OPERATING FOR APPENDICITIS.

Therefore it is resolved, that as nothing positive is known of the trouble in the location above described, it is guessed that it is a disease of the vermiform appendix. Therefore they etherize and dissect down for the purpose of exploring, to ascertain if the guess is right or wrong. In the diagnosis this is a well-defined case of appendicitis; the surgeon's knife is driven through the quivering flesh in great eagerness in search of the vermiform appendix. The bowels are rolled over and around in search of the appendix. Sometimes some substances are found in it; but often to the chargrin of the exploring physician, it is found to be in a perfectly healthy and natural condition, and so seldom is it found impact with seeds or any substance whatever, that as a general rule it is a useless and dangerous experiment. The per cent of deaths caused by the knife and ether, and the permanently crippled, will justify the assertion that it would be far better for the human race if they lived and died in ignorance of appendicitis. A few genuine cases might die from that cause; but if the knife were the only known remedy, it were better that one should occasionally die than to continue this system, at least until the world recognizes a relief which is absolutely safe, without the loss of a drop of blood, that has for its foundation and philosophy a fact based upon the longitudinal contractile ability of the appendix itself, which is able to eject by its natural forces any substances that may by an unnatural move be forced into the appendix.[8]

[Footnote 8: My first Osteopathic treatment for appendicitis was in 1877, at which time I operated on a Mr. Surratt and gave permanent relief. During the early eighties I treated and permanently cured Mrs Emily Pickler of Kirksville, mother of our representative, S. M. Pickler, and mother of ex-congressman John A. Pickler of South Dakota. The infirmary has had bad cases of appendicitis probably running up into hundreds without failing to relieve and cure a single case. The ability of the appendix to receive and discharge foreign substances is taught in the American School of Osteopathy and is successfully practiced by its diplomates. In the case of Mr. Surratt I found lateral twist of lumbar bones; I adjusted spine, lifted bowels, and he got well. When I was called to Mrs. Pickler she had been put on light diet, by the surgeon, preparatory to the knife. She soon recovered under my treatment without any surgical operation and is alive and well to this date.]

EXPELLING POWER OF THE VERMIFORM APPENDIX.

To a philosopher such questions as this must arise: Has the appendix at its entrance a sphincter muscle similar in action to that of the rectum and oesophagus? Has it the power to contract and dilate?—contract and shorten in its length and eject all substances when the nerves are in a normal condition? And where is the nerve that failed to execute the expulsion of any substance that may enter the cavity of the appendix? Has God been so forgetful as to leave the appendix in such condition as to receive foreign bodies without preparing it by contraction or otherwise to throw out such substances? If He has He surely forgot part of His work. So reason has concluded for me, and on that line I have proceeded to operate for twenty-five years without pain or misery to the patient, and given permanent relief in all cases that have come to me. With the former diagnosis of doctors and surgeons that appendicitis was the malady, and the choice of relief was the knife or death, or possibly both, many such cases have come for Osteopathic treatment, and examination has revealed that in every case there has been previous injury to some set of spinal nerves, caused by jars, strains or falls. Every case of appendicitis, gall or renal stones can be traced to some such cause. These principles I have proclaimed and thought for twenty-five years.

CARE EXERCISED IN MAKING ASSERTIONS.

We should use much caution in our assertions that nature had made its work so complete in animal forms and furnished them with such wisely prepared principles that they could produce and administer remedies to suit, and not leave the body to find them. Should we so conclude and find by experiment that man is so arranged, and wisely furnished by deity as to ferret out disease, purify and keep the temple of life in ease and health; we must use great care when we assert such is not undeniably true up to the present. The opposite opinion has had full sway for twenty centuries at least, and man has by habit, long usage, and ignorance so adjusted his mind to submit to customs of the great past that should he try, without previous training, to reason and bring his mind to such altitude of thought of the greatness and wisdom of the infinite, he might become insane or fall back in a stupor, and exist only as a living mental blank in the great ocean of life, where beings dwell without minds to govern their actions. It would be a great calamity to have all the untrained minds shocked so seriously as to cause them to lose the mite of reason they now have, and be sent back once more to dwell in Darwin's protoplasm. I tell you there is danger, and we must be careful and show the people small stars, and but one at a time, till they can begin to reason and realize that God has done all that the wisest can attribute to Him.

REASONING TESTS.

There is but one method of reasoning. That method is by the laws governing the subject to be reasoned upon.

Reasoning is the action of the mind while hunting for truths.

THE ABDOMEN.

As we are about to camp close to the abdomen for a season of explorations and a more reasonable knowledge of its organs and their functions, we will search its geography first, and find its location on the body or globe of life. We find a boundary line established by the general surveyor, about the middle of the body, called the diaphragm. This line has a very strong wall or striated muscle that can and does dilate and contract to suit for breathing, and quantities of food that may be stored for a time in stomach and bowels for use. The abdomen is much longer than wide. In short, it is a house or shop builded for manufacturing purposes. In it we find the machinery that produces rough blood or chyle, and sends it to heart and lungs to be finished to perfect living blood, to supply and sustain all the organs of this division. This diaphragm or wall has several openings through which blood and nutriment pass to and from abdomen to heart, lungs and brain. I want to draw your special attention to the fact that this diaphragm must be truly normal. It must be anchored and held in its true position without any variation, and in order that you shall fully understand what I mean, I will ask you to go with me mentally to all the ribs, beginning with the sternum, see attachments, follow across with a downward course to the attachments of this great muscular septum to the lower lumbar region, where the right crus receives a branch or strong muscle from the left side, and the left crus receives a muscle from the right which becomes one common muscle known as the left crus, the same of the right crus receiving a muscle or tendon from the left, which you will easily comprehend from examining descriptive cuts in Gray, Morris, Gerrish, or any well illustrated work of anatomy. You see at once a chance for constriction of the aorta by the muscles under which it passes, causing without doubt much of the disease known as palpitation of the heart, which is only a bouncing back of the blood that has been stopped at the crura. Farther away from the spine near the center of the diaphragm we find the return opening through this wall, provided to accommodate the vena cava. To the left a few inches below the vena cava we find another opening provided for the oesophagus and its nerves; like the aorta, it has two muscles of the diaphragm crossing directly between oesophagus and the aorta, in such shape as to be able to produce powerful prohibitory constriction to normal swallowing.

