Writings of Dr. J. Martin Littlejohn, Ph.D., M.D., D.O., L.L.D.
  (First Dean of the College of Osteopathy, Kirksville Missouri,
founder of the Chicago College of Osteopathy, and
founder of the British School of Osteopathy)
  
 
THE THEORY OF THE TREATMENT OF THE SPINE
 

[NOTE: The following article comes from The Journal of the Science of Osteopathy, Volume 3, Number 6, December-January, 1902-1903; pp. 258-277]
 

NO 1.

    It is important to reason out the philosophy of our system of treatment. True therapeutics must be scientific and philosophic. In saying this we mean that therapy must conform to the science of the structure and functions of the organism and to the philosophy of vitality revealed in the vital mechanism and its life phenomena.

    The osteopathic system is based upon the fundament of the nervous system. The framework of the body is simply a piece of vitalized machinery, constructed for the manifestation of nervous and mental life and used as a medium of the expression of the deeper life forces. These life forces must come to the front if our system is to be deemed of value.
 

THE TWO NERVOUS SYSTEMS.

    The first nervous system to be developed is the sympathetic nervous system, and that takes in all the viscera in the body, including the brain. Now the sympathetic nervous system represents from that standpoint the inherent rhythm of organs and the inherent peristalsis of arrhythm of organs. These are the two types of activity that we find everywhere in the body. There is no part of the body that does not have one of those two types of activity and that inherent activity is depend upon the sympathetic system.
 

CEREBRO-SPINAL SYSTEM DOMINANT AND CONTROLLING.

    When the cerebro-spinal system comes to be evolved, it projects out into the sympathetic system and gains control over those visceral functions, which have been originated in connection with the sympathetic system, and the great functioning changes. This cerebro-spinal function is inhibitive, exerting an inhibitive control. For example, we can illustrate that. The heart beat of the child when born is from 140 up. That represents the heart beat or the pulse rate. Now, later, when the cerebro-spinal system gains control over the heart it is brought down to an average of 70. Take that as an average. That simply means this, that the sympathetic system, in relation to those organs like the heart, has an accelerating function; its reduction in rate represents the inhibition of the heart, under cerebro-spinal control.

    All the organs in the body have just the same relation to the cerebro-spinal system as the heart. The physiology of a few years ago (probably the physiology of today with some) speaks of the tenth cranial nerve as having an inhibitive function in the thorax and an accelerator function in the abdomen. The pneumogastric nerve has an inhibitive (in the sense of control, check, restraint) function all the way down through the visceral organs, in the intestinal organs, in the liver, in the stomach, and so on, just the same as in the heart and in the lungs. Now what does that mean? It means that the great controlling nervous system in the body is the cerebro-spinal nervous system, the brain standing at the head of that cerebro-spinal system.
 

CYCLE OF NERVE LIFE AND CONTROL.

    Now we can express that idea in this way. The primary activity of the visceral organs is aroused by the sympathetic nervous system; that sympathetic nervous system, when it comes into connection with the cerebro-spinal system, arouses in the latter a reaction and that reaction is backward through the cerebro-spinal and sympathetic systems, so that this is where we find the nerve cycle in development, first, in the sympathetic system, second, passing into the cerebro-spinal system, third, then back again through the sympathetic system into the visceral organs.

    Now what does that mean in relation to the body? It means that in a state of health that cycle is complete, that is, there is complete co-ordination between the sympathetic and cerebro-spinal systems, completing the cycle of nerve control or nerve influence over the different organs and functions of the body. Co-ordination and co-operation are the principles of vital functioning.
 

ORIGIN OF DISEASED CONDITIONS IN CYCLE.

    What does that mean in relation to the pathological states of the body? It means that the pathological state of the body may originate either in the sympathetic plane or in the cerebro-spinal plane. Now, if it originates in the sympathetic plane, the result of its origin there will be that the visceral organs will be affected first of all through the sympathetic system, the cerebro-spinal system will be involved and the reaction will then come back again just in the regular routine of the cycle, into the organs once more, so that you will have progress from superficial to deep, or from circumference to center, completing the cycle of the pathological. Suppose it originates in the cerebro-spinal system; then it will exert it pathological influence through the sympathetic and then the reaction will be from the viscera, and from the sympathetic system to the cerebro-spinal system. In every case you will have the complete cycle.
 

HEALTH CONDITION - NERVE CO-ORDINATION.

    That brings us to this point, that the great basis of the health condition, so far as the nervous system is concerned, is the co-ordination or adjustment of these two nervous systems, and the great cause of disturbance in the body activities is the inco-ordination, or lack of adjustment, between these two nervous systems, starting in either one but finally settling down in the cerebro-spinal. Why does it finally settle down in the cerebro-spinal? Because that is the great system which exerts the control over the body in its maturity. It is the last one to be completely evolved, but it is the one that develops the highest degree of perfection and exercises the greatest control over the body influence.
 

SPINAL CORD IN DISEASED CONDITIONS.

    Now the old idea held by some from the osteopathic standpoint was that most diseases, if not all diseases, originated in connection with the sympathetic system, and that all treatment must be directed through the sympathetic system. That is not correct, because we found before, form the subject of embryology, that the spinal cord is the great objective point where all diseases are likely to originate, either in origin or in expression, and that is true in connection with all diseases, so that the great objective point will not be the sympathetic system but the spinal cord, which is the cerebro-spinal nervous system.

    It is important to reason out the philosophy of our system of treatment. True therapeutics must be scientific and philosophic. In saying this we mean that therapy must conform to the science of the structure and functions of the organism and to the philosophy of vitality revealed in the vital mechanism and its life phenomena.

