Dr. J. Martin Littlejohn, Ph.D., M.D., D.O., L.L.D.
[NOTE: THIS DRAFT TEXT WAS PROVIDED BY CHRIS CAMPBELL OF THE LITTLEJOHN
OSTEOPATHIC CENTRE IN IRELAND. THANKS CHRIS. I HOPE TO BE ABLE
TO ADD THE FINAL PUBLISHED VERSION OF THIS WORK IN A LATER EDITION OF THIS
MOUTH AND THROAT
1. The main thing is to know the history. Whether or not periodicity
in the case, applies particularly to functional diseases, Object is to
avoid spasms etc., before they come on. Find out what causes periodicity
as irritation etc. In treatment to abort treat just before the condition
is due, this is true of different types of heart diseases, as regurgitation
of the heart.
2. Find out weak and strong points in patients system, history of diseases
good way to know this. Many times the best way to strengthen weak parts
is to make the strong parts stronger. Try to find out by questioning and
by reasoning what relation previous diseases have to present disease. Find
out in each particular case the strength and weakness of the blood and
lymph system is predominate, in later life blood system becomes predominate.
Note tendency to explosives.
3. Find out the susceptibilities of the nervous system, we can discover
ways and means of aborting disease, especially nervous diseases.
4. Find out the different influences or effects that are caused by changes,
as, changes in diet, changes in the time of taking food of resting periods,
5. Object in diagnosis is to see whether the condition is physiological
or pathological. Here we have weakness and strength of the system
brought out. To strengthen heart, tone up heart from weak side, example,
in the vast majority of the cases the trouble is on the sympathetic side,
that is, it is over-active. Heart diseases are mostly heart habits. Heart
life is acceleration and inhibition. Best thing to do is to inhibit its
function, this is also best for sick children, same true of nervous patients
and dipsomaniac patients. All diseases of children are on sympathetic side,
tone down through the cerebro-spinal system. Quiet restless children by
articulating the spine lightly, the average child can be put to sleep by
the manipulation of the head. Read Halleck's "Education of the Central
6. Find out the condition and the extent of the intoxication of the
system. One reason why paralysis agitates cannot be cured is that the cells
are in a state of toxicity. Overcome intoxication by persistent nutrition.
Auto-intoxication and hetero-intoxication are terms applied to two different
means of acquiring diseases. In most cases of intoxication the excretory
functions are abnormal and when abnormal attempt to restore. As a general
rule the intoxication settles in (a) weakest point, (b) most over-worked
point, all, (d) in injured part and field of traumatism; also filed of
surgery. Treatment must be according to the kind and extent of the intoxication.
In all cases of auto-intoxication we can deal with intoxication without
any assistance from drug line, in cases of hetero-intoxication we can deal
with these only in the toxicological field.
7. Physical examination and treatment are to be viewed from point of
adjustment. In the field of the so-called osteopathic lesions there are
three points to be looked into in particular:
(a) Condition of adjustment
of the structures of the body toward normal.
(b) Harmony under the reign
of vital force. (In treatment operate through nervous system.
(c) Condition of harmony
or disharmony in the elements or processes in the body. The elements equal
the proximate principles, the processes are chemical, physical and vital.
These three points include minute as well as crude structures of the body
as heart, urine, blood, sweat, stomach, etc.
8. Note symptomatic condition in the history of the patient and try
to form a diagnosis that will explain the symptoms. This is sometimes called
the method of exclusion. In getting the history, get life history of the
disease normal, as well as abnormal, try particularly to trace out the
progressive development by (a) symptoms, (b) by changes in the patient
as a whole; that is, if at one stage the patient lost appetite or the reverse,
(c) by remission in the condition of the patient, that is, the reassertion
of tendency to normal. Try to find out how the history of the disease processes
taking place in the development has been modified by what the patient has
been doing in the meantime, eating, resting, etc. There are direct and
indirect differential methods; in direct method all symptoms point in one
particular part of the body. In indirect method we differentiate weak,
weaker and weakest organs. The value of this differential diagnosis lies
in the field of therapeutics, there is an absolute rule which has no exception
namely that all symptoms disappear in reverse order to their appearance,
the last symptom disappears first. Note whether symptoms are at harmony
or at variance with one another, in order to see whether the organism as
a whole or only a part is disorganized, or whether one part is antagonistic
to another part. The most serious condition is where one part is antagonistic
to another part, in this case work to CO-ordinate.
Based on Mechanic and Physiology; not anatomy.
1. Treat each case as if it were a particular
case. How can you make an application to a particular case? It must
be based on a theory of the disease in that particular case. It is of importance
to find out whether the case is vaso-motor, lymphatic, nervous, cerebro-spinal
or gastro-intestinal or intoxication and the treatment is always directed
back towards your theory. If the case is lymphatic or cerebro-spinal give
general treatment, if the lymphatics are weak treat down.
2. In the treatment object is not to replace
but to adjust structures, activities or environments. Articulation is the
basic principle of treatment; in doing this:-
(A) Articulate spine to
adjust spine to the ribs in
this way always reach general blood and nerve supply.
Always articulate spine to set ribs. Each individual tissue has its own
mobility and articulate in relation to contiguous tissues.
(B) The objective point
in treatment is not to relieve a symptom or soothe a condition of
pain or remove pressure or irritation, but to make the patient, as a whole,
better. There is a tendency in osteopathy to treat only in one field; to
get the best results treat as a whole.
Always remember that manipulation is a mechanical means towards a physiological
end. Physiology is the foundation of life and unless treatment is
directed towards the physiological it is no good to patient. A mechanical
treatment to be effective must be converted into a physiological equivalent.
(D) Sometimes necessary
to give general treatment, in
this case the specific treatment will not cure. The lesions in many cases
are secondary, the spine is not only the origin of disease but also the
expression of disease. There are several conditions that call for general
(1) Cases in which find general superficial rigidity,
here necessary to produce general relaxation. Begin relaxation at a point
as far from seat of pain as possible.
(2) Cases of static condition of general superficial
circulation or some part of the superficial circulation for example pulmonary
congestion. In this case we must stir up the general superficial circulation.
(Treat 2-3 cervical and 2-3 dorsal for eyes). (a) General relaxation of
soft tissue over the body. (b) Strong articulation at 3-4-5 dorsal.
(3) Where the nervous system is in a state of in
CO-ordination or some part is under or over-active, or where some superficial
condition causes the peripheral nervous system to be under or over-active,
in this case stir up the general nervous system, especially in its peripheral
distribution, by articulation of the spine, to get at spinal and sympathetic
(4) The body requires to be prepared for specific
treatment. In nearly all cases whether acute or chronic, it is necessary
to get relaxation of the muscles, ligaments and stimulation of the circulation.
In some cases this general treatment will correct the specific conditions.
(5) Cases of high or low circulation as applied to
pressure, found in about fifty per cent of the cases. Pulse is hard or
soft, Relaxation, followed by stimulation of circulation to and from point
of obstruction, equalizes circulation.
(6) Cases in which local condition depends on general
or some wider constitutional condition, ex., asthma, in many cases the
fifth rib on right side is involved, depending on condition, but the correction
of the fifth rib may not remain corrected or the fifth on the right side
may cause displacement of the fifth on the left side. Reason is that behind
the local condition there is a constitutional condition, namely, condition
of the spine or the general lung or chest expansion. The treatment called
for in this case is treatment of the thorax as a whole, a general respiratory
(7) In hyperemia, hyperdilatation or hyperacidity
localized in some particular field as stomach or liver, the reason that
this requires a general treatment is that this involves not only the stomach
or liver secretion but also the entire secretory system.
(E) Treatment should not
be too hard, lighter treatment if it satisfies the condition is
better. The force of the osteopathic treatment is a matter of skill. Physical
force results in bruised tissues or straining of the soft tissues. The
proper treatment of even bone takes place through the attachments of soft
tissue, the vital element in the adjustment of the body structure is the
The best method of adjusting structures is that of articulation,
this applies to bone, muscle, cartilage and even blood and nerve supply.
It is not good policy to push a bone back into place forcibly, and in pushing
a structure into place it is not good to tear or rupture structures. (Referring
to Dr. Lorenz's method of tearing tissues to set dislocations). Articulation
is the best method, because first it results in no injuries to tissues;
and second, articulation always appeals to function, the primary law of
tissue life is mobility. This applies to both organs and tissues, most
applicable in the field of gynecology. In gynecology lay down this one
principle; the less you can do of local treatment the better
in the replacement of the organs. Let the organ itself alone unless it
is so displaced as to require replacement and probably not one in a thousand
need this. The organ if displaced is disarticulated. Apply the articulatory
treatment to the attachments of the organ, this applied to the uterus,
kidney, spleen, etc. In the replacement of the organ or in relieving the
adhesions of the organs depend on:-
(1) Supports and attachments of the organ.
(2) Depend on nerve supply controlling activity of
the organ, every organ has vaso-motors; stir up this action.
(3) Depend on blood supply. (To restore free circulation
between the uterus and rest of body is rotation of limbs. Pelvic congestion.
Rotate fifteen to twenty times inward to relieve venous statis, then outward).
(4) Correct internal cavity pressure, this is done
by (a) toning up the muscles and attachments of the organ; (b) correct
the adjustment of the organ in relation to the trunk of the body and to
the organs. The more you work on the organ directly, the more it loses
its tonality. If an organ is in an atonic state it will never stay in its
place. The uterus is not supported by its ligaments, the anatomy of the
uterus and its attachments demonstrates that they are lateral and downward,
not upward. This means that the uterus, instead of being a supported body,
is a floating body, and the only way to correct the uterus is to restore
the normal condition of the structures represented by the abdominal and
pelvic cavities. In this tubular structure of the pelvic cavity, the floor
is the perineum, and the roof is the stomach and the intestines. The same
principle applies to the kidneys, the liver and the spleen.
(G) Each case must be treated
as an individual case.
(1) In many cases one cannot diagnose condition if
by that is meant giving it a name. The point is to get the cause and if
there are several causes differentiate between them as to primary and secondary.
(2) The patient is to be treated as a whole, that
is, in treating a particular condition deal with the patient as an organism,
ex., in typhoid fever, do not deal with the small intestine alone,
but deal with the derangement of the entire secretory apparatus; in pneumonia
relieve entire lymphatic system. This is the only way you can reach pneumonia
and if you can stimulate this strongly enough your patient will get well.
One of the best symptoms is the appearance of perspiration. Why do we have
to reach this lymph system? Because of differentiation of the vaso-motor
in pulmonary field.
(3) When all the typical lesions in the etiological
field are found, classify as to primary and secondary and then begin to
treat secondary so as to get back gradually to the primary. For ex., in
appendicitis we have behind the condition, constipation, liver disorders,
dyspepsia, and the appendicitis is a complication that develops in connection
with these preceding conditions. There are many cases in which the one
(i.e. primary) is treated without the other, for ex., in appendicitis you
must remove the cause. There is no such thing as "Recurrent Appendicitis"
either the primary or the secondary condition only has been cured
and the other condition remains, you must remove the cause. Remove the
last appearing condition, the main point is to get rid of the secondary
condition before we deal with the primary. The removal of the primary cause
without the removal of the secondary, as a general rule, will cause some
complication. A complication implies first that the original disease is
not cured, and second, that the disease is side-tracked along some weaker
lines of organs or structures or functions. There are some cases in which
we treat the primary before the secondary condition. Summary in one
general rule:- in all cases where secondary condition represents chronic
condition resulting from or kept up by original acute condition, the original
acute has become the chronic. Two exceptions to this:-
(a) The chronic of previous acute primary; example,
curvature of spine of traumatic or organic origin; primary and tertiary
conditions on the basis of toxic conditions, ex., curvature of the spine.
It may be classified under two different headings, traumatic and organic.
The organic is more frequently found being caused by some original weakening
of some organic structure. In this case condition persists and we must
get back to the organic cause, and not depend on articulation of the spine,
which is the secondary condition. Tertiary conditions may come up, that
is, acute manifestations of previous conditions, for ex., syphilis, in
this case proceed as above. No use to attempt to cure the acute manifestations
leaving the original conditions in primary form, remove that and then work
down through the chronic and double chronic.
(H) In treating patient
always make patient assist in treatment,
this does not necessarily mean the assistance given by the patient at the
time you are giving the treatment. Here distinguish between active and
Active of two types:
(1) Absolutely active in which the patient assists
certain passive movements, ex., the patient assists relaxation of the muscles
of the abdomen by the active contraction of the muscles of the abdomen.
Illustration, while kneading muscles have patient hold the breath, breathe
deeply either exhale or inhale. Deep breathing when expanding the lungs.
Passive treatment is given by the operator
with the patient purely passive, this is the typical osteopathic treatment.
Have your patient hold breath while inhibiting over the abdomen. The assistance
of the patient is mainly in the field of exercise. The active exercise
field is a field which as yet is undeveloped, chief point to note in this
field is that:
(1) Exercise should always be prescribed for patient
(2) The exercise must be physiological, not physical.
(3) In dealing with muscles it is necessary to exercise
certain groups as in paralysis, locomotor ataxia, here we have to re-educate
muscles on the same principle that a child is taught to walk. In some cases
of paralysis one of the manipulations is stretching the muscles to be followed
by some kind of active exercise, that will bring the will power down into
the muscles. In this case best thing to do is first make the muscles do
the work involuntarily (passive movement or treatment) second followed
by making patient attempt to do it voluntarily while it is done involuntarily.
For example, to touch the forehead with the hand, first lift the hand to
the forehead (with patient passive) so he will understand just what you
want him to do, then have the patient determine to help you and try with
all his strength as you slowly lift the arm the second time. Same applied
to body as to arm and limbs and different parts of the body.
Suggestion as a therapeutic means or agent. Here
we have auto-suggestion and aleino-suggestion. Suggestion is a means
of reaching the voluntary side of the organism. Simple suggestion is applied
continuously. Suggestion is not necessarily applied in the hypnotic sense,
yet it is the same, no matter by whom it is applied.
(1) In the application of suggestion the main point
is to make the suggestion as simple as possible, also the suggestion must
conform to the individuality of the patient.
(2) In the use of suggestion, where the mind is involved,
use the strong part of the mind to help to strengthen the weak part of
the mind. If a patient has a hobby or is a maniac along one particular
line try to open up some new field in his mental conception and perception.
(3) Use suggestion to replace the principle idea
in the mind by a substitute on a similar plane ex., when some people are
sick they are sure they are going to die, give them something definite
to life for (mother and her child, mother must live for her child). You
cannot make a negative suggestion do any good.
Remember the strongest method of influencing is by
suggestion; that is why it is good to make a patient adhere strictly to
a particular day or hour of the day; it is the suggestive part of it, also
the same in treatment. Make the patient think only a certain time to take
treatment will do, it will strengthen the individuality of the patient.
In prescribing exercise always prescribe for the
weaker parts of the organism, ex., paralysis is a disease which affects
the motor side but paralysis nearly always starts on the sensory side.
In paralysis the sensory side is the weaker side. Paralysis seems to come
on suddenly when it in fact takes weeks, months and sometimes years to
come on. The sudden onset of paralysis is the transference from sensory
to motor side. Paralysis comes on suddenly when it comes on the motor side,
but slowly on the sensory side. Make sensory stimulation the basis of movement,
example, heat. The hypersensativeness of the muscle is the basis underlying
the condition behind the paralysis. If you get the condition in the hypersensitive
stage limit the hypersensativeness either from the active or passive side.
Example, if the muscles are hypersensitive over-exercise them because that
takes away the excessive impulses for example in writers cramp treat it
osteopathically and make patient begin to write with the other hand, this
takes the strain off the hand with the cramp and puts the strain on the
other hand. In cases of hypersensativeness where the arms get sufficient
exercise or where both arms are involved in cramp, give exercise for the
lower limbs. Consequently in the field of diagnosis the test of muscles
in paralysis is the test of reflexes. Test for sensitiveness or the degree
of sensitiveness various ways test is applied:-
(1) Use of heat and cold
in minute form called heat pencils and cold pencils.
(2) Pricking or pinching
the tissues done by forceps.
(3) Dynamometer test, the
principle is to get grade of work a muscle can do in so many meters.
(4) Ultimate test of muscle
is the electrical test, this is used to discover the presence or absence
of degeneration. Physiology calls
it the negative variation of the muscles. Principle of this is that if
the central nervous system is cut off from the peripheral nervous system,
consequently no positive reaction when electrical test is applied, but
get a negative variation. This is the test for locomotor ataxia. The curability
or incurability of locomotor ataxia depends on whether the central nervous
system is involved, if the central nervous system is involved the case
is incurable, if the peripheral nervous system is involved the case is
curable, no matter how long it has been developed. The last point is in
connection with sensitiveness or hyper-sensitive. Test by pressure or friction.
Limit the hypersensitive condition either from passive
or active side, example, in the hypersensitive state the muscles get more
stimuli than they should, consequently:
(1) Exercise other muscles
to take away impulses from hypersensitive muscles and distribute them.
(2) To overcome hypersensitive
(a) Inhibit directly over
the muscle itself.
(b) Stir up other muscles
not involved by means of some passive treatment as kneading, rubbing etc.,
having patient in passive condition. One reason for the existence for these
conditions is toxemia, the toxic elements depositing:-
(1) In the field of the
(2) In the field of the
(3) Greatest evidence of
this toxemia is found as a reaction in the tetanic condition of the muscles.
The net result is congestion of the nerve where it leaves the spinal
foramen enlargement. Hot water palliative in writers cramp. Put hands in
water as hot as can be borne. There the nerve leaves the spinal foramen
enlargement, the result is that the passage of impulses is prevented to
and from the central nervous system. This leaves the peripheral arc complete
but the peripheral 1 central arc broken. Example, apply electricity in
case of locomotor ataxia at the point of the spine involved (this point
is the point of the highest girdle pain) the result is there will be motion
of the muscles in the lower extremities and this motion cannot be controlled
by the patient voluntarily.
Traumatism in some point in the peripheral system
is the same as toxemia, this also may produce locomotor ataxia. In the
majority of the cases the primary cause is obstruction involving blood
circulation, and in the earliest stage can be treated by CO-ordination
deep and superficial circulation. (This also applied to pneumonia). This
is the secret of aborting diseases in whatever form it appears, that is
if you can diagnose a disease when it is in its primary form it can be
aborted by controling circlation either capillary superficial and deep
circulation. Diseases can be aborted if we can get the disease in the blood
stage of its symptomatology before it has passed on to the stage of neurosis.
The secret of abortion of diseases is in CO-ordination, in some cases CO-ordination
is difficult because of the natural defects of certain circulation fields,
example, pneumonia as a tendency is present in every one because of two
(a) The vaso-motor condition of the lungs is imperfect
in every one.
(b) Because of the inequality between the systemic
and pulmonic circulation. This is the reason why from the osteopathic side
lay so much stress on circulation of the blood and this co-ordination of
the spine. In co.-ordination from spine we attend to circulation:-
(a) From its vaso-motor side.
(b) In connection with the splanchnic or visero-motor
(c) Through sympathetic system in relation to the
spinal cord circulation itself.
Note: 1/100 part of the blood is in spinal cord.
The oasis of the spine is the sacrum and is the point
from which to work in diagnosing and treating spinal lesions.
There are two centers of gravity lines:-
(1) With reference to the
body anterior posterior.
(2) With reference to the
body from side to side.
Owing to the locking of the lumbar vertebrae there
can be but five lesions of the lumbar. (1) Posterior. (2) Rotation.
(3) Separation. (4) Inpaction. (5) Tilting. Anterior or lateral lesions
In the dorsal there may be a sixth form. (6) Lateral.
Same in cervical, except, axis
is only one that can be anterior with reference to one above. Atlas is
only one that can be anterior with reference to one below.
Acute always shows tissue lesions and usually
Chronic cases always have bone lesions.
To set innominate.
(With reference to bodies of vertebrae).
