Ventricle, is the powerful muscular chamber which pumps the blood into and distends the arteries.
    Innervation of the Heart. - When the heart is removed from the body, or when all the nerves which pass to it are divided, it still beats for some time, so that its movement must depend upon some mechanism situated within itself.  The movement lasts longer in cold-blooded animals (frog and turtle), extending even to days, than in mammals.  A rabbit's heart beats from three to thirty-six minutes after it is out of the body.  The average of many experiments is eleven minutes.  If the heart has ceased to beat, it may be excited to action for a short time by direct stimulation, more especially by heat.  The ordinary rhythmical movements of the heart are undoubtedly associated with the presence of nerve ganglia which exist in the surface of the heart, but the movements of the heart are influenced by nervous, impulses which reach it from without.
    The cardiac plexus is composed of the following nerves: The cardiac branches of the vagus, a branch of the same name from the external branch of the superior laryngeal, a branch from the inferior laryngeal, and sometimes branches from the pulmonary plexus of the vagus; the superior, middle, inferior, and lowest cardiac branches of the three cervical and the first thoracic ganglia; the inconstant twig of the descending branch of the hypoglossal nerve, which arises from the upper cervical ganglion.  From the plexus there proceeds the deep and superficial nerves.
    It will be observed that the nerves which form the cardiac plexus are composed of branches of nerves which can be reached by direct pressure, either in the cervical or upper dorsal region; hence the osteopath, by thorough knowledge of anatomy, is enabled to so manipulate these nerves as to slow or quicken the action of the heart.
    It has been found that stimulation of the cervical portion of the spinal cord causes quickening of the heart-beat, while a steady pressure on the same nerve-centers slows the action of the heart.  It is thus that in fever, working from this center, we slow the heart's action, and are thereby enabled to reduce any fever in an incredibly short time.