    The osteopathic system is based upon the fundament of the nervous system. The framework of the body is simply a piece of vitalized machinery, constructed for the manifestation of nervous and mental life and used as a medium of the expression of the deeper life forces. These life forces must come to the front if our system is to be deemed of value.
 

ARTICULATION OF THE SPINE FOR CO-ORDINATION.

    In addition to that, every treatment that is directed to the cerebro-spinal system reacts upon the body through the sympathetic system. Hence one of the strongest treatments that can be given from an osteopathic standpoint is what is called articulating the spinal vertebrae. That is done by taking each one of the vertebrae down along the spine and moving it. There is a certain degree of mobility in every one of these spinal vertebrae, in some more than it others, but there is a certain degree of mobility in every one of vertebrae, and in articulating the vertebrae we directly affect the spinal cord. Now the cerebro-spinal spinal system is the great center of reflex and autonomic activities. Here we include the medulla, which is really the spinal bulb, and that means in relation to the entire organism; so that if you articulate the spinal column, and in that way appeal to the spinal cord, you are appealing to the body through the sympathetic system, in other words, establishing order through the great central nervous system, which has the control of order in the body organism.
 

FUNCTIONS OF THE SYMPATHETIC SYSTEM.

    What are the functions of the sympathetic system?

    This brings up a subject of great and wide importance.

    The first great function of the sympathetic system is the vaso-constrictor function in relation to the blood supply. Now you will remember we mentioned before that there are three sets of rami communicantes between the spinal cord and the sympathetic ganglia; two sets of white rami, one originating from the occiput down to the coccyx representing the dilator functioning. The constrictor function in the cord originates from the second dorsal to the second lumbar, although the primary origin is in the medulla center of vaso-motion; that is the great autonomic center of vaso-constriction, but the great co-ordinating centers are in the spinal cord.

    Now, that vaso-constriction origin in the spine is connected with the sympathetic ganglia all the way down along the spine through the two white rami communicantes, and in connection with those white rami we have the control of the vessels all over the body. Now this constriction of the blood vessels includes the spinal cord as well as the rest of the body, and when we take account of the fact that in the spinal cored there is a very small proportion of blood distributed as compared with the rest of the body, that vaso-constrictor function over the rest of the body is a very important one.

    What do we mean by the vaso-constrictor function. That controlling of the caliber of the blood vessel walls. These walls are kept in a state of tonic contraction, and that state of tonic contraction is produced in the blood vessel walls by the sympathetic nerve influence.
 

VASO-CONSTRICTION PRIMARY IN SYMPATHETICS.

    The question arises, is that function primary to the sympathetic system or does it originate in the cerebro-spinal system? My answer to that question is that it is primary to the sympathetic system. The ganglion cells of the sympathetic system have the power of constriction over the blood vessel walls. They are stimulated to exert that constriction by the cells in the spinal cord and the cells in the medulla, that is, these higher cells in the medulla and spinal cord stimulate the function of the sympathetic system over the blood vessel walls.

    You will see what an important point that is in relation to the blood system, because this stimulus keeps those blood vessels in a continued tonic state, the state of contraction, all the time.
 

THE RAMI COMMUNICANTES FUNCTION.

    The question has been asked, what is the function of the two sets of white rami that communicate between the cerebro-spinal and the sympathetic systems. Well, one is an afferent system and the other is an efferent system between the spine and the sympathetic ganglia. Those white fibers that come from the spine to the sympathetic ganglia terminate in the sympathetic ganglia if they are constrictor. The fibers which are gray fibers originate in these sympathetic ganglia and pass outward to the blood vessel walls. How do the blood vessels all over the body communicate back again with the sympathetic system in the spine? They communicate back again by sensory nerves, which are not sympathetic but cerebro-spinal; these sensory nerves going back to and through the ganglia of the sympathetics without terminating, passing right on into the posterior cells in the spinal cord; so that in that way the blood vessels all over the body send the sensory stimuli along the sensory path to the spinal cord, in order to arouse the spinal cells. Now that shows that the constrictor function is essentially a sympathetic function, the sympathetics being stimulated to that peristaltic function by the cerebro-spinal system.
 

SPLANCHNIC FUNCTION.

    The second great function of the sympathetic system is what we call the splanchnic function. Some claim that the splanchnic function is the same as the constrictor function. It is not the same as the constrictor function. What do we mean by the splanchnic function? We mean the sympathetic control of visceral movements: that is sometimes spoken of as the viscero-motor function. We said that every organ, every visceral organ in the body has its inherent motivity, and that inherent motivity it has in virtue of its connection with the sympathetic system. Now that is the starting point of the splanchnic function; that embryologic connection with the sympathetic system is continued through all of life, in virtue of which the heart has rhythm, the intestines have peristalsis or arrhythm, a peculiar movement that belongs to these viscera or intestinal organs under the control of the splanchnic nervous system.
 

SPLANCHNIC DISTRIBUTION IN SPINE.

    Now we shall speak of the three great splanchnic nerves. We have the greater splanchnic, fro the fifth dorsal ganglion down to the ninth dorsal ganglion; then we have the smaller splanchnic, form the tenth and eleventh dorsal ganglia. Now these nerves both come out from the sympathetic ganglia, passing down through the diaphragm, and are distributed in connection with the semi-lunar ganglion to the organs in the thorax and the organs in the upper part of the abdomen. The smallest splanchnic comes off from the twelfth dorsal ganglion and is distributed through the supra-renal ganglia and the renal plexus in connection with the supra-renal bodies and kidneys.

