A Manual of Osteopathic Manipulations
Wilfred L. Riggs, D. O.
DISEASES: THEIR OSTEOPATHIC CAUSES, CONDITIONS AND
THE Osteopathic treatment consists in stimulation
to the kidneys and correction of spinal lesion at eleventh, twelfth dorsal
or first lumbar and in the cervical region interfering with the action
of the vaso-motors. Also, correction of any condition which may affect
the action of the bowels. The
vaso-motors should be stimulated and all impediments to the circulation
removed. In cases of females it is essential that all uterine disorders
be corrected. Some cases are remarkably obstinate. Pay especial attention
Diet. Milk, eggs, cereals, meat broths
and game. Avoid all pastry, sweets, and greasy foods.
CHILLS AND FEVER, INTERMITTENT FEVER.)
In this disease the Osteopath considers a parasite
as the exciting cause though the general condition of the patient makes
the disease possible. Corrective treatment is directed towards the lesion
usually found at the seventh to eleventh dorsal vertebrae. To aid
in restoring the system the liver and spleen should be vibrated daily as
these glands are directly implicated. The chill may be broken by
strong stimulation of dorsal nerves, third to eleventh. This will usually
produce a perspiration in three to five minutes. To prevent the pyrexia,
strongly bend head backward holding firmly the vertebral arteries at junction
of atlas and occiput; this may be alternated with steady pressure on the
inferior cervical ganglion at head of first rib. The sweating may be relieved
by steady pressure in the upper dorsal region and by sponging with tepid
water. The bowels must be kept open.
Diet. Avoid all foods tending toward biliousness
Anaemia is not a disease but a symptom. The causes
are various; so must be the nature of the treatment. The most common causing
conditions are to be found in the lesions which produce constipation, digestive
troubles, menstrual disorders and derangement of the circulatory system.
Common chlorosis will yield to strong stimulation in the circulation
centers, together with corrective treatment for various lesions mentioned
above. A very common lesion is in the lumbar region, second and third
or fifth, causing either constipation or uterine disorders, one or both.
Thorough vibration of the liver and spleen, stimulation at the eighth and
ninth dorsal, together with correction of any lesion at this place will
be of value. Frequently a depressed clavicle and drooping ribs arc causes.
Should digestive disturbances accompany the condition, look for displaced
rib or vertebra from fourth to eighth dorsal. Outdoor exercise, cold
baths, change of occupation will all be valuable.
Diet. Milk between meals and especially
at bed time, eggs in all forms, rare meats and ice cream.
Avoid pickles, vinegar, gravies and rich sauces.
In true angina there is a neurosis of the nerves
to the heart. In pseudo anginas the trouble is intercostal. Occasionally
it is reflected from the stomach. Examine carefully the thoracic
wall, second to sixth rib and vertebrae. In nearly all such cases the third,
fourth or fifth ribs on left side will be found sub-dislocated. This dislocation
is usually at the vertebral end. There is marked tenderness at the angle
of the rib, at the costo-chondral or costo-sternal articulations, and usually
intercostal spaces. Occasionally the first rib is deflected.
Look carefully to the fifth and sixth cervical for disturbances at the
middle cervical ganglion. Anterior or lateral curvature in upper dorsal
region is common. In cases of tachycardia and high blood pressure a steady
pressure on middle and inferior cervical ganglion will be effective.
In cases of bradycardia the heart may be aroused by thorough stimulation
of these points. Friction over the heart and separation of the ribs
will be valuable. The use of tobacco, alcohol, etc., must be prohibited.
Quiet outdoor life is indicated. The false anginas may be completely cured.
True anginas can be relieved, but perhaps never cured.
Diet. Use concentrated, nutritious and easily
The lesion in this disease is to be found in the
lower dorsal and lumbar region. This may be either primary or it may be
merely contraction, the result of constipation, impaction, etc. This disease
may be a sequella to various acute diseases. The treatment should be directed
towards correcting the slip in the vertebrae and this will in most cases
be effective. Examine the eleventh and twelfth ribs carefully. Gentle
manipulation over the rigplaht iliac fossa, quiet manipulation of the limb
with external rotation is of some value. Constipation and impaction must
be overcome by the enema. Osteopathy has been marvelously successful in
this disease. Hot applications will be of value in removing congestion
and pain. Treatment should be administered several times daily in
order to keep the pain and inflammation under control. Avoid cases in the
Diet. Milk and buttermilk,
beaten eggs, nutritive broth. Avoid foods with residue.
In addition to the usual precautions in nursing,
bathing, diet, etc., the Osteopath would proceed as follows: First
thoroughly relax the congested and contracted muscles of the cervical region;
this will reduce pressure by facilitating drainage and by decreasing vaso-constrictor
action. The circulation may be further equalized by thorough quieting manipulation
of the muscles of the back on either side of the spine. Dislocated atlas
and axis are apt to be causes of these conditions. Reduction of these dislocations
will give relief in some cases. Clavicle and first rib are important
Manipulation of affected nerves and muscles will
be valuable in maintaining vitality of tissue. Keep bowels open and
kidneys active. Ice bags at head and neck, and heat at feet are advised.
Diet. All nourishing foods in liquid
form. Soft cooked eggs, beef broth, etc. Avoid alcoholic stimulants.
The cause is often remote. Examine carefully for
evidences of uterine trouble in female. The disease seems to be a referred
effect upon the central nervous system of peripheral irritation. There
are usually spinal lesions which correspond with joints affected. The treatment
consists in correcting these lesions, manipulating the nerves to the joints
and in thorough massage of surrounding structures to induce lymphatic absorption
and to facilitate drainage. The depurative organs must be kept active and
the circulation maintained at its normal. The affected joints must
be extended and flexed several times at each treatment. Bathing is a valuable
adjunct to our treatment. If taken in early stages a cure is the
rule. Later, the prognosis is not so favorable. There is no particular
virtue in a short course of treatment, and you should make it thoroughly
understood that months and even
years may be required to effect a cure. Diet and exercises are valuable.
Diet. Good roast beef, beefsteak, mutton,
fowl, fish, eggs and milk. Avoid low diet.
The lesions in this condition must vary with the
cause. The condition may result with disturbed heart action, valvular
incompetency, hepatic and renal affections. Careful examination of these
organs must be made to determine the location of the lesion. Vertebral
or costal slip from seventh to tenth may be a cause of hepatic obstruction.
The lesion will be eleventh to twelfth dorsal if from renal disturbance,
and from third to sixth dorsal if due to cardiac incompetency. Stimulate
the heart action, increase the drainage. A general treatment in addition
to the specific treatment is indicated. Treat daily until the excess of
fluid is overcome. Cases taken early yield readily; advanced cases are
more obstinate, and in many instances cannot be controlled. The diet
is an important part of the treatment, and must be varied according to
the organs affected.
Diet. Must be dry diet, consisting of bread
and meat chiefly. Some advise a liquid diet; we do not think this wise
except where urine is very scant.
The lesion in this disease is usually to be found
in the region of the third to seventh rib. The condition is usually caused
by one or more of these ribs being thrown downward. This lesion may occur
on either side. There is usually tenderness on pressure at the angles of
the ribs and at their costo-transverse articulation. Tenderness is sometimes
manifest at the head of the first rib.
Raise the ribs by any of the methods given. (See
plates 13, 17 and 32.) Strong inhibition at the inferior cervical ganglion
is palliative. In some cases pressure at the head of the first rib will
relieve the most violent paroxysms. Treat twice a week; it is rarely necessary
to treat oftener. Stop treatment when lesion is reduced.
Prognosis. Is good. Almost
all uncomplicated cases yield in one or two months.
ATAXI, LOCOMOTOR (TABES
In this disease there is always a spinal lesion,
although it in impossible to say where it will be found in a given case.
Usually the trouble is in the lumbar and lower dorsal regions. In some
cases there are lesions of ribs implicating the intercostal nerves. Thoroughly
relax the spine with extension, reduce the dislocations, separate the ribs.
Control the gastric crises in the dorsal region by correction and by steady
pressure. The exacerbation of pain may be overcome by inhibition in the
lumbar region. Give strong external rotation and steady pressure on the
sciatic nerve about midway between the great trochanter and the tuberosity
ischii. Require patient to gradually leave off the use of morphine, as
little or nothing can be done while the patient is using opiates. Applications
of heat may be useful.
Prognosis. Nearly all cases may be alleviated most
of them permanently benefited - a few cured. Long and persistent
treatment is necessary. Do not promise a cure,
as it is impossible to foretell the result even where there is a definite
lesion. It may be secondary or incidental.
Diet. A generous diet may be prescribed, such
as butter, gravies, cream, cod liver oil, etc. Avoid liquors, tobacco,
etc., to excess.
ATROPHY, PROGRESSIVE MUSCULAR
In this disease, whose cause is unknown to the medical
world, the Osteopath has had but slight experience. The condition would
indicate trouble in the upper dorsal and cervical regions. The trophic
nerves to the muscles of the arm seem to be associated with the brachial
plexus and may be affected either through it or through its vaso-motor
control in the upper dorsal region. Attention to the cervical ganglion
ix indicated. Look for involvement of the vertebral arteries. Thorough
relaxation and extension of the cervical and dorsal spines will be helpful.
Or the lesion may be found in the lower dorsal and lumbar region. Bathing
and exercise in moderation are valuable.
Prognosis. Is bad. All that may be expected
in advanced cases is to stay the progress of the disease.
Diet. Any nourishing foods.
Look to the emunctory organs. As a preventative the
skin must be thoroughly cleansed daily. Friction with a turkish towel will
aid in obtaining this result. Where the boils are confined to certain regions
the indications point to a local lesion interfering with the drainage.
If the head and neck are affected the trouble is in the cervical region.
If the lower limbs are affected look for the trouble in the lumbar and
sacral regions. In all cases stimulate the lymphatics by manipulations.
Look for circulatory disturbances; the liver and spleen are frequent causes
of this condition. The sexual organs may be at fault. Sexual perversion
or irregularity may cause it.
Diet. Cereals, fruits, lean meats, broths,
light vegetables and buttermilk. Avoid butter, gravies and all greasy foods,
rich milk, sugars, etc.
The Osteopath's work is directed toward two primary
First. The equalizing of the general
circulation of the blood.
Second. The continued control of the blood supply
to the brain and the correlative drainage.
To accomplish these ends the circulatory centers
are first thoroughly treated; the muscles, ligaments and tissues which
surround them are relaxed by pressure and by movements which will stretch
the tissue. The next treatment is a stimulation put upon the deeper structures
so as to secure the action of the heart and arteries. The third to fifth
dorsal is the region for this work. Next, raise the clavicles; notice carefully
the first rib and put steady pressure on the inferior cervical ganglion.
The solar plexus, controlling the lumen of the mesenteric vessels, aid
in controlling blood pressure. The hand laid firmly over the solar plexus
will reduce general arterial pressure and by equalizing the flow will relieve
congestion in any part of the body. The tissues of the neck demand a complete
relaxation. This is for drainage. Then by holding' the vertebral arteries
for three to five minutes, the head thrown backward, the cerebral congestion
is overcome. In cases of cerebral congestion the feet should be placed
in warm water and ice bags applied at basis crani.
