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PRACTICE OF 
 
 OSTEOPATHY 
 
 ITS PRACTICAL APPLICATION 
 TO THE VARIOUS DISEASES 
 OF THE HUMAN BODY 
 
 Fifth Edition Revised and Enlarged 
 
 ILLUSTRATED 
 WITH OVER 
 
 100 HALFTONE 
 ENGRAVINGS 
 
 ^X BY 
 
 CHAS. H. MURRAY, A. B., D. O. 
 
 AUTHOR OF OSTEOPATHIC GYNECOLOGY, GENUINE OSTB- 
 OPATHY, THE OSTEOPATHIC TRUTH, PRACTICAL 
 HEALTH HINTS, THE PRACTICE OF SOMAP- 
 ATHY, AND THE SUCCESSFUL PROMO- 
 TION OF GENUINE OSTEOPATHY 
 
 ELGIN, ILLINOIS 
 1918 
 
1^2 54 
 
 COPTRIGHT, 1909 
 BY CHAS. H. MURRAY 
 
 COPYRIGHT, 1912 
 BY CHAS. H. MURRAY 
 
 COPYRIGHT, 1918 
 BY CHAS. H. MURRAY 
 
 ©CI.A481625 
 
 FEB -5 ibiy 
 
 /Wo - \ 
 
Preface to the Fifth Edition 
 
 We trust that, wherever EngUsh is read, this edi- 
 tion will meet the hearty approval of doctors, as 
 did former editions. 
 
 Special attention is called to the new treatment 
 for Partial Deafness and Deafness and Hay Fever. 
 
 Chas. H. Murray. 
 
 Elgin, 111. 
 
 Preface to the Third Edition 
 
 When after the brief space of two and one-half 
 years I had the pleasure of being informed by the 
 publisher that a third edition of my Textbook of 
 Practice of Osteopathy was called for, I resolved to 
 make it in every respect as perfect as was in my power. 
 The entire work has been carefully and thoroughly 
 revised, considerable new material has been added, 
 bringing the work up to date and fully in the forefront 
 of all recent but proven investigations. Many new 
 illustrations have been added. 
 
 By these improvements I have tried to make the 
 book worthy of the kind reception accorded it by the 
 Medical and Osteopathic profession and the medical 
 press. The second edition was largely taken by Osteo- 
 paths. The writer has been pleased with the way 
 medical doctors have been successful in obtaining 
 splendid results from the treatments herein described. 
 
 Chas. H. Murray. 
 
 Elgin, 111. 
 
Preface to the First Edition 
 
 Osteopathy was born in the fertile mind of Doc- 
 tor Andrew Taylor Still in 1875. Like other good 
 gifts from God it bears) evidence of being sent by 
 Divine providence. Drugs having proven of no 
 value in serious cases in the doctor's own house- 
 hold he was led to look for something better. Oste- 
 opathy had its necessary growth and development 
 amidst surroundings that tested its right to exist- 
 ence at every step. The science withstood the fire of 
 merciless criticism, but the scientific truth, that 
 God made the human machine perfect, and as long 
 as it is kept in order it will perform its proper func- 
 tions and keep in good health to a ripe old age, 
 came out more than conqueror. 
 
 No one but Doctor Still and his devoted family 
 will ever know the hard and bitter struggle, when 
 deserted by many relatives and friends he bore 
 the brunt of the battle which was waged after he 
 stepped out of the medical profession and declared 
 for Osteopathy. 
 
 So successful was he in curing those whose dis- 
 eases had resisted all other forms of treatment that 
 he was compelled to teach the science that others 
 might treat suffering humanity. 
 
 There have been a number of other schools start- 
 ed, both East and West, which have also been send- 
 
 5 
 
ing out graduates until thousands of practitioners) 
 are now practicing the science in the United States, 
 and there are representatives in nearly all parts 
 of the world. So the work has grown and pros- 
 pered and is rapidly making its impress felt for 
 good among all schools of healing. 
 
 While the above is true, those In the field can 
 not do a tithe of the work that is necessary. Many 
 in the smaller towns and in the country must go 
 without the treatment, while very many are at- 
 tempting to practice who know comparatively little 
 of the science. 
 
 The object of this work is to meet this very 
 urgent need on the part of practitioners of all 
 schools, and to present the practical side of Oste- 
 opathy in a very plain and simple manner. 
 
 To the many practitioners of the science who 
 have not taken the regular work in colleges, yet 
 who will continue to practice, it will prove of the 
 greatest value. Whil-e the work does not deal with 
 the theory of Osteopathy to any great extent, the 
 practical side of the science is presented and empha- 
 sized in such a manner as to be of great assistance 
 to medical doctors who have not time nor the in- 
 clination to take a regular course in Osteopathy, 
 and who will here receive a knowledge of the 
 science that will be of value to them and to their 
 patients. 
 
 Thousands in every walk of life will be helped by 
 the general treatment as indicated in this work. 
 They will live longer and feel more like living while 
 
 6 
 
they live if the various ligaments of the spine and 
 joints are not allowed to become hard and stiff and 
 short, thus creating a tension and stiffness in parts 
 that should be soft and pliable to permit a good 
 nerve supply and circulation. 
 
 The author believes that all that is good in 
 medicine should become common property; that 
 there is too much ignorance among the people con- 
 cerning the healing art. He fully believes that 
 Osteopathy is the very best in medicine, and in 
 helping to make its use more universal he is help- 
 ing humanity. 
 
 Chas. H. Murray. 
 
 Elgin, Illinois. 
 
PRACTICE OF 
 OSTEOPATHY 
 
 OSTEOPATHIC TECHNIQUE 
 
 The most important part of osteopathic pro- 
 cedure is the examination of the patient, the de- 
 termination of the lesion, the discovery of what is 
 wrong in the human building. In some cases nature 
 has taken care of a former abnormality of struc- 
 ture, and then what was once abnormal has become 
 normal. An attempt to make a forcible correction 
 of the apparant abnormality would lead to trouble. 
 In some cases most serious results would ensue. 
 
 In other cases, where the real lesion is not dis- 
 covered, months of routine treatment would be 
 worse than useless and might be a detriment rather 
 than a help to the patient. So we say the first th'ing 
 and the most important thing to do is to make a 
 careful and painstaking examination of the patient. 
 
 If there are no marked osteopathic lesions, the 
 disease in question having been brought on by 
 overwork or abuse of function, as overeating or 
 drinking, there are certain definite areas in which 
 the Osteopath works, and by securing a better 
 nerve and blood supply hastens the recovery of the 
 patient. This is especially true in cases of sickness 
 induced by the various specific microorganisms 
 which are the exciting agents of a long list of 
 
10 Practice of Osteopathy 
 
 acute diseases, as pneumonia, la grippe, typhoid 
 fever, scarlet fever, measles, chicken pox, mumps, 
 v^hooping cough, diphtheria, erysipelas, tubercu- 
 losis, etc., etc. Even in many of these diseases 
 there are predisposing lesions that weaken certain 
 areas of the body and permit the entrance and 
 growth of these exciting organisms. 
 
 Yet in these very regions in which the Osteopath 
 works to help recoveries there are, in a majority of 
 cases, lesions of muscle, ligament, and of the bony 
 structure as well, which have been induced reflexly. 
 The abused organs or the diseased organs have 
 sent nerve impulses to the cord, and they have sent 
 them in such large numbers that they have in turn 
 been sent out to the muscles and other structures 
 lying in close proximity. A muscle is tense in pro- 
 portion to the number of nerve impulses communi- 
 cated to it. These abnormal nerve impulses, long 
 continued, have produced contractures; these in 
 turn, by pulling on the bones to which they are 
 attached, have produced bony lesions. Some of 
 these bring pressure to bear on the spinal cord 
 and other structures, and in this manner aggravate 
 the disease. 
 
 For the beginner in Osteopathy it will be better 
 to have the back of the patient bare. If the patient 
 is a lady, a gown or kimono may be worn which 
 opens in the back. A suitable kimono for taking 
 the treatment is illustrated in Fig 2. After the 
 operator has had some experience he will readily 
 examine the spine of patients through the gar- 
 
Osteopathic Technique 11 
 
 ments, the under clothing at least. As a general 
 thing we know very little about our own 
 bodies. Many are more conversant with the normal 
 cow, horse or hog than with the normal human 
 body. It will be an excellent thing for the one who 
 expects to make a vocation or even an avocation 
 of Osteopathy to study carefully the normal body. 
 Study a number of them. Become thoroughly ac- 
 quainted with the normal body, and especially with 
 the normal spine. In this way you will be all the 
 more readily able to detect the abnormal. 
 
 The practitioner should study the various de- 
 grees of motility of the spines, joints, necks, backs, 
 etc., of normal individuals. He should learn the 
 various degrees of tension, tenderness, and pliability 
 of the various muscles of persons in health. A knowl- 
 edge of anatomy and physiology will be very helpful. 
 
 Lesions. It is not every vertebra that is out 
 of line laterally, or deviates anteriorly or posterior- 
 ly, that may be said to be out of position in such 
 a manner as to constitute a lesion. Before we can 
 say that a deviation of such a character constitutes 
 a lesion it ought to produce some pathological con- 
 dition, or ill feeling of some kind. There should 
 be some change in color and some temperature near 
 the abnormality. There should be some contraction 
 in the muscles and ligaments. There should be 
 some inflammation, or a congestion bordering on in- 
 flammation, near the seat of lesion. There will be 
 pain in nearly all recent lesions. Pain will be 
 present on pressure. In some conditions the 
 
12 Practice of Osteopathy 
 
 muscles in close proximity will be slightly swollen 
 and have a rigid feeling when worked over with 
 the hand. It will be always safe and beneficial to 
 manipulate the spine, ribs, ligaments, muscles, and 
 other tissues, but do not attempt to correct a mis- 
 placed bone until it is known to be out of place in 
 such a manner as to cause pressure, or is forming 
 an obstruction that is causing some illness. Never 
 manipulate a tubercular joint or spine. Do not 
 cause pressure on lymphatic glands. 
 
 Since the publication of the second edition of this 
 book, doctors who are doing research work in Osteop- 
 athy are of the opinion that pressure on nerves re- 
 sulting from vertebral displacements is not a cause of 
 disease. This view is in harmony with the author's 
 experience, with one exception, and that is in those 
 cases where a vertebra or vetebrae are misplaced an- 
 teriorly. This allows pressure to be exerted upon the 
 spinal nerves as shown in Fig. A. In backward dis- 
 placements the spinal foramen is made larger, and 
 there can be no pressure exerted on spinal nerves. 
 This is especially true in those cases where Pott's 
 disease exists and there is a backward displacement of 
 the vetebrae amounting to deformity. See Fig. B. 
 
 Disease and disturbances of the circulation are not, 
 as is generally believed by Osteopaths, caused by arte- 
 rial or venous obstructions occasioned by misplaced 
 vertebrse. Vertebral displacements and an obstructed 
 circulation have been the two great points which 
 Osteopaths have kept before the public. They have 
 believed this, and acting on this belief, in attempting to 
 
 
Osteopathic Technique 13 
 
 adjust vertebrae have done much harm to suffering 
 humanity. I want to show later how the best results 
 may be secured from Osteopathy, or mechanical treat- 
 ment, with no danger of injury to the patient. 
 
 The real lesion, or spinal abnormality, when it exists, 
 is in a tightened vertebral joint or series of such joints. 
 The ligaments binding such vertebrae together have 
 become shortened. The inter-vertebral substance be- 
 comes thinner and is frequently absent. In sorie cases 
 it entirely disappears and ankylosis sets in. When a 
 vertebral joint is not as free in its movements as it 
 should be the adjacent microscopic tissues are involved 
 and the flow of lymph and circulation in such struc- 
 tures is impeded. For this reason we claim that the 
 real spinal lesion is immobility of spinal joints. Other 
 joints may be affected in much the same manner. 
 
 For the above reasons we would be more explicit in 
 giving caution to avoid harsh and severe treatment 
 and to refrain from adjusting or attempting to adjust 
 bones of the spine or pelvis unless we are positively 
 certain that such apparent maladjustments are the 
 cause of diseased conditions. 
 
 It follows that the best treatment will be directed to 
 loosen the tightened joint or joints and so manipulate 
 the surrounding tissues that circulation will be restored. 
 Chiropractors have been doing their work, using a 
 theory that is entirely wrong, but In practice they have 
 only loosened such joints, and in that way have se- 
 cured good results. They would secure better results 
 if they paid some attention to surrounding tissues. 
 
 A Chiropractor performs his work by placing both 
 
14 Practice of Osteopathy- 
 
 hands on a spinal vertebra, one over the other, enfor- 
 cmg it, and giving a quick thrust. The patient is in the 
 recumbent position, and this thrust is given with the 
 idea of adjusting misplaced vertebrae; but the only 
 effect is to secure more mobility of the joints. Were 
 force used sufficient to move the vertebrae serious in- 
 jury would result. This has proved to be the case re- 
 sulting from some treatment given by both Chiroprac- 
 tors and Osteopaths. Fig. No. 51 A illustrates the 
 manner in which the Chiropractor thrust is delivered. 
 Some have the elbow bent, and in straightening out the 
 elbow the thrust is given. Other practitioners attempt 
 to withdraw the hands after making the thrust to allow 
 the vertebrae to recoil. 
 
 The effect of working on a spinal articulation with 
 sufficient force to loosen the joint, is to stimulate the 
 segments of the spinal cord nearest that joint, and 
 send nerve impulses in increasing numbers over the 
 nerves that find their origin in that portion of the cord. 
 This nerve stimulation will be caused by any mechani- 
 cal force acting on the spinal column sufficient to in- 
 fluence the cord. 
 
 The circulation of the blood, both arterial and 
 venous, must be kept free. Tightened, tense muscles 
 and ligaments, various abdominal organs out of posi- 
 tion, as in enteroptosis, interfere with the proper circu- 
 lation of the blood, lymph and nerve impulses. This 
 quickly leads to disease. For example, when the 
 tissues tighten in the neck from any cause, circulation 
 is obstructed and inflammation of the tonsils, pharynx, 
 and other structures takes place. And on account of 
 
Osteopathic Technique 15 
 
 the stagnation of the circulation, pathological germs 
 find a lodging place and various diseases such as diph- 
 theria, scarlet fever, etc., begin. When there is trouble 
 with the ears, eyes, nose or throat we may be sure that 
 there is interference with their blood and nerve supply 
 somewhere, and oftentimes that obstruction is in a 
 tense muscle or ligament. 
 
 Spinal vertebrae, of course, are found out of position, 
 but this is very seldom a cause of disease, unless such 
 malposition is the result of a severe accident. Dis- 
 placement of a vertebra sufficient to cause pressure on 
 a nerve would be very serious, indeed, but is very 
 rarely found. 
 
 The founder of Osteopathy is very fond of claim- 
 ing that " the Great Master Mechanic left nothing un- 
 finished in the machinery of his masterpiece — Man — 
 that is necessary for his comfort or longevity." But if 
 spinal vetebrae are so easily misplaced as to cause pres- 
 sure on nerves and blood vessels and thus cause dis- 
 ease. Deity has made a mistake in designing his mas- 
 terpiece — Man. 
 
 The reader must not think from the above that I 
 undervalue the good results to be obtained in Osteop- 
 athy, or mechanical treatment, only to obtain better 
 results than have been secured in the past we must 
 perform our work with a view to loosen tight joints, 
 relax muscles, ligaments and fascia, and not attempt to 
 move bones that are not causing pathological condi- 
 tions. Much good has been accomplished with the old 
 theory as a basis, but where it has been carried to its 
 logical conclusions harm has also resulted. 
 
16 Practice of Osteopathy 
 
 All honor to the founder of Osteopathy, even if his 
 theory was, in part, resting on false premises. 
 
 Diagnosis, Methods of. The method of diagnosis 
 most in vogue and the principal one which the" Os- 
 teopath uses is palpation, the use of the hand or 
 hands in determining the condition of nearly all 
 the tissues of the body. With careful work and 
 much practice, comparing the normal with the ab- 
 normal, the sense of touch becomes very acute, 
 and the least difference in the density and the 
 motility of the various tissues is readily determined. 
 The patient should be requested to relax all tissues 
 as much as possible and not to make any resist- 
 ance to the various movements unless requested 
 so to do. The other methods of diagnosis are in- 
 spection and percussion. With the beginner, in- 
 spection is also important, as by it he notes curva- 
 tures, unequal development of muscles, differences 
 in the color of the skin, apparent age, height, 
 weight, peculiarities of gait, manner of standing, 
 sitting, etc. 
 
 Percussion enables us to learn the condition, size, 
 shape and position of various organs, the presence 
 of cavities, gas, tumors, etc. This form of diag- 
 nosis calls into use a small hammer, but more gener- 
 ally the second and third fingers of the right hand 
 are used to strike the middle finger of the left hand 
 which has been placed over the part to be percussed. 
 In examining a patient it may be well to begin with 
 the neck. 
 
 The important point in the diagnosis is to discover 
 
Osteopathic Technique 17 
 
 the pliability and mobility of the spine. If it is too 
 pliable there is danger of curvature. If portions of 
 the spine are too stiff and there is not proper motion 
 in the joints of the vertebrae it is a cause for disease. 
 This may be determined, for the dorsal and lumbar 
 portions of the spine, by examining as in 
 Fig. 32; in the cervical region by examining as in- 
 dicated in Figs. 14 and 15. The ease with which this 
 movement is accomplished, together with a rotation 
 of the head, determines the amount of pliability. By 
 examining a few persons who are in health you 
 can determine what the normal should be. 
 
18 Practice of Osteopathy 
 
 EXAMINATION AND TREATMENT. 
 
 In many of the descriptions of treatments which 
 follow you might think that you were to put a bone 
 into its proper position at once, but you will not, and 
 it would not be best to do so. It often only results in 
 making an articulation more pliable, which is the real 
 object in view, looking to the ultimate result of restor- 
 ing the patient's health. The utmost care must be 
 taken not to injure a patient, which may be easily done 
 in the case of a child or a weak person. 
 
 Special Directions for Treating. In giving a gen- 
 eral treatment, try to do the work in twenty min- 
 utes. When you begin to practice Osteopathy it 
 will take thirty minutes or longer to give the gen- 
 eral treatment, but after you have practiced for a 
 while you will feel that you are wasting time if you 
 do not give it in twenty minutes or less. In using 
 the shorter time you will do the work very effective- 
 ly. In treating many cases you will obtain better re- 
 sults to give a short and very specific treatment. 
 Not more than five minutes is necessary for the en- 
 tire operation. As the founder of Osteopathy used 
 to say, " Do what is needed and then quit." He 
 called those who spent time in going over the entire 
 body " engine wipers." He wished Osteopaths to 
 be mechanics, first-class engineers, and to fix what 
 was wrong in a workmanlike manner. 
 
Osteopathic Technique 19 
 
 In nervous troubles and in many constitutional 
 diseases Osteopaths have discovered that they get 
 better results when they give the general treatment. 
 This helps the circulation and makes a tired patient 
 feel like new ; and the treatment, after all, when 
 there are no specific lesions to remove, is but little 
 more than deep massage, in which nearly all the 
 muscles of the body are manipulated. 
 
 One may give this treatment, in such a manner that 
 many patients come to look upon it as a luxury. And 
 many will take it when they are only slightly indis- 
 posed. Some business men take the treatment as a 
 means of relaxation. Many others take it when they 
 are simply tired. 
 
 In acute cases the Osteopath treats every day and 
 sometimes more often. When the patient becomes 
 better three treatments, and then twice per week, will 
 be sufficient. In treating chronic cases I have obtained 
 good results by giving the treatment every day for a 
 week and then treating three times per week. When 
 the patient became better, treatment was given twice 
 per week, later only once per week. In chronic cases 
 I found it necessary to treat my patients for three to 
 six months, though some did fairly well after one 
 month's treatment. A number of cases I have found 
 it necessary to treat from one to two years. That is 
 a long time, but results justified the time spent. In 
 treating such cases I have found it to be be-neficial 
 to let the patient rest from the treatment for from 
 one to three months and then begin treatment again. 
 Some patients do not seem to improve for the first 
 
20 Practice of Osteopathy 
 
 six months ; then they continue to improve until they 
 are well. I have had patients who did not make any 
 visible improvement in a year. They would quit the 
 treatment and begin to improve from that time on. 
 That is one reason why I have found it advisable to 
 have patients rest from the treatments for a month or 
 more. 
 
 Office Examination. In outlining the examina- 
 tion of patients in the office, where by far the great- 
 er number of an Osteopath's patients are treated, I 
 will give my own methods, which I tried in every 
 way to simplify and was successful in doing so as 
 time progressed. 
 
 My reception room was well lighted and kept very 
 clean. Everything about it was bright and cheerful. 
 The hardwocKi floors were well covered with bright- 
 colored Indian rugs. There were plenty of rockers. 
 A good supply of up-to-date popular literature, in- 
 cluding some bearing on Osteopathy, was always on 
 hand. There was a good library of the latest medical 
 works. 
 
 There were four good-sized treating rooms in con- 
 nection with the reception room. These contained a 
 treating table, costumer, dresser with mirror at- 
 tached, and a couch on which many of the patients 
 rested after treatment. This added greatly to the 
 benefit of the treatment in the cases of many nervous 
 patients. For the ladies there were many full-length 
 and full-fashioned kimonos, which were kept well 
 laundered. In the treating rooms were running 
 
 I 
 
Osteopathic Technique 21 
 
 water and a good supply of towels and soap. The 
 kimonos were open in the rear, which permitted of 
 a thorough examination of the back, which I al- 
 ways did on first treating the patient. The gen- 
 tlemen were nearly always examined the first time 
 on the naked back. They removed only the top 
 shirt, and I lifted the undershirt when I wished to 
 examine them. This permitted of a thorough exam- 
 ination. 
 
 The patient sitting, the examiner stands behind 
 and notes any inequalities on either side of the neck. 
 Sometimes one side bulges and on the other side 
 there is a corresponding hollow. This condition 
 indicates curvature in this region, with the con- 
 vexity to the full side. On this side the tissues 
 will be found to be hard, tense, and tender. When 
 this condition is present it is frequently indic- 
 ative of a curvature lower down. We now note 
 whether there are enlarged tonsils, hypertrophied 
 lymphatic glands, goiter, or any unusual pulsations 
 or enlarged vessels. 
 
 With the patient now reclining on the back in a 
 comfortable position, with all muscles relaxed, we 
 proceed with the examination by palpation. The 
 neck may be gently manipulated by placing one 
 hand on the forehead, for the purpose of rotating 
 it by using the forehead as a lever, while the other 
 hand manipulates the muscles in the back of the 
 neck for the purpose of further relaxation. In ex- 
 amination, as in treating, the Osteopath never rubs. 
 
22 Practice of Osteopathy 
 
 He never allows the hand to slip on the skin, but 
 is concerned with moving all the deeper tissues. 
 
 The Osteopath now with the points of the fingers 
 examines the tissues just beneath the skull. Often 
 these are found tense, and the patient complains of 
 pain here during examination and treatment. The 
 fingers are now allowed to travel down the mid line 
 at the back of the neck^ and find the spinous proc- 
 esses. The first one to be felt beneath the skin 
 is the second, or axis. The position of the first, or 
 atlas, is rarely determined by the spinous process, 
 though in some cases, about one in fifty, it may be 
 found. We are able to count the vertebrae in this 
 manner and to note their position. The seventh, or 
 vertebra prominens, has a very prominent spinous 
 process. It can be differentiated from the first dor- 
 sal, the one just beneath it, by rotating the head 
 when the patient is in a sitting position and noting 
 that the spinous process of the seventh cervical 
 moves perceptibly while the spinous process of the 
 first dorsal does not move. 
 
 Anterior, posterior, or lateral deviations may be 
 determined by the examination of the spinous proc- 
 esses. The position of the transverse processes 
 may be noted by turning the head to one side, mov- 
 ing the examining fingers up a little and to one side 
 from the spinous process. A prominent projection 
 will be found when the one on the other side will 
 be found in the same manner and the fingers will 
 then move down from one to the next process on 
 both sides, determining the relative position of each 
 
Osteopathic Technique 23 
 
 with reference to neighboring processes. This en- 
 ables us to determine lateral deviations, twists, or 
 torsions of vertebrae ; also posterior or anterior de- 
 viations from the normal. 
 
 Osteopathic treatment of the neck is for the pur- 
 pose of removing lesions, which may consist of any 
 departure from the normal in any tissue and which 
 is causing abnormality of function. In following the 
 description let us remember that all patients are not 
 to be subjected to the same routine. This is too fre- 
 quently done, to the detriment of the patient. What 
 follows is for the purpose of describing the work in 
 detail and to describe the work necessary for the 
 removal of the various lesions usually found. This 
 section of the book will be very frequently referred 
 to by the numbered paragraphs where the descrip- 
 tion of the specific treatment is referred to in the 
 proper treatment of each disease. 
 
 1. While the patient is in a sitting position on 
 the side of the table, the operator, standing behind, 
 the right hand placed on top of the patient's head, 
 rotates the head so as to bring the neck of the pa- 
 tient against the thumb of the operator's left hand. 
 The left thumb is moved successively along against 
 the arches of the vertebrae, as shown in Fig. 1. In 
 this manner there is secured a free motion between 
 the vertebrae, and the movement also assists in re- 
 laxing the tissues preparatory to removing any ver- 
 tebral lesion that may be present. 
 
 2. The patient is sitting and the operator is stand- 
 ing behind, and bends the neck of the patient as far 
 
24: Practice of Osteopathy 
 
 forward as possible on the chest of the patient. 
 This stretches the strong posterior neck muscles, 
 including the ligamentum nuchse. 
 
 3. The patient sitting, the operator stands in 
 front and puts his arm about the neck of the patient, 
 so that the bend of the elbow comes beneath the 
 chin of the patient, and the hand grasping the base 
 to the skull. The other hand is free to manipulate 
 any of the vertebrae in any desired direction, though 
 this hold is more applicable to the atlas and the axis. 
 The head of the patient may be given a lifting 
 motion and moved over in the required direction. 
 See Fig. 3. 
 
 4. The scaleni muscles, the deeper ones at the 
 side of the neck, are often tight and contracted. 
 Pressure may be made on the first rib on the con- 
 tracted side, as in Fig. 4, while the other hand bends 
 the head forcibly to the other side, at the same time 
 rotating the head. 
 
 5. The patient lies on his back. The operator 
 stands at one side with one hand on the patient's 
 forehead, the other beyond to the other side of the 
 neck. The hand on the forehead rotates the head 
 from side to side, alternately relaxing and stretch- 
 ing the muscles at the side and back of the neck, 
 while the hand placed at the side of the neck 
 stretches the muscles toward the operator with each 
 movement of the neck. The hand on the neck will 
 be moved from one position to another as the tis- 
 sues relax beneath it, and the hand may be brought 
 down onto the shoulder during the process of re- 
 
Osteopathic Technique 25 
 
 laxation. This same treatment may be applied to 
 all the tissues in front of the neck down to the 
 clavicles. See Fig-. 5. 
 
 6. The hyoid bone may be found just above what 
 is often called Adam's apple, the thyroid cartilage, 
 the largest cartilage of the larynx. The bone feels 
 as if it were shaped like the wishbone of a chicken, 
 minus the protuberance at the angle. While it 
 should be freely movable it is often held tight by 
 the muscles, the supra hyoid and the infra hyoid, 
 attached to it. This bone is frequently drawn back- 
 ward and downward, and by pressure on nerves 
 is the frequent cause of nervous coughing and may 
 be responsible for complete loss of voice. By 
 manipulating the neck from side to side the thumb 
 and forefinger may be gradually insinuated under it, 
 and it may be lifted up and forward. The tissues 
 all about it should be thoroughly relaxed. See 
 Fig. 6. 
 
 7. The pneumogastric nerve may be pressed up- 
 on, manipulated and stimulated by deep pressure be- 
 hind the anterior border of the sternomastoid mus- 
 cle on a level with Adam's apple, as in Fig. 7. This 
 is a very important nerve, osteopathically, owing to 
 its large distribution to important organs. 7 A. 
 The spinal accessory and glosso-pharyngeal nerves 
 may be reached by deep pressure upward and in- 
 ward behind the angle of the jaw. 7 B. The sub- 
 occipital, great occipital, small occipital, and great 
 auricular nerves may be stimulated as in cases of 
 fever, headaches, etc., by deep pressure on both 
 
26 Practice of Osteopathy 
 
 sides of the spine, just at the base of the skull, as 
 in Figs. 8 and 9. The founder of Osteopathy, Dr. 
 A. T. Still, when but a small boy, made pressure 
 on these nerves by placing his head in a swing. 
 See Fig. 10. He found that this pressure relieved 
 his headache. This accidental discovery may have had 
 something to do with his discovery, later in life, 
 of Osteopathy. 7 C. By deep pressure of the tissues 
 of the neck against the transverse processes of the 
 second and third cervical vertebrae we may stim- 
 ulate the superior cervical ganglion. See Fig. 9 A. 
 
 8. We will have occasion to refer to spring- 
 ing the lower jaw by opening and closing the mouth 
 against resistance. The operator stands behind the 
 reclining patient, with hands under the chin and at 
 both sides of the jaws of the patient, who is directed 
 to open and close the mouth slowly, the operator 
 resisting. This frees the tension of muscles and 
 allows more freedom of blood vessels below the 
 jaw. See Fig. 11. 8 B. In connection with the 
 above the hands may be used to draw up the tissues 
 under the chin. Let the movement be circular and 
 deep. The points of the fingers are used to execute 
 this movement. See Figs. 12 and 19. 
 
 9. The head may now be twisted as far as 
 possible to one side without causing inconvenience 
 to the patient; then to the other side in the same 
 manner. We often notice in executing this move- 
 ment that it moves further to one side than to the 
 other. On the side to which it turns the least we 
 
Osteopathic Technique 27 
 
 look for muscular or ligamentous lesions. See 
 Fig. 13. 
 
 10. The head may be pushed as far forward as 
 possible onto the chest, loosening the posterior 
 muscles and other tissues far down the spine. See 
 Figs. 14 and 15. 
 
 11. Some operators can use a very effective 
 spiral treatment of the tissues of the back of the 
 neck. One hand is placed on the forehead of the 
 reclining patient, the other beneath the neck. The 
 neck and head are both raised. The head is rotated 
 in one direction, the neck in the opposite direction. 
 Then the movement is reversed. See Fig. 16. 
 
 12. A number of movements have been devised 
 fo reduce atlas lesions. One has been given above 
 as in No. 3. These movements may be used in a 
 slightly different way for the other cervical verte- 
 brae. The operator stands at the head of the table, 
 the patient reclining. The operator grSiSps the head 
 firmly with both hands and makes pressure with 
 the fingers against the arch of the atlas behind. He 
 raises the head slightly, supporting it against the 
 body. Now as he rotates the head he presses the 
 bone toward the normal position. See Fig. 17. 
 
 13. The neck tissues may be stretched as in Fig. 
 18. In some cases it will be of material assistance, 
 in the case of light patients, to have an assistant to 
 hold the feet of the patient, to afford greater resist- 
 ance. 
 
 Many other movements in the treatment of the 
 neck will be developed in the regular routine of 
 
28 Practice of Osteopathy 
 
 practice by the skillful operator. This will be true 
 of every portion of the anatomy as well as of the 
 neck. 
 
 THE HEAD. 
 
 Most of the treatment for the purpose of affect- 
 ing the head is given in the neck, upper dorsal and 
 other portions of the body. Nevertheless the Oste- 
 opath does some direct work on the head. 
 
 14. While the patient is lying on the back the 
 palms of the operator's hands are passed from the 
 center of the forehead each way, with varying 
 pressure down over the temples and behind the 
 ears. This movement has a quieting effect on the 
 patient, soothing the nerves, and is frequently used 
 in headaches. It affects branches of the fifth nerve 
 on the forehead. See Fig. 20. 
 
 15. One palm is placed across the forehead and 
 the other beneath the skull, or both palms may be 
 placed on the forehead, one on top of the other, 
 and great pressure exerted for a few seconds and 
 repeated several times. See Fig. 21. This is useful 
 in colds, headaches, etc., as it helps to relieve the 
 pressure in the longitudinal and lateral sinuses, 
 large veins of the brain. 
 
 16. Treat along the midline of the skull, from 
 the nose to the back of the neck, using the thumb 
 in a circular, pressing motion with varying degrees 
 of pressure for the same purpose as Nos. 14 and 15. 
 See Fig. 22. 
 
 17. We may tap with the knuckles or percuss 
 
Osteopathic Technique 29. 
 
 with one finger laid upon the center of the forehead 
 in treating headaches, colds, etc. 
 
 18. Manipulate on each side of the nose and 
 loosen all the tissues for the purpose of affecting 
 the fifth nerve and freeing structures in close con- 
 nection with it. See Fig. 23. 
 
 19. Use deep pressure, with a gliding movement 
 of the little finger, to work over a portion of the 
 fifth nerve, supplying the tear duct, for the purpose 
 of opening it or keeping it open. Begin at the 
 inner corner of the eye. See Fig 24. 
 
 20. The forefinger will find a little depression 
 in the skull, just below the eyebrows, between the 
 center and inner margins of the eye, where the 
 supraorbital branch of the fifth nerve emerges 
 from the skull. It is a nerve of nutrition to the eye, 
 and passes outward over the forehead at an angle 
 of forty-five degrees. Free the tissues about and 
 in this little opening with a gentle, pressing, cir- 
 cular movement of the tip of the forefinger. See 
 Fig. 25. Work along the nerve with the palm 
 of the thumb. In some cases of neuralgia it will 
 be found to be extremely sensitive, which will be 
 greatly lessened as tissues are relaxed about it. 
 In treating the eyes this nerve is often stimulated. 
 The nerve may be felt beneath the skin. 
 
 21. The fifth nerve may be treated where it 
 emerges from the skull above the eye, in Figs. 
 25 and 20. Also over both jaws, above and below 
 the roots of the teeth. It may also be treated below 
 the malar cheek bones, as in Fig. 26. It may be 
 
I 
 
 80 Practice of Osteopathy 
 
 treated along the sides of the nose, as in Fig. 23. 
 Thorough treatment of this nerve is frequently 
 necessary in cases of neuralgia. 
 
 THE EYES. 
 
 22. The fingers must be very clean as they work 
 inside of the orbit to tone up weak or contracted 
 muscles in cases of strabismus. The finger may 
 be inserted deeply, yet carefully, and worked around 
 the eyeball, both to relax and free up the tissues 
 and to promote a better circulation. 
 
 23. The nail must be thoroughly clean as it is 
 used to break up the little blood vessels which form 
 a network running into the pterygia, which, if let 
 alone, will grow towards and cover up the pupil of 
 the eye. 
 
 24. Granulations may be broken up by crushing 
 them between the thumb and forefinger. For this 
 purpose, folds of the lid may be lifted up, or one 
 finger may be inserted beneath the lid. 
 
 25. The patient, lying on the back, the eyeballs 
 may be pressed back into the orbit several times 
 with the palms of the thumbs and held there for a 
 few seconds. This helps in toning up the various 
 structures and assists in the general circulation of 
 the eyes. 
 
 26. The palm of one finger may be placed over 
 the eyeball and tapped, as in percussion, by the 
 forefinger of the other hand. This acts very much 
 as No. 25, and is useful in cases of cataract. See 
 Fig. 27. 
 
Osteopathic Technique 31 
 
 THE SPINK 
 
 27. The patient sits on the side of the table and 
 the operator notices any deviation from the normal 
 in exaggerated curves, lateral curvature, or any 
 number of vertebras or a single vertebra which may 
 be misplaced. He notes any tenderness, as he 
 palpates with the fingers, that may be found in 
 the tissues on either side of the spine or between 
 the spinous processes. See Figs. 28 and 29 for 
 fairly normal spines. 
 
 28. The tips of the spines, the spinous processes, 
 may be noted by the red color brought out on them 
 by swiftly passing the hand over them with some 
 pressure. In this manner their position may be 
 noted, thus disclosing any deviation from the 
 normal. 
 
 29. A finger may be placed each side of the 
 spinous processes and passed down, in this manner 
 noting any lateral deviation from the normal. 
 This may be done either on the bare spine or over 
 the clothing worn in treating. See Fig. 30. 
 
 30. The palm of the hand may be passed down 
 rapidly, from the base of the skull to the sacrum, 
 for the purpose of noting any deviations from the 
 normal, either posterior or anterior. 
 
 Pressure exerted on the top of the head, as in Fig. 
 69, will frequently reveal tenderness at some point 
 in the spine. 
 
 31. The patient rests in the prone position, lying 
 on his stomach, while the operator, with the palms 
 
32 Practice of Osteopathy 
 
 of the fingers, notes contracted muscular tissues, 
 pulling the muscles away from the spine on either 
 side. These contracted muscles often feel like 
 small ropes beneath the fingers. See Fig. 31. 
 
 32. The limbs of the patient are flexed as he lies 
 on his side, and the operator holds them in this 
 position as he gently springs the spine, as in Fig. 
 32, noting its relaxed or contracted condition. 
 
 33. While the patient is lying on the side in a 
 comfortable position the vertebra are carefully ex- 
 amined by the fingers of the operator. Pressure 
 is made between the spinous processes of each one, 
 to note the condition of the ligaments and the ap- 
 proximation or separation of the various vertebrae. 
 See Fig. 33. When the ligaments have grown too 
 thick they fill the spaces and produce what is 
 known as the smooth, stiff spine. 
 
 34. With the patient sitting on the side of the 
 table, and the operator standing behind, he may be- 
 gin the treatment of the back by placing the tips of 
 his fingers on the patient's shoulders and with the 
 thumbs loosen the muscular tissues in the upper 
 part of the back. If the hands are long he can 
 travel up and down a good portion of the back with 
 the fingers in the above position. See Fig. 34. The 
 fingers may now be used in relaxing all the tissues 
 on the shoulders from the neck over the top of the 
 shoulders. 
 
 35. While the patient is sitting the operator 
 passes one arm over one shoulder and under the 
 opposite arm in front With the other hand he 
 
Osteopathic Technique 33 
 
 makes fixed points on the spine with the thumb, 
 against which he rotates the body with the other 
 arm, and in this manner thoroughly loosens the 
 structures and replaces misplaced vertebrae. See 
 Figs. 35 and 36. The position is reversed and the 
 other side of the spine is treated in the same 
 manner. The patient may be held, as in Fig. 68, 
 one shoulder braced against operator's body. 
 
 36. The patient sitting, and the operator stand- 
 ing behind places one hand on the top of the 
 patient's head and with the other hand makes fixed 
 points with the thumb along the spine, using the 
 head and neck as a lever. The use of the hands 
 may then be reversed and the other side of the spine 
 treated in the same manner. The operator will be 
 surprised with the efhciency of this movement and 
 the power that can be exerted at any given point 
 along the spine against the thumb by making the 
 right pressure on the head. See Fig. 37. 
 
 37. The patient sits, preferably on a stool, and 
 places his hands behind his neck. The operator 
 stands behind and passes his hands under the 
 patient's arms and takes his wrists and places one 
 side of the flat of his knee at the patient's spine and 
 lifts the patient up and backward against the knee. 
 This is an efficient treatment for loosening the 
 various articulations and stretching the ligaments 
 which have become tightened. It stretches the 
 spinal, scapular and neck muscles. The lower ribs 
 are raised. See Fig. 38. 
 
 38. The patient sitting, the operator stands to 
 
34 Practice of Osteopathy 
 
 one side and behind, or kneels beside the patient 
 on the table, and passes one arm back of the 
 patient's neck and under the patient's arm on the 
 other side, thus bending the patient's neck forward. 
 With the free hand fixed points are made along 
 the spine and the patient's body is rotated against 
 the thumb of the operator. This movement is 
 very effective in upper dorsal regions. See Fig. 39. 
 
 39. The patient sitting, the operator stands be- 
 hind and places one knee beneath the arm of the 
 patient in the axilla. This holds the shoulder and 
 the ribs on that side in a fixed position. The 
 operator may use one or both hands in raising one 
 or more ribs or in stretching the opposite side. 
 See Fig. 40. This may be used in combination with 
 Figs. 46, 47. 
 
 40. The patient is sitting, and the practitioner 
 stands behind to one side and reaching around the 
 patient in front grasps the lower edge of any rib. 
 With the other free hand he raises the arm of the 
 patient on the same side as he lifts the rib. This will 
 be helped by having the patient take a deep breath 
 as the rib and arm are raised, then holding both 
 as the patient expels the air. See Fig. 41. 
 
 41. The patient is sitting on a stool with the 
 knees against the wall. The operator stands behind 
 and places his knee on the appropriate round of 
 the stool, with the knee against the vertebrae he 
 wishes to correct, seizes the patient by the 
 shoulders or under the arms and pulls the patient 
 back against the knee, rotating the patient to make 
 
Osteopathic Technique 35 
 
 the necessary correction of the spine. Extreme 
 care must be exercised in executing this movement 
 for fear of injury to the patient. See Fig. 42. 
 
 42. The patient while sitting on the side of the 
 table is bent forward so that his head is between his 
 knees, the operator using forcible pressure on the 
 upper dorsal region and head. This relaxes the 
 ligaments of the lumbar and sacro-iliac regions. 
 See Fig. 43. 
 
 43. The patient is sitting on the side of the table. 
 The operator is standing in front of the patient, 
 with a pillow between himself and the patient. 
 Both hands clasp the spine of the patient as in Fig. 
 44, when deep pressure may be made, sinking the 
 vertebrae well in ; then by rotating the body 
 pressure may be made to the side wished. This is 
 an excellent movement to correct a lateral curva- 
 ture or any lateral or posterior displacement. In 
 case of an anterior displaced vertebra the vertebrae 
 above and below may be brought forward in this 
 manner, thus gradually correcting the one which 
 is anterior. 
 
 44. The position is the same as in 43 for both 
 operator and patient. By grasping the spine firmly 
 on each side the patient may be lifted and the spine 
 stretched, or correction may be made in this manner 
 when only two or three vertebrae are approximated 
 too closely. See Fig. 45. 
 
 45. Fig. 46 shows an excellent movement in 
 cases of spinal curvature. The side which is 
 shortened may be stretched by using the wrist under 
 
36 Practice of Osteopathy 
 
 the patient's arm, and the hand, as shown in the 
 figure, raises and stretches the side. The other free 
 hand moves from point to point along the spine 
 and forces it over into position. 
 
 46. The side may also be stretched, as in Fig. 47. 
 Firm upward pressure may be made with the hand 
 grasping the ribs while traction is made on the 
 upstretched wrist of the patient. 
 
 47. The patient lies in as easy a position as pos- 
 sible, with the face downward, but for comfort the 
 face may be turned to one side, with the toes ex- 
 tending over the end of the table. Let the arms 
 hang over the side of the table. Have the patient 
 relax as much as possible. The operator uses the 
 palms of the hands in a circular, pressing move- 
 ment to relax all contracted tissues of the back. 
 See Fig. 48. With the cushions of the fingers he can 
 pull the muscles away from the spine, as in Fig. 31. 
 
 48. With the patient lying in the prone position, 
 the operator standing at one side of the table grasps 
 the hip of the patient on the further side in front. 
 The heel of the other hand can then travel up and 
 down the spine, exerting considerable pressure 
 while the other hand pulls the hip upward, giving 
 the spine a torsion. The operator works from both 
 sides. This movement is very effective in removing 
 lesions and relaxing contracted tissues. See Fig. 
 49. 
 
 49. With Mie patient in the prone position, lying 
 across the ta.aie as in Fig. 50, the opera-xvyi* stands 
 at the head of the patient, and with th*^ tshumbs 
 
Osteopathic Technique 37 
 
 working each side of the spine he can further re- 
 lax tissues and stimulate the nerves through the 
 spinal cord. 
 
 50. With the patient in the prone position, and 
 the operator standing at the head of the table with 
 the thumbs each side of the spine, as in Fig. 51, he 
 can further relax the tissues and can also exert con- 
 siderable pressure when necessary to correct poster- 
 ior displaced vertebrae, or for the purpose of 
 stimulating the spinal cord and through it the organ 
 or organs which receive their nerve supply from 
 any particular section of the spinal cord. 
 
 51. The patient is in the prone position, and the 
 limbs are raised in the operator's arm, as in Fig. 52, 
 and rotated while the other hand makes fixed points 
 with considerable pressure on the lower part of the 
 spine. 
 
 52. The patient is in the prone position, and 
 pressure is made in the lower part of the spine, 
 while first one then the other limb is raised, as in 
 Fig. 53. This movement, as well as No. 51, assists 
 the operator in relaxing the tissues and replacing 
 posterior vertebrae. 
 
 53. The patient lies on his side in a comfortable 
 position. The operator stands in front and grasps 
 the patient's uppermost arm, as in Fig. 54. With 
 the other hand he relaxes the tissues about the 
 shoulders and down to the spine and pretty well 
 down the back, using the arm as he holds it at the 
 elbow as a lever, working it back and forth to aid 
 in the manipulation. The spine is manipulated 
 
38 Practice of Osteopathy 
 
 and any deviations are corrected at the same time 
 and in the same manner. 
 
 54. The tissues may be so relaxed that the 
 shoulder may be manipulated quite freely. One 
 hand may pull up the scapulae, while the other 
 presses on the shoulder, as in Fig. 55. The hand 
 may also be insinuated under the scapulae, as in 
 Fig. 56, and the tissues thoroughly manipulated 
 and loosened. 
 
 55. While the patient is reclining on the side, 
 and one hand has made its way under the patient's 
 scapulae, the other hand grasps the patient on the 
 shoulder and rotates the entire shoulder. See Fig, 
 57. 
 
 56. The patient is lying on his side on the table. 
 The operator places one hand beneath the patient's 
 neck and grasps the occiput, as in Fig. 58. The 
 operator brings his chest against the other side of 
 the patient's head. In this manner considerable 
 traction may be made on the neck and upper dorsal 
 region, and very effective corrective work may be 
 done with the spine with the free hand as shown in 
 the cut. 
 
 57. The limbs of the patient may be flexed and 
 braced against the operator, who bends over and 
 grasps the spine thus brought into relief, as in Fig. 
 32. The spine at any point may now be manipulated 
 by pulling it toward the operator. 
 
 58. With one elbow on the hip, the other on 
 the shoulder, as in Fig. 59, as the patient is lying 
 on the side, the operator's arms may be extended, 
 
 I 
 
Osteopathic Technique 39 
 
 thus stretching the hip away from the shoulder 
 while the hands are free to manipulate tissues and 
 the spine as well. 
 
 59. The patient lies on the side, and the opera- 
 tor, with one hand in front of the hip and the other 
 hand behind the shoulder as in Fig. 60. By pulling 
 on the shoulder and pushing against the hip the 
 spine may be twisted for the purpose of relaxing 
 tissues, including muscles, nerves and ligaments. 
 With the same motion the side of the back upper- 
 most may be stretched by separation of the opera- 
 tor's arms. 
 
 60. Fig. 61 is the exact opposite of the above, 
 and the torsion is applied by reversing the position 
 and motion. This is very useful for stretching 
 and relaxing the various tissues of the back and 
 spine. 
 
 61. The patient lies comfortably on his back. 
 The elbow of the patient is held by the operator 
 with one hand, while with the other he reaches 
 across the body of the patient and grasps the 
 muscles of the back, as in Fig. 62. The arm may 
 be stretched as movements are made to loosen the 
 tissues manipulated with the free hand. The spine 
 may also be manipulated with the free hand its 
 entire length. 
 
 62. The patient lies on the back, and the operator 
 stands at the side of the table and reaches across 
 the body of the patient and grasps the spinal edge 
 of the scapulae, pulling it out as he brings the arm 
 of the patient across the chest, as in Fig. 63. 
 
40 Practice of Osteopathy 
 
 63o A small patient lies on the back. The knees 
 are grasped in one hand and flexed, as in Fig. 64. 
 The free hand is introduced under the patient, 
 grasping the lower part of the spine and manipulat- 
 ing it as the knees are made to describe a circle. 
 This is a very thorough method of manipulating 
 the lower dorsal and lumbar regions of the spine. 
 
 64. The patient lies on the back. The knees are 
 flexed on the thighs and the thighs are brought 
 forcibly against the abdomen. The pressure may 
 be relaxed, then increased. This movement relaxes 
 the ligaments and muscles of the lumbar and sacro- 
 iliac regions. See Fig. 65. 
 
 65. The fifth lumbar vertebra is frequently found 
 posterior. With the patient on his back, the 
 clinched fist of the operator is placed under the 
 vertebrae and one limb at a time is taken by the 
 ankle and forcibly put through the motion of ex- 
 ternal circumduction, straightening the limb out 
 with considerable force, thus bringing the weight 
 of the body on the vertebra. 
 
 66. In case the fifth lumbar vertebra is anter- 
 ior the lesion is more difficult to reduce. The liga- 
 ments may be loosened, as in Nos. 63 and 64, and 
 the vertebra moved from side to side, as in Nos. 
 35 and 57, thus gradually bringing it into its prop- 
 per position. 
 
 67. In case we desire strong inhibition, for the 
 purpose of lessening the number of nerve impulses 
 passing from any section of the cord to any given 
 organs, we may hold the spine with a strong grip, 
 
Osteopathic Technique 41 
 
 partially liftin*g the body from the table, as in 
 Fig. 32; or we may place a book under the spine, 
 requesting the patient to recline heavily upon it, 
 as in Fig. 66. The position of the book, as indicated 
 in the cut, is for the purpose of quieting the peris- 
 taltic action of the bowels in cases of excessive 
 diarrhoea. 
 
 68. When the sacrum is found to be posterior 
 it may be moved to its proper position in many 
 cases by properly relaxing the sacro-iliac ligaments 
 as in Nos. 47, 51, 52, 64. Then have the patient lie 
 on the side of the table. The operator then places 
 his knee against the sacrum and pulls back on the 
 hip and shoulder, thus gradually forcing the sacrum 
 into position. See Fig. 67. 
 
 69. Another movement for restoring to its proper 
 position a posterior sacrum is for the patient to sit 
 on a stool. The operator places his knee against 
 the sacrum, and holding the patient about the body 
 rotates it as he pulls it backward, thus bringing 
 pressure to bear on the sacrum. See Fig. 42. 
 
 70. The coccyx is frequently misplaced. It can 
 be manipulated after relaxing the tissues about it. 
 Frequently it is found necessary to insert the fore- 
 finger into the rectum, when the coccyx may be 
 grasped by the thumb and finger and moved in 
 the desired direction. This latter treatment should 
 not be given oftener than once per week, and must 
 be carefully done for fear of injuring the delicate 
 tissues. 
 
 71. The finger, anointed with vaseline, is inserted 
 
42 Practice of Osteopathy 
 
 into the rectum for various purposes by the Oste- 
 opath. In doing so, time must be given for the 
 sphincter muscle to relax. In piles, the finger 
 presses the blood out of the congested veins, and 
 with a circular, sweeping motion with the palm 
 of the finger smooths out, frees and stimulates the 
 action of nerves and blood vessels. In case the 
 rectum is prolapsed it may be pushed up into posi- 
 tion. 
 
 72. The clavicle, or collar bone, is frequently 
 found displaced. The sternal end, when out of posi- 
 tion, affects the tissues of the throat and is a promi- 
 nent factor in diseases affecting this region, in- 
 cluding goiter and circulatory and nerve disturb- 
 ances in the arms. The operator stands at the side 
 of the table and takes the elbow of the patient, who 
 is reclining, and inserts the fingers of the other 
 hand under and above the clavicle, near the sternal 
 end. The elbow is now brought over the breast 
 of the patient and the fingers inserted more deeply 
 under the clavical. This movement brings heavy 
 pressure onto the fingers by the clavical, which re- 
 sults in raising the latter, when the sternal end 
 can be placed in or toward its normal position. 
 See Fig. 70. This treatment may be applied at 
 either end of the clavicle as the case may require. 
 