    Now these are said to be the only three splanchnics that we have, but we may be allowed to make an addition. There is a fourth splanchnic, and that fourth splanchnic originates from the second, third and fourth and probably the fifth dorsal ganglia of the sympathetic, and it passes upward to the cervical ganglia in the neck along the sympathetic chain, to be distributed in the brain, in the face and in the neck. That represents the fourth great splanchnic that has control of the movements in that region of the body above the clavicles.
 

THE SPLANCHNIC FUNCTION PRIMARY IN SYMPATHETICS.

    The covers the entire body, giving us a splanchnic function for the entire body. Now what does that mean? That means that the sympathetic ganglia from the second dorsal ganglion down to the first lumbar ganglion of the sympathetics have the power within themselves of stimulating motivity in connection with the heart, the lungs, the liver, the stomach, intestines, etc., including the brain, every one of the visceral organs.

    Is that a primary function of the sympathetic system? It is, just in the same sense as the constrictor function is primary in the sympathetic system. The ganglion cells of the sympathetic system have the power to stimulate the motivity, but they themselves are stimulated to functioning by the cells that we find in the spinal cord. Here we have once more the co-ordination between the cerebro-spinal and the sympathetic systems in relation to the great splanchnic nervous function that is exerted all over the body.
 

TEMPERATURE REGULATION.

    The third great function of the sympathetic system is that of temperature regulation. Some of the old physiologists said that the great temperature center was located in the medulla; modern physiology has shown that it is not. It is located in the upper cervical region of the spinal cord. Now you will remember in speaking of embryology I said that in the embryonic life there is a state in which the child respires like a fish. This part of the neck between the nose and the sternum takes in the arches and clefts and through those the blood passes in, goes through a kind of purifying process, is then distributed through the different parts of the body.
 

THERMOGENESIS PRIMARY IN SYMPATHETICS.

    In connection with that process the three cervical ganglia which lie just opposite these arches and clefts have the function of stimulating heat production in connection with the embryonic life. The control of those sympathetic ganglia in the neck in connection with heat production is exerted, therefore, from the upper cervical sympathetic ganglia; that means that temperature regulation is a kind of united vaso-motor and splanchnic function, under the control of the cervical sympathetics, and you will notice how that fits in nicely with the idea of the splanchnic function being limited to the dorsal and upper lumbar region. How do we know this? What is heat production? Heat production, or thermogenesis as it is commonly called in physiology, depends primarily upon the motivity of all the organs of the body. Every organ that moves produces energy, and that energy is converted into heat. It is a heat-producing organ in connection with its motivity. Its energy is converted into heat. In addition to that, friction in the blood electricity in the blood and probably a number of other physical conditions, also give us energy that is converted into heat; and last of all, all the metabolic activities of the metabolic organs in oxidation produce heat directly.

    How is that metabolism in such an organ as the liver controlled? Why, it is controlled by the inherent activity of the cells of the liver itself, and all of these are subject to the control of these three cervical ganglia of the sympathetics. Under the upper cervical region of the cord most of the physiologists say, as you know, that heat production is almost exclusively a vaso-motor function. It is a vaso-motor and a splanchnic function, under the control of these sympathetics in the neck. These sympathetics are stimulated to function by the great center of thermogenesis in the upper region of the spinal cord.
 

HOW TO CONTROL THE SYMPATHETIC ACTIVITIES.

    These are the three great functions of the sympathetic system. There are other subordinate functions, but they are not of sufficient importance to justify us in mentioning them specifically, and you will see that they are all primary, but they are subject to stimulation from the cerebro-spinal cells; they function under the control of the cerebral cells, so there you have the general continuity of all the functional activity.

    What does that mean in relation to the subject of treatment? It simply means that if we want to get complete control of any of the sympathetic functions, we must get it from the cerebro-spinal side; that is to say, if a sympathetic function is sluggish, you will stimulate it to activity from or through the cerebrospinal system. Supposing a sympathetic function is going too fast, how can we control it? We will control it from the cerebro-spinal side, because it is impossible to inhibit the sympathetic side by temporary mechanical inhibition unless through the cerebro-spinal system. Why are the diseases associated with the spine? Because, I do not care what sympathetic trouble we have anywhere in the body, it affects, either by action or reaction, the cerebro-spinal system along the spinal cord, and the only way we can restore that function to the normal is to get at it through the function of the spinal cord, bringing us back to the point where we started in the discussion of the theory of osteopathic treatment.
 

DIFFERENT PLANES OF ACTIVITY.

    We may ask the question here, are we going no higher than the spinal cord? Certainly we are. The lowest plane that we have in the body is the sympathetic plane; the next is the reflex plane of the spinal cord; the next plane is the autonomic plane of the medulla and the next plane is the voluntary plane of the cerebro-spinal, the psychic or rather psycho-physiological plane.

    How is one plane below brought in relation to another plane above? By education. I use that word education in the wide sense. The sympathetic nervous system is brought under the training of the spinal cord, that is evidenced, as I said before, in the reduction of the heart beat from 140 to 72 or 70. That is because the sympathetic system is brought under the mastery or control of the centers in the spinal cord and other centers that are above.
 

SPINE UNDER HIGHER CONTROL, EDUCATION DOWNWARD.