Diet. A frequent change of diet is advisable.
Foods should be light, nourishing and laxative.
Spinal lesion is from tenth dorsal to second lumbar.
This must be corrected. There is always contraction of muscles and tightening
of ligaments in this region, though there may be no osseous lesions.
The patient lies first on face, and steady pressure upward and outward
of the muscles of the dorso-lumbar region will give a thorough relaxation.
Oscillating lower part of spine has the desired result. Patient lies
fiat on face. Place one hand firmly on spine at point desired and apply
steady pressure; with other hand oscillate the limbs from side to side.
Place patient on back, legs and thighs flexed, leaning over patient place
fingers under the spines and lift him on finger tips; or give the same
treatment, the patient lying completely extended and thoroughly relaxed.
The patient's weight is thus an aid to the end sought. Stretching
the spine in the swing is indicated. The warm pack, sweating and alkaline
waters are adjuvants. Several months' treatment will be necessary
in pronounced cases.
Diet. In no disease is the diet of more importance
than in this. Skimmed milk is the all-important food in many cases;
if patient is an invalid, seven or eight pints a day will be sufficient;
if patient exercises a good deal add cereals, nuts, rice and stale bread
to his milk diet. Avoid meats, alcohol, tobacco, etc.
In either acute or chronic bronchitis the treatment
is directed to the vaso-motors of the bronchial tubes as well as to the
motor filaments. The best results are obtained by stimulation at the second,
third and fourth ribs. The patient is placed on stool and these ribs are
elevated by pressing thumb against the head of 'the rib and throwing the
arm upward and slightly backward. Use care to avoid dislocating shoulder.
Patient is placed on side and ribs are separated by holding rib with one
hand and lifting rib next above with other hand. This is done with the
first four ribs consecutively. The patient is next placed on back and the
costal cartilages are separated by placing the fingers between them, then
turning fingers and spreading hands at the same time. At close of treatment
put your knee in upper dorsal and bring arms up and back, the patient taking
deep inhalation, then exhaling as the arms are released. Acute cases
should be treated daily or oftener.
For this symptom the cause must be found. In most
cases the trouble is in the sympathetic fibers of middle and inferior cervical
ganglion. The lesion is usually in the upper dorsal. Rarely it is a reflex
from peripheral disturbance to the pneumo-gastric (tenth cranial) nerve.
Stretching the spine, raising the clavicles and correcting the upper ribs
will usually correct the difficulty. There is marked tenderness at
the spines of the second to fifth vertebrae, with contractures and tenderness
between the ribs at their vertebral portion. There is usually a corresponding
tenderness between the ribs anteriorally; in many cases it is most pronounced
at the sternal - or costo-chondral articulation. I have found a strong
dilation of the sphincter ani very effective in securing a permanent cure.
Prognosis. Recovery is the rule.
BLADDER TROUBLE - CYSTITIS
The lesion may be peripheral through irritation from
preputial adhesions, etc., or from morbific substances in the bladder itself.
In case of much pus it is best to thoroughly wash the bladder with movements.
Then correct the osseous lesions, potassium bichromate or hydrogen peroxide..
The second, third and fourth sacral nerves will be found involved. Often
the twelfth dorsal and first lumbar are at fault. Sometimes the trouble
is at the second and the third lumbar. Always relax thoroughly in these
regions by steady pressure and by stretching Thorough relaxation in the
ischio-rectal fossa works through the perineal branches of the pudic nerve
and thus allays the irritation of the bladder. The rectum should be examined,
as it may reflexly affect the bladder.
The prostate gland is often involved.
BILIARY CALCULI - (GALL
The liver is usually enlarged and shows marked tenderness
on palpation. The characteristic lesion is usually to be found at the eighth
to tenth dorsal, or at the corresponding ribs. In case of paroxysms
relief is obtained on pressing inward at a point two inches above and the
same distance to the rigplaht of the umbilicus. Thorough manipulation of
this entire region, together with a downward movement in the line of the
bile duct, will aid in expelling the calculus from the duct. A strong stimulation
at the margin of the cartilages of the ninth and tenth ribs will produce
peristalsis of the cyst and ducts and aid in relieving this condition.
The ribs should be elevated and separated. Any osseous lesions at
the eighth to tenth dorsal must be corrected. A general stimulation to
the heart and lungs is indicated so as to increase oxidation processes.
Prognosis. Relief is almost certain. A cure
is the rule.
CALCULUS, - RENAL
The treatment is directed to the liver and the kidney
regions in the spine. Gentle manipulation downward over the line of the
ureter is indicated during the passage of a stone. Relief may also be obtained
by steady pressure at tenth dorsal to first lumbar. Gentle manipulation
of the abdomen over each kidney is useful. Thorough relaxation of the quadratus
lumborum eases the condition. In case the urine shows uric acid, alkaline
waters are indicated. If oxalate of lime, then thorough general treatment
must be given to increase oxidation. The patient must take plenty of outdoor
exercise. The respiratory activity must be increased by placing the knee
in back and drawing the arms upward, or by any other method. The hot bath
frequently gives relief.
Prognosis. Treatment usually effects a cure.
Diet. Meats, if urine shows phosphates; milk
and vegetables, if it hits uric acid deposit. In either condition patient
must drink not less than four pints of water daily.
In case there are irregularities or incompetency
much may be done toward correcting the condition, but a cure is impossible
in organic lesions after puberty.
Lesions. At cervical vertebrae, fifth
to seventh; at head of first rib; at fifth dorsal and fifth rib on left
side; tenderness at costo-chondral articulation of fifth rib, sometimes
fourth to sixth.
Treatment. Relax the muscles in regions
named; correct any osseous lesions. Raise the ribs and separate those on
left side. Set fifth dorsal and fifth rib. Raise the clavicle. A cure is
rare; marked improvement is the rule.
Diet. Give nourishing food, all
digestible meats, etc. Avoid soups and liquid diet, coffee, tea and all
In this condition there is usually reflex or a primary
disturbance at the atlas or the cilio-spinal center in the upper dorsal
region. In 1 per cent there is diabetic condition; in 6 per cent urine
shows albumen. This shows that the quality of the blood and the condition
of the nervous system are strong conditions favoring the disease. Absorption
by thorough drainage is the only Osteopathic indication. Correct any lesion
in cervical and upper dorsal regions. Treat the superior cervical ganglion
very lightly, not oftener than two or three times a week. The eye should
be vibrated daily by laying the fingers of one hand on the closed lids,
and rapidly, yet lightly, striking it with the other. By moving the eye
from side to side with thumb and finger the lymphatics are stimulated.
The general health of the patient must be carefully attended to by out-door
exercise. See that patient is correctly
fitted with glasses.
Prognosis. In many cases success has
attended Osteopathic treatment. Unless there is decided improvement
after two or three months' treatment a surgical operation should be recommended.
Diet. Must be nutritious in order to build
up entire system.
CATARRH - CORYZA-RHINITIS
Lesion. Usually in upper cervical region.
As an adjuvant, daily morning sponge-baths in cool
or cold water, followed by it brisk rub down should be recommended.
Daily exercise in breathing deepest possible inhalation and holding the
breath as long as possible, followed by forcible exhalation, is a great
feature in securing proper circulation and oxidation. Do not allow mouth
breathing; close mouth by chin support at night. Treat by relaxing the
muscles in upper cervical. Treat superior cervical ganglion at the second
and third cervical. Strongly inhibit at supra-orbital, infra-orbital and
mental foramina. Strongly press on nose at inner canthus. Bring the
thumbs down on either side of nose briskly several times. Dipping
the finger in cold water, reach back through mouth to posterior nares and
gently move the tissue from side to side. Put fingers just behind angle
of inferior maxillary, and while pressing gently have patient open and
close mouth; repeat several times.
This disease rarely requires the aid of a physician.
Isolation until desquamation is completed is necessary. Daily sponge baths
and airy rooms will aid. In case of temperature, reduce it by holding the
sub-occipital region or by pressure on the inferior cervical ganglion.
A general treatment will relieve any unpleasant feeling. Vaseline
or oil will allay the itching. Prognosis. Good.
The Osteopathic treatment consists in steady pressure
on abdomen over solar and inferior mesenteric plexuses. A very gentle manipulation
of abdomen is good. Steady pressure over splanchnics and spinal nerves,
from the dorsal to the coccyx, will usually give relief; the thumbs pressed
on either side of spine in lumbar region, with patient lying on his face,
is the most effective treatment. The spine should be sprung forward by
bending legs upward and backward, pressing in lumbar region. Treatments
must be given several times daily. Enemas, as hot as the elbow may comfortably
endure, may be given. This should be of castile soap suds and not less
than two pints so as to thoroughly wash the colon. This may be followed
by an injection of cooler water with tannic acid, twenty grains to the
pint, to precipitate the poisonous proteids.
Prognosis. If taken early, good -- later,
Diet. No milk must be given until all symptoms
have abated. No food for twenty-four to thirty-six hours. A spoonful of
champagne or a little whisky and water will prevent collapse. Baths in
warm mustard water with friction also aids in preventing collapse. After
twenty-four hours give barley water; next, meat-juice broths and egg albumen.
To stop the nausea and vomiting, pressure is applied
at fourth and fifth rib on rigplaht side, at same time separate the ribs
by elevating the rigplaht arm. Treat by steady pressure on the splanchnic
and lumbar nerves. An enema of hot soapsuds is indicated. Keep the patient
quiet. Little water should be allowed. Thirst may be relieved by
iced tea without sugar, or by cracked ice. Treatments may be rather severe
in case of adults. Nothing should be eaten while symptoms are pronounced.
Diet. Meat broths, milk and lime-water in
small quantities until convalescent, then restore usual diet very gradually.
CHOREA - ST. VITUS' DANCE
Lesions. When affecting the face and arms
only, the lesion is found in the cervical vertebrae or in the upper dorsal
region, either the rib or the vertebrae. When only a set of muscles are
involved the lesion is in the spinal region, which marks the emergence
of the nerves to the muscles involved. Thorough spinal treatment,
including thorough extension, together with correction of the lesion will
produce a cure. In cases of long standing there may be no marked tenderness
at the seat of the lesion.
Uterine trouble in females, constipation and flatulency
are conditions to be suspected and corrected if present.
Stimulating baths and outdoor exercise are beneficial.
Prognosis. About 50 per cent arc cured.
Diet. A nourishing diet should be prescribed.
CIRRHOSIS OF LIVER
Look for lesion in the splanchnic region, usually
at or near the eighth to tenth dorsal. Stimulation of these nerves with
correction of the vertebral lesions will be effective. Raise the ribs from
sixth to tenth. Often there is contracture of the intercostal muscles which
irritate the nerves from this segment of the cord. Examine the nerves of
the diaphragm and the ribs to which the diaphragm is attached, as this
muscular partition may bc at fault by preventing drainage. The spleen is
often involved and much enlarged. The patient should lie on his back with
legs flexed. The liver should be thoroughly kneaded. The patient may take
a deep inspiration, and as the breath is released the operator presses
upward under the seventh to tenth costal cartilages. The use of alcohol
must be interdicted. If accompanied by inanition, dyspepsia and malnutrition
the stomach and intestines must be carefully manipulated. Give careful
attention to the heart centers (first and fifth ribs). If ascites is present
give a thorough
stimulation of the kidneys, anteriorly and a relaxation and inhibition
over kidney center, eleventh dorsal to first lumbar; avoid liquid diet
when ascites is present.
