Dr. A. T. Still Founder of Osteopathy
M. A. Lane
1918
 
CHAPTER VI
 
OSTEOPATHY IN THE GROUP OF SO CALLED RHEUMATIC DISEASES
 
 
Rheumatism is a disease as old as history, and in ancient times men resorted to mineral springs for the relief of the pains, the twinges, the swellings, the soreness, the sudden sharp stabs, the acute disabling inflammation, the chronic pain and deformity-all of which were lumped together in the ancient medical mind and labeled in gross rheumatismus. Perhaps under no one name have so many widely divergent and radically different disorders been classified as under this old term rheumatism.

NEARLY ALL PAINS ONCE CALLED RHEUMATIC

Until yesterday one may say, "rheumatism" was perhaps the most mysterious of diseases that tortured with strong pain or only just annoyed its victim. For in this many-headed disease all degrees of symptoms were recorded, from the smallest, most insignificant "pain" in the end of the toe or finger, which came and vanished so quickly that the individual could not be certain it was there at all, to long drawn out chronic torture that inflamed, enlarged and deformed the joints of the body with such racking and exhausting pain that one might well wonder how the victim could remain sane in mind.

"Rheumatism," as this panorama of pain was called from of old, was studied in modern times by the best physiologists, bacteriologists and pathologists in the world without result. It was believed to be due to some chemical disturbance or unbalance in the body in which uric acid, or lactic acid, or some other acid, was not destroyed in the body, or was poorly eliminated, as is the known case with uric acid in gout. But this theory was long ago abandoned. It was believed to be due to diet, but no proof of this belief was ever brought forward. It was more recently believed to be due to the growth in the body of a microscopic germ, called by the man who believed he had found it, micrococcus rheumaticus. But bacteriologists in general were never convinced that this particular germ was the cause of rheumatism. The mystery of rheumatism promised never to be solved, and so it was that the old name lingered, and the doctors continue to prescribe anodynes, that is, drugs that that dulled pain opiates - not because the anodynes could cure or were believed to cure rheumatism, but because so-called rheumatism was accompanied by pain, and anodynes would dull pain of any kind. Dosing the "rheumatic" patient with anodynes - or pain killers - helped to kill the patient, to ruin the heart, to make the suffer suffer more. And so the use of anodynes in rheumatism came to be regarded as dangerous, and the wise doctor, for the patient's own good preferred to allow the rheumatic person to suffer rather than to risk killing him with drugs.

But the mystery of rheumatism has been recently and finally cleared up by the discovery - which has been for several years dawning on the scientific mind - that what has been called rheumatism is not one single disease, that is, a disease due to one unvarying cause, but a great number of symptoms caused by several different causes, the one thing common to all being the various kinds of pain. Until very recently we used to classify rheumatism into several kinds - inflammatory rheumatism (rheumatism accompanied by inflammation); rheumatoid arthritis (which was an inflammation of the joints milder than articular rheumatism or "like" rheumatic joints); articular rheumatism (in which the joints were swollen and the pain intense); muscular rheumatism (when the pain was in the muscles); neuralgic rheumatism (in which the pain was dull, chronic and distinctly of the tooth-ache variety); rheumatic neuralgia (in which the pain was like that of the no less mysterious neuralgia, mixed with rheumatic signs); neuritis (which resembled rheumatism but was different in some ways); sciatica (pain in the great sciatic region); lumbago (pain in the lumbar region of the back); certain symptoms of the heart (called rheumatism of the heart); similarly of the stomach, and so on, without end.

Only a short time ago, it was believed that rheumatism was caused by the entrance into the body of some mysterious germ thru the tonsils; and forthwith it became the fashion for people to have their tonsils removed (by a rather bloody and distressing if simple surgical operation). But even this last stand on the old ignorant basis has now been abandoned, and it has been seen that while one of the troubles that was labeled rheumatism can and does come in by way of the tonsil, removing uninfected tonsils is a rather crude, hit-and-miss way of preventing disease; is rather, an excellent method of inviting other and worse disasters by taking away the natural fortifications of the body against invading organisms of many kinds.