To reduce lumbar rotation, - patient seated on stool,
stand on side of concavity and with one arm grasp upper chest of patient
and give flexion and extension while the heel of the other hand makes pressure
on the prominent transverse processes on side of convexity. Give thrust
just when the patient is relaxed.
Patient on table. To correct by holding spine of
vertebrae above the rotated one. Place patient on side of rotated spines
up. Have assistant take upper arm of patient and draw it to the front and
down, putting the spine on a firm stretch. The operator stands at back
of patient with one hand hold the spine of the vertebrae (right above the
lesion) from below, with the other he takes the flexed legs and after getting
relaxation rotate the whole pelvis and lumbar region below the other hand,
this throwing the rotated vertebrae back into line.
Not good practice to try to give this correction
from the other end of spine because you could produce lesions in the dorsal
In the field of diagnosis
the first point is the condition of the scalp. Two possible conditions,
hyperrigidity and hyperelaxation. Main point in relation to scalp in is
relaxation to headaches, best way to treat the scalp is at the back of
the neck at the base of the occipital region.
1. Congestive Headache:
This is commonly caused by rigidity of the scalp.
Here the rigidity is accounted for by "Head's Law" congestion of blood
and cerebro-spinal fluid in the cranial cavity, this involves:-
(a) The venous blood fields represented by the sinuses.
(b) The meninges of the brain particularly the pia mater.
(c) Ventricles of the brain and subarachnoid spaces, in relation to lymph
cushion. In this congestive headache
there is partial suspension of the three rhythmic movements and of the
peristaltic movement of the brain substance. Rhythm of systole of heart.
One corresponding with the inspiration part of respiration. One corresponding
with vaso-motion, all over the body. Basis of reflex headache 3rd, 4th,
5th dorsal, 2nd dorsal to 2nd lumbar. In differentiating between different
factors that come in connection with congestive headaches, the type depends
on which form of blood and cerebro-spinal fluid predominated:
Venous blood involvement caused general fullness all over the head,
a sense of fullness with sensation of stupidity and ache, from within out,
following particularly along the longitudinal sinus.
(2) Pia mater involvement
or arterial blood condition gives patient pain within the head from
without in, from the superficial towards deep portion of the brain. Here
symptomatology of congestion, example, epistaxis, blood shot eyes, stupor,
dizziness, fainting etc.
(3) In the cerebro-spinal
fluid involvement find delirium, unusual or horrible dreams, rigidity
of the suboccipital region and sense of weight, (distinguishing symptom)
in the head as if the head were actually being weighed down into the neck.
Treatment in dealing with these conditions:-
(a) Always begin by relaxing
muscles from base of neck to occipital region.
(b) Relax the scalp from
suboccipital to forehead in giving this treatment:-
(1) Light rolling treatment
with fingers, followed by deep inhibition all over scalp from the base
of the neck upward.
(2) Vibration following same
path, friction in place of vibration if it does not cause special pain.
(3) Rotation of the fingers
over the scalp rotating the tissues as much as possible, beginning at the
base of the head.
(4) In cases of dry scalp
(dandruff) apply rubbing or friction or vibration before giving inhibition,
(before (1)) in giving this give in stroking fashion.
(5) In the dry scalp also
stimulate the lymphatic for head over the transverse processes of 5-6-7
cervical vertebrae upward (7-6-5) by articulation.
(6) If the scalp is exceedingly
relaxed begin by giving strong inhibitory treatment. In this case begin
at forehead and move towards base of occiput.
(7) If the relaxation amounts
to congestion give strong inhibition in the suboccipital region of the
neck before giving (6) treatment.
(8) Extreme relaxation indicated
by general lymphatic derangement, the blood congestion being produced by
reaction from lymphatic system, in this case:-
Treat lymphatics by strong inhibition before treating sub- occipital in
order to drain away lymph and lay down basis for relieving congestion 7-6-5
Also raise clavicles, first, and second ribs, using the arms as levers,
diagonally out and upward.
Treat downwards and towards and through the thoracic region from the 7th
2. Pressure Headache
When the involvement is within the cranium, main
point in relieving brain headache is to reach the circulation to and from
When the brain is over supplied with blood begin treatment by giving strong
pressure between suboccipital and forehead tipping the head backward at
the same time, this backward movement of the head starts the cerebro spinal
fluid in second and third lumbar begin at that point.
Follow this by strong vibratory treatment (good in paralysis), following
the path of the longitudinal sinus, posterior to anterior.
Vibratory treatment around the sutures this reaches the sub arachnoid spaces
and the lymph channels, the reason for this is that the brain is built
on lymph fluid foundation. All through life brain tests on lymphatic and
the direction of both blood and lymph is determined by lymph cushion. If
this cushion is kept soft and in a fluid condition, the cycle of movements
of the fluids in the brain is kept normal; if on the other hand, the cushion
becomes rigid (as in intoxication), or if it rises upward from the base
of the brain, then the fluid circulation within the brain is interfered
with; treat by vibration over the sutures and pressure from sub-occiput
Strong vibration right over the forehead itself will reach frontal sinus
and the circle of Willis if it is made deep enough, this circle of Willis
represents the center of the brain circulation. Use the hands, never use
mechanical vibration in connection with the head in relation to the brain.
In relaxing the muscles of the neck do not treat patient sitting up in
cases where there is heart trouble because liable to disturb heart and
cause vertigo. Always test for yourself for possible presence of vertigo,
have patient standing, then move head around laterally as far as possible,
then shut eyes, then turn head back to normal and open eyes, other side
the same way, if vertigo is present will stagger when eyes are opened.
In treating this type -
(1) Strong inhibition over muscles of the neck either
by catching at the centre of the muscle and by stretching it or by general
treatment downward along muscle from its origin. (Frees blood supply).
(2) In most cases of headache of this type there
is a thick layer of fat in the basi-occipital region, relax by inhibition
and kneading from back of ear towards the posterior median line. In treating
muscles treat upward from base of neck give circular movement from antero-lateral
aspect of neck to postero-lateral, then up towards and over head.
3. Lymphatic Congestive Headache
This is due to congestion of lymphatic fluid, here
the congestion is outside of cranium, especially in the neck, the headache
in this case is the reaction from the excess of lymph contiguous to the
Treatment in this case:
(a) Pressure between occipital
region and forehead, tilting head backwards as far as possible. Apply pressure
from anterior to posterior, note that it is not from posterior to anterior,
but from anterior to posterior.
(b) Stimulation of the circulation
of arterial blood by friction or vibration or both over forehead just above
eyes to reach Circle of Willis or articulation of the neck or rotation
of the head or stimulation of the carotids or all of these in combination.
(c) Stimulation of lymphatic
circulation by articulation of the 5-6-7 cervical vertebrae, rotation and
elevation of clavicle and first rib.
(d) This is analogous to
what is called the "jag headache", you can overcome the effects produced
by alcoholism if you treat in the delirium trements condition, the after
effects, or the headache is a semi-coagulation of the cerebro-spinal fluid.
Treat this condition same as in alcoholism, that is stir up lymphatic system
all over body.
(e) Through treatment, articulation,
in lower dorsal and upper dorsal simultaneously, lower dorsal and upper
lumbar simultaneously, this reaches cerebro-spinal fluid. Drain cerebro
spinal fluid out of brain. Rhythm of brain controlled by cerebro-spinal.
4. Vaso-Motor Headache
In this case the head is either anemic or hyperemic,
the congestive condition involving the blood. Always reaction to vasomotion
Treatment in anemic headache.
(a) Begin at 4-5 dorsal relaxing
spinous muscles upward to occiput. Patient on back.
(b) Follow this by relaxing
scapular and interscapular muscles.
(c) Articulation of the vertebrae
from 4-5 dorsal upward.
(d) Give scalp treatment
from posterior to anterior.
(e) Articulate hand on neck.
In regard to the hair one thing to note in dryness
and falling out of the hair is not to treat too often, to treat too often
increases the tendency to fall out because the reaction from the deficient
circulation will increase the dryness of the hair. Do not treat more than
once a week.
(1) Treatment of the scalp once a week so as to produce
relaxation of the scalp, best methods in treatment are vibration and circular
rolling movement of the fingers over the scalp.
(2) The hair aught to be washed about once in two
weeks and always by the use of salt and water slightly warmer than tepid
water, this will cause absorbtion of the water and salt which tends to
restore color and tonicity. Dry by means of a course towel or flesh brush
(not electric brush), rubbing the hair until dry, not using any artificial
heat. Give sun bath after the hair is dry, drying the hair in the
sun bleaches it and causes the hair to fall out.
(3) Do not use any ointment or lotions. In regard
to the use of oils, where the hair is excessively oily use alcohol or lavender
water for cleansing the hair, if it gets sticky use eucalyptus water in
connection with warm water bath. If hair and scalp is dry use olive oil
not on hair but on scalp or use "glycothymolin" heated with warm water.
(4) In hyperemic condition give similar treatment
in reverse order, instead of stimulation give inhibition to scalp from
anterior to posterior, from subocciput downward instead of up, strong inhibition
in lower dorsal region, sweat and lymphatic fields. Where there is too
great relaxation of the scalp find rigidity of the facial muscles, for
example, in many of the types of neuralgic headache the vice versa of this
is also true. In treating headache of this kind first begin by relaxing
facial muscles, same true in treating the scalp:-
(a) Inhibit facial muscles
until relaxation obtained, in any case of muscular rigidity, if you want
to get permanent results, you must inhibit in the long muscles as nearly
as possible in the centre of the muscle, follow this by
(b) Inhibitory treatment
followed by slow rotating treatment all over scalp from anterior to posterior.
The reason why you begin at the anterior is because the rigidity is anterior,
along the facial muscles.
(c) Articulation of the spine
from the 5th dorsal upward towards occipital region.
Note: - In neuralgia of the face the best thing to
do is relax the facial muscles. Hair exuding a fluid substance from itself
- use alcohol or lavender water.
Muscles of the Face
These are rigid in neuralgic headache, laryngeal
troubles, bilious conditions, diseases affecting the salivary glands particularly
when parotid gland is involved, hyperrelaxation of the scalp, hyperemia
and enema of the brain.
In cases of facial muscle rigidity there is concentration
of the muscles of the face, the focusing center of contraction being the
angle of the jaw (inferior angle). This causes a drawn condition of the
face towards the angle of the jaw, sometimes taken for facial paralysis,
example, in some cases of biliousness there is sometimes almost a paralysis
of the facial muscles causing an effort in opening the mouth.
(1) In this case articulation of the spine upward
from lower dorsal relaxing spinous muscles at the same time, here vaso-motor
field for the face.
(2) Relax the facial muscles by application of tension
at the angle of the jaw on opening the jaw. Stand at the head of the patient
and catch with your fingers under the angle of the jaw, and pull up tight,
have patient try to open the mouth, it may be impossible to open the mouth
but the effort will tend to relax the muscles.
(3) Give inhibition followed by rotatory treatment
of the facial muscles beginning at the forehead along the angle of the
nose, and treating downwards to the angle of the jaw.
1. The face and facial muscles are involved in many forms of diseases,
example, in all pulmonary troubles, in acute tuberculosis and in pneumonia
a drawn condition of the muscles of the face the center of origin of drawing
or the focusing centre of contraction in this case being the chin, so that
you have what is sometimes called a "pointed face". In this case give same
treatment as in previous one:
(a) Beginning with spinal
(b) Follow by treatment to
open up the circulation.
(c) Treatment to relax muscles,
inhibition and rotation ending at chin instead of angle of jaw.
2. The facial conditions are also found in gastro-intestinal and pelvic
disturbances, in all of these there is a tendency to a drawn condition
of the face, the focusing centre being in this case the forehead, so that
you will find the facial muscles drawn up towards the forehead, the "drawn
forehead" it is sometimes called. In this case give similar treatment instead
of downward treat upward. (Palliative).
3. In some cases have to treat headache through the facial muscles,
in these cases the headache is reflex and in some cases the headache takes
in only part of the head, example, in bilious conditions find drawn condition
of the face almost always on the left side, that is to say in acute form
there is a condition exactly like hemiplegia, there is one different point,
the movement of the tongue, there is no interference in that case with
the movement of the tongue. In biliousness the tongue is dry, you could
not depend on that as a differential point. In some cases the focusing
centre is altered, example, sometimes the tongue. In biliousness we find
at times two centres, one facial the other the tongue.
4. Another condition we require to take note of, the drawn condition
of the muscles of the face the contraction passing to the scalp, and the
region of the occiput becoming the focusing centre. This is found as an
important diagnostic point in all nervous diseases particularly where the
spinal cord is involved, this is exaggerated in spinal and cerebro-spinal
meningitis, where the tension of the head is so great that the head is
To overcome this:
(1) Articulate dorso-lumbar region, beginning at
the 9th dorsal articulate downward through the lumbar region. There is
a static condition of the cerebro-spinal fluid, the congestive condition
starts at the cauda equina. Outside of the nervous disease proper you will
find this contraction at the back of the head, that is the focus in the
scalp rather than in the occiput, this is a typical condition in Frysipoles.
(2) Relax muscles and articulate vertebrae upward
from lower dorsal to sub-occipital region.
(3) Articulate (flex, rotate, etc.) the lower extremities
to stir up circulation in the lower extremities and to and from the trunk.
(4) Treatment of the facial muscles taking the forehead
as the focus of contraction (that is treating up towards the forehead).
(5) Scalp treatment from anterior to posterior. Many
of the cases appending acute nervous diseases could be aborted by following
this line of treatment.
Dr. Hamlin's formulae of stimulation and inhibition
and results as shown by sphygmomanometer.
1. Stim. 1 to 6 c - Vaso-constrict - H.B.P. - L.P.R.
2. Inhib. 1 to 6 c - Vasi-dilation - L.B.P. - H.P.R.
3. Stim. 6 to 12 d - Vasi-dilation - L.B.P. - H.P.R.
4. Inhib. 6 to 12 d - Vasi-constrict - H.B.P. - L.P.R.
5. Stim. 4 & 5 L - Vasi-constrict - H.B.P. - L.P.R.
6. Inhib. 4 & 5 L - Vasi-dilation - L.B.P. - H.P.R.
Stimulation of the 6 and 7 dorsal, increases blood
to stomach, increases secretion.
Inhibition of 6 and 7 dorsal, decreases blood to
stomach, decreases secretion.
The two great fields of eye
disturbances are represented by:
(1) Vascular disturbances, extending all the
way from simple congestion to complete atrophy of the optic nerve.
(2) Interference with the nerve supply,
producing symptomatic conditions of the eye really not eye diseases.
Eye diseases in the proper
sense of the term are but symptomatic conditions of the eye. Among the
causes of the eye diseases classify:
(a) Traumatic including direct
injury to the eye.
(b) Injuries to the head
causing reflex disturbances in the eye.
(c) Osseous and ligamentous
lesions in the cervical and upper dorsal these vaso-motor and those in
the upper cervical sensory.
(d) Muscular of soft tissue
contractions or relacations of upper dorsal these vaso-motor and those
in the upper cervical, sensory.
These last two (c) and (d) represent obstruction
to either blood or nerve supply or both. In regard to blood supply, the
supply to the eye comes from the opthalmic artery, a branch of the internal
carotid; the drainage of the eye takes place through the ophthalmic vein
which unites with the jugular vein along the side of the nose, this jugular
vein drains into cavernous sinus at base of cranium, outside of the oranium
drainage is established -
(1) Through the internal jugular.
(2) Through the subclavian and innominate veins.
(3) Superior vena-cava in relation to the heart.
It is very important to keep in mind the accessory
drainage of the eye which serves the best purpose in drainage of the eye
from the mechanical side when nature is weak, that it is an emergency field,
drain through the superior and inferior palpebral veins and through the
facial vein into the internal jugular, emptying tinto the internal jugular
just below the angle of the jaw. This will explain why we treat down towards
the angle of the jaw in the treatments of the eye.
The muscles of the eye
The muscles of the eye act in opposition to each
other (a) in changing the focus of the eye; (b) in determining the accommodation
of the eye to light; (c) the muscles also act as protectors of the eye
chiefly through the eye lids, that is, by opening and closing the lids
to protect the eyes (1) from foreign substances; (2) excessive light; (3)
The principle nerves in connection with the eye are
the optic, motor oculi, patheticus, abdusens and branches of the facial
nerves, also sympathetic fibres in connection with the superior cervical
ganglion and first dorsal ganglion of the sympathetics, the medium through
which these nerves are distributed being the lenticular ganglion. The central
origin of the nerves is in the medulla, the medulla representing three
(1) The vital processes of mobility.
(2) Co.-ordination of movement in determining accommodation,
(a) centrally from the medulla, (b) coordinately from the cerebellum, the
optic thalami and corpora quadrigerrina (space or angularity of vision).
(3) The reflex centre field particularly in antagonistic
action of the muscles to overcome abnormal changes in the eye.
The medulla therefore as a centre is self adjusting
in relation to the eye.
The lesions found in eye disturbances are 1-2-3 cervical;
2-3-4 dorsal; 3-5 cervical posterior. Third dorsal representing cilio-spinal.
Fifth cervical to fifth dorsal representing anterior condition of the whole
field. The atlas is nearly always involved in congestive conditions of
the eye, granulation’s etc.
The muscular disturbances are of the nature of strabienus
following supra and infra orbital nerve field indicated by tenderness over
foramen, forehead and facial tension. The contraction of the forehead is
intense. The optic neuritis involves engorgement of the veins with involvement
of the sheath of the optic nerve.
Reflex lesions. We get reflex lesions in the congestive
and muscular conditions of the eye, example, lesions in stomach area, uterus,
ovary, heart, intestinal, etc. there are two types of lesions:
(1) Original lesions corresponding with the visceral
disturbance; is transmitted (a) through sympathetic system, (b) through
the spine, (c) blood in change of pressure, (d) special sense nerve.
(2) The reflex lesion corresponding with the eye
involvement generally this is nervous and blood involvement’s as in toxemia’s,
(disturbances as in chronic constipation).
General points in regard to eye treatments.
(1) You can get a more direct effect upon the eye
by treatment than any other organ in the body, that is by direct stimulation
(2) Inhibitory pressure on the back of the neck,
2-3 cervical field represents visceral contraction field. This is given
on both sides of the spinous processes causing dilation of the pupils of
the eye, this is a very important point which renders it unnecessary to
use, as oculistedo atropine. In the average case the dilation will be kept
up from three to five hours by an inhibitory treatment, this varies in
individuals, some retain the condition longer than others. Determine the
length of the inhibition by the response, there may be blood causes that
you must correct by equalising the circulation, but in average case you
will get immediate results.
(3) Relaxation by inhibition followed by strong stimulation
of the muscles at the angle of the jaw, to stimulate the flow of blood
away from the eyes, if the eyes are in a state of congestion.
(4) If the venous blood is in a static state of if
there is stasis of the lymph fluid strong inhibition at a point just beyond
the external canthus of the eye will establish drainage from the eyes,
outer angle of the eye one half inch towards the upper angle of the ear.
This applies to lymphatic conditions of the eyes as puffy eyes except where
caused by kidney conditions. If the condition is associated with the kidneys
treat through the kidney. Puffy eyes generally indicates Bright's disease,
though it may be diabetes, if from the kidneys the urine will show albumen,
there is a tendency to become bluish. In both Bright's disease and diabetes
the patient may become blind, in Bright's disease due to accumulation of
fatty substance, in diabetes to cataracts. Taken in time it is curable
by elimination, in many cases of diet, you can cure up a diabetes eye temporarily
by dieting, when organisation takes place it is necessary to operate.
(5) Strong inhibition of the second and third dorsal
causes dilation of the eyes, this applies to (vasi-motor) the pupils of
the eye. Stimulation at the same point will cause constriction. This is
not true of (3) because at the second and third cervical there is only
a dilator centre. Here (3-4 dorsal) there is rhythmic center of visero-motion
in connection with the eyes. In this dorsal field we have a typical dilator
and constrictor centre called the cilio-spinal centre, 2-3-4 dorsal taking
in the entire field. Note this: - the strongest effects are gained
by treatment on the right side because these fibers distribute themselves
through the sympathetic system. In this distribution two things to note:
(a) Third dorsal nerve sends
out fibers passing through the sympathetic system to the muscular fibres
of the iris. Rib relation to eye, 3-4 rib, common lesions.
