A Manual of Osteopathy
Eduard W. Goetz, D.O.
SPECIAL MOVEMENTS WITH ILLUSTRATIONS
The succeeding pages give some of the special movements
with illustrations and are given in this manner to avoid repetition in
the text and duplication of the cuts, as will frequently be referred to
in the text.
BACK VIEW OF BODY
FRONT VIEW OF BODY
VIEW OF SIDE OF HEAD AND NECK
FRONT VIEW OF FACE AND NECK
PRESSURE ON THE GREAT OCCIPITAL NERVES
WITH the patient sitting on a chair, place your
left hand on his forehead, and with the right hand place the thumb
on one side and the fingers on the other, of the spine, over
the site of great occipital nerves which leave the skull at a point
shown in cut No. 1 K. K.,
page 24; press these two points hard, and at the same time push
the head backward with the left hand and hold same for two or three
minutes. This treatment will usually stop any headache, but
for more severe attacks see treatment for same, page 77.
PRESSURE ON THE FOREHEAD
WITH the patient on his back, place your hands upon
the forehead, press downwards with considerable force and hold for a few
seconds. Has the effect of the had in catarrhal conditions.
MANIPULATION OF THE CERVICAL REGION IN THE BACK OF THE NECK
WITH the patient lying on his back, place the
left hand on his forehead, and the right hand on the muscles in
the back of the neck near the spine, in the region of the upper
cervical vertebrae, and, while rolling the head away from you with
the left hand, pull the muscles of the neck towards you, but not
allowing the fingers to slip on the skin, the idea being to stretch
the muscles. Now move the hand down the neck a little and
repeat the above movement, and so on down as far as the 7th cervical
vertebra, location of which may be seen in cut No.
1, A, page 24.
MANIPULATION OF THE MUSCLES IN THE SIDE OF THE NECK
WITH the patient on his back, place the left hand
on his forehead, and with the other manipulate the muscles of the side
of the neck from the angle of the jaw to the collar bone. While turning
the head away from you, draw on the muscles, pulling them towards you without
fingers slip on the skin.
This treatment and No. 7 should be given to both
sides of the neck and should be given about three minutes.
STRETCHING THE NECK
WITH the patient lying on his back, place one hand
under the chin and the other at the base of the skull and pull on the head
until the body moves; next, while pulling, turn the head slightly from
side to side two to three times. This treatment frees the circulation
in the neck and especially between the vertebrae of the entire spine.
TREATMENT OF THE SUPRA-ORBITAL NOTCHES
HAVE the patient sitting on a chair or
stool; with one finger of each hand press against the notches which
may be felt in the bony arches above the eyes, the location of which
may be seen in cut No. 4 A
A, page 27. If used in connection with the treatment for headache,
inhibit the nerves that leave the skull at this point, by holding
same for about a minute. If for eye trouble, stimulate the
nerves by a vibrating motion.
TREATMENT OF THE NASAL DUCT
WITH the patient sitting on a stool or chair, place
thumb of each hand in inner corner of each eye, press hard and hold for
a few seconds. Now move the thumbs down either side of the
nose about half way, and in a circular motion, with out allowing the thumbs
to slip on the skin, work the muscles in this region for a few seconds.
This treatment is used in connection with the others for all affections
of the nose and eyes, especially for catarrh, cold in the head, and obstructions
to the nasal duct which runs from the eyes to the nose.
SPRINGING SPINE IN THE UPPER DORSAL REGION
WITH the patient sitting on a chair, grasp his wrist
and raise the arms high above the head; at the same time place your knee
in the middle of the back, high between the shoulder blades, and with the
pressure there, bring the arms outward and downward to the side; this should
be repeated several times, each time lowering the knee about two inches,
until you get as low as the twelfth dorsal vertebra, the location of which
is shown in cut No. 1, B, page 24. This
treatment is used in all affections of the throat, lungs, and heart.
TO INHIBIT PHRENIC NERVE (IN ATTACK OF HICCOUGH)
WITH the patient sitting on a chair, stand behind
him; place the first finger on each side of the neck just above
the collar bone at a point, shown In cut No.
4 C C, page -27. Press in deeply and hold for a minute
or until the hiccough has ceased. The other treatment for
hiccough is shown on page 37.
TO INHIBIT PHRENIC NERVE
WITH the patient sitting on a chair, with the
fingers of each hand press against the front part of the transverse
processes of the third, fourth, and fifth cervical vertebra and
inhibit same for about a minute holding them firmly with considerable
pressure. (See location of transverse processes in cut No.
3 C, page 26, and which may he felt through the skin at the
side of the neck.) This treatment should be given in connection
with treatment No. 13, page 36.
