Osteopathy Complete
Elmer D. Barber, D. O.

    The stomach is a sac-like, pear-shaped dilatation of the alimentary canal, between the esophagus and beginning of the small intestine.  Its large end is directed above and to the left, to the diaphragm; its small end, below and to right.
    The mouth of the stomach is the cardiac opening, which passes from the esophagus like an inverted funnel without visible external limit.  On the inner surface a definite line is seen between the esophagus and cardia; above the line the mucous membrane is whitish and made largely of pavement epithelium, while below the color is red and the mucous membrane shows characteristic cylindrical epithelium.  Sometimes an external ring, as well as an internal projection, is found between the cardia and the rest of the stomach, forming a kind of antrum cardiacum.
    Passing from the cardia to the left and above, we find the first great pouch, blind sac, or fundus, whose relative size varies with age.  In early youth it is slightly developed; in the adult man it forms one-fifth of the stomach.
    This continues on the right into the body of the stomach, which has two surfaces, anterior and posterior, and two borders.
    At the right the body of the stomach gradually contracts towards its duodenal end.
    The division between the stomach and intestine is marked externally by a circular constriction, sulcus pyloricus, and more deeply by a muscular ring, sphincter pyloricus, and internally by a corresponding projection of mucous membrane called valvula pylorica, or pylorus.
    The valve usually presents a round opening, the orificum duodenale, which may have a central or eccentric position.  It may not be an enclosing ring, but a crescentic projection, and rarely consists of two halves lying opposite each other.
    The size of the stomach varies, according to age, sex, individual, and the degree of distension.  A woman's stomach increases more in length, is more slender, and is generally smaller than that of a man.
    The stomach lies in the epigastric region and left hypochondrium, slightly in the right hypochondrium, about five sixths to the left of the median line and one-sixth to the right.  Of the left segment, the greater part lies in the left hypochondrium - viz., the cardia, fundus, and the most curved part of the body.  The rest of the body and a part of the pars pylorica fall in the left part of the epigastrium.  The only part belonging to the right half includes a very small portion of the pars pylorica and the pylorus.  The stomach lies under the diaphragm and liver, above the jejunum, ileum, and transverse colon, extending its greater part into the left hypochondrium, and its smaller part into the epigastrium, between the spleen on the left and the gall-bladder on the right.  It does not lie transversely, unless in the infant, or in the female deformed by corsets.  It is directed from above and the left downward and forward to the right.  An empty stomach may hang nearly vertically, and present an anterior and posterior surface; but there is usually some obliquity.  If the small intestines are much distended, it may be transverse, or, if rigor mortis be rapid, it may be cylindrical, especially below.
    Movements of the Stomach. - When the stomach is empty, the great curvature is directed downward, and the lesser upward; but when the organ is full, it rotates on an axis running horizontally through the pylorus and cardia, so that the great curvature appears to be directed to the front, and the lesser backward.
    The movements of the stomach are of two kinds: One is the rotary or churning movement, whereby the parts of the walls of the stomach in contact with the contents glide to and fro with a slow rubbing movement.  Such movement seems to occur periodically, every period lasting several minutes.  By these movements the contents are moistened with the gastric juice, while the masses of food are partially broken up. (The formation of hair-balls in the stomachs of dogs and cattle indicates that such rotary movements of the contents of the stomach take place.)
    The other kind of movement consists in a periodically occurring peristalsis, whereby, as with a push, the first dissolved portion of the contents of the stomach is forced into the duodenum, beginning after a quarter of an hour, and recurring until about five hours after a meal.  This peristalsis is most pronounced towards the pyloric end, and, the muscles of the pyloric sphincter relax to allow the contents to pass into the duodenum.  The longitudinal muscular fibers, when they contract, especially when the pyloric end is filled, may act so as to dilate the pylorus.
    The Nerves of the Stomach. - The stomach is supplied by nerve-fibers from the two vagi and the solar plexus.  After forming the esophageal plexus, the left vagus descends rather anterior to, and the right posterior to the esophagus, along which they continue to the stomach.  The left supplies chiefly the lesser curvature and the anterior surface of the organ, together with branches to the liver and the duodenum.  The right gives branches to the posterior surface of the stomach, about two-thirds of its fibers passing to the solar plexus.
    From the solar or celiac plexus branches, composed chiefly of non-medullated fibers, constitute the gastric plexus of the splanchnic nerves along the gastric artery to the stoma h, while they intermingle with the branches from the vagi under the peritoneal covering.  Small ganglia exist in the course of these nerves.  Branches penetrate the coats of the stomach, alone, with the arteries and between the longitudinal and circular muscular coats.
    Nerve-Influence on the Stomach. - Auerbach's ganglionic plexus of nerve-fibers and cells, which lie between the muscular coats of the stomach, must be regarded as its proper motor center, and to it motor impulses are conducted by the vagi.  Section of both vagi does not abolish, but diminishes the movements of the stomach.  The muscular fibers of the cardia may be excited to action, or their action inhibited, by fibers which run to the vagi.   If the vagi be divided in the neck, there is a short temporary spasmodic, contraction at the cardiac aperture.  On stimulating the peripheral end of the vagus with electricity, after a latent period of a few seconds, the cardiac end contracts, more especially if the stomach is distended, but the movements are slight if the stomach be empty.  Stimulation of the vagi in the neck causes contraction of the pylorus, when the latent period maybe several seconds.  Stimulation of the splanchnics in the thorax arrests the spontaneous pyloric contractions, the left splanchnic being more active than the right.
    In the cardia are automatic ganglionic cells, which are connected with the vagus and sympathetic.  The efferent channel for impulses seems to be through the vagi, and partly through the splanchnics.  The center for the opening of the cardia lies in the anterior inferior end of the corpus striatum, and the conducting paths in the vagi.  The cardia may be opened reflexly by stimulation of the sensory abdominal nerves of the kidney, uterus, or intestine.
    The body of the stomach also possesses a few automatic ganglia in connection with the vagi and sympathetic.  A center for its contraction lies in the corpora quadrigemina, and the efferent paths lie in the vagi, but chiefly in the spinal cord, and from the latter into the sympathetic.  Inhibitory centers lie in the upper part of the spinal cord, and the efferent paths are in the splanchnics.
    The pylorus also contains automatic centers.  The center for opening the cardia also inhibits the movements of the pylorus, the path being through the cord and splanchnic.  Inhibitory pyloric centers lie in the corpora quadrigemina and olives; the paths are in the spinal cord.  The centers in the cortex for opening the cardia at the same time contract pylorus.  The contraction centers for the pylorus lie in corpora quadrigemina.

