Osteopathy Complete Elmer D. Barber, D. O. 1898              INTRODUCTION  
 
OSTEOPATHY

    Osteopathy is a progressive science, and is as yet in its infancy. Valuable discoveries are being continually made by skillful members of the profession while engaged in research and experiment.  It does not claim to cure all the ills flesh is heir to; neither would it presume to detract from the virtues of any other method of healing.  It is simply the response to the demands of mankind for a therapeutic science eminently superior in point of rationality of method, freedom from injury to the patient, and successful results, as compared with all other methods in use.  Its necessity was to a large extent due to the fact that the oldest and most general method of practice has had, since the sixteenth century, some of the most intellectual men of the world engaged in research along the lines of its theory, and still claims to have discovered and presented to the world but three absolute specifies for the ailments of humankind, and the efficacy of these has not Yet been attested by the experience of the subjective patients.
    While Osteopathy does not expect to entirely supplant materia medica, its merit has already been established beyond any peradventure, and no other method of healing has, in so short a time made such rapid strides into public favor and confidence; which is entirely due to its remarkable record, which, although a majority of the cases treated were termed chronic, and had previously tried almost all other methods without the result of a cure, shows about ninety per cent of the cases treated benefited, seventy-five per cent completely cured, while only ten per cent received no relief, and not one injured or made worse.  In view of the wonderful record, a number of States have passed laws recognizing it as a safe and efficacious method of treatment; and it is not only receiving the attention and endorsement of the most intelligent classes where it is being introduced, but is commanding the consideration of the progressive minds of the medical world.
    Owing to the literal translation of the word "Osteopathy," its appropriateness to the science, as taught and practiced, has to some extent been criticized.  It may be necessary, therefore, to explain that, while it seems to have been the original idea of the founder of the science that nearly all diseases are caused by dislocated bones, the experience of his students does not prove this theory to be correct, but find that the adaptation of the name lies not so much in the treatment of bones as in the use made of them in applying the treatment; so that it may be said that the name "Osteopathy" is significant of the science, not only to the extent that bones constitute the framework or basis on which the superstructure of the human body is constructed, and which must be perfectly adjusted and functionally normal to make possible a complete physiological condition, but the skeleton furnishes indispensable starting points to the osteopath when examining the body in search of abnormalities, as well as the exact location of important nerve-centers, arteries, and veins, so essential to intelligent treatment.  Further than this, the bones of the extremities are often used as levers, fulcrums, etc., where the treatment requires the stretching of contracted muscles, freeing the circulation of the nutritive fluids and nerve-currents of the body.
    Osteopathy is veritably a common-sense method of treating diseased conditions of the body, either structural or functional - without knife or drugs, by means of strictly scientific manipulations.  It makes no demands upon the vitality of the patient, but enlists the curative powers contained within the body, which readily respond when properly appealed to.  Its method is purely mechanical, and its cardinal principles might be classified as follows: Skeleton Adjustment, Glandular Activity, Free Circulation of Blood, and Coordination of Nerve-Force.
    The art of applying its methods is dependent upon a thorough knowledge of anatomy and physiology, and a proper application of the principles involved therein, as well as a knowledge of the organic powers of the body, and the nerve-centers through which they may be excited to action and regulated.
    The osteopath, being "a student of forces," deals with the body as a wonderfully constructed machine, composed of various tissues and organs, each performing some specific function in the promotion of vital economy, under the supervision of vital forces; and when perfectly adjusted, will continue to operate its full appointed time, unless interfered with by accident or abuse.
    All lesions causing pathological conditions are not only the excess, defect, or perversion of some structure or function, but it is a physiological conclusion that they will be found accompanied by incoordination of the vital forces of vital energy, as compared with some other in a corresponding the body; that is, an excessive or excited condition of some degree of deficiency or inactivity.  The vital forces being thus deranged, harmony is destroyed and the system becomes diseased.
    To detect a pathological conditions the osteopath must know well a perfect anatomical and physiological being; just as a detector of counterfeits must be perfectly familiar with every point of the genuine before he can be skilled in his profession; and although the osteopathic application of the principles of anatomy and physiology differs materially from that made by any other science of therapeutics; it is perfectly rational and purely scientific.  The proper deducing of the cause from the effect being an elementary principle of intelligent treatment, the osteopath applies his methods to the removal of the cause, be it the reduction of a dislocation, the arousing of an enervated organ, equalization of the circulation of the body fluids, or the coordination of the nerve-force; harmony - which is the beauty and strength, not only of all institutions, but of all mechanism as well-being thus restored, health is the result: whereby is promoted by osteopathic methods the production and maintenance of healthy tissue and function in the system.
 