TO RAISE THE CLAVICLE
WITH the patient lying on his back, bend the
arm at the elbow, taking hold at that point with the right hand;
at the same time push the shoulder upwards and with the fingers
of the left hand, placed deep behind the clavicle or collar bone
in the supra-clavicular fossa (shown in cut No.
3 E, page 26, or 4 B B
page 27), bring the patient's arm upward, outward, and then downward,
slowly and not too strongly; hold in this position for a few seconds,
while drawing upward with the left hand, and repeat the same operation
on the other side. This releases the blood vessels to and
from the head and frees the circulation to the head and neck.
TO LOWER THE FIRST RIB
HAVE the patient lie on his back, with your left
hand draw the patient's left arm above his head, and place the thumb
of the right hand in the supra-clavicular fossa (see cut No.
3 E, page 26, for same). Close to the neck, and while
pulling on the out-stretched arm, press in the opposite direction
with the thumb on the first rib, which may be plainly felt close
to the neck, and now return the arm to the patient's side, with
a forward and downward movement. As the first rib is frequently
drawn upwards by contraction of the muscles in the side of the neck,
thus interfering with free circulation to the head and neck, this
treatment will have the effect of removing the obstruction.
Use same treatment on opposite side if necessary.
TO STIMULATE THE CIRCULATION TO THE HEAD
WITH the patient sitting on a chair, draw one arm
well above the head, at the same time with the thumb of the disengaged
hand press on the angle of the ribs between the shoulder blade and the
spinal column, beginning at the second dorsal vertebra on the side corresponding
to the arm that is raised; now lower the arm with a backward and downward
movement to the side; next lower the thumb an inch to the next rib and
repeat the movement with the outstretched arm; lower the thumb again to
the next rib and repeat the movement; and so on down the back to the tenth
rib, which is about an inch below the lower edge of the shoulder
blade. Now treat the other side in a similar manner. Will require
about three minutes to make these movements.
(See cut No. 1 B, page 24, for location of the
ribs from second to tenth.)
MANIPULATION OF THE MUSCLES IN THE BACK, IN GENERAL TREATMENT OF
HAVE the patient lie on his side, with his arm
loosely thrown over yours as shown; begin at the second dorsal vertebra
and work all the way down the back to the end of the spine, working
the muscles on the side of the spine towards you. With considerable
pressure, draw the muscles upward and outward away from the spine;
now move your hands down the back a few inches and repeat the movement
and so on down, releasing the patient's arm after you have reached
the tenth dorsal vertebra. (The location of the vertebrae
may be seen in cut No. 1, page 24.) Now turn the patient to
his other side and work the muscles away from the spine in an endeavor
to stretch them. This treatment may be made more effectual
and complete by placing your fingers on the opposite side of the
spine and drawing it upwards towards you; work so all the way down
the spinal column.
MANIPULATING THE MUSCLES AND SPRINGING THE SPINE LATERALLY IN
THE LUMBAR REGION
WITH the patient on his right side, draw up his
legs, and place your left hip against his knees and your right hand under
his legs, and with the fingers of the other hand work the muscles in the
lumbar region, drawing the muscles toward you and not allowing the fingers
to slip. Work from the twelfth dorsal to the fifth lumbar vertebrae.
While drawing on the muscles push the legs against the abdomen. To
spring the spine reach over to the opposite side of the vertebrae and draw
them towards you. Both these treatments should be given on the other
side also, having the patient turn over to the left side. Treat about
three minutes. These movements are valuable in cases of lumbago,
lame back, rheumatism, and suppressed menstruation.
MANIPULATION OF THE SPLANCHNIC REGION
WITH the patient lying on his right side, let the
left arm hand loosely over your left, and with considerable pressure with
the fingers work the muscles in the back between the sixth and twelfth
dorsal vertebrae, on the side of the spine nearest you, drawing the muscles
upward and outward. Now have the patient turn over to the left side
and give the same treatment.
The work on the splanchnics is very important in
all diseases of the liver, stomach, kidneys, spleen, small intestines,
and the pancreas.
FLEXING THE LEG ON THE ABDOMEN
FOR stretching and loosening the ligaments and muscles
of the leg and hip, and increasing the circulation.
With the patient on his back, take his leg by the
knee with your right hand and flex it strongly several times against the
abdomen as shown in the cut. (See treatment No. 22 for completion
of this movement.)
MANIPULATION OF THE LEGS (COMPLETION OF TREATMENT NO. 21)
TAKE hold of the patient's ankle with the one hand
and the knee with the other, as shown in cut, and turn the foot inward
and the knee outward, then straighten the leg, bringing it down with a
slight jerk; this should be repeated several times with each leg and every
other time turn the
knee inward and the foot outward.
