Neuropathy
A. P. Davis, M.D., N.D., D.O.
1909
  
DESCRIPTION OF PLATES
 
 
[NOTE: To view the graphic associated with each description, click on the plate number or title.]
 
 
PLATES 1a AND 1b
FIRST OF THE GENERAL TREATMENT

    Place the patient on the table, or bed, on the back, all the muscles limp as possible, neck bare of clothing, ties, etc., Put both hands, fingers touching at the spines of vertebrae, hands at the side of the neck, head of patient well up to the head of table; raise the neck with both hands, letting the forefingers pull hardest, so that the head will incline to droop somewhat, pressing the person against the top of the head of patient, and when the neck is well bent and stretched upwards, move backward from head of the patient yourself, raising the fingers next to the occiput so as to level the head, and let it down on the table.
    This move should be done two or more times. The object of this move is to stretch the neck muscles, stimulate the general circulation - and thereby start dormant conditions of all of the fluids in that region, arouse the vasomotor nerves, regulating the caliber of all of the blood vessels in the body; and determines normal or abnormal contour of the vertebrae themselves, the softness or rigidity of the various muscles of the neck, condition of the venous and lymphatic vessels, glands, etc.
 
 
PLATE 2
TREATMENT OF THE SIDE OF THE NECK MUSCLES

    Place the heel of each hand on each side of the head of the patient, on the mastoid portion of it, behind the ears, putting the fingers as near together as may be; drop the fingers of one hand to the junction of the occiput and neck; now roll the head over on that hand by pressing with the heel of the other hand, pressing at the same time with the palm of the fingers against the side of the neck, inclining to pull the finger ends upward, and enforcing that move by the pressure of the palm of the other hand, or rather the heel of the hand against the side of the head, back of the ear (as seen in the plate). Continue these moves several times, moving the fingers on the sides of the neck up and down over the muscles, catching fingers at a new point on the neck each turn of the head, with the fingers of the hand underneath the side of head and the neck. The fingers of the hand that rolls the head over on the other hand need not be pressing on the neck as the heel of said hand rolls the head over on the opposite hand, but may be lifted up therefrom in an easy, graceful curve, but drawn down when pressure is to be made on the neck of that side. The object of this move, or these moves, is to free the circulation of the blood and other fluids in all of the muscles of the neck, removing any and all rigidity, contraction of muscles, etc.
 
 
PLATE 3
STRETCHING OF NECK MUSCLES

    Place the hand under the neck, fingers ending near mastoid process of occipital on opposite side, other hand under chin of patient; pull easily, firmly and steadily in a direct line lengthwise until you perceive that the body is moved enough to move the feet of the patient, and, holding the hands and body taut, at the same time turning the head on toward finger ends of hand on back of head, pressing moderately with finger ends, and before slackening hold turn head till straight with body; then let go. Change the hands and repeat same process on opposite side of head. This, you perceive, stretches the neck muscles, and cervical vertebrae as well, thoroughly.
    The stretching of the spine is done as follows: An assistant takes hold of the feet, and the operator takes hold of the patient under, or by the arms or wrists, and gentle and steady extension is made. If patient lies on face, a second assistant may be of service in adjusting spine for any deviations found, such as curvature, contracted muscles along spine, atrophied, shrunken or affected muscular structure.
    This treatment is greatly beneficial in all spinal affections, in a large variety of pains, lameness, rheumatic or neuralgic, sciatica, lumbago, etc. It relieves spinal congestion in cerebro-spinal meningitis. The stretching of the spinal cord will be advisable for a great many affections, and properly performed, frequently produces the most marvelous results imaginable. Lameness that has existed for years frequently yields at once. Remember that the important thing to do is to take off the pressure. Freedom's holy influence blesses mankind physically, as well as morally, spiritually. "Freedom!"
 

PLATE 4
VIBRATION OF NECK MUSCLES, PATIENT RECUMBENT

    With the tips of the fingers of both hands placed near the cervical vertebrae, hands at the sides of the neck, pressing gently against the neck with ends of the fingers, move the hands rapidly in such a way as to move the muscles of the side and back of the neck upwards, downwards and sidewise, vibrating, for several successive moves.
 

PLATE 5
ANGLE OF THE JAW MOVEMENT

    Place the fingers (one or more) at the angle of the jaw; have the patient open the mouth widely; at the instant the mouth is opened draw the fingers up firmly to the side of the head, back of the ear, stretching the skin and adjacent tissues at the same time; and as the patient closes the mouth, loosen the pressure of the fingers. Do this two or three times, being careful not to produce pain by holding the fingers in position as the jaw is closing.
 

PLATES 6a AND 6b
TREATMENT OF THE EARS (6a)
EAR EXTENSION BACKWARD (6b)

    The ear movement is made as follows: Place the end of the forefinger palmar surface on the Tragus (the little protuberance just below and in front of the meatus-auditorius externus), the ear being held between first and second fingers; Move them quite vigorously up and down several times, then press them backwards with a steady but rather sudden jerk, and revolve the integument with the whole ear several times.
 

PLATE 7
VIBRATION OF THE TEMPLES AND FOREHEAD

    Place the fingers, the pulps of them, on the temples, and, with an up and down or rotary movement, vibrate in and over and around in all directions on the temples for several quick, successive movements, and at the same time dropping the thumbs on the forehead and vibrating them over every part of it, upwards and downwards.

 
PLATE 8
STIMULATION OF THE SUPRAORBITAL NERVES

    This movement is made by placing the palmer portion of the thumbs on either side of the nose, pulling them upward and outwards over the eyebrows across the supraorbital notch two or three times, with moderate pressure.

 
PLATE 9a
VIBRATION OF SIDES OF NARES

    Put the thumb oil one side of the nose, fingers on other side, compress slightly, and move them up and down the length of nose, pulling skin at the same time, moving quite rapidly for several successive moves.

 
PLATE 9b
STIMULATION OF LACUS LACHRYMALES

    Put thumb and index finger of either hand on papillae lachrymal at inner cautious of eyes, squeeze gently, then, finger and thumb in position, gently push them down to the sides of the nose with a sudden push, being careful to hold them together so as not to spread out and run them into the eyes. Two or three vigorous motions should be made.
 

PLATE 10
VIBRATION OF THE FACIAL MUSCLES

    This move is made by placing the thumbs on either side of the alae of the nose, and using pressure on the malar bone, letting the thumbs slide downwards and outwards on the under edge of the malar processes of the superior maxillary bones. Repeat the movements two or more times.
 

PLATE 11
THE DIVULSION OF THE NARES

    Introduce the forefinger of each hand into the nostrils and place the thumbs on outside; press them together, then pull nostrils outward (straight), stretching moderately so as to dilate the sphincter alae. This is one of the treatments for catarrh.
 
 
PLATE 12
MANIPULATION OF THE MUSCLES OF THE NECK

    The movements of the muscles of the neck are shown in this plate, and being important, it is essential that they be well understood. This movement, or the movements are made by standing at the side of the patient, the operator placing the hand on the forehead of the patient, the other hand on the side of the neck, fingers close to the cervical vertebrae, but not beyond the vertebrae of the side of the neck the hand is placed, the fingers forming a gentle curve, and the tips pressing evenly and vertically on neck; and now, with a rolling motion of the head, done by the use of the hand of the operator, on forehead, pushing forehead from him, and at the same time pulling the other hand toward himself, the operator being careful not to let the fingers slip over the skin, but pulling the skin and deeper structures with the fingers, rising sufficient pressure to do so and yet not hard enough to be painful or uncomfortable to the patient. The hand should course up and down on the neck, being particular to manipulate all of the side of the neck with that sort of a motion; then change sides of table; get around on the other side and go through the same process as on side left. The moves should cover every portion of the neck, and should be thoroughly done so as to reduce all of the rigidity that exists in the neck muscles at one sitting, if possible.
 
