Cayce, Osteopathy, General and Specific Treatments

General and Specific Treatment Formats

[NOTE: THE FOLLOWING SECTION IS EXCERPTED FROM PRINCIPLES & TECHNIQUES OF NERVE REGENERATION  BY DAVID MCMILLIN]

    In attempting to explain the meaning of Cayce's statement about osteopathic and neuropathic "coordination WITH drainage," we have considered the theoretical aspects of these forms of regulation as well as specific clinical techniques.  However, to help make this information more practical in its application it is necessary to utilize a format which recognizes general and specific treatments.
    In certain respects, the distinction between general and specific treatments is merely an extension of the concepts of anatomical correction and physiological regulation into a clinical setting.  The practitioner provides specific treatments for specific structural defects.  For regulatory purposes, a general treatment may be useful to put the body through it paces and thereby increase coordination and improve eliminations.
    In making therapeutic recommendations, Edgar Cayce often made the distinction between general and specific treatments. In the following excerpt, he recommended a general osteopathic treatment for relaxation:

    Once a week, or once in ten days would be preferable, have an osteopathic relaxation.  This does not mean that there are to be corrections attempted.... This should be a treatment not so much for adjustment as for a thorough, thorough relaxing, each and every segment, each and every muscular force of the body receiving special attention.  Use the limbs or the structural portions as leverage to make muscular reaction.  (3095-1)

    Often, Edgar Cayce would recommend both specific and general treatments for the same person.  Sometimes these two types of treatment would be alternated:

    With the corrective forces as will be made through those of adjustments OSTEOPATHICALLY given, and the massage following same - two of the general treatments to one of the [specific] adjustment treatments should be given.  These should be given at least every week, two general, one corrective ...  (53-1)

    We would take, now, about twice each week, the osteopathic manipulations, - a general manipulation at one treatment and a specific adjustment at the next, as has been indicated. (1844-2)

    In other instances, Cayce would recommend that general and specific treatments be combined in the same session:

    After the condition is lessened, begin with deep manipulation, osteopathically given - a general treatment every other day, and the specific treatment in the region of the lower cervical, the upper dorsal and the sacral and lumbar.  These would be given together (the general and the specific treatment), that the whole system may be aroused to better elimination and better relaxation.  (4999-1)
    We would have at least two treatments osteopathically each week, one of these being an adjustment treatment followed with a general manipulation - the other rather the massage over the whole system, keeping the coordination of nerve impulses from the ganglia in this area of the cerebrospinal with the cerebrospinal ganglia in the locomotory areas and the sympathetic areas.  (3722-1)
    The osteopaths of Cayce's era were also well aware of the distinction between general and specific treatments.  Some practitioners focused mainly on specific treatment following A. T. Still's admonition of "Find it, fix it and leave it alone" (in Brantingham, 1986).  Other early osteopaths were inclined to use general treatments as a regular part of their practice (e.g., Goetz, 1909; Riggs, 1901; Barber, 1898; Murray, 1925).
    "A General Treatment is given by a great many Osteopaths in connection with the specific treatment needed for the ailment for which the patient is being treatment.  General treatment is an advantage in a number of cases.  It is given for nerve troubles and for the general circulation."  (Murray, 1925, p. 61)
    "In giving a general treatment, try to do the work in twenty minutes.  When you begin to practice Osteopathy it will take thirty minutes or longer to give the general treatment, but after you have practiced for a while you will feel that you are wasting time if you do not give it in twenty minutes or less.  In using the shorter time you will do the work very effectively....
    In nervous troubles and in many constitutional diseases Osteopaths have discovered that they get better results when they give the general treatment.  This helps the circulation and makes a tired patient feel like new; and the treatment, after all, when there are no specific lesions to remove, is but little more than deep massage, in which nearly all the muscles of the body are manipulated.
     One may give this treatment, in such a manner that many patients come to look upon it as a luxury.  And many will take it when they are only slightly indisposed.  Some business men take the treatment as a means of relaxation. Many others take it when they are simply tired."  (Murray, 1925, pp. 18-20)
    Here is an example of a general osteopathic treatment as described in the Text-Book of Osteopathy (American College of Mechano-Therapy, 1910).