 73. The clavicle may also be raised and placed 
 in its normal position with the patient sitting, as 
 in Fig. 71. The elbow is grasped and raised, which 
 raises the clavicle, when the thumb may be inserted 
 above and under it. By bringing the elbow upward 
 
Osteopathic Technique 43 
 
 and across the chest the clavicular ligaments may 
 be stretched and the clavicle properly replaced. 
 This treatment is effective for either end of the 
 clavicle. 
 
 THE THORAX. 
 
 In treating the thorax we must remember that 
 the ribs are connected with the vertebrae, and that 
 when the spine has a curvature, or one or more 
 vertebrae are twisted or displaced in any manner, 
 the ribs connected with those vertebrae are very 
 frequently misplaced as a result. These combined 
 lesions cause secondary lesions of the muscles, 
 ligaments and cartilages. In correcting any malad- 
 justment of the ribs advantage is taken of the mus- 
 cles attached to them, especially the pectoral and 
 latissimus dorsi muscles. 
 
 74. The vertebral end, or head of the rib, is nearly 
 a fixed point. Pressure exerted at the angle of the 
 rib tends to move the rib about that fixed point. 
 This movement is made more effective by the forci- 
 ble elevation of the arm and in some cases by the 
 rotation of the shoulder. 
 
 75. The first rib is often raised near the sternal 
 end. It may be depressed after the scaleni, the 
 muscles of the neck, are thoroughly loosened. It 
 may be depressed by pressure as the operator stands 
 behind the sitting patient, as in Fig. 4. The head is 
 bent forward and rotated, as in the cut. This 
 stretches the scaleni muscles attached to the rib. 
 The pressure is still appHed as the head is turned 
 toward the rib. 
 
44 Practice of Osteopathy 
 
 76. The first rib may be also corrected as the 
 patient is in the recumbent position, as in Fig. 72. 
 The head is raised and rotated away from the rib, 
 while the pressure is applied to the rib. Later the 
 head is rotated toward the rib as the pressure is 
 again applied. 
 
 77. A further treatment for the first rib is applied 
 as the patient is in the recumbent position, as in 
 Fig. 72. With the head turned toward the affected 
 rib and slightly elevated, pressure is made on the 
 rib with the thumb, and the elbow on the same side 
 is grasped and carried across the chest to the 
 opposite shoulder. 
 
 78. When the first or second rib is displaced 
 downward it can be raised ; the patient sitting, 
 the operator standing behind. The operator places 
 the tips of the fingers at the lower border of the 
 rib and lifts on it as he rotates the head, with the 
 free hand, forward and then strongly backward. 
 This uses the neck muscles, the scaleni, to pull 
 the rib upward. Should the anterior cartilages 
 protrude they may be pressed into position as 
 the above treatment is being given. 
 
 79. Should the first and second ribs need elevat- 
 ing, nearer the spine, the operator may stand in front 
 of the sitting patient while he presses and lifts up . 
 near the head of these ribs, while he rotates the 
 head forward and to the opposite side with con- 
 siderable force. See Fig. 73. 
 
 80. The first rib may be depressed, with the 
 operator sitting at the side of the patient with the 
 
Osteopathic Technique 45 
 
 patient's arm across the operator's shoulder. This 
 elevates the structures on that side. Pressure is 
 now made on the upper border of the rib, just above 
 the clavicle, as the head is rotated to that side and 
 forward. See Fig. 74. 
 
 81. The practitioner stands in front of the sitting 
 patient. One arm reaches around the patient, a 
 little past the spine to the angle of the ribs, as in 
 Fig. 47, while the arm of the patient is raised on 
 the same side. The arm is stretched up and rotated 
 back and down while the operator lifts on the angle 
 of the rib. This serves to lift the rib in front as well 
 as at the angle, because of the traction exerted on 
 the pectoral muscles in front by the elevation of the 
 arm. This motion should be carefully executed, 
 yet sufficient strength should be used to make it 
 effective. It may be repeated several times if 
 necessary. The hand which holds the ribs may 
 select one after another, as may be necessary, as 
 the arm is stretched and rotated. In giving the 
 above treatment the muscles, nerves, and ligaments 
 are strengthened and toned. If one rib is very 
 much lower than it should be the patient should 
 take a full breath when the rib is pulled up, and as 
 the breath is expelled the rib is still held for a few 
 seconds. 
 
 82. Fig. 46 represents another method of elevat- 
 ing and separating ribs. The patient sits and the 
 operator stands in front. The operator forces the 
 spine to the side in question, which helps to separate 
 the ribs. The arm of the patient is raised by the 
 
46 Practice of Osteopathy 
 
 wrist on that side, which raises the ribs. A com- 
 bination of 81 and 82 is frequently effective. 
 
 83. The patient sitting and the arm of the 
 patient across the shoulder of the operator, as in 
 Fig. 75. This gives more of a hold on the lower 
 rib while the patient's head is bent away from the 
 side being treated, curving the spine and throwing 
 the rib more into relief. 
 
 84. The patient sits on a stool and the operator 
 stands behind, with his knee against the angle of 
 the rib. With one hand the operator elevates and 
 rotates the arm of the patient, and with the fingers 
 of the other hand, beneath the rib in front, lifts upon 
 it as the patient takes a deep breath. The entire 
 treatment may be reversed and the rib depressed. 
 See Fig. 41. 
 
 85. The patient is sitting. The operator standing 
 in front grasps the head of the rib in question, with 
 one hand passed about the patient, while the other 
 hand presses on the sternal end of the rib. By 
 rotating the body of the patient the rib may be 
 sprung into position. 
 
 86. The patient is reclining on the back. The 
 operator, standing to one side, reaches over and 
 takes the arm of the patient on the other side. With 
 the free hand he takes the rib at or near the angle, 
 as in Fig. 62, and as he pushes it into place he 
 lifts up on the outstretched arm and rotates it 
 backward. This calls into play the anterior muscles 
 attached to the rib or ribs and assists in the move- 
 ment. The patient may further assist the operator 
 
Osteopathic Technique 47 
 
 by taking a deep, full breath as the rib is lifted up, 
 which the operator holds for a few seconds as the 
 breath is exhaled. 
 
 87. The patient may lie on the side. The 
 operator uses the same general movements as in 
 No. 86. This of course applies more to the upper 
 ribs. 
 
 88. As the patient lies in the prone position the 
 heads or angles of the ribs may be replaced, as in 
 Figs. 76, 50, 51, by working directly over them. 
 
 89. When the patient lies in the prone position 
 many cases of luxated ribs may be treated by pres- 
 sure of the thumbs against the angles of the ribs, 
 throwing the ribs either upward or downward, as 
 indicated by the needs of the condition. 
 
 THE ELEVENTH AND TWELFTH RIBS. 
 
 90. These ribs are very frequently found dis- 
 placed. The surrounding tissues must be fully 
 relaxed. When the rib or ribs are displaced upward 
 we have the patient lie on the side, with the limbs 
 flexed on the abdomen, when the ribs may be 
 grasped by the operator and pushed into position, 
 forcing them upward. 
 
 91. The patient sits on the side of the table, 
 while the operator holds each end of the rib. The 
 patient takes a full breath, and as the patient ex- 
 hales, the rib is pushed into position. 
 
 92. When the rib is displaced upwards the 
 patient takes either position, lying on the side or 
 
48 Practice of Osteopathy 
 
 sitting, and the rib is manipulated, as in Nos. 90 
 and 92, only in the opposite direction. 
 
 93. Frequently we find the ribs flattened over the 
 liver or stomach. They may be pulled out, as in 
 Fig. 77 . Then they may be rounded into shape 
 by using pressure on the ribs at the sides, as in 
 Fig. 78. Repeated treatment in this manner will 
 materially affect their shape. 
 
 In treating and manipulating affected ribs or 
 misplaced ribs we find it necessary to repeat the 
 treatment. In some cases it takes considerable 
 time, a number of treatments being necessary for 
 permanent results. The ribs are so prone to slip 
 back into their old positions when they have been 
 out of position for a long tim-e. 
 
 THE ABDOMEN. 
 
 The Osteopath in examining the abdomen uses 
 inspection, percussion and palpation. The latter 
 conveys the most information concerning the con- 
 dition of this important region and its contents. 
 We note displacements of various organs, new 
 growths, tumors, relaxed or tense conditions of 
 the muscles, differences in temperature, enlarged 
 or pulsating vessels, muscular contractions, dis- 
 tended or contracted walls, etc. 
 
 94. A general treatment of the abdomen is fre- 
 quently very helpful, either for relaxing or toning 
 muscular tissues, for increasing or decreasing the 
 amount of blood in the abdominal vessels, and for 
 its general effect on the nerves. The patient lies 
 
Osteopathic Technique 49 
 
 on the back, with the knees flexed. The operator 
 stands at one side of the table, and with the palm 
 of the hand, not the tips of the fingers, relaxes the 
 muscles of the abdomen. The operator may begin 
 low down to one side and work up on that side, then 
 on the other side in the same manner. The ribs may 
 be slightly sprung inward to assist in the relaxation 
 of the abdominal walls as they are undergoing 
 manipulation, as in Fig. 79, which shows the general 
 position of the hands. The abdomen may be 
 spanned by the hands, with the thumbs on one 
 side and the finger tips on the other side, and the 
 abdominal contents moved in this manner from one 
 side to the other. 
 
 95. In treating any part of the body, but es- 
 pecially the abdomen, the hands should be of such a 
 temperature as not to be disagreeable to the patient. 
 Cold hands used here will cause a contraction of 
 the tissues, and thus interfere with the work. Direct 
 pressure may be made with the flat of the hand, 
 as in Fig. 80, over the center of the abdomen well 
 below the umbilicus. Pressure may be gradually 
 increased, with some side pressure to force the con- 
 tents of the small intestine toward the caecum, the 
 lower part of the large intestine which lies low down 
 on the right side. 
 
 96. It is often advantageous to lift up the intes- 
 tines, as in Fig. 81. With the patient reclining, the 
 knees should be flexed to allow of more thorough 
 relaxation of the abdominal muscles. This move- 
 ment should be repeated several times and the 
 
50 Practice of Osteopathy 
 
 abdominal contents held for a minute or so each 
 time. 
 
 97. The patient is sitting, and the operator is 
 standing behind. He places the sides of the palms 
 of the hands deeply beneath the abdominal contents, 
 as in Fig. 82. The patient is requested to bend 
 forward as the operator twists his wrists, so that 
 the sides of the hand next to the patient are turned 
 inward and upward. Then request the patient to 
 straighten up as the operator lifts the contents, 
 and holds for a moment. 
 
 98. The patient lies on the side, permitting a 
 relaxed condition of the abdominal walls. The 
 operator stands behind, as in Fig. 83, and lifts the 
 abdominal contents upward, and may also lift them 
 toward the median line, thus straightening out the 
 caecum, or sigmoid flexure, as the position may 
 allow. 
 
 99. The operator may straighten out the sigmoid, 
 and at the same time tone up the muscular tissues, 
 by insinuating the palms of the hands deeply and low 
 down on the left of the abdomen, and suddenly 
 lifting the contents. The movement must be care- 
 fully and cautiously performed. 
 
 100. It is often of advantage, as will be indicated 
 in various treatments, to tone up the solar plexus. 
 This may be done by deep steady pressure, with a 
 slightly circular motion just below the sternum. 
 Pressure should be directed backward and upward, 
 as in Fig. 84. 
 
 101. The liver, spleen, and stomach and other 
 
Osteopathic Technique 51 
 
 upper abdominal viscera may be toned by placing 
 one hand on either side of the ribs, as in Fig. 85. 
 Pressure, alternating with a few seconds of rest, is 
 made as indicated. 
 
 102. The liver and adjacent abdominal viscera 
 may be toned by alternating pressure and relaxa- 
 tion directly over that organ, as indicated in Fig. 
 78. 
 
 103. The gall bladder lies underneath the ante- 
 rior portion of the liver, just beneath the points 
 of the ninth and tenth ribs on the right side. The 
 bile duct leaves it at this point and proceeds to 
 the duodenum, in the shape of a reversed letter " S '' 
 when it enters that portion of the small intestine, 
 about one and a half inches below the umbilicus. In 
 cases of gallstones, or inflammation of the bladder or 
 duct, we may assist nature in emptying the bladder 
 and pass stones along the duct by manipulation. 
 
 THE PELVIS. 
 
 In the treatment of diseases peculiar to women, 
 and some diseases peculiar to men, lesions of the 
 pelvis play a most important part. One may never 
 expect to effect a cure while these lesions are permitted 
 to remain. To remove them is of the greatest import- 
 ance. 
 
 Pelvic lesions will also be considered here because 
 they affect the limbs, causing sciatica, paralysis, en- 
 larged veins, errors in circulation, etc. These lesions 
 are often accompanied by spinal lesions, which al- 
 so affect the spine and through it other internal 
 
52 Practice of Osteopathy 
 
 organs. The discovery of these lesions requires 
 considerable anatomical skill, and an attempt to 
 correct lesions here should only be made when the 
 operator is absolutely sure of his diagnosis. 
 
 The whole pelvis may be tipped backward, in 
 which case the superior posterior iliac spines will 
 be found to be too prominent. In case the whole 
 pelvis is on a torsion, one side back, the other side 
 forward, one superior posterior iliac spine will be 
 found prominent and the other less prominent than 
 normal. In case one side of the pelvis is higher than 
 the other, the superior posterior spine will be higher 
 on the high side. The limb on the high side will be 
 shorter than the limb on the low side. This may be 
 determined by slightly manipulating both limbs to 
 relax all tissues, and then comparing the internal 
 malleoli of the tibia with each other. This may be 
 done by placing them close together. Another way 
 is to have the patient hold a tape line between the 
 front teeth, and measure to the anterior superior 
 spines of both ilia, and also to each internal malleo- 
 lus of each tibia. In case the upper portion of the 
 pelvis has moved forward, the superior posterior 
 iliac spines will be found to be less prominent than 
 in the normal pelvis. 
 
 In making the examination the operator will best 
 determine the condition by having the back bare. 
 Great care must be exercised in making the examina- 
 tion. The points of tenderness in case of luxation 
 will be found over the sacro-iliac articulation, both 
 
 i 
 
Osteopathic Technique 53 
 
 in the muscles and in the ligaments, interfering with 
 nerves in the same region. 
 
 104. When the pelvis is tipped backward have the 
 patient sit on a stool or table. The operator stands 
 behind and places his knee against the upper part of 
 the sacrum, while he takes the patient beneath the 
 arms and pulls upward and backward on the trunk 
 with a rotary motion to first one side and then the 
 other. The assistant sits in front and draws the 
 pelvis forward. See Fig. 42. 
 
 105. For backward tipping of the pelvis the pa- 
 tient may recline on the table with the face down. 
 With one hand the operator makes pressure on the 
 upper part of the pelvis, while he lifts the limb on 
 that side with considerable force. This treatment 
 is given first on one side then the other. 
 
 106. For a backward tipping of the pelvis the 
 patient lies on the side on the table. The operator 
 stands behind. The knee is placed firmly against the 
 sacrum, and the shoulder and the leg are both drawn 
 backward. This forces the pelvis forward. See 
 Fig. 67. 
 
 107. When the pelvis is tipped forward the patient 
 may lie on the side. The operator stands behind, 
 and as he presses against the lower part of the sa- 
 crum and pelvis with one hand he pulls back with 
 the other hand from the upper part of the front of 
 the pelvis, the anterior superior spine of the ilium. 
 
 108. The patient sits on a stool, while the operator 
 stands in front. The assistant is stationed behind 
 the patient and holds the pelvis in front and draws 
 
54 Practice of Osteopathy 
 
 it backward, while the operator with his arms under 
 those of the patient manipulates the body of the 
 patient forward with a lifting, rotary motion. 
 
 109. Should the pelvis tip upward on one side, 
 the quadratus lumborum muscle may be stretched, 
 as in Figs. 59, 60, 61. Then No. 108 may be applied, 
 with the assistant holding down the high side of 
 the pelvis. 
 
 INNOMINATE LESIONS. 
 
 We frequently have lesions which affect only one 
 side of the pelvis. We often find one of the innomi- 
 nates backward and downward at the same time; 
 again one will be upward and forward. The former 
 will lengthen the limb on the same side, the latter 
 will shorten it. These lesions are the most common, 
 but we may find their exact reverse. We may find 
 both innominates luxated in different ways or in 
 similar ways at the same time. 
 
 In order to determine these lesions we must de^ 
 pend on the position of the posterior superior iliac 
 spines as indicated in lesions of the whole pelvis. 
 We must compare the length of the limbs. Make 
 measurements between the coracoids of the scapulae 
 and the anterior superior spines of the ilium. Look 
 for tension and tenderness in the sacro-iliac liga- 
 ments ; also at the pubic symphysis. Examine the 
 lumbar region of the spine for curvature or torsion. 
 Compare the waist lines. We may measure also 
 from the teeth to ilium and to the internal malleoli. 
 See Figs. 86 and 87. 
 
Osteopathic Technique 55 
 
 110. When the innominate is luxated backward 
 have the patient He on the back. The operator places 
 his fist beneath the posterior superior spine of the 
 ilium. The other hand grasps the ankle and flexes the 
 limb on the patient's abdomen, when the limb is rotated 
 outward and downward with considerable force. 
 In this manner the weight of the patient helps to 
 force the innominate into position. 
 
 111. The operator may grasp the crest of the 
 ilium, and also the tuberosity of the ischium, and by 
 alternately pushing on the one and pulling on the 
 other may set either a forward or backward luxa- 
 tion. This is done with the patient either lying on 
 the back or on the side. 
 
 112. Combinations of the above movements, 110, 
 111, or the work used in correcting the whole 
 pelvis, may be used in correcting any lesion of an 
 innominate. 
 
 THE LIMBS. 
 
 The general treatment of the limbs may be modi- 
 fied in various ways for the treatment of different 
 and definite lesions. 
 
 113. The limb may have various tissues relaxed 
 preliminary to other work, by manipulating the 
 various tissues by seizing the limb in both hands, 
 as in Fig. 88, and with a rotary movement of the 
 hands move and relax all the tissues to the bones. 
 
 114. Both internal and external rotation and 
 circumduction of the limb may be performed, flexing 
 the calf of the leg on the thigh and the thigh on 
 
56 Practice of Osteopathy 
 
 the abdomen, then straightening the limb out with 
 the proper rotation, with more or less force. See 
 Fig. 89. 
 
 115. The sciatic nerve may be stretched by ex- 
 tending the limb, as in Fig. 90, at the same time 
 bearing down considerably on the foot. 
 
 116. The patient reclining, the knee may be 
 slightly flexed and the operator works under it with 
 both hands, stretching the muscles outward and 
 working in quite deeply. See Fig. 91. 
 
 117. The foot may be flexed, extended and 
 rotated with considerable force on the ankle. Liga- 
 ments and other tissues are thus relaxed and the 
 circulation is promoted. See Fig. 92. 
 
 118. In treating the feet the arches may be 
 sprung to increase the arch, and pressure and trac- 
 tion may also be applied to it. This relaxes liga- 
 ments, permits of replacing misplaced small bones 
 and tones up the muscular structures of the foot. 
 See Fig. 93. 
 
 119. The toes may be stretched and rotated with 
 force at the same time. In some cases they must 
 be handled with care. The treatment assists in the 
 circulation by freeing all tissues, nerves and blood 
 vessels. 
 
 120. The saphenous opening, through which the 
 long saphenous vein passes, lies one or two inches 
 below the lower end of Poupart's ligament, on the 
 inner side of the thigh. This opening is often prac- 
 tically closed by tense muscles. It may be made 
 free by external and internal rotation of the limb, as 
 
Osteopathic Technique 57 
 
 in Fig. 89. Then the opening itself may be manipu- 
 lated. 
 
 121. The extended limb may be seized by the 
 foot when the patient is in the reclining position, 
 and turned outward as far as is comfortable for the 
 patient, then be allowed to come to its normal posi- 
 tion, See Fig. 94. This may be done, say ten times. 
 Then it may be turned inward the same number of 
 times. This movement puts the muscles on a strain 
 by torsion, tones them up and assists in the cir- 
 culation. 
 
 Old subluxations cause considerable trouble. A 
 slight misplacement at the hip is often treated as 
 disease of the knee, neuritis, etc. These misplace- 
 ments are not always discovered by the ordinary 
 physician, but when the real cause is removed the 
 case is cured. Reducing these luxations, when the 
 case is an old one, requires a course of treatment 
 to relax all muscular tissues, to render the parts 
 flexible and the ligaments more pliable. 
 
 122. When we discover that the hip is dis- 
 located, with the head of the femur up and back 
 on the dorsum of the ilium, in which the limb is 
 short and the toes turned inward, we flex the knee 
 and rotate it inward. This frees the head of the 
 femur. Then we rotate outward and make exten- 
 sion while we press on the great trochanter to 
 force the head into the acetabulum. See Fig. 95. 
 This luxation comprises one half of all hip dislo- 
 cations. 
 
 123. The head of the femur is sometim^es down 
 
58 Practice of Osteopathy 
 
 and back near the sciatic notch. This also shortens 
 the limb and turns the toes inward. The treat- 
 ment is the same as above, as one writer puts it, 
 "bend up, turn in, roll out and extend." Use one 
 hand to manipulate the great trochanter. See 
 Fig. 95. 
 
 124. Sometimes there is a thyroid dislocation 
 of the hip, in which the head has been forced down- 
 ward into the obturator foramen. In this case the 
 knee is flexed and the toe points either inward or 
 outward. To make the proper reduction the leg 
 is flexed on the thigh and the thigh on the pelvis. 
 The knee is rotated inward as far as possible, 
 followed by extension. Pressure is made at the 
 same time to force the head of the bone into its 
 proper position. See Fig. 95. 
 
 125. When the head of the femur is forward 
 and onto the pubis the toe turns outward. The head 
 of the bone can be felt and seen. Treat as in No. 
 124. Should this prove unsuccessful place the 
 patient on the side and draw the limb backward 
 with considerable force, stretching all the muscles 
 about the head of the bone ; then lift the head over 
 the pubis and place it in its proper position. 
 
 126. Ankle dislocations are reduced by simple 
 traction. The knee is flexed on the thigh, the thigh 
 on the pelvis. An assistant holds the knee and the 
 operator holds and pulls the foot, giving it at the 
 same time a slight rocking motion. See Fig. 96. 
 
 127. Dislocations of the knee are reduced by strong 
 traction. Pressure to force the tissues into plac^ 
 
Osteopathic Technique 59 
 
 may be made at the same time. The knee joint 
 may be sprung by placing arm under the knee and 
 pressing down on foot. See Fig. 97. 
 
 128. In treating the shoulder and arm the 
 shoulder may be rotated as in Fig. 57. The opera- 
 tor grasps it before and behind the shoulder. 
 
 129. The shoulder joint may be sprung, as in 
 Fig. 98. The forearm of the operator is placed in 
 the axilla, and the arm of the patient pushed toward 
 the side. This relaxes tissues and frees up the cir- 
 culation. It may be freed of adhesions and the 
 circulation promoted by seizing the wrist, bringing 
 it back and up under axilla and stretching out in 
 front with force. See Figs. 103, 104. 
 
 130. The elbow may be flexed on the same prin- 
 ciple as indicated as in No. 129, by placing the 
 clenched fist of the operator on the patient's arm 
 just above the elbow and bending the arm upon 
 the hand so placed. See Fig. 99. 
 
 131. In some cases it is well to work carefully 
 down the arm, rotating the muscles on the bones 
 and working carefully on the forearm between the 
 bones. See Figs. 103 and 104. Fig. 105 represents 
 the stretching of the long head of the biceps, after 
 which the arm will be flexed and the tendon pressed 
 into its groove. 
 
 132. All dislocations of the shoulder may be 
 reduced by having the patient recline. The opera- 
 tor places his stockinged foot in the axilla and makes 
 strong traction on the arm of the patient. The 
 
60 Practice of Osteopathy 
 
 knee may be used instead of the foot, as in Fig. 
 100. 
 
 133. In cases of elbow dislocations, where both 
 bones are displaced backwards or displaced exter- 
 nally or internally, or the ulna is backwards, the op- 
 erator places his knee in front of the elbow joint, 
 pressing against the ulna and the radius with the 
 knee and bends the forearm. This plan uses the mus- 
 cles to pull the bones into place. When the radius is 
 backward the above or simple pressure, with ma- 
 nipulation, may be used. For forward dislocation 
 bend the elbow over the knee. Use extension and 
 manipulation. See Fig. 101. 
 
 134. The various wrist dislocations are all re- 
 duced by traction. Some manipulations may be 
 used. 
 
 135. Should the ulna be dislocated at the wrist, 
 pressure will be sufficient. 
 
 136. For the various dislocations of the hand 
 use pressure, traction and rotation. 
 
 In many cases of old dislocations a prolonged 
 course of treatment is necessary. 
 
 137. A table and stool are represented in Fig. 
 102. The stool is fourteen inches square on top 
 and twenty-one inches high. The table is a folding 
 one with a steel frame and thin wood top. It 
 can be carried easily to the patient's home. One 
 for regular office use would be padded and more 
 substantial in design. The table represented in 
 the cut is five feet and ten inches long, and twenty 
 inches wide and twenty-six inches high. 
 
Osteopathic Technique 61 
 
 138. A General Treatment is given by a great 
 many Osteopaths in connection with the specific 
 treatment needed for the ailment for which the pa- 
 tient is being treated. General treatment is an advan- 
 tage in a number of cases. It is given for nerve 
 troubles and for the general circulation. The treat- 
 ments will vary greatly with different Osteopaths 
 but the following is a sample : 
 
 139. The patient reclines on a table, lying on his 
 side. The Osteopath begins by loosening up the 
 tissues of the back, as indicated in Nos. 53, 56, 58. 
 The shoulder is manipulated, as in Nos. 54, 55, 
 the lower limb as in No. 113. The spine is 
 sprung from one end to the other, as in No. 57. 
 The patient then lies on the other side and the 
 treatment is given as before. The patient then 
 takes the reclining position, when further treat- 
 ment is given the back as in Nos. 47, 48, 50, 51, 52. 
 
 Afterward the patient lies on the back and the 
 treatment is commenced at the head, as in Nos. 
 14, 15. 
 
 The neck is treated as in Nos. 7B, 9, 10, 11, 13. 
 The arms are treated as in Nos. 130, 131. 
 
 Further treatment is given the back, and the ribs 
 are raised as in Nos. 61, 62, 86, 64. The abdomen 
 is treated as in Nos. 94, 95, 96, 100, 101, 102. The 
 lower limbs are treated as in Nos. 113, 114, 115, 
 116, 121. The patient now sits on the side of the 
 table and the back and spine are further treated 
 as in Nos. 1, 2, 5, 34, 36, 37, 43, 44. 
 
62 Practice of Osteopathy 
 
 140. A treatment that has come Into use, recently 
 among Osteopaths, is shown in Fig. No. 108. It is 
 spreading the ischia. If. is used in casejof enlarged 
 prostate gland. The founder of Dsteopathy claims 
 that spreading these bones invariably helps this 
 condition. 
 
 In sciatica, the pyrafomis muscle which crosses 
 the sciatic nerve is frequently contracted and causes 
 pressure on this nerve. This muscle may be 
 stretched by forcibly carrying one leg over the other 
 as seen in figure No. 90B,. 
 
 The muscles and other structures of the leg may 
 be stretched as indicated in figure No. 88A. This 
 movement helps to reduce contractions and assists 
 circulation in the lower limbs. The muscles in the 
 anterior portion of the leg may be stretched by ex- 
 tending the limb as in figure 89B. 
 
 A good method of raising the ribs Is illustrated in 
 figures 47A and 77A. In the first mentioned il- 
 lustration we see by holding and stretching the arm 
 upward we bring into play the pectoralis major and 
 minor muscles which help in raising the ribs. In 
 figure 77A it will be well to have the patient elevate 
 his arms and while he lowers them to spread and 
 raise the ribs. This movement acts in stretching 
 the diaphragm which is attached to the ribs. An- 
 other method is illustrated in figure 76A. 
 
 Figure 69A represents closing and spreading the 
 knees against resistance. 
 
 In figure 29A we have represented an abnormal 
 spine. This patient suffered a severe attack of ty- 
 
Osteopathic Technique 63 
 
 phold fever, and was very badly constipated. No- 
 tice the lateral swerve, but what is worse the an- 
 terior condition of two lumbar vertebra. 
 
64 Practice of Osteopathy 
 
 THE SPINE. 
 
 The spine, in its normal condition, is a chain 
 of flexible nature. It is formed of a number of 
 bones called vertebrae, from the Latin vertere, to 
 turn. There are thirty-three of these vertebrae, 
 of v^hich seven are in the cervical, or neck 
 region, twelve are in the dorsal region, which oc- 
 cupies the space from the neck to where the small 
 of the back begins, five are in the lumbar region, 
 the small of the back to the sacrum, five are in the 
 sacral and four in the coccygeal region, which is 
 the coccyx. The twenty-four upper vertebrae 
 should remain separate and flexible through life. 
 Those in the sacral and coccygeal region, in the 
 adult are firmly united and form two bones, the 
 sacrum and coccyx. 
 
 The spine has four normal curves, the cervical, 
 dorsal, lumbar, and pelvic. The first, or cervical, 
 extends from the base of the skull to the second 
 dorsal vertebra. This curves inward. The dorsal 
 curve extends from the second dorsal vertebra 
 to the first lumbar vertebra. This is an outward 
 curve. The lumbar curve extends from the first 
 lumbar to the sacrum. This curve is a forward 
 one. The sacral curve begins at the union of the 
 last lumbar vertebra with the sacrum and extends 
 to the tip of the coccyx. This is an outward curve. 
 
 In very young children the cervical and lumbar 
 curves are absent, and when the child is sitting the 
 spine presents only one curve from the base of the 
 
Osteopathic Technique 65 
 
 skull to the end of the spine, and this curvature is 
 an outward one. The cervical and lumbar curves 
 are called compensatory, and develop a little later. 
 The curves of the normal spine should be frequent- 
 ly examined, until the operator has a good idea 
 of the normal spine. He should be acquainted 
 with the normal flexibility of the spine as well. 
 
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DISEASE AND ITS 
 TREATMENT 
 
 SPINAL CURVATURE. 
 (Scoliosis.) 
 
 We frequently find very serious cases of spinal 
 curvature which may be cured or greatly benefited 
 by Osteopathic treatment. There must be a process 
 of building up muscles and ligaments, of restoring 
 and strengthening wasted parts. At the same time 
 other muscles and ligaments must be relaxed. 
 Where the spine is ankylosed, that is, where the 
 vertebrae have practically grown together, it can not 
 be straightened but a false ankylosis, due to rigid- 
 ity of the surrounding parts, may be straightened, 
 where there is a curvature. 
 
 The operator should remember that nearly all 
 spines have a little lateral curvature in the dorsal 
 region, and in right-handed persons this curvature 
 is directed to the right, and in the case of left- 
 handed individuals the curvature bends toward the 
 left. The more muscular a person is and the more 
 the arms are used the more pronounced will we 
 find this curvature. This is due to over-developed 
 muscles pulling the spine to one side. This will 
 
190 Practice of Osteopathy- 
 
 be true of numerous occupations which tend to 
 develop one side of the body more than the other. 
 For this reason we always ought to know the occu- 
 pation of the patient and use this information in 
 determining the form and force of treatment needed. 
 
 Of course if both sides are equally developed 
 muscularly there will be no lateral deviation of the 
 spine. In some cases of spinal curvature, in addi- 
 tion to the Osteopathic treatment, it will be well to 
 give the patient some muscular exercises to develop 
 the muscles on the concave side of the curvature, 
 and thus help to straighten the spine. 
 
 There are three forms of spinal curvature, or 
 scoliosis : Functional, which is the result of faulty 
 positions, assumed as a habit or occupation, or as 
 a result of a Aveak eye or ear. It may also be caused 
 by some deformity in some other part of the body. 
 This often appears before the age of ten. There are 
 no pronounced symptoms and it is often discovered 
 accidentally. One of my cases had been under 
 treatment for a number of years, by a regular physi- 
 cian, for various troubles, when her mother, in giv- 
 ing a bath, discovered a severe case of spinal 
 curvature. This first class of spinal curvature may 
 be easily cured but if left, it becomes Transitional 
 curvature, when the case is progressing into what 
 is called Structural curvature, in which the shape of 
 the vertebrse is changed. On account of this change 
 in the structure and shape of the bones which form 
 the spinal column such a case is very difficult to 
 cure. This type of curvature is not only caused 
 
Disease and Its Treatment 191 
 
 by neglected functional cases, but may have begun 
 before birth and is congenital. Rickets, arthritis 
 deformans, infantile paralysis and pathological af- 
 fections of the vertebrae act as a cause. 
 
 Many cases require a long course of treatment. 
 A great deal of preliminary work must be done. 
 Where the tissues are contracted in the back they 
 must be loosened by some of the treatments, as 
 Nos. 34, 36, 44, 43, 58, 59, 60. The vertebrae must 
 be frequently worked over into their proper posi- 
 tion. See Nos. 45, 57, 38, 39. It is often well to 
 begin at the lower vertebra that is out of position, 
 and force it over, then the next and so on up the 
 spine as far as the curvature extends. Do not 
 attempt to do too much at a time, but it will be 
 necessary in most cases to continue the work for 
 from one to three years, treating most of the time 
 from two to three times per week. Special attention 
 must be paid to the ribs in many cases. See the 
 examination and treatment of the ribs. 
 
 In cases where the spine is too flexible it may be 
 necessary to use appropriate exercises to strengthen 
 the spinal muscles. They may be worked over and 
 manipulated, as in Nos. 47, 31. 
 
 In many cases of Pott's disease, where the de- 
 structive processes have ceased and left the spine 
 in a very stiff condition, much can be done to cor- 
 rect the deformity and to restore the health. 
 
 If one wishes to be better informed on this sub- 
 ject it will be well to secure Lovett's work on 
 " Lateral Curvature of the Spine." Many cases of 
 
192 Practice of Osteopathy 
 
 structural curvature require some form of casts or 
 braces to hold improvement gained, and this book 
 enters into detail respecting the treatment. 
 
Disease and Its Treatment 193 
 
 THE BACK. 
 
 Kyphosis. This is a curvature of the spine 
 directed backwards. We find this condition in many 
 elderly persons, in persons who are naturally weak, 
 and in children who have the rickets. We must 
 distinguish this condition from the sharp angle 
 of Pott's disease. 
 
 The treatment will be given as indicated in Nos. 
 34, 43, 37, 35, 38, 50. It will be necessary to give 
 the treatment for some time twice per week ; later 
 once per week will do. In elderly people we may 
 not expect to straighten the spine to a marked 
 degree, but the work will greatly improve the 
 health, by securing a better blood supply to the 
 spinal cord. 
 
 Lordosis. This is an exaggerated curvature of 
 the lumbar region, the curve of which is directed 
 forward. It is frequently seen in women who have 
 had frequent pregnancies and those who have drop- 
 sy. The treatment is directed to strengthening the 
 ligaments and muscles and the gradual correction 
 of the curvature. See Nos. 64, 57, 63. Also see 
 kyphosis. 
 
194 Practice of Osteopathy 
 
 RIGID SPINE. 
 
 This is a chronic inflammation of the spine in 
 which there is pain of a varying nature. There is rig- 
 idity and deformity. The intervertebral disks atro- 
 phy and firm, bony unions form between the ver- 
 tebrae, which gradually extend to the whole spine. 
 The muscles atrophy and there is a forward bending 
 of the whole spine. The pain varies greatly and 
 in some cases amounts to a severe neuralgia. This 
 is caused by the pressure of the vertebrae on the 
 nerve roots, which they are allowed to do on ac- 
 count of the absence of the intervertebral disks. 
 
 This disease is caused by violent injury to the 
 spine, from falls, blows and carrying heavy bur- 
 dens when too young. Gonorrhoeal infections and 
 articular rheumatism act as causes. 
 
 When the spine has grown quite rigid from 
 ankylosis I have failed to loosen the joints, but the 
 treatment has built up the muscular tissue and has 
 helped in overcoming pain. In cases where such 
 bony union had not taken place it could be pre- 
 vented and the case cured. The treatment consisted 
 in a thorough spinal manipulation three times per 
 week, with a general treatment. See general treat- 
 ment. One case in which a number of vertebrae 
 had become ankylosed I sent where three Osteo- 
 paths could treat him at one time. He was very 
 strong and could stand heroic treatment. The ver- 
 tebrae were loosened in thirty treatments, and after 
 following up this treatment for some months, at 
 intervals, a good cure was effected. 
 
Disease and Its Treatment 195 
 
 OSTEOMALACIA. 
 
 Mollities Ossium. 
 
 This is a disease in which pain first appears in 
 the bones, and is at first often mistaken for rheu- 
 matism. The bones gradually soften, later bend 
 and easily fracture. Some writers claim that it is 
 a disease of adults of from twenty to forty years of 
 age. But I have treated very marked cases in chil- 
 dren and young persons under twenty. When it 
 occurs in older women it is thought that child- 
 bearing is an exciting cause, as the first signs of the 
 disease often appear during pregnancy. 
 
 The symptoms begin with pain in the back of the 
 neck, thighs and sacral region. Then weakness 
 develops in the legs, so that the person desires help 
 fn walking. After the deformity appears in the 
 lower limbs there is danger of spontaneous fracture. 
 There is a peculiar, uncertain, wabbling gait. The 
 pelvis will be found to be deformed. Later the 
 whole skeleton is deformed. Some writers claim 
 that the urine has an excess of calcium salts. 
 
 ^ In cases that I have treated Osteopathically the 
 disease was arrested and the patients enjoyed a fair 
 degree of health afterward. The cause of the dis- 
 ease is uncertain, and why the disease was arrested 
 under treatment I can only conjecture. A normal 
 
196 Practice of Osteopathy 
 
 nerve and blood supply was secured to all parts. 
 A general treatment was given as far as possible. 
 See general treatment. In only one case was any 
 deformity corrected — that of the lower legs. 
 
 Many cases are bedridden. They die from gen- 
 eral debility and pneumonia. Much can be accom- 
 plished by the use of good food, pure air and baths. 
 
Disease and Its Treatment 197 
 
 ^STVO-AUTUMNAL FEVER. 
 (Bilious Remittent and Typho-Malarial.) 
 
 This type of fever occurs in temperate climates, 
 chiefly in the late summer and autumn. We find 
 the more severe forms in the Southern States and in 
 tropical countries. There may be a tired, weak feel- 
 ing with a running off at the bowels for a few days 
 before the appearance of the fever. The symptoms 
 are very irregular. The paroxysms of fever average 
 above twenty hours, instead of ten or twelve as in 
 malarial fever. It may be distinguished from ty- 
 phoid fever by the sudden rise and fall of the tem- 
 perature at varying intervals. There may or 
 may not be a chill after the first preliminary weak- 
 ness. The urine is highly colored. There may be 
 jaundice. The tongue is furred and heavily coated. 
 There is vomiting, in which there is very much 
 bilious matter. The patient looks very ill. 
 
 The treatment should be a general one (see gen- 
 eral treatment) paying considerable attention to the 
 upper lumbar region and the entire dorsal. Treat 
 two or three times per day until the patient is much 
 better ; then once a week for a while. 
 
198 Practice of Osteopathy 
 
 TYPHOID FEVER. 
 
 Typhoid fever is an infectious, variable disease, 
 caused by the bacillus of Eberth. This bacillus 
 maintains its existence for one or two weeks in 
 water. It multiplies in water and milk, and in these 
 mediums it has been conveyed into the human 
 system, causing the disease. The bacillus may live 
 for months in the soil and in ice, as freezing does 
 not kill it, but it may be destroyed by boiling for 
 from fifteen to thirty minutes. Persons with spines 
 which are stiff and in a posterior position in the 
 lumbar region are predisposed to this disease. 
 This condition of spine weakens, through the nerve 
 supply, the lymphatics and drainage of the bowels 
 and creates a lodging place for the proliferation and 
 development of these disease-producing germs. 
 
 The first stage of the fever comes on gradually. 
 There is oftentimes a general feeling of ill health 
 for some time prior to the more pronounced symp- 
 toms. There may be nosebleed, sense of chilliness, 
 slight fever, backache, sore throat. The fever rises 
 day by day, each succeeding day higher than the day 
 before, until in four or five days the highest is reached. 
 
Disease and Its Treatment 199 
 
 The highest will be 103 to 105 degrees. The 
 tongue is furred. There is no appetite. Constipa- 
 tion is present, though it may alternate with 
 diarrhcea. The pulse is 90 to 110 per minute. The 
 patient is thirsty. There is headache and the skin 
 is hot and dry. 
 
 The secondary stage of the disease begins on the 
 fifth day and lasts about two weeks. The general 
 symptoms are more marked, the fever is high and 
 continued, the pulse is faster and the headache 
 disappears, "but there is mental dullness and there 
 may be delirium. The abdomen is tender, and 
 about the eighth day rose-colored spots appear on 
 the trunk. The second week of this period is the 
 most dangerous, but varies with the severity of the 
 case. Complications may now set in, as lobar 
 pneumonia, perforations and peritonitis. 
 
 If the disease is following a favorable course the 
 stage of decline in the fever begins on or about the 
 twenty-first day of the disease. The symptoms 
 begin to disappear and the temperature drops each 
 day about one degree until the normal is reached. 
 
 In the treatment of this disease we must be very 
 careful that the utmost cleanliness prevails. The 
 stools, urine, vomit and sputum should be treated 
 with a five per cent solution of carbolic acid in order 
 to destroy the bacilli-. All clothes should be 
 changed daily and treated to a dip in the same solu- 
 tion, after which they should be boiled for half 
 an hour. During an epidemic it will be well for all 
 water and milk to be boiled, especially that used 
 
200 Practice of Osteopathy 
 
 for drinking purposes. All foodstuffs should be 
 carefully cleaned. 
 
 Typhoid fever to a certain degree is contagious, 
 and it is advisable to keep the rest of the family, 
 as far as possible, away from the patient. The bed 
 should have a rubber sheet beneath the linen or 
 cotton sheet, and the patient should be in a well- 
 aired, sunny room. The patient should not arise 
 from the bed, so a bed pan and urinal are absolutely 
 necessary. The mouth should be washed two or 
 three times daily with a three per cent solution of boric 
 acid. The throat may be occasionally sprayed with 
 the same. When the lips, mouth and tongue are 
 parched they may be moistened with equal parts 
 of glycerine and water. In case there is danger 
 of bedsores the back, hips and heels may be 
 moistened with dilute alcohol in which there is a 
 mixture of alum and salt. Afterwards dust the 
 parts with talcum powder or boracic acid powder. 
 The diet should be liquid. The principal part of 
 it should be milk. It may be diluted with water 
 or with lime water. A feeding of milk would be 
 four ounces, diluted with two ounces of lime water. 
 This may be given every four hours. Albumen 
 water may be given every four hours, which makes 
 the time of feeding every two hours. In making 
 the albumen water the whites of one or two eggs 
 may be used and about the same amount of water. 
 It may suit the taste of the patient better if the 
 juice of half a lemon or orange be added or it may 
 be flavored with vanilla. Sometimes the milk may 
 
Disease and Its Treatment 201 
 
 be flavored with a little tea, coffee or brandy. A 
 small cup of coffee may be given to the patient in 
 the morning. Buttermilk or peptonized milk may 
 be substituted if the milk can not be taken or the 
 milk is not properly digested. Allov^ the patient 
 all the ice water he wants. As much strong lemon- 
 ade may be given as the patient may desire, but 
 use very little sugar in it. As an agreeable change 
 a cup of bouillon or strained vegetable soup may 
 be given. Ice cream may be given. 
 
 When the fever subsides the greatest care must 
 be exercised in the diet, as a return to solid food 
 at too early a date may result in a serious relapse. 
 It is unsafe to allow any solid food for ten days 
 after the temperature has become normal. The 
 intestines are in a greatly weakened condition, 
 ulcers have not healed and perforations may result 
 from the ingestion of solid food. The diet should 
 be gradually changed, still using the milk until it 
 is replaced by solid food. The following may be 
 gradually and carefully introduced : Mutton or 
 chicken broth, junket, a very small piece of cream 
 or milk toast, baked custard, strained vegetable 
 soup, wine jelly, the soft parts of three or four 
 oysters, meat soup thickened with egg, blancmange, 
 calves' foot jelly, chicken jelly. Two or three of 
 the above articles of food may be allowed daily 
 with the milk. 
 
 Treatment. Osteopathic treatment may be ad- 
 ministered with very gratifying results. If begun 
 early the fever may often be aborted. If it is begun 
 
202 Practice of Osteopathy 
 
 later the disease shows favorable symptoms im- 
 mediately. The musculature of the back should be 
 thoroughly but gently loosened. See Nos. 61, 62, 
 32, 53. The spine may be gently sprung from the 
 lower part to between the shoulders. See Nos. 
 57, 61. The tissues in the neck must be relaxed 
 and treatment administered in the suboccipital 
 fossae, just beneath the skull either side of the spine. 
 See Nos. 5, 7, 9, 11, 13. Work in the lower part of 
 the back helps to regain control of the circulation 
 in the abdomen where the typhoid bacilli are at 
 work. See No. 61. There must be no manipulation 
 of the abdomen. This treatment or a portion of 
 it may be given two or three times per day with 
 great benefit to the patient. 
 
 Give strict attention to diet, bathing and the 
 above treatment, and many of the bad after effects 
 of the disease will be overcome. The drug treat- 
 ment has been left out of this article, as drugs sap 
 the vitality of the patient and do no good. The 
 greatest living authority among the medical doctors 
 of today says, " A great many of my cases do not 
 receive a single dose." 
 
 The use of water, both externally and internally, 
 has been found to be very beneficial, in its effects 
 on the nervous system, the kidneys, the heart, and 
 decreasing the liability to bedsores. It also assists 
 in the reduction of the fever. 
 
 In using the cold pack the patient is placed in a 
 sheet wrung out of water at a temperature of 65 
 degrees, The water may afterwards be sprinkled 
 
Disease and Its Treatment 203 
 
 on the sheet. This treatment may be prolonged 
 for twenty minutes or more at a time. 
 
 In using the cold sponge bath a piece of gauze or 
 old toweling is better than a sponge. One portion 
 of the body may be bathed and dried at a time, be- 
 ginning with the head. The water may be as near 
 ice-cold as the patient can stand it. Twenty 
 minutes or more should be consumed in giving the 
 bath, and it should be thoroughly done. 
 
 When the temperature is 102 or more the patient 
 may be placed in the full bath, with the tempera- 
 ture at eighty degrees. This should gradually be 
 reduced to seventy degrees. If the bath is given 
 in an ordinary bath tub canvas supports should be 
 arranged to comfortably support the patient in the 
 water, every part being covered but the head. The 
 patient may remain in the water for fifteen minutes, 
 unless there are signs of his being too cold, when he 
 should be removed. A little stimulant and food 
 should be given after the bath. While the patient 
 is in the water the limbs and trunk should be 
 thoroughly rubbed. When taken out wrap the 
 patient in a sheet and cover with a blanket. 
 
 Should constipation be present an enema should 
 be given every third day. 
 
 MALARIAL FEVER. 
 (Ague, Chills and Fever.) 
 
 This is an infectious disease, in which there is 
 fever every second, third or fourth day. Sometimes 
 
204 Practice of Osteopathy 
 
 there is a continuous fever, with remissions. The 
 disease is caused by a specific microorganism, 
 often transmitted to man by the bite of a mosquito. 
 
 The preventative treatment calls for protection 
 from mosquitoes. Have the house well screened. 
 Have all marshes, ponds, and all stagnant water 
 drained. In the malarial season petroleum should 
 be used freely on all stagnant water. This kills 
 the larvae of the pest. 
 
 Marked bony lesions are found oftentimes in per- 
 sons suffering from the disease. Great improve- 
 ment follows their correction. A thorough spinal 
 treatment, giving special attention to the portions 
 between the shoulders and the center of the back, 
 should be given. See Nos. 1, 2, 4, 5, 34, 35, 36, 37, 
 43, 44, 47, 48, 50. The abdominal treatment should 
 be given with vigor, as it assists in equalizing the 
 circulation. A general treatment may be given. 
 See general treatment. 
 
 Osier claims that quinine is a specific for the 
 disease, and recommends that a person going to 
 a malarial district should take ten grains of quinine 
 daily. When the fever is present he recommends 
 twenty or thirty grains daily for the first three days, 
 to be given in divided doses, and then continue in 
 smaller doses for the next two or three weeks. He 
 further recommends that quinine should be given 
 every spring and fall for several years afterwards. 
 Others claim good results from the administration 
 of two or three grains of quinine three times per 
 day. Quinine pills and tablets are not recommend- 
 
Disease and Its Treatment 205 
 
 ed, but it should be taken in either a capsule or in 
 solution. 
 
 SCARLET FEVER. 
 
 Scarlet fever is an acute, infectious disease with 
 a general scarlet eruption, with high fever and sore 
 throat. 
 
 The fever begins from two tO' four days after 
 exposure to the disease, though it may be from 
 one to seven days. The fever may reach 104 to 
 105 degrees on the first day. The eruption may be 
 seen on the second day, though sometimes it ap- 
 pears on the first day. The skin is dry and very 
 hot, tongue furred, throat is dry and face flushed. 
 
 The rash is scattered, red points on a red flushed 
 background, appearing first on the neck and chest 
 and spreading rapidly to the entire body. At its 
 height it is a bright scarlet. This persists for five 
 or six days and then the skin begins to scale off. 
 This period lasts from eight to twenty days. 
 
 Treatment. The patient should be carefully iso- 
 lated and when possible other children should be 
 sent from home. The disease can not be cut short. 
 The bowels should be kept open and a light diet 
 of broths, milk and fresh fruit should be given. Let 
 the room be well ventilated. As the patient gets 
 better, the fever becoming lower, the diet may be 
 increased, but milk should largely predominate to 
 avoid the danger of Bright's disease, which some- 
 times attacks the patient when convalescence is 
 well under way. When the skin begins to scale 
 
206 Practice of Osteopathy 
 
 off it should be thoroughly rubbed with sweet oil 
 or carbolized vaseline each day. 
 
 Should the fever reach 103 a sponge bath is in- 
 dicated. If the fever be higher the child may be 
 placed in a warm bath and the water gradually 
 reduced in temperature to 80 degrees. When there 
 is delirium present a cold pack is very beneficial. 
 A rubber sheet is placed on a thick layer of blank- 
 ets, a sheet is wrung out of cold water and the child 
 wrapped in it and wrapped in the blankets. The 
 cold water may be renewed from time to time. An 
 ice cap should be applied to the head when the 
 fever is high. None of this is necessary unless the 
 fever is high. A thorough relaxation of the muscles 
 and other tissues of the back and neck will be very 
 helpful. See Nos. 5, 10, 13, 14, 31, 47, 50, 53. 
 
 LA GRIPPE. 
 
 La grippe is a very contagious disease. It 
 spreads with remarkable rapidity, and the symptoms 
 begin in from one to four days after exposure. It 
 begins abruptly with fever and a profound feeling 
 of prostration. 
 