 
PLATE 13
RAISING OF THE CLAVICLES ON TABLE

    Standing at the side of the patient, place the arm of patient at the side of the body, flexed at elbow, catch hold of arm at elbow with hand, right arm of patient with right arm of operator, push the arm upwards gently. This pushes the clavicle upwards, and away from the first rib somewhat; now place the fingers of the other hand between the neck and clavicle, gently pull it outwards and at the same time raise the arm up to a level with the shoulder, keeping it on the level with the body, sliding it up on the table to that height; then let go with both hands, as you have the clavicle sufficiently raised for one time. This is the manner of raising the clavicle while patient is lying on the back of the operating table.
 

PLATES 14a AND 14b
ARM MOVEMENT, PATIENT ON TABLE (14a)
CONTINUED ARM MOVEMENT (14b)

    Standing at the side of the table, patient lying with face toward operator, relaxing as much as possible every muscle in the body, the patient is taken hold of by the operator, by the wrist, the fleshy part of the wrist next to the palmer surface of the operator, the forefinger extending between the thumb and forefinger of the patient, which gives secure and easy control of the movements to be made by the operator.
    The hand of the operator now should be placed with the fingers somewhat gently curved, the pulps of the fingers near the spinous processes of the dorsal region, beginning midway between scapulae, and on the side of spines next to operator, keeping patient on the side, leaning a little from the operator, close to the edge of the operating table, pretty nearly opposite the patient's shoulders, with foot extended beyond the head of the table, and the other foot placed so as to brace the body firmly and comfortably. Now extend the arm upward loosely to the side of the head, trying its natural position to the side of the head without straining, having hold of hand or hand and wrist as aforementioned, and the hand as before stated near spines of dorsal vertebrae; pressing gently two moves are made at once, simultaneously the arm is extended, and at the same moment there is sudden pressure made in the back, then the hand on the back should be firmly held in place while the patient's elbow is bent, flexed, upon itself, and suddenly brought back, with the hand closed around the wrist, to the side, over the arm of the operator (see Plate 14b) with a sudden movement. This sort of a movement is to be repeated a number of times; the operator moving the fingers down the side of the dorsal vertebrae, an inch or two at a time, so as to cover all the space in the different moves as far down the back as the tenth or twelfth dorsal vertebra. This may be repeated two or three times. This should be done on both sides the same way. This constitutes all of the dorsal treatment from the arm movement. The reader will not confound this movement with other dorsal treatments, remembering that this is the arm movement on the table for the back treatment. This move is an important one, and should be thoroughly understood, for upon the right kind of execution of it depends important results. These movements will be often referred to in the body of this work.
 
 
PLATE 15
NECK MOVEMENT

    Patient lying on the back, the operator places his hand under neck, finger ends on opposite side of cervical vertebrae, pressing gently on muscular structure, and holding fingers in that position, with other hand on the forehead of the patient, rotates it from him, toward ends of fingers of hand under neck, thus pushing muscles away from their moorings, as it were, continuing this process from base of skull clear down the cervical vertebrae to the shoulders, or first dorsal vertebra. This is to be done on both sides of the neck, changing hands, of course. Notice position in this plate.

 
PLATE 16
MOVEMENT FOR FLUX AND DIARRHEA

    The patient being seated on a stool, the operator, seated behind on another stool, places hands under arms of patient in such a manner as to include the shoulders, and placing the knees on either side of the spinous processes, gently draws the shoulders backward, and rolls the body of patient either way, using his knees as pivotal points against sides of spines, in the lumbar region, gradually pulling body upward as the body of operator is inclined backward. This stimulates the nervous system in that region and stretches the lumbar muscles, takes off the pressure, and relieves distress. This move may be utilized in the treatment of diarrhoea, flux, kidney troubles, by placing the knees in the proper position on the sides of vertebrae, in lower dorsal and lumbar region. This will be fully explained elsewhere in this book.
 

PLATES 17 AND 18
SHOWING FLEXION OF LOWER LIMB (17)
MANIPULATION OF THE SCIATIC NERVE (18)

    The patient lying on the back, the operator takes hold of the ankle, flexes the leg, presses it against or toward the abdomen, rotates it to ascertain whether the articulation is normal, addicting and abducting it as well as flexing and extending it. Then hold the leg at the knee in either one of the methods desired, flex the thigh upon or toward the abdomen, placing the fingers of the other hand just above the sacroiliac junction, pressing firmly with the ends of the fingers, and rotate the knee outward, downward and backward, repeating this process several times, bringing the fingers down a line half way between the ischium and the great trochanter, following the course of the great sciatic nerve as nearly as possible. The pressure may be modified according to effect desired. The various methods of holding the leg may be seen in the plates. The various methods of reducing luxations of the hip joint, described in books on the science of surgery, are familiar to surgeons, and, being duly explained in this book, need not be mentioned here. But the adduction and abduction are frequently used in the various muscular contractures in the hips and thighs which cause pain, rheumatism and kindred affections, such as neuralgia, varicose veins, ulcers, etc., that will not down of their own - accord, but will recover if the proper manipulations of the hip joint are made. We have other movements of the hips that demand our special attention.
 
 
PLATE 19
VIBRATORY MOVEMENT OF KNEES AND HIP JOINT

    The patient lying on the back, the operator should take hold of the ankle, placing the other hand below the knee; flex the leg upon the thigh and press the thigh well toward the abdomen; raise the foot a little, and press the thigh further toward the abdomen, and while thus taut, hold it quite firmly with the hand just below the knee, and with the hand holding the ankle move the foot from the other leg, describing about an eighth of a circle, moving it backward and forward a few times; this vibrates the hip and knee joints.
 

PLATE 20
SHOWING ABDUCTION OF THIGH

    With the hand holding the ankle, and the other one holding the leg below the knee joint, and the leg flexed on the thigh, and the thigh on the abdomen, and held there firmly, pass the hand from below the knee above the knee, as in Plate 17, and gently push the knee toward its fellow over the other thigh, at the same time bringing the ankle outward, and as the leg is brought to a straight line letting the hand above the knee come down on it as it comes to a level with the other limb. This last move should be made in a quick and rotary manner, coming down suddenly with the leg on the table.
 

PLATE 21
CONCLUSION OF MOVEMENT SHOWN ON PLATE 20

    This plate is the finishing of Plate 20. This manipulation should be gone through with two or three times each treatment.
 
 
PLATE 22
ABDUCTION OF THE THIGH

    The stretching of the adductor muscles is done in the following manner: Take hold of the ankle with one hand, flex the leg upon the thigh, turn knee outward, foot at right angles with other leg, knee pressed down with other hand, the hand above the knee, pressing firmly and steadily, continuously, while the hand holding the ankle draws the leg down with a quick jerk to a straight line, and the forefingers of the other hand pressing against the side of the leg thus extended so as to suddenly go against the side of the leg as it stops, with a sudden stop. This gently jerks the hip joint, as well as the knee joint, with a slight shock.
 

PLATE 23
CONCLUSION OF ABDUCTION OF THIGH

    This plate shows the conclusion of Plate 22 very perfectly, with the hand beside the leg, and just above the knee.
 