GENERAL OSTEOPATHIC TREATMENT     "Uses - A general treatment is indicated for the correction of nerve troubles and general circulation.
    Patient reclines on table, lying on the side.  Relax the tissues of the back by the following methods:

1. Stand in front of patient and grasp uppermost arm.  Relax the tissues about the shoulders and down to the spine and back with the other hand.  Hold the arm at the elbow, and using the joint as a lever, work the arm back and forth.  By this means the spine is manipulated and any deviation corrected.
2. With patient in same position, place one hand beneath the neck and grasp the occiput.  Rest the other side of the patient's head against your breast, and apply traction to the tack and upper dorsal region.
3. Place one elbow on the hip and the other on the shoulder. Stretch the spine by extending the arms and stretching the hips away from the shoulder.
4. Manipulate the shoulder.  Pull up the scapula with one hand, while with the other press the shoulder.
5. Place one hand under patient's scapula and grasp the shoulder with the other hand.  Then rotate the shoulder.
6. Manipulate the limbs by seizing the limb in both hands, relaxing all tissues with a rotary movement of the hand.
7. Manipulate the spine by pulling it toward you, while patient is lying on his side with knees flexed and braced against you.
8. Turn patient on other side and repeat above treatment.
9. Place patient face downward, with toes extended and arms hanging down over the sides of the table.  Describe a circular movement with the palms of the hands, at the same time apply pressure, to relax all contracted tissues of the back.  Pull the muscles away from the spine with the fingers.
10. With the patient lying in a prone position, stand at one side of the table and grasp the hip of patient on further side in front.  Apply pressure up and down the spine with the heel of the other hand, while pulling the hip upward.  Treat both sides.
11. Patient in same position.  Operator stands at head of the table.  Apply considerable pressure on each side of the spine with the thumbs.
12. Raise the limbs in one arm and rotate them, while applying considerable pressure at the lower part of the abdomen with the other hand.
13. Apply pressure to lower part of spine while one limb is raised.  Raise the other limb and repeat the pressure." (American College of Mechano-Therapy, 1910, pp. 12-15)

    The significance of the general treatment is that it provides a simple format for regulatory techniques such as coordination and drainages.  By its very nature, a general treatment will improve circulation which is a prerequisite for drainages.  Because the general treatment tends to stimulate all the nerve centers, it also has a coordinating effect that is lacking if only a specific adjustment is made.
    Yet, the osteopathic literature contains certain reservations against general treatment.  The primary concern is that general treatment may lapse "into routinism, to be followed by carelessness or slipshod methods"  (McConnell, 1932, in Jordan, 1994, p. 58).  However, like the Cayce readings, McConnell does see a valid role for general adjustment when it is precisely and intelligently performed in conjunction with specific corrective adjustment.
    "Unquestionably, as stated, there is merit in various soft tissue general manipulations.  They do affect circulation and nerve impulses.  They help to release abnormal tensions and to tone flabby musculature.  No doubt many beginning lesions are normalized and others are more or less modified as to severity.  But (and this is an extremely important "but") general manipulations will not, can not, adjust the serious deep-seated lesions.  Only skilled operative work can do this.  The very nature of the pathologic condition demands specificity in order to normalize it....
    Integration: What may be termed therapeutic integration of structure is essential, because each part of the structure is requisite to the unified action of the organism [coordination].  This means that not only should the local solution of structure be rectified [specific adjustment], but also that all abnormal correlative mechanisms should be carefully adjusted.   Integration [coordination] implies the necessity of general treatment, but not in the sense of general or routine manipulation....
    Diagnosis of the primary physical abnormal condition is of first consideration.  But unless one subsequently elicits the full value of the integrative [coordinating] trend of the organism, many pathological factors will be overlooked....
    Too much time, relatively, may be given to the local physiochemical derangement.  Ignoring the coordinative function and integrative trend of nerve impulse and chemical activity may defeat the very purpose of a localized therapy. Hence therapeutic specificity ofttimes depends upon adjustments of more than one region.  Function is no more confined to a local influence than is structure to a local requirement.  Both are adapted to body wholeness." (McConnell, 1932, in Jordan, 1994, pp. 58-59)
    Thus it is the careful integration of specific adjustment and general coordinating/integrating treatment that is the highest achievement of the osteopathic profession.