Diet. Milk with toast and crackers; hot water
in large quantities. Avoid fats, sweets and fried foods.
COLD - CORYZA
Thorough relaxation of all the tissues of the neck
and stimulation of cardiac centers are indicated. Thorough stimulation
of the dorsal region will close the mesenteric capillaries and throw blood
to the surface. Stimulation of the fifth nerve at all its exits is well.
Put patient to bed; give hot foot bath and hot lemonade. Induce perspiration.
Use caution that there is no exposure following sweating.
Lesion. Lesion in lumbar region, usually twelfth
dorsal to third lumbar. Sometimes due to dislocated coccyx. In females
retro-flexion or retro-version may be the cause. Occasionally a lesion
in the liver region, sixth to tenth dorsal, produces this condition. Atomy
of the bowel, impaction and, in rare cases, invagination of the intestines
Treatment. Correct the vertebral lesions.
In all cases, except strangulation, the liver must be treated both directly
and in its splanchnic nerve supply. The bowels must be kneaded, following
the line of the colon. Usually begin at the left iliac region over sigmoid,
kneading with it downward motion, yet moving each time to a higher portion
of the intestines. In this way the entire large intestines should be treated.
The coccyx must be set if dislocated, and the sphincter dilated with a
rectal dilator, as it is more effective than the fingers. Never use oftener
than twice a week.
Outdoor exercise will be helpful, as will light gymnastics.
In complicated cases I have found most satisfactory
results from liver vibrations and from kneading the abdomen. Urge regular
hours for stooling.
Prognosis. Good. Treatment is
usually effective in from four to ten weeks.
Diet. The diet is an important adjunct.
Fruits, cereals and plenty of water are indicated. Little meats but
an abundance of oils and fats. A glass of cold water before breakfast and
a pint of hot water on retiring will give good results.
(PULMONARY PHTHISIS TUBERCULOSIS OF LUNGS)
Always include a sputum test in your examination
of pulmonary troubles.
Lesions in addition to symptoms usually mentioned,
ribs depressed and tenderness at angles of ribs covering effected part
of lung.. Also marked tenderness in intercostal spaces, and at the costo-chondral
articulations. The spine is invariably straight or anterior in the dorsal
region, the normal curve being practically obliterated.
Rarely a turned rib or, perhaps, two or three
will be the sole cause of the symptoms in suspected cases. See that clavicles
are not depressed.
Treatment. Treat vigorously in
the dorsal region from first to eighth. Pay particular attention
to the circulation. Inhibit at inferior cervical ganglion to reduce rate
of heart beat. Raise the ribs by any method. Separate them anteriorly
by placing fingers between the ribs with palmar surfaces flat downward,
press gently and turn the hand. Place patient on a stool with knee in back,
draw arms upwards and backwards, the patient inhaling' deeply. Night sweats
are controlled by strong inhibition in dorsal region. Keep patient out
doors as much as possible with some light occupation; insist on light exercise
Prognosis. Favorable in early
stages. In advanced cases there is no hope of complete cure. Unpleasant
symptoms can be abated in all cases and patient made easy.
Diet. The diet is of primary importance.
Idiosyncrasies must be consulted, but meats, ripe fruits and fats
are the basis. Cream, butter, oils and eggs, unless there is gastric
trouble. In emaciation there is nothing better than cod liver oil. It should
be discontinued in case it interferes with digestion. Nutrition is the
key to recovery.
If from poisonings, of course the proper antidote
is indicated. Look for phimosis, ouitis, indigestion, teething, worms,
etc. To check the convulsion, grasp the head firmly, one hand on forehead
and the thumb and second finger of the other in the sub-occipital region.
Bend head strongly backward. Hold in this position. An assistant grasping
the ankles and putting extending force on spine is also helpful. Free the
neck so as to give perfect drainage to the brain.
Knead the abdomen in intestinal and gastric
In convulsions from dentition a hot bath,
95 to 96o F., is recommended, with cold applications to head.
Treatment will depend on the nature of cough. In
many cases it is due to an elongated uvula. For this, dip finger in cold
water and gently manipulate the palate and uvula. In case it is pharyngeal
look for lesions in upper and middle cervical. If bronchial, the lesion
is usually at second or fourth dorsal or along the corresponding ribs.
In all cases thoroughly relax the muscles of the neck. Then inhibit by
steady pressure, slowly moving the hand downward over the trachea on either
side from the first ring of trachea downward to sternum.
Relax the sterno-hyoid and sterno-thyroid muscles.
Contracted muscles often cause the irritation here.
Pressure at the third dorsal will usually relieve
the paroxysm. In pneumonia and other pulmonary troubles it is very necessary
to be able to relieve the coughing as it prevents exhaustion. The
point will usually be found from second to fifth dorsal, at which place
steady pressure and throwing the ribs upward will be efficacious.
Remember, a cough may be symptomatic of many troubles;
find the cause; it may be from any organ of the body.
Thoroughly relax all muscles of the neck; steady
and prolonged work is necessary. Extend the neck forcefully. Work downward
over the jugulars to secure drainage. Dip finger in cold water and stimulate
pharynx. Use cold compresses; flannel cloths wrung from ice water wrapped
closely about the neck give instantaneous relief in many cases. The nerves
involved are the ninth, tenth and eleventh cranial and the sympathetic.
In chronic cases trouble will be found in cervical vertebrae.
In case emesis is desired thrust finger down fauces
or use ordinary emetics.
In diphtheria and membraneous croup isolation and
disinfection are necessary. A disinfecting spray is necessary to the diseased
part. Bichloride of mercury l: 1000 or 2000 is perhaps best. Carbolic 3
per cent solution in 30 per cent alcohol is much used. Boric acid and hydrogen
peroxide are also used. Follow usual methods of reducing the fever.
Prognosis. Good if case is taken early.
If pronounced, suspect tubercular trouble and seek
for history. Examine carefully the condition of the organs of the chest.
The heart and lungs may be causes of this condition. Look to the condition
of the ribs. Depressed ribs and elevated costal cartilages are often secondary,
yet must receive special treatment.
In all cases of curvature except those from lack
of osseous development thorough relaxation is required. Extension
either on swing or table is the first step. Steady pressure is put
on the deep muscles of the spine for thorough relaxation.
In case of imperfect hardening of the bones cereal
foods, morning baths and gymnastics, etc., together with extension of spine
followed by stimulation will correct the troubles.
In all lesions the theory is to thoroughly relax
the part, then increase the dislocation and on movement in opposite direction
the tendency is to overcome the luxation. After a thorough extension and
relaxation, the patient should be placed on stool; the physician standing
behind places knee in back just below the vertebrae which are anterior.
Passing his arms below those of the patient he takes hold of the ribs corresponding
to vertebrae to be corrected. As the patient takes a deep inhalation, strong
traction is made against the ribs, the knee being held firmly in position.
Another method is to have patient recline on table - the patient's legs
and thighs are flexed and the physician and an assistant stand on either
side, the hands are placed beneath the vertebra above the one
to be set; using this as a fulcrum, the spine is forced backward by turning
the body and legs up towards the head. This is a successful method.
This movement is not to be given in many cases. It is successful
from sixth dorsal downward. In the upper dorsal region the anterior tendency
may be overcome by having the patient thoroughly relaxed on back. Elevate
the head and shoulders, bending the upper part of the spine upon
the vertebra below the one to be set.
A good method is to have the patient clasp his hands
behind his neck; standing behind, pass your arms beneath his, clasp his
wrists, force the head forward and sway the body from side to side. This
will correct any anterior tendency. Must be used cautiously.
First, seat patient on stool. Standing at the side
pass one arm around in front and back to angle of rib corresponding to
vertebra involved. Lifting upward with this arm, at the same time sway
the body first forward to the limit and then, pressing with the free hand
on vertebra to be corrected, throw the body suddenly backward.
A very good method is to have the patient lie on
his face thoroughly relaxed. The physician gently presses on the
transverse processes of the vertebra in succession until the one which
is posterior is reached, then in addition to the steady pressure the physician
throws sudden weight upon the vertebra and it is slipped into place. A
little practice will make one an adept. Care must be used in case of a
Practically the same movements are used in overcoming a
lumbar curvature, varying the movements to suit the changed condition.
You will find the usual contracture and tendonous
condition of the muscles. This contracture may be overcome by repeated
application of steady pressure, although it may require some time to accomplish
this. At each treatment the patient should be placed on his face and the
spine made fixed at the curvature, the body swung from side to side
as above indicated. Extension is most valuable. Have the feet
fastened, or an assistant may hold them, while you reach under the arms
so as to put the force on the spine. The "swing" is a good method
of treating curvature. Swinging from a bar by the arms is always to be
recommended, as well as gymnastics, physical culture, etc.
In all spinal curvatures in which there has been
no extended destruction of bone tissue, these measures will be successful.
The time will vary from two to thirty months, according to the severity
of the case.
When there is evidence of active tubercular processes
little can be expected. In all cases the circulation to the spine
can be greatly improved by thorough manipulation along the spine and by
the foregoing movements very gently applied.
In dementia the lesion is to be found in the neck
or else in the region controlling the genital organs. The causes
being so varied and the lesions so widely remote it is impossible to give
a definite treatment. A careful examination of the spine, finding
the lesion and correcting it will be followed by a recovery. It must
be remembered that in many cases no osteopathic lesions can be found.
The causes in these cases being idiopathic, little or nothing can be promised.
Lesion is found from eighth dorsal to second lumbar.
Treatment. Correct lesion in this region.
Strong inhibition down spine from lower dorsal to sacrum. Even the
bladder region, second and third sacral, may profitably be inhibited.
Also in the ischiorectal fossa. Correction of above named lesions will
cure in most cases. Place patient on back, flex leg and thigh, and
leaning over patient place hands beneath the dorsal and lumbar spine and
spring it forward.
Another method. Patient on side,
physician standing in front, flex the legs by putting them against your
side or hip and reaching over, place your fingers on side of spinous processes
and spring the spine forward. Or have patient sit on stool,
stand in front and have patient extend arms across your shoulders.
Strongly grasp and press forward the dorsal and lumbar spinal regions,
at the same time lifting the shoulders and throwing them backward.
Prognosis. Must be guarded.
Diet. Meat and soup broths, eggs, fresh fish
of all kinds, fowls and game, olive oil, fats, butter and gluten bread.
Saccharin must be used instead of sugar. Following vegetables may
be allowed: Dandelion, horseradish, celery, lettuce and cranberries.
Avoid breads, potatoes and other starches, sweets
of all kinds and liver.
Diarrhea is controlled by extension of the spine
and by springing the spine forward in the lumbar and lower dorsal region.
The patient is first extended with force, the shoulders and ankles being
the points of traction. He is next laid on his face and a quiet,
steady pressure is applied on either side of the spine from the middle
dorsal region to the coccyx. This will occupy about ten minutes. One hand
is then placed in the lumbar region of the spine, while the legs are strongly
extended backward. This will usually be sufficient in acute cases.
