Book of Year 1941

VOLUME 4
SELECTED PAPERS
FROM THE
SECTlONS OF TECHNIC
AND
MANlPULATlVE THERAPY
GIVEN AT ATLANTIC CITY
1941
Published by the
OSTEOPATHIC MANIPULATIVE THERAPEUTIC

and
CLINICAL RESEARCH ASSOCIATION

Affiliated with the
AMERICAN OSTEOPATHIC ASSOCIATION
All Rights Reserved American Academy of Osteopathy
FOREWORD
The papers printed in this volume were selected from the papers
given in the Technic and Manipulative Therapy Sections. One very outstanding paper that we had planned to use will be printed shortly in the
Journal of the American Osteopathic Association. The title is Manipulative Treatment in Eye, Ear, Nose and Throat Diseases by T. J. Ruddy,
D. O.
We are very happy to be able to include for the first time several
papers from the Technic Section, It is to be hoped that from now on these
two Sections will be cooperating in putting on a well rounded osteopathic
program and that it may be our privilege to continue to use papers from
both Sections in the future as a result of closer cooperation between these
Sections.
These papers are printed as given without editing and carry only the
opinions of the authors and do not reflect endorsement of the American
Osthpathic Association or this Association. They are gratefully accepted
as the opinion of the author who has generously given of his time preparing each paper. When studying these manuscripts, please remember
that they were prepared by busy men without any pretense of complete
coverage of the subject. They are the observations and opinions of the
author who has made his contribution for the benefit of the profession
and he is entitled to be credited with the same honesty of purpose and
accorded the same charity for errors which we would like under similar
circumstances.
We are deeply indebted to those who have made these contributions
and we trust that those who study these manuscripts will be willing to
make additional contributions by writing out some of their own experiences for the good of the profession and send them to the secretary.
THOMAS L. NORTHUP, D. O.
Secretary and Treasurer
Altamont Court Apts.,
Morristown, N. J.
Nov. 15th, 1941
PLEASE TAKE NOTICE

These papers were given as a part of the program of the National
Convention of the American Osteopathic Association and are put in this
form by permission. They may not be reproduced without special permission arranged for through The Osteopathic Manipulative Therapeutic
and Clinical Research Association or The American Osteopathic Association.
,.
SELECTED PAPERS
FROM THE
SECTIONS OF TECHNIC
AND
MANIPULATIVE THERAPY
GIVEN AT ATLANTIC CITY
1941
VOLUME 4
Published by the
OSTEOPATHlC MANIPULATIVE THERAPEUTIC

and
Affiliated with the
AMERICAN OSTEOPATHIC ASSOCIATION
PALLIATIVE TREATMENT IN CARDIAC PAIN

GEORGIA A. STEUNENBERG , D. O.
Cardiac pain has a cause. To find the cause and remove it, if possible, is the prerogative of the Osteopathic Physician. If the cause cannot
be removed, I maintain that Osteopathic manipulation, properly applied,
Will give more relief, withbut danger to the patient, than any drug now
known.
Dr. A. T. Still said, The rule of the artery is supreme. Do we
realize the full meaning of this short sentence? All parts of the body must
receive the required amount of blood-but the blood itself must contain
the elements necessary to maintain health.
THE BLOOD SUPPLY TO THE HEART
The right and left coronary arteries arise from the sinus of Valsalva
-pouches in the aorta and pulmonary artery behind each semilunar valve.
The coronary veins return the blood from the substance of the heart and
terminate in the coronary sinus.
THE NERVE SUPPLY TO THE HEART
The superior cervical ganglion is situated opposite the transverse
process of the second and third, and sometimes the first, cervical vertebra.
The superior cardiac nerve arises from the lower part of the ganglion
and in the neck communicates with the upper cervical cardiac branch of
the vagus and with the middle cardiac nerve of the sympathetic and with
the external and recurrent laryngeal nerves. It sends small branches to
the pituitary gland. The superior cardiac nerve is vasomotor and inhibitory-and is distributed to the superficial cardiac plexus.
The middle cervica1 ganglion is situated, at the level of the sixth cervical vertebra. It communicates with the fifth and sixth cervical nerves
and is connected with the inferior cervical ganglion. The middle cervical
ganglion gives off branches to the thyroid and the middle cardiac nerve.
The middle cardiac nerve is distributed to the deep cardiac plexus.
The inferior cervical ganglion is placed in a depression between the
neck of the first rib and the transverse process of the seventh cervical
vertebra. It communicates with the seventh and eighth cervical nerves.
It is united with the first thoracic ganglion. It gives off branches to the
inferior cardiac nerve which communicates with the middle cardiac and
recurrent laryngeal and joins the deep cardiac plexus. Some fibres are
vasodilators.
The inferior cardiac nerve occasionally arises from the first thoracic
ganglion. Some sympathetic fibres terminate in the middle and lower
cervical ganglia-these are the cardiac accelerators and some of the secretory fibres of the sweat glands of the upper extremity. This accounts for
the profuse perspiration of the head and neck in certain heart ailments.
The autonomic nervous system through the vagus plays an important
part in certain heart conditions-especially is this true in an imbalance of
the pituitary, thryoid, and suprarenal glands.
Angina pectoris vasomotoria or pseudo-angina pectoris is a condition marked by precordial pain due to vasomotor disturbance with no
apparent disease of the heart, but has many symptoms in common with
true angina pectoris-such as intense paroxysmal thoracic pain with a
suffocation and syncope.
My first severe case of this type I treated, with the help and encourage2
ment of the Old Doctor, while on the staff of the American School of
Osteopathy. It was the case of a male patient, age 48. When we first
saw him he was propped up in bed, with severe pain in. the upper left
chest, unable to speak; profuse perspiration from the level of the fourth
thoracic to the top of the skull ; face; pale. The Old Doctor placed him
in a highbacked rocking chair with support for his arms. We placed
blocks under the rockers, tilting the chair to an angle of about 40 degrees,
with his feet elevated. The Old Doctor proceeded to do considerable
soft tissue work, using steady pressure in the lower cervical and upper
thoracic area. He then adjusted the sixth and seventh cervical and. the
first and second thoracic vertebrae, telling me to always be sure that the
ligamentum nuchae was in normal position. Then he adjusted the first
rib. The patient received immediate relief. I treated him through six
succeeding attacks during the following year, but needless to say, I could
not give relief as quickly as the Old Doctor did. This patient did not
have an attack after a year. He died at the age of 70 as the result of an
accident.
I have had during my many years of practice, 266 cases of this type.
I have had 180 cases of angina pectoris-ten of whom had aortic
aneurysm, 150 with diseases of the coronary artery, and 20 cases in which
I did not complete my diagnosis. I have noticed one clinical symptom characteristic of the true angina cases-severe pain in the left arm. Thirty
of these cases came to me complaining of pain in the left arm, with no
other symptom of a heart lesion. When I examined them carefully and
had an electro-cardiograph made, I found heart involvement.
The following case is a typical one of true angina:
Patient, male, age 56, confined to his bed. I examined him between attacks. He had just returned from a noted Eastern clinic. Their diagnosis
was angina pectoris with general arteriosclerosis and that he would not
live through another attack. He had been given nitroglycerin and instructed how and when to take it and to remain in bed the rest of his life.
I agreed with the diagnosis but not with the prognosis. I instructed the
nurse to give him an eliminative diet, containing all the essential vitamins.
I gave him soft tissue manipulations, consisting of steady pressure in the
lower cervical and upper thoracic area, every day. On the third day an
attack started just as I entered the room. The nurse started to administer the nitroglycerin. I objected. I was sure I could give him more
relief than any drug could. After this attack he refused to take a drug
of any kind, saying he felt good after the Osteopathic treatment. After
three months he was comfortable and lived sixteen years.
He led a normal life, attending to his business. One thing I cautioned
him about-to never allow himself to become violently angry. He had
a group lesion of the ninth, tenth, eleventh, and twelfth thoracic vertebrae.
with overactivity of the suprarenal glands. We know that the active principle of medulla of the suprarenal bodies is epinephrine-its action is
to slow the heart and increase the blood pressure. We also know that,
loss of emotional control activates the suprarenal bodies. During the
sixteen years, I treated him every three or four days, to support the heart.
One day he became violently angry, had a cerebral hemorrhage, and died
in twelve hours. The autopsy showed one coronary artery closed and the
other partially occluded. I have described this case minutely to demonstrate the relief Osteopathy can give in the agonizing pain of angina
pectoris.
3
A case of myocarditis. This type does not as a rule have severe pain
but rather a general distress with some pain in the chest, weakness of
the arms and legs, considerable apprehension, persistent characteristic
cough, and shortness of breath on slight exertion. I have had 310 cases
of this type, ranging from four years to old age. The area from the sixth
cervical to the fifth thoracic, with the upper ribs on the left side, are the
usual lesions. The results Osteopathy secures in this type of case is truly
wonderful.
RECAPITULATION
1. Violent correction of bony lesions is contraindicated.
2. Steady pressure and careful manipulation of the tissues over the area
from the sixth cervical to the first thoracic, freeing the vasodilators.
Remember that the action of nitroglycerin is vasodilator, but it is
also a poison. Osteopathy leaves no bad after effects.
3. Gentle manipulation over the area of the third cervical relieves hypertension.
4. In cases of myocarditis gentle correction of lesions from the sixth
cervical to the fifth thoracic, including correction of rib lesions.
5.. Steady pressure over the area of the ninth, tenth, eleventh, and
twelfth thoracic to normalize the suprarenal glands.
6. Normalize the occipito-atlantal area to relieve the irritation to the
vagus and the autonomic nervous system.
I have found that when I have failed to relieve the patient it was due
to my own inefficiency ; not to the limitation of Osteopathic Therapeutics.
SCIENTIFIC MANIPULATION OF THE LOW BACK

R. E. MARTINDALE , D. O.
The title of this paper is not intended to suggest that other papers
on this much discussed subject are not scientific or perhaps even more S O
than this one. The above title was chosen because of the fact that thoughtful osteopathic manipulation of the low back is scientific and must be
scientific to succeed.1
Much valuable material has been written and much excellent work
has been done to give us a better and more workable understanding of
low back disorders. This paper is not intended to discredit these contributions ; it is hoped that it may render them more valuable by the presentation of observations covering a period of thirteen years of osteopathic
practice by one man.
Osteopathic management must be just as scientific as surgery or
dentistry or any other branch of the healing arts, because the conditions
which exist in the body in the form of structural maladjustments are just
as precise in detail as are those conditions calling for surgical or dental
care. Because we are dealing with definite mechanical abnormalities it
is our responsibility to diagnose these abnormalities and to institute corrective measures which are corrective from a scientific point of view.
In order to do this, whatever measures are determined upon for a giver
case must be pushed systematically. Substantially the same routine must
be followed each time the patient is seen unless a change in diagnosis has
altered the treatment requirements. Under this system no physician can
become guilty of giving routine treatments. Likewise, no physician can
4
treat both sides of the spine alike unless he is dealing with a normal spine.
These are not so common in osteopathic practice.
The obstacle that has prevented osteopathy from growing with the
same degree of rapidity that characterized its early days, and that will
continue to halt osteopathic progress if not removed, is the lack of a
uniform method of arriving at a correct structural diagnosis. Osteopathic
structural diagnosis has been made to seem so difficult that the average
osteopathic physician feels that it is only a gifted few who have the skill
of palpatory technic to enable them to make the necessary findings and
then use those findings to get results which no ordinary mortal could hope
to match.
In this paper I shall try to set forth a method of treatment, based on
a method of diagnosis and backed by sound mechanical principles, that is
workable for every one of us. Not only is it workable, it gives results
that are uniformly excellent. The method is not confined to the treatment of the lower back, but is equally applicable to the entire spine. I
firmly believe that this method, if in general use by our physicians, would
renew the old enthusiasm so common to the older men in osteopathy, who
somehow caught the secret of successful osteopathic manipulation from
Dr. A. T. Still. Enthusiasm commensurate with what osteopathy has to
offer is only enjoyed by those who get uniformly good results from osteopathic procedures. It is my hope that every osteopathic physician may
realize the good that he may do with his hands if he will use them intelligently and with a sound reason for every move that he may make in treatment. Treatment procedures for which we cannot give a definite and
logical reason are questionable and probably should not be employed.
Manipulative treatment procedures not based on a previous structural
diagnosis have no basis to recommend themselves. Results obtained by
them will only approximate those obtained by massage and may not even
be as satisfactory. Great harm may be done to the patient if osteopathic
technic is employed in exactly the opposite manner from what the diagnosis indicates to be necessary. One would not usually open the left
lower abdomen to remove an appendix.
Osteopathic manipulation is not scientific if it is directed to a spinal
area simply with the idea in mind of restoring mobility. The often quoted
statement, roll the bones and they will go home, and a similar one, if
we get motion the tendency is always towards the normal, are subtle
and damning insults to osteopathy. If motion between vertebrae in lesion
is not produced in a scientific manner, ligaments may be damaged which
are already doing their utmost to prevent greater deformity of structure.
The resultant increased flexibility brought about by this mobilizing action
may bring about an increase of structural derangement. Scientifically,
mobilization of a lesioned area should never be attempted unless some
method of improving the cause for that lesioned area is a part of the treatment. The mobilization should be done according to definite plan with.
the purpose of counteracting the forces which have produced the lesion
or which may act to maintain it.
It matters little what particular technic one uses to correct a lesioned
area of the spine if he corrects it with a minimum of trauma and if the
technic employed reverses in its mechanical details the action of any abnormal forces which may be having an influence upon the lesioned area.
The important thing to remember is that in the interest of the patient
every lesion must be corrected, the term lesion being used in this paper
5
to denote a maladjustment of structure or function of localized areas of

the spine or pelvis.
While Dr. Arthur D. Becker was at Kirksville he impressed upon me
the importance of scoIiosis as a factor to be reckoned with in the successful
handling of spinal disorders. Since that time I have constantly kept in
mind the influence which scoliosis, however slight, may have in hindering
the progress of patients under osteopathic care, and the evidence that
scoliosis plays a major role in the development and maintenance of spinal
lesions has been accumulating.
It has become more and more apparent to me that if osteopathic technical procedures are to have anything like maximum effectiveness they
must be so directed that in addition to the usual mobilizing and relaxing
effect, there will also be the effect of lessening the influence of the scoliosis
which is present in a very high percentage of cases. Every corrective
move should be aimed at correcting the lesion, plus mitigation of the
rotation and side-bending that are present in scoliosis. This is not difficult
and simply requires that corrective forces be so applied that they will
directly oppose the forces which produced the existing scoliosis. Of course
this means that an understanding of the mechanics of scoliosis is necessary,
for without that understanding it is obvious that we should be unable to
use reverse mechanics in treatment.. If one is careless in his treatment,
or does not take into account the scoliotic factor, or if he mis-diagnoses
the curvature in the spine, it is easy to see how forces may be used which,
instead of reversing the mechanics of the curviture, are inadvertently
used to make it more pronounced.
There will be little time in this paper to discuss the many and varied
conditions which are responsible for the development of some degree of
scoliosis in about ninety percent of osteopathic patients; but I believe that
if all growing children were checked every three months for spinal and
especially sacro-iliac lesions, and if all children got sufficient exercise of
their back muscles to keep them strong, most of the factors which today
produce scoliosis would be eliminated. The time to correct scoliosis is in
childhood and even then energetic steps must be taken or our efforts will
result in failure. This applies as definitely to the mild as to the severe
case, because as soon as any degree of curvature exists forces are set in
motion which we must oppose with the utmost vigor or our efforts to normalize that spine will fail.
We must never lose sight of the fact that once a curve is started the
following factors must constantly be borne in mind-the child's muscular
weakness ; a sacro-iliac subluxation if present, and it usually is; the
shortening of muscles, ligaments, and fascia of the concave side of the
curve ; wedging of the intervertebral fibro-cartilages ; and a tendency to
vertebral rotation. Taken collectively, these factors which oppose any
effort to correct scoliosis may not be taken lightly. Add to these the
tendency to slumped posture, which, by the way, is almost always produced
by scoliosis of one degree or another, and it will be seen that we really
have a job cut out for us.
A subluxated sacrum is to my mind the first ranking cause of scoliosis in children, and the tragic thing about it is the fact that it almost
never produces local symptoms which would direct the parents attention
to the cause. The usual symptoms are of a general nature-loss of color,
loss of appetite, nervousness, poor posture, a tendency to colds and other
illness, enlarged tonsils, and loss of vitality to a considerable degree. The
6
longer the spine of the individual child, the more pronounced these symptoms usually become. This is because a longer spine gives a longer lever
arm for the force of gravity to work with, and greater care must-be taken
of these cases. If the spine and sacrum can be straightened all of these
symptoms will usually disappear. Whenever we see a child who is chronically pale or nervous, or both, almost always there will be found a sacroiliac subluxation together with some spinal curvature. If the public were
informed of this we would not see so many little ghosts walking about.
The time will come when spinal X-Ray examination of children in
the standing position will be the routine rather than the exception. That
time will come a bit late for some of our children of today. And when these
same neglected children become the low back cases of tomorrow they will
no doubt express regret that they did not live in a more enlightened day.
The time is ripe for some of you X-Ray men who are in key positions to
do a little research work. It would indeed be interesting to see what the
spines of children from an entire school would look like. My impression
is that it would make ones eyes pop!
There are many etiological and contributory conditions entering into
this low back situation which must all be taken into consideration, but
it will be assumed that most of these are well known to us. Scoliosis has
been heavily stressed because lower back disorders are rarely found except
in the presence of some degree of scoliosis. Other important points are
disorders of the abdomen and pelvis, but in my opinion these disorders are
usually secondary to the spinal ones. However, when present they present
a very definite problem in the treatment. In this connection the surgeon
must remove pathology from our inner man, but it is seldom that he can
tell us why that same pathology developed. Is it not likely that most of
this pathology is caused by abnormal spinal conditions? Once it has
developed it can certainly kick back at the spine.
May I give just one little example of the probable effect of spinal
lesions upon internal organs. Some years ago an article on prostatic
disorders came to my attention. The author stated that a very high percentage of men over forty years of age were affected with some nonspecific prostatic infection. My curiosity was aroused, so a good many
of my male patients became the victims of a prostatic investigation. The
truth of the authors contention was confirmed. In addition, some interesting osteopathic observations were noted. In treating a prostatic abnormality it was my routine to massage the prostate as the first step in
treatment. The osteopathic examination and treatment followed this.
It was observed that whenever improvement of the prostatic condition had
been progressive and then suddenly a change was noted, the gland being
more swollen or inflamed than it had been at the previous visit, a subluxated sacrum was found in every case. What better evidence could one
want to incriminate sacro-iliac subluxations as the probable cause of much
of our prostatic disorders?
Another observation regarding prostatic disorders as related to low
back troubles should be of interest. In a rather high percentage of acute
low back disorders in men treatment of a diseased prostate gland assists
very materially in getting a satisfactory result. Every case of this nature
should at least have a prostatic examination as a part of the routine
physical examination.
If it is realized that the mechanics involved in the production of individual spinal lesions is much the same as the mechanics involved in the
7
development of scoliosis, lesion diagnosis and treatment becomes less of

a nightmare. It is felt by the writer that most lesions are produced by
easy flexion, side&ending and rotation, and in that order. By easy flexion
I refer to the much misunderstood physiologic flexion. This is to be distinguished from anatomical flexion in that in anatomical flexion forward
bending of all areas of the spine is considered flexion, while in physiological flexion forward bending of the thoracic spine but backward bending
of the cervical and lumbar spine is flexion. In other words, physiological
flexion might be defined as the act of increasing the anatomical anteroposterior curves of the spine. Of course physiologic extension would decrease these curves.
In scoliosis with rotation of the vertebrae the rotation of the vertebral
bodies is usually toward the convex side of the curve in any given area.
Often there is no frank rotation, but a tendency to it. Occasionally rotation of the vertebrae will be present with little apparent scoliosis, but in
these cases there is usually a tendency for the spine to curve to the side
to which the rotation occurs. This rotation factor is important as it seems
to create an instability of the spinal column.
Because of the observation that the laws which operate in the development of scoliosis are similar in many respects to the laws which govern
the development of spinal lesions, it seemed logical to me that a system
of treatment directed at correcting the side-bending and rotation of any
existing scoliosis should have a corrective effect on most spinal lesions
within that curve. Accordingly, an effort was made in treatment to combine the technic of treating the scoliosis with the technic of treating individual lesions in such a way that they have synergistic action. The
effects of this combination proved to be extremely gratifying, not only
in the effective correction of the lesions but also in the permanence of such
corrections.
In outlining treatment on this basis the first thing to determine is
the type of scoliosis which is present. Right here is a stumbling block
because of the confusion that seems to prevail when one mentions a curved
spine. To clarify the picture of curvature I will say right here that when
a right dorsal curve is spoken of the dorsal spine as a unit describes an
an arc to the. right in the dorsal area. W-hen a right dorso-lumbar curve
is referred to the spine of the combined dorsal and lumbar regions describes an arc to the right. A right simple total curve is one that describes
an arc to the right from the occiput to the sacrum, wheras a compound
curve is one which crosses the mid-line once or more than once between the
occiput and the sacrum.
Total simple curves seem to give rise to more symptoms than compound curves, but the results from treatment of simple curves are much
more dramatic. I can usually give a better prognosis where a total simple
curve, or at least a dorso-lumbar curve is involved, because it may usually
be improved much more quickly and the symptoms relieved much faster
than in the case of compound curves. On the other hand, one occasionally
finds rather severe compound curves where nice compensation has taken
place with very few important spinal lesions.
One must learn to diagnose curves in the spine, especially minor ones,
if he is to treat in this manner. This is not as simple as it would seem.
After checking the clinical findings in some 800 cases and subsequently
making X-Ray examinations I find that I slip up in my diagnosis too often
for comfort. Several methods would be used in checking a given case,
8
using the positions of sitting, standing, lying prone and on the sides. In
the lumbar spine the spine tends to sag toward the table or bed lying on
the side. This is a very important point to remember in both diagnosis
and treatment. If the patient is lying on the right side and the lumbar
spine describes an arc upward, it is pretty good evidence that we are dealing with a left lumbar curve. If the lumbar spine is straight it is pretty
good evidence that we may have a left lumbar curve. If we now have the
patient lie on his left side and the spine describes an arc toward the table
or bed, it is extremely good evidence that we are dealing with a left lumbar
curve.
After a diagnostic check-up my first step in handling the manipulative
angle of low back disorders would be to correct the sacrum and fifth lumbar lesions if possible, for these segments are involved in most low back
disorders. The next step would be to have the patient lie always on the
opposite side from that to which the lumbar spine curves. This eliminates
some or all of the lumbar curve unless the muscle spasm is too great. With
one hand on the shoulder or the hip and the fingers of the other hand over
the upper transverse processes, the transverse processes are pulled forward with counter force being applied to the hip or shoulder. This is to
establish de-rotation and straightening to some extent of the lumbar spine.
This de-rotation and slight straightening of the lumbar spine removes
considerable torsional stress from the sacrum, thus preventing to some
extent the recurrence of the lesions at the fifth lumbar and sacrum. Then
while still in this position lesions of the lumbar and lower dorsal regions
are corrected, using forces which, unless contra-indicated by the nature
of the lesions, are designed to coincide with forces which would reverse
the rotation of the vertebrae in the lumbar curve. The patient is then
instructed to lie on the concave side of the lumbar curve as much as POSsible and to avoid the opposite side unless the case is very acute and seems
to be aggravated by such a procedure. In such cases the curve may be
exactly opposite from what existed before the acute muscle spasm intervened. A really true picture is not obtained then until after the acute
muscle spasm has subsided. All other lesions and curves of the upper
spine are treated in fundamentally the same manner, for they, too, may
have an important influence upon low back disorders. It is understood
that prior to this manipulation every effort has been made to ascertain
any facts pertaining to the disorder that seem to be indicated.
Much is heard today about herniated disc and spasm of the tensor
fascia lata, but I am certain that if the procedures which I have outlined
are followed carefully, together with any other conservative measures
which good sense and accurate diagnosis indicate, most cases of low back
trouble will not require surgical measures for relief except where foci of
infection are found.
OSTEOPATHIC MANIPULATION AND ITS INTERPRETATION

IN PRENATAL CARE
ROBERT B. BACHMAN , D. O.
In Williams Obstetrics by Stander, 8th edition, page 181, it states
It should be constantly borne- in mind that pregnancy is not a mere local
condition effecting the gentalia, but is a process associated with fundamental changes in the entire organism. Ordinarily, one fails to realize
how radical these changes are and to how great an extent the childbearing
woman differs from man. The contrast was strikingly illustrated by
Sellheim when he estimated that a woman-who has borne six children has
produced by her generative function-including menstruation, but excluding the production of milk-an amount of tissue twice as great as her
original weight.
Every portion of the maternal organism reacts to a greater or lesser
extent under the influence of pregnancy. Formerly, these changes were
attributed in great part to nervous impulses originating in the pregnant
uterus, but more extended clinical observation and experimental work
shows that they represent marked alterations in metabolism based in
great part in physiochemical changes.
What a challenge to the healing art to keep an organism, so radically
altered and functionally taxed, in the performance of a hysiological process of comparatively short duration, in an efficient state of compensatory
functionings for organic hypertrophies and structural developments. Every
organ of the body reveals evidences of increased function or hypertrophy.
Every endocrine gland enlarges except the posterior lobe of the pituitary
and the thymus, the former remains the same and the latter atrophies
if it has been active. Even the skeleton is altered by pregnancy as evidenced by the development of puerperal osteophytes on the inner surface
of the cranial bones and the changes in the pelvic girdle as found in comparison of measurements taken early and late during gestation, especially
of the expectant mothers in the lower twenties or younger and with their
first pregnancy. Pregnancy changes are necessary and vital, organically
and functionally.
Governmental agencies, city, state and federal have regulated industry
and provided for suitable inspection. Possibly aircraft manufacturing
and flying is one of the most rigidly regulated industries and enterprises
under government inspection. So specific are the aeronautic rules and
regulations that each product must be capable of maximum efficiency,
specified loads and regulated performances. Each craft is licensed to
comply with minor and major inspections, rebuilding according to hours
of flight and relicensing when structural changes are made or equipment
placed or removed. If one structural defect is found, all models of that
type are grounded until those changes are made.
It is not my intention to create the impression that the practice of
Obstetrics or any other portion of preventative or curative therapy should
be regulated so minutely by the government; but to call to attention that
the creator and builder of the individuals that regulate these industries
and enterprises, be given as much consideration as the product, her offspring manufactures and operates.
It is the purpose of the writer and within the scope of this paper to
evaluate the need of regulated and controlled function. Every abnormal
function of pregnancy and labor is a failure of nature to compensate for
10
its required task. Pathological conditions of a grave nature or limited

function and capacity presents a phase of discussion too extensive to
mention at this time.
My airplane illustration presented three phases; first the manufacture, second, the specified loads and performances and third, inspection
and the regulating of repairs and changes.
I will carry out the comments on my assigned subject in three phases.
First, the expectant mother. Second, the changes necessary for pregnancy compensation. Third, the evidences of compensation failures.
The expectant mother should know her physical standing to safeguard her health as well as assure a healthy child. Her doctor should
know her physical condition during the first month or six weeks of pregnancy, first so that he will be able to classify his findings as existing prior
to or developing with pregnancy. Second, so that any existing conditions
of abnormal function can be corrected before getting out of control or
pregnancy strain retards recuperation. Third, to prescribe for her welfare.
One can usually ascribe as the undermining factor of disease and
malfunctioning. faulty nerve control and circulation ; also nutrition, as
unbalanced diets and vitamin and mineral deficiencies leave their effects.
The founder of our science, Dr. A. T. Still frequently stated the
moment the blood and nerve supply to any portion of the body is disturbed
the foundation for disease is laid. It may appear unnecessary and a bit
elementary to reiterate to this group of doctors the value of Osteopathic
treatment but I am eager to sell Osteopathy as a stabilizer of body function
and part of a program in preventative medicine and not as a routine to
pile up treatments for revenue.
Dr. Still stated The blood soured, that idea was scoffed time and
time again, now the word soured has been replaced with the term pH and
its variation theory accepted as a scientific discovery.
In the earlier years before civilization afforded the conveniences and
luxurious background for an easier physical existence, the human body
tolerated exertion and endurance more readily so that mild organic malfunctionings were overcome by the simple method of determined perserverance and the varying degrees of malfunctionings were not so divitalizing.
Highly specialized duties of the human race and its related activities
have gradually changed the routine of the more laborsome type of work
to tasks and duties of a lighter nature with the gradual disappearance of
the more rugged individual. Many people engage in physical recreation,
and thereby retain, to some extent, a fair degree of physical strength but
not to a routine of activity sufficient to balance organic and physical
function. This breach can be spanned only by Osteopathy and advantages gained by directing passive activities and manipulative work, on
cases where general activity cannot be tolerated. The most potent reactions however are produced by the changes in the tissue chemistry as
directly effected by mechanical control of the nerve and blood supply.
Many people ask for a general treatment, they generally get worked
on and the reactions are only general. When a general treatment is asked
for it at once indicates that the patient is suffering from an indefinite ailment which requires specific diagnosing and specific work as the cause
of the disturbance has a very diffuse effect. In fact tracing down lesions
giving a general off-color feeling is excellent training and specific work
11
is definite in obtaining results. Even the various moods are evidences of