    We will now briefly refer to the blood-carrying mechanism, our object being to prove to our readers that the heart, arteries, and veins are simply different parts of the same machine, and that the contraction of a muscle, throwing a pressure on an artery or vein, will affect the heart, on the same principle that a force-pump attached to a rubber hose would be affected should you stand on the hose.
    The channels which carry the blood through the body form a closed system of elastic tubes, which may be divided into three varieties: Arteries, Capillaries, and Veins.
    Arteries. - The arteries are those vessels that carry the blood from the heart to the capillaries.  The great trunk of the aorta springs from the left ventricle and gives off a series of branches, which in turn subdivide more and more freely in proportion to their distance from the heart.  The aorta is divided into the arch, ascending and descending portions.  The descending aorta is divided into two portions, the thoracic and abdominal, in correspondence with the two great cavities of the trunk, in which it is situated.  The thoracic aorta commences at the lower border of the fourth dorsal vertebra on the left side, and terminates at the aortic opening in the diaphragm, in front of the last dorsal vertebra.  The abdominal aorta commences at the aortic opening in the diaphragm, in front of the body of the last dorsal vertebra, and descending a little to the left of the vertebral column, terminates opposite the body of the fourth lumbar vertebra, where it divides into the right and left common iliac arteries.  The common iliac arteries are about two inches in length, and divide opposite the intervertebral substance of the last lumbar vertebra and sacrum, into the internal and external iliac arteries, the latter supplying the lower extremities.  The external iliac artery passes obliquely downward and outward along the inner border of the psoas muscle from the bifurcation of the common iliac arteries to Poupart's ligament, where it enters the thigh and becomes the femoral artery.  The femoral artery commences immediately behind Poupart's ligament, midway between the anterior and superior spine of the ileum and the symphysis pubis, and, passing down the front and inner part of the thigh, terminates at the opening of the adductor magnus muscle at the junction of the middle with the lower third of the thigh, where it becomes the popliteal artery. The popliteal artery commences at the termination of the femoral at the opening in the adductor magnus, and, passing obliquely downward and outward behind the knee-joint to the lower border of the popliteus muscle, divides into the anterior and posterior tibial arteries.  The anterior tibial artery passes forward between the two heads of the tibialis posticus to the deep part of the front of the leg; then descends on the anterior surface of the interosseous membrane, Gradually approaching the tibia, and at the lower part of the leg lies on the bone, and then on the interior ligament of the ankle to the bend of the ankle-joint, where it lies more superficially and becomes the dorsalis pedis.  This artery passes forward from the bend of the ankle along the tibial side of the foot, and terminates in two small branches, the dorsalis hallucis and communicating.  The posterior tibial artery is of large size, and passes obliquely downward from the lower border of the popliteus muscle along the tibial side of the leg to the fossa between the ankle and the heel, where it divides into the internal and external planter arteries.
    Now, having traced this river of blood, which throws branches to each organ and muscle in its course from the heart to its termination in the lower extremities, passing as it does through, over, under, and between the numerous muscles on its journey, it will not be hard for the intelligent reader to believe that an obstruction to its free flow, caused by contracted muscles, would affect the heart.  Cramping of the muscles is so very common, often leaving the muscles in ridges, that the most skeptical will not dispute the fact that muscles will contract and remain in that condition.  The heavy muscles of the thigh and those below and about the knee, from their peculiar relation to the artery and their great strength, are usually at fault, and by a simple twist of the leg, throwing these muscles on a strain, and thereby freeing the femoral artery, we have cured cases of heart disease that had baffled the best physicians of modern times.
    Having followed this river of blood from the heart to its termination, we must now trace it back to the heart and endeavor to locate along its channel the cause of dropsy and consequent heart trouble.  The frequently branching arteries finally terminate in the capillaries, in which distinct branches can no longer be recognized, but their channels are interwoven into a network, the meshes of which are made up of vessels all having the same caliber.  They communicate with the capillary network of the neighboring arteries, so that any given capillary area appears to be one continuous net of tubules connected here and there with a similar network from distant arterioles, and thus any given capillary area may be filled with blood from several different sources.
    Veins. - The veins arise from the capillary network, commencing as radicles, which correspond to the ultimate distribution of the arterioles, but they soon form wider and more numerous channels.  They rapidly congregate together, making comparatively large vessels, which frequently intercommunicate and form coarse and irregular flexures.  Thus it will be seen that we have two rivers, one distributing, the other gathering up and returning the blood to the heart.  While a pressure on an artery, cutting off the supply to the extremities, causes them to be cold, at the same time affecting the heart, a pressure on a vein, stopping the return current, will necessitate an engorgement of the blood in the capillaries; the heart, working against heavy odds in trying to force the blood past the contracted muscles, will certainly be affected, while the stagnant blood, unable to escape, will cause either inflammatory rheumatism, dropsy, or erysipelas.
    In treating diseases of the heart, three great principles must be constantly kept in mind:
 (1) An obstruction, from any cause, to the free circulation of the blood overworks the heart, and in time must certainly affect that organ.  This condition can be relieved by very careful and thorough manipulation of the muscles and by rising the limbs, arms, and neck as levers to stretch any and all muscles to which they give attachment
    In very many cases of organic heart trouble, in which we cannot hope to effect a cure, to free the circulation by manipulation relieves the pressure upon the heart to such an extent that the patient improves rapidly, and his life may be prolonged for years.
    (2)  A contraction of the thorax or enlargement or misplacement of any organ is very liable to affect the heart, in which case we must remove the cause, and the heart will be immediately relieved.  We have very often cured a case of heart disease by a few applications of our Asthma treatment.  We have cured others by relieving a severe case of dyspepsia; one, where the patient lay dying, with two MDs at his bedside, by placing the thumb of the right hand upon the angle of the fifth rib, and with the left drawing, the left arm high and very strong above the head, pressing hard upon the angle of the rib as the arm was lowered with a backward motion.
     It is impossible to lay down a line of treatment that can be used successfully in all cases; so many complications are liable to exist that a great deal will depend upon the skill and good judgment of the operator, who should apply such treatment as, in his judgment, the condition indicates.
    There is a prevailing idea among the medical fraternity that in many cases of heart disease it is very dangerous to draw the arms high above the head.  We consider this idea erroneous, if due caution is exercised in giving a very light treatment at first, gradually increasing the strength employed, as the patient becomes accustomed to the manipulations.
    In treating osteopathically, for any disease, the treatment should be slow, gentle, and no stronger than the patient can stand without fatigue.
    (3)  The vaso-motor nerve-center, controlling as it does the caliber of the arteries, must be carefully studied and never forgotten, in all cases that would indicate any complication of a nervous origin.