A LIST OF UNEXPLAINED DISEASES.

At this point I will draw your attention to what I consider is the cause of a whole list of hitherto unexplained diseases, which I think are only effects, caused by the blood and other fluids being prohibited from doing normal service by constrictions at the various openings of the diaphragm. Thus prohibition of free action of the thoracic duct would produce congestion of receptaculum chyli, because of not being able to discharge its contents as fast as received. Is it not reasonable to suppose a ligation of the thoracic duct at the diaphragm would retain this chyle until it would be diseased by age and fermentation, and be thrown off into the substances of other organs of the abdomen and set up new growths, such as enlargement of the uterus, ovaries, kidneys, liver, spleen, pancreas, omentum, lymphatics, cellular membranes, and all that is known as flesh and blood below the diaphragm? Have you not reason to explore and demand a deeper and more thorough anatomical knowledge of the diaphragm and its power to produce disease while in an abnormal condition, which can be caused by irritations, wounds or hurts, from the base of the brain to the coccyx? Remember this is an anatomical and philosophical question that will demand your attention to the mechanical formation, physiological action and the unobstructed privileges of fluids when prepared in the laboratory of nature, to be sent at once to their ordained destination, before such substances are diseased or dead with age. You must remember that you have been well drilled, or talked out of patience in the room of symptomatology and all you have learned is, something ails the kidneys, and are told their contents when analyzed are not normally pure urine. In urinalisis you are told "here is sugar," "here is fat," "here is iron," "here is pus," "here is albumen," and this is diabetis, this is Bright's disease, but no suggestion is handed to the student's mind to make him know that these numerous variations from normal urine are simply effects, and the diaphragm has caused all the trouble, by first being irritated from hurts, by ribs falling, spinal strains, wounds and on from the coccyx to the base of the brain. Symptomatology is very wide and wise in putting this and that together and giving it names, but fails to give the cause of all these abdominal lesions. Never for once has it said or intimated that the diaphragm is prolapsed by misplaced ribs to which it is attached, or that it is diseased by hurts of spine and nerves above its own location. Allow yourself to think of the universality of the distribution of the superior cervical ganglion and other nerves which are of such great importance that I will by permission insert in the last chapter of this book a description of that great system of the sympathetic nerves by Dr. Wm. Smith, whose superior knowledge of anatomy makes him eminently qualified to describe the location and uses of this great sympathetic system of the nerves of life.

CONCLUDING REMARKS.

As you read his able essay remember there are four other sets of nerves equal to, and just as important in their divisions of life, which are the motor, nutrient, voluntary and involuntary. All of which you as an engineer must know, and by proper adjustment of the body give them unlimited power to perform their separate and united parts in sustaining life and health. Now as I have tried to place into your hands a compass, flag and chain that will lead you from effect to cause of disease in any part or organ of the whole abdomen I hope that many mysteries which have hung over your mental horizon will pass away, and give you abiding truths, placed upon the everlasting rock of cause and effect. You have as little use for old symptomatology as an Irishman has for a cork when the bottle is empty. Osteopathy is knowledge, or it is nothing.



CHAPTER XVII.

OBSTETRICS.

Overloading—Similarity of Stomach and Womb—Births—Preparation for Delivery—Caution—Lasceration Need Not Occur—Care of Cord—Severing Cord—Putting on Belly Band—Delivery of Afterbirth—Preparing for Mother's Comfort—Post-Delivery Hemorrhage—Treatment for—Food for Mother—Treatment for Sore Breast.

OVERLOADING.

When in the course of human events and actions of life, a woman disregards the laws of nature to such an extent as to overload the stomach beyond its powers and limits; or another way to present the thought, we will say, if you fill the stomach so full as to occupy all space, or so much of the space as to cripple the laws of digestion and retain the food, the decomposition sets up an irritation of the nerves of mucous membrane to such a degree as to cause sickness and vomiting, or any other method of disgorging the stomach, which is the natural process to unload an overloaded vessel. When the nerves cannot take up nutrition, they will then take up destruction and other elements which are detrimental to the process of nutrition, and there is no other process for relief but to unload. The loading that has been deposited in the stomach was for the purpose of sustaining a being. The stomach itself is a sack. When filled to its greatest capacity, it irritates all the surroundings, and in return they irritate the stomach. Thus it unloads naturally for relief. Now we wish to treat of another vessel similar in size, similar in all its actions, which receives nourishment for a being, which nourishment is contained in the blood, and conveyed from the channels commonly known as uterine arteries. To all intents and purposes this nourishment is taken there to sustain animal life, after having constructed the machinery then it appropriates the blood to the growth and existence of a human being. One is the womb, the other the stomach. The placenta in the womb is provided with all the machinery necessary to the preparation of blood, such as is used for all purposes in forming and developing a child. Which is the stomach? Which is the womb? and what is the difference? Both receive and distribute nourishment to sustain animal life. Both get sick, both vomit when irritated and discharge their loading by the natural law of "throw up" and "throw down." Now note the difference and govern yourselves accordingly. One is mid-wifery, or treatment of the lower stomach during gestation and delivery. The other is the upper stomach that takes coarser material and refines the unrefined substances, keeps the outer man in form and being; the other contains the inner man or child, and by the law of ejection, when it becomes an irritant, it is thrown out by the nerves that govern the muscles of ejection.

BIRTHS.