    Vomiting is caused by contraction of the walls of the stomach, the pyloric sphincter being closed.  It occurs more readily when the stomach is distended.  Dogs usually greatly distend the stomach by swallowing air before they vomit.  It readily occurs in infants, in whom the cul-de-sac at the cardia is not developed.  It is quite certain that in children vomiting occurs through contraction of the walls of the stomach, without the spasmodic action of the abdominal walls.  When vomiting is violent, the abdominal muscles act energetically.  Vomiting is generally preceded by a feeling of nausea, and usually there is a rush of saliva to the mouth, caused by a reflex stimulation of the afferent fibers in the gastric branches of the vagus; the efferent nerve for the secretion of saliva being the corda tympani.  After this, a deep inspiration is taken and the glottis closed, and a violent expiratory effort is made, so that the contraction of the abdominal muscles acts upon the contents of the abdomen, the stomach being forcibly compressed.  The cardiac orifice is open at the same instant, and the contents of the stomach are ejected.
    The center for the movements concerned in vomiting lies in the medulla oblongata, and is in relation with the respiratory center, as is shown by the fact that nausea may be overcome by rapid and deep respiration.
    In vomiting, the afferent impulses may be discharged from the mucous membrane of the soft palate, pharynx, root of the tongue - glosso-pharyngeal nerve - as in tickling the fauces with the finger; the nerves of the stomach - vagus and sympathetic - stimulation of the uterine nerves; the mesenteric nerves; nerves of the urinary apparatus; nerves to the liver and gall-duct; and nerves to the lungs - vagus.  Vomiting is also produced by direct stimulation of the vomiting centers.  The efferent impulses are carried by the phrenics to the diaphragm; by the vagus to the esophagus and stomach; and by the intercostal nerves to the abdominal muscles.
    Vomiting produced by the thought of something disagreeable appears to be, caused by the conduction of the excitement from the cerebrum to the vomiting center.  It may also be excited through the brain by a disagreeable smell, a shocking sight, or by other impressions on the nerves of special sense.  Vomiting is very common in diseases of the brain.

    The intestinal canal is in the form of a curved tube, passing uninterruptedly from the pylorus to the anus.  Its length is about six times the height of its possessor, though in the adult it may be independent of the age, weight, or height.  Vegetarians may have a longer intestine than those living on a mixed or flesh diet.  This canal is divided into the Small intestine, the upper four-fifths; and the lower one-fifth, the Large Intestine.
    Small Intestine. - This is that part of the alimentary canal extending from the pylorus to the ileo-cecal valve.  Its average length is about 22 feet, the extremes being 34 feet and 8 feet.  Its circumference decreases from the stomach towards the large intestine.  The small intestine is divided into three parts, the Duodenum, the Jejunum, and the Ileum.  The wall of the ileum is so thin and translucent that a newspaper may be read through it.
    Large Intestine. - The large intestine extends from the termination of the ileum to the anal orifice, differing from the small intestine in its larger size, more fixed position, sacular form, and appendices epiploicae.  It is about 5 or 6 feet in length.  Its circumference decreases from beginning to end, except at the ampulla of the rectum.  In its course the large intestine describes a horseshoe-shaped arch, which surrounds the convolutions of the small intestine.  It begins in a blind sac in the right iliac fossa ascends along the right posterior abdominal wall to the right hypochondrium, where it is connected with the under surface of the liver.  It here bends to the left, and takes a transverse, somewhat ascending, course to the spleen.  In the left hypochondrium it bends again and descends along the left posterior abdominal wall to the left iliac fossa, then becomes convoluted, as the sigmoid flexure.  It enters the pelvis, and descends as the rectum, along its posterior wall to the anus.  It is divided into the Cecum, Ascending Colon, Hepatic Flexure, Transverse Colon, Splenic Flexure, Descending Colon, Sigmoid  Flexure, and Rectum.
    Movements of the Intestines, Peristalsis. - The best example of peristaltic movements is afforded by the small intestine; the progressive narrowing of the tube proceeds -from above downward, thus propelling the contents before it.  Frequently, after death, or when air acts freely upon the gut, the peristalsis develops at various parts of the intestine simultaneously, whereby the loops of the intestine present the appearance of a heap of worms creeping among each other.  The advance of new intestinal contents again increases the movement.  In the large intestine the movement is more sluggish and less extensive.  Peristaltic movement may be seen and felt when the abdominal walls are very thin, and also in hernial sacs.  They are more lively in vegetable feeders than in carnivorous.  The movements of the stomach and intestines cease during sleep.
    Nerve-Influence on the Intestines. - Stimulation of the vagus increases the movements of the small intestine either by conducting impressions to the plexus mesentericus, or by causing contraction of the stomach, which stimulates the intestine in a purely mechanical manner.  The splanchnic is the inhibitory nerve of the small intestine only as long as the circulation in the intestinal blood vessels is undisturbed and the blood in the capillaries does not become venous.  When the latter condition occurs, stimulation of the splanchnic increases the peristalsis.  If arterial blood be freely supplied, the inhibitory action continues for some time.  Stimulation of the origin of the splanchnics of the spinal cord in the dorsal region, under the same conditions, and even when general tetanus has been produced by the administration of strychnine, causes an inhibitory effect.
    It is believed that the splanchnic contains, besides the inhibitory fibers, which are easily exhausted by a venous condition of the blood, motor fibers, which remain excitable after death, for a longer time, because, stimulation of the splanchnics always causes peristalsis, the same as stimulation of the vagus.  It is the vaso-motor nerve of the intestinal blood-vessels, governing the largest vascular  area in the body. When it is stimulated, all the vessels of the intestine, which contain muscular fibers in their walls, contract; when it is divided, they dilate.  In the latter case a large amount of blood accumulates within the blood-vessels of the abdomen, so that there is anemia of the other parts of the body, which may be so great as to cause death, owing to the deficiency of blood in the medulla obloncata.
    Effect of Nerves on the Rectum. - The nervi erigentes, when stimulated, causes the longitudinal muscular fibers of the rectum to contract, while the circular muscular fibers are supplied by hypogastric nerves.  Stimulation of the hypogastric also exerts an inhibitory effect on the longitudinal muscles.  Stimulation of the nerve erigentes inhibits not only the spontaneous movements of the circular fibers of the rectum but also those movements excited by stimulation of the hypogastric nerves.
    Excretion of Fecal Matter. - The contents of the small intestine remain in it about three hours, and about twelve hours in the large intestine, where they become less watery, and assume the character of feces.  The feces are gradually carried along with the peristaltic movement until they reach a point a little above that part of the rectum which is surrounded by both sphincter muscles.
Immediately after the expulsion of the feces, the external sphincter usually contracts vigorously and remains so for some time; afterwards it relaxes, when the elasticity of the part surrounding the anal opening, particularly the two sphincters, suffices to keep the anus closed.  In the interval between two evacuations there does not seem to be a continuous tonic contraction of the sphincter.  As long as the feces lie above the rectum, they do not excite any conscious sensation.  The sensation of requiring to go to stool occurs when the feces pass into the rectum; at the same instant the stimulation of the sensory nerves of the rectum causes a reflex excitement of the sphincter.  The center for these movements lies in the lumbar region of the spinal cord.

