=The Neck and Head.=—In the treatment of the neck the patient may
assume the sitting posture or lie flat upon the back. The latter is
preferable, as then one has complete control of the neck and head.
Absolute control of a part is always necessary and when this is secured
the dangers are reduced to a minimum, provided always that reasonable
discretion as to the amount of strength, is used. Before correcting
the various deviations of the cervical vertebræ it is usually best to
thoroughly relax all the muscles, superficial and deep, about the field
of operation. In relaxing muscles three methods may be employed. The
muscle may be firmly grasped and manipulated until relaxed, or a firm
pressure may be exerted upon the muscle and thus inhibit its nerve
force until the muscle relaxes, or the muscle may be longitudinally
stretched. The second method is comparatively slow and is usually
given in acute cases where the patients are so weak and exhausted that
they cannot stand any severe manipulation. This method, however, has
certain advantages when employed as a preparatory step in interosseous
adjustments, though steady traction accompanied with slight rotation,
if precisely localized, has many advocates.
In relaxing muscles by manipulation, grasp firmly the belly of the
muscle and draw outward on the muscle several times until it relaxes.
If the patient is sitting, place one hand upon the head of the patient
or about the chin in such a manner that complete control of the head is
maintained throughout the procedure; then with the fingers of the other
hand upon the contracted muscular fibres a manipulating or kneading of
the muscle can be given. It is best to flex the neck and head to the
side where the contracted muscles are, so that a better hold of the
muscle may be maintained; then by a series of flexions and extensions
with manipulation of the contracted muscles outward, results can be
readily obtained. When the patient is lying on the back the physician
may stand to one side of the patient’s head and with one hand on the
forehead of the patient and the other hand around the opposite side
of the neck, a rotary motion of the head and neck, which is equal to
flexion and extension in the sitting posture, may be given by the hand
on the frontal region while the other hand relaxes the muscles; or the
osteopath may stand at the head of the patient and with either hand
on the side of the head and neck of the patient a series of rotary
movements of the head and neck may be given with manipulation of first
one side of the neck and then the other; the hands and fingers being
placed in such a manner that when the fingers of one hand are relaxing
the muscles on its side the other hand is executing the movements of
the head and neck, each hand continually alternating in the work. This
latter method requires some practice in order to do the work readily
and successfully, for quite a variety of movements are required.
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