A Manual of Osteopathy
Eduard W. Goetz, D.O.
    THE sciences, Anatomy and Physiology, are the foundation of the theories and principles of Osteopathy.

    HUMAN ANATOMY is that science which treats of the construction of the human body, giving a description of the various organs or parts which make up the body; their external form, their internal arrangement, and their relation to each other.

    All the tissues and the organs of which the body is composed were originally developed from the microscopic body (the ovum), a cell from which every part of the body has been developed, these cells differing only in their constructive power to build the different parts of the body, such as bone, cartilage, muscle, skin, nerves, glands, etc.

    'The skeleton contains 206 distinct bones and these are divided in the body as follows:

    Bones of the skull, 29, exclusive of the teeth.

    Bones of the trunk, 51.  Vertebral column, 26; ribs, 24; and the sternum, 1.

    Bones of the upper limbs, 64.  Arms, 2; forearms, 4; hands, 26; fingers, 28; scapulae, 2; collar bones, 2.

    Bones of the lower limbs, 62.  Pelvis, 4; thighs, 2; legs, 4; feet, 24; toes, 28.

    The above does not include the knee caps, of which there are two.

    The bones of the body are bound together by cartilage and ligaments, completing the bony framework; to these are attached the muscles which move the different parts that are movable.

    The skull contains the brain and the sense organs of sight, smell, hearing, and taste.

    The trunk contains, in the upper part, the lungs (2), and the heart with its blood vessels.  In the lower part or abdomen, separated by the diaphragm, are the stomach, liver, spleen, kidneys (2), pancreas, and intestines.

    The pelvis contains the bladder and generative organs of woman, uterus, ovaries (2), Fallopian tubes (2).

    The relation of these different parts may be seen in cuts Nos. 1 and 2, pages 24 and 25.


    HUMAN PHYSIOLOGY is that science which treats of the functions performed by the various organs of the human body in the state of health.

    The Physiologic Apparatuses of the body are:

1.  Digestive Apparatus, composed of the mouth, stomach, intestines, with the glands connected with them; the function of which is the complete digestion of food.

2.  Absorptive Apparatus, composed of the capillary blood vessels and lymphatic vessels, especially those in relation to the small intestines; the function of which is the introduction of new material into the blood.

3.  Circulatory Apparatus, composed of the heart and blood vessels; the function of which is the distribution of blood to all parts of the body.

4.  Respiratory Apparatus, composed of the lungs, trachea, diaphragm, and walls of the chest; the function of which is the introduction of oxygen into the blood and the elimination from it of carbon dioxide and other injurious products.

5.  Urinary Apparatus, composed of the kidneys, ureters, and bladder; the function of which is the excretion of waste matter from the system.

6.  Perspiratory Apparatus, composed of the skin and the sweat glands; the function of which is the excretion of waste products from the system.

7.  Secretory Apparatus, composed of the liver, pancreas, mammary glands, and all other glands; the function of which is to elaborate some specific material necessary to nutrition to the individual.

    [The function of the foregoing apparatuses is to nourish the body, and they have for their final object the preservation of the individual.]

8.  Nervo-muscular Apparatus, composed of the nerves and the muscles; the function of which is the production of motion.

9.  Sense Apparatuses, composed of the eye, the ear, the nose, the tongue, and the skin; the function of which, as a whole, is the reception of impressions and the transmission of nerve impulses to the brain where they give rise to the sensation of seeing, hearing, smelling, tasting, and feeling, respectively.

10.  Vocal and Articulating Apparatuses, composed of the larynx, and its accessory organs, the lungs, trachea, respiratory muscles, and the mouth; the function of which is to produce voice, and articulate speech.

    [The Sense and Articulating Apparatuses are classified as functions of relation, bringing the individual into conscious relationship with the external world.]

11.  Reproductive Apparatus, composed of the ovaries, the Fallopian tubes, the uterus, and the vagina in the female, and the testes and urogenital canal in the male; the function of which is the development of new being and the perpetuation of humanity.

    The body is made up of minute cells which exhibit the fundamental properties of life: growth, motion, and reproduction.  Through this power of the cells the different organs of the body, are developed.  By organs are meant all the different parts of the body: bones, cartilage, blood vessels, nerves, glands, skin, teeth, besides the well-defined structures, such as the heart, lungs, stomach, brain, liver, kidneys, etc.

    The voluntary muscles closely invest the bones of the body and are the immediate cause of the active movements of the body.  In addition to the muscles that. are attached to the skeleton are also the involuntary muscles surrounding the stomach, intestines, blood vessels, etc., which impart motility to their walls and so influence the passage of material through them.

    The Nervous System which unites and co-ordinates the various organs and tissues of the body, and brings the individual into relationship with the external world, is arranged in two systems, termed the Cerebro-Spinal and the Sympathetic.