functional derangements which change under manipulative therapy. The
saying, that a mans liver is off when he has displayed a grouchy disposition, carries with it a truthful meaning and what he needs is a good
shaking up supports the mechanical manipulative idea. No portion of
the human body is immune to periods of under functioning. Routine
check-ups and treatments, dubbed by some as their canned exercise, are
always a prerequisite for good health.
In animal husbandry each animal is carefully selected for propagating
its kind in maintaining an excellent strain, but how often in the humans
do we find that conception is the result of, may we say, accident, indifference or chance. So it is evident that the defective as well as the
normal make up the human race.
Many an individual has credited Osteopathic treatments as being the
vitalizing factor of conception, when it has occurred, whether planned or
not. If a state of poor health and lowered fertility existed, and that
lowered state of health and fertility has increased sufficient only to result
in fertilization and nidation, the questions may be asked how will that
product of conception compare with one of known high virility and excellent health. Will that off-spring always develop in a prenatal and
mature in a postnatal life to a normal being? Rarely are abnormal conditions, functional, physical and mental recognized in the neonatal child.
The conclusions one draws from the thousands of cases he observes,
prompts him to set these conclusions forth as practical theories, and these
theories -may be presented as facts after reviewing the writings of Dr.
Louisa Burns in which she reports her findings on lesioned animals, as to
the effect on conception, the duration of pregnancy, the course of labor
and the development of the off-spring. It is almost needless to state the
ultimate effect of spinal lesions whether accidentally or idiopathicall acquired will produce the same effect as those produced experimentally.
I doubt if any of us will discredit the value of Osteopathic treatments
and yet our enthusiasm to put in force a principle of proven value is low.
I sometimes wonder if the type of treatment required, proves to be too
time consuming or too demanding on physical strength since there is a
general tendency to drift to the use of adjuncts or substitute them for
treatments than returning to treatments when other measures fail.
The second, the changes necessary for pregnancy compensation, I
had previously mentioned Osteopathic treatments and conception. Other
phases of allied effects are just as obvious; as, expectant mothers habitually aborting and then carrying succeeding pregnancies to terms after
Osteopathic treatments were given, and this the only therapy administered.
Labor itself reveals no less outstanding reactions to previously administered Osteopathy. Though my topic does not include labor, I interjected
this comment because the effect of Osteopathic manipulation on labor is
so specifically evident that it merits mentions.
The anterior lobe of the pituitary gland is reported to have more control of the reproductive function than any other structure. Its numerous
functions and potent secretions requires that it act unimpaired. The boost
and lift experienced from a neck treatment demonstrates the speed with
which it reacts. The anterior lobe which normally doubles in size during
pregnancy, according to Eidheim, Stumme, Cushing and Evans, will leave
many of the structures effected by its secretions deficient, if glandular
functions of the lobe of the pituitary fails to fully compensate for pregnancy.
12
Pregnancy function will not be normal, if the lutenizing factor which

effects corpus luteum formation is low. Poor corpus luteum formation
is responsible for faulty development of the progestational phase of the
endometrium, abnormal formation of the decedua and unstable nidation.
A functional derangement effecting the suprarenal glands, thyroid, pancreas and liver, and variation in developmental changes as characterized
by the acromegaly like appearances of normal gestation, all revert back
to anterior pituitary malfunctionings.
To enable the anterior lobe of the pituitary gland to function normally
for pregnancy it must not be hampered in its changes. Since it is accepted
that the pregnalionic fibers exert an influence on the pituitary gland and
its functions, any Osteopathic lesion occuring in the cervical area, along
the course of that nerve decidedly effects its development and action.
It has definitely been proven that the thyroid hypertrophies during
pregnancy and the metabolic rate is about ten percent higher at term than
at the onset of pregnancy. The cervical area and the clavicles have a
direct and indirect influence on thyroid function.
The heart is reported by Drysel to be 8.8% larger and by Jagie to be
20 grams heavier due probably to muscle hypertrophy, at term than in a
non-pregnant state. One must conclude then that some specific entity
is responsible for that change. This same entity which has a specific
effect on heart hypertrophy must assert no little influence on heart function in a number of cases where patients have been heart conscious.
Certain types of heart disturbances that would show a rapid increase in
rate on activity, produce pains in the heart region on exertion, develop
a murmur or show a variation of pressure of the various beats, after
slight activity will frequently stabilize and normalize under the stimulation
of pregnancy and pregnancy changes. In others this change does not
so readily occur and there is a below par feeling that can easily be
changed with specific work on centers specific to heart control and function. At no time does Osteopathic therapy prove as relieving to the depressed, tired and all gone feeling as it does in the latter part of pregnancy when, weight of the abdomen, changes in posture and upward displacement of the diaphragm exerts its pressure.. The hypertrophied
breasts have their effect on the freedom of chest action also.
Possibly the most seriously effected organs of the body are the kidneys
and the liver. While it is known that these organs when normal and in
normal life do not work at full capacity, cases present themselves that
appear to be working those organs at full or a little beyond full capacity.
It may not readily be determined whether part of the organic structure
has been damaged beyond repair with a previous illness, or its capacity
limited by an acute pathology. There is another phase to consider. Does
a particular pregnancy case present a condition in which toxic elements
develop in such amount that no maternal organism has eliminating organs
with a capacity capable of carrying off the toxins or does a condition exist
where the eliminating organs do not respond to the demands of pregnancy,
and the toxins accumulate to such an amount that their concentration deranges the action of those organs and the pathological lesions develop?
Whatever the findings of that case may prove to be, its mild or
threatened complications gradually subside under the normalizing effects
of Osteopathic treatments. These changes will continue as long as the
stimulating entities for functional control are potent and continues enough
to override those of the existing complications.
13
Many times the question has been raised about the use of adjuncts,
and are they used by the Osteopaths
? Another question may be asked;
in these days of research and new discoveries with practically the whole
theory of the medical practice revolutionized, would we be willing to practice and be practiced upon with only the known principles of practice of
thirty-five to forty years ago ? One thing I wish to emphasize, the efficient
doctor labors for the best interests of his patient and employs or makes
available any practical therapy or procedure regardless of the school of
healing.
The third phase, the evidence of compensation failures. A few conditions may be mentioned. How about morning sickness, if all day
sickness is pathological why is morning sickness considered a part of a
normal pregnancy any more than swollen ankles? If pregnancy sickness
can be, and has been, eliminated by hormones when injected in proper
amounts, why is it that these body produced hormonies are not produced
in sufficient amounts to avoid this sickness condition? Some cases never
develop the sickness complex. Some mothers develop it in one pregnancy
and not the other. What is the clinical picture in these cases. Can Osteopathic therapy obtain the same results. I have observed cases where
the administration of serum obtained no result and Osteopathic manipulation did, also the converse of that has frequently been found.
A multipara was hospitalized during a period of persistent vomiting
that had received no relief from any form of serum or medical therapy.
She lost weight until she weighed less than one hundred pounds, markedly
dehydrated and ptyalism had developed until she was expectorating about
a pint of fluid every twelve hours. Intraverious instulations of glucose and
saline bolstered the fluid content of the body but gave very little relief to
the vomiting. I ordered Osteopathic treatments thirty to twenty minutes
before each meal and on the pretext of giving the internes an opportunity
to observe the case, instructed each of three to treat differently and then
noted the results. About the time I had convinced myself of the spinal
centers most effective for relief, she requested that a certain doctor treat
her all the time as his treatments were more of a benefit than the other
two. After explaining my plan to the internes, redirected their treatment
procedures with the result that the patient commented. I guess it
must be me because Dr. Ss treatments are loosing their effect and I dont
seem to be getting any good from them, the other two received favorable
comment. In my third procedure all the doctors treated the same specified
centers in the same manner and noted uniform results. She then commented, "I sure must be better as I am beginning to enjoy and keep down
my meals, it certainly is strange how that sickness shifts around to different parts of the day before one begins to improve.. I am convinced
if a psychic complex were there, that procedure did not support such a
theory.
Another evidence of a break in compensation, and often too casually
considered, is a condition referred to as an occult edema. Above-theaverage gain in weight, of one-half to one pound a week and swelling of
the feet and limbs in hot weather are the most common evidences of its
existence. Only two things can be done, first reduce the maternal load
and second increase body function. Limited activity to. lessen physical
exertion is essential, emptying the uterus is rarely necessary in this type
of disturbance. Increased body function is imperative. If the cells fail
to release the water they are holding the thyroid must be considered.
1 4
When circulation is sluggish and edema of the extremities develop, the

cardio-vascular system needs support.
Some cases of edema develop when the kidneys reach the ceiling of
their function in mild or recurrent types of kidney derangements, with
little, if any, urinary findings. This condition usually subsides with conservative kidney stimulation.
A more marked kidney lesions presents a more serious picture. In
the early part of the acute stage and in the chronic stage with some kidney
reserve available, a definite reduction of the albumin in the urine can be
noted and the total urine volume increased with specific spinal work on
the kidney centers. Some times this change will be evident for twentyfour to forty-eight hours only, supporting the theory that Osteopathy is
effective as long as the reactions of a treatment are stronger than those
produced by the disease itself. Adjuncts and reducing the maternal
load are essential procedures to put in force whenever any edema is
detected.
The use of adjuncts, their field of usefulness and the circumstances
under which they may be used is a subject too extensive to discuss at this
time. Reducing the maternal load may be mentioned under three points.
First, diet and activity, second, focal infection and elimination and third,
emptying the uterus.
In no other condition is the Osteopathic principle more practically
applied, of eliminating the cause of disease than in the case of lightening
the maternal load. The idea, that many people still have, that it is necessary for expectant mothers to exercise is wrong, oft times exercise produces more harm than good. Many cases are found where the additional
strain of a pregnancy is all that that maternal organism can carry and
to superimpose on that already taxed expectant mother, the drudgery and
strain of unaccustomed routine exercise, raises a question of practicability
and sound judgment. On the contrary, every expectant mother should
rest at least one to two hours after the noon lunch during the latter half
of gestation. Diet as well as minerals and vitamins must be regulated
and prescribed.
In twenty-five years as a specialist in Obstetrics, I have found more
cases with kidney and toxemia complications due to infection from the
teeth and gums than any other source. There are too many dentists of
the old school that treat infection too lightly and consequently the patient
is a victim of an infection complication before she realizes the treachery
of a dead tooth. Other infections of whatever origin and location they
may be are of equal importance.
Emptying the uterus is necessary in complications that do not respond
to the best organized treatment procedures.
The changes in the soft structures of the pelvis are not to be overlooked. Innominate lesions are common, especially in the latter part of
pregnancy. Lesions of the sacro-iliac joint effect the second, third, and
fourth sacral nerves, a few fibers from these form the nerve erigens which
are the vaso dilators and relaxors of some of the pelvic structures, so it
can readily be noted that when an osseous lesion occurs effecting nerve
control, the compensatory changes are retarded. Labor must then be
carried on against less elastic tissues.
Many of the individuals suffering from dilated veins of the pelvis,
rectum and limbs show a definite increase in the lumbar curve with
flexion lesions of the innominates on the sacrum. These usually develop
16
as postural changes of pregnancy, again they are found when not associated with pregnancy. These conditions are improved and oft times
cured with correction of the lesions. The benefit derived from abdominal
supports with the suggestion that it takes the weight off of the pelvic
structure, in reality merits mention for its aid in changing the inclination
of the pelvis and minimizing the weight factor in innominate flexion.
The full meaning of blood pressure variations may not be known at
this time, but it is known however that the pressure elevators during
pregnancy appear to be associated with certain types of toxemias and that
the pressure readings drop when the toxic causes are reduced or eliminated.
It must be borne in mind that Osteopathic therapy rarely produces
a radical change in pressure readings but works as a normalizing factor
so that nature can return to normal levels when tension is no longer
needed to carry on with unbalanced function. No other force is so far
reaching in its reaction on the entire body or any therapy so effective in
regulating the various functions as Osteopathy but few there are who stay
by this mode of treatment until nature has re-established these functions
of normal routine. In these days of speed and high pressure activity
quick results are demanded, so with the current highly specialized stimulants we whip ourselves up to a point of a workable routine and hold ourselves there until nature compensates, as she is kind, or flops. When
everything else seems to be exhausted we fall back on manipulary therapy
for a cure.
It is not my purpose to discuss nerve centers in this paper but to
review a principle in Osteopathic therapy to widen our vision and stimulate thinking along the lines of a practical therapy in the light of present
day science.
We all recall the astounding report of Dr. Burns in her experimental
work of galvanic current on spinal areas and its visceral reactions. She
reported on opening the spinal area applying the current to the joint
articulating surfaces and noting a sharp reaction to visceral circulation;
when touching other structures of al1 kinds in relation to the articulating
surfaces, practically no reaction was noted.
Osteopathy when used and effectively applied is hard work with no
substitutes for specific treatments. The principle Osteopath in the interest
of his profession, his patients and his own personal welfare must se11 himself to the idea and carry on with a four point routine of practice. First,
to familiarize himself with a complete history of every condition that may
or may not effect the individual whether ailing or not, and evaluate the
existing pathology as to its possibility for response to treatment or progressive changes. In other words a complete investigation and diagnosis
and a carefully reported prognosis. It appears to me that many failures
in obtaining results and cures are due to coexisting conditions overlooked
by incomplete examinations.
Second, furnishing information and advice for supplying the proper
kinds and amounts of foods, minerals and vitamins to build, repair and
maintain the human body, as we11 as instructing the patients in physical
capacity limits in sickness and health.
Third, the employment of approximate and conventional supplementary measures and therapy within the scope of the licensed practitioner and arranging a place and background suitable for such procedures.
Fourth and the most important, evaluating the principles and capacity
of Osteopathic therapy : Check every articulation, determine its range
16
of movement and the necessity of its movement. See that each spinal
vertebrae, bony deformities and caries excepted, lies in the center of its
arc of movement. Employ such manipulation that the closely adherent
and adjacent tissues are exercised to a point of normalizing movement and
the freeing of circulation. Satisfy yourself that the preverterbral structures, including the sympathetic chain, receives its share of tissue activity.
The theory had been advanced that a stimulation of the posterior
primary divisions of the spinal nerves were all that need to be worked
upon. It now is quite obvious that the manipulative measures must go
beyond that limited field and change tissue relations relieving stasis of the
fluids whether of the spinal area or more distal.
It appears quite evident that tissue chemistry varies sufficiently to
change tissue function and until proven otherwise, suspect that a nerve
impulse traveling over a nerve fibre lying in an area with an altered pH
registers distorted function as a radio when it picks up static.
We must not discredit the value of Osteopathic therapy as it may be
the operator and not science that fails. Many of our cures and claims for
treatment may lie obscure but in time receive their due reward. Take
for instance poliomyelitis, how our treatment of the cases were criticized
by those that immobolized affected limbs.
In Time Magazine, June 23, 1941, page 71 is an item on Polio, referring to an article by Drs. Cole and Knapp in the Journal of the American
Medical Association. It starts out A new and apparently successful
treatment for infantile paralysis-reversing all accepted methods of
treating the disease at its onset. It goes on to describe manipulative
therapy. We Osteopaths have been advocating manipulative therapy on
these cases for years. Osteopathy is an unequalled therapy with many
unheralded cures and possibilities and the success we gain from it depends
upon the successful application of its principles.
MANIPULATION OF THE UPPER CERVICAL IN INFANTS

F RANK M C C RACKEN , D.O.
Manipulation of the Upper Cervical in Infants is the subject assigned me; The subject could have been The Thrills That Come To One
in the Practice of a Manipulative Therapy or Some Live Reasons for a
Belief in Manipulative Therapy.
All of you, at some time, have been asked: Do you treat children and
how old must they be before you start your manipulation? The answer
always is: As soon as they are born they are old enough to receive a
manipulative type of treatment. The mechanics involved in childbirth
may be the contributing cause of many of the structural maladjustments
found in the new born, especially in the cervical area. When you think
of the stress that is placed upon the cervical region during a long hard
labor, this can be easily understood. Likewise, when you have a very
rapid, almost an expulsive type of labor, the external pressure applied by
the obstetrician to the perineum and to the oncoming head of the infant in
the attempt to protect and save the mother may also produce these cervical
lesions.
There should be a careful routine examination at least of the cervical
area for these lesions. If this examination were routine, no doubt some
17
of the early days of the new born might be made less disturbing and permit
the father to sleep more, and walk less at night. No doubt some of the
digestive disturbances and the irritability in the infants could be attributed to these overlooked cervical lesions instead of a faulty development
of the digestive tract.
Remember the injunction of the Master mind of our profession, Dr.
Andrew Taylor Still, To find it and fix it: To find it means correct
diagnosis, to fix it is the application of our technic to the correct diagnosis.
The method of diagnosing and treatment differs with each and every
physician. Likewise, the ability to describe these procedures differ with
individuals. Some physicians are very fluent and can very graphically
and technically describe their findings and treatments so that all who
read or hear may readily grasp their view point and method of treatment.
There are many others who lack this ability, but may be like Moses, a
good organization man, who needed an Aaron to do his talking for him.
TO this latter group I certainly belong.
Recently I heard a very excellent and successful Osteopathic physician
describe his technic much as follows: Gently but firmly get tension and
then keep teasing and coaxing until you get normal motion restored in the
joints involved. That in brief describes my technic.
For the purpose of illustrating two different types of technic, I wish
to present the following two case reports:
CASE No. 1
I was called by an Osteopathic physician to consult with him regarding an infant that was about thirty-six hours old. The history revealed
that the labor and delivery were rapid. He experienced some difficulty
in getting the infant to breathe but after respiration was started the
infant was laid to one side, since the mother was requiring immediate
attention. Some twenty minutes later the physician discovered that the
infant was cyanotic and had ceased breathing. Artificial respiration was
administered and the breathing was immediately restored. This stopping
and starting procedure continued. The longest period between stop and
start had been about two hours. Breathing seemed to be quite normal
until a minute before it would stop and then it would become quite irregular and then cease altogether. An examination revealed what seemed
to be a slight sideways slipping of the condyles of the occipital bone to the
left on the axis. After a nights observing of the stopping and starting, I
recommended to the Osteopathic physician in charge and to the father
that we attempt a correction of the lesion, warning them that there was
a possibility in the correction of this lesion, that there might be sufficient
shock to the respiratory centers to prove fatal. There was no choice in
this case but to make the attempt. This was before the days of the respirator which is used now in some of the poliomyelitis cases. With the
consent of both the physician and father the correction was attempted.
Grasping the upper cervical in one hand and holding it firmly but very
gently-with the other hand at the #occiput, I used traction and side bending. Following this correction the breathing remained normal afterwards.
CASE No. 2
Male child-twenty-two months old-lack of muscular development,
could not sit up ; in fact could not even swallow anything but liquid. Not
only was there a lack in physical development, but there was also evidence
of a lack of normal mental development. The parents had been advised
by the family physician and specialists to send the child to the home for
18
the feeble minded, since in their opinion there would never be any mental
development. Like many others, as a last resort, they investigated Osteopathy. This boy was the only boy in a family with six older sisters.
Like all proud parents they wanted a boy and a normal boy, so when they
came inquiring the answer was Lets see the baby, then we can say what
we may or may not be able to do. Just because some well-trained and
well-meaning doctor says a case is hopeless does not mean it really is
always hopeless. My view point may differ from his even as your view
point might be different from mine. Always refuse to take any doctors
word on diagnosis and prognosis. See for yourself. I could obtain no
history regarding the birth that was of any importance. They noticed
that when about a month old it was not using its arms and legs as the
other children had. Then they began the round with the various doctors
and specialists who gave them the prognosis and advice of taking it to a
feeble minded institution. Examination showed a fairly well nourished
body but the muscles were soft and flaccid except in the upper right dorsal
and right cervical area where the muscles were spastic and very sensitive
upon palpation. Especially was this true in the right suboccipital tissue.
The prognosis in a case of this type should be guarded; in fact all that
should be promised was Lets see what we can do. Treatment was
begun-a very gentle, firm, deep muscular massage was applied, beginning
in the mid-dorsal and. continued up to the occiput. This treatment was
continued three times a week for the first month, twice a week thereafter
for about five months. At the end of the first month, arm and leg move
ments were much the same as of a child of two or three months. There
was very rapid toning up of the muscles and the baby was able to sit UP
by the end of the second month, also was eating solid food and attempting
to jabber. Case was dismissed at the end of six months for all of the
functions seemed to have become normal for a child of two and one-half
years.
I have given you here the two very different types of technic, one a
radical quick correction-the other a prolonged soft tissue type of technic
and I can only say that the injuction of the Master mind can always be
depended upon-finding it and staying everlastingly with it until you fix it.
SHOULDER TECHNIC.
J. S. DENSLOW , D. O.
Technic Section
The shoulder girdle presents a pecular anatomical arrangement which

must be taken into account in the diagnosis and treatment of shoulder
lesions. There is a joint between the clavicle and scapula, one between
the scapula and the humerus and a third joint between the scapula and
the trunk. We commonly think of a joint being composed of two or more
bones separated by cartilage and united by ligaments and muscles. In
the joint between the scapula and the trunk, however, there is no cartilage
and muscles are the only uniting structures.
The arrangement of these muscles is very complex. The scapula
is bound to the trunk, directly, from above, from below, from the spine
posteriorly and from the thoracic cage anteriorly.
19
In addition it is held indirectly by muscle attachment to the clavicle

and humerus-which are in turn fixed to the trunk by supporting tissues.
There are eighteen muscles, most of them large, which function to both
maintain position and to move the upper extremity.
These muscles are interwoven and crisscrossed to insure effective
support in all directions and from every angle. For example, the teres
major muscle is covered in part by the subscapularis and the latissimus
dorsi, its distal portion lies between the triceps brachii and the coracobrachialis and, in addition, it forms one border of the important quadrilateral
space thru which passes the auxiliary nerve and the posterior circumflex
artery of the humerus.
However, as each muscle is invested with its own layer of fascia the
potential space between them permits freedom of motion.
Someone has appropriately termed the fascial planes which exist
between contiguous muscles which have a varied function as facial joints.
The term is particularly applicable to the shoulder due to the numerous
muscles which interlace.
PATHOLOGY
Clinically, in shoulder lesions, there are areas thruout the shoulder
girdle which are abnormally tender. These areas apparently are in
portions of muscles and in the facial spaces between the muscles. Some
common areas of tenderness (altho there is not sufficient similarity in all
cases to delineate these areas in all patients) are found at the anterior
and posterior edges of the deltoid, over the mid-line of the deltoid, in the
supraspinatus muscle just above the middle of the spine of the scapula,
in the infraspinatus just above the middle of the fossa and in the quadrilateral space.
These are clinical observations. They accompany tensions in the
muscle and limitations of one or more of the three joints of the shoulder
girdle. Unfortunately, however, a sound understanding of referred pain
and of hyperesthesia has not as yet been reached and we are unable to
follow the exact pattern of the pathological physiology in this condition.
Whether the tension is muscle contraction or some chemical disturbance is merely of academic importance. Clinically the acuteness of the
disturbance is determined by the degree and extent of tension and hyperesthesia.
It would be in error if shoulder pathology were considered entirely
as an independent abnormality. Spinal lesions have a profcund effect
on the conditions of the tissues in this region. We have observed that the
spinal lesions in shoulder disturbances do not predominate in the area
of nerve supply to the shoulder (5th to 8th cervical) but are in the area
of the nerve supply to the blood vesseIs of the shoulder girdle (1st to 5th
thoracic). An-interesting case will illustrate this point. A middle aged
man had a severe injury to his shoulder. Under medical care a diagnosis
of torn ligaments was made and the shoulder girdle was placed in a
plaster cast where it remained for three months. At the end of this time
the patient could move his arm forward and backward to a slight degree
but had lost the movement of abduction. He was turned over to a physiotherapist who placed the patient on a table, put his heel in the patients
axilla and jerked the arm away from the side. The patient immediately
corn;lained of severe pain in the shoulder joint, and, of course, still could
not move his arm. We saw the patient a short time later and immediately
instituted manipulative treatment to the shoulder (which consisted of deep
20
stretching movements which stopped short of pain. There was marked

spinal pathology from the 2nd to the 5th thoracic segments on the same
side and this was treated in the usual manner. In about three months
the patient had regained nearly full motion of his arm. Occasionally
when he fatigued or when there was a marked weather change, the
paralysis returned. We were always able to relieve the condition by
the deep stretching movements referred to above and by mobilization of
the upper thoracic joints.
On one occasion, when the patient temporarily lost the use of his arm,
we limited treatment to stretching and relaxation of the tissues of the
upper back and to mobilization of the segments. Care was taken not to
manipulate the shoulder. Immediately after this treatment, i.e. applied
only to the spinal segments, the patient was able to abduct his arm fourteen
inches.
Because of experiences of this type it is our opinion that while local

pathology in shoulder disorders is important it never comprises the entire
picture.
D IAGNOSIS
In lesions involving the posterior one-half of the shoulder girdle soft
tissue changes seem more important than abnormalities in positional
relationships. The muscles of the upper arm of both the anterior and
posterior folds and those attached to the scapula should be palpated carefully for areas of tension. When such areas are found the degree and extent of involvement must be determined. If it is minor, comparatively
extensive effort might be used. If it is major, manipulative treatment is
definitely indicated but must be stopped short of pain.
TREATMENT
There are innumerable methods of applying forces to the musculature of the shoulder girdle. Some of the most effective procedures may
be applied with the patient lying on his side. One of the operators hands
protects the acromioclavicular joint and determines the amount of force
being used on the shoulder joint while the other carries the arm to its
limit of motion and then applies a stretching force.
Deep kneading massage of the muscles of the posterior axillary fold
and of the tissues of the quadrilateral space is indicated.
When the muscle spasm is sufficiently marked we have used adhesive
tape to provide physiological rest. 2 inch tape is applied to the lateral
surface of the upper arm. At this point the tape is split one tail going
over the shoulder, behind the neck, and the other going across the chest
anteriorly.
21
GERIATRIC TECHNIC
C. HADDON SODEN, D.O.
Technic Section
In treating elderly patients, we must keep in mind the rigidity of the

articulations, due to thickened ligaments, decrease of muscular tone,
chemical changes in or decrease of the synovia, potential or true Arthrosis.
The ideal technic, giving the maximum results, is one whereby each articulation or the articulations are put through their normal physiological
articular ranges of motion with the least possible effort or muscular
traction.
FE E T
Cuboidial Motion
The patient is lying supine on the table or bed, The physician places
the hypothenar eminence of his right hand medial to the right calcaneous
bone, the thumb under the external cuneiform. The thenar eminence and
thumb of the left hand is resting on the 4th and 5th metatarsals, the index
finger lateral to and under the cuboid.
Mobilization
Mobilization is produced by pressing lateralward and upward with

the right thumb, while using a medial, and plantar flexion pressure with
the left hand and index finger.
4th and 5th Metatarsal Motion (Lateral Longitudinal Arch)
The physician grasps the right calcancous bone in his right hand
which is resting on the table, and places the thenar eminence and thumb
of his left hand on the dorsum of the 4th and 5th metatarsal bones.
Mobilization
Motion is produced by using a IateraI circumduction or lateral plantar

flexion with the left hand while holding the calcaneous with the right hand.
Ist, 2nd and 3rd Metatarsal Motion (Medial Longitudinal Arch)
The physician grasps the right calcaneous with his left hand, and
places the thenar eminence and thumb of his right hand ever the dorsum
of the 1st 2nd and 3rd MetatarsaI bones.
M o b i l i z a t i o n
Motion is produced by using a media1 circumduction, or a medial

plantar traction with the right hand, while holding the calcanecus bone
with the left hand.
Torsal Motion
The physician grasps the calcaneous bone with his left hand, the space
between the right thumb and index finger is placed over the lst, 2nd cuneiform and navicular (scaphoid) bones.
Mobilization
Motion is produced by using a medial circumduction or medial plantar

traction with the right hand, while holcling the calcaneous with the left
hand.
Cuboid, 3rd Cuneiform Motion
The physician grasps the calcaneous bone with his right hand, and
places the space between the left thumb and index finger over the cuboid
and 3rd cuneiform bones.
Mobilization
Motion is produced by using a lateral circumduction or lateral plantar

flexion traction, while holding the calcaneous with the right hand.
Tarsal-Metarsal-Phalangeal Motion
22
The physician grasps the right calcaneous bone with his right hand
and places the hypothenar eminence and little finger of the left hand under
the metatarsal, phalangeal articulations.
Mobilization
Motion is produced by using a dorsi-flexion pressure, lateral Circumduction and a release or plantar flexion with the left hand, while holding
the calcaneous with the right hand.
Tibial, Talus, Calcaneous Separation (Right Foot)
The physician stands to the right side of the patient. He grasps the
talus with the thumb and index finger of his right hand, flexes the leg on
the thigh, places his left arm against the posterior aspect of the patients
right thigh and grasps the talus with the thumb and index finger of the
left hand.
Separation of Talus from the Tibia
Separation and motion is produced by maintaining flexion on the

thigh with the arm, holding the tibia against the side with the forearm
and applying traction on the talus with both hands. Then move the talus
in inversion, eversion, plantar and dorsal flexion.
Talus, Calcaneous Separation
The same technic is used as for tibial, talus separation, with this
exception, hold the talus with one hand, while moving the calcaneous with
the other.
KNEES
Forced flexion should never be used, particularly where there is a
hypermobility and nature has been trying to compensate by reinforcement
over a period of years.
Mobilization
Motion is produced by flexing the leg on the thigh, in order to open

the articulation, and use a lateral and medial circumduction with gradual
extension of the leg on the thigh.
Hip joints, Sacro-iliac, Lumbar and Lower Dorsal Vertebral motion
The patient is in the left (side) latera. recumbent position, thighs

flexed and both arms over the sides of the table (Sims position). The
physician standing back of the patient, places his left hand posterior to
the right trochanter, and grasps the patients right leg, proximal end.
Mobilization
Motion is produced by flexing, elevating and extending the right thigh

while pressing slightly forward with the left hand.
The same technic is used in mobilizing sacro-iliacs, lumbar and lower
dorsal vertebrae as in the hip joint with these exceptions: Posterior
sacro-iliac lesion, and left hand placed posterior to the right posterior,
superior iliac spine, whereas in an anterior sacro-iliac lesion, the left hand
is placed posterior to the sacrum, and in the lumbar and lower dorsal areas,
the left hand is placed posterior to the spinous processes.
Upper and Middle Dorsal vertebral Motion
Flexion-extension Motion
The patient is sitting on a chair, both arms and forearms extended.

