Readjustment or adjustment is many times particularly emphasized in
this work as the key to osteopathic therapeutics.
If the theory of readjustment can not stand the most searching tests
of science osteopathy will have to be relegated to a most subservient
place, on a par with massage, Swedish movements, and various medical
gymnastics. Consequently the readjustment theory is again referred to,
and especially so when the subjects of osteopathic centers, stimulation
and inhibition are outlined.
No doubt many stimulatory (so-called) and general treatments exert
their greatest influence by inadvertently readjusting tissues. Then
how much more effective would the readjustment treatment be if applied
intelligently. In certain acute disorders, e. g., “colds,” immediate
relief is often obtained by relaxing muscles through either stimulation
or inhibition; in reality the final result, as far as the muscle
is concerned, is one of readjustment. Likewise in stretching and
rotation of tissues and sections of the body the effect may either be
stimulatory or inhibitory, and still it may be, also, readjustive.
After all has been said the ultimate physiological effect of any
of these treatments, if of any therapeutic value, must be one of
stimulation to a part or to the body generally. But there is a vast
difference between physiological stimulation and the one method of
obtaining the same termed mechanical stimulation. It is not the purpose
here to enter into anything like an exhaustive survey of stimulation
and inhibition but simply to outline a few practical hints on the
relative values. Everyone is aware that overstimulation is equal
to inhibition, and even applying it to very delicate subjects the
therapeutic end we may wish to obtain may be lost and as a consequence
the patient exhausted; whereas at the same time readjustment possibly
could have been employed and real permanent effects secured.
So we should whenever possible utilize the basic principle of our
therapeutics, readjustment, for this represents in the majority of
cases, first, permanent results; second, a saving of much time, and
third, less exhaustion on the part of both patient and physician.
McConnell[36] has shown in his series of laboratory experiments on
animals the reality and potency of the readjustment fundamental.
The effect of malaligned vertebræ and ribs upon contiguous vascular
channels and nervous tissues, not only affects immediate skeletal
muscles by simple contractions but even produces interstitial myositis.
Through narrowing of the intervertebral foramina and tension upon the
fibrous tissue anchoring the spinal nerve in its exit, and through
pressure and strain on the sympathetics in contact with the heads of
the ribs, which are secured there by the parietal layer of the pleura,
organs in corresponding cavities become diseased. Some of the diseases
produced in the series of experiments were catarrhal and parenchymatous
changes in the stomach and intestines, congestion of the liver and
spleen, acute nephritis, goitre, inflammation of the lymphatics, edema
of the cornea, and degenerations of nervous tissues. Still too much
emphasis should not be placed upon the narrowing of the foramen for
certain pathologic changes are shown to be due to other conditions than
Wallerian.
The osteopath, as stated, may inadvertently correct osteopathic
lesions. _Vis medicatrix naturae_ undoubtedly corrects many osteopathic
lesions; this is evident from the fact that many bodily strains,
sprains, and injuries are overcome naturally or involuntarily, that
is, without any voluntary assistance from an osteopath. On the other
hand all osteopathic lesions are not due to outside influences or
forces, e. g., in pneumonia the severely contracted dorsal muscles
often partially dislocate the vertebral ends of the ribs and thus
increase the seriousness of the disease; and this is true in many acute
conditions wherein visceral changes will reflexly contract spinal
muscles and also through these contractions produce osseous lesions.
Here is where osteopathic treatment in acute diseases will not only
correct the primary lesion but also these secondary ones and thus
abort, or shorten, or lessen severity, or prevent complications of
the disease. But it should always be borne in mind that when certain
disease processes occur it will take a definite time at best for
curative changes to predominate. In other words pathological changes
are just as real and potent as physiological facts or anatomical data
and the character of the same should always be considered.
Consequently in readjustment work a distinctive etiology and pathology
has to be taken into account. The color, contour (whether the lesion is
simply a local one or there is a composite or group lesion), condition
(irritation, debility, contractions, and tenderness), and movement of
the several regions, and the spine as a whole should be noted. And
the student should always keep in mind that the osseous vertebral
lesion may be, (a) a twist between two vertebræ (this generally means
a rotation of one section of the spine on another section), (b)
malalignment of several vertebræ (the composite or group lesion), or
(c) the impacted or strained lesion, (this is a lesion that Clark
attaches considerable significance to, wherein there is injury to the
articular surfaces and ligaments without osseous derangement, followed
by exudation and other inflammatory products, limited motion, etc.).