An enema of warm water is helpful. Withhold food and curtail the
drink for twelve hours.
Diet. Diet and drinks must be restricted.
Boiled milk and arrow root may be given when strength is impaired.
Return to the usual diet gradually; oatmeal water, barley water, corn-starch
pudding, broths and dry toast are allowable.
Treatment same as for membraneous croup, which see.
Strict isolation is imperative.
A displacement of the vertebrae at third and fourth
lumbar is almost invariably found. Correct this at once. Then
give strong and continued inhibition over the sacral region. The abdomen
should be treated by steady pressure over the solar and inferior mesenteric
plexuses. In many cases one or two treatments will suffice. In others
it is necessary to repeat the treatment several times.
Diet. Same as in diarrhea, q.v.
The lesion is usually found in the region lying between
the second and sixth dorsal. Occasionally it may involve the intestines
as well as the stomach, in which condition the lesion may be found lower
in the dorsal region. Rarely does a lesion in the cervical region affect
the stomach - such conditions being coincident rather than causative. There
may be an irregularity of the cartilages of any of the ribs overlying the
stomach. The gases present may be removed by steady pressure over the stomach
- either absorbing them or in many cases forcing them down the intestines
- pressure serving to relax the muscular walls. The bowels and kidneys
must be kept active. Outdoor exercise is advisable.
Diet. No specific diet can be prescribed
but the following are allowable: Cereals, breakfast foods, etc., chicken,
turkey, broiled beefsteaks, fish (boiled or broiled), oysters and light
vegetables, such as peas and lettuce. Avoid rich soups, gravies,
condiments, pickles, fresh bread, sugars, tea, coffee, tobacco, very
acid or very sweet fruits.
The causes may be various. Some of the commoner ones
being from the eyes, the stomach, the liver, the kidneys and the circulatory
system. Examination will reveal the source of the trouble. In many
instances the glasses are at fault. Should it prove to be a vaso-motor
disturbance the trouble is usually to be found in the cervical region.
To relieve this condition press deeply beneath the clavicle so as to reach
the fibers of the cardiac plexus. Throw the head well back, holding
strongly with one hand at the junction of occiput and atlas.
Draw the hands firmly downward over the lines of
the jugulars. Raise the clavicles. Treat the various organs affected.
Correct the cervical lesions.
EAR - DEAFNESS
Always examine with endoscope for perforated membrane and
for accumulation of cerumen. Lesion is usually found from second to fourth
cervical vertebrae. Sometimes disturbance in the vaso-motors as remote
as the lower cervical may produce disturbance. Contractures of the
scaleni, the sterno-cleido-mastoid, the omo-hyoid or the digastric may
produce disease of the ear.
Treatment. Reach the great occipital
at the second cervical and at the basi-occiput; the seventh, at its
exit from the stylo-mastoid foramen; the ninth and tenth at their exit
from the jugular foramen just posterior and inferior to the lobule of the
ear. Thorough relaxation of the tissues in this region is very beneficial.
In addition, the finger should be inserted in the mouth and the tonsils
and the openings of the Eustachian tubes thoroughly stimulated. Cerumen
should be removed with oil and soapsuds.
Prognosis. If trouble is catarrhal,
favorable; if from other causes, doubtful.
If the eruption is local, then it is certain that
an interference in the drainage of that region, either lymphatic or venous,
is the exciting cause. The cause is either a disturbance
in the cervical sympathetics or else at the kidney center, interfering
with excretion. The atlas and axis are frequently misplaced, particularly
in case of eczema of the head and face. The bowels and kidneys should
be kept open and the stomach in good condition. By watching the diet
carefully it is possible to make this a valuable adjunct to the treatment.
Treatment. Correct any lesions in the cervical
region (see cervical vertebrae). Next treat kidneys and bowels thoroughly
(see kidneys and bowels). Cleanse the affected parts with a solution
of hot boric acid twice daily.
Prognosis. Most cases can be cured.
Diet. The diet should be wholesome and
nourishing. Remember, that more than half the cases are from too much or
improper food. Milk, whole-wheat bread, fresh vegetables plainly cooked,
chicken and fresh fish; meats very sparingly; oatmeal is often injurious.
Avoid pastry, sweets, sauces, rich soups and heavy vegetables.
This disease is a sequel of other disturbances and
represents changes which have taken place in the lung tissue.
Lesion. In the lung region of the spine or
else in the cervical sympathetic. The vagus may be involved. The costal
lesions are compensatory and cannot be considered in the light of causes.
For treatment. Correction of the spinal and
costal lesions. The liver and heart must be carefully watched as these
two organs are closely associated with the general condition of the blood.
The only hopes of benefit is through the general vaso-motors and the vagal
branches to the bronchial tubes, the vaso-motors to the lungs.
Prognosis. Little can be done; there is no
hope of curing cases of long standing.
In acute cases rest and nourishing diet are the first
Lesion. Tenderness will be found in the dorsal
region from the third to the sixth, usually at the fourth and fifth.
Treatment. Treat by strong inhibition anteriorly
at fifth and sixth cervical, also at head of first rib and annulus of Vieussens.
Raise the ribs gently but strongly.
In chronic cases the ribs should be raised on left
side. In many cases there is a displacement of the first rib upward, interfering
with the inferior cervical ganglion. The fifth rib is usually displaced
downward and correction of this lesion will be followed by marked improvement.
In case there is mitral incompetency, the condition of the lower ribs and
the diaphragm must be examined carefully. The diaphragm may by traction
on the aorta occlude its lumen.
Prognosis. Treatment is helpful.
Diet. (See heart troubles.)
The lesion may be found anywhere in the dorsal or
lumbar vertebra, usually in lower dorsal and upper lumbar. Some error in
diet is usually the exciting cause; this should be carefully guarded until
the recovery is complete.
Treatment. Control by steady pressure in the
splanchnic region. Relaxation by steady pressure in the lumbar region is
helpful. The knee in the dorso-lumbar region, the spine being thrown backward,
is usually sufficient to quiet the peristalsis. Steady pressure over the
solar and mesenteric plexuses corrects flatulency and quiets peristalsis.
Hot fomentations applied to abdomen or a hot bath will relieve the pain.
The liver should be treated to throw the bile into the intestines to prevent
decomposition. Impaction, etc., must be relieved.
Prognosis. Cure is almost certain and permanent.
Lesion. Usually found at second to fourth
Treatment. Correct lesion. Spring the spine
forward and give strong inhibition at the lower dorsal and lumbar, region.
Use irrigplaation for the large intestines; cool or cold water. Rest in
bed, and a proper diet in connection with treatment three to five times
daily, will effect a cure.
Diet. Broths, egg albumen and beef juice are
the proper food. Avoid over feeding.
Lesion. Lesions are as various as the causes.
Most osteopathic cases show marked lesions in the cervical regions, but
this is not always the case. Occasionally a single lesion in the
dorsal region is the entire cause. Rarely it is a reflex from uterine disturbances,
phimosis, or masturbation, in which cases there will be secondary lesions
in the lumbar region. In case no lesion is apparent and the case is of
long standing, there is little hope for success.
Treatment. The treatment will vary with the
lesions, but the neck must always be carefully treated for the circulation
to the brain. The spine must be thoroughly relaxed and the irritation to
the nervous system released. A healthful attitude of mind on the part of
the patient is essential as is outdoor exercise.
Prognosis. Unfavorable; several months are
required to accomplish anything.
Diet. Nourishing diet; meat sparingly.
Few cases have been treated osteopathically, but
those have been with uniform success.
Lesion. The lesion is usually found in the
cervical region, either in the vertebrae themselves or the muscles.
Treatment. Restlessness is overcome by sponging
in cool or tepid water and by thorough manipulation down the spine. Thorough
drainage must be} secured, and treatment of the lesions usually found in
the cervical region, or as low as the fourth dorsal, is effective.
Avoid local treatments and confinement cases while attending erysipelas.
Cold water is perhaps the best application.
Diet. Food in small quantities, an ounce
every hour; pancreatinized milk, beef juice, egg-nog and gruel.
Stimulate the superior cervical ganglion. Steady
pressure at inner canthus of eye. Thorough relaxation of the muscles over
jugulars is indicated. Raise arms over head. Compress the facial artery
at angle of inferior maxillary. Ice may be applied at basi-occiput.
In extreme cases the anterior and posterior nares may be plugged.
Three symptoms - exophthalmus, enlargement of the
thyroid gland and a rapid and peculiar heart beat - are usually present,
but only two of the three may be. Occasionally complications may occur.
Lesion. In cervical vertebra usually the fifth
or sixth, lateral; at the last cervical vertebra; or the upward dislocation
of the first rib; also the fifth rib on the left side may be involved.
Vaso-motor fibers may come from the third dorsal nerve to the thyroid;
hence the lesion producing vaso-motor change in the gland may be from this
region. The eye should be gently manipulated and a relaxing treatment over
the line of the internal carotid artery is suggested. The region just below
the ear is very important. Keep the upper ribs raised and the upper dorsal
spine thoroughly relaxed.
Prognosis. Thirty-three per cent cured;
It is not in the province of this work to give the
minute details of this treatment in various troubles which affect the eye.
Lesion. The lesion is usually in the
upper cervical region; either the first, second, third or fourth. There
is a prevalent idea that the atlas is dislocated in all eye troubles. While
this is true in some cases, yet not always do you find it so. Lesions are
also found at the first rib and the second and third dorsal vertebrae and
even as low as the fifth.
Treatment. Find and correct the lesions. Additional
treatment to the eyeball should be given by laying the tips of the fingers
lightly on the closed lids, tapping these lightly and rapidly with the
fingers of the other hand. By placing the thumb and forefinger, one at
either canthus, the eye may be compressed. By gently working as far back
of the eyeball as is possible, both above and below and laterally, the
muscles of the eye may be reached and relieved. The fifth nerve at its
various points of exit, - on the eyelids, at inner canthus, at supra-orbital
notch, and infra-orbital foramen, should be treated chiefly by inhibition.
The inferior maxillary branch may be reached below the tempero-maxillary
articulation. If the circulation or drainage of the eye is interfered with,
the application of hot and cold water alternately is recommended.
Prognosis. Very favorable in most troubles.
The general treatment for pyrexia is as follows:
The muscles of the spine are thoroughly relaxed, giving particular attention
to the splanchnic region. The ribs over the heart, third to sixth, are
raised and the muscles of the neck are thoroughly relaxed. Steady pressure
is now put upon the sub-occipital region, the hand covering the segment
from the occiput to the fifth cervical vertebra. This diminishes the impulses
sent in from the cervical nerves to the thermogenic center in the corpus
striatum; next place the thumb and finger against the atlas, holding the
vertebral arteries, and strongly bend the head backwards. This should be
continued for some five or six minutes. Press deeply and steadily downward
at the head of the first rib; you here reach the augmentor fibres to the
Next, put steady pressure on abdomen over the solar
and inferior mesenteric plexuses. These steps carefully and quietly taken
will usually reduce the rapidity of the heart beat, and after a half hour
will reduce the temperature. Sometimes it is necessary to repeat the treatment
within two or three hours. Do not allow the patient to take his temperature
or pulse. A cool sponge bath or a dip into cool water is a very safe method
of controlling temperature.