    Our object in entering thus briefly into the anatomy of the above named organs is to prove to our readers by such standard works as Gray and Landois the intimate relation existing between the alimentary canal and the nervous system.  We will endeavor to prove to the satisfaction of the most skeptical that the human system is a machine governed by the great dynamo, the brain, reinforced and assisted by numerous nerve-centers; that an obstruction of undue pressure upon any nerve or nerve-center, from any cause, breaks the circuit, and causes partial or complete paralysis of the part controlled by the nerve involved, and consequent disease.  We also expect to prove that irritation, or undue stimulation from any cause, to the brain, nerve-centers, or any nerve, has the opposite effect, and consequent disease in a different form.
    If the osteopath, by a thorough knowledge of anatomy and physiology, can remove the cause by skillful manipulation, thus equalizing the forces, health will be the inevitable result in all cases where the disease has not reached a stage in which the tissues are hopelessly destroyed.  This last proposition all unprejudiced, fair-minded physicians will admit.
    While we cannot agree with the discoverer of Osteopathy, that in all cases of constipation a rib is dislocated, pressing upon the splanchnic nerve, and thereby causing constipation and kindred troubles, we believe there are instances where such is the case, and that by reducing the dislocation we turn on the current from the brain, thereby starting the peristaltic action of the bowels, which immediately move.
    It is always advisable, in examining the patient, to first satisfy yourself that the framework is in line, as very many diseases have been traced to a partial or complete dislocation, obstructing the nerve-wave or blood-supply, perhaps, to a distant part; and a speedy cure effected by reducing the dislocation.
    It has been our experience that the muscles are usually at fault, and we believe that Dr. Still and his associates, in a vain attempt to reduce an imaginary dislocation, accidentally stretch the right muscles, thereby freeing the obstructed nerve-wave or blood-supply.
    It is always well, in endeavoring to ascertain the cause of any disease of the thorax or abdomen, (1) to place the patient upon the face, and carefully examine the spine and ribs for dislocations; (2) beginning at the atlas, with one finger on each side of the spine, move the hand downward, slowly and gently.  If careful, we are very apt to discover, upon one or possibly both sides of the spine, an irregularity in the temperature, which must be equalized by a skillful manipulation, if we hope to obtain satisfactory results; (3) once more beginning at the cervicals, and moving the hand down the spine in a similar manner, working more deeply, we are very liable to discover contraction of the muscles, which may be detected by their hard, cord-like, knotty condition.  By referring to cut 15, and carefully inspecting it, the reader will begin to realize how utterly impossible it would be for the brain to control the various organs of the body, unless the muscles which surround and assist in protecting this delicate piece of mechanism - the nervous system - are in a perfect and normal condition; one had as well expect an uninterrupted telephone service immediately after a cyclone, when the wires are crossed, broken, and covered with fallen timbers.  By a thorough understanding of anatomy, the osteopath is enabled to so manipulate the muscles at fault as to restore harmony of action.
    It would be impossible to lay down a set of manipulations that could be correctly applied in all the complications arising in various cases.  A great deal must depend upon the good judgment of the operator.  Anyone at all familiar with anatomy and physiology may hope to attain very gratifying results in almost all diseases of the stomach and intestines by keeping in mind the fact that we must not only have a free and uninterrupted circulation of blood, but must have a free and uninterrupted circuit of nerve-wave between the brain and each muscle and organ of the system.
    Take, for instance, the solar plexus, or "Great Abdominal Brain," formed by the pneumogastric and splanchnic nerves; is it not reasonable to suppose that any obstruction or pressure upon either of these nerves, breaking the circuit with the brain, would cause constipation or torpid liver, or that an undue stimulation or irritation might cause diarrhea or bloody flux?  Is it not equally reasonable to suppose that to remove the cause in the same common-sense and methodical manner in which the telephone company adjusts its wire would cure the disease?
    After locating the cause of the trouble, the operator will have the best success who applies the manipulation, or combination of manipulations, which seems best adapted to the case in question.
Diseases of the Stomach, Intestines, and Peritoneum
(Sluggish action of the bowels.)

    While we admit that constipation is not desirable, and may almost invariably be avoided, yet persons thus predisposed are generally long-lived, unless they commit suicide by purgative medicines, while those who are subject to frequent attacks of diarrhea are soon debilitated.  A daily action of the bowels is no doubt desirable in most cases, but by no means invariably so.  An evacuation may take place daily, or every second day, or even every third day, in persons who are equally healthy.  There is no invariable rule applying to all persons.  Purgation produced by drugs is an unnatural condition, and although temporary relief often follows the use of aperients, they tend to disorganize the parts on which their force is chiefly expended.  The intestinal canal is not a smooth, hard tube, through which can be forced whatever it contains without injury; it is part of a living organism, and needs no force to propel its contents on their way; nor can such force be applied with impunity.  Not only does the frequent use of purgatives overstimulate the liver and pancreas, but also and especially the numerous secretary glands which cover the extensive surface of the intestinal canal, forcing them to pour out their contents in such excessive quantities as to weaken and impair their functions, producing a state of general debility, and thus suspending the normal action of the stomach and intestinal canal.

    Nausea, vomiting, griping, and even fainting, are produced; the brain and vital energies are disturbed, occasioning lowness of spirits and melancholy, alternating with mental excitement and peculiar irritability of temper.

    We will now endeavor to prove to the satisfaction of our readers that, viewing man as a machine, constipation can be traced to its true cause, and cured by an application of the never-failing principles of Osteopathy.  The digestive organs in constipation may be compared to an electric car with the current partially cut off; with a light load it might possibly work in a feeble, halting manner, while the slender wire transmits the power to move the heavy car.  The dynamo generates that power; break the connection, and the car stops.  So in the human being; the brain is the great generator, the center of all power.  Stop for one instant the current on these slender nerves, and the heavy muscles of the giant are weaker than those of a tiny child.  There is one peculiarity about the nerves which is liable to lead one astray, and that is the fact that a pressure on the main trunk of a nerve causes no pain at that point, but at the extremity of the nerve.
    In constipation we find the intercostal and spinal muscles contracted from the fifth dorsal vertebra and fifth rib to the eighth.  The sixth or seventh rib may be turned slightly, and either the muscles or rib pressing on the splanchnic nerves (which, with the pneumogastric, control the digestive organs), thus depriving the intestines of half their motor power.  Taking physic for constipation is like whipping a weak, half-starved horse.  He will go just as long as you continue to apply the whip, but is left in a more enfeebled condition after each application of the lash.  Would it not be more human and sensible to increase his feed and reduce his load, as we now propose doing with the splanchnic nerve?
    By relaxing the contracted muscles we not only allow the ribs to spring back, thus releasing the nerve, but also permit the blood to pass down and supply the nerve with food, and in a comparatively short time it will be able to once more convey the current that will start the peristaltic action of the bowels, and also furnish a motor power to the sluggish liver and pancreas, enabling these organs to resume their work.  As an obstruction to the nerve-force of the splanchnic system not only weakens the peristaltic action of the bowels, but also the action of the liver: that great chemical laboratory, placed on the highway by which the great majority of material absorbed from the intestines reaches the blood, it is obviously in a position to act as the guardian of the blood's purity and health.  It certainly in some respects performs this duty, for many poisons, when introduced into the digestive tract, are stopped by the liver, and, if their amount be not excessive, are eliminated with the bile.  But we have reason to believe that this enormous mass of protoplasm is placed in this peculiar position in the circulation to preside over much more important duties than that of a mere gatekeeper.  Many if not all of the absorbed materials are found to be altered during their visit to the liver.  In fact, we must regard this organ as the great chemical laboratory of the blood, where many important analyses are made.  It has an immense double blood-supply; it receives all the blood of the portal veins coming from the digestive tract and spleen.  This supply of blood varies much in amount; after meals, it equals one-fourth of all the blood in the body.  Among the many important functions of the liver are the formation of the urea and uric acid, and the secretion of the bile.  Its failure to supply in sufficient quantities the latter (which is mixed in the abdomen with the pancreatic juice, to assist in digesting the food) is one of the secondary causes of constipation; another is the inability of the pancreas, through lack of nerve-force, to do its part in furnishing pancreatic juice.  Thus, when we turn the current on the splanchnic, we start a three-horse team, which, pulling together in perfect harmony, will safely carry our constipated friend to the highway of perfect health.