    Now, can the spine be brought into subordination to the higher centers? It certainly can. For example, in the spine we get some great automatic centers. Notice how we have the transference of the plane. The automatic plane is in the medulla, but that automatic plane can be thrown down into the spinal cord. One great example of that is in the heart, because in the heart we have two kinds of muscles, the voluntary and involuntary. These muscles make it necessary that this center at the fourth and fifth dorsal, if it is going to control the heart properly, must be educated up to an automatic centers. And it is, so that we have in the two kinds of muscles in the heart the basis for the automatic and reflex control of the fourth and fifth dorsal center as the great heart center and that is the point where we control different pathological conditions of the heart. The same is true of other parts of the body. Take the rectum, for example. At the second lumbar we have what is called the defecation center. That defecation center is both reflex and automatic. Why? Because we have two sphincters, the one is voluntary and the other is involuntary, and these two sphincters are brought together at the reflex point in the spine, the voluntary control of the brain being thrown down to one of the sphincters through this second lumbar center.

    Some may say, we cannot get at the voluntary sphincter because its center is located in the brain; but we can, because the brain center function is thrown down, in order that through this center it may control the voluntary sphincter and also originate and regulate the autonomic activity.

    The same thing is true of the heart, of the stomach, etc. The conditions found in the stomach and the intestines are a little more difficult to explain and to grasp than those of the heart and the rectum. In the stomach we have the cardiac and pyloric ends of the stomach controlled from the sixth, seventh, eighth and ninth dorsal; the sixth and seventh the cardiac end of the stomach, the eighth and ninth dorsal; the pyloric end. What about the middle of the stomach? The middle of the body of the stomach is controlled by the pneumogastric nerve. That pneumogastric nerve represents the cerebro-spinal element thrown down from the brain into the stomach. And how does it come down? The pneumogastric nerve is connected with the cervical ganglia; it is also connected at the fourth and fifth dorsal with the spinal cord, we don't know how, and that makes it, with the reflex center at the sixth, seventh, eighth and ninth dorsal in the spinal cord reflex and automatic in activity. That gives us a reflex center and automatic center in connection with the stomach, and when we treat at that point we affect, not only the spinal centers, but we also affect the nucleus of the tenth cranial nerve in connection with the brain, so that in that way we see a spinal center may be educated up to a higher point than a purely reflex.
 

PSYCHIC PROJECTED DOWNWARD - ITS INFLUENCE IN DISEASE.

    We can carry this even further. The purely psychic centers may project themselves down into the spine and through the spine into all organs that we find in the thoracic and abdominal cavities. And here is one of the great sources of disease. These organs in the thoracic and abdominal cavities are under the involuntary or subconscious control. Now what does that mean? That means that we ought not to be conscious of what is going on in the heart, in the stomach, in the liver and in the intestines. Just in so far as we do become conscious of what is going on in these organs, these organs become pathological in their functioning and hence you will find that the individual who is continually moping over some stomach trouble is the one we can never cure unless we cure the mind. The mind in such a case is projected down through the spinal cord into the stomach, and there it settles, and it continues and will continue unless we can successfully dislodge it from above. This is true of every diseased condition that we find associated with the viscera. When these are under the normal influences that come from the psychic apparatus self conscious of their activities; that means, that the psychic apparatus must be corrected first in order that we may set right the different parts of the organic apparatus that we find deranged in the thoracic and abdominal cavities.
 

GREAT CENTRAL FACT OF OBJECTIVE LIFE.

    The question may arise, how are those centers affected by the higher centers? That is explained in what we stated before. The great central fact of life is motivity, and the fundamental basis of life so far as our objective life is concerned is vibratility.

    I will explain this somewhat from my own standpoint. I do not care whether a man is a believer in the superhuman or whether he is not, it does not make a bit of difference, the one who believes in the superhuman cannot object to this point and the other who disbelieves cannot object. Man has a higher being; I do not care whether it is called a soul or a spirit or a life power or a sun power, or whatever else it may be called; the higher being comes into relation with the body. The body of itself is absolutely lifeless but when that life power, or soul or sun power is brought into contact with the body, the body represents the earth substance. A connection established between these two, the life power and the body, gives us what we call objective mind.

    That objective mind is what gives to us all the manifestations of life. All the intelligence and will power we have in the body is associated with that objective mind. It is the nexus or perhaps better the result of the nexus of spirit and body. What is that objective mind? That objective mind is simply vivified or vitalized vibratility. As soon as the spirit animates the body, then the heart begins to beat, the liver begins to pulsate, the intestines begin to pulsate, and theses vibration impulses are thrown down along the nerve fibers and they pass out to the different parts of the body. Some people say that a nerve impulse is electricity; it is not, but it is analogous to electricity. It is vibratile in its nature and vibrates to its activity.

    We have reached the point now at which I think every natural philosopher will say that heat, light, electricity and all of the other physical forces are simply modes of motion. We call, as the Greeks did thousands of years ago, the life which is first in the body the vital force, and I know of no better name that we can give it. It is the vital vibratility. Now that vital vibratility animates the whole body, and when a tissue or part of the body ceases to have that vital vibratility, we cease to life objectively, and so long as we have that vibratility we have objective life.

    That is the medium of communication between every one of those planes of vital activity. The sympathetic plane is in communication with the spinal plane and these with the cerebral plane.
 

THE HIGHEST CLASS OF CELLS IN NERVE TISSUE.

    Up in the cerebral cortex we have cells that are called the caudate cells. These caudate cells are generators of every nerve fiber that comes down into the body. These caudate cells are also the generators of every nerve impulse. You know embryologists say that when the child is born there are within its brain the same number of cells, very minute and small, that are going to be in that brain all through the rest of that life, and those are the caudate cells; and all that takes place afterwards in the development of that child's brain is that the system opens up and pushes a little of its substance out, and that keeps pushing out and out and out, until we have the complete nervous system developed.