 The majority of cases begin with a cold in the 
 head, with a profuse discharge from the nostrils. 
 After these catarrhal symptoms bronchitis may set 
 in and the fever increase. There is a tendency to 
 pneumonia, which is a very dangerous complica- 
 tion. In some cases the catarrhal symptoms are 
 absent, but there is pain in the joints, headache, and 
 backache in the lumbar region. In other cases 
 
Disease and Its Treatment 207 
 
 there are severe stomach and intestinal symptoms 
 with vomiting, pain in the abdomen and diarrhoea. 
 
 In some epidemics many patients have as a com- 
 plication heart trouble (pericarditis and endocardi- 
 tis). If there is a weakness in any part of the body 
 it is apt to be augmented by la grippe. 
 
 Treatment. A warm bath should be given and 
 the patient placed in a warm bed and confined there 
 until the fever has entirely left. An enema, in 
 which there is a tablespoon of salt to a quart of 
 water, should be given and the patient instructed 
 to retain it as long as possible. If this cannot be done 
 either Epsom or Rochelle salts should be given. 
 Some medical authors advise a grain of calomel to 
 be taken, one-fourth of a grain each hour until 
 the grain has been taken. Then the salts should 
 be taken after this, say about six hours. 
 
 The neck and back on palpation will be found to 
 be very tender, and a thorough osteopathic treat- 
 ment will be the best possible treatment. It pre- 
 vents all of the many complications, such as heart 
 trouble and pneumonia, and quickly reduces the 
 fever. In cases the author has handled the patients 
 were usually at their accustonied vocations in two 
 to three days, while the ordinary run of cases were 
 being kept in from ten days to two weeks under 
 the ordinary treatment. The neck tissues are to be 
 thoroughly loosened. See Nos. 1, 4, 5, 9, 10, 11, 13. 
 The tissues of the back must be relaxed. See Nos. 
 34, 36, 37, 38, 40, 43, 47, 50. Give strong stimula- 
 tive treatment for the fever at the base of the skull 
 
208 Practice of Osteopathy 
 
 in suboccipital fossse. See No. 7. Stimulate in 
 the upper dorsal region as in Nos. 50, 53, 56. Raise 
 the ribs. See Nos. 81, 82, 84, 86. Work over the 
 abdomen as in Nos. 94, 95, 100. The treatment 
 should be given two or three times per day at first, 
 and as the fever subsides and the patient is better, 
 once per day will be sufficient. When the fever is 
 high an ice bag should be applied to the head. The 
 food should be liquid and nourishing. 
 
 CHICKEN POX. 
 (Varicella.) 
 
 Chicken pox is an acute, contagious disease. It 
 is characterized by a papular eruption, commen- 
 cing with a sHght fever and a feeling of illness. The 
 temperature may reach 103. The papules soon be- 
 come vesicles and may be umbilicated as in small 
 pox, holding a cloudy or clear fluid. These dry and 
 form a crust, which drops off, leaving no scar. In 
 severe cases when the true skin is involved scars 
 may remain. 
 
 The eruption in chicken pox first occurs on the 
 trunk and neck, not on the forehead and face. The 
 vesicles break easily and form successive crops, so 
 that papule, vesicle and crust may be seen in the 
 same locality at the same time. The papules do 
 not feel like small shot and do not disappear on 
 pressure. After exposure the attack may be ex- 
 pected in from fourteen to sixteen days. 
 
 Treatment. The bowels should be kept open. A 
 warm bath should be given when the eruptions 
 
Diseasp and Its Treatment 200 
 
 first appear. Avoid taking cold. Should the itch- 
 ing prove troublesom-e apply carbolized vaseline. 
 Keep the skin clean and do not allow infants to 
 scratch. If the eruption is troublesome use a wash 
 of a two per cent solution of chlorate of potas- 
 sium. Apply cold cream to the vulva if necessary. 
 
 SMALL POX. 
 (Variola.) 
 
 Small pox is an acute, contagious and infectious 
 disease. In from nine to fifteen days, generally 
 twelve days, after exposure, the patient may be 
 seized with a chill, which may be repeated during 
 twenty-four hours. Children sometimes have con- 
 vulsions as an initial symptom. Headache, pain 
 in the lower part of the back, and vomiting are com- 
 mon, while the fever rises to 103 or 104. If the 
 fever runs high there may be delirium and a flushed 
 face, with clear bright eyes. In other cases there 
 may be sweats. The symptoms are not always 
 constant, but vary in the extreme. 
 
 Accompanying the fever there may be a red rash 
 resembling that of scarlet fever. In other cases 
 it may assume a macular or measly form. In some 
 cases it may be altogether absent. 
 
 Usually on the fourth day macules begin to 
 appear on the forehead, and within twenty-four 
 hours may be seen on the face and other parts of 
 the body. There may be quite a few on the upper 
 part of the back, the hands and feet. They are a 
 bright red color and disappear on pressure. They 
 
210 Practice of Osteopathy 
 
 feel as if a small shot was hidden beneath the 
 skin. On the fifth or sixth day these papules 
 change to vesicles. The summits are clear, elevated 
 and circular, with a small depression in the center, 
 termed an umbilication. These change on the 
 eighth or ninth day to pustules. They become more 
 elevated and the depression disappears, and the 
 appearance is a grayish-yellow from the contained 
 pus. 
 
 The skin about the pustules becomes red and 
 swollen. There is a painful pulling sensation in 
 the face, and the eyelids in a severe case are closed. 
 
 The secondary fever arises and the first symp- 
 toms return, but the fever does not remain high 
 longer than twenty-four hours. In many cases it 
 is entirely absent. The pustules dry rapidly in 
 the order of their coming and form scabs. 
 
 The small pox patient has a very peculiar odor, 
 which is a help in diagnosing doubtful cases. 
 
 Confluent Small Pox. The symptoms are the 
 same as above but of much greater severity. The 
 macules are set closer together. They are more 
 abundant on the face, hands and legs. The temper- 
 ature does not entirely leave after the breaking out 
 and when the change is made to pustules the tem- 
 perature rises to 103 to 104 with the pulse from 110 
 to 120. The pustules have a tendency to run to- 
 gether and to form large superficial abscesses. 
 
 Haemorrhagic Small Pox. In this form the blood 
 runs into the eruptions and is a very da-ngeroiis 
 type of the disease. Its severity depends largely 
 
Disease and Its Treatment 211 
 
 on the early appearance of this symptom. If it ap- 
 pears later in the disease there is much less danger. 
 
 Varioloid is not a different disease, but is a very 
 modified form of small pox. Even in mild cases 
 the early symptoms may be severe. The fever may 
 rise to 103, The papules appear on the third or 
 fourth day and the fever drops and does not again 
 appear. The patient feels well and the papules and 
 vesicles begin to disappear with the drop in the 
 fever. 
 
 Treatment. Drugs should not be given to reduce 
 the fever, as they greatly weaken and depress the 
 patient. When the temperature is high, a cold 
 sponge bath may be given and an ice bag applied 
 to the head. The diet should be light, mostly fluid, 
 consisting mostly of milk and soups. When there 
 is no fever, poached or soft-boiled eggs and toast 
 may be added to the diet, with either tea or coffee. 
 
 A gauze mask may be worn on the face, kept 
 moist with cold water containing mercuric bichloride 
 enough to make a 1 to 5,000 solution. When the 
 crusts form they should be kept moist with vase- 
 line. The eyes should be kept clean with a salt or 
 boric acid solution. More than enough boric acid 
 crystals than will dissolve may be kept in the water 
 for this purpose. The mucous lining of the nose 
 should be kept moist with vaseline. 
 
 If the patient is constipated a salt water enema 
 should be given every other day. At the onset of 
 the disease, if no other treatment is available, a 
 thorough purge with calomel may be taken. A half 
 
212 Practice of Osteopathy 
 
 grain in one-tenth grain doses at intervals of an 
 hour should be sufficient, in ordinary cases. Bed 
 clothes should be soaked in a 1 to 4,000 solution of 
 mercuric chloride, before going through the 
 laundry. 
 
 All surplus furniture, such as rugs, curtains, etc., 
 should be removed from the room. 
 
 CEREBRO-SPINAL FEVER. 
 
 (Malignant Purpuric Fever. Cerebro Spinal Men- 
 ingitis, Petichial Fever, Spotted Fever.) 
 
 This is an infectious disease, caused by a specific 
 microorganism, the diplococcus introcellularis. The 
 coverings of the brain and spinal cord (cerebro- 
 spinal meninges) are afifected. The course of the 
 disease is very irregular. There is severe headache, 
 pain in the back and upper part of the spine, con- 
 traction of the muscles in the back of the neck, and 
 delirium. 
 
 There is a malignant type of this disease which 
 proves rapidly fatal. It comes on suddenly with 
 violent headache, chills, muscular spasms, light fever, 
 but slow pulse, being 50 to 60 per minute. A purple 
 rash may develop slightly raised places on the skin 
 which fills with dark blood. 
 
 The common form sets in suddenly, usually be- 
 tween noon and midnight, with a chill. There may 
 be convulsions with headache. There is pain in 
 the back of the neck and sensitiveness to light and 
 noise. There is great rigidity of spinal muscles and 
 loss of control of bladder and rectum. There are con- 
 
Disease and Its Treatment 213 
 
 vulsions, delirium and set eyes. The skin has va- 
 rious symptoms. Sometimes a dusty mottling may be 
 present, again rose-colored spots, as in typhoid 
 fever. A purple rash, as spoken of above, may 
 appear. The disease may last from a few hours to 
 several months. Favorable symptoms of the dis- 
 ease are apparant when the temperature falls. Mus- 
 cles become less rigid and intelligence returns. 
 
 There is an abortive type which sets in as above, 
 but the case begins to improve in a day or two and 
 the patient is soon well. 
 
 Treatment. Use an ice bag or an ice coil on the 
 head. Use warm mustard baths for the feet and 
 cold sponge baths for the rest of the body. An 
 enema of salt water should be given daily, using 
 a tablespoonful of salt to a quart of water. If 
 vomiting distresses, one drop of tincture of iodine, 
 in sweetened peppermint water, may be given every 
 two hours. Let the food be liquid or semi-fluid 
 and nourishing. Have the sick room quiet and let 
 it be darkened. 
 
 The patient may be greatly benefited and the 
 course of the disease shortened, with the prevention 
 of the usual bad after effects, by thoroughly, 
 gently and persistently loosening the musculature 
 of the back, and especially of the back of the neck. 
 See Nos. 5, 9, 11, 7B, 10, 13, 14, 47, 48, 50, 53, 57, 
 61. The abdomen may be thoroughly treated. It 
 will draw the blood away from the congested spine 
 and spinal coverings. See Nos. 94, 95, 98. 
 
214 Practice of Osteopathy 
 
 GENERAL COLDS. 
 
 The author of this book fears a cold more than 
 many of the diseases that are regarded as being 
 serious. Never be afraid of breathing cold air or 
 night air. Pure cold air will never cause a cold. 
 Nansen, the arctic explorer, said that there were no 
 colds among his officers or crew while they were 
 in the Far North in the regions of ice, but when they 
 returned to civilization they nearly all contracted 
 severe colds. 
 
 Those leading an out-of-door life, though exposed 
 to the elements, seldom contract colds, but the 
 persons who spend much time in illy-ventilated 
 rooms, which are overcrowded and overheated, fre- 
 quently have colds ; or when these conditions exist, 
 without the overcrowding, in the houses of the rich, 
 we find the inmates are very susceptible to colds. 
 
 When we are exposed to draughts while we are 
 sitting still the tissues of the upper part of the 
 back and the neck become contracted. This inter- 
 feres with the circulation and any latent germs read- 
 ily find a lodging place. When a person is over- 
 worked, either mentally or physically, or is suffer- 
 ing from some chronic illness he is more predis- 
 posed to a cold. 
 
 The S3^mptoms of a common cold are varied. 
 There may be pain on swallowing, loss of voice or 
 
Disease and Its Treatment 215 
 
 severe hoarseness, cough and expectoration, a 
 slight fever with headache and a general aching 
 over the body, sneezing and running of the nose. 
 
 In treating a cold it is best to give a general 
 treatment rather briskly. Take a hot foot bath, an 
 injection of warm salt water, a tablespoon of salt 
 to a quart of water, a hot lemonade and go to bed. 
 It will be best to remain in bed as long as the fever 
 lasts. The treatment equalizes the circulation. If 
 you are liable to colds it will be better to sleep in 
 a cold, well-ventilated room. See that the bowels 
 have a free movement once each day. Take a daily 
 cold sponge bath each day. Discard furs and neck 
 mufflers and wear thin underwear, keeping warm 
 by the use of heavy outer garments. My objection 
 to the furs is that we are liable to leave them off 
 on some occasion and thus contract a severe cold. 
 It would be well for those liable to colds to take a 
 course of Osteopathic treatments, build up their 
 constitution, and thus avoid colds. 
 
216 Practice of Osteopathy 
 
 LOBAR PNEUMONIA. 
 
 (Lung Fever, Pneumonia, Croupous Pneumonia, 
 Fibrinous Pneumonia.) 
 
 This is an acute, infectious disease which pro- 
 duces an inflammation of the lungs. It usually 
 begins with a chill and the fever rises rapidly to 
 104 or 105. 
 
 Some of the factors that predispose to the dis- 
 ease are weakness of the lung tissue, caused by 
 lesions to spine and ribs, affecting the circulation 
 which nourishes the substance of the lungs, old 
 age, injuries, operations, overwork, exposure, al- 
 coholism, influenza, diabetes, tuberculosis and colds. 
 The immediate cause is the diploccocus lanceolatus, 
 a specific microorganism which is found in a very 
 large percentage of the cases. 
 
 Symptoms. On inspection we note that the 
 patient has a very bright eye, dilated nostrils, pale 
 face or mahogany flush on the cheek. The skin 
 is harsh and dry. The respiration runs from 30 to 
 60 in an adult and from 60 to 90 in a child per 
 minute. The inspiration and expiration are both 
 brief, yet often separated by a long pause. There 
 is deficient expansion on the affected side, and a 
 pain stabbing in character beneath the nipple or 
 axilla. The cough is short, dry and painful. It 
 sets in early and is usually attended with a rusty 
 or blood-stained sputum. It may be white, glairy 
 and scanty at first. 
 
 In elderly persons this disease is peculiarly dan- 
 
Disease and Its Treatment 217 
 
 gerous. The prostration is marked, but the fever is 
 irregular and is not high, the cough, pain and expec- 
 toration are very slight and may be altogether ab- 
 sent. The disease may seem light, but with persons 
 sixty years of age the mortality rate is 60 to 80 per 
 cent, under the regular medical treatment, while at 
 all ages Osier says that it is the most fatal of all 
 acute diseases. 
 
 Treatment. The osteopathic treatment, as out- 
 lined below, is very successful in the subjection of 
 this disease. If the patient is taken in hand early 
 we may expect to abort the case. Kt any stage it 
 gives great relief. The patient may be turned on 
 the sound side and a very thorough relaxing treat- 
 ment be given to all the muscles of the back, partic- 
 ularly on the affected side. See Nos. 53, 57, 59, 61. 
 The spine should be worked upon and sprung from 
 one end to the other. See No. 57. When this is 
 accomplished turn the patient on the back and treat 
 the neck, both front and back, for the purpose of 
 relaxing all the tissues, both deep and superficial. 
 See Nos. 4, 5, 9, 18. Raise the clavicles. See No. 
 70. Depress the first ribs, as in No. 76. Treat in 
 the suboccipital foss^ for the purpose of reducing 
 the fever. See No. 7B. Raise the ribs on both 
 sides. See Nos. 86, 87. Give a thorough abdominal 
 treatment. See Nos. 94, 96, 100, 101, 102. This 
 helps to draw the blood away from the lungs. This 
 treatment may be given in full once per day, but 
 the ribs may be raised, treatment for the fever and 
 some relaxing work over the chest and abdomen may 
 
218 Practice of Osteopathy 
 
 be given three or four times per day. Very quick 
 improvement is expected under this treatment. The 
 treatment should be moderate in strength when the 
 patient is weak. 
 
 Dr. Osier says that there is no specific treatment 
 for the disease, and cautions that patients are more 
 often damaged than helped by the promiscuous 
 drugging that is only too prevalent. 
 
 Some medical writers recommend when the 
 symptoms of pneumonia are present to give a laxa- 
 tive and tonic composed of 
 
 Calomel 5 grains. 
 
 Quinine 10 grains. 
 
 to be given in one dose, and to give a warm mustard 
 foot bath. Should the heart be weak, good whiskey 
 may be given at intervals during the day. It is both 
 a food and a stimulant and if necessary from one- 
 fourth to a pint may be given in one day. It mmst 
 be given to those who have been drinking it prior 
 to the attack of the disease. 
 
 Cold packs are splendid in their efficacy. When 
 the temperature is above 102 they should be ap- 
 plied every half hour. When below that point every 
 hour, and discontinued when the temperature is at 
 
 The compress should consist of three layers, when 
 applied, of old linen, cut in such a way that it will 
 fit the entire chest, both front and back, from the 
 neck and over the shoulders and down to the umbil- 
 icus. A piece of flannel should be so cut as to cover 
 the linen. The linen is wet in water at 60 degrees 
 
Disease and Its Treatment 2.19 
 
 and applied and covered by the flannel and pinned 
 with safety pins. There should be two compresses, 
 using one after the other. 
 
 Diet. The diet should consist largely of milk, 
 soft-boiled eggs, meat juices and egg albumen. Give 
 plenty of cold water, lemonade and soda water. 
 
 BRONCHO PNEUMONIA. 
 
 (Lobular Pneumonia, Capillary Bronchitis, 
 Catarrhal Pneumonia.) 
 
 Broncho pneumonia is an acute disease, in which 
 there is an inflammation of the terminal bronchus 
 and the air vessels connected with it. The condition 
 is due to an infection, which is allowed by a weak- 
 ened condition, which may be brought on by a num- 
 ber of causes. 
 
 There are two forms recognized. The primary 
 form sets in with a chill and a cough. A child may 
 have convulsions. There may have been no previous 
 sickness, but there may have been a cold. Fever 
 rises rapidly and ranges from 102 to 104. The skin 
 is dry, hot and harsh. The cough is hard and pain- 
 ful. Breathing is diflicult. Respiration may be 60 
 to 80 per minute. The face may become dusky and 
 the finger tips and lips blue. The expectoration is 
 white, glairy, tenacious and is often tinged with 
 blood. 
 
 The secondary form follows some other illness 
 and is the more common of the two. It is most fre- 
 quently met with in children. The symptoms are 
 usually veiled by the previous sickness. The initial 
 
220 Practice of Osteopathy 
 
 chill is rare. The fever develops or increases sud- 
 denly. Respiration quickly jumps to 60 to 80 per 
 minute. The pulse is high. Fever is 102 to 104. 
 It may last from one to eight weeks. 
 
 Treatment. We may expect great relief and a 
 speedy recovery of the case by giving the osteo- 
 pathic treatment as outlined in lobar pneumonia. 
 This is the best possible treatment. In the case of 
 children good hygiene and careful nursing are of 
 the utmost importance. Let there be plenty of 
 fresh air. If possible let the child be in one room 
 while the other is being thoroughly aired. Change 
 the position frequently. Do not allow the patient 
 to lie on the back for too long at a time, as this 
 predisposes to congestion of the lungs. A warm 
 bath and an enema should be given at the first 
 symptoms. 
 
 When the nose and throat are dry pour into the 
 nostrils 10 to 15 drops of salt water, three or four 
 times per day from a teaspoon. When the digestion 
 is poor and the tongue is coated the following has 
 been recommended : 
 
 Dilute hydrochloric acid. . . .one dram. 
 
 Essence of pepsin two ounces 
 
 Give a teaspoonful four times per day. 
 
 If the osteopathic treatment is properly given no 
 drugs are ever necessary in any case. 
 
 In the treatment of this disease in an adult the 
 feet should have a hot mustard bath. The following 
 is recommended to be given in one dose in case the 
 medical treatment is followed: 
 
Disease and Its Treatment 221 
 
 Calomel 5 grains 
 
 Quinine 10 grains. 
 
 The patient may have whiskey, as indicatec^ in 
 lobar pneumonia. In case there is trouble in rais- 
 ing the phlegm, raise the foot of the bed six or seven 
 inches. 
 
 DIPHTHERIA. 
 
 Diphtheria is an acute, infectious and contagious 
 disease caused by the Klebs-Loeffler bacillus, with- 
 out which it is a simple membranous inflammation. 
 The disease is characterized by a fibrinous exudate 
 or grayish-white membrane in the throat, extend- 
 ing over the tonsils and soft palate. There is ir' 
 regular fever and great prostration. 
 
 In many cases the fever may not be above 102 
 or 103, while the pulse is from 100 to 120. As the 
 disease advances the urine becomes highly colored 
 and scanty. The mind may sometimes remain clear, 
 but as the poison generated by the disease becomes 
 more abundant the patient become dull and list- 
 less. 
 
 Osteopathic treatment is very successfully given 
 in this disease. The tissues of the neck, both front 
 and back, should be kept thoroughly loosened. See 
 Nos. 4, 5, 6, 7B, 8B, 10, 11, 13. The clavicles should 
 be raised. See Nos. 72, 73. 
 
 The first ribs should be depressed. See No. 76. 
 Relax the tissues back of and beneath the clavicles. 
 This work should stop the growth of the membrane 
 and loosen that already formed. The thumb should 
 
222 Practice of Osteopathy 
 
 relax the tissues in front of the transverse processes 
 of the vertebrse in the neck and the cervical sym- 
 pathetic ganglia should be stimulated. See No. 7C. 
 The back should be treated twice daily, paying par- 
 ticular attention to the middle portions. See Nos. 
 34, 36, 35, 43, 53. Keep the patient in a cool, sunny 
 and well-ventilated room. 
 
 For cleaning the nostrils and pharynx a salt solu- 
 tion may be used, a teaspoonful to a pint of water. 
 A little of this may be poured into the nostrils from 
 a spoon every two hours. Should the nostrils be 
 stopped it may be necessary to use a syringe. For 
 this same purpose a mercuric bicloride solution may 
 be used, in water 1 to 10,000. 
 
 When the digestion needs aid the following pre- 
 scription is sometimes given : 
 
 Essence of pepsin 2 ounces 
 
 Dilute hydrochloric acid . . .^ drachm. 
 Give a teaspoonful three times per day. 
 
 When a stimulant is needed one-fiftieth of a 
 grain of strychnine three times per day, or give 
 whiskey or Tokay wine. 
 
 In case there is incessant vomiting, give one to 
 two drops of tincture of iodine in sweetened pepper- 
 mint water every two hours until the stomach is 
 quiet. 
 
 The diet is important. It should be nutritious and 
 easy of digestion, custard, eggnog, cornstarch. If 
 the bowels are too active give burnt flour soup. In 
 addition there may be given pineapple juice, milk, 
 cocoa, eggs, cream and farina. 
 
Disease and Its Treatment 223 
 
 ECZEMA. 
 
 This term is from a Greek word, meaning to boil 
 over. There are a number of varieties of the dis- 
 ease. Several types may be present at once or 
 they may appear one after the other. There is in- 
 tense itching, burning, redness and swelling of the 
 parts affected. The skin is harsh, dry and thick- 
 ened. The parts may become scaly. On scratch- 
 ing, as the result of irritation, there is inflammation 
 and crusting of the surface. There is a papular type 
 in which there is a number of closely set, bright red 
 papules, particularly about the joints, and the itch- 
 ing is intense. The vesicular type begins with pin- 
 point vesicles, very closely set together. Solid 
 sheets of eruption form, the vesicles break and there 
 is a raw weeping, sometimes spoken of as weeping 
 eczema. 
 
 Among the causes ascribed are rheumatism and 
 gout, digestive disturbances, general debility and 
 a poor nerve supply; immoderate use of food and 
 drink, alcoholic beverages, tea and coffee drinking; 
 exposure to heat and cold, and overwork of a men- 
 tal character. 
 
 In treating, the Osteopath has splendid success 
 with this disease. The treatment is thoroughly 
 given, paying considerable attention to that region 
 
224 Practice of Osteopathy 
 
 of the spine from the atlas to the first lumbar ver- 
 tebra. With the heel of the hand the entire fascia 
 of the spine is relaxed from sacrum to occiput. See 
 Figs. 48, 50 and 51. Give a general treatment. See 
 general treatment. This should be given twice per 
 Vi^cek and should take from twenty to thirty minutes 
 to a treatment. 
 
 The diet should be plain and nutritious. Avoid 
 all meat, gravies and pastries, cheese, condiments 
 and sauces. It will be better to avoid tea and coffee, 
 and all alcohol must be left alone. Out of doors in 
 good weather is best. The prognosis is very favor- 
 able. 
 
Disease and Its Treatment 225 
 
 CROUP. 
 
 The onset of catarrhal croup is sudden. It comes 
 on mostly at night. Generally it is preceded by a 
 slight cough and running at the nose the preceding 
 day. The cough is very characteristic, harsh, dry, 
 metallic, loud and hoarse. The fright of the child 
 in having difficulty in breathing adds to the severity 
 of the symptoms. The lips and nails become bluish 
 in color. The symptoms during the following day 
 have almost disappeared or are much milder. 
 
 Treatment. The osteopathic treatment is the 
 sa-m^ as for diphtheria, which see. 
 
 An emetic, promptly administered, will generally 
 relieve the symptoms. The following is frequently 
 used: 
 
 Triturate of antimony, 1-100 of a grain. 
 
 Ipecac, 1-100 of a grain. 
 
 Give one every fifteen minutes until the patient 
 vomits. Give one every four hours during the day. 
 
 Coal oil, fifteen to twenty drops on sugar, given 
 every fifteen or thirty minutes, sometimes proves to 
 be of great value. This may be also used as an ex- 
 ternal application on the chest and throat. 
 
 Give the child plenty of fresh air and bathe the 
 child's chest with cold water. 
 
 ERYSIPELAS. 
 (St. Anthony's Fire.) 
 
 Erysipelas is an acute, contagious disease charac- 
 terized by inflammation of the skin, which is red, 
 
226 Practice of Osteopathy 
 
 tense and shining. Spots form, which are reddish in 
 color, which coalesce and small blisters appear. 
 There is a rapidly-rising temperature, often pre- 
 ceded by a rigor. The constitutional symptoms are 
 often marked. There may be delirium, dry tongue 
 and feeble pulse. The disease is often confined to 
 the face, but may wander (erysipelas migrans) to 
 the neck, chest and other parts of the body. 
 
 ISTo medical treatment has any effect on the dis- 
 ease. A two per cent solution of carbolic acid in 
 cold water may be used, but cold water is as good 
 as any local application. The disease is caused by 
 a poor circulation in the part affected, and a lowered 
 vitality which allows the direct exciting cause of 
 the disease (the streptococcus erysipelatosus) to 
 gain a foothold. 
 
 The quickest way to rid the patient of the disease, 
 if in the face, is to relax all the tissues of the neck. 
 See Nos. 1, 3, 5, 8B, 9-10, 11. Spring the lower 
 jaws against resistance. See No. 8. Give a thor- 
 ough spinal and abdominal treatment, to quicken 
 the action of the bowels and kidneys and to aid in 
 carrying off the poisons. See Nos. 31, 32, 34, 35, 43, 
 48, 50, 94, 97, 100. Give a salt water enema. Fur- 
 nish the patient with a good, nutritious diet. As in 
 most acute cases, the patient should receive the os- 
 teopathic treatment daily. 
 
 TONSILLITIS, Acute. 
 
 This is an inflammation of the tonsils which may 
 result in a cure, suppuration (quinsy), or in chronic 
 enlargement. 
 
Disease and Its Treatment 227 
 
 This disease is contagious and is often a fore- 
 runner of rheumatism. It affords a medium of en- 
 trance for various microorganisms. It is preceded 
 by a pain in the back and Hmbs, with a rapidly ris- 
 ing fever. The tongue is coated and furred. Swal- 
 lowing is difficult. The urine is dark. The tonsils, 
 which may be felt below the angle of the jaw, are 
 swollen and tender. On inspection they may seem 
 to nearly close the throat. They are red, with a 
 glazed surface at first, but later are covered with a 
 thin layer of pus. This in some cases may assume 
 a grayish hue. If it spreads over the throat and 
 upwards on the roof of the mouth diphtheria may be 
 suspected. See diphtheria. 
 
 Treatment. The best possible treatment is os- 
 teopathic. All the tissues of the neck are relaxed, 
 both front and back. See Nos. 1, 3, 5, 8B, 9, 10, 
 11, 13. The clavicles are raised and corrected. See 
 Nos. 72, 73. 
 
 The first rib is lowered. See Nos. 75, 76. Many 
 cases will be helped by a general treatment, which 
 see. All the above will insure a good circulation to 
 the affected parts. All neck lesions are to be re- 
 moved, as in this portion of the spine arises the 
 nerve supply to the tonsils. In ordinary practice in 
 treating tonsillitis one attack predisposees to an- 
 other, but the author has treated a number of pa- 
 tients osteopathically for the trouble and the disease 
 did not return. Of course the lesions affecting the 
 circulation were removed. Keep the bowels open. 
 Salt water enema will be beneficial. Drop salt 
 
228 Practice of Osteopathy 
 
 water into the nostrils every two or three hours. 
 Cold compresses will prove helpful, placed on the 
 throat. See cold compresses. 
 
 QUINSY. 
 
 (Follicular Tonsillitis.) 
 
 The inflammation is more deeply seated than in 
 acute tonsillitis. The patient is greatly prostrated. 
 A high temperature of from 104 tO' 105 degrees is 
 common. The tendency is for the glands to sup- 
 purate. The treatment will be the same as for 
 acute tonsillitis. The only difference is that hot 
 fomentations will be better than the cold pack in 
 the latter stages. The glands should be opened 
 early. If taken early with osteopathic treatment the 
 case may be aborted. 
 
 CHRONIC TONSILLITIS. 
 
 (Enlarged Tonsils.) 
 
 Enlarged tonsils are found in many children fol- 
 lowing tonsillitis, diphtheria or some of the eruptive 
 fevers. This condition, in many cases, causes mouth 
 breathing. The sense of taste, hearing and smell 
 is often impaired. In cases that are very marked 
 the mental faculties are impaired. Such patients 
 take cold easily and are susceptible to diphtheria. 
 The osteopathic treatment is the same as outlined 
 in acute tonsillitis, with the exception of cold packs. 
 It should be given three times per week. When the 
 case is better, then twice per week for a while. In 
 
Disease and Its Treatment 229 
 
 the chronic condition the tonsils may be manipu- 
 lated with benefit. See No. 8B. 
 
 In addition to the above treatment it will be well 
 to use pressure with the flat of the hand on the front 
 and sides of the neck for the purpose of opening- up 
 and freeing all vessels to and from the tonsils. If 
 these channels had been free there would have been 
 no chronic trouble with the tonsils. Most Osteo- 
 paths give a general treatment, giving attention 
 to the excretories. 
 
 The prognosis under Osteopathic treatment is 
 very favorable. The Osteopath keeps the drainage 
 of the venous blood in good condition and thus 
 speedily cures the case. Of course quicker results 
 are secured in acute cases than in chronic ones. 
 
 Some persons are subject to attacks of tonsillitis 
 every year, developing into quinsy. In such cases 
 when I commenced treating them soon after the 
 yearly attack began I found that the quinsy was 
 aborted and the tonsillitis soon cured. But what 
 was still better the yearly attacks ceased entirely. 
 
230 Practice of Osteopathy 
 
 MEASLES. 
 (Moribilli.) 
 
 This is an acute, infectious, very contagious dis- 
 ease. Before the eruption there will be a cough, cold 
 in the head with running at the nose and fever. This 
 will be followed by a brownish-red eruption at the 
 end of the fourth day of the sickness. It appears 
 first on the neck, then on the face, forehead and 
 trunk. One or more papules may be seen on the 
 hard palate twenty-four hours before it appears on 
 the face. 
 
 Small red spots with a minute bluish-white center 
 may be seen on the inside of the lips and cheeks, 
 from one to three days before the eruption is seen 
 on the body. This is known as Koplik's sign. 
 
 If the rash is slow in appearing a general spinal 
 treatment should be given, paying particular atten- 
 tion to the upper part of the neck. See Nos. 1, 5, 9, 
 10, 36, 43, 48, 50, 53. The author has caused the 
 rash to appear very quickly with one treatment, as 
 indicated above. This causes the headache and 
 fever to disappear. Treat the head, Nos. 14, 16 ; 
 neck, Nos. 4, 6, 7B ; throat. No. 8B ; first rib and 
 clavicle, Nos. 76, 75, 72, 73. Raise the ribs to guard 
 against pneumonia, Nos. 81, 86, 87. Other than this 
 nothing can be done to lessen the severity or short- 
 en a case of measles. It is best to have the room 
 darkened on account of the eyes. If the eyes are 
 
Disease and Its Treatment 231 
 
 sore, keep clean with a saturated solution of boric 
 acid. Cover with cloths wet with ice water. The 
 food should be liquid and light. When the itching 
 is troublesome anoint with plain or carbolized vase- 
 line. When the rash has abated a warm bath should 
 be given daily. Be careful of the eyes for several 
 weeks after convalescence. 
 
 GERMAN MEASLES. 
 (Rotheln, Rubella.) 
 
 This is a very mild, contagious disease. It spreads 
 with great rapidity. There is a very mild fever and 
 there is a headache, pain in the back and limbs 
 and sore throat, with swelling of the cervical glands. 
 
 The symptoms are very mild, and it is much less 
 serious as a disease than measles. There is a macu- 
 lar rose-red eruption on the throat, which extends 
 to the face and chest and then to all parts of the 
 body. Sometimes the eruption is confined to the 
 upper part of the body only; again it may even in- 
 vade the soles of the feet, and the palms of the 
 hand. The rash reaches its height on one part of 
 the body while it fades on another. Its duration 
 is from two to five days or longer. When the rash 
 leaves, the skin is pigmented with a brownish color, 
 which disappears in a few days. It is well for the 
 patient to remain in bed. The diet should be light. 
 Drink plenty of water for the sake of the kidneys. 
 Keep the bowels open. The tissues about the neck 
 and throat should be relaxed. See Nos. 1, 5, 6, SB, 
 10, 7B. The entire musculature of the back should 
 
232 Practice of Osteopathy 
 
 be relaxed and a spinal treatment given. This helps 
 in keeping the skin more active, which aids in bring- 
 ing the disease to a speedy termination. For the 
 spinal treatment see Nos. 34, 36, 43, 48 49, 52, 59, 
 61. 
 
 WHOOPING COUGH. 
 
 (Pertussis.) 
 
 This is a very highly contagious disease, caused 
 by a specific-microorganism. It is characterized by 
 a catarrhal inflammation of the respiratory pas- 
 sages, with a peculiar series of spasmodic coughs, 
 which end in a long-drawn inspiration, or " whoop." 
 In infancy it is a very severe disease, but in child- 
 hood it is mild. The nervous symptoms may be- 
 come so severe as to become apparent in convul- 
 sions. Broncho pneumonia is one of the frequent 
 complications. 
 
 There is no remedy in the drug line for this dis- 
 ease. Holt says that much harm is done by indis- 
 criminate drugging. Keep the child out of doors 
 as much as possible, and keep the rooms in which 
 the child lives as well aired and as fresh as possible. 
 Unless this is done the disease may be unduly pro- 
 longed by reinfection. The bowels should be kept 
 open and keep to a liquid diet as far as possible. 
 
 Should the case be severe the tissues in the neck, 
 both front and back, should be carefully loosened. 
 The first rib should be depressed and the clavicle, 
 or collar bone, raised. See Nos. 1, 2, 4, 5, 6, 8B, 
 
Disease and Its Treatment 233 
 
 9, 72, 73, 75, 76. The other upper ribs should be 
 raised. See Nos. 86, 82. 
 
 This stimulates the lungs and eases respiration, 
 and prevents pneumonia by keeping up a good cir- 
 culation. Thorough and careful manipulation of 
 the tissues of the back will benefit the case. See 
 Nos. 34, 43, 44, 47, 48, 50. Keep the hyoid bone free. 
 See No. 6. 
 
 TUBERCULOSIS. 
 
 Tuberculosis is the greatest scourge and most 
 widespread malady of the human race. It has aptly 
 been termed a social disease, for it prevails more 
 largely in the great cities and in those spots where 
 humanity has been crowded together. 
 
 According to the United States census report of 
 1900 more than ten per cent of deaths were at- 
 tributed to the White Plague. More than 150,000 
 in our country die annually of this dread disease. 
 So prevalent is the disease, that no less an authority 
 than Dr. William Osier says that few persons reach 
 maturity without infection and that none reach old 
 age without a focus or infected area somewhere. 
 
 When we consider that every tubercular patient, 
 when the disease is active, throws off countless mil- 
 lions of the germs of tuberculosis daily, that these 
 germs have extraordinary vitality, and can withstand 
 freezing, that they may survive months in water, 
 and have great power to resist active chemical 
 agents, even nitric acid, and still retain power to in- 
 fect for mouths, when we further consider the care- 
 
234 Practice of Osteopathy 
 
 lessness, both of the pubHc and the victims, it 
 is a wonder that we are not all infected early 
 in life and the earth swept clean of mankind. 
 As it is one-seventh of all deaths, the world 
 over, are the result of these germs. 
 
 The parts of the body most frequently attacked 
 are the lymphatic glands, the lungs, the intestinal 
 tract, bones, skin, brain, joints, uterus. Fallopian 
 tubes, spleen and testicles. 
 
 CHRONIC TUBERCULOSIS. 
 (Chronic Pumonary Tuberculosis.) 
 
 The disease m^ay be latent in the system for some 
 time in the form of miliary tubercles, which are 
 small, gray, hard nodules ranging in size from a mus- 
 tard seed to a bean. These break down and scatter 
 the bacilli through the system, which sets up new 
 points of infection. An injury, a severe cold or 
 some acute disease may cause them to break up 
 and disseminate. Some of them may lodge in 
 weakened lung tissue. The infection may come from 
 without and the onset, whether it be abrupt or 
 gradual, will depend on the number and activity of 
 the bacilli at work and the weakness of the tissues 
 which they attack. 
 
 When the onset is sudden the symptoms may re- 
 semble those of lobar pneumonia^ only the fever is 
 more irregular, the expectoration is more abundant 
 and blood-stained and the bacilli are present. Chills 
 and fever may be the first symptom noted, and in 
 malarial regions mistakes in diagnosis are frequent- 
 
Disease and Its Treatment 235 
 
 ly made. The first warning may come with hem- 
 optysis (a bleeding from the lungs), which is bright 
 red in color and is to be distinguished from blood 
 from the stomach, which will be dark in color. In 
 many cases much blood will be lost and frequent 
 hemorrhages follow, but after the first there may be 
 an absence of this symptom for years. Every case 
 exhibiting this symptom should be regarded as hav- 
 ing tuberculosis, and treatment should be com- 
 menced and every precaution taken to ward off the 
 disease. 
 
 The disease may come on gradually with symp- 
 toms of bronchitis, pleurisy, stomach and intestinal 
 disorders. About one-third of all cases of pleurisy 
 terminate in tuberculosis. The stomach and intes- 
 tinal disturbances cause loss of weight and general 
 debility, which lowers the resisting powers of the 
 body. 
 
 Cough. In a very few cases this symptom may be 
 absent. In the beginning of this disease it is dry 
 and hacking and is most pronounced on retiring and 
 rising from bed in the morning. The cough in some 
 cases becomes very distressing and weakening, and 
 may be so pronounced as to cause vomiting. 
 
 Pain. This symptom varies considerably. Pain 
 in the chest may be absent, or it may be an early 
 and nagging symptom. It may be sharp and stab- 
 bing and more or less constant, or only present when 
 coughing. 
 
 Sputum. This varies in character as the disease 
 progresses. At first it is white, glairy and scanty. 
 
236 Practice of Osteopathy 
 
 Later it may be tinged with blood. As the case ad- 
 vances there are larger quantities and it becomes 
 more purulent, with greenish gray masses and sinks 
 in water. 
 
 Expansion. There should be a difference of not 
 less than three inches in the measurement of the 
 chest in inspiration and expiration. Less than this 
 points to tubercular tendencies. 
 
 Fever is often an early indication of the progress 
 of the disease. The high temperature occurs about 
 five o'clock in the afternoon, the low about five in the 
 morning. It should be taken on rising and every 
 two hours afterwards until retiring. This should be 
 done for several successive days. A part of the 
 time it may fall below normal. If it rises to 99.6 
 F. at night for several successive evenings the diag- 
 nosis of tuberculosis is strongly confirmed. 
 
 Emaciation. On account of the fever, loss of 
 appetite and cough, the loss of flesh, both fat and 
 muscle, is oftentimes rapid and may be marked early 
 in the disease. This symptom with the cough, ex- 
 pectoration, fever and the flattening of the chest on 
 the affected side, loss of expansion and dullness on 
 percussion just above, over or below, the clavicle 
 are the principal points of diagnosis. To be certain 
 of the diagnosis in the early stages the bacilli must 
 be found by microscopic examination. This can 
 only be done in a well equipped laboratory. 
 
 Treatment. Preventative measures are of the 
 greatest importance. Children of families in which 
 there is a taint of the disease should be taken in 
 
Disease and Its Treatment 237 
 
 hand early and every effort made to build them up 
 in order to resist the inroads of the bacilli. If there 
 are any anatomical deviations from the normal they 
 should receive osteopathic treatment. This will in- 
 sure the proper nourishment to the part, or parts, 
 liable to be infected. 
 
 Particular attention should be paid to catarrhal 
 troubles. Let the child be out of doors as much as 
 possible. The underclothing should be woolen. 
 Have the diet plain and substantial, with plenty of 
 milk and fat. 
 
 Those suffering from the disease should not be al- 
 lowed to spit anywhere but in some receptacle, 
 which can be thoroughly cleaned and the contents 
 burned. Paper receivers have been recommended. 
 The utmost cleanliness, in this respect, is necessary 
 for the welfare of the patient. He should never 
 swallow any of the sputa, as he is liable to start 
 new foci of infection. 
 
 The open-air treatment is of great value. This 
 has been emphasized in the case of rabbits which 
 have been inoculated. Those confined in cellars 
 died, while those allowed tO' run out recovered. 
 Fresh air and sunshine -are invaluable. The patient 
 should remain out most of the day. If he has fever 
 he must be quiet, but still he may be out of doors. 
 Cold should not be allowed to drive him in, and 
 arrangements should be made for sleeping out of 
 doors. If he must stay inside let him sleep alone in 
 a large, well-ventilated room. 
 
 Osteopathic Treatment. Its value can hardly be 
 
238 Practice of Osteopathy 
 
 overestimated. The nerve supply to the lungs, of 
 course, governs the blood supply to the lung tis- 
 sue. When the spine is rigid in the upper dorsal 
 region, or v^^hen the vertebrae are misplaced, or when 
 the ribs are out of proper relationship with the 
 spine, or too close together, or twisted, or drooping, 
 they press upon and interfere with nerves closely 
 related with the vasomotor nerves of the lungs 
 and pleura. When derangements occur, as 
 spoken of above, other organs, as heart, stomach, 
 liver, bowels, kidneys, etc., may be affected, and this 
 in turn weakens the general system and has an in- 
 direct effect on the lungs. We cannot be too care- 
 ful of the general health. To build up the resisting 
 power of the patient is of the greatest importance. 
 
 The spine should be carefully examined, paying 
 particular attention to the dorsal region. Examine 
 the ribs and clavicles. The work should be directed 
 to the removal of all lesions found. 
 
 In the general treatment of this disease a thor- 
 ough spinal treatment should be given for the pur- 
 pose of toning up the entire system. See treatments 
 Nos. 32, 34, 35, 36, 38, 43, 51, 53, 57, 47. The ribs 
 should be raised, giving special attention to the first 
 and second ribs. See Nos. 78, 80, 81. Raise the clavi- 
 cles. See Nos. 72, 73. All tissues of the neck 
 should be thoroughly relaxed. See Nos. 1, 2, 4, 5, 
 6, 7, 8B, 9, 10, 11, 13. The abdomen should be 
 treated as in Nos. 94, 95, 96, 98, 100. The treatment 
 should be given gently and carefully at first, and 
 its severity increased as the patient grows stronger 
 
Disease and Its Treatment 239 
 
 and is able to stand it. About three times per week 
 is sufficient in most cases, for the treatment. 
 
 Drugs. Medical texts are almost in accord as to 
 the uselessness of drug therapy. The cough is na- 
 ture's effort to expel a foreign substance, but when 
 it becomes irritating at night and exhausts the pa- 
 tient by preventing sleep a fourth of a grain of 
 morphine is frequently advised or one-tenth of a 
 grain of heroin. Before resorting to drugs for this 
 purpose use osteopathic measures as advised in 
 Nos. 5, 6, 7, 8B, for treating the throat and hyoid 
 bone. 
 
 Deep Breathing. It will be well for the patient to 
 secure all the oxygen possible. At the same time 
 the muscles of the chest may be built up and its ca- 
 pacity greatly enlarged. Proper breathing will help. 
 To do so properly your clothing must be loose. 
 Relax your muscles. Stand easily with the hands on 
 the abdomen. Now take a full, deep breath slowly, 
 allowing the abdomen to swell out. Then exhale 
 slowly, forcing the abdomen in. The abdominal 
 type of breathing brings into full play the dia- 
 phraghm, which increases the capacity of the chest 
 and aids in expelling the air. When you can breathe 
 correctly in this manner, and it will take practice, 
 you may inhale a long, deep breath, bringing the 
 arms slowly from the sides until they meet over the 
 head, at the same time rising on the tiptoes. Ex- 
 hale slowly, bringing the arms back to the sides 
 again. Do this several times per day, ten or fifteen 
 minutes at a time, preferably in the open air. When 
 you walk see that your breathing is correct. 
 
240 Practice of Osteopathy 
 
 Diet. The diet should be nourishing and ample. 
 The battle against the disease depends largely on 
 the ability of the patient to digest his food. It 
 should consist largely of the following: Oyster, 
 clam, barley, bouillon and chicken soups. Also heavy 
 soups made of peas, beans, tomatoes, celery, flavored 
 with meat extracts. Rare roast beef, beefsteak, 
 lamb or mutton, chicken, turkey, eggs, ham, tongue, 
 oysters, herring, cereals of all kinds, butter, olive 
 oil on lettuce or raw tomatoes, cream on everything 
 with which it is palatable, fat bacon, potatoes, green 
 peas, string beans, spinach, cauliflower, asparagus, 
 onions, green salads, milk, buttermilk, honey, coffee, 
 chocolate, cocoa, puddings, ice cream, etc. 
 
 Keep the bowels open, eat five times per day, not 
 too much at a time. Five drops of dilute hydrochlo- 
 ric acid taken in a wineglass of water, twice per 
 day, will aid digestion. 
 
 MUMPS. 
 (Parotitis.) 
 
 This is a specific, contagious disease characterized 
 by pain, swelling and inflammation of the parotid 
 glands. This gland is located on the side of the 
 face, immediately below and in front of the external 
 ear, the lobe of which is lifted up when the swell- 
 ing occurs. The pain is increased by chewing, swal- 
 lowing and taking acid substances into the mouth. 
 The pain often precedes the swelling. Both sides 
 may be involved at the same time. It may occur 
 
Disease and Its Treatment 241 
 
 in only one, or one may be several days later than 
 the other. The symptoms generally last for from 
 three to five days, as the disease is self-limited. 
 
 If the pain is severe, apply warm applications. 
 The hot water bottle or bag is the best. The diet 
 should be liquid. The gland may be supported by 
 cotton held in position by a bandage. Keep the 
 bowels open and the room well aired. 
 
 Osteopathic treatment is excellent in this disease. 
 It adds to the comfort of the patient and shortens 
 the malady. The spine should be thoroughly treat- 
 ed, paying especial attention to the neck. See Nos. 
 1, 5, 9, 34, 36, 43. Very careful, relaxing work may 
 be performed over the glands. Have the patient 
 open and close the mouth against resistance. See 
 No. 8. 
 
 AUTUMNAL CATARRH. 
 
 (Hay Fever.) 
 
 This is an affection of the upper air passages, not 
 unlike a bad cold in the head, with varying symp- 
 toms, often with asthmatic attacks. It occurs most- 
 ly in the warm weather, generally in the late sum- 
 mer. It occurs each year at about the same time, 
 often to the very day. It is very abrupt in its at- 
 tack. There is a copious, thin, watery discharge 
 from the nose. The eyes are red, swollen and suf- 
 fused. The sense of taste and smell may be im- 
 paired. The appetite is poor and there is frequently 
 a slight fever. The attack continues for from four 
 to six weeks, or until a hard frost appears. 
 
242 Practice oi Osteopathy 
 
 The first cause is an impairment of the circula- 
 tion to the mucous membrane of the upper air pas- 
 sag-es, and is generally caused by lesions in the neck, 
 upper dorsal, clavicle and ribs, as low as the fifth, 
 affecting the vaso-motor and sensory nerves and 
 also the blood vessels. 
 
 Cases of many years' standing have been cured 
 by removing these real first causes. Particular at- 
 tention must be paid to these lesions. All of the 
 muscles of the upper part of the thorax, the spinal 
 and neck muscles should be thoroughly relaxed. See 
 Nos. 1, 2, 5, 7B, 9, 10, 11, 36, 34, 43, 44, 47, 48. 
 The ribs and clavicles should be raised. See Nos. 
 72, 73, 86. Relax all the tissues of the face and fore- 
 head and about the eyes. See Nos. 14, 16, 20, 17, 
 21. Exert pressure on the head, as in No. 15. Open 
 the mouth against resistance. See No. 8. Treat 
 along the sides of the nose. See No. 18. Give deep 
 abdominal treatment. See Nos. 94, 95, 100. 
 
 Have the patient avoid overwork. Treat three 
 times per week. Treatment should be commenced a 
 month or more before the attack is expected. 
 
 ACUTE CORYZA. 
 (Cold in the Head.) 
 
 This trouble is an inflammation of the upper air 
 passages, accompanied by a catarrh. It sometimes 
 precedes another disease, as in measles. It is often 
 epidemic and there is supposed to be a specific mi- 
 croorganism as the cause. 
 
 When the disease is frequent it leads to chronic 
 catarrh. 
 
Disease and Its Treatment 243 
 
 Treatment. A general osteopathic treatment 
 should be given with vigor. See general treat- 
 ment. Give special attention to the bowels. See 
 Nos. 94, 95, 100, 97. Such a treatment will keep 
 the cold from becoming serious and will abort a 
 case of la grippe or pneumonia. Special attention 
 should be given to the head and neck treatment. See 
 Nos. 1, 5, 7, 9, 14, 7B. It will be well to take a hot 
 lemonade on retiring. Some writers recommend 
 snuffing from the hand every two or three hours 
 some witch hazel (fluid extract of hamamelis), or 
 Pond's extract. The bowels should be kept open. 
 
 LARYNGITIS. 
 
 This disease is an acute inflammation of the mu- 
 cous membrane lining the larynx. It often appears 
 with cold in the head, or may appear as a result of 
 a blow or the effects of burning by hot drinks or 
 poisons. Or it may be the result of the over use or 
 improper use of the voice. It is very frequently due 
 to lesions affecting the nerve and blood supply of 
 the larynx. The above causes are then the second- 
 ary causes. 
 
 Treatment. The specific lesion must be removed 
 as soon as possible. All of the tissues of the neck 
 must be thoroughly relaxed. See Nos. 1, 2, 5, 9, 
 10, 11, 8B, 7B. The muscles of the upper part of 
 the chest and back must be manipulated for the 
 purpose of restoring them to normal, that there may 
 be no pressure on nerves and that the circulation 
 
244 Practice of Osteopathy 
 
 may be free. See Nos. 34, 36, 43, 86. Open the 
 mouth against resistance. See No. 8. Work deep- 
 ly along the trachea and larynx. See Nos. 6, 8B. 
 