    Make careful examination of the spine to ascertain the cause of the trouble.  The ribs, in the normal condition, should present a flat surface and be an equal distance apart.
    If one is turned partially on its side, presenting its edge as is very often the case, we have discovered the cause of a multitude of evils; if pressing either directly or indirectly upon the splanchnic, it cannot fail to produce constipation; while its pressure upon the intercostal nerve, artery, and vein produces other complications; neither is the pressure of its edge upon the vital organs which it is supposed to protect pleasant to contemplate.  If physicians would make this examination in chronic cases which had failed to respond to drugs, they would be surprised at the number of cases in which this condition exists.

    To set the rib, place the patient on the side; with the thumb of one hand upon the angle of the rib at fault, place the thumb of the disengaged hand upon the edge of the rib at about its middle; have the patient inhale, filling the lungs to their utmost capacity, while an assistant draws the arms high above the head.
    It will be observed that the pectoralis major attaches to the seven or eight upper ribs, and to the humerus at the external bicipital ridge; thus the arm can be used as a lever to pull any of the upper ribs into line; at the instant the arm is thrown backward to be lowered while the assistant is pulling hard, and patient's lungs are expanded, spring the rib forward by a hard pressure of the thumb upon its angle; at the same instant a pressure of the thumb upon its edge will turn it into position (cut 16).    This treatment may not necessarily occasion much pain, and should be continued, making two or three trials each treatment, until the dislocation is reduced, providing it is stubborn and fails to respond promptly to the first treatment. The time required to set the rib will depend much upon the skill of the operator and length of time that the rib has been in an abnormal position.
    In all cases where the difficulty is traced to an abnormal temperature in the spinal column, or contraction of muscles, thus affecting a nerve-center, the following accessory treatment should be given.  This treatment should also be given where a rib is turned or partially dislocated.

    1.  Place the patient on the side, and proceed to free all the muscles of the spine on each side as low as the twelfth dorsal vertebra.  Let the arm of the patient rest on that of the operator, the patient's elbow pressing against the humerus, forming a lever with which the muscles of the scapula can be manipulated.  With the fingers between the spine and scapula, pressing hard, move the scapula and muscles under the fingers upward (see cut 7), being particular not to let the hand slip over the muscles, but to move them.  After each upward motion, move the fingers down an inch, until the last dorsal vertebra is reached, taking care not to work lower than the last rib.
    2.  With the patient lying on the back, grasp the right wrist with the right hand, drawing the arm slowly but with some strength high above the head, at the same time placing the left hand between the shoulder-blades on the right side of the spine, about two inches below the upper part of the shoulder-blades, pressing hard as the arm comes up; lower the arm, the elbow passing below and at the side of the table.  Repeat, moving the hand down the spine one inch every time, until you have reached the tenth dorsal vertebra, which will be found one inch below the inferior angle of the scapula.  This excites and stimulates the splanchnic nerve.
    3.  Knead the bowels (cut 17),  beginning on the right side and at the lower portion of the abdomen, close to the bone, and immediately over the ileo-cecal valve.  Work lightly at first, gradually using more strength, following the ascending colon upward from its commencement at the cecum to the under surface of the liver on the right side of the gall-bladder, where it bends abruptly to the left, forming, the hepatic flexure; it now becomes the transverse colon, and passes transversely across the abdomen from right to left, where it curves downward beneath the lower end of the spleen, forming the splenic flexure.  The descending colon passes almost vertically downward to the upper part of the left iliac fossa, where it terminates in the sigmoid flexure.  The sigmoid flexure is the narrowest part of the colon.  It is situated in the left iliac fossa, commencing at the termination of the descending colon at the margin of the crest of the ileum, and ending in the rectum opposite the left sacro-iliac syphysis.  Work across the abdomen, following the transverse colon and down the descending and sigmoid portions to the rectum.  Next knead the small intestine, which is contained in the central longer part of the abdominal cavity, surrounded above and at the sides by the colon or large intestine.
    4.  Place the patient upon the back; with one hand upon the ribs, over the liver, press them down several times quite strongly, holding them a moment in this position before slowly removing the pressure, thus starting the circulation in and through the liver.  Work as deeply as possible with the fingers over the liver, under the ribs, raising them gently.  Also carefully knead and manipulate the gallbladder, endeavoring empty its contents into the duodenum.
    5.  Place the hand lightly over the liver, vibrating gently for two minutes.  See Vibration.
    6.  Place the patient upon the back; and with the hand under the chin, pull the head backward to the right and left, thus stretching the muscles, and freeing as much as possible the pneumogastric nerve, which so largely controls the digestive organs.  It is also well to manipulate, thorough and deep, the muscles on the front and sides of the neck, the object being to remove all obstructions, and equalize as much as possible the nerve-wave between the brain and solar plexus.
    This treatment should be given every other day, and can be administered in fifteen minutes.  It will cure the most stubborn cases of constipation or torpid liver.  Care should be taken to work as deep and as far under the ribs as possible.  Children and young people are often cured in a single treatment, but the average time required for a cure is from two to six weeks.  In very stubborn cases it is well to flush the bowels once or twice, until Nature begins to act.  This treatment, if applied as directed, will be found infallible.

(Inflammation of the stomach, characterized by difficulty or failure in changing food into absorptive nutriment.)

    These vary greatly, both in character and intensity, but there is commonly one or more of the following: impaired appetite, flatulence, and nausea; eructations, which often bring up bitter or acid fluids; furred tongue, often flabby, large, or indented at the sides; foul taste or breath and heartburn; pain and a sensation of weight and inconvenience or fullness after a meal; irregular action of the bowels; headache, diminished mental energy and alertness, and dejection of spirits; palpitation of the heart or great vessels, and various affections in other organs.