How, then, let us ask, has the mystery been cleared up, and if there is no such thing in reality as rheumatism, what is the nature of the many different things that produce in the body the various aches and pains, swellings and tortures, twinches and "touches" that have been all along thrown together and labeled rheumatism from time out of mind?

WHEN DUE TO ANATOMICAL MAL-ADJUSTMENTS

The osteopathic practitioner of five or ten or twenty years experience will understand much of the mystery when he thinks in retrospect of the persistent "rheumatisms" he has cured - occasionally with a single treatment. Well does such an osteopathic practitioner know, and well has he known for years, that an enormously large proportion of the "rheumatism" going the rounds of the human race was and is anything but mysterious, at least in its cause; for every such a practitioner has seen many cases of "rheumatism"cases that would be labeled such by all the doctors in the world - which were caused by a ridiculously simple slip or misplacement or strain in some joint or tissue, the results of which were not always so simple as the cause. Such cases vary from long continued -nearly incessant - pain in a hand, a foot, an entire arm or leg, in both arms or legs, in the breast, in the entire upper part of the body, or in the entire lower part - from such a pain, we say, to intermittent stabbings and shootings of pain, which, like the true old "rheumatics" come and go with the weather and without it. But give the required adjustment, and such rheumatism is gone for good.

It is quite impossible to say what percentage of "rheumatisms" are caused by just such lesions. It is likewise impossible to say how many cases of neuritis, in which the entire upper body, the trunk, or large areas of it, are due, if not to bony lesions in the back, then to hardened and tense muscles along the spine, for the osteopath is familiar with such cases also, and has removed the ill permanently by loosening up the joint-binding tissues of the spine.

Here, then, is one great source of many of the pain - complexes known in the past as rheumatism - anatomical disturbances, often minute in their nature. Let us illustrate.

INTERCOSTAL NEURALGIA

The wife of a certain well known national statesman had "rheumatism" in the breast and arms for years - rheumatism it was called by some; a kind of neuralgia by others; a neuritis by others; and some of her many doctors had reservations in their minds that it might be that peculiar thing called angina pectoris, or, in common English, "breast-pang". She finally came into the hands of an osteopath who found a twisted rib which was plainly to be seen on a front view, or distinctly felt by drawing the fingers across the side of the chest. The cure was made by adjusting the rib into line with its fellows, and the mysterious "rheumatism" of years standing vanished, and never recurred. You cannot blame this lady for being a "comfirmed believer" in osteopathy, can you?

BRACHIAL NEURITIS

A young man for years was partially disabled by pain in the right arm-pain that came and went suddenly, that gave him token of changes in the weather (at least so he himself was convinced), and pain that was clearly rheumatic. Also pain that was clearly a "neuritis" and was so diagnosed time and again. He was a portly man and a good liver, and he was for many years a victim of the diet regimen - starving himself to get the "poisons" out of his system. An osteopath found one of his ribs out of joint - had been out of joint for years - and slipped it back into its proper adjustment. Cure - perfect.

PROMISCUOUS TONSIL SLAUGHTER

A form of "rheumatism" much more common than is generally supposed, called bursitis when its nature has been recognized by osteopaths, consists of pain in or near a joint and extending down the limb, as pain in one of the shoulders, with involvement of the arm, often accompanied by sensations of numbness in the arm and fingers. Bursitis is an inflammation of a bursa, or tissue pad found in the joints - a kind of water cushion for the joint. This inflammation can be caused by physical strain from accident and is due in a vast majority of cases to some such accidental wrench or strain, as described. During the past few years several osteopaths who were themselves almost disabled by such "rheumatisms" have been perfectly restored by osteopathic treatment, and today such cases are almost invariably not only relieved but absolutely cured by making proper adjustments. Until osteopathy was found available in these cases the only remedy was the surgeon's knife, by which the bursa itself was removed, thus leaving the arm more or less disabled. Shoulder and arm "rheumatisms", persistent in their character, are frequently found to be due to this so-called bursitis which in all probability is not caused at all by disease germs but by simple mechanical tissue lesions.

