I. DEFINITION AND APPLICATION
Direct Manipulation, Purpose, Integral Part of General Technic, Not Essential in every Gynecological Treatment, Possibilities of Harm, Knowledge and Skill Demanded, Manipulative Surgery, Removal of Secondary Conditions.

II. INDICATIONS AND CONTRAINDICATIONS
Displacements, Lessened Mobility, Subinvolution, Metritis, Ovaritis, Salpingitis, Passive Pelvic Congestion, Inflamed and Obstructed Ureters, Pregnancy, Malignancy, Tubercular Inflammation, Confined Pus, Ectopic Pregnancy, Acute Inflammation, Menstruation, Fever.

III. ANATOMY
The Pelvic Cavity, The Uterus, The Ovaries, The Uterine Tubes, The Vagina, The Bladder, The Urethra, The Ureters, The Pelvic Colon, The Rectum, The Small Intestines, The Parovarium, The Pelvic Connective Tissue, The Peritoneum, Blood Supply (arteries, veins, pelvic plexus), Nerve Supply (ovarian plexus, hypogastric plexus, cervico-uterine ganglion).

IV. EXAMINATION
Intra-pelvic is Final Examination, Not Necessary in every Case, Demanded by Certain Conditions, Rectoabdominal Examination in Virgins, Inspection, Position, and Preparation for Examination, Palpation (of vagina, cervix, uterus, ovaries, uterine tubes, ureters ), Recto-abdominal Palpation, Recto-vaginal-abdominal Palpation, Examination in Erect Posture.

V. ADHESIONS
Causes, Relationship of Deranged Spinal Innervation, Occurrence in Peritoneum and Connective Tissue, Gonorrhoeal Inflammation, Inflammation due to Pus Germs, Differentiation important in Treatment, Reflex Effects, Symptoms (variable, pain, disordered menstrual function, leucorrhoea, sterility, constipation), Diagnosis, Biananual Palpation, Diminished Mobility, Pain, Pelvic Mass, Treatment, Restoration, of Motion, Methods, Force and Frequency, Relief of Pain from Treatment.

VI. DISPLACEMENTS
Definition, Agencies Maintaining Normal Position, Pelvic Floor, Adjacent Organs, Abdominal Walls, Uterine Ligaments, Position, Size and Weight of the Uterus, Varieties of Displacements, Lateral Displacements, Diagnosis, Treatment, Upward Displacements, Causes, Torsion of the Uterus, Anteflexicn, Varieties, Frequency, Two-fold Pathology, Causes, Symptoms, Diagnosis, Treatment, Anteversion, Definition, Causes, Pathology, Symptoms, Diagnosis, Treatment, Method of Replacement, Backward Displacements, Varieties, Causes, Pathology, Symptoms, Diagnosis, Treatment, Methods of Replacement, Downward Displacements, Degrees of, Relation of Pelvic Floor, "Settling of the Uterus," Causes, Pathology, Symptoms. Diagnosis, Prognosis, Treatment.

VII. ENDOMETRITIS-SALPINGITIS-0VARITIS
Chronic Endometritis, Causes, Pathology, Symptoms, Diagnosis, Prognosis, Treatment, Salpingitis, Cause, Pathology, Symptoms, Diagnosis, Treatment, Chronic Ovaritis, Causes, Pathology, Symptoms, Diagnosis, Treatment.

VIII. TAMPONS AND PESSARIES
Tampon, Purposes, Materials, How Made, Medicaments, Introduction, Pessaries, Artificial Supports, Useful Devices, Materials and Forms, Support Tissues, Fitting, Rcshaping, Special Application, Introduction, After Care.

Literature upon the manual treatment of pelvic pathology is surprisingly meager. It is by no means a new subject. During the same years two men in widely distant parts of the world were developing the treatment, Major Thure Brandt (1822-1895) a layman and an officer in the Swedish army and Dr. Andrew Taylor Still (1828-1917) an American physician.

These men were developing the treatment along different lines. Major Brandt, decording to his training, along the lines of gymnastics and massage. Dr. Still with his newly discovered principle that mechanical perfection is the chief element in the maintenance of health, along the lines of mechanical adjustment of bodily structure. Nor did Major Brandt give any consideration to spinal maladjustment, with consequent disturbance of spinal innervation, as being related in any way to pelvic pathology.

So the teachings of these two men and their followers are related as massage is to osteopathy. Massage is by no means useless but is merely an adjunct. It lacks the definite, specific ideal of adjustment (the essential principle of osteopathy), but is sometimes useful as a means to accomplish this end.

With a desire to aid in the further development of this most valuable therapeutic measure the following pages are presented.

PERCY H. WOODALL, M. D., D. 0.
Birmingham, Alabama November 25, 1925.