 If there is an irritating cough at night some medi- 
 cal authorities would give ten grains of Dover's 
 powder. 
 
 SPASMODIC LARYNGITIS. 
 
 (Laryngismus Stridulus. False Croup.) 
 
 This trouble is often associated with acute laryn- 
 gitis in children, and has its origin in an affection of 
 the nerves. The osteopathic treatment should be 
 a relaxing one and should follow that for laryngitis. 
 By inserting the finger into the throat and tickling 
 the fauces the patient may be made to vomit, which 
 Vvill prove helpful. A warm bath will assist in break- 
 ing up the spasm. A cold sponge bath should be 
 given daily. The treatment should be directed to 
 building up the general health of the patient. See 
 general osteopathic treatment. In ordinary cases 
 it should be given twice per week. When the pa- 
 tient is better once per week will be sufficient. 
 
 BRONCHITIS, ACUTE. 
 
 This disorder is a catarrhal inflammation of the 
 bronchial tubes. It follows coryza (cold in the 
 head), and is often a continuation of that cold by a 
 continuity of tissue. It is frequently called " cold 
 in the chest." 
 
 The Osteopath looks for tightened tissues in the 
 upper part of the back and neck and finds them. 
 
Disease and Its Treatment 245 
 
 The tissues of the neck, both front and back, are 
 thoroughly relaxed. See Nbs. 1, 5, 9, 10, 11, 8B, 
 7B. The muscles and ligaments of the back are 
 well loosened. See Nos. 34. 34, 36, 43, 44. Relax 
 all the tissues over the chest. The ribs are to be 
 raised. See Nos. 62, 86. The clavicles should be ad- 
 justed, generally by raising them. See Nos. 72, 73. 
 In a severe case of bronchitis, with coughing, an 
 ice bag applied to the spine from the fourth dorsal 
 to the first lumbar will prove helpful. A hot mus- 
 tard foot bath, with a mild mustard plaster on the 
 chest, will also give relief. Give hot lemonade. 
 Some medical authorities would recommend a laxa- 
 tive and at bedtime a ten grain Dover's powder for 
 the cough. 
 
 CHRONIC BRONCHITIS. 
 
 The aged are afflicted with this disease when there 
 has been a number of attacks of the acute form. 
 The osteopathic treatment, as outlined for acute 
 bronchitis, will be found very helpful. It may be 
 given twice per week. 
 
 ASTHMA. 
 
 Asthma is a chronic affection of the bronchi, in 
 which there are paroxysms of difficult breathing, sup- 
 posed to be due to the muscular contraction of the 
 smaller bronchial tubes. It may last for a few min- 
 utes or for several hours, and often occurs nightly for 
 a few days or up to two weeks. Some patients have 
 
246 Practice of Osteopathy 
 
 warning symptoms peculiar to each, while in other 
 cases the attack comes suddenly, without warning. 
 
 Asthma is supposed to be a nervous affection. 
 Heredity plays an important part. There are many 
 exciting causes acting as irritants, such as reflex 
 irritations from other parts of the body, as stomach, 
 bowels, ovaries, uterus, etc. Chemical vapors, dust, 
 fog, smoke, the smell of certain animals, as cat, 
 horse, dog, also the pollen of plants, also colds, anger 
 and fright may also excite the disease to activity. 
 
 The real cause of the disease is to be found in 
 anatomical derangement of the spine and ribs. This 
 is proven by the fact that many who have had the 
 disease for years and have tried everything in the 
 form of treatments, without benefit, were cured 
 when the anatomical maladjustments were removed. 
 There will generally be found in the neck, clavicles, 
 first to the sixth ribs and corresponding vertebrae 
 some lesion that will account for the disease. 
 
 When we wish to relieve the patient the spinal 
 muscles are relaxed, as are the tissues of the neck. 
 See Nos. 1, 5, 7B, 9, 10, 11, 13, 34, 36, 43, 44. The 
 clavicles and ribs are raised. See Nos. 72, 73, 82, 
 83, 88. Great relief should follow at once. When 
 there is no paroxysm the treatment may be given 
 once in ten days. Find and remove any vertebral 
 or rib lesion present. See treatment of spine and 
 ribs. See Nos. 52, 53, 57, 58, 86. Give the relaxing 
 treatment as above. 
 
 In addition to this a thorough general treatment 
 may be given. 
 
Disease and Its Treatment 247 
 
 Medical Relief. A few whiffs of chloroform will 
 give temporary relief. The patient may inhale a 
 solution of nitrite of amyl, three to four drops on 
 a handkerchief. For the prevention of the disease 
 fifteen grains of iodide of potassium, given three 
 times per day, is recommended. Hot coffee or hot 
 whiskey toddy will (sometimes) ward off an attack. 
 Tobacco smoke inhaled has proven helpful. If 
 the attack is caused by overeating or a disordered 
 condition of the stomach or bowels or both they 
 should be emptied. 
 
 Diet. It will be well to be careful with the diet. 
 The heavy meals should be taken not later than 
 noon. The sweets, or any article of food that tends 
 to form gas in the stomach, should be interdicted. 
 
 CONGESTION OF THE LUNGS. 
 
 The blood vessels of the lungs are engorged. This 
 causes difficult breathing, with coughing, during 
 which bloody sputum is raised. The active form 
 may be caused by over-exertion or exposure to the 
 extremes of heat and cold. The passive form may be 
 secondary to a weak heart, or to valvular heart trou- 
 ble, or to continued lying on the back. The Osteo- 
 path finds lesions in the upper dorsal vertebrae 
 and upper ribs. 
 
 The treatment is directed to a stimulation of the 
 nerves by a thorough treatment of the upper 
 dorsal vertebrae. See Nos. 43, 50. Relaxing of all 
 tissues of the chest, especially between the ribs, also 
 
248 Practice of Osteopathy 
 
 the tissues of the upper part of the back. See Nos. 
 1, 5, 34, 36, 37, 43. Raise the ribs. See Nos. 82, 
 84, 86. The pneumogastric nerve and the superior 
 cervical sympathetics should be treated. See Nos. 
 7, 7C. Let there be thorough work over the abdo- 
 men. Nos. 94, 96, 100. This will assist in drawing 
 the blood away from the lungs to the vessels of the 
 bowels. Flex and rotate the limbs. Immediate re- 
 lief may be expected. 
 
 EDEMA OF THE LUNGS. 
 
 In this trouble there is a transudation of the serum 
 from the capillaries into the air cells. The prognosis 
 is not favorable. The treatment is the same as for 
 congestion of the lungs. In acute cases medical 
 treatment calls for a free movement of the bowels. 
 
 EMPHYSEMA. 
 
 This disease is an abnormal condition of the lungs, 
 in which air has been retained, weakening the lung 
 cells. The vesicular, or hypertropic form, of the 
 disease, is when the cells and smaller tubes have 
 been stretched by pressure of the air and conse- 
 quently weakened. The chest is enlarged and the 
 breathing is difficult. On percussion the note is 
 hyperresonant. 
 
 The disease comes on gradually. It may be well 
 advanced before it is noticed. A shortness of 
 breath, a slight lividity, may be noticed qn slight 
 
Disease and Its Treatment 249 
 
 exertion. The chest presents a barrel shape and in 
 respiration moves as if it were in one piece. The 
 heart sounds are weak. 
 
 Bronchitis and asthma are often associated with 
 this disease. These are frequently the cause of the 
 most distressing symptoms. The tendency is for 
 the patient to grow worse as cold weather advan- 
 ces. The disease also grows worse as the patient 
 grows older. 
 
 In interstitial (interlobular) emphysema the air 
 escapes from the ruptured vesicles into the inter- 
 lobular tissue. 
 
 Treatment. The patient's condition may be im- 
 proved under osteopathic treat ment, but not cured. 
 Osier says, " No remedy is known which has any 
 influence over the progress of the condition itself." 
 Of course this refers to drugs. The osteopathic 
 treatment will be the same as for bronchitis, with 
 the addition of a stimulating treatment between the 
 second and seventh dorsal to improve the heart ac- 
 tion and help the circulation. See Nos. 34, 37, 43. 
 It will help the patient to raise the ribs when he is 
 taking a full breath and to compress the thorax as 
 he expels the air. See Nos. 82, 86. Stimulate the 
 vagi nerves. See No. 7. Treat three times per week. 
 
 PLEURISY. 
 
 There are two main forms, which may be specified 
 as dry or adhesive pleurisy, and pleurisy with effu- 
 sion. 
 
250 Practice of Osteopathy 
 
 The disease is an inflammation of the pleura, the 
 lining of the lung. In the dry pleurisy a friction 
 murmur may be heard. There is a slight fever and 
 pain in the side over the point of inflammation. 
 
 In pleurisy with effusion there is frequently a 
 chill, followed by a fever which rises to 102 to 103 
 and remains for a week or for several weeks. The 
 pain is very sharp and may be referred to the nipple, 
 or to the axilla, or to the back, or to the abdomen. 
 There is difficult breathing and the pain is aggra- 
 vated on coughing. 
 
 Treatment consists in the removal of all vertebral 
 and rib lesions. Clavicle and rib lesions are often 
 the actual cause of the disease. All of the spinal and 
 intercostal muscles should be relaxed. See Nos. 34, 
 36, 40, 43, 44, 53. The tissues of the neck should 
 be thoroughly treated. See Nos. 1, 5, 7B, 6, 8B. 
 Ribs and clavicles should be raised. See Nos. 72, 
 73, 82, 84, 86, 88. A thorough spinal treatmeni 
 should be given, with special attention to the tenth 
 eleventh and twelfth dorsal vertebrae. See Nos. 49, 
 50, 57, 48, 51, 52. Give a treatment over the bowels. 
 See Nos. 94, 96, 100. The treatment may be given 
 daily for a while. 
 
 The chronic case may be treated for about three 
 times per week. Hot water bottles or bags should 
 be applied over the seat of the pain. Some cases 
 are benefited by wearing a moist compress, wrung 
 out of cold water and changed every two hours. 
 
 Under medical treatment the patient who has 
 pleurisy with effusion is given saline purges in th^ 
 
Disease and Its Treatment 251 
 
 nope of reducing the fluid. This failing the patient 
 is tapped. 
 
 PNEUMOTHORAX. HYDROPNEUMOTHOR- 
 AX. PYOPNEUMOTHORAX. HYDRO- 
 THORAX. HEMOTHORAX. 
 
 In all of the above conditions in which there is 
 air or gas, water and gas, pus and gas, water or 
 blood in the pleural cavity the osteopathic treatment 
 will be the same, which is the same practically as for 
 pleurisy. 
 
 The relaxation of muscular tissues, both front and 
 back of the chest. See Nos. 34, 36, 40, 43, 44, 53. 
 Raise all the ribs and clavicles. See Nos. 72, 82, 84, 
 86, 88. Give a thorough spinal treatment. See Nos. 
 48, 49, 50, 51, 52, 57. All of this work will give more 
 room for the lungs and make the breathing much 
 easier. 
 
 In many of these cases there is some disease acting 
 as a primary cause. It may be of the lungs, kidneys, 
 liver, blood or heart, or it may be the result of some 
 accident. In such cases the primary disease needs 
 treatment in connection with the active symptoms 
 caused by it. 
 
 These cases are very serious and may need the 
 assistance of the surgeon. 
 
 RICKETS. 
 
 This is an infantile disease, in which the body is 
 poorly nourished and changes appear in the growing 
 
252 Practice of Osteopathy 
 
 bones, which tend to deformity. The disease comes 
 on slowly about the time of teething. Restlessness 
 at night, sweating of the head, constipation and 
 beading of the ribs are early symptoms. The beads 
 spoken of are at the junction of the costal cartilages 
 and the ribs. If the child has walked he does not 
 want to walk now. The body is sore and he does 
 not wish to be moved. There may be a slight fever. 
 The skin is pale, the tissues are soft and flabby. The 
 sternum projects, causing the child to become chick- 
 en-breasted. 
 
 The head is larger than it should be, owing to a 
 thickening of the bones. The face looks small, the 
 forehead is broad and square. In some cases there 
 is a deformity of the bones of the arms and legs, and 
 in some cases there is not a bone in the body that 
 escapes. Some children grow thin, some fat, but in 
 the latter case the flesh is soft and flabby. 
 
 Osteopathic treatment will stop the deformity and 
 give better nutrition. The treatment is general in 
 its scope, with special attention paid to reducing the 
 deformities and removing spinal and rib lesions. See 
 general treatment. 
 
 Some medical writers recommend one-one hun- 
 dred and twentieth of a grain of phosphorus dis- 
 solved in olive oil, given twice per day. Cod liver 
 oil in teaspoonful doses is also recommended. 
 
 Diet. Do not allow candy, sugar, etc., but give 
 eggs, milk, cream and good meat. 
 
 The child should be in the open air as much as 
 possible and have a warm bath about three times 
 per week. 
 
Disease and Its Treatment 253 
 
 OBESITY. 
 
 (Corpulence.) 
 
 Obesity is an excessive amount of fat, that not 
 only becomes an inconvenience but seriously im- 
 pairs the health by infiltrating and weakening the 
 heart muscles, also the lungs, liver and kidneys. 
 
 The controlling factors may be heredity, bad 
 habits of eating and drinking, lack of exercise, and 
 spinal lesions which interfere with the proper work 
 of the liver, pancreas and lymphatic system. 
 
 This condition must not be overcome too sudden- 
 ly. The lesions may be removed as soon as possible. 
 The clavicles are to be raised and the first rib 
 lowered. See Nos. 72, 73, 75, 76. A thorough spinal 
 treatment must be given for the stimulation of the 
 liver, pancreas and kidneys. See Nos. 2)2, 43, 57. 
 Vigorous treatment over the fat tends to its absorp- 
 tion. Give a general treatment, which see. 
 
 Diet. The diet must be restricted. Starches, fats 
 and sweets are to be eliminated as much as possible. 
 The use of water is to be restricted and alcoholic 
 drinks are to be prohibited. 
 
 Regular exercise must be taken. If the heart is 
 weak begin moderately and gradually increase the 
 exercise. Walking is very beneficial. 
 
 Some medical authorities give from three to five 
 grains of the dry, powdered thyroid gland, three 
 times per day. It must be discontinued when it 
 causes any heart disturbance. It should not be tak- 
 en if there is any heart trouble. 
 
254 Practice of Osteopathy 
 
 My experience in treating obesity along Osteo- 
 pathic lines has been very satisfactory. One lady 
 about twenty-four years of age, who was a teacher, 
 weighing over two hundred pounds, had a valvular 
 heart lesion and I concluded that her weight ought 
 to be reduced. 
 
 The patient was put on a diet as follows: For 
 breakfast and supper, one soft-boiled egg and one 
 piece of toast, and for dinner the same, with the 
 addition of some green vegetable which grew above 
 the ground. This diet was adhered to with Osteo- 
 pathic treatments three times per week for two 
 months. In this time the patient lost fifty-two 
 pounds. Her appetite was too large before she be- 
 gan to diet, and she had considerable trouble in 
 adhering to the menu. As the odor of cooking food 
 made her ravenous, she left the house while meals 
 were being prepared. At about the end of two 
 months she asked if she could have all the hot bis- 
 cuits and honey she wanted. The request was 
 granted, the food prepared, and her capacity was 
 one half a biscuit. 
 
 She ate what she desired afterward. Her appe- 
 tite was more moderate and she still holds her light 
 weight, though she is married and has one child. 
 She was treated four years ago. 
 
 Another case was that of a lady about thirty. 
 She weighed something over three hundred. She 
 had apparent good health and was quite muscular. 
 This patient was put on a restricted diet by simply 
 telling her to eat much less. The Osteopathic treat- 
 
Disease and Its Treatment 255 
 
 ment was given about three months. The patient 
 lost some during the treatment, but lost more after 
 the treatment. In six months her loss in weight 
 was sixty pounds, which made a great change, for 
 the better, in her personal appearance. In both of 
 the above cases the good results were secured by 
 improving the lymphatic circulation. This is done 
 by raising the clavicles and lowering the first rib 
 and paying considerable attention to the spinal 
 treatment in the upper dorsal region. In addition 
 to this a general treatment was given. In giving 
 Osteopathic treatment for different troubles you will 
 find that if the treatment is adapted to each case in 
 a proper manner, it tends to restore the patient to 
 the normal in weight as well as restore the health. 
 A thin person would take on flesh and a heavy one 
 would be reduced. 
 
256 Practice of Osteopathy 
 
 DIABETES INSIPIDUS. 
 
 This is a chronic condition, in which large quan- 
 tities of urine are passed daily of low specific grav- 
 ity, and without sugar or albumen. While the dis- 
 ease occurs most frequently among the young, there 
 has been no definite cause given by medical writ- 
 ers. It is often accompanied by nervousness and 
 may be caused by an injury to the spinal cord or 
 brain. 
 
 As in diabetes mellitus, the disease may come on 
 suddenly as a result of fright or injury, but gener- 
 ally it is gradual in its appearance. There is great 
 thirst and the patient drinks great quantities of 
 water. The skin is dry and harsh and the appetite is 
 good, and the general health does not seem to be im- 
 paired. It is incurable from the medical standpoint, 
 but cases have been greatly benefited and many have 
 been cured under osteopathic treatment. 
 
 Lesions are found in the middle of the back, from 
 which the kidneys are enervated. The neck also 
 furnishes some lesions where the medulla would be 
 affected through nerves in that region. The treat- 
 ment should be a thorough general one, as in neuras- 
 thenia, paying especial attention to the lesions in 
 the middle of the back and in the neck. See Nos. 
 34, 36, 37, 43, 48, 51, 52, 1, 4, 5, 7B, 9, 11, 13. See 
 general treatment. 
 
Disease and Its Treatment 257 
 
 DIABETES MELLITUS. 
 
 This a constitutional disease, characterized by a 
 copious amount of urine, in which there is a large 
 percentage of sugar. A disordered nutrition allows 
 the sugar to accumulate in the blood, from which it 
 is eliminated by the kidneys. It is not a disease of 
 the kidneys. 
 
 It is claimed that in some cases it is hereditary. 
 Males and Jews and the better classes are afflicted 
 with the disease more frequently than others. The 
 real cause is unknown from the medical standpoint. 
 It often follows worry, mental shock, and severe 
 nervous strains and diseases or injury to the spinal 
 cord. Some writers believe the disease to be conta- 
 gious. Osteopaths find lesions in the middle and 
 lower part of the back with occasional neck lesions. 
 
 Symptoms. An unusual thirst and the passing of 
 urine frequently are generally the first symptoms 
 noted. The onset of the disease is gradual, but may 
 be sudden, following fright, shock, etc. The tongue 
 is dry, red and glazed. The gums are tender and 
 bleed easily. The appetite is enormous. Patient 
 grows progressively weak and thin. Skin is dry 
 and harsh. The urine may amount to two or three 
 quarts or as high as four or five gallons daily. 
 
 Boils, carbuncles, eczema and gangrene, associated 
 with arteriosclerosis, constipation, enlarged liver 
 and profuse sweating are some of the complications 
 of the disease. 
 
 Treatment, The osteopathic treatment is most 
 
258 Practice of Osteopathy 
 
 vdluMc. It should be general and thorough, suited 
 to the strength and requirements of the patient. See 
 general treatment. The lesions are generally in the 
 lower and middle part of the back and sometimes m 
 the ribs, over the liver. Spinal lesions must be re- 
 moved. See Nos. 34, 36, 43, 51, 52, 57, 58, 98. 
 
 Diet. The diet is of the utmost importance. All 
 starches and sugars in all forms should be elimi- 
 nated. Avoid everything made of flour, as much as 
 possible, such as cake, pie, pastry, pudding, maca- 
 roni, also rice, tapioca, oatmeal, corn meal, hominy. 
 
 Avoid potatoes, peas, beans, turnips, cauliflower. 
 The patient must not eat oysters, clams or liver. 
 Avoid sweet fruits, chestnuts and peanuts, beer and 
 sour wine. 
 
 Good Things to Eat. 
 
 Clear soups made of any kind of meat. Eggs in 
 all styles. Fresh fish. Fresh meats of all kinds ex- 
 cept livers. Fats of all kinds. Vegetables such as 
 lettuce, tomatoes, spinach, cress, radishes, asparagus, 
 cucumbers and celery. 
 
 Fruits. All acid fruits. 
 
 Drinks. Lemonade, tea, coffee, chocolate, cocoa. 
 The above may be sweetened with saccharin, but no 
 sugar. Buttermilk and sour milk may be used. 
 
 Bread. Gluten and bran bread and breads made 
 of aleuronat and reborat flours are to be recom- 
 mended. 
 
 In families predisposed to the disease, starches 
 
Disease and Its Treatment 259 
 
 and sugars should be interdicted. The patient 
 should avoid worry and colds. Luke-warm or cold 
 baths may be taken daily. 
 
 RHEUMATIC FEVER. 
 (Acute Articular Rheumatism.) 
 
 This is an acute, noncontagious fever, most like- 
 ly caused by a germ, and manifesting itself by an 
 attack on one or more joints. In the joint afflicted 
 there will be heat, pain, redness and swelling, the 
 nbrous tissue being inflamed. 
 
 The disease sets in quickly, though it may be pre- 
 ceded by slight, irregular pains in the joints, sore 
 throat and tonsillitis. The fever rises to 102 to 
 105, the pulse is generally above 100 and one or 
 more joints become very painful. The urine is high- 
 ly colored, scanty and acid. There is a very profuse, 
 acid, sour-smelling sweat, which has a very char- 
 acteristic odor. The tenderness, redness and swell- 
 ing subside in one joint as the pain begins in an- 
 other. There is prostration, loss of appetite and 
 considerable thirst. 
 
 The most serious complications of this fever are 
 the heart affections, endocarditis, pericarditis and 
 myocarditis, inflammations of the inner and outer 
 lining and heart muscle, respectively. Osier quotes 
 several writers who say that it is a self-limited dis- 
 ease and that medicine has no influence on its du- 
 ration or course. 
 
 Treatment. Osteopathic treatment performs won- 
 
260 Practice of Osteopathy 
 
 ders in cases of rheumatism. The treatment begins 
 at the nerve supply of the joint affected, which is in 
 the lower part of the spine in case the joints of 
 the lower limbs are affected, and in the neck and up- 
 per dorsal region in case the joints of the arms axe 
 attacked. In case the knee joint was the part that 
 suffered the most, the treatment would begin in 
 the lower dorsal region and lumbar region of the 
 spine, thoroughly loosening the muscles and work- 
 ing there as in Nos. 61, 48, if possible. Then work 
 gradually down the limb, as in Nos. 113, 116. When 
 you reach the knee it will be generally ready for a 
 firm, careful, relaxing treatment. Loosen all the 
 tissues about it and end this part of the treatment 
 by grasping the calf of the leg and the tissues below 
 the knee with both hands and giving the leg a care- 
 ful pull, thus stretching the joint and allowing a 
 better circulation. After this is completed a general 
 treatment will be in order, giving attention to the 
 middle of the back, in the lower dorsal and lumbar 
 regions. See general treatment. Raise the ribs. 
 See Nos. 86, 87. Give a stimulating treatment in 
 the upper dorsal region for the purpose of stimulat- 
 ing the heart. This treatment, given in connection 
 with the compresses, spoken of below, will be found 
 to be satisfactory and no drugs will be needed. 
 
 On account of the profuse sweating, flannel night- 
 gowns should be worn and blankets used instead of 
 sheets. The diet usually used in fevers is best, be- 
 ing sure that the foods are light and nutritious. 
 
Disease and Its Treatment 261 
 
 Lemonade and oatmeal water may be very freely 
 used. 
 
 Cold compresses are used with a great deal of sat- 
 isfaction in Germany. Old linen or worn-out cotton 
 sheeting should be so folded that when applied there 
 will be only three or four thicknesses of the material. 
 This, wet in very cold water, placed snugly on the 
 joint and covered closely with flannel. To avoid 
 changing too frequently the flannel may be removed 
 and cold water allowed to drip on the bandage, after 
 which the flannel is replaced. 
 
 Another treatment is the hot fomentation. Prep- 
 aration is made for this by securing two pieces of 
 old woolen blanket, fifteen to eighteen inches square. 
 One of these is to be used at a time and is to be 
 saturated in boiling water. That it may be wrung 
 out well, so that but little water will remain, take 
 a strong crash roller towel. Fasten two strong 
 sticks at either end of the towel and place the blan- 
 ket between the layers of towel. Immerse in boiling 
 water and remove, wringing as dry as possible by 
 twisting on the sticks. Place the blanket on the 
 joint and cover with another piece of blanket. The 
 part to receive the hot application should be anoint- 
 ed with olive oil or vaseline. The compress should 
 be renewed every fifteen minutes for an hour, when 
 the part should be carefully dried and wrapped in 
 cotton batting or woolen. 
 
 Another treatment : If the pain in any joint is 
 severe, hot cloths wrung out of the following solu- 
 tion may be applied: 
 
262 Practice of Osteopathy 
 
 Carbonate of soda 6 drachms. 
 
 Laudanum 1 ounce. 
 
 Glycerine 2 ounces. 
 
 Water 9 ounces. 
 
 Chloroform liniment is also recommended as an 
 external application. 
 
 The medical internal treatment is very unsatis- 
 factory. The best for the pain and for general relief 
 is salicin, twenty grains of which may be taken every 
 hour and a half until the pain is reduced. Another 
 treatment is twenty grains of salicylic acid, given 
 every two hours in a capsule until the pain is re- 
 lieved. Still another is twenty grains of salicylate 
 of soda, every two hours until the pain is reduced, 
 and then every five hours after until the tempera- 
 ture begins to be reduced. Still another, in case any 
 of the above are tried and fails to agree, is twenty 
 minims of oil of wintergreen given every two hours 
 in milk. 
 
 ARTHRITIS DEFORMANS. 
 (Rheumatic Gout, Rheumatoid Arthritis.) 
 
 Rheumatic arthritis is a chronic disease of the 
 joints. The disease is believed to originate in the 
 spine. The fact that after making an attack on any 
 particular joint of one hand it will next attack the 
 corresponding joint of the other hand, indicates that 
 the disease is of central origin, which is referred back 
 to the spine. 
 
 Another theory is that the disease is caused by a 
 
Disease and Its Treatment 263 
 
 specific microorganism and is the result of this in- 
 fection. 
 
 The bone in the joint enlarges. The cartilages and 
 the muscles waste. The skin becomes pigmented 
 and glossy, which intensifies the appearance of the 
 deformity. In most cases there is intense pain, while 
 in others the disease may progress and the deformi- 
 ties increase with little or no pain. In the early 
 stages the disease often resembles acute articular 
 rheumatism, but the disease persisting in joints first 
 attacked is an important point in the diagnosis. 
 
 The disease is rarely curable, but is not dangerous 
 to life. 
 
 Treatment. Any lesion found in the spine should 
 be removed. The articulation should be kept pliable, 
 and the joints affected should be stretched to facili- 
 tate circulation. When the joints are inflamed, cold 
 compresses should be applied. When taken off the 
 parts should be thoroughly massaged. This tends 
 to reduce the swelling and builds up the wasted 
 cartilages and muscles. In addition to the above 
 a general treatment should be given to build up the 
 system. See general treatment. The patient should 
 have a generous diet, as much as can properly be 
 digested of wholesome, nutritious food, such as 
 roast beef, beefsteak, mutton, chicken, eggs, milk, 
 cod liver oil, olive oil, butter, cream, etc. Alcoholic 
 beverages in small amounts may be taken with the 
 meals for their tonic effect, and malt liquors are al- 
 lowable. Of course alcohol in any form is not ad- 
 missible in cases of rheumatism, as it tends to ag- 
 
264: Practice of Osteopathy 
 
 gravate the disorder. In the disease under consider- 
 ation, alcoholic or malt liquors should not be al- 
 lowed when there is fever or much pain in the joints. 
 
 GOUT. 
 
 (Podagra.) 
 
 Gout is a nutritional, constitutional disease, ac- 
 companied by attacks of inflammation of the joints. 
 Most generally only the joints attacked are those of 
 the great toe, but the joints of the ankle, knee, hands 
 and wrist may be attacked as well. 
 
 The disease is often hereditary, generally on the 
 male side. Alcohol, rich food and lack of exercise 
 are predisposing causes, though poor food and bad 
 hygiene, with an excess of malt liquors, may cause 
 what is known as " poor man's gout." If a person is 
 susceptible to the disease it may be brought on by 
 worry, fright, mental shock, or surgical operation. 
 
 The attack usually comes on at night or early in 
 the morning. There is insomnia, fever and rest- 
 lessness. The joint is swollen, tender, and exceed- 
 ingly painful. The urine is scanty and high colored, 
 Constipation is a varying symptom and dyspepsia is 
 often present. 
 
 The Treatment. The spine should receive a treat- 
 ment, especial attention being paid to the lower and 
 lumbar region. The kidneys should be stimulated. 
 See Nos. 34, 43. A general treatment should be 
 given in many cases. See general treatment. If the 
 great toe is painful begin the treatment in the lower 
 
Disease and Its Treatment 265 
 
 part of the back and work slowly, carefully, and 
 thoroughly down the limb to the toe. See Nos. 113, 
 116, 117, 118, 119. Move all the tissues to the bone 
 to assist circulation. The joint may be gently ma- 
 nipulated from side to side and carefully stretched. 
 This, if carefully done, will eliminate the pain and 
 assist the circulation to carry away the deposit in 
 the joint. The part in which the pain is present 
 should be carefully protected from the cold and kept 
 elevated. Those who are susceptible to this disease 
 should be very careful with the diet, and should 
 abstain from alcohol in all its forms. An outdoor 
 life, with plenty of exercise, is best. Keep the skin 
 active by frequent bathing. If the patient is strong, 
 have him use cold baths in the morning, followed by 
 a vigorous friction with a coarse towel. If the pa- 
 tient is weak, warm baths should be taken on retir- 
 ing at night. Straining efforts, both mental and 
 physical, must be avoided. 
 
 Flannels should be worn next to the skin at all 
 times. A glass or two of water, taken on retiring 
 and the same on rising, helps to rid the system of 
 waste material. Plenty of water should be taken 
 during the day. The great value of the various 
 mineral waters is the water and not the substance 
 it contains. If one will drink the same amount of 
 water at home the benefit will be the same. Of 
 course the change in environment is often desirable. 
 
 The diet should be restricted, as overeating and 
 drinking and the indulgence in meat, rich food and 
 liquors, predispose to the disease. Let the living 
 
266 Practice of Osteopathy 
 
 be plain. Meat once per day, with vegetables pre- 
 ponderating, will be best. String beans, salads, 
 cabbage, spinach, peas, fresh green vegetables, 
 fruits, except bananas ; tomatoes, strawberries, far- 
 inaceous foods, as rice, hominy, sago, tapioca, 
 cracked wheat, butter, milk and stale bread, are 
 all good and indicated for use for one subject to 
 gout. 
 
 Avoid highly seasoned foods, pastry and sweets. 
 
 When there is fever use milk, farinaceous foods 
 and plenty of water. Peppermint water may be 
 given. 
 
 MOUTH, DISEASES OF. 
 
 The mouth should be kept clean. Left to itself 
 it is the foulest cavity in the body. A dirty mouth is 
 a prolific cause of disease, by harboring germs that 
 cause constitutional diseases. We should do this 
 when well, but should be doubly sure to keep the 
 mouth absolutely clean when sick. Take good care 
 of the teeth, and do not kiss on the mouth, nor allow 
 children to be kissed there. 
 
 Stomatitis Acute, resulting from local irritation or 
 intestinal disturbances, may affect the gums or the 
 entire surface of the tongue or mouth. At first there 
 is heat, redness and dryness, followed by active 
 secretion and swelling. There is often pain in mas- 
 tication. 
 
 Cleanse the mouth frequently with a two percent 
 boric acid solution. 
 
Disease and Its Treatment 267 
 
 Stomatitis Aphthous is a more severe form than 
 the above. Vesicles appear and there is consider- 
 able pain. The following washes will prove effi- 
 cient : 
 
 Alum one teaspoonful. 
 
 Water one-half pint. 
 
 Or the following: 
 
 Tannic acid one drachm. 
 
 Glycerine one ounce. 
 
 Use thirty drops of this to a wineglass of water. 
 
 Geographical Tongue (eczema of the tongue), 
 circular patches of the superficial skin of the tongue 
 become loosened and fall off. As it heals in the 
 center the sore grows and enlarges about the healed 
 part. The patches sometimes look like a map, hence 
 the name. The cause of the disease is unknown, 
 but in the case of adults it proves very obstinate. 
 The following mouth wash may be used : 
 
 Boric acid six parts. 
 
 Salicylic acid one part. 
 
 Water 500 parts. 
 
 A weak solution of nitrate of silver will relieve 
 the burning. 
 
 PHARYNGITIS. 
 (Sore Throat.) 
 
 This is an acute catarrhal condition of the phar- 
 ynx. The condition generally follows exposure and 
 cold. It may be also due to the constant use of the 
 voice, to excessive smoking, the use of certain 
 
268 Practice of Osteopathy 
 
 drugs. It may be caused by a valvular disease of the 
 heart or by an anurism or tumor. 
 
 There is dryness of the throat, at first, with pain 
 on swallowing, followed by a profuse secretion and 
 a yellowish discharge. 
 
 The best treatment is to thoroughly relax all the 
 tissues of the neck, both front and back. See Nos. 
 1, 2, 5, 6, 7B, 8B, 9, 11, 13. Depress the first ribs 
 and raise the clavicles. See Nos. 75, 77, 72, 73. 
 Give a spinal treatment. See Nos. 34, 43, 48, 53, 57. 
 Work over the abdomen. See Nos. 94, 96, 100. 
 This serves to draw the blood aAvay from the con- 
 gested parts and keeps the bowels active. An 
 enema, using a tablespoon of salt to a quart of water, 
 will be beneficial. Use a hot foot bath and apply a 
 cold compress to the throat. See cold compress. 
 
 In severe cases the medical treatment would in- 
 dicate a calomel purge, followed by salts and a 
 swabbing of the throat with a solution of nitrate 
 of silver, 40 grains to the ounce. 
 
 PHARYNGITIS, CHRONIC. 
 
 This follows repeated acute attacks. Avoid ex- 
 posure. Clergymen should learn to use their voices 
 better. Smokers should cease smoking and drinkers 
 should not use intoxicants. The general health 
 should be built up. The osteopathic treatment as 
 outlined in acute pharyngitis, should be given three 
 times per week, then twice, and then once per week 
 as the patient grows better. 
 
Disease and Its Treatment 269 
 
 SCURVY. 
 
 This disease resembles purpura, and is due mainly 
 to the use of improper food, causing chronic pto- 
 maine poisoning from intestinal putrefaction. 
 Tainted animal food and an infection of the mouth 
 with microorganisms, associated with privation, are 
 causes. Indirect causes are poor air and water, 
 damp, unfavorable and overcrowded quarters and 
 lack of sunlight, previous disease, cold moisture and 
 persistent heat. Many authorities claim that a con- 
 tinuous use of exclusive salt meat diet is a cause, 
 but that lack of vegetables is not a first cause, as 
 was formerly supposed. 
 
 Diagnosis. The gums are swollen and pulpy. 
 There are lesions of the bones, muscles, skin, gums 
 and viscera, which indicate a change in the compo- 
 sition and properties of the blood. The disease 
 comes on slowly. There is shortness of breath and 
 flitting pains in the back and legs. The skin is 
 sallow, resembling the cachexia of cancer. There 
 is physical and mental weakness. The skin soon 
 grows dry and rough and is marked by small purple 
 spots, mostly on the legs. Patches, looking like 
 bruises, are soon seen, and soft, tender swellings 
 appear on the legs. The eyelids are sometimes 
 swollen and purple and the conjunctiva red. The 
 urine is scanty and there is constipation. 
 
270 Practice of Osteopathy 
 
 The treatment indicated is a general Osteopathic 
 one. See general treatment. Pay particular atten- 
 tion to the entire spine. Treat three times per 
 week. Massage gently over the swellings. 
 
 The diet should be varied and plentiful. Fresh 
 potatoes, cabbage, carrots, onions, lettuce and in 
 fact all green vegetables. Oranges and lemons 
 should be used plentifully; soup, beef tea, milk and 
 eggs. The meat should be fresh. 
 
Disease and Its Treatment 271 
 
 VOMITING. 
 
 In many cases of acute and chronic diseases we 
 frequently are called upon to combat nausea and 
 vomiting. When the patient remains quietly in 
 bed allow him to sip ice water at intervals. Or he 
 may have a little iced tea, either peppermint or 
 black. In case the vomiting is obstinate, medical 
 writers recommend one-drop doses of tincture of 
 iodine in sweetened peppermint water every hour 
 until the condition is overcome. When the tongue 
 is heavily coated and the stomach is foul it will be 
 well to give a pint of warm water. This will cause 
 vomiting and the tendency will be to clean out the 
 stomach. 
 
 In cases of nervous or paroxysmal vomiting the 
 writer has had splendid success by applying an ice 
 bag to the dorsal region from the fourth to the 
 eighth vertebra. In many cases there is a peris- 
 taltic action of that organ, during which it is very 
 active in secreting, and the application of the ice 
 bag tends to inhibit the nerves controlling this 
 function. Some time ago I was called to treat a 
 patient who had been suffering a half day with per- 
 sistent vomiting, which was growing worse. Our 
 usual method would be to inhibit the spine, which is 
 a tedious operation and not always satisfactory. 
 
272 Practice of Osteopathy 
 
 I applied an ice bag, as above, and the patient soon 
 became quiet and slept all night. Soon after I 
 had an engagement in another town to treat a pa- 
 tient who had suffered an apoplectic stroke. When 
 I arrived I found the patient had been vomiting 
 about two hours. The usual means had failed to 
 stop the trouble, as there were two doctors in at- 
 tendiance. Another stroke was feared, but the ap- 
 plication of ice bags to the spine and head quieted 
 the patient at once and there was no further vomit- 
 ing and no cerebral hemorrhage. Since that time 
 I have placed great reliance in the ice 'bag for vom- 
 iting when caused by nervousness. 
 
Disease and Its Treatment 273 
 
 GASTRITIS. 
 (Acute Gastric Catarrh. Acute Dyspepsia.) 
 
 Some forms of stomach trouble seem to be heredi- 
 tary. Many are caused by a predisposing weakness 
 found in the spine, which affects the nerve supply 
 to this important organ. Many cases of severe 
 stomach disease are brought on through errors in 
 diet, too much or too rich food, or tainted food, or 
 the inordinate use of alcohol in some form, or the 
 use of ice cold water at meal time. 
 
 Symptoms. There is headache, nausea, pain in 
 the stomach and abdomen, belching of gas and 
 vomiting. The tongue is heavily furred. There is 
 pain in the back between the shoulders, and the 
 tissues here will be found to be abnormally tight. 
 Sometimes there is diarrhoea. Often there is consti- 
 pation. The abdomen is distended. The vomit con- 
 tains food, mucus and bile. 
 
 Treatmient, Osteopathic. See chronic gastritis. 
 
 Medical treatment. For a child, a dose of caster 
 oil; for an adult, five to eight grains of calomel, 
 followed in a few hours by a dose of salts. After 
 this give the stomach a rest. Soda water and ice 
 may be given. See chronic gastritis. Repeated at- 
 tacks of this will lead to the chronic condition. 
 
274 Practice of Osteopathy 
 
 CHRONIC GASTRITIS. 
 
 (Chronic Catarrh of the Stomach. Chronic Dyspep- 
 sia.) 
 
 This is a diseased condition of the stomach in 
 which the digestion of the stomach is impaired. 
 There is an increase in the formation of mucus and 
 changes in the digestive fluids. The muscular coats 
 of the stomach are weakened, lessening its activity. 
 
 Symptoms. They vary greatly and change as the 
 disease progresses. Pain, nausea, distress and feel- 
 ing of oppression after eating are early symptoms. 
 There is a constant feeling that something is wrong, 
 and the patient is apt to be discouraged. He is 
 melancholy, and loses ambition and dislikes exertion 
 of any kind. There is considerable gas at times, 
 and percussion over the stomach elicits a peculiar, 
 hollow sound. The stomach may become so dis- 
 tended with gas as to cause palpitation of the heart. 
 There is a bad taste in the mouth and the tongue is 
 coated. There may be vertigo, " heartburn," and a 
 stomach cough. The urine is dark red and there 
 is a deposit on standing. 
 
 Causes. An interference with the nerve and blood 
 supply, which weakens the stomach. This inter- 
 ference may be in the neck, in the back from the 
 fourth to the eighth dorsal vertebra, or a displace- 
 ment of the corresponding ribs, or the ribs over the 
 stomach. The trouble may be also caused by errors 
 of diet or the long-continued use of alcohol. 
 
Disease and Its Treatment 275 
 
 Treatment. Osteopathic treatment, with the prop- 
 er diet, has cured countless cases after nearly every 
 other treatment had been tried. Lesions of the neck 
 must be corrected. Stimulate the vagus nerve which 
 helps to supply the stomach with nerve force. See 
 Nos. 1, 5, 3, 7, 7B. Also see Nos. 9, 10, 11, 13. Rib 
 lesions must be carefully looked after and the spine 
 treated between the fourth and the eighth dorsal. 
 See Nos. 34, 43, 35, 53. Stimulate the solar plexus. 
 See No. 100. 
 
 Should any ribs cause mechanical pressure over 
 the stomach they should be corrected. See No. 93. 
 A vigorous, brisk treatment may be given over the 
 stomach and abdomen. See Nos. 94, 99, 100, 101, 
 102. This treatment cures permanently because it 
 removes the underlying causes, other than errors 
 in diet. 
 
 Medical treatment in many cases aims to supply 
 the digestant lacking. The one most frequently 
 needed is hydrochloric acid. Its use is indicated 
 when gas is belched and the taste is sour. To supply 
 this need from 15 to 30 drops of dilute hydrochloric 
 acid is taken in sugar water about fifteen minutes 
 after each meal. Ten grains of pepsin may be taken 
 at the same time. Rochelle salts or Carlsbad salts 
 or sodium phosphate may be taken in a tumblerful 
 of hot water in the morning thirty minutes before 
 eating. This cleanses the stomach and prevents con- 
 stipation. The bowels should move freely at least 
 once per day. It is difficult to help the stomach 
 much while constipation persists. 
 
276 Practice of Osteopathy 
 
 Dietetic. This phase of the treatment is most 
 important. The patient should be free from care 
 and worry and should spend as much time out of 
 doors as possible, and take plenty of time for meals, 
 masticating the food well and carefully. Never 
 eat when tired and rest, when possible, both before 
 and after eating. A daily sponge bath in cold water, 
 followed by active friction with a rough towel, will 
 be helpful. 
 
 In ordinary cases the following foods may be 
 allowed : Wheat bread, stale or toasted very dry, 
 soda crackers, zwieback, dry or toasted, thin slices 
 of bacon broiled, butter; thick soups, thoroughly 
 cooked, made of asparagus, tomatoes or fresh peas or 
 potatoes ; eggs, but not hard boiled or fried ; oysters, 
 fresh fish, boiled or broiled. Meats should be young 
 and tender. They may consist of broiled steaks and 
 chops, roast beef, mutton and chicken. Oranges, 
 peaches and grape fruit are good, and it is well 
 to eat them and other fresh fruit between meals. 
 Prunes and apples may be baked or stewed. Black 
 coffee may be taken after dinner. 
 
 Foods Absolutely Forbidden. Fresh soft bread, 
 hot bread, cakes, pastry, doughnuts, sweets, candies 
 and sugar ; fat or greasy food ; heavy vegetables, 
 dried, salt or corned meats or fish, veal, cheese, 
 sweet fruits, hash or twice-cooked meats. 
 
 In very severe cases, where there is Bright's dis- 
 ease or heart trouble, it may become necessary to 
 give an exclusive milk diet. From two to four 
 quarts of fresh milk may be given in twenty-four 
 
Disease and Its Treatment 277 
 
 hours. It may be given seven or eight times per 
 day. If it is not well borne or the patient has an 
 annoying thirst, it may be diluted with equal parts 
 of soda water or Vichy or Apollinaris water. If 
 the milk is taken without this a little bicarbonate 
 of soda (common baking soda) may be added and 
 a pinch of salt. 
 
 Good fresh buttermilk may be used with good 
 effect. If the patient can not take as much milk as 
 indicated above, or enough to support strength, 
 scraped meat is allowable; oysters, raw or broiled. 
 Some can eat soft cooked eggs and calves' brains. 
 
 URTICARIA. 
 (Hives, Nettle Rash.) 
 
 This trouble appears suddenly on any part of the 
 body. There are small reddish or pink spots which 
 cause a pricking, stinging, itching sensation. The 
 spots may occur in spirals or rings, or they may be 
 combined with papules. 
 
 This trouble is generally attributed to errors of 
 digestion and nervous disorders. With some in- 
 dividuals strawberries or shellfish cause the hives 
 to appear. 
 
 A general treatment may be given, paying es- 
 pecial attention to the stomach. See treatment for 
 gastritis. Avoid foods that are known to disagree 
 in this manner. The itching may be allayed with 
 the use of carbolized vaseline. 
 
278 Practice of Osteopathy 
 
 HEMORRHOIDS. 
 (Piles.) 
 
 Hemorrhoids, or piles, are varicose vessels, 
 caused by an engorgement of the venous hemor- 
 rhoidal plexus, forming tumors at or near the anus. 
 They are internal or external, bleeding or dry. The 
 internal are generally bleeding and the external dry. 
 
 The symptoms vary with the size, number and 
 seat of the tumors. There is a sensation of a for- 
 eign body being in the rectum. There is a throb- 
 bing, aching or burning pain, during and after a 
 hard stool. As the tumor grows, sitting is uncom- 
 fortable. Many reflex symptoms accompany piles, 
 as irritable bladder, urethra and vagina. 
 
 Any trouble that interferes with the return cir- 
 culation from the rectum, as impacted faeces, con- 
 stipation, a heavy or backward misplaced uterus, 
 a pelvic tumor or a poor nerve supply to the plexus 
 of veins affected acts as a cause. There must be 
 proper tone in the muscular walls of these vessels for 
 the blood properly to circulate. In diseases of the 
 liver, lungs and heart we find piles in many cases. 
 
 In treating this condition we must remove the 
 underlying cause as soon as possible. If it is a 
 simple case of piles, without complications, we often 
 find trouble in the articulation of the coccyx and 
 
Disease and Its Treatment 279 
 
 sacrum, or in iliac-sacral synchondrosis. I have se- 
 cured excellent results, in some cases, by a stimu- 
 lating treatment over the sacrum. The patient lying 
 on the table, in a prone position, v^ork over the 
 sacrum with the flat of the hand as indicated in Fig. 
 48. This loosens up all the structures there and 
 stimulates the nerves. The coccyx is frequently 
 found misplaced. The patient lying across the 
 table, on his breast, and his feet on the floor pre- 
 sents a fine position for manipulating a coccyx. 
 With two thumbs it may be pushed forward, or 
 from side to side as indicated. It may also be 
 placed in position as in paragraph 71. The sacrum 
 may be treated as in paragraphs 68 and 69. 
 
 Do not allow the patient to become constipated, 
 but regulate the diet so as to secure free daily evacu- 
 ations of the bowels. Violent exercise should be 
 avoided, such as long walks and heavy lifting. Do 
 not sit on damp or warm seats. Do not use highly- 
 seasoned food, and leave alcohol alone. 
 
280 Practice of Osteopathy 
 
 APPENDICITIS. 
 
 This disease is an inflammation of the vermiform 
 appendix. It is thought by many, at the present 
 time, to be a very common and serious malady. 
 
 Cause. It may be caused by a fall or blow, result- 
 ing in a spinal or rib lesion which interferes with 
 the blood and nerve supply of this little organ, 
 thereby producing a weakened condition. Da Costa, 
 in his surgery gives the reason for men having the 
 disease more frequently than women, is that women 
 have a better blood supply to the appendix than 
 men, a small twig being given off by the ovarian 
 artery, thereby making it stronger in women than 
 in men. 
 
 Of course, when the organ is weakened and it 
 is not performing its function in furnishing a secre- 
 tion, which is bacteriacidal, and which assists in 
 keeping the illeo-coecal valve in order, fecal matter, 
 foreign bodies, such as seeds, etc., may force them- 
 selves into it and help to set up inflammation. On 
 this account many textbooks give erroneous causes 
 for the disease, such as impactions, seeds, poison of 
 rheumatic fever, la grippe, structural defects and 
 "trictures and heredity. 
 
 Symptoms. The pain is the first and most com- 
 mon symptom. It comes on suddenly, and may be 
 either sharp and intense or may be characterized 
 as a dull ache. The pain is located in the lower 
 right side of the abdomen. Pressure of the thumb 
 applied at a point half way between the anterior 
 
Disease and Its Treatment 281 
 
 superior point of the ilium and the umbilicus on 
 the right side will cause intense pain. 
 
 The muscles in the lower right side of the ab- 
 domen are tense and contracted. The patient has 
 a desire to lie on the back, and the limbs, especially 
 the right one, is drawn up. 
 
 Even in the mildest forms of appendicitis there 
 is always fever in the early stages of the disease. 
 The temperature ranges from 101 to 103.5. Stomach 
 and intestinal disturbances are present. The tongue 
 presents a furred, whitish appearance and is moist. 
 There is nausea and vomiting in most cases. Con- 
 stipation is the rule but diarrhoea may be present. 
 
 Operations are often performed for appendicitis 
 and the appendix is found to be entirely normal. 
 One writer in a prominent medical journal recently 
 said that he witnessed thirty-four operations for 
 this disease, but did not see one diseased appendix. 
 Doubtless many lives have been lost by over-zealous 
 surgeons through hasty operations when the case 
 was not properly diagnosed. There are so many 
 troubles that simulate the symptoms of appendicitis 
 that partially excuse some of these errors. The 
 following are mistaken for appendicitis: Abscess 
 of the liver, intestinal obstruction, renal colic, twists 
 of the ureter, colic of intestines, peritonitis, tubercu- 
 lar or otherwise, gallstone colic, coxitis, acute rheu- 
 matism of the rectus abdominis muscle, inflammation 
 of the Fallopian tube or ovary, herpes zoster of the 
 twelfth intercostal nerve, and typhoid fever. 
 
 The treatment of this disease calls for the removal 
 
282 Practice of Osteopathy 
 
 of the causative lesion as soon as possible. In severe 
 cases we must wait for the acute symptoms to sub- 
 side before attempting to remove the real cause, yet 
 in many cases this may be done at once. The oste- 
 opathic treatment for the removal of the lesion in- 
 creases the nerve and blood supply to the appendix 
 at once, and assists in lowering the inflammation. 
 It may be commenced by a stimulating treatment to 
 the spine, while the patient is lying on the back, 
 by reaching under the back and manipulating the 
 spine in the upper lumbar and lower dorsal region. 
 See No. 61. If possible use 34, 43, 57, after which 
 careful manipulative work may be attempted over 
 the abdomen for the relaxation of all the tissues 
 and the improvement of the circulation. See Nos. 
 94, 96, 98, 99, 100. This must be very carefully per- 
 formed, but will give great relief to the patient. 
 The two lower ribs should be slightly manipulated 
 and raised. See Nos. 90, 91, 92. Between treatments 
 an ice bag or hot fomentations should be applied 
 to the seat of the inflammation. 
 
 Constipation should be removed as soon as pos- 
 sible, and it will be well to give an enema to re- 
 lieve the bowels of foreign matter and permit of a 
 more free circulation. In many cases the contents 
 of the appendix may be removed by manipulation. 
 Should the pain be too severe inhibit from the eighth 
 dorsal vertebra to the first lumbar. 
 