The physician is standing to the left side of the patient, his feet on a
line with the patients feet. He holds the patients right arm (distal end)
with his left hand and places his right hand posterior to the spinous
processes.
23
Mobilization
Motion is produced by drawing the right arm forward, while pressing

against (extension) the vertebra and then pressing the arm backward
(flexion) while releasing the vertebral pressure.
Rotation
The patient is sitting on a chair, with both forearms folded at right

angles to the arms. The physician standing in front of the patient,
passes his hands and forearms between the patients forearms and arms,
his hands posterior to the transverse processes.
Mobilization
Motion is produced by bringing the patient forward into easy flexion

and then rotating the trunk to one side or the other.
Lateroflexion (Side bending)
The same technic is used as for rotation, the only difference being
that the trunk is lateroflexed instead of rotated.
The Cervical Column
The patient is sitting on a chair. The physician standing back of

the patient, places the thumb and index finger of the left hand lateral to
the transverse processes of the Atlas, and his right hand on the patients
head.
Mobilization
Motion is produced between the occipital bone and the Atlas by moving the head in flexion, extension and side bending while fixing the Atlas.
This technic applies to all; the cervical vertebrae.
The Shoulder Joint
The patient is in the supine position.

The physician standing back of the patients right shoulder fixes the
acromion end of the clavicle with his left hand and holding the right arm
with his right hand moves the arm in circumduction.
The Elbow Joint
The patient is supine.

The physician standing to, the left side of the patient, holds the
patients left wrist with his right hand, and places the index and middle
fingers of the left hand along the radial head.
Mobilization
Supination and pronation with traction is produced by the right hand,

while maintaining extension with the left hand.
THE HURT PATIENT

W. J. DOHREN, D. O.
Technic Section
This title may sound rather peculiar or unimportant to the majority

of you right now, but I think you will understand it before I finish. I am
sure that its significance hardly enters the mind of the student in school.
His technic instructors very often seem to ignore the patients side of an
osteopathic treatment. As a result, many students start into practice
without enough thought about the feelings of the patient who is on the
receiving end of a do or die for Old Rutgers osteopathic treatment.
So the young graduate digs right in and treats his first few patients
from stem to stern making a lot of noise as he goes about it. First
24
thing he knows is that patients fail to come back at all after one treatment
or they come back complaining that their necks hurt where they were
cracked, etc. This starts the development of smoother technic in this
new doctor.
The other extreme of such a picture is the D. O. who hardly ever
moves a bone. This man is usually much older so that he is too weak
to move them, or he is much smarter-having learned that it isnt always
necessary to secure noisy corrections. In the middle ground, between
these extremes, are all possible combinations of ways of hurting and not
hurting patients.
Now physical trauma incurred by injudicious osteopathic treatment
is not the only way of hurting patients. We may injure our patients
psychologically by ignoring their feelings. We may hurt or offend them
by telling them too much, or too little. We may hurt our patients by seeing
them more or less often than they think they should be seen. We may
hurt our patients attitudes by giving them medications by one avenue or
another. Many patients are bothered a great deal if their doctors give
them medication. On the other hand, there are a good many patients
who feel hurt if they arent given some form of medication. Surgical
procedures similarly produce peculiar psychological reactions in patients.
We have all seen the hurt expression develop in patients as we tell them
that they need this or that surgery done. This hurt cannot always be
avoided, but the blow can usually be softened by the doctors approach
to the explanation. The antithesis of this case is very common. We are
all too familiar with the woman who is greatly disappointed with the
doctor who says No, madam, it is not at all necessary for you to have
your uterus removed. The chances are that madam will probably
shift from doctor to doctor. until she gets ahold of one who will remove
her uterus. Of course, al1 of the preceding doctors will then be on the
black-list as far as this patient is concerned.
There is one very common phenomenon that arises in the study of
these psychologically and physically hurt patients. Patients will suffer
the discomfort and pain of an intra-muscular injection or the unpleasant
taste of this or that prescription or the rigors of a surgical operation
without a whimper. But, just let some osteopath hurt them just a
little bit, and the whole neighborhood hears about it. The old bromide
that a sick person has to get a little worse before he can get better
seems to be taken as a matter of course except in the cases treated by
oeteopalhic measures. We are all too familiar with the poor scared
patient who comes cringing into the office asking You wont hurt me?
will you, Doctor?.
Many of the reasons for these kinds of hurt patients are very obvious.
The explanation lies in a few cold facts. Osteopathic doctors have been
responsible for hurting patients, both physically and psychologically.
I am sure that in the early years, many men didnt feel that they were
treating their patients adequately unless they did hurt them. Then, too,
these doctors were undoubtedly guilty of treating conditions in which
certain types of osteopathic treatment are obviously detrimental. Most
of us have learned, for example, that we can do only harm by vigorous
treatment of an acute psoas spasm or an acute rheumatic arthritis.
Along these same general lines, I would like to inject this thought.
Dr. Still was undoubtedly a good technician; but the extent of his teachings was limited by time and available facilities. Today-our graduates
25
leave school with a much better knowledge of manipulative therapy than

was given to the early graduates. This is not meant to be sacrilegious in
any way. Hundreds of men since Dr. Still have literally put the sweat
of their brows into adding to the original technical procedures which he
laid down. Consequently, we have available today, as the result of the
carrying on of the work started by Dr. Still, a better brand of osteopathic
technic than the early graduates ever dreamed of.
But we cant stop here. As I said at the beginning of this dissertation-our graduates are still somewhat crude as they leave school regarding the matter of the hurt patient. So we will try to present a few
suggestions as to how we may practice with the smallest possible percentage of hurt patients.
A discussion of the many psychological hurts that doctors may inflict
on patients would be outside the scope of this paper so we will devote our
time to trying to cover the purely physical phase of the problem.
If we are trying to improve ourselves as technicians, it goes without
saying that we must improve our abilities as diagnosticians first. By this,
I refer to both general diagnosis and the diagnosis of specific osteopathic
lesions. It goes without saying that we should know pretty well what
is wrong with each patient before we start treating. If the patient has
a low back ache we should, if at all possible, find out what is causing
that back ache before we start treating the patient. Is it psoas spasm,
sacrospinalis spasm or reflex pain? Is it an arthritic spine? Is there a
fracture? Is there metastatic malignancy? Is the patient anemic? Does
he have focal infection, etc.? All of these questions, plus a good many
others, should be thought of and at least partially answered before treatment is started.
Then, one should record a definite osteopathic lesion diagnosis, describing each lesion in terms of standard terminology. Some method of
notation of tissue resistance, mobility and tenderness should be made.
We should know whether we are dealing with a flexion or an extension
lesion and whether we have rotation to the right or to the left. This type
of lesion analysis will help to prevent exaggeration of the lesion by application of incorrect technics.
At this time, I would like to demonstrate a few of the ways that
patients may be hurt by injudicious osteopathic treatment. I have learned
most of these things by sad experience. I hope the younger men can
avoid some of these experiences and I know that the older men will recall
some of their bad experiences along these lines, with a feeling of bitter
nostalgia :
1. Soft tissue treatment
2. Cervical area
3. Dorsal area
4. Lumbar area
5. Sacro-iliac
26
OSTEOPATHIC TECHNIC FOR INFANTS

M ARGARET W. B ARNES
Technic Section
The newborn baby and the infant require osteopathic care just as
much as the older child and adult. The manner of handling these small
patients is somewhat different from treating older people. The same
underlying principle of normalizing deranged tissue structure holds true.
Technics applicable to infants :
Occipital traction
1) Baby on back-operator at head, grasps head with palms of
both hands, forefingers at the occipito-atlanto junction. Let
weight of extended head produce the traction. If an assistant
is present let him hold the pelvis of the baby while traction is
applied to the head.
2) With one hand the occipito-atlantal joint may be grasped while
the other hand holds the babes pelvis. Traction is then applied
gently, but firmly.
3) Hold head as before-brace both thumbs against shoulder of
baby in order to obtain traction.
Rotation of Occipit
Head is grasped as for occipital traction and then rotated slowly in

plane of facets. Usually the force is applied through the tips of the forefingers rather than with the metacarpal-phalangeal joint. Occipital technics are used in many instances in newborn babies especially those who
show some evidence of neurological disturbance. Tremor and convulsions
if not due to actual hemorrhage will occur in those babies who have
occipital lesions, the correction of which does in some instances overcome
the distress.
In other cases there are gastro-intestinal upsets due to vagal irritation. This in turn can be caused by upper cervical lesions as the vagus
pathway is from the jugular foramen along the antero-lateral aspect of
the cervical vertebrae.
Dorsal technic is quite simple. For the most part in young infants
one can do soft tissue, articulation and even correction with the infant
on his back. The hands of the operator encircle the rib cage and the
fingers are placed either side of the spines. Gentle cross-belly traction
on the spinal muscles is often all that is necessary to relieve the tension,
especially in those who are being treated for fever, whether it is from
dehydration or from an infectious process.
At times it is wise to treat infants while holding them in ones arms.
This gives them more sense of protection, yet it is still possible to adequately treat the dorsal area. The weight of the child is usually sufficient
counterforce in treating the dorsal spine of young infants. Older babies
are best treated by holding upright to make a correction of a single lesion.
General contractures require slow even relaxation with patient on back
or side.
Lumbar technic. In the lumbar area one must remember the normal
C curve which is present until the child is walking well. Lumbar relaxation and articulation is best done by having the infant face down and
using the legs as a leverage to secure both traction and rotation. Steady.
prolonged pressure over the sacrum aids in overcoming the tension due
to intestional upsets.
27
In general the smaller the patient the lighter and shorter the treatment should be. It is easy to over treat the muscular lesions, thereby
causing more spasm than before. A fever will be reduced by very little
manipulation to the sympathetic centers in young babies. It is difficult
to appreciate muscular relaxation in the baby who is crying hard and
resisting, but results can be obtained all the same, so one must not stop
treating just because a child holds himself tense. One should make every
effort to overcome fear in the patient, but temper and dislike at being
restrained have to be disregarded. Technics to suit the operator and the
patient are just as essential in the babies as in the adult.
LOW BACKS
A. F. MCW ILLIAMS , D. O.
Technic Section
Low back cases are what we as a profession See and Lose more of
than any other one thing.
The subject of low back conditions is a big one and I for one am not
capable of covering the entire field and I doubt if anyone could cover all
aspects of the subject. Therefore, I will attempt to give you only some
of the practical points for every day use. No doubt, I will fail to mention
some points, but dont let that bother you as this is not an up to the
minute scientific paper.
There are good articles published in the Osteopathic Magazines and
you can get a lot out of reading them. Dr. Facto has had an excellent
article on low backs in the Log Book running for the past several months.
My talk is based on the experience of thirty-seven years of successful
Osteopathic practice and thirteen years as Director of the Out Patient
Department of the Massachusetts Osteopathic Hospital, where I have
ample opportunity to see and demonstrate on low back cases.
Why do we lose so many low back cases?
Is it because we are careless?
Is it because we dont know low back troubles?
Is it because we dont know technic or is it that after a diagnosis
is made and the correct treatment is given, we do not explain the condition
to the patient, what he might expect and the palliative measures the
patient might use? If the patient understands the condition, what to
expect and what he can do for himself, you will not lose as many patients.
They will no doubt, become loyal supporters of Osteopathy. We cannot
afford to lose any case.
When you consider that low back troubles are caused or are associated
with :-Poor Posture, Improperly balanced shoes, Anemia, Malnutrition,
Nephritis, Call Bladder, Pelvic and Rectal diseases, Strains, Infections.
Endocrine Imbalance, Financial and Domestic Worries, Weak Arches, and
Emotions. Then too that you sometimes find Cancer, Fractures, Ankylosis, Arthritis, etc. in the lower back. With this picture in mind it calls
for the taking of an adequate history, a Spinal examination from the
Occiput to the Coccyx, and an examination of the lower extremities before
attempting treatment of any kind to the low back. X-Ray pictures are
a help, as outside of diagnostic purposes, it lets the patient know what he
is up against. It helps the family and the patients state of mind.
28
Right here is a good time to mention what I think few of us take

into consideration and that is the production of subluxations and dislocations. To produce a dislocation direct force is necessary. Subluxations
are not caused by force but might be caused as a result of force. Yet
many of our treatments are given just opposite to their production. To set
a dislocation that, mind you, is caused by force we must know the anatomy
of the part and use finesse, but to adjust a subluxation that probably is
most commonly caused or predisposed by emotions, drafts, colds and other
conditions previously mentioned, we use force and lots of it. Sometimes
by the two man technic method, another well known method is the strap
technic. Most of these cases would and do clear up without treatment. If
a mechanic worked on a machine of ours as we sometimes do on the human
machine I doubt if we would employ him again. Does it seem right that
we who are supposed to know something about the structure of the body
should use force in low back adjustments when the cause of the low back
condition is elsewhere in the Spinal Column?
Several years ago one of the profession brought a man to see me from
a distance of seven hundred miles. The complaint was a bad low back
trouble of forty-five years standing. He said that he had probably seen
every good Orthopedic Specialist in the country and he thought that he
had seen every Osteopathic Physician of any note (about 25) sometimes he
had half an hours relief and two or three times a year about half an
hours relief from Osteopathic treatments. After making an examination
I explained to -him the type of lesion, and that on account of his build,
why it was the lesion at the point of lesion could not be adjusted. I looked
at the X-Ray Films, pointing out the type of lesion, etc. I then told him
that I was going to give him a demonstration, which I did by adjusting a
lesion of the first Dorsal Vertebra without force or discomfort to the
patient, this adjustment mobilized the fifth Lumbar Vertebra. He got
off the table and said he felt fine. I have heard through him and the
Doctor for five years and during that time he didnt have a sign of any
trouble with the lower back.
The Osteopathic theory is that structure determines function. TO
have disturbed structure you must have a disturbed Spinal Nerve Center
and as the Spinal Cord ends at the Second Lumbar Vertebra, your key
lesion must be elsewhere than in the law back.
The spinal Column is made up of two anterior and two posterior
curves.
The fifth Lumbar Vertebra is said to be the base or foundation of the
Spine and that posture depends upon the prober position of the fifth. From
a purely mechanical standpoint if the foundation is out of line the structure above must be out of plumb, therefore, with lesions of the fourth
and fifth Lumbar Vertebrae and the Sacrum you have corresponding
lesions at the tops of each curve of the Spine and which you will find to
be as follows:A lesion of the Sacrum has corresponding lesions of the twelfth Dorsal, seventh Cervical and the Atlas.
A fifth Lumbar Lesion has corresponding lesions of the eleventh and
first Dorsals and the second Cervical.
A fourth Lumbar lesion has corresponding lesions of the tenth and
second Dorsals and the third Cervical.
Other Vertebral and Rib lesions likewise have corresponding lesions,
as the first and twelfth Ribs, the second and eleventh Ribs, etc.:29
If a ball is bounced you will note a change at top, bottom and sides,
the same principle applies to the two anterior and two posterior curves
of the Spine.
I spoke of poor posture as a predisposing cause of low back trouble.
I cannot remember of ever having a low back case in one who had good
posture, but one rarely sees a good posture, as outside of an accident they
are in good condition.
To have a good posture one must walk and stand with feet absolutely
parallel, otherwise the Pelvis and lower back is out of alignment, therefore,
the Spinal Column above is out of plumb. Try standing with feet parallel
and note how uncomfortable it is to slump.
Speaking of some of the conditions that cause, or are associated with,
low back conditions, I think the common lesions found with each are as
follows :Asthma-Sixth and seventh Cervical Vertebrae some say the third
and fourth Dorsals and one says a Sacral lesion.
Arthritis-A rigid approximated Lumbo Dorsal area.
Worry-Grief-Fright-The sixth, seventh, and first DorsaIs.
Gall Bladder and Liver-Right mid DorsaI or the eighth Dorsal and
with the eighth Dorsal lesion you have corresponding lesions of the first
and eleventh Dorsals, Axis and fifth Lumbar on the right side.
Obesity-The old Doctors said the seventh Cervical, The fat mans
hump.
Endocrine Imbalance-Can be helped through the adjustments of the
sixth and seventh Cervical Vertebrae.
Not that it is anything original but to me some of the Spinal muscles
are likened unto cables, some of which run the length of the Spinal Column
and a contraction or contracture of these muscles at any point through
nerve irritation often does cause low back troubles. A very common
area for this nerve irritation to take place is in the Inter Scapular or lower
Dorsal area. It is as if there were a turn buckle placed on a cable or
cables in this area and turned up. The pull being very often the greatest
in the low back.
In stubborn cases of low back troubles you frequently find an extension lesion with or without side bending of the fourth Dorsal Vertebra.
After adjustment of the fourth Dorsal Vertebra, if necessary to adjust
other lesions they adjust very easily. In many instances when you have
adjusted an extension lesion of the fourth Dorsal Vertebra you have done
all that should be done at the time as the muscle tension will be sufficiently
released to mobilize the low back lesions. An extension lesion must be
reduced in flexion. A pop to one side or the other does not constitute an
adjustment of an extension lesion. The adjustment of any corresponding
lesions releases tension at the tops of the other three curves.
The old Doctors formula for adjustment of Vertebral or Rib lesions
is Exaggeration-Rotation and Approximation. I believe that is the
same as saying that to adjust the articular lesion you must reverse the
arc in which the lesion was formed.
The value of being able to adjust or relieve a low back disturbance
from a distant point will be appreciated when there is, or a suspected bone
disease or fracture, you want to give the patient relief but you cannot or
dare not give Osteopathic treatment to the low back lesions.
Many of you here will remember that to Doctor Arthur Hildreth the
30
fourth Dorsal Vertebra was almost a pet lesion as he quoted it so frequently in his talks.
I wish I had more time to talk about an extension lesion of the fourth
Dorsal Vertebra and of the apparently miraculous results obtained when
adjusted. I would think I were hepped on this lesion if it was not that
I so seldom find it. I will mention this case just to give you an idea of the
amount of relaxation that can take place by adjusting an extension lesion
of the 4th Dorsal Vertebra. A woman age fifty with Parkinsons disease,
no tremor but of the rigid-woodeny type muscles, to move the large joints
is like doing it against resistance. Immediately after adjustment the
joints are flexible and the muscles about as pliable as any normal muscle.
After adjusting your Vertebral lesions see that there are no Rib
lesions. Rib lesions will be indicated by tension remaining at the point
of lesion in the low back or at the corresponding lesions.
ANGINA PECTORIS TECHNIC

By CARL KETTLER, D. O.
Technic Section
Before taking up the actual demonstration of the osteopathic treatment for Angina Pectoris, I wish to go over again a few of the fund?mentals as stated in my paper this morning. This will help those who
were not present.
It is fair to say that research has settled down to the belief that
Angina Pectoris is a condition of anoxemia, a dimished oxygen supply to
the working cardiac muscle.
Six years ago I began to think that there might be something done
osteopathically, to help the inner mechanics and chemistry of the angina
heart. In trying to find a few answers to this condition it became clear
from the beginning that there would have to be established, a better interchange of oxygen in the heart. This study and period of preparation
served as a basis for establishing the technic which I shall endeavor to
show. There is nothing complicated about this new osteopathic weapon.
It assists the human body to fight and overcome the paroxysms of Angina
Pectoris.
The fundamental reactions of contracting muscle are oxidations.
It is my opinion that the oxidations are not rapid, enough or thorough
enough in an angina heart.
The heart in its metabolic processes brings about a chronic tonus
stasis in this type of trouble.
When the heart is called upon to put forth more than the customary effort (and it is with angina of effort we are dealing) these products
reach a high degree of concentration which stimulates the afferent nerves
along the adventitia of the coronary arteries and the aortic arch.
A low oxygen content in the blood stream and a low storage of muscle
hemoglobin in the heart produces an oxygen want everywhere in the
heart muscle. It is not sufficient and fast enough to cover its requirements.
By our direct physical treatment, we assist the biochemistry of the
heart, principally its oxidative processes. The supply of oxygen must
always be sufficient and positive to the never resting heart. Our treat31
ment increases the diffusion rate of oxygen. This permits the heart
to operate a longer period of time, without running off its batteries so
quickly. This generalization based on experience requires that the osteopathic physician keep in mind also, the dual mechanism of oxygen supply
to the heart, Viz., Blood hemoglobin and muscle hemoglobin.
I do not mean this technic is complete. It is, however, the culmination of a long period of study and experience. It is presented with the
belief that in the years which follow, there shall be additional significant
contributions which will further develop a clearer understanding of the
angina heart, and out of these investigations there shall evolve a definite
osteopathic technic for dealing with this trouble. The enormous number
of deaths annually from heart failure should arouse our interest. Our
osteopathic conceptions and approach may some day be accredited with a
new treatment of real practical importance in this field of heart failure.
We know up until now, the treatment of Angina Pectoris has been and
continues to be paliative and precautionary.
TREATMENT
Technic of Theory
There is an immense amount of fear among these Angina Pectori;

cases. It has affected them with the belief that their condition is hopeless. Therefore, it is important that we make them ready, psychologically,
to accept our methods. There is no better way to do this than to reassure
them that some progress has been made in treating this trouble, that you
reasonably believe their particular case is no exception to the results, providing they are willing to cooperate. You will have to be a believer and
a persuader when you come to talk with an Angina case.
Whether a belief is true or not depends ultimately upon its practicability and its consequences as experienced.
My faith and belief in osteopathy accomplishes much for me in
handling these heart conditions and generates a good deal of buoyancy
and energy to my life and helps me when it comes to persuading and winning a patient to this new method of treatment, almost unknown to him.
Many of these patients are intelligent and will give you support if
you convey to them your faith and ability to handle their case.
It is curious how strongly this type of case leans toward his former
physician. Some cannot stand the stress of breaking away. All you want
is the chance to prove what you can achieve osteopathically and it will not
be long before you will be withdrawing him from the administration of the
time honored nitro-glycerin. So much for the treatment of him, psychologically.
Next you study his blood pressure, which usually is high. (Take note
of the ventricular amplitude.) This high blood pressure is merely a concomitant system and has no consistent essentia1 relation to Cardiac
Angina. However, the treatment commences by reducing the blood pressure. We simply observe the tensions and pressures at the superficial
parts of the liver. The region of the gall bladder especially concerns us.
We are not here discussing what causes these physical actions and theirintense effect upon the heart. We merely conclude that in certain cases
of Angina it is possible to conceive that the heart is indirectly more or
less strained in overcoming back pressure with a consequent rise in blood
pressure.
In reducing the blood pressure we treat the area of the abdominal
viscera and we keep in mind the arteries of the brain and the diaphragm.
32
I am sure you have your own method of choice in the reduction of hypertension.
PHYSICAI, EXAMINATION
The physical examination usually shows several sites of tenderness
as the anterior or posterior of the sternocleidomastoid muscle in direct
line from the superior margin of the laryns. To the left of the sternal
border, about an inch to the side of the second and third ribs, we have
points of pressure tenderness. In some instances you will find at the apex
of the heart, a markedly sensitive section-more or less a pressure rain.
At the eighth cerival, first, second, third and fourth dorsal segments,
are areas commonly referred to as sensitive and it is in this section we
meet with impactions. The space immediately under the scapula on the
left side is often complained of. All these areas lend themselves beautifully to osteopathic manipulation and relief.
If there is no respiratory injury and no acute or sub-acute phases of
coronary diseases, our treatment is very effective in producing a specific
functional improvement by augmenting chemical changes of oxidation and
the storage of muscle-hemoglobin. (This report, however, is concerned
exclusively, with the more chronic phases of an Angina heart.) This is
done by having the patient on his stomach and by gradual pressure upon
the thorax, you help him expel as much of the residual air as possible from
the lungs. We do this four times to each side of the chest.
Since it is with the oxidative mechanism we have to deal in getting
rid of stagnant air and some of the residual air, we find this the important
part of the technic.
The lowering of oxygen tension in the alveoli can be brought about
by irregular and unequal and shallow breathing. Man can hold his breath
for only a minute or so if respiration is shut off without preparation. The
limiting factor is probably the accumulation of carbon dioxide. When
the breath is held after a period of forced breathing (or preparation),
respiration can be suspended for as long as five minutes or slightly longer.
The limiting factor is the oxygen capacity of the body and it can be calculated that the breath can be held only so long as it takes to use up the
oxygen in the blood, tissue fluids, lungs and muscle-hemoglobin. If the
lungs are filled with pure oxygen after forced breathing, there are some
experimentors who have been able to hold their breath for as long as
fifteen minutes. One of the mechanisms that may operate to permit such
endurance while holding the breath is the amount of muscle-hemoglobin
and its capacity to store oxygen. Therefore, it is recommended to stimulate respiration. I am sure that the increase of pulmonary ventilation
corresponds to the symptomatic relief of the paroxysms even when standard methods of drug therapy have failed to produce any lasting benefit.
It is indicated as a routine treatment in all Angina cases.
There are fundamental precautions which should not be discarded
while working on an Angina case:
(1) Never be in a hurry.
(2) Do not treat too long (have them at first come in more often,
if necessary).
(3) Let your patient see and feel you are specific..
(4) All the manipulative movements should be performed deftly
with due regard to the impression being made upon the patient
in order to win his confidence.
33
(5) We should absolutely keep away from our proclivity toward

the correction of osseous structure until such proper time arrives and the organisms can take the particular osseous adjustments without a reactive effect.
(6) Never apply percussion on any spinal vertebra. No part of
our treatment should augment constriction.
(7) Reassure yourself if you are doubtful and disappointed with
results, by continuous study. May we hope you will express
your convictions freely and give us the benefit of your thought
and experiences so that we might have an orderly stabilized
method of approach and prove the superiority of osteopathy over
all other methods in the treatment of Angina Pectoris. I
thank you !
CONSIDERATIONS FOR OSTEOPATHYS SURVIVAL AS AN