A DISABLED ARCH OF THE FOOT

Another similar simple example was found in an elderly lady who for years suffered with "rheumatic pains" in her foot. Once, long ago, she had turned a bone in her instep, and the joint, as is common in such cases, would slip in and out with stress in walking. The rheumatism would "come and go suddenly as by magic", to use the phrase of the "confirmed rheumatic". She had avoided red meats, acid foods, and other supposed aggravators of the rheumatic tendency for years, and to no purpose. An osteopath was found who understood the sources of the pain, and subsequently would invariably "cure" the rheumatic attack by a simple deft rotation of the joint.

SCIATICA FROM A SLIPPED PELVIS

Another case was that of a professional man who for many years had been tortured with severe "sciatic rheumatism" and who had gone the "usual round of the doctors", and was cured in the usual way - by osteopathy. It was found that this man had a twisted pelvis, which, when it had been "twisted" back again into its normal bony relations, by osteopathic technique, was seen to be the cause of the entire trouble. Such instances could be multiplied many times over with as many variations according to the determination of the dislocation, the stress, the tensity of the tissues involved, in various parts of the body, every osteopath being able to cite numerous cases of his own, in which his own experience has taught him that these anatomical causes lie at the root of innumerable examples of that great pathological octopus labeled in the museum of disease as rheumatism. This patient had long worn red flannel undergarments, summer and winter, in the belief that the conservation of his body heat would relieve him of his pain, and had resorted to the use of various drugs and other remedies, and hygienic measures in general, but of course could get no help from such methods of treatment as long as the lesion in
the pelvis was there to disturb the normal relations of the great nerve and the tissues it supplied.

Another form of pain, commonly called rheumatism, and most often neuritis, is caused by slight displacement of one of the vertebrae of the neck - frequently that next to the skull itself. The slight pressure resulting gives the patient a chronic "headache", or neuralgia", the real cause of which is not always recognized. But if the case is carefully studied and the lesion reasoned out, its correction is reasonably sure, and adjustment of the bone back into its normal bearing will cause the pain to disappear, with what relief to the patient those who have suffered or are suffering in this way, can easily imagine.

But there are causes of "rheumatism" other than imperfect articulations or hardened tissues and here, too, the osteopath has a method of rational therapy unique and helpful, more so than any other known method, although these other causes are more strictly classifiable as diseases. We refer to pain called rheumatic, or neuritic, or neuralgic, that are caused by disease germs, or their poisons, in the blood and the tissues or by so-called auto-intoxications, which will give one "rheumatic" twinges and sharp pains in any or in all parts of the body.

INFECTIOUS VARIETIES OF "RHEUMATISM"

To these classes of rheumatisms belongs that severe and most striking disease called articular rheumatism which is frequently followed by heart lesions more or less serious according as the disease germ is highly or mildly virulent and the patient's blood and tissues susceptible to the germ in high or low degree.

It was in such cases of intensely painful "articular rheumatism" that the bacteriologists sought for their causative germ, with the discovery, or what was thought to be the discovery, of the micrococcus rheumaticus. The cause of this disease is now definitely known, and it is a germ mentioned in former numbers of this magazine, namely, streptococcus pyogenes, the same germ that causes virulent tonsillitis, inflammation of the valves and muscle wall of the heart, abscesses in various parts of the body, erysipelas, and that deadly thing called "blood poisoning" of the most virulent type.

INFLAMMATORY "RHEUMATISM"

In rheumatism of this kind the germ finds lodgment perhaps in the tonsil, and from the tonsil works its way into the blood and becomes what pathologists and bacteriologists call a "septicemia". Reaching the joints, the germs grow in the fluids bathing the tissues and cause there the "reaction" of the body to this germ, for the same reaction occurs no matter where the germ may be growing in the body. This reaction is decidedly inflammatory, the joints swell up because of the exudation from the engorged blood vessels, the delicately sensitive nerve endings in the tissues are pressed upon by the swelling, and this pressure causes the intense pain which is characteristic of this disease, when the invading germ is highly virulent and the patient's body is highly susceptible to the growth of the germ itself. If the organism be not so highly virulent, or the resistance of the individual be comparatively high, the inflammatory reaction in the joints will be correspondingly mild, and the "rheumatism" not so painful or marked. It will be seen therefore why this particular disease may vary from a very slight attack which passes away quickly if the patient's resistance be high and the germs easily be overcome and their toxin neutralized to an "attack" that may last for months and exhaust the patient's strength with pain.

