The Concept of Regulation
[NOTE: The following section is borrowed from
Principles & Techniques of Nerve Regeneration by David McMillin
© copyright 1995, all rights reserved, used with permission.]
During Edgar Cayce's lifetime, osteopathic and
neuropathic treatment consisted of two definite approaches to treatment.
The most obvious emphasis was on finding structural problems with the body
and correcting anatomical abnormalities (lesions). On the other hand,
manual therapy was also used to regulate the physiological processes of
the body (e.g., coordination and drainages). Regulating treatments
focused on re-establishing equilibrium and balance among the various systems
and processes of the body. Thus, the two aspects of treatment were
(1) correction of structure (anatomy) and (2) regulation of function (physiology).
In practice, these two aspects were often addressed
by the same treatment. For example, correction of a spinal subluxation
would naturally remove a source of incoordination and assist the body in
re-establishing equilibrium and coordination. Here are a couple of
quotes from Cayce's era which acknowledges the two basic approaches to
manual therapy as exemplified by traditional osteopathy. Note Hazzard's
reference to "centers along the spine," a key concept for understanding
regulation as the basis for coordination and drainages:
"In our treatment of a spine there are two points
which we may take into consideration; two objects which we may have in
view. In the first place, we may wish to TREAT THE SPINE ITSELF [anatomical
correction]. In the second place, we may wish to REACH, BY
TREATING THE CENTERS ALONG THE SPINE, THE VISCERA TO WHICH THESE NERVES
RUN [physiological regulation]. It is not always possible to disassociate
these in your practice. I have divided these points thus simply for
convenience in the consideration of them." (Hazzard, 1899, p. 32)
"Osteopathic manipulation is applied for two
broad purposes; first, for the correction of spinal and other articular
lesions, and second, for its ability to effect alterations in tissue pathology....
In actual application, no clear distinctions can be made between measures
applied solely to correct lesions and those used for reestablishing physiological
balance [regulation/coordination] through other means, for it is probably
that many of the manipulative procedures used accomplish both objectives
at the same time." (Long, 1938, p. 440)
Although much has been lost in the clinical knowledge
of the regulatory type of osteopathic treatment, there are still a few
practitioners who are familiar with this lost art of osteopathy:
"The majority of DOs [doctors of osteopathy]
do not use manipulation. Many of those physicians who do so, use
it primarily for treating musculoskeletal complaints. They do not
use manipulation for its homeostatic benefits [regulation] to the body's
physiology." (Kuchera, 1991, p. 117)
The neuropathic profession also emphasized the
importance of physiological regulation as well as specific anatomical adjustment.
Here is a brief example from the writings of A. P. Davis, M.D., D.O., the
self-professed founder of neuropathy:
"Starting at the base of the brain, at the atlas,
we regulate all the nervous system involved by our particular treatment
in the adjustment of the atlas.... Our adjustment affects the pneumogastric
nervous system [parasympathetic], the phrenic nervous system, the circulation
of blood, and regulates the heart's action ... The upper portion of the
cervical region we denominate the vasomotor area; hence our adjustments
in that region regulate the circulation of the blood, not only the arterial,
but the circulation of all the fluids in the body as well.... Still
further down, from the first to the fourth dorsal, we have influences,
through the nervous system in that area, over the pyloric end of the stomach
and lungs; and from the fourth to the twelfth dorsal influences are carried
to the pneumogastric nervous system [parasympathetic] in the abdominal
viscera, and neutralizing excess of acid or alkaline secretion by the union
of the footlets of the two systems of nerves in that area.... Still lower
down in the lumbar area, including all the dorsal nerves in the lumbar
region, by our treatment called adjustment, we regulate the action of all
the region or regions to the treatment in the middle and lower area of
the lumbar nerve-area.... All conditions of irritability, excessive nervousness,
may be avoided by first regulating the circulation of the blood in the
vasomotor area and at the fourth and eighth dorsal, for the reason that
the first regulates the circulation of the fluids and lessens irritation,
and the second unites the forces and equalizes the secretion, resulting
in a normal or natural condition." (Davis, 1909, pp. 58-62)
This brief excerpt from the neuropathic literature
contains six specific references to physiological regulation as the focus
of treatment. Like the osteopaths, neuropaths also assessed and corrected
abnormalities in the structural components of the system by specific adjustment.
Edgar Cayce often recommended both types of treatment
(structural correction and functional regulation) in his readings.
Typically he spoke of "specific adjustments" and "coordinating treatments."
For example, he would frequently suggest that the clinician make the specific
correction of a spinal lesion and then go on to assist the body in establishing
coordination. Here are some excerpts from the Cayce readings illustrating
these concepts. As with the previous quote from Hazzard, note the
frequent references to "centers."
"While the adjustments have in a measure been
at times helpful, these have not been - as we find - as correctly given
as some that have been had heretofore. To make simply an adjustment
and not coordinate same with the sympathetic centers along the spine at
times makes for a strain and a lack of coordination, see? In making
these adjustments, then, we would make an adjustment in the upper cervical
- as in the 1st, 2nd, 3rd and 4th cervical; and then massage, by rotary
movements, the nerves and centers and the muscular tendons that react from
same in the head, the jaw, side of the face and the like, see? especially
the vagus nerves and the 5th and 6th nerves that come to portions of the
head ... Also, as indicated, it is necessary to make some adjustments or
rather movements in the lower dorsal and throughout the lumbar area.
These we would coordinate with the muscles and nerve ends about the coccyx
end, or along the lower spinal end, see? close to the orifices that
make their connections with the cerebro[spinal] and the sympathetic nervous
systems in the brush end of the spine." (567-7)
"First, then, we would apply corrections in the
lumbar and the cervical areas as specific. A coordination of the
centers along the cerebrospinal system, between the sympathetic and the
cerebrospinal system. As indicated, in the 4th lumbar area - coordinated,
of course with the 2nd and 3rd. The upper dorsal area or through
the brachial plexus area. The more specific in the hypogastric and
pneumogastric plexus in the upper cervical areas. These made to coordinate;
not so much by adjustments, but by using the structural portions as the
leverage for not irritating but relaxing the ganglia that make for coordinations
in these conditions." (657-1)
"Q. Have the corrections been made properly
in the 6th, 7th, 8th and 9th dorsals?
A. These have been corrected in a much
better manner than was indicated when we had the body here before, - but
those conditions existing in the 11th and 12th dorsal and the first of
the lumbars need to be corrected, so there is perfect alignment....
Q. Should the osteopath treat only those
areas, or give a general treatment?
A. Those areas would be specifically treated,
but coordinating all of the reflexes from same. For, the one who
gives the osteopathic treatments, if thoroughly acquainted with his business
(though many think they are when they are not!), will find that there are
centers or areas from which both the cerebrospinal and the sympathetic
or vegetative nerve system form conjunctions. If specific treatments
are given and there is not a coordination of those plexus or areas where
the specific conjunctions are made, these may tend to contract the body
rather than relax same. Hence there should be the consideration of
all of these when treatments are given." (2094-2)
References
Davis, A. P. (1909). Neuropathy:
The New Science of Drugless Healing Amply Illustrated and Explained.
Cincinnati, Ohio: F. L. Rowe, Publisher.
Hazzard, C. (1899). Principles
of Osteopathy (Third Edition). Kirksville, Missouri: Charles Hazzard.
Kuchera, W. A. (1991). Our osteopathic
uniqueness needs nurturing. (Letter to the editor). Journal of
the American Osteopathic Association, 91(2), 117-121.
Long, F. A. (1938). The Fundamental
and Applied Principles of Osteopathy. Philadelphia, PA: Frederick
A. Long.
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