 
SKELETON ADJUSTMENT

    It is obvious to the student of physiology, of even ordinary intelligence, that there can be no complete condition of health without a perfectly adjusted skeleton.  Its relative importance to the weal of the body is that of the foundation to the house.  That luxations are much more common than supposed, and can be produced by an accident so slight as to go unobserved, is painfully demonstrated by the thousands of cases that have been overlooked. by some of the most eminent practitioners; when, had they been searched for from an osteopathic standpoint, they could no doubt have been easily reduced, thus removing the cause of many morbid affections that often prove so perplexing to the practitioners of the usual methods.
    A dislocation is not necessarily the result of external violence.  It may be caused by the ulceration of a process of bone, elongation of ligaments, or by muscular action; so that its discovery must not depend too much upon the history of some violent accident, but should be arrived at by a minute examination and comparison with a normal joint, the success of which largely depends upon the practitioner's familiarity with a perfect anatomical condition.  There will usually be found in case of a dislocated member, alteration in the form of the joint and axis of the limb, impaired circulation in the parts involved, loss of proper motion, pain on manipulation, lengthening or shortening, prominence at one point and depression at another, but in some cases precise measurements to and from certain fixed points about the joint as compared with a normal joint are necessary in order to discover the true condition.
    The first examination of a patient by an osteopath is, or should be, with special reference to the normality of the skeleton, for though a luxation may be but partial, it may be causing a pressure at some point upon a nerve or blood-vessel of which the patient is entirely unconscious, and thus remain unaccounted for as a barrier to the recovery of health.
    To undertake to heal a diseased body with a dislocated member without first reducing the dislocation is like trying to operate a machine with an important cog-wheel out of gear.
 
 
GLANDULAR ACTIVITY

    The normal action of the secreting glands is absolutely essential to health, and particular attention to the proper performance of this function is not only  demanded of the performance of the osteopath, but remedies influencing the secretions are given a first place in the practice of materia medica.
    Secretions are divided into two classes, known as "recrementitious" and "excrementitious."  The process is carried on by cells, which in most cases are grouped in organs known as glands.  These cells are defined as "nucleated masses of protoplasm of microscopic size." Protoplasm is germinal matter of a gelatinous nature - a proteid compound consisting largely of muco-globulin.  Chemically it contains C. H. N. O. S., and its reaction is albuminous.  The nucleus is a small vesicular body imbedded in the protoplasm.  Chemically it is a nitrogenous constituent, and its purpose is largely that of cell-reproduction.  Biologically, cells are the fundamental elements of living tissue, and in view of the demands made upon them by the process of destructive metabolism, whereby the protoplasm of cells is being constantly destroyed by active use, Nature has wisely provided them with the power of reproduction of kind that they may remain constant.  They have the power of motion in response to stimuli, and the power of absorbing certain portions of food and rejecting the rest.
    The function of the principal secreting glands of the body is not a mere physical process of filtration, as might be inferred from some authorities, but is in fact a vital process; for these glands not only separate from the blood certain materials for reabsorption, but by their elaborating processes convert these materials into higher degrees of tissue products; dependent upon a course of chemical operation of their own by which they manufacture new substances not found in the blood, the whole forming a secretion known as recrementitious matter for use in the promotion of animal economy.      They separate certain other materials from the blood to be discharged from the body as excrementitious matter, being either useless or harmful if retained.
    It is therefore apparent that with glandular activity the body possesses laboratories of its own capable of manufacturing within itself all the remedial properties conducive to its well-being; so that it is not only unnecessary to introduce unorganized chemicals into the system, but to do so and expect them to become organized by inactive glands is unreasonable in the extreme.  All materials must be especially organized by the glands of the body before they can promote the function of tissue nutrition, and to introduce unorganized matter into the system and expect it to be appropriated without becoming organized, one had as well undertake to add inches to pounds.  Furthermore, the majority of chemicals in crude state are injurious to the system, and Nature has unerringly provided that one of the special functions of the liver shall be to filter from the blood containing fresh absorptions from the digestive tract all materials that would be poisonous to the body if permitted to enter the general circulation, and reject them back to the intestines to be discharged.  Might it not then be an interesting problem the solving of which would cause confusion - as to how much of the chemical introduced reached its destination and accomplished its purpose, without causing a corresponding injury to the system.
    It is a well-established physiological principle that glandular activity is affected by the amount of blood passing through the gland, and that the function of secretion is dependent upon proper innervation and free circulation of blood.  It is through these agencies that the osteopath corrects glandular irregularities and promotes the function of secretion.
    The cause of lesions of secretions may be local or general, and the local or general secretion is affected accordingly.  A sharp pain is evidence of excitation; a dull pain, with sensations of weight and fullness, of glandular inactivity.  If these symptoms are not local, the condition is likely general; and if the condition is one of inactivity, the skilled osteopath applies his method of increasing the general blood-pressure, by increasing the force and frequency of the heart's action; regulating the caliber of the arteries, through the vaso-motor centers; and coordinating the general nerve force.  If the condition is local, his method would be to increase the local blood-pressure, by relaxation of the arteries supplying the gland affected, without compensating relaxation elsewhere; or by constriction of the arteries other than those supplying the gland.  If the condition should be one of  excitation or excess, methods opposite those used for inactivity would be applied.
 