TO SPRING THE LEGS APART
WITH the patient on his back and the legs drawn
up, take hold of each knee and force the legs apart with considerable force.
This stretches the muscles on the inner side of the legs.
TO INHIBIT THE ACTION OF THE LOWER BOWELS
PLACE the patient on his back, with his legs drawn
up, and with the flat of the fingers of both hands paced as shown in the
cut, near the pubic bone, and with a moderate pressure draw the hands toward
the head, not allowing them to slip; now hold for a few seconds; this will
quiet the movement of the intestines and is a valuable treatment in cases
of griping pains in the lower intestines.
MANIPULATION OF THE LIVER
HAVE the patient lie on his back, with his legs
drawn up, and, standing on his left side, place your right hand underneath
the short ribs, and with the left hand press, with a moderate degree of
force, well up underneath the floating ribs in front, as shown in above
cut, and while pulling upwards and toward you with the right hand, press
on the liver with your left hand, and draw same towards you, not allowing
your hand to slip on the flesh. Work from the side to the middle
line of the body in front. Manipulate these parts about one minute.
MANIPULATION OF THE STOMACH AND SPLEEN
THE work on the stomach is practically the same
as that for the liver, as shown in Treatment No. 25, but on the opposite
side of the body. Manipulate about one minute.
DEEP PRESSURE ON EITHER SIDE OF THE NAVEL
WITH the patient on his back and his legs drawn
up, place the flat of the hands, with the fingers slightly bent, at the
side of the navel towards you and press gently but deeply, and, without
allowing the fingers to slip, draw them towards the side of the body on
which you stand; repeat several times and then treat the other side in
a similar way.
MANIPULATION OF THE SIGMOID FLEXURE
WITH the patient on his back and the legs drawn
up, work the abdomen with the flat of the hand and the fingers slightly
bent, beginning at the sigmoid flexure, where the hand rests as shown in
the above cut, and with a deep and firm pressure draw the hand upward towards
the head, not allowing the hands to slip; now move the hand upwards a few
inches, and press and draw again, and so on around the abdomen, following
the course of the large intestine.
This treatment should take about three minutes.
MANIPULATION OF THE SMALL INTESTINES
WITH the patient on his back and his legs drawn
up, place the hands near the outer side of the abdomen as shown in the
cut, and with the fingers draw the abdomen toward you and push it back
again in the opposite direction with the "heel" of the hand, a motion very
similar to that of kneading bread, using a moderate degree of pressure,
but not enough to make it painful to the patient. Work here should
be done about two minutes.
GENERAL TREATMENT OF THE BODY. THIS IS A COMBINATION OF TREATMENTS
1. Treatment No. 7.
2. Treatment No. 8.
3. Treatment No. 9
4. Treatment No. 19
5. Treatment No. 20.
6. Treatment No. 21.
7. Treatment No. 22.
8. Treatment No. 23.
9. Treatment No. 25.
10. Treatment No. 26.
11. Treatment No. 27.
12. Treatment No. 28.
13. Treatment No. 29.
The full treatment is considered a tonic to the general
system, stimulating the nervous and circulatory systems. It requires
about twenty minutes.
TO STRETCH THE SCIATIC NERVE AND THE FLEXOR MUSCLES OF THE LEG
WITH the patient on his back raise the leg at the
right angles to the body, drawing down the toes with one hand, and with
the other pushing against the knee, as shown in cut, and with your knee
hold down the patient's other leg; now push the upright leg towards the
patientís head as far as possible; do this several times. Perform
the same movement with the other leg.
This is largely used in cases of rheumatism, cramp
in the legs, cold feet, etc.
MANIPULATION OF THE MUSCLES OF THE LEG
WITH the patient on his back, beginning at the upper
part of the thigh near the body, and spanning the limb, as shown in above
cut, work the muscles with a circular movement around the leg, first turning
them to one side and then to the other, and so work on down the leg.
This treatment has the effect of stimulating the circulation and is, therefore,
valuable in cases of rheumatism, swelling of the legs, cold feet, etc.
MANIPULATION OF THE SHOULDER JOINT
WITH the patient on his back, work all the muscles
around the shoulder joint, on the chest in the region of the joint, and
the muscles that cover the shoulder blade. Then take hold of the
patient's arm with one hand, and with the other grasp the shoulder as shown
in the above cut, and while holding the joint firmly, raise the arm forward
and upward, bringing it above the head, and lower it again backwards and
downwards; repeat this several times. This treatment may be painful
at first if the joint is affected, and therefore the arm should only be
raised as high as the patient can bear. After a few treatments, which
should be given every other day, the soreness will have disappeared sufficiently
so that lie will be able to stand the full treatment.