    Heart disease is often caused by constipation and a diseased condition of the alimentary canal.  Those cases can be readily distinguished, as the patient will find great difficulty in breathing when in a recumbent position, and upon resuming an upright position will feel immediate relief thus proving that the organs are distended to such an extent that there is at all times a pressure on the diaphragm, left lung, and heart, and that their own weight, when in an upright position, will partially free the last named organs.  It will be readily understood that our Constipation or Indigestion treatment, or both, as the case may seem to require, will cure this form of heart disease as it has done in hundreds of cases.  Other cases - and they are very numerous - are caused by a contraction of the muscles, depressing the ribs immediately over the heart, thus interfering with its action.  We are led to believe that there are very few cases of actual "enlargement of the heart," but that the so-called "enlargement of the heart" is really a compression of the cavity in which the heart is contained.

    1.  Free all the muscles attached to the ribs immediately over the heart, from the spine to the median line, on each side, always moving the flesh upward, using the arm as a lever in treating the muscles of the spine (cut 7).
    2.  Place the patient on the back; two operators, one grasping each wrist, placing the disengaged hands between the patient's shoulders, the fingers pressing hard upon the angle of the rib between the spine and scapula, draw the arms slowly, but with some strength, high above the head; move the hands down one inch, and repeat until you have reached the lower angle of the scapula.
    This will usually give instant relief, and seldom fails to effect a cure in from two to four weeks' treatment.  A treatment should be given every other day.
    Of the many cases cured by us in this manner, it might be well to mention an old gentleman of Galena, Kansas.  As a drowning man will grasp at a straw, when he was dying and nearly all hope had fled, we were called in, and, in the presence of two medical doctors and the members of his family, we raised his ribs, thus permitting the heart to act.  In a few minutes we had our patient out of danger.  We will also add that he never afterward experienced any difficulty with his heart.


    This trouble is caused by an almost imperceptible contraction of all the muscles, thus interfering with the entire circulation.  An aching, tired sensation, so often felt, is caused by the contracting muscles, as is readily proven beyond the shadow of a doubt by the fact that after a general treatment, stretching and moving all the muscles, permitting the sluggish blood to move more rapidly through the arteries and veins, the heart's action is increased and the tired, aching, worn sensation has entirely disappeared.


