A Manual of Osteopathic Manipulations and Treatment
Wilfred L. Riggs, D. O.


    The osteopath who treats all cases alike is not in any sense deserving of the name, yet there are many cases in which it is helpful to administer what is known as a "general treatment;" as when there is complaint of "ennui," lassitude and drowsiness, torpidity of glands, weariness, lack of circulation, loss of appetite and similar conditions. This is the most easily administered of osteopathic manipulations, and has given use to the common belief that there is no possible harm in osteopathic treatments. This is an error. A general treatment, if given gently, produces no harmful effect, but if incautiously administered by one ignorant of the science, may do incalculable injury.

    Proceed as follows: First, have patient (prepared by removing clothing so as to permit spine to be exposed) recline on table. Relax muscles of neck by gently rocking head from side to normal position, at same time putting pressure with other hand upon muscles of side of neck. Do this for each side. Then lift patient's head in one hand and put pressure on muscles on back of neck. Repeat this three or four times. This will relax the muscles of neck and aid in equalizing the circulation through the cervical sympathetics. Next, with patient on side, using arm as lever, press upon muscles of the spine, beginning at first dorsal and going downward through each region of the spine successively. This is done for both sides. The patient next lies on face, the arms hanging freely. Thorough relaxation is necessary. The physician then presses strongly upward and outward on the muscles from upper to lower portion of spine. Patient now lies on back with legs flexed. The abdomen is kneaded thoroughly, following the course of the colon. The regions of liver, spleen and pancreas are thoroughly kneaded.  Lastly, spine is thoroughly stretched by placing patient in "swing" so feet will just reach the floor, then standing behind him he is pushed forward or laterally; or patient lies on back and an assistant grasps ankles while operator takes hold of the shoulders and steadily stretches. The value of this is accentuated by steadily oscillating the body from side to side. The physician may place palm of one hand on patient's chin, another at occiput and stretch as before. Use care in this treatment as injury may be done.


    All osteopaths agree that the dislocation of a rib is of frequent occurrence. To correct, first determine the exact nature and amount of the dislocation. To raise vertebral portion, patient lies on opposite side;  with one hand grasp patient's arm and forcibly extend it, swinging it upward across face; at same time, with the other hand, strong pressure is applied at head of rib with fingers and at angle with the thumb, presses inward and upward. The patient strongly inhales as the arm is thrown upward, then the arm is brought downward and the patient exhales. The pressure at the vertebral portion is maintained until the arm is returned to its normal position. (See plate 17.)


    Position same as above. Place patient's elbow against your abdomen or chest. Reach over and with your hands free ribs from vertebrae by pressure outward on angles. Then turn them upward or downward as is necessary.

    Patient lies on face; after a thorough  relaxation, place thumb of one hand on angle of ribs, or between angle and head, the other hand beyond the angle pressing upward or downward as is necessary, then suddenly through pressure on head of rib with thumb turn the head into its place.

    Patient may lie on back, the physician places his hand under the patient with palms of fingers under the affected rib. Draw arm across chest and grasping elbow firmly press outward and downward. This relieves the rib from pressure and allows it to slip into place. A very successful method of raising a rib consists of putting the knee in back against the angle of rib, reach around opposite side to sternal articulation.  Have patient draw full breath. Then draw the arm up and backward, pressing the rib into its position by the hand in front and knee behind.