OSTEOPATHY BUILDS UP THE BODY'S OWN RESISTANCE

In such cases of "rheumatism," whether mild or virulent, the germ and its toxin not only attack the joints of the body in general, but also the joints in the spine, causing considerable tissue injury and consequent tensity along the spine and interfering, much or little, as the case may be, with the spinal nerves and their control, indirectly thru their connections with the sympathetic nerves, of those cells of the body that are concerned with the making of the antibodies that neutralize the toxins of the germ and cause the germs to be removed from the tissues. This principle of osteopathy applies in so-called articular rheumatism also, and osteopathy can be depended upon to facilitate and to accelerate the body reactions which ultimately (though more slowly) enable the body to recover from the disease by the use of its own mechanism of resistance. Treating the infected spine of such a patient by the use of osteopathic technique is an absolutely sound procedure, grounded on thoroughly scientific theory and practice, and results vindicate the osteopath's contention that the spinal tissue lesion in infectious diseases (when such lesion is actually caused by the infection in the first place) is the block to nature in her attempt to overcome the infection by supplying the remedy which nature itself has planted in the body. Furthermore, osteopathic treatment is the only available treatment in this infection, no serum or vaccine having ever been found which can do the work, although vast effort has been made in this direction.

"RHEUMATIC" HEART

One of the unpleasant results of so-called articular rheumatism, or rather one of the results of the general infection which is the cause of that disease, is a lesion of the heart that is generally known as "rheumatic heart", although it is easily seen, in view of what we have already said about rheumatism in general, that the word "rheumatic" here has really no definite meaning whatever. The bacteria (streptococcus pyogenes) being carried into the blood stream, and by it to the joints, also frequently settle on the heart valves, and are likewise carried into the small blood vessels that nourish the muscle wall of the heart, plugging up the vessels, the toxin causing the vessel wall to thicken and harden, thus producing an arteriosclerosis in the organ, and at the same time destroying a certain amount of the muscle tissue of the heart itself. This kind of a heart is the typical "rheumatic heart", and it can, in common with the inflammation of the joints in this disease, be prevented to a high degree by osteopathic treatment in the early stages of the infection. Patients with articular rheumatism, in justice to themselves, should call in an osteopath early in their infection, no matter what their medical doctor may say about it, for the medical doctor professedly can do nothing for such a patient but call daily and look on, prescribing the usual anodynes, usually with danger to the patient's heart, and advising chloroform liniment or other liniments, which are at best the most superficial kind of makeshift. One of the last procedures in these cases is for the doctor to advise the calling in of some masseur, Swedish or other, at a stage of the disease when the slightest touch is condign punishment for the patient, and then, when all things fail, the patient is reluctantly told to try Hot Springs, Mudlavia, or some other popular cure for rheumatism, and the patient is carried out on a stretcher exhausted in body, mind and pocketbook.

THE EARLIER OSTEOPATHY IS APPLIED, THE BETTER

To how many sufferers is this story familiar? And how much of this expense can be saved will be known only when, with popular enlightenment and education, the victim of streptococcus pyogenes (in the form of "articular rheumatism"), learns to avail himself of the virtue of scientific osteopathic treatment in the earliest stages of the disease.

Long before bacteriologists and pathologists found and identified many of the different germs that cause disease, osteopaths knew that by their own peculiar manipulation and adjustment of the bones and softer tissues of the spine they could stop different infections, reduce temperature, and, in short, work a cure of the disease. Thus the osteopath is not only the sole doctor in cases of the so-called rheumatisms directly caused by anatomical lesions, but is also one of the most important factors in the treatment of rheumatisms, neuritis, neuralgias, lumbagos and sciaticas due to infections wherever they may be.