INDEPENDENT SYSTEM
ASA WILLARD , D. O.
A.
There are two essentials for Osteopathys survival as an independent

profession.
1. Its practice must be distinctive.
2. It must not be dominated in regulation by those representing
antagonistic systems which seek to choke it.
Many details of policy center in these two essentials.
There has developed a disturbing pollution of its practice which
threatens its distinctiveness-and hence its professional existence.
Some of its practitioners have become so broad that the osteopathy
which they practice is like the water of the river which broke loose upon
the desert-it has spread out until it has disappeared.
These practitioners are like the Australian duck bill-half fish, half
bird-but neither. They are like the Missouri mule-without pride of
ancestry-without hope of posterity.
Indications are that we might do we11 to professionally adopt the
slogan for ourselves : Try Osteopathy First.
A distinction of osteopathy as it rapidly came into public acceptance
was, in the eyes of the public, that it was essentially a non-drug practice.
It was and still should be. Upon that conception we built to where we
are, the oft-repeated statements of even some of our officials in recent
years to the contrary notwithstanding.
It is a testimony to the fundamental soundness of the osteopathic
concept that we are still a profession in spite of our blunders of policy.
There never was a time in Dr. Stills day when he contended that
there was no place in practice for drugs, and our professional policy admitted that, and I think the public had a fair conception of our attitude.
It was an incident however, and conceding it as an incident, was
certainly a sounder policy than that pursued in recent years of emblazoning at every opportunity, even officially, we do use drugs along with
policy tactics and procedures which tend to emphasize our conformity
with old school practice, rather than our distinctiveness, and to confuse
the public generally and bewilder our followers.
34
If we survive as a profession, it will not be because the public feels

that were like the other fellow, not even that we can give drugs like he
can, but because we are different and have something helpful that he has
not.
It is the patient who has been helped by distinctive osteopathy who
comes to your help in legislative halls and in our contentions generally
when prefessional antagonists seek to hamper us.
Again I say, we didnt get where we are because we were like the
other fellow, but because we were distinctively different.
Whenever we are not different, in more than name, then there is no
longer reason for our survival as an independent system.
That being true, it would seem to be common sense to emphasize cur
difference rather than do things that confuse us with another profession.
Let us take stock: First, theres that constant going out of our way
insistence from even our official circles, We do use drugs. I picked up
a chemical journal-and there it was from our central office.
I hold here a booklet on osteopathy for lay or prospective student distribution, gotten out by a Chicago publishing firm.
Right at the beginning, under the heading Osteopathy, we read
Contrary to what appears to be a somewhat general impression, osteopathy is not, and never has been, a drugless school of practice.
And theres the foreword right across the page, stating that data and
suggestions were furnished and the manuscript approved by our Public
Welfare Committee.
Formerly, somewhere incidentally in the pamphlet, would have been
the statement in essence that While Osteopathy is essentially a drugless
system, that in certain instances the use of drugs is indicated.
But here, even before we amplify our premise of practice, the time
cannot be lost to hit them right between the eyes with the idea that we
do use drugs.
Youve run across this repeatedly of recent years-it seems to be
almost an obsession in some quarters-a really hurtful one, for why push
away our friends who come to us to get away from the old drug stuff, or
our would-be friends, who want to come to us to get away from it, who
want something different.
P RESCRIPTION B LANKS
One unconscious tendency to conformity is in the use by some of our
people of prescription blanks. Use them to write notes on for patients
even. Conformity instead of establishing distinction.
Probably few know that that little mark as placed across the tail of
the R on prescriptions in remote days was a sign of propitiation to the
gods-but maybe it propitiates our ego.
O STEOPATHIC M EDICINE?
Within our ranks we have evolved the hurtful term Osteopathic Medicine, and some seem to roll it lovingly on the tongue. It is certainly
confusing and misleading to the layman with his popular idea of medicine
as associated with drugs.
To, in a legal sense, establish that Osteopathy is a system of Meditine, is pertinent, but infinitely more obvious that you are using medicine in a broad sense.
The term Osteopathic Medicine contributes nothing popularly but
the idea that were now living up with the drug folks, and if generally
35
used, the osteopathic will be dropped and our practice just referred to
as medicine, and what we accomplish will exalt another profession.
I illustrate . . . . . .
I hold in my hand a copy of Liberty magazine. Its leading and
feature article is The Private Life of Bob Taylor by Adele Rogers St.
John. As some of you know, Bob Taylors father was Dr. Spangler
Brugh, an osteopathic physician, who practiced in Nebraska.
The article tells in a most human-interest way, the life of Spangler
Brugh-of his marriage to Ruth Stanhope when she was eighteen, a
lovely character-A beautiful love story. Then, how she became ill with
what the doctors called an incurable condition, one which precluded her
having a child.
Then the story tells how Stanley Brugh finally gave up everything
and entered an Osteopathic school and his wife was cured by osteopathy,
and could have a son and Bob Taylor was the son, and how Bob idolized
his father and planned to study Osteopathy.
Did it tell that. . . . . .?
No, Adele St. John said Stanley Brugh decided to study medicine.
All through her story she used the terms medical medical practitioner,
medical school, not once was osteopathy mentioned, and of the millions
of people who read the beautiful story and saw Bob Taylor on the screen
and thought of it, all but a few hundred, who know there is no medical.
school at KirksviIle, (which is named, incidently, once in the article) as
the laity think of a medical school, would give credit to osteopathy.
Dr. Brugh is depicted as a fine character, which he certainly was, and
because of the phraseology used, a competing system gets credit for him
and for curing a case which they had failed with, instead of osteopathy,
which cured the case after regular medical practice had failed.
Doesnt that illustrate how we, when we are buried in medicine
are eliminated ?
Doesnt it illustrate the advantage of even being designated distinctively?
Ive seen a number of office doors, stationery, etc., in recent years,
of members of our profession who indicated in no way whatsoever that
they had any osteopathic connection.
Why not be distinctive and proud of your distinction?
I have here a clipping from a Los Angeles daily paper, reporting on
a dinner gathering of osteopathic physicians some time ago. They discussed, it was reported, the drug, scopolamine, and it was reported as
the consensus of the meeting that the drug should not be condemned
because a group of people in one state down South had been killed by a
wrong combination of the drug. That was the total publicity that came
from that so-called osteopathic meeting.
Would the public get any hint of distinctiveness from that meeting
which would make them champion our contention for professional independence?
Our professional publications, which should be first, last, and all the
time, mediums to fortify us in our convictions, contain drug advertisements with claims absolutely contrary to our preachments for our own
profession. If the claims of those ads are true, then osteopathys claims
are not. I have even checked individual issues of our professional magazines in recent years; yes, our organization journals, too, and found them
36
containing more ads for internal drug therapy than the corresponding issue of the A. M. A. Journal. Perhaps you didnt realize that, but
its a fact. When some of us protested this, we were told that we had to
have the money from those ads in these times to run our organization.
There were so many demands, etc.
Well, taking money for that which controverts what YOU are issuing
the magazine to put over reminds me of the fellow who sold his only pair
of pants to buy himself suspenders.,
How can we expect the students in our colleges not to feel friendly
toward drugging when our own official publications thus have continuously
urged them to drug.
I have no doubt whatsoever that this sort of professional sanction
has had a part in the drug trend and, hence, the elimination of distinctiveness in such a percentage of our profession.
There has been marked improvement as to number of internal drug
ads in our magazines that were carrying internal drug ads in the last
couple of years, especially our Association Journal, but some still carry
ads totally inconsistent.
Ill read one here (Reads ad for hydrosulphosol.) Now, youll note
its seeming recognition of osteopathy and naive appeal for its osteopathic
readers to use it.
Says its as direct and logical in restoring normal chemical balance
as is osteopathy in restoring mechanical function.
Well, in the last analysis, you restore mechanical function to restore
normal chemical balance, and if this drug has already restored it, osteopathy is superfluous. And, its easier to give the drug than an osteopathic
treatment.
May we hope to soon again see the time that we are consistent enough
that we will carry no ads in our journals boasting internal drugging for
the care of disease conditions.
Heres a copy of the last issue of one of our magazines. Featured
in the front of the magazine is a case history given by a D. O.
The only time osteopathy was used on the case was to relieve the
patient of the agonizing and extremely complicating effects of a drug used
internally, which the osteopath himself had ,administered. The patient
was completely relieved of all pain, but minor discomfort by the
osteopathic treatment, the D. O. reports.
Yet, he reports, before leaving, administered morphine sulphate
hypodermically and, shades of A. T. Still, after two or three clays and
the soreness and blood passage from kidney and ureters caused by the
tissue injury of the drug he had used had ceased, the osteopath again gave
the patient the same drug for several days.
Well, there is such a thing as curing patients without killing them.
Osteopathy aids greatly in doing that, as well as relieving them of the
harsh tissue destroying effects of drugs.
What a conception of our profession? Just use Osteopathy to relieve
the patient of the effects of internal drug administration by the osteopathic physician himself.
**TRY O STEOPATHY F TRST!**
I have seen a number of cases of acute gonorrhea, some presenting
a much worse picture than the one reported above, get well without the use
of any drug internally, and without the drug induced agony described in
37
this case, and they stayed cured; for laboratory and clinical checks have
been made by both D. Os and M. Ds at least every six months for years
on some.
Dr. Harry Vastine has a splendid article, titled A plea for Osteopathy in this same issue of this magazine, quoting from high medical
authority that recent studies are showing that the bodys healing resources must be credited with many recoveries from syphilitic infection,
and indicating that the harsh arsenical and mercuria1 drugs used for
that condition have received excess credit.
Many years ago, when in professional charge of a hot springs one
summer, I took the occasion to experiment with gonorrhea and syphilis
cases. Since then, supported by further observation on more occasional
cases, I have been absolutely convinced that, by care based primarily upon
osteopathy, diet, and boiling them out, that the vast majority of these
cases can be cured and without permanently injuring them as is often
done with the internal drug agencies for some years regarded as classic
for these conditions.
And might we not often solve a lot of problems osteopathically if we
would TRY OSTEOPATHY FIRST rather than just assuming internal
drug administration as the last word.
Here at Atlantic City we have just finished part III of National Board
Examinations. In principle and practice, I asked, tell what you would
do for a case of scarlet fever. One applicant, after outlining briefly,
cause and treatment, concluded : and in severe cases use sulphanilimede,
and I asked why?
He said thats what I was taught, wouldnt you use it? I said Ive
happened to have had dozens and dozens and dozens of cases some of them
certainly severe, and with osteopathy have been fortunate enough never
to have lost a case nor did any case have any detectable hurtful after
effects. Osteopathy with fruit juice diet and care is certainly the answer
in scarlet fever.
Now, if that were your experience over a long period of years, would
YOU feel that there was reason for you to use sulphanilimede? He said,
Certainly not.
Well, I asked, how are you going to exhaust the possibilities of osteopathy if you dont? TRY OSTEOPATHY FIRST.
If we dont TRY OSTEOPATHY FIRST how will we ever advance?
If Dr. Still hadnt tried OSTEOPATHY FIRST, we would not have
gotten started. He said, as to osteopathy, he had gotten hold of the, cats
tail and it was our job to pull the cat out of the hole. Instead, are we
losing what he gained?
Sometimes, it looks like some labeled as his followers have let loose
of even the tail and got hold of a skunk.
And what gravitation there is into the attitude of mind that internal
drugging is essential in some conditions where we have already proven,
positively, that it isnt?
The case report just discussed mentioned hypodermic use of morphine sulphate.
Within the month, a prominent D. O. spoke to me of the handicap
we were under in Montana in practicing obstetrics without being able to
register under the Harrison Act, and I know there are osteopaths who
have been taught the use of morphine as a routine procedure in obstetrics.
38
Dr. George Payne, aided by his wife, Dr. Mabel, in Columbus, Montana, a town of 800 people, has delivered nearly 1700 babies in the last
twenty years. Lost two babies and never lost a mother. Never uses
morphine nor pitruitin.
Not having morphine for obstetric cases cant be any terrible handicap, can it?
Dr. F. O. Harrold, over at Fairview, Montana, has delivered hundreds
of them with like enviable record.
I can name a number of whose work I know. Dr. Harry Bennison
of Clay Center, Kansas has had a marvelous record in over 1330 cases
through just osteopathy helping Nature.
Why, Dr. Charlie Still, way back when I was little more than in the
diaper stage, delivered almost a thousand eases without using dope and
with extra-ordinarily kind results as to the mothers.
You, who listen to me, know that repeatedly you meet patients who
had been to osteopaths who made no effort to TRY OSTEOPATHY FIRST.
I recently met a young lady whom I hadnt seen for two years. Asked
her where she had been. She said, teaching naming the town. I
said, met my young friend, Dr.. . . . . . there yet? She said, Oh yes, he
gives me my shots. What shots, I asked, Cold shots,, Didnt he
ever treat you? No, just the shots.
Well, have you never treated anyone, perhaps for some other condition, and have them say, Doctor, I always have colds in winter, but
I havent had any this winter since youve been treating me. TRY OSTEOPATHY FIRST.
Not so long ago an Irishman dropped into the office with a pain in
his side. I told him the trouble was in the ribs position and adjusted
it and the pain was immediately relieved. I said, That ribs position
has been at fault for some time, as you go along down the coast, get a
treatment occasionally until it stays where it belongs. Six months later
he came back and said, Doctor, for God sake, fix the rib. He said, I
have been chasing up and down the coast with a fountain syringe in one
end and a castor oil bottle in the other for that rib, now fix the rib. I
fixed it and he took a little bottle of pills out of his pocket, that an osteopath had given him,, opened it, looked at them and said, Ah, you little
clivils, I have been wondering how you knew how to go to my rib, instead
of my big toe. WHAT PHILOSOPHY.
Havent you sometimes marvelled at the way lay folks grasp Dr.
Stills philosophy, even better than we do? They encourage us to stick
to the ship.
We, instead of considering the drug angle with our pristine vigor softpedal at times, even when some medical mediums are speaking out frankly.
Two years ago, the week Dr. William Mayo died of pneumonia, he was
given sulphanilimide and it quickly so reduced his blood cell count that his
son was hastily called and gave him a blood transfusion. A Chicago
paper reported this-1 said to one of our magazine editors, a splendid
all the way osteopath himself-That story should be reproduced in our
journals, its something our people should know. He replied, Im
afraid to because of its effect on the Kansas situation.
As to No. 2 of the essentials named for osteopathys survival as an
independent system, at the beginning of these remarks.
It must not be dominated in regulation by those representing antagonistic systems which seek to choke it.
39
The foregoing, which I have recited in the last few minutes, as indi-
cative of a trend from distinctive osteopathic practice, is certainly also
furnishing ammunition to our enemies to aid them in their efforts in

legislative halls to eliminate us as an independent profession.
Some of our folks have expressed that if we produce osteopathic osteopaths and practice distinctive osteopathy, we need not worry about
legislation.
I think, as a practical proposition, beyond that there is required
united well-planned action, to insure that those who are antagonistic to us
do not get legal bars set up preventing our service.
The opportunity for service must be kept open.
The University of Chicagos president said, a few days ago, that a
truly liberal education is just as important in this country as national
defense.
Certainly-but at the moment national defense is the thing to take
care of, or our youngsters chance for a liberal education will soon be gone.
So, if we lie down to, or collaborate with, regular medicines regulatory arrangements which give them influence and domination over our
colleges, hospitals and practice, the chance of those to come, to practice
osteopathy, will be gone-and the profession gradually be eliminated.
The poorest Independent Board Law in the United States, if it allows
the practice of distinctive osteopathy in all diseases and deformities, is
better for our professional existence in the long run than the most liberal
medically dominated law. It is only a matter of time until we get stung
under the latter.
Yielding to the sop of equal practice rights or unlimited privileges
drugs, general surgery, etc., some of our people in given states at certain
times have conceded, and even worked for, arrangements which allowed
those who would, choke us professionally to dominate state regulation and
put up bars against those to come.
This State of New Jersey is one where that has occurred! !!
The District of Columbia, just below us, is another-eleven years ago
some of our people in the D. C. collaborated in the establishment of the
present medically dominated regulatory arrangement. Then, there were
thirty-six osteopaths in the D. C., now there are but twenty-three. Meanwhile, both lay and medical population have much increased.
The basic Science bill was deliberately formulated by the A. M. A.
especially to cut us down and it is doing it.
And it is so vulnerable to attack because of the evidence which we
can adduce that that is a fact and because, as a practical educational test,
it is a joke, that it couldnt have passed in any state in the Union if our
people had unitedly done their best against it and it need not pass in
another state if our people will wake up and meet the effort with their
full power and properly organize for it, anticipating it before the legislative sessions convene.
It is indeed a reflection upon osteopathic loyalty when twenty-five
prominent D. Os in Missouri indorsed the passage of the recently defeated Basic Science bill there. Their argument was that the state was
getting too crowded and we needed. to cut down on their coming in.
Well, if that were true, the thing to do would be to establish more
rigid tests as to their osteopathic fitness. Tests kept in the hands of our
profession-instead of turning our regulation over to a regulatory medium
of our enemies.
40
And that recalls to mind that to aid us in fighting for, and keeping
our independence, and to give expression on other policy issues vital to
us all, we have a great need for a medium that will reach our Professional
people and let all of US know what is going on and in which we can express
our views vigorously.
Leaving vital legislative and other matters to the understanding
of a few people and expurgating to a- look-out, Ill hit you with a feather
degree, anything vigorous that might arouse to action, because it might tip
off the A. M. A., or disturb some of our own people, isnt calculated to make
our people generally understand and fight.
Sometimes a few misguided ones sell us out before the rank and file
know anything about it.
When, what is the present New Jersey law was being pushed in
the New Jersey legislature, I read about what it conveyed and
required of our people in the American Medical Association
Journal and not our own, and when I wrote an air mail to prominent New Jersey D. Os and pointed out what the law would do
and asked them why on earth they were standing for that, they
wrote that neither they nor a large part of the New Jersey D. OS
knew the situation as presented at all, that they had gotten busy
at Trenton, but found that things had gone too far already. I
dont think the rank and file of New Jerseys D. Os would have
stood for the passage of that thing, now the law, if they had
understood its significance..
We have lost ground in some states by asking for rights for all of
us that all of us are not entitled to. Not been fair with the public. Our
policy adopted way back in 1920 of legally requiring added training of
our general surgeons was sane and appealing to the public. We should
follow it from here on. Id like to say more on that, but havent time.
Its pertinent to my caption. Some minutes ago I said that whenever
we are not different in more than name, there is no longer reason for our
survival as an independent profession.
Well, there are those who would even sell out the name.
At a recent meeting in one of our cities, the vote in a group of D. OS
was 103 to 38 for the M. D. degree to be issued to our graduates.
A few days ago a gentleman flew from Los Angeles to my town for
his sons wedding. He was a druggist. He said, I take an osteopathic
treatment frequently, did just before I took the plane, but its getting
harder and harder to get one. He asked me then, When are you people
going to give up your colleges? I expressed surprise at his question.
He said he had heard that we soon would make arrangements with medical
schools and give up our colleges. He added, Whenever you do the chiros
will perk up their courses a littlei and take over the manipulative therapy
and the osteopaths will fade out. Let some JUST GIVE THAT A
THOUGHT.
No, not the M. D. degree and teaching everything to our students and
leaving the befuddled grad to take his choice.
My dream of an osteopathic college is one where every instructor is
himself enthusiastic about osteopathy and where in each subject that is
taught, each day it is a primary didactic aim of the instructor to link up
that days instruction to distinctive osteopathic practice and conservative
surgery, the latter generally to be used after we have TRIED OSTEOPATHY FIRST.
41
Make osteopathic thinkers and reasoners.

That is a distinctive problem which our colleges have and one which
merely standardizing our curriculae in harmony with medical colleges
will not solve.
Dr. Still said one day: Im no Normal professor, Asa, (The State
Normal was at Kirksville) I dont pretend to know the fine points of
pedagogy, but I do know you students have got to learn to think osteopathy.
One day he dropped into Dr. Bill Smiths anatomy class. Dr. Smith
was a graduate of Edinburgh, Scotland, and one of the best anatomy instructors that ever lived.
Dr. Still listened as he lectured on the quadratus lumborum muscle.
When he had finished, Dr. Still said, Whats all that got to do with the
practice of Osteopathy?
Dr. Smith thought a moment, and replied, Well, if that quadratus
lumborum was contractured, it might pull that 12th rib down on that side,
and it would hold the body that way.
Dr. Still said, Well, why didnt you tell them that?
And Dr. Smiths application of his teaching to osteopathic practice,
as he conducted his anatomy classes, made his students do a lot of osteopathic thinking.
Dr. C. W. Proctor was brought over from the State Normal faculty
to teach chemistry. Dr. Still quietly came into the class one day, listened
awhile and abruptly asked, Whats all that stuff got to do with the
practice of osteopathy?
Dr. Proctor was quite embarrassed and had no ready answer. Evidently, he later gave the matter thought, for thereafter, frequently as he was
on some aspect of chemistry, he would outline how normal chemistry
might be changed by lesion conditions, the secretions of the stomach,
perhaps, and his students got some good food for osteopathic thought,
for Dr. Proctor thoroughly believed in osteopathy.
A few years ago an Ex-president of A. O. A. advocating getting
trained instructors for certain basic subjects regardless of their osteopathic
attitude said, when it was insisted that they should always be osteopathic
that it isnt much of an osteopathic college that cant convert an instructor. Well, he isnt there to be converted. Hes there to convert.
You cant put conviction into others when you dont have it yourself.
If we do not profit from the already evident results of our lack of
conviction and vision and individual and group selfishness, and from the
history of Homeopathys downfall, we are indeed the exterminators of
our own profession.
Homeopathys great appeal to the public was that it got away from the
heavy drug closing of Allopathy, and as many, if not more, of the people got
well under it.
They got well without being made sick to get weI1, so, many of the
people turned to Homeopathy. Homeopathy traded its independence here
and there and yielded to Allopathic control for equal practice rights for
those at the time in practice, until finally its schools were closed.
Its later practitioners, sought to mix Homeopathic and Allopathic
drug ideas, became more and more Allopathic and the profession is a
memory.
As Homeopathy faded out, the public began looking to Osteopathy
as the non-drug hope. They found that Osteopathy had something to offer
them even besides the Homeopathics common sense with the patient and
42
the negation of caring for them without the use of powerful drugs.
It had a positive, appealing, distinctive nature-aiding therapy, and
no new system ever in a like period received the attention and indorsement of the public that it did in its first professional decade.
It delivered and did not disappoint its adherents. In fact, the demand
for the service exceeded the supply of those trained to render it to such
an extent that imitators, of little training, took advantage of the situation
to practice it crudely under other names.
So great are the possibilities of Osteopathy, even when applied crudely,
that these imitators helped many people, became legalized under these
other names and still exist.
What a sad commentary upon our vision and intestinal fortitude
it would be if we continue to allow our practice to become so infiltrated
and polluted with antagonistic drug practice that these crude imitators
become the medium to carry on the torch.
Unless this profession hewes to the line, practices Osteopathy first,
in every day practice, exhausts the possibilities of Osteopathy to the extent
available before using agencies antagonistic in principle or more radical
it has reached its peak, has seen its day of greatest influence, and some Of
you will live to see Osteopathy as a profession out of the picture.
We can allow this, supinely embracing the agencies of our destruction, a la Lava, Darlan and the Viche Government, or with a continuing
willingness to sacrifice for a worthy cause, though it has been sadly hurt,
those who still have faith in the fundamental principles of Osteopathy,
and believe that it is essentially a non-drug system, can pool energy and
wisdom and carry on. I believe those with such faith and belief can still
dominate this profession if they work together, and can force and pursue
policies in harmony with their beliefs that will maintain their profession
in the appreciation of the public, and as the developer and apostle of the
greatest philosophy of healing the world has every known.
We must consistently maintain and contend for our professional independence at all hazards, allowing no antagonistic system to dominate
in the regulation of our teaching institutions or the licensing of our
practitioners.
We must be true to, and play fair with, the public seeking no rights
for all that all of us are not qualified for, and in which the public is not
safeguarded against the selfishness and lack of preparation of individuals
in our own ranks.
Our publicity should emphasize our distinctiveness, rather than our
conformity to another system.
We must pay larger attention to research to develop scientifically the
Osteopathic conception and practice.
And, greatest of all, we must tune our colleges primarily to the production of Osteopathic conviction, Osteopathic reasoners, Osteopathic
Practitioners-never sacrificing emphasis there to standardized medical
education, and we must carry out that mood in our publications and conventions.
Standing together in such effort in a spirit of willingness to make
some sacrifice to keep alive, develop and advance a great idea in behalf
of suffering and crippled humanity, we ourselves will actually effectively
serve more people and relieve more suffering and then when our work
here is ended, we will not just have made a living practicing, but will have
had a part in a movement which will give us and those who care most for
us, a feeling of comfort and pride.
43
MANIPULATIVE THERAPEUTICS FOR GALL BLADDER DISEASE

E. P. MALONE, D. O.
Osteopathic theory of the cause of gall bladder disease including gall
stones was first enunciated by A. T. Still in the following words: In
my opinion gallstones are the result of temporary paralysis of the splanchnic nerve system which I have found compressed by malpositions of
the 5th 6th, 7th, and 8th ribs on either or both sides. I have never
found a case of gallstones where there was perfect rib articulation with
the 5th, 6th, 7th, and 8th vertebrae,
According to this theorv malpositions and rigidity of the spine and
ribs in the splanchnic area are primary causes. By interfering with
nerve impulses they bring about congestion and stasis and alter the chemistry of the bile. Inflammation and precipitation of stones are the results.
Stills theory has, of course, been universally accepted by osteopathic
physicians and for more than forty years gall bladder pathology including
gall stones has been successfully treated by methods in accord with it.
Let us formulate a second osteopathic theory to explain those good results
which will correlate with Stills theory and let us state it thus:
Correction of malpositions and rigidity in the spine and ribs in the
splanchnic area reestablishes normal nerve impulses, overcomes congestion
and stasis and normalizes bile chemistry. In the presence of normal, free
flowing bile precipitation of stones will not occur and stones already formed
tend to become disintegrated.
In the belief that this second theory is susceptible of reasonable
clinical proof the case study which I wish to present was undertaken, the
object being, first, to benefit the patient and, second, to test the theory and
if possible add something to our present knowledge.
The patient is a housewife of 47, mother of four grown children. For
years she suffered with chronic indigestion. She had several attacks of
acute abdominal pain which were pronounced as probably due to gallstones before she decided to go to a famous northern clinic for examination and treatment. While on her way to the clinic by automobile she
was taken with a devastating abdominal pain accompanied by chills and
a rise in temperature. She stopped in a small city in Iowa and while
waiting for a physician to come to her car the pain suddenly ceased. She
spent three days in a hospital in the Iowa city and then proceeded on her
way. As soon as possible after her arrival at the clinic she was operated
upon. The surgeons report of the findings and the scope of the operation
reads in part as follows:
The gallbladder showed a subsiding, acute cholecystitis on a chronic
cholecystitis which had perforated into the omentum and onto the anterior
abdominal wall. I opened into the gall bladder and into the abscess which
was walled off by the omentum and removed considerable purulent material
and many black, faceted stones from the gallbladder. The gallbladder
itself was contracted into an hour glass constriction and in order to completely empty the gallbladder I had to cut its walls all the way down to
the cystic duct. I removed the upper portion of the gallbladder leaving
only a small portion of the pelvis. There was considerable inflammatory
infiltration in the region of the ducts so it was impossible to explore them
. . . The liver and pancreas appeared to be normal.
After stormy convalescence she returned home and gradually resumed
her household routine. She had no trouble for nearly two years, then
44
without warning she had an attack of acute pain in the right upper quadrant around to the back and accompanied by nausea and mild fever. She
wrote her surgeon about this attack and his reply reads in part as follows:
It occurs to me that either a new gallstone has formed in the remains
of the gallbladder or such stones in small form were present in the bile
duct which did not permit of exploration or removal owing to the infected
condition of the surgical field at the time of operation. Of course if such
a stone or stones are present attacks such as you describe in your letter
may recur. There is nothing we can do about it and a second operation
may eventually be necessary.
An X-ray study reveals that the technician refers to as a cluster of
shadows evidently biliary calculi in the stump of the gallbladder. Seemingly the surgical interference however urgently indicated has done nothing to remove the cause of stone formation.
The patient was of course, anxious to avoid further surgery if possible. She was also apprehensive of the effect of manipulation over the
gallbladder thru the abdominal wall. For that reason treatment which
was begun at this time has consisted of spinal manipulation and nothing
else. Spinal conditions noted were mainly rigidity in the splanchnic area
and the appearance of backward displacement or undue prominence of
the ribs on the right side. This appearance of the ribs is one which I
believe is commonly to be found associated with gallbladder pathology.
Whether it is due to a group rotation to thickened and contracted muscle
overlying the ribs or to- both-or to some other cause I do not know. Persistent effort was made to mobilize the rigid spine and to reduce the prominent appearance of the ribs.
Two months after the preliminary study and after about 18 treatments had been given a second study was made. The technician reports
that the shadows are not as distinct as in the previous picture.
The patient had had no further attacks and the spine seemed to he
responding to treatment. It was thought that time was now working
for the success of the experiment and as it was believed desirable to keep
the patient under observation for some time, treatment was reduced to
one each week and after another five weeks a third X-ray study was made.
This was a good clear picture but as it was thought to be inconclusive for
the presence or absence of stones another study was made with the use
of dye. Altho the dye seems to have filled what is left of the gallbladder
no shadows arc visible.
OSTEOPATHY IN AN EPIDEMIC OF DIPHTHERIA

C. E. STILL, D. O.
I promised a number of years ago that I would write the story of
my first experience as an osteopathic practitioner wherein I had to depend
entirely upon myself. Osteopathy had been claimed by a great many
to be a gift to A. T. Still and, therefore, not teachable. This experience
that I had in Minneapolis was the first that anybody had ever undertaken
where Dr. A. T. Still, my father, was not close enough for consultation.
In the winter of 1892-93 a gentleman by the name of O. H. Wernicke,
of Minneapolis, came to Kirksville for treatment. He had been injured
in a fall and used a crutch and cane in order to get about. I was called
45
in to see him at the old Poole Hotel. He was a very large man and I felt
that I needed help in order to make an examination and to treat him, so
I called my brother Harry. (Now I might say that my brother Harry and
I had been practicing osteopathy under father for a number of years
before the school started.) Mr. Wernicke, at this time, was President of
the Altman-Miller Harvesting Company, of Minneapolis, and after staying
in Kirksville about a month he entirely recovered from his injury and
went back home. Later he sent his field foreman, Mr. H. O. Willey, who
had also had a fall and had injured his shoulder to such an extent that
his arm was almost helpless, if not entirely so. It so happened that Mr.
Willey was assigned to me by father and I treated him so successfully that
he got entirely well and he went back to Minneapolis and reported to Mr.
Wernicke. They invited me to spend a month or two during the summer
of 1893 in Minneapolis. I arrived in Minneapolis about the 5th of July
and went to the Windsor Hotel where Mr. Wernicke had made arrangements for me for one month. In a very few days after starting in to
practice in Minneapolis I received a letter from Dr. Hewitt, the Secretary
of the Minnesota Board of Health, in which he advised me to stop my
unlawful practice or I would be prosecuted. I immediately went to see
Mr. Wernicke and he advised me to see an attorney by the name of F. F.
Davis, considered the outstanding Minnesota attorney and one of the most
outstanding in the Northwest. I did, and he told me to advise Dr. Hewitt
that any further business he wanted to transact with me to do it through
my attorney, Mr. Davis. That is the last I heard from the ,Minnesota
Board of Health at that time.
During the time that I was at the Windsor Hotel, Mr. Willey and a
Mr. Burke, of Diamond Bluff, Wisconsin, came in to invite me to visit
Diamond Bluff on my way to Chicago. (I might say that I was intending
to go to the Worlds Fair before leaving Minnesota to go home.) I told
these gentlemen that I would stop off there for one month providing they
would guarantee me twenty-five patients. Mr. Burke, who was a banker,
spoke up and said that he would make that guarantee himself, as my SUCcessful treatment of Mr. Willey had encouraged them to invite me to
spend a month in Wisconsin.
I was very busy in Diamond Bluff and had patients from a number
of surrounding towns. Two gentlemen from Red Wing, Minnesota, an
ex-senator, Peter Nelson, and an ex-representative, August Peterson,
invited me to spend the winter in Red Wing after I had concluded my
visit to the Worlds Fair. I accepted their invitation and arrived in Red
Wing about the middle of October, 1893. Business was flourishing there
from the beginning. One very prominent man by the name of Curtis,
president of a business college there in Red Wing, had had a fall and had
injured himself to such an extent that he was walking on crutches. Some
of his friends encouraged him to come in to see me, and, knowing how
important this case was, I hesitated to try to do anything for him without
the advice and assistance of my father so I sent him a message, receiving
the reply that he would be up in a day or two. I made arrangements for
Professor Curtis and my father to meet in my office at a certain time
and at that time there were two or three prominent men from Red Wing
present. This happened to be one of the very many spectacular cases of
fathers, as he reduced a dislocation of the hip and one or two partial dislocations of the vertebrae and the sacro-iliac. That, of course, created
quite a favorable impression for osteopathy among the people there.
46
Before father left for Kirksville, Senator Nelson and Representative