To illustrate: I will say, just as long as digestion and assimilation keep in harmony and the mother generates good blood in abundance, the child grows, and by nature the womb is willing to let the work of building the body of the child go on indefinitely; but nature has placed all the functions of animal life under laws that are absolute and must be obeyed. We by reason are asked to note the similarity of the stomach and the womb, as both receive and pass nutriment to a body for assimilation and growth. When a stomach gets overloaded, sickness begins, as digestion and assimilation has stopped, then the decaying matter is taken up by the terminal nerves, and conveyed to the solar plexus, and causes the nerves of ejection, to throw the dying matter out of the stomach which is above. Try your reason and see the stomach below sicken and unload its burden. Is this sickness natural and wisely caused? If this is not the philosophy of mid-wifery what is? As soon as a being takes possession of its room, the commissary of supplies begins to furnish rations for that being, who has to build for itself a dwelling place. The house must be built strictly to the letter of the specifiction. Much bone and flesh must be put into the house of life, and some of all elements known to the chemist, must be used and wisely blended to give strength; also all material to be used in the house must be exact in form and given strength equal to all forces, that may be necessary to execute the hard and continued labors of the machinery that may be used in all transactions and motions of mind and body. Now we must go to the manufacturing chief, and have him through the quartermaster deliver and keep a full supply of all kinds of material for the work, and when the engine is done, put it on an inclined plane and cut the stay-chains and let it run out of the shop. Be careful and not let the engine deface nor tear the door as it comes out. A question is asked: On what road does the quarter-master send the supplies? As there is but one system over which an engine can bring supplies, we will call that road the uterine system of arteries. The mechanic reports that he will open the door of this great shop of manufacturing, and let it roll out the engine by the power and methods prepared to run out finished work. First you see a door open because the lock is taken off by a key that opens all mysteries; and the great ropes that have been far inferior to the force of resistance, that has held the door shut, are all sufficient in power. By getting sick, muscles become convulsed to rigidity of great strength with force enough to push the new engine of life out into open space easily, by nature's team that never fails to obey orders to deliver all goods intrusted to its care.

PREPARATION FOR DELIVERY.

A student of mid-wifery can only learn a few general principles, before he gets into the field of experience. Actual contact with labor teaches him that much that he has read and had told to him by professors of mid-wifery in the lectures, is of but little use to him at the bedside. What he needs to know is, what he will have to do after he gets there. He must know the form and size of the bones of a woman, how large a hole the three bones of the pelvis make, for the reason that the child's head will soon come through that hole. He must know a normal head cannot come through a pelvis that has been crushed in so much as to bring the pubis within one and one-half to two and one-half inches of the sacrum. He must examine and know, and do this soon after he is called, for the reason, that he will have to use instruments in such deformities, and may wish the counsel of an older and more experienced doctor. And this precaution will give him time to be ready for any emergency.

But more than ninety per cent of all cases are of a very simple nature. The mother is warned by pains in back and womb, coming and repeating at intervals of one-half hour to less time. When by the finger the doctor can tell the mouth of the womb has opened to the size of a quarter or half dollar, he then may know that labor will soon start in good earnest, and at this time it is well to call for a twine, cut two strings about a foot long, to tie around the navel cord.

CAUTION.

The first duty of the obstetrician is to carefully examine the bones of the pelvis and spine of the mother, to ascertain if they are normal in shape and position. If there is any doubt about the spine and pelvis being in good condition for the passage of the head, through the bones, and you find pelvic deformity enough to prohibit the passage of the head, notify the parties of the danger in the case at once, and that you do not wish to take the responsibility alone, as it may require instruments to deliver the child, as there is danger of death to the child and mother also, but less danger to the mother than to the child. Now you have done that which is a safeguard against all trouble following criminal ignorance.

I will give you a condensed rule of procedure in all normal cases of obstetrics. With index finger, examine os uteri; if closed and only backache, have patient turn on right side, and press hand on abdomen above pelvis, and gently press or lift belly up just enough to allow blood to pass down and up pelvis and limbs. Relax all nerves of the pelvis at pubes.

SECOND EXAMINATION.

Caution: Wait a few hours; examine os again. If still closed and no periodical pains are present, you are safe to leave case in the hands of the nurse, instructed to send for you if regular pains return at intervals. On your return, explore os again, if found to open as large as a dime, you are by this notified that labor has begun its work of delivery. You now place patient on her back, propped to an easy angle of near thirty degrees, with rubber blanket in place. After you find os, dilated to nearly the size of a dollar, then relax nerves at pubes. Soon you will find in mouth of womb an egg-shaped pouch of water, which you must not press with fingers till very late in labor, for fear of stopping labor for perhaps many hours. Remember the head can and does turn in pelvis to suit the easiest passage through the bones, while in the fluids of the amniotic sack. Now, as you know why not to rupture sack and spill fluids, you are prepared to proceed to other duties, which are to prevent rupture of perineum. Place the left hand on the belly, about two inches above symphesis and push the soft parts down with the left hand; support the perineum with the right hand until head passes over. This is necessary to prevent rupture of perineum.

LASCERATION NEED NOT OCCUR.

If you follow this law of nature, lasceration may occur in one out of a thousand cases, and you will be to blame for that one, and may be censured for criminal ignorance. Now you have conducted head safely through pelvis and vagina to the world. You will find pains stop right short off for about a minute, which is the time to learn whether the navel cord is wrapped around the child's neck.

CARE OF CORD.

If it is found all around the neck once or more, you must slip finger down neck and loosen cord to let blood pass through the cord till next pain comes, in order to ward off asphyxia of child.

When pain comes, gently pull child's head down toward the bed. There is no danger of hurting the perineum now since the head has passed the soft parts. At this time the danger is suffocation of child. Never draw child too far away from mother's birth place by force, as you may tear navel string from the child and cause it to bleed to death. If you value the life of the child, then you must be careful not to place the navel end of the string in any danger of being torn off. Now you have made a good job for both mother and child so far. The child is in the world; and you want to show the mother a living baby for her labor and suffering of the past nine months. The baby is born and the mother is not torn, but the baby has not yet cried. Turn it on its side, face down, run your finger in its mouth and draw out all fluids, thick or thin, to let the breath pass to the lungs. Then blow cold breath on its face and breast to cause its lungs to act.

SEVERING CORD.

Baby cries, all is safe now. Baby is born safely and cries nicely, but still has cord fastened to afterbirth. It has no further use for cord, as life does not depend upon blood from the afterbirth any longer. Take the cord about three inches from the child's belly, between thumb and finger, and strip towards child to push bowels out of the cord if there should be any in it, as a safeguard for bowels, then tie a strong string around cord, first three inches from child's belly, second, four inches; take the cord in your hand and look what you are doing. If baby's hand should fall back to cord, you might cut off one or two fingers, or wound the hand or arm very seriously. Cut cord between the two ties just made on navel string. Look out for your scissors; pass the child over to the nurse to be washed and dressed, while you deliver the afterbirth from pelvis or womb.