 
FREE CIRCULATION OF BLOOD
 
    It is conceded by all leading authorities that a normal circulation of blood is one of the most important functions of life, and it can hardly be more forcibly demonstrated than by the fact that in a normal condition a quantity of blood equal to the entire amount in an ordinary human being passes through the heart about every thirty seconds.  The blood represents about one-twelfth of the body weight, and normally is distributed about one-fourth in the liver; one-fourth in the muscles; one-fourth in the heart, lungs, and large vessels; and one-fourth in other organs.  It is composed of serum - a nearly colorless liquid - and red and white corpuscles.  Chemically it contains proteids, fats, sugar, salts, and hemoglobin.  The corpuscles represent about forty to forty-five per cent of its total weight, and there are about 14,506 white corpuscles to 5,000,000 of the red in each cubic millimeter; the proportion varying in different conditions of health and disease.  The red corpuscles have a definite life, and degenerate as do other parts of the body.   The white corpuscles have the power of ameboid movement, by which they are able to pass through the walls of capillaries into the surrounding tissues.  They have their source of origin in the lymph glands and the spleen; and some of them end in red corpuscles, while others take part in inflammatory processes being sacrificed in pus-formation.
    The blood is propelled by the heart through the arteries to the capillaries in the substance of the tissues, where it is collected by the veins and returned to the heart; thus serving as a transportation medium, carrying food and oxygen to the tissues of the body for their nourishment, and bringing back morbid elements for excretion.  Not only is glandular activity dependent upon a free flow of blood, but the minute and equal distribution of this nutritive fluid is indeed essential to the proper appropriation of tissue-building elements, as well as the no less important process of retrograde metamorphosis, whereby are removed waste and worn-out materials, which, if retained in the system, would inevitably produce disease.  Further than this, the union, in the body, of oxygen received by the blood from the lungs, with carbon and hydrogen, produces a process of combustion by which the normal heat of the body is maintained, so that with an obstructed circulation the part of the body involved would of necessity stiffer from a lack of proper warmth.  Being the basis, therefore, for the vital performance of assimilation and elimination, as well as the maintenance of the body temperature, health must be dependent upon a regular and uniform circulation of blood, and disease will surely follow any continued variation of this function.
    The osteopath refers more causes of pathological conditions to impairment of this function than to any other of the body and through its agency effects more cures.
    The constriction of an important artery or vein, caused by a slightly displaced bone or organ, or an indurated muscle, will produce an excess of blood in one part of the body, and a corresponding deficiency in another, probably resulting in headache, and a corresponding coldness of the lower extremities; depending, of course, upon the location of the obstruction, which, if not removed, will almost certainly cause irregular action of the heart.  To illustrate: A hose with two branches being attached to a force pump, and one branch being constricted by pressure of the hand or foot, more water is of necessity forced through the other branch, and a greater effort is required of the pump in propelling the given amount of water, resulting in an early impairment of the pump if the obstruction is not removed.
    A free flow of blood is the remedial agency in the osteopathic treatment of inflammatory processes; their termination by resolution being promoted by relaxation of the structures involved, thus freeing the blood-passages through and from the affected area, whereby the capillaries are flushed with a fresh supply of blood and morphological elements rapidly removed as the circulation is being restored.
    Not only is this method efficacious in simple processes, but especially so in those known as infective where micro-organism is a peculiar characteristic, such as diphtheria or typhoid fever.  Osteopathy has for its purpose, in the treatment of all such diseases, simply the restoration of healthy tissue claiming that no microbe can inhabit tissues physiologically normal, and that only such as have imperfect elimination of waste materials are susceptible of their invasion, and suitable for their development.  They are found, therefore, as the result rather than the cause of pathological conditions.
    This theory is strongly demonstrated by the fact that two individuals may be exposed to an infectious disease at the same time, and one may contract it while the other does not, which is owing to the difference in the physiological condition of the two systems.  In one case there was free circulation of blood rich with leucocytes, or white blood corpuscles; the eliminating processes were active, thus giving the system the power of resistance; or, in other words, it was physiologically normal.  In the other case, the circulation of blood was sluggish, and perhaps deficient in white blood-corpuscles; there was no doubt glandular inactivity and impaired elimination, thus giving the system no power of resistance; or, in other words, it was already in a pathological condition.
    Leading physiologists teach that one of the most important offices of the white blood corpuscles is to attack, devour, and destroy invading micro-organism.  They are, therefore, beyond any question, a powerful microbicide, and a remedial agency in these processes especially provided by Nature, and consequently uninjurious to the system.  It is within the province of the skillful osteopath not only to increase their number through their sources of origin, but to aid the great transporting medium in conveying them to the scene of conflict.
    Osteopathy stands without a formidable competitor in the art of equalizing the circulation of blood,, and though its method of freeing the blood-passages and regulating the action of the heart are so evidently in accord with the principles of anatomy and physiology, yet they are not even remotely approximated by the methods of any other science of therapeutics.
 