Peterson took him out on a little tour of the city to show what a beautiful
little town Red Wing was. On this trip father saw a number of quarantine
signs and he asked what they were up for and they said, We are having
a diphtheria epidemic. He asked them why they didnt call Charlie in.
Then they asked if osteopathy could help diphtheria and he replied in the
affirmative. Wthin a few hours after father left on the next morning
I was called to see a case and found that is was in a family where several
members were down with diphtheria, one of them already having died.
I stayed all night and treated these children-and, by the way, I had an
assistant, Dr. Charles W. Hartupee, who stayed in the office, while I attended to the diphtheria cases.
I did not understand the law there (doctors must make a report
within twenty-four hours after seeing a patient with a contagious disease)
and, not reporting this condition, I was prosecuted. That sort of aroused
some of the people in Red Wing and they wanted a fight. The medical
men had given up the cases at this home and when the health officer went
around in the morning to see how many were dead the father of the little
family replied that all of them seemed to be doing some better-that he
called in Dr. Still who had treated them during the entire night.
During my experience in Red Wing I was prosecuted three times
but none of the cases were ever tried. The first prosecution, however,
we got ready for the trial. Mr. Frank Wilson was my lawyer and on the
night that the summons was served on me I offered to give a cash bond
but they said that they wanted me to give a -regular bond signed by some
of the prominent citizens. I did, with Nelson and Peterson signing it.
The date was set for the trial but the prosecuting witness, the health
officer, failed to materialize, so after a little discussion between my lawyer
and the court I was dismissed. The other cases were also dismissed.
During the time that I was in Red Wing I treated something like
sixty diphtheria cases. I lost only one wherein I was the first physician
to see the case. I thought it was excusable in that loss because I had
been called over into Wisconsin where I got into a blizzard, and when I
returned the child was practically dead.
There was quite a good deal to contend with there because the Secretary of the State Board of Health lived in Red Wing and when the Prosecuting Attorney of Red Wing refused to make any more prosecutions Dr.
Hewitt went to St. Paul and consulted Governor Nelson, asking him to
have the Attorney General of the state to have me prosecuted as the prosecutor in Red Wing had refused to go any further in any of these cases.
The Governor replied to Dr. Hewitt that he had been treated by Dr. Still,
also had the Secretary of State, Brown, and their Auditor, Bierman, so
he was of the opinion that General Edgerton, who was Attorney General
at that time, would not issue the order for he was very much in favor
of Dr. Still because of his successful treatment of a number of individuals
in the Capitol Building. I spent the entire winter in Minnesota and then
came back to Kirksville to take my place in the school.
Now this is practically my Minnesota story.
47
SELF SAVING TECHNIQUE

ASA WILLARD , D .O.
The ideal osteopathic technique is that which accomplishes its purpose
in the shortest time with the least pain or discomfort to the patient, and
the least expenditure of energy on the part of the operator.
Back of such technique must be a thorough understanding of the
texture and relation of the structures involved and the mechanics of their
normal movement.
Besides what you can learn from textbooks about muscle, bone, and
fibrous tissues that texture of the structures will include something
which is called the feel of tissues which the books do not and cannot
exactly describe. If you are reasonably intelligent, you will more and more
unconsciously adjust yourself to it as you work with patients.
We generally give little attention to expenditure of energy during the
early years of practice. We are young, have an excess of energy, what
boots it whether the pull is ten or 100 lbs. We can do it and do, with no
thought of counting the ultimate cost.
As the years go by, practice enlarges. More and more you have to
make the pull when you are fatigued, and that vastly increases the tire
of muscle tissues and nerve cells.
By that time you have adjusted or habituated yourself in considerable
measure to certain manipulative procedure and the chances are you keep
going along that line.
Studying how to conserve yourself and at the same time as effectively
adjust structure and in acute conditions break the circle of irritative nerve
impulses, is as worthwhile as is studying how to conserve your bank
account.
By not considering their own physical conservation in their methods
of work, too many of our people have unnecessarily shortened their years
of service and added grief to themselves through various untoward results.
Particularly through inter scapular tension and rigidity, upper rib and
sacro iliac lesions with resultant neuritis.
Working constantly with a pull, not fully utilizing the patients
weight, lifting when not set protectively are the factors which cause too
much stress upon the operator. These factors apply universally regardless of our individual differences in physical makeup which in many instances make the difference between non-taxing and stressful technique in
given procedures.
The constant year in and year out pull upon the shoulder girdle
results in upper rib and vertebral lesions and that condition I find to be
the most common occupational development.
A substitution of push for pull, of hypothenar eminence instead of
the thumb in frequent instances, and of better use of the patients and
the operators weight in manipulating will accomplish the same happy
results and save the energy and structural integrity of the osteopathic
physician himself.
48
HOW TO BECOME PROFICIENT IN OSTEOPATHY AND HOW

NOT TO BECOME PROFICIENT IN OSTEOPATHY
CHARLES CARTER, D. O.
(Condensed from a paper read at the A. T. Still Day program
at Atlantic City, June 24, 1941)
The man who said, The more I see of men, the better I like dogs.
expressed only a partial truth. His fellowman who said, I do not like
Mr. Blank. Maybe it is because I do not know him well, was nearer
the truth, for often we dislike a man when knowing him casually and
become really fond of him when we know him well. Let us hope that
this is the situation in our osteopathic ranks and when we know each
other better, and when we know just what we believe and why we believe
it, there will be a greater measure of unity among us. Unifying our
forces is good strategy in any cause. It strengthens us with ourselves and
with the opposition. Certainly there is much, very much, common
ground upon which a large majority, if not all, can stand.
Osteopathy is not a temporary or incidental thing. It is a great
reality and is founded upon facts-facts not only true in theory, but in
experience and that are in harmony with the teaching of anatomy and
physiology. All of this carries a grave responsibility with it, for its exponents to promote it and develop it to the largest possible good for suffering humanity. Among the things that constitute a common ground
and an important one, let us agree that there should be a feeling of
friendliness and fellowship among all osteopathic physicians. This does
not mean that we must necessarily see things in exactly the same light,
but the fact that we are osteopathic physicians sets us apart in a measure
from all other physicians.
The two things that set Dr. A. T. Still apart from all other physicians
of the time were: He was widely known as the drugless doctor, and he
cured by manipulation. These were, each, almost revolutionary claims.
This does not mean that he claimed that drugs were never indicated, but
he was almost fanatical in his opposition to promiscuous or unnecessary
drugging. He appreciated the harmfulness of many drugs, much more
than the average physician, and very rarely used drugs.
We should all agree that maladjusted tissues is a common cause of
disease. This is one of our fundamentals. Probably no osteopathic
physician will dissent from this. Apparently it is a well established
fact that Dr. A. T. Still was the first physician to cure diseases by locating
maladjusted tissues as the cause and by removing this cause. Even after
all these years there are many, in almost every community, who are suffering because of maladjusted tissue and do not realize that they can be
cured. Hence the often repeated statement, I wish I had known of it
sooner. It is our business to let them know. Unless emphasis is put
entriely upon the importance of correcting the lesion the patient may give
the credit to something else and not to osteopathy. This is largely the
cause of the present confusion. Any effort to cure without removing the
cause means temporary relief at best.
We should all agree that a cultivated sense of touch to distinguish
between the feel of normal and abnormal tissue is essential. It takes
months or years to reach anything like perfection along this line. Dr.
A. T. Still liked to say, "You cannot practice osteopathy without having
brains in your fingers. Deficiency here often spells failure.
49
We should all agree that the usual way (natures way) of getting
well is through the circulation. Arterial blood brings repair material and
venous blood carries away broken down tissue. Thus we have the process
of life and repair carried on before us. In other words, health is obtained
and maintained through the circulation.
That we can influence circulation in any part of the body by osteopathic manipulation is another of our fundamentals. This also applies
to the glands of internal secretion in theory, at least, and most of us think
tha experience proves that it does in reality. The old Doctors, The rule
of the artery is supreme fits in here. His, find it, fix it, and let it alone
is fine for corrective treatment, but no doubt he meant this to be followed
by palliative treatment where needed, thus making the rule of the artery
supreme.
Now with these things that many of us consider a common ground
before us, various questions arise. These must be met in an intelligent
way. By sophistry and such measures, the settlement may be postponed
for years or even for generations. This is something to be avoidedavoided for the good of, osteopathy and for the good of those needing
treatment. One of these important questions in reaching a conclusion
is this-Was man created self-curative? Consideration of the following,
may help us to the correct conclusion. Could the all wise Creator have
made mans body self-curative? Would it be to mans advantage to have
been thus created? Does the great Creator love man ? (Jno. 3-16). If
these three questions can be answered in the afirmative, it is not logical
to conclude that he was made self-curative. Is there any fallacy in this
reasoning? Has any definite proof been offered that he was not made
self-curative?
Another question arises-we have admitted, or will admit, that we
obtain most of our results by impulses over the nervous system. We have
admitted, or will admit, that some drugs deaden, to some extent, (perhapa
to a great extent) the nervous system. Other drugs exhaust nerves. If
nerves are either deadened or exhausted they will not convey impulses
in a normal way and our efforts are, at least, partially destroyed. It is
not a logical conclusion to reach to say that drugs are harmful to osteopathy and not helpful? At this point it may be in order to say that the one
source of worry above all others, for this writer at time of graduation, was
what to do in case of severe pain. He had no legal right to administer
narcotics and very little knowledge of how to do so. To his delight he
found from experience that the cases that could not be relieved by osteopathy alone were very rare.
To experiment with drugs that weaken the heart or slow up circulation is a dangerous thing to do. The most practical research of the
present time would be to send out committees and get a report on all
sudden deaths as to what proportion of these patients had been taking
some drug that weakened the heart. The report would probably indicate
that such drugs were the chief factor in most sudden deaths. If this is
true, can we claim to be guiltless if we fail to give warning. Is not such

a test past due? It would probably be a blessing and add to the prestige
of osteopathy.
Some fifty or sixty years ago Dr. A. T. Still was a rolling stone going
from place to place in two mid-western states. As a rolling stone he
gathered no moss. Instead he gathered ideas. He translated those into
theories and these into facts and cures. wherever he traveled he left
50
cures behind. The fruitaye of all this was the most wonderful growth
in school enrollment in the history of medicine. The enrollment at A.S.O.
increased from less than twenty the first year to about 500 in about five
years. This was marvelous, and was accompanied by an equally marvelous amount of enthusiasm. Students flocked in, in such numbers that
it kept the management and faculty on their mettle to take care of them.
Several factors contributed to all of this. The most important factor, of
course, was merit-merit that produced cures. Of almost equal importance in results was the fact that at that time very few, if any, accessories
were used. So osteopathy was given due credit for cures it made and
students wanted to learn this new way of curing people. It was an innovation, and people were talking, even almost gasping, over the wonders
that were being performed. As only osteopathy was used, it was regarded
as almost miraculous. Some drugs, and other accessories were introduced
into the treatment. As people could hardly grasp the idea of how osteopathy could perform the cures, they gladly gave the accessories the chief
credit for them. The public, that reluctantly admitted it was osteopathy
that was doing the wonderful things that were being done, more than willingly gave the credit to the accessories. Thus they appeased, Uncle John
M. D., or Cousin Bill M. D., who were ridiculing the idea that some simple
handling or rubbing of the body could cure diseases. Then the claim could
also be made, why you see that the osteopathic physicians themselves are
loosing faith in it and are turning to all kinds of aids. As people had
held to the misconception that drugs were essential in curing diseases,
for generations, so naturally they gave drugs credit for the cures. These
factors combined to lessen the prestige and potency of osteopathy and
many who were considering making it their life work turned to something
else. Possibly this is the answer to the question of why the present day
shortage of osteopathic students. If this is true, or partly true, what is
the remedy? If the confidence and enthusiasm of the early day could be
restored, the questions would be largely answered. An osteopathic physician who had returned to the U. S. after a sojourn of more than ten years
in England wrote this writer, in substance, I attributed the fine progress
that we made in establishing osteopathy in England, to the fad that the
law required us to stick to osteopathy alone and nothing else. Thus osteopathy got fall credit for its cures." Add to the above, the fact that in flu
epidemic and in all acute diseases, we have proved our ability to cope with
diseased conditions as well, or better, than others. It was claimed, probably justly claimed, that the death rate was much lower under osteopathy
than under medical treatment in flu. Quite a fair per cent of the osteopathic physicians did not lose a case though busy almost night and day
treating Flu patients. Practically all inflammation can be modified or
cured by manipulation and this without pain. The fact is that in nearly
100% of cases, osteopathy improves general circulation and relieves nerve
tension,. This alone, is quite a factor in curing. Comparisons are said
to be odious, but, if facts are set forth in a fair way, none should object.
Would it be fair to either credit cures made by osteopathy to something
else or to fail to report the harmfulness of some drugs when comparing
the two methods or treatment? Suppose one should take the whole list
of diseases as given in books of Medical Practice and consider what osteopathy can do in the way of curing these diseases. In the first place, we
find that inflammation is present in many of them, as a factor. Now all
osteopathic physicians of much experience know that inflammation can
51
often be readily reduced by osteopathic manipulation. This can frequently

be done promptly and without pain. This is true of inflammation in, at
least, nearly all parts of the body. Why not, when this is strictly in accord
with one of our fundamental principles, that circulation can be influenced
in all parts of the body by osteopathic manipulations. Of course, all will
admit inflammation is a disturbed circulation. All words having itis
in them indicate inflammation. From these facts one can form some idea of
the number of diseases that are amenable to osteopathic treatment along
just this one line. The list is surprisingly long Add to this all cases due to
maladjusted tissue which we think is a common cause of disease. This is
also one of our fundamentals. Perhaps, no osteopathic physician will
deny this. Add to these the class of disease that osteopathy has demonstrated that it can cure, not by only a few cases, but by scores or more and
we will have the whole list pretty well covered. All of this with no probability of serious harm from the treatment as compared with the serious
harm that sometimes follows the administration of drugs.
These things, together with what has been said to prove that the
human body is very probably self-curative, would seem to justify the statement that osteopathy with its reasonable accessories in connection with
expert and conservative surgery can make a fair claim to the most complete, logical and harmless system of healing in the world. When we
believe this and discard all experimentation and make osteopathy the
basis for all our work we will again merit the confidence of the public and
enthusiasm and students will be in adundance. Not only this but we have
before us an opportunity for the most forward step in helping the sick
and afflicted that has been taken in years. Shall we make the most of
the opportunity that has fallen in our lap or dodge it and leave it to some
man, or set of men, with more vision and more courage than we have?
HOW TO BECOME PROFICIENT IN OSTEOPATHY AND HOW NOT
TO BECOME PROFICIENT IN OSTEOPATHY.
To become proficient in osteopathy we must believe in it wholeheartedly as a great reality, as one of the greatest blessings,, if not the greatest,
along health lines. That its principles are facts and that facts are the only
abiding things in the world and will be the factor by which all discussions
must be settled. We must believe it to be our birthright. It belongs to
us. It is ours to nourish and protect and develop. It is an honor conferred upon us. It is a permanent thing. It carries a responsibility with
it to keep it pure and free from all entangling alliances that will dilute it
or strangle it. All of this implies thorough training for the work including the trains in the fingers touch. The record that osteopathy has
made in curing the so-called incurables in not just a few cases, but hundreds of them should be inspiring. In the early day of osteopathy perhaps
90% of cases treated were those that others had failed to cure. Its record
in these hard eases secured favorable legislation in nearly all states. This
good work is still going on. The field is almost inexhaustable. Those
suffering from maladjusted tissues alone would total many thousand.
If we are practicing osteopathy, let us always emphasize it to the
extent that we will make it the basis of all our work. If one is ashamed
of osteopathy it seems that he would want to change his vocation. Paul
said, I am not ashamed of the gospel of Jesus Christ. It is the power of
God unto salvation to all who believe. So we should say, I am not
ashamed of osteopathy for it is the power of nature (Gods nature) to all
who believe in it, to cure a greater number of sick people than any other
52
method. Then you will realize that few can equal what we can do and
we should be filled with joy unspeakable and full of glory. The greatest
battle ever fought is fought in the hearts of men. As a man thinketh
in his heart, so is he. Many are deciding in their hearts today, their
attitude toward osteopathy. Their decision may determine the usefulness of osteopathy and also the peace of mind of the one making the
decision.
HOW NOT TO BECOME PROFICIENT IN OSTEOPATHY
One qualification for this dishonor is not to believe in it fully yourself
Another is to be looking around for some accessory that will carry, at
least, part of the responsibility. Patients and others may see in this, a
lack of confidence in osteopathy and may lose confidence in you or your
osteopathy. Cherish all your maybes. Think maybe a little drugs will
help. Maybe baths would help. Try this, and try that, forgetting that
absolute belief in and encouragement to a theory is its best fertilizer.
When we have done all this and other things to discredit it, write this
Epitaph over its grave. Here lies osteopathy, the greatest blessing that
suffering humanity has ever had. Betrayed, unconsciously, by its friends.
Its enemies could not kill it. The opposition tried to pass laws in nearly
every state to prevent the practice of osteopathy, but failed. We are all
guilty in proportion to our unbelief in it. I am sure that none of us desire
a dead. osteopathy. It can stand alone and live, or can be loaded down
with accessories and die in lingering and pitiful death. Which shall it be?
If the latter is chosen, we should be shamed to tears and mourn in sackcloth and ashes a beloved friend whose blessing we have rejected.
TWO things seem absolutely necessary to bring osteopathy back to its
own. One is to give it full credit for its cures. The misconception of the
public that drugs are essential to a cure, is a tradition carried over from
the dark ages of medical practice and is now obsolete. In defiance of these
facts there is a tendency to give drugs credit for cures if both are used in
practice. The remedy is to discourage the use of drugs in our practice.
The other is to quit trying to measure osteopathy by the medical yard
stick.
Our medical friends have much merit. Let them show their wares.
Let us show our wares. This does not necessarily mean a conflict. Possibly the good in each may help to sustain the other. We certainly have
a record that we should be proud of and we have only scratched the surface of our possibilities. None of us begin to grasp what these possibilities are. Nature alone heals. Who can say that it can not do this or can
not do that? Who dares to measure just what nature can do or put a
limit on the power of nature to heal.
The defeat of Christ-his crucifixion, was his greatest victory. It
enables his disciples to sing joyfully In the Cross of Christ I Glory. It
makes true the comforting passage Every knee shall bow and every tongue
confess that Jesus is the Christ, and enables his followers to know that
the combined powers of Hitler, Stalin, and Mussolini are not enough to
destroy one soul that has made peace with God.
Suppose osteopathy should be strangled to death by accessories or
otherwise then a husky youngster could arise from The ashes of its grave,
proclaiming I am osteopathy, and can stand alone without any accessories
and bring hope and cheer to all chronic sufferers of the world because
most of this suffering is due to maladjusted tissue and this can be corrected
and relief or cure would follow in most cases. This is not only a pos53
sibility, but is a history making probability. This would be osteopathys

greatest victory. All of this is said without any spirit of irreverence.
With malice toward none and with charity for all, I am for osteopathy, a
living osteopathy, an abiding osteopathy, a perpetuating osteopathy.
NOTE-Dr. Carter, still in active practice in Farmville, Va., wrote and
delivered the above after many years of osteopathy practice and in
his 84th year.
MANIPULATIVE TREATMENT OF ASTHMA

EARL J. DRINKALL , D. O.
(Dictated to stenographer at Atlantic City, June 28, 1941)
The asthmatic patient comes to us with one symptom only- a difficulty in breathing.
Dr. Still in speaking of asthma, as always, called attention to the
fifth, sixth, seventh, eighth, ninth and tenth ribs on either side being out
of their perfect physiological position. Dr. Still also spoke of the variance
of the presence of symptoms in that on one day your asthmatic patient
is distressed and on the next day is free of all symptoms.
To my mind this led to the thought that there must be something
behind asthma which is not constantly present.
Call to mind the anatomy of the tenth pair of cranial nerves which
originate in a nucleus in the floor of the fourth ventrical in the brain, pass
down through the neck thorax to their ultimate distribution in the abdomen. The vagus nerve carries sensory nerve stimuli from the stomach
and intestines back to the brain and motor stimuli out particularly in
asthma to the bronchioles of the lungs.
The vagus nerve supplies the external canal of the ear with sensory
nerve fibers. This calls to mind a patient who came with only the symptom
of itching in the ears and I told her this was from her stomach. She
looked at me so dumbfounded that I burst out laughing and apologized for
having laughed due to her astonishment and then I made a drawing showing how the vagus nerve supplied the external canal of the ear and had
everything to do with the stomach. This explains the reflex action arising
in the stomach or small intestines being transmitted back to the brain and
since the brain cannot be effected by such stimuli their continuance is
transmitted by commissural fibers to the motor nerves.
Asthma, to my mind, is a reflex condition arising from materials
causing stimulation of the sensory ends of the vagus nerve in the stomach
and intestines and transmitted back to the nucleus of the nerve and thence
over the motor nerve path to the bronchials of the lungs.
In our treatment of Asthma you have two stages, one is the acute
stage and the other is the fundamental underlying cause. Behind all
disturbance of function there is a disturbance of structure, whether we
are able to find it or not and this disturbance of structure must be corrected for a permanent relief from asthmatic symptoms.
Keeping in mind the variance of the presence of symptoms then leads
to the seeking of an exciting cause and to my mind this exciting cause is
sugar, or anything made from sugar or the other carbo-hydrates. The
54
first fermentation of any sugar or carbo-hydrate is an alcohol and the fermentation of an alcohol is an acid. Every individual who makes homebrew wine is fearful that it will become vinegar. The alcohol resulting
from the fermentation of sugars and starches is a simple alcohol and must
not be confused with the distilled processed alcohol put up in bottles.
This simple alcohol is relatively a moon-shine alcohol which is deadly.
The major structural disturbance you will find to be an occipitoatlantal lesion. The second region where we will look for trouble is in
the upper dorsal area, where disturbance may affect the second or third
dorsal vertebrae. The third area of trouble is usually in the lower dorsal
region of the tenth, eleventh and twelfth dorsal vertebra.
Recall again the connections of the vagus nerve through the stellate
ganglion which lies immediately in front of the second dorsal vertebrae and
gives us the connection between the vagus and the spinal nerves. The
vagus nerves are the cerebral sympathetics. The next major connection
of the vagus nerve with the spinal nerves is through the superior cervical
ganglion. If a middle and lower cervical ganglion are present these also
will receive a connection from the vagus nerves. The upper cervical
region is the shortest distance to the nucleus of the vagus nerves.
Recall for a moment the origin of the phrenic nerve from the fourth
cervical segment of the spine, which in turn is motor to the diaphragm.
We have recalled this anatomical set-up of the vagus nerves, the
phrenic nerves and the spinal nerves so that you may have a picture in
your mind as to how stimuli arising in the stomach and intestines from
fermenting sugars and starches may be transmitted back to the brain or
more particularly the nuclei of the vagus nerves and transmitted to the
motor nerves which in turn produce a contraction of the muscles of the
bronchiols of the lungs or the diaphragm and present the symptom, difficulty in breathing.
Now as to treatment: First, is your treatment of the acute stage of
asthma where you will find the patient unable to lie down and either
sitting up in a chair or propped up in bed with the most distressing
symptoms, and of which they are scared to death that they will die. And,
you are scared too.
If the patient is sitting up or in bed begin the treatment of the acute
stage by having them drink a cup of very hot water with the juice of onehalf a lemon or a whole lemon in it. Repeat this every ten minutes while
you are in the home. If the patient is sitting in a chair, stand at their
side and place the thumb of one hand on the base of the occiput just above
the center of the atlas and with the finger resting along the side of the
neck put your other hand over the forehead and push the entire head back
over your thumb at the base of the occiput and while pressing back lift
up on the occiput. Count twenty and let down easily, rest a few moments
and repeat. This should relieve the acute attack within a reasonable
length of time.
Another method is the one shown to you by Dr. Perrin T. Wilson
during the past several years, of standing beside the patient on the side
opposite to where the arch of the atlas is prominent and usually you will
be standing on the left side of the patient because the most prevalent
deviation will be a left unilatero-flexion lesion of the occiput. Place the
patients head against your chest using a small pillow so that they cannot
push your ribs out of place. Then place the fingers of your left hand
under the right; jaw and the thumb of the right hand with the top of the
55
thumb just behind the ear, with the shaft of the thumb against the occiput
just above the arch of the atlas. Press gently but firmly on the head to
exaggerate the side-bending of the occiput, then pull forward on the jaw
and at the same time lift up with the right hand on the occiput and set
it forward and up on the articulation with the atlas.
If your patient is in bed propped up on pillows sit behind them and
with a pillow between the top of their head and your chest, place the
second fingers placed by the index fingers along the occiput, just above
the atlas and while pushing down gently on the patients head, lift up with
your fingers and rock up and down, side to side, or back and forth, to
release the tension of the ligaments holding the occiput to the atlas and
axis. Often with this simple procedure you can rock the atlas into place
on the axis and the occiput on the atlas. Also, while still keeping the
head in the same position against the pillow separate your thumb and
index finger of one hand apart and place it under any of the vertebra
of the cervical region and with the other hand under the chin now rock
the head up and down, side to side, back and forth or rotate, with the
object of adjusting any of the vertebra easily and gently without shock
to the patient.
Neither of these manipulative measures require any force or great
strength and they may be repeated every few minutes until the acute
attack begins to lessen
Do not forget the lemon juice and water. which neutralizes the
alcohols and acids in the blood and this simple procedure in combination
with the manipulation should give you a very gratifying result within
twenty-four hours. Immediately instruct the patient not to eat any sugar
or carbo-hydrates until you see them again. Have them eat fresh, raw
vegetable salads and any of the fresh, raw citrus fruits such as lemons,
limes, grapefruit, strawberries, pineapple, but no oranges. Due to the
fact that the oil of orange contained in the orange is a poison when the
oranges have not grown to maturity on the tree, the orange becomes a
detriment to the clearing of your asthmatic patient.
The above procedures together with the use of lemon juice and water
at least every hour while not sleeping for 24 hours, should give a most
gratifying result.
The next part of the treatment has to do with the eradication of the
disturbance of structure which is the fundamental underlying cause of
asthma. We will direct our attention first to the lower dorsal region
which controls the elimination function of the goblet cells of the mucus
lining of the bowel which eliminates the poisons from the blood stream and
the solitary lymph follicles which eliminate the poisons from the lymphatic
circulation. Also from this lower dorsal region comes the control of the
elimination function of the kidneys. The internal secretion of the adrenal
glands and the internal secretion and hormone action of the ovaries and
testicles are controlled from this lower dorsal region.
The lesions usually found in the lower dorsal region will be a right
latero-flexion lesion of the tenth, eleventh and twelfth dorsal vertebra,
with the ribs on the right side being in a position of inspiration and down.
Have the patient lie on the stomach with their. face rotated toward
you to increase the efficiency of the treatment. Now reach with one arm
around and under the thighs just above the knees and with the thumb
of the opposite hand holding the spine of the ninth vertebra, twist the
patients body from the tenth dorsal down, over and on to your thigh. Do
56
not lift the lower limbs with your arm, just roll and twist with the patients weight on to your thigh. Change to the opposite side having the
patient turn their face toward you and again twist the body on to your
thigh and on to the table. Thoroughly work in this lower dorsal region
to remove all thickenings of ligaments which are holding the vertebra
and ribs out of position. This particular method will set up quickly the
eliminative function of the bowels and kidneys.
With the patient still lying on the stomach, stand along their left
side with their face to their right side. Now, lift the right thigh and
leg over the left thigh, then with your right hand at the ankle of the
patient and with the thenar process of your left hand, holding the ninth
rib on the right side, push down on the ankle firmly enough to feel the
separation of the tenth rib from. the ninth where the angle joins the
transverse process of the vertebra. You may also swing the ankle away
from the table to increase the pull. Now hold the tenth rib and separate
the eleventh from the tenth. Now hold the eleventh rib and separate the
twelfth from the eleventh. Now hold the twelfth rib and stretch the
muscle fibers of the erector spinae mass of muscles. Now, with the fingers
of your left hand on the shaft of the ninth rib, just mesial to the inter
axillary line, pull down and out on the right angle to separate the shaft
of the tenth rib from the ninth. Now, hold the tenth rib and pull the
eleventh away from it. Now, hold the eleventh and pull the twelfth
from it. Now, hold the twelfth and stretch the muscle fibers.
The next area of adjustment will be the ribs particularly spoken of
by Dr. Still, the fifth, sixth, seventh, eighth, ninth and tenth. The vena
asygos major and minor veins lay on the front of the dorsal ribs coming
through the diaphragm and effected by the contraction of the diaphragm
or the malposition of the ribs. Any interference with the drainage from
the organs of the abdomen by the vena asygos major or minor will stagnate impure blood in the mucus line of the stomach and intestines and
aid in the reflex we have spoken about before.
One of the easy methods of adjusting these ribs is to stand facing
the head of the patient who is lying on his back on the table and with
your hands under his thorax and with your fingers placed on the angles
of a pair of involved ribs have the patient reach behind your back and
clasp his hands together. Now bend back against the patients hands
and with a slight lifting motion of your fingers you will arch the thorax
up, thereby spreading all of the ribs and aid in the drainage of all the
impure blood and lymph from the organs of the abdomen and thorax.
As you relax your pushing against the patients hands behind your back
the thorax is returned to normal. Now, move to the next rib and lift,
then come back to normal. Repeat this with each rib. This movement
is a most marvelous lymphatic pump. Any of the ribs can be corrected
with this same method. If the rib is in a position of inspiration and up,
then place your fingers just above the angle of the rib and in place of
bending back with your body against the patients hands behind your
back, just hold your fingers at the ribs still and push your back straight
back. If the ribs are in the position of inspiration and down, then put,
your fingers under the angle of the rib and then bend back so that you
separate the ribs in front and at the same time exert a slight upward pull
with the fingers and the ribs should be easily adjusted.
The next area is that of the upper dorsal region which to many of
our profession is worse than trying to put the horizontal words into the
57
vertical position of a cross-word puzzle. The upper dorsal deviations in

asthma are usually of a compound rather complex nature in that the
second dorsal vertebrae may be in the position of right latero-flexion and
the first dorsal vertebrae in the position of left latero-flexion. The best
method for the adjustment of this complex condition is to have the patient
lie on their stomach with the head over the end of the table. You now
kneel on your right knee and with your right hand under the chin of the
patient drop their head down, place the thumb of your left hand on the left
transverse process of the third dorsal vertebra, hold firmly, increase the
flexion of the head, then rotate the head so that it rests with the ear on
your forearm-now with your chest against the head push the head toward
the left shoulder in a side-bending movement-wait until the patient
thoroughly lets loose and then with a slight upward rotating movement
of the chin, set the second dorsal vertebra in its proper position with the
third. Before rising mark the second dorsal position by holding one of
your fingers of the left hand against the spinous process, now turn to the
opposite side and bending on your left knee, hold the head as before, but
with the thumb of your right hand on the right transverse process of the
Second, now place the first in its proper position with the second.
Our next and most important readjustment area is of the upper
cervical with the occiput. For, as we explained before, the anatomical
relationship of the superior cervical ganglion with the nucleus of the vagus
nerve give us the key to the quick and permanent eradication of asthma.
With the patient lying on their back and a pillow between their head and
your abdomen, repeat the procedures mentioned under the acute stage
with the patient in bed, namely; place the fingers of your hand under the
occiput and rock head up and down, back and forth, from side to side,
to remove all thickenings in the ligaments which are holding these vertebra out of position. There are forty ligaments holding the occiput and
the atlas and axis and any lesion puts one-half of these on tension and the
other one half relaxed. Nature thickens ligaments to maintain the malposition which must be removed. Now, you may use the other method
of the thumb and index finger cradled under the vertebra. Again rock
the vertebra into position. Do not use any severe force until you have
proved that the thickenings are so thick that force is required to break
them up prior to absorption. We are ofttimes dumb-founded at the very
small amount of force needed when thickenings are removed and forceful
but delicate leverages are thought out.
Now the bugaboo of most all practitioners is the occiput on the atlas.
The usual lesion is uni-lateral with the pivot joint through the center of
one of the articulations. This lesion is usually a left uni-lateral flexion
lesion of the occiput, superimposed on a left latero-flexion lesion of the
atlas on the axis.
Many times the occiput can be most easily corrected by the method
given you by Dr. Wilson and explained under the acute stage, with the
patient on the chair. If the lighter method of adjustment is not sufficient
then you may use this slightly more drastic, but extremely specific method
of adjustment. Place a pillow between your abdomen and the head of
the patient. Then, with the second finger of your right hand along the
occiput, just above the right arch of the atlas and the second finger of
your left hand on the left arch of the atlas, lift the head slightly from the
pillow, side-bend to the right shoulder as far as the head will go toward
58
the shoulder. Bend your knees even to the floor, if necessary and let the
head of the patient drop back in extension as far as it will go, but resting
in complete relaxation on your abdomen or chest. Now, carefully, without
changing the position, rotate the head to the left as far as it will go, then
while maintaining the side-bend, extend, and rotate position, again side
bend the head to the midline. Then lift up so that the head will be in a
right angle to the thorax and the face pointing toward the left shoulder,
bend the head toward the left shoulder, ask the patient to let loose thoroughly, then rotate the. head slightly to the left with your right hand.
This above method of adjustment pivots the head in the left articulation
of the occiput and atlas, lifts it forward, up to the right on to the right
articulation.
With the absolute perfect adjustment of the occiput and atlas and
the other articulations together with the eradication or proper regulation
of the eating of sugar and other carbo-hydrates, should give you a permanent relief from asthma.
The disturbance of structure is the fundamental underlying cause of
asthma and the wrong food chemistry is the exciting cause of the acute
attack produced through a reflex over the sensory ends of the vagus nerves
and manifested by symptoms over the motor nerves.
May I call your attention to another very important factor behind
asthma and that is the use of corn sugar or glucose in the making of candy
or the canning of fruit. Instruct all of your patients not to eat any fruit
canned with corn sugar because corn sugar makes moonshine corn whiskey
and this is acknowledged to be deadly poison.
This thought with reference to glucose and corn sugar may be used
in many of the other conditions, other than Asthma.
SCIATICA-A Case History