WHEN DUE TO PUS POCKETS

Aside from articular rheumatism so called, there are many more or less severe pains and inflammations generally labeled rheumatism, caused by pus-forming germs that find lodgment and grow in various parts of the body, often in the mouth of the roots of the teeth, or in the tonsils, or in other parts of the body such as the kidney, for example. The pus-forming bacteria that are the main offenders in this respect are staphylococcus pyogenes aureus and streptococcus pyogenes - the identical germ that causes articular rheumatism - (pyogenes meaning "pus-making", and pus meaning dead white cells of the blood that have lost their lives by ingesting, or taking in, the germs and killing them, in the body's attempt to get rid of these invading germs in a natural way). Pockets of these bacteria with their accompanying pus, may continue in some corner of the body for years, and produce their toxins which in turn cause the pains of so-called rheumatism, strong pains if the organism be virulent and the patient highly susceptible, mild pains if the reverse be true. In such cases it is of course needful to remove the pus pockets by operation on or even extraction of the teeth, if the germs be growing there, or by operation on the tonsil if that be the place of growth, and the removal of the germs will be followed by spontaneous recovery if all the centers of germ growth be removed.

PULLING TEETH RUTHLESSLY ANOTHER ERROR

But great care in diagnosis is necessary before these things be done, and the patient should not be deprived of teeth or tonsils without a thoroughly scientific examination. The removal of the teeth as a cure for "rheumatic" pains has run riot of late, and many a man and woman has had good and useful teeth extracted for the cure of some localized chronic pain, without deriving the slightest benefit from such a serious operation. In localized "rheumatic" pain it is mainly the anatomical lesion the strain, the tensity, the mal-adjustment of tissue and bone, that should be looked for first and above all things. After this it is well enough to figure upon pus pockets in the vicinity-pain in the leg from pelvic infection, and so on. Generalized pains most frequently are the indicators of long continued centers of pus-making infection.  But the doctor who would have the teeth extracted from every patient with general or local "rheumatism" of any kind, is a dangerous man to be at large, and too many of that kind of doctors are licensed to practice medicine by unenlightened law.

WHEN RESULTING FROM INTESTINAL PUTREFACTION

Another source of "rheumatic pains" not yet discussed and a most common and important one, is what is known as intestinal auto-intoxication. This consists of the manufacture of poisonous substances by the decomposition of undigested food in the intestine, the "food" consisting of protein, that is meat, eggs, or fish. Such decomposition, or putrefaction, is encompassed by the germs that normally grow in the intestine by the inconceivable billions. One-third of the dried contents of the large intestine consists by weight, of bacteria, but these bacteria are normally harmless. The heavy meat eater acts as a purveyor of food for these germs in the intestine, and large numbers of persons are diet-sick in this way. Reduction of meat in the diet to a reasonable degree will do more to cure rheumatisms from this cause than any other kind of treatment; but this method of dieting has nothing to do with the old-time tradition that red meats are bad for the rheumatic patient. Dieting in that way will not do much to cure or relieve anything.

What used to be called rheumatic neuralgia of the muscles of the abdomen in the vicinity of the stomach has in numerous cases been found to be what is called "flatulent indigestion". For some obscure reason - in some cases maybe a nervous one - the lining of the intestine does not secrete its normal juices, or secretes them in too small a quantity. There is hence a consequent deficiency in power of the secretion of the great digestive organ, the pancreas, owing to the very malfunctioning of the intestine. The result is that the starches do not digest in the intestine, fermentation follows, the intestine is charged with gas, and the pressure causes pain in the region of the stomach, and you have rheumatic neuralgia, or neuralgic rheumatism, for it is all one, so far as the real disorder is concerned. Mineral waters and other laxatives and purgatives fail. Many of such cases are directly traceable to osteopathic lesions in the spine which can be corrected with subsequent relief and disappearance of all symptoms; and when the disorder is due to reflex tensity of the softer tissues of the spine, correction of these accomplish the same result.