 
PLATE 24
THE METHOD OF TREATING THE SAPHENOUS VEIN
(VARICOSE VEINS; VARICOSE ULCER TREATMENT)

    Place patient on the back, on operating table, take hold of the leg just below the knee, flex the leg on the thigh, and with the other hand take hold of the thigh about two inches below the bend of the hip joint, fingers about the middle of the front of thigh, fingers forming a gentle curve, gently grasping the muscular structure; hold firmly and at the same time flex the thigh more against the abdomen, directing the knee toward the opposite shoulder of the patient in a slightly outward circular rotary movement, and at the same instant squeeze the fingers down on and enclosing the front part of thigh and pulling the elbow slightly backward and the wrist with an outward, backward, circular move, repeating these moves several times. This is for the purpose of freeing the veins in that region, especially the saphenous, which empties the blood from the deeper veins of the thigh into the femoral vein. The closure of this vein (saphenous) causes that condition called varicose veins of the leg.
 

PLATE 25
THE MANIPULATION OF THE ABDUCTORS
(VARICOSE VEIN TREATMENT CONTINUED)

    Letting the foot rest on the table, knee at right angle, patient on the back, take hold of the side of knee with one hand, the other hand with fingers slightly curved around on and under inside of the muscles low down on thigh, pull the ends of fingers against the muscles and at the same time push the leg and knee inward toward other leg, carefully moving all the muscles of the inside of the thigh as far up as the adductor brevis, and then the move as shown in Plate 24 may be repeated in the treatment. This is the most important movement in the treatment for varicose veins, for stoppage of the blood in the deeper veins and the saphenous vein means trouble below in leg.
 

PLATE 26
TREATING FIBULA AND LEG MUSCLES
(A FURTHER TREATMENT OF THE LIMB TO FREE THE VENOUS CIRCULATION, WARM THE FEET AND REMOVE OBSTRUCTIONS TO RETURN CIRCULATION)

    The patient lying on the back, catch hold of the ankle, other hand placing thumb resting on tibia about the insertion of quadriceps extensor muscle, fingers of the hand under head and back of fibula, grasping that bone, using some compression; flex the leg on the thigh several times, bring considerable pressure to bear each time, and lower the fingers into the posterior peroneal space, using the leg as a lever to squeeze the muscular tissue and deeper structures in that region, extending and flexing the leg repeatedly. This is an excellent move to aid the return circulation of the fluids.
 

PLATE 27
STRETCHING MUSCLES OF BACK OF LEG
(THE METHOD USED TO WARM THE FEET)

    The patient lying on the back, take hold of the ankle with one hand, place the other hand above the knee on the lower end of thigh, raise the leg with hand holding ankle, press firmly with other hand above knee, stretching all of the back muscles of the leg. Let the knee bend a little, and bring the pressure against the thigh with other hand suddenly, though gently, several times, and the feet warm up as if by magic. A still better way to increase the circulation of the blood in the leg and foot is to place the leg on the shoulder, lock both hands around the thigh just above the knee, moving up so as to let the leg flex at the knee, and spring the hands gently towards operator, bringing the leg straight with a sudden jerk - not strong, but easily, as prudence may dictate in each given case. This move may be made several times at one sitting, and no treatment will bring better results for cold feet. It will be referred to frequently for various other affections.
 

PLATE 28
STRETCHING TENDO ACHILLES

    This move should not be ignored, for it has its uses, and is frequently needed. The operator should take hold of the tendo achilles with one hand, holding it in such a manner as that the ankle may be firmly fixed, catching hold of the foot with the other hand, more nearly or around the toes, placing his shoulder or chest against the inner side of the forearm to steady his moves; now entry push the toes and metatarsal bones toward the front part of the tibia, pulling firmly in heel, counterbalancing the pressure made by the other hand. This stretches the muscular fibers of the back of the leg and lengthens them, equalizing the muscular strength of all the muscles of the leg. While the hands are thus holding the foot, rotation may be made to adjust any displacements of bones existing in the foot or ankle.
 

PLATE 29
TREATMENT OF OUTSIDE OF THIGH

    Place the patient on the back, flex the leg opposite, take hold of the knee, inside of opposite side of patient (to operator), and pressing knee outward, pulling inward with hand holding muscles of thigh, following course of sciatic nerve - that is, half way between the ischium and the great trochanter, pulling the muscles quite firmly, going over the parts two or more times. This treatment not only frees the muscular tissue on the outside of the thigh, but stretches the muscles on the inside of thigh, and in cases of sciatica or rheumatism, myalgia or diseases resulting from contracted muscles and sluggish circulation in that part of the body, is what should be done.
 

PLATE 30
EXPANSION OF CHEST BY TWO PERSONS
(RELIEVING MANY AFFECTIONS OF THE VISCERA IN CHEST)

    The patient lying on the back, two persons, one on each side of table, take hold of the wrist of patient, with the other hands placed near the sides of spinous processes, pressing firmly, beginning about the first dorsal vertebrae (each operator on his own side of the body next to him), with the arm of patient stretched strongly upwards and outward, as well as backwards and downwards, using the arms as levers and the ends of fingers as fulcrums, and at the same time having the patient inhale deeply; the arms are returned to the sides of patient with a sudden push and down on table to side of patient. This process should be repeated, moving the hand of operator down spine an inch or two each time the operation is repeated, going down as low as the tenth dorsal vertebra. The angles may vary from a right angle, to a vertical, pulling up to the side of the head. If there is no assistant, one operator may treat one side at a time. This is a most excellent way to expand the chest, and the patient invariably feels better. Care should be exercised in all the moves made, and due regard to the comfort of the patient. The various manipulations should be made with the view to benefit, and not to exhibit skill simply for the sake of praise as a mechanic, but for the good of the one operated upon. Disgrace always follows an awkward manipulator; justly, too.
 
 
PLATE 31
BACK AND SHOULDER TREATMENT

    This plate represents the arm and scapular movement, and comes in the general treatment, and by it the scapula is moved, raised from it's moorings, and the pectoral muscles, deltoid, coraco-brachialis, teres major and minor, latissimus dorsi, trapezium, supra- and sub-scapular muscles, stretching muscular fiber and aiding in promoting free circulation of the blood and other fluids in muscles and tissue involved in them. The patient lying on the side, the operator takes hold of the elbow in the one hand, and puts the end of his fingers of the other hand at the upper and posterior border of the scapula, pushes the elbow backward, and edging the fingers of the other hand under the edge of the scapula, moving fingers downward at each move of the elbow backwards until lower edge of scapula is reached.
 
 
PLATE 32
STRETCHING THE DIAPHRAGM

    Place the patient on the back on a table, hands down to the sides, limp, relaxed; the operator, standing at the head of the patient, reaches arms down to the lower edge of the chest, in front and on either side of sternum, placing fingers of both hands at the junction of ribs and abdomen, as if to take hold of ribs, and while holding there require the patient to take a deep inspiration, expanding and drawing up the chest as well as the abdominal muscles; then have patient let go - that is, cease to hold - suddenly (this relaxes all of the muscles made taut by the inhalation), and just at that instant put the ends of the fingers under lower edge of ribs and pull steadily upwards and outwards, using moderate strength. This surely does the work effectually. It is a means of overcoming much of the constriction around the waist caused by heavy skirts in females, and tight lacing of former years (of course, we have no tight lacing now!), and freeing the lower tension and constriction caused by contracted abdominal muscles.
 
 
PLATE 33
TREATMENT OF THE LIVER

    The patient should be in a recumbent position, lying on the back, a little inclined to the left side, the operator on the left side of patients right hand with fingers somewhat curved, ends placed on right side of spinous processes between the sixth and the tenth dorsal vertebra, with left hand (the heel of it) or the ends of fingers placed on abdomen at or under edge of the ribs on right side of patient, and while pulling with the right hand, he presses ends of fingers of left hand against liver, circling the entire edge of that side of the body, having regard to the susceptibility of the patient as regards pressure. The kneading of the liver should be done gently, but thoroughly.
 
