Principles of Osteopathy
Dain L. Tasker, D. O.
CHAPTER III - The Lesion as an Effect
Analysis of the Causes of Lesions. - As previously
noted, the inspection of the vertebral and paravertebral tissues in almost all
cases of illness involving the trunk of the body will show physical signs of
compensatory reactions. These physical signs we call "lesions." They seem
to be identical in character with those which we noted as traumatic lesions,
i. e., there is deviation in osseous alignment, muscular contraction and hyperaesthesia.
It may be impossible to secure from the patient any history of trauma as the
foundation of this lesion, therefore two explanations are open to us; either
we must willfully hold to the hypothesis that a trauma did occur of so light
immediate effect as to escape the notice of the patient, or use the facts of
anatomy and physiology to build up a rational theory of normal reactions.
It is much easier to declare trauma as the cause than analyze the protective
reactions of the body. This fact has led the exponents of the various
forms of spinal adjustment to explain every lesion by claiming an obscure trauma
as the cause. Since no one ever goes through life without many slips,
falls and other strains which can be called to mind, it is easy for the patient
to be convinced that some remote experience of this kind is in fact the foundation
for all the trouble.
The Attractiveness of the Traumatic Lesion Theory.
- The theory that an obscure trauma in the spinal tissues is the essential
and adequate cause of bodily disorders is captivating both to the physician
and the patient. It has so many definite elements which are evident
both to the mind of the physician and of the patient. The physician's
palpitating finger feels the change in osseous alignment and muscular tone.
The patient recognizes the difference in sensitiveness between this
lesion area and those outside the lesion influence. Specific
manipulation having for its aim the correction of alignment in the lesion
area gives so frequently almost instant sense of relief that it is no wonder
physician and patient become convinced that the hypothesis of trauma is
correct. Under the influence of such a theory as this our osteopathic
literature is well spiced with statements tending to belittle the influence
of all other causes of disease. The writer wishes to emphasize the
fact that lesions can be divided into two great classes, i. c., primary
and secondary. The first class is made up of those of traumatic origin
and are undoubtedly causes of disorder in their areas of influences.
The second class is made up of those lesions which are physical sign of
the body's efforts at adaptation and compensation.
Classification of Lesions. - A given lesion
can be classed as primary or secondary only after careful study of all
those factors which constitute the history and symptomotology of the case.
Visceral lesions cause muscular contractions in the spinal area from which
they receive their cerebrospinal nerve communications. They also
cause pain in areas of higher sensibility, cutaneous areas, with which
they are associated by innervation from the same segment of the spinal
cord. These referred pains and contractions of spinal muscles are
beginning to be recognized by specialists in pulmonary, digestive and renal
diseases. There has been no well ordered effort to coordinate the
facts which lie at the foundation of these phenomena. It is hoped
that we may make for our students a beginning in this work by what is to
Examples of Secondary Lesions. - As examples
of various secondary lesions we will call attention to the lesion phenomena
found usually to be synchronous with involvements of some of the organs
of the body. Rather than rush into an analysis of lesions, we deem
it more to the student's interest to have a clear picture of the phenomena
we desire to analyze later on. Our practitioners who are devoting
much time in treating the eye recognize that in diseases of the eye and
orbital tissues there are points in the neck which are rarely free from
tenderness. Along with the tenderness are found muscular contraction
and malalignment, these completing our trinity of localized lesion phenomena.
Such lesions may be located as low as the second dorsal.
The Spinal Lesion an Objective Symptom. -
Disturbance of circulation in the tonsil is associated with spinal lesions.
These lesions vary in number and extent according to whether the disease
process is simple and decidedly local, or is of enough severity to produce
constitutional symptoms such as chill, fever, etc. The spinal lesions
multiply and intensify in proportion to the extent and severity of the
disturbance of the body. This is the case no matter in what organ
or tissue our original disturbance made its appearance. Just as the
symptom complex varies according to the severity of a disease, so the spinal
lesions proportion themselves in like manner. Therefore, in this
sense, spinal lesions are physical signs: objective and subjective evidence
of disturbance in tissues innervated by branches of nerves from the same
segment of the spinal cord.
Visceral Reflexes. - Each viscus, or localized
tissue, such as glands, mucous or serous membranes, tend to establish reflex
lesions in the spinal area tissues which are supplied with nerves from
the same spinal cord segment as they themselves are supplied. In
proportion to the amount of compensatory assistance required by any organ
or tissue from those parts of the body ordinarily called upon for such
assistance, our spinal lesion increases in extent and intensity.
As a common example of the foregoing, the stomach may fail to do its work
thoroughly and thus throw added work on the small intestine and its related
glands, liver and pancreas. If these are somewhat overtaxed by their
cornpensatory efforts, our spinal lesion which represented the stomach,
extends further down over the spinal areas from which the liver and pancreas
receive a portion of their innervation. Such examples as this can
be recognized in a majority of cases.
Pleurisy. - Disease processes in the lungs
produce spinal lesions of various kinds, according to their intensity and
destructiveness. Pleurisy produces so great contraction in respiratory
muscles, which act particularly on the ribs lying over the inflamed area,
that friction of the pleural surfaces at this point is reduced to a minimum.
Physicians, taking their plan from this natural compensatory contraction,
frequently reinforce natural efforts by strapping over the contracted area
with adhesive. The thorax adapts itself to the state of its contents,
hence when a portion of the lung is destroyed the antero-posterior diameter
of the chest is lessened in proportion. The vertebral and costo-vertebral
articulations enter into this adaptive process and hence exhibit decided
Cardiac Lesion Patterns. - In case of heart
lesions the body is called upon to make extensive compensatory reactions
and hence our spinal lesion phenomena may be limited to the area of the
heart's innervation, or extend in proportion as the heart's condition involves
the pulmonary circulation, the portal circulation or the kidney.
Unity of the Body. - Disease processes in the pelvic
viscera produce their characteristic spinal lesion phenomena just as the thoracic
and abdominal organs. The point we desire to emphasize is that the unity
of the body is exemplified by the spinal lesion phenomena. No organ or
tissue can or does suffer injury without other tissues being drafted to compensate
for its condition so as to maintain not only existence but the most satisfactory
life of which the organism is capable. If the spinal lesion is viewed
not only as a possible cause but, also, as a quite probable effect of tissue
disturbance elsewhere, we will appreciate more fully the manner in which the
body strives to live up to its best.