A general correction of lesions should be made in order to give perfect
alignment and equilibrium. Lesions that affect the nerve and blood
supply will be found from the fourth thoracic to the occiput; more
often at the occiput, atlas and axis in the cervical region and the
second and third thoracic in the dorsal region including the ribs.
Correction of these lesions must have specific attention in every case
of eye disease that shows any tendency to chronicity or in repeated eye
disease and exacerbations.
A thorough upper spinal treatment to insure good mobility of all joints
and establish freedom of fluids and forces is recommended.
The =nose=, _throat_ and =sinuses= should be examined for pathology. If
the tonsils and pharynx are not normal the cotted index finger should
be introduced into the mouth until the anterior pillar of the fauces
is reached. A mouth gag may or may not be used. Massage the tonsil
through the anterior pillar then move to the top and press down on
the tonsil with a pumping motion. Repeat this from below the tonsil
and posteriorly. Slip the finger under the soft palate and stretch it
thoroughly. Clean out any adhesions and vegetations in the vault of the
nasopharynx and fossa of Rosenmuller. Stretch the pillars of the fauces
by pressing down on each side at the root of the tongue.
If the sinuses are diseased they should be drained. If the nose is
diseased and has abundance of secretion, first use irrigation for
cleanliness.
Manipulation in the nose will be of great benefit in some eye diseases
as pathology there frequently has an important bearing on diseases of
the eye. The nose is often too narrow and contracted. The first inch of
the nose is muscular and cartilaginous; it is of even more importance
to dilate the nose in contractured conditions than it is the sphincters
at the lower end of the rectum. The great benefit derived from rectal
dilatation has been recognized for years.
In dilating the contracted nose a wide blade nasal speculum may be
used. The cotted and oiled little finger may be used where it is
properly adapted in size. The dilating can be done with practically
no pain and no damage to membranes or other tissues. It should not be
extended beyond the cartilaginous and muscular part. Manipulation of
the turbinates and tissue further back may be done if needed, by the
use of instruments. The Edwards turbinate adjuster instrument (Aloe
Co., St. Louis) or the Ruddy Nasal Third Finger (Sharp and Smith,
Chicago) are the best instruments so far devised for this operation.
A thorough stretching of the =eyelids=, manipulation of the =eye ball=
and the points of the fifth nerve are indicated in many diseases.
The lids may be stretched by pulling them from side to side. The cotted
forefinger well oiled (sterile vaseline) may be slipped into the
conjunctival sac back of either lid and with the thumb on the outside
the lid may be massaged or stretched in any direction. The points of
the fifth nerve may readily be influenced at their respective exits
about the orbit. The eye ball and deeper contents of the orbit can be
profoundly treated by pressing the finger into the orbit above, below
and at the sides of the bulb and pushing it in all directions as far
as possible. The Ruddy eye finger instrument was devised for this deep
manipulation of the orbital and bulbar structures. It is of high value.
One finger may be laid on the closed eye and with a tapping motion with
the other hand a vibration or oscillation of the orbital structures may
be had. This is a useful treatment.
The wise selection and skillful use of these various methods of
treatment for the eye will solve most of our difficulties.
This short survey of osteopathic methods will aid us in the more
specific discussions to follow.