PUTTING ON BELLY BAND.

When the child's shirt is on, cut a hole the size of your thumb in a doubled piece of cloth, five inches long by four wide, put the hole two inches from one end, and run the cord through the hole. Lay the cloth across the child's belly, then fold the cloth lengthwise over the cord, which must lie across the child so it will not stretch cord by handling or straightening child out. Now you are ready to finish the delivery of the afterbirth. You have a plug of soft and tender flesh to get out of the womb and vagina.

DELIVERY OF AFTERBIRTH.

As the afterbirth has been grown tight to the womb during all the days of mother's pregnancy, and furnished all the blood to build and keep the child alive in the womb for nine months, it has done all it can do for the child, and is now ready to leave the womb.

You are there to assist it to get out of the place it has occupied so long. You must begin first to rotate or roll the placenta first one way and then another, up, down and across the vagina, by gently pulling the cord. Look out or you will pull the cord loose from the placenta; then you will have made your first blunder,—no cord to pull placenta with, and the mother bleeding and faint from loss of blood. Now is the time and place to save life. Pass your hand forward into the soft parts to get your fingers behind the placenta; now give a rolling pull and bring it out with the hand. You will find it an easy matter to get your hand into the vagina and womb after the birth of the child. Get all the placenta out, then take a wad of cloth or rags as large as the child's head, and press it under the cross bone of the pelvis; push the cloth under and up, so as to completely plug the pelvis. Now pull the hair gently over the symphesis, which will cause the womb to contract by irritation.

PREPARING FOR MOTHER'S COMFORT.

All is now done but to provide for the mother's comfort, which is your next duty. Draw her chemise down her back and legs until it is straight, then with safety pins, pin the chemise on inner side of thighs so that the chemise will go around both thighs separately. Now you have the shirt fast to keep it from sliding upwards, and you are ready to make a band of the chemise to support the womb and abdomen. Bring the chemise tightly together for two or three inches above the pelvis to form a band. Previous to pinning, draw the lump (womb) you feel above symphesis, up, then pin, and the belt you have made of the chemise will support the womb. All is safe now, but you must not leave for two hours. You may have delivered a feeble woman, who may flood to death after delivery of the child, if you do not leave her safe. I have in mind one case who flooded all of two quarts at a single dash. The first symptom was a pain in the head.

POST-DELIVERY HEMORRHAGE.

I know of only two causes that would produce hemorrhage or bleeding after the child is delivered. One is when the afterbirth (placenta), is separated from its attachment to the womb and still retained in the womb or vagina, or when a part is separated and still lies in the womb, that retention of placenta prevents the natural circular contraction of the womb, to close on itself and retain it, with force enough to prevent the further discharge of blood, would give a chance for a continued stream. Then should the patient bleed profusely after the placenta has been removed, another cause would be in pulling away the afterbirth, as part of the upper portion of the womb may be pulled to an inverted position, which would be like a hat if you press the top down with the hand. Then there is a chance for leakage because of this unnatural fold made in the womb.

TREATMENT FOR.

My method of relief is to insert the hand, and with back of fingers smooth out all folds. Before you draw the right hand from the womb place left hand on abdomen, catch the womb between the thumb and finger and withdraw hand. With the left hand pull the hair above symphesis or scratch the flesh just above across the region of the symphesis, just enough to make an irritation. After the hand is out of vagina pass a small bundle of cloths as far under the symphesis as would be necessary to hold everything up, then fasten chemise; beginning at symphesis draw it tight for about two inches above symphesis and with strong pins fasten it. Be sure you keep garment tight by pulling down between limbs. The coarser the chemise the better, as you want to make a strong bandage at that point so as not to push the womb down into the pelvis. If the patient's general health is fairly good let her tell you what she wants to eat, and go and get it. Let her diet be after her usual custom. You must remember she has just left the condition of a full abdomen. Lace her up, fill her up and make her comfortable for six hours; then change her bedding.

FOOD FOR MOTHER.

Remember this, if you stop digestion on her for some hours with teas, soups and shadows to eat, you carry her to the condition where it would be dangerous to give her a hearty meal. My experience and custom for forty years has been crowned with good success. I never lost a case in confinement. I have universally told the cook to give her plenty to eat.

TREATMENT FOR SORE BREAST.

If she begins to have fever followed by chilly sensations, with swelling of one or both breasts, I relieve that by laying her arm ranging with her body. Let some one hold the arm down to the bed, then I place both of my hands under the arm, pull it up with considerable force till I get it as high or higher than normal position of the shoulder. Then pull her shoulder straight out from the body a fairly good pull, then pull the arm up on a straight line with the face, and be sure that you have let loose the axillary and mammary veins, nerve and artery, which have been cramped by pulling the arm down during delivery. No breast should become caked in the hands of an Osteopath. Do not bother about the bowels for two or three days. It may be necessary to use the catheter if the water should fail to pass off after inhibiting the pubic system. This is straight mid-wifery and will guide you through at least in ninety per cent of the cases you will meet in normally formed women.

Right here I wish to say one word: I think it is very wrong to teach, talk and spend so much time with pictures, cuts, talks and lectures, and hold up constantly to the view of the student, births coming from the worst imaginable deformities and call that a knowledge of mid-wifery. It is normal mid-wifery you want to know and be well-skilled in. The abnormal formations are few and far between, and when a case of that kind does appear, it is your knowledge of the normal that guides you through the variations. You will very likely never find two abnormals presenting the same form of bone. As this is intended to only present to the student natural delivery I will let the subject drop with one word about the sore tongue of the mother. Adjust her neck, relieve constrictor and all other muscles that would impede any blood vessel that should drain the mouth and tongue. Remember this, that a horse that is always hunting bugars never finds a smooth road.



CHAPTER XVIII.

CONVULSIONS.

Old Phrases—Results of Stoppage of Fluids—Old Theory of Fits—What the Real Cause may be—Listen for the Cause—What is a Fit—Sensory System Demanding Nourishment—The Causes—The Remedy—Dislocation of Atlas and of Four Upper Ribs.