Edgar Cayce on Osteopathy

EDGAR CAYCE ON OSTEOPATHY

By Theodore Jordan, D.O. [NOTE: Dr.  Jordan, a practicing osteopath in Columbus, Ohio, and an A.R.E. member, has devoted several years to researching early osteopathic literature, the better to understand the Edgar Cayce readings that recommended manipulation and its role in health care.  The following article was published in Venture Inward, July/August 1994, Volume 10, No. 4.]
    Osteopathic treatment is of the most frequently recommended therapeutic measures suggested in the Cayce readings.  Chiropractic adjustments are recommended only occasionally.  This has caused much confusion for contemporary physician practitioners because osteopathic and chiropractic manipulative treatments seem so similar today.
    A look at the development of osteopathy and how it was originally practiced shows how it differed from chiropractic.  More important, osteopathy in philosophy and practice more closely reflected the healing philosophies of the Edgar Cayce readings.
    Osteopathy was developed by a Midwest physician, Andrew Taylor Still (1828-1917).  When three of his children died of meningitis despite the best available medical treatments, he began to question the exceedingly harsh and seemingly useless practices of his day.  This led him to search for a better understanding of health and disease.
    Dr. Still dissected many human corpses, thus gaining a knowledge of anatomy that was legendary.
    " A thousand experiments were made with bones until I became quite familiar with the bony structure.  I might have advanced sooner in osteopathy had not our Civil War interfered with the progress of my studies."
    Nine years after the war ended, in 1874, Dr. Still advanced his concept of osteopathy.  He believed that the human body, being a work of God, was perfect and inherently had all the properties needed to maintain a state of health.  Disease only existed if there was some obstruction to health such as impaired circulation of blood, lymph, or nerve forces.  The osteopath need only remove this obstruction, he reasoned, and the body would then naturally heal itself.
    In his autobiography, Still traced his confidence in manipulation as a healing therapy to an incident when he was 10 years old.  Suffering from a headache, he lay on the ground with his head resting on a blanket that lay over a rope tied between two trees about eight to ten inches above the ground.  "Thus I lay stretched on my back, with my neck across the rope.' He fell asleep and woke up feeling fine.  "I followed that treatment for 20 years before the wedge of reason reached my brain, and I could see that I had suspended the action of the great occipital nerves, and given harmony to the flow of the arterial blood to and through the veins, and ease was the effect." He came to believe that "the artery is the father of the rivers of life, health, and ease, and its muddy or impure water is first in all disease."
    He viewed the body allegorically as a "finely tuned engine" and the osteopath as a mechanic whose job was to correct any parts of the engine that were out of order.
    Dr. Still taught that when a bone or vertebra is slightly out of position there is also a strain on the surrounding tissues including the ligaments, muscles, blood vessels, nerves, and lymphatic vessels.  This strain causes a decrease in the local circulation of fluids and alteration of the nervous impulses.  Disease results when tissues and organs:

• Do not receive sufficient arterial blood supply to provide them with oxygen and nutrients
• Do not have properly balanced nervous supply to regulate and coordinate their function with the rest of the body, and/or
• Do not have adequate drainage through the veins and lymphatics to carry away their wastes.