    Dyspepsia, or indigestion, is usually caused by a constipated condition of the bowels, which, becoming overloaded, hinder the action of the stomach until the glands of that organ become diseased.  Thus we are again confronted with the parallel of an electric car, which, having lost its current, obstructs the main track.  We expect to prove to the intelligent reader that when the peristaltic action of the small intestine loses part of its nerve-power, occasioned by a pressure on the splanchnic center at or near the spine, the foundation is laid not only for constipation, liver complaint, and various stomach and kidney troubles, but by blocking the main track, one organ after another becomes diseased, and finally the stomach, bloated or filled with gas, presses so hard upon the diaphragm, compressing the left lung, that it affects even the lungs and heart.  Many cases of heart trouble we have traced directly to this cause, and cured by working on these never-failing principles.

    1.  Place the patient on the side; with the fingers of both hands upon the spine, beginning at the upper cervicals, move the muscles upward and outward, very deep and thoroughly, as low as the last dorsal (see cut 7).  Tender spots will usually be found between the second, and sixth dorsal, over the nerves of assimilation, and should be treated thoroughly.  As soon as the soreness begins to disappear, the patient will commence to recover.  Careful investigation in the immediate region where the tenderness is discovered will usually enable the operator to detect some slight contraction in the deep muscles, thus obstructing the circulation, and producing a congested condition.
    2.  Place the hand gently over the stomach and vibrate strongly two minutes, thus stimulating the circulation through that organ.
    3.  In all cases where constipation is present, beginning at the cecum manipulate the colon very thoroughly and carefully, following it its entire length to the rectum, endeavoring to manipulate and move forward any hardened lumps of feces that may be discovered.  Also manipulate the gallbladder and liver.  See Constipation.
    4.  Stand behind patient, and, raising the right arm high above the head, lifting strong, press hard with the thumb on the fourth dorsal vertebra, lowering the arm with a backward motion.  This pressure reaches the nerves that control the pyloric valve, causing, after a few treatments, the pyloric orifice to permit the escape of gases and undigested food into the duodenum.
    5.  With left hand under patient's chin, draw the head backward and to the side; with the right manipulate the muscles of the neck, thereby freeing the pneumogastric nerve (cut 18).
    This disease is usually caused by a complication of troubles, all of which must be removed before we can hope to effect a cure.  A great deal, therefore, depends upon the good judgment of the operator in discovering the real cause, and employing such treatment as will reach the conditions as they exist.
    6.  In all cases of fever, hold the vaso-motor two or three minutes.   See Vaso-motor.

(Neuralgia of the stomach.)
    Spasmodic pains, shooting and shifting, usually brief in duration, and may be relieved by vomiting or belching.

    1.  Place the patient on the back; if there are any indications of constipation, give thorough treatment for same.
    2.  Place the hand lightly over the sternum, and vibrate gently for three minutes.
    3.  Place the patient on a stool; and with the thumbs upon the angles of the fifth pair of ribs, have an assistant standing in front, raise the arms high above the head, lifting quite strong, as the patient fills the lungs with air; press hard with the thumbs as the arms are lowered with a backward motion, patient permitting the elbows to bend, as the arms are pressed quite strongly backward and downward.  This treatment stretches the muscles, frees the intercostal nerves, arteries, and veins, at the same time acting upon the splanchnic nerves.  Place the thumbs upon the next two lower ribs, raise the arms as before, and repeat until the tenth dorsal is reached.
    4.  Place the patient on the back, with one hand under the chin, draw the head backward, rotating it from side to side, at the same instant manipulating the muscles over the pneumogastric with the disengaged hand (cut 18).  It is also advisable to place one hand under the occipital, the other under the chin, and give gentle extension.
    This treatment usually gives immediate relief, and a continuation of the same once each day, occupying about fifteen minutes, a speedy cure.

(Dilatation of the stomach, due to obstruction of the pyloric orifice.)

    Heart dislocated, action rapid; upper portion of the abdomen enlarged; pressure on the surrounding structures; palpitation; difficult breathing; and inability to remove the gas.

    In this disease, while we can hardly hope to effect a cure, the patient can often be greatly benefited by the following treatment:
    1.  Place the patient upon the left side; an assistant holding the hip, draw the right arm slowly but strongly above the head, holding it in this position for a moment; lower the arm with a backward motion, pressing hard with the thumb of the disengaged hand upon the fourth dorsal vertebra; repeat this operation, pressing hard the second time upon the fifth dorsal.
    2.  Place the patient on the back; the hand of the operator resting lightly, as near as possible, over the pyloric orifice, vibrate strongly for three minutes.
    3.  Place the patient upon a stool; the knee of the operator between patient's scapula, grasp the patient's wrists, and draw the arms slowly but strongly high above the head pressing hard with the knee as the arms are lowered with a backward motion (cut 5).  Repeat this operation two or three times, as it expands the chest and relieves the difficult breathing.
    This treatment should be given every day, and occupy about ten minutes.

(Cancer of the stomach.)

    Loss of appetite, flesh, and strength; the vomitus is dark and streaked with blood.
    No cure in Osteopathy.

(Ulcer of the stomach.)

    Annoying and burning pain, confined to small area in the epigastrium; pain increased by food, and relieved after digestion or by vomiting; pain and tenderness near the spinal column, opposite the site of the epigastric pain.

    1.  Place the patient on the side; beginning at the upper cervicals, move the muscles upward and outward the entire length of the spinal column, deeply but gently, being very thorough in the dorsal region, and particularly thorough and gentle in the immediate region of all spots where tenderness exists along the spinal column.
    2.  Place the hand under the chin, and draw the head backward, rotating it from right to left; with the disengaged hand manipulating the muscles immediately over the pneumogastric nerve.
    3.  Place the hands under the shoulders of the patient, an assistant grasping the ankles, and give thorough and strong extension of the spinal column, as this extension, together with the two preceding treatments, tends to stimulate and equalize the nerves which control the alimentary canal.
    4.  Place the hand lightly and as near as possible over the ulcer, and vibrate gently for three or four minutes.
    This entire treatment should not occupy over ten or fifteen minutes; should be administered each day; and if given correctly, will produce very gratifying results.

(Functional derangement of the stomach, due to impairment of motor or sensory powers, or secretions.)

    Manifestations of hysteria; feeling of fullness, tension, and nausea; sensation of heat or cold, annoying or pulling; may be relieved by food, apt to be aggravated by fasting, or restriction of diet.

    1.  See 1, 2, and 3, Treatment for Gastric Ulcer.
    2.  Flex the limbs strongly against the chest, abducting and adducting them several times and extending with a light jerk.  This treatment starts and increases the circulation to the limbs.
    Should the patient bit constipated, apply Constipation Treatment.
    3.  Place the patient upon a stool; operator placing knee between the shoulders, draw the arms strongly above the head two or three times as the patient inhales; lower the arms with a backward motion, pressing hard with the knee as the shoulders are forced backward.  This treatment is very beneficial, as it expands the chest and frees the circulation.
    4.  Place the hand on the stomach and vibrate gently two or three minutes.
    In case of fever, place the hands upon the sides of the neck, the fingers almost meeting over the spinal processes of the upper cervicals, and press gently two or three minutes on the vaso-motor center.
    This treatment will occupy about fifteen or twenty minutes; should be administered every other day.  We should expect to see a decided improvement after the first few treatments, a continuation of which will effect a cure.