OLD PHRASES.

As old phrases that have long been in use as names for the various diseases have almost grown to the degree of disgust, I laid them aside and have been trying and have succeeded in unfolding natural laws to a better understanding, which do and should be our guide and action in treating all diseases that mar the peace and happiness of the human race by misery and death. By such old systems with their foolish and unreliable suggestions, of how to guide the doctor in treating diseases which have proven unworthy of respect, if merit is to be our rule of the weights and measures of intelligence. I have become so disgusted with such verbiage with the sense that follows the pens that have written treatise on disease, that I have concluded to do like Adam of old, give names that may appear novel to the reader when I wish to draw the attention of the student who is trying to obtain a knowledge of the mysteries hitherto unsolved and unexplained. We have panned and washed by their suggestions and have obtained no gold. There are two very large and powerful rivers passing their fluids in opposite directions over a territory that I will call the Klondike of life. This territory is bounded on the east by a great wall, which according to the old books has been called the diaphragm, through which comes forth a great river of life that spreads all over the plains of the anterior lumbar region. On that plain we find a great system of perfect irrigation of cities, villages, and fertile soils of life.

RESULT OF STOPPAGE OF FLUIDS.

This region of country covers one of the greatest and most fertile fields of life producing elements, and places them on the thoroughfares, and sends them back over the great central railroad, the thoracic duct, from lymphatics of the whole abdomen, to the heart and lungs to be converted into a higher order of living matter. When finished it is called blood, to sustain its own machinery, and all other machines of the body, giving rise to the mental question: "What would be the effect produced to life and health, if we should cut off, dam up or suspend the flowing of the aorta as it descends close by the vena cava and thoracic duct as they return with contents through the diaphragm on their journey to the heart and lungs for manufacture and finish. And after having supplied the plain, what would be the effect if the vena cava and its system of drainage, and the thoracic duct should be dammed up so that chyle and blood could not be carried to the heart and lungs for renewal, purification, and finish. How much thought would be required to see that by stopping the arterial flow or that of the vena cava an irritating and famishing condition would ensue, with congested veins, lymphatics and all organs of the abdomen, to that condition called fermentation, congestion and inflammation, which in time is thrown off by sloughing away the substances of the lymphatics of the whole abdominal system of glands that belong to a liver, a kidney, the uterus and the bowels, to the condition that has long since been a mystery, and called typhoid fever, dysentery, bilious fever, periodical spasms, and on through the whole list of general and special diseases of winter and summer. I would advise the practicing Osteopath to do some very careful panning up and down the rivers of this Klondike, for if you fail to find gold, and much of it, you had better spend the remainder of your life where reason dwelleth not. Ever remembering that ignorance of the geography and customs of this country is the wet powder of success."

OLD THEORY OF FITS.

We often see a woman or man afflicted with fits or falling sickness which the doctor has failed to cure. What is a fit? For want of a better knowledge we have an established theory that "hysteria" is purely her imagination and as we must respect old theories, we will call it a fit of meanness. This is what we have had for breakfast, dinner and supper and we are asked to respect such trash because of the "established theories."

We are instructed by the universal "all" of the graduates of various medical schools to call her a criminal and proceed to punish her with a wet towel, well twisted, and administered freely—more comprehensively expressed by the term "spanker" and "spank her" very much—late from Scotland with all Europe, and schools in America, except the American School of Osteopathy, which recommends to "wallop" and "wallop" very freely the empty headed schools and theories that have no more sense than to torture a sick person and do so to disguise their ignorance of the cause of her disease, which is shown by the spasmodic effect that has been named by a little book of guess work, generally called and universally known as symptomatology.

WHAT THE REAL CAUSE MAY BE.

Not a single author has hinted or in any way intimated that the cause of her disease is a failure of the passing of the blood, chyle and other substances to and from the abdomen to nourish and renovate the abdominal viscera caused by a prolapsed diaphragm, which would cause resistance to the passing of the aorta, through which passes the arterial blood through the crura, and the vena cava that returns the venous blood, and through which crura the chyle is conducted from the receptaculum chyli before decomposition by fermentation sets up.

LISTEN FOR THE CAUSE.

The afflicted is intoxicated. Here is where she gets a poisonous alcohol and will never be relieved permanently until the "wet towel" of reason has slapped on both sides of the attending physician's head, so he can hear the squeezing and rattling of regurgitation, and straining and creaking of the fluids in their effort to pass through that great and strong towel called the diaphragm. Until he learns this I would apply the wet towel of reason to the doctor, for fear he becomes lukewarm in his studies and gives his patient a hypodermic injection of morphine, which is the advice as given at the last council of medical men who practice "old established" theories rather than be honest enough to say: "The woman is sick and I know it, but I do not know the cause of her trouble."

WHAT IS A FIT?

What is a fit? If God's judgment is to be respected a fit is the life-saving step and move, perfectly natural, perfectly reasonable, and should be so respected and received as divinely wise, because on that natural action which is produced on the constrictor nerves first, then the muscles, nerves, veins and arteries with all their centers. It appears at this time that the vital fluids have all been used up, or consumed, by the sensory system, and in order to be temporarily replenished, this convulsion shows its natural use by squeezing vital fluids from all parts of the body to nourish and sustain the sensory, which has been emptied by mental and vital action, until death is inevitable without this convulsing element to supply the sensory system, though it may be but a short time.

SENSORY SYSTEM DEMANDING NOURISHMENT.

The oftener the fits come, the oftener the nutrient system of the sensory cries aloud in its own, though unmistakable language, that it must have nourishment, that it may run the machinery of life, or it must give up the ghost and die. In this dire extremity and struggle for life, it has asked the motor system to suspend its action, use its power and squeeze out of any part of the whole body though it be the brain itself, a few drops of cerebro-spinal fluid, or anything higher or lower, so it may live.

Those of you acquainted with the fertile fields of the Klondike referred to, will be enabled to furnish the sensory system with such nutriment, as will not make it necessary to appeal to you through the language used by the unconscious convulsions with all their horrible contortions.