    1.  Place the patient on the side; using the arm as a lever (cut 7), with the fingers pressing rather hard close to the spine, beginning at the first cervical vertebra, move the muscles upward and outward gently but deep, the entire length of the spinal column.  Treat the opposite side in a similar manner.
    In giving this treatment the operator should endeavor to avoid as much as possible using the ends of the fingers, but should place the hands flat, using the fingers as far back as the second phalanges, which will give the patient no pain, while the ends of the fingers are apt to go too deep, thus causing the patient unnecessary discomfort.
    Tender spots upon the spine are very apt to be discovered; in which case a little additional treatment should be given in this immediate region, which will assist in relieving the congested condition, possibly immediately over some nerve-center, which may control some distant part of the anatomy, and hence could not be expected to do its work correctly with such a condition existing at its origin.
    2.  Flex the limbs against the chest, the patient lying on the back; rotate the leg from side to side quite strongly two or three times, extending the limb with a light jerk (cuts 32 and 36).  Flex the limbs strongly against the chest, abducting the knee and adducting the foot as the limb is extended.  This treatment stretches the adductor muscles of the thigh, thereby freeing the femoral artery and vein and the long saphenous vein, and should never be omitted in any case where the patient is troubled with cold extremities.
    3.  Grasp the thigh firmly, with one hand on each side, the fingers meeting; beginning close to the body, move the flesh to the bone, if possible, from side to side (cut 29).
This treatment is beneficial in all cases of impaired circulation of the limbs.
    4.  Place the left hand under patient's right shoulder, the fingers on the angle of the second rib; with the right hand grasp the patient's right wrist', drawing the arm slowly, with some strength, above the head as the patient inhales; press hard with the fingers upon the angle of the rib as the arm is lowered with a backward motion.  Treat the third, fourth, and fifth ribs in a similar manner.  This operation should be repeated on the opposite side.
    It is remarkable what a relief the patient will experience in almost all cases of heart disease if this treatment, which expands the chest and equalizes the circulation, is given in a correct and scientific manner.
    5.  Place one hand under the chin, the other under the back of the head, and give gentle extension (cut 8), rotating the head from side to side.  In all cases where the action of the heart is too rapid, place one hand on each side of the of the four neck, the fingers almost meeting over the spines or five upper cervicals; press gently with the fingers for three or four minutes upon the vaso-motor center (see cut 13).  A pressure at this point causes the arteries to relax, thus increasing their caliber and slowing the action of the heart.
    In all cases of heart disease or diseases of the blood, in addition to this treatment, such other treatment should be given as the condition for accompanying complications would indicate.
    In applying osteopathic treatment, the operator must determine with the utmost nicety just how strong or light a treatment will produce the best results.  Always begin with a very light treatment, which should increase in strength with each succeeding treatment until a point is reached beyond which we can go no further without unduly fatiguing the patient.  If the treatment is correctly given, the patient should feel refreshed and relieved after each treatment
    This treatment will require from fifteen to twenty minutes, and in acute cases should be given each day; in chronic diseases every other day is sufficient.
    Of the numerous cases cured by this treatment, we will mention that of an old gentleman of Galena, Kansas.  He could not climb the steps to our office.  We treated him on the counter in a grocery store near by.  His pulse, which was hardly perceptible, was down to 38.  When he came for his second treatment, two days later, his pulse was strong and had increased to 58.  He could hear better, and recognized people on the street for the first time in months.

(Structural changes in the valves, causing either obstruction or regurgitation at the orifices affected.     Includes Valvulitis and Valvular Incompetency.)

    As long as the heart muscle is sufficiently enlarged to compensate for the  impaired circulation there are no symptoms; otherwise it may be distinguished by the appearance of Dilatation or Hypertrophy.

    In this disease we do not hope to effect a cure.  The patient can be often relieved and greatly benefited by a very careful application of Treatment to Equalize the Circulation.

(Expansion, usually more prominent in the right heart.)

    Irregular and rapid action of the heart; pulse weak; poor circulation; venous congestion; edema; syncope, sudden faintness with loss of consciousness; dyspnea.

    This disease can be greatly relieved, and the patient's life prolonged.  See Treatment to Equalize the Circulation.
    Treatment must be given in a gentle and very careful manner.

(Abnormal enlargement of the heart.)

    Action of the heart rapid and regular; pulse full and strong; rush of blood to the head; shortness of breath; vertigo; ringing in the ears; insomnia; palpitation; and paroxysmal cough.

    Sometimes benefited by a Treatment to Equalize the Circulation.

(Dizziness, usually associated with cerebral anemia, and closely allied to fainting - also may be associated with fatty heart and dilatation of its right cavities.)
    Swimming sensation in the head; darkness falls on the eyes; patient becomes weak and chilly.

    See Treatment to Equalize the Circulation.

(Abnormal structure or shape of the heart.  Imperforated interventricular septum and a failure of the foramen ovale to close are the most common.)

    Cyanosis is the most common; patient seldom reaches adult life.
    No cure in Osteopathy.

(Congenital displacement of the heart on the right side.)

    Sound and impulse of the heart are on the right side instead of the left
    No cure in Osteopathy.

(Abnormal rapidity of the heart's action.)

    Heart-beats rapid, accompanied with palpitation.

    This disease is often benefited by thorough and very careful Treatment to Equalize the Circulation.

(Neuralgia of the heart.  Breast-pang.)