Diet. Nutritious foods. Milk, eggs, etc.
There is no disease in which more varied complications
may occur than in scarlet fever, and for this reason the utmost vigilance
is required on the part of the physician. The ear and the kidneys are the
organs most likely to be affected. The temperature is to be controlled
as in any other fever, by holding the sub-occipital region and by inhibition
at the annulus of Vieussens. A gentle manipulation of the abdomen with
steady pressure on the abdominal plexuses will aid in equalizing the circulation
and in reducing the temperature. The muscles of the entire spinal region
must be relaxed, particular attention being given to the upper dorsal and
cervical groups. This relieves the hyperaemia of the nerve centers and
restores normal heart action, heat production and dissemination. By careful
manipulation, securing efficient drainage of the neck, the inflammation
of the cervical lymphatic glands, so apt to follow cases in which the pharyngeal
symptoms were severe, can be controlled or prevented.
Should arthritis occur, gentle manipulation producing
drainage is required. In case the fever become high, use the sponge bath,
and if delirium, the cold pack or the cold bath should be used. A cold
compress around the neck will relieve the throat symptoms. Should heart
action become poor, stimulation of the inferior cervical ganglion and separating
the ribs will be successful. If the care has been thorough there
is little danger of any of the complications.
Diet. Milk, a small amount of vanilla
ice cream, lemonade and barley water; but milk should form the basis.
Isolation. and disinfection must be
This, like gastric ulcer, gastralgia, gastrodynia
and related troubles, presents no lesions differing from those of dyspepsia.
The diet is of much importance but the chief reliance must be in correcting
the lesions which occur either in the vertebrae or the ribs in the region
of the third to sixth, or sometimes the seventh or eighth. In gastrodynia
and gastralgia the trouble is frequently found to be a dislocated or turned
rib. For specific lesions and treatment, see dyspepsia.
Lesion will be found in the cervical, or the
upper dorsal region The clavicle is most frequently depressed. The first
or second ribs are elevated. Thoroughly relax the muscles of the
neck, and correct the lesions in the cervical vertebrae; gently manipulate
the gland itself, following the direction of its drainage. Treatment similar
to that of exophthalmic goitre is indicated.
Correct any lesion in the splanchnic region. Keep
the head low and the patient quiet. Inhibition of the vagi will quiet the
peristalsis. Hot foot bath or dry heat applied to feet, with an ice bag
over abdomen is valuable.
Lesion is in region of eleventh dorsal to first lumbar.
Correct this and thoroughly inhibit in the lumbar and sacral regions.
If hemorrhage is from bladder the trouble is at second to fifth lumbar.
Ice bags should be applied to loins.
This is usually an indication of tuberculosis
It may be the result of other conditions, as menstrual disorders, cardiac
To stop the hemorrhage is in many cases impossible.
In case it is not too rapid, it may be checked by having patient lie in
bed. Stimulation of the pneumogastric nerve will reduce blood pressure
in the pulmonary system by acting on the pressor nerves to the bronchial
vessels and by decreasing the rapidity and strength of the heartbeat. Cracked
ice held in the mouth is beneficial.
HAEMORRHOIDS - PILES
Constipation is a frequent complication, and when
such is the case the cure of this condition will usually overcome the haemorrhoids.
Examine the coccyx, as this is frequently a source of trouble; a slipped
innominate, or a lumbar lesion, is often a cause. A congested liver causing
stasis in the portal circulation is oftimes a cause of poor drainage through
the superior haemorrhoidal vein; therefore pay especial attention to the
liver. Treat the pudic nerve, and especially relax structures in the ischio-rectal
region. Stimulation of the ganglion impar is helpful to the drainage.
Prognosis. Usually one to three months' treatment
will effect a cure.
Diet. Such as would prevent constipation or
Lesion in cervical region interfering with nutrition
to the mucous membrane of the nasal passages.
Treatment at the points of emergence of the fifth
nerve and over the surface of the nose will give relief.
Steady pressure with the fingers over the frontal
sinuses and over the sinuses of the superior maxillary and ethmoidal bones,
and on the sides of the nose will also relieve the symptoms. Relaxing the
muscles at the occiput, and correcting the lesion in the cervical region
will make the cure permanent. Treating the pharyngeal plexus and
the palatine nerves at the tonsils and over the hard palate helps the condition.
Meckel's ganglion also sends branches to the nasal fossa, which are both
vaso-motor and trophic.
Outdoor exercise, gymnastics, baths, etc., are adjuvants.
In constant or periodic headache, lesion may be found
either in cervical, upper dorsal or in lumbar regions. It may be
associated as a result with various conditions. To make the cure permanent
these conditions must he corrected. The usual treatment is to thoroughly
relax the tissues of the neck and of the upper dorsal region. Raise the
clavicles, secure free drainage for the brain through the jugular veins
by working downward from jugular foramina with thumbs following line of
veins. Quiet the heartbeat by steady pressure on the annulus. Steady
pressure over the points of emergence of the fifth nerve will often stop
the pain anteriorly, while pressure on the sub- and great occipital nerves
will stop a posterior pain. Firmly holding the sub-occipital region
and throwing the head backward will stop the flow from the vertebral arteries
and at the same time facilitate drainage. Press gently on solar plexus;
give thorough relaxation in the splanchnic region.
HEMICRANIA - SICK
HEADACHE - MIGRAINE
Reduce the heart action by freeing the ribs on the
left side and holding the inferior cervical ganglia. Should there be nausea,
it is relieved by elevating and separating the third to fifth rib on the
rigplaht side. Look for cervical lesions as well as in other regions.
The treatment is similar to that for headache, q. v.
The cause may be either cerebral or spinal. The circulation
to the nerve centers must be maintained by relaxing the muscles in the
entire spinal region from occiput to coccyx. In the spinal type of hemiplegia
the lesion is found to be a slipped vertebra.
There will be marked muscular and usually osseous
lesions in the cervical region in cerebral cases. The treatment is correction,
but it is more. The strongest extension must be used. Every muscle must
be kneaded, every nerve traced and stimulated. All articulations, even
to the phalangeal must be flexed and extended at each treatment. Experience
shows the corrective spinal treatment should be given three times each
week. The muscular, nerve and articular manipulations should be given daily.
Keep the bowels, kidneys and the heart in good condition.
Prognosis. Improvement marked and permanent.
A complete cure is rare.
Inhibit the phrenic nerve over the third, fourth and fifth
cervical. If severe, treat splanchnic area. Often associated with
other diseases, affecting the nervous system. Direct treatment to diaphragm
HIVES - URTICARIA
Lesion may be remote. This is reflex from various
causes, such as intestinal, gastric, uterine, ovarian, renal or nervous
troubles. The whole spine must be examined and patient questioned
for other symptoms. Irregularities in diet must be corrected. Give a general
treatment to equalize the circulation and treat the special conditions
according to requirements.
Occurring along the distribution of a certain nerve,
it clearly has a local cause. We treat it as due to a neurosis of the nerve
caused by a failure of the veins and capillaries to drain the region.
Seek for the impediment - usually a contracted muscle. A few local
treatments daily along the course of the nerve is effectual.
HYPERAEMIA - OF ANY ORGAN
Find the local vaso-constrictor nerves, of the organ.
Stimulate them by the method of alternate or varying pressures. This will
reduce capillary pressure. Next, see that the tissues of the organ are
relaxed; third, secure drainage by relaxing all structures lying on or
near the veins which drain the organ; fourth, reduce the pressure generally
by an inhibitory treatment in heart centers, third to fifth dorsal and
at the annulus of Vieussens.
HIP - DISLOCATION OF
Though the strongest of the freely movable articulations,
the hip is frequently partially or completely dislocated. If the
hip is completely out, the gait will usually indicate the condition.
The Osteopath must bear in mind the fact that even
partial or complete dislocation may be the result of tubercular processes.
Motion in such cases is a positive injury, though treatment may be effective
if directed toward the blood and nerve supply. In dislocation the
ilio-femoral ligament, the most resistant portion of the capsular, determines
largely the position of the hip.
To detect dislocation the patient should be lying
straight, face upward; place the thumbs on the anterior superior spines
of the ilia. A comparison of the two sides is usually the surest way of
determining relative positions of the parts. Nelaton's line is useful.
It is a line from the anterior superior spine to the tuberosity ischii.
On this line lies the center of the acetabulum and at the same level as
the trochanter major. The femur may he dislocated in any direction; backward,
either above the dorsurn ilii, or below the obturator internus muscle into
the sacro-sciatic notch, or it may be anterior on the pubes or inferior
into the obturator or thyroid foramen.
The effect of the dislocation may be manifest in
the gait, muscular condition of the limb, pain at hip or at knee, and in
the condition of the blood vessels of the limb; these various tissues may
be affected in various ways. Venous stasis, neuritis and muscular atrophy
are very common sequelae of femoral dislocation.
To set a dislocated femur, have the patient lie on
his side on a low table or couch with his dislocated hip upward. Flex both
legs. With one arm clasp his leg at knee and with the other hand on the
trochanter the hip may be turned into place. Patient may sit on stool and
the physician sits on the knee of sound limb. Now take hold of ankle and
trochanter, as above, and turn into place. Either of these positions relaxes
the tissues and makes the work much easier.
Find if possible the cause. Local examinations
for pelvic troubles may be necessary. In many cases the cause seems
to be a reflex, the deep muscles of the back being contracted. In
such a case a strong extension followed by quieting treatment along the
spine is indicated. A turned rib may be the causus causans. Avoid all stimulants.
Use nourishing and easily digested food. Be master of your patient.
Suggestion is, in such cases, a most valuable aid. A gentle downward
stroking of the spine will produce sleep.
A cool bath each morning aids the circulation; the
rest cure is some times productive of good. At other times a shock or a
scolding will produce a change.
Pressure in the sub-occipital region or on the ganglia
of the cervical sympathetic will stop the muscular spasms. No two cases
can be treated alike.
ICTERUS - JAUNDICE
This is a symptom of many diseases. The one constant condition
is obstruction of the biliary ducts.
Treatment. Vibrate the liver, the patient lying
on left side or on back. Press upward beneath seventh to tenth cartilages
on rigplaht side. Knead the bowels. Open bowels thoroughly; relax the muscles
in lower dorsal region. Careful examination will reveal lesion in
the dorsal region eighth to tenth. Not infrequently a rib is pressing
upon the liver. Readily yields to the treatment. Give light diet and abundance
ILIUM - DISLOCATION OF
The pelvis may be considered as formed of three bones,
viz., the sacrum and the two innominates. Of course the sacrum articulates
with the last lumbar vertebra above and the coccyx below, but these may
be treated as vertebral articulations.
This will then give us three points for dislocations
- at the sacro-iliac synchondroses and at the pubic symphysis.
Causes may be varied. The most common are sudden
jars, strains in rowing or lifting, falls, and childbirth.