THE CAUSES.

Thus you surely see with the microscope of reason that the sensory nerves must be constantly nourished, and that all nutriment for the nerves must be obtained from the abdomen, though its propelling force should come directly from the brain.

THE REMEDY.

The nerve courses from the brain must be unobstructed from the cerebrum, cerebellum, the medulla oblongata, and on through the whole spinal cord; with a normal neck, a normal back, and normal ribs, which to an Osteopath means careful work, with power to know, and mind to reason that the work is done wisely to a finish. I hope that with these suggestions you will go on with the investigation to a satisfactory degree of success.

DISLOCATION OF THE FOUR UPPER RIBS.

I wish to insert a short paragraph on a few effects following a down, front, and outer dislocation of the four upper ribs of either side. We have been familiar with asthma, goitre, pen-paralysis, shaking palsy, spasms, and heart diseases of various kinds. We have been as familiar with the existence of those abnormal variations as we are of the rising and the setting of the sun. Our best philosophers on diseases and causes have elaborately written and published their conclusions, and the world has carefully perused with deep interest, what they have said of all the diseases above named, also diseases of the lung, and to-day we are by them left in total darkness as to the cause of the above named diseases, also fits, insanity, loss of voice, brachial agitans, and many other diseases of the chest, neck and head. As the field is open and clear for any philosopher to establish his point of observation, note and report what he observes, I will avail myself of this opportunity, and say in a very few words, I have found no one of the diseases above indicated to have an existence without some variation of the first few of the upper ribs of the chest. With this I will leave farther exploration in the hands of other persons; and await the report of their observations pro and con.



CHAPTER XIX.

CONCLUDING REMARKS.

Thoughts for Consideration—Offering a New Philosophy—Lymphatics and Fascia—A Satisfactory Experiment—Natural Washing Out.

THOUGHTS FOR CONSIDERATION.

"Let us not forget the assembling of ourselves together." Whether this quotation applies to us or not, as an Osteopath I will venture to say that the honored dead, and the honest living intelligent healers of all schools, and all systems of trying to relieve our race from disease and suffering, so far as I have been able to ascertain, have been forced to guess how to proceed when they enter the "sick room" for want of a philosophical system of procedure. We have collected together many or few symptoms, named the disease, opened the battle, and on our side have met the enemy and fought bravely all battles very much the same way. I have spent one-half of a century in the field trying the many methods of attacks; and used the best arms and ammunition to date, and designed to do the greatest good. For twenty years or more I was content to be governed by the opinions and customs of older and more experienced physicians. I gave the disease its proper name. I gave the medicine as taught and practiced, but was not satisfied that the line of procedure was philosophically correct.

OFFERING A NEW PHILOSOPHY.

I believe at the present time I am fully prepared to say I can offer you a more rational philosophy of what should be the physician's first object, when called to repair a vessel that has become unseaworthy by accumulated barnacles, and is placed upon the dry dock for restoration to that condition called seaworthy, again. I believe this philosophy will sustain the strongest minds in the conclusion that our first and wisest step to successfully combat all diseases would be to inhibit first the nerves of the lymphatics, then produce muscular constricture and cause them to unload their diseased contents, and keep them unloading until renovation is absolutely complete; leaving the lymphatics in a purely healthy state, and keep them in this condition at any period of the disease. I have long since been of the opinion that if we could keep all impurities from accumulating in the lymphatics, and never allow them to become overloaded, we would have no such diseases as bilious fever, typhoid, mountain fever, malaria, pneumonia, flux, heart disease, brain disease, fits, insanity and on to the whole list of climatic troubles, and the troubles with the changes of winter and summer.

LYMPHATICS AND FASCIA.

I have thought for many years that the lymphatics and cellular system of the fascia, of the brain, the lungs, and the heart throughout the whole system of blood supply, do get filled up with impure and unhealthy fluids, long before any disease makes its appearance, and that the procedure of changes known as fermentation, with its electromagnetic disturbances, were the cause of at least ninety per cent of the diseases that we labor to relieve by some chemical preparation called drugs. When I was fully satisfied that we were liable to do more harm than good with such remedies, I began to hunt for more reasonable methods to relieve the system of its poisonous gases and fluids, through the excretory system of the lymphatics and other channels, through which we had hoped to renovate and purify the system.

A SATISFACTORY EXPERIMENT.

For twenty-five years I have tried to balance myself, divert my mind from all previous methods and see if I could not get more directly to the lymphatic system of nerves, and cause the millions of vessels known to exist in the body to begin to unload their contents and continue that action until all impurities were discharged by way of the bowels, lungs, kidneys and porous system.

NATURAL WASHING OUT.

At the conclusion of this philosophy I will endeavor to explain just how nature has provided to ward off diseases, by washing out before fermentation should set up in the lymphatics, from being received and retained the length of time, that destructive chemical changes would begin its work of converting elements into gas and discharging them from the system as unsuitable for nutriment. In order to avoid this calamity we are met with two important thoughts, one of the power of the nerves of the lymphatics to dilate and contract, also that of fascia and muscle, to dilate or constrict with great force when necessary to eject substances from gland, cell, muscle and fascia. Thus we see a cell loaded to fullness by secretion which it cannot do without; open-mouthed vessels through which it receives this fluid. Then again the system of cellular sphincters must dilate and contract in order to retain the fluids in those cell-like parts of the body. Now we are at the point when ready for use in other parts of the system, those sphincters must temporarily give away, that the gland may relax and dilate. Then the universal principle of constriction throughout the whole body can discharge the contents of the lymphatics of all divisions of the body, which is surely the normal condition. Let the lymphatics always receive and discharge naturally. If so we have no substance detained long enough to produce fermentation, fever, sickness and death.

I think this thought has been presented plainly enough to be fully understood and practiced by the reader, if an Osteopath.



CHAPTER XX.

THE SUPERIOR CERVICAL GANGLION.

With what it has Communication—Its Position—One of its Functions—Stimulation or Inhibition—Results Produced.

WITH WHAT IT HAS COMMUNICATION.