    That means that the nucleus of that cell is the center of objective life. It is the center of development. It is the center of the generation of impulses. There is nothing that does not center there, and if you or I run across a condition in which a man is treated from the disease standpoint by plastering over his body, it is applied at the wrong place. The starting place of vibrations, the starting point of vitality, the center of the organism, that is the only central part where we can influence the body so as to influence it for good. When we treat along the spine the objective point is to influence a nerve path that is leading up to the brain, so that when that impulse reaches the brain, the brain may take care of it and function it off so as to stimulate the vis medicatrix of nature. This represents the true basis of our objective life.

    That we have a subjective life, a soul or spirit life, I firmly believe. This is the life that belongs to us by virtue of our relation to the first great cause. It cannot be overlooked because it is the originating cause of our objective life, but the life that we live in the body is its expression and manifestation, and therefore this objective life is the true life that we live under the influence of the constructive soul. This constructive soul being embodied, we must deal with the embodied aspect of life from the therapeutic side.
 
 

NO. 2
BASIS OF THERAPEUTICS.

    The osteopathic system of treatment then depends on the fact that there is a definite relation between the nervous system and every tissue and organ in the body, the great central point of control being the neuron cells in the brain and the nervous system, the nervous system being the medium of distribution for energy, force and nutrition. Those are three points that we must clearly distinguish from one another in the economy of nerve distribution.
 

THE THREE SIDES OF LIFE.

    Now in speaking of life, we found that the body as an organism has three sides; first, a physical side, second, a reflex side, and thirdly, the vital side. These are taken in their order, from below up.
 

THE PHYSICAL ASPECT OF LIFE.

    Physical side, that is to say, the body is built on a definite plan of architecture. In the development of the body, the soft tissues of the body are first developed and later the hard tissues are developed. By these I mean the bones and the cartilages. After the body is developed, in its developed form the hard tissues form the foundation of the physical structure; that is to say, the bone in the cartilaginous parts of the body are the foundation of all the rest of the body structure, the soft tissues being added on as attachments, in connection with the hard tissues, attachments, for example, for the purpose of maintaining the erectness of the body, assisting in motion and locomotion. The muscles along the spine, along the anterior part of the body and the attachments of the trunk, the muscular attachments of the trunk to the extremities, enable us to move the body upon itself and to move the body from place to place, so that motion and locomotion depend upon the attachment of the soft tissues to the hard tissues. Now that is what we mean by the physical side of life, the foundation being in the framework, and the attachments of that framework, including the filling in by fascia, connective tissue, etc., to make up the complete physical organism.
 

ADJUSTMENT - THE LAW OF STRUCTURAL RELATIONS.

    Now the physical structure of the body implies that each separate part of this structure has a certain relation to its neighbor structure or structures, whether soft tissue or hard tissue, and therefore the physical principle that is applied here as the law governing and regulating the physical conditions of the organism is adjustment. Each bone is adjusted to every other bone and adjusted to its muscular, cartilaginous and other attachments, that is, its other soft attachments.
 

LACK OF ADJUSTMENT - LESIONS, THEIR CORRECTION.

    Now from the physical side we find, as we have stated before, distinctive lesions, muscular lesions, osseous lesions, cartilaginous lesions, organic lesions, that is lesions of the organs, etc. Now the physical side of the osteopathic treatment is the correction of the lesions, that is to say, bringing part into relation to part, so as to co-apt the parts in order to gain and maintain what we might call physical integrity.
 

LAWS OF PHYSIOLOGICAL PHYSICS.

    Now some regard this as the only field there is in the osteopathic method of treatment, that is to say, primitive osteopathy was the osteopathy of osseous lesions and it was supposed that in the correction of those osseous lesions we had all there was in the osteopathic system. Hence we have been called "bone setters" and "bone manipulator," and such names as these, which in a sense are quite correct if that is the view. But that is not the complete osteopathic system.

    The principles that are applied here are physical principles, that is, in treatment, I mean. The principles that are applied in the correction of lesions, the different physical lesions, are physical principles: they are not however, the law of pure physics, they are what we call physiological physics. Now that side of physiological physics is a very big one and of course we cannot go into it as we might. The law of physiological physics are to be applied to the body, in fact the body cannot get along unless these physiological principles are in operation. The blood, as a circulatory system, depends upon physical laws. The heart, for example, represents two kinds of pumps, the force pump and the suction pump, the force pump on the one side of the circulation, the arterial side of the circulation, and the suction pump on the venous side of the circulation.

    In the circulatory system we have the laws of blood pressure, which are simply the laws of fluid pressure in an elastic tubular system. Then we have the laws and the principles of tension, arterial tension especially, which represents simply the principles of extensibility and elasticity.

    On the venous side of the blood we have a muscular force, to help propel forward blood which would not move were it not for that muscular force. Aiding that muscular force as an accessory we have valvular system of the venous blood vessels. There are no valves in the arterial blood system proper; the valves are found only on the venous side. Why? Because the blood has to flow through vessels that are not elastic and hence the pressure must come from behind the blood and from before the blood. The blood moves in sections, or in segments, and because the blood move in segments from one valve to another valve represents a blood segment on the venous side. Now these are laws and principles that every practitioner knows, even if he does not apply them. Take the big field of chronic endocarditis. Now what is the primary cause of chronic endocarditis? Some men may say that it is a germ, another man may say that it is something else, but the primary cause of chronic endocarditis is a physical cause, and what is it? It is a change in arterial tension, due to the fact that the constrictor influence is cut off or exaggerated in connection with the arterial blood vessels, and the only possible way to correct that condition is to correct the tension and to correct the constrictor influence which lies behind the tension.
 