 After the recovery of the patient the treatment 
 should be persisted in for some time, as changes 
 have taken place which only a good circulation can 
 
Disease and Its Treatment 283 
 
 restore. This should be done to prevent a recur- 
 rence of an attack. If constipation has been a dis- 
 turbing factor this must be treated and a diet 
 ordered. See diet for constipation. 
 
 INTESTINAL OBSTRUCTION. 
 
 (Strangulation, Volvulus, Intussusception, Stric- 
 ture, Tumors.) 
 
 Strangulation by bands from adhesions is a com- 
 mon form. Volvulus, a twisting of the bowel, is 
 common in the sigmoid flexure. Intussusception., 
 the invagination of a portion of bowel into the 
 lumen of an adjacent part. The latter causes most 
 cases of obstruction of the bowels in ciiildren. Stric- 
 ture of the bowels may be caused by tissue of new 
 formation of the nature of scar tissue or by cancer. 
 Tumors outside the bowels, or fecal mass-es inside 
 of the bowel may be responsible for obstruction. 
 
 In acute ot)struction the pain comes on suddenly, 
 first severe and then decreasing in severity, but 
 the pain remains for some time. Cpnstipation soon' 
 becomes evident, and is so absolute that even gas 
 does not pass the rectum. The abdom-en becomes 
 filled with gas, is very much distended and exceed- 
 ingly tender on pr-essure or on movements- made by 
 the patient. There is vomiting, some fever with a 
 rapid pulse. 
 
 In cases of chronic obstruction there are oc- 
 casional spells of vomiting and constipation. The 
 stomach is uneasy and there is a tendency to vomit. 
 
284 Practice of Osteopathy 
 
 There are occasional spells of diarrhoea. The attacks 
 have a tendency to recur at frequent intervals. 
 
 Many of these forms of obstruction may be over- 
 come vi^ithout the use of the knife, which is often 
 considered necessary. Some cases require careful 
 and persistent v^ork over the abdomen. The work 
 must be directed to remove the cause after the symp- 
 toms are overcome to a certain extent. Adhesive 
 bands may be carefully broken up. Twists when 
 located may be corrected. They are often caused 
 by enteroptosis. This condition is often met with 
 on the left side in the sigmoid flexure and on the 
 right side in the caecum. Both may be lifted up 
 and straightened. See Nos. 96, 97, 98, 99. In cases 
 of intussusception the invaginated portion may be 
 pulled out. 
 
 In cases where there are fecal masses, these may 
 be gradually broken up and passed along the bowel. 
 Some writers recommend that the patient be placed 
 on his knees, with the head and shoulders down, 
 the knee-chest position, and a large injection given. 
 Some authors recommend that the patient be placed 
 in various positions and shaken. 
 
 It may be necessary to give frequent enemas and 
 to continue the work with the patient for some time, 
 until the bowels are made to move. 
 
 In case the pain is very severe we may inhibit the 
 spine from the eighth dorsal to the first lumbar ver- 
 tebra. See No. 67. 
 
 When the patient has become better the real 
 first cause must be treated, which we will find in 
 
Disease and Its Treatment 285 
 
 spine or rib lesions, disturbing the nerve and blood 
 supply to the bowels. A section or segment of the 
 cord may have some pressure, and affects the nerves 
 in such a manner that one portion of the intestine 
 is too active and the adjacent portion is partially 
 paralyzed, thus accounting for the intussusception 
 or volvulus. For a complete cure this condition 
 must be corrected. We must stay with the acute 
 cases until they are better, and the chronic cases 
 may be treated twice or three times per week. A 
 general treatment may be indicated in the chronic 
 cases. See general treatment. 
 
 JAUNDICE. 
 (Icterus.) 
 
 This is a condition in which the bile pigments 
 color the skin, mucous membranes and some fluids 
 of the body. 
 
 Lesions of the spine and ribs, which interfere with 
 the nerve supply of the liver and surrounding tis- 
 sues, are a frequent cause of the trouble. The direct 
 cause will be found in some obstruction, it may be 
 of the liver itself, which interferes with the free flow 
 of the bile into the intestines. Parasites, gallstones, 
 strictures or tumors may be among the causes. 
 
 Symptoms. In catarrhal jaundice the color will 
 be lighter, perhaps a lemon color. In obstructive 
 jaundice the color will be much darker, may be dark 
 green or bronzed. In some cases the skin is of a 
 leathery, greenish-black hue. This latter condition 
 
286 Practice of Osteopathy 
 
 is sometimes called black jaundice. The secretions 
 of the body are colored with bile pigments. The 
 sweat may color the underclothing. The color is 
 apparent in the urine. The first place where the 
 yellow hue is noted is in the white of the eye. 
 
 Itching may be intense in various parts of the 
 body. In some cases it precedes the attacks of the 
 disease; in other cases it appears when the dis- 
 ease is very much prolonged. As the bile fails to 
 pass into the intestines, where it assists in the di- 
 gestion of the food, the stools are whitish or grayish 
 in color. 
 
 Treatment. The condition calls for a thorough 
 general osteopathic treatment. Special attention 
 must be given to the liver. See treatment for 
 cirrhosis of the liver. See also general treatment. 
 The bile duct may be worked over and some pres- 
 sure brought to bear on the gall bladder under the 
 points of the ninth and tenth ribs, pressing inward 
 and upward. Rib lesions, if any, must be removed. 
 See Nos. 81 to 93. The spine must be manipulated 
 from the fourth dorsal vertebra to the lumbar re- 
 gion. See Nos. 34, 43, 48, 51, 53. Keep the liver 
 active. 
 
 Diet. It is well to avoid starches, fats, and sweets. 
 Eliminate fried foods as much as possible. The ap- 
 petite must be tempted. Give lemonade, the juice 
 of pineapples, and oranges. Stewed fruits, soft 
 cooked eggs and cereals are excellent. Drink plenty 
 of water. 
 
 The medical treatment would be calomel, five to 
 
Disease and Its Treatment 287 
 
 eight grains, taken in fractional doses, followed by a 
 dose of salts. Sodium phosphatee is given as in the 
 treatment for gallstones, which see. To control the 
 itching, use talcum powder or powdered starch, or 
 sponge with a warm solution of warm baking soda. 
 
 GALLSTONES. 
 
 (Cholelithaisis.) 
 
 This affection is very widespread, occurring 
 chiefly in women. It is claimed that they have three- 
 fourths of all the cases. It has further been authori- 
 tatively stated that twenty-five per cent of all wom- 
 en over sixty years of age are afflicted with the dis- 
 ease. 
 
 The stones form chiefly in the gall bladder, though 
 they sometimes start in the liver. Anything that 
 interferes with the free flow of the bile may be pro- 
 ductive of the stones. The Osteopath finds lesions 
 in the back, from between the shoulder blades to the 
 eleventh dorsal vertebra. The ribs in the same re- 
 gion are often out of proper relationship, either with 
 the spine or with themselves. These spinal and rib 
 lesions interfere with the nerve and blood supply 
 of the liver. The peristaltic action of the gall blad- 
 der is also interfered with by the same lesions. 
 Tight lacing, the dropping down of the intestines or 
 a kidney, constipation, lack of exercise, the inordi- 
 nate use of rich food, or too much of any one kind 
 of food, continual bending over and sedentary oc- 
 cupations all predispose to this disease. 
 
288 Practice of Osteopathy 
 
 When the stones are forming there are no symp- 
 toms, but when the stone begins to pass through the 
 duct, on its way to the intestines, intense pain de- 
 velops suddenly in the upper right side of the abdo- 
 men, radiating towards the umbilicus and over the 
 abdomen, and under the right shoulder blade. The 
 patient vomits, sweats and is in great agony. The 
 temperature rises to 102 to 104. There is tenderness 
 in the region of the liver and the gall bladder is 
 swollen. The gall bladder lies under the thin edge 
 of the liver at about the point between the ends of 
 the ninth and tenth ribs. The attack lasts until the 
 stone reaches the intestine. 
 
 Treatment. All lesions found in the spine and 
 ribs require immediate removal, as far as possible. 
 Give a stimulative treatment in the middle of the 
 spine. See Nos. 43, 44, 48, 57. The bowels may be 
 manipulated carefully, and when the pain is most 
 severe the spine may be held, as in No. 67. Hold 
 firmly for inhibition at the eighth, ninth and tenth 
 dorsal vertebrae. At the same time an attempt may 
 be made to assist the stone through the duct. Re- 
 member that it runs from the gall bladder in the 
 shape of a reverse letter " S " to a point about one- 
 half an inch below the umbilicus ! When the pa- 
 tient is better, treatment should be given each day 
 for awhile, paying particular attention to constipa- 
 tion. The writer has successfully treated by the 
 above method when surgeons said that an immedi- 
 ate operation was necessary. 
 
 The medical treatment would be about one-fourth 
 
Disease and Its Treatment 289 
 
 of a grain of morphine, administered hypodermical- 
 ly, assisted by a little chloroform, if the pain is very 
 severe, which the patient breathes until the mor- 
 phine has taken effect. Of course the morphine is 
 to be given only when there is great pain. Fur- 
 ther treatment would call for from two to five grains 
 of calomel, followed by a dose of salts. This should 
 be repeated when there are evidences of constipa- 
 tion. The bowels should move at least once per day. 
 A teaspoonful of the saturated solution of sodium 
 phosphate should be taken in a wineglass of water 
 every three hours. After the patient becomes bet- 
 ter it will be well to take the sodium phosphate for 
 some time at least once per day. 
 
 When the disease is troublesome an enema of cold 
 water should be used each day. Plenty of water 
 should be drunk at all times. The use of hot fomen- 
 tations over the liver and gall bladder will assist in 
 relieving pain and will promote circulation in the 
 affected point. 
 
 Diet. Starches, fats and sugars should be avoided 
 as much as possible forever after an attack. Avoid 
 peas, carrots, sweet vegetables and sweet fruit; 
 also egg yolks. 
 
 Fresh green vegetables and acid fruits are highly 
 recommended. Meat may be eaten once per day. 
 Cereals should be well cooked. 
 
290 Practice of Osteopathy 
 
 INFLAMMATION OF THE GALL DUCT 
 AND BLADDER. 
 
 The symptoms may be much the same as in gall- 
 stones and it requires the same treatment. 
 
 CIRRHOSIS OF THE LIVER. 
 
 There are many forms of this disease, in which 
 there is an increase of the connective tissue of the 
 liver and a destruction of the secreting cells. 
 
 Atropic cirrhosis of the liver is also known as hob- 
 nailed liver, granular liver, and chronic interstitial 
 hepatitis. It occurs in middle-aged persons. The 
 liver is much reduced in size. The disease may be 
 caused by alcohol, syphilis and some of the poisons 
 of infectious diseases. 
 
 Symptoms. There is progressive loss of strength. 
 The patient falls off in weight, and there are dis- 
 turbances of the stomach and bowels. There is 
 constipation, difficult breathing, and insomnia. The 
 obstruction of the portal circulation may cause 
 dropsy and piles. The stools will be found to be 
 clay colored. The abdominal veins around the navel 
 are enlarged and form what is called the " Caput 
 Medusae." There is no jaundice. The outlook is 
 not very favorable,. 
 
 Hypertrophic Cirrhosis. In this disease the liver 
 is enlarged. The disease occurs chiefly in young 
 people. There is jaundice. It may be very marked. 
 There is no dropsy. There is pain in the region of 
 
Disease and Its Treatment 291 
 
 the liver, with nausea and vomiting. The liver may 
 be felt in the upper abdomen on the right side. 
 Normally it comes down to the edge of the ribs. 
 
 Treatment. We may expect the best possible re- 
 sults from osteopathic treatment. There are cases, 
 though, that resist all treatment. The liver may be 
 stimulated by treatment in the middle and upper 
 part of the back, say from the sixth dorsal to the 
 first lumbar. See Nos. 34, 43, 44, 48, 49, 52, 53. 
 This work will assist in regaining vaso motor con- 
 trol. All lesions found must be removed. The liver 
 may be worked over, as in Nos. 101, 102. Also work 
 under the lower ribs carefully, as in Nos. 93, 94, 103. 
 This work is to be done, of course, on the right side. 
 
 A deep, careful abdominal treatment should be 
 given. See Nos. 95 to 100. This is for the purpose 
 of freeing up the circulation of the portal vein. The 
 ribs on the right side must be raised if depressed. 
 Correct them if luxated in any manner. See No. 
 93, also Nos. 101, 102. The diet should be food eas- 
 ily digested. Alcoholic drinks should be prohibited, 
 as well as tea, coffee, spices, and all condiments 
 which tend to excite the intestinal tract. Never al- 
 low the patient to overeat, and never eat too much 
 of any particular diet. Cabbage, beans, pork and 
 pastry are forbidden. Some difficult cases call for 
 an exclusive milk diet, which may be diluted with 
 vichy if the patient is unable to take it straight. 
 Drink plenty of water, vichy, ginger ale and pepper- 
 mint tea. Regular hours should be kept as regards 
 
292 Practice of Osteopathy 
 
 sleeping. The patient should take regular exercises. 
 In many cases walking in the open air is good. 
 
 The patient should bathe regularly and keep the 
 skin active. In addition to the full tub bath, taken 
 once or twice per week, the patient should take a 
 cold sponge bath every morning with a brisk rub. 
 Under medical treatment the bowels are to be kept 
 open with Epsom salts. 
 
 FATTY LIVER. 
 
 (Fatty Infiltration of the Liver. Fatty Degenera- 
 tion of the Liver.) 
 
 This disease is treated practically the same as for 
 cirrhosis of the liver, which see. 
 
 PERIHEPATITIS, ACUTE AND CHRONIC. 
 
 Treatment is the same as for cirrhosis of the liver, 
 which see. 
 
 CONGESTION OF THE LIVER. 
 (Hyperaemia of the Liver.) 
 
 When digestion is under way the liver is con- 
 gested. A lazy man who is a hearty eater has a 
 congested liver constantly. It may be caused from 
 over indulgence in eating and drinking, or it may 
 be occasioned by the various infectious fevers. 
 
 In active congestion of the liver there is constipa- 
 tion or diarrhoea, scanty, high-colored urine, a loath- 
 
Disease and Its Treatment 293 
 
 ing of food, nausea, vomiting, fever, with headache 
 and coated tongue. 
 
 The osteopathic treatment should be very suc- 
 cessful. The spine should be thoroughly treated. 
 See Nos. 34, 43, 36, 47, 48, 50, 53, 57, 58. Remove 
 all spinal and rib lesions. Raise the ribs. See Nos. 
 82, 86. Work over the liver as in Nos. 93, 101, 102. 
 Give a thorough abdominal treatment. See Nos. 
 94, 95, 96, 97, 98, 99, 100. It will be well to give an 
 enema, a tablespoon of salt to a quart of water. 
 Drink plenty of water at various times during the 
 day. Use sour lemonade. A liquid diet is to be pre- 
 ferred. Let up on the eating. 
 
 The medical treatment would be a half grain of 
 calomel every hour for six hours, followed later by 
 a dose of salts. Rest in bed with diet and drink as 
 above. 
 
 PASSIVE CONGESTION OF THE LIVER. 
 
 This may be caused by diseases of the lungs or 
 pleura, pressure on the vena cava, and from valvular 
 heart disease. The treatment for this condition, of 
 course, must vary with the cause of the disease. 
 Most cases of congestion are to be treated as above, 
 with treatment of the underlying cause. 
 
 PERITONITIS. 
 
 Is an inflammation of the peritoneum, a serous 
 membrane lining the abdominal cavity, and enclo! ^ 
 ing the contained viscera. 
 
294 Practice of Osteopathy 
 
 The disease may be acute or chronic. It may be 
 caused by a blow or strain, or infection following 
 obstruction, or typhoid fever, or tuberculosis, or 
 gonorrhoea. 
 
 When the disease is acute there is distension of 
 the abdomen, with tenderness and great pain. There 
 is constipation and vomiting. The temperature 
 ranges from 102 to 104. The pulse is hard and is 
 from 110 to 140, and the patient breathes 25 to 40 
 times per minute. 
 
 The treatment calls for relaxation of all the spinal 
 tissues, with inhibition in the lower dorsal and up- 
 per lumbar region. See Nos. 47, 48, 50, 52, 53, 67. 
 Give a careful abdominal treatment. See Nos. 94 
 to 103, 67. The inhibition checks peristalsis of the 
 bowels and the relaxation of tissues assists circula- 
 tion. This work may all be done with the patient 
 lying on the back. This treatment should be given 
 two or three times per day. A liquid diet should 
 be given, cracked ice for the thirst and give an enema 
 for constipation. The ice bag or hot fomentations 
 are used over the bowels. Medical treatment calls 
 for the use of morphine to control the pain. 
 
 Inflammation of the bowels, hysterical peritonitis, 
 obstruction of the bowels of any kind, the rupture 
 of the superior mesenteric artery, or a tubal or other 
 extra uterine pregnancy may simulate peritonitis. 
 
Disease and Its Treatment 295 
 
 CHOLERA. 
 
 Cholera Nostras. Sporadic Cholera. Acute Gas- 
 troenteritis.) 
 
 This is an acute condition, characterized by vom- 
 iting, purging and abdominal pains. It is frequent- 
 ly accompanied by muscular pains and cramps. 
 
 This disease is frequently met with in the sum- 
 mer, and follows sudden changes in the temperature 
 of thirty to forty degrees and over. It is caused by 
 exposure to wet and cold, and the eating of unripe 
 or overripe fruit; also vegetables of the same kind 
 and canned goods and ice cream, etc. 
 
 It begins suddenly. There may be a temperature 
 of from 101 to 105 degrees. As the case progresses 
 the pulse becomes weak and the extremities cool. 
 
 Treatment. Rest in bed. Thoroughly relax all 
 the spinal tissues. See Nos. 34, 43, 47, 48, 53, 57. 
 Spring the spine gently from the upper dorsal to 
 the lumbar region. See Nos. 57, 61. The spine 
 should then be inhibited by holding it strongly just 
 above the lumbar region as in No. 67, or a book 
 may be placed under this same region as in No. 67, 
 Fig. 66. This treatment will stop the peristalsis 
 of the bowels, and thus stop the drain on the sys- 
 tem. This inhibition should not be given until we 
 are sure that all irritating substances have been ex- 
 pelled from the bowels. 
 
 Most medical writers recommend an evacuation 
 of the bowels, either with a dose of castor oil, about 
 one ounce for an adult, or a dose of Epsom salts. 
 
296 Practice of Osteopathy 
 
 The diet should be bland and mild. Burnt flour 
 soup, tea and toast, peppermint tea, some boiled 
 rice. 
 
 For the intense thirst give cracked ice, very weak, 
 cold tea, without sugar, and not much water, be- 
 cause it tends to further loosen the bowels. In a 
 very severe case food may be withheld for twenty- 
 four hours and a slow return made to solid food, 
 among which should be well-boiled rice, soft-boiled 
 eggs, milk toast and crackers. 
 
 CHOLERA INFANTUM. 
 
 This is a disease with symptoms much the same 
 as cholera morbus, only in many cases more pro- 
 nounced. When occurring in children two years or 
 younger it is called cholera infantum. It is often 
 due to poisons generated in the milk or other food, 
 which profoundly affects the nerve centers. 
 
 The stomach and intestines should be emptied 
 as soon as possible. This is quickly effected by irri- 
 gation. The temperature when high should be reg- 
 ulated by baths, and if below normal, hot water 
 bags should be applied to the body. The bath for 
 reducing fever should last for from ten to twenty 
 minutes. It should be given often. An ice cap may 
 be applied to the head. 
 
 After the stomach is cleansed nothing should be 
 taken but a little ice and brandy. The regular diet 
 should be restored only gradually after the symp- 
 toms have subsided. 
 
Disease and Its Treatment 297 
 
 The pain and colic may be relieved by strong in- 
 hibition above the small of the back. See No. 67 
 The child may be lifted well off the bed by clasping 
 the hands beneath the back where we desire to in- 
 hibit. This will give the desired pressure. Hold 
 for a minute or two. All of the tissues of the back 
 should be thoroughly relaxed. See Nos. 48, 57, 58, 
 34, 43. Relax the tissues of the neck. See Nos. 1, 5, 
 9, 10, 11. Pressure above the sacrum will stop 
 cramps in the legs. An ice bag applied there and to 
 the lower lumbar region will do the same. 
 
 DYSENTERY. 
 (Bloody Flux.) 
 
 This is an acute or chronic disease of the colon, 
 or large intestine. It may lead to ulceration. There 
 are mucous and bloody stools. There is griping 
 pain in the bowels, and a bearing down sensation, 
 with an almost constant desire to go to stool. There 
 may be a low fever and vomiting at the beginning of 
 the trouble. 
 
 The disease may be brought on by polluted drink- 
 ing water, indigestible food, sudden changes of 
 weather or unsanitary conditions. 
 
 Treatment. The patient should rest in bed. A 
 thorough relaxing spinal treatment should be given. 
 See Nos. 47, 48, 57, 58, 43. Deep inhibitive treat- 
 ment should be given over the abdomen. See Nos. 
 94 to 100. Pressure should be exerted on the spine 
 (inhibitive) from the middle dorsal to the lower lum- 
 
298 Practice of Osteopathy 
 
 bar. See No. 67. One prominent medical writer 
 recommends the giving of one drachm of Glauber's 
 salts (sodium sulphate), from four to eight times 
 per day, until blood disappears from the stools, usu- 
 ally for two or three days. Light poultices, or tur- 
 pentine stupes or fomentations, will be especially 
 soothing to the patient. 
 
 The diet should be restricted to milk, broth, beef 
 juice and Qgg albumen. 
 
 DIARRHOEA. 
 
 It is always well to determine the cause of the dis- 
 ease. With this trouble there may be several causes, 
 one or more of which may be present. They may be 
 enumerated as follows : (1) Indigestible, overripe 
 or green fruit. (2) Sudden changes in the weather 
 temperature. (3) Poisons generated in the food, 
 as in milk, ice cream, etc., or minerals which may 
 have been taken as drugs. (4) Nervous symptoms 
 resulting from the emotions as fright. (5) Various 
 diseases as cholera, typhoid fever, tuberculosis, etc. 
 (6) Predisposing causes as anatomical derange- 
 ments of the spine. 
 
 Treatment. If the disease arises from either of the 
 first three of the above causes a dose of castor oil, 
 followed by an enema, is indicated, followed by a 
 relaxation of all of the tissues of the spine and back. 
 See Nos. 34, 36, 43, 48, 57, 58. If the condition 
 arises from nervousness, rest is indicated and a thor- 
 ough general treatment for the underlying causes 
 
Disease and Its Treatment 299 
 
 should be given three times per week for two or 
 three months. See general treatment. 
 
 A boiled-milk diet and egg albumen may be re- 
 sorted to until the troublesome symptoms have 
 abated. 
 
 When there are anatomical misplacements they 
 should be removed. There are such causes in 
 every chronic case, and hundreds of such cases have 
 been permanently cured by the removal of suc^ 
 lesions. As a paliative measure to relieve when the 
 peristalsis of the bowels are persistent see No. 67. 
 
 CONSTIPATION. 
 
 This is a very common trouble with all ages and 
 both sexes. It poisons the system, and by undue 
 pressure of the fecal mass against soft tissues, is a 
 prolific cause of many other diseases. Retention and 
 hardness of feces, irregularity and insufficiency of 
 bowel evacuation, are regarded as constipation. 
 
 This trouble may be caused by any one or any 
 combination of the following: Lesions of the spine 
 or ribs, affecting the blood or nerve supply of the 
 bowels, poor peristaltic action, mechanical obstruc- 
 tion, impairment of quality or absence of bile, a 
 flabby or pendulous condition of the abdominal 
 walls and muscles, inattention to the calls of nature, 
 dependence upon purgatives, improper diet, lack of 
 exercise. 
 
 Treatment. The most important thing to do is 
 to remove the real cause of the torpidity of the 
 
300 Practice of Osteopathy 
 
 bowels. The lower half of the spine will be gener- 
 ally found at fault. A common condition is a ten- 
 sion of the ligaments binding the vertebrae together, 
 with a posterior condition of the lower dorsal and 
 lumbar vertebrae. This affects the nerve supply to 
 the bowels. This may be overcome by a thorough 
 loosening up of these tightened conditions by manip- 
 ulation, as in Nos. 43, 44, 48, 49, 51, 63. The entire 
 muscular structures of the lower part of the back 
 must be relaxed. See Nos. 64, 47, 53, 58. The low- 
 er ribs if down must be raised. See Nos. 90, 91, 92. 
 The bowels should be thoroughly manipulated. See 
 Nos. 94 to 100. Fecal obstructions may thus be 
 loosened and passed along the intestinal tract. 
 Some writers recommend rolling a cannon ball, 
 wrapped in some suitable covering, over the intes- 
 tines for five or ten minutes each morning and even- 
 ing. All spinal lesions, of whatever nature, should 
 be removed. See examination of the spine. 
 
 In a very elderly person, or where the abdominal 
 walls are flabby and pendulous, a suitable abdominal 
 belt should be worn until the tissues can be toned 
 up by the osteopathic treatment. This will hold 
 the contents from sagging and obstructing the gen- 
 eral circulation of the pelvis. 
 
 Every one should have a regular time to go to 
 stool, and those liable to suffer from constipation 
 should let nothing interfere with this important 
 duty. Many cases of fecal retention start from neg- 
 lecting the calls of nature. When suffering from 
 constipation go whether you feel the necessity or 
 
Disease and Its Treatment 301 
 
 not, and when you go do not be in a hurry, but ex- 
 pect a movement. Do not strain. It is very injur- 
 ious for a woman to do so, and in either sex may 
 cause piles. 
 
 Stop the use of purgatives, however simple and 
 harmless they may be said to be. In using purga- 
 tives the doses must be increased, the drug must be 
 changed for another, until it is almost impossible to 
 secure an action. Nature grows dependent upon 
 these and their use only confirms the condition and 
 makes the cure all the more difficult. 
 
 Should the bowels prove a little obstinate to the 
 above treatment, at first, use an enema, in which 
 a tablespoonful of salt is used to a quart of water. 
 Use a fountain syringe. Retain the water a half 
 hour if you can, meanwhile massaging the bowel 
 contents. This should not be done but every other 
 day, and must not be continued long. Continued 
 use of such a treatment weakens the tissues and 
 stops the proper secretions. 
 
 Diet. The diet should receive special attention. 
 Most people are accustomed to a too concentrated 
 diet, in which there is too little to pass through the 
 intestines to help excite the peristaltic action by 
 friction on the nerve terminals. All of the following 
 foods are splendid for constipation. A diet may be 
 selected from them, and in case anything is known 
 not to agree with the patient it may be omitted from 
 the list: Tomatoes, lettuce, spinach, asparagus, 
 beans, peas, corn, potatoes, cabbage, celery, boiled 
 
tj2 Practice of Osteopathy 
 
 Spanish onions, carrots, turnips, squash, pumpkin, 
 and cauliflower. 
 
 Corn and Indian meal, oatmeal, shredded wheat, 
 coarse graham bread, graham gems, bran bread and 
 t)ran biscuits. The bran may be mixed with gra- 
 ham or white flour. The bran may also be eaten 
 raw, as much as three or four tablespoons per day. 
 Olive oil may be eaten on salads, lettuce and toma- 
 toes. Use plenty of butter. All fruits with small 
 seeds are excellent, such as figs, raspberries, black- 
 berries, strawberries, grapes and huckleberries. 
 
 Grapefruit, cherries, prunes, oranges, pears, 
 peaches and apples are all splendid. Some of the 
 above may be stewed if the raw fruit disagrees. 
 
 English walnuts, butternuts, walnuts and al- 
 monds. Water, coffee, cider, grapejuice, buttermilk 
 and sour milk are all desirable. 
 
 Foods to Avoid. 
 
 Fried foods, rich sauces and gravies, sweets, 
 pastry, pickles, cheese, starchy puddings, tea, sour 
 wine, red wine, eggs, milk, or any other highly con- 
 centrated foods. 
 
 Two glasses of water should be taken on rising 
 in the morning. Drink plenty of water between 
 meals and a glass or two on retiring. Water taken 
 on an empty stomach is absorbed by that organ and 
 goes through the portal circulation to the liver, 
 where it performs a healthful work. If plain water 
 disagrees, flavor it with lemon juice or a little spice. 
 
Disease andi Its Treatment 303 
 
 ^ A daily cold bath, followed by a vigorous rub un- 
 til the skin is made to glow, is a useful adjunct. 
 
 If the patient follows a sedentary life, and is in- 
 doors much of the time, exercise is to be recom- 
 mended, such as walking, horseback riding, tennis 
 playing, bowling, etc. 
 
 ENURESIS. 
 Incontinence of Urine. Bed Wetting. 
 
 This trouble is a nervous condition, which inter- 
 feres with the normal nerve impulses in the lumbar 
 region of the spinal cord and produces an involun- 
 tary discharge of urine. The lesions found are in 
 the lower dorsal, lumbar and sacral regions. Their 
 removal leads to a permanent cure. Frequently the 
 lumbar portion of the spine is stifif and straight. 
 Treat about twice per week. See Nos. 51, 52, 57, 
 58. 
 
 While the patient is in the knee-chest position 
 the ischia may be gently separated as in Fig. 108. 
 The abdominal contents may be lifted up, as de- 
 scribed in paragraph 96, taking care to begin as low 
 down as the pubis, so the bladder and uterus may 
 be elevated some. The sacroiliac synchondrosis 
 should be slightly loosened, as indicated in para- 
 graphs 106 and 107. 
 
 This treatment, properly given, will effect a cure. 
 If the patient is nervous give a general treatment in 
 addition. See general treatment. 
 
 The patient for a time should eat the largest meal 
 
304 Practice of Osteopathy 
 
 at noon. Drink plenty of water early in the day and 
 up to about three hours before bedtime, after which 
 very little or none should be taken. The foot of the 
 bed may be elevated at night. A cold sponge bath, 
 followed by a brisk rubbing with a crash towel, 
 should be taken on rising in the morning. 
 
 Holt says that punishment of any kind should 
 never be employed, as it is absolutely harmful, but 
 he finds that a system of rewards, in the case of 
 children, works well. If the child especially de- 
 sires a doll, bicycle or pony allow him to have it, 
 as long as the bed remains dry. A nickel for each 
 night that remains dry is very helpful. With the 
 above treatment the author has been very suc- 
 cessful in overcoming this very annoying condition. 
 
Disease and Its Treatment 306 
 
 CYSTITIS. 
 
 (Inflammation o£ the Bladder.) 
 
 This inflammation may be acute or chronic, and 
 may be caused by gonorrhoea, unclean catheters, re- 
 tention of urine, and colds. 
 
 The symptoms are bearing down pains over the 
 bladder, with tenderness in the same region on pres- 
 sure. The urine is scanty and often highly colored. 
 It may be tinged with blood and contains blood and 
 mucus. 
 
 Treatment. The patient should rest in bed, with 
 the hips slightly elevated. Remove any lesions found 
 in the lower dorsal an,d lumbar regions, and stim- 
 ulate over the lumbar and sacral region. See Nos. 
 51, 52, 57, 58. Should there be pain in the bladder 
 inhibit in the above regions. See No. 67. Local 
 abdominal treatment should be given, lifting up on 
 the contents of the abdomen, especially the lower 
 part. See Nos. 96, 97. Give a thorough general and 
 inhibitive treatment to the bowels. This helps to 
 draw the blood away from the bladder. See Nos. 
 94, 95, 100. Treat in acute cases once or twice daily. 
 
 Hot sitz baths and hot applications over the blad- 
 <ier will be helpful. Use the liquid diet. Drink 
 plenty of water. Peppermint tea is splendid. The 
 medical treatment often recommended is to keep 
 the bowels open with the use of salts. Irrigation 
 of the bladder, with a soft rubber tube and a foun- 
 tain syringe, using a two per cent solution of boric 
 acid. A formalin solution is used for the same pur- 
 
306 Practice of Osteopathy 
 
 pose, five to ten drops to a pint of water. In either 
 case the water should be sterilized by boiling. 
 
 UPEMIA. 
 
 Is a poisoned condition of the syttem, which some- 
 times develops in nephritis or anuria, due to the 
 presence of toxic material, which should have been 
 eliminated by the kidneys. It may also follow gout, 
 scarlet fever and typhoid fever. 
 
 The onset is sudden, the face is pale, pulse is slow. 
 There is often a dropsical condition and the breath- 
 ing is difficult. The urine is scanty and contains al- 
 bumen. There is nausea, vomiting, delirium and 
 convulsions. There may be paralysis. 
 
 The treatment is administered for the purpose of 
 stimulating the kidneys and skin to activity. Thor- 
 ough work must be performed from the fifth dorsal 
 to the second lumbar vertebra. See Nos. 43, 44, 
 48, 51, 52. Treat the abdomen deeply and thorough- 
 ly at and above the umbilicus. See Nos. 94 to 100. 
 Treat the upper dorsal and neck region to stimulate 
 the heart and lungs. See Nos. 53, 1, 5, 7B, 7C. 
 Raise the ribs. See Nos. 81, 88. Treat strongly at 
 the base of the skull. See No. 7B. Give a warm 
 salt water enema, in which a tablespoonful of salt 
 has been dissolved to each quart of water. Hot 
 packs will help to induce sweating. 
 
 Some medical authorities advocate active pur- 
 ging, with the use of salts. To induce sweating use 
 either the hot bath or give one-tenth of a grain of 
 pilocarpine three times per day. 
 
Disease and Its Treatment 307 
 
 ANURIA. 
 (Suppression of Urine.) 
 
 Anuria commonly means that the urine does not 
 reach the bladder, a suppression of urine. Cases 
 in which the suppression is absolute are very rare. 
 
 The trouble may be caused by acute Bright's dis- 
 ease, by lowered pressure of the blood, or when the 
 fluids are depleted by diarrhoea. The ureter of a 
 healthy kidney may be obstructed by pressure, or 
 calculi may block both ureters. Severe injuries, or 
 an operation, or lead, turpentine or phosphorus 
 poisoning may act as a cause. Patients have lived 
 for ten days with complete suppression of the urine. 
 One writer records recovery after a suppression of 
 nineteen days. 
 
 Treatment should be given mainly to stimulate 
 the spine at the tenth, eleventh and twelfth dorsal 
 vertebrae. This may be extended from the sixth dor- 
 sal to the second lumbar vertebra. See Nos. 43, 44, 
 48, 51, 52. 
 
 Draw the muscles away from the spine, as in Nos. 
 31. Treat the abdomen in a thorough manner to 
 draw the blood there and relieve congestion. See 
 Nos. 94 to 100. The bowels should be kept open. 
 The skin should be kept active by hot tub baths 
 and hot packs. Hot salt water enemas should be 
 taken. 
 
308 Practice of Osteopathy 
 
 ADDISON'S DISEASE. 
 
 This is an affection of the suprarenal glands. It 
 is characterized by heart weakness, gastro-intes- 
 tinal symptoms, and a bronzed condition of the 
 skin. Medical writers claim the real cause to be 
 unknown, but the disease has followed blows upon 
 the back and abdomen; also caries of the spine. 
 They say that the disease is fatal and recovery is 
 unknown. It occurs mostly in men btween the ages 
 of twenty and forty. Ninety per cent of those who 
 suffer with this disease are laborers. 
 
 Do not diagnose every case of pigmented skin 
 as Addison's disease. Prostration is present before 
 any other symptom and becomes more marked. 
 Remember, that in cancer, tuberculosis, liver trou- 
 bles, pregnancy, exophthalmic goiter, and in marked 
 brunettes this bronzed condition is present. 
 
 The patient may be kept in bed. A light diet, 
 but nutritious, should be employed. Some prefer 
 a strict milk diet. In some cases a light, agreeable 
 form of exercise may be employed. 
 
 This disease has been cured under Osteopathic 
 treatment. A general treatment should be given, 
 paying particular attention to the articulations of 
 all the vertebrae. See general treatment. Lift the 
 lower bowel from the pelvis. See paragraphs 96 
 and 97. The patient should receive a treatment 
 every other day for a while. 
 
Disease and Its Treatment 309 
 
 CONGESTION OF KIDNEY. 
 
 The osteopathic treatment will be the same as 
 for anuria. Medical writers recommend a calomel 
 purge of from five to ten grains, followed by a good 
 dose of salts in a few hours. Warm baths and ene- 
 mas are recommended. 
 
 MOVABLE KIDNEY. 
 
 Floating kidney, palpable kidney, nephrotosis, are 
 terms used to denote the various degrees in which a 
 kidney may be removed from its normal position. 
 Its most common occurrence in women is due to the 
 wasting of the fat tissues which hold it in place, 
 weakness of the abdominal walls from repeated 
 pregnancies, and tight lacing. In men it may be due 
 to heavy lifting, strains, tumors, etc. 
 
 With the patient lying on the back, the knee 
 flexed, the operator stands at the left of the patient 
 and with the left hand placed behind the eleventh 
 and twelfth ribs on the right side, the right hand 
 just below the liver over the upper abdomen, pres- 
 sure may be made with both hands, and a hard, 
 rounded body may be detected with a tendency to 
 move upwards. It may be so low that the upper part 
 of the kidney may be palpable, or it may be felt in 
 the lower part of the abdomen. 
 
 In most cases there are no symptoms. There may 
 be nervous symptoms and dyspepsia. With the float- 
 ing type there may be severe pain, chills, fever and 
 vomiting with collapse. 
 
310 Practice of Osteopathy 
 
 Treatment. Build up the patient. Increase the 
 fat. See diet in tuberculosis. Give a general os- 
 teopathic treatment three times per week. The kid- 
 ney may be pushed up and an abdominal belt worn 
 to hold up the abdominal contents, thus assisting in 
 holding the organ in place. 
 
 ACUTE BRIGHT'S DISEASE, 
 
 (Acute Nephritis. Acute Inflammation of the Kid- 
 neys.) 
 
 Acute inflammation of the kidneys may be caused 
 by exposure to cold and wet and to poisons 
 generated by the acute infectious diseases, such as 
 scarlet fever, measles, diphtheria, small pox, chicken 
 pox, malaria, meningitis, tonsillitis, etc. It may 
 also be caused by turpentine, cantharides, carbolic 
 acid, and potassium chlorate. Pregnancy is also a 
 cause, occasioned by pressure on the renal veins. 
 Extensive burns are frequently followed by this 
 disease. 
 
 Symptoms. The urine is high colored and scanty. 
 It contains blood and albumen. To test for al- 
 bumen, boil a little urine in a test tube over a 
 spirit lamp. If it becomes cloudy add a drop of 
 nitric acid. Should the cloudy condition persist 
 it indicates albumen, but if it clears up on adding 
 the acid it is an indication of phosphates. The 
 pulse is hard. The face, particularly under the eyes, 
 and the ankles may be swollen. There may be pain 
 
Disease and Its Treatment 311 
 
 in the back, with vomiting. There may be fever 
 of from 101 to 103 degrees. The skin is dry. 
 
 Treatment. Lesions should be looked for from the 
 cervical region to the lumbar. Lesions found 
 should be removed. Special stimulation should 
 be given from the sixth dorsal to the second lumbar 
 vertebra. See Nos. 34, 43, 44, 48, 51, 52. Work 
 over the lower lumbar region and stimulate the 
 sacral nerves. See No. 57. Give a thorough ab- 
 dominal treatment at and above the umbilicus. See 
 Nos. 94 to 100. Give an inhibitive treatment in the 
 lower abdomen. Use hot tub baths and the hot 
 packs. See hot packs. Until the patient is better 
 treat each day. Later, three times per week will 
 be sufficient. The patient should rest in bed. Use 
 a liquid diet. Drink plenty of water, lemonade, 
 mint tea and buttermilk. It would be best to live 
 on an exclusive milk diet for several days. It 
 should be sipped slowly. An adult needs from two 
 quarts to four quarts daily. It may be diluted with 
 vichy or carbonic acid water. If the milk can not 
 be made to agree with the patient, gruels may be 
 given, made of arrowroot, rice, oatmeal, etc., but 
 vegetables and meat are interdicted. A splendid 
 drink is a drachm of cream of tartar in a quart of 
 boiling water. Add the juice of a lemon and a little 
 sugar. Drink when cold. 
 
 Orange juice, baked apples, stewed prunes, rice 
 pudding and blancmange may be added later. Re- 
 turn to a regular diet should be slow. Even then 
 use plenty of milk and avoid highly-seasoned and 
 
312 Practice of Osteopathy 
 
 spiced foods, rich foods, pastry, alcoholic drinks, 
 tea and coffee. 
 
 The medical treatment, if desired, would be to 
 have the bowels kept active with calomel, followed 
 by salts. In case the hot bathing and packs failed 
 to induce sweating, give children one-twelfth to 
 one-eighth of a grain of pilocarpine three times 
 per day, and for adults one-sixth to one-fourth of a 
 grain until the skin becomes active. 
 
 CHRONIC BRIGHT'S DISEASE. 
 
 There are two forms recognized, the chronic dif- 
 fuse, or parenchymatous nephritis, and the inter- 
 stitial nephritis, or cirrhosis of the kidney or con- 
 tracted kidney. 
 
 Symptoms. In diffuse nephritis the urine is 
 scanty, high colored, cloudy and contains much al- 
 bumen. In interstitial nephritis the urine is 
 abundant, light colored and contains albumen. See 
 the acute form. In both there are stomach and in- 
 testinal disturbances, headache, loss of appetite, 
 dropsy, puffing under the eyes, rapid heart beat, 
 changes in the retina. The outlook is bad in both 
 cases, but more favorable in interstitial nephritis. 
 
 From the osteopathic standpoint the treatment 
 will be along the same general lines as for acute 
 nephritis, only it will be given from three to four 
 times per week in hope of prolonging the patient's 
 life. 
 
 Systematic exercise out of doors is a good thing 
 
Disease and Its Treatment 313 
 
 for a patient with this disease. He must be free 
 from care and worry. Thoroughly masticate the 
 food and do not overeat. Oranges, lemons, apples 
 and stewed prunes will be helpful in keeping the 
 bowels open. After the discovery of the disease 
 it will be well to try a milk diet for two to four 
 months. The milk may be thickened with tapioca, 
 sago or rice. Large amounts of the milk may be 
 taken in weak coffee or tea. From two to four 
 quarts will be sufficient for an adult in a day. 
 When a change is made to solid food it will be well 
 to take some milk. Corn bread, sago, tapioca, rice, 
 macaroni, fresh, green vegetables, bacon, butter, 
 potatoes, olive oil, the white meat of chicken, raw 
 oysters, clams and fresh fish, a little mutton or 
 fresh beef may be taken. The patient is urged to 
 drink plenty of water, both hot and cold, also 
 lemonade, buttermilk, ginger ale and the cream of 
 tartar drink advised in acute nephritis. 
 
 DROPSY. 
 (Ascites, Renal Dropsy.) 
 
 Ascites is dropsical condition of the abdomen, 
 due to the accumulation of fluid in the peritoneal 
 sac. It is generally caused by some other disease 
 or diseases. It may follow diseases of the liver, 
 heart, lungs, kidneys, or it may be secondary to la 
 grippe, fever, etc. It may be caused directly by an 
 obstruction to the portal circulation or to an ab- 
 dominal tumor. We look for lesions in the spine, 
 
314 Practice of Osteopathy 
 
 in the upper lumbar and lower dorsal regions, also 
 among the ribs. 
 
 The treatment in general should be directed to 
 the removal of the first cause, and in addition we 
 should stimulate the kidneys. See treatment in 
 Bright's disease. 
 
 It will be well to give a thorough general treatment. 
 See general treatment. Special attention should be 
 given to the upper dorsal region. Work here will 
 stimulate the skin. Give a deep abdominal treat- 
 ment. See Nos. 94, 95. Treat the solar plexus. 
 See No. 100. Manipulate and treat the limbs as 
 in Nos. 113, 114, 116. Work over the liver and keep 
 the bowels active. See Nos. 93, 101, 102. 
 
 Renal Dropsy. This is an accumulation of fluid 
 in cellular tissues and lymph spaces from the arter- 
 ies and veins, and is caused by the failure of the 
 kidneys to carry off the surplus fluid, as they fail 
 to do in various kidney diseases. See acute and 
 chronic Bright's disease. The main treatment is, 
 of course, directed to the cure of the primary con- 
 dition. Keep the kidneys well stim.ulated by treat- 
 ment in the lower dorsal region. Give a thorough 
 general treatment for the purpose of toning up all 
 the tissues. This assists the general circulation 
 and retards the flow of fluid out of the blood vessels 
 into the lymph and other spaces. 
 
Disease and Its Treatment 315 
 
 ARTERIOSCLEROSIS. 
 (Atheroma.) 
 
 This disease is a thickening of the walls of the 
 arteries, due to chronic inflammation of the inner coat 
 (intima). It is often hereditary. Gout, syphilis, 
 rheumatism, alcoholism, high and fast living act as 
 exciting causes. This disease is often a forerunner 
 of heart, liver, and Bright's disease and apoplexy. 
 One great cause of this disease is overeating. We 
 eat too much. We keep it up too long. I agree 
 v^ith George Cheyne, that every man after fifty, 
 it v^ould be well to begin at forty, ought to lessen 
 the amount of his food, and every seven years after 
 lessen it sensibly and gradually, and at last descend 
 out of life as he ascended into it, even into the 
 Child's Diet. He says that this would keep the 
 faculties and senses clear and keep us free from 
 great and dangerous distempers. He further says: 
 " Milk and sweet, sound blood differ in nothing but 
 color. Milk is blood." 
 
 Symptoms. They are obscure, but in many cases 
 there is a hard, bounding pulse, difficult breathing, 
 and insomnia. It generally appears after forty. 
 
 Treatment. A general osteopathic treatment is 
 indicated. See general treatment. Stimulate be- 
 tween the second and fifth dorsal vertebrae. See 
 Nos. 34, 38, 43. Raise the ribs. See Nos. 84, 86. 
 Work over the liver. See Nos. 93, 101, 102. Give 
 a thorough abdominal treatment. See Nos. 94, 95. 
 Stimulate the solar plexus. See No. 100. 
 
316 Practice of Osteopathy 
 
 Diet. Let the meals be taken regularly. Drink 
 plenty of water between meals. Leave alcohol 
 alone. Use vegetables rather than meat. If there 
 are renal symptoms, skimmed milk is a most ex- 
 cellent diet. 
 
 PHLEBITIS. 
 Inflammation of Veins.) 
 
 This may be simple or it may be septic, or it may 
 be septic with bacteria from some neighboring sup- 
 purative process. The veins are firm and painful to 
 the touch, and are surrounded by inflamed tissue. 
 There is swelling and pain, with some heat. There 
 is stiffness of the limb. The skin is discolored. 
 Pressure, without or with injury, may act as a 
 cause for this disturbance. Often there is no his- 
 tory of violence or accident. Most simple cases 
 occur in the lower limbs. Should it be in the pelvis, 
 ear or portal vein, the condition is most grave and 
 surgical assistance may be necessary. 
 
 Treatment. The patient must rest, sometimes for 
 a month or six weeks. When the trouble is in the 
 lower limbs the trouble is looked for at the eleventh 
 dorsal and below this point, as far as the sacrum. 
 Remove the lesions as far as possible and give 
 stimulating treatment in the lower dorsal and lum- 
 bar regions. See Nos. 43, 44, 48, 51, 52. Rotate and 
 manipulate the lower limb with great care, as in 
 Nos. 113, 114. 
 
 Give slight torsion about ten times each way per 
 
Disease and Its Treatment 317 
 
 treatment, as in No. 121. Gently rub tissues of the 
 limb in the direction of the heart. 
 
 Diet. The diet should be light. Keep the limb 
 elevated as much as possible. Hot fomentations 
 may be applied for a while. Some medical authori- 
 ties advocate the use of lead water, used as a cold 
 compress. 
 
 VARICOSE VEINS. 
 
 Varicose or enlarged veins are more common in 
 the lower limbs. In general they are due to an 
 obstruction to the return circulation. The condi- 
 tion may be partly caused by a diseased liver or 
 heart, relaxed abdominal walls, and ptosis of the 
 intestines. Constipation may help in increasing 
 this disorder, as may a pregnant or misplaced 
 uterus. The Osteopath looks for lesions in the 
 lower dorsal and lumbar vertebrae, or in a slipped 
 innominate bone which brings undue tension on 
 some muscles and ligaments. 
 
 Treatment. In general this is a stimulating one 
 in the lower dorsal and lumbar regions. See Nos. 
 43, 44, 48, 50, 51, 52. Manipulate the limb. See 
 Nos. 113, 114, 121. Give abdominal treatment. See 
 Nos. 94 to 100. Lift up abdominal contents. See 
 Nos. 96, 97. If the heart or liver is involved, this 
 calls for treatment for this special ailment. If 
 constipated, see special treatment for that. 
 
 Some medical writers order salts to keep the 
 bowels open and order an elastic stocking. Under 
 osteopathic treatment the elastic stocking may be 
 removed. 
 
318 Practice of Osteopathy 
 
 HODGKIN'S DISEASE. 
 
 Adenia, General Lymphadenoma. 
 
 An affection of the lymphatic glands, character- 
 ized by progressive enlargement. Nodular growths 
 also form in the spleen, liver and lungs. The en- 
 largement usually begins on one side of the neck. 
 Three-fourths of all cases occur in males. It is a 
 disease of young and middle-aged people, from 10 
 to 40 years. The medical profession have been unable 
 to find a cause. The submaxillary and cervical 
 glands are first noticed to be enlarging. These 
 grow to be as large as a hen's egg or orange, and in 
 months or years, lymphatic glands in the axillary 
 and inguinal, and, it may be, other internal glands, 
 enlarge. During the first stages of the trouble the 
 general health seems fair, but as the disease pro- 
 gresses the patient becomes pale and weak. There 
 are headache, difficult breathing and disturbances of 
 the stomach and bowels. There appears a chronic 
 relapsing fever. Of course as the glands enlarge 
 there will be various pressure symptoms, as the 
 glands affect different nerves. The pressure of the 
 axillary glands on nerves there will cause pain and 
 swelling in the hands and arms. The inguinal 
 glands, in the same manner, will be the cause of 
 great pain in the limbs and swelling of the feet. 
 
Disease and Its Treatment 319 
 
 Cough, pain and difficult breathing will be the result 
 of swelling mediastinal glands. Tuberculosis is so 
 often present that it is thought to be one cause of 
 the trouble. In young persons it is difficult to de- 
 termine whether it is Hodgkin's disease or tuber- 
 culosis when the glands of the neck begin to swell, 
 but more frequently it is tuberculosis. When there 
 is considerable progress in the disease the patient 
 becomes greatly emaciated. 
 
 In some cases the enlargement of the glands pro- 
 gresses rapidly and the case ends fatally in three or 
 four months, but under medical treatment we ex- 
 pect the patient to last two or three years. 
 
 In treating this disease the Osteopath desires to 
 secure an unobstructed circulation of the blood, 
 lymph and nerve supply, for he believes that this 
 disease, as most other troubles, is the result of the 
 obstruction of these functions of nature. An ob- 
 struction of these forces occurring, the lymph and 
 blood stream grows stagnant and proves an ex- 
 cellent breeding ground for any pathogenic germ. 
 