 
COORDINATION OF NERVE-FORCE

    It is not, only agreed that pathological conditions may be of neurotic origin, but that the phenomena of all lesions of the body are to some extent portrayed through the nervous system.  The control of the nervous system over the functions concerned in the motion, sensation, and nutrition of the entire body places it among the leading agencies through which the osteopathic methods of healing are applied.
    To exercise a controlling influence over this system has baffled the skill of the most eminent practitioners of the old schools.  Their methods having been confined almost exclusively to experiments with electricity and chemicals.
    The osteopath regards the nervous mechanism of the body as an immense electrical system, containing its own batteries, wires, and other necessary appliances.  It is capable of generating all the force needed and simply requires perfect continuity and coordination by mechanical methods.
    The brain receives sensory impressions, and transmits motor impulses.  The spinal cord conducts them to and from the various wires which carry the impulses to the most remote tissues of the entire being.
    The white or fibrous nerve-matter is composed of a number of tubes, each containing an axis-cylinder, insulated and protected by the White Substance of Schwann.  A bundle of these tubes is invested by a covering, the neurilemma, and is called a "nerve" - the arrangement having been likened to a submarine telegraph cable.  The axis-cylinder connects the nerve-center with the cells of the periphery.  The fibers contained in the nerve are classified as afferent and efferent fibers, and their function is the transmission of stimuli.  The former carry impulses from the periphery to the center, and are known as sensory fibers.  The latter carry them from the center to the periphery, and are known as motor fibers.  This system has two divisions, the Cerebro-spinal, and the Sympathetic.  The cerebro-spinal includes the brain, medulla oblongata, and spinal cord, also the nerves proceeding from them.  The sympathetic consists of a double chain of ganglia - small nerve-centers  - which lie on either side of the vertebral column, extending its entire length, and are closely connected with the spinal nerves, each of which gives off a communicating branch, containing both motor and sensory fibers, to a neighboring sympathetic ganglion.  Indeed, the two systems are so closely allied that practically they may be considered as one, for by following closely the anatomy and physiology of the sympathetic system it will be found that the fibers of most of its nerves have their origin in the spinal cord.  For instance, the  splanchnic nerves, which form a great part of the solar plexus supplying the abdominal viscera, have their fibrous origin in the spinal cord, as do the accelerator nerves of the heart in the cervical and upper dorsal region of the cord, stimulation of which center physiology teaches will increase the heart's action.  There are certain fibers, known as the vaso-motor fibers, whose function has to do with the regulation of the caliber of the blood-vessels, especially the arteries.  They are divided into constrictor and dilator fibers, and, though controlled by the sympathetic system, come from the spinal cord, their most important spinal center being in the cervical region; while the nutritive function of the entire body is under the immediate supervision of the sympathetic system, that it is dependent upon the connection of that system with the spinal cord is a physiological fact which needs no particular comment.