The condition may be that of both innominates tipped
either forward or backward, giving the patient a peculiar gait, halting
step and a constant fear of falling; or one innominate may be slipped either
upward or downward, the other remaining in its true position. In this case
there will be it marked slip at the symphysis pubis accompanied by exalted
These conditions affect the cutaneous sensations
and muscular condition of lower limbs. They are also accompanied by neuritis,
rheumatism, sciatica and circulatory disturbances. They frequently produce
a direct effect on the condition of all the pelvic organs, including the
rectum and its sphincters.
To correct a forward innominate, the iliac crest
and the tuberosity ischii offer points for obtaining leverage, the patient
lying on his side. Force, by a rotary motion, the crest backward and the
tuberosity forward and the work is done. The reverse motion will replace
a backward slip of the innominate; or, it. may be done as in plate 27.
Should both innominates be tipped backward, they
may be corrected by placing the patient on his face, placing solid yet
soft padding beneath the pelvis so as to support the lumbo-sacral portion
of the spine. Now place one hand on the sacrum and with the other arm draw
upon the thighs so as to straighten the body and at the same time stretch
the lower spinal region. A series of treatments of this kind will correct
the condition and relieve the various symptoms mentioned.
INCONTINENCE OF URINE
Examine for preputial adhesions or for irritations
to the clitoris. In many cases relieving the trouble at these points is
all that is necessary. The spinal lesion is found in the second to fourth
lumbar, and irritation in the sacral region.
Treatment. Place the patient face downward.
Put one hand in the upper lumbar region and with the other make strong
traction of legs. Then place the hand firmly on third lumbar vertebra and
move the legs from side to side bending the body at the middle lumbar region.
Then lay patient on side facing you. Flex the lugs and place them against
your body reaching over with one hand and pressing against the vertebra
that is affected. Now, again place the patient on face and beginning at
lower dorsal region press strongly upward and outward opposite each spine
successively till you have reached the coccyx. A complete cure will result.
The osteopath is usually called to these cases several
years after the condition first came on. Much can be done to restore use
to the limb, yet the progress must be slow. Lesion is usually in the cervical
or lumbar region, though it may be at any point. Thorough spinal extension
is always indicated. Manipulation of the nerves to the paralyzed member
Prognosis. Complete recovery is rare.
No promise can be made as to time. Little can be expected in less than
six months, while two or three years may be required in some instances.
INFLUENZA - LA GRIPPE, GRIPPE
Put patient to bed. Strong and steady treatment
along the spine from occiput to sacrum. The fever must be controlled
by holding the sub-occipital region and by steady pressure at the inferior
cervical ganglion. Use a sponge bath. Relieve the headache
by gently treating the fifth nerve, pressing steadily one hand on occiput
and one on forehead; also press the temples between the palms, etc.
A hot lemonade and a good sweat must be given. Do not allow patient
to get up too soon. Use little food. Treat two or three times
per day. Of hundreds of cases of La Grippe treated osteopathically,
scarcely a case has had a bad sequela.
In many cases a definite spinal lesion will be found,
usually in the cervical region. In some cases where there seems to
be only deep contractions, the relaxation from the treatment relieves nervous
irritation and effects a cure. In others the treatment is ineffective.
The causes may be various.
Prognosis. Will depend on the case and the
result of the examination. As a usual thing it is not favorable.
In this condition there is usually a marked contraction
of the muscles in the cervical and upper dorsal region. In females it may
be from pelvic diseases. Relaxation is the key to the cure. There will
usually be found one or more osseous lesions in the upper spinal segments.
Correction of these, accompanied by a thorough inhibition along the spine
will be effective. Have patient cultivate deep breathing and holding breath
as long its possible. Outdoor exercise, light diet, sleeping in room
alone and gymnastics will aid in the cure. Warm water drunk freely, or
a glass of hot milk, at bed time, will produce good effects. Setting every
muscle in the body with a forcible contraction will be followed by complete
relaxation and sleep.
Prognosis. Good. These means will
always cure if persisted in.
To treat the kidney, the patient is placed on his
side facing the physician. The lumbar spine may be relaxed by placing
one hand on crest of ilium and the other on thoracic wall or shoulder and
giving a bias stretch, pulling forward on ilium and backward on ribs, and
vice versa. Then reaching below the patient lift the body clear of
table, the hand being beneath the lumbar vertebra. This will relax the
quadratus lumborum muscle and also move the abdominal viscera, releasing
pressure from the kidney, its veins and lymphatics. The patient is now
placed on his back, his legs and thighs flexed. Place the hand beneath
the dorso-lumbar region, palms up, pressing one arm over the patient. Now
elevate the patient on finger tips. Manipulate the patient over the kidneys
Flex the legs and then separate the knees, the patient
both passive and also resistant. Rotate the leg outward as far as possible
to put traction on the psoas muscle. The lesion is usually found at the
eleventh dorsal to the second lumbar. This must be corrected according.
to its nature. The genupectoral position affords a convenient position
for taking pressure from kidney structures.
Diet. Varies according to nature of
the disease. In nephritis avoid nitrogenous foods and use abundance
of broths, skim milk and water.
The lesion is evident. If there is tubercular process
use care in movements.
Treatment. Thoroughly relax muscles
along spine by pressure upward and outward. Next thoroughly extend
patient by stretching on the table, or seat patient on a stool and stand
in front of him, his hands clasped back of his head; then pass arms
beneath his and draw his upper spine upward and forward. This will
relax and at the same time correct the spine. Another method is to
have patient lie on his face and after thoroughly relaxing him throw the
posterior vertebra forward by putting pressure upon them suddenly.
Another method: patient sits on stool, stand at his
side, reach around in front with one hand lifting up, and with the other
hand press the vertebra forward.
Lesion in cervical vertebra causing disturbance to
sympathetic nerve of larnyx and pharnyx. Acute cases are often
due to contraction of the muscles of this part of the neck, the sterno-cleido-mastoid,
the scaleni, the infra-hyoid and the supra-hyoid groups of muscles.
Treatment. Relax by thorough manipulation
the muscles of this region. Gently work over the tonsils. Treat internally
by wetting the linger in cold water and pressing it over the hard palate.
The ninth, tenth and eleventh nerves may be reached just below the lobule
of the ear. This region must be treated thoroughly. Acute cases may be
treated twice per day. Chronic cases daily or every alternate day.
A cold compress will aid the treatment.
General relaxed condition of the spine. Look for
lesions in the middle to lower dorsal region. Tenderness along the line
of the ninth and tenth ribs. These ribs are sometimes turned.
Treat the liver and spleen. Give general stimulating
treatment to the heart. Knead the abdomen. Treat the splanchnic nerves.
Pay close attention to the ribs from eighth to tenth. The daily morning
bath, outdoor exercise and a nourishing diet are aids
The liver is often at fault, therefore the lesion
is in region of eight dorsal. Treat the splanchnics. The kidneys
must be treated. Look carefully to diet. Amount of meat should be small.
Raw apples and acid fruits of various kinds are tolerated, but sweet fruits,
starches, etc., are to be avoided.
LIVER - TREATMENT OF
This is it a most important gland and should be treated
in many diseases. The center is in the splanchnics, seventh to tenth
Treatment. First, relax in splanchnic region. Second,
have patient sit; standing behind him, reach around in front and as he
expels air after a deep inspiration, lift the abdominal wall and press
up beneath the eighth, ninth and tenth ribs. Third, have the patient lie
on his back and thoroughly knead the liver. Press inward and upward at
a point two and a half inches above and to the rigplaht of the umbilicus.
Fourth, have patient lie on left side, and standing at his back reach over
and press upward on abdomen, just above umbilicus; then with the other
hand vibrate forcibly the wall of abdomen lying over the liver. This changes
the blood in the liver and increases its activities. Gymnastics,
outdoor exercise and plenty of water, three to six pints daily, must be
supplementary to the treatment.
Diet. In all liver troubles alcohols
and liquors arc forbidden. Avoid pork, fried foods, salt foods, sugars,
starches and oils. Only fresh food should be given and in reduced
quantity; fish, oysters, sweetbread, lean meat, eggs, milk, buttermilk,
green vegetables, dry toast and fresh fruit are allowable. Do not
drink at meals. Rest an hour before and after eating.
Treatment is for the circulation and drainage to
the particular region and to the liver.
Lesion usually found in the lumbar region; occasionally
in the dorsal region.
Treatment. Relax muscles on either side.
In all cases a strong extension. In dorsal region, seat patient on
stool, stand behind and lift up ribs and push them backward by grasping
them at the sternal ends and pulling backwards. The patient may be
placed on side and bent forward, at the same time holding the spine from
above and below so as to put the tension at the location of the anterior
condition. Place the patient on his back and flex legs and thighs.
Place one hand under the vertebra above those to be moved; now come down
with some force on the legs. If this anterior condition is in the upper
dorsal region the same movement may be made with the neck and shoulders.
Examine kidneys. Lesion in the lumbar
vertebrae or at the dorso-lumbar or the lumbo-sacral articulations. Sometimes
in dorsal region. Look carefully for dislocations of the eleventh and twelfth
Treatment. Nothing better than stretching
the spine at this point. Correct the lesion. Flex the thighs on abdomen,
or, if patient is on face, legs are vibrated from side to side. Any movement
may be beneficial. Do not neglect the bias stretch. (q. v.)
LUNGS - TREATMENT OF
The one object in all treatment is to secure a return
to normal conditions. Good lung circulation and regular deep breathing
will cure any incipient pulmonary trouble.
Lesion. In dorsal region from second to sixth,
usually a forward condition. Also any one of the six upper ribs may
be at fault. Examine carefully at both spinal and sternal ends.
Treatment. First, lay patient on side and
thoroughly manipulate interscapular region. Second, lay patient on table,
stand at patient's head and placing one hand beneath the angle of the ribs
take hold of arm with the other and draw it upward, downward, and then
back to its position. Now move the hand to the next rib and repeat.
Do this for both sides. An assistant is valuable here as both sides can
be manipulated at the same time. Third, patient lies on back; stand at
his head, draw arms above his head; the patient inhales deeply; after holding
breath as long as possible force the arms back to their normal position.
Fourth, patient sits on stool and arm is pulled upward and backward. Fifth,
patient lies on back. Separate the ribs and release the intercostal nerves
by putting fingers between ribs near articulation and spreading them.
Avoid exposure to cold. No osseous lesions.
A secondary lesion in cervical and upper dorsal region. Relax these muscles
thoroughly. Should the eruption be imperfect, a thorough stimulation
in the upper dorsal region will produce it as well as sponging in tepid
water; also hot drinks. Protect the eyes from light. Keep room
cool and well ventilated and patient indoors; preferably in bed.
Watch the bronchial tubes. Treat in the first to third dorsal and
over the second and third ribs anteriorly. General treatment
along the spine with special treatment for the fever will be all that is
necessary in worst cases.
Treatment same as hysteria. Change of surroundings
and occupation is also helpful.
Lesion may be in any part of spine producing the
condition as a reflex from eye, stomach, hepatic, intestinal or uterine
disturbances. No specific treatment can be prescribed. Correct
these conditions. To effect a cure a thorough course of treatment is necessary.
Do not expect to be successful in all cases during
paroxysms of pain. The treatment must be given regularly. During
paroxysm give the regular headache treatment.