 The Osteopathic treatment is given by thor- 
 oughly treating the neck (see treatment of the neck, 
 paragraphs 1, 2, 3, 4, 5, 9, 11, 13), the object being 
 to secure a thorough relaxation of all the tissues of 
 the neck. The clavicles are raised as in paragraphs 
 72 and 73. The ribs are adjusted as it is found nec- 
 essary from the examination. See paragraphs 74 
 to 89. The spine is treated as in paragraphs 48 to 
 64, using such treatments as are indicated from the 
 examination. Treat over the abdomen. See treat- 
 
320 Practice of Osteopathy 
 
 ment of the abdomen. Remove all lesions where 
 found and look for some spinal curvature. Lift up 
 the glands carefully, so as to improve the circula- 
 tion, and hold for a few minutes. Do not handle 
 these glands roughly, as it is easy to injure them. 
 In treating, after the manner described, we expect 
 to stop the course of the disease and to secure im- 
 provement, with sometimes a cure. 
 
Disease and Its Treatment 321 
 
 THE HEART. 
 
 In treating all diseases the Osteopath is very much 
 concerned in securing a free passage for lymph, blood 
 and nerves, for he knows that if the nerve and fluid 
 circulation is free in every way the patient will soon 
 regain his health. The arterial system should be kept 
 free and the venous return should be unimpeded on 
 its way back to the heart and lungs for purification. 
 The obstruction of the return circulation is a very 
 prolific cause of disease. When the impure blood is 
 held back, in or near any organ, it stagnates, ferments, 
 is the cause of hypertrophy and furnishes a breeding 
 place for germs. 
 
 When there is an obstruction to the circulation, in 
 or near any organ, due to mechanical maladjustment 
 of some part of the anatomy, or in the capillary sys- 
 tem, due to arteriosclerosis, an added burden is placed 
 upon the heart to supply all parts of the body with 
 blood. This extra burden often leads to hypertrophy. 
 So important is the work of the heart in keeping the 
 body well nourished with blood and keeping the blood 
 in motion that we ought to be well informed as to its 
 anatomy, nerve supply and physiological functions. 
 
 In nearly all cases of heart disease we find some 
 pressure on the pneumogastric nerve. We remember 
 that this nerve supplies both the heart and lungs. It 
 
322 Practice of Osteopathy 
 
 also goes to the stomach. When the lungs or stomach 
 do not perform their work properly an extra burden 
 is thrown upon the heart. Disorders of the stomach 
 often result in palpitation of the heart. So in treating 
 cases of heart disease we must carefully examine 
 other organs and lesions which will affect them. 
 Special attention is given to following the courses of 
 all the branches of the pneumogastric nerves. In 
 giving Osteopathic treatment we must look for first 
 causes before giving the treatment. Unless we know 
 and treat by removing these causes we may do more 
 harm than good. This is especially true in treating 
 heart troubles. 
 
Disease and Its Treatment 323 
 
 FATTY DEGENERATION OF THE HEART. 
 
 (Fatty Infiltration of the Heart.) 
 
 The heart muscles may be infiltrated with and 
 largely converted into fat. There may be a fatty 
 overgrowth, in which large amounts of fat are de- 
 posited in and about the heart. Of course this 
 condition greatly weakens the heart. The oste- 
 opathic treatment is given with a view of stimu- 
 lating and overcoming the condition. The nerve 
 supply to the heart and vessels is corrected at the 
 same time. This increases the strength of the beat 
 and the general heart tone. The stimulation is 
 given in the area of the second to the fifth dorsal 
 vertebra. See Nos. 34, 43. The sympathetic gan- 
 glia in the neck are also stimulated. See Nos. 7C, 
 also 1, 5, 7B. The ribs are to be gently raised. See 
 Nos. 82, 86. A light general treatment, including 
 the above, may be given three times per week. 
 See general treatment. This will build up the 
 general health. The diet should be nutritious, yet 
 it ought to be light. Take the largest meal at noon. 
 The patient should not be allowed to have fat, 
 rich foods, cheese, goose, duck, sausage, cabbage 
 and beans. 
 
 Exercise should be light, yet it may be gradually 
 increased. Graduated exercises in hill climbing 
 have been recommended. They should be carefully 
 performed. The patient should be instructed in 
 deep breathing, which see. 
 
324 Practice of Osteopathy 
 
 VALVULAR LESIONS OF THE HEART. 
 
 The outlook in most cases presenting valvular 
 difficulties is not favorable, yet a number of cases 
 have been cured by osteopathic procedure. At any 
 rate, most cases may be benefited. Should these 
 cases arise from lessened contractile power, or dil- 
 atation, the prognosis is very fair. 
 
 In the treatment we should look for spinal and rib 
 lesions which have weakened the heart. These 
 should be corrected. In general the patient will be 
 treated as for pericarditis, omitting all inhibition. 
 
 The patient should lead a quiet, even life. All 
 strenuous exercise should be prohibited. The 
 bowels should move each day. Keep the body free 
 from sudden changes of temperature, by the use 
 of light woolen. The diet may be generous, but 
 rich and heavy articles of food should not be eaten. 
 Omit pastry. Do not take Turkish or Russian 
 baths. Do not go into high altitudes. Cool sponge 
 baths are good. Walking is splendid exercise. 
 
 Conservative medical treatment, in the early 
 stages, would assist digestion with five drops of 
 dilute hydrochloric acid in sweetened water after 
 each meal. 
 
 PERICARDITIS. 
 
 This is an inflammation of the pericardium. It 
 may be caused by the passage of a foreign object 
 through the oesophagus or by arthritis, tonsillitis, 
 rheumatism, necrosis of bone, puerperal fever, 
 
Disease and Its Treatment 325 
 
 chorea, Bright's disease, pneumonia, scarlet fever, 
 tuberculosis, gout and arteriosclerosis. 
 
 The patient should have rest. He should be quiet 
 mentally as well as physically. The best treatment 
 is osteopathic. It is given to quiet the heart's ac- 
 tion. We look for lesions of the first and second, 
 fourth and fifth ribs and of the clavicles, all affect- 
 ing the drainage of the pericardium. Stimulate the 
 vagus nerve. See Nos. 7, 72, 73. This will inhibit 
 the heart's action. Inhibit the spine from the 
 sixth cervical to the sixth dorsal. See No. 67. The 
 pressure here for inhibition should be prolonged. 
 It is done while the patient is lying on the back 
 with the left arm raised and held well above the 
 head. See No. 61. Raise the ribs carefully. It 
 gives the heart greater space in which to work and 
 secures better drainage from the heart. See Nos. 
 82, 86. Work deeply and slowly over the abdomen 
 and inhibit the spine from the tenth dorsal to the 
 second lumbar. This draws the blood to the ab- 
 dominal vessels and relieves the heart. See Nos. 
 67 , 94, 100. Treat once or twice daily. 
 
 The ice bag should be applied over the heart an 
 hour at a time with intermissions of ten minutes. 
 Later keep it there continuously. Keep the air 
 out of the bag as much as possible. The diet should 
 be light and liquid, 
 
326 Practice of Osteopatliy 
 
 TACHYCARDIA, BRACHYCARDIA, ARRHY- 
 THMIA. 
 
 Tachycardia is a rapid beating of the heart, but 
 without special sensation to the patient. Brachy- 
 cardia is a slow beating of the heart without any 
 noticeable sensation to the patient. Arrhythmia is 
 an irregular beat, during which a beat may be 
 skipped at intervals. 
 
 The rapid heart beat would be treated osteopathic- 
 ally the same as palpitation, which see. The brachy- 
 cardia is treated the same, except the region be- 
 tween the second and sixth dorsal is stimulated 
 instead of being inhibited. Always remove lesions 
 wherever found. 
 
 Arrhythmia calls for the same general treatment. 
 For an irritable heart treat the same as above. In 
 all the above cases the patient should avoid alcohol, 
 tea and coffee. The patient should not allow him- 
 self to become excited. The diet should be light. 
 Articles of food which have a tendency to produce 
 gas should be left out of the diet list. 
 
 PALPITATION. 
 
 Palpitation of the heart is a rapid beating percep- 
 tible to the patient. It may be accompanied with 
 difficult breathing, increased force, irregularity, pain 
 and anxiety. It is a sign of weakness when we are 
 conscious of the heart beat, even though it be nor- 
 mal otherwise. 
 
Disease and Its Treatment 327 
 
 Some of the secondary causes are the excessive 
 use of coffee, tea, alcohol or tobacco. It may occur 
 after some fevers. It may accompany neurasthenia, 
 hysteria or dyspepsia, especially when the stomach 
 fills with gas. It has been noted at time of puberty, 
 or the climacteric, and in some forms of functional 
 trouble at menstruation. 
 
 The Osteopath looks for the primary cause in 
 some anatomical maladjustment of the atlas or axis, 
 first and second vertebrae, or one or more of the 
 first five ribs, or the clavical. The upper spinal 
 muscles may be abnormally rigid. The entire thorax 
 may be too small on account of the ribs having too 
 much downward slant. 
 
 Treatment. At the time of the attack the left 
 hand of the patient may be held above the head and 
 a steady pressure or pull be brought to bear on the 
 second to fourth spinal vertebra. Continue this 
 for five or ten minutes. See No. 67. Raise the ribs. 
 See Nos. 82, 86, 87. Give a deep, inhibitive abdom- 
 inal treatment for the purpose of relaxing the caliber 
 of the abdominal vessels and drawing the blood 
 there, thus quieting the heart's action. See Nos. 
 94, 95, 100. Stimulate the pneumogastric nerve. 
 See No. 7. Raise the clavical. See Nos. 72, 73. 
 Apply an ice bag over the heart. Should the atlas 
 or axis be out of position, correct. See Nos. 1, 3. 
 Loosen the upper spinal muscles. See Nos. 34, 43, 
 53. If the case is a chronic one give a treatment 
 three times per week. 
 
328 Practice of Osteopathy 
 
 ENDOCARDITIS AND MYOCARDITIS. 
 
 These diseases are inflammation of the endo- 
 cardium and myocardium. Both are very grave 
 diseases, owing to the pathological changes taking 
 place. The simple endocarditis is frequently cured. 
 The treatment in both cases is the same as for peri- 
 carditis, with special attention to any specific lesion 
 in the anatomical location named. See pericarditis. 
 
 ANGINA PECTORIS. 
 (Stenocardia, Breast Pang.) 
 
 These are paroxysms of intense pain over the 
 heart region, which radiate to the neck, back and 
 arms, generally to the left arm. It is associated 
 with disease of the heart and vessels. There is a 
 sensation of impending death. The attack usually 
 comes on during some muscular exertion. It may 
 be induced by cold, excessive anger or excitement. 
 
 Treatment. Inhibit at second to sixth dorsal 
 vertebra. See No. 67. Loosen all tissues over the 
 heart. Raise the ribs on the left side. See Nos. 
 82, 86. Treatment should be given afterwards to 
 remove any lesions causing heart trouble. See 
 pericarditis. Pay special attention to the bowels 
 and kidneys. A quiet life should be led and the 
 sleeping room should be cool. Do not overexert, 
 and avoid excitement. Do not eat heavy, indigest- 
 ible food. 
 
 Medical authorities advise if the patient is sub- 
 
Disease and Its Treatment 329 
 
 ject to the disease for him to carry a vial of amyl 
 nitrite. When the attack seems pending inhale 
 from two to five drops by dropping it on a handker- 
 chief. This failing, inhale chloroform. 
 
 HYPERTROPHY OF THE HEART. 
 (Enlargement of the Heart. Dilatation of the Heart.) 
 
 This condition is due to a strain of the heart 
 muscles. It may be due to prolonged overexertion. 
 It is sometimes caused by valvular disease, due to 
 nature's effort to normalize the defect. Exoph- 
 thalmic goiter is a frequent cause. Obstruction of 
 the circulation in the small arteries adds a burden 
 to the heart's work. Nephritis, hepatitis and em- 
 physema increase the heart's labor and are respon- 
 sible for some cases. Alcohol, tobacco, coffee, and 
 lead poisoning are sometimes responsible. 
 
 The treatment, of course, demands the removal 
 of the primary cause, and if that cause is some dis- 
 ease then that needs treatment. The same care as 
 to diet and general living is necessary as in valv- 
 ular heart troubles. Lesions should be removed 
 as in pericarditis, which see. 
 
 ANEMIA. 
 
 (Secondary Anaemia. Toxic Anaemia.) 
 
 Anaemia is a term which is used to define any 
 marked change in the blood, in the number of 
 either white or red corpuscles, or in the amount of 
 
330 Practice of Osteopathy 
 
 the hsemaglobin, or albumen. It may be used to 
 denote a deficient quantity as well as quality of the 
 blood. 
 
 Secondary anaemia refers to anaemia resulting 
 from loss of blood, due to hemorrhage. Toxic anae- 
 mia is caused by the action of poisons on the blood, 
 as mercury, arsenic, lead and the poisons of syph- 
 ilis, malaria, etc. For treatment, see Progressive 
 Pernicious Anaemia. 
 
Disease andl Its Treatment 331 
 
 CHLOROSIS. 
 
 Green Sickness. 
 
 This is a special form of primary anaemia which 
 frequently affects girls, generally between the ages of 
 fourteen and eighteen. It is associated with unde- 
 veloped vascular and generative systems. There is no 
 loss of fat and the patient has a greenish-yellow tint 
 of the complexion, from which the disease takes its 
 name. 
 
 This condition dates from a scanty menstruation, 
 which begins late, and therefore it appears to be con- 
 nected with the evolution of the sexual life. It is 
 hereditary, and if the mother's side of the family 
 have tuberculosis the girls are liable to this disease. 
 It is common among poor and overworked factory- 
 girls. Bad air, lack of outdoor exercise, rest and 
 sleep, irregular eating and poor food all predispose to 
 this disease. 
 
 The symptoms are fatigue and indisposition to 
 mental or physical activity in the beginning of the 
 trouble. Palpitation of the heart, difficult breathing, 
 headache, constipation and scanty menses soon be- 
 come prominent symptoms. The appetite is poor. 
 The tongue is pale and dry and there is vertigo. The 
 fat may be increased and the person maintain her 
 
332 Practice of Osteopathy 
 
 rotundity. But there is the peculiar color which may 
 vary from the characteristic greenish shade to safifron, 
 lemon-yellow, or muddy tint. There may be some 
 irregular fever, nervous symptoms, mental depression 
 and oedema of the ankles. 
 
 The prognosis is favorable under Osteopathic treat- 
 ment. We should begin the treatment carefully, and 
 not give it too severely at first. It would be well to 
 give a gentle general treatment each day for about 
 one week before searching for definite lesions. See 
 general treatment. Look for lesions in the innomi- 
 nates, spine and ribs. If the treatment is followed 
 carefully and persistently for some time we may ex- 
 pect the best of results. 
 
 The diet and hygiene should be carefully looked 
 after. There should be plenty of fresh air, rest and 
 sleep, with regular habits. Change of location or a 
 trip to the sea or mountains will be helpful. If the 
 girl is an indoor worker a change of occupation to 
 out of doors should be tried. Plenty of easily-di- 
 gested food should be allowed: green vegetables, 
 stewed and fresh fruit, milk, eggs, fish and meat. 
 Leave tea and cofifee alone. A warm bath three times 
 per week is indicated. 
 
 PROGRESSIVE PERNICIOUS ANEMIA. 
 
 (Idiopathic Anaemia.) 
 
 This is usually defined as a grave disease of the 
 blood, in which there is destruction of red corpus- 
 
Disease and Its Treatment 333 
 
 cles. The cause is unknown and the condition 
 grows worse. There is pallor, shortness of breath, 
 palpitation of the heart. The patient is tired. The 
 white of the eyes is pearly. The pulse is large but 
 soft. There is headache and vertigo. The food is 
 repugnant. The skin assumes a lemon yellow color. 
 The patient becomes more feeble and the flesh more 
 soft and flabby, and the bed is soon taken. Fever 
 is moderate. The tendency is towards paralysis. 
 The ankles swell slightly. Under osteopathic treat- 
 ment the procedure is about the same as in all 
 cases of anaemia. 
 
 Treatment. The spine is to be carefully examined 
 and all lesions are to be removed as fully as pos- 
 sible. The treatment is general. See general treat- 
 ment. The treatments must be given lightly at first, 
 and as the patient improves they may be given with 
 more force and at greater intervals. At first the 
 treatment should be given daily, later three times 
 per week. This may be reduced to twice and once 
 per week as the patient improves. The treatments 
 should be continued for a long time. Keep the 
 heart stimulated. See Nos. 34, 43, 7C. Constipation 
 and headache should be treated as indicated as 
 under those general heads. 
 
 Diet. Strict attention should be given to the diet. 
 As the patient can handle it, good, nutritious food 
 should be provided. See diet of tuberculosis. Let 
 there be good ventilation. Out of door sleeping 
 would be better. Take plenty of time for sleep. 
 Keep regular hours. Exercise moderately. Give up 
 
334 Practice of Osteopathy 
 
 school for a time and avoid all social functions. 
 Hot baths may be taken twice per week. Take a 
 cold sponge bath, followed by brisk rubbing, each 
 morning. 
 
 Medical Treatment. The bowels should be given 
 attention and should be made to move daily. In 
 chlorosis Blaud's pills are given, which contain 
 two grains of the sulphate of iron. The pills are given 
 in increasing doses. The first week one pill three times 
 per day. The second week two pills three times 
 per day. Third week three pills three times per 
 day. This latter is kept up for three months. 
 
 In progressive pernicious anaemia arsenic in in- 
 creasing doses is used. Three drops of Fowler's 
 solution three times per day is increased to five 
 drops at the end of the first week, ten at the end of 
 the second week and fifteen the third week. Vomit- 
 ing and diarrhoea are symptoms of an overdose. 
 
 Five to ten drops of dilute hydrochloric acid may 
 be given, in all cases, in water, after each meal to 
 aid digestion. 
 
 GOITER, SIMPLE. 
 (Big Neck. Bronchocele.) 
 
 This disease is an enlargement of a whole or a 
 part of the thyroid gland. The causes of this disease 
 have been variously given by different medical 
 writers. Those given, however, are the exciting 
 or secondary causes. The disease is much more 
 frequent in women than in men. The goiter in- 
 
Disease and Its Treatment 335 
 
 creases in size at the menstrual period, and during 
 each pregnancy it becomes larger. It is more prev- 
 alent in limestone regions and often hereditary. 
 
 The growth is painless, but may cause difficult 
 breathing, difficult swallowing or loss of voice. It 
 has caused sudden death by pressure on the vagi 
 nerves. 
 
 The outlook under medical treatment is unfavor- 
 able, guardedly favorable as to life, but the disease 
 is generally cured by osteopathic treatment. The 
 real cause of the disease is an interference with 
 the nerve and blood supply of this very vascular 
 gland. 
 
 The neck should have the tissues thoroughly 
 loosened, both front and back. See Nos. 1, 5, 6, 8B. 
 9, 10, 11. The cervical vertebrae should be lined up 
 if found out of position. See Nos. 1, 3. The clavi- 
 cles should be raised. See Nos. 72, 73. Depress 
 the first rib. See Nos. 75, 76, 77. But little work 
 should be done over the goiter, but it may be 
 raised up gently at each treatment. See No. 8B. 
 In many cases a general treatment will be helpful. 
 See general treatment. Treatment may be given 
 two or three times per week at first. When improve- 
 ment is marked only once per week is indicated. 
 
 EXOPHTHALMIC GOITER. 
 
 (Graves* Disease. Basedow's Disease.) 
 
 This disease not only presents the large neck 
 (thyroid gland), but there is a protrusion of the 
 
336 Practice of Osteopathy 
 
 eyeballs, a rapid heart, and a peculiar muscular 
 tremor. The pulse may be from 100 to 160. The 
 breathing, on exertion, is difficult. 
 
 This disease often yields quite readily to oste- 
 opathic treatment. The procedure is the same as 
 for simple goiter, which see. In addition to this a 
 general treatment is to be recommended as for 
 nervousness. See general treatment. A wet pack 
 may be placed about the neck at night. The patient 
 should avoid excitement and should rest in a re- 
 clining position a great deal. 
 
 PARALYSIS. 
 
 Hemiplegia, paralysis of one side of the body; 
 paraplegia, paralysis of the lower part of the body. 
 In the various forms of paralysis, regardless of what 
 may seem to be the cause, we are to look for lesions 
 in every part of the spine, the ribs, the hips, the 
 innominates and coccyx. When these lesions are 
 found they are to be removed. The lesions in the 
 neck, of the atlas and axis, are very important. 
 Here may be the cause of paralysis in either arm or 
 in any part of the body below this lesion. 
 
 Very many cases of paralysis, including all the 
 types, from infantile to all the more severe types 
 of the aged, have been greatly benefited and cured 
 by Osteopathy. 
 
 In connection with the specific treatment for the re- 
 moval of the lesion, a general treatment should be 
 given. See general treatment. Give special atten- 
 
Disease and Its Treatment 337 
 
 tion to the neck. See Nos. 1, 3, 5, 9, 10, 11. Attend 
 to the clavicles. See Nos. 72, 73. Spinal treatment 
 will be necessary. See Nos. 34, 35, 36, 37, 38, 41, 
 48, 50, 52. 
 
 In some cases it is necessary to give the treat- 
 ment for months in order to get a good blood supply 
 to the nerve centers for the purpose of regenerating 
 them and the nerves most affected. 
 
 The general health must be looked after. Partic- 
 ular attention should be given to the kidneys, 
 bov^els, liver and stomach. The affected limb or 
 limbs should receive a thorough local treatment. 
 
338 Practice of Osteopathy 
 
 INFANTILE SPINAL PARALYSIS. 
 
 Acute Poliomyelitis. 
 
 This disease comes on and develops very quickly. 
 The child may have symptoms of fever, with tem- 
 perature of from 100 to 103 degrees, with some 
 stomach trouble one day, and the paralysis may reach 
 its height the following day. The symptoms vary 
 greatly and there is no certainty of making a correct 
 diagnosis until the paralysis appears. A child may 
 retire at night in apparent health and awaken in the 
 morning with paralysis. Boys are more subject to 
 the disease than girls, and the cases are more com- 
 mon in the warm months. Over eighty per cent 
 of the cases occur before the patient reaches the age 
 of five, but a few young adults have the disease. 
 There is almost no pain and there are no sensory 
 disturbances. If the paralysis persists for a long 
 time there is great muscular wasting in the part 
 affected. In many cases there is recovery of most 
 muscles without treatment of any kind, but a group 
 of muscles almost always remains permanently 
 paralyzed. These are often in one arm or one leg. 
 In one to four weeks there will not be much change 
 in the aflected muscles, but in the following three 
 months there will be some improvement and the 
 paralysis that remains will most likely be permanent. 
 Some have been greatly benefited when one and 
 sometimes two years have elapsed since first being 
 taken with the malady. 
 
Disease and Its Treatment 339 
 
 The Osteopathic treatment should be commenced 
 early. If begun at once we may hope to stop the 
 inflammation in the spinal cord and limit the destruc- 
 tion of nerve cells. When these are destroyed we 
 can only hope for a partial recovery. The part of 
 the cord involved may be determined by the portion 
 of the body affected. If the leg, look for trouble 
 from the eleventh dorsal through to the lumbar por- 
 tion of the spine. If an arm is affected, we expect 
 the cervical and upper dorsal portions of the spine 
 to be affected. Administer the treatment carefully 
 at first. See the treatments for the neck and spine. 
 Keep the limbs warm. Put them through a passive 
 motion, at least three times per day. Friction and 
 massage will be of great value in keeping up the 
 circulation and should be given twice daily for a 
 long time. Some writers recommend that a spinal 
 ice bag be used in the early stages of the disease. 
 This tends to keep down the inflammation of the 
 cord and at the same time helps keep the extremities 
 warm. Do not use braces if you can possibly get 
 along without them. The circulation is better and 
 the improvement is more noticeable when the af- 
 fected parts are entirely free. When there is a great 
 deal of weakness braces often help one to get about 
 and may be used in old cases. 
 
 In cases which are of several years' duration we 
 do not expect to do much, but by giving the spinal 
 treatment there will be improvement for a year or 
 more. We never expect a complete cure. 
 
340 Practice of Osteopathy 
 
 APOPLEXY. 
 
 Cerebral Hemorrhage. 
 
 There are two forms of apoplexy: One, from the 
 rupture of a blood vessel, intracranial hemorrhage; 
 and two, thrombosis or embolism, which is occasioned 
 by accute softening of the brain. The brain, soften- 
 ing, does not give the proper support to the walls of 
 the blood vessels. This is accompanied by endarter- 
 itis, in which the lumen of the vessels is obliterated 
 and embolism and rupture is the result. 
 
 This trouble is more common after the fiftieth 
 year, but may happen in children of ten. Men are 
 more liable to this disease than women. Among the 
 many causes might be mentioned, the overactivity of 
 modern life. There are many men who have at- 
 tained the age of fifty years and have not been guilty 
 of doing any of the things that ordinarily lead to this 
 trouble. They have been temperate in eating and 
 drinking and have not had any venereal diseases, 
 nor have they had gout, but they have had apoplexy 
 as a result of high-pressure living. They have been 
 at a high tension attending to business and social 
 duties all day and a part of the night, without suffi- 
 cient time for needed rest. They find themselves at 
 last with hardened arteries and some form of kidney 
 trouble. 
 
 Overeating is another cause of apoplexy. There 
 are many cases of apoplexy for which there is no 
 other cause. Men really dig their graves with their 
 teeth. We may harm ourselves by overeating as 
 
Disease and Its Treatment 341 
 
 well as by being intemperate in the use of liquor. 
 We need to heed the advice of that old-time physi- 
 cian, Dr. George Cheyne, who said : " Every wise 
 man, after fifty, ought to begin to lessen the quantity 
 of his aliment, and if he would continue free of great 
 and dangerous distempers and preserve his senses 
 and faculties clear to the last he ought, every seven 
 years, to go on abating gradually and sensibly, and 
 at last descend out of life as he ascended into it, 
 even into the child's diet." This advice, if followed, 
 would ward off a number of diseases, including 
 stomach troubles, obesity and kidney diseases. 
 
 Chronic Alcoholism, gout and lead poisoning are 
 also important factors in causing this disease. They 
 change the quality of the blood, and this in turn 
 affects the arteries. They also set up renal changes 
 which affect the blood and arteries as well. In most 
 persons alcohol conserves fat, and this infiltrates in 
 the walls of the blood vessels and weakens them, 
 allowing the blood to force its way through. 
 
 Prolonged Muscular Exertion is a cause. This 
 hardens the arteries by raising the peripheral resis- 
 tance, thereby increasing the blood pressure, which 
 gradually weakens the arteries. 
 
 Undue Blood Pressure in the brain is a great 
 cause of apoplexy. The brain is a great storehouse 
 of energy and nerve force. From it emanate thous- 
 ands of nerve fibers, controlling every function of 
 the body. This great work on the part of the brain 
 requires an enormous amount of nutrition and elimi- 
 nation. This is especially true when the man is a 
 
342 Practice of Osteopathy 
 
 brain worker. This brain nourishment is conveyed 
 through the arteries, veins, capillaries, lymphatics 
 and serous channels which reach the head through 
 the neck. We find surrounding the neck vertebrae 
 more than thirty neck muscles, together with liga- 
 ments. 
 
 In and between these muscles lie the arteries and 
 veins that convey the blood to and from the brain. 
 The blood is pumped under direct pressure of the 
 heart walls of the arteries. But the return blood, 
 through the veins, which have thin walls, is under 
 light pressure and may be held back by obstructions 
 in the neck until undue pressure is exerted by the 
 blood in the vessels of the brain. This pressure 
 often results in the rupture of capillaries, which 
 means apoplexy and paralysis, depending on the 
 amount of blood escaping into the brain tissue and 
 the seat of the lesion. In young persons we expect 
 the capillaries to be more elastic and not to rupture 
 so easily as in the case of older people. 
 
 When there is normal relaxation of the muscles of 
 the neck there is normal circulation to and from the 
 brain. When there is contraction of the muscles, the 
 return flow from the brain is impeded, while the 
 heart is still forcing the blood under increasing pres- 
 sure through the arteries to the brain. This causes 
 heavy, expanding pressure in the capillaries of the 
 brain tissue. The blood cannot return fast enough 
 through the veins on account of interference in the 
 neck. The pressure rises higher and the capillaries 
 break, the oozing blood forms a clot and apoplexy 
 
Disease and Its Treatment 343 
 
 is the result. Overexertion, a little excitement, 
 brings on the attack without the least warning. 
 
 Symptoms. Before the attack it is very rare to 
 have any warning symptoms. The symptoms of the 
 attack vary very much in different individuals. The 
 loss of consciousness may be sudden and complete 
 or it may come on slowly. In many cases the face 
 is cyanotic, pupils are dilated, one more than the 
 other. The respirations are slow and noisy. The 
 pulse manifests increased tension and is slow and 
 full. The temperature is normal or subnormal, ex- 
 cept in cases of basal hemorrhatge, when it is fre- 
 quently high. The head and eyes are often turned 
 toward the side on which the hemorrhage exists. 
 The muscles on the paralyzed side are flaccid. On 
 elevating the paralyzed limb it will fall more quickly 
 than the other. If bed sores develop within forty- 
 eight hours it is a very bad sign. If the patient im- 
 proves there may be paralysis on one entire side of 
 the body. This paralysis will be more severe in some 
 parts than in others, the arm being usually worse 
 than the leg. The paralysis of the throat may be so 
 severe that the patient can not swallow, and the 
 tongue deviates to one side. The reflexes are in- 
 creased after a week or so. When the patient begins 
 to walk he drags the foot of the affected limb. 
 There may appear a condition in which there is 
 secondary contraction of the muscles, more especially 
 of the arm, with considerable pain. 
 
 Diagnosis. It is sometimes difflcult to diagnose 
 this condition. When it is coming on slowly and 
 
344 Practice of Osteopathy 
 
 consciousness is not lost the apoplexy is sometimes 
 not recognized. When you first see the patient and 
 he is in a deep coma it may be the result of epilepsy, 
 alcoholism, ursemia, or diabetes. Doctors in hospital 
 practice need to be very careful in passing upon 
 patients who are admitted in an unconscious con- 
 dition when they have the smell of liquor upon the 
 breath. Many are drunk at the time of an attack. 
 Such cases should be regarded as serious and not as 
 simply alcoholic coma. 
 
 Prognosis is very difficult to make with any de- 
 gree of certainty. When the hemorrhage is slight 
 the patient may entirely recover. When the paraly- 
 sis persists for six months some grade of permanent 
 palsy will remain. When the condition was first 
 caused by an embolism stopping in a principal artery 
 and shutting off the blood supply of a portion of the 
 brain, resulting in softening, the outlook is serious. 
 
 Treatment. The patient should be kept quiet. 
 The head of the bed should be raised. Place an ice 
 bag at the head and use hot water bottles at the feet, 
 not too hot. Place the patient on his side, changing 
 from one to the other. This is for the purpose of 
 avoiding pneumonia. The bowels should be moved 
 freely and a good movement secured every day. It 
 is significant that Dr. Osier says : " No medicine 
 should be administered, at least during the first 
 month after hemorrhage." 
 
 The Osteopathic treatment may be given at once. 
 The muscles of the neck may be gently and 
 
Disease andl Its Treatment 345 
 
 thoroughly relaxed while the patient is in the recum- 
 bent position. See paragraphs 5 and 10. Also 
 loosen the muscles in the suboccipital region, as in 
 paragraph 7B. Keep the spinal tissues relaxed 
 (see paragraph 53), also treat the muscles of the 
 spine while the patient lies on his side as shown in 
 Figs. 59 and 31. Give inhibitive treatment over the 
 abdomen, as in paragraphs 94 and 100. This treat- 
 ment should be given twice per day at first, gradually 
 diminishing until two treatments are administered 
 per week. The paralyzed limbs should be treated 
 and massaged to prevent contraction of the muscles. 
 The joints of the elbow and shoulder may be kept 
 from ankylosis by properly manipulating them. 
 
 The diet should be very light for some time, at 
 least one month. Fruit juices are to be preferred. 
 Light broths may be used. The patient should al- 
 ways, as long as he lives, be underfed rather than 
 overfed. Avoid meat and all nitrogenous food. Do 
 not drink more than one and a half quarts of water 
 daily. The object is tO' keep down the amount of 
 blood as much as possible. 
 
 Avoid all excitement as much as possible, live 
 quietly and do not overexert, either mentally or 
 physically. Do not use intoxicants. The patient is 
 often easily irritated, but he should avoid becoming 
 angry. A cheerful, happy and hopeful disposition 
 should be cultivated. Some light mental occupation 
 will be beneficial, but it should not be persisted in 
 when the patient becomes weary. 
 
346 Practice of Osteopathy 
 
 INSOMNIA. 
 (Sleeplessness.) 
 
 Insomnia may be due to various causes. Con- 
 gestion or anaemia of the brain, Bright's disease, 
 liver, stomach and intestinal disorders may cause 
 sleeplessness, or it may be due to nervousness or 
 excessive headache. The Osteopath believes, and 
 has splendid success in following it out to its legiti- 
 mate conclusions, that the basis of the trouble may 
 be found in some bony, ligamentous or other lesion, 
 that disturbs the circulation and allows pressure to 
 disturb proper nerve function. A large number 
 of these cases are met and successfully overcome 
 by the Osteopath. Frequently an improvement is 
 noted with the first treatment. In many cases but few 
 treatments are required. 
 
 In treating for this disorder the Osteopath looks 
 for neck and upper spinal lesions. He pays partic- 
 ular attention to the clavical and two upper ribs. 
 See Nos. 72, 73, 75 to 81. 
 
 Fully relax all spinal tissues. See Nos. 34, 36, 43, 
 44, 53. Give a strong abdominal treatment. See 
 Nos. 94 to 100. After the specific lesions, that are 
 found, are treated, a general treatment is in order. 
 See general treatment. 
 
 When the person is excitable and there is a feel- 
 ing of distension in the head, it will be well to keep 
 the bowels regular. See the treatment for consti- 
 pation. At night before retiring a hot bath, fol- 
 lowed by a cool sponge bath, will be beneficial. 
 
Disease and Its Treatment 347 
 
 Another help is a cold pack applied to the abdomen. 
 This soon becomes warm and draws the blood there. 
 See cold pack. Ten minutes of good, cool, pure air, 
 breathed properly, will materially assist in gaining 
 needed rest. See correct breathing. It is often rec- 
 ommended that a glass of warm milk be taken just be- 
 fore retiring. Medical writers recommend a dose of 
 trional, ten to twenty grains, to be given with food 
 half an hour before retiring. 
 
 If the insomnia is caused by anaemia of the brain 
 the patient is apt to start sleeping very well, but 
 wakes later and can not fall asleep again. In ad- 
 dition to the osteopathic treatment as outlined 
 above, cold water or ice, then hot water, may be 
 applied to the spine in long rubber bags, each for 
 fifteen minutes. For this form of insomnia medical 
 treatment would recommend some form of stimu- 
 lant at bed-time, say one-sixtieth of a grain of 
 strychnine, or some form of alcoholic drink. 
 
 NEURALGIA. 
 
 (Facial Neuralgia, Brachial Neuralgia, Intercostal 
 
 Neuralgia, Spinal Neuralgia, Neuralgia of 
 
 the Stomach, Tic Douloureux.) 
 
 Neuralgia is a severe pain along the course of a 
 nerve, unaccompanied by any change in the body 
 of the nerve. 
 
 The Osteopath usually finds some bony or mus- 
 cular lesion causing pressure on the nerve or on 
 some of its connections. A misplaced vertebra is 
 
348 Practice of Osteopathy 
 
 a very common cause. In cases of facial neuralgia 
 we expect to find contracted muscles in the neck 
 or a misplaced atlas or axis, the first and second 
 cervical vertebrae. Treatment for this would be as 
 in Nos. 1, 3, 5. In brachial neuralgia, which in- 
 volves the arm and shoulder, we look for lesions 
 from the first cervical to the sixth dorsal. This will 
 be treated as in Nos. 1, 3, 5, 9, 10, 11, 34, 43. All 
 the upper spinal and neck tissues will be relaxed 
 as in Nos. 5, 83, 34. Intercostal neuralgia is easily 
 handled and is frequently caused by a twisted or 
 misplaced rib or ribs too close together. Treat as 
 in Nos. 75 to 89. Thoroughly relax all spinal tis- 
 sues, as in Nos. 35, 36, 47, 48, 50. 
 
 Spinal neuralgia and neuralgia of the stomach 
 will be caused by misplaced vertebrae, the stomach 
 lesions occurring from the fourth to the eighth 
 dorsal. See spinal treatments. Nos. 43, 34. 
 
 Tic douloureux is a neuralgia of one or more 
 branches of the fifth nerve, and lesions are looked 
 for in the upper dorsal and cervical regions. A 
 misplaced atlas or axis is most frequently to blame 
 for the condition. Treat as in Nos. 1, 3. Pay atten- 
 tion to the upper back tissues, as in Nos. 34, 43. In 
 many cases a thorough abdominal treatment will be 
 of assistance. See Nos. 94 to 100. In all cases of 
 neuralgia or of neuritis the muscles and nerves 
 should be relaxed. 
 
 In facial neuralgia, tic douloureux and brachial 
 neuralgia a hot water bag may be applied to the 
 back of the neck and the upper dorsal region. Tic 
 
Disease and Its Treatment 349 
 
 douloureux has been helped locally by the appli- 
 cation of the inner skin of a fresh egg, sprinkled 
 with black pepper. Some medical writers in cases 
 of tic douloureux recommend one one-hundredth of a 
 grain of nytroglycerine until relief is obtained. 
 
 PEDAL NEURALGIA. 
 (Neuralgia of the Feet. Tarsalgia.) 
 
 This is often caused by a broken-down arch of the 
 foot. The patient should rest as much as pos- 
 sible. Let the shoes have broad, thick soles. Some- 
 times it is best to have a supporting arch, made 
 of steel and covered with leather, for the instep. 
 They may be found in many shoe stores. The 
 foot should be manipulated. See Nos. 117, 118. 
 
 ERYTHROMELALGIA. 
 (Red Neuralgia of the Feet.) 
 
 This is a disease of the feet, characterized by 
 pain and extreme redness of the feet. In some cases 
 there is so much swelling that the patient is un- 
 able to walk. The condition is worse in warm 
 weather. The disease is accompanied or generally 
 followed by some disease of the spine or some 
 severe nervous trouble. 
 
 From the medical standpoint the cause is un- 
 known, but is due to a disturbance of nerve function 
 due to pressure, disturbing nerve impulses. 
 
 The treatment should be directed to the removal 
 
350 Practice of Osteopathy 
 
 of any lesions found in the spine. A thorough re- 
 laxing treatment should be given in the lower dorsal 
 and lumbar region. See Nos. 43, 36, 41, 48, 51, 52. 
 
 Should the pelvis or either innominate bone be 
 out of place, proper correction should be made. 
 See lesions of the pelvis and innominates. Work 
 on the tissues of the legs, as in Nos. 113, 116. Per- 
 form circumduction and extension, as in Nos. 113, 
 114. Manipulate the foot, as in Nos. 117, 118, 119. 
 Put the muscles on a torsion, as in Nos. 121. 
 
 Should there be any other disease it should re- 
 ceive its proper treatment. Some of these cases 
 are badly constipated. 
 
 In some cases great relief is experienced by 
 putting the foot in ice-cold water. Keep the feet 
 elevated and rest as much as possible when the 
 attack is severe. 
 
 INTERCOSTAL NEURALGIA. 
 
 (Pleurodynia. Muscular Rheumatism.) 
 
 This affection is generally classed as muscular 
 rheumatism. It causes intense pain, which is ag- 
 gravated by the breathing. The ribs should be 
 separated and lifted up as in Nos. 86, 82. 
 
 Some of the hot applications should be applied 
 as recommended in lumbago, which see. 
 
Disease and Its Treatment 351 
 
 TORTICOLLIS. 
 
 (Stiffneck.) 
 
 The muscles of one side of the neck are very 
 stiff and sensitive, frequently drawing the head 
 to the affected side. Lesions of the neck should 
 be removed. These are the direct cause of the dis- 
 turbance by making pressure on the nerve. When 
 this pressure is removed a permanent cure should 
 be effected. Thoroughly relax all tissues of the 
 neck. See Nos. 1, 3, 5, 9, 10, 11, 12, 13. Replace 
 any vertebra which may be out of its proper posi- 
 tion. Nos. 1, 3. Local hot applications as in lum- 
 bago will be found to be helpful. 
 
 MUSCULAR RHEUMATISM. 
 
 This is a painful affection of the voluntary mus- 
 cles in various parts of the body. The attacks fol- 
 low exposure to cold, wet, and exposure especially 
 after a severe bodily exertion. One attack renders 
 others more liable. Some writers consider this dis- 
 ease a form of neuralgia, rather than rheumatism. 
 The varieties of this disease are often named from 
 the portion of the body affected, as lumbago, tor- 
 ticollis, pleurodynia, cephalodynia, etc., all of which 
 see for treatment. 
 
352 Practice of Osteopathy 
 
 LUMBAGO. 
 
 This is a rigid, painful condition of the muscles 
 in the lower part of the back. Stooping or turning 
 the body or any sudden movement causes pain. It 
 is caused by an affection of the lumbar vertebrae, 
 causing an inflammation of nerves supplying the 
 muscles of the back in this region. 
 
 Treatment. The muscles should be gently re- 
 laxed, as in Nos. 43, 44, 47, 48, 50, 52, 53, 57. The 
 spine should be gently stretched and rotated, as in 
 Nos. 58, 59, 60, 61. This is done for the purpose 
 of taking the pressure off the nerves. Hot fomenta- 
 tions should be used. See treatment of acute artic- 
 ular rheumatism. Hot water bags may be applied, 
 or sacks filled with hot salt or hops. A heav} piece 
 of flannel may be applied and a warm flat iron may 
 be used over it for a few minutes, literally ironing 
 the back. This treatment is very efficient. Pressure 
 is helpful. 
 
 Acupuncture has been highly recommended. Take 
 an ordinary bonnet needle, three or four inches 
 long. Sterilize it and thrust it into the lumbar 
 muscle at the seat of pain. Leave it there for 
 five or ten minutes. The needle should be thorough- 
 ly sterilized. 
 
 The best treatment, though, is the osteopathic, 
 as outlined first, the manipulation of the spine 
 and spinal muscles and ligaments. Those who 
 suffer from periodic attacks of the disease may be 
 permanently cured in this manner. 
 
Disease and) Its Treatment - 353 
 
 Long and successful experience in treating this 
 disease has led me to believe that often we are wrong 
 in ascribing the cause of this trouble to the poor 
 alignment of the lumbar vertebrae. It is rather 
 caused by poor circulation, that does not permit the 
 venous blood properly to escape from the lumbar 
 portion of the spinal cord which, in turn, overstimu- 
 lates the spinal nerves and causes them to send too 
 many nerve impulses. This makes the muscles 
 which they supply over tense. 
 
 In many cases I have treated there would be im- 
 mediate relief and the patient could make very free 
 movements without any discomfort, but in a few 
 hours the trouble would appear and give as much 
 pain as ever. One evening I was called to treat a 
 very strong and muscular young man, who had been 
 suffering wnth lumbago for several days, and had it 
 so severely that he could hardly move in bed. After 
 treating him about one half hour in the regular way 
 I discovered that about the only relief I could give 
 him was steady pressure on the spine while he was 
 lying face downward. The bed was rather low and 
 he was lying on the side, when I applied some weight 
 with both knees, and upon his saying, " Doctor, I feel 
 it going out," I applied my entire weight and walked 
 with my knees for fully five minutes on the lumbar 
 portion of his spine. I weighed then over 200 
 pounds. But you must bear in mind that he was 
 more than an ordinarily strong man. 
 
 He immediately arose from his bed and dressed 
 and insisted on my remaining for dinner. His folks 
 
354 
 
 Practice of Osteopathy 
 
 looked upon his appearing at the table much as they 
 would had a miracle been performed. He came to 
 the office for further treatment, next day. The 
 treatment was then applied with the knees for about 
 five minutes, and there was no further return of the 
 trouble. 
 
 This treatment inhibited nerve impulses and im- 
 proved the circulation to the spinal cord. 
 
Disease and Its Treatment 355 
 
 MENTAL DISORDERS. 
 Insanity. 
 
 Insanity is a mental disorder marked by delusions, 
 illusions and hallucinations, by changes in character 
 and habits, and by unreasonable actions and language. 
 It is more or less permanent in character, but with- 
 out loss of consciousness or will. 
 
 There are many causes for some forms of insan- 
 ity, which an Osteopath will fail to find. There are 
 causes which his or any other form of treatment can 
 not reach. But when the general treatment is given, 
 paying particular attention to the cervical region, the 
 patient will be benefited under Osteopathic treat- 
 ment. Many cases of insanity are due to an accident 
 of some kind in which the head or neck is involved. 
 Many of these patients become mentally unbalanced 
 at once, while others are affected gradually. The 
 extent which Osteopathy will cover in this field of 
 psycho-pathological conditions as a therapeutic agent 
 is still unknown. Osteopaths are not given the op- 
 portunity to get hold of such patients in large num- 
 ber, but what experience they have had has been 
 very gratifying. 
 
 I have known patients who had become violently 
 insane as the result of an accident. It was necessary 
 for strong men to hold them while an Osteopathic 
 
356 Practice of Osteopathy 
 
 treatment was being administered. After the treat- 
 ment they would fall asleep. After waking they 
 were entirely rational. A prominent Osteopath, be- 
 fore studying the science, was confined in an insane 
 asylum in Iowa. In some way he became possessed 
 with the idea that if he could get to an Osteopath he 
 would be cured. He escaped, went several hundred 
 miles in search of the treatment, and was entirely 
 cured, after which he became a splendid Osteopath 
 and enjoys a large practice. 
 
 My experience with insanity has been limited, but 
 the treatment has proved very quieting and benefi- 
 cial, even when the case was of long standing. 
 
 We may expect to find serious trouble in the neck, 
 in vertebrae, ligaments and muscles. The deeper 
 muscles here are very strong, and when they become 
 tense as a result of some nerve irritation are often 
 abnormally tense, and thus act as obstructions to 
 various vital fluids. For the treatment read care- 
 fully all about the various treatments of the neck. 
 The ribs and dorsal vertebrae should be carefully 
 examined and treated. 
 
 In recent cases we may expect the best of results. 
 In other cases look for considerable improvement. 
 
Disease and Its Treatment 357 
 
 ST. VITUS' DANCE. 
 (Chorea.) 
 
 Chorea is a disease characterized by an incoordi- 
 nate movement and twitching of the muscles either 
 local or general. There is often some slight psychic- 
 al disturbance and great liability to endocardi- 
 tis. About three-fourths of the cases are girls be- 
 tween the ages of five and seventeen. In many 
 cases the disease is hereditary. Among the excit- 
 ing causes may be mentioned fright, worry, grief, 
 modern forced methods of education, eye diseases 
 or weakness. 
 
 The Osteopath expects to find some anatomical 
 lesions as a predisposing cause, the correction of 
 which leads to the cure of the disease. 
 
 The symptoms manifested in chorea have such a 
 wide range and are so varied in character that for 
 convenience they are classified under three divi- 
 sions in which the mild, severe and most severe or 
 extreme cases are described. The disease generally 
 attacks a hand with a jerky motion, then attacks 
 the face, and later the legs. In the mild forms only 
 the hand or hands and face are attacked. The child 
 is restless, cries easily and often. There is head- 
 ache and pains in the limbs. The patient loses the 
 temper frequently and is easily frightened at night. 
 
 In the severe forms the trouble becomes more 
 general in character. The speech is affected and 
 the patient may be unable to dress and attend to 
 
358 Practice of Osteopathy 
 
 ordinary duties. The extreme form may develop 
 into insanity. 
 
 Treatment. The disease yields most readily to 
 osteopathic treatment. The lesions are usually in 
 the upper dorsal and cervical regions. Muscular 
 tissues are found in a tightened condition. Of 
 course the first thing for the Osteopath to do as 
 soon as possible is to remove the lesion. In addi- 
 tion, a thorough general treatment is indicated. 
 See general treatment. Special attention should 
 be given to the groups of muscles most affected. 
 They should be thoroughly massaged, and the limb 
 or arm, as the case may be, thoroughly manipulated. 
 See Nos. 113, 114, 131. Treatment should be given 
 daily until the patient is better, then three times per 
 week and later twice per week. The cases ordi- 
 narily call for a long course of treatment. 
 
 Make sure that there are no intestinal worms, 
 eye strain, sexual disorders, cause for worry, mental 
 strain, overwork or severe muscular exertion. At- 
 tention should be given to the heart and bowels. 
 See constipation. A soap suds enema may be used 
 when necessary. 
 
 The Diet. Sweets and starches are better left 
 alone, otherwise the patients may be encouraged to 
 take as much nourishing food as they can digest. 
 Meat, eggs, oysters, fish with plenty of green vege- 
 tables are recommended. 
 
 A warm bath on retiring and a cool sponge bath 
 with a brisk rub on rising will be found to be bene- 
 ficial. 
 
Disease and Its Treatment 359 
 
 EPILEPSY. 
 
 This disease is an affection of the nervous system, 
 marked by attacks of unconsciousness occurring at 
 irregular intervals. There may be convulsions. If 
 they are severe general convulsions it is called 
 Grand Mai. Localized convulsions, without loss 
 of consciousness, is known as epileptiform, or corti- 
 cal, or Jacksonian epilepsy. 
 
 Cause. Osteopaths find various spinal and rib 
 lesions, which when removed have cured a fair pro- 
 portion of cases. Syphilis and alcoholism, on the 
 part of parents, are believed to be a prolific cause 
 of this disease. In some cases it has been caused 
 by worms, an adherent prepuce, foreign bodies 
 in the ear or nose, or some other local affection 
 setting up reflex influences. 
 
 Symptoms. Grand Mai. In most cases there is 
 an aura or subjective symptom in some part of the 
 body which warns the patient of the impending 
 attack. This aura may be a peculiar sensation in 
 the hand or foot or heart or stomach. With others 
 it seems to be a flash of light or some form of per- 
 verted appetite. The patient often utters a cry or 
 yell, the epileptic cry, and falls where he is as if 
 shot. The first spasm, which lasts but a few se- 
 conds, is followed by convulsions, during which 
 the patient may froth at the mouth. He may al- 
 so lose control of the bladder and bowels. From 
 this he passes into a sleep when he is in a relaxed 
 condition. On awakening he complains of fatigue. 
 
360 Practice of Osteopathy 
 
 Petit Mai. The patient becomes unconscious for 
 but a moment. The expression becomes blank and 
 the face pale. A person talking to him will be 
 conscious of the condition, but the patient is some- 
 times not. The patient does not fall and frequently 
 picks up the thread of the conversation and con- 
 tinues it. 
 
 Jacksonian Epilepsy. A spasm that is only local 
 and affects a hand or arm or a single group of mus- 
 cles. There is generally an aura, but the con- 
 ciousness is preserved. 
 
 Epilepsy may be distinguished from hysteria by 
 the sudden onset with a cry, without apparant cause, 
 the rigidity followed by convulsions and biting of 
 the tongue. There may be defecation or micturi- 
 tion, but no talking. 
 
 Hysteria comes on gradually, with emotions pre- 
 ceding. If there is a cry it is during the attack. 
 They bite other things than the tongue and talk 
 frequently, but there is no micturition or defecation. 
 The attack may be terminated by the use of water. 
 