THE PHYSICS OF ARTERIAL SWAY.

    The fundamental physical basis of the osteopathic system of treatment lies in the fact that arterial sway or arterial control practically, that is in a practical way, governs the entire body organism. What do we mean by that? We mean that the arterial system furnishes the nutrition for the body, including the nervous system, without which the body would not continues to exist. How is it that nutrition regulated and controlled in its distribution? It is regulated and controlled in its distribution by arterial contraction and arterial relaxation. That combined cyclical arterial relaxation and contraction is found throughout the entire arterial system of the body, and upon it the integrity of the tissues depends. What lies behind the arterial tension or the arterial control or sway? There lies behind that the nervous force, which is generated in the great organ of generation of the nervous system, the brain, and is transmitted down through the nervous system in the form of impulses.

    Now what is an impulse? An impulse is wave of vibration. What is it that we feel when we feel the pulse? A great many people say that when you feel the pulse you feel the blood. It is not the blood you feel. When you feel the pulse you feel the pulsation of the arterial wave of contraction and relaxation that is passing along the entire arterial system from the heart. Now that arterial wave is the product of the waves of vibration that come down as impulses from the brain and along the nervous system, to be distributed in the walls of the arteries. So there we have the foundation for the physical integrity of the body.
 

THE REFLEX LIFE OF THE ORGANISM.

    The second aspect of the osteopathic system as a system, from the standpoint of treatment, is the reflex life. What do I mean by that? I mean by that that the body consists of, as we said before, a mass of cells. These cells are divided up into tissues and organs; that is to say, groups of cells are differentiated on a particular basis, so that we have a number of different types of tissues and a number of different types of organs. Each tissue has its own vitality; each organ has its own vital process, but each tissue and each organ is connected to every other tissue and organ on a reflex basis through the nervous system. Now what does this reflex basis mean? This reflex basis means that we have the great cerebro-spinal system, which has as its main function, control and inhibition, and we have the great sympathetic system, which has as its special functions visceral activity and the acceleration of that visceral activity.
 

CELL, TISSUE AND ORGAN RELATIONS.

    Now if the body, on a reflex basis, is normal, every cell sustains a definite relation to every other cell; every tissues sustains a definite relation to every other tissue; every sustains a definite relation to every other organ. How? Through the nervous system. There is no part in the body that we know of that has not its own nerve supply, and we might go a step farther than that and say, there is no part of the body that does not have a double nerve supply, a nerve supply from the cerebro-spinal system and a nerve supply from the sympathetic system.
 

DISEASES AS REFLEX CONDITIONS.

    Now in treatment we utilize that reflex basis of life, because a great number of the disease we have to deal with are reflex conditions. What is disease? We defined disease before as the abnormal action of the cell, the tissue, the organ or organism. How does that abnormal action take place? That abnormal action takes place from this reflex side, because of either over-stimulation or under-stimulation. That means that the sum total of nerve energy and nerve force in the body should be distributed in such a way that each cell, each tissue, each organ, has its own proportion. If that distribution does not take place proportionately, then we have a reflex disturbance somewhere. How are we going to rectify that reflex disturbance? We are not going to rectify that reflex disturbance by what some people would call organo-therapy, whether from the manipulative side or from the medicinal side. We are going to rectify that reflex condition by setting in order the generator of the nerve impulses and the nerve forces, and at the same time removing every obstruction to the free distribution of those nerve energies and nerve forces, so that when the generator sends out the impulses they will be distributed proportionately to every cell, every tissue and organ in the body. Now what does that mean? That means that the great primary treatment, osteopathically, in all reflex disease conditions, is the co-ordination of the cerebro-spinal and sympathetic systems.
 

CO-ORDINATION OF NERVOUS SYSTEMS.

    How does that co-ordination take place? The point, the only point where these two systems come together is, as we found before, along the spine. The cerebro-spinal system in the spinal cord has, as its great functions: motion, sensation and nutrition. The sympathetic system, on the other hand, has as its great functions the stimulation of splanchnic rhythm or peristalsis throughout the entire body, and the vaso-motor regulation of the blood supply to the entire body organism, including the blood supply to the spinal cord. Therefore, the spinal cord furnishes to the sympathetic system stimuli, which causes that sympathetic system to function along the splanchnic and vaso-motor lines. But the sympathetic system also supplies stimuli to the spinal cord, because the spinal cord is dependent for its nutrition and the regulation of its nutrition upon the activities of the sympathetic system. Hence we have the two sides working in correlation and any interference with that correlation means a reflex disorder or a reflex diseased condition.
 

CONSTITUTIONAL SPINAL TREATMENT.

    Hence the first great primary treatment from the osteopathic standpoint in correcting those reflex disturbances is to co-apt the operative activities of the spinal cord in the sympathetic system. Now that is the reason why we speak so often of a constitutional spinal treatment. What does that constitutional treatment consist of? The constitutional spinal treatment consists, in the first place, of correcting muscular, osseous or articular lesions that are found along the spine.

    Secondly, the relaxation of the muscles, if they are contracted; the tonic contraction of the muscles, if they are relaxed and the trophic upbuilding of the muscles, if they are in atrophic or badly nourished or debilitated condition. That is the second point.

    Third point, the stimulation of the spine from the sub-occipital region down to the coccyx on both sides.

