Orthopedic surgery deals with the mechanical or surgical prevention
and correction of all deformities, especially those of children. It
is not alone justifiable, but imperative, that orthopedic surgery be
given a prominent position in any up-to-date text on the Principles
and Practice of Osteopathy. The justification is threefold: though
orthopedics was practiced to a limited extent before the Science of
Osteopathy was developed, it has always been considered to be outside
the realms of true surgery, in that it is practically bloodless, and
those engaged in such practice have sought to establish it upon a
platform of its own.
The basis of the practice of orthopedic surgery and osteopathy is
similar, if not identical, in that it deals almost entirely with bony
abnormalities. It is recognized by the whole osteopathic profession,
and unconsciously by some adherents of medical science, that the
maintainance and restoration of normal function are alike dependent on
a force inherent in bioplasm and that function perverted beyond the
limits of self-adjustment, is dependent upon a condition of structure
perverted beyond those limits. This, then is the platform upon which
the two sciences of osteopathy and orthopedic surgery are erected.
The technique of osteopathic practice consists of passive manipulative
measures, designed to render to the organism such aid as will enable it
to overcome or adapt itself to the disturbed structure; and does not
seek, in itself, the aid of any instrument, mechanical appliance or
plaster of Paris cast.
Surely it is but a short step from our osteopathic therapeutics to
a system of therapeutics where we find all sorts of mechanical and
plaster of paris appliances, etc., to help our passive manipulation in
rendering to the human organism such aid as will enable it to overcome
or adapt itself to a disturbed structure. This latter, of course, is
the modern science of orthopedic surgery, and because of the shortness
of this step, I insist that it is one of the most valuable adjuncts
of the science of osteopathy. It is frequently necessary for the
osteopathic practitioner to take this step as conditions are met with
that have progressed beyond the possibilities of passive manipulations
and again other conditions of perverted structure can be much more
quickly reduced by the aid of each.
It is then indisputable that the therapist who approaches disease from
the osteopathic standpoint, above enunciated, is far more competent
to deal with the mechanical problems of orthopedic surgery than any
other known therapist. Secondly, in many conditions originally treated
by orthopedic methods, subsequent ordinary osteopathic manipulations
obtain a much more satisfactory and more lasting result than if it is
withheld. Thirdly, in order to avoid possible error, it is of extreme
importance that all osteopathic practitioners be particularly familiar
with the conditions hereinafter described, more especially tubercular
conditions of the spine, bones and joints, primary spinal curvatures
and others.
It is reasonable and furthermore true that osteopathic physicians are
confronted in practice with an unusually large percentage of cases
indicated above, and the early recognition of such conditions is of
fundamental importance in order that osteopathic manipulations be
withheld and supplemented or replaced by orthopedic methods.
Space of course will not permit of the entire discussion of this vast
subject but the most important and serious conditions met with in
general practice are fully discussed in the following pages of this
chapter.
Perhaps the commonest condition coming under this line of therapeutics,
and one in which we, as osteopaths, are most vitally interested is
rotary lateral curvature of the spine. From my personal observation
and from experiences of some of the most prominent members of our
profession, I am led to believe that this is one of our most difficult
lesions to overcome osteopathically, hence my desire to go further
into this condition than most of us might expect. I had opportunity
to obtain personally some very valuable information from Dr. Joachim
Stahl in the King’s Charity Hospital in Berlin, and to him I am
deeply grateful for many of the ideas of treatment presented in the
following article. I believe that I have an accurate conception of the
pathological condition that exists in connection with this deformity,
and I believe that my treatment of it has been more successful than
any that I have seen under other methods, in that I have gotten most
excellent results, in selected cases, in a comparatively short time,
entirely because osteopathic manipulations and exercises were used in
connection with the modified Abbott method.