    Intense tearing and squeezing pain in the precordial region, extending to the shoulder and arm; irregular pulse; paroxysm; features drawn; apt to follow atrophy or fibroid degeneration suffocation in the breast.

    Very thorough and careful Treatment to Equalize the Circulation, being careful to give No. 4  slowly, gently, but very thoroughly.

(Inflammation of the endocardium.)

    Heart action rapid; dyspnea; face flushed and countenance anxious; elevation of temperature; irritable stomach; slight cough; delirium; diarrhea.  May accompany acute rheumatism.

    1.  Very thorough Treatment to Equalize the Circulation.
    2.  Place the hand lightly over the heart and vibrate gently two minutes.  See Vibration.

(Inflammation of the pericardium.)
    Irregular and rapid action of the heart; pain in the precordial region; elevation of temperature; dyspnea; nausea; and vomiting.

    1.   See Treatment to Equalize the Circulation.
    2.  Place the hand lightly over the heart and vibrate gently two minutes.  See Vibration.

(Inflammation of the cardiac muscular tissue.)

    Somewhat similar to those of Endocarditis and Pericarditis.  Often occurs with rheumatism.

    1.  See Treatment to Equalize the Circulation.
    2.  Place the hand lightly over the heart and vibrate gently for two minutes.   See Vibration.

(Dropsy of the pericardium.)

    Similar to those of Pericarditis, without elevation of temperature; evidence of edema and pleural effusion; also signs of nephritis.
    No cure in Osteopathy.

(Coagulation of the blood in the cavities of the heart.)

    Rapid action of the heart, feeble and irregular; surface of the body cold and livid; vomiting; syncope; delirium; venous turgidity; nervous excitement.
    No cure in Osteopathy.

(Rupture or dilatation of one or more of the coats of the thoracic aorta.)

    Irregular heart action; venous stagnation and edema; inability to swallow; localized perspiration; pulsating tumor; contraction or dilatation of one of the pupils.

    This disease is sometimes benefited by a Treatment to Equalize the Circulation.

(Degeneration of the walls of the smaller blood-vessels.)

    Impairment of the nutrition and mental faculties; numbness and coldness of the extremities; shortness of breath; impeded circulation; vertigo; and irregularity of heart action.

    This disease is sometimes benefited, but never cured, by Osteopathy.  See Treatment to Equalize the Circulation.

(Deranged action of the heart without structural lesion.  Due to impaired digestion and nutrition, resulting from dissipation, overwork, or excessive use of stimulants.)

    Irregular action of the heart; palpitation; dyspnea; vertigo; and pain.  Often develops into structural change.

    While in all organic diseases of the heart we cannot expect to give more than temporary relief, often succeeding, however, in prolonging the life of the patient for years; in all functional diseases we are very successful.
    It is always advisable to give the Treatment to Equalize the Circulation.  This treatment not only frees the circulation, but expands the chest, thereby relieving the short, difficult breathing which often accompanies this disease.
    A great deal will depend upon the good judgment of the operator in treating these cases.  So many different complications are liable to arise, for which such treatment should be given, is the judgment of the operator would indicate.

(Morbid dilatation of the veins.)

    The affected veins are dilated, tortuous, knotted, of a dull leaden or purplish blue color, with much discoloration of the parts and some swelling of the limb; if a great many small cutaneous veins are alone affected, they present the appearance of a close network; the enlarged veins and local swelling diminish after taking the horizontal position.

    Varicose veins are caused by a stoppage of the veins, usually by a pressure on the long saphenous or femoral vein.

