To reduce vertebræ that are =deviated anteriorly= in the dorsal region,
especially between the scapulæ, is often a hard matter. A satisfactory
method is to stand behind the patient, while he is sitting upon a
stool, and reach around both sides of him upon the sternal ends of the
ribs corresponding to the anterior vertebræ; then have the patient
relax with the head upon the chest, and at the same time take a full
inhalation while pressure is exerted posteriorly upon the sternal ends
of the ribs. The object of this method is to pull back the rigid ribs
(the lungs being filled with air) which are attached to the anterior
surfaces of the transverse processes of the vertebræ, and thus upon the
anterior vertebræ pushing them posteriorly; all of the muscles of the
body being quite passive and the head relaxed on the body, a separation
of the vertebræ is accomplished, thus favoring a crowding posteriorly
of the subdislocated vertebræ.
To correct =vertebræ= of the =lumbar region= is on the whole much
easier than in the dorsal region. Here the legs can be used as levers
to great advantage. By the same method of flexion, rotation, and
extension, as employed in the dorsal region when the patient is lying
on the side, the result can generally be obtained.
Sidebending is the most common single lesion of the lumbar vertebræ,
though there may be some rotation at the lumbo-sacral juncture.
Occasionally malformation is found at the fifth. To correct the lumbar
lesions the following method is often used: place the patient upon the
side of the rotation or sidebending with knees flexed, buttocks well
back and entire spinal column straight. Next bring torso and head,
with spine straight, well forward to edge of table. Then with hand
upon ilium tilt it slightly forward, and with other hand upon shoulder
rotate entire spine, including head, so that spine is locked and the
point of localization exactly corresponds to the lesions. This brings
the spine back to nearly a straight position. Next, after a moment
or two of tension-relaxation, either thrust back upon the shoulder
or forward upon the ilium. Again exactly coordinating localization,
relaxation and leverages is the key of the method.
=The Abdomen.=—Direct treatment of the abdomen is given in many
diseases of its organs. The patient should lie flat upon the back, the
legs flexed upon the thighs and the thighs flexed upon the abdomen, so
that the abdominal muscles will be thoroughly relaxed; and then the
various organs of the abdomen can usually be manipulated with ease.
Remember that in many diseases of the abdominal viscera the treatment
of the splanchnics and vagi will be the primary treatment rather than
direct abdominal treatments.
Public-domain text, read in full here on John Shaqi.
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