The lesion is reflex, a contraction in cervical and
upper dorsal regions. Keep patient warm and quiet. Good ventilation;
avoid colds. Relax cervical regions and especially relieve by gentle
manipulation the swollen glands. Care for eyes and ears and the reproductive
organs. Keep temperature down by usual fever treatment and do not permit
patient to exert himself too soon.
MUSCULAR RHEUMATISM -
Lesion usually in the lower dorsal region, embracing
the liver and kidney region; these organs are usually at fault.
Treatment. Treat the liver and kidneys
according to directions given under head of those organs. Treat the upper
dorsal and cervical regions for affections in the arms, and the lumbar
and sacral regions for the legs. Relax the muscles and follow the nerves
from their exit to the part affected, putting steady pressure on them.
Thoroughly relax the spinal musculature. Treat gently once or twice
per day. Hot fomentations often give relief.
Diet. Cereals, broths, and light meats.
Avoid meats in excess, sugars and starches. Drink hot water in abundance.
Lesion in upper dorsal region and in ribs.
Treatment. Separate and set the ribs.
Treat the vaso-motors to lungs and heart. Relax all contractures in upper
dorsal region. Outdoor air and exercise are helpful. Diet, light and strengthening.
Lesion in the lower dorsal and upper lumbar. Correct
this. (See kidneys.) Watch the urine very carefully.
Diet. Avoid all proteids, meats, heavy foods,
etc. Meals should be light and consist chiefly of milk, buttermilk, gruel,
broths. Should symptoms abate, eggs, meat-broths, etc., may be allowed.
Diet is of utmost importance.
Find the nerve affected and release the pressure,
removing the irritation. To do this, usually it is only necessary
to trace the affected nerve to the spine and release it near its exit.
Intercostal type. Either raise the rib or
set the vertebra which is causing the trouble.
Cardiac type. Usually the trouble is
in the third, fourth or fifth rib. Raise and separate these and put steady
pressure at their angles or near spine. Hot fomentations are useful.
Gastric Type. Trouble is usually
in the intercostal nerves. Sometimes it is reflex from uterine troubles.
Look for lesion in sixth to eighth ribs; sometimes it is higher and with
the vertebrae. Steady pressure is always able to give relief. It is often
difficult to restrain patient from taking morphine, but if the treatment
is persisted in relief will follow. Corrective treatment must be administered
between the attacks.
Facial Neuralgia. Frequently
due to decayed teeth; also, often from dislocated axis or atlas. Treat
the various terminal branches of the fifth nerve. Correct the lesion in
the cervical region.
Lesion. Not in any definite point.
It is a nervous irritation. Examine as to condition of sexual organs. The
liver is often at fault. Lithemia is a common condition. Deep spinal contractures
are always present.
Treatment. Stimulate the liver.
Relax the muscles of spine in upper dorsal and cervical regions. Stimulate
the heart. Manipulate the neck for drainage of head. A general treatment
is indicated. A treatment just at bed time will often insure a night's
rest. No two cases can be treated alike.
NEUROSES - OCCUPATION
Lesion is always in the spine near exit of affected
nerve, or else at vaso-motors to the nerve. For the arms it is in cervical
region second to seventh, or else in the upper dorsal. In many cases it
is simply long standing contractures.
Treatment. Thoroughly relax these
regions and correct any lesions present. Manipulation of the structures
lying along the course of the affected nerve will aid in its recovery.
A change of occupation is indicated.
Prognosis is good.
In these conditions there in a tightening of all
the contractile substances along the spine including deep muscles and ligaments.
Treatment. A thorough relaxation
of every vertebral articulation, followed by a stimulation to the nerves
of the superficial spinal region.
Lesion oftimes from dislocation or luxation of vertebra
in the upper dorsal region. The nerve affected will point the lesion.
Treatment. Rest in bed. Relax
the entire spine. Gently massage the structures surrounding the nerve
affected. Hot applications will aid in drainage and in reducing the pain.
Diet should be nourishing and easily assimilated.
Diet, exercise and gymnastics are all that can be
done in this condition.
It is safe to assume that a woman apparently well
formed will come safely through childbirth, so it is not necessary to examine
the pelvis unless there is a deformity or a rachitic history. But there
are certain precautions which every woman should take during pregnancy.
Diet of fruits and cereals, outdoor exercise and baths are conducive to
an easy delivery and a perfect child.
When called, the physician should carry with him
a cool head and willing hands. In addition he should have a case containing
tablets of mercury bichloride, shears, surgeons' cotton, a roll of clean
muslin, a sponge and a spool of silk thread.
Uncleanliness and untidiness in a case of this kind
is a crime. The expectant mother should first be given a sitz bath, carefully
cleansing the perinaeum. Then the hand of the operator, after a thorough
scrubbing with soap and water, should be held in a bichloride solution,
1 to 1,000, for a few minutes, and then an examination of the patient should
be made. The hand should be thoroughly cleansed and rendered aseptic previous
to each examination. This must never be disregarded.
The bed should be prepared by placing either oilcloth,
rubber or a layer of newspapers beneath the sheet. The perinaeum and vagina
should be thoroughly relaxed. Pressure upon and manipulations of the perineal
body will produce a very satisfactory result. The dilatation of the os
may be very much hastened by passing the finger, thoroughly aseptic, around
the edge of the os, also by pressure on clitoris and on round ligaments.
This will lessen pain. To reduce the pain, press on either side of the
spine in the lumbar region, fourth and fifth, and in the eighth to tenth
dorsal; this does not retard the progress of the case. Should the pains
and the expulsive movements of the uterus become tardy, stimulation in
the lumbar region may be effective. Relaxation of the round ligaments as
they pass over the pubic crest will allow the uterus to protrude further
into the canal of the vagina. Steady pressure at the symphysis pubis will
also aid in relaxation of the parts and reduction of pain.
Should the child be large and the labor difficult,
it is well to guard the perinaeum by holding the hand against the perineal
body, thus guiding the infant through the vaginal opening. Push the tissues
from the symphysis toward the perineal body.
As soon as the head is born examine to see if the
cord be around the neck. If so, loosen and follow it with the fingers,
one on either side, within the vagina to protect it from occlusion. In
foot presentation, the body should be wrapped in cloth or cotton to protect
from the air until the head is born. The cool air against the skin may
stimulate the respiratory center, causing the child to breathe.
As soon its the child is born, open its mouth, cleanse
the mucous passages until it has given a good cry, then keep it covered
and wait until the pulsations have ceased in the umbilical cord. Now draw
the cord between the thumb and finger toward the umbilicus and tie with
a clean thread about two inches from the infant's navel, and snip the cord
just outside this point.
If the placenta has not yet been delivered, gentle
traction on the cord may produce it. The mother can usually assist by an
expulsive movement, as coughing or blowing into the closed hand. There
is no need to hurry in this matter; an hour may sometimes elapse before
placenta is passed. In case it is not easily secured, pressure on
the abdominal wall above the pelvis may secure it. Place the palms flat
upon the walls and press forcibly downward. Do not insert the hand into
the uterus unless absolutely necessary. If the hand is inserted, be sure
that it is aseptic. Pass the fingers between placenta and the uterine wall,
and the air entering will often release it. If this is not sufficient,
gently force it from the wall of the uterus.
After the delivery, if there has been no laceration
and no cause to suspect infection, the external genitals should be carefully
cleansed, the vulva protected by a cloth fastened as the napkins are usually
fastened. Between the napkin and the vulva should be a pad of surgeon's
cotton. Should there be post-partum hemorrhage it can be checked by stroking
sharply, with the cold hand, the mons veneris.
The uterus must be reduced to contract the vessels
and close the sinuses. This is done by gently manipulating the fundus
through the abdominal wall. This will reduce the intensity and the
number of the afterpains and shorten the lying-in period and prevent hemorrhage.
The mother should, after being made scrupulously
clean, be left to sleep. Rest is the great restorer. The nurse should
be instructed to carefully cleanse the external genitals with soap and
water, following with a solution of bichloride of mercury, 1 to 2,000.
Should it be deemed necessary to use an injection, a perfectly sterile
pipe must be used, having been dipped in boiling water, and both tube and
pipe having been left in a bichloride solution of 1 to 1,000 for ten minutes.
The injection may be 1 to 4,000 bichloride, or creolin 1 to 100 (1%).
The nurse should be given explicit directions as
to the care of the patient. The breasts should be watched carefully. A
scanty secretion of milk may be increased by a separation of the upper
five or six ribs, lifting scapula, and freeing the subclavian and axillary
arteries. This affects the internal mammary branches which supply the mammary
gland. It also stimulates the intercostal nerves in this region. We spread
the ribs, increasing the blood supply through perforating arteries, and
giving a perfect drainage through the veins. The internal mammary artery
may be reached at its origplain from the subclavian, producing effect through
the plexus derived from the subclavian, and from the inferior cervical
ganglion. Let me repeat that the introduction of the hand into the uterus
to take the placenta is the most dangerous part of childbirth. It should
be done only as a last resort.
See cardiac troubles for treatment of heart. Press
upon the inferior cervical ganglion, raise the ribs to overcome this condition.
Press upon the solar plexus.
PANCREAS - TREATMENT OF
Lesions affecting this gland are in the splanchnic
area. The solar plexus affords the means of reaching it anteriorly. Treatment
should be directed to ninth and tenth ribs and vertebra.
Lesions. First, cerebral hemorrhage. Second,
in cervical regions, atlas and axis. Third, in the upper dorsal region,
and fourth, less often in cases of paraplegia in the lower dorsal and lumbar
Treatment. The various organs, as stomach,
intestines and kidneys, must be carefully watched that proper nutrition
and excretion may be performed. Give a general treatment, but treat specifically
to correct the lesion. In case there is cerebral lesion the cervical region
should have the most careful attention. Relaxation and a soothing
spinal treatment will overcome sleeplessness. Manipulate each joint
should there be tendency toward anchylosis.
Prognosis. Almost always an aid toward recovery,
though complete recovery
is the exception.
PAROTITIS - MUMPS
Lesion. Contraction of muscles of cervical
region both anteriorly, laterally and posteriorly. Treatment consists in
gentle manipulation of these. Treatment around the enlarged glands
will reduce the inflammation. Rest in bed and either hot or cold applications
to the swollen glands will be helpful. In case of orchitis, rest and a
support together with gentle manipulation around the external abdominal
ring will be sufficient. Treatment in lumbar region will aid orchitic complications.
For osteopathic treatment of, see Cardiac Troubles.
Lesion. Muscular contraction in the splanchnic
and lumbar regions. Usually osseous lesions in lumbar region.
Treatment consists in opening the bowels by enemas
of soap-suds, if necessary. Relaxation in the regions named above. Gentle
manipulation and pressure over the areas of solar and inferior mesenteric
plexuses. Hot bath with quiet abdominal manipulation will usually avert
an attack. Hot fomentations are invaluable. Diet should be liquid or semi-solids;
raw eggs and milk beaten together, or eggs and wine, custards, broths,
gruel, etc., should be the diet until symptoms have subsided. Treatment
should be given as often an pain returns.