(b) The fourth dorsal nerve
sends out fibers distributed vaso-motorily to the blood vessels of the
eye; hence, the third dorsal nerve gives direct muscular dilation, the
fourth dorsal gives vaso-constriction hence inhibition of this fourth
dorsal nerve causes vaso-dilation.
(6) The sensory fibres to the ciliary muscles, the
iris and the cornea come from the nasal branch of the opthalmic branch
of the fifth nerve, hence in cases of pain in the eye inhibit the fifth
nerve along the side of the nose close to the eye, will relieve pain except
in optic neuritic.
(7) The accessory sensory fibres pass in connection
with the short ciliary fibres from the ciliary ganglion (just back of eye).
In this case pain is caused by over-stimulation of these ciliary fibres,
causing a change of arterial pressure in the eye, this is relieved by inhibitory
pressure in connection with the ciliary ganglion, lay the finger over the
eye ball pressing eye ball gently back into the orbit against the ciliary
In summing up from the above treatments we find that:
(a) Nervous pain is relieved
by treatment along side of nose and in general along face. (Manifested
along muscle field).
(b) Blood pain is treated
directly over ciliary ganglion, pressure over ciliary ganglion.
(c) Neuralgia pain of the
stomach reflexed to the eyes is relieved by treatment along side of nose
or any part of the fifth cranial nerve. This means that eye troubles can
be traced back to the nerve and blood field as the direct fields of causation.
For example, blood pain, congestive conditions -
for example uterine congestion, or in connection with congestive headache,
would be relieved by direct pressure over the ciliary ganglion through
the eye ball itself. Give splanchnic treatment also. The direct causes
of trouble in the eye can be traced to the regions that supply the nerves
and blood to the eye. The indirect causes are to be traced to reflexes
from diseases in other parts of the body as the abdominal and pelvic organs.
Any soothing treatment to system will react beneficially on eyes.
The eye processes the most delicate nerve mechanism
in the body, and as such is more liable to derangement than any other organ
or structure in the body, particularly when reflexes react on the nervous
of Eye Troubles
Here we have a condition in which the eye ball is
too long and the rays of light are focused in front of the retina. All
children are born with the condition of hypermetropia, the eye developing,
under normal conditions, from the hypermotropia to emmetropia, the normal
eye. If the child uses the eye too much or if the eyes are subjected to
strain the eye balls enlarge slowly and as they enlarge the elongate with
the result of myopia.
Among the causes of myopia development is the effect
caused by light thrown upon the eyes in the wrong direction or wrong angle.
The light should be thrown over from behind or in front, the light to be
thrown upon the eye in diffused form not so that the light will strike
the eyes as direct rays. Another cause is the strain of the eyes by long
continued use or close work, the stooping or sitting posture in children
produces congestion resulting of softening of the eyes. The first part
to suffer is the sclerotic coat this is the part of the eye that maintains
the form or shape of the eye ball, it is the stroma of the eye. When the
sclerotic coat looses its tension there is change of tension in extra-ocular
muscles and this produces a lengthening of the antero-posterior diameter
of the eye ball, if this goes on without check the softening continues
and myopia results.
Hence there are two conditions involved here: -
(1) The extra-ocular (tension) muscles, modified
(2) Intra-ocular substance softening, that is
excess of fluid.
Myopia should yield quickly to treatment unless there
is thickening or hardening of the sclerotic coat.
(1) Patient should be fitted temporarily with glasses
to maintain a restful condition until nature removes the abnormality, the
glasses remove tension of the muscles and thereby make treatment more successful.
(2) Correction of the tensions, 1st cervical, 3-4
cervical, 2-3-4 dorsal reflex fields.
(3) Co.-ordination of the circulation applied to
blood and lymph circulation of the eye.
(4) Vaso-motor treatment, namely, articulation in
the vaso-motor field of the eye. Constrictors 2-3-4 dorsal, dilators, 2-3-4
(5) Co.-ordination of functions that tend to react
upon the eye. Thyroid gland, lungs, muscle system.
Here eye ball is too short in antero-postero diameter,
the result is the eye requires an extra effort to focus the rays of light
upon the retina; consequently the after effect of hypermetropia is strong
tension on the extra-ocular muscles. The ommetropic eye (the normal eye)
is absolutely at rest, and, like the heart, we ought not to be conscious
of the existence. In hypermetropia there is a conscious effort to keep
the eyes fixed, that is, in fixation on the object of vision, this fixation
uses both the intra- and extra-ocular muscles. The cause, therefore, of
hypermetropia is exaggeration of the congenital condition of the eye or
of the nerve supply.
Causes that exaggerate this congenital condition
(a) Too rapid development
of the brain in early child life keeping up continued congestion of blood
in the head area.
(b) The reaction of gastric
and intestinal diseases upon the eye causing reflex disturbances, sometimes
in connection with the teeth.
The hypermetropic eye is a much more serious condition
to deal with than myopia because it may ultimately end in insanity. Among
the symptoms are pain on top of head, the lower part of the neck, with
nausea, vomiting, gastro and intestinal disturbances etc. The first symptoms
of irritation of hypermetropia is slight itching of the eyes, this sometimes
is a burning sensation. This symptom can be relieved by palliative treatment
slight pressure on eye ball inward or gentle manipulation of the muscles
around the eye or orbit.
(1) Palliate symptoms (a) pain, vortex pain, this
represents vaso-motor condition therefore go to vaso-motor area. Inhibit
splanchnic - follow with articulation down the lumbar. (b) Irritating and
itching sensation in the eyes, this is a secretory motor condition relieved
by stimulation of the secretory processes in and around the eye, example,
stimulate glands both lacrymal and meibornian glands.
(2) Corrective treatment from structural standpoint.
Increase antero-postero diameter by pressure between the two canthus
(3) Establish drainage from the eyes by pressure
at the notch beyond external canthus this is primarily from lymph side,
follow this by pressure along the side of nose and downward towards the
angle of the jaw represents venous blood.
(4) Stimulate strongly circulation to and through
eyes by treating blood field directly at 3-4 dorsal (articulation).
(5) Correction of lesions in cases typical, 4-5 cervical
(sympathetic also filed of ophthalmic goiter) and 2-3-4 dorsal (vaso-motor
In this case the rays of light entering into the
eye in one meridian are not focused at the same point as the rays that
enter from the opposite meridian, the result is the blurring of a particular
part of the field of vision, both for near and distant vision, or for one
There are two types of astigmatism:
(1) a condition of the cornea in which we find different
degrees of curvature in the different meridians, the most common
is where the horizontal curvature is greater than the vertical curvature.
(a) Congenital malformation,
a very common one and easily cured in the child stage. Examine after 3rd
or 4th year, the child's eye is myopic before and up to about the 3rd or
(b) Spasm of the muscles
of the orbit of the eye results in either contraction or tetanus this causes
(c) Tumor in orbit of eye
either blood or fat tumor just back of eye ball.
(d) Ulceration in cornea
or sclerotic coat.
(e) Scar tissue formation
result of abscess, accident or operation cornea or sclera.
(2) Second type of astigmatism is astigmatism caused
by spasm of the extra-ocular muscles or In CO-ordination in action
of these muscles or intra-ocular pressure example increase of blood pressure
or accumulation of fat around the eye orbit.
The first type is called corneal astigmatism, the
second type is called lenticular astigmatism. In the first type the trouble
is in the cornea, in the second type in the lens, the lens being unable
to index in all its parts at the same time, or with the same degree of
inequality. The reason for this is the lens is made up of three sections
and each section may have its own degree of density therefore if the density
is unequal in the three sections there will be a corresponding inequality
in the refraction.
There is a third type, asthenopia, is a weakened
vision and is very painful.
(1) Main point is in connection with vaso-motor system.
Vaso-motion to the eye originating in the medulla the fibers passing down
along spinal cord to 2-3-4 dorsal nerves and then passing out along white
ramie to the sympathetic chain distributing fibers to the eye from the
cavernous and carotid plexuses through the sympathetic chain in connection
with the ophthalmic division of the fifth cranial nerve and also through
the long ciliary nerves. The medulla nerve trunk is tonic, that is constrictor.
This passes down into the spine and distributes:- (a) Fibers through the
1-2-3-4-5 cervical nerves to and through the superior cervical ganglion,
these represent the sensory fibers. (b) Establish connections with the
fifth cranial nerve and are distributed through the ophthalmic division
of the fifth cranial nerve and (c) through the long ciliary nerve. The
centers for pupils of the eye are (a) the superior cervical ganglion and
the first five posterior spinal nerves representing the sympathetic side
of sensation, (b) the spinal or cerebro-spinal center is dilator center.
This local or regional centre is dilator and located at the 2-3 dorsal.
That center is simply and purely dilator, it is specific in action. Explains
why we get the rhythmic center at 2-3-4 dorsal.
(2) The treatment of astigmatism depends on whether
it is complicated by myopia or hypermetropia. A simple (not complicated)
case of astigmatism depends on In co.-ordination of the ocular muscles,
spasm of ocular muscles, paralysis of some of the muscles. The causes of
these mechanical conditions are generally reflex, unless there is a congenital
defect in the structure of the muscles. The majority of these cases are
curable (meaning by majority those that are reflex) and the cure depends
on the restoration of the tonicity of the muscles. The congenital types
are perhaps incurable, because it is impossible to alter the form or structure
assumed by them. There is a very small percentage of congenital cases.
Hypermetropia is congenital, but there are far more cases of astigmatism
than either myopia or hypermetropia.
(3) Correction of the lesions in the case, 1-4 cervical
and 1-4 dorsal and occipital-atlantal lesions.
Here condition in which the lens of the eye becomes
hardened and opaque. Have two types of cataract (a) cortical type which
is practically incurable, (b) muscle type caused by mechanical obstruction
to nutrition in the eye. Nutrition is governed in this case by the tunic
coats of the eye ball, hence disturbed nutrition has some relation to those
(A) Disease in which there is an abnormal accumulation
of substance in the blood, example, toxins of scarlet fever, measles, smallpox,
sugar of diabetes, albumen of Bright's disease. In this case the toxic
substance must be eliminated. Many times the elimination of these toxic
substances will cure the condition.
Here are three lines of treatment.
(1) Local circulatory treatment with object of flushing
the eye with blood by persistent articulation of the cervical region upward.
(2) Vaso-motor stimulation of the circulation aside
from the correction of the lesions of 2-3 cervical, articulation of the
3-4-5 cervical stimulates contractile and dilator function.
(3) Drainage of the eye from the venous side. Drain
the eye from the outer canthus downward towards the angle of the jaw.
(B) Second type of cause is traumatism
This may be either local in the eye or in the spine.
Under the head of traumatism include lesions, that is, a lesion, if it
is the primary cause of the condition, is a traumatic injury, for example,
find lesions 1-2-3-5 cervical, injuries or lesions involving the 7th cervical
and 1st dorsal, in this latter case you have a lesion or direct injury
interfering with the vertebral blood circulation. Overcome the traumatism
or correct the lesion, and follow that up by stimulation of the circulation.
If you have the cataract developed, that is, solidified, you must deal
with that after you have corrected the circulation.
In the cortical type nothing can be done outside
of surgery to remove the lens. There are some methods that are recommended
by some people as being of service in some cases, but it is a question
whether anything can be done or not. Absorption can be obtained even in
very severe cases, there is a German preparation that is used to absorb
cataracts, made of mountain and honey and aloes (Father Kneipp). Those
cataracts call for persistent treatment, not general but specific treatment.
Here we have an increase in the ocular pressure,
there are two forms:
(1) Acute form
Comes on suddenly with acute pain in the eye and
sudden loss of vision, it is really a spasm of the vaso-motors and therefore
can be relieved very quickly by vaso-motor treatment to stir up the vaso-motor
system (rhythmic). Condition not generally one that depends so much on
osseous lesions as muscular condition in the back of the neck. Glaucoma
in the right eye generally involves muscles on the opposite side of the
neck. Acute glaucoma will develop into inflammatory conditions.
(2) Chronic type
This type comes on slowly and has two symptoms:-
(a) bulging out of the cornea, (b) increase of tension of the eye ball.
Patient will complain of eye ball squeezed on every side, that is, increased
tension, a feeling like being squeezed in a vice. The chronic drainage
type is a congestive condition of the eye, due to lack of drainage from
the anterior chamber of the eye, in addition to this there is an excess
of fluid in connection with the vitreous humor of the eye; the obstructive
condition is probably always found in connection with the Schlemm's canal,
that is, the canal that establishes drainage from the anterior chamber
of the eye and also the vitreous humor of the eye. the cause may be a lesion
in the cervical region, correct the lesion and give tonic vaso-motor treatment.
If the chronic case is a long standing case it will perhaps stimulate or
become optic atrophy. Many of the so called cases of optic atrophy are
simple chronic glaucoma, and if you relieve the tensions you can relieve
the condition; if it is kept up the sight is lost because of the tension
and the accumulation of the fluid in the eye the light is prevented from
getting back to the retina. The eye is not beyond repair unless it is long
continued so that the retinal portion of the eye has begun to degenerate.
In glaucoma the eye generally looks healthy except there is no normal elasticity
and can get no normal reaction to light at least in the chronic type. In
the acute there is deficiency of vision, in chronic type there is no vision
at all. (Dr. L. has cured cases in which vision was gone, but no optic
6. Optic Neuritis
Here we have inflammation of the optic nerve caused
by extension of the inflammatory process from some other field, meningitis,
albuminuria. Also a type produced by pressure or tumors. There is also
a type caused by excessive contraction of the muscles in eye strain. Also
a type reflex from suppressed menstruation, gastric irritation, ptomaine
poisoning, alcoholism, morphinism, cocainism. In this last (cocainism)
there is apparalytical condition.
In diagnosis of optic neuritis use the opthalmoscope
test for congestion. The optic neuritis may be symptomatic in deep seated
diseases of the brain. In using opthalmoscope look for a congested condition
of the retinal arteries and veins. In diabetes and Bright's disease it
is one of the first physical signs. In arterial sclerosis it is also one
of the first signs.
(1) Engorgement of the veins amounting to venous
(2) In the secondary stages thickening and softening
of the veins and nerve fibers.
(1) Palliative. Rhythmic vaso-motor treatment to
relieve congestion given in upper dorsal region 2-3-4 dorsal.
(2) Give palliative treatment for congestion along
the same lines as drainage of the eye and get back to irritating cause.
(3) A traumatic cause in lesions of the cervical
region especially at the 3-4 cervical for example in many cases following,
the toxemia of epilepsy, in practically all cases of apoplexy, whooping
(4) Best line of treatment is articulation from upper
cervical downward this will relieve pain associated with engorgement and
7. Optic Atrophy
Here have condition seldom found. Among the causes
here obstruction or pressure in connection with the optic tract or nerves
in optic tract field, by tumors, in optic nerve lesions in cervical vertebrae
1-2-3 particularly. This is what is called primary optic atrophy. The secondary
type is found in connection with tabes dorsalis.
8. Optic Neurosis
This is a reaction of the optic nerve to embolism
of the central retinal artery and in some cases spinal cord degeneration.
One of the first signs is dimness of vision, the only absolute test being
ophthalmic examination of the retinal membrane.
(1) Fifth cranial nerve. (1st and 5th cervical).
(2) Sympathetic nervous system especially the superior
(3) Lesions in the middle cervical vertebrae field
3-4-5 cervical, here have connecting link between optic neurosis and optic
In cases of developing optic neurosis best results
are gained by palliative tonic treatment.
(1) To sympathetic chain from first dorsal upward,
stimulation. Paying particular attention to superior cervical ganglion
in order to get viscero-motor control over the eye.
(2) Stimulation of the 5th cranial nerve at the angle
of the jaw and Gisserion ganglion.
(3) Direct treatment from the orbit of the eye down
to the ciliary ganglion to effect the ciliary ganglion and ciliary fibers.
(4) Inhibition to relieve hypersensativeness, (a)
the inhibition of the eye over the eye, (b) inhibition all around neck
and down long spine.
(5) If the inhibition does not control the spinal
neuritis sufficiently to check optic neurosis then articulation of the
ribs is called for.
(6) The curvature treatment of the optic neurosis
depends on the continuing of the palliative treatment with correction of
the lesions that may be found as causes particularly 3-4-5 cervical. (until
complete balance is established in eye field).
9. Inflammation of the eye
Two types, primary and secondary.
The primary is due to traumatism or some specific
lesion involving the blood or nerve supply to the eye, that is in any of
the eye regions in the spine, in the neck or even around the eye itself.
Secondary or reflex (a great majority of inflammations of the eye are reflex)
in connection with pelvic conditions, general nervous debility, incoordination
in the distribution of the blood, especially following or accompanying
Diagnosis in inflammation is generally easy because
of pain, heat, itching, prickling sensation, irritation, nearly all of
these are present. Resulting from the inflammation we may find tertiary
adhesions following degeneration in the cicatricial or scar tissue formation.
In these cases practically the only thing that can be done is operation
on the eye for the removal of the adhesions. Cut out the little adhesions,
and bring parts together to get the connective tissue formation.
(1) Always use some antiseptic in treatment of inflammatory
processes in the eye "Alphozone" is the best. A very good antiseptic is
boric acid, if you do not have complications; but the Alphozone is stronger,
it is the best antiseptic in use at the present time for inflammatory conditions
in the eye, you can use it internally as well as externally as it is non-poisonous.
In typhoid fever give it in a glass or half glass of water to render the
alimentary canal antiseptic. One of the advantages over boric acid is that
while boric acid is an irritant to the eye Alphozone does not irritate.
(2) Protect the eyes from the
light by the use of the simple pebble glass, this is a glass that does
not have any special refractive power but is used simply to shut off the
rays and keep them from falling on the eye. Do not use dark or smoked glass
unless there is hypersensitiveness in the eye. Pebble glass has no magnifying
element in it.
(3) If the patient is myopic or hypermetropic
take off the correcting lenses and substitute the simple pebble glass,
and have patient wear them all the time. The pebble glass is soothing to
the eyes and prevents the rays of light from falling on the eyes.
(4) Do not shut patient in a dark room as the medical
men do. Darkness is an irritant itself, the rays of light in a dark room
that are not taken away, not permeated by a white light, are worse for
the eyes than the light. Blue light is good, any color except red is good,
violet is the best color that we have (we can seldom get the real violet
color), green is also good.
(5) Attend particularly to the hygienic and nutrition
of the patient. The nutritive irritation or irritant is carbohydrate food
substances, therefore reduce the carbohydrate food substance to a minimum.
Note: - Eliminate all cereal foods in all conditions
of the eye, the only one that can be used is oatmeal and this not oftener
than once a week.
10. Conjunctivitis - Under inflammations
(1) Relaxation of the muscles of the neck downward.
(2) Articulation of the vertebrae, 1-2-3 cervical,
2-3-4 dorsal (vaso-motor field) and the correction of the lesions in that
(3) Direct local treatment to the conjunctiva membrane
itself. This given by:
(a) Extension or stretching
of the conjunctival membrane by placing the fingers between the inner and
outer canthus and pulling apart. This also brings a tension on the cartilage
and ligaments of the eye.
(b) Light tapping over eye
lid followed by light pressure.
(c) Where the conjunctival
membrane is freely injected with blood or thickened by accumulation of
blood, squeeze the eye lid gently between finger and thumb, pull the eye
upward and inward and give your treatment in that direction, begin at the
outer canthi and pull the lid toward the inner canthus, do not pull it
in the opposite direction. You require to pull out the conjunctival membrane
it is generally tight around the edge, you could not get far in. Wash your
fingers and use antiseptic, the same as in the treatment of the eye.
(d) In case of extreme congestion
of the membrane manifested by a ridging along the conjunctiva in that case
use a constrictant in the eyes, best are "adnophrin", this is the best,
use one drop, or use adrenaline.