    There are thirty-one pairs of spinal nerves; each arises by two roots, an anterior motor root and a posterior sensory one; these unite, and the nerve then divides into two branches, an anterior and a posterior, both having motor and sensory fibers.  The anterior nerves supply the body in front of the spinal column, also the limbs, and send communicating branches to the sympathetic ganglia.  The posterior nerves supply the muscles and integument of the back, and contain both afferent and efferent fibers.
    The function of the spinal cord is the "conduction of impulses," and the "origination of reflex action in response to stimuli," whereby an impulse may be transmitted through afferent fibers to a. center in the spinal cord, and there transformed into an efferent impulse and conducted to the part of the body receiving its innervation from the nerve center thus operated upon.  The spinal cord contains many of the most important centers of the nervous system, and which are capable of being excited reflexly; such as the spinal vaso-motor centers, cardio-accelerator center, parturition center, etc.; the action of the cells of the cord being independent of the will, and occurs before the mind is conscious of it.  It is therefore within the power of the skillful osteopath to produce effects in almost any part of the body through the wonderful mechanism of this spinal key-board.
    Although it is a well-established principle of, neurophysiology that the action of nerves can be influenced by mechanical stimuli, it has remained for the osteopath to demonstrate that it is entirely practical, and that it is more effectual to apply the stimulus to the nerve supplying the tissue or organ than to apply it directly to the structure involved.  He has furthermore proven the physiological teaching that a sudden pressure over a nerve followed by immediate retraction will stimulate or excite the nerve action; and on the other hand, a gentle steady pressure quiets or deadens the action, producing for a time the effect of nerve-section, paralysis, or osteopathic desensitization.  It is not only obvious that there must be perfect continuity of nerve-force in order that any organ may receive a message to discharge a certain function, but proper innervation is an indispensable factor in the vitality of every tissue and organ.  Coordination of the nerve-force of the body is no less essential, for with the nervous energy of one part of the body in a state of excitation as compared with the rest, there is excess of some function which makes unnecessary demands upon the vitality of the body at the expense of its delicate machinery producing a result probably similar in a measure to that of an electrical apparatus charged beyond its capacity.
    With a thorough knowledge of the various nerve-centers, and the innervation of the different tissues and organs, the osteopath is able to coordinate the nerve-force of the body.  He can increase the nerve-current to almost any part of the being, and can quiet an excessive one as well.  The efficacy and practicability of this theory has been satisfactorily demonstrated in the treatment of ataxia, paralysis, anesthetic and hyperesthetic conditions, as well as in the regulation of the peristaltic action of the bowels, the regulation of the heart's action, controlling the caliber of the blood vessels, and the relief and assistance so effectually rendered in parturition.