O RREN E. SMITH, D. O.
This patient-a woman of some fifty years of age-came into the

office with a very painful sciatica. The right leg was extremely sensitive.
There were herpes, containing fluid, over the posterior aspect of the leg,
from the hip down into the bottom of the foot, following the course of the
sciatic nerve. There were heavy contractures of the muscles of the right
leg, and in the lumbar muscles across from one innominate to the other;
the ligaments around the sacro-iliac joints were very tense and hypertrophied; the lumbar vertebrae were approximated and the sacro-iliac
joints were locked in immobilization. The patient was badly constipated
and the pain in the sciatic nerve was constant.
Her treatment consisted of a great deal of soft tissue work on the
skeletal muscles along the spinal column and lumbar-sacral tissues to
relieve the pain and soreness in the sciatic nerve prior to any attempt at
correction of the bony lesions. Soft tissue treatment was given twice a
week for four or five weeks. As the fibrotic condition of the muscles began
to give way to a more elastic state, and as the adhesions began to loosen,
cases this will often stop the hiccough.
trial correction of bony lesions was begun alternating with the continuing
soft tissue treatment.
59
The question may be asked, When is it time to begin bony lesion

corrections? The condition of the soft tissues must determine the
answer to this question. The reaction of fundamental activity-the
amount of pain resulting from treatment-the general feeling of wellbeing of the patient-are sign posts of direction that must be studied to
determine bony lesion corrections. By constant study of reactions from
lesion correction,, the physician obtains a fair yardstick of measurement
which is very useful in determining the speed which may be used in correcting lesioned tissues, and will be useful in adapting structural change
to functional reaction.
The treatment consisted of separation and mobilization of the articular surfaces of the lumbar vertebrae and the sacro-iliac bony structures.
There are graduations of structural mobilization of joint surfaces
which are worthwhile being considered.
1. The well-known rotation of the lumbar vertebrae in which the
patient lies on the side and the physician makes counter pressure against
the innominate and shoulder is used at first-a force which may be made
very mild or very severe, depending upon timing and the force used.
Of course it goes without saying that in a case such as we are considering, when soft tissues are fibrosed, adhered and inelastic and Where
there is a low grade of inflammation in these tissues, that the mildest kind
of treatment must be used at first. As soreness and inflammation begins
to subside, then more drastic technique may be used.
2. A combination of soft tissue and bony lesion treatment may be
used which is somewhat more effective than the preceding: The patient
lies prone on the table. The physician stands at one side, grasps the
ankle of the patient, on the opposite side from which he is standing,
flexes the leg of the patient at the knee, then uses circumduction, abduction,
and add&ion of the flexed leg, the physician using counter-pressure over
the sacrum of the patient with his disengaged hand. This rotary treatment of the leg mobilizes the sacro-iliac joint very satisfactorily, but is
not reliable for correction of the pelvic bony lesions.
3. Another method for mobilization of the sacro-iliac joints may be
used in which the patient lies on his or her back. The physician stands
at the side of the table, flexes the knee of the patient-on the opposite
side from which he is standing-as far down on the abdomen as it will
go, then makes pressure on the flexed knee of the patient with one of his
hands, while adducting the leg inward toward the median line of the
patient, and making downward pressure on the flexed leg.
To reinforce this movement, the disengaged hand of the physician
is placed on the table beneath the patients posterier superior spine of the
opposite ilium which will act as a fulcrum on the sacro-iliac joint, of the
opposite side, which is being mobilized, as pressure is made downward on
the flexed knee.
4. For actual correction of the sacro-iliac joint, after sufficient sort
tissue work has prepared the tissues forming the joint for correction
the patient is placed on the back, and the knee flexed on the abdomen, just
as described above. With one hand on the knee to produce pressure,
flexion, adduction, abduction, and extension of the leg as in the order
named, the other hand is placed on the table beneath the innominate to
be corrected, the posterior superior spine of the innominate being cradlea
in the palm of the hand of the physician which acts as a fulcrum of leverage
to spread the joint surfaces; then external circumduction of the flexed
60
knee from the median line outward is used to the extent that the tissues
will allow, with instructions to the patient to extend the leg, pointing the
hee1 of the extending leg downward and inward toward the opposite heel
lying on the table, and also to extend the leg slowly, and without touching
the heel to the table until the leg is fully extended.
This patient was under treatment some five or six months before
mobilization of the joint and normalization of tissue-tone was established.
She made a normal recovery.
It is the custom of the writer to give the patient a me-view of coming
events in treatment. For instance, often in correcting a bad sciatic lesion,
the pain will shift into the opposite sciatic nerve. This event will very often
cause the patient to become alarmed and apprehend that he is getting
worse-that when he came in for treatment., he had pain only on one side,
but that now he has it on both sides. Now if you have prepared the
patient for this event, when it does happen, he gives you credit for knowing coming results from treatments and his confidence in you is increased
instead of being diminished. As a matter of fact, the pain never shifts
into the opposite side until partial correction of the bony lesion is beginning
to take place, and is therefore a most favorable sign of progress.
Then increased pain in the sciatic nerve is often unavoidable from
treatment. This the patient should know on beginning treatment. The
surgeon does not offer immediate relief from pain upon performing a
major operation. We should not offer immediate relief while producing
radical structural changes in tissues of the body. But rather give the
long time view before work is completed.
TECHNIC FOR HICCOUGHS

W. C. ARMSTRONG , D. O.
Have the patient lie supine, operator at the right side, flex the knees,
slide left arm under shoulder and neck, grasp right arm around flexed
knees then forcibly bring your two arms as near together as you canhold there firmly.
Now, what you have done is to force the viscera up against the
diaphragm so tight it can not vibrate and the hiccoughs are stopped.
This is usually permanent and if it has to be repeated once or twice
be suspicious of gall duct trouble.
In a lean subject place a small pillow low down on the abdomen
before bringing the knees and shoulders toward one another.
TECHNIC FOR HICCOUGH

S. W. IRVINE , D. O.
Either one of two methods may be used. The first method is to use
traction on the soft palate. This can be done by having some instrument
with a hook on it or by using the index finger. Go in behind the soft
palate and use steady traction for at least one minute, or as long as patient
can hold his breath. The second method is the use of traction on the
61
tongue. Often very good results can be obtained by inserting two fingers
in the mouth, reaching back as far as possible on the tongue. Use traction
on pressure forwards. Ofttimes patient will gag but in the less obstinate
cases this will often stop hiccough.
CONNECTIVE TISSUE
FROM THE DIAGNOSTICATOR BULLETIN
Issued by C. H. KAUFFMAN , D. O.
The importance of connective tissue health has been underestimated.
The famous experiment of Dr. Carrel, later reported by Dr. P. LeCompte du Noiiy, in which an aged dog was rejuvenated by removing twothirds of his blood, then washing the cells and replacing these cells plus
new fluid, is a clue to the cause of senility.
The fact that later the dog returned to its senile state means that we
must look further back for the cause of senile toxicity.
As an osteopathic physician, the writer would seek in the connective
tissue for the first contamination of body fluids. Re-absorption of senile
fluid by venous plexuses no doubt takes place in the connective fascia.
In youth, by virtue of elasticity conferred on connective tissue by
elastic fibres, we have the elastic pump.
The elastic pump is the tissue resiliency by which body movement
exercises fascia. It serves to move to lymph channels through highly
vascular lymph. glands for filteration and thence via lymphatic duct to
heart veins. By passing into central circulation at regular intervals the
fluids are more quickly taken to the source of oxygen supply in lungs and
more quickly reach eliminative organs.
Delay in fascia according to Dr. Still is the beginning of disease.
Modern scientists state that disease is one cause of senility and that practically all aged people die from disease and not old age. The statements of
Dr. Still and that of modern science closely parallel and supplement each
other.
The contention of the writer is that loss of elasticity disturbs the
elastic pump and is a cause for senility, in spite of the fact that some arth
ritic patients are said to be long-lived. We all cannot afford to lie down
even to prolong life.
Prolonged stretching of any connective tissue or injury from sudden
strain in addition to metabolic changes due to the ravages of illnesses and
toxins introduced into the body is cause for connective tissue ill-health
and loss of elasticity.
We know lesions produce toxicity both from a nervous (v.m.) and
from a drainage standpoint.
We should know that maintenance of the elastic pump is necessary
if toxins are to be promptly removed.
Osteopathic treatment by slow force and slow release repeatedly applied not only serves to maintain the elastic pump but repairs it. (See
Connective tissue cells-specialized differentiation into elastic fibers, etc.
MacCollum, 4th Ed., Textbook of Pathology, Pages 188-194).
The diagnosticator (see description below) specifically drains, tissues,
restores health and elasticity to connective tissues under the rule that
structure is governed by function.
62
Mere popping of joints and yanking of connective tissues is not an

all-round treatment. We should pay special attention to the elastic pump
and maintain elastic fibers, otherwise body movements will not serve to
regularly exercise the function of resiliency and the elastic pump will cease
to operate.
We are apt to forget the importance of lymphatics as a short cut
for quick oxygenation and to underestimate the possibility of fluid rejuvenation thru lymph, which is acted on by highly vascular lymph glands
(reticula-enthothelial system.)
The diagnosticator mentioned above is a mechanical device
invented by Dr. Kauffman which exerts a rhythmic lifting pressure to
the patient while being examined or manipulated. It adds the lifting
force to whatever manipulation the operator may be doing or mobilizes
a part while the examining fingers note tissue reaction and motion or
lack of motion. Any one interested in a mechanical aid to manipulative treatment would do well to communicate with Dr. Kauffman.
The above paper is included with these papers for it is felt that the
influence of connective tissue in osteopathic work is very often overlooked.
EDITOR'S NOTE -
TIMELY HELP FROM FORMER PUBLICATIONS

A Paper Published in Volume 2 of Selected Papers gave great assistance to an Osteopathic Physician in Australia.
The following correspondence is published in the hope that it may
help someone else in like manner and encourage someone to give us the
benefit of their experience for publication in subsequent issues of these
papers.
Bisbane, Australia
Dear Dr. Wilson:Some months back a patient (female, 60+)developed tie douloureux
following lower molar extraction. The dentist was her son-in-law, notwithstanding which, I am sure he was as gentle as he could be. She had
had an attack previously by two years, following an extraction then, which
she said broke her lower jaw.
This time the pain grew rapidly so much worse (and an X-ray showing no fracture or tooth fragments left) that her husband insisted she see
someone else. She wasnt getting enough relief from what I did, and
sedatives became useless.
She went to an allopathic specialist, who gave her opiates, and who,
after several consultations with his brothers, decided on alcohol injections
into trigeminal.
I finally thought of your articles in the notes of the Manipulative
Section, Vol. 2, 1939. After going over it again, I asked her if I could
visit her home and try once again before she risked paralysis. Well,
your technic worked, while mine had not. And so I want to express my
appreciation to you for having passed on your knowledge. The patient
63
avoided the operation, and gradually over the period of months has apparently lost the most of her symptoms.
Fraternally,
M ILTON CONN, B. SC., D. O.
Aug. 11, 1941

Dear Dr. Conn:I am delighted if I have been of any service to you. I am taking the
liberty of showing your letter to Dr. Northup. The experience you had
with that severe case of Tic impresses upon me more than ever that there
is a best way to treat every disease.
N OW as to Tic-since talking with Dr. Sutherland at the St. Louis
convention, I developed Tic myself from a very difficult extraction of a
lower left molar. My assistant and I spent many hours studying the skull
in conjunction with Dr. Sutherlands book The Cranial Bowl. I developed the following technic to add to my armamentarium. I feel confident it has hastened recovery in those cases I have had a chance to try
it on.
The object of this technic is to draw backward the temporal bone on
the side affected. This, as Dr. Sutherland shows, swings the anterior
end of the petrous portion of the temporal bone inward, relieving the
strain on the gasserian ganglion.
The patient lies on the back. The operator stands on the side opposite to the one affected with Tic. (For this discussion let us consider
a right-sided Tic.) The operator, facing the left side of the head, passes
his right hand under the patients head to a point where the occipital protuberance rests in the depression between the base of the first metacarpal
and the pisaform bone. Thus the operators fingers of the right hand
extend beyond the left side of the patients head. The operator now
places the base of his left first metacarpal between the ear and the mastoid
portion of the left temporal bone. The ear is necessarily pushed forward
by the operators left hand, which is as low on the mastoid portion as is
convenient. In this position the operator will find the fingers and thumbs
in a natural position to clasp each other-this is done. At this point the
operator stoops his body until it comes in gentle contact with the patients
forehead to prevent rolling or slipping away from the operators hands.
The operator is now ready to make the adjustment. The finger
muscles do all the work. Bearing in mind the direction of the forces, the
occipital protuberance is forced straight upwards-the mastoid portion
is drawn downward towards the table, remembering to get as deep into
the groove in front of the mastoid portion as possible. An easy springing
motion is used by clasping and relaxing the fingers with the object of approximating the wrists.
It may require many attempts before the operator gets that sense
of give in the sutures, which is a signal that he has accomplished his
purpose.
May I say that in one case, on the eighth manipulation, I felt and
created a pop audible to the patient and the doctor who brought her to me
for treatment. Following the eighth manipulation there was a marked
cessation of symptoms which entirely disappeared three weeks later.
64
May I congratulate you on being able to dig out technic from written
instructions. I find it hard.
Many, many thanks for writing me.
Sincerely,
PERRIN T. WILSON, D. O.
Another Osteopathic Physician says that he has had much better
success treating low back conditions since reading an article published
in Volume 3 of Selected papers by Drs. Carl J. and A. B. Johnson. This
article is being rewritten and it is hoped that it will soon be published
for the benefit of the entire profession.
The paper on the treatment of Tic Douloureux was written as a
reserve paper for the Atlantic City Convention and we have the promise
of early publication in the Journal of The American Osteopathic Association and for that reason it is not included here.
WHAT DID YOU GET FROM THE OLD DOCTOR?
What did Andrew Taylor Still teach you that was of particular value
to you in practice that is not common knowledge in the profession today ?
What bit of Osteopathic Therapy did you get from him that you have
found useful and reliable in your practice that is not now in print?
Dr. Stills grandson, Dr. Charles E. Still, Jr., is this year arranging
the program of the section of Manipulative Therapy and in collaboration
with Dr. Lonnie L. Facto, chairman of the Technic Section, they are
planning a joint program for the Los Angeles Convention, featuring A. T.
Still Osteopathy.
These two sections are operating under the sponsorship of The Osteopathic Manipulative Therapeutic and Clinical Research Association and
every effort is being made to stress the kind of Osteopathy that Dr. Still
taught and practiced, and this Association is asking as a special contribution from those members of the profession who actually studied under
Dr. Andrew Taylor Still some bit of technical or therapeutic instruction
that they learned from him and they have found useful. If it is now in
print and they wish to emphasize it, call attention to it briefly and give
accurate reference to book, edition and page, but if it is not in print and
now available for study, please write it out as clearly as possible and send
it to Dr. Thomas L. Northup, Altamont Court Apartment, Morristown,
N. J. You will receive credit for your contribution and if it is printed
your name will be mentioned as contributor. It is hoped that a good
volume of this material may be had for publication with the papers from
the Los Angeles Convention.
This notice has appeared in all the Osteopathic Publications and
already contributions have been received. Wont you send in your contribution? All material received by this Association is being made available to Dr. C. B. Rowlingson who is editing a text book of Osteopathy for
the Associated Colleges of Osteopathy. He is doing a splendid and much
needed work and every member should contribute some bit of Manipulative
Therapy that may help someone to be a better Osteopathic Physician.
Why not write it out today?
65
FOURTH ANNUAL MEETING OF THE OSTEOPATHIC MANIPULATIVE THERAPEUTIC AND CLINICAL RESEARCH ASSOCIATION
H OTEL D ENNIS , ATLANTIC C ITY, N. J.
June 27, 1941-2 P. M.
There were sixty-five members at the luncheon and one hundred and
twenty present for the A. T. Still Day Program.
The Secretary and Treasurers report was read and accepted.
The names of about fifty members of the profession who had been
in practice forty years or more, and who had, on invitation, sent a letter
of greeting, were read by the Secretary. Portions of some of the most
outstanding letters were also read. Some of the outstanding letters are
printed following this report.
The secretary read the names recommended by the Board of Governors for places on the Board, and the following were regularly elected
for three years:
C. Haddon Soden, D. O
Asa Willard, D. O
Paul Van B. Allen, D. O.
Orren E. Smith,D.O.
Grace R. MeMains, D. O.
Dr. H. M. Vastine called the attention of the Association to the passing
wthin the year of Dr. Arthur G. Hildreth and recommended the passing
of suitable resolutions in view of the keen interest that Dr. Hildreth had
shown for the Association from the day it was first organized.
Dr. Wilson appointed Dr. Vastine and Dr. Willard to draw up such
resolutions. This was by unanimous vote approved by the Association
and the Secretary was instructed to make the resolutions a part of the
records of the meeting and send copies to Mrs. Hildreth and Dr. Hildreths
daughter, Mrs. A. E. Van Vleck.
RESOLUTIONS ON THE PASSING OF DR. ARTHUR G. HILDRETH
WHEREAS, death has invaded our ranks and removed from our midst
one of the greatest apostles and advocates of Osteopathy, Dr. Arthur G.
Hildreth, and
WHEREAS, he had the full confidence of the illustrious founder of Osteopathy, Dr. A. T. Still, and has contributed both in formulating and
securing legislation, teaching, writing, lecturing and broadcasting on
Osteopathic philosophy, and in practice presenting the best type of Osteopathy with a marvelous record of service to humanity, next to that of
Dr. Still himself, and that through his varied and great achievements Osteopathy has made great forward strides,
THEREFORE BE, and it is hereby resolved, that this body which subscribes and is dedicated to the advancement of the type of Osteopathy for
which Dr. Hildreth stood, is particularly grieved at his passing and
believes that through it an irreparable loss has been suffered that will
profoundly affect the whole profession.
BE IT FURTHER R ESOLVED that this resolution be spread upon the
minutes of this body and a copy of it be sent to the widow and daughter.
Submitted by
H. M. VASTINE
ASA W ILLARD
66
Following the business meeting The A. T. Still Day program continued to well past six oclock.
Respectfully submitted,
THOMAS L. NORTIIUP , D. O.
Secretary and Treasurer
The following letters and parts of letters were received from members
of the American Osteopathic Association who have been in practice more
than forty yearsPiqua, Ohio, June 23, 1941
Thomas L. Northup, D. O.
Altamont Court Apartments
Morristown, New Jersey
Dear Doctor Northup :
Thanks for the invitation to be present for the A. T. Still Program
June 27, Atlantic City, but it is rather a long trip for a fellow when he
gets to be seventy-nine.
Therefore, I regret I cannot be present, but I send my greetings and
good wishes to those present.
I have held an unbroken membership in our National, State and Local
Societies ever since they were organized-forty-five years.
With Dr. Still, Osteopathy is the Science of Healing by Adjustment
and Alignment. By adjusting the structures to their normal relation to
their fellow parts, thereby removing the interference to the fluid and forces
to and from the parts permitting nature, without help or hindrance, to
normalize herself. Not just manipulation of the soft tissues Nurses and
Masseurs manipulate.
Every Osteopath will be helping themselves to become more efficient
if they keep in mind Dr. Stills words: Its how, where, and when to
apply the touch that sets free the chemicals of life, as nature has designed
them.
To make clear what I am trying to say, the wheel of an automobile
may have all kinds of free motion on its axis and, yet, be so out of alignment with its fellow parts that the tires will soon cut itself to pieces, and
so it is in Osteopathy, so long as these exist in the body structures, the
abnormal relation of one part to its fellow part, the destructive force will
continue to destroy. Only the skilled auto mechanic will be able to give
the car its proper alignment and adjustment, and so it is with Osteopathy.
Only those who become familiar in every detail with body structures will
be able to secure results.
Perhaps some very valuable lessons I learned from Dr. Still may serve
its purpose to those striving to give all that Osteopathy has to offer to
the patient.
After the writer had advanced to where Dr. Still thought he could
assume the responsibility of caring for the patients, I was sent to a home
and found a patient suffering with inflammatory rheumatism of both knees,
and of course, I was up a stump, so to speak. I reported my finding to
Dr. Still with the statement, Dr. Still that patient cant stand to have me
even touch his knees, and he said, Of course he cant neither could I let
you poke your fingers in my eyes, and turned around to the blackboard
and with a piece of chalk, made a sketch of the human legs with the knees
very much enlarged and wrote beneath it Mud Puddle with the statement, Thats what most diseases are an accumulation of waste or worn67
out parts that the body in its normal way has been unable to remove, and
said, NOW if I knew where to go above that knee and open up a faucet
that will turn into it, the normal fluid and forces that have been suspended,
and go below it and open up a faucet that will let them go through and
normally eliminate them just as a fresh supply of water will clear up a
mud puddle, so with that patients knees.
And I said, But Doctor Still, how do I do it?-and he lost his
patience and said, You Darn Fool, what have you been doing all these
months in school ? I am not running a school to teach a lot of Parrots;
I want men and women to study Osteopathy who reason and think for
themselves. You must learn that, neither Osteopathy or its application
to the patient, is something that can be passed around on a platter-one
must delve and dig for it themselves. That Osteopathy is anything but
a System of Movements. That it is neither sane nor safe to treat a
patient by imitating the other fellows way of doing it. That the only
technique you will ever succeed with, is your own understanding of what
needs to be done. How to do it and to know when you have accomplished
it, thats the-principle of how to do it and is all that one can give you.
Viz : First-the point or place to make the contact, the direction to apply
the force and the amount of force necessary to use, and the Key lesion to
the group lesions, plus the follow-up alignment to the supporting tissues.
Dr. Stills Clinics to the students were always the normal or well
patient, as he would say, Get fixed in your mind first the normal thing,
adding nature; only ask of the Doctor 10% assistance. If you keep the
rhythm and nutrition of the cord in tact, viz,: the fluids and forces to and
from the Cerebro-Spinal Centers, and would add, but remember they
must move on time. That in both quantity and quality, you may find the
blood stream normal as revealed by the Lab. test; but unless it is moving
on time, there is the beginning of disorder which is disease.
For the rule of the artery is supreme, and keep in mind the fact, the
heart only gives the circulation; its initial impulse, and it is good or bad,
according to the disturbance throughout the entire circulatory tree; and
like any other mechanic operating or repairing a machine, you must know
just how far to turn the screw driver; how much to twist with the monkey
wrench, and how hard to strike with the hammer.
That any moveable part of the body machine, that is carried much
less forced beyond physiological range of motion, will be injured often
beyond repair.
That it is not the length of frequency or the severity of the treatment
that counts, but the correctness of the one given.
That patients differentiate between the fellow who oils, greases, and
washes, and polishes the machine, and the skilled mechanic who makes the
proper adjustment and alignment, and so they do with the Doctors.
That a limb across the line, meaning (lesions of every description)
across the line. Meaning the structures, fluid and forces of the body from
the power house throughout its distribution may not only interrupt, but
may entirely suspend them.
Examine the machine (Patient) from the crown of their head to the
soles of their feet and wherever you find a limb across the line, knock
it off.
That Nerve impulses are like projectiles, they travel along the line
of least resistance. The cause of the cause may be far remote from where
the patient feels the pain-the thing that sends them to the Doctor.
68
Keep in mind that for every force in the body, there is an opposing
force and that most often, it is a loss or unbalancing of the opposing forces
that we have to contend with.
That neither the circulatory or the nervous system has a fixed
stability; both have a very sensitive equilibrium, of necessity must be So
to meet the changing environments of life, and the things that disturb
this equilibrium are manifold.
Nothing but nature is creative. If there was, we would have the
secret of life that no one need die-much less be sick.
That if you cannot get nature to using her own in her own way, YOU
will have a heck of a time getting her to use what you think she should
use.
That in her building, maintaining and repairing the body, she will
use only those things which belong to the realm of foods.
Its well to get results, but the real satisfaction is in knowing how,
why, and when you secured them.
With the belief that others today are asking the same question I ask
Dr. Still, How do I do it? It has occurred to me that I might best serve
in this letter by recording some of the many things I learned from Dr.
Still, which I have set down just as they have come to my mind, having
made no effort to record them in a connecting line of thought.
For me Osteopathy has proven its worth in successfully handling most
curable diseases that our bodies are heir to from infancy to old age; till
there is loss of memory, thinning of the hair, and dimming of the eyes and
we pass out of this world as helpless as we came into it and it comes to
saint and sinner alike, in spite of any line of treatment.
Would I be willing to rely on Osteopathy and good nursing in case of
Lobar Pneumonia to myself or a member of my family? Yes, if the Osteopath in charge knew how, when and where to apply the touch. No, if he
has learned only enough of Osteopathy to manipulate the superficial tissues
because it is always the deeper structures that are responsible for keeping
the parts in lesion. When they have once formed, and no amount of
manipulating of the superficial tissues will suffice.
Specific adjustment and alignment of the fifth and sixth cervical,
first ribs and clavicles works wonders in both chronic and acute bronchitis.
I do not mean to give the impression that I think Osteopathy is going
to die when the quitting time whistle blows for we older fellows, or that
our schools no longer teach Osteopathy, on the contrary, our schools are
the best equipped for teaching the subjects. I think that best acquaints
the student with the structures of the human body than they ever have
been; that the students are getting Oodles of Osteopathy but dont know
it. The thing that needs to be Stressed to the students, is the fact that
they are getting Osteopathy from the very minute they begin to acquire
a thorough understanding of the body structures, fluids, and forces, and
that there never will come a time, during their stay in school, that either
Osteopathy or its application to the patient will be handed out on a platter
to them, as altogether too many are under the impression that it is something that can be so dispensed. A failure to understand this is, I believe,
the reason they say they were not taught Osteopathy. What the old and
young in the profession most need is a continual emphasizing of that
which is Osteopathy. Viz: that it is only when by knowledge, by
sight, by sense of touch, one has become so familiar with that which is
normal, first will they be able to recognize and normalize that which is
abnormal.
69
We have grown faster than we could properly be instructed and

managed. In our clamor for changes in our school, we must first determine whether it is progress or destruction, keeping in mind that the
power to force and the power to tax is also the power that destroys; and
I would have those engaged in its practice to everlastingly keep in mind,
Osteopathy is for invalids as well as athletes ; that sledge hammer technique but adds insult to injury.
That if we keep ourselves Osteopathically right, no power on earth can
destroy us.
Wishing each one in attendance, a most profitable meeting, I am
Fraternally,
H. H. GRAVETT , D. O.
145 North Main Street
London, Ohio
June 26, 1941.