 Treatment. The best osteopathic authorities have 
 found various lesions from the neck to the lumbar 
 region, including rib lesions, which have been the 
 cause of the disease. The neck lesions are the most 
 frequent, and we should make diligent search for 
 them for the cause of the disease. At the time of 
 the attack we need not expect to do much for the 
 case. Strong treatment and pressure at the base of 
 the skull, suboccipital fossae, helps some cases (see 
 No. 7B), while others are helped by treatment over 
 
Disease and Its Treatment 361 
 
 the solar plexus. See No. 100. Give a thorough 
 abdominal treatment for the purpose of calling the 
 blood away from the head. A thorough general 
 treatment should be given at least three times per 
 week. Lesions wherever found should be removed. 
 See general treatment. Especial attention should 
 be given to the neck treatment. See Nos. 1, 3, 5, 
 9, 10, 11, 13. Have the patient open the mouth 
 against resistance. See No. 8. The clavicles should 
 be elevated and the first rib depressed. See Nos. 72, 
 73, 75, 80. 
 
 The cervical sympathetic nerves should be treated. 
 See No. 7C. The bowels and stomach should re- 
 ceive attention. See stomach. Stomach and in- 
 testinal indigestion may act as a cause by allowing 
 the food to ferment and poison the system, causing 
 autointoxication. The diet should be light and nu- 
 tritious and easily digested. Indigestible food should 
 be forbidden. See dyspepsia. 
 
 In children adenoid growths should be looked 
 for, and in a male child if phimosis exists it may be 
 necessary to perform circumcision, or at least to 
 break up adhesions. Should there be evidences of 
 digestive disturbances with constipation treat as 
 such. 
 
 The Medical Treatment. With children 25 to 50 
 grains of sodium bromide are given per day, giving 
 the larger part of it a short time before the seizure 
 generally occurs. The dose is alwaj^s largely di- 
 luted with water, say a glass three-fourths full. 
 Should there be chronic constipation a dose of 
 
362 Practice of Osteopathy 
 
 calomel is recommended once per week, followed in 
 a few hours by a dose of salts, an enema of salt 
 water, a tablespoonful of salt to a quart of water, 
 to be given twice per week. An adult may take a 
 drachm to a drachm and a half of sodium bromide 
 daily, sometimes at a single dose. This drug is 
 best taken under the direction of a physician, as it 
 must be taken a long time and the system must be 
 saturated with it, certain diagnostic symptoms of 
 which must be watched for and kept at that point. 
 By all means the osteopathic treatment as out- 
 lined above should be given a thorough trial first. 
 
 NEURASTHENIA. 
 (Nerve Exhaustion.) 
 
 Neurasthenia is a nerve disorder, in which there 
 is nervous and bodily weakness. This is accom- 
 panied by irritability. The disease is very common 
 in America. It is due to hereditary weakness, ex- 
 cessive expenditure of nerve force, and in most 
 cases anatomical misplacements which impair nerves 
 by pressure direct and interference with proper nu- 
 trition. Other causes are manifest, as, living at too 
 rapid a rate, overwork, overstudy, worry, mental 
 depression, the use of tobacco, alcohol, sexual over- 
 indulgence, indigestion, gout, rheumatism, la grippe 
 and malaria. 
 
 The symptoms are many and varied and differ in 
 different individuals. Headache is common and 
 may be either at the base of the skull, in the fore- 
 
Disease and Its Treatment 363 
 
 head or in the top of the head. Some complain of 
 a constricting band about the head. The memory 
 is poor, the patient is afraid of places and things, 
 and is irritable. There is pain in different parts of 
 the spine. The limbs feel weak. The patient com- 
 plains of hot flashes and has cold sensations. The 
 flesh turns blue in spots. There may be constipa- 
 tion, indigestion, dyspepsia, palpitation of the heart 
 and various affections of the eyes and ears. 
 
 Treatment. All lesions should be sought for and 
 removed. A gentle general treatment may be given 
 each day for awhile. Then three times per week, 
 reducing to once per week, as the patient grows bet- 
 ter. See general treatment. The treatment must 
 be a searching one and complete. Warm baths 
 twice per week at night. A cold sponge bath fol- 
 lowed by brisk rubbing each morning will prove 
 of benefit. Rest, with moderate exercise and good 
 food, is essential. The treatment must be kept up 
 for a long time. 
 
 SCIATICA. 
 (Sciatic Rheumatism.) 
 
 This disease is an inflammation or neuritis of the 
 sciatic nerve, or of the nerve cords which form the 
 sciatic nerve. In some cases it may be a neuralgia. 
 
 The pain frequently comes on gradually, but it 
 may be sudden and very severe. At first it may be 
 a dull pain in the back of the thigh, but later it may 
 spread down the limb even to the bottom of the foot. 
 In some cases it is complicated with lumbago. 
 
364 Practice of Osteopathy 
 
 The osteopathic treatment is directed to the re- 
 moval of any lesions that may be present in the low- 
 er part of the back. The tissues are fully relaxed, as 
 in lumbago. The work is carried down carefully 
 over the affected nerve and limb, all tissues being 
 thoroughly relaxed. See lumbago and Nos. 113, 51, 
 52. The pyriformis muscle, which lies across the 
 trunk of the nerve, is frequently contracted and 
 causes pressure on the nerve. This may be stretched 
 by strong internal circumduction of the limb. See 
 No. 114. 
 
 The nerve may be stretched carefully, as in No. 
 115. Careful treatment followed up in this manner 
 will remove all irritation and result in a permanent 
 cure. 
 
 Heat will prove beneficial, used along the course 
 of the nerve by the application of the hot water 
 bag. When the pain is severe an ice bag applied to 
 the spine in the lumbar region will prove helpful. 
 
 HYSTERIA. 
 
 Hysteria is a functional disease of the nervous sys- 
 tem. It is characterized by loss of self control, and 
 accompanied by disorders of all or of a part of the 
 bodily functions. It occurs most frequently in wom- 
 en and children. 
 
 Osteopaths look for the primary cause in some 
 bony lesion of the spine, or ribs, or pelvic bones, 
 or some malposition of some organ. The secondary 
 causes may be emotional disturbances, mental or 
 
Disease and Its Treatment 365 
 
 physical strains, domestic troubles, masturbation, 
 sexual excesses, ovarian or uterine diseases. 
 
 The symptoms cannot be said to follow any fixed 
 rule, as a hysterical patient can imitate any symptom 
 or diseased condition. The patient frequently feels 
 a ball in the throat, which seems to come from be- 
 low and produces a choking sensation. This is re- 
 ferred to in medical literature as " globus hysteri- 
 cus." There may be convulsions, after which the 
 patient seems to be bloated with gas, and passes 
 large quantities of urine. The voice is often lost 
 and the various forms of paralysis are often simu- 
 lated. The joints may become stiff and there may be 
 spasms. Intense pain may develop in the head, 
 spine, abdomen, or ovarian region and in the breast. 
 There may be rapid and difficult breathing, vomit- 
 ing and nausea. The temperature is nearly always 
 normal. 
 
 Treatment. Particular attention should be given 
 to the lower ribs. They are often found displaced, 
 generally downward. See Nos. 90, 91, 92, 93. The 
 intestines should be lifted up. See Nos. 96, 97. A 
 general relaxing treatment should be given. See gen- 
 eral treatment. Remove any lesions found in the 
 spine or ribs. A change of enviroment may be 
 helpful in many cases. The patient should be dealt 
 with kindly, yet firmly. If possible, get the patient 
 to exercise self control. A warm tub bath twice per 
 week and a cold sponge bath every morning, fol- 
 lowed by a brisk rub, will prove helpful. Out of 
 door exercise should be taken each day. If a child, 
 
366 Practice of Osteopathy 
 
 avoid overstudy under competitive methods. Avoid 
 over indulgence of every nature. Let the diet be 
 plain, but there should be plenty of nutriment. 
 
 OCCUPATION NEUROSIS. 
 
 Telegrapher's cramp or telegrapher's paralysis, 
 writer's cramp, or paralysis, pianist's paralysis, milk- 
 er's paralysis, cigar maker's paralysis, are all due to 
 the over-use of the nerves through the over-use of 
 certain groups of muscles used in some occupations. 
 
 Osteopaths find, in most cases, some obstruction 
 to the nerve force, through pressure, which acts as 
 a primary cause of the difficulty. Sometimes the 
 first, second and third ribs are too close together. 
 Frequently the cervical and upper dorsal vertebrae 
 are affected. In some cases the clavicle is too close 
 to the first rib. 
 
 The very worst of these cases make good progress 
 under osteopathic treatment. Remove the lesion 
 in every case. All tissues in the neck, shoulder and 
 arm should be relaxed as in a general treatment, 
 which see. Stretch the elbow and shoulder joints. 
 See Nos. 129, 130, 131. Give the arms thorough 
 treatment. See treatment for arms, No. 131. See 
 treatment for ribs and clavicles. Sometimes rest is 
 necessary. The clothing should be loose. Let noth- 
 ing interfere with the circulation. 
 
Disease and Its Treatment 367 
 
 PARALYSIS AGITANS. 
 (Parkinson's Disease: Shaking Palsy.) 
 
 A chronic nervous disease, characterized by tre- 
 mor or rapid alternate contraction and relaxation of 
 the muscles, a peculiar gait and speech and progress- 
 ive loss of power. 
 
 The causes are found in spinal and upper rib 
 lesions, v^hich weaken the nervous system, rheu- 
 matism, rheumatoid arthritis, exposure, fright and 
 mental anxiety. It is a disease that affects men 
 more than women and is more frequently found be- 
 tween the ages of forty and sixty. 
 
 The first appearance is in a muscular tremor, gen- 
 erally of the forearm. The thumb and forefinger are 
 approximated and have been spoken of as " the act 
 of making a pill." The head is not often involved, 
 but when it is the motion is a nodding one. When 
 the patient is sleeping the tremors cease, and some- 
 times when the patient does something in which he 
 forces the affected parts to act, the tremors are 
 quiet but are resumed immediately when the act is 
 completed. 
 
 In walking, the head is bent forward, the steps 
 are short and hurried, gradually, in some cases, be- 
 coming faster until it seems as if the patient was 
 about to fall. In severe cases he must stop and hold 
 to something before getting a fresh start. 
 
 The face has a peculiar aspect, spoken of as " the 
 mask-like expression," due to the set condition of 
 the facial muscles. Ordinarily the disease has a 
 
368 Practice of Osteopathy 
 
 long, slow course and the patient generally dies of 
 some other disease. One may not expect help of 
 the regular medical treatment. The leading works 
 on the subject offer no hope of a cure. 
 
 Treatment. The neck and the upper part of the 
 back and the ribs should have a careful examination, 
 and all lesions found should be carefully removed. 
 See treatment of neck, spine, ribs and clavicles. 
 
 This disease has conditions that require a gen- 
 eral osteopathic treatment. See general treatment. 
 In addition to the removal of all departures from the 
 normal which are found, the neck, shoulders and 
 spinal tissues should be thoroughly relaxed. See 
 N'os. 1, 5, 8B, 34, 43, 53. Give special attention to 
 the treatment of the kidneys, liver and bowels. 
 
 Salt baths may be given twice per week. The pa- 
 tient should take exercise, but should stop before 
 becoming very tired. 
 
 SPASTIC PARAPLEGIA. 
 
 This is a disease of the spinal cord, in which there 
 is a loss of muscular power. There are exaggerated 
 reflexes, a peculiar gait and precipitate micturition. 
 
 The disease is more apt to occur in a family with 
 a nervous history. It is frequently brought on 
 through exposure, accidents resulting in blows, falls, 
 etc. It may also follow some of the acute diseases. 
 
 In most cases the onset of this disease is slow. 
 Weakness of the lower limbs is a symptom. The 
 patient complains of feeling tired and has increasing 
 
Disease and Its Treatment 369 
 
 difficulty in walking. The muscles frequently be- 
 come rigid. This rigidity assumes the nature of a 
 passing spasm. When the disease is further ad- 
 vanced the legs grow weaker and stiffen When the 
 patient walks the toes scrape the ground. The 
 Osteopath looks for lesions along the spine, and ex- 
 amines the ribs to see that they are in a normal posi- 
 tion and treats as in locomotor ataxia, which see. 
 
 LOCOMOTOR ATAXIA. 
 
 This is a nervous disease, caused by a hardening 
 of the posterior columns of the spinal cord. The 
 disease is characterized by loss of coordination of 
 the muscles. When the patient stands with the 
 heels close together, with the eyes shut, there is a 
 tendency to fall (Romberg's symptom). With the 
 arms stretched from the sides the patient is unable 
 to approximate the forefingers with the eyes closed. 
 The walking is peculiar. The limbs are lifted high- 
 er than necessary and brought down with vigor. 
 There is a slight staggering and difficulty in walk- 
 ing at night. When lying, the patient finds difficulty 
 in bringing the heel of one foot to the knee of the 
 other leg. The muscles have a tendency to waste. 
 
 The disease is frequently a long time in develop- 
 ing, and may be in progress a number of years, with 
 but little notice of the patient. There are occasional 
 pains in the legs, slight changes in vision, often an 
 impairment in sexual power, sometimes, though 
 rarely, an increase. Later the pain in the limbs be- 
 
370 Practice of Osteopathy 
 
 comes more pronounced. There is a boring sensa- 
 tion, coming and going with great rapidity, termed 
 lightning pains. The pupils fail to contract to light. 
 To determine this symptom, darken the room for 
 awhile. Then hold a lighted match before the pa- 
 tient's eye. The pupil, if it contracts at all, does 
 so very slowly. This is known as the Argyll-Rob- 
 ertson pupil. There is loss of knee jerk. To de- 
 termine this symptom, have the patient sit on the 
 side of the table with the feet hanging, not touch- 
 ing the floor. Strike the tendon, just below the pa- 
 tella, a sharp blow with the edge of the palm of 
 the hand. If in normal condition the foot will kick 
 out. If there is probably locomotor ataxia it will re- 
 main stationary. 
 
 Diagnosis. The Argyll-Robertson pupil, Rom- 
 berg's sign, lightning pains and absence of knee jerk 
 are enough of the symptoms to determine that the 
 patient has locomotor ataxia. 
 
 Prognosis. While but little can be promised as 
 far as a cure is concerned, there are few if any cases 
 that will not be helped and many may be helped to 
 a large extent by osteopathic treatment. Of course, 
 the earlier the treatment is begun the better. In a 
 great many cases the progress has been checked. 
 Control of bladder and rectum is regained, and many 
 cases which had lost the power of walking regained 
 this function under treatment. 
 
 Treatment. This disease requires a general spinal 
 treatment, with special attention to all specific 
 lesions of the spine and ribs. See general treat- 
 
Disease and Its Treatment 371 
 
 ment. The lower limbs should also receive careful 
 attention and manipulation. Care must be taken 
 not to fracture the long bones, as in this disease 
 there is a predisposition to fracture. We must not 
 forget thorough abdominal work. See Nos. 94 to 
 103. Special attention should be given to this. 
 Tone up the solar plexus. The regular treatment 
 should be given three times per week. The author 
 would recommend as a home treatment, in addition 
 to the above, each day the application of a long ice 
 bag to the spine for fifteen minutes, followed by a 
 hot water bag for fifteen minutes, then the ice again, 
 followed by the hot water, in all an hour's treat- 
 ment. This will serve to promote the circulation in 
 the spinal cord. The application of the ice bag 
 alone will help to relieve the lightning pains. It is 
 well for the patient to exercise, but he must avoid 
 overexertion. 
 
 The ataxia may be overcome in part by the con- 
 tinued practicing of fine movements. Some of 
 these may be executed by the patient with the limbs 
 as he lies on his back. 
 
 SICK HEADACHE. 
 (Migraine, Hemicrania, Cephalgia.) 
 
 Migraine is an intense headache, occurring fre- 
 quently, with or without disturbances of vision or of 
 nausea. Medical writers as a general rule claim 
 that no lesions h^ve been discovered, but Osteopaths 
 frequently find neck lesions, also upper dorsal 
 
372 Practice of Osteopathy 
 
 lesions, the removal of which has resulted in cures. 
 
 The patient can tell for some time previous when 
 an attack is to be expected, by the sensations and 
 symptoms peculiar to each given case. The pain 
 at the beginning of an attack is on both sides of 
 the head, but after awhile it localizes on one side. 
 With some patients the attack localizes on one side 
 at one time ; at the next time it localizes on the other 
 side. Some cases continue from childhood to old 
 age. 
 
 Most of the lesions have been found in the neck 
 and upper dorsal region, though some have been 
 found in the lower dorsal and lumbar regions. 
 Stomach troubles, uterine misplacements, eye strain, 
 and tumors are sometimes responsible. These causes 
 must have special treatment. 
 
 Treatment. The neck must be thoroughly ma- 
 nipulated. See Nos. 1, 3, 5, 7, 9, 10, 11, 13. All 
 spinal muscles and tissues should be relaxed. Nos. 
 4, 43, 48, 53. The abdomen should receive a deep 
 inhibitive treatment. Nos. 94 to 99. Give heavy 
 pressure over the solar plexus. No. 100. Misplaced 
 vertebrae and ribs should be corrected. Tissues over 
 the nerves in the face should be relaxed. Nos. 14, 
 20, 21. Work vigorously and deeply with thumb and 
 finger on a line straight over the head, from the 
 nose to the base of the skull at the back of the neck. 
 See No. 16. Give heavy pressure on the skull. No. 
 15. Give heavy deep treatment at the base of the 
 skull, on each side of the spine. This may be tem- 
 porarily painful, but will be effective. No. 7B. 
 
Disease and Its Treatment 373 
 
 Pressure may be given in the upper dorsal region. 
 No. 67. The clavicles should be raised. Nos. 72, 73. 
 The treatment should be given deliberately, and is 
 probably the longest that the Osteopath gives. Great 
 relief should be given during the first treatment. 
 A very general treatment will be helpful. See gen- 
 eral treatment. Give particular attention to the 
 stomach and bowels. The patient should avoid over- 
 exertion, as becoming tired acts as an exciting 
 cause. A hot mustard foot-bath, heat at the base of 
 the skull, and an ice bag on the forehead is often 
 helpful. Should there be nausea, use the ice bag on 
 the spine from the fourth dorsal down to the first 
 lumbar vertebra. Some patients are helped by a 
 cup of strong, clear coffee. 
 
 The drug treatment for this condition is very 
 unsatisfactory. Headache powders, pills and the 
 various pain killers are dangerous. The extract of 
 cannabis indica is sometimes given for a long time, 
 two or three times per day, in doses of a fourth to a 
 third of a grain in hope of curing the condition. At 
 the time of the attack the following pills are some- 
 times given : 
 
 Acetanilid 20 grains. 
 
 Codein Sulphate 5 grains. 
 
 Camphor monobromate 5 grains. 
 
 Make of this ten pills and take one every two hours 
 until relieved. The heart action should be watched 
 when using these pills. Menthol pencils are used 
 locally for the purpose of relieving the pain. Rub 
 them over the seat of the pain. 
 
374 Practice of Osteopathy 
 
 TUMORS. 
 
 Fibroid Tumors, Benign Tumors, Malignant 
 Tumors.) 
 
 Tumors of every nature have been removed by 
 osteopathic treatment. In addition to those above, 
 many uterine tumors, as well as ovarian and cystic 
 tumors, fatty tumors, abdominal and intestinal tu- 
 n.ors, even those supposed to be of cancerous nature, 
 have been removed under the treatment. Especially 
 good results have been secured with tumors of the 
 breast. 
 
 The cause for most tumors will be founcl' in some 
 spinal or other bony lesion, or in some misplaced 
 soft tissue which interferes with the nerve supply 
 or with the circulation, especially of the venous 
 and lymphatic drainage of the part affected. When 
 the blood or lymph at any given point is obstructed, 
 whether it be from a defective nerve supply or by 
 direct pressure of some bone or organ, that blood or 
 lymph often causes an abnormal growth or tumor. 
 
 Abdominal Tumors. In case the tumor is located 
 in the abdomen it will be well to carefully examine 
 the spine for any spinal lesions, and remove them, 
 using Nos. 34, 43, 44, 36, 37, 41. The ribs must be 
 carefully looked after and any misplaced ones must 
 be corrected. See Nos. 81 to 93. The abdomen 
 must be carefully treated, as in Nos. 94 to 100. 
 Should there be enteroptosis (which see), that must 
 be treated according to directions. In general, tumors 
 should not be worked directly-over or massaged, 
 
Disease and Its Treatment 375 
 
 but they may be lifted up and their position carefully 
 shifted and adjoining tissues may be manipulated. 
 A general treatment is often advisable for the entire 
 circulation and for the nervous system. Treat about 
 three times per week. When better treat twice and 
 once per week. The treatment in the main is di- 
 rected to restore the proper circulation. In some 
 cases the treatment must be continued for some 
 time, but often the improvement is noted soon. 
 
 Uterine Tumors. Intrauterine, extrauterine or in- 
 terstitial tumors are frequently removed by osteo- 
 pathic treatment. The intrauterine tumor is fre- 
 quently pedunculated, and at the menstrual period 
 causes great pain, because the uterus at that time 
 tries to expel it. The interstitial is a part of the 
 enlarged wall and the extrauterine is on the outside 
 of the wall and attached to it. These tumors are 
 frequently caused by a misplaced uterus. This cor- 
 rection should be made by a well-qualified practi- 
 tioner. Very frequently there is a luxated pelvis, or 
 innominate bone, or a misplaced vertebra which, 
 when corrected, restores the proper circulation and 
 results in the removal of the tumor. In addition to 
 the local corrective work necessary the spine and in- 
 nominates may be treated. See Nos. 43, 51, 52, 57, 
 104 to 112. In addition to the above a general treat- 
 ment, which see, will be found very beneficial as the 
 patient is generally nervous. 
 
 Ovarian Tumors will require a careful examina- 
 tion of the lower spine and the removal of all lesions 
 found, and the pelvis should be looked after and 
 
376 Practice of Osteopathy 
 
 treated in the same careful manner. See treatment 
 for uterine tumors. The abdomen should be care- 
 fully treated as in Nos. 94 to 100. Lift up the tu- 
 mor and carefully manipulate the tissues about it, 
 but do not work directly over it. 
 
 Tumors and Nodules of the Breast. These are 
 often caused by a misplaced rib or clavicle. See 
 treatment for clavicles. Nos. 72, 73. Examine the 
 ribs carefully, look for twisted ribs and ribs that 
 are luxated in such a manner as to be too close to- 
 gether, and treat as directed under treatment for 
 ribs. Lift up the ribs. See Nos. 81, 82, 86. Give 
 the general treatment, which see. Many operations 
 may be avoided in this way. 
 
 DISEASES OF THE EYE. 
 
 Impaired vision, weak eyes, pterygium, granu- 
 lated lids, strabismus, atrophy of the optic nerve, 
 blindness, cataract, diplopia, conjunctivitis, glau- 
 coma, closed tear duct, astigmatism, keratitis, ptosis 
 or drooping lids. All of these diseases of the eye are 
 frequently cured osteopathically. The lesions are 
 generally found in the cervical and upper dorsal re- 
 gions. These lesions interfere with both the blood 
 and nerve supply. 
 
 Treatment. The treatment would call for a thor- 
 ough relaxation of all neck tissues. See Nos. 1, 3, 
 .5, 7B, 9-11, 13. Relax all tissues in the upper dor- 
 sal region. See Nos. 34, 43, 53. The fifth nerve 
 may be treated, as in No. 21. Pay attention to the 
 
Disease and Its Treatment 377 
 
 clavicles and first ribs. Nos. 73, 72, 75 to 80. Open 
 mouth against resistance. See treatment of the ears 
 and No. 8. With the lids closed considerable work 
 may be done about the eye and in the bony cavity. 
 In some cases, as in cataract, we may percuss over 
 the eyeball, as in Nos. 20, 22, 25, 26. 
 
 All lesions in the cervical and upper dorsal verte- 
 brae and in the corresponding ribs should be re- 
 moved. Should it be advisable to use an antiseptic 
 solution a four per cent boric acid solution may be 
 used, or a bichloride of mercury solution, 1 to 5,000, 
 may be used. 
 
 Conjunctivitis and trachoma, in addition to the 
 osteopathic treatment, as outlined above, should be 
 kept very clean with a boric acid solution. Should 
 the case be very severe and there be evidence of in- 
 fection it should each day receive an application of 
 a silver nitrate solution (one per cent). Hot appli- 
 cations should be used, cloths wrung out of hot 
 water and applied as can be borne. In cases of 
 keratitis, there is great pain, an aversion to the 
 light, considerable inflammation, redness. In addi- 
 tion to the osteopathic treatment, use hot water ap- 
 plications. Keep the eyes clean with a boric acid 
 solution, four per cent. A thorough general treat- 
 ment is indicated each day. See general treatment. 
 
 DISEASES OF THE EAR. 
 
 In cases of deafness the neck and back treatment 
 are similar to the treatment in cases of diseases of 
 the eye, which see. 
 
378 Practice of Osteopathy 
 
 In addition to the above, use peroxide of hydrogen 
 to loosen wax, after which an ear syringe should be 
 used to cleanse the external ear of any discharges 
 or secretions which may have remained in it. The 
 mouth of the patient should be opened against re- 
 sistance. The operator stands at the head of the 
 reclining patient, and with both hands under the 
 chin of the patient who furnishes the resistance. 
 It should be opened slowly against this two or three 
 times. This greatly assists the circulation to both 
 ears and eyes. 
 
 In case of earache, lie with the ear on a hot 
 water bag. If the patient is an infant, breathe into 
 the ear. In some cases of earache a glass ear tube 
 with a recurrent flow is used, with the water at a 
 temperature of about 100 degrees. 
 
 JOINT AFFECTIONS. 
 (Deformities. Slight Dislocations. Bow Legs.) 
 
 The various affections of joints have been very 
 successfully treated by Osteopathy. In many cases 
 a slight dislocation may be the real first cause of 
 the trouble. In other cases the cause may have been 
 rheumatism. Still other cases may be due to in- 
 sufficient bone nourishment in youth. 
 
 In all such cases it is best to begin at the origin 
 of the nerves supplying the joint in question. If the 
 joint is below the waist the nerve supply is looked 
 for in the lower dorsal and lumbar regions of the 
 spine. If the trouble is in the arms or shoulder we 
 
Disease and Its Treatment 379 
 
 treat in the neck and as low down as the third and 
 fourth dorsal vertebrae. Treat all the tissues down 
 to the affected joint from its nerve supply. Work 
 to secure a good nerve and blood supply as well. 
 
 Don't treat the joint too severely at first. Work 
 to relax the ligaments of the joint. A gentle treat- 
 ment is more successful in relaxing ligaments than 
 a severe treatment. The joint may be stretched, 
 rotated, bent and manipulated in all possible ways. 
 Should there be a perfectly immovable joint it may 
 be necessary to break it up under an anesthetic, 
 but if there is some movement in the joint it is 
 caused by a tightened condition of the ligaments 
 rather than a bony ankylosis. Such a joint may be 
 greatly improved, and in many cases complete res- 
 toration of function may be accomplished. 
 
 Slight dislocations may be manipulated and grad- 
 ually forced back into their normal position. Of 
 course, if the condition is one of long standing it 
 may take some time. In recent cases the work may 
 be frequently accomplished in a few minutes. 
 
 Bow Legs. This condition is often the result of 
 weakness, sometimes rickets may cause the trou- 
 ble. The case should be taken in hand early. Such 
 cases do not get better of themselves. The spine 
 should be treated as in Nos. 34, 43, 48, 50, 51, 52. 
 The joint at the knee should be well manipulated. 
 Give particular attention to the outside ligaments. 
 One mother has the satisfaction of having a son 
 with perfectly straight limbs who was badly de- 
 formed in childhood. The good result came as a 
 
380 Practice of Osteopathy 
 
 result of her own efforts patiently and consistently 
 followed for some months. She rubbed the knees 
 and especially the outside ligaments with salt water. 
 She gave the treatment every night. This was be- 
 fore Osteopathy was known in her State. She ex- 
 erted pressure to straighten the limbs at the same 
 time. 
 
 Where the bend is just above the ankles the treat- 
 ment in the back should be given as above. Thor- 
 oughly manipulate the limbs. Use pressure to 
 straighten them daily. See treatment of limbs. 
 
 ARTIFICIAL RESPIRATION. 
 (Sylvester's Method.) 
 
 The patient is placed on his back, as in Fig. 106. 
 It will be well to have the lower part of the body 
 raised. The operator takes the arms near the elbow, 
 as in the figure, and draws them forcibly outward 
 and upward, where he holds them for two seconds to 
 permit the air to enter the lungs, then the arms are 
 brought down and pressed with considerable force 
 against the sides of the chest for two seconds. 
 These movements are made fifteen times per minute. 
 See Figs. 106 and 107. It may be necessary in some 
 cases to keep up the work for thirty minutes or 
 more. 
 
Disease and Its Treatment 381 
 
 KUATSU AND SPONDYLOTHERAPY. 
 
 The Japanese have employed kuatsu in connection 
 with jiujitsu for many centuries, as a method of 
 resuscitation when a person was " knocked out " by 
 the use of jiujitsu. In restoring a person to con- 
 sciousness with kuatsu the patient is placed in the 
 prone position and the operator strikes with his 
 wrist on the seventh cervical vertebra a series of 
 severe blows with regularity, the same as if a car- 
 penter were striking blows with a hammer. See Fig. 
 109. 
 
 They now use it for persons who have suffered 
 from sunstroke or drowning. It has been employed 
 in this country, in a modified form, for the same pur- 
 pose and for increasing the heart's action in emer- 
 gencies. There has also been built up a system of 
 treatment, based on kuatsu and a few of the prin- 
 ciples of Osteopathy, for which a few claim consid- 
 erable merit. Spondylotherapy claims to perform 
 cures by percussing over certain areas of the spine 
 in different diseases. This would appear to an Os- 
 teopath to be spinal stimulation. But it would fail 
 to remove any definite lesions which were the original 
 cause of the disease, and the effects would be only 
 temporary. 
 
 The first effect of an Osteopathic lesion is over- 
 
382 Practice of Osteopathy 
 
 stimulation of the organ that later becomes diseased. 
 The organ overworks itself and soon becomes a vic- 
 tim of this overwork. The lesion leads to a stimula- 
 tion which finally becomes an irritation and the 
 organ becomes diseased. After this stimulation the 
 nerve fails to perform its function and more stimu- 
 lation would only further weaken the nerve. It 
 might be of some value in an emergency, but I fail 
 to see its value in a chronic case. Osteopathy re- 
 moves the lesion and restores the nerves, and thus 
 the organs, to normal functioning. 
 
Disease andi Its Treatment 383 
 
 FLAT FOOT. 
 
 Weak Arches, Broken Down Arches. 
 
 This trouble is due to general muscular weakness, 
 to heavy strains, to lesions in the lower part of the 
 back or innominate bones, which cause faulty atti- 
 tudes, thereby straining supporting ligaments and in- 
 terfering with the proper nourishment of the foot. 
 Poorly-fitting shoes may be a causative factor. 
 
 When the arches begin to break down the pain is 
 often ascribed to a sprain or rheumatism. Improper 
 treatment is applied and when the patient is heavy 
 the trouble becomes worse quite rapidly. There is 
 pain along the inside of the foot. There may be 
 pain in the heel; also the calf of the leg. This pain 
 may extend to the knee. The circulation becomes 
 poor, with all the attendant symptoms, numbness, 
 cold and, at times, perspiration. The pain may be 
 out of all proportion to the deformity and there may 
 be considerable deformity with very little pain. The 
 foot grows more deformed, becoming flat and rigid. 
 
 The treatment should be applied in such a manner 
 as to secure pliability of the foot with the utmost 
 freedom of motion. See paragraph 118, also Fig. 
 93. Several weeks will be necessary to accomplish 
 this. In the meantime have the patient wear a shoe 
 with low, flat heels and broad toes. When walking 
 
384 
 
 Practice of Osteopathy 
 
 it will be well for him to place most of his weight on 
 the outside of the foot. The inside of the shoe sole 
 may be built up a little. Careful exercise may be 
 carried on with benefit, but it should be carried only 
 to the point of fatigue. Walking with toes turned 
 slightly in and upon tiptoes will be helpful. In some 
 cases after a certain amount of pliability is secured 
 a cast may be necessary. Braces may help, but the 
 difficulty with them is they are hard to fit. The use 
 of adhesive strips in holding up the arch after it has 
 been placed into something like normal position is 
 advocated by some, and in many cases the treatment 
 is successful. A lono" course of treatment is re- 
 quired. 
 
Disease and) Its Treatment 385 
 
 CRAMPS IN THE LEGS. 
 
 Many persons are affected with cramps in the 
 legs, which prove very painful. They most fre- 
 quently occur in the calf of the leg and attack a 
 patient after retiring for the night. The cause of 
 the trouble is too many nerve impulses going to the 
 muscles of the leg. Overexertion in walking or 
 running, or any .occupation that would unduly ex- 
 cite the lumbar segment of the spinal cord, might 
 result in this trouble. When we get too warm, by 
 having too much cover in bed, contractions of the 
 calf muscles may result. Many have found that by 
 stepping upon the floor they obtained relief. This 
 stretched the muscles, as the Osteopath does, as 
 shown in Fig. 90A. At the same time he inhibits 
 the nerves of the lumbar region, as is shown in Fig. 
 32. 
 
 An easier way, and one that will be just as ef- 
 fective, is to place a bag of ice or very cold water 
 on the lumbar region of the spine. This will give 
 instant relief. 
 
386 Practice of Osteopathy 
 
 DISORDERED SWEAT GLANDS. 
 
 This trouble is characterized by perspiration that 
 is excessive or absent, fetid or accompanied by small 
 vesicles upon the skin, accompanied by much sweat- 
 ing. The scientific names for this disturbance, in 
 the order given above, are hyperidrosis, anhidrosis, 
 bromidrosis and sudamina. 
 
 This trouble is caused by impairment of the nerve 
 supply to the sweat glands, and as it is not certainly 
 known where these centers may be found we give a 
 thorough general treatment about twice per week. 
 The founder of Osteopathy, Dr. A. T. Still, recom- 
 mends that the facia all over the spine be thoroughly 
 loosened, much as would be indicated in Figs. 48, 50 
 and 51. See the pictures. In cases of unilateral 
 sweating pay particular attention to loosening the 
 structures of the neck. See neck treatment. The 
 above treatment is recommended in cases of sweat- 
 ing of the feet and axilla. 
 
Disease and Its Treatment 387 
 
 ACNE AND COMEDO. 
 Pimples and Black Heads. 
 
 The acne is distended sebaceous follicles found 
 mostly on the face and eyelids. They are small, 
 white, opaque, seedlike grains. The black heads are 
 small, sebaceous plugs, found mostly on the face, 
 neck, chest and back. The former may be punctured 
 and both should be squeezed out. 
 
 The cause is very obscure from the medical stand- 
 point. Osteopathy regards them as being caused by 
 poor nerve supply and deficient circulation to the skin 
 and superfical fascia. Upon improving the circula- 
 tion and bettering the nerve supply they disappear. 
 
 The treatment is largely directed to the neck. The 
 muscles are well worked and kneaded, and some 
 treatment, though not so severe, is given to the face 
 or part affected. Treat about twice per week for a 
 while and then once per week. If there are any in- 
 dications of constitutional weakness a general treat- 
 ment is indicated. 
 
388 Practice of Osteopathy 
 
 HICCOUGH, OBSTINATE. 
 
 Hiccough is a reflex spasm of the diaphragm with 
 simultaneous closure of the glottis. It is a very dis- 
 tressing trouble and if continued for several days 
 may prove fatal. I have noted cases that stopped 
 while the patient slept and began upon awakening. 
 It is sometimes very difficult to cure. In the milder 
 forms a sudden reflex irritation will cure at once. A 
 teaspoonful of salt and lemon juice has been recom- 
 mended. Salt and vinegar will do as well. Strong 
 traction on the tongue may cure. 
 
 The Osteopathic treatment calls for a thorough re- 
 laxing of the neck muscles. I have found cases 
 where the hyoid bone was pulled backward and 
 downward and relief was secured at once by forcibly 
 elevating the bone with the fingers. Sometimes firm 
 pressure is to be applied upon the phrenic nerve, 
 over the scalenus anticus muscle. This inhibits the 
 action of that nerv^e. The same effect may be ob- 
 tained by the application of cold. This nerve ener- 
 vates the diaphragm. 
 
Disease and Its Treatment 389 
 
 EPISTAXIS. 
 Nose Bleeding. 
 
 Bleeding from the nose may occur from a variety 
 of causes — injuries, nasal diseases and erosions. It 
 may be caused by general conditions, as in the case 
 of delicate children about the age of puberty. In 
 stout persons it may indicate liability to apoplexy. 
 It is common in ascending heights, as in mountain 
 climbing, or ascending in balloons. Bleeding from 
 the nose precedes typhoid fever and is common in 
 anaemias. In cases of suppression of the menses the 
 epistaxis is sometimes vicarious. 
 
 The treatment in most cases is very simple. In 
 many cases it stops itself. In case the bleeding is 
 obstinate, hot or cold water may be injected into 
 the nose. Alum, an astringent, may be used. A me- 
 chanical form of treatment will be simply to hold the 
 hands of the patient above his head. The operator 
 may place his thumbs just beneath the nose, on the 
 upper lip, and his forefinger in the notch of the 
 facial artery, which is found about one-half an inch 
 forward of the angle of the lower jaw. Pressure 
 may be made here for five minutes and repeated if 
 necessary. This form of treatment is illustrated by 
 Fig 23 A. When the bleeding is very bad and obsti- 
 nate it will be well to plug the posterior nares, using 
 absorbent cotton which has been well saturated with 
 alum water or tannin and glycerine. Remove on the 
 third day and renew if necessary. 
 
390 Practice of Osteopathy 
 
 SUNSTROKE. HEAT-EXHAUSTION. 
 
 Sunstroke Is caused by excessive exposure to heat. 
 Any factor that lessens the bodily resistance to a 
 high temperature will predispose to sunstroke. Ex- 
 haustion of mind or body, excitement or worry, ac- 
 companied by unsanitary conditions, overeating, al- 
 coholism, previous attacks, when coupled with ex- 
 posure to extreme heat will bring on the condition. 
 When the atmosphere is hot, still, sultry and humid, 
 working hard in the direct rays of the sun predis- 
 poses to heat-stroke. It may be brought on by labor 
 in poorly-ventilated, excessively hot, close and con- 
 fined places. 
 
 The symptoms come on suddenly. There may be 
 loss of consciousness and the face is flushed, while 
 there is full, rapid pulse. The skin is hot and dry. 
 The temperature is from 100 to 106. In fatal cases 
 the coma becomes deeper and deeper, the pulse is 
 more rapid, and the temperature may reach from 106 
 to 115. Heat-exhaustion may have more warning 
 symptoms. There may be headache and nausea, with 
 faintness and thirst. The extremities may have 
 numbness and tingling. These symptoms will be 
 followed by great muscular weakness and prostration. 
 There will be clamminess and coldness of the sur- 
 face, with pallor and a small, rapid pulse. In grave 
 
Disease and, Its Treatment 391 
 
 cases there may be collapse. The temperature is at 
 first subnormal, 95 to 97, though in some cases there 
 may be a mild fever, ranging from 100 to 102. We 
 look for such cases to recover in one or two days 
 and with prompt treatment in a few hours. When 
 the patient is weak death may take place. 
 
 Treatment. Notice the difference in treating the 
 two cases. In sunstroke, promptly place in an ice 
 bath, with plenty of ice in the water. Reduce the 
 temperature to 101. Take from the bath and rub 
 the patient dry. Then thoroughly loosen all spinal 
 muscles. See paragraphs 47, 48, 49, 53, 54, 56, 57, 
 58, 59, 60. All of these movements may not be neces- 
 sary in some cases, but use as many as you need 
 thoroughly to relax all spinal tissues. Pay especial 
 attention to the neck. See that there are no con- 
 tracted tissues in the neck. See paragraph 5, 
 also use paragraph 7 as indicated in Fig. 7B. 
 Also Figs. 8 and 9A. Give an inhibitive, re- 
 laxing treatment to the abdomen. See para- 
 graphs numbered from 94 to 100. In case the 
 temperature is again rising, repeat the bath, but do 
 not lower the temperature below 101. To lower 
 the temperature an ice water enema is a useful help. 
 Use an ice cap for the head, and give a liquid diet 
 for several days. In case of heat-exhaustion get 
 the patient into the shade in a cool place. Loosen 
 all clothing, especially about the neck. If the tem- 
 perature is subnormal use a warm bath. Give a little 
 brandy and treat Osteopathically as in sunstroke. 
 
 Extra precaution should be taken in warm weather 
 
392 Practice of Osteopathy 
 
 by those who do physical work. Sleep in a well- 
 ventilated room. Bathe frequently. Avoid alcohol 
 and heavy eating. Stop work and seek the shade at 
 once if sweating stops. Wear cool, wet cloths or 
 green leaves inside a light hat. 
 
Disease and Its Treatment 393 
 
 ALCOHOLISM AND DRUG HABITS. 
 
 Morphine, Cocaine and Cigarette Habits. 
 
 Alcoholism is accompanied by profound tissue 
 changes in various parts of the body. It often results, 
 when long continued, in a chronic inflammation of 
 the liver, stomach, heart, blood vessels and kidneys. 
 Neuritis, epilepsy and paresis may be caused by the 
 disease. 
 
 The drug habits produce changes in the nerves and 
 operate to change the character of the patient. 
 
 In treating alcoholism we give a thorough general 
 treatment each day for about two weeks, and after 
 that every other day for from one to three months. 
 Should there be constipation, liver or kidney 
 troubles, special treatment should be given for these 
 diseases. We give special attention to the treatment 
 of the pancreas, spleen and liver. In treating the 
 spleen and pancreas the location for spinal work is 
 the same as for the liver. In working over the spleen 
 we treat the same as for the liver, remembering that 
 they are on opposite sides of the body. 
 
 The founder of Osteopathy believes that the 
 chronic drinker has the thirst for liquor in a more 
 aggravated form because there is some failure of the 
 system to supply healthy fluids, and the thirst for 
 alcohol is nature craving a substitute. While the 
 patient is undergoing the treatment he should be well 
 
394 Practice of Osteopathy- 
 
 fed. The system must be well nourished and built 
 up. Allow beef tea and malted milk with red pepper 
 to be taken when the thirst for strong drink is ex- 
 cessive. Treating such cases is not very pleasant 
 work, but there is great satisfaction in saving such 
 men to their families. 
 
 The doctor must use considerable firmness and 
 tact in dealing with these cases. Each one is 
 different and requires different treatment. One 
 man was made to promise that he would come 
 to me when he had to have a drink. I prom- 
 ised to give it to him and did so, but he was 
 eventually cured. One man after he had been under 
 treatment for a week said he felt as if his delirium 
 tremens was coming on again (he had been confined 
 for this cause). He begged for a quart of whiskey. 
 In the presence of his wife, who had accompanied 
 him to the office, I told him he might take a quart 
 home. He consumed three-fourths of it that night. 
 A little over a year after this he was accidentally 
 killed, but he had never touched a drop of whiskey 
 since that night. 
 
 In treating the drug habits the same treatment as 
 for alcoholism is given. Morphine must be gradu- 
 ally withdrawn. Coffee may be used as a stimulant. 
 The cocaine habit is, perhaps, the most difficult to 
 overcome. Its victims are most pitiful. The drug 
 must be gradually withdrawn. Great excitement, 
 sometimes paranoia, follows its discontinuance. The 
 treatment will be best given in an institution where 
 you can have absolute control of the patient. 
 
Disease and Its Treatment 395 
 
 WORMS. 
 
 Tape Worms (Cestodes), Round Worms (Ascaris 
 
 Lumbricoides), Pin Worms (Oxyuris Ver- 
 
 micularis), Thread Worms. 
 
 Tape Worms. There are two varieties, in the 
 United States, of tape worms, the taenia solium and 
 the taenia saginata. They are allowed to secure an 
 entrance into the system by eating raw or partially 
 cooked beef or pork, which had previously become 
 a host for the eggs of the worm. There are numer- 
 ous symptoms, but the only sure method of diagno- 
 sis is to find segments of the worm which have been 
 passed in the stools. 
 
 There is a long list of drugs that are effective, the 
 best of which is the oleroesin of the male fern. This 
 should be given in a capsule. For a child ten years 
 old the dose should be 15 minims, four of which 
 should be taken at hourly intervals. Immediately 
 after the last dose take one-half an ounce of castor 
 oil. Very little should be eaten the day before, and 
 a dose of salts should be taken the previous evening. 
 Nothing should be eaten in the morning when the 
 treatment begins. 
 
 An adult may take a two-drachm dose of the 
 ethereal extract of the male fern, followed in two 
 hours by an active purge. When the worm is being 
 passed warm water should be placed in the com- 
 mode. This keeps the worm from contracting and 
 breaking. 
 
 Another splendid remedy is to take three or four 
 
396 Practice of Osteopathy 
 
 ounces of pumpkin seeds, bruise and macerate them 
 for half a day. This infusion is to be taken after 
 a fast, and the bowels thoroughly cleansed by a 
 salt-water injection and a dose of Epsom salts. Fol- 
 low the infusion of pumpkin seeds in an hour by a 
 thorough purge. Unless the head of the worm is ex- 
 pelled the segments will again appear in the faeces 
 in about three months. 
 
 Round Worms. 
 
 These are small and round, from five to ten in- 
 ches long, tapering at the ends, grayish in color, 
 with sometimes a pink tint. Generally there are 
 from two to ten of them, but there may be many 
 more. 
 
 Sometimes they migrate, enter the stomach and 
 are vomited. They have been known to enter the 
 nose, the middle ear and the bile duct. They cause 
 a number of nervous symptoms. Positive evidence 
 of their presence is their appearance in the stools. 
 
 The best remedy is sanotin. A one-grain dose is 
 enough for a child five years of age, and three should 
 be given at hourly intervals in the powdered form, 
 mixed with pulverized sugar. This should be pre- 
 ceded by a day of fasting and a dose of salts at 
 night and next morning. After it acts the remedy 
 may be given, and should be followed by an active 
 purge, say one-half ounce of castor oil. 
 
Disease and Its Treatment 397 
 
 Pin Worms, 
 
 They are very much like short pieces of white 
 thread. The worm is from one-sixth to one-third of 
 an inch in length and tapers toward the tail. 
 
 These worms cause intense itching, usually at 
 night, because they migrate to the anus and to the 
 genital organs, where they cause inflammation and 
 may lead to masturbation. Large quantities of 
 mucus may be discharged from the bowels. Ir- 
 regular nervous symptoms may be caused, which 
 sometimes lead to convulsions. The worms may be 
 found in the faeces or on the person near the rec- 
 tum. 
 
 Treatment. Cold injections of strong salt water 
 are very helpful. Strict attention must be given 
 at all times to absolute cleanliness, to avoid reinfec- 
 tion. A solution of bichloride of mercury, 1 to 10,- 
 000, may be used to bathe the anus two or three 
 times per day. This is also a splendid injection, and 
 may be used after an injection in which one tea- 
 spoonful of borax to a pint of water has been used, 
 to remove the mucus. After the mucus comes away 
 use about half a pint of the bichloride of mercury 
 solution. Retain as long as possible and repeat 
 every third or fourth night. On the other evenings 
 use the salt water injections and occasionally give 
 a dose of Epsom salts. 
 
 One very obstinate case was cured by using as au 
 injection a decoction of garlic. At the same tini^ 
 large quantities of garlic were used by the mouth. 
 
398 Practice of Osteopathy 
 
 The itching may be allayed by the use of carbol- 
 ized vaseline. 
 
 CHILBLAINS. 
 
 When the chilblains affect the feet, care should 
 be taken to keep up a good circulation. Loose 
 shoes, with woolen stockings, should be worn. Fre- 
 quent bathing, followed by vigorous friction, will 
 be of value. An occasional application of a lini- 
 ment composed of equal parts of turpentine and olive 
 oil may be rubbed on. at night. 
 
 The itching may be allayed by rubbing in the fol- 
 lowing ointment: 
 
 Powdered camphor 1 dram. 
 
 Ichthyol 1^ drams. 
 
 Lanolin i/^ dram. 
 
 Cosmolin 4 ounces. 
 
 FROST-BITE. 
 
 A person with any part of the body frost-bitten 
 should not be brought into a warm room. The part, 
 if recently frozen and red in color, should be rubbed 
 with snow or with cloths dipped in ice water until 
 the redness disappears. If the person is nearly 
 frozen to death, induce breathing by using the meth- 
 ods for artificial respiration, which see. See Figs. 
 106, 107. Rub him thoroughly with flannel satu- 
 rated with whiskey. Apply vigorous pressure on the 
 spine between the shoulders, as in No. 67. Give an 
 
Disease and Its Treatment 399 
 
 enema of brandy and water. When possible admin- 
 ister brandy by the mouth. Give warm drinks, as 
 coffee, beef tea, etc. As the patient improves the 
 temperature of the room may be raised. 
 
 CORNS. 
 
 These are the result of pressure or friction, and 
 when the irritative cause is removed the corn will 
 disappear. Salicylic acid is the basis of nearly all 
 corn cures. A valuable preparation is: 
 
 Salicylic acid IJ^ drams. 
 
 Extract of cannabis indica . . 10 grains. 
 
 Collodion 1^ drams. 
 
 This may be painted over the corn daily, preferably 
 at night, and carefully scraped away in the morn- 
 ing. 
 
 If the feet are very much inflamed a very grate- 
 ful treatment will consist of a thorough cleansing 
 with ethereal soap. Soak in hot water and wrap 
 them in cloths which have been soaked in the fol- 
 lowing : 
 
 Linseed oil 2 ounces. 
 
 Lime water 2 ounces. 
 
 Spirits of camphor 1 dram. 
 
 Soft corns may be treated by washing the feet 
 thoroughly with ethereal soap. After drying care- 
 fully remove the dead and loosened skin. Dust 
 the toes with borated talcum powder and place a 
 thin layer of absorbent cotton between. 
 
400 Practice of Osteopathy 
 
 BURNS. 
 
 Sun burns, or burns slight in character, may be 
 kept moistened with a saturated solution of bicar- 
 bonate of sodium (common baking soda). When 
 the burn is more serious the following ointment 
 should be used: 
 
 Iodoform 20 grains. 
 
 Antipyrin 75 grains. 
 
 Boric acid 75 grains. 
 
 Vaseline 1^ ounces. 
 
 Burns of a very serious nature call for immediate 
 surgical attention. 
 
 IVY POISONING. POISON OAK. 
 
 Portions of the body exposed are often covered 
 with blisters. There is great swelling, itching and 
 burning. Apply the following solution : 
 
 Grindelia robusta 4 drams. 
 
 Water 1 pint. 
 
 Later a salve made as follows may be applied: 
 
 Carbolic acid 10 grains. 
 
 Boric acid 30 grains. 
 
 Petrolatum 1 ounce. 
 
 WARTS. 
 
 For warts on the face apply each day some of the 
 following prescription : 
 
 Subliminal sulphur 5 drams. 
 
Disease and Its Treatment 401 
 
 Glycerine 1^ drams. 
 
 Acetic acid 2^ ounces. 
 
 For warts on other parts o£ the body a very effect- 
 ive application is to paint daily with the following: 
 
 Corrosive sublimate . . . .^ of a dram. 
 
 Collodion 15 drams. 
 
 It is a well known fact that if a wart is kept 
 constantly wet with castor oil it will frequently 
 drop off and disappear. Another useful application 
 is: 
 
 Resorcin 30 grains. 
 
 Alcohol , 1 ounce. 
 
402 Practice of Osteopathy 
 
 HAY FEVER. 
 