(Dizziness, usually associated with disorders of the stomach.)

    In acute form there is coldness; objects appear to go round and round; patient reels; seasick feeling; may vomit! face pale; pulse feeble; vision blurred.  In chronic form there is headache; noise in the ears; feeling of reeling and dizziness.

    See General Treatment.

(Inflammation of the small intestine.)

    Colicky pains about the umbilicus; urine highly colored and scanty; tenderness over the abdomen; diarrhea.

    1.  Very gentle but thorough kneading of the bowels, being very particular to work from left to right, as this treatment not only assists in checking the diarrhea, but starts the circulation, thereby assisting in reducing the inflammation in the small intestine. (Treating from left to right assists in checking the peristaltic action of the bowels, and diarrhea.  Manipulating the bowels from right to left assists in increasing the peristaltic action, and should be always given in constipation.)
    2.  Place the hand lightly over the intestine, and vibrate gently two or three minutes.
    3.  Standing at the side of the bed or table, place the arms around patient's body, the ends of the fingers pressing upon each side of the spine in the lumbar region and immediately below the last dorsal vertebra; raise the patient gently until only the shoulders and limbs touch the bed (cut 19); hold in this position a moment, and repeat.  This treatment seems to get the body in such a position as to throw a direct pressure upon the solar plexus, thereby obstructing the nerve-wave to the bowels and checking the peristaltic action
    4. Drawing the arms slowly but strongly above the head, pressing strongly upon the fourth or fifth dorsal vertebra as they are lowered with a backward motion, will almost instantly check the colicky pains in the region of the umbilicus.
    5.  In this disease we often discover the lumbar region in a very sensitive condition, in which case the muscles of this region on each side of the spine should be manipulated, moving them upward and outward gently but deeply.  The soreness will immediately begin to disappear, and with it the urine will resume its normal quantity and color.
    In all cases of fever hold the vaso-motor two or three minutes after each treatment.
    This treatment, which must be given in a very gentle and careful manner, occupying fifteen or twenty minutes each day, should give the patient immediate relief.

(Usually follows acute attacks.)

    Sallow complexion; constipation, alternating with diarrhea; stools containing undigested food; headache; impaired nutrition; colicky pains; and abdomen distended.

    1.  Place the patient on the side; beginning at the upper cervicals, move the muscles upward and outward, gently but deeply, the entire length of the spinal column, being very particular to treat thoroughly in all regions where any tenderness is discovered.  Stimulation in this manner over all the nerve-centers the entire length of the spinal column tends to equalize the nerve-wave to the various organs.
    2. Place the patient on the back; with the hand under the chin, draw the head backward, rotating it from side to side, with the disengaged hand manipulating the muscles immediately over the pneumogastric nerve.
    3. In all cases where constipation is present, a light Constipation Treatment should be given.  In cases of diarrhea, give a light treatment for the same; the object being to equalize the action of the bowels.
    4. Drawing the arms strongly above the head two or three times, at the same instant pressing hard upon the fourth or fifth dorsal vertebra, will relieve the colicky pain.
    This treatment will occupy about fifteen minutes; will usually give immediate relief; and should be given every other day until complete recovery is effected.

(Inflammation of the stomach and intestines, resulting from an irritating diet.)

    Cholera morbus is a violent purging and vomiting, attended with gripes and a constant desire to go to stool.  It comes on suddenly, and is most common in autumn.  There is hardly any disease that kills more quickly than this when proper means are not used in due time for removing it.  It is generally preceded by heartburn, sour belchings, and flatulence, with pain in the stomach and intestines; to these succeed excessive vomiting and purging of green, yellow, or blackish colored bile, with distension of the stomach and violent griping pains.  There is likewise great thirst, with a very quick unequal pulse, and often a fixed acute pain about the region of the navel.  As the disease advances, the pulse often sinks so low as to become quite imperceptible; the extremities grow cold or cramped and are often covered with a clammy sweat, the urine is obstructed, and there is palpitation of the heart.  Violent hiccoughing, fainting, and convulsions are the signs of approaching death.

    Cholera morbus can often be cured instantly.  Of the hundreds of cases treated by us, we have yet to find the first that did not respond, and we stand ready to wager our reputation that there never was and never will be a case of this disease that cannot be cured by this method of treatment if properly applied.  This may justly be considered the grandest discovery of this or any other age.  And we beg the medical fraternity throughout our land, who usually look with eves of skepticism on anything out of the ordinary, to try this one great principle, which is destined to save thousands of lives each year.  We trust that each and every one who may chance to read these pages will remember our treatment for cholera morbus.  Not because it is more reliable than any other great principle laid down in this work, but it is so simple and of such vast importance in times of need, so infallible, and gives such immediate relief.
    That the reader may gain a correct understanding of this great principle, we will return to the anatomy of the machinery of human life.  Once more comparing the cerebrospinal cord, the brain, and the nerves to a telegraphic system, we will trace the cause of cholera morbus and the excited condition of the digestive organs directly to the brain.  It will be wise, in this connection, as some of our readers may not be very familiar with anatomy and physiology, to sketch briefly the process of digestion.
    Food, when taken into the mouth, undergoes two processes, which are inseparable and simultaneous in action, being mastication and insalivation.  In the short time occupied by the passage of the food through the esophagus no special change takes place.  In the stomach the food is mixed with the juices of that organ, and is converted into chyme.  The chyme begins to leave the stomach through the pyloric orifice soon after gastric digestion has begun, some passing into the duodenum in about half an hour.  The materials which resist gastric secretion or are affected very slowly by it are retained many hours in the stomach, and the pylorus may refuse exit to such materials for an indefinite length of time, so that, after causing much uneasiness, they are finally removed by vomiting.  Many solid masses escape through the pylorus, however, when it open s to let out the chyme.
    The small intestine is a convoluted tube, varying in length from twenty to thirty feet, which gradually diminishes in size from its commencement to its termination.  The power which forces the food and chyme through this long convoluted tube is called the peristaltic action and is controlled by the "main battery," the brain.  A wave of contraction passes from the pylorus along the circular fibers so as to look like a broad ring of constriction, progressing slowly downward.  The longitudinal fibers at the same time contract so as to shorten the piece of intestine immediately below the ring of constriction, and also causes a certain amount of rolling movement of those loops of intestine which are free enough to move.  In cholera morbus this peristaltic action becomes increased to an alarming extent.  Food has been taken into the stomach, to remove which a great amount of nerve-power is required; and when it is finally expelled, and the current still on, we have a machine running away with itself.  We are as yet unable to determine the precise cause of Nature failing to apply her brakes, and check the current at the proper moment, but we have succeeded in locating the point on which a slight pressure of the hand will instantly slow up the machine.
    The great splanchnic and right pneumogastric nerves form the solar plexus, or "great abdominal brain," and control the peristaltic action of the bowels.  Now it is obvious that a pressure on these nerves long enough to break the current will check the peristaltic action of the intestines.  The pneumogastric has a more extensive distribution than any of the other cranial nerves.  Passing through the neck and thorax to the upper part of the abdomen, it is composed of both motor and sensory fibers.  It supplies the organs of voice and respiration with motor and sensory fibers, and the pharynx, esophagus, stomach, and heart with motor fibers.  It emerges from the cranium through the jugular foramen, passes vertically down the neck within the sheath of the carotid vessels, lying between the internal carotid artery and the external jugular vein as far as the thyroid cartilage.  Thus it will be seen that it can be reached by a strong, steady pressure on the right side of the windpipe, as it is commonly called, in the lower part of the neck.  The right splanchnic nerve will respond to a pressure close to the spine between the sixth and seventh ribs.
    While this treatment will cure cholera morbus, and was arrived at by studying man as a machine from a scientific standpoint, a much simpler method, producing the same results, will be given as our infallible mode of treating these diseases.

