Manual Therapy Lecture and Demonstration

Presented at the Health Professionals Symposium
Virginia Beach, Virginia
September, 1999

Carl Nelson, DC

[Note: The following excerpts represent the lecture portion of Dr. Nelson’s presentation on manual therapy.  A lengthy demonstration followed.  The full presentation is available from Meridian Institute on video (VHS) and audio tape.]

Hippocrates wrote 2400 years ago. Probably about 10 to 15 percent was on what he called the “articulations.” Good descriptions of manipulating the spine. Good descriptions of setting broken bones and setting dislocations. But also manipulation as well. And at that time, 400 BC, he described this as an ancient art and said, “No physician should be unacquainted with the art of the rub.” This information was largely lost with the fall of the Roman Empire. It was passed from parent to child through the centuries. Beginning to be re-explored in the 18th century by the French, who really ignited the spirit and kept it alive.

These people called themselves “bonesetters,” the ones who passed it from parent to child, and were renowned for their ability to set dislocated bones as well as do work on what came to be known later on as osteopathic lesions or chiropractic subluxations. Or what we sometimes think of as a “pinched nerve.”

This began to be really seriously studied in this country during about the middle of the last century. It was during this time that Dr. Still began to look into it himself, ultimately developed what he defined as the science of osteopathy, meaning disease that’s related to the position of the bones. Still was the master of what we have come to think of as the osteous lesion or the subluxation or the pinched nerve. He had skills in manipulation that far transcended any of his contemporaries. And he had the savvy, from decades of medical practice, to understand that there were certain other applications that could be done to the body other than the replacement of misaligned segments, that would also be of benefit. Certain types of touch, certain pressures, throughout the body here and there that could be used with great efficacy.

One of the recommendations that Still learned early on was that in difficult childbirth, where there was a lot of pain with labor and delivery, that steady pressure on the delivery mother’s pubic hair in an upward direction would stop the pain. It would somehow anesthetize this region and allow birth to proceed as normal.

The osteopaths had an apocryphal story later on that, after his schools had been open for a few years, a gentleman who had been seen hanging around, taking occasional courses at the college, moved to Davenport, Iowa from Kirksville, Missouri, where the school was located, and set up his own variety of what he had learned from Still. That was Daniel David Palmer, the father of chiropractic. If this is the case, then what Palmer took away from the early osteopathic training was a good knowledge of manipulation and the setting of bones. But what he lost, and perhaps never realized was going to become available, was the therapeutic application of specific scientific, deliberate, intentional touch in order to effect changes throughout the body itself. This had been discovered in about 1865 by the great French physiologist Claude Bernard, who in the process of experimenting with animals, severed the nerve of the ear of a rabbit. Separating the neurovascular bundle, he pinched the sympathetic nerve to the blood supply of the ears to see what would happen. He discovered that the ear reddened dramatically and almost immediately. From this, when word of this came across the ocean, the osteopaths took this and realized it was a very exciting discovery at the time that the sympathetic nervous system’s main function was that of motor function as well as contraction of the arterial and capillary supply.

When the osteopaths discovered that they could use this, they called this “inhibition.” Which is kind of a strange, backwards way of describing this, because osteopathic inhibition actually would increase blood supply to an area. The reasoning was that, by Bernard pinching this nerve, and inhibiting the vasoconstrictive fibers of the nervous system to the blood supply of the ear, he inhibited the vasoconstriction. Therefore vasodilation resulted.

This became a major focus of osteopaths later on in the 1890s, and then on through the early years of this century. They described this technique of inhibition. In the readings, Cayce would call this stimulating for relaxation. He didn’t use the term that I’m aware of, osteopathic inhibition. But that’s the meaning of the term that he used.

There was an opposing type of pressure that could be exerted to the body as well, to specific segments or areas. They called this stimulation, which of course would encourage the sympathetic nervous system to be vasoconstrictive in nature. This is what Cayce was talking about when he mentioned what I said yesterday, from reading 849-22, that the osteopath can do three things: he could encourage blood supply, increase blood supply to any given organ, tissue or area; or he could divert same or decrease same; or he could make a structural correction.

This was the great crowning glory of the osteopaths. And I don’t think that anybody really has paid a whole lot of attention to the extreme value of this. Of course it’s been lost as the decades have passed.

Current osteopathic manipulative techniques realize that they used to do something of this nature, but they’re not sure exactly what it was. About the only things that remain are the larger drainage techniques, the lymphatic pump. Which if you’re familiar with I don’t need to demonstrate, and if you’re curious about, I’ll show you. Some of the larger areas of drainage. These people could stimulate blood supply to and from the body, any direction they wanted to. They could affect organ function. And, as time passed, they became interested in what they called, “setting up drainages.” Which would alter the collection of blood in specific organ systems. Draining the gall bladder was something that osteopaths did quite regularly, and something that Cayce recommended.

Setting up drainages was something that Cayce was real big on having accomplished. And drainages could be accomplished two different ways. One, with the osteopathic general treatment, with the overall movement of the body, “putting the body through its paces,” as Cayce said. Or, specific attention to specific organs and areas to encourage the flow of circulation from, and then to, the organ itself. You can drain the spleen, drain the liver, drain the gall bladder, drain the intestines. You can drain the lymphatic system. Or, in certain cases as I’ll talk about, you can set up drainage throughout the entirety of the system.

The last thing that Cayce talked about, which I’m not sure was dealt with that much by the osteopaths at that time, was something called “coordination.” Now coordination was one of the most important factors to be dealt with in the functioning of the nervous system vis a vis the Cayce materials. When there was incoordination in the nervous system, that is to say, when the central nervous system and the sympathetic nervous system were not functioning harmoniously, then this would set up a situation where the sympathetic nervous system could kind of go crazy. And either become hyperactive or hypoactive, leading to a lack of proper, fresh blood flow to and from any given tissue or organ. It was Cayce’s contention that this lack of coordination was a major factor in the development or the sustaining of processes of dis-ease or even disease.

So Cayce’s focus was primarily on the general treatment, which would accomplish a lot of different things in just a very simple and straightforward manner. Then, setting up drainages as necessary. And then finally, achieving some type of recoordination or reconnecting between the central nervous system, or what Cayce called, the “cerebrospinal” system, and the sympathetic nervous system.

He recommended a number of different ways to do this, but, as I say, the general treatment was one that was mentioned most frequently in this. The general treatment, as practiced by most osteopaths, was diagnostic and therapeutic at the same time. The premise was that, if there were structural lesions, osteopathic lesions, or what the chiropractors call subluxations, that is to say, distortions or misalignments in the relation of the vertebral segments to themselves, or, in other joints and in the extremities, then by the process of this general treatment, which was a mobilization of the entirety of the body tissues. A manipulation, mobilization, which was partially massage, but more was almost a passive, yogic type of manipulation of the body. This would allow the osteopath to diagnose the presence of any suspected osteopathic lesions. And, if there were some present, they could be addressed during the period of the general treatment. If they were not present, then the general treatment could be carried on as a very invigorating and ultimately relaxing and beneficial therapeutic activity.