 In addition to the regular Osteopathic treatment 
 for hay fever, as noted on page 242 of this work, the 
 attention of the reader is called to some additions 
 in the technique and modus operandi of the treat- 
 ment. Before beginning this special work it will be 
 well thoroughly to irrigate the upper nasal pas- 
 sages with a salt solution at a temperature of about 
 105 degrees Fahrenheit. This solution should be 
 conducted from a glass container, elevated about 
 three feet above the head of the patient, through the 
 medium of a rubber tube. As the patient bends 
 over a fountain cuspidor, the solution should be 
 made to enter one nostril and flow out of the other. 
 About a quart of this solution may be used at one 
 time. When a pint has been used, the rubber tube 
 with its nasal attachment may be transferred to 
 the other nostril. This solution, by an effort on 
 the part of the patient, may be made to enter the 
 mouth, and thus it will assist in cleansing the naso- 
 pharynx. This solution may be prepared in the 
 following manner: Five ounces of sodium chloride 
 (common salt) ; three and one-half ounces of sodium 
 biborate (borax) ; two ounces of bicarbonate of soda 
 (common baking soda). This may be kept for all 
 
Disease and Its Treatment 403 
 
 practical purposes in a dry state. The ingredients 
 should be thoroughly mixed, and then a teaspoon- 
 ful may be used in each quart of water intended for 
 the irrigation. 
 
 On beginning the treatment it is advisable to use 
 about three teaspoonfuls, and as the treatment 
 progresses it may be reduced to one. The stronger 
 the solution the greater is its cleansing power. But 
 if it is used too long a time at its maximum strength 
 it will tend to irritate the mucous membrane of the 
 nasal passages. 
 
 When these antiseptic precautions have been tak- 
 en, the forefinger of the operator may be thorough- 
 ly cleansed, upon which is used a mild antiseptic. 
 A ten per cent solution of iodine and glycerine will 
 be excellent for this purpose. The finger is inserted 
 back of the soft palate, at one side of the uvula. 
 The soft palate may then be pulled forward and 
 bent at almost right angles with the hard palate. A 
 short, simple massage treatment may be given it, 
 and this will tend to reduce its size, as in these 
 cases it is often found enlarged. The soft palate may 
 be swept from side to side and the back of the finger 
 may sweep over the posterior part of the naso- 
 pharynx. This tends to break up any pockets in 
 which mucus may collect and assist in cleansing 
 out this space. After this is done the cleansing solu- 
 tion may be used for a short period as a douche as 
 before, and the mouth thoroughly cleansed. In 
 order to keep these membranes from any undue ir- 
 
404 Practice of Osteopathy 
 
 ritation until the natural secretions have been 
 established, pinoleum may be used as a spray in 
 the nostrils or glycothymoline may be used on a 
 cotton applicator. If this treatment is commenced 
 several weeks before the time for the hay fever to 
 put in an appearance, we may hope to effect a cure, 
 or greatly benefit the patient. 
 
 The treatment should be given about three times 
 per week. If you do not get to treat the patient 
 until the disease is active, we may hope, by admin- 
 istering the treatment each day for several days, 
 to give the patient considerable help. 
 
 THE TREATMENT OF DEAFNESS AND 
 PARTIAL DEAFNESS. 
 
 Great strides have been made in the past few 
 years by various members in the Osteopathic pro- 
 fession in the treatment of deafness and partial 
 deafness. This has been especially true when the 
 deafness was caused by catarrh. The exudates from 
 the catarrhal condition partially fill the Eustachian 
 tubes. The special Osteopathic procedure is di- 
 rected to the opening up of these tubes, and the 
 normalization of all surrounding tissues. This 
 should go hand in hand with the general Osteo- 
 pathic treatment, which has for its purpose the 
 loosening up of all the tissues of the neck and upper 
 dorsal regions of the back. Many Osteopaths con- 
 sider this to be of first-class importance. It has been 
 the experience of a number of Osteopaths in giv- 
 
Disease and Its Treatment 405 
 
 ing their regular treatment, in which it has been 
 necessary to do considerable work in the upper part 
 of the back and the neck, to find patients laying aside 
 their glasses and having their ears improved, when 
 the treatment was not especially directed either to 
 the eyes or the ears. 
 
 The antiseptic precautions, and the method of 
 irrigation with the same salt solution, as noted here 
 in the treatment of hay fever, are used in the treat- 
 ment of deafness and partial deafness. In treating 
 the ears it will be best to look after the general 
 health of the patient, in order to obtain the best re- 
 sults. Nervousness, stomach troubles, liver diseas- 
 es, female troubles, overeating and drinking, all tend 
 to aggravate most cases of deafness. The appropri- 
 ate prohibition of all bad habits should be made, and 
 in some cases the proper diet should be followed. 
 
 Some cases of head noises are caused by too high 
 blood pressure. The careful physician will take the 
 blood pressure of most of his patients and work to 
 reduce such pressure as is above normal. 
 
 Before accepting a case of deafness or partial 
 deafness it will be well to make certain tests with 
 the tuning-fork, and also give the watch test, and an 
 examination of the outer ear should be made, and 
 also the nasopharnyx. You should determine 
 whether the deafness is caused by the impairment of 
 the essential organ of hearing, or the conduction ap- 
 paratus; whether the difficulty is in the labyrinth 
 or auditory nerve, or whether it is due to an obstruc- 
 
406 Practice of Osteopathy 
 
 tion of the Eustachian tube, the external auditory 
 canal, or some affliction of the tympanic membrane. 
 We expect, under our treatment, greatly to benefit 
 those cases where the deafness, or partial deafness, 
 is due to some impairment of the conducting ap- 
 paratus. And we find that the greater part of deaf- 
 ness is due to the latter cause. In testing any par- 
 ticular case it will be best to use the tuning fork. 
 If it be impractical to have a number of forks, the 
 best fork adapted for ordinary use will be one that 
 is fairly loud and one sounding the note C2; that is, 
 512 vibrations per second. 
 
 When a vibrating tuning fork is placed against 
 the head of a person whose hearing is entirely 
 normal, he will hear it better if both ears are closed. 
 Or if one ear is closed he will hear the fork better 
 in that ear. So, if the hearing in one ear is im- 
 paired because the Eustachian tube is closed from 
 any cause, the vibrating tuning fork will be better 
 heard in that ear. This will also be the case if the 
 external auditory canal is obstructed, or if the men- 
 brana tympani is thickened. In making this test 
 the handle of the tuning fork should be held against 
 the teeth, or on the head midway between the ears. 
 If the difficulty in hearing is due to an affection of 
 the labyrinth or of the auditory nerve, the vibrat- 
 ing tuning fork will not be heard as well in the im- 
 paired ear. 
 
 Some persons will imagine that they hear the 
 tuning fork better in the ear in which they are ac- 
 
Disease and Its Treatment 407 
 
 customed to hear well, under other circumstances. 
 Ask the patient to listen to the fork as he closes 
 first one ear and then the other. Be sure that he 
 hears as he really does, not as he thinks he ought to 
 hear. 
 
 Another test that may be used in connection with 
 the tuning fork will be the watch test. For this 
 purpose a common Ingersoll dollar watch which has 
 a loud tick will be best. It may be well to use in 
 connection with this a better grade watch, whose 
 tick has a greater number of vibrations. Be certain 
 to have the room in which the test is made free from 
 all noise. Have the eyes of the patient covered. 
 Hold the watch on a level with the ear, and move 
 it slowly towards that organ. By testing in this 
 way it will be an easy matter to know how the case 
 is progressing as each treatment is being given. 
 
 When you are examining a case for the first time 
 it is always well to examine the exterior auditory 
 canal and the membrana tympani. A reflector and 
 ear speculum will be useful for this purpose. The 
 writer uses a head lamp which throws its light into 
 the ear, and a nest of Gruber's specula. Sometimes 
 you will note a thickening of the membrane, and the 
 exterior ear often is filled with cerumen or other 
 matter, and must be removed. Frequently you will 
 find cases of deafness where this is the only thing 
 necessary to do. A mass of such material, after be- 
 ing made soft, can readily be removed by syringing 
 with warm water. Have the patient soften it by 
 
408 Practice of Osteopathy 
 
 filling the ear with warm water several times a day, 
 and at night introduce a few drops of sweet oil. 
 Then, the next day, you can syringe the ear and re- 
 move the mass in this manner. 
 
 Examination of the Nasopharynx. 
 
 In examining a patient, where you expect that 
 the deafness is induced by catarrh affecting the 
 Eustachian tubes, it will be well to examine the 
 nasopharynx. For this purpose it is well to have 
 several small mirrors, ranging in size from 00 to 5. 
 The frames of these mirrors are attached to wire 
 handles at an angle of forty-five degrees. One of 
 these mirrors is slightly warmed and introduced in- 
 to the open mouth of the patient. It should be 
 carried back to the pharyngeal cavity while holding 
 the tongue down with a tongue depressor. It should 
 be so placed that it will reflect the light into and 
 upward, so as to obtain a good image of the vault 
 of the pharynx and the posterior nares. We note 
 the posterior margin of the nasal septum, the pharyn- 
 geal tonsil just above it, and still lower, on each 
 side, are the pharyngeal orifices of the Eustachian 
 tube. They look like two open elevations. They 
 have a border of cartilaginous Hps which, in the 
 normal state, has a deep-red color, while the mucous 
 membrane at the tube entrance is lighter in color. 
 If the mucous membrane covering the lips of the 
 tubes is lighter in color and the parts appear shrunk- 
 en, the tubes are atrophied. If the Eustachian tube 
 
Disease and Its Treatment 409 
 
 mouth appears dilated and swollen, and there is 
 mucus showing in it, catarrh of the tube is indi- 
 cated. 
 
 Difficulties of This Examination. 
 
 We should not touch the back of the tongue or 
 wall of the pharynx, as a gagging of the patient will 
 start and we cannot proceed with the examination. 
 Should the palate rise and shut off our view we may- 
 request the patient to breathe through the nose. To 
 this end it will be best to have the patient take a full 
 breath as you insert the mirror, and then request 
 him to exhale through the nose. 
 
 The Treatment Proper. 
 
 After you have selected your case and you are 
 certain that the external auditory canal is open and 
 free of wax, or other deposit, and that the essential 
 organ of hearing is not seriously impaired, we ex- 
 amine the Eustachian tubes by means of the small 
 throat mirrors. 
 
 Then, if they are closed, or partially so, we care- 
 fully insert the forefinger back of the soft palate, at 
 one side of the uvula, on the same side that the tube 
 is closed. Run the palm of the finger outward and 
 forward until you reach the tubercle back of the 
 mouth of the Eustachian tube; then allow the 
 finger to go backward into the fossa of Rosenmiiller. 
 In doing this do not use too much pressure, but by 
 using a little pressure, should there be adhesions or 
 
410 Practice of Osteopathy 
 
 adenoids, they will be broken up after a few treat- 
 ments. About the third or fourth treatment after 
 you have inserted the finger as above you may use 
 a kind of a stretching and pumping motion over the 
 orifice of the tube. This slight manipulation or 
 massage tends to open the tube and to clean it of 
 mucus. At each treatment pull forward on the soft 
 palate. This movement tends to empty the tube. 
 
 After you have treated the patient for about a 
 month, three times per week, and you have cleared 
 the space about the tube's mouth of adenoids, mor- 
 bid growths, and adhesions, you may insert the soft 
 tip of the finger into the tube and rotate it a little. 
 This will cause pain as it breaks up adhesions. Aft- 
 er you have opened the tube thus, you may further 
 open it with the Politzer air bag, as directed under 
 that head. This should be done two days after the 
 finger tips are placed in the tubes. Two days after- 
 wards use the air bag again and pull the soft palate 
 forward. 
 
 The hand should be well cleaned before the 
 finger is inserted in the throat, and a mild antisep- 
 tic should be used on the finger. A 10 per cent 
 solution of iodine and glycerine will be excellent. 
 The patient should use a mild spray or nasal douche 
 twice per day, or better after each meal, as long as 
 he is under your care. This will tend to keep down 
 all inflammation. If, after any of the work, there 
 is undue soreness or inflammation, a cold pack may 
 be placed over the throat just beneath the chin. 
 
Disease and Its Treatment 411 
 
 In bad cases it is sometimes necessary to keep up 
 the treatment for from three to six months, while 
 in some cases, not so severe, pathologically, but 
 where the hearing is badly affected, you will ob- 
 tain surprisingly good results in a very few treat- 
 ments. 
 
 A Simpler Treatment. 
 
 Use the above technique, but very lightly, three 
 times on the first day. The second day use it twice, 
 and perhaps also on the third day. Then use it 
 daily for awhile. Then treat three times per week 
 for two weeks. But do not attempt to place the 
 finger in the tube mouth. Use antiseptic precau- 
 tions as above. During the last week of treatment 
 use the Politzer air bag once or twice. This mas- 
 sage in many cases will open up the tube. Be sure 
 to massage the tubercle of Gerlach and spring the 
 soft palate forward. This loosens the folds in the 
 tube and forces out the mucus. In cases which are 
 quite deaf, but in which the pathological conditions 
 are not so very serious, you may expect good re- 
 sults in a very short time. Be sure always to work 
 over and massage an enlarged soft palate. This is 
 for the purpose of reducing its size. This treatment 
 will improve a speaker's or singer's voice. 
 
 The Simplest Treatment. 
 
 The simplest and easiest method that I have found 
 for clearing out the Eustachian tubes, and at the 
 
412 Practice of Osteopathy 
 
 same time restoring their patency, is to treat over 
 them each day for a week or ten days before using 
 the PoHtzer air bag. They can be reached for the 
 purpose of expressing the mucus by treating over 
 the anterior wall of the nasopharynx, just to one 
 side of the uvula and soft palate. In this way you 
 reach the Eustachian tube through the wall of the 
 nasopharynx, and treat the tube much as you would 
 treat the appendix, manually, through the abdomen. 
 Use the same antiseptic precautions as in the 
 treatments noted above. 
 
 The Use of the Politzer Air Bag. 
 
 Place the nosepiece of the bag in one nostril and 
 close both nostrils about this nosepiece with the 
 thumb and finger. A little water having been 
 previously placed in the patient's mouth, he is told 
 to swallow. As soon as the operator notes the lar- 
 ynx rise as the patient begins to swallow, he quick- 
 ly presses the bag, thus forcing the air into the 
 Eustachian tube and on up to the middle ear. Do 
 not use any more force to accomplish this purpose 
 than necessary. You had better make several at- 
 tempts than to cause pain or possibly rupture a 
 diseased drum membrane. You can inflate the mid- 
 dle ear of a child easier than that of an adult. For 
 the average practitioner an eight-ounce bag will be 
 the best. 
 
INDEX 
 
 Abdomen, Examination of, 48 
 
 " Treatment of, 49 
 
 Abdominal Tumors, 374 
 
 Abnormal Spine, , 62 
 
 Abnormality, Careful of, 9 
 
 Acne, 387 
 
 Acupuncture, 352 
 
 Acute Articular Rheumatism, .... . , 259 
 
 " Bright's Disease, 310 
 
 " Cystitis, 305 
 
 " Nasal Catarrh, 242 
 
 " Nephritis, 310 
 
 " Poliomyelitis, .338 
 
 Addison's Disease, 308 
 
 Adenia, 318 
 
 Aestvo-Atumnal Fever, 197 
 
 Affection of Joints, 378 
 
 Agitans Paralysis, 367 
 
 Ague, 203 
 
 Albuminaria, See Bright's Disease, 312 
 
 Albumen, Examination for, 310 
 
 Alcoholism, 393 
 
 Alveolar Emphysema, 249 
 
 Anaemia, 329 
 
 Idiopathic, 332 
 
 " Pernicious, 332 
 
 Toxic, : 329 
 
 " Secondary, 329 
 
 Anatomy, 11 
 
 A-ngina Pectoris, 328 
 
 Ankle, Dislocation of, 58 
 
 Ankylosis, 189, 379. 194 
 
 Anuria, 307 
 
 Aphonia, See Loss of Voice, 25 
 
 Appendicitis 280 
 
 Apoplexy, Cerebral, 340 
 
Practice of Osteopathy 
 
 Arches, Weak, 383 
 
 Argyll-Robertson Pupil, 370 
 
 Arrangement of Vertebrae, 64 
 
 Arrhythmia, 326 
 
 Arteriosclerosis, 315 
 
 Articular Rheumatism, Acute, 259 
 
 Artificial Respiration, 380, 381 
 
 Arthritis Deformnans, 262 
 
 Ascites, 313 
 
 Asthma, Bronchial, 245 
 
 Astigmatism, 376 
 
 Ataxia, Locomotor, 369 
 
 Ataxic Paraplegia, 368 
 
 Atheroma, 315 
 
 Atlas, Examination of 22 
 
 " Treatment of, 25 
 
 Atrophy of Optic Nerve, Zld 
 
 Autumnal Catarrh, 241 
 
 Axis, Examination of, 22 
 
 " Treatment of, 24 
 
 B 
 
 Back, 31 
 
 " Examination of, 31 
 
 " Treatment of, 32 
 
 Basedow's Disease, 335 
 
 Bed Wetting, 303 
 
 Benign Tumor, 307 
 
 Big Neck, 334 
 
 Bilious Remittent Fever, 197 
 
 Black Heads, 387 
 
 Bladder, Inflammation of, 305 
 
 Blindness ZTd 
 
 Blood, Diseases of, 329 
 
 Bloody Flux, 297 
 
 Bow Legs, 378 
 
 Brachial Neuralgia, 347 
 
 Neuritis, 348 
 
 Brachycardia, 326 
 
 Breaking-up-Treatment of Spine, 33 
 
 Breast Pang, 328 
 
 " Tumors of, Z7^ 
 
 Breathing, Correct, 239 
 
 Bright's Disease, Acute, 310 
 
 Chronic, 312 
 
Index 
 
 Bromidrosis, 386 
 
 Bronchial Asthma, 245 
 
 Bronchitis, Acute, 244 
 
 Capillary, 219 
 
 Chronic, 245 
 
 Bronchocele, 334 
 
 Bronchopneumonia, 219 
 
 Burns, 400 
 
 C 
 
 Cancer, 374 
 
 Cancerous Tumors, 374 
 
 Capillary Bronchitis, 219 
 
 Caput Medusae, 290 
 
 Cartilage Thyroid, 25 
 
 Cataract, ~7il6 
 
 Catarrh, Acute Nasal, 242 
 
 Autumnal, 241 
 
 " of Stomach, 273 
 
 Catarrhal Jaundice, 285 
 
 " ^ Pneumonia, 219 
 
 Cephalgia, 371 
 
 Cerebral Hemorrhage, 340 
 
 " Apoplexy, 340 
 
 Cerebro Spinal Fever, 212 
 
 '; '; Meningitis, 212, 338 
 
 Cervical Region of the Spine, 64 
 
 Cestodes, 395 
 
 Chest, Examination of, 43 
 
 " Treatment of, 42 
 
 Child's Curve of Spine, 64 
 
 Chilblains, 398 
 
 Chicken Pox, 208 
 
 Chills and Fever, 203 
 
 Chiropractic Treatment, 13 
 
 Chlorosis, 331 
 
 Cholangitis, 290 
 
 Cholelithiasis, 287 
 
 Chorea, 357 
 
 Cholera Infantum, 296 
 
 Morbus, 295 
 
 " ^ Nostras,^ 295 
 
 Chronic Interstitial Hepatitis, 292 
 
 Circulatory System, Diseases of 315 to 329 
 
 Cirrhosis of Liver, 290 
 
Practice of Osteopathy 
 
 Cirrhosis oi Liver, Hypertrophic, 290 
 
 Clavicle, Examination of, 42 
 
 " Treatment of, 42 
 
 Cocaine Habit, 393 
 
 Coccyx, Examination of, 41 
 
 " Treatment of, 41 
 
 Coccygeal Curve of the Spine, 64 
 
 Cold Compresses, 218 
 
 Cold in the Head, 242 
 
 Colas, General, 214 
 
 Compresses, 218 
 
 Congestion of Kidney, 309 
 
 " Liver, 290 
 
 " Lungs, 247 
 
 Confluent Small Pox, 210 
 
 Conj unctivitis, 376 
 
 Contraction of Spinal Muscles, 10 
 
 Constipation, 299 
 
 Consumption, 234 
 
 Corns, 399 
 
 Cortical Epilepsy, 359 
 
 Coryza, Acute, 242 
 
 Corpulence, 214 
 
 Cramps, Milker's, 366 
 
 Pianist's 366 
 
 Cigar Maker's, 366 
 
 " Telegrapher's, 366 
 
 Writer's, 366 
 
 Crossed Eyes, 376 
 
 Croup, 225 
 
 False, 244 
 
 Croupous Pneumonia, 216 
 
 Curvature of Spine, Functional, 190 
 
 " Structural, 190 
 
 " Transitional, 190 
 
 " Rotary, 189 
 
 Curves of Spme, Cervical, 64 
 
 " " Coccygeal, 64 
 
 " " Dorsal, 64 
 
 " in Infant, 64 
 
 " " Lumbar, 64 
 
 " Normal, 64 
 
 Sacral, 64 
 
 Cystic Tumors, 374 
 
 Cystitis, 305 
 
 Danger in Treating, 13 
 
Index 
 
 Deafness, 378 and 404 
 
 Deep Breathing, 239 
 
 Degeneration of Liver, 292 
 
 " Heart, 323 
 
 Deformities, 378 
 
 " See Curvatures, 190 
 
 " See Dislocations, 57 
 
 Diagnosis, Methods of, 16 
 
 Diabetes Mellitus, 257 
 
 " Insipidus, 256 
 
 Diarrhoea, 298 
 
 Diet in Tuberculosis, 240 
 
 " See Each Disease. 
 
 Digestive Tract, Diseases of, 266 to 302 
 
 Diplopia, Vd 
 
 Diphtheria, 221 
 
 Diseases, Basedow's, 335 
 
 Graves', 335 
 
 Parkinson's, 367 
 
 Pott's, 191 
 
 of the Bladder, 305 
 
 " " Circulatory System, 315 
 
 " " Blood, 329 
 
 Cardiac, 323 
 
 of the Digestive Tract, 266 to 302 
 
 " Ear, 377 
 
 " Eye, 376 
 
 " Heart, 323 
 
 " Intestines, 280 
 
 " Kidneys, 307 to 313 
 
 " Larynx, 243 
 
 " Liver, 290 
 
 " Lungs, 234 
 
 " Nervous System, ZZ^i 
 
 " Pharynx, 267 
 
 " Pleura, 249 
 
 " Stomach, 273 
 
 " Respiratory System, 245 
 
 " Thyroid Gland, 334 
 
 " Tonsils, 226 
 
 " Urinary System, 305 to 314 
 
 Dislocation of Ankle, ; 58 
 
 " Elbow, 60 
 
 " Finger, 60 
 
 " Hip, 57 
 
Practice of Osteopathy 
 
 Dislocation of Knee, 58 
 
 Slight, 378 
 
 of Shoulder, 59 
 
 " Toes, 56 
 
 " Wrist, 60 
 
 Dorsal Region of Spine, 64 
 
 " Curve of Spine, 64 
 
 Dropsy, 313 
 
 Drug Habit, 393 
 
 Dysentery, 297 
 
 Dyspepsia, Acute, 273 
 
 " Chronic, 274 
 
 E 
 
 Ear, 2>n 
 
 Treatment of, 378 
 
 Earache, 378 
 
 Eczema, 223 
 
 of Tongue, 267 
 
 Edema of Lungs, 248 
 
 Elbow, Dislocation of, 60 
 
 " Treated, 60 
 
 Emphysema, 248 
 
 Alveolar, 248 
 
 Hypertrophic, 248 
 
 " Interstitial, 249 
 
 Vesicular, 248 
 
 Endocarditis, 328 
 
 Enlargement of Heart, 329 
 
 Enteritis Catarrhal, 295 
 
 Enteroptosis, 50 
 
 Enuresis, 303 
 
 Epilepsy, 359 
 
 Cortical 359 
 
 " Jacksonian, 360 
 
 Epistaxis, 389 
 
 Erysipelas, 225 
 
 Erythromelalgia, 349 
 
 Examination, Important, 9 
 
 " Preparation for, 10 
 
 of Abdomen, 48 
 
 " Atlas, 22 
 
 « Axis, 22 
 
 " Back, 31 
 
 " Clavicle, 42 
 
 " Coccyx, 41 
 
Index 
 
 Examination of Head, 28, 30 
 
 " Hyoid Bone, 25 
 
 " " Innominates, 54 
 
 " Limbs, 55 
 
 " Neck, 22, 27 
 
 Office, 20 
 
 of Pelvis, 51, 52 
 
 " Ribs, 43, 47 
 
 " Sacrum, 41 
 
 " Rectum, 67 
 
 Exophthalmic Goiter, 335 
 
 Extra-uterine Tumors, 375 
 
 Eyes, 376 
 
 " Crossed, 376 
 
 " Diseases of, Z76 
 
 " Weak, 377 
 
 Eyelids, Drooping of, 376 
 
 Treated, 30 
 
 Facial Neuralgia, 347 
 
 Fatty Degeneration of the Heart, 323 
 
 " " Liver, ....292 
 
 " Overgrowth of Heart 323 
 
 " Tumors, 374 
 
 Feet, Neuralgia of, 349 
 
 Fever and Chills, 203 
 
 Fever, Hay, 241 
 
 Lung, 216 
 
 Malarial, 203 
 
 Malignant Purpuric, 212 
 
 Petichial, 212 
 
 Rheumatic, 259 
 
 Scarlet, 205 
 
 Spotted, 212 
 
 Typhoid 198 
 
 Fifth Lumbar Vertebra, 40 
 
 " ^ Nerve, Treated, 29 
 
 Fibrinous Pneumonia, 180 
 
 Fibroid Tumors, 374 
 
 Finger, Dislocations of, 158 
 
 Flat Foot, 383 
 
 Flux. Bloody, 297 
 
 Fomentations, Hot, 261 
 
 Fossae, Suboccipital, 202 
 
 Frontal Sinus, 29 
 
 Frost Bite, 398 
 
Practice of Osteopathy 
 
 G 
 
 Gait, Ataxic, 369 
 
 " in Spastic Paraplegia, 368 
 
 Gall Bladder, Inflammation of, 290 
 
 " " Located, 51 
 
 " Duct, 290 
 
 " Stones, 287 
 
 Ganglion, Middle Cervical, 26 
 
 " Superior Cervical, 26 
 
 Gastralgia, 347 
 
 Gastritis, Acute, 273 
 
 Chronic, 274 
 
 Gastroenteritis, Acute, 295 
 
 General Treatment, Osteopathic, 61 
 
 of Abdomen, 48 
 
 Geographical Tongue, 267 
 
 German Measles, 231 
 
 Glaucoma, 376 
 
 Globus Hystericus, 365 
 
 Goiter, Exophthalmic, 335 
 
 Simple, 334 
 
 Gout, 264 
 
 Grand Mai, 359 
 
 Granular Liver, 290 
 
 Granulated Lids, 376 
 
 Graves' Disease, 335 
 
 Grippe, La, 206 
 
 H 
 
 Habit, Cigarette, 393 
 
 " Cocaine, 393 
 
 Drug, 394 
 
 Morphine, 394 
 
 Hands, in Treating, 49 
 
 Hay Fever, 241 and 402 
 
 Head, Examination of, 28 
 
 " Treatment of, 30 
 
 Headache, 372 
 
 Sick, 371 
 
 Heart, 321 
 
 " Dilatation of, 329 
 
 " Diseases of, 323 to 329 
 
 " Enlargement of, 329 
 
 " Fatty Degeneration of, 323 
 
 " " Infiltration of, 323 
 
Index 
 
 Heart, Fatty Overgrowth of, . . .- 323 
 
 " Hypertrophy of, 329 
 
 " Palpitation of, 326 
 
 " Valvular Lesions of, 324 
 
 " Irritable, 327 
 
 Heat-Exhaustion, 390 
 
 Hemicrania, 371 
 
 Hemiplegia, 336 
 
 Hemorrhage, Cerebral, 340 
 
 of Lungs, 235 
 
 " Stomach, 235 
 
 Hemorrhoids, 278 
 
 Hemothorax, 251 
 
 Hepatitis, Chronic Interstitial, 290 
 
 Hiccough, 338 
 
 Hip, Dislocation of, 57 
 
 Hives, 277 
 
 Hob-Nailed Liver, 290 
 
 Hot Fomentations, 261 
 
 Hydropneumothorax, 251 
 
 Hydrothorax, 251 
 
 Hyoid Bone, Examination of, 25 
 
 " Treatment of, 25 
 
 Hyperemia of Liver, 292 
 
 Hypertrophic Cirrhosis of Liver, 290 
 
 Hypertrophy of Heart, 329 
 
 Hysteria, 364 
 
 Hysteroepilepsy, 364 
 
 I 
 
 Icterus, 285 
 
 Iliac Spines, 54 
 
 Impaired Vision, Z16 
 
 Incontinence of Urine, 303 
 
 Indigestion, 274 
 
 Infant, Normal Curve of Spine, 64 
 
 Infantile Paralysis, 338 
 
 Infectious Diseases, 205 
 
 Infiltration of Liver, 292 
 
 Inflammation of Bowels, 293 
 
 " Gall Duct, 290 
 
 " Veins, 316 
 
 Inhibition of Spine, 40 
 
 Innominates, Examination of, 54 
 
 " Lesions of, 54 
 
 " Treatment of, 55 
 
Practice of Osteopathy 
 
 Insanity, 355 
 
 Insomnia, 346 
 
 Inspection, 16 
 
 of Spine, 189 
 
 Intercostal Neuralgia, 347 
 
 Interstitial Nephritis, 312 
 
 " Tumors, 307 
 
 Intestinal Obstruction, 283 
 
 Tumors, 284, Zn 
 
 Intestines Raised, 50 
 
 Intra-uterine Tumors, 375 
 
 Intussusception, 283 
 
 Invagination of the Bowel, 284 
 
 Ischia, Treatment of, 62 
 
 Ivy, Poison, » .400 
 
 J 
 
 Jacksonian Epilepsy, 360 
 
 Jaundice Catarrhal, 285 
 
 Obstructive, 286 
 
 Joint Affections, 378 
 
 Joint Deformed, 311 
 
 K 
 
 Keratitis, , . . . . 376 
 
 Kidney, Cirrhosis of, 312 
 
 Congestion of, 309 
 
 Contracted, 312 
 
 Floating, 309 
 
 Inflammation of, 310 
 
 Movable, 309 
 
 Palpable, 309 
 
 Knee, Dislocation of, 58 
 
 Knee-jerk, Loss of, 370 
 
 Koplick's Sign in Measles, 230 
 
 Kuatsu, 381 
 
 Kyphosis, 193 
 
 La Grippe, 206 
 
 Laryngitis, Acute, , . .243 
 
Index 
 
 Laryngitis, Chronic, 245 
 
 " Spasmodic, 244 
 
 " Stridulus, 244 
 
 Legs, Bowed, 378 
 
 Lesions, Determined, 11 
 
 " Innominate, 54 
 
 " Ligamentous, 25, 32 
 
 " Osteopathic, 11 
 
 Pelvic, 50 
 
 Produced Reflexly, 10 
 
 of Ribs, 43 
 
 of Spine, 31 
 
 Lids, Granulated, Z1(i 
 
 " Drooping, 377 
 
 Ligamentous Lesions, 25, 32 
 
 Ligaments, Sacro-iliac, 41 
 
 Limbs, Examination of, 55 
 
 " Old Subluxations of, 57 
 
 " Treatment of, 57 
 
 Liver, Atrophic Cirrhosis of, 290 
 
 Cirrhosis of, 290 
 
 Congestion of, 293 
 
 " Degeneration of, 292 
 
 Fatty, 292 
 
 Granular, 290 
 
 Hob-nailed, 290 
 
 Hyperemia of, 292 
 
 " Hypertrophic Cirrhosis of, 290 
 
 Infiltration of, 292 
 
 Nutmeg, 290 
 
 Treatment of, 291, 293 
 
 Lobar Pneumonia, 216 
 
 Lobular Pneumonia, 219 
 
 Locomotor Ataxia, 369 
 
 Lordosis, 31 
 
 Loss of Voice, 25 
 
 Lumbago, 352 
 
 Lumbar Curve of Spine, 64 
 
 " Region of Spine, 64 
 
 Lung Fever, 216 
 
 Lungs, Congestion of, 247 
 
 " Edema of, 248 
 
 " Hemorrhage of, 235 
 
 " Tuberculosis of, 234 
 
 Lymphadenoma, 318 
 
Practice of Osteopathy 
 
 M 
 
 Malarial Fever, 203 
 
 Malignant Purpuric Fever, 212 
 
 " Tumors, 374 
 
 Measles, 230 
 
 German, 231 
 
 Meningitis, Acute, 212, 338 
 
 " Cerebro Spinal, 212 
 
 " Spinal, 213 
 
 Infantile, 338 
 
 Mental Disorders, 355 
 
 Methods of Diagnosis, 16 
 
 Migraine, 371 
 
 Mollities Ossium, 195 
 
 Morbilli, .230 
 
 Morphine Habit, 393 
 
 Mouth, Diseases of, 266 
 
 Dry, 266 
 
 Inflamed, 266 
 
 " Opened Against Resistance, 26 
 
 Ulcers of, 267 
 
 Mumps, 240 
 
 Muscle, Pyriformis, 364 
 
 Muscles, Diseases of, 350, 352 
 
 Pain in, .350 
 
 Scaleni 24 
 
 Muscular Rheumatism, 350, 351 
 
 Myalgia, 351 
 
 Myocarditis, 328 
 
 N 
 
 Nasal Catarrh, 242 
 
 Neck, Examination of, 22, 27 
 
 " Spiral Treatment of, 27 
 
 Stiff, 351 
 
 " Treatment of, 23 
 
 Nephritis, Acute, 310 
 
 " Chronic, 312 
 
 Interstitial, 312 
 
 " Parenchymatous, 312 
 
 Nephrotosis, 309 
 
 Nerve, the Fifth, 29, 348 
 
 Nervous Exhaustion, , 362 
 
 " Prostration, 362 
 
 Nettle Rash, -. ,,,,.,,.,,.,,,,, ,277 
 
Index 
 
 Neuralgia, Brachial, 348 
 
 Facial, 348 
 
 Feet, 349 
 
 " Intercostal, 350 
 
 Pedal, 348 
 
 Red, 348 
 
 Spinal, 347 
 
 Stomach, 347 
 
 Neuritis, Brachial, 348 
 
 Neurasthenia, 362 
 
 Neurosis, Occupation, 366 
 
 Normal Curves of Spine, 64 
 
 " " " in Child, 64 
 
 Spine, 64 
 
 Nose, 29 
 
 Nose Bleeding, 389 
 
 Nostrils, 29 
 
 Nutmeg Liver, 290 
 
 O 
 
 Oak, Poison, 400 
 
 Occipital Nerves, . ._ 25 
 
 Occupation Neurosis, '. 366 
 
 Obesity, 253 
 
 Obstruction, _ Intestinal, 283 
 
 Office Examination, 20 
 
 " Description of, 20 
 
 Optic Nerve, Atrophy of, 376 
 
 Osteomalacia, 195 
 
 Osteopathic Lesion, 11 
 
 " Treatment, General, 61 
 
 Stool, 60 
 
 Table, 60 
 
 Technique, 9 
 
 Ovarian Tumors, 377 
 
 Oxyuris Vermicularis, 315 
 
 P 
 
 Palpation, 16 
 
 Palpitation of Heart, 326 
 
 Palsy, Shaking, 367 
 
 Paralysis, 336 
 
 " Agitans, 367 
 
 Cigar Maker's, 366 
 
 Infantile 338 
 
Practice of Osteopathy 
 
 Paralysis, Milker's, 366 
 
 " Pianist's, 366 
 
 Spastic Spinal, 368 
 
 " Telegrapher's, 366 
 
 Writer's, 366 
 
 Paraplegia, 336 
 
 Spastic, 368 
 
 Parkinson's Disease, 367 
 
 Parotitis, 240 
 
 Passive Congestion of Liver, 293 
 
 Pedal Neuralgia, 349 
 
 Pelvis, Examination of, 50, 52 
 
 " Treatment, 50, 53 
 
 Penman's Paralysis, 366 
 
 Pericarditis, 324 
 
 Percussion, 16 
 
 Perihepatitis, Acute, 292 
 
 " Chronic, 292 
 
 Peristaltic Action, 41 
 
 Peritonitis, 293 
 
 Pernicious Anaemia, 332 
 
 Pertussis, 232 
 
 Petechial Fever, 212 
 
 Petit Mai, .360 
 
 Phthisis, 234 
 
 Pharyngitis, Acute, 267 
 
 " Chronic, 267 
 
 Phlebitis, 316 
 
 Physiology, Knowledge of, 11 
 
 Pianist's Paralysis, 366 
 
 Piles, 278 
 
 Pin Worms, 397 
 
 Pleurodynia, 350 
 
 Pleurisy, Acute, .249 
 
 Chronic, 250 
 
 Dry, 250 
 
 with Effusion, 250 
 
 Pneumogastric Nerve, Located, 25 
 
 " Treated, 25 
 
 Pneumonia, Broncho, 219 
 
 Catarrhal, 219 
 
 Capillary, 219 
 
 " Croupous 216 
 
 " Fibrinous, * 216 
 
 Lobar, 216 
 
 Lobular, .219 
 
 Pneumonitis, ^..^=....,,. .^^..^...,.216 
 
Index 
 
 Pneumothorax, 216 
 
 Podagra, 264 
 
 Poliomyelitis, 338 
 
 Pott's Disease, 191 
 
 Poison Oak or Ivy, 400 
 
 Preparation for Treatment, 10 
 
 Prostration, Nervous, 362 
 
 Pterygium, 376 
 
 Ptosis, 377 
 
 Pupil, Argyll-Robertson, 370 
 
 Purpuric Fever, Malignant, 212 
 
 Pyopneumomothorax, 251 
 
 Pyriformis Muscle, 296 
 
 Q 
 
 Quinine in Malaria, 204 
 
 Quinsy, 228 
 
 Quotidian Fever, 203 
 
 R 
 
 Rachitis, 251 
 
 Rash, Nettle, 277 
 
 Rectal Treatment of Coccyx, 41 
 
 Rectum, Treatment of, 41 
 
 Red Neuralgia of the Feet, 349 
 
 Renal Dropsy, 313 
 
 Respiration, Artificial, 380, 381 
 
 Respiratory Tract, Diseases of, 251 
 
 Retinitis, 376 
 
 Rheumatic Gout, 262 
 
 Fever, 259 
 
 Rheumatism, Acute Articular, 259 
 
 Inflammatory, 259 
 
 Muscular, 351 
 
 " Sciatic 363 
 
 Rheumatoid Arthritis', 262 
 
 Rickets, 25''1 
 
 Ribs, 43 
 
 " Examination of, 43 
 
 " Treatment of, 43, 47 
 
 " First, 43 
 
 " " Treatment of, 44 
 
 " " Examination of, 44 
 
 " Lesions of, 43, 44 
 
 " Twelfth, Examination of, 47 
 
Practice of Osteopathy 
 
 Rib, Twelfth, Treatment of, 47, 48 
 
 Rigid Spine, 194 
 
 Romberg's Symptom, 369 
 
 Rotary Curvature of Spine, 189 
 
 Rotheln, 231 
 
 Round Worms, 314 
 
 Rubella, 231 
 
 Rubeola, See Rubella, 231 
 
 S 
 
 Sacral Curve of Spine, 64 
 
 " Region of Spine 64 
 
 Sacrum, Examination of, 41 
 
 " Treatment of, 41 
 
 Scaleni Muscles, 24 
 
 Scarlatina, See Scarlet Fever, 205 
 
 Scarlet Fever, 205 
 
 Sciatica, 363 
 
 Sciatic Rheumatism, 62, 363 
 
 Nerve Stretched, 56 
 
 Scurvy, 269 
 
 Scoliosis, 189 
 
 Shoulder, Dislocation of, 59 
 
 " Treatment of, 59 
 
 Shaking Palsy, 367 
 
 Sick Headache, 371 
 
 Sinus, Frontal 28 
 
 Lateral, 28 
 
 " Longitudinal 28 
 
 Sleeplessness, 346 
 
 Slight Dislocation, 379 
 
 Small Pox, 209 
 
 Smooth Spine, 32 
 
 Solar Plexus, Treatment of 50 
 
 Sore Throat, 267 
 
 Spastic Paraplegia, 368 
 
 " Spinal Paralysis, 368 
 
 Spinal Curvature, 139 
 
 " Neuralgia, 347 
 
 " Inhibition, 40, 271 
 
 /' Paralysis, Infantile, 338 
 
 Spine, The, 64 
 
 " Abnormal, 62 
 
 " Arrangement of Vertebrae, 64 
 
 " Cervical Region, 64 
 
 " Coccygeal Region, 64 
 
Index 
 
 Spine, Dorsal Region, 64 
 
 " Examination of, 31 
 
 " Inspection of, ' 31 
 
 " Lumbar Region of, 64 
 
 " Normal Curves of, 64 
 
 " Rigid, 34, 194 
 
 " Sacral Region of, 64 
 
 Smooth, 32 
 
 Treatment of, 33 to 41 
 
 Spines, Iliac, 54 
 
 Spiral Treatment of Neck, 27 
 
 Spondylotherapy, 381 
 
 Sporadic Cholera, , 295 
 
 Spotted Fever, 212 
 
 St. Anthony's Fire, 225 
 
 Stenocardia, 328 
 
 Sternum, 43 
 
 Stiff Neck, 351 
 
 Stomach, Catarrh of, 274 
 
 Diseases of, 273 
 
 " ^ Neuralgia of, 347 
 
 Stomatitis, Acute, 266 
 
 Apthous, 267 
 
 Stool, Osteopathic, 60 
 
 Strabismus, 376 
 
 Strangulation of the Bowel, 284 
 
 Stricture, 283 
 
 St. Vitus' Dance, 357 
 
 Subluxations of Limbs, 57 
 
 Sub-Occipital Fossae, 25, 202 
 
 Sudamina, 386 
 
 Sun Stroke, 390 
 
 Supraorbital Nerve, 29 
 
 Superior Cervical Ganglia, 26 
 
 Suppression of Urine, 307 
 
 Sweating of Feet 386 
 
 Sweat Glands, Disordered, 386 
 
 Sylvester's Artificial Respiration, 380 
 
 T 
 
 Tabes Dorsalis, 369 
 
 Table, Osteopathic, 60 
 
 Tachycardia 326 
 
 Taenia, Saginata, 395 
 
 Solieum, 395 
 
 Tape Worms, 395 
 
Practice of Osteopathy 
 
 Tarsalgia, 349 
 
 Tear Duct, Closed, 376 
 
 " Treated, 29 
 
 Technique, Osteopathic, 9 
 
 Telegrapher's Cramp, 366 
 
 Paralysis, 366 
 
 Tic Douloureux, 348 
 
 Thorax, Examination of, 43 
 
 " Treatment of, 86 
 
 Thread Worms, 397 
 
 Throat, Sore, 267 
 
 Treated, 277 
 
 Thyroid Cartilage, 25 
 
 Toes, Dislocation of, 56 
 
 Tongue, Eczema of, 267 
 
 " Geographical, 267 
 
 Tonsillitis, Acute, 226 
 
 Chronic, 228 
 
 Follicular, 228 
 
 Tonsils Located, 227 
 
 Enlarged, 228 
 
 Torsion of Spine, 39 
 
 Torticollis, 351 
 
 Toxic Anaemia, 329 
 
 Trachoma, 377 
 
 Traction of Spine, 27 
 
 Treatment, Kimono for, 10 
 
 of Abdomen 49 
 
 " Atlas, 27 
 
 " Back, 31 
 
 " " Coccyx, 41 
 
 " Clavicle, 42 
 
 " Eyes, 30 
 
 " General Osteopathic, 61 
 
 of Head, 28 to 32 
 
 " Hyoid Bone, 25 
 
 " " Innominate Bones, 54 
 
 " Ischia, 62 
 
 " Limbs 55 
 
 " Liver, 291, 293 
 
 " Neck 23, 25 
 
 " Pelvis, 50, 53 
 
 " " Pyraformis Muscle, 62 
 
 " Rectum, 41 
 
 " Ribs, 62, 43, 47 
 
 " " Sacrum, 41 
 
 " Special Directions, 19 
 
Index 
 
 Treatment of Thorax, 43 
 
 " Time Necessary, 18 
 
 of Solar Plexus, 50 
 
 Tuberculosis, 233 
 
 " Chronic Pulmonary, 234 
 
 Diet in, 240 
 
 of Lungs, 234 
 
 Tumors, Abdominal, 374 
 
 Benign, 375 
 
 of Breast, Zld 
 
 Cancerous, 374 
 
 Cystic, 374 
 
 Extra-uterine, 375 
 
 Fatty, 374 
 
 Fibroid, 374 
 
 Interstitial, 375 
 
 Intestinal, 284 
 
 Intra-uterine, 375 
 
 Malignant, 374 
 
 Ovarian, 375 
 
 Uterine, 375 
 
 Typhoid Fever, 198 
 
 Typho-Malaria Fever, 197 
 
 U 
 
 Uremia, 306 
 
 Urinary System, Diseases of, 305 to 314 
 
 Urine, Examination of, 310 
 
 " Incontinence of, 303 
 
 " Suppression of, 307 
 
 Uterine Tumors, 375 
 
 Urticaria, 277 
 
 V 
 
 Valvular Lesions of Heart, 324 
 
 Varicella, 208 
 
 Varicose Veins, 317 
 
 Variola, 209 
 
 Varioloid, 211 
 
 Veins, Enlarged, 317 
 
 " Inflammation of, 316 
 
 Varicose 317 
 
 Vertebra, Atlas Examined 22 
 
 " Axis Examined, 22 
 
 ** Atlas Treated, 25 
 
Practice of Osteopathy 
 
 Vertebra, Axis Treated, 25 
 
 Lumbar, Fifth, 40 
 
 Seventh Cervical, 22 
 
 Vertebrae, Approximation of, 32 
 
 " Deviation of, 31 
 
 Lesions of, 31 
 
 " Separation of, 32 
 
 Vision Impaired, 308 
 
 Voice, Loss of, 25 
 
 Vomiting, 271 
 
 Volvulus, 283 
 
 W 
 
 Warts, 400 
 
 Weak Eyes, 376 
 
 Wet Pack, 206 
 
 Whooping Cough, 232 
 
 Women, Diseases of, 51 
 
 Worms, 395 
 
 Pin, 396 
 
 Tape, 395 
 
 Round, 395 
 
 Thread, 396 
 
 Wrist, Dislocation of, 60 
 
 Writer's Cramps, 366 
 
 Paralysis, 366 
 
 Wry Neck, See Torticollis, 351 
 
t 
 
 Osteopathic Gynecology | 
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 Disease and Rational 
 Therapy 
 
 By Alva Emery Gregory, M. D., D. C. 
 
 This work contains seven chapters, teaching help- 
 ful drugless methods. 
 
 It also treats, alphabetically, practically every dis- 
 ease, giving the definitions, etiology, pathology, 
 symptomatology, diagnosis and prognosis, and also 
 directions for the correct spinal adjustment and spin- 
 al concussion, and when and how to apply four other 
 drugless auxiliary methods, best to be used in each 
 and every case. 
 
 This work will serve as a handy and valuable refer- 
 ence in difficult cases when your other method fails 
 or is slow in securing results. 
 
 This work is worth a hundred times what it costs. 
 And the money will be refunded if it is not satis- 
 factory. 
 
 Second Edition Enlarged. About 600 pages. 
 $5.00 prepaid. Half Morocco $6.00. 
 
 Address all orders to 
 MURRAY PUBLISHERS, 
 465 Douglas Ave., Elgin, 111. 
 
4^ Chiropractic Books. — Continued 
 
 ^ 
 
 Spondylotherapy Simplified 
 
 By ALVA EMERY GREGORY, M. D., D. C. 
 
 This work contains directions for spinal concus- 
 sion which are brief, clear, concise. 
 
 The first chapter of this excellent work treats of 
 the philosophy of spinal concussion, and tells the 
 rate of concussion, the force of the concussion and 
 the proper time of continuance. 
 
 The chapter names the centers to concuss, to con- 
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 The third chapter teaches the different effects pro- 
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 The fourth chapter names the different diseases in 
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 This work contains within three hundred pages 
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 Life is short. You want your information in a nut- 
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 Prepaid $3.00. 
 
 Legal Rights 
 
 Col. Sol. L. Long prepared this book, which con- 
 tains a summary of all the laws affecting the Drug- 
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 supreme court affecting them. 
 
 It also outlines the proper line of defense in cases 
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 Sheep Library Binding, Prepaid $3.00. 
 
The 
 
 Successful Promotion 
 of Drugless Practice 
 
 OF ALL SCHOOLS 
 
 This book tells how to quickly secure 
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 read here exactly what he did and why 
 and how. 
 
 The various methods are fully ex- 
 plained by which a practice grew from 
 nothing to the treatment of 83 patients 
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 months 50 patients were being treated 
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 What is the use of waiting " for some- 
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 Your services are needed. 
 
 This is a book of facts not Padded, 
 64 pages. 
 
 Price $2.50 
 
 Address all orders to 
 
 MURRAY PUBLISHERS 
 
 465 Douglas Ave., Elgin, 111. 
 
Sex Force 
 
 This remarkable book presents private 
 lessons in the cultivation of Sex Force, 
 [t shows this to be the Vital Power of At- 
 traction between the Sexes. The work 
 teaches its control and Transmutation for 
 Greater Strength and higher Develop- 
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 The author of this work has been 
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 Finding that these teachings did so much 
 good he finally acceded to the urgent re- 
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 there will be many misinterpretations of 
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 This book is bound in cloth and has 202 
 pages. 
 
 Price $1.10. 
 
 Send all orders to the 
 
 MURRAY PUBLISHERS 
 
 465 Douglas Ave., Elgin, 111. 
 
A A A ^^ A A A A A ^^ A ^ 4 ^4 ^4 A ^4 ^ 4 A A t^^ A- 
 
 Sex Secrets 
 
 By Robert B. Armitage, M. D. 
 
 You should turn on the light by reading this great 
 work by this Eminent Authority. The book is in 17 
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 The main divisions of the work are: 
 
 Why Sex Secrets Should Be Told. 
 
 The Anatomy and Physiology of Sex. 
 
 The Human Sexual Organism. 
 
 The Psychology of Sex. 
 
 The Evolution of Marriage. 
 
 The Future of Marriage. 
 
 The Fall and Rise of Women. 
 
 The Mistakes of the Bridegroom. 
 
 Immorality in Marriage. 
 
 The Purpose of the Sexual Relation. 
 
 The Dual-Function of the Sex Life. 
 
 Is Continence Harmful? 
 
 The Merits of Continence. 
 
 Standards of Sex Morality. 
 
 The Social Evil. 
 
 Birth Control. 
 
 The price of this book in cloth binding is only $2. 
 
 For sale by 
 
 MURRAY PUBLISHERS 
 465 Douglas Ave., Elgin, 111. 
 
 
Private 
 
 Sex Lessons 
 
 of a Physician 
 FOR 
 
 Married Men and Women 
 
 The greatest amount o£ personal instructions ever 
 put in the same number of words. 
 
 Of Special Importance to the Children. 
 
 THE SCIENCE OF BIRTH CONTROL. 
 
 Fewer but better babies should be the aim of every 
 married couple. 
 
 THE TIME AND APPEARANCE AND SEX of 
 the child under absolute control of the parents. 
 
 By David H. Reeder, Ph. D., M. D., D. O. 
 
 $1.10 prepaid. 
 
 Send for circulars on other sex books. 
 
 For sale by 
 MURRAY PUBLISHERS 
 465 Douglas Ave., Elgin, 111. 
 
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