    Now the best method of doing that, as I have it in experience, is first of all to take the finger and thumb, with the patient lying on the face, and begin at the sub-occipital region, putting the finger on the one side of the spinous processes and the thumb on the other side of the spinal processes, then moving the fingers gradually down along the spine to the coccyx. After that do up to the occiput again and come down faster, - the first was a slow movement, - along the spine, and next take the fingers in the same way and push them in deeply on either side of the spinous processes between the bodies of the vertebrae. Of course you understand what that will mean in connection with the heads of the ribs, but that is the way in which it is applied all the way down the spine. Follow that by placing the patient on the side (and I have found the best results by always putting the patient first on the left side. I cannot tell you why, but that is a matter of experience) putting the patient first on the left side, and then begin at the cervical region and take the two hands, put down the two hands on the muscles, as close into the spinous processes as you can get the tips of the fingers, then pull the muscles out, straight out from the spinous processes and move them upward. Do that all the way down along the spine to the coccyx. Do the same thing on the other side; turn the patient then on the right side and do the same thing along the left side of the spine. That is what we call a constitutional treatment, and that is the treatment for co-ordinating the cerebro-spinal and sympathetic systems.

    Now in all reflex disturbances, as I have said, that is the treatment. It does not make any difference is; it may be located in the heart, lungs, liver or any place else. Later on we will find there is a specific treatment going along with that for the particular organ, but that is the treatment going all the way through. And that is the reason I mention it now.
 

VITAL SIDE OF LIFE.

    The third line which the osteopathic treatment goes is along the vital side of life. We said before that in the body we find a vital force. What is that vital force? Well, the body, as the body organism, as we said before, consists of the body and the mind, both the subjective mind and the objective mind. Now, in the formation of the body, everybody admits that there is some great first cause of life, whatever that first great cause may be, so that if we place at the top the great first cause, then we will have certain manifestations of that great first cause in everything that exists. Hence we find a philosopher like Thomas Henry Green speaking about a spirit in the rock or in the stone. Now what does he mean by that? He simply means by that, that the great first cause (whatever that may be) did not make anything that it does not itself animate, so that a rock, a piece of wood, a tree, a human body is animated by the great first cause. Now that is what philosophers and religious people call the spirit or the soul. How does that spirit or immaterial something express itself? That immaterial something expresses itself in everything that exists, in forces, in certain forces that mark the life causes.
 

THE GREAT FORCES OF NATURE.

    Now in nature, universal nature, we find at least seven great forces, which are the expressions of the immaterial in nature. I don't take the seven because it is said to be the perfect number, but it happens to coincide with that idea. The first great force we find in nature is what is called inertia; secondly, gravitation; third, heat; fourth, light; fifth, sound; sixth, electricity; seventh, vitality. Those are the seven great forces we find in universal nature, and note particularly the point that they all stand exactly on the same plane. I don't need to explain what these forces mean. You all know what they mean. Inertia is the latent energy or power a body possesses in virtue of which it remains at rest, but it has the latent power of mobility. That is the lowest grade of mobility we find in the universal life, because you have the negative of force; the only force that is resident there is chemical force, with the physical force in latency.

    Now gravitation, heat, light, sound, electricity and vitality are simply different grades of vibratility. We know that for light, for example, we have the colors of the spectrum, and the red color that is the lowest in the spectrum differs from the violet, which stands highest in the spectrum, in the fact that in the one case you have from three to four hundred billion vibrations every minute. In the other you have, I think, seven or eight hundred billion.

    Now what is electricity in relation to light? Sometimes it is called the ultra-violet. That is simply saying the vibrations in electricity are continued away above the point where we have the violet light; and what is vitality but simply the same phenomenon, standing at the head of the scale of vibratilities. Here we are speaking of physiological vitality. How do we know that? We know that because by the use of vibration we can stimulate the rhythmic action of the body and of its organs, and hence one of the most important therapeutic agents in the osteopathic field (it is not exclusively osteopathic), but one of the most important therapeutic agents in the osteopathic field is vibration, and the one that is at the present day yielding some of the finest results. The time is coming, I believe, when we will be able to work out arithmetically the work of vibration of every particular tissue and organ in the body, and the therapeutic principle is that the nearer we approximate to the vibratility of the particular part of the body that we are treating the better the results we get. If we are vibrating the heart, for example, we will vibrate at a different rate from the vibration we will apply to the lungs, simply because we want to appeal to the existing rate of vibration that is in the heart and that is in the lungs, and so on over the different organs that are found in the body.

    Now what is a nerve impulse? A nerve impulse is spoken of by some writers as electrical energy. Well, I don't believe it is electrical energy, but it is analogous to electrical energy; it is on the same plane as electrical energy, but it is a different kind of vibratility. It is a higher kind of vibratility than electricity, but they are of the same nature. The only difference there is is a difference in degree.

    Now physiological psychology, as you know, is able to estimate how long it takes and what is the rate of vibration for the discharge and transmission of an impulse by sticking a pin in the tip of the finger until that impulse reaches the brain; and it can also estimate the amount of time and the rate of vibrations that go on in the brain in transferring that sensory impulse over to the motor side and driving it down to the hand, so as to make the hand move away from the pricking pin. Now that is getting pretty close to the point where we can estimate the vibratility of nerve energy, nerve force, and even the vibratility of mental force, or mental energy.
 

THE TRUE BASIS OF LIFE.