Every ganglion on the great chain of the sympathetic nerve has special and important functions, but upon the superior cervical falls the greatest burden of responsibility. This ganglion has communication with a greater number of nerves and organs than any other; is in direct communication with three cranial and four cervical nerves, indirectly with four more cranial nerves, and enters, by its branches into the formation of a large number of plexuses. Through this ganglion it is that much Osteopathic work is done, and the purpose of this brief paper is to point out some of the many effects which may be produced by its stimulation or inhibition.

ITS POSITION.

Anatomically we know that the superior cervical ganglion is situated in relation to the transverse processes of the upper three cervical vertebrae. It gives off branches which communicate directly with the vagus, glosso-pharyngeal and hypoglossal nerves; another branch, the ascending, passes into the carotid canal and enters into the formation of the carotid and cavernous plexuses; other branches pass to the pharynx, and a branch enters the formation of the cardiac plexuses. From the carotid and cavernous plexuses pass many nerves, only a few of which need special mention; one unites with the great superficial petrosal to form the Vidian nerve which goes to Meckel's ganglion, branches pass to the Gasserian ganglion, while we have others passing to the third, fourth, the ophthalmic division of the fifth and the sixth nerve, also we have derived from the nerve the sympathetic root of the lenticular ganglion.

ONE OF ITS FUNCTIONS.

Physiologically we know that one of the special functions of the sympathetic nervous system is to control the tone of non-striate muscular tissue, and that we have filaments distributed from the sympathetic system in the muscular wall of every blood vessel, duct and organ throughout the body. We also know that the sympathetic is the accelerator nerve of the heart, being opposed in its action by the vagus which, is inhibitory; further, that the vagus is constant in its brake-like action, while the sympathetic only acts when stimulated either directly or reflexly. While the vagus is inhibitory to the heart it is motor to the lungs. Nerve force is not generated in the sympathetic system; the cerebro-spinal nerve force is conveyed to the ganglia by the rami communicantes and in the ganglia is transformed into sympathetic nerve force. We might compare the ganglia to electrical transformers. Such being the case it is not difficult to see that if the superior cervical ganglion receives the nerve-force for transformation from the upper four cervical nerves and we can prevent, or lessen, the passage of nerve-force from the spinal cord through those nerves to the ganglion, that we will, to a corresponding degree, lessen the amount of sympathetic nerve-force transformed in the ganglion and transmitted from it by its branches.

STIMULATION OR INHIBITION.

We can produce stimulation or inhibition of a nerve at will; press suddenly and with a little violence upon the ulnar nerve where it lies in relation with the internal condyle of the humerus and we will find a manifestation of its physiological action, evidenced by a sense of pain in the ulnar and radial sides of the fifth finger and the ulnar side of the fourth, together with contraction of the muscles supplied by that nerve. But if our pressure be less intense and more prolonged we will inhibit the nerve and produce a sense of numbness in the same area together with temporary loss of muscular control.

Osteopaths well understand how to produce either stimulation or inhibition of the ganglia by way of the nerves passing to them from the spinal cord, and the results of such inhibition or stimulation in any sympathetic area can be prophesied readily by anyone who has read with attention what I have written; for instance, in the case of inhibition in the region of the nerves supplying the superior cervical ganglion with nerve force, we will find, first, throughout the area of distribution of the branches of this ganglion a relaxation of the vascular walls. This will be marked by two indications, first, the skin will become flushed and moist; second salivary secretion and lachrymal secretion will be increased. Second, the vagus is now allowed full sway, and we will find slowing of the heartbeat. It is well known that pressure over the seat of the first spinal nerve for a very brief period of time will control a congestive headache; the pressure in such case is made only for so long time as to produce stimulation of the sympathetic to greater activity, when we will attain a vaso-constrictor action, lessen the volume of blood in the cranial cavity and so abolish the headache. The arteries of the body may be divided into three groups, the large, the medium-sized and the small; in the first of these we find little muscular tissue and much elastic; in the second they exist in about equal proportions, while in the small arteries we find much muscular tissue and little elastic. As a consequence it is upon the smaller arteries that the sympathetic system has its greatest effect. As we dilate the smaller arteries and slow the heart action, it follows that we reduce the blood pressure, as we reduce blood pressure we reduce temperature, and within a very few minutes after the commencement of this inhibitory pressure on the upper four cervical nerves we will find in the large majority of cases, the capillaries over the entire surface of the body flushed, this being accompanied by a fall in the pulse rate and a marked diminution of the temperature. Indirectly at the same time we produce an effect upon the lungs; as we lessen blood pressure and the frequency of the heart action we find in accordance with the physiological rule an alteration in the respiration, it becomes slower and deeper. Arguing along these lines, and applying similar reasoning to each of the branches of this ganglion, anyone can trace out the many subsidiary results which may be expected from either stimulation of the rami communicantes nerves distributed to it, or their inhibition. Exactly similar rulings will find their prompt proof with regard to any other of the ganglia of the sympathetic system. We will find corresponding results in the cases of the thoracic ganglia which form by their branches the pulmonic plexuses; we get the same results from the splanchnic ganglia; while in the lumbar region we find that we have a ready means of control of the vascular system in the lower abdomen and pelvis. Much, very much, is still to be learned concerning the sympathetic nervous system, and all such increase in knowledge can come in one way only, clinical observation of Osteopathic treatment.

WILLIAM SMITH, L. R. C. P. and S., (EDIN.), D. O.

THE END.

* * * * *

A. T. Still's Table or Device,

That He Has Constructed For

THE USE OF THE OPERATOR, THE EASE AND COMFORT OF THE PATIENT.

It is a welcome success and does away with the lubberly old tables. It gives ease and support to all classes of patients. By its use the patient can sit in a chair or on a stool and feel at perfect ease during all treatments, then the operator gets results and is not tired to death when he has treated a patient; knows and feels that there has been some good done.

The asthmatic knows he has gotten help because pain has left his chest and he breathes as with new lungs; he knows he is helped more by one treatment while sitting on a chair with his body easy and at rest in the cushioned swinging device than he would or has received by the best skill on any table. Then the operator says, "Thank fortune, I am not worn out, and know I have gotten every bone to the place it belongs, and I know I have given satisfactory relief because my patients say so."