 
PLATE 34
TREATMENT FOR CONSTIPATION

    After the liver has been treated as directed in Plate 33, while the right hand is in position as shown in that plate, and the patient on the back, let the operator place the fingers of the left hand on the left side of the abdomen, down in the region of the sigmoid flexure, pressing gently with the fingers, and at the same time pull gently with the right hand against the right side in the region of the liver, moving the fingers of the left hand upwards, along the course of the descending colon, pressing at short intervals as the other hand is drawing against the side and liver.
 
 
PLATE 35
SHOWING THE PERCUSSION OF BOWELS

    This plate shows the manner of percussion of the abdomen with the finger ends all gathered in a bunch, each hand. The object of this treatment is to arouse peristalsis of the intestines; and it often does it while patient is receiving it to that of desire to empty the bowels at once. The patient lying on the back, abdominal muscles relaxed, begin with one hand at the iliocaecal valve region of the abdomen, begin the tapping and alternate the taps with the ends of the fingers, up, ascending colon to the hepatic flexure, then across abdomen to splenic flexure, thence down descending colon to sigmoid flexure. Repeat this process the same way several times, not tapping heavily, and your efforts will be crowned with satisfactory success for constipation; but the other methods used for constipation should not be neglected, remembering all the that the hepatic secretion, called bile, is an irritant that stimulates the mucous membrane of the intestinal tract, and is set in motion and action through the splanchnic nervous system. The next number of our plates represent another step in the manipulation of the abdomen that is very efficacious in relieving constipation, peristalsis, etc.
 

PLATE 36
SHOWING VIBRATORY MOVEMENT OF VISCERA

    The patient lying on the back, the operator places one hand out and covering as much of the abdomen as one hand will, placing the other hand on his own, over abdomen of patient, using gentle pressure rotates from left to right slowly and firmly for several moments, then disengages his hands and goes through a process of kneading for a little time; then repeat the rotary process and the percussing (tapping) process. These measures should be applied at least every other day to insure satisfactory results in cases of chronic constipation. There are other manipulations sometimes necessary in the cure of constipation that will receive attention at the proper place in this book.
 
 
PLATE 37
MANNER OF TREATING SOFT PALATE
(THROAT TREATMENT FOR CATARRH)

    The patient, either lying on the back or sitting up on a chair or stool, head inclined backward, mouth wide open, the finger of the operator is put into the mouth just behind the last upper molar tooth, palm of finger looking forward; begins by gentle pressure at that place, and follows posterior border of soft palate across to opposite side, and back to place of beginning, not pressing too hard, only moderately. This stimulates the palative nerve filaments and aids in removing venous stasis, the direct cause of the condition resulting therefrom, called catarrh. This should be done three times a week, and should be the finishing-up treatment each time the general treatment is given for catarrh. Care should be exercised that bruising be avoided, as the palate is fragile. The finger should be thoroughly cleansed, with due regard to hygienic results, and in fastidious patients the cleansing will be a matter of intense consideration.
 
 
PLATE 38
DORSUM, LEG-EXTENSION TREATMENT

    The patient Iying on the table or mattress, face down, the operator takes hold of the patient's foot, opposite the side he is on, places the heel of one hand about the middle of the back, on opposite side of spinous process, pressing firmly downward and outward, raising the foot, drawing the whole limb upwards and in a gentle curve, springing the back a little beyond the comfort of the patient. The patient should be inert, all of the muscles relaxed as regards his holding is concerned, or stiffening himself. Each time the leg is thus raised and sprung against the hand as the fulcrum, it should be lowered to the table, the hand moved the width of it down the spine, and this may be repeated several times at one sitting, the patient's head resting on side of face turned toward operator. This tends to relax the muscles on opposite side of body. The other side of back should be treated the same way at the same sitting. The ease with which this treatment is given is greatly increased by the operator getting up on the table at the side of the patient, his foot - one of them - placed on the mattress beside the leg of patient, the body resting on the other knee, up near the arm of patient, same side. The results of this treatment are apparent in many pathological conditions, as will be adverted to elsewhere at various times, as occasion requires, in this work.
 
 
PLATE 39
DORSUM TREATMENT OF KIDNEYS

    Operator on the side of table, standing. The patient reclining on the couch or table, on the stomach, face downward, all of the muscular system as nearly relaxed as may be, lying near the edge of the table, next to operator. The manipulator, using whichever arm most convenient, places arm underneath the limbs of patient, just above the knees, placing the other hand about the middle of the back, finger knuckle placed on one side of spinous processes and thumb on the other; he presses firmly, inclining to push upwards, and at the same time raises the limbs upward, making the back form a gentle curve, holding it there and swinging it from side to side a time or two, then halting on a line with the body, increasing the pressure on the back by gently raising the limbs a little higher, then lowering the limbs to the table. This should be repeated several times, moving the pressure down the back, covering the whole of the lumbar region at one sitting. One operator may do this on reasonably light persons without straining himself, and to great advantage of the patient, which will be further explained elsewhere.
 
 
PLATE 40
SCAPULA, DORSUM AND SHOULDER TREATMENT

    The patient lying on the couch, face down, and face turned from operator, the operator places the one hand on the back of subject about the middle of dorsal region, on the opposite side of spinous processes, heel of hand pressing on the body close to the spines of dorsal vertebrae, in such a position as to press muscular tissue away from their moorings, then place the other hand under the axilla of opposite arm of patient, pulling shoulder toward, and pushing with hand on back from the line of axis of the body. This should be done on both sides, moving hand down the back a little each move.
 
 
PLATE 41
SPINAL CONCUSSION, KNUCKLE TREATMENT

    The patient lying on the stomach, perfectly relaxing the whole system as nearly as possible, arms lying loosely to the side or hanging off the side of table, face looking away from operator, the thumbs and fingers are placed on either side of the spinous processes, near them; the operator makes a sudden, springing push downward with both hands, beginning at upper edge of scapulae, and at each such sudden pressure moves down the back, stopping at the last lumbar vertebra. If the operator is strong, the table not too high, this treatment may be properly done while standing on the feet, but where the operator is small, the patient large, it is better done, easier and more effectually, when the operator places himself on the table beside the patient, on his knees. This gives more ease in producing the necessary sudden pressure; but the hardness of these shocks must be governed by the case treated, susceptibility of force, and effect desired.
 
 
PLATE 42
LIVER, CHEST AND SIDE TREATMENT

    Place the patient on a chair or stool, the operator, standing at one side, places one arm around the shoulders and neck of patient, placing hand in front of upper chest region and holding shoulder so as to control it, places the other arm across front of chest, with hand to opposite side, finger ends placed at the sides of the spines, beginning about the sixth dorsal, and then pull the side forward (toward operator), using the arm around neck and shoulder as an antagonizer, pushing shoulder backward, while the other hand is pulling forward, the fingers endeavoring to draw the muscles from the vertebrae, as shown in the plate. This is one of the manipulations used in treating the liver, colic, pleuritic and lung affections that may be frequently utilized.
 

PLATE 43
MANIPULATION OF SPINE, DORSAL TREATMENT
(THE "PULL-BACK" TREATMENT)

    Place the patient on a table, lying on the sidle; the arm uppermost should curve under the neck and reach back to and catch hold of the edge of the table he is lying on, so as to keep from being turned off of the table during the treatment. Let operator take hold of patient's ankle with one hand (the one above), place the thumb and fingers of the other hand on either side of the spinous processes about midway of the back, pressing firmly, inclining to push upwards pull the foot and leg gently backward, giving to the motion a sort of a spring, then let it go to its normal position. Repeat this movement several times, moving the fingers down an inch or so at a time as the leg is drawn backward. This move not only stimulates the terminal filaments of the spinal and sympathetic nerves, but it stretches the abdominal muscles and the anterior muscles of the thigh, and can be extended on down the thigh over the course of the great sciatic nerve, as in the treatment for sciatica and uterine affections mentioned elsewhere, more particularly that of amenorrhea and affections due to abnormal functions of these organs caused by capillary congestion.
 