    The osteopath's duty was to help elicit the body's natural healing forces by removing any obstruction to health.  This most often meant correcting the bony misalignment so that all the surrounding tissues and nerves could work unimpeded.
    "Remove all obstructions, and when it is intelligently done, nature will kindly do the rest," Dr. Still wrote.  He also often said that anyone can find disease, but an osteopath's job is to find health.
    Many parts of the Edgar Cayce readings and their recommendations parallel the osteopathic philosophy of health.  A book that outlines the similarities between these two systems is Osteopathy: Comparative Concepts - A. T. Still and Edgar Cayce, written by J. Gail Cayce.
    The Cayce readings contain many very complimentary comments about osteopathy of that day, such as: "There is no form of physical mechanotherapy so near in accord with nature's measures as correctly given osteopathic adjustments." (reading 1158-31) Also, "... and nature is better even than the osteopath - though the osteopath is the closest to the natural means." (1497-4) "Seek out, then, an instrument of the curative forces known as the osteopath, that is capable - through the proper manipulations, using the structural portions of the body as leverage - of stimulating the secretions through the various activities of glands and centers and ganglia along the system to bring about a coordination of the activities of the physical forces within the system itself." (531-2)
    Cayce seldom recommended chiropractic treatments and even on occasion warned against them.  What was the major difference that Cayce saw between the two schools of practice at that time which influenced him to suggest osteopathic much more often than chiropractic treatments?  It seems that the primary difference between osteopaths and chiropractors of that day was their method of adjusting the body.  Before these differences can be explained, a clarification of terminology is essential.
    A bone out of proper alignment is termed a lesion, or a subluxation, or somatic dysfunction.  There are many ways to correct these misalignments; but they fall into two therapeutic categories, the direct and the indirect techniques.
    Most direct techniques are associated with the popping or snapping of joints, usually the vertebrae of the spine.  In many direct techniques, the operator applies a thrust that is directed to force a displaced bone back into position.  If a single vertebra is displaced so that it is rotated and facing slightly to the right, the thrusting technique forces that vertebra to the left with the intent of leaving it centered in the midline where it should be.  This is achieved, once the patient is positioned, by a quick thrust which causes the joint spaces to open, producing an audible pop.  This mechanism is the same as when people crack their knuckles.  The sound is produced as two joint surfaces are quickly pulled apart, creating a small vacuum.  The same effect is achieved by pulling a small suction cup from a smooth surface.  This does not directly damage a joint, and often frees any restriction.  Injury to the surrounding ligaments can occur only if the operator puts too much force into the motion, thereby stretching the surrounding ligaments beyond their physiologic range.
    Depending on the operator's intent and skill, this thrust can be very specific and only adjust one segment.  With a slightly different approach, many joint spaces may be opened quickly, producing a crunch sound instead of a single pop.  It appears that early chiropractic adjustment was administered in this way - with quick thrusts to correct any vertebrae that might be out of place.  Over the years many variations on this basic technique have been developed.  Some use a great deal of force, while others are quite delicate and specific.
    Dr. Still and the early osteopaths who trained under him seem to have rarely used these direct techniques. Instead they used much gentler, indirect techniques.  Their method of correction involved gentle exaggerations of the position of the dysfunction until the tensions in the ligaments were felt to balance.  Then the job was to wait, feel for the body itself to correct the dysfunction, and to assist gently the body's natural corrective movement until the bone returns to normal, or to a more normally balanced position.  For example, in the case of a vertebra facing slightly to the right, instead of thrusting it to force it left, the osteopath would gently exaggerate its position; turning it even more to the right until a balance was felt, then allowing the body's intrinsic forces to take over and return the vertebra to its proper position.  The main focus of the operator is on the tension of the surrounding ligaments and muscles.  The corrective action comes not from the physician, but from the body's natural healing forces.
    Ample evidence of their preference for indirect techniques is found in the writings of some of the early osteopaths.  Indeed, they even warned against the harsher direct techniques.
    "I don't think I ever saw the 'Old Doctor' (A. T. Still) snap a joint with any noticeable sound, "writes M. L. Bush, D.O., who boarded with the Still family while a student at the first osteopathic school.  "His technique was practically painless to the patient.  I have often heard him say, ‘When you hurt a patient in treatment, you don't deserve to be called an osteopath."'
    G. V. Webster, D.O. summarized their philosophy when he wrote: "Living things prefer persuasion to force, consideration to trauma, intelligence to ill-expended force.  It is better to work with the tissues than at them.  Nature has her rewards and penalties for the manner in which lesions are treated. Co-operate with nature."
    Edgar Cayce echoed this in reading 1158-24: "Then the science of osteopathy is not merely the punching in of a certain segment or the cracking of the bones, but it is the keeping of a balance by the touch - between the sympathetic and cerebrospinal system!" and "With the adjustments made in this way and manner, we will find not only helpful influences but healing and an aid to any condition that may exist in the body...... Also, "A long series of such (osteopathic adjustments), just pulling or cracking here or there, has nothing to do with healing forces!  They have to be scientifically or correctly administered for the individual or particular disturbances, just as we have indicated here."
    Reading 304-2 further explains this difference: "Osteopathic treatment is needed, not chiropractic. If we had wanted this we would have given it. The body does not need adjustment, what it needs is relaxation of the muscular forces .... Chiropractic treatment is adjustment, not relaxation of the muscular forces."