(4) Strong inhibitory pressure just external to the
external angular process, continuing that inhibitory pressure down towards
the angle of the jaw, this drains blood from lymph side.
In the case of puffy eyes give this the same treatment
and along with it extension of the head and rotation of the head on its
articulation with the atlas, and of the neck itself downward. Give articulation
of head on its atlas by catching the transverse processes of atlas with
fingers, hold atlas firm while moving head, keep trying until you get some
movement, then go down to the next vertebrae, now move the head on the
atlas and so on down the whole length neck. (Never give rotation with neck
(5) Place the finger on the temple and the thumb
between the atlas and axis and apply pressure at these two points while
rotating the head on the axis and atlas. This is effective in reliving
bloodshot eyes, inflammation and congesting of the eyes.
If the muscles are involved for example tension contraction,
particularly if there is an equality in the tension of the muscles apply:
(a) Give strong inhibition
at the 2-3 dorsal pressing in as deeply as you can at the junction. Then
articulate. This a rhymtic centre to eye.
(b) Follow this by a light
inhibition over transverse process kneading muscles in this region upward
and outward towards inferior cervical ganglion. Following upward from inferior
cervical ganglion to superior cervical ganglion.
(c) Give light kneading treatment
around the orbit of the eyes pressing the tips of your fingers well inward
around the side of the orbit.
(d) Give light vibtory treatment
right over the eye from inner cannthus outward using the first finger.
Exception in lacrymal conditions reverse the order, threat from without
(e) Give light gradually
increasing pressure over the pulloys of the superior oblique muscles, treating
the two pulloys at the same time,and this treatment is especially called
for when you find what is called "Sparks" before the eyes, and in cases
here the eyeball quivers, quivering eye. In quivering of the eye lid this
treatment would not be of any importance, the best treatment you can give
is to stretch the eye from the internal to the external canthus, stretching
the cartilage between the canthi. Superior Oblique coordinates the muscular
movements of the eye.
(f) Give steady light pressure
followed by gentle moving pressures over the tendo-oculi. Locate tendo-oculi
(a)by pulling out outer canthus of eye and then place your finger beneath
the inner canthuus of the eye and press towards the nose and palpate with
the finger until you locate small thready tendon, this tendon overlaps
the lacrymal sac. If the lacrymal sac is full of fluid you may locate the
small sac in this case apply light vibration downward and towards the nose
continuing this along side of nose to point of excretion of nasal duct.
(g) In muscular conditions
of the eye pay attention to the supra and infra orbital nerves, there is
generally hypersensitiveness of the nerves and when irritated get twitching
of the eyes. In this case:
Apply pressure between the finger and thumb right
in connection with the granulation itself, do not apply pressure sufficiently
strong to break the little sacs, but increase the pressure to cause absorption
from within . Remember to have fingers clean, use antiseptic.
If the eye is congested and sore give similar treatment
Relive pain by the application of cold water
to the eye, to do this use cotton In water or sponge or eye cup. Take a
little piece of sponge and wrap it in gauze or absorbent cotton and keep
it on for some time over the eye, put a bandage around the head. Use "thymolin"
to cleanse the lids.
Use milk instead of water (a)in case
of excessive secretion: (b)where there is a whitish accumulation in the
mucus membrane and remember to boil the milk.
Note : In cases of secretory diarrhea one of the
best and most effecient means of stopping that type of diarrhea is milk,
boiling the milk is antiseptic, the lukewarm condition of the milk is also
Another point in the application of the milk is that
it has the power of separating the muccoid secretion from the mucas membrane.
This is applicable in conditions outside of the eye for example in Tapeworm
you can give milk freely and it will separate off the mucoid substance
on the wall of the intestines and is frquently the means of bringing out
the tapeworm, before the fangs of the tapeworm are fastened in the mucoid
substance. For the mucoid substance in the conjunctiva the best thing that
you can do is apply milk, take a piece of white bread and soak in milk
and put over the eye.
In cases of styes use the same thing and in addition
dust the surface with the bread soaked in milk with powdered burned alum.
Incase of destruction of the mucus menbrane, giving you a rare condition
of the eye lid, the best thing to do is to make an application of milk
sugar, grind absolutely fine between two flatirons and use same as burned
alum. This is also a good means for overcoming proud flesh anywhere, will
destroy proud flesh and the saccharine secretions it produces by disintegration
of the proud flesh causes the healing of the tissues. Dust the sugar on
the wounds. Some people use burned alum for thiis purpose but that is not
so good as it is a caustic. Do not use sugar in liquid form.
Growths In The Eye
The Special type of organized growth in the eye is
cataract. In most cases his represents a muscular condition therefore first
point in the treatment is treatment of the incoordination of the muscles.
These developing cataract are quick to respond to treatment. When it has
developed it represents a mucoid substance (a)destroying the normal characteristics
of the lachrymal secretions;(b) accumulation in the lens of the eye over
the surface of the eye,over the pupil,in solid form , this means that the
second point in treatment of cataract is treatment of the lachrymal secretion
to stir it up to normal . A cataract growth therefore is an artificial
development either in connection with the lens of the eye or the surface
membrane of the eyeball. Sometimes it is stimulated by injury to the eye
, in this case it is generally a soft mucoid growth in connection with
the external covering of the eye ball. This represents an accumulation
of the deposit ,here we get white scummy growth all over the eye ball.
The secondary conditions in cataracts are (a) Excessive mucoid secretion
in connection with conjunctiva. (b)Diminished lacrymal secretion.
1. Through drainage in connection with the lacrymall sac the nasal duct.
The best method to drain the eye is to stretch the tendo-oculi,one of the
functions of the tendo-oculi is to drain the lacryal sac. Then vibrate
along the nose.
2. Direct stimulation of the blood supply to the eyes (a) in carotid
field (b) in vertebral circulation field. (c)Vaso-motorily by articulation
of the third and second corvical and 2-3 dorsal.
3. Direct stimulation of the lacrymal gland to increase lacrymal secretion.
Vibrate over joint of palpating finger.
4. In all cases of cataract something abnormal in function of the lacrymal
gland therefore stimulate lymphatic function from upper half of the body.
5. The primary origin of most cataract is some defiency in the gastric
apparatus. (This is the field if the mucus gland secretion). The best preventative
of cataract is normal stimulation of the mucas glands of the mouth and
stomach. The trouble in most cases is excessive action of the mucoid glands
and insufficient action of the thyroid glands therefore stimulate to throw
out excessive secretion in the blood,and it will be carried away by the
6. The reasons why the lesions are found in connection with the sympathetic
a. The sympathetic
systems controls mucoid secretion;
b. Because cataract
always represents a visero-motor distortion either in the stomach or in
the eye field or both.
7. In some cases lesions involving corda-tympani, here deficiency
of the limpid secretion and this by reaction stimulates an excessive mucoid
In the general treatment of cataract four points:
(a) Limit conjunctivitis
conditions (cannot cure it until cataract is removed)
(b) Stir up lacrymal secretion
(c) Up eliminative side of
lacrymation,(Lacrymal sac and nasal duct)
(d) Stir up lymph circulation
of face and eyes by:-
(1) Articulation in lower cervical region.
(2) By stimulation of the lymph glands in the neck
beginning at the lower end of the neck and going upward.
(3) Strong stimulation at small notch at outer canthus
of the eye.
In some cases it is necessary to remove the growth,
these are caisson which the growth becomes so orginised or solid that it
cannot be absorbed.
8. Attend to the antiseptic condition of the eye in the cases of treatment
of cataract. Best antiseptic is "Alphozone"
9. In the cases of the treatment of cataract limit the amount of light
permitted to gain access to the eye and keep the eye as much as possible
free from irritation of the wind.(very important). In regard to the light
determine the amount of light by the effect of the light producing a glaring
effect on the eye and producing the retention of the light in the eye especially
10. Watch for development for the colours in the eye. In treating at
this stage of cataract absolutely blind the eyes. First color to appear
in the cure will be red and then all the other colours of the spectroscope
in order, when violet reached then the next is white light. Test the eye
in blindness to fine out if cataract is curable by one test,especially
that at the 2-3-4 dorsal. Twist the spinal vertebrae at this point as strongly
as possible and you get sparks before the eyes(see stars) the colour of
the sparks will sometimes determine the stage. If the sparks are seen the
case is curable. For a more minute test use the electric test,a strong
electric current by placing the pole on forehead between the eyes, when
current is turned sparks will appear before the eyes, if the case is curable.
The above two test are very valuable. You can test the eyes frequently
to see if both eyes are being cured equally. The same applies in optic
(Fasting essential. Two or three days at a time.)
The principal field of lesions in diseases of the
nose are in the vaso-motor area:-
(a) Sympathetically 1st
to the 6th dorsal taking in the superior and middle ganglion.
(b) Cerebro-spinal 2nd,3rd,4th,and
5th dorsal representing the vaso-m otor and the visero-motor.
All of these originate in the vaso-motor paresis.
(c) Reflexly in relation
to the diaphragm 9-10 dorsal and corresponding ribs. Brachial and asthmatic
at 3rd,4th and 5th ris and vertebrae.
Gastro-intestinal 5th-7th dorsal. Mucas membrane
in any field. Ovarian 12th dorsal; 1st,2nd,3rd
(d) Nasal affections in connection
with cerebral and meningeal disturbances, e,g, through cerbro-spinal fluid.
Inflammatory conditions of the brain. Here we have subocciptal lesions
Of the diseases of the nose the most common is hemorrhage,
epistaxis. The best method to stop a general hemorrhage from the nose is
by strong inhibition, inhibitory pressure at the 6-7th cervical
and the 1st dorsal. Inhibitory pressure at the outer tips of
the transverse processes, where you catch the vertebral arterial circulation.
Throw the head of the patient well back and give lateral movement from
side to side while continuing this pressure. As an aid to this treatment
use the ice pack in the lower cervical region, never apply over the head
as it does not do any good, apply to neck.
In vicarious Hemorrhage in connection with menstrual
(a) Give same treatment as
(b) Inhibitory treatment
in lower splanchnic
(c) Inhibitory treatment
in sacral region, object of this is to try to establish a congestion in
the abdominal and pelvic area. Do not give the rotation and flexion of
limbs because that tends to drive the blood away from the lower part of
In the case of rupture in the posterior naries apply
inhibitory pressure through the mouth in posterior naries, if this fails
insert plug of cotton(absorbent cotton)through the mouth. Use plug about
the size of the first movable joint of the thumb of the patient. (this
can be done with middle finger; wrap cotton around the finger).
Some cases of rupture can be treated directly in
posterior navies field, in addition to this give splanchnic and sacral
treatment, and keep the patient in a semi-sitting posture, bolstered up
Catarrh of the Nose
1. Give local treatment around side of bridge of nose, consisting
of light pressure followed by light kneading treatment downward.
2. Try to establish drainage in connection with the venous blood
and lymphatic systems. Drain venous blood from inner canthus of eye to
inferior angle of the jaw. Foe lymphatic apply strong pressure at external
canthus of the eye, continuing the pressure downward along side of cheek.
3. Vaso-motor treatment. Treatment to neck from above downwards,
extend down to the 5th dorsal.
(a) Relaxation of the muscles
of that area.(Palliative treatment for hay fever, use tapping treatment).
(b) Articulation of the vertebrae
in that entire field
4. Look particularly to the condition of the scapula, there is
found almost always in nasal catarrh a one sided rigidity (scapular) on
the opposite side to the side involved. Sometimes both sides are involved,
but not so common as with one side.
5. If the throat is involved you will almost always find an involvement
of the left scapula, rigidity, scapula bound down to the thorax. Also if
there is a cough with the nasal catarrh you will find an involvement of
the left scapula, and in some cases the ribs just below the inferior angle
of the scapula involved . Right scapular involvement when nose without
mouth is involved. Left scapular when nose and throat are involved.
6. A very typical lesion in nasal catarrh is involvement of the
5th rib on the right side, this is a typical lesion found in
hay fever cases. How compare with asthma ? When 5th rib is involved
in asthma it is on the left side.
7. Tapping over forehead light at first then heavier just over
the bridge of the nose is a very good palliative treatment in nasal catarrh.
In some cases you will find a soft (superficial) tissue ridge right up
from the nose over the forehead , also may find tumor masses in forehead
over nose. This is found in what is called the "snuffles". There is a softening
of the cartilage’s, "snuffles" may be an indication of hereditary catarrh,
if found at the time of birth it is one of the symptoms of hereditary syphilis.
Hard breathing in case of "snuffles" can be relived
by this tapping treatment. In grown persons where those snuffles are secondary
to nasal catarrh, or where they come on account of irritation, tapping
on the forehead and throwing the head back, and applying pressure from
forehead to suboccipital will relieve.
8. In irritating the nose use the normal salt solution atomizer
or spray etc. Do not use dry salt. Salt solution is also good in hemorrhage
from the nose. Pine oil pinoleum is valuable in catarrh or in hay fever.
Where there is suppurative tendency of the nose use eucalyptus oil in spray
for noose 50% solution. In irritated conditions of the nose in hay fever
and catarrh use gum camphor liquid in pure Vaseline
9. In chronic forms saturate small sponge with eucalyptus oil
and breathe through the sponge. This is of use especially in epistaxis
and incipient tuberculosis. In Diptheritic conditions of the throat the
pine oil is one of the best that can be used . It is a relaxant and has
given good results in relaxing rigid muscles. It is quite frequently used
now by the doctor in dipitheritic conditions to relieve the rigid muscles
of the throat and neck. Also used internally. If it is impossible to get
pure pine oil use pure pineapple juice. Pineapple juice is an antiseptic.
Sometimes in osteopathic treatments there are cases where you cannot manipulate
the muscles to relax them, they are sometimes to sore that you cannot reach
them and you must have something to use. At such times use the pine oil
or the eucalyptus oil as a relaxant, eucalyptus is best used in combination
with olive oil in ratio:
Water and eucalyptus oil 1-25 makes a good solution
for rectal injections in intestinal catarrh or in any inflammation.
The most common condition of the ear are catarrahal
deaf-ness, nearly always secondary to a general catarrh or some general
condition or some toxic condition of the blood for example secondary to
an resulting from measles, tonsillitis, scarlet fever or diphtheria. In
Toxic condition of the blood representing a slow and sluggish circulation
and thick blood
(1) Atlas, axis and third cervical, principally atlas
representing cerebro-spinal type.
(2) Vaso-motor lesions 4-5-6 cervical and 2-5 dorsal.
(3) Lesions involving the ear through the throat
especially where Eustachian tube involved lower corvical and upper dorsal,
visero and vaso-motor field of the throat 5-6-7 cervical and 1-2-3 dorsal.
The evidence of these ear conditions are crackling or buzzing sounds in
the ears or noises in the ears indicating Eustachian tube involvement either
closure or Quinzy; 2nd beating sound like a hammer sounds indicating
verso-motor disturbance here the ear becoming dry and shriveled, this indicates
secretory condition and at this stage the is a clear sizzling sound (instead
of beating sound).
Where both ears are involved you will find generally
an atlas lesion either anterior or posterior, on both sides, the real lesion
being occipital relation, occiput to atlas. Where one ear only is involved
the most common lesion is anterior lateral or postero-lateral lesions of
the atlas to opposite side to the ear that is effected. In this case there
is a rotated and twisted atlas and therefore the lesion is atlanto-occipital
and in other cases is occipito-atlantal.
According to this where two ears are involved the
primary trouble is suboccipital, where one ear is involved the trouble
is atlanto-axial (that is an articulation between atlas and axis).
Mouth and Throat
Correct lesions, that is one case in which correction of lesions is generally
almost specific in relation to secondary conditions of the ear.
See that the muscles and soft tissues around the ears are thoroughly relaxed,
using the external auricle of the ear(gently) to relax the muscles etc.,
use it as a lever.
Pay particular attention to the structures around the mastoid process,
because the function of the mastoid cells is to equalizes the pressure
of air between the Eustachian tube and ear. In most cases of ear involvement
you will find a thickening or hypertrophy or infiltration of the mastoid
The best treatment for (3) is vibration and tapping right over and around
the mastoid cells. If you get the patient to give the ear a good relaxing
treatment to the soft tissues around the ear ever morning it will help
the case considerably. Sometimes periodical paraxyeme can be found and
those can entirely overcome by this treatment , vibration and tapping.
These operate through circulation and through vaso-motor side.
In mastoiditis be careful not ot treat mastoid process too severely, and
give relaxing treatment away from mastoid into the neck. The reason for
this is that the mastoid is so thin that there is liable to be absorption
through the almost membranous structure into the ear and brain. If it develops
into delirious conditions there maybe an operation. This absorption is
what develops delirium in mastoditis. Do not use vibration over the mastoid
process, but vibrate with fingers.
In all ear troubles remember there is a relation between the eye and the
ear. This relation is especially through the sympathetic systems via, the
ciliary ganglion and superior cervical ganglion.
Pay particular attention to the sterno-Mastoid muscles on the same side
as the involved ear. In cases where there is ear trouble one good thing
to do is to always to treat the two mastoid muscles (sterno-mastoid) simultaneously,
give kneading relaxing treatment so as to stir them up to coordinated action.
In abscesses involving the antrum of highmore there is generally a connection
of antrum and mastoid or abscesses condition of the ear. In this case treat
directly over antrum by inhibition and vibration. (b)By pressing downwards
towards the angle of the jaw followed by good rotation of the head and
follow this by through lymphatic treatment in the glands of the neck and
lower cervical region.
The principle condition to be dealt with is the condition
of the mucus membrane and the gland; (1) secretory conditions,(2)visero-motor
conditions from the side of peristalsis in mucus membrane; (3)circulatory
conditions; for example, rupture,varicose veins, dilated arteries etc.
(4)accumulations or deposits in connection with the mucus membrane or glands,
for example leucoplasia as a preliminary stage in carcinoma of the tongue.
(1) The principle treatment in connection with the
mouth is internal treatment around the lower part of the mouth, under the
tongue, towards the back of the mouth at the base of the tongue. This is
applied in cases of excessive salivary glands secretion (inhibition) or
diminished salivary secretion in which case give stimulation.
(a)Sympathetic through superior
and middle cervical ganglion of sympathetic in relation to solid secretion.
limpid side of secretion.5-7-9-12 cranial nerves, spinal nerves 1-6 cervical.
In excessive secretion give inhibition and in diminished give stimulation.
(3) Local treatment in excessive secretion. With
your fingers apply steady pressure backward towards root of tongue all
over the internal surface of the mouth, follow this by inhibitory treatment
around the lower jaw externally both in the upper part of the jaw and underneath
always applying the pressure towards the base of the tongue.
(4) In diminished secretion give light moving or
kneading pressure both in the mouth and outside along the lower jaw,always
backward towards the base of the tongue, also articulation of the 3-4-5
cervical, strong stimulation over superior cervica ganglion follow this
by treatment called opening the mouth against pressure. "Catch the inferior
angle of the jaw and make the patient open the mouth against your attempt
to keep it closed.
(5) In catarrh of the throat the mouth is always
involved, secondary to the catarrh. In this case inhibit superior cervical
ganglion which increases salivary secretion and washes away mucus.
(6) In sore throat where the mouth is involved secondary
to tonsillitis and pharynx similar treatment to back of mouth and root
of tongue moving the fingers around upward and backward towards base of
(7) Relaxation of the muscles in the neck, direct
vibration over the tonsilar region externally, followed by kneading treatment
from anterior median line towards mastoid process, amd then downward to
region posterior to sterno-mastoid muscles. Object is to catch chain of
(8) Where you have the condition of tonsilier enlargement
and swelling it is as well to use some antiseptic, because the condition
is so to develop and spread (autoinfection)use "alphzone" in addition to
this use boric acid real hot (boric acid solution), white of an egg in
water especially In intense inflammation. If the inflammation is high use
the white of an egg alone. Putting the white of egg right on the inflamed
tonsil, use it like a plaster and it will remove the inflammatory condition.