PLATE 44
ARM EXTENSION, UPRIGHT TREATMENT

    The patient seated on a chair or stool, the operator standing in front, knees between operator's knees, so as to steady the body on stool, the operator takes hold of the wrist of patient with one hand, places the other hand and arm on same side of patient in such a manner as to let the fingers press on the sides of spinous processes on the side next to operator, and up between scapulae, about the fourth or fifth dorsal vertebra, fingers gently curved, so as to apparently grasp the muscular tissue under skin, and now, with the arm extended, carrying arm of patient upward, places same to the side of the neck (of operator), straightens himself upward and backward, stretching all of the muscles of the side of the patient, then holding them in that position, pushes the arm backward gently, firmly, steadily, cautiously, as far backward as a line of the back of the head of patient; then, having a firm hold of the wrist of patient, fingers of the other hand still in position on the sides of spines, bends the elbow of patient at right angles and pushes it down over arm to the side of
patient, firmly, suddenly. Repeat this move several times, lowering the hand on the back each time the width of the fingers, covering locality on the back as low down as the lower edge of ribs. The other side should usually be treated the same way. A moment's reflection shows the importance of these moves in raising all of the chest, side and intercostal muscles.
 
 
PLATE 45
METHOD OF STIMULATING VASO-MOTOR NERVES

    The patient sitting on a stool, chair, bed or bench, the operator, standing in front, places both hands around neck, letting fingers meet posteriorly with ends of same somewhat curved, pulps of ends of fingers pressing against back of neck on either side of cervical spinous processes, with the thumbs looking upward at the sides of the head, steadies the head of patient, pulls gently, yet firmly with fingers, and steadying head with hands, inclines to bend neck forward and head backward at the same time, making gentle pressure on back of neck, embracing vasomotor region, holding the fingers in position for a moment, then changing fingers to other points on neck and giving springing motions of neck. This is one of the moves for headache, and comes in the general treatment, and utilized in the treatment of many diseases, stiffness of the muscles of the neck, neuralgia, rheumatism, spinal affections, etc.
 
 
PLATE 46
EXTENSO-ROTARY NECK TREATMENT

    This plate is designed to represent the continuation of Plate 45. Whilst the hands are holding the neck, fingers nearly meeting at back of neck, close the hands somewhat, raising one elbow and lowering the other, rotate the head partially on its axis, going through that motion, raising first one elbow, then the other, inclining to press upward at the same time, so is to stretch the muscles on all sides of the neck while the movements are being executed; then finish the movement by closing the finger-ends against the sides of the spines of the cervix, pressing so on the fingers as to pull the muscles of the sides of the vertebrae forward, changing positions of fingers two or three times before letting the patient go. This movement should be done with caution, so as not to dislocate the vertebrae. This treatment will relieve much contracture of the cervical muscles, and greatly aid in relieving congestion of the head.
 
 
PLATE 47
TREATMENT OF MUSCLES OF BACK OF NECK

    The patient sitting up, the operator places one hand on the forehead, the other on the back of the neck, one or more fingers on one side of spinous processes, the thumb on the other side, and both close up to the atloid-occipital junction, where the finger and thumb are made to press gently - or even strongly, as the comfort of patient seems more or less susceptible to impression - then counterpress with other hand against the forehead, inclining to push upward with the thumb and fingers on neck. Lower the finger and thumb a little and repeat movements until all of the cervical region is gone over. This move not only stimulates the nerves in the vasomotor region, but stretches the muscles on front and back of the neck, aiding in removing much congestion of tile venous blood and the lymphatics, emptying them into the large jugulars.
 
 
PLATE 48
CHIN-OCCIPITAL-NECK EXTENSION

    This plate represents a neck treatment, and a method of stretching the muscles in many cases where movement is not so much needed as stretching the whole muscular system upward, and at the same time controlling nerve influence as well as arterial circulation, venous and lymphatic activity. It is curative for many severe headaches.
    The arm of the operator should be placed under the chin, the bend of the elbow receiving the chin, and the arm so held as not to choke the patient, the fingers and thumb of other hand situated on either side (both sides) of the spinous processes of vertebrae, tip close to the base of skull, rather firmly pressed; lift chin gently with the arm, pulling upwards, and at the same time pressing with finger and thumb against the back of neck. The head should be tilted gently backward and forward several times, using gentle upward tilt each time. This should be done easily, but firmly, changing the position of thumb and fingers so as to cover all of the cervical vertebrae at one sitting.
 
 
PLATE 49
VIBRATORY MOVEMENTS; NECK AND BACK

    The patient being seated on a stool or chair, the operator bends head of patient forward against chest, places the ends of the fingers of both hands close tip to the edge of occiput, just posterior to mastoid processes on either side of neck, and with quick successive movements, holding finger ends against the skin so as not to slip, but move the skin with the fingers; makes movements with ends of fingers, held steadily toward spinous processes and back towards ears of patient, several times rapidly; then moves ends of fingers downward, and goes through same sort of moves, continuing this until these moves include the muscles of back of neck down to top of shoulders. This is a thrilling, vigorous, exhilarating treatment, and aids in promoting circulation of the blood, regulating it, and stimulating recurrent nerves along side and back of neck in all of the cervical region, and embraces the spinal accessory as well, on either side of spine all the way- or anywhere over body.
 
THE VIBRATORY MOVE ON BACK MUSCLES
 
    The patient lying on the face, on table or mattress, the operator, standing at the head of patient, places the tips of fingers on either side of spinous processes, pressing on pulp ends of fingers moderately firm, moves them up and down the sides of the spines, or in a vibratory manner, changing them to different localities at short intervals, so as to frictionize all of the muscles along the whole length of the back. This same sort of a vibratory move may be used in various places on the body, depending on what is indicated in the various pathological conditions. This is a most excellent and effectual means of soothing the system, of increasing surface capillary activity, and stimulating peripheral nerve action.
 
 
PLATE 50
SHOWING MANIPULATIONS OF NECK AND THROAT

    This plate shows a special movement for sore throats, catarrh, enlarged tonsils, etc. The patient lying on the back on a bed or table, the operator, standing at the side, places one hand on the forehead, the other across the upper part of the chest, not letting either hand or arm rest on the patient, but places one or two of the fingers on the opposite side of the neck, pressing pulps of fingers against side of neck; push the head with a rolling move over toward opposite side, and at the same time holding the fingers steadily on the skin on the side of the neck so as to seemingly pull the deeper tissue toward him, then bring the head back to former position; repeat process a number of times, placing the fingers at different places on the side of neck at each and every turn of the head from you. Cover all that side of the neck thereby, then do the same on the other side of the neck. Continue moves for several minutes.
 
 
PLATE 51
SHOULDER AND ARM RAISING

    The patient seated on a stool, the operator takes hold of wrist with one hand, places the other forearm in axilla of patient, extending arm and pulling tip in axilla hard enough to distinctly raise the shoulder of the patient, being careful not to use greater strength than simply to lift the shoulder joint slightly upward, the arm being drawn down to the side of the patient, with the hand of the operator, as seen in the plate. This is an excellent movement for lifting the whole shoulder joint, including the clavicle and scapula on either side, as well as both sides. It stretches the serrati muscles, and all of the muscles inserted or attached to the arm, and liberates much of the impeded circulation of venous blood in the whole arm, aiding in the cure of many diseased and semi-ankylosed shoulder joints. Much good may be accomplished by this movement, which should be done on both sides.
 