    Can be readily cured by stretching the muscles of the thigh and otherwise treating the limbs as in Inflammatory Rheumatism, being very careful in handling the flesh below the knee.
    We will mention our first case of varicose veins to prove to our readers how easily this disease may be cured by viewing the human system as a machine and the arteries and veins as rivers of blood, easily obstructed.  The veins of the right limb below the knee were almost bursting, while the dead, stagnant blood in the capillaries formed sores, on which scales formed occasionally dropping off, exposing the raw, bleeding surface beneath.  Every known method had been tried and failed during the ten years he had suffered with this apparently incurable disease.  The long saphenous vein, which empties into the femoral vein in the thigh, and whose branches gather and return the venous blood from the lower part of the leg, gorged, knotted, and distended as large as the little finger, could be traced to the obstruction, a contracted muscle in the thigh.  It almost seems incredible that, where its cause was so apparent, for years the medical fraternity would work on the effect, encasing the limb in a rubber stocking to strengthen the bursting veins, while throwing medicine into the river above, with some object in view, unknown to the writer and possibly equally unknown to themselves.  We gave the gentleman four treatments, stretching and freeing all the muscles of the thigh and starting the blood up the long saphenous vein.  His limb immediately became easier.  At this time we were called to southern Kansas, and after a year, when we had. almost forgotten the incident, we met our old friend in a small Missouri town, entirely recovered.

(Inflammation of a vein, which may be caused by traumatism, thrombosis, or gout.)

    Similar to those of Thrombosis, with a dusky red line in the course of the vein.

    Such treatment should be given as will free the circulation through and from the affected area.

(An abnormal accumulation of serum in some serous cavity of the body, or a diffusion of such fluid through the cellular tissue.)

    It is of two distinct varieties, for, besides its occurrence in the meshes of the loose tissue beneath the skin, it may take place as a local dropsy in any of the natural cavities or sacs of the body, and is named according to the parts involved.
    Partial dropsy is always due to excessive venous repletion and this overdistension of the small veins is the result of some mechanical impediment to the venous circulation.  Dropsy due to obstructed portal circulation may be recognized by the following clinical characters: It begins in the abdomen; difficult breathing follows, but does not precede the ascites.  There is a tendency to vomiting, diarrhea, and piles; further, the spleen becomes enlarged and there are varicose veins on the right side of the abdomen.
    Dropsy at first partial, but afterwards becoming general, commences in the feet and extends upward, and this is also due to excessive venous repletion from obstructed venous circulation.
    Dropsical swellings are soft, inelastic, diffused, and leave, for some time, the indentation made by the pressure of a finger.  In chronic cases and when the swelling is very great the skin becomes smooth, glassy and of  a dull red or purple color; and where the skin is less elastic it becomes livid or blackish and troublesome, even grangrenous, or sloughs may form.

    In treating dropsy, of whatever organ, it is necessary to use such remedies as will act on the kidneys and skin and excite them to increased activity; the result of this activity is to diminish the fluids which have collected in one or another part of the body and remain there unabsorbed, and cause them to be taken up by the kidneys or thrown off by the skin, and thus carried out of the system through the natural outlets.  Any remedy that accomplishes this object effectively cures dropsy occurring in any part of the body.
    1. Place the patient on the side; and move all the muscles of the spine very deep from the tenth dorsal to the last sacral vertebra.  This will excite the nerves which control the kidneys to renewed action, thereby enabling them to separate the immense amount of water about to be poured into them from the blood.
    2. Give Treatment to Equalize the Circulation, being very careful to stretch all the muscles near the affected parts.
    In a very short time, usually from two to six days, the kidneys will begin to act very freely, throwing off the decomposed and watery particles of blood, while in from six to twelve weeks the patient will be entirely well.
    Of numerous cases of dropsy cured by us we will mention that of a lady of Joplin, Missouri, whose case had not only been treated by the best physicians of her own city, but those of Kansas City and St. Louis.  She came to us in a hopeless condition; her abdomen, limbs, and feet were swollen to more than twice their normal size.  After the second treatment, she began to improve rapidly, and in ten days her ankles could be spanned by the thumb and fingers; in one month the dropsy had entirely disappeared.  She gained strength rapidly, and in a short time had entirely regained her health.
    Another remarkable case was that of an old gentleman of Baxter Springs, Kansas, who had been for five years gradually losing the use of his lower limbs, and during the last year dropsy had made its appearance.  After the second treatment, the dropsy had almost entirely disappeared; his limbs regained their long-lost strength, and he would leap about the office like a boy in an ecstasy of delight, kicking higher than the doctor's head and springing from the floor to our operating table with apparent ease.