Hot boric acid or lemon acid is useful in canker of the mouth. Use the
white when cracks in the mouth, same true when have cracked or bruised
skin anywhere, as the egg coagulates it becomes like skin and acts very
much like colodian. Where there is any heat the egg also controls the localized
heat and congestion. When have bruises and rupture combine white of egg
with powdered white sugar. If tissue in mouth becomes gangrenous use peroxide
of hydrogen. Do not use the peroxide of hydrogen in other case then gangrene
as it will cause the condition to go down in the eliminatory canal. Listerene
is not so strong as the peroxide of hydrogen hence not so valuable in this
In the throat find similar conditions to those found
in the mouth, that is involvement’s of the mucus membranes and the glands.
Treatment: - General:
Secretory conditions. Over or under secretion in the mucus membrane and
Visero-motor conditions from the side of peristalia in the mucus membrane
and other organs of the throat.
Circulatory conditions, foe example ,rupture, varicose veins, dilated arterties,
congested mucus membranes followed by thickening of the mucus membrane.
Accumulation of deposits in the mucus membrane, or glands. (sometimes resulting
(1) One of the main treatments is articulation of
the neck with the patient either in the sitting posture or lying on the
(a) Patient in sitting posture,
stand at the side of the patient, place one hand over the vertex of the
head, and with the other hand catch the transverse processes of the cervical
vertebrae, beginning at the 7th or 1st dorsal, and
atriculate up. Articulating by the push and pull movement and follow this
by rotary movement of the neck against resistance of the head .Stand at
the back of the patient (patient sitting) catch the transverse process
of the 7th cervical in one hand between the finger and thumb, and with
the other hand rotate the head. If the neck is very stiff put the arm around
the head and give same movement. Be careful in this treatment
If the anterior structures of the neck are very tight
place the hand over the transverse processes with your finger and thumb,
then apply the rotation of the head and neck as in the other case, and
in addition push the neck and head forward while you pull the soft tissue
Forward. This treatment sitting up is contra-indicated in heart conditions.
(b) Patient lying on the
back, this is always the position when the heart is involved and in some
cases where great rigidity. Extend or stretch the neck by pulling the head
up to the point of moving the body , that is to say , put the entire weight
of the body of the patient into the neck and spine extension. Follow this
by extension with lateral movement of the neck towards the two sides. Then
place the fingers and thumb of one hand over the transverse processes in
the lower cervical region moving the head and neck to the same side with
the fingers on the transverse processes, pulling on the transverse processes
in the opposite direction. Or place the fingers of the two hands on both
sides of the neck, standing at the head of the patient, and give rotary
and lateral movement to the head and neck. Remember to always keep the
fingers back of the carotids.
(2) Patient lying down on back. Place the fingers
and thumb of one hand over the transverse process of the 7th
cervical and apply pressure downwards towards the table and then with other
hand under the occiput move the head slightly from side to side,and then
gradually move the head upward from the table as far as you can and forwards
towards the chest. Do not give jerky movements in throwing the head forward.
(3) In relaxation of the muscles and ligamentous
structures of the neck:
(a) First should always be
(b) Follow this by rotation
of the head and neck on itself in relation to each of the separate vertebrae,
beginning always at the lower part of the neck.
(c) Give direct extension
and kneading of the individuals muscles,sterno-mastoid, trapezius, If they
are loose enough get your fingers in and pull on the muscle, if they are
very tight go to the middle of the muscle and flex the head to the opposite
while you pull on the muscle upward and outward
(4) Active treatment of the head and neck by the
patient, this is given in what is called head circulating; patient begins
to rotate head and neck in a circle gradually increasing the size of the
of The Throat.
In croupy conditions of the throat we have a secratory
(1)Stagnation of the secretions. (2)accumulation
(because of the suspension of visero-motion in mucus membrane)of theses
secretions in connection with the surface membrane. The accumulations may
represent(a)simply exudate as croup;(b)an organized structure here we have
the secretory cell secreting abnormal substance and throwing it out in
the mucus membrane as in diphtheria. (bacteriologists say membrane is produced
by the germs-more visonier then sensory-a true secretion-substance accumulated
and formed into a membrane by secretory cell-a perverted physiology.
(1) Give through extension of the neck and spine.
(2) Relax muscles upward, beginning at the coccygeal
region;to appeal to sympathetic system.
(3) Special attention to the heads of the ribs especially
articulation to stir up the sympathetic system all along the spine.
(4) The croup paroxysms always give rigidity of the
neck, in this case treat spine upward to overcome spasmodic rigidity.
(5) Articulation of the upper dorsal region representing
vaso-motor field. In children be very careful in giving articulation because
structures are cartilaginous. The best way in this case is to give articulation
bu using the shoulder as a lever ,with the child on face.
(6) Through relaxation of the muscles upward along
neck, this give constrictor effect.
(7) Pull up the trachea. Catch as low down as you
can, get the fingers in, then throw patients head and neck backwards and
lift up the trachea. This is very good treatment relaxation of the deep
(8) Open the mouth and pull tongue, using a towel
to catch hold of the tongue. This is good for stimulation of the heart.
(9) As an aid in these cases of croup use pure lemon
juice or better pineapple juice, allowing it to trickle down the throat
or used as a gargle. Do not put this juice on the tongue,the object of
throwing it on the throat is to prevent mixing with silica. Put on root
of tongue, this cuts the membranous formation if applied to the small patches.
If a cough is started by the use of the juice getting into the trachea,
apply powdered milk sugar to the mucus membrane or allow it to drop down
the throat the same as the juice. Sometimes the juice is mixed with powdered
alum to draw out any tendency to inflammation that may be found. These
things can be used as accessory to the treatment, or in times when you
cannot be there. Do not use these things individually, but advise them
until you get on to the scene.
(10) In chronic croup the best thing to use as a
preventive is to saturate the chest and throat with eucalyptus oil and
olive oil in combination using heat to drive it in. Heat the two oils and
apply, have rays of heat right on surface to be applied, keep this up until
you get eucalyptus oil in breath. Use this every night if the child is
susceptible to croup. In proportion of 1/5 eucalyptus to 4/5 olive oil.
(11) Another accessory is steam. Pass the steam through
tan eucalyptus medium, saturate a large sponge with eucalyptus oil and
place it in a large funnel, if that is not at hand roll a newspaper in
the shape of a funnel and put the sponge in and pass the steam through
this. Have the child breath this steam. If goose grease is available that
is the best kind of oil to use under any circumstances.
Goiter represents abnormal activity of the thyroid
gland. In goiter must distinguish first pseudo-goiter, here we have not
enlargement of the thyroid but accumulation of the fluid in the cystic
form or in the isthmus field. In the systic form have typical surgical
goiter, in this case is obstruction to the circulation and that must be
dealt with from the side of the obstruction. Function of the thyroid gland
is detoxination and it may be said that the two gland In opposite sides
of the neck are concerned in arterial and venous blood and in normal conditions
there is in coordination of circulation and removable of whatever obstruction
causes localization. (2) True goiter here the gland is abnormally active
with resultant accumulations. Over functioning of the thyroid causes toxination.
(3)Type in this true goiter. (a) Type that involves parathyroids without
involving thyroid proper. Parathyrois have Mucin functions.(B)Type that
involves the thyroid proper, either subdivision.
The worst condition of the throat that we can have to
deal with is goiter largely because there is the prevision of circulation,
this extends beyond the throat. The lesions commonly found from physical
diagnosis side are(a first rib and clavicle lesions;(B)3-4-5 cervical;
(C) 7th cervical,1-2-3 dorsal.
Enlargement by proliferation of the gland.
Systic enlargement of the gland.
(a) Take the arm of the patient,
(on back) pull up at right angle to the body of the patient, then put the
finger under the clavicle at the inner third, and pull the arm over the
head, and then pull the arm around in a circle, keep it on the same plane
as the body, and throw it right across the chest.
Palliative treatment, relive the tightness of the muscles and make the
goiter floating. Relaxation and vibration around the base.
Relive rigidity of the clavicle, object of this is to relive congestion
of the blood. To relax the clavicle if rigid;-
(b) Take the arm of the
patient. Place the arm resting across the chest at the level of the elbow,
place the elbow of the patient against your chest and catch clavicle at
the outer third, and pull the clavicle while you push down from the elbow,
holding patients arms down tight.
(c) Pull the arm of the patient
across the chest in semi-circular direction around towards the opposite
shoulder, then place the hand over the scalp, hold hand in that position
and apply traction on the acromian process. The clavicle is most tightly
bound on the same side as the goiter, in that case.:-
(d) Pull head and neck of
patient over towards the side as the goiter (laterally)as far as you can,
then take the arm of the patient and pull up to the right angle to the
body, drop it down at an acute angle to the axilla ,and while dropping
it down give it the shaking vibratory treatment,and let it go down slowly,
at the same time pull head and neck of patient down slowly, at the same
time pull head and neck of patient to the opposite side. Repeat this three
or four times.
The primary condition is interference with vaso-motor
condition representing excessive stimulation of the vaso-motor dilation.
Normally the thyroid gland stimulates vaso-dilation by its secretion, stimulating
the cerebro-spinal side of the vaso-motor (secretory) results in an accumulation
of the substance we find in the gland or in the cyst of the gland.
In some cases goiter is a reflex from some other
organs, the reason for this is the gland has accessories, (1) in all of
the mucus glands of the mouth, throat, stomach and brain, as these are
accessory to the thyroid function, and as the whole secretion is controlled
from the cerebro-spinal side, there is an excess of mucoid matter in the
blood circulation. When the thyroid is in an abnormal state it is unable
to destroy the excess, this is the cause of myxoedema and edema.
(2) The reaction of all the vaso-dilator field in
the body sometimes produces goiter, for example, the uterus particularly,
in connection with dysmenorrhea at the period of menstrual puberty, also
(b) Reaction of the disturbed
heart or pulmonary condition on the thyroid gland, for example, exopthalmic
goiter.here the heart is in a flabby condition allowing more than the normal
amount of blood in the heart. We deal with this first through the periphery
by construction; 2nd through the heart proper at 2-5-4-5 dorsal.
In goiter then we find:
(a) An involvement of the
thyroid gland proper or
(b) An involvement of the
(c) Cystic condition.
(d) Involvement of the accessories
to the thyroid namely the mouth, throat, stomach, etc.
Remember that the obstructive condition or the disturbing
condition is cerbro-spinal that means always some type of vertebral lesion.
In dealing with the condition of the goiter having found primary or irritating
1.Treat goiter in relation to the general secretion(the lesion is secondary
to disturbed secretion). The first thing to do is to get hold of the general
secretion by treating the lymphatic system. In treating for secretions
look after gastric, salivary intestinal secretions, and the uterine functions.
Most goiters depend on changes in life in the female
(disorganization of internal secretion is the cause).
If silvary secretion is involved, either too much
or too little, all the other secretions will ultimately be involved.
2. Reestablish venous drainage from the thyroid gland particularly in
relation to the clavicle and the first rib. In doing this remember that
is also applies to the entire venous system of the body. In order to do
this we must reorganize the vaso-motor control of the circulation of the
blood, that is it means we must pay more attention to the cerbro-spinal
than to the sympathetic side is exaggerated in its function. To get control
apply inhibition, particularly over the three great cervical ganglions
, this represents the real brain of the sympathetic systems. In dealing
with secretions from the side of goiter we must rectify from cerebro-spinal
side. That is pay attention to the inferior cervical ganglion, because
this ganglion checks, or holds in check, the cervical sympathetic ganglia.
3. In the vaso-motor field look for some localized vaso-motor disturbance
in relation to the ovarian and uterine organs. The liver or spleen or both
. The disturbance of menstruation is not the cause of goiter, the suppressed
menstruation is the result of extreme vaso-dilation over the rest of the
body. The uterus attempting to balance the circulation by its own dilation,
that is the uterine congestion of dysmorrhea is a compensatory condition.
To meet this condition the only treatment Is to establish
control of the vaso-constriction through the sympathetic system.
In giving vaso-motor treatment, there are two points
to be noted.
(a) If you want to reach
the cerebro-spinal side of the vaso-motor, articulate the spine thoroughly
in the dorsal region ,2nd dorsal to 2nd lumber.
(b) To reach the sympathetic
side do not articulate the spine, but articulate the ribs, the heads of
the ribs and the transverse processes of the vertebrae being objective
points of treatment. Also deep manipulation along the spine.
4. In all cases of goiter do not treat directly over the goiter
(a) If goiter is rigid continue
to treat around at the base to make it movable.
(b) Treat muscles in the
neck particularly by extension
(c) As soon as the gland
is freely movable apply frictional vibration to the gland and shaking treatment
to the trachea.
(d) Articulation of the spine
contra-indicated, at least under the vaso-motor treatment.
Here we have field that particular controls a number
of functions. (1 ) All vital functioning, in the field of the ribs, of
the vital processes are controlled through the medulla in relation to the
first five cervical nerves.
(1) Respiration is controlled through the neck.
(a) through the 10th
(b)through the phrenic nerve,
(c) through the third cervical
(2) The lymphatic function, this is in the field
of the anterior transverse processes of the last three cervical vertebrae.
(3) Secretion, chiefly salivary secretion this is
(a) Through Lymph
(b) Through spinal and cranial
distribution to the glands.
(5) Peristaltic movement, this applies to the entire
(6) Visero-motor and vaso-motor in the pelvic organs,
both male and Female.
(7) Control of the entire sensor-motor apparti and
their functions, this applies:
(a) to the whole field of
motion and locomotion.
(b) to the entire field of
General Treatment Of The Neck.
1. Articulate the upper three ribs in order to reach the sympathetic
systems, this applies to vaso-motion particularly.
2. Extension of the neck and spine. First extend the spine and
then stretch the neck by pulling on the head. Break rigidity by articulation,
then apply the twisting movement to the neck.
3. Give articulation to the muscles of the neck by twisting movement
beginning in the upper cervical region. If there is head or neck congestion
relax muscles from below upward and articulate downward in the neck. Reason
for this is congestion is localised condition not dependent on the general
blood circulation but some lesion.
4. Relax sterno-mastoid muscle, place thumb on one side and fingers
on the other and hold these two points and rotate head increasing stretching
treatment antero-laterally. Increase stretching on one side and decrease
on the other and visa-versa until entire length of the neck is twisted.
5. The best method is by articulation for neck lesions, applying
pressure either rigidly or by jerking or twisting movement in the direction
required for the correction of the lesion. Three principles were laid down
before and these apply here in the neck as in any other part of the body.
(a) Exaggeration , in the
neck flexion to the opposite side.
(b) Extension, that is pulling
right out on the neck in exaggeration
(c) Flexion, towards same
side as the lesion maintaining extension. These are the three principles
applied in the correction of any lesion. Applies o ribs, inmominates, vertebrae,
any other part of the spine or any bone lesion in the body
6. Best way to articulate the neck is to catch the head in the
palm of the hands, one on either side and place fingers(index),on the transverse
processes of the same vertebrae, with finger and hand in this position
hold vertebrae and head in fixation, rotates head by the force that can
be exerted by the hands assisted in some cases by the pressure on the vertebrae
or pressure of the superior occipital region against the chest of the operator
take such vertebrae in turn, one by one, and follow the treatment mentioned
above in congested conditions,relax from below upward, and articulate down,
in any case of the congestion of the head and neck, in all other cases
relax and articulate down.
(a) Treat the 10th
cranial nerve in the neck, push neck to one side and extend it a little
then push the carotid artery slightly forward so you can get your fingers
right in behind the pulsation of the carotid, then apply the steady pressure
or moving pressure, to the 10th nerve. There are several points
at which we can reach the 10th nerve:
(b) At the occipito-atlantal
articulation here we catch the 10th nerve unmodified by sympathetic
system,e.g.,on the heart trophic or inhibitory side. The visero-and vaso-motor
functions of the 10th nerve are through the sympathetic at the
4-5 dorsal, the sensory through the superior cervical ganglion ( lower
end 4 cervical)
(c) At the lower end of the
superior cervical anaglion we reach sensory function of the 10th
cranial nerve via sympathetic system, e,g in palpation of the heart stimulate
at this point on the left side.
(d) Just above the clavicle
along side of the sterno-mastoid muscle,here you get effect on the 10th
cranial on the lungs and stomach outside of the sensory function to the
right side only.
(e) At the head of the 1st
rib in its articulation with the vertebrae we get vaso-motor of the 10th
cranial nerve through the depressor nerve function, this is the vaso-motor
side of the 10th cranial nerve. The vaso -motor effect is dilator,
(all cranio-spinal nerves are dilators) .
(f) At the 4th
and 5th dorsal through the sympathetic ganglion at the heads
of the ribs we get 10th cranial nerve on the left side and phrenic
nerve on the right side. These two nerves being correlative at this point
through sympathetic system, the methods of reaching these two nerves is
articulation at the head of the ribs. This is the visero-motor side of
the 10th cranial and phernic nerves.
8. In syphilis, cancer, scrofula enlarged and soft glands,(a)stir
up glands by direct treatment around base of gland to make glands very
movable.(b)As soon as the gland is gloating give treatment to the gland
itself. (c) Use vibration or friction to gland to start up visero-motion.(d)
In tuberculosis of the gland or glands loosen muscles in gland field and
then kneed the glands. This condition we find in chronic hardening of the
gland, this hardening of the gland may be found in syphilitics types and
in bilious types,in the bilious types there is a brown discoloration of
the enlargement. In tuberculosis the gland is hardened but not bound together
like a solid mass, it is like a soft pulpy condition. In cancerous and
sorofular glands there are irregularities in the internal part of the glands,in
treating be careful not to get over the gland in any of these types. In
simple hard gland that we get in a cold or sore throat we have a history
of colds or tonsillitis or something to differentiate it from tuberculosis..
In this case we have a simple hard gland any kind of treatment is indicated.
Direct treatment . In tuberculosis where we have
enlarged glands or cancer it is not advisable to treat in any local way
the gland itself but remove it surgically unless there is a septic condition
of suppuration that endangers the organism
9. In case of Boil and Carbuncle, (a)differentiation between boil
and carbuncle is that the carbuncle has roots which are imbedded in that
tissue, under the living tissue, where as a boil has localized base without
roots. (b) In carbuncle there is infection or danger of infection, in boil
there is not. Nature tries to shut in the process of pus formation and
pus accumulation. In the carbuncle the walls become imbedded in the tissues.
It is the wall rather than the carbuncle proper that forms the roots, if
a carbuncle is taken in time the growth of these roots can be prevented
because roots belong to the wall and not to the carbuncle proper.
Treatment of Boil and Carbuncle
1. Cause the boil to be reabsorbed unless in the case where it
has already pointed in that case it must be removed or opened to let out
the pus. Pus unless infected is always sterile, hence no danger In reabsorbation
into the system. We find boil, e,g,in cases where body is intoxicated with
malaria without any bacteria or germs or where system is intoxicated by
rheumatism and diptheritic poisons.
2. Stimulate circulation to and through parts affected.
3. Give good eliminative treatment.
1. Apply treatment to root of carbuncle and keep soft tissue softened,
use oil (Antiiphilogistine, etc.).
2. In absorption of the boil keep tissue soft, stir up blood and
lymph supply to stimulate the absorption process, assist this by pressure.
3. In case of infection of the pus drainage must be established.
In determining whether there is infection, it is determined by temperature.
4. Another method is using ice loosely over he boil.
5. In the case of drug poisoning this can be dealt with by antidotal
6. In the surgical treatment of boil all that is necessary is
incision and drainage. In the carbuncle you must cut out the root or the
sac. The old surgical method of aborting a boil was to bind a piece of
ice with gauze over the boil or carbuncle. In the surgical removal of boil
or carbuncle best to use some local anesthetic, as Ethel chloride. In small
abscesses, e,g, abscesses that come out on the face or neck secondary to
some infection or contagious disease treat by keeping soft tissue loose,
pressure around and over abcess. Treat internal abcess in the same way
as abcess of the stomach, small intestines etc. In the cases of abcess
take away all fluid from the patient foe three or more days (cause the
lymphatic system to operate as washing fluid to wash it out of the system).