 
PLATE 52
SHOWING HOW TO STRAIN ELBOW JOINT

    After raising the shoulder joint, as seen in Plate 51, the patient sitting on a chair or stool, the operator takes hold of the arm of patient at wrist with one hand, and with the other hand just above the elbow, thumb above, and all of the fingers encircling the arm, letting the finger ends rest above external condyle of humerus, in contact with ulnar nerve as nearly as may be where it passes around the condyle of humerus, holding arm of patient against the body in such a manner as that the back of arm shall rest against the body of the operator; and now bend the arm gently backward, springing it a little, then, letting up with the springing backward pressure, holding the arm in position against the body, with the hand holding the wrist, roll the forearm toward the body of the patient, describing as nearly as may be a half circle, squeezing the fingers of the hand holding the arm above the elbow, so as to pull all the muscles forward, and articulate the elbow joint briskly for several successive moves at one sitting, then treat the other likewise. Do not fail to recognize the fact that this move assists in freeing the muscles, the nerves, blood vessels, etc., in that quarter of the body.
 
 
PLATE 53
RAISING CLAVICLE, PATIENT SITTING UP

    The patient sitting up, the operator, standing at the side, takes hold of wrist of patient and places the other hand at the side of the neck, with the second finger on upper margin of the clavicle, about half way between the two ends, the third and fourth fingers resting on the side of the neck, and the forefinger placed above or at the inside of clavicle, in as easy a position as may be; now raise the arm gently, and at the same time push the finger down between the neck and clavicle, then carry the arm to the other side of neck of patient as if to place hand on opposite shoulder, extending it somewhat, which causes the clavicle to be moved outward. This should be repeated, and the other clavicle served in the same way. This is one way to raise the clavicle, and not the least important, either; and, being used in almost every general treatment, should be done with perfect ease, and dexterously, and need not be painfully done to the patient.
 
 
PLATE 54
RAISING CHEST MUSCLES AND TREATING SPINE

 
    The patient sitting on a stool, body as near erect as may be, the operator, standing directly behind, takes hold of the patient at the wrist, letting thumb rest on the palm of patient's hand, with fingers encircling patient's wrist, one foot placed at the side of the patient a (at the side the arm is to be manipulated), the other foot placed farther to the rear, the thumb of the other hand placed on the side of spinous process about the upper dorsal vertebra, on the side of processes next to arm to be manipulated; then, being in such a position as to be able to follow the arm to the side of patient, cause the arm to rotate inwards, upwards and backwards, and just as the arm is being brought over the shoulder axis, wrist about even with top of head, the thumb, used as a fulcrum, is suddenly pressed against the back at the side of the spine, and the arm drawn suddenly toward the line of axis of thumb, and as suddenly the thumb pressure is made, so that a sudden stop is now made as the wrist is drawn a little beyond the posterior border of the shoulder, and then the arm is allowed to resume its position at the side of patient. The same move is repeated, the operator bringing the thumb down an inch or so at each manipulation, as aforementioned and described. Care should be taken in this move that the circular move is adhered to, for if the arm is drawn up to the side of patient, pain is experienced in the shoulder joint, and care should be had not to wrench the shoulder out of joint. This is one of the most difficult movements to properly execute, without personal showing - similar to the one made on the table, with arms extended. It is an important move, for all of the intercostals and chest muscles are involved in it, and as the arm is such an important lever, this move becomes the more important. This move will be very frequently referred to in the treatment of disease.
 
 
PLATE 55
THE KNEE-CHEST EXPANSION PROCESS

 
    The patient being seated on the stool or chair, the operator takes hold of patient by the arms (above the elbows - hands outside of), holding arms steadily, places the knee on the back between the scapulae, foot turned to one side so that the side of the knee will be against the back, and not the end of the knee, so as to produce pain; now gently pull upon the arms, pushing with the knee as a fulcrum, having patient at the time inhale deep inspiration, the arms being pulled upward and backward at the time. This should be repeated three or four times, letting the knee be moved down each time two or more spaces of vertebrae. When it is known that this move takes off the pressure from nearly all of the chest muscles, the thoracic viscera, relieving many supposed incurable pathological conditions, its importance will be recognized. Asthma is usually relieved at once by this move; painful inspiration, pleurisy, heart troubles and many other conditions are treated in this way. There will be frequent references to this move in the body of this book, and its importance will not be overlooked when tried by the operator.
 
 
PLATE 56
SIDE OF NECK AND SHOULDER TREATMENT

 
    The patient seated on a stool or chair, the operator, standing in front, takes hold of the wrist of the patient with one hand, places the other hand on the shoulder of patient, raises the arm with one hand, and with the fingers of other hand extended, grasps the supra- and infra-scapular region, pushes arm upward and backward, pulling and grasping the side, top and back of shoulder region with a gently gripping motion, as the arm is pushed upward and backward, so as to in several such moves embrace all that side of the neck and shoulder; then treat the other side in the same manner, at the same sitting. Care in making these moves stimulates the health region of the body in such a way as that much relief is experienced at once by the patient.
 
 
PLATE 57
RAISING CLAVICLE HEART TREATMENT AND GOITER

 
    The patient sitting up, the operator places himself as follows: Standing beside the patient, and taking hold of the arm at the elbow, the elbow bent, forearm flexed, and with the other arm holding the other shoulder, and letting the forearm cross the side and front of the chest to the opposite side, he places the thumb above the clavicle, and as the arm of the patient is drawn up by the operator, the thumb is gently pressed behind the clavicle so as to push it outward as the arm on that side of the body on which the clavicle is to be raised; he now pulls, the arm steadily and firmly backward and upward, pressing against the clavicle at the same time, then lets go arm at once. This is one of the methods of raising the clavicle, and should be used for goiter as a first move, as it presses the clavicle away from the large veins which carry the blood from the head to the heart, thus aiding in relieving the pent-up blood in the thyroid gland, that produces enlargement of that gland. This, and "a particular altitude on the mountains of Switzerland," produce goiter; and the Osteopath cures them. It requires a treatment two or three times each week for months in some cases, but there are some cases cured in a few treatments. The soft variety yields more readily.
 
 
PLATE 58
MANIPULATION FOR GOITER

 
    Treat the patient on a stool or chair, the operator standing behind the patient, both hands are placed around the neck, letting the finger of each hand touch and be placed on the sides and posterior borders of the tumor, thumbs on or near the temples; begin a sort of rotary motion of the head, pressing with the fingers on the tumor, gradually encroaching on the tumor from behind forward, as each rotary move is made, as shown in the plate. The clavicle should be raised previous to beginning the pressure on tumor. Several moments should be used in this treatment at each sitting, and treatment should be made three times a week. While some cases are easily reduced to normal size, there are others which require months of steady treatment to effect. The soft goiter readily yields to this sort of treatment. This movement greatly aids in freeing stiffness of the neck muscles, freeing the pent-up venous blood, the lymph as well, so that it cures many troubles of the neck and throat. It is a good movement indeed.
 
 
PLATE 59
DIPHTHEREA AND SORE THROAT

 
    The patient being seated on a stool, the operator, standing at the back, places one hand on the forehead, the other on the side of the neck, fingers gently curved so as to grasp the skin, and as the head is rolled toward opposite side of neck, the hand on neck on opposite side grasps the skin up close to the posterior angle of lower jaw, or anywhere at the side of the neck, pulling the hand gently as the head is pushed or turned in that direction, and then head returned to its normal condition, face looking straight in front of body; then same move is repeated a number of times, the fingers being placed in different places on the neck, and so on until all of the muscles of that side of the neck are thoroughly manipulated. This sort of treatment is requisite in many diseased or congested conditions of the neck, and is one of the treatments for goiter, diphtheria, tonsilitis, croup, wry neck, headache, etc.
 