Dear Doctor Northup :In response to your kind letter I send my greetings to the 1901 class
of A. S. O., especially remembering the following if they be present: H. L.
Chiles, Walter N. Dobson, J. Falkner, Jessie B. Johnson, E. L. Longpre,
W. A. Merkley, B. W. Sweet and Clara Wernicke.
YOU ask what experience I have had with Pneumonia. I can report
that of the great number of such cases treated, all but two were halted
in the first stage by persistent manipulation and careful nursing. The
two exceptions were as follows:
No. 1. Male, age 54, with complication of infected tonsils, removal
of which had been advised six months previously. Lobar pneumonia
developed. Case cleared in due time after fight with relatives and inlaws, and tonsillectomy performed. No colds or other trouble since,
period of about seven years.
No. 2. Female, age 64. Diagnosis was made as follows-Pneumonia
on left lung, pleurisy in right chest. Careful work seemed to give no
results. The use of Miller Lymphatic Pump technique put recovery in
reverse, and in desperation, after the family, nurse and doctor were at
point of exhaustion, patient was taken at midnight of fourth day to hospital twenty-five miles distant, where x-ray confirmed diagnosis but
showed old, calcified, tubercular nodules throughout chest, which had
flared up under the stimulation of osteopathic treatment. Patient was
considered hopeless, but after seven weeks in hospital was sent home where
our type of treatment was continued for several months with subsequent
complete recovery, patient moving later to a distant state and still living
and active at seventy-two years.
If there is any lesson to be learned from this it is: Do not use the
Lymphatic Pump technique if you know the patient has old tubercular
lesions. But how are you going to know without the x-ray? Any doubt
as to the efficacy of our treatment should cause suspicion and immediate
removal of patient to hospital for x-ray of chest, for observation, and for
special care if necessary.
Most certainly I can say that I would be willing to depend solely on
competent manipulative treatment and good nursing if I or one of my
own family were stricken with Lobar Pneumonia. I am quite sure that
there would probably be no Lobar Pneumonia if the patient were clear
70
of focal infection and were under competent osteopathic care from the
beginning of symptoms.
To some such statement as the following, which paraphrases a wellknown formula, I believe we can all subscribe:
I pledge allegiance to Osteopathy and to the truths for which it
stands. For I am not ashamed to advocate the principles laid down by
Dr. Andrew Taylor Still, and bravely to fight under his banner against
ignorance, prejudice and disease, and continue his faithful disciple and
admirer unto my lifes end.
With all best wishes, I am
Yours sincerely and fraternally,
P AUL S. CHANCE, D. O.
Mankato, Minn.
Fraternal Greetings:
June 13, 1941
To the intelligent and experienced group of osteopathic physicians

of forty years and more; the group who, without other equipment than
ten little fingers trained in the skillful art of thinking, feeling and seeing,
went forth into a field of experience of guiding bodily tissues into normal
relationship; and the group who through that wonderful experience not
only proved for themselves but demonstrated to the world Doctor Andrew
Taylor Stills scientific therapeutic principle as superior to all others.
As one of these forty yearlings I have been requested to include
Some brief description of a bit of osteopathic technic
that can be applied to some specific condition and be
depended upon for results. Something that I know
from experience works.
As an indication that my experience concerns the pelvic bowl as well
as the cranial bowl, my bit relates to the muscular floor of the pelvis.
During that early day experience I found it necessary to compete with the
needle. So, when modern ambulant protology methods entered our fold,
my fingers began thinking, feeling and seeking out another pathway in
competition. This competitive venture being in the nature of force of
habit and the pleasure of personal accomplishment, rather than criticism
of the modern method. Well, the venture was quite satisfactory, and it
works for others, judging from a recent letter from a 1922 graduate to
whom it has been my pleasure to pass along the technic. He writes:
It has been astonishing a time or two, when I raised
pelvic organs or other organs that have migrated to the
pelvis by your method, how it changed the patients
symptomatology.
In this method, the patient stands facing the table, with hands resting
thereon. The physician sits comfortably in a chair behind the patient.
Two fingers, the first and second, are gently inserted between the external
wall of the rectum and the internal area of the ischium. The patient then
sits gently downward upon the fingers, which are gently crawling upward
into the pelvic bowl. When they have reached a desired field, detected
only by a trained tactile sense, they hold gently and firmly, while the
patient takes a slow deep inspiration. As the patient slowly exhales the
organs that have migrated down into the pelvis jump upward away
from the fingers.
71
In answer to the question regarding experience in pneumonia: Yes,

I would not only or solely be willing, but insist upon competent manipulative treatment and good nursing in my own case as well as that of my
family.
W. G. SUTHERLAND , D. O.
Sheridan, Wyoming
June 23, 1941

Dear Doctor Northup :
I send greetings in this letter to you who are still able to practice
five-fingered osteopathy after forty years. In those early days we got
results without knowing the scientific reason therefore. I know I had as
good success treating the infections long before Mike Lane told us about
the opsonic index.
You asked for a bit of specific osteopathic technic. Among others
I think one of the most striking is my technic for treating heart failure.
I apply vigorous percussion to the seventh cervical vertebrae, giving
three or four sharp strokes with the side of my hand. That will revive
a patient when nothing in medicine will. I have passed this bit of technic
on to many osteopaths and they have reported wonderful results.
You ask if I would rely on strictly manipulative treatments in
pneumonia. In my own family the answer is yes, but in my present

physical condition I am not so sure. You old timers who have treated much
pneumonia know the active opposition of well-meaning friends and

relatives who do not understand the merits of osteopathy. In these cases
I am apt to follow the path of least resistance. In my years of practice
I have cared for many cases of pneumonia and can truthfully say that I
have never buried a case under purely osteopathic manipulation, where I
could have full charge of the case from the beginning. I have never
failed to wonder what takes place in the lungs when a case is cured by
crisis. We know what hepatization looks like and I would like to know
what takes place when a pneumonia case is cured instantly.
I could recite many cases but perhaps one of the most outstanding
was the two year old daughter of a medical friend. I was given per-
mission to treat her when they had given up hope and said she could not
live over ten minutes. The entire muscles of her body were contracted;
her eyes set in her head; her respiration sallow and panting, and she was
practically moribund. I manipulated the cervical and dorsal muscles
and raised the ribs as much as possible on both sides for perhaps twenty
or thirty minutes. When she suddenly relaxed and broke into a profuse
perspiration. Her doctor father called it a miracle. I wish someone
could tell me just what took place in that poor little body. That has been
my experience in over forty years of practice and that goes for all of the
infections and not for pneumonia alone. I sincerely hope our profession
will continue to use manipulative methods as I know we have something
our medical brothers lack.
Very truly,
G. H. BUFFUM, D. O.
72
Springfield, Missouri
June 17, 1941

Dear Dr. Northup:
To the one hundred and eighty-five members of the American Osteopathic Association who have been in Osteopathy forty years or over,
greetings to you and congratulations that it was our privilege to sit at
the feet of the Old Doctor and to get from him the ideals and the inspiration that has carried us successfully thru all the intervening years.
To have served suffering humanity thru forty years has been a
privilege, and the assurance that much of that suffering has been relieved
thru osteopathic ministrations is reward in itself, and added to that is
the knowledge that Ostepathy has provided a sufficient compensation and
an honored place in the social order. What more need one ask?
I have been asked by Dr. Northup, What experience have you had
with Pneumonia. After these years in practice would you be willing to
depend solely on competent manipulative treatment and good nursing if
you or one of your own family were stricken with Lobar Pneumonia?.
Thru the years many cases of Pneumonia have been under my care
and I have lost some of them, but comparing my losses with those of other
systems of treatment I would say to the second part of the question an
unqualified yes.
With heartiest greetings to each of you, and wishing you many more
years of successful practice, I am,
Fraternally yours,
T. M. KING, D. O.
Denver, Colorado
June 11, 3941

Dear Dr. Northup:
I am very glad for the manipulative association which you doctors
are promoting.
I have been in practice for 42 years. I am a graduate in medicine
as we11 as in osteopathy. In all the various studies of the many therapeutic ideas I never could be educated out of the idea of the body being
a mechanism with which we have to deal from a mechanical standpoint.
I have specialized in Eye, Ear, Nose and Throat. Practically every
case that comes into my office gets osteopathic treatment. I believe in the
Osteopathic concept just as firmly and a good deal more intelligently than
I did when I graduated at Kirksville in 1899. Of course I am liberalized
somewhat from my study of the chemical law. I use sprays, douches,
antiseptics, styptics and other medical measures in my work as an Eye,
Ear, Nose and Throat specialist and surgeon.
I am very sympathic toward what you are doing. I am sure mu-h
good will come out of it.
When you get your book written here is an order for it in advance.
Yours fraternally,
C. C. REID, D. O.
Kansas City, Missouri
June 13, 1941

Dear Dr. Northup:
Greetings to the Old Timers and to the Osteopathic Manipulative
Therapeutic and Clinical Research Association in convention assembled.
73
I am most sorry indeed to be among those not present, but I am with

you in an osteopathic spirit which increases as the years pass.
I have no hobbies in technic. I can give you nothing along that line
which would be enlightening or particularly helpful to you. I could
learn much from you.
I would like to call your attention to the fact that gallbladder disturbances very frequently have their beginnings in the first decade of
life, even within the first five years. In my experience the most frequently lesioned area is at the 7th dorsal which corresponds to the 9th
segment of the cord affecting the sympathetic to the gallbladder. We
should be on the alert always in treating the children for acute belly
conditions to scrutinize these areas carefully, and to make the necessary
corrections.
Also when I see so many youngsters, even to very small children,
wearing glasses, I wonder what about the integrity of the lst, 2nd and 3rd
dorsals. Are we all not a bit negligent in interpreting eye troubles from
the standpoint of lesions involving that area? What are our eye specialists
doing about it, aside from fitting glasses which will make these children
addicts thereto the rest of their lives ?
The time is ready, here now, for a renaissance of the concept of the
lesion and a more devout adherence to the principles, the application of
which is our only reason or excuse for existence.
More power to you!
Sincerely,
GEORGE J. CONLEY, D. O.
Dear Dr. Northup:
Los Angeles, Calif.
June 20th, 1941

With me the practice of Osteopathy has been a continual joy, it has
been forty-four years of service for others--A normal life.
In answer to your question, regarding Lobar Pneumonia my answer
is emphatically yes. All necessary details in the hands of a competent
nurse. I have met the test in my family.
Fraternally yours,
LOUISE P. CROW, D. O .
Springfield, Mass.
Greeting to the Grads. of forty and more years!
All honor to the Founder of Osteopathy, Dr. Andrew Taylor Still,
whose vision of the DIVINE creation of man, thus permitted him to prove
HIS perfection through Osteopathic Art-adjustment. Research may
formulate the reasons why, while Art of application is the Osteopaths
function. As the Dutchman said The longer I do live, the more I find
By-tam out.
QUESTION
1. Would you depend on Osteopathy and good nursing
for your family in Lobar Pneumonia?
YES ! Forty-four years in practice when first man called; also, all
cases fatally prognosed by Drug Therapeutists with the exception of four
recovered. Two fatalities moribund and bowels had not moved for five
days. One had gone from Flu to Pneumonia to Enterits and Peritonitis.
74
The fourth, bowels had not moved for four days and kidneys not functioned for 36 hours.
2. Any treatment proven successful in my years of
practice?
YES! Long or short Shoulder Joint Leverage. First ascertain condition at 6th C. and 2nd D. vertebral alterations. These may be primary
or peripheral from Shoulder Joint injury. Either must be relieved before
too much Leverage, i. e., best to know nerve control of any alteration of
function, before applying the Antiphlogistic touches of your Therapeutic
TEN FINGERS !
Dr. A. T. Still never ceased stating It is not Osteopathy that fails.
It is the Osteopath.
M. T. MAYES, D. O.
New Bedford, Mass.
June 13, 1941

Dear Dr. Northup:
Have been treating Pneumonia for forty-one years-would not trust
any method but Osteopathy. When our son had Pneumonia he had Osteopathy alone: Got my gray hair during the Flu and Pneumonia epidemic
in 18. I did not take it myself or lose a patient ever with either Flu or
Pneumonia.
Fraternally,
MARY W. WALKER , D. O.
Pasadena, Calif.
Dear Doctor:
June 23, 1941
LOBAR PNEUMONIA
Replying to your question Would you depend on manipulative treatment and nursing for yourself or family in case of Lobar Pneumonia.
Now, Doctor, that is a foolish question-I never expect to have Lobar
Pneumonia, neither will my family.
I have never in forty-five years of general practice had a case of Lobar
Pneumonia develop where I was the first doctor called. I have treated
many cases I received from other doctors and never lost one of them.
For example (a bonifide case) A woman of wealth and leisure, past
middle life, whos limousine carried her to the place she wished to go, was
hardly out of doors all winter. She attended a funeral of a prominent
person on a bright sunny day in March, the melting snow made the ground
wet and cold. She stood on the cold wet ground at the graveside while
the minister said a long burial service, getting her feet damp and cold.
About 2 a. m. the next morning she awoke with a violent chill. She called
me immediately. I found her with fever, tight labored breathing and still
chilling. I gave her a vigorous treatment, stimulating the bronchial
circulation-told her she had the preliminary symptoms of Pneumonia and
I would be back after breakfast to treat her again.
That was before osteopathy was as well known as it is now. As
soon as I was out of the house they called their former medical doctor
who told them she had Pneumonia, put a nurse on the case and prepared
for a long siege. I was politely dismissed.
75
In three or four days she was well and strong again. The M. D. said
he had never seen such a quick recovery. I told her why. I dont think
she ever had an M. D. treat her for the balance of her life.
I have had many such cases with equally good results. As to the
treatment of Lobar Pneumonia, just get the patient to swetting and keep
him at it and a cure is assured. (Imean normal perspiration), and not
with aspirin.
Recently I treated a case which was so bad I did not go home for
breakfast, just stayed on the job treating her every 15 or 20 minutes
until a profuse perspiration came out of her. In two days she was well.
Yours sincerely,
W. J. CONNER , D. O.
La Jolla, California
June 13, 1941

Dear Doctor :
Responding to the call for greetings from the members of the fellowship of our glorious profession there comes this hail from the far west.
Our sincerity of purpose and fidelity to the ideals in the practice of
the principles of Osteopathy as given to us (fortunate ones) by our
honored founder Dr. A. T. Still, is needed today as never before if the
profession is to survive as an independent therapy and continue to grow
and develop on the high plane of service to humanity upon which it was
originally established.
I wish that I could be with you today in person but the miles between
and the seventy-eight years to my credit plus the frailities of the flesh that
are mine make this reunion for me impossible. However, never in my
life have I enjoyed my work more or been more enthusiastic and convinced
of the efficacy of the healing power of manipulative osteopathy. This is
one of the rewards that come with the years.
Regarding your request for an expression of faith in this therapy
in the treatment of Lobar Pneumonia I can say that in my forty-one years
of practice I have never lost a case of Pneumonia and that I could and
would ask for nothing better than true osteopathic care in such case for
myself or my family.
In the spirit of loyalty to our profession and gratitude for the years
that I have been permitted to practice and serve humanity as only it can
be served through osteopathic concept I will leave it to my young brother
of eighty-three to further represent me among you.
With cordial good wishes:Fraternally yours,
WALTER C. CARTER, D. O.
Class of 1900
Minneapolis, Minn.
June 20, 1941.

Dear Doctor :
In answer to your question, I will say, most emphatically-Yes.
No feeding-the alarming prostration is from the disease, and the
function of digestion is suspended.
Food decomposes, with serious results.
Very Sincerely Yours,
D. J. KENNEY , D. O.
76
Santa Cruz, California
June 24, 1941.

Dear Dr. Northup:
Greetings, to you and all members of the American Osteopathic ASsociation who attend the meeting Friday, June 27th. I deeply regret not
being able to be with you to enjoy the program arranged for this, A. T.
Still Day.
I am very happy to be one of the one hundred and eighty-six who
have practiced Osteopathy forty years or over. 11 was graduated in June,
1900. My faith in Osteopathy grows stronger with each passing year,
and I hope I may be permitted to serve my community for many years to
come. I am in good health and enjoy my work.. Established my office
here August 10, 1906, and have remained in the same offices to date.
In reference to my confidence in Osteopathic treatment for Lobar
Pneumonia. I have proven to my own satisfaction that Osteopathic treatment has brought results, and in some of these cases when all other treatment failed. I would not want any other treatment for myself or my
family than competent manipulation and good nursing. In my experience,
I have found most pneumonia cases need short, careful treatment every
few hours until H am sure the danger point has passed. I have spent nights
with desperate cases, treating them as often as every two hours, but the
treatment was short, inhibition in the dorsal region, raising the ribs carefully and correcting lesions of ribs or vertebra, when necessary.
With every good wish to you and to all those who are interested in
our dear Osteopathic profession, I am,
Sincerely and fraternally yours,
PEARL OLIPHANT, D. O.
Letters were also received from the following, containing Greetings

and many valuable suggestions, a good number of which will be used in
another volume of notes after further correspondence to clear up or amplify statements made.
Francis K. Byrkit, D. O.
C. W. Mahaffay, D. O.
W. E. Dean, D. O.
R. H. Williams, D. O.
Louis D. Martin, D. O.
F. P. Millard, D. O.
Harry W. Gamble, D. O.
J. Henry Hook, D. O.
F. Hollingsworth, D. O.
J. T. Watson, D. O.
Byron F. McAllister, D. O.
Evelyn U. Wanless, D. O.
Richard Wanless, D. O.
Helen Marshall Giddings, D. O.
J. Pierce Bashaw, D. O.
Berton W. Sweet, D. O.
F. W. Bechly, D. O.
Anna Holme Hurst, D. O.
H. C. Jaquith, D. O.
Jessie B. Johnson, D. O.
Gussie Phillips, D. O.
P. M. Agee, D. O., M. D.
George H. Carpenter, D. O., M. D.
Ruth K. Haley, D. O.
Louise P. Crow, D. O.
Wallace L. Roberts, D. O.
Warren B. Davis, D. O.
C. E. Still, D. O.
Frank R. Heine, D. O.
The following question was included in the letter of invitation After
these years in practice would you be willing to depend solely on competent
manipulative treatment and good nursing if you or one of your own family
77
were stricken with Lobar Pneumonia? Twenty-four said yes. Five

had never lost a case. Three had lost a few cases and one would insist
on leaving it to the doctor in charge to use his best judgment as conditions
indicated.
PUTTING NEW EMPHASIS ON MANIPULATIVE THERAPY
Early in 1937 a group of enthusiastic members of the profession
began to realize more forcibly than ever the need for greater emphasis
on Manipulative Osteopathy and more research to prove scientifically
that which has been demonstrated clincally.
An organization was formed consisting of the following:
H. L. Chiles, D. O.
Riley D. Moore, D. O.
W. P. Dunnington, D. O.
Carl P. McConnell, D. O.
Harrison 1-I. Fryette, D. O.
A. F. MeWilliams, D. O.
George M. Laughlin, D. O.
H. M. Vastine, D. O.
with T. L. Northup, D. O., secretary for the committee.
A breakfast meeting was held at the Hotel Stevens in Chicago, July
6th, 1937 at which time sixty-three leaders of the profession were present
and a petition signed for the establishment of a Section of Manipulative
Therapeutics of the American Osteopathic Association. The petition was
granted and the first section program given at Cincinnati in 1938. At
this time a sponsoring and supporting organization was formed and
granted affiliation with the American Osteopathic Association. The articles of organization follow.
OSTEOPATHIC MANIPULATIVE THERAPEUTIC

AND
General Objects And Purposes
Adopted at Cincinnati, June 12, 1938

Amended at Dallas, June 24, 1939
Amended at St. Louis, June 28, 1940
That since Osteopathic manipulative or adjustive therapy, properly
and accurately applied, is the most important single factor in the therapeutic world, therefore this group or organization, believing that a rennaisance of these tenets is not only imperative, but should be definitely
and immediately undertaken, we the subscribers to this Association hereby
constitute ourselves members of and sponsors for
The Osteopathic Manipulative
Therapeutic and Clinical Research Association.
Art. l-That the foremost object and purpose of this Association is to
develop the science and art of Osteopathy to the fullest possibilities its principles justify; to disseminate to the profession the
accumulated knowledge of its most experienced practitioners
as relates to manipulative therapeutics; to utilize additional data
which may accrue from research, experience, discussions, and
demonstrations of technique for the purpose of improving the
technical skill of the individual Osteopathic physician in the application of manipulative or adjustive therapy.
78
Art. 2-That this section shall confine its discussions and papers to the
treatment and cure of disease by manipulative or adjustive
therapy.
Art. 3-That all of its endeavors shall be to advance the importance of
manipulative Osteopathy as the chief business of Osteopathic
Physicians.
Art. 4-That membership shall be open to any member of the American
Osteopathic Association who may wish to assist in the work of
this organization.
Art 5-That the officers -of this organization shall be Chairman, ViceChairman, Secretary-Treasurer and a Board of Governors consisting of fifteen members, five to be elected each year for three
years. The governors shall be elected by the membership of the
Association at the annual meeting. The Board of Governors
shall elect the other officers and with them control the policy of
the Association.
Art. 6-That it shall be non-political in character-its officers counting
their terms of service as a privilege to advance the great principle of Osteopathic manipulative therapy as given to the world
by Dr. A. T. Still, and not personal preferment; and that it shall
select its officers and Board of Governors and members with this
major aim.
Art. 7-That the Annual dues of this Association shall be $2.00.
Its further objects and purposes are :
l-To produce a program at each annual meeting of the A.O.A.
specifically demonstrating the best methods of applying the
philosophy and principles of Osteopathy to disease as taught
and practiced by Dr. Still. Such programs to consist of experience meetings and the demonstrations of technique. This
program to be known as A. T. Still Day.
2-TO search out members of the profession who by study and
experience have developed successful manipulative methods
not generally in use and to secure the appearance of these
Osteopathic physicians at the annual sessions of this organization.
3--TO seek to secure attendance of the members of this organization at local, state and national meetings, and where practical their appearance on programs to the end that the effectiveness of proper osteopathic methods in restoring health
to sick people may be more confidently and more generally
stressed.
4--T O encourage its members, when requested, to visit osteopathic
colleges, the fraternities and sororities of such colleges, and
before small groups of students demonstrate technique and
methods which have survived for nearly half a century.
5--T O encourage its members, where practical, to aid in the founding of local clinics for treatment of the poor. Also to strive
to form local or regional study or conference groups for the
exchange of experiences and the forming of closer relations
of osteopathic physicians holding these views. Such groups
or clinics to be addressed by members of this section at
regular intervals, endeavoring to organize them along the
79
same lines as the parent group, and thus further extend the
work undertaken by it.
6--TO encourage the preparation of osteopathic tests; to aid in
having approved text books printed and sold.
PETITION OF OSTEOPATHIC MANIPULATIVE

THERAPEUTIC
AND CLINICAL RESEARCH ASSOCIATION
To the Board of Trustees of the
American Osteopathic Association
meeting at Cincinnati, July 1938.
We the undersigned members of the newly formed Association known as
The Osteopathic Manipulative Therapeutic and Clinical
Research Association
hereby make application for affiiliation with the American Osteopathic
Association.
In making this application it is understood that during the term of this
affiliation only members of the A.O.A. shall be accepted as members and
only registered convention visitors admitted to its pre-convention meetings.
The purpose of this organization isl-Banding together those who are primarily interested in Manipulative Therapy.
2-Exchange of experiences and ideas relative to Manipulative
Therapy.
S.-Collecting and studying Clinical reports of cases treated principally by Manipulative Therapy.
4-Disseminating among its members the results of its discussions
and research investigations as it applies to Manipulative Therapy.
5-Recording for publication and further study the experiences of
men who have been long in practice and have relied for their
results principally on Manipulative Therapy.
Signed by 62 members of the
American Osteopathic Association
80
DIRECTORY OF MEMBERS
Arizona
Collins, Paul R.
542 Tenth St., Douglas
Stoner, A. B.
422 Security Bldg., Phoenix
Towne, C. E.
916 Valley Bank Bldg., Tucson
Arkansas
Champlin, Chas. A.
404 S. Elm St.. Holne
McAllister, B. F.
225 N. Block St., Fayetteville
Nies. Carl H.
514 W. Main St., Blytheville
California
Barker, Michael A.
209 Post St., San Francisco
Biddle, J. Russell
10 Oasis Court, Indio
Blair, Glenn Doty
313 S. Sycamore Ave., Los Angeles
Burns, Louisa
810 Prospect Ave., South Pasadena
Carlsen, M. Elise
17218 State St., Santa Barbara
Carter, Hedley V.
3348 Carleton St., Box 278
Point Loma, San Diego
Carter, Walter C.
7850 Ivanhoe Ave., La Jolla
Chandler, Louis C.
GO9 S. Grand Ave., Los Angeles
Chapman, L. R.
403 E. Foothill Blvd., Glendora
Cramer, Nellie M.
975 B. St., Hayward
Darnall, E. C.
1106 AmericanTrust Bldg., Berkeley
Emery, Robert D.
927 S. Gramercy Place, Los Angeles
Farnham, D. C.
323 Geary St., San Francisco
Fryette, Harrison H.
126 N. Palm Drive, Beverly Hills
Gibbs, Benedicta L.
225 West E. St., Ontario
Gotsch, Otto R.
300 Lettunich Bldg., Watsonville
Hain, Grace E.
2287 Telegraph Ave., Berkeley
Hamilton, Susan H.
Rickey, Geo. W.
805 N. Central Ave., Glendale
Houghtnling, Edward B.
610 Bank of America Bldg., San Diego
Johnstone, Edward O.
5049 Haskell Ave., La Canada
King, O. Van Meter
4004 Orange St., Riverside
Kowan, Maurice H.
1648 Beverly Blvd., Los Angeles
Loveland, Mark M.
6331 Hollywood Blvd., Hollywood
MacCracken, Daisy B.
1651 L,. St., Fresno
MacCracken, Frank E.
1651 L,. St., Fresno
Miller, Clara MacFarlane
1213 Lafayette St., Alameda
Miller, M. Alvera
3412 Haley Ave., Oakland
Morgan, Muriel
303 American Trust Bldg., Berkeley
Morgan, Thomas L.
Nelson, Lura B.
5364 Lemon Grove Ave., Los Angeles
Palmer, H. R.
325 Latham Square Bldg., Oakland
Palmer, Kenneth E.
501 American Trust Bldg., Berkeley
Parish, Chester W.
518 N. Central Ave., Glendale
Pike, Arthur E.
1729 American Ave., Long Beach
Rice, Ralph W.
578 N. Berendo St., Los Angeles
Ruddy, T. J.
3780 Wilshire Blvd., Los Angeles
Schultz, Lavertia L.
2719 Randolph St., Huntington Park
SeChrist. W. T.
1657 E. Nadeau St., Los Angeles
Shelley, Helen H.
309 American Trust Bldg., San Jose
Sisson, Ernest
1419 Broadway, Oakland
#Smith, Georgia B.
802 Hollingsworth Bldg., Los Angeles
Sprecher, Eldo C.
119 Business & Professional Bldg.,
Stelle, Truman Y.
423 Security Bldg., Glendale
Steunenberlg, Georgia A.
519 N. Ardmore Ave., Los Angeles
Still, Charles E., Jr.
337 Psalm Canvon Drive, Palm Springs
Stillman, Carl S., Jr..
527 Commonwealth Bldg., San Diego
Taylor, Wesley II.
210 Andrew Bldg., Redwood City
Theobald, Paul K.
1419 Broadway, Oakland
Tilley, C. E.
431 C. St., Oxnard
Vallier, A. E.
2035 N. Main St., Santa Ana
Walker, Ray D.
5514 Wilshire Blvd.. Los Angeles
Wallace, Iva Still
804 Bank of America Bldg., Fresno
Weber, Caroline L.
925 Medocino Ave., Santa Rosa
Weis, Caroline
1423 S. Bonnie Brae St., Los Angeles
Woodbury, G. W.
702 DOS Robles Place, Alhambra
Wyland, Samuel G.
617 Johnson St., Santa Rosa
COLORODO
Fry, O. D.
408 Bennett Bldg., Colorado Springs
Magoun, Harold I.
1550 Lincoln St., Denver
Reid, Charles C.
1600 Ogden St.. Denver
Slater, A: B.
First Natl. Bank Bldg., Center
Townsley, P. E.
415 N. Tejon Ave., Colorado Springs
Connecticut
Crawford, S. Virginia
5 Terrace Place, Danbury
Fuller, Caroline
1236 Eufield St., Thompsonville
Kauffman, Chas. H.
81
20 West St., Danbury

Kingsbury, L. C.
983 Main St., Hartford
Wentworth, Alda C.
180 #Church St.: Naugatuck
District of Columbia
Moore, Riley D.
502 Stoneleigh Courts, Washington
Florida
Coker, R. Philip
Box 66, Panama City
Coker, Doris R.
Box 66, Panama City
Harris, Frances W.
121 North Ocean Ave., Daytona Beach
Jennings, Bertha
111 E. Morse Blvd., Winter Park
Larimer, John M.
456 41st St., Miami Beach
Mochrie, Elizabeth F.
408 Holt Ave., Winter Park
ONeill, Addison
Box 267, Daytona Beach
Schumacher, E. L.
P. O. Box 1166, Eustis
Stinson,. James A.
601 Times Bldg., St. Petersburg
Georgia
Phillips, Gussie
816 Peachtree St., Atlanta
Wiley, Kenneth H.
904 Atlanta Nat. Bank Bldg., Alanta
Idaho
Meredith, Ortiz R.
l-2 Nampa D Building, Nampa
Miller, D. E.
P. O. Box 642, Twin Falls
Warner, W. S.
Warner Bldg., Idaho Falls
Illinois
Blust, Marian A.
Box 115, Galva
Borton, E. C.
758 E. 79th St., Chicago
Bowman, E. Ruth
440 W. 61st St., Chicago
Carter, J. Allen
506 Central Life Bldg., Ottawa
Clunis, Grace E.
526 Crescent Blvd., Glen Ellyn
Drinkall, Earl J.
25 E. Jackson Blvd., Chicago
Esser, A. C. H.
6861 Stony Island Ave.. Chicago
Evans, R. N.
43 So. Kensington Ave., La Grange
Fitch, Nellie
555 N. Dean St., Bushnell
Foreman, Oliver C.
58 East Washington St., Chicago
Gallivan, Catherine L.
55 East Washington St., Chicano
H e c k e r ,
G .
E
1109 Rockford Natl. Bank Bldg,
Rockford
Johnson, Hilda E. C.
212 So. Marion St., Oak Park
Knecht, P. E.
609 Volkmann Bldg., Kankakee
Linebarger, H. A.
Chrisman
Little, Kenneth E.
1610 Washington Ave., Alton
Medaris, C. E.
909 Rockford Natl. Bank Bldg., Rockford
Miller, Harry T.
Reichert Bldg., Canton
Moriarty, J. J.
Moloney Bldg., Ottawa
Murphv. F. J.
157 E. 155th St., Harvey
McCaughan, R. C.
540 N. Michigan Ave., Chicago
Nelson, C. R.
33 South Island Ave., Aurora
Parker, F. A.
133 W. Park Ave., Champaign
Peterson, Ernest R.
308 N. Oak Park Ave., Oak Park
Pollock, Edith W.
202 18th St., Quincy
Record, Blanche B.
1131 Second Ave., Rock Island
Shain, F. B.
7106 Crandon Ave., Chicago
Stanley, S. Edward
1645 W. Garfield Blvd., Chicago
Strachan, Wm. Fraser
1525 E. 53rd St., Chicago
Wendell, Canada
610 Lehmann Bldg., Peoria
Young, Alfred W.
59 E. Madison St., Chicago
Indiana
Allen, Paul van B.