PERTUSSIS - WHOOPING COUGH
Lesion. Is always reflex, no constant osseous
lesion. All muscles of throat and neck congested, the contraction extending
down to mid-dorsal region. Examine scaleni affecting first and second ribs.
Treatment. Remove pressure from
laryngeal filaments of tenth nerve by relaxing muscles of neck. Remove
disturbance to the vaso-motors of the lungs in the upper dorsal region.
Correct the upper two ribs and relax the muscles in the deeper layers at
the heads of these ribs.
Prognosis. If treated at beginning,
the disease may be aborted. Paroxysms may be stopped by pressure
at the second and third dorsal vertebrae.
Lesion. In cervical region; either muscular
or osseoas, or both.
Treatment. Stimulate the superior
cervical sympathetic after having thoroughly relaxed all the muscles of
the infra-hyoid and lateral muscles. Reach the ninth nerve just below
the lobule of the ear. The tenth may be reached here or in the sheath of
the carotid artery. Treatment internally with finger over the mucous membrane
of tonsils and pharynx reduces inflammation. A cold compress from ice water
PILES - SEE HAEMORRHOIDS
Lesion. Invariably found in the dorsal
region. The ribs on the affected side are usually down. The location
of the pain will indicate the lesion.
Treatment. Raise the rib, stretch the intercostal
muscles. Give steady pressure on the affected nerves at their exit from
the spine. The usual lung treatment may be given. Perhaps an hour may be
required to control the pain.
Prognosis. Is very favorable.
Diet. In the form of pleurisy with effusion,
the diet should consist of very lean meat and stale bread, with as
little fluid as will allay thirst. Ice may be sucked to avoid drinking
Lesion. In the dorsal region from second to
sixth vertebra. The intercostal muscles are all contracted.
Treatment. Relax the muscles in the
upper dorsal region. Use arm as a lever, put one hand between spine and
scapulae and force arm and scapula backward. This will relax the levator
angili scapula, the rhomboids, and the continuations of the erector spinae.
Thoroughly relax all the muscles along the spine by pressing upward and
outward. Manipulate anteriorly. Overcome sleeplessness by gently manipulating
the spine downward and by treating filaments of fifth nerve. Bowels are
to be kept regular by kneading. Stop coughing by pressing with thumb at
third and fifth dorsal. Pain can be relieved by pressure at certain
point; examination will reveal it. Pyrexia controlled at sub-occipital
region and first rib by steady pressure. Sponging with cool or tepid water
will regulate temperature. This must be done daily.
Diet. Milk, custard, broths, fruit
juice, etc., every two or three hours. Even after defervescence the return
to solid diet must be very gradual.
Lesion. In the dorso-lumbar region. Examine
tenth, eleventh and twelfth ribs.
Treatment. Correct lesion. Relax
quadratus lumborum muscle. Spring the spine forward in case of kyphosis,
frequently a lateral trouble. Treat as a kidney lesion.
Prognosis. Recovery is usually accomplished
by this treatment.
Lesion. Is evident. Treatment is wholly corrective
and to relax the muscles along the spine thus affecting drainage. In case
the disease is well marked, care must be used to avoid violence. A swing
is necessary to suspend the patient from his arms, thus relieving the pressure
on the spine. No violent treatment should be given.
Prognosis. In advanced cases the
prognosis is very poor. In early stages it is hopeful
Treatment for pyelitis does not differ in any marked
respect from that of nephritis.
QUINSY - SEE TONSILLITIS
Lesion. In spinal region at various
Treatment. Stimulate the nerves to the
digestive organs; particular attention to the splanchnics. Correct any
lesions. Diet and hygiene are important. Special treatment. with exercise,
baths, gymnastics and the following diet will overcome the condition.
Diet for Infants. Milk sterilized, oatmeal
water and barley water.
For older Children. Fats and proteids should form
the basis of the diet. Cream, bacon occasionally, stale bread, scraped
beef and fruits. Avoid starches and sugars.
RECTUM - DISEASE OF
Treatment. Control function and nutrition
of the rectum in the lumbar region through the pudic nerve; also in middle
sacral region. The rectum may be treated through the ischio-rectal fossa.
Always examine the liver, as portal stagnation may be a cause.
Lesion. Referred, it may be at any point in
the body. Primary lesion in liver or kidney regions of the spine.
Treatment. The liver, kidneys and intestines
are three points of attack. In case of arthritis, the joints must
be manipulated at each treatment. Correct the spinal lesions and
separate the ribs. Often the ribs overlying the liver are dislocated. The
muscles in the vaso-motor region of spine, second to eighth dorsal, are
invariably contracted and must be released. Thorough relaxation of the
scapular attachments, together with the muscles overlying the brachial
plexus, will relieve the arms. Steady pressure along the course of the
median, ulnar and musculo-spiral nerves in the arm, and over the anterior
crural, sciatic and oblurator nerves in the leg relieves pain and stiffness.
Treat the liver and kidneys. In acute or articular
rheumatism the utmost care must be used. The kidneys and the liver must
be treated as in the above. Two or three treatments should be given per
Diet. Soups, broths and farinaceous
foods, fish, eggs and fowl in small quantities. In chronic cases meats
in small quantities may be allowed. Acid waters, as dilute lemonade, may
be administered. Plain water in abundance is just as efficacious.
Fats are indicated, should arthritis be manifest.
Prognosis. Favorable in all recent cases.
Lesion. In lumbar region, usually lateral.
Sometimes due to muscular contractions around sacro-sciatic notch.
There is often a sacro-iliac slip.
Treatment. Thoroughly relax all muscles
in lumbar region. After relaxing structures around sacro-sciatic notch
stretch the pyriformis muscle by rotating the thigh inward. To do this,
flex the leg on the thigh and grasp the ankle. Hold the knee and turn the
leg so as to rotate the thigh. Flex thigh on abdomen and leg on thigh,
keeping the thigh flexed, straighten the leg. This stretches the sciatic.
Treat in popliteal space and at saphenous opening. Liver and kidneys
are important. These treatments are paliative. The lesions in the lumbar
vertebra, or at the sacrum must be corrected.
Diet. Same as in rheumatism.
Prognosis. Very favorable.
Lesion. Since this is tuberculosis of the
lymphatic glands, the location of the lesion will vary with the location
of the disease. The glands of the neck and axilla arc controlled by nerves
from the upper dorsal and cervical regions. The groin and limb by middle
dorsal to lumbar (vaso-motor). The ribs are frequently at fault.
Treatment. Correct the usual vertebral
lesion. Occasionally a rib is at fault. A general treatment is given here.
Exercise, outdoor life and nourishing foods are indicated. Avoid pork.
Lesion. Is near exit of nerve to muscle
affected. For cranial nerves it is in cervical or upper dorsal regions.
Sometimes caused by improper nourishment to nerve - disturbance in
Treatment. Thorough manipulation of limb affected
will give relief usually. Steady pressure along course of the nerve
will stop the spasm. Effective treatment will be to correct the osseous
SPLEEN - TREATMENT OF
The lesion is usually at the eighth to tenth vertebrae
or else at the ninth or tenth rib on left side. Treatment is applied by
manipulation in spinal region and by flexing the limbs on abdomen and treating
the spleen beneath the costal margin. Thorough vibration over ninth rib
on left side
changes circulation through spleen. In case of splenitis, heat is applied.
The liver should always be treated with the spleen, as the venous drainage
is via liver.
Lesion. In sunstroke or heat exhaustion
the reflex lesion is a tensely drawn condition of the muscles from the
sixth dorsal upward. These must be relaxed as soon as patient has been
removed to a cool place. If the temperature is high, as in thermic fever,
use the ice pack, the bath, ice water enema, ice cap, etc. In heat exhaustion
when temperature is sub-normal the hot bath must be used. Do not omit the
TONSILLITIS - QUINSY
Lesion. The muscles of neck always tensely
contracted; usually a primary lesion in middle or upper cervical region;
this is always present in chronic cases.
Treatment. In acute cases
the manipulation must be gently applied to all muscles of neck Quietly
apply pressure to the swollen tonsils until they have been reduced. Dip
the fingers in cold water and press upon the tonsils and palate internally.
The cold water prevents gagging. A cold compress is useful. In case
of suppuration a gargle of listerine, 1:3, or a spray, 1:2, is advised.
In acute cases treat several times per day. In chronic cases the lesion
in the vertebra must be corrected and the connective tissue removed by
a natural process of absorption. This will follow when the circulation
Diet. In advanced cases a liquid diet
is necessary. Sometimes swallowing is impossible. A small ice bag to suck
will relieve thirst and allay the pain. Rectal alimentation is rarely required.
Prognosis. Very favorable. If taken
early, the case need not be serious.
Lesion. Can be found in the spinal region
controlling the region either in its innervation or its blood supply.
Osteopathic practice proves that most tumors are caused by nervous irritation
and imperfect drainage. Should the tumor be of the breast, the lesion
is found in the ribs of that side or in the lower cervical region. Should
the tumor be uterine, the lesion may be either lumbar, sacroiliac, or
hyperaemia of the pelvic organs may result from an imperfect support of
the abdominal organs. In many of these tumors a restoration of the
normal condition of blood supply and drainage is effective. Do not
manipulate the tumor itself very much, as irritation may follow.
Prognosis. Each case is a law unto itself.
The progress of the case and condition of the patient must be considered.
Many cases are helped, some are cured, some are not affected.
Lesion. Very likely the lesions are secondary
only - a reflex of intestinal disturbance.
Treatment. The usual hydro-therapy treatment
and nursing are important factors in the care of typhoid patients.
The bowels should be kept in a natural condition by thorough relaxation
of the splanchnic and lumbar area twice each day. The cerebral symptoms
are prevented or allayed by treatment in the upper dorsal and cervical
regions. The fever can be controlled by cool spongings in some cases, in
others it is necessary to use the bath. This treatment will not avert the
disease, but it will lighten all symptoms. Gentle manipulation of the abdomen
and pressure over the solar and hypo-gastric plexuses, will prevent the
tympanitis if begun early. Holding the sub-occipital region will relieve
the headache. Relax the entire spine.
TORTICOLLIS - WRY NECK
Lesion. In middle cervical region usually,
may be at the atlas or even in lower region. It is a type of muscular
Treatment. Put hand on sterno-cleido
mastoid muscle at a point of entrance of the eleventh nerve. Turn the neck
as far as possible each way. Putting the neck on tension by bending
it and suddenly rotating the head in that same direction will usually overcome
Prognosis. Good in all recent cases.
In some cases of long standing nothing can be done.
In most cases of vomiting the lesion is located in
the middle and upper dorsal region usually at the third to fifth ribs.
Elevation of these ribs, steady pressure at their angles and a thorough
relaxation of the intercostal muscles will stop the paroxysms. This will
usually stop vomiting in "morning sickness."
In vaso-motor disturbances the heart, the eyes, the
stomach and the vaso-motors are closely connected. If the disturbance is
from the vaso-motors look for lesion in the upper dorsal region, usually
from second to sixth dorsal. Again the lesion may be in the lower
cervical region affecting the middle or inferior cervical plexus.
Treatment. Correction or the lesion.
Treatment of the stomach, thorough relaxation and stretching of neck will usually
bring about the desired result.