 
PLATE 60
CHEST AND SPINAL CORD EXTENSION

 
    The patient sitting on a chair or stool, the operator, standing in front, holding patient's knees between his, places hands on either side of the neck of invalid, so as that his fingers press on either side of dorsal vertebrae in the scapular region, well up to the top, the patient locking hands back of his neck, holding tightly, but not holding elbows stiff; the operators pressing fingers against sides of spinous processes, at the same time pressing the arms of patient outward, using his own fingers as the fulcrum, and the arms of the patient as levers, spreading his own arms so as to push the patient's arms backward and outward at the same time, thus causing expansion of the chest of patient. The fingers should be placed lower as each move is made, so as to cover several successive localities down the dorsal region, and at the same time pulling the hands upward and outward each move, stretching the chest muscles thereby. The importance of this move may be readily appreciated in all diseases of the chest.
 
 
PLATE 61
CHEST EXPANSION AND SPINAL STIMULI

 
    The patient seated on a stool, the operator standing before him, the hands locked back of the neck; the operator places the arm on one side of the neck, hand extending backward, he places fingers on opposite side of spinous processes; taking hold of the elbow of patient, pushes arm backward, and at the same time presses against the back, so as to press the muscles away from the spines, using considerable force, and at the same time letting the other arm be held so as not to displace the (his) fingers on the back - that is, manages to steady the shoulders during these moves. The hand of the operator is lowered a little each move that is made, to press the muscles from spines. The importance of this move may be readily understood in the treatment of diseases of the chest, shoulder joint, and in asthmatic and heart affections, as well as of the lungs.
 
 
PLATE 62
TO STRETCH CHEST MUSCLES AND CORD

 
    The patient being seated on a stool, the hands locked and raised perpendicularly over the head, the operator, standing at the side or nearly so of patient, places his elbow through the loop thus formed, with elbow pointing forward of patient, puts his own hand in the locked hands of the patient, and if the patient is heavy, brings hands up to the side of his own neck, then steadies it there, pressing thumb and fingers on either side of the spines on dorsum, beginning as high up as the middle of scapulae; he now raises the arms and patient upward, rather inclining the body backward against his fingers, which are against the back. In the succession of these moves, the fingers are to be gradually lowered each move until the whole dorsal vertebrae are covered by the fingers, stretching the body of the patient upward as much as may be, regarding comfort. This movement enters into a series of manipulations that serve to move all of the muscles of the body and chest, both in front and rear, as well as on both sides. It should be done carefully and dextrously, and will be of great benefit many times. Consumptives derive great benefit from this manipulation, as it stretches the pectoral muscles, serrattis muscles, raises the clavicles, the intercostal spaces, and at the same time stretches the abdominal muscles, removing congestion of venous blood, and has a wonderfully exhilarating effect on the whole person.
 
 
PLATE 63a
CHEST, ARM AND BACK MOVEMENT

 
    Place patient on a chair or stool, the operator standing in front, takes hold of both hands around wrists, and assistant standing behind patient, places thumbs or fingers on either side of spinous processes, well up between scapulae, holds them at this point as the operator raises the arms of the patient, upwards, pressing them backward by side of head, so as to stretch the pectoral, intercostal and all of the chest muscles upward, and now, with a quick drawing forward of the arms, brings both bands down in front of patient, when the operation is repeated, the assistant moving thumbs down spine one or two inches each time until the back is treated as far as the tenth or twelfth vertebrae, using pressure as if directing thumbs upward each time, raising muscles from the spinous processes, outward as well as upward. These movements relieve many chest difficulties that other means fail to reach. Patient should take deep inspirations each movement.
 
 
PLATE 63b
DIFFERENT POSITIONS OF PLATE 63a

 
    This plate represents the position of patient and operators of preceding plate, in the position when manipulation begins, and when arms of patient are brought forward after each move of raising arms above head and backward toward assistant.
 
 
PLATE 64
ONE TREATMENT FOR PAINS IN BACK

 
    The patient seated on the table, couch or chair, the operator, at the side, places one arm in front of the body so as to embrace the shoulder of the patient between his own arm and shoulder, taking hold of the arm - it flexed at the elbow, so that it may be used to draw the patient upward as patient is inclined backward. The operator now places thumb and fingers of other hand on either side of the dorsal spines about the fourth dorsal vertebra, placing his neck behind the neck of patient, patient resting neck on neck of operator, and fingers in place on the back, pulls patient backward and upward, and inclining backward until the elbow of operator rests on the table directly back of patient; then raises patient in sitting posture, relaxing all holds, placing fingers on the back a little lower, presses fingers on the back; repeats these moves until the whole of the spine is thus treated, observing to draw his own elbow toward his own side of the table, so as to give room for the body of patient to come as low as may be to receive due pressure upward each move, as the body of patient inclines backward. This treatment should include all of the dorsal from the fourth clear down to the last lumbar, being particular to control the amount of pressure on the sides of the spinous processes according to the susceptibility of the patient, and as the necessity demands. This treatment is essential in many pathological conditions, and should be utilized when needed.
 
 
PLATE 65
SHOWING PLATE 64, CONTINUED

 
    Same as 64, only the inclined position, with neck of patient on neck of operator, showing how movement is made, and elbow on the table.
 
 
PLATE 66
SHOWING HOW TO EXTEND PECTORAL MUSCLE

 
    This move is for stretching the pectoralis, major and minor, coraco-brachialis, and supra-scapular muscles. Useful in many shoulder troubles, rheumatism, paralysis, etc. The operator, standing behind patient, places his arm directly across the upper and front of chest, embracing the shoulder on the side opposite the arm to be treated, so as to steady the chest, letting the point of shoulder be fixed; extends arm to the opposite shoulder (the one to be treated), gathering the muscles under the patient's arm with his own fingers, and with his other hand holding the elbow of the patient, pulls arm backward and upward, and at the same time counter-pulling with the fingers under the arm with the hand placed there, holding the muscles, stretching them with caution, gradually increasing the stretching as the arm and muscles become more pliable. This manipulation and the one succeeding (No. 65), may be used quite frequently for many seemingly stiff and immobile shoulder joints, to great advantage, as well as for rheumatism, neuralgia, and to reinstate normal circulation in muscles of the arm.
 
 
PLATE 67
TREATING SHOULDER AND SIDE MUSCLES

 
    The operator, standing behind the patient, takes hold of wrist of patient with one hand, standing against the side and back of, so as to, steady the body, places other hand under lower, outer aspect of shoulder joint embracing with his fingers the several muscles under the arm in his own grasp, pulling the arm of patient directly forward and across the front of the chest, antagonizing the hold of muscles under arm with the hand holding the wrist. This stretches various muscles at the side, back and under arm - serratus, teres, latissimus dorsi, biceps, etc., and takes off the pressure, increases capillary circulation and relieves pain in shoulder very often like magic.
 
 
PLATE 68
SPINE, LIVER AND STOMACH TREATMENT

 
    The Patient seated on a moderately low stool, the operator standing in front, patient having hands locked and placed at back of neck, the operator extends arms under those of the patient, back, so as to let ends of fingers be placed on either side of the dorsal vertebrae beginning with fingers anywhere, according to object intended in the treatment, using such pressure as desirable, or needed to raise, and at the same time tilt the body of the patient from side to side as the pressure is being made on the sides of the spinous processes by the fingers, letting the whole body be suspended as nearly as may be, while these moves are being made. The operator may begin with hand down as low as the sacro-lumbar vertebrae, or anywhere between the scapulae. This treatment is essential, in many spinal affections, constipation, lung and liver torpor, spinal irritation, backache, lumbago, amenorrhea. The arms rest on arms of operator as these movements are being made, and if the knees of patient are embraced between the knees of operator, steadiness is the better maintained, and a more complete control of patient secured. These moves may embrace any part or all of the lower dorsal or lumbar regions of the back.
 