WORK ON THE SPLEEN
WITH the patient sitting on a chair or stool, take
hold of his left wrist and raise the arm high above the bead, and while
pressing on the ninth rib with the thumb of the other hand, at a point
about two inches to the left of the spinal column, as shown in cut, draw
the arm downward with a backward motion. Now lower the thumb of the
right hand to the next rib below and repeat the movement with the left
arm. Lower the thumb again to the next rib and repeat the operation.
CORRECT APPLICATION OF COMPRESS TO THE THROAT
WET a cloth, preferably old linen, in cold water
and fold to several thicknesses and long enough to reach from the angle
of the jaw on one side to the angle on the other, and about three inches
wide; now cover this with a woolen cloth large enough to cover the wet
cloth completely, and to be pinned or tied over the crown of the head.
Another cloth may now be tied around the forehead as shown, and pinned
to the throat cloth to keep it from slipping during the night. Remove
the cloths in the morning, and wash the throat with cold water and rub
with alcohol to prevent taking cold. This application should be made
nightly until relief is felt. The cloths should be scalded before
being applied again, to destroy the poisonous matters that have been thrown
off through the skin and taken up by them.
SPRINGING LOWER JAW
WITH the patient on his back, place the first finger
of each hand behind the angle of the lower jaw on each side. Now
have the patient open his mouth; at the same time, with a limited degree
of pressure, push the jaw forward and have the patient slowly close the
mouth. Repeat this several times. This movement acts on the
fifth cranial nerve and is a valuable treatment in all eye and ear troubles.
MANIPULATION UNDER THE JAW
WITH the patient on his back, place one hand on
his forehead, and with the other work deeply under the jaw, beginning near
the ear and gradually working towards the chin, not allowing the fingers
to slip on the skin. Go through the same, movement on the other side
of the head. This treatment is given in case of catarrh, mumps, diphtheria,
and any throat trouble.
SPRINGING SPINE IN UPPER LUMBAR REGION
WITH the patient sitting on a chair or stool, stand
behind him and place your knee against the back at a point below the last
rib, and with the hands take hold of the patientís shoulders, as shown,
and draw them backwards at the same time pressing against the spine with
INHIBITING THE SUPERIOR CERVICAL PLEXUS
WITH the patient on his back, place one hand
on either side of the upper part of the neck, close to the spine,
in the region of the second, third, and fourth cervical vertebrae,
and hold same for two or three minutes. (For location of the
superior cervical plexus, see cut No. 1 MM, page 24.)
MANIPULATION OF FRONT OF THE NECK
WITH the patient on his back, place one hand on
his forehead, and with the finger and thumb of the other placed on either
side of the windpipe work the front of the neck from the chin down to the
collar bone, moving the structures crosswise to the neck. Work in
this region should require about two minutes. An essential movement
in the throat diseases.
TO RAISE THE RIBS
WITH the patient on his back, stretch his arm
out sidewise, and while bearing down and at the same time pushing
it upward, press upward on the ribs with the fingers of the other
hand, beginning with the third, as shown in above cut, then the
fourth, fifth, and so on down to the seventh, the location of which
may be seen in cut No. 2 C, page 25, This work should he done on
both sides of the body alike, but only on the left side in case
of neuralgia of the heart.
SPRINGING THE SACRUM
WITH the patient lying face downwards, place your
left hand on the sacrum and with the other raise the legs and swing them
from side to side several times and then lower same with a circular motion,
being careful not to raise the legs any higher than the patient can bear.
Should be repeated several times.
SPRINGING SPINE IN THE LUMBAR REGION
WITH the patient lying face downwards, place
the thumb and first finger, one on each side of the spine, beginning
at the first lumbar vertebra (the location of which may be seen
in cut No. 1 C, page 24), and with the other hand under the legs
as shown, raise them and lower again with a circular motion from
left to right. Repeat this several times and then lower the
hand on the back an inch and repeat, being careful not to raise
the legs any higher than the patient can bear. This treatment
is especially valuable in leucorrhea, suppressed menstruation, and
incontinence of urine.
MANIPULATION OF THE OVARIES
WITH the patient on her black, and legs drawn up,
press deeply in the region of the ovaries on the opposite side from which
you stand, and draw your hands towards you; repeat several times and do
the same on the other side.
GENERAL TREATMENT OF THE NERVES ALONG THE SPINE
WITH the patient lying face down and arms hung off at the
sides of the table, place your thumbs, one on each side of the spine, and with
a moderate pressure work the muscles, pushing them upward and outward; beginning
at the second dorsal vertebra work down the entire length of the spine moving
the thumbs down one inch each time. This treatment should require about