Give absolutely dry food, ( uninfected boil or abcess, dry diet. Infected
boil or abcess plenty of water).
In case of boils on the forehead or face, these are
found as post menigeal disturbances, also hydrocephalus, also in hereditary
syphilis and gonorrhea, in those cases where the scalp becomes the eliminative
canal, cause the elimination externally and use surgical means to have
them drained out.(Head is the favourite point for these types of hydrocephalus).
In this case give patient "wet" food and deal with as a surgical abscess.
Note: - In chicken pox where papules have intense
itching use some mild acid as weak vinegar, carbolized Vaseline, etc.
Boric acid is the best thing to use in the case of
hives. "Glycothymoline" also good.
1. Position and examination.
Patient sitting on stool or table, make patient take
position himself (to get easiest position to himself). In the first examination
of the patient have the patients hands resting lightly on the anterior
surface of the limbs, to get the normal position have the limbs far enough
apart so that the femurs will be exactly parallel.
Three or four inches apart.
(a) In the examination
and treatment of the scapular and the interscapular between the 2nd
and the 6th dorsal, the sitting position is best because this
gives the natural position of the body and the trunk. There are three sets
of muscles that cone into prominence, the trapezius, latissimus dorsi and
serrati muscles. Trapezius and Latissimus play in opposition to one another,
for example, there is contraction of the trapezius muscle when there is
relaxation of the latissimus dorsi unless in exceptional cases where you
have more specific disturbances in the particular case. The serrati are
in between the two other sets and has a mediating influence between the
opposing actions, this means that in controlling the action of the trapezius
and lattisimus dorsi we must depend on the serrati muscles, therefore in
dealing with rigidity or relaxation the serrati muscles are the chief muscles
to attend to.
(b) The interscapular
area also takes in the vaso-motor area to the heart and lungs, also the
stomach area, the area for the upper part of the intestines and liver.
(2nd to 8th dorsal).
Remember that in relation to the heart and lung rhythm
the pulmonary plexus representing primarily the spinal nerves is intermediary.
This also applies to the stomach, liver, intestines and Spleen. The nerve
supply is primarily sympathetic through the solar plexus, this means that
in the heart and lungs conditions the vertebrae and their attachments,
and in the stomach intestines and liver, including the spleen it is the
ribs and their attachments(intercostal etc.) that are involved. If you
have a history of stomach trouble you will know what to pay particular
attention to. If the rib condition is the condition that we find on examination
for example you have the means of locating the intestines, and spleen where
as if we find vertebrae conditions in some area then we look for heart
and lung conditions; via pulmonary plexus. (spleen is not developed from
gut tract, thus there is independent nerve control in relation to other
The most common type of lesion in this region is
a lateral curvature, the next to this the anterior or posterior
curvature. In the lateral curvature case, the starting in general of the
curvature is a movement of the individual vertebrae, the most common individual
movement being the 3rd ,(two forced (a) pressure above (b) suspension
below), 5th (takes place from the rib side ) and 6th dorsal,
(initial break between 5th and 6th dorsal vent. Thorax
strong). The reason for this is that there are more motor nerves than sensory
nerves supplying the general distribution, as there are two motor nerves
supplies to one sensory nerve supply the disturbance tends to fall on the
weaker side of the nervous system. That does not mean necessarily traumatism,
but traumatism will tend to settle down in the weaker side. The lesion
in the spine, therefore will be found generally one or two vertebrae above
the common center for the organ involved, e,g, the heart centre localized
at the 4-5 dorsal, will show a sensory lesion at the 2-3 dorsal. The 3rd
dorsal is the weakest point in the upper half of the spine representing
the lateral (posterior) apex of the dorsal arch. This is also accounts
for the frequency of the posterior lesion, if lesions are primary anterior
lesions in this case seldom if ever are primary, they are secondary to
lesions in the lower in the lower dorsal or lumber region, in the pelvis,
or to organic lesions, functional lesions involving organs.
It is probably true that there are never anterior
primary lesions in the upper dorsal or lumbar vertebrae field, they are
always secondary to some other type of lesion, this is of importance in
differentiating between the secondary and primary lesions in the upper
dorsal which extends as far down as the 6th dorsal.
The first dorsal belongs to the cervical region;
the upper dorsal beginning at the second dorsal and extending down to the
6th dorsal; the lower dorsal from the 9th down. The
5th dorsal is also a weak point in the spine but this is due,
not to a spinal condition, but to the weakness of the 5th rib,
consequently the dorsal is weakening of the articulation between the 5th
and 6th dorsal either the 5th or 6th showing a tendency,
as a result, to be displaced. Where the individual vertebrae are involved
the 6th tends to move posteriorly, the 5th tends
to move anteriorly that is the general rule of cases.
(c) The 5th rib
nearly always bulges out anteriorly that tends to cause the 5th
dorsal vertebrae to fall away in an anterior lesion secondary to the rib
lesion, this tends to throw out the specific lesion of the 6th rib posteriorly
while there seems to be no specific lesion at the 5th rib. That
indicates the line of treatment to follow in correction of these lesions;
(d) In cases of an involvement
of a portion of an arch articulate the arch as a whole and its corresponding
ribs where there are ribs. There are a number of points in connection with
the arches to be noted. The 1st to 4th cervical vertebrae
represent a unit, that is to say theses are an arch; the 5th
articulates by itself. The 5th cervical 3rd dorsal,
9th dorsal and 5th lumber vertebrae are the individual
vertebrae that are liable to be in single mal-position as distinguished
from multiple mal-position in the arches or groups of vertebrae. All the
other vertebrae are liable to be in mal-position because the other vertebrae
outside of theses articulate in groups. The 6th cervical to
the 8th dorsal represents the upper arch , the 9th
dorsal lies in between the two arches, 10th dorsal to 4th
lumber is the lower arch and the 5th lumber lies between the
lumber arch and the sacrum. The point to emphasize is the ides of articulation
in relation to the arches consequently if you have a third dorsal vertebrae
lesion correct this by correcting the cause that weakens the dorsal arch,
that is to say, the condition of the lumber vertebrae or the condition
of the pelvis or lower extremities, or if it is a cervical lesion correct
Among the individual vertebrae there are two classes:
(a) The 3rd
and 9th dorsal , 5th lumber and the 5th
cervical , theses are the articulating facets between the arches and therefore
they represent variation in the positions of the arches themselves, that
is to say if you have a 5th cervical lesion it may be in relation
to the first four cervical or the 6th cervical to the 8th
dorsal. The principle of correction here therefore would be to correct
the position relation of the arches in order to correct the inter arch
(b) The 3rd
dorsal stands alone as a vertebrae in the spine representing the centre
of the cervico-dorsal arch and the pivoted point of the spine in relation
to the centre of gravity line, therefore in all lesions of the third dorsal
there are two things to be looked after:
(1)The condition of the spine as a whole in its relation to the central
2. The 3rd dorsal is the key to the upper arch and therefore
the correction of the 3rd dorsal lesions means rounding out
of the upper arch, that is to say if you have anterior upper dorsal and
along with that 3rd dorsal lesion correct the whole anterior
upper dorsal, same true of posterior or lateral curvature of the upper
dorsal. Correction of the 3rd dorsal depends on the cause, mechanical
force is not osteopathic therapeutics,. It is impossible to say how to
correct the 2-3 or the 3rd dorsal vertebrae unless you know
its cause, that is the reason why some of the osteopathic work is so bad,
and does not produce good results. In correcting the 3rd dorsal
must get down to the cause, and that cause is the weakening of the articulation
of the spine except in one single case where vertebrae is thrown out by
violence. When you have corrected the cause of the weakening articulate
the spine from the point of the lesion. If thrown out by violence you must
follow the surgical rule , namely repeats as much as possible the original
movement of the spine in causing the lesion, this is the only way in which
we can correct the traumatic lesions of the vertebrae.
In the 5th dorsal vertebrae lesion you
must first correct the rib condition, there as we said before a 5th
dorsal lesion is impossible unless there is a previous rib condition. In
this case correct the rib and then articulate the vertebrae above and below
the 5th dorsal, including the 5th dorsal itself.
Begin at the 2nd dorsal because where you have a lesion in any
vertebrae from the 3rd to the 8th dorsal you must
treat the whole field as a unit. If there is a 6th dorsal lesion
correct this also by correcting the 5th rib because in the 5th
dorsal vertebrae lesion you will find that the 5th rib was primarily
at fault, the cause of the 6th dorsal lesion being the rigidity
of the dorsal vertebrae just below the 5th, that is the articulation
of the 5th and 6th dorsal vertebrae. You require
to pay attention to the rib first, and then articulate in the same region
from the 2nd to the 8th.
Vibration is of service in this field because of
the direct effect of the vibration upon the ribs in establishing mobility.
Hand vibration practically of no value here use a vibrator, the vibration
is equally good for the ribs or vertebrae. It is impossible to get the
delicate vibration on the long stretch of the ribs, that is where the vibrator
comes in. Use it, not on the head of the rib, but at its sternal attachment,
and it follows the path of the rib around to its head. The depth of the
vibration is the important factor here because the deep vibration is valuable
in reaching the ligamentous articulation (these bind vertebrae together)
In the 7-8 dorsal lesions they are always secondary
unless traumatic, this applies to the lesions of the liver field for example,
7-8 dorsal vertebrae are the liver lesion fields , if the liver is disturbed
(a) primarily it will show itself at the fifth dorsal then (b) when there
is a weakening at the 5th dorsal we get secondary lesion at
the 7-8 dorsal because that is the motor field of the liver, passing around
the nerve arch from the sensory side to the 7-8 dorsal motor. In correcting
this lesion then go on to the primary origin at the 5th dorsal
correct any disturbance there then articulate downward to the 8th
dorsal. We often find lesions in this 7-8 dorsal secondary to dorso-lumber
lesions in this case follow same principles as before, that is correct
original cause in dorso-lumbar region and then articulate from point of
cause to point of lesion. The reason for these points is that it is a question
of laying the foundation and making the vertebrae into line , that is correct
the position of the vertebrae and then correct the general position, for
example a child growing quickly will tend to develop a straight spine,
to correct this we cannot correct this by correcting the individual lesions
but by establishing the normal curves of the arches and then forcing the
individual vertebrae into line.
In treating this area of the spine as a whole(2nd
to 8th dorsal):-
(1) The only way in which you can get free movement
of the spine is by bending the head and shoulders slightly forward.
(2) The clavicle and scapula must be free before
this part of the spine can be articulated therefore in treating this part
of the spine first give preparatory treatment (In this case relaxation)
to the clavicle and scapula.
(3) In articulating this portion of the spine have
patient in sitting posture, if possible, place one hand in front of the
patient, place the other hand underneath the axilla and support the lateral
half of the body on that side in that position and (1) Apply articulation
from under the other axilla with the other hand, or support the two lateral
halves of the spine and trunk of the body with the two hands underneath
the axilla. (2) Catch the neighbor vertebrae with the fingers of the two
hand and pull the vertebrae in opposite directions from under the axilla.
The operator in front of the patient. This finishes up position one.
(4) Patient sitting on stool with arms folded tightly
across the chest, in this position the scapula are:
(a) Thrown close to the spine
and therefore thrown out into prominence. Away from axillary line. Position
of treatment in pigeon chest.
(b) If there is a tendency
to winged scapula this will exaggerate the winged condition, because in
the movement of the upper part of the scapula towards the median line the
lower part will resist, that will tend to throw it out in a more prominent
position, for example particularly in relation to the scapula.
(c) In relation to the scapular muscles and interscapular
area and the interior condition of the vertebrae down to the 6th
(d) It is also used to test the degree of posterior
expansion in the upper thorax in connection with respiration.
Treatment in this position is of value principally
in (a) treating the articulation of the shoulder, especially where it is
rigid. With the patient in that position , for example, take one hand and
lay it across the shoulder (clavicle and scapula) and with the other hand
pull the arm up and down from this position in which it is lying as the
patients arms are folded tightly across the chest , that will push the
shoulder upward, with your hand over the clavicle and scapula, or if it
is to rigid pull it out and allow the scapula to drop, that way you will
get relaxation. It is (b) also of value rigid condition of the trapezius
muscle, the best method is to stand behind the patient, apply one hand
right over the trapezius muscle region as it comes down posteriorly, and
with your other hand take the arm at the elbow, push up and back , pushing
out the ribs from anterior to posterior, here you are pushing out the ribs
from the anterior towards the posterior at the region of the angle of the
scapula when you apply your pressure over the trapezius that strengthens
the trapezius. Push or pull on the anterior spine of ilium while you pull
on the spine of the 5th lumber, while you give swaying motion.
Another method of treating the rigid articulation
of the shoulder is to have the patient keep one arm folded across the chest,
bring your arm up above the patient. Stand behind the patient and in doing
this, and place your second hand lightly over the shoulder of the patient,
first on the same side as the free hand and then on the other side, hold
that part of the shoulder tight while you are giving that movement up over
Treatment of the Ribs.
1. Stand in front of the patient, apply pressure over the crossed
arms (tightly folded) with your chest (for example) and with the hands
behind the angles and heads of the ribs pull forward on the ribs , at the
same time apply pressure over the ribs anteriorly and over the folded arms.
2. Another way of treating the ribs in this position is to keep
the one arm across the chest, use the free arm of the patient to pull up,
apply pressure forward and upward at the angle of the rib on the same side
as the free arm. This is especially valuable in one sided rib conditions.
Same treatment with hands in lumbar region while
you sway patient from side to side.
3. Patient in the sitting position with arms lightly folded across
the chest, in this position the inferior end of the scapula tends to move
towards the spine, for example, this is the position particularly applicable
in the examination and the treatment of the scapula, except where the scapula
are winged, especially the scapula are too close or over lapped; for example,
in this last case, where the scapula are to close to give treatment to
the scapula separately. Stand at the side of the patient, throw one of
your arms around the anterior thorax of the patient, with your hand grasp
the outside of the arm( arms folded lightly) use your hand to pull the
scapula on the same side as you stand, around towards oneself, then without
changing position pull the scapula in the opposite direction treat the
other scapula in the same way.
Another method of relaxing the scapula is to stand
in front of the patient, the arms folded lightly over the chest, push the
head back and pushing the shoulders down as far as you can without any
danger, leaving them in that position. Apply pressure outward on the two
inferior angles of the scapula, put hands around patient and pull scapula
outward towards the axillary line, apply pressure to the inferior angle
of the scapula, apply pressure on head of patient with your chest. Bend
head down as far as possible, put knee in lumbar region applying traction
on sternal end of ribs and pull back. This can be used in articulation
using thumb in place of knee.
Another method: - With the patient in the same position,
stand in front of the patient with the head, neck and shoulders of the
patient erect ( in this case make the patient breath deeply)apply pressure
against folded arms( across the chest), and then pull the two scapulae
towards the axillary line on the two sides. (good pleurisy treatment).
In this third position you can also articulate the
spinal vertebrae. Stand in front of the patient, place the arms around
the patient to the spine. Catch one vertebrae in each hand and the neighbor
vertebrae with the other hand and pull in the opposite directions, do not
pull too hard to pull them apart, this is a good method of applying articulation
in cases where the patient cannot lie down, for example asthma. This can
be given to patients who are bedridden even on back.
4. Patient still in sitting posture, arms hanging down parallel
to the sides of the body, head and shoulders inclined well forward, (this
is the position for examination), and for treatment of the deeper layers
of the muscles along the spine. The same kind of treatment can be applied
with the patient on the side, when the patient is in that position. One
advantage of the sitting posture is that you can reach the two sides sitting
posture is that you can reach the two sides (muscles)of the patient at
the same time. Stand in front, put your arm from anterior to posterior,
grasp muscles near the spinal processes, move out and up.
Same treatment applied to the side, only you must
stand behind, and then it is a pushing movement, and you do not get too
much good results. This applies to the muscles and articulation as far
down as the 8th dorsal vertebrae.
In the same position you can correct lateral, posterior
and anterior displacements of the vertebrae. Stand at the side of the patient
and apply the three principles we have mentioned for correcting lesion:
(2) Extension and then
(3) Flexion to same side and then to opposite, applying
pressure against the direction the movement you will give.
5. Patient lying on the table , straight but on side, preferably on
the left side, particularly in female patients, because of the difference
in the length of the ligaments, you require the longer ligaments up so
as not to cause strain. If you are treating on both sides treat the left
side first , and then on the right side afterward. Have the patient on
the left side first and then treat from the right side later on, if there
is anything abnormal in the circulation it would be better to lie the right
side, the blood is freer on the right side, sometimes the patient gets
almost varicose veins when lying on the left side.
This difference in the length and tension of the
structure applies not only to the ligaments but also the peritoneum and
the pleura, both of which are shorter on the left side, more tense, in
case of localized peritonitis keep patient on the right side to obtain
Another reason for this position is that the spleen
occupies less space than the liver, if there is an enlargement of the spleen
then you are required to reverse the condition, both as too treatment and
position in sleep.
(1) When the patient is put on the right side for
treatment or for examination make sure that you relax the tension of the
muscles and ligaments, and this also applies to the peritoneum by flexing
upper and lower extremities giving rotary treatment. With the patient in
this position you can give articulator treatment, for example, for the
upper half of the spine, stand in front of the patient catch the spine
of the vertebrae at its under side pulling upward and applying resisting
pressure over the shoulder.
(2) In cases where vertebrae are exceedingly rigid,
pull the upper dorsal and the lower lumber simultaneously, and then towards
each other, down the dorsal and up the lumbar, to give the articulatory
treatment, relaxing muscles and vertebral circulation.
(3) In this position you can give the crossed or
diagonal treatment-------pushing at the shoulder and pulling at the innominates.
This is good where the diaphragm is involved. With the patient in this
position (a) examine the soft tissue on the other side;(b)Examine the vertebrae
particularly in connection with the rigidity, articulation with the shoulder
and ilium as the two points of leverage, with the 8th dorsal
as the dividing line between the two halves of the spine. (c)Examine the
condition of the ribs with one hand at the head of the rib and the other
at the angle and sternum alternatively.
6. Patient on back.
(1) This is the position (a)for examination and treatment
locally for the thoracic and abdominal organs in their relation to one
another and the spine. Place one hand on the spinal area corresponding
with the organ and with the other hand use palpitate pressure over the
organ itself, for example, in examination on the liver examine the organ
with your hand directly, and place your hand on the liver area of the spine.
In many cases that are uncomplicated you can differentiate between, in
that way, structure and function lesion primarily.
(2) Examination of the individual ribs in treatment
for the spreading of the ribs, and in testing for the depth and extent
of respiratory action.
(3) It has been demonstrated that by limiting down
respiratory action we get such a rigid condition of the spinal muscles
that in a few minutes it might be impossible to breath. In relaxation of
the muscles apply circulatory treatment.
(4) This is the position for flexion, rotation and
articulation of the head and neck and lower limbs.
(5) This is the position for stretching the diaphragm,
in this case throw the anterior trunk of the body forward by placing something
solid in the region of the 9th dorsal and then stretch the diaphragm
from the costal cartilage’s.
(6) This is the position for local treatment of the
abdominal organs through the abdominal wall. If the abdominal muscles are
tense always flex the limbs, in locating the organs for examination and
in the treatment for the uterus and bladder flex the limbs as much as possible
on the abdomen and apply palpating pressure through the abdomen moving
the limbs upward and downward while palpating.
7. Patient on the face
For the physical diagnosis of all conditions on the
posterior wall of the thorax and abdomen and of the entire spinal column
lesions muscular and osseous. Treatment for the patient in this position.
(1) Relaxation of the muscles in the thoracic and
abdominal fields here you apply kneading or vibrator treatment.
(2) Articulation of the vertebrae and the ribs using
the leverage of the shoulder and the hip.
(3) Relaxation of the scapula and the arm in articulation
at the shoulder.