 
PLATE 69
TREATMENT FOR SCIATICA AND LOCOMOTOR ATAXIA

 
    The patient being seated on a stool or chair, the operator places himself behind the patient, takes hold of the knee on the one side, places other hand, with thumb and fingers - or simply the thumb - against the side of sacrum, over sciatic nerve, raises knee by gentle pulling of hand, while pressure is made with thumb over sciatic nerve, in a somewhat rotary, springing motion, aiming to use considerable pressure on sciatic. This move may extend the whole length of sacrum or lumbar region, or both.
 
 
PLATE 70
TREATMENT FOR EYE TROUBLES

 
    The patient seated on a chair or lying on a couch, or in any position the operator may elect for convenience, the edge of upper lid is raised at the outer canthus with thumb and finger of one hand, and the index finger of the other is introduced into the eye at the outer canthus, and carried as far back as the retrotarsal fold - the posterior border of upper eyelid; the thumb placed on outside of eyelid in juxtaposition to the finger, and compression is made of thumb and finger together, and a gradual stretching of the lid, pulling it from the eyeball, and at the same time compressing granules on inside of lid, moving finger in the eye to inner canthus - that is, the inner edge of the eye - clear up to the side of the nose; then, with a sudden move, take the finger out of the eye. This is the upper eyelid treatment for granulated eyelids, and should be done every three to five days. No lubricant should be used on the finger, but the fingers used in and about the eyes should be well cleansed with good soap and water, nails made smooth and clean, and after the above treatment patient should bathe eyes in water, with a teaspoonful of salt to each pint of water used. If there are granules or enlarged follicles on inside of lower lid, introduce end of forefinger into outer canthus so as to let palm of finger be down toward inferior border of eye, facing the orbital plate of superior maxillary bone, pressing finger on upper edge of that bone, carrying all of the tissue against the curved portion of it, and pressing somewhat firmly the tissue before the finger down on that plate, carrying the finger to the inner canthus of the eye, and turn palmer surface upward as it is removed to the side of the nose, pressing the whole surface of the inner canthus, and on that portion called the lacus lachrymalis, coming out of the eye quickly - not with any delay or rubbing motion. Get away from the eye when done treating it, at once. Patient will then bathe eyes with the salt and water solution above named, either warm or cold, as seems most pleasant. This treatment should be repeated as often as once in five or eight days. There is great benefit to be derived from this treatment. It takes off the pressure of contracted lids, which causes ulcers of the cornea, and perpetuates them, and cures ectropium, entropium, as well as almost all other inflammations of the lids and eyeball, blepharitis-marginalis, etc. Reference will be had to this plate frequently. The two plates represent the treatment of both eyelids, for all sorts of eye troubles - chronic especially.
 
 
PLATE 71
FLEXING KNEE ON THIGH AND THIGH ON ABDOMEN

 
    Patient lying on back on couch or table, operator seizes leg just below knee and proceeds to bend limb at the knee and thigh, doing so strongly, stretching muscles of the whole limb, and while in that position the hip joint may be manipulated with other hand and fingers, beginning on sides of lumbar vertebrae, as high up as desirable to liberate muscles of that area and proceed to treat along down the course of the sciatic nerve, bringing the limb outward and downward each time the fingers are pressed upon area covered by them. This is the method of moving hip joint in nearly all of the ailments of the hip joint, and in confinement to rest the loins and hips after parturition. It soothes, rests, stimulates, promotes free circulation of the blood, and very often relieves all or any of the muscles of the hip joint of pain or the limb from soreness.
 
 
PLATE 72
VARIOUS DORSAL TREATMENTS

 
    The patient seated on a stool or chair, the operator places bands under patient's arms, placing his finger tips against the sides of the spinous processes, gently lifting the body of patient, and swaying him from side to side, using alternate pressure each move, changing position of hands each sway, beginning either at sacro-lumbar junction, or anywhere along the spine, according to effect desired. This movement is used for many conditions of the spine and abdominal viscera.
 
 
 A WORD ABOUT OSTEOPATHIC MANIPULATIONS

    The seventy-two illustrations given in the Osteopathic Department of this book will be found to be the best in the ranks of osteopathic treatment; but when the Neuropathic Department is thoroughly comprehended it will be found that the manipulations will be much better adapted to the accomplishment of the purpose than any others known, and yet we would not underrate the efficacy of these in this department. They are really for the same purpose - freeing the nervous system - and they being of my own improvising, may as well be classed under, the name neuropathy as not. (Every osteopathic treatment should be accompanied with a neuropathic treatment.) I make this statement that there be no confusion as regards treatment. In many cases the two may be combined, but too much treatment at one sitting is not to be considered, for overdoing is apt to be done than just what suffices. Too long treatments - osteopathically - are exhausting rather than beneficial. The freeing of the nerves involved and uniting the forces will be enough, usually. As all the manipulations are for that purpose they should be classed under neuropathy. There is no such a thing as bone pain, therefore no such a thing as osteopathy, in fact. We believe that what is contained in this book will be amply sufficient to meet all of the conditions called disease, if rightly applied, and conscientiously submit the same to the afflicted everywhere.
 
 
THE WAY TO GET SATISFACTORY RESULTS FROM OSTEOPATHY

    If the several plates are studied and their several instructions carefully mastered as shown in the part which describes  them, any treatment can be selected which will meet the indications for any condition which may be found to exist anywhere in the body.
    It will be understood that osteopathy is more especially applied to restore the circulation of the fluids of the body than for any other purpose, and that neuropathy has for its sphere the removal of nerve pressure and irritation of nerve filaments; therefore, when either condition is to be considered and treated, the part which is applicable is to be utilized used.
    The Ophthalmogical Department has for its object the arrest of the nerve-waste through the effort to see - to shut out oblique rays of light - and to make all rays as nearly parallel as may be to see clearly; hence the use of glasses needed, in all such conditions.
    If the several indications found in the multitude of conditions, known as disease, receive special  consideration, as shown in this book, there need be no mistake in selecting what sort of treatment to apply.
    Whether one is suffering from fever, colic, or spinal curvature or from nerve waste, the indications are easily found, and treatment should be instituted accordingly.
    The suggestions given herein may be the means of doing a vast amount of good in the way of suggesting new means of applying treatment which the author has not shown.  The important things to be done are to meet the demand in any given case, and afford relief from suffering, and we know that what is shown herein will be amply sufficient in the larger majority of human ailments.
    Study the conditions found or existing, and then study what is indicated, then apply the remedy faithfully and the results will be as stated, most generally.
    Do not expect any benefit from the science - any part of it - without it is used applied - and that, too, according to directions and for the purposes intended.  It is not a guess-work system, but scientific and effectual, and will not fail in any case which has not exceeded the limit of possibility to cure.
    We make these bold assertions for we know whereof we affirm, having proven everything shown in this book, and know that the applications for the several conditions are just what they are recommended for, and will not disappoint, when properly applied - used.
    If the reader will fix in the mind the fact that disease is a product, and that it has a cause for its existence, and that when the cause is removed the disease cannot exist, and know that the causes are as stated in the very beginning of the book - nerve-pressure, nerve-waste, impeded circulation of the fluids of the body, irritation, poisons and accidents - there need be no lack of confidence in applying the instructions for their removal.
    We, therefore, urge the reader to go at the study and the application of the several departments of this book, implicitly relying upon the whole as a reasonable proposition, and that can be verified to the letter when directions are strictly carried out.