    Not every dysfunction will fully correct on the first treatment but the osteopath's job was to acknowledge the body's wisdom and allow the body to correct itself at its own pace. As C. P. McConnell, D.O. wrote, "Always make it a point when working upon dislocated vertebrae in any region that just as soon as one has obtained a slight movement in the lesion do not attempt to correct it any more for the time being. A slight movement toward the right direction may be all that is necessary to relieve the ill effects of the lesion. In fact it might be impossible to get the lesion anatomically correct......
    Likewise, reading 2519-3 states: "...but to act in the manner as will allow nature itself - for, this - this would be well for all physicians of every character to remember: That they may only aid nature to; adjust itself. You can't force nature to do anything! Only aid it in adjusting itself to meet conditions."
    Along with these indirect techniques, osteopaths also used a number of different approaches to correction.  Some osteopaths preferred direct techniques to correct vertebral misalignment, but even these techniques were performed gently and without much popping or cracking of bony joints.  Edythe Ashmore, D.O., in a 1915 osteopathic text, wrote this about treating the neck: "The habit of putting a cervical joint upon tension and 'popping' it is one to be condemned in no uncertain language .... Cervical treatment should be mastered by slow processes."
    Even before A. T. Still's death in 1917, it appears that the direct, thrusting techniques were slowly becoming more popular with osteopaths.  In the 1920s, Still's influence waned as these techniques became, and remained, quite popular among the younger osteopaths.  Some osteopaths remained true to the original methods, however, and criticized this new approach.  Among them was J. B. McKee, D.O., who in 1979 warned that hearing a pop was no indication of correction.
    "... the main danger [is the] confusion resulting from confounding the sound of articular separation with the correction of the existing lesion," wrote McKee.  "Even the veriest layman knows that he can pop his knuckle without any way changing the relation of the joint surfaces and it would be well perhaps if osteopaths would give the thought more consideration than seems to obtain at present."
    These direct, thrusting techniques have remained the most popular mode of treatment among the majority of chiropractors.  Among osteopaths, these techniques became increasingly popular until they were apparently the primary method of manipulation taught in osteopathic schools from the 1930s through the 1960s.  Some reasons, I believe, are fairly obvious.  The older osteopathic techniques require a highly developed sense of touch, focused concentration, and are slower to perform and very difficult to teach correctly.  The direct, thrusting techniques on the other hand, are quick, efficient, and can be taught relatively easily to large classes of students.
    Both the chiropractic and osteopathic professions have changed.  Over the last century, osteopaths have fought for and have won full licensure in all 50 states and are able to prescribe medications as well as to perform surgery.  Today doctors of osteopathy are found practicing in all specialties of medicine.  Manipulation is still taught in every osteopathic school and many osteopaths continue to utilize these skills in their practices.
    Today, however, not all osteopaths continue to use their manipulative skills on their patients.  Nonetheless, there remains a strong core of osteopaths who maintain the highest proficiency in manipulative medicine.  Although many expertly utilize the direct, thrusting techniques, the older styles of manipulation never completely disappeared.  Today an increasing number of osteopaths are interested in learning, developing, and thus continuing this older, gentler style of manipulation, especially with the current renewed interest in natural medicine and the emphasis on assisting with the body's own power for healing.  Some chiropractors are also now using more of the gentler techniques and methods of correction.
    My explanation of all these techniques has been necessarily oversimplified.  To perform any of these techniques requires a detailed knowledge of anatomy, palpatory and diagnostic skills, knowledge of indications and contraindications in the treatment of patients, and extensive formal instruction for safe, correct, and successful treatment.  Most persons receiving manipulation therapy today are being treated with direct, thrusting techniques.  When done intelligently and properly, these treatments are certainly beneficial, as many can attest.
    The purpose of this article has been to explain why the Cayce readings made such a distinction between osteopathic and chiropractic treatments, to explain some therapeutic differences within these disciplines, and to suggest that from the readings, it may be realized that these gentler, indirect methods of manipulation first used by early osteopaths, and still in use today, are more in tune with the body's natural healing forces, and thus kindred in philosophy with health care as prescribed by Edgar Cayce.  As reading 1158-24 put it:
    "Then, the science of osteopathy is not merely the punching in a certain segment or the cracking of the bones, but it is the keeping of a balance - by the touch - between the sympathetic and cerebrospinal system!  That is the real osteopathy!"  
    The founder of osteopathy, Dr. Andrew Taylor Still, was certainly an extraordinary individual, having started the first osteopathic college at the age of 64, after which he wrote four books.
    In addition to his indefatigable stamina he was considered to have special powers of clairvoyance by those who knew him.  He used this clairvoyant ability on occasion, as Edgar Cayce had, accurately diagnosing medical conditions of people in distant locations.  He told one pupil, Dr. Ellen Ligon, that he could see a patient's aura and could tell from its appearance whether the patient was sick or well.
    During one period of his life, Dr. Still regularly met with a local spiritualist group, and with a medium named Mrs. Allred, who supposedly channeled an Indian spirit named "Metah." Dr. Charles Teall wrote that "He was psychic to a degree and held communion with unseen powers who helped him over the rough road he was compelled to travel ."
    In his Autobiography of A. T. Still, he stated, 'I was good at seeing visions all of my life.' Although these particular talents of Dr. Still were never emphasized, they provide a more profound understanding of the unique talents and insights of the founder of osteopathy.