INTRA-PELVIC TECHNIC (Manipulative Surgery of the Pelvic Organs)
Definition and Application

We shall limit the term "intra-pelvic" technic, as nearly as possible, to,those manipulations applied with the hands directly to the organs and tissues within the pelvis, though occasionally it may be necessary to describe other collateral treatment. Its purpose is to readjust and reconstruct the soft tissues within this region to the end that their functions may be restored. It is an integral part of the usual spinal and innominate technic. It presupposes the application of this technic and is by no means a substitute for it. It is merely a part of the treatment necessary in many cases and by no means the only necessary measure. It is not presented as an essential part of every gynecological treatment but as the best way and often the only way of successfully attacking certain pathological conditions within the pelvis.

There is a great deal of meddlesome gynecology practiced. We sometimes forget that every female ill does not originate in the pelvis. So intra-pelvic technic is not to be used  indiscriminately, but only when there are definite indications for it.

Being an agency of greatest good in selected cases it has possibilities of proportionate harm if improperly used. Among these possibilities are the rupture or an abscess, a pyosalpinx, a cyst (if of an infecting character), the sac of an ectopic gestation; an acute or subacute inflammation may be aggravated, or hemorrhage may follow the tearing of adhesions.

This technic and its contraindications require the nicest discrimination and the best of judgment. In no field of manipulative therapeutics is there a wider field for the expression of knowledge of structure, of skill in palpation, or a more delicate sense of touch demanded.

The therapeutic value of this measure is enormous and is limited only by the knowledge and skill of the operator.

Surely if any manipulative technic deserves the appellation of "manipulative surgery" this does. Nowhere in the body can those conditions ordinarily demanding surgical intervention, be as successfully treated and surgical operations prevented by manual technic, as in the pelvis.

Whatever may have been the primary cause of intra-pelvic pathology, whether tissue maladjustment or normal resistance overwhelmed by the quantity or quality of an infection, even though this cause may have been removed, or has ceased to operate, certain secondary conditions remain. So an inflammation in the pelvis may have subsided but has left in its wake many injurious sequelae. The removal of these is of equal importance with the removal of the primary cause, if function is to be established.