(4) Articulation of the head and neck on the upper
dorsal vertebrae and the attachments of the same, especially for the posterior,
catch the head across the forehead and use the pressure of the thumb and
finger beginning at the middle dorsal region pushing the head to one side
or the other.
(5) Free articulation of the pelvis on the trunk
using the leverage of the limbs and the other hand to keep the limbs solid.
(6) Articulation of the sacrum, here we use only
one limb as a lever and the other hand in direct relation to the innomiinate
or the sacrum.
(7) Inhibition in the lumbo-sacral region this is
given from the dilator side.
(8) In dealing with conditions of the ankle and knees.
(9) Interscapullar area place arm behind and on back
and knee back at elbow and press on vertebrae.
8.Patient standing on head, held by operator
This is especially valuable in treating the diaphragm
as in incurable cases of hiccups or pelvic congestion, this is also the
ideal position for the relaxation of the diaphragm. In stomach conditions
of children’s cramps etc. Inability to vomit. Breaking up adhesions in
9. Patient standing in the erect position .
This is the position for the physical diagnosis
(1) In relation to the line of gravity, that is the
central line from the symphasis of the chin to the symphasis of the pubes.
(2) In determining the relation of the shoulders
to one another and also determining the relation of the innominates to
(3) In determining the relation of the head to the
trunk of the body.
(4) In determining the relation of the organs in
the cavities of the body, more particularly the stomach the liver and spleen.
(a)For treatment, this is the position for treatment of enteroptosis. (b)In
giving the tapping and striking treatment and also the rolling and the
kneading to the abdomen and its contents.
1. First position standing or sitting.
This is the best position for the movement of the
thorax either from the anterior or the posterior, for example.
(a) Stand in front of the
patient, and apply pressure against the chest, giving a springing movement
to the thorax with one hand on either side, either at the angle of the
ribs or at the heads.
(b) The same treatment can
be applied standing behind the patient , giving the springing movement
in that case from a point just about one inch from the anterior rib attachments.
(c) In the asthmatic rigidity
of the thorax sometimes unilateral and sometimes bilateral, this is the
treatment especially during paroxysms, pull the thorax well forward, for
example apply pressure right along the sternum in any way then catch the
ribs with the flat of the hand from the head or angle and pull forward.
(d) In the case of the patient
with stomach involvement stand behind the patient and give strong inhibitory
pressure upward from the point of the stomach at the same time give expansion
of the ribs from the cartilage’s, applying pressure with the flat of the
hand, at the same time pulling the thorax forward. This is also good treatment
for inhibition of the solar plexus by pressing the stomach back against
the aorta. For stimulation of the solar plexus press backwards and let
go with jerking movement. Put the knee at the solar plexus field right
over the stomach, push upward and give the thoracic treatment at the same
time. This is also good for those who are great eaters for the amount used
in the bodily activities , generally found in old people.
(e) For the correction of
the ribs, for example , in the dislocation of the ribs, this excludes the
1st and 2nd ribs, attempt to articulate the rib,
e.g. if the rib is on the right side catch the corresponding vertebrae,
pulling the head around the right side (standing in front)and with the
other hand catch the angles of the rib involved, and apply strong pressure
anteriorly, really a pulling pressure, at the same time apply pressure
on the anterior thorax and pressure on vertebrae, follow this by same treatment
of the second hand at the head of the rib. Then catching the rib at its
lower border midway between the head and the angle apply pressure upward
upon the rib while you pull the vertebrae ,and with the arm that is around
the patient push his body over to the right side, you will articulate the
vertebrae and remove the rib at the same time. On the other side reverse
the points. In twisted rib treat in the same way but apply pressure at
the point of the twist or the center of the rib and also in the direction
of the twist.
In treating the thorax as a whole have the patient
in a sitting or standing position, apply pressure either anterior or posterior.
In case of anterior pressure stand in front of the patient and lift the
thorax from behind, first at the 10th dorsal vertebrae then
in connection with the 10th rib, on both sides. When the pressure
is applied posterily apply traction outward and backward at the cartilidges
of the lower solid ribs. In this case have the patient assist the treatment
by deep breathing , determined by his condition and what is to be accomplished.
(f) Treatment of the clavicles.
Patient sitting or standing: -
(1) Place fingers behind the acromion end of the
clavicles, applying traction forward and slightly downward while you move
the arms out at right angles to the lateral aspect of the body, and then
gradually move the arms around the anterior of the body, arm still at right
(2) If the clavicles are tight pull the arms of the
patient above the head before inserting fingers, and then give the above
treatment. Follow this by placing the fingers behind and under the clavicle
at its sternal end, and move the arms gently, being careful, if it is tight
or you may break it ,and give vibratory treatment of the arms. Examine
the clavicle for a previous fraction, palpating ridges, and in such cases
you must be more careful in this treatment.
(3) Place the arm of the patient across the thorax
and apply pressure from the elbow while you pull on the clavicle or on
the acromion process
2.Second position in treatment of the thorax.
This is especially good for springing the ribs or
for the twisted ribs.
Patient on the side
(a) Stretch the entire length
of the thorax by giving the diagonal pressure treatment from the shoulder
and pull from the ilium.
(b) Follow this by stretching
the arm upward towards the head, then forward and around the head and upward
across the chest
(c) To help this movement
place your hand at the angle of one of the lower flexed ribs, for example,
the 10th and hold thorax above that point in fixation pressure.
If the ribs are rigid apply anterior fixation over the 5th 6th
7th 8th, 9th ,10 ribs at the cartilage
point while you move the arm above the head across the forehead and chest
while applying the fixation pressure backward.
In spreading or separating the ribs apply the same
(d) In springing the spine
. with the patient on the side apply similar treatment , and in addition
when the arm of the patient is pulled across the chest and then pull forward
on the ribs, one hand anterior with the fingers at the sternal end, and
one posterior at the angle of the ribs.
3. Third position. For treating clavicles and springing the ribs.
Patient on the back.
One of the best methods is to stand at the side,
take the arm of the patient and pull strongly above the head, then apply
with the fingers.
(a) At the angles of the
ribs to spread the ribs
(b) At the head of the ribs
to articulate them:
(c) Midway between the head
and angle to give maximum tension to the rib to straighten or increase
the movement. Do the above while you pull the arm down at right angles
to the sides of the body, and as low down as possible.
Also give the same treatment by putting your arm
under the patient and at the same time place the other hand between the
head and angle of the rib, push up while dropping the arm towards the floor,
and give it a vibratory.
In case of depression of the sternum. Apply strong
pressure laterally on the ribs while you get some elastic movement, and
then follow this by giving the treatment, just mentioned.
In reaching the aorta. In case where the aorta is
involved, particularly in anerurysmal condition give this treatment to
relive blood circulation placing one hand over the cartilage instead of
posteriorly, beginning at the ensiform cartilage.
4. Fourth position
Patient on face
This is a good position in treatment of unilateral
conditions of the thorax, for example bulging of one side of the thorax,
simple hypertrophy of the heart. In cases of sunken ribs posteriorly, for
example, where ribs are depressed below too level of the other ribs, the
depression being between the angles and the head, indicating a dislocation
of the rib, give a similar treatment with the hand under rib anterior in
this case. Apply pressure at angle instead of head. When rib is sunken
anterior not twisted, there is a depression. The best position is patient
sitting or on back, pull the arm over head, applying strong traction from
posterior to anterior at the angle of the rib, at the same time putting
the arm above the head and rotating it down and back in a circle while
keeping traction on the rib from the posterior.
In case of involvement of the 6th ,7th,
8th ribs apply strong pressure upward on the rib itself, between
the angle and the head of the rib , while the patient breathes as deeply
as possible. This is for articulation of the ribs and vertebrae in the
In the examination of the diaphragm there are two
1. Standing, this gives the normal position.
(a) In this position make
the patient breath deeply to expand the thorax and bring out unilateral
or bilateral condition of deviation
(b) Have patient fold arms
across the back and breath deeply this gives you extent and degree of relaxation
of the diaphragm, in this exaggerate lumber curve by throwing the shoulders
(c) Have patient fold arms
across the chest and gradually incline body forward (1) so as to obliterate
the lumber curve; (2)to increase tension on the spinal column at the 8th,9th,and
10th dorsal, this throws the rib out into prominence posteriorly.
2. Lying on the back.
(a) Lying on the back straight
out on the table. This is particularly good where there is contraction
of the diaphragm. If the diaphragm is contracted the patient will not be
able to continue this position very long. If only a slight degree of contraction
the patient will be able to retain this position longer.
(b) Lying on the back with
the limbs flexed, and with the limbs flexed on abdomen. In this position
we can palptate the diaphragm and find out its tension, we can locate the
position of the aorta and its relation to the heart, and also the relation
of the diaphragm to the abdomen.
In treating the diaphragm:
Place the patient on the back and apply stretching
and extension, standing at the head of the patient and extending and stretching
from the cartilage’s of the ribs. This applies in both contracted and relaxed
diaphragm. In the relaxed condition of the diaphragm it is better to have
the patient in a position so that the extremities are on a higher plane
than the heart or the upper part of the body, in this position you bring
all the abdominal visera on the abdominal surface, and this acts as mechanical
In this case we get:
(a) Direct action on the
nerve supply to the diaphragm, distributed on the under surface.
(b) Mechanical pressure of
organs from the abdominal and pelvic cavities which inhibits solar plexus
and also in the diaphragm inhibiting visero-motion of the diaphragm. This
explains the quieting effect of the treatment.
(c) Blood pressure is altered
largely through the reverse force of gravity action
(d) No dragging of the aorta
in connection with the diaphragm, hence, you relive the heart condition
by reliving the dragging sensation, e.g. in aneurysm of the aorta the patient
gets relief by lying in this position the greater part of the time.
We can also treat the diaphragm with the patient
sitting. Stand behind the patient and apply the same treatment, applying
pressure posterily with the knee, first at the level of the 2nd
lumber, and then gradually move up to the 9th dorsal, all the
attachments of the diaphragm between these two points. This is the best
treatment except where the heart is involved.
In the examination of floating ribs.
(1) Standing posture, here use palpation and percussion.
(2) Patient lying on back.
(a) Have patient lie flat
on back limbs on the table.
(b) Take limbs on the same
side as the abnormal ribs on which examining, Flex the limbs and rotate
it outward. Here we are able to discover degree of rigidity of the abdominal
muscles or the spinous muscles or of both in relation to the floating ribs.
(3) Patient on the side with the normal ribs down
towards the table. Place a pillow under ribs normal side, place the hand
over the last of the solid ribs extending the fingers towards the spine
so as to place the thorax in fixation, and then apply pushing movement
of the iluim. This will enable us to discover the amount of rigidity in
the floating ribs and also the degree of displacement.
In Treating Floating Ribs:
(1) Have the patient on the side or back , if ticklish
have on side, with the limbs flexed. Place the fingers at the head of the
rib involved and apply strong pressure upward from posterior to anterior.
(2) While you keep up this pressure from posterior
to anterior apply pressure over the abdominal end of the rib.
(3) If there is not tension ( if rigidity has being
relieved) raise the arm of the patient above the head and then apply increasing
pressure at the head of the rib and then move the move the arm downward
along the side of the body while keeping up the pressure at the head of
the ribs, If the rib or ribs are dropped downward pull the arm well forward
in this treatment. If the rib is dropped from the anterior towards the
posterior pull the arm well backward in giving the treatment.
(4) After relieving tension bring the arm of the
patient resting above the head and get the fingers in inferior to the head
of the rib and apply pressure on the anterior to posterior on the same
rib and move rib up or down anteriorly according to the disturbance.
(5) If the floating rib is overlapping the ribs above
apply strong pressure from anterior to posterior or visa-versa, at the
heads of the two ribs, tenth and eleventh or eleventh or twelfth, and move
the two ribs at the same time both anterior and posterior, using the bow
characteristic of the rib as a leverage.
(6) Then apply pressure at the head of the overlapping
rib above keeping up the pressure of (5) and get the fingers of the other
hands at the anterior and articulate the rib and move rib according to
In Physical Examination of the Abdominal Cavity.
(1) Patient standing, here we have the free pendent
position of all the organs, the presence of fluid will tend to gravitate
downward, if gas it will tend to gravitate upward in this position.
(2) Patient on the back. Palpating with both of the
limbs straight out on the table and with the limbs flexed, in this latter
case we get the maximum of relaxation of the muscles and ligaments and
the true position and condition of the kidneys and the spleen.
(3) Patient on the side. This is chiefly used as
a position in what is called floating organs, which are the stomach, intestines
and uterus, therefore they float in the interabdominal negative pressure
field, the other organs the spleen, liver, pancreas and the kidneys are
the stable or fixed organs.
The Treatment of The Abdominal Cavity.
1. Patient sitting or standing. The advantage in standing is that
we get the organs in their natural position, and you also get the organs
in relation to one another without relaxation or extension for muscles,
for example, it is the best position to apply the shaking , vibratory,
kneading, hacking and stroking treatments to the abdomen. These are direct
local treatments to abdomen. The stroking treatment is applied superficially
by applying it quickly, or deep which is applied slowly and deep.
2. Patient on the side.(a) Here the patient may be on either side
except in heart trouble them left side. Put the patient on the left side
in case of liver trouble except when the spleen is enlarged. The two sides
of the abdomen are not symmetrical, the organs on the right side are larger
and occupy a larger space in the abdominal cavity(b)The ligaments on the
right are longer and more elastic in the normal subject.( C)In prolapse
of the rectum, and in intense contraction of the sigmoid flexure, place
the patient on the left side because this position throws the organs towards
the left side and relieves the tension. (d)In the motor type of constipation
make the patient lie on the left side while sleeping. (Visero-motor type
as shown by loss of resistance or tonicity of the walls of bowels)Change
to right side when bowel’s wall have been toned up its entire (colon)length.
In motor type of constipation peristalsis begins at sigmoid flexture, begin
treatment rotatory here.
3. Patient on the back with the limbs flexed. This is the most
common position in the treatment of the abdominal conditions:
(a) Because it causes relaxation
of the pelvic organs and their attachments.
(b) It relives tension on
the blood circulation.
(c) This is a good position
when heart is rapid in action because this relieves the pressure on the
(d) In the treatment of the
abdomen in giving the general treatment use this position .Begin this treatment
with the ball or soft part of the hand over the abdomen, starting pressure
where contraction is at its maximum and relaxation at its mimuimn and gravitate
toward the point of minium contraction. Apply the same principle in relaxation.
In treating the organs determine the beginning by the organ involved e.g.
where the pelvic organs are involved the contraction begins in or below
the pelvic region, the organs in this case ought to be treated from the
diaphragm down. In the abdominal organs therefore begin at or above the
organ because relaxation and contraction begins below the level of the
pelvic organ. (Pelvis organ begins at perineum.)
(e) The second general treatment
is light kneading treatment, given with the cushion part of the hand and
fingers. Remember to give the treatment much more slowly than in treating
the skeletal muscles. In the latter condition try to get elastic reaction,
before giving the kneading treatment.
(f) In treatment of the abdominal
(1) Give treatment to the solar plexus, (inhibition)lay
down the fingers midway between the umbilicus and the ensiform cartilage,
and apply steady pressure in ward and upward. If the anterior part is to
be reached give the pressure inward and downward and if the posterior part
is to be reached give treatment in and up. In stimulating the solar plexus
as a whole give a moving pressure and give the treatment from left to right.
(2) In treating the gall bladder (in relation to
acid and alkaline)locate it first at the anterior cartilage of the ninth
rib and follow it downward by a semi-inverted letter -s- from the cartilage
of the 9th rib downward along the intestinal path. The best
treatment for the excretory stimulation from the gall bladder is the miling
treatment. Catch the duct between the finger and the thumb and treat downward.
Slight pulling treatment. (vibration and hacking)
(3) In treating the liver most important treatment:
(b) Rhythmic treatment, alternate
stimulation and inhibition, when the organ is practically inactive reverse
this. In giving treatment to the liver always begin at the left lobe and
treat from left to right, in this treatment push the structures of the
(c) Another treatment is
to push the fingers forward and down, with the other hand at the median
line applying pressure. This treatment has especial reference to the rhythmic
or peristaltic action of the liver.
4. In the treatment of the spleen place the patient in the same
position as in the treatment of the liver;place the knee against the ribs
in the spleen area and apply pressure to the ribs to push the spleen area
towards the median line and then place the fingers under the ribs and give
same treatment as to the liver. (flex right limb).
5. In treating the stomach. The local treatment is similar
to that of the liver :-
(c) Insert fingers of both
hands on either side of the stomach and pull towards the median line. Flex
the stomach on itself so as to increase the tension of the greater curvature.
Get out the gas in this way if it is present.
(1) Too tone up the stomach follow the direction
of the peristaltic action
(2) Where the pyloric oriface is involved in spasms
of rigidity or contraction give deep inhibitory pressure over the pyloric
end and follow this by kneading treatment upward and towards the cardiac
orifice, and then inhibit over the cardiac oriface and then come down and
(3) Where the cardiac orifice is in a state of chronic
contraction knead upward from the pyloric to the cardiac orifice and then
inhibit over the cardiac orifice.
(4) In congestion, tumerous or cancerous conditions
of the stomach, which generally effect the ends, apply your treatment to
the body of the stomach as the treatment to the ends is contra-indicated.
(5) In dilation of the stomach ,gas etc, apply steady
inhibitory pressure over the body of the stomach up to the point of elastic
reaction, and follow this by the treatment of the solar plexus from the
alkaline point of view.
6. In the intestines. In all treatment of the intestines
(1) Begin by getting a complete relaxation of the
abdominal walls as possible. If there is excessive relaxation give strong
inhibition pressure up to the point of elastic reaction.
(2) Pull up intestines from the iliac fossa region.
In giving this treatment do not pull intestines up from the umbilical region
as it may cause irritation.
(3) Pull up small intestine by a pushing or wringing
movement. Fix your fingers in about the symphasis, and lay the other hand
above the stomach, apply pressure there and then push deep with the other
hand above the symphasis, continue treatment until the intestines are drawn
(4) In giving kneading treatment to the intestines
first steady inhibitory pressure and then follow by rolling movement of
the finger associated with the kneading treatment. As a general rule in
this kneading treatment begin at the sigmoid flexure. This is useful in
motor types of diarrhoea or constipation. In vaso motor types of begin
at the ileo-coecal region, kneadaround to the sigmoid flexure and then
(5) In appendicitis, typhilitis, paratyphilitiis,
etc. apply steady pressure over the appendical region, follow this by light
vibratory and kneading treatment towards the appenndix from above, below
and laterally to the organ.
(6) In peritonitis, give steady inhibitory pressure
deeply upward along the symphasis, (just above the symphasis), from side
to side and below the ensform area, and then give gentle pressure followed
by vibration and kneading treatment around the margin of the ilium both
sides, and then over the abdominal wall treating upward.
7. In treatment of the pelvis and lower extremities.
(1) First position. In the sitting or standing posture.
In the examination make the anterior and posterior spines the objective
points of comparison, also the sterno-illiac synchrondrosis, looking particularly
for rigidity and tenderness at this point. The advantage of examination
with the patient standing is that the patient assumes a position that favours
the weak side.
The pelvis may be moved as a whole, or in parts.
The most common lesion is one or both innominates and that lesion may be
of three forms, upward ,backward and twisted.
Best method of correcting is to have the patient
on the back if the lesion is posterior, pull the body of the patient out
to the end of the table so the limbs and part of the body hang over the
table supported on the posterior superior spines. Elevate the limbs and
the pelvis and then drop the limbs and pelvis gradually over the edge of
the table giving (a) rotary movements, (b)artiiculatory movement applying
pressure at any point at which the rigidity is greater than normal. That
you will test by pulling of the muscles or the pain.