I think to an operator this device is his best friend. With it well understood he can do as much work as three good operators can do on the old tables. Remember this device does no part of the treatment but places the patient to your convenience while you do the work.

I feel as I am the discoverer of the device, that I know its needs and feel free to advise pupils.

The device will cost you $25 only.

A. T. STILL, Founder.



The American School of Osteopathy,

KIRKSVILLE, MO.

The course of study in The American School of Osteopathy is a carefully graded one, and is divided into four terms, of five months each. The terms beginning September and February of each year. The course thus requires two years for completion.

COURSE OF STUDY.

The course of study extends over two years, and is divided into four terms of five months each.

FIRST TERM.

The first term is devoted to Descriptive Anatomy including Osteology, Syndesmology and Myology; lectures on Histology illustrated by micro-stereopticon; the principles of General Chemistry and Physics.

SECOND TERM.

The second term includes Descriptive and Regional Anatomy; didactic and laboratory work in Histology; Physiology; Physiological Chemistry and Urinalysis; Principles of Osteopathy; Clinical Demonstrations in Osteopathy.

THIRD TERM.

The third term includes Demonstrations in Regional Anatomy; Physiology; lectures in Pathology illustrated by micro-stereopticon; Symptomatology; Physiological Psychology; Clinical Demonstrations in Osteopathy.

FOURTH TERM.

The fourth term includes Symptomatology; Minor Surgery; didactic and laboratory work in Pathology; Psycho-Pathology; Gynaeocology; Obstetrics; Sanitation and Public Health; Venereal Diseases; Medical Jurisprudence; Clinical Demonstrations; Clinical Practice.

* * * * *

The school is open to students of both sexes without distinction, and all have equal opportunities and privileges, and are held to the same requirements.

The methods of instruction are such as obtain in the best academic and collegiate institutions, and include recitations from standard text-books, lectures, quizzes, practical laboratory work, and practical clinical work.

The equipment of the school is complete in every respect. The recitation and lecture rooms are amply provided with all necessary means of illustration, such as specimens fresh and preserved, skeletons, models, charts, manikins and diagrams.

The respective laboratories are fitted up with all the necessary apparatus for practical work in the Anatomical, Histological, Microscopical, Chemical and Physiological departments.

The clinical facilities and opportunities enjoyed by students in this school are exceptional. An abundance of material is always available for clinic demonstrations, which are continued daily through two terms, with practical work in the clinic operating rooms by each student, under the direction of the regular operators, daily during the whole of the last term.

In addition to the regular clinical department, the A. T. Still Infirmary has constantly under treatment from three hundred to five hundred patients, and although the students do not see these patients, the many cases of diseases of all kinds under the care of the regular operators in the Infirmary give them constantly fresh and varied illustrations for use in their lectures. Sometimes, too, patients whose cases may be of special interest offer the use of their cases for the purpose of demonstration before the students.

Opportunities are thus furnished to students for such practice and drill in the actual work of treating diseases as we believe is not equaled by any similar institution anywhere. The course of study is progressively graded with a view to giving students a thorough and comprehensive knowledge of the facts and principles upon which their future work is to be based. These clinic exercises in connection and immediately following give them facility and readiness in the art of applying the facts and principles which they have acquired in recognizing and treating diseased conditions.

Catalogue mailed upon application. For information as to terms, etc., apply to

A. T. STILL, AMERICAN SCHOOL OF OSTEOPATHY. PRESIDENT. KIRKSVILLE, MO.



The A. T. Still Infirmary

Cures by the Science of Osteopathy all Diseases Which are Known as Curable.

Dr. A. T. STILL, founder of the Science of Osteopathy, has associated with him, in his infirmary organization, the oldest and most successful practitioners and exponents of the science, selected with special reference to their fitness for the work of practically demonstrating the principles of Osteopathy and occupying positions as teachers and lecturers in the American School of Osteopathy. All are regular graduates of this school.

The students in the school are not permitted to even assist in treating the Infirmary patients. All the work is done by regular operators.

The examination previous to treatment is conducted by Dr. Still's three sons assisted by the operators. After examination the patient is assigned to the room in which he or she will receive treatment, and placed under the care of an Osteopath best suited to the case.

The fees for treatment at the Infirmary are $25 per month. Where patients are unable to come to the Infirmary for treatment, an extra charge of $1 to $2 per visit is added.

The Infirmary maintains a complete bathing department in charge of competent attendants. As good baths are therefore obtainable in Kirksville as in any city. The charges are very moderate—twenty-five cents for a single bath, or $2.00 for a commutation ticket for ten baths. When bath tickets are procured no other fees to attendants are necessary.

A representative of the Infirmary meets all trains, day and night, to help all patients who may need assistance and see that they are properly cared for.

OPERATIVE SURGERY.

To correct a misapprehension on the part of many, it should be understood that the A. T. STILL INFIRMARY is fully prepared to receive and handle the most difficult cases requiring the highest order of skilled surgery, and it is not necessary to send such cases to the great city hospitals in the east for even the most difficult and delicate operations.

Dr. J. B. Littlejohn, of the faculty, is a graduate in surgery from the University of Glasgow, Scotland, and held for three years the position of Surgeon under the Government Board of England, besides other important and responsible positions in Europe and America.

Dr. Wm. Smith holds evidences of qualifications as follows: Licentiate of the Royal College of Surgery, Edinburg; Licentiate of the Royal College of Physicians and Surgeons, Glasgow; Licentiate in Midwifery, Edinburg and Glasgow; etc.

Cases requiring careful and delicate Surgery, the removal of fibroid tumors, and in fact any operation of whatever nature will receive the best and most scientific treatment and care in this institution.

The management has now secured a powerful and perfect Roentgen or X-Ray apparatus which will be used in connection with this department, in the examination of difficult cases.

Patients coming to the A. T. Still Infirmary may rely upon the fact that they will in no case be subjected to unnecessary surgical operations, as the knife is never used unless absolutely necessary.

Address all letters of inquiry to

A. T. STILL INFIRMARY, KIRKSVILLE, MO

- Transcriber's note: Corrections have been made to everyday words printed incorrectly, but all technical terms are as in the original. -

THE END