GONORRHEAL ARTHRITIS

Another disease that was formerly called rheumatism, and a disease unfortunately by no means rare, is due to an escape into the blood of the germ called gonococcus, which causes by its primary growth in the urinary passages, the venereal disease called gonorrhea. This disease is most frequently acquired by immoral living, and communicated to innocent ones by the guilty. Perhaps some will say that such disease should be discussed only in the consultation room of the physician, and it is this very false "modesty" that has accomplished the physical wreckage and in thousands of cases the death of the unfortunate wife of the libertine husband. Popular knowledge in these things is now being widely cultivated and spread abroad under the name "sexual hygiene", and vast suffering and social error might have been saved in the past had every young woman, and the parents of every young woman possessed such information on these subjects as would have safe-guarded the innocent victim of an unwise marriage.
 
And yet even with the most careful scrutiny it is almost impossible to guard the innocent or enable the uninfected to guard against deception when dealing with an unconscionable and ignorant man. Such men themselves are the main victims of this disease, and it is in many ways a pity that disastrous consequences do not as a rule follow the usual infection. Then perhaps this social evil would stop or prevent itself. This germ does not only itself produce pus centers in the body, but it also paves the way for the entrance into the body of other pus-making organisms which work the final disaster, disabling or causing the death of the infected person by a mixed infection. But when this germ enters the blood and settles out for its further growth in the joints of the body it produces what has in recent times been called gonorrheal arthritis, or an inflammation of the joints similar in some ways to articular rheumatism, and in others different from that disease. Frequently in such cases the germs, like streptococcus pyogenes, settle on the heart, causing the heart lesion called endocarditis, although endocarditis can be, and usually is, caused in other and less disastrous ways. This kind of rheumatism has been treated by vaccines but not with the success which would be desirable, and osteopathy has been found practical and beneficient in these cases, as it has been found in rheumatisms of other kinds.

RHEUMATOID ARTHRITIS

Another species of rheumatism, common in persons who have passed middle-age, is the so-called "rheumatoid arthritis", an inflammation of the joints, which often produces considerable deformity, and even disablement, in many cases causing the patient to become more or less crippled and unable to move about or use the hands with freedom. In all chronic cases of this kind there is absolutely no treatment which yields as good results as osteopathy. Persons whose joints were practically clear out of use, have been relieved in some measure by manipulations which loosen up to a considerable degree the old stiffness, and have been restored, in a measure, to the use of their limbs. When osteopathic treatment can produce such gratifying results in old chronic cases, it is most rational to believe that this infection could be handled in an entirely satisfactory way if taken early in its course.

The osteopathic physician will be careful to consider and look for some primary source of the infection in the tonsils, the teeth or elsewhere, for when the symptoms in the joints begin to appear, it is clear there is some source of infection that has been at work for some time, unperceived by the patient. In such cases it is well to have x-ray shadowgraphs made of the teeth, or other parts, to locate the focus, or foci, of infection, which can be removed by surgery - dental or other - and to let this treatment be intelligently followed up by osteopathic therapy, which will help the body to take care of the germs and their toxins that have escaped and are doing the general tissue destruction at places far removed from the original portals of the invasion.

OSTEOPATHY AVAILABLE IN PAINS OF MECHANICAL AND GERM ORIGIN BOTH

In conclusion one may say the "rheumatic pains", when directly traceable to some comparatively prominent or comparatively obscure tissue disturbance, either in the spine or elsewhere, are reasonably certain to be cured by osteopathic adjustment of the lesions. A large percentage of "rheumatism" is directly caused by these anatomical displacements, tensions, or mal-adjustments, and for all of these osteopathy is the only and at the same time the perfect remedy. In other forms of so-called rheumatism, when the pains are due to the presence of germs in the body, osteopathy may still be relied upon as one of the most important factors in the relief and cure of these infections, especially when the germs or their poisons have rendered the tissues of the spine tense or hard. And osteopathic treatment in general may be depended upon as one of the most salutary measures in maintaining a state of body well calculated to be resistent to the several germs that cause the swellings and pains formerly called rheumatism, as also to other germs and to germ diseases in general.