    1.  Place the patient on a stool, the operator standing behind.  The operator now places his knee on the spine, just below the last rib, grasping the patient's shoulders, and draws him gently but firmly backward as far as possible (cut 20).  Let all motions be slow, allowing the patient time to relax the muscles.  Ninety per cent of all cases will be cured instantly by this one move.  In aggravated cases, where the patient is bedfast, while lying on the back, place one hand under each side, the fingers pressing on each side of the spine just below the last ribs, and two or three times slowly raise the patient until only the shoulders and pelvis touch the bed (cut 19).
    2.  Press lightly with the palm of the hand on the umbilicus (and stronger as the patient becomes accustomed to the pressure) for one minute.
    3.  Hold the vaso-motor center for two or three minutes, and your patient is out of danger (see cut 13).  It is very seldom that anything further than one backward movement is necessary.
Taken suddenly with cholera morbus between St. Louis and Kansas City, the writer cured himself instantly by bending far backward over the back of the car seat.  Any of our readers can do likewise.
    While on this subject, we will mention the case of a lady at Miami, I. T. We received an urgent call from her husband one Tuesday morning, but, being overwhelmed with office work, it seemed impossible for us to take the time to drive twenty miles into the Indian Nation; so it was arranged that if the drugs of the local doctors failed, and she was still alive, we should drive down Friday night.      We reached her bedside at midnight (Friday night), and found her just alive.  We treated her once, and in a week she was walking on the streets of Miami in perfect health.


    Cramp in the bowels is caused by the too rapid action of the intestines, one fold being thrown over another; this can usually be instantly cured by bending the patient far backward as in flux.  In rare cases it will be found necessary to place the patient on the back and gently but firmly knead the bowels, working deep, thus freeing the parts and giving immediate relief.
    Vibration two or three minutes over the bowels is very beneficial in all cases of diarrhea or cramp in the bowels.  See Vibration.

(Inflammation of the stomach and bowels of children.)

    Usually occurs in the summer months.  Rapid wasting; fever; vomiting; watery and fetid diarrhea; convulsions; coma; depressed foutanelles.

    1.  Place the child upon its back; the hands of the operator on each side of the spine below the last dorsal, the ends of the fingers pressing hard on each side of the spine; raise and hold the patient a moment in this position, the head and limbs only touching the bed.
    2.  Place the hand lightly over the bowels, and vibrate gently one or two minutes.
    3.  Place the hands upon the sides of the neck, the fingers almost meeting over the spinous processes of the upper cervicals; press gently two or three minutes with the fingers upon the vaso-motor (cut 13).
    This treatment, if properly applied, is infallible.  If the child is restless, and refuses to submit to the operation, it can be treated upon the mother's lap by bending it backward while pressing upon the lumbar vertebra; the object being to get the body in such a position as to throw a direct pressure upon the solar plexus.
    We might mention in this connection a very prominent physician at Galena, Kansas, who was converted to Osteopathy by the results achieved in the treatment of a case of cholera infantum. While the doctor was fairly liberal in his views, and willing to investigate this new science, it seemed unreasonable to him to believe that this disease could be cured without the use of medicine.  Having a case of cholera infantum, in its last stages, after having applied the drug treatment in vain, he gave the little one, one evening, an osteopathic treatment, and was surprised upon his visit the next morning to find it improving quite rapidly.  A continuation of the treatment in a few days effected a cure.


    1.  Bend the patient backward as in diarrhea.
    2.  Press steadily on the pit of the stomach with the palm of the hand for a moment.
    3.  Place the knee between the shoulders, raising the arms high above the head (see cut 5).
    4.  Permit the patient to lie on the back, and, reaching over as in cut 21, with each of the fingers close to the spine, between and a little below the scapulae, press strongly a moment, after which hold the vaso-motor center (cut 13).
    This treatment will cure the most aggravated cases, usually in a few moments.  It will be observed that we are working here on the splanchnic nerves, which are in direct communication with the stomach.

(Frequent evacuation of the bowels, usually resulting from amyloid diseases, but may be due to chronic inflammation of the bowels, causing increased peristalsis.)

    Increased movement of the bowels; stools light in color, containing mucus; nervousness; intestinal indigestion.  More common in females.

    1.  Place the patient on the side; beginning at the upper dorsal, move the muscles upward and outward) very deeply, the entire length of the dorsal region.  Treat the opposite side in a similar manner.
    2.  Place the patient on a stool; the operator placing the knee against the back of the patient, just below the last dorsal, draw the patient backward, slowly but strongly, as far as the patient can stand without too much inconvenience; hold in this position a moment and repeat.
    3.  Place the hand lightly over the bowels, with the patient lying on the back; vibrate gently two minutes.
    4.  Place the hand under the chin, drawing the head backward, rotating it gently from side to side, with the disengaged hand manipulating the muscles immediately over the pneumogastric.
    This treatment should be applied each day; will require about fifteen minutes; and, if correctly given, will cure any case of chronic diarrhea.

(Inflammation of the large intestine, with frequent evacuation of the bowels.)

    Prostration; fever; evacuations mucous and bloody; vertigo; weakness; vomiting; nausea; and headache.  Usually occurs in summer or fall.

    1.  Place the patient on the side; beginning at the upper cervicals, move the muscles upward and outward, gently and carefully, along the entire length of the spinal column.  Treat the opposite side in a similar manner.
    2.  Stand beside the bed, patient lying on his back; place one hand on each side of the spine, below the last dorsal, the fingers pressing close to the spine upon each side; raise the patient, his weight resting upon the ends of the fingers, until his body is several inches off the bed; hold in this position for a moment; and repeat, this time placing the fingers nearer the sacrum.
    3.  Place the hand lightly over the bowels, and vibrate gently two or three minutes.
    4.  Place the hands upon each side of the neck, the fingers almost meeting over the spinous processes of the upper cervicals (see cut 13); press gently two or three minutes, to reduce the fever.  See Vaso-motor.
    Treatment will occupy ten or fifteen minutes, and should be given every four hours.

(May follow an acute attack.)

    Similar to the acute form, but without fever; complexion sallow; wasting; skin dry; urine albuminous; and anemia.

    See Flux or Acute Dysentery.  Treatment should be given each day, omitting No. 4.