(2) Second position. With the patient in the sitting
posture put your knee in sacral region and apply strong pressure forward
while you articulate the trunk of the body backward on this sacral articulation
. (This requires two operators)
(3) Third position. In the sacral displacement,
place the patient on the back, place one hand under the patient at the
sacrum so that the hand will reach the anterior superior spine on the opposite
side, pull strongly downwards from the anterior superior spine while you
rotate the limbs.(The swing is not so good.)
(4) Fourth position. In the movement of the pelvis
as a whole, we have the tipping of the pelvis forward or backward,
and in some cases twisting, in this case give treatment similar to (3)on
both sides. You also can give treatment by moving body downward on the
table to the level of the 5th lumber, and then give articulatory
treatment in that position, holding the feet up on the same level as the
body while you rotate the limbs and pelvis on the 5th lumber.
Pelvis and Lower Extremities.
The lumber region and the pelvis are very closely
related, the pelvis is the base on which the entire spine, and in relation
to which the entire spine articulates, the 5th lumbar therefore
represents the pivotal point of articulation between the spine and the
pelvis therefore it is liable to be a weak point and if weak it reacts
on the entire spine.
Among the 5th lumbar lesions we find first
rotation of the vertebrae chiefly posterior. Second a lateral movement
of the vertebrae ,in this case their is tenderness at the muscles at the
anterior superior spines of the ilium and the ilium is elevated. (On the
side of lesion).
(1) Examine in relation to the spine because in pelvis
lesions and spinal irregularities especially compensatory curves are found.
The pelvis as a whole may be tipped anterior or posterior in relation to
the spinal column.
(2) The pelvis as a whole may be twisted on the spinal
column. (Pelvis being twisted while the spine remains absolutely straight).
(3) The pelvis as a whole may be tilted, one ileum
up and the other down.
In lesions of the entire pelvis the point of displacement
is the lumbo-saral articulation.
(a) In some cases the 5th
lumber follows the pelvis.
(b) In some cases it follows
the entire lumbar region (2-3-4-5 lumbar as solid piece).
(1) In the posterior luxation of the pelvis both
posterior superior spines are prominate.
(2) In the anterior luxation of the pelvis as a whole
both posterior superior spines are depressed.
(3) In the twisting of the pelvis as a whole one
posterior or superior spine is prominate while the other is depressed.
(4) In the tilting of the pelvis as a whole one posterior
superior spine is elevated and the other is lowered. In this case also
there is tenderness at the crest of the ilium at the lowered side and the
waist line is deepened on the high side and there is an inequality in the
length of the Limbs.
Examine the patient in the sitting posture to find
out the condition of the posterior superior spines and the crest of the
ilila. Examine the patient with the patient lying on the back to find out
the conditions of the crest of the ilium and the soft tissue around the
crests. Examine patient with patient lying on face to find out the condition
of the soft tissue in the sacro-illac region, here there is sensitiveness
to pressure over the sacral prominence.
Parts Of The Pelvis.
These indominates may be moved anterior , posterior,
up or down, or there may be a combination of these movements . Here the
various bones in the pelvis are found in special positions, that is the
lesions is a physical misplacement.
1. If the innominate is down the ischium is posterior and the iliumn
2. If the innominate is up the ischium is anterior and the ilum posterior.
3. If the innominate is forward or backward the ligamentous tension
all around the innominate field is exaggerated.
4. If there is a combination in these other variations of movements
, the most frequents is downward and backward movement with the limb lengthened
on the corresponding side. Next to this is forward and upward movement
with the limb shortened on the corresponding side. According to this the
innominates are liable to rotate around some focal point forward or backward
displacement depending on this rotation , that is the displacement is dependent
on the abnormal rotation. (Twisting being the real lesion).The downward
and backward movement is most common on account of the belved edge of the
sacrum representing a broadened wedge lying upward in articulation with
the ilium, it is this articulary relation that is rotated or twisted as
the cause of the displacement.
(a) In examining the patient
have the patient sanding in the erect posture, in this position compare
crest of ilia and the posterior superior spines of the ilia. The one is
higher than the other in a lesion.
(b) With the patient lying
on the back grasp both ankles and rotate limbs laterally first to one side
and then to the other side and give pull and push movements to the limbs
to relax the muscles and then bring heels together and first compare the
length of the limbs at the heels and at the internal malleoli. Second compare
in relation to the anterior superior spines of the ilia (to find out if
these are equal or higher or lower). If the innominates are effected a
difference is noted at the internal malleoi and hell points, in no 1 the
limb is lengthened and in no 2 there is a shortening of the limb. (Innominates
In addition to these in innominates lesions use the
following sings and symptoms:-
(1) Tenderness on symphasis pubis on side of lesion.
(2) Tenderness at the ilio-sacral articulation on
the side of the lesion and rigidity of the muscles and ligaments at the
(3) Tenderness along the iliac crest over the muscular
(4) Tension of the tissue around the sigmod and iliac
fossa on the effected side.
(5) Tenderness of the pubic bones. (Bladder ,Uterus,
Prostatic conditions, etc.)
(6) Tenderness of the pubic nerve as it crosses the
iliac spine on the sound side.
(7) Test the length of the limbs with the patient
on the back, relax the tissue, rotate, and apply pull the push movement
to the limbs and then place the heels together.
(8) Test The position of the posterior superior spines
of the ilia with the patient in the sitting posture, and standing and compare.
(9) The waist line is deepened on the side of lesion,
on the other side it is fuller down towards the pelvis.
(10) The curving of the spines are located in connection
with the tension of the pelvis and on the same side as the tension of the
In the examination of the patient to find out the
condition have the patient first standing erect to find out the relations
of the two innominates to the sacrum. (band one limb at knee and put foot
on stool then examine ilia.)
Second with the patient on the face , the sacrum
is commonly or generally displace anterior and downward except in cases
of traumatism when the displacement may be posterior. Physical signs of
the anterior and downward displacement which is the most common one are:
(1) Tenderness at the sacro-iliac articulation.
(2) Separation from the 5th lumber vertebrae,
the separation being downward.
(3) Tenderness between the 5th lumber
and the sacrum.
Examine the coccyx (a) with the patient in the erect
posture (standing);(b)with the patient lying on the face. The most common
lesions of the coccyx is the anterior displacement or the lateral displacement.
The lateral displacement is found in connection with rigid muscular conditions.
Examine (a)by pressure directly over the coccyx.
(b)By lateral pressure over the coccyx while elevating the limbs backward
one at a time and then two together; (c)while rotating the limbs (apply
lateral pressure),from side to side, that is also the routine of treatment
of cocygeal lesions.
1. Relax the muscles with the patient on the face, manipulate the muscles
upward following this by flexion and rotation of the limbs. The treatment
is to be given in all cases especially in the case of pelvic lesions over
the sacral foramina when the soft tissue are rigid.
2. In correcting the rotation of the pelvis on the 5th lumbar
(a)patient on the side hold body firmly with one hand or arm and move pelvis
back and forward.(b)With the patient on the back place one hand under the
posterior superior iliac-spine and lift the limbs so as to get a good grip
on the entire pelvis and lower the extremities and then rotate or articulate
the pelvis and lower extremities on the 5th lumber. (c)Patient
on the face, elevate the limbs and rotate the limbs and pelvis while holding
spine in fixation at the 5th lumber. (especially when the 5th
lumbar is posterior)(d) Patient sitting fix the pelvis while standing behind
the patient by holding the crest of the ilum from the posterior;(1)in the
tipping of the pelvis forward pull the pelvis backward while gradually
working the trunk of the body forward; (2)In the backward tipping have
an assistant standing in front and pulling the pelvis forward while you
stand behind the patient grasp the patients body beneath the axillary raise
and pull trunk of body backward, while pressing the knee against the sacrum
and rotating the body trunk from side to side.
3. Correct the innominate lesions. Place the patient on the side, stand
in front of the patient place one hand between the limbs and grasp the
tuberosity of the iechium and place the other hand on the crest of the
ilium posterior. In this position we can move the ilium up or down or backward
or forward pulling or pushing on the two points.
(a) In giving this treatment
pull forward on the crest and push back on the tuberosity in the posterior
lesions, and pull forward on tuberosity backward on crest on anterior lesions.
(b) Patient on the back.
Pass the arm under the spine and grasp with the hand the crest of the ilium
raise the limb with the other hand and arm as a lever while pulling upward
and downward, backward and forward on the crest of the iluim.
(c) Patient lying on the
side with the effected side up , stand behind the patient apply pressure
with the hand on the upper part of the inanimate and draw thigh backward
while pressing the bone forward. If the lesion is the one in which we find
the ileum posterior and the ischium anterior, stand behind the patient,
place the knee against the sacrum, one hand on iluim and with the other
hand grasp the ankle on the effected side and apply pressure over the ilium
then pull the limb backward and elevate or lower limb gently. In the upward
displacement. Patient in the sitting posture. Have an assistant
standing in front of the patient, placing in fixation the pelvis by firm
pressure downward on the crest of the ilium. Operator standing behind the
patient, grasping the trunk beneath the axilla lifting upward and rotating
trunk away from side of lesion.
4. In lesions of the sacrum. If anterior displacement use the
same treatment as in innominates lesions, in which the ilum was posterior
and ischium anterior, because this is really the same thing as a posterior
In case of downward displacement of the sacrum
have the patient sitting on the table, stand in front of the patient, grasp
patient over the posterior superior spine of the ilium and give lateral
rotation while someone stands behind the patient and pulls backward on
the anterior crest of the ilium.
In posterior displacement of the sacrum the
patient sitting on stool, place the knees against the sacrum and grasp
the anterior superior spines of the ilium and applying strong pressure
with your knee, traction with the arms and at the same time give lateral
5. Coccyx In displacement of the coccyx;-
(1) Relax all the tissues around the sacrum and coccyx
and then insert the fingers back of the anterior aspect of the coccyx and
elevate the limbs upward. On the other side do the same thing. The upward
and backward pulling of the limbs with traction on the coccyyx from anterior
will gradually loosen and relax the soft tissues and coccyx.
(2) In some cases it may be necessary to insert the
fingers into the rectum and first carefully relax the internal tissues
and then place the fingers along the coccyx and apply pressure internally
against resistance pressure from without .(Given with the fingers)"Only
In the fracture of the coccyx relive pain.
(a) By relaxation of the
soft tissues around the coccyx and internal tissues per rectum.
(b) Inhibit the nerves internally
(c) Give strong inhibition
over the rectum.
(d) Replace in case of displacement,
do not treat too frequently, not more than once a week.
6. Prostatic Gland This gland is located beneath the anterior
wall of the rectum about one half of an inch from the anus. In enlarged
prostatic gland apply pressure over and around the gland internally, gradually
increasing the pressure upward and forward while you get entirely over
the gland field. In some cases there is prolapsed condition of the rectal
walls and in addition to corrective treatment the fingers are used to smooth
the walls and push the soft tissues upward in order to aid in toning up
and replacing the walls in normal position.
In Hemorrhoids where great rigidity of tissues
per rectum give internal manipulation to relax the tissuue and free circulation
also to empty engorged blood vessels alone recto-vesicle walls. In connection
with the pelvic condition the hypo-gastric plexus is an important nerve
center. This is located by deep pressure about two inches below the umbilical
region, just beneath the level of bifurcation of the aorta. The pelvic
plexus which is accessory to the hypo-gastric is located slightly lower
down and anterior from the median line lying deeply along each side of
the rectum. The spermatic or ovarian blood vessels are located by deep
pressure along a line beginning at the umbilical region, and one inch external
to the anterior superior spines of the ilium. The iliac blood vessels are
located by a line beginning at a point two inches below the level of the
umbilical area and from there passing out diagonally to a point where femoral
blood vessels pass out of the pelvis beneath Pouparts ligament.
In attempting to reach the gluteal arteries rotate
the thigh forward and then apply pressure at a point between the upper
and middle thirds of a line drawn from the posterior superior spines of
the ilium to the external side of the great trochanter.
Pubic arteries and nerves are located by placing
patient on side, stand in front of the patient and bend upper thigh backward
to relax the soft tissues and then apply pressure over the spine of the
ischium at the point between the middle and lower thirds of the line drawn
from the posterior side of the ilium to the external side of the tuberischi.
In examining The Uterus. It is not necessary
for internal examination and treatment unless in specific cases and these
are rare. In examining the uterus; first locate the uterus with the patient
standing and then examine with the patient first on the back then on the
side. In examination of the uterus:-
(1) Locate the round ligament over the upper border
of the pubic arch about one half inch external to the symphasis.
(2) Place the fingers over the ligament and apply
pressure while you rotate the limbs on the same side, then place the fingers
over both ligaments and rotate and flex both limbs.
(3) Follow this by flexing both limbs well on abdomen
and inserting the fingers along the sides of the ligament in the iliac
fossa region pressing the fingers deep so as to catch the uterosaral ligament.
(In case of displacement you generally have to locate one side and then
the other). Then push the finger and thumb down into the pelvis through
the abdominal wall while flexing and rotating the limbs. In this way locate
uterus and palpate around it to find out if it is floating or in fixation
or if there are any adhesions, or weather the uterus is flexed on itself
or is twisted on itself.
(4) Pressure over both great ligaments if there is
great tenderness indicates prolapsed uteri, if unilateral tenderness is
present on side of greater tension the organ is falling to the opposite
side, that is to say lateral displacement of the uterus. Normally uterus
is to right.
In the case of internal examination, this applies
to cases particularly those representing tumerous conditions, have the
patient on the back with the limbs flexed using the bimanual method of
examination, the external hand locating the organ through the abdominal
walls and the internal finger palpating (a)vaginal walls, especially for
flabby hyperrelaxed condition of the walls, cystic conditions, warty conditions,
polypoid growths etc.
(b) Cervis as it projects
into the upper vaginal canal. The main abnormal conditions found here are
hardening, softening and tumorfaction. In hardening (benign tumors)we get
rigid conditions, this is very typical of degenerative changes preceding
maligent disease locally. Erosion and ulceration these are palpated as
follows, the ulceration’s as little elevations and in the case of erosions
little pits. The typical differential point is pain. In tense pain in palpating.
(c)The internal ossuteri opens transversely at the lower end of the cervix,
here the two chief conditions are hardening and softening.
In regard to the ossuteri:
(1) If the transverse oss assumes an oblique position
in the pelvic cavity then the uterus occupies a corresponding condition,
turns to the one side or to the other corresponding with either prolapse
or version of the uterus in one position or the other.
(2) If the cervix points forward and upward the fundus
is downward and back, this places the fundus against the rectum, or it
may be turned (version), in falling backward the sciatic region and then
have most extreme form of recto-flexion with pain over the sacrum.
(3) If the cervix points back and upward the fundus
had dropped forward upon the bladder. According to this the key note of
determination in regard to malposition or displacement of the uterus depends
(a) The direction of the
(b) The direction of the
(c) The location of the fundus
(d) In flexion’s the determination
of the misplacement depends on the relative position of the cervix and
the fundus. The uterus being either forward on itself or backward on itself.
From the side of treatment it is of no importance to know the position
of the uterus , the only thing to know is direction of the oss, and cervix,
and position of the fundus.
In case of pain in the arms or shoulders the cause
may be in the shoulder joint, it may be due to the fibers contracting over
the coracoid process, or due to clavicle or rib lesions. In some cases
,the fibers may slip out of the bicipital groove.
Pain in the hand or fingers are generally secondary
to rib, vertebrae, elbow or shoulder lesions.
In the treatment of the arm.
(1) General flexion and rotation of the arm.
(2) Place closed hand in the axilla and force the
arm of the patient against the side springing the head of the humerous
outward in order to relax the ligaments and free the blood circulation.
(3) Grasp the arm just above the elbow and flex the
hand on the arm, or grasp the arm above the elbow and flex forearm to right
side then pull away from elbow. This relaxes the tissues.
(4) Inhibition or stimulation may be applied to the
axillary artery. The fibers of the brachial plexus by pressure on the inner
side of the humerous just beneath the axilla.
Grasp arm just above elbow and pull it straight back
at the level of the shoulder and then move it forward at the same level
and upward to right angle level to the shoulder, that is the best treatment
for relaxing the deltoid muscles.
(5) To stretch the biceps extend the arm and stretch
back and upward; in the case of displacement of the tendon of the biceps,
long head , give same treatment then flex arm and apply pressure directly
over tendon rapidity moving the flexed arm towards the sternum and then
outward laterally and upward horizontally.
In the limbs aside from the subject of dislocations
a general treatment of the limbs is called for.
(1) Flexion of the thigh on the abdomen followed
by extension and internal rotation after this manipulate directly over
the saphenous opening and under popliteal space to increase circulation
and relax contracted muscles and ligaments. Here we get especially the
stretching of the quadriceps extensor muscles, the posterior parts of the
gluteal muscles and the gluteal portion of the sciatic nerve.
(2) Hyper extension of the thigh stretches the anterior
muscles and particularly the anterior crural nerve and femoral vessels.
The hyperextension of the foot stretches the muscles of the foreleg and
strong flexion of the foot extends the muscles of the calf of the leg.
(3) Strong abduction is used to stretch the abdominal
muscles of the thigh with patient on the back, one leg straight out on
table the other is extreme abduction or circumduction stretches muscles
in external rotation and also stretching the pyriformiis muscles and the
(4) To stretch extensor muscles of the thigh and
sciatic nerve extend the limb at right angles to the trunk, this extension
is increased by extension of the foot while the limb at right angles to
the trunk.(Dangerous in weak heart)
(5) Patient on back, stimulation or inhibition of
the popliiteal nerve or blood vessels in the popiteal space by drawing
limbs over edge of table supporting foot between limbs while giving manipulation
deeply just below the knee posteriorly.
(6) Flexion, extension and version of the foot to
relax ligaments of the ankle and also relaxation of the ligaments by spinal
treatments, applying pressure on arch above and traction at the same time
below by increasing and decreasing arching of the foot by pressure has
similar effect. Similar treatment to the foot as a whole tends to free
blood circulation of the foot, follow this by lateral rotation and flexion
of the foot.
(7) In order to free femoral circulation rotate thigh
with limbs flexed at knee, first external then internal and follow this
by manipulation over the saphenous opening downward to get relaxation of
(8) In order to relax the tissues place the patient
on the back and note whether the foot as compared with the other, rotates
outward or inward too much this indicating relaxation or rotated conditions
of the muscles and ligament of the thigh. Elevate the foot gradually raising
it up towards right angle position, when limb has been raised as high as
patient can stand grasp the limb just above the knee and rotate limb in
opposite direction to the rigid or relaxed condition of the limb. Then
apply pressure right over knee rotating internal and then external while
applying pressure over the thigh just below articulation of the head of
the femur. (In treatment of extremities , hand and foot, begin at spine
and work out).
In Norton’s toe. Here is an involvement of the 2nd
or 3rd toe with intense pain, surgery considering this a case
for amputation. Either of the toes or removal of some of the small bones.
Norton’s toe involved the cuneiform bone, which is displaced upward and
anterior. Treat this condition by strong articulation at the ankle, followed
by strong articulation at the ankle, followed by extension of the phalanges,
and then articulation with pressure applied strongly over ankle joint,
then take the foot in both hands and pull it upward from phlanges diagonally
placing thumbs on tarsal bones to increase traction.
In case of sprains, either in the ankle joint,
in small bones or ligaments, for example, astragalus, on calciis, etc.
We find frequently cuneiform or os calcis thrown upward. In treatment begin
at the hip joint and thoroughly relax the muscles and soft tissue downward
along the limb, then articulate the bones, giving at the same time through
stretching to the bones and ligaments of the limb. If there is great pain
in ankle sprain soak the foot of the limb in hot water just before treatment
. This also applies to the arm. In sprains of ligaments give strong stretching
treatment and apply bandage to the ankle and foot using cotton under bandage.
In applying bandages in sprained foot or ankle begin at the leg and bandage
down, in sprain at the toe begin at the toe . If tenderness is very great
use a large amount of cotton. In cases of sprains leave the bandage on
all day and night and do not leave bandage off only when bathing foot,
say twice a day. The bandage should be changed twice a day. Best book on
sprains is "Houllin’s book on sprains.