    Perhaps you have seen recently an article by Dr. Loeb and Dr. Matthews, of the University of Chicago, in which they attempted to explain life on a new basis. They combine together to explain it on an electrical basis, and they have written a long article and formulated some fourteen or fifteen propositions, in which they try to prove that the food that is taken into the body is, first, chemically changed; then second, after, it is chemically changed it is electrified, either positive or negative, and the result is you have positive ions or negative ions, the one is charged with positive electricity and the other is charged with negative electricity. And what are these doing? These are coming into relation with each other in the body on a mechanical basis, because, as you know, electricity, the most refined electricity, static electricity, is mechanical. There you have a pretty close approximation to the idea we are presenting now. The only point of difference that I would make with these two men is that I would not identify vitality with electricity, as I say it is a very much higher, more refined and more perfect degree of vibratility than electricity. For example, you know that in connection with static electricity you have an electricity that has very little volume, if any. Volume is reduced to a minimum, at least, and you can take the force generated by twelve or twenty-four revolving plates and you can run it through the human body without the body twitching. Now what does that mean? You could not run the same volume of chemical electricity. The same amount of chemical electricity would electrocute a man. What is the difference? The difference is simply this, that in the one case you have the higher, refined degree of vibratility without the volume, and that can flow into and flow through the body without affecting the vibratility of the body.

    Why does the electricity electrocute a man? Electricity electrocutes a man simply because a volume of electricity goes into the body and suppresses, in other words, the vibratility of the body itself; the man is crushed, as it were, crowded down to death, simply because his own vibratility is overcome. Now that, it seems to me, is very strong evidence that the vibratility of vitality is of a higher order than that of electricity.

    What is it that all vibratility possesses? It is energy, all vibratility possesses energy. So does the body. Hence, we speak of the body from the standpoint of the vital force as containing a certain amount of energy, vital energy. That vital energy, normally, should be distributed over the body in the different cells, tissues and organs on a vital basis, and if that vital energy is not present the individual is incurable, that is, is in an incurable condition. If the vital energy is present the body is curable, subject to whatever disease or diseased condition it may be. Now, that is just saying the same thing as that the body must possess the power of reaction; otherwise, if it does not possess the power of reaction we need not attempt to cure the body of any disease condition. If we don't get a response, in other words, from the body to anything that you do, whether it is medicinal or manipulative, or otherwise, you cannot cure the body because you have not the key that holds the situation within the body. Therefore the great final arbiter in the restoration of order in the body is the vitality, the vital force, and that is what is what we get after.
 

HOW WE CAN REACH THE VITALITY.

    Now the questions arises here, can we reach the vitality of the body by the osteopathic system? This is one of the strongest criticisms that have been made on the osteopathic system, that we cannot reach the vitality. We require something more refined, more delicate, more potent than manipulation or vibration to get at the vital force, according to this criticism.

    Well, the primitive osteopath, whom I mentioned before as being simply a bone manipulator, could not answer the question because he cannot reach the vital force. If he is simply a bone setter or bone manipulator he cannot reach the vital force, but if we take the system in its all-comprehensive sense, as we have outlined it, from the physical side, from the reflex side, and the vital side, we can reach the vital force. What is the vital force? The vital force, as we find it in the body, from the one side is that force which expresses the immaterial in man, this from the one side. From the other side, the vital force is that force which sums up within itself all of the vital processes and vital activities that take place within the body organism, that is to say, the vital force from the other side is the representative of the immaterial in the vital processes and functionings of the vital mechanism. From the body organism side it is the sum of all those activities that we find in the cells, in the tissues and in the organs of the body; or, to put it briefly, it is the sum of the body vibratility as a unified force, unified within the organism.

    Now, we can reach the great center, the brain, - the brain is the center which sums up in itself all the vibratility of the body, - can we reach the brain in that way? We certainly can. Why? Because there are thousands of sensory nerve paths which have no other function than simply to communicate from the outside to the inside, from the circumference to the center. These sensory nerves that are coming from every part of the body, over the skin, over the internal membranes of the body and over the tissues of the body, these sensory nerves have no other function than to communicate with this great central generator of force, or vibratility , so that whenever we can reach a sensory nerve there we have a pathway that goes directly into the center of vibratile energy. Not only so. Physiology has pointed out that a nerve is simply a pathway, and that every nerve, whether it is motor or sensory, will carry an impulse in both directions. So that not only in the case of the sensory nerves have we a pathway that reaches the great center of the vital force but in every motor nerve we have a pathway that will also reach the great center of the vital force, because the impulse will be transmitted toward the center, and from the center it will be distributed along the pathway of least resistance to the point where it is demanded. Now that means that in manipulating, especially by vibration, we can appeal to the vibratility of the nervous system, either directly or indirectly, through the organs and the tissues in which the nervous system is distributed.

    It is here that we get the two great fundamental principles of treatment that we mentioned before, stimulation or acceleration and inhibition. What is stimulation from this standpoint? Stimulation from this standpoint is the acceleration of the local vibratility that is associated with a particular path or ganglionic center, - that will cover the sympathetic system, spinal cord and vibration that is applied to the brain. What is inhibition? Inhibition is simply the checking or restraining or lessening the rate of vibratility locally, in a nerve-fiber or a ganglionic center, from the same standpoint, and we certainly know that these two methods can be applied in connection with the nerve fibers, the nerve centers and the organs and tissues in which the nerve fibers and the ganglionic cells are distributed. Hence, we have a means of getting at that vital force, and the most characteristic, the most powerful means of getting at that vital force is by the principle of vibration. Why? Because vibration is that which is similar to the vibratility that is within the tissue itself or the cell or the organ, and it appeals directly to the vibratility that is an inherent characteristic of the organ or of the tissue that is involved.

    Now that lays down, in my opinion, the foundation principles, from the theoretical side, in the three great fields, the physical field, the reflex field and the vital field, which lie at the basis of all treatments we find in connection with the osteopathic system.