(Inflammation of the vermiform appendix.)

    Fever; anorexia; severe pain in the right iliac fossa, increased by motion; indication of a sausage-shaped tumor; vomiting usually attended with nausea, but may not occur if there is diarrhea.

    1.  Place the patient on the back; beginning at the ileocecal valve, manipulate gently, but as deep as possible, the ascending, transverse, and descending colon, endeavoring to move any hardened lump of feces toward the rectum.
    2.  Place the patient on the left side and manipulate very gently at first, gradually working deeper and stronger over the cecum and vermiform appendix, manipulating these parts as thoroughly as possible.  If this treatment is given in a very gentle, careful manner, it is surprising bow deep and thorough these parts can be manipulated, without giving pain, and the immediate relief experienced by the patient.
    3.  Place the hand lightly over the cecum, and vibrate gently one or two minutes.
    4.  Grasping the right hand of patient, an assistant holding the hip, draw the arm strongly above the head, giving thorough extension (cut 22).
    5.  Place the patient on the side; beginning at the upper cervicals, move the muscles upward and outward gently the entire length of the spinal column, giving particular attention to that portion which seems sensitive to the touch; treat the opposite side in a similar manner.
    6.  Place the hands on each side of the neck, fingers almost meeting over the spinous processes of the upper cervicals; press gently with the fingers three or four minutes upon the vaso-motor, to check the fever.
    This treatment should be given each day, and occupy about fifteen minutes.  First treatment will usually give immediate relief.

(Inflammation of the cecum.)

    Pain in the right iliac fossa; nausea; constipation; fever; sausage-shaped tumor.

    See Appendicitis.

(Inflammation of the tissues surrounding the cecum.)

    It usually occurs in the course of appendicitis or typhlitis.  Symptoms, except the tumor is not sausage-shaped, similar to the latter.  Patient usually lies with thighs partly flexed upon the right side.

    See Appendicitis.

(Falling down of a number of the abdominal organs on account of relaxation of the supporting ligaments.)

    Heaviness and weight in the abdomen, with distress; and displacement of the organs.

    This disease can be greatly benefited and is sometimes cured by a long continuation of our General Treatment, the object being to free and stimulate the circulation to the weakened muscles and ligaments supporting the displaced organs.

(Slipping of one part of the intestine into another.)

    Paroxysms; sudden pain; sausage-shaped tumor in the abdomen; dysentery; small intestine entering the large one at the ileo-cecal orifice is the most common.

    Beginning a few inches above the sausage-shaped tumor, manipulate the bowels, gently at first, gradually working stronger and deeper, endeavoring, if possible, to move the intestine backward and out of the larger one.  This treatment should be very careful and thorough, and continued at intervals until the desired result is accomplished.  It is always advisable to place the hand lightly over the tumor and vibrate two or three minutes.

(May be calculus, gall-stone, or fecal impaction.)

    Pulse feeble and rapid; surface cold and clammy; abdominal pain; vomiting; rumbling, and distended abdomen.

    1. Very thorough, careful manipulation of the large and small intestines; working gently at first, gradually deeper and stronger, as the patient becomes accustomed to the manipulation.  Patient should lie upon the back, with the limbs slightly flexed, thus relieving the tension upon the abdominal muscles.  After manipulating the bowels a few moments, work deeper, and endeavor to locate, if possible, the obstruction, which must be kneaded and manipulated in any manner which will best tend to move it onward toward the rectum.
    2.  Thorough and careful Treatment to Equalize the Circulation.
    Treatment should be given every day, and will occupy about twenty minutes.

(Cancer of the bowels.)

    There may be no symptoms, except general failure of the health, until obstruction of the bowels takes place.
    No cure in Osteopathy.

(Consumption of the bowels.)

    Anemia; diarrhea; irregular fever; rapid emaciation.
    No cure in Osteopathy.

(Starch-like wasting of the bowels.)

    Diarrhea, associated with amyloid diseases of other organs; changes in the urine; and enlargement of the liver and spleen.
    No cure in Osteopathy.

(The most common are Cestodes, or  Tape-worms, and Nematodes, or Round-worms.  The former are Penia Solium, Penia Mediocanellata, and Bothriocephalus Latus.  The most common of the latter are Lumbricoides, Oxyuris Vermicularis, and Prichina Spiralis.)

    Capricious appetite; uneasiness in the abdomen; colicky pains; nausea; insomnia; possibly vomiting; itching of the nose and anus; and epileptic convulsions.
    No cure in Osteopathy.

(Inflammation of the peritoneum.)

    Sudden and chilly feelings, or rigor; intense pain in the abdomen, aggravated by movements or pressure; patient lies on the back, with legs drawn up; tympanites; nausea; vomiting; elevation of temperature; drawn face and anxious expression.

    1.  Place the patient on the back; beginning at the cecum, manipulate very gently, following the colon its entire length to the rectum.  This treatment should occupy several minutes; gradually working deeper and stronger.  The small intestine must also be kneaded very carefully.  Great caution must be exercised to begin very gently, gradually working deeper and stronger, as in this manner the patient can be greatly relieved and the treatment given with very little pain.
    2.  Place the hand lightly over the intestine; vibrate gently for two minutes, thus starting the circulation, and reducing the inflammation in the peritoneum.
    3.  Grasp the patient's wrists, and draw the arms slowly, gently, but with some strength, above the head, as the patient inhales.
    4.  Place the patient upon the side; moving the muscles upward and outward the entire length of the spinal column, gently but deep; treat the opposite side in a similar manner.
    5.  Place the hands on each side of the neck, the finger-tips almost meeting over the spinous processes of the upper cervicals (cut 13); press gently with the fingers three or four minutes, to reduce the fever.
    This treatment, if carefully given, will occupy about thirty minutes, and give immediate relief.      Should be give once each day, until recovery.

(May follow an acute attack.)

    The omentum is hard and rolled up close to its attachment to the stomach; coughing or speaking often increases pain; tongue often cracked and red; greenish vomit; and constipation.

    See Acute Peritonitis.

(Dropsy of the abdomen.  Fluid in the peritonea cavity.)

    Skin tense; enlargement of the abdomen; the navel may project; fluctuation or waving of fluid on tapping.

    1.  Thorough manipulation of the bowels and abdomen.  See Constipation Treatment.
    2.  Place the patient on the side; beginning at the tenth dorsal, move the muscles upward and outward very thoroughly and deeply to the lower end of the sacrum.  This treatment stimulates the kidneys to more rapid action.
    This treatment should be very thorough and careful, and occupy about fifteen minutes, every other day.

(Cancer of the peritoneum.)

    This disease usually occurs in old people, and follows cancer in other organs; pain, with appearance of a tumor.
    More common in females.  Progressive emaciation; ascites usually develop, with bloody exudation.
    No cure in Osteopathy.

(Tuberculosis of the peritoneum.)

    May continue without any symptoms; may simulate suppurative peritonitis, except that its course is more prolonged and less pronounced; fluctuation of temperature.
    No cure in Osteopathy.