516 Merchants Bank Bldg., Indianapolis
Baker, J. E.
1 East Jackson St., Brazil
Browne Louis E.
430 Lincoln Bank Tower, Fort Wayne
Caine, A. B.
Marion Natl. Bank Bldg., Marion
Dannin, A. G.
505-507 Guaranty Bldg., Indianapolis
Ramsdell, L. P.
909 Michigan Ave., La Porte
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302 S. Main. New Castle
Smith, Orren E.
1003 Odd Fellow Bldg., Indianapolis
Turfler, F. A.
220 J. M. S. Bldg., South Bend.
IOWA
Caldwell, Della B.
303 Flynn Bldg., Des Moines
Chance, E. V.
Box 367, WinfieId
Facto, Lonnie L.
3111 Ingersoll Ave., Des Moines
Freeman, Beryl
1212 Equitable Bldg., Des Moines
Gamble, Harry W.
Missouri Valley
Gehman, R. W.
2901 Beaver Ave., Des Moines
Golden, Mary E.
1320 Equitalble Bldg., Des Moines
Gordon, W. C.
419-20 Frances Bldg., Sioux City
Hudson, B. M.
Ellis Bldg.., Charles City
Jordan, Lydia T.
1209 Brady St., Davenport
Kimberly, Faye
MenloMeyer, C. O
912 Liberty Bldg., Des Moines
Meyer, S. W.
General Hospital, Algona
Phenicie, Ellen M.
1126 Des Moines Bldg., Des Moines
82
Saylor, Frances G.
318 Geneseo, Storm Lake
Wright, H. D.
Box 108, Hampton
Kansas
Du Mars, A. E.
Box 266, Coffeyville
Lacey, Burr
Pretty Prairie
Leolpold, Roy A.
617 N. Main St., Garden City
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E. I. Fish Bldg., Sedan
Mayhugh, Alice
813 Kansas Ave., Atchison
Smith, E. Claude
701-02 Mills Bldg., Topeka
Smoot, Esther
Third & Pine Sts., Eureka
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1007 W. Douglas Ave., Wichita
Swanson, H. G.
1005 Brown Bldg., Wichita
Kentucky
Prather, Nora
134 Weissinger-Gaulbert Apts.,
Louisville
MacDonald, John A.
173 Bay State Rd., Boston
Moore, Floyd
1248 Beacon St., Brookline
McWilliams, A. F:
30 Huntington Ave., Boston
Nelson, Frank C.
506 Highland Ave., Malden
Nicholls, Melvin H.
80 W. Foster St., Melrose
Nicosia, A. W.
59 Lewis St., Lynn
Parlin, Ralph B.
39 Mill St., New Bedford
Sauter, C. W. 2nd
87 S. Main St., Gardner
Steeves, Herbert O.
Walker, Mary W.
286 Union St., New Bedford
Wilson, Perrin T.
1626 Massachusetts Ave., Cambridge
Wood, Chas. W.
Hadley Falls Trust Co. Bldg., Holyoke
Young. Paul E.
230 Main St., Hyannis
Young, W. E.
Middle St., Woods Hole
Michigan
Louisiana
Forcade, J. MiIler
110 N. Royal St., De Ridder
Maine
Betts, Addie K.
180 High St., Portland
Brown, W. C. and N, R.
80 Elm St., Waterville
Gross, Olga H.
47 Grove St.. Augusta
Keating, Clifford H.
36 Exchange St., Rumford
Sanborn, Genoa A.
14 Lisbon St., Lewiston
Tomes, Rudolph
74 Whipple Rd., Kittery
Maryland
Heatwole. W. S.
I. O. Box 252, E. Main St., Salisbury
McMains, Grace R.
700 Cathedral St., Baltimore
Massachusetts
Barstow, Myron B.
Bryant, Ward C.
31 Federal St., Greenfield
Brykit. Francis K.
19 Summit Rd., Wellesley
Elderkin, Emma C.
5 Haynes Park, Roxbury
Ellis, Sidney A.
687 Boylston St., Boston
Evers. J. Harold
Edison Hotel Bldg., Lynn
Fielding. Anne M.
262 Federal St., Greenfield
Goode, George W.
687 Boylston St.,. Boston
Katwick, Arthur D.
70 Park St., Stoughton
Keene, Walter N.
128 Lowell Ave., Newtonville
Knowles, Wm.
279 ,Marlborough St., Boston
Lindquist, Willbert
548 High St., Medford
Becker, Alan R.
601 First St., Jackson
Benton, Floyd M.
2337 W. McNichols Rd., Detroit
Bethune. Wm. H.
83 Monroe St., Grand Rapids
Bruer, Walter P.
3-168 General Motors Bldg., Detroit
Cathcart, Nelson H.
504 N. State St.. Davison
Congdon. Earl E.
451 Madison St., Lapeer
Cottrille, W. Powell
1208 Jackson City Bank Bldg., Jackson
Darling, W. E.
2111 Woodward Ave.. Detroit
Everal, Ralph E.
211 Wabeek Bldg., Birmingham
French, Car1 C.
Box 135, Ida
Howlett. J. Maurice
12523 Third Ave., Detroit
Kistler, R. C.
P. O. Box. 105. Wyandotte
Koening, Jack
4359 Grand River, Detroit
Laird, John H.
1113 Union Industrial Bldg., Flint
Lawyer, George H.
708-09 Kalamazoo
Nutt, John E.
35104 Michigan Ave., Wayne
Peterson, Russel
100 W. Grand River Ave., Williamstan
Phillips, Keene B.
708-09 Kalamazoo Natl. Bank Bldg.,
Kalamazoo
Rausch, Chas H.
I.19 Jefferson St., Blissfield
Reinhart, C. W.
2 E. Front St., Monroe
Rinefort, Harry E.
16712 East Warren Ave., Detroit
Simons, Verna
301 State St., Grand Rapids
Warthman. A. I.
18212 Grand River , Detroit
83
Montana
Minnesota
Lee, Minnie R.
207 Powers Bldg., Helena
Mahaffay, C. W.
21 Pittsburgh Bldg., Helena
McCole, Geo. M.
First Nat. Bank Bldg., Great Falls
Willard, Asa
Wilma Bldg., Missoula
Clark, Robert H.
11 Bridge Square, Northfield
Goblirsch, E. C.
210 S. E. 2nd St., Little Falls
Kenney, D. J.
401 Masonic Temple, Minneapolis
Meyers, Grace H.
402 Masonic Temple Bldg.,Minneapolis
Quade, Selma L.
First Natl. Bank Bldg., Virginia
Sharp, F. J.
105 N. Broadway, Crookston
Sheggeby, E. C.
Nebraska
Hartner. Chas.
Madison
JoDon, M. Mary
401 Security Mutual Bldg., Lincoln
Kani, P. F.
2226-28 Jones St., Omaha
Wirth. F. J.
341 Main St., Chadron
Stewart, Harry H.
3002 Hennepin Ave., Minneapolis
Su,therland, W. G.
Box 345, Mankato
Taylor, Arthur
4-6 Torinus Block, Stillwater
New Jersey
Arthur, Eleanore M.
114 So. Illinois Ave., Atlantic City
Bailey, Hannah W.
246 Harrison Ave., Hasbrouck Hgts
Bugbee, W. C.
17 Watchung Plaza. Montclair
Butterworth, C. A.
16 Old Short Hills Rd., Millburn
Chastney, James E.
40 Passaic St., Hackensack
II. L. Chiles
58 Main St., Orange
Hoffman, Linford, L. B.
306 N. Broadway, Pitman
Lippincott, Howard A.
122 W. Main St., Moorestown
Maxwell, H. I.
47 Maple Ave., Morristown
Miller, Walter H.
229 Liberty St., Bloomfield
Murray, John H.
212 E. Hanover St., Trenton
McSpirit, J. R.
40 Glenwood Ave., Jersey City
Nelson, Ellen
822 Madison Ave., Plainfield
Northup, George W.
Altamont Court Apts., Morristown
Northup, Thomas L.
Altamont Court Apts., Morristown
Pike, George H.
9 Red Rd., Chatham
Reger, Alfred W.
23 Elliott St., Dover
Ryel, Jennie Alice
40 Passaic St., Hackensack
Sewall, N. K.
270 Belleville Ave., Bloomfield
Szalny, S.
931 Garrison Ave., Teaneck
Thompson, L. L.
26 Evelyn Place, Nutley
Tieke, William H.
670 Clinton Ave., Newark
Walker, O. M.
329 Belleville Ave., Bloomfield
Walling, H. Cory
69 Park Place, Morristown
Williams, Grill M.
909 Wood Ave., N., Linden
Wilson, Dorothy H.
51 So. Park St., Montclair
Missouri
Bartlett, Maud E.
310 N. Skinker Blvd., St. Louis
Bohrer, O. L.
Commercial St., Lebanon
Camp, Lenia
902 W. Chestnut St., Savannah
Chappell, Nannie J.
5023 Washington Blvd., St. Louis
Conner, Luella R.
Raytown
Connet, Dorothy
820 Chambers Bldg., Kansas City
Davis, C. J.
5 North Gore Ave., Webster Groves
Denslow, J. S.
Kirksville College of Osteopathy,
Kirksville
Drennan, Quintus L.
Ambassador Bldg., St. Louis
Englehart, W. F.
705 Olive St., St. Louis
Heising, Marie D.
3530 Magnolia Ave., St. Louis
Hildreth, Hazel W.
Macon
Larson, R. Terry
8029 Forsythe Blvd., Clayton
Laughlin, George M.
Laughlin Hospital, Kirksville
McRae, Ralph I.
1014 Locust St., St. Louis
Noves. Alston W.
33 N. Meramec Ave., Clayton
Pearson, Wallace M.
Box 722, Kirksville
Pfeiffer, Walter B.
5815 Nottingham Ave., St. Louis
Pickering, Hugh S.
5563 Herbert St. Louis
Rickett, J. D.
801 Francis St., St. Joseph
Rohweder, Helen A.
217 W. Jackson St., Mexico
Ruff, J. H.
300 H. & H. Bldg., Cape Girardeau
Samuelson Ann2056 Citizens Natl. Bank Bldg.,
Chillicothe
Seibert, Wm.
3 S. Meramec Ave., Clayton
Simmons, Grace
First Natl. Bank Bldg., Milan
Stanley, Robert R.
Malta Bend.
Wilson, Wm. C.
St. Charles
New York
Bailey, Albert W.
114 Union St., Schenectady
Beal, C. J.
17 Vick Park A., Rochester
84
Haas, Robert F.
722 Harries Bldg., Dayton
Hess, Carl E.
12910 Miles Ave., Cleveland
Hill, Robert C.
415 Ludlow Ave., Cincinnati
Hutchison, Carrie E.
624 Harries Bldg., Dayton
Keyes, W. J.
4521 Montgomery Rd., Norwood
Lawrance, Chauncey
507 Arcue Bldg., Springfield
Marsteller, Charles L.
622-26 Dollar Bank Bldg., Youngstown
Mulford, J. W.
1818 Carew Tower, Cincinnati
Neth, Robert G.
430-31 Orr-Flesh Bldg., Piqua
Roscoe, Robert S.
630 Osborn Bldg., Cleveland
Ross, Chas. A.
506 Neave Bldg., Cincinnati
Samblanet, H. L.
1900 Market Ave., N. Canton
Seiple, H. C.
208 Kresge Bldg., Warren
Sorensen, L. C.
1014 Second Natl. Bank Bldg., Toledo
Southard, Robert P.
1000 N. Market Ave., Canton
Spinney, A. O.
109 N. Main St., Middletown
Thomas, Robert L.
17 So. High St., Columbus
Ulrich, N. A.
137 E. Main St., Kent
Weaver, Charlotte
259 S. Main St., Akron
Weichel, H. W.
4248 Pearl Rd., Cleveland
Wernicke, Clara
2475 Madison Rd., Cincinnati
Wherrit, P. M.
10609 Euclid Ave., Cleveland
White, Frances L.
1392 Neil Ave., Columbus
Brill, Morris
18 E. 41st St., New York City
Burdett, Fletcher H.
420 Lexington Ave., New York City
Bush, Lucius M.
551 Fifth Ave., New York City
Campbell, L. Reginald
840 Dewey Ave., Rochester
Conklin. Roger H.
1 Maple Ave., Warwick
Fiske, Franklin
350 Madison Ave., New York City
Fleck, Charles E.
760 Park Ave., New York City
Fletcher, Daisy
59 W. 44th St., New York City
Green, Charles S.
52 Vanderbilt Ave.. New York City
Hughes, Angie C.
258 Genesee St., Utica
Hulett. A. S.
Lalli, John J..
37-68 74th St.. Jackson Heights. L. I.
Latimer Omar C.
Continental Ave., Forest Hills, L. I.
Matthews, S. C.
Merkley, W. A.
487 Clinton Ave.. Brooklyn
Morrison, Thomas H.
1303 Main St., Port Jefferson, L. I.
Pike, John R.
90 State St., Albany
Purdy, F. L.
748 Ellicott Square, Buffalo
Riley, George W.
Hotel Roosevelt. New York City
Robertson, Lawrence
60 E. 42nd St. New York City
Rosch, Fanny M.
6 Lyon Place, White Plains
Sinsabaugh, E. D.
36-20 Bowne St., Flushing, L. I.
Smith, Charles K.
239 N. Long Beach Ave., Freeport, L. I.
Strong, Leonard V., Jr.
133 E. 58th St., New York City
Thompson, J. W.
201 Lincoln Bldg., Watertown
Walker, J. Jay
116 Park Ave., Medina
Zea, Paul Howard. Jr.
30 E. 2nd St,, Riverhead
Oklahoma
Card, F. C.
211-212 Atco Bldg., Tulsa
Clark, Ivan L.
403 S. Main St., Kingfisher
Montano, H. L.
411 Simpson Bldg., Ardmore
Pool, w. O.
Box 543, Wynnewood
Rummel, C. D.
Box 635, Bristow
Oregon
Beaumont, Katherine M.
827 Morgan Bldg., Portland
Eaton, Ruth L.
210 Masonic Bldg., Oregon City
Howland. L. 1-T.
1215 Selling Bldg., Portland
Logue, F. D.
U. S. Natl. Bank Bldg., The Dalles
Parker, E. Tracy
827 Corbett Bldg., Portland
North Carolina
Rowlett, Thomas M.
402-03 Cabarrus Bank & Trust Bldg.,
Sharp, F. C.
815 Security Bank Bldg., High Point
Smith, Elizabeth E.
414 Wachovia Bank Bldg., Asheville
Stafford, E. M.
111 Cocrane St., Durham
Ohio
Barker, Mable V.
2010 E. 102nd St.. Cleveland
Cosner, E. H.
965 Reibold Bldg., Dayton
Currence, B. C.
216 S. Washington St., Tiffin
Custis, W. W.
1005 Reibold Bldg., Dayton
Eschliman, John C.
320 Mahoning Bank Bldg.. Youngstown
Flynn, J. I.
402 Alliance Bank Bldg., Alliance
Pennsylvania
Armstrong, W. C.
205 Lincoln Ave., Bellevue Sta,
Pittsburgh
Baur, Marie E.
York Rd., & West Ave., Jenkintown
Bellew, Henry McD.
3343 N. 15th St., Philadelphia
85
Button, Boyd B.
224 Mattison Ave., Ambler
Chase, Jennie M.
109 N. Easton Rd., Glenside
Cole, O. C.
12 E. 3rd St., Lewistown
Davis, H. Edward
339 Market St., Lewisburg
Dorrance, R. Gilbert, Jr.
1301 Benedum Trees Bldg., Pittsburgh
Dunnington, Wesley P.
307-10 Stephen Girard Bldg.
Philadelphia
Evans, Margaret
120 N. Washington St., Scranton
Green, David
1302 W. Wyoming Ave., Philadelphia
Hughes, Roy E.
39 South Sixth St., Indiana
Irvine, S. W.
721 Thirteenth St., Beaver Falls
Krohn, G. W.
214 Pine St., Harrisburg
Lindsay, Joseph
1106 N. 2nd St., Harrisburg
Maxwell, Bertha M.
749 W. 3rd St., Williamsport
McClelland, Howard G.
534 Lincoln Ave., Bellevue
Simmons, H. F.
336 Fourth Ave., Pittsburgh
Soden, C. Haddon
12 So. 12th St., Philadelphia
Thornley, H E.
420 William St., Williamsport
Van Doren, Sara
123 Cathedral Mansions, Oakland Sta.,
Pittsburgh
Vastine, H. M.
109 Locust St., Harrisburg
Yeater, I. F.
1127 7th Ave., Altoona
Yoder, S. E.
239 East King St., Lancaster
Rhode Island
Nordstrom, Ragnar H.
574 Broad St., Providence
South Dakota
Betts, C. S.
Box 205, Huron
Burkholder, F. E.
207 Paulton Bldg., Sioux Falls
Cheney, James H.
207 Paulton Bldg., Sioux Falls
Farran, R. S.
204 Johnson Bldg., Mitchell
Millard, C. W.
P. O. Box 21, Summit
Timmons, C. L.
402-03 Capitol Bldg., Aberdeen
Tennessee
Blair, James S.
212 Broad St., Kingsport
Buffalow, O. T.
915 Volunteer Bldg., Chattanooga
Roberts, H. W.
Box 471, Morristown
Yowell, M. Elizabeth
30 N. Crest Rd., Chattanooga
Texas
Beyer, R. B.
415 Adams Bldg., Port Arthur
Chandler, J. H.
60X Oliver-Eakle Bldg., Amarillo
Dunlap, Emmett E.
San Diego
Hitch, Sam H.
3404 West Sixth St., Fort Worth
Kenney, Helene E.
1301 Lipscomb St., Fort Worth
Logan, Louis H.
436 Wilson Bldg., Dallas
Smith, A. Foster
314 Crescent-Rd., Waco
Strum, Charlotte
209 W. Poplar St., San Antonio
Utah
Nelson, Pearl Udall

687 Second Ave., Salt Lake City
Vermont
Atwood, Dale S.
65 Railroad St., St. Johnsbury
Martin, Lewis D.
Miles Granite Bldg., Barre
Martin. R. L.
24 Elm St., Montpelier
Virginia
Akers,. C. C.
Medical Bldg., Lynchburg
Churchill, A. G.
1014 No. Irving St., Arlington
Dickerman, Charles P.
Professional Bldg., Staunton
McCoy, L. C.
308 Bankers Trust Bldg., Norfolk
Washington
Hoover, H. V.
709 Fidelity Bldg., Tacoma
Pugh, S. M.
3010 Hoyt Ave., Everett
West Virginia
Graham, A. B.
420-22 Wheeling Bank & Trust Bldg.,
Wheeling
Smith, Asa Beadle
Hall Block, Fairmont
Thomas, Robert B.
827 First Huntington Nat. Bank Bldg.,
Huntinaton
Whitright; W. F.
416 Charleston Nat. Bank Bldg.,
Charleston
Wisconsin
Gordon, R. B.
450 Washington Bldg., Madison
OLeary, George P.
Rhyme Bldg., Portage
Rea, Charles W.
Bank of Oconomowoc Bldg.,
Ocononiowoc
Schuster, J. K.
838 First Wisconsin Nat. Bank Bldg.,
Milwaukee
Wyoming
B u f f u m , G . H .
47 N. Main St., Sheridan
Grange, Josephine H.
P. O. Box 1156, Sheridan
Australia
Evans, David J.
Temple Court, 422 Collins St.,
Melbourne
Canada
Heist, Mary L.
144 King St., W., Kitchener, Ont.
McVity, J. R. G.
2904 Yonge St., Toronto, Ont.
86
I N D E X
P A L LIATIVE T RE A T M ENT IN CARD IAC PA IN ......................... 2
G EORGIA A. STEUNENBERG, D. O.
.
SCIENTIFIC MANIPULATION OF THE LOW BACK ................. 4

R. E. MARTINDALE , D. O.
OSTEOPATHIC MANIPULATION AND ITS INTERPRETATION

IN PRENATAL CARE - ROBERT B. B ACHMAN , D. O. ................10
MANIPULATION OF THE UPPER CERVICAL IN INFANTS ............17
F RANK M C C RACKEN, D. O.
SHOULDER TECHNIC -J. S. DENSLOW, D. O. ................................19

GERIATRIC TECHNIC - C. H ADDON S ODEN, D. O. ...........................22
THE HURT PATIENT - W. J. DOHREN, D. O. ...............................24

OSTEOPATHIC TECHNIC FOR INFANTS-MARGARET W. BARNES ...27
LOW BACKS - A. F. MC W ILLIAMS, D. O . .....................................2 8
ANGINA PECTORIS TECHNIC- C ARL K ETTLER, D. O ...............31
CONSIDERATIONS FOR OSTEOPATHYS SURVIVAL AS AN
INDEPENDENT SYSTEM - ASA W ILLARD, D. O. .................34
MANIPULATIVE THERAPEUTICS FOR GALL BLADDER
DISEASE - E. P. M A L O N E, D. O ............................................. 4 4
OSTEOPATHY IN AN EPIDEMIC OF DIPHTHERIA ..................... 46
C. E. STILL, D. O.
SELF SAVING TECHNIQUE - ASA W ILLARD, D .O. ....................... 48

HOW TO BECOME PROFICIENT IN OSTEOPATHY AND HOW
NOT TO BECOME PROFICIENT IN OSTEOPATHY .................. 49
C HARLES C ARTER, D. O.
MANIPULATIVE TREATMENT OF ASTHMA .................................. 64

E ARL J. DRINKALL , D. O.
SCIATICA-A Case History - ORREN E. SMITH, D. O. ...................59

TECHNIC FOR HICCOUGHS - W. C. A RMSTRONG , D. O. ................ 61
TECHNIC FOR HICCOUGH - S. W. IRVINE, D. O. ..............................61
CONNECTIVE TISSUE FROM THE DIAGNOSTICATOR
BULLETIN - Issued by C. H. KAUFFMAN, D. O. .................... 6 2
TIMELY HELP FROM FORMER PUBLICATIONS ........................... 63

WHAT DID YOU GET FROM THE OLD DOCTOR?. ......................... 65
FOURTH ANNUAL MEETING OF THE OSTEOPATHIC MANIPULA-
TIVE THERAPEUTIC AND CLINICAL RESEARCH ASSOCIATION

HOTEL DENNIS, ATLANTIC CITY, N. J. ....................................... 6 6
LETTERS FROM MEMBERS ............................................................. 67

PUTTING NEW EMPHASIS ON MANIPULATIVE THERAPY........ 78
O S T E O PA TH IC MANIPULA T I VE THERAPEUTIC AND CLINICAL
RESEARCH ASSOCIATION - General Objects And Purposes ............. 78
PETITION OF OSTEOPATHIC MANIPULATIVE THERAPEUTIC
AND CLINICAL RESEARCH ASSOCIATION ............................... 80
DIRECTORY OF MEMBERS.................................................................. 81
ASSOCIATION OFFICERS
PERRIN T. WILSON, Chairman
H. L. CHILES, Vice Chairman
THOMAS L. NORTHUP, SECRETARY AND TREASURER
BOARD OF GOVERNORS
CHARLES E. FLECK
H. W. GAMBLE
H. M. VASTINE
ASA WILLARD
RILEY D. MOORE
J. S. DENSLOW
ORREN E. SMITH
GRACE R. McMAINS
JOHN A. MacDONALD
GEORGE W. GOODE
C. HADDON SODEN
PAUL Van B. ALLEN
JAMES A. STINSON
MANIPULATIVE THERAPEUTIC SECTION OFFICERS

CHARLES E. STILL, JR., Chairman
PAUL K. THEOBALD, Vice Chairman
THOMAS L. NORTHUP, Secretary
TECHNIC SECTION OFFICERS

LONNIE L. FACTO, Chairman
MARTIN C. BEILKE, Vice Chairman
WM. W. W. PRITCHARD, Secretary

Book of Year 1941

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VOLUME 4

OSTEOPATHIC MANIPULATIVE THERAPEUTIC

CLINICAL RESEARCH ASSOCIATION

AMERICAN OSTEOPATHIC ASSOCIATION

All Rights Reserved American Academy of Osteopathy

PLEASE TAKE NOTICE

All Rights Reserved American Academy of Osteopathy

OSTEOPATHlC MANIPULATIVE THERAPEUTIC

All Rights Reserved American Academy of Osteopathy

PALLIATIVE TREATMENT IN CARDIAC PAIN

All Rights Reserved American Academy of Osteopathy

All Rights Reserved American Academy of Osteopathy

SCIENTIFIC MANIPULATION OF THE LOW BACK

All Rights Reserved American Academy of Osteopathy

All Rights Reserved American Academy of Osteopathy

to denote a maladjustment of structure or function of localized areas of

All Rights Reserved American Academy of Osteopathy

All Rights Reserved American Academy of Osteopathy

development of scoliosis, lesion diagnosis and treatment becomes less of

All Rights Reserved American Academy of Osteopathy

All Rights Reserved American Academy of Osteopathy

OSTEOPATHIC MANIPULATION AND ITS INTERPRETATION

All Rights Reserved American Academy of Osteopathy

its required task. Pathological conditions of a grave nature or limited

All Rights Reserved American Academy of Osteopathy

is definite in obtaining results. Even the various moods are evidences of

All Rights Reserved American Academy of Osteopathy

Pregnancy function will not be normal, if the lutenizing factor which

All Rights Reserved American Academy of Osteopathy

All Rights Reserved American Academy of Osteopathy

When circulation is sluggish and edema of the extremities develop, the

All Rights Reserved American Academy of Osteopathy

All Rights Reserved American Academy of Osteopathy

MANIPULATION OF THE UPPER CERVICAL IN INFANTS

All Rights Reserved American Academy of Osteopathy

All Rights Reserved American Academy of Osteopathy

The shoulder girdle presents a pecular anatomical arrangement which

All Rights Reserved American Academy of Osteopathy

In addition it is held indirectly by muscle attachment to the clavicle

All Rights Reserved American Academy of Osteopathy

stretching movements which stopped short of pain. There was marked

Because of experiences of this type it is our opinion that while local

All Rights Reserved American Academy of Osteopathy

In treating elderly patients, we must keep in mind the rigidity of the

Mobilization is produced by pressing lateralward and upward with

4th and 5th Metatarsal Motion (Lateral Longitudinal Arch)

Motion is produced by using a IateraI circumduction or lateral plantar

Motion is produced by using a media1 circumduction, or a medial

Motion is produced by using a medial circumduction or medial plantar

Motion is produced by using a lateral circumduction or lateral plantar

All Rights Reserved American Academy of Osteopathy

Separation and motion is produced by maintaining flexion on the

Motion is produced by flexing the leg on the thigh, in order to open

Hip joints, Sacro-iliac, Lumbar and Lower Dorsal Vertebral motion

The patient is in the left (side) latera. recumbent position, thighs

Motion is produced by flexing, elevating and extending the right thigh

The patient is sitting on a chair, both arms and forearms extended.

All Rights Reserved American Academy of Osteopathy

Motion is produced by drawing the right arm forward, while pressing

The patient is sitting on a chair, with both forearms folded at right

Motion is produced by bringing the patient forward into easy flexion

Lateroflexion (Side bending)

The patient is sitting on a chair. The physician standing back of