    The Cerebro-Spinal System consists of the brain, spinal cord, and the nerves emanating from them, and controls motion and sensation.

    The Sympathetic System consists of a double chain of nervous centers, connected nerves situated on each side, anteriorly, of the spinal column, extending from the base of the skull to the end of the coccyx, and communicating with the cerebro-spinal system; it controls nutrition, growth, secretion, etc.  While each of these two nervous systems has separate functions, yet they must work together and in harmony; the sympathetic nerves being modifiers of the actions of the other set of nerves.

    All nerves which emerge from the brain and spinal cord have the power of carrying impulses to and from the peripheral terminations.

The Efferent and Afferent Nerves

1.  The Efferent nerves convey impulses from the brain and spinal cord to the various peripheral organs.  They are:

a.  Muscular or Motive nerves, which conduct impulses to the muscles and give rise to the muscular contraction.

b.  Glandular or Secretory nerves, which conduct impulses to the glands and excite secretion.

c.  Vaso-motor or Vascular nerves which convey impulses to the walls of the blood vessels. which stimulating or inhibiting the muscular fibers, vary the caliber of the blood vessels.

d.  Inhibitory nerves, which conduct impulses that inhibit the activity of any organ.

2.  The Afferent nerves carry the impulses from the peripheral or to the brain and spinal cord.  They are:

a.  Special Sense nerves, which conduct impulses from the different organs of sense, e. g., eye, ear, nose, mouth, skin, which give rise in the brain to conscious sensations.

b.  Reflex nerves, which conduct impulses to the nerve centers to be reflected out through the efferent nerves to muscles, glands, blood vessels, etc.


    Digestion is a physical and chemic process, by which the food, introduced into the alimentary canal, is transformed by digestive fluids into nutritive substances capable of being absorbed into the blood.

    The digestive apparatus consists of the alimentary canal and its appendages, viz., teeth; salivary, gastric, and intestinal glands; liver; and pancreas.

The different stages of digestion are:

1.  Mastication, the trituration of food in the mouth.

2.  In salivation, the incorporation of the food with the saliva secreted by the glands in the mouth.  This saliva softens and moistens the foods preparatory to swallowing, and has the power of converting starches into sugars.

3.  Deglutition, the act of transferring the food from the mouth to the stomach accomplished by the muscular walls of the esophagus, which contract from above downward, propelling food onward to the stomach.

4.  Gastric digestion, the action of the gastric juice upon the food, acidulating it, preventing fermentative changes, converting the proteid foods into peptones, and liquefying the contents of the stomach for passage into the small intestines.

5.  Intestinal digestion: the action of the pancreatic juice, the bile, and the intestinal juice on the chyme (a term given to the food after having been acted upon by the juices of the stomach), which prepares it for absorption by the blood vessels and the lymphatic vessels.  The waste matter is carried on to the large intestine and expelled through the rectum.

    ABSORPTION: Certain elements of the food which has been converted into chyle are taken up by the lacteals in the small intestines and conveyed through the lymphatic vessels to the thoracic duct, and thence emptied into the blood stream.  The other part of the food is absorbed by the blood vessels and carried to the liver through the portal vein, where it is elaborated by the secretions of the liver and then sent to the heart, which organ pumps the blood into the lungs, where carbon dioxide is exchanged for oxygen; it is then returned to the heart which sends the blood into the general circulation to all parts of the body, and the nutritious part deposited with each organ or tissue, which is essential to the growth and repair of such parts.  The waste matters are taken up by the capillaries, conveyed through the veins to the different excretory organs and expelled.

    EXCRETION: The principal excrementitious fluids discharged from the body are urine, perspiration, and bile; they hold in solution principles of waste generated during the progress of nutrition, and are the ultimate forms to which the organic constituents are reduced in the body.

    KIDNEYS: The organs for the secretion of urine, which is extracted from the blood, carried to the kidneys by the renal arteries.  The urine passes down the ureters to the bladder and from there to be expelled.

    LIVER: A complex organ having a variety of relations to the general processes of the body.  The physiological actions of this organ are not yet wholly understood, but it may be said that it:

1.  Secretes bile.

2.  Forms glycogen.

3.  Assists in the formation of urea and allied products.

4.  Modifies the composition of the blood as it passes through it.

    BILE is both a secretion and an excretion.  It contains new constituents which are found only in the substance of the liver and play an important part, ultimately, in nutrition.

    It has the power to prevent putrefaction of the foods contained in the small intestines and is the natural purgative of the bowels.

    SKIN serves as a protective covering to the body; an organ for tactile sensibility, and an organ for the elimination of waste matters, sweat, etc.