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The Mystery and History of Spinal Manipulation

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The Mystery and History of Spinal Manipulation Michael C. P. Livingston The Mystery and History of Spinal Manipulation SUMMARY SOMMAIRE This paper reviews the history of spinal Cet article raconte l'histoire de la manipulation de la manipulation and shows its origin in an colonne vertebrale, ses origines, son passe obscur obscure past among many cultures. The dans les diff6rentes civilisations. L'auteur suggere author suggests reasons for the medical plusieurs raisons qui peuvent expliquer le manque d'interet relatif de la profession medicale pour la profession's relative disinterest in manipulation et il s'interroge sur les motifs de cette manipulation, but questions this attitude. attitude. (Can Fam Physician 1981;27:300-302). I-i.....1 Dr. Livingston practices family Manipulation, meanwhile, was The doctress of Epsom has outdone medicine in Richmond, BC. being practiced in different localities you all . Reprint requests to: Suite 305, 7031 by different types of individuals in- A century later, Dr. Riadore, a Lon- Westminister Highway, Richmond, cluding priests, virgins and tame don physician, suggested a source for BC. V6X 1A3. bears-all trampling on the sufferers' much disease was the irritation of spi- backs. Captain Cook was "squeezed" nal nerves, while across the Atlantic, MANIPULATION of the spinal by Tahitian women for his sciatica in at Ohio Medical College, John Eberle Joints may be defined as an ex- 1777, noting in his diary that "they wrote: amination treatment procedure in made my bones crack". "When the pains are situated in the which the spinal joint or joints are In Europe, certain families came to head and upper extremities, the spi- moved beyond their restricted range to be called bone-setters, "knochen- nal affection, if any exist, will be their normal range of movement. This brechers" (Germany), "les rebou- found in the cervical vertebrae; and procedure may be accompanied by im- teux" (France), or "kotnackare" when a part about the chest, and provement in the patient's symptoms. (Scandinavia). The name developed upper portion of the abdomen, is the The mechanism of improvement is un- from their belief that they put a bone seat of the painful affection, there certain. back in place. An Augustinian monk, will probably be spinal irritation in Massage and manipulation are two Friar Moulton, compiled the Compleat one or more of the dorsal verte- of the oldest remedies known to man, Bonesetter about 1590.4 Bone-setters, brae."5 while "a bone out of place" is an an- having no formal education, passed Hugh Owen Thomas, the father of cient concept. In Genesis, Jacob, their knowledge on to their sons. With British orthopedic surgery, came from wrestling with an angel, found the rare exceptions, such as Friar Moul- a family of bone-setters. A strong ad- "hollow of his thigh was out ofjoint". ton, they did not write. During the vocate of rest, he severely criticized James Cyriax, in his Textbook of Orth- 17th century, a bone-setter and an as- the work of the bone-setters after see- opaedic Medicine, ' included a picture sistant bone-setter were appointed to ing the damage caused to tuberculous of a Buddhist temple with a statue over St. Bartholomew's Hospital in Lon- bones and joints. The medical profes- 2,000 years old showing manipulation don, but history does not reveal the sion condemned the bone-setters and of the lumbar spine. reason for the lapse of their appoint- later the osteopaths and chiropractors Hippocates,2 the father of Greek ment. who followed. However, Hugh Owen medicine, described the treatment of A woman, Sarah Mapp, caricatured Thomas himself, suffering a pain for spinal deformities by "succussion" in by William Hogarth and George many years, consulted the renowned which the patient was suspended and Cruikshank and nicknamed "Crazy bone-setter Hutton and was "instantly shaken upon a ladder. He added, "I Sall" or "'Cross-eyed Sally", devel- relieved of pain".6 Hutton's tech- have been ashamed to treat all such oped a remarkable reputation for bone- niques were later described by Dr. cases in this way, because such modes setting at Epsom, England, about Wharton Hood in Lancet (1871).7 of procedure are usually practised by 1736. Some described her as "an ig- Richard Hutton taught his nephew, charlatans." The Iranian physician, norant, illiberal, drunken female sav- Robert Hutton, who taught John At- Abu' Ali Ibn Sina, known also as Avi- age" but a popular song proved more kinson, who in turn taught Herbert cenna (980-1037) later reproduced il- generous: Barker (1869-1950). lustrations of Hippocrates' methods of You Surgeons of London who puz- Sir James Paget, one of the few traction combined with direct spinal zle your pates, medical leaders who advocated learn- pressure. The father of French sur- To ride in your coaches and pur- ing from bone-setters, delivered a clas- gery, Ambroise Pare, (1510-1590) chase estates; sic lecture, later published in the Brit- used and wrote about spinal manipula- Give over for shame, for your pride ish Medical Journal of 1867-"Cases tion.3 has a fall, that bonesetters cure". He noted that: 300 CAN. FAM. PHYSICIAN Vol. 27: FEBRUARY 1981 Patient. Torhsmokingprandltheeffectively treat the. cardiovascular problem, it's A. 1 Indication: N.icorette Chewing Gum is design- . E Hw .e N ed to provide partial substitution for the tan the 2mg pr nicotine in cigarette smoke, which is believed gain Is sometimes associated with abstention (pale yellow) and 2 mg (fawn colour) square asto beaotrviempoaryiaidone of the principalinsubshiuioningrfactors inthepainthe per- of smoking. For this reason, a patient on of highly spiced chewing resin base and pack- peItation orette Chewing Gumis intended Nicorette shou.ld beweighed at regular Inter- aged In blister pack strips of 15 pieces and petatimon of t oingcshaningt. nt vals, with modifications in diet as necessary contained in boxes of 7 strips (105 pieces). against the psychopharmacologica trauma of Treatment of Overdose: 1. In a conscious, alert Nicorette 2mg - D N 456586 withdrawal. Its justification as part of the patient, prompt evacuation of the stomach Nicorette 4rmg- DIN 456594 treatment of cigarette addiction lies in its be- should be performed. When evacuation is Product monograph available on request. ing the least of three evils present in tobacco complete, activated charcoal may beadminis- smoke. It is therefore important that it should tered by mouth if necessary. be regarded merely as an aid to the first stage 2. In comatose patients, a clear airway must References: of cigarette abstention, and that the ultimate be established immediately. Other thera- 1 Wilhelmsen, L., Focus on Smoking aim should be the abandonment of all forms of peutic measures are purely symptomatic and Cessation: Clinic experience. College of smoking and all forms of nicotine chewing. should be conducted according to the attend- Family Physicians Invitational Symposium is contraindicated ing physician's assessment of the patient on Smoking Cessation, Toronto, Contraindications: Nicorette When the status in pregnancy because of the known adverse patient's clinical stabilizes, June 27, 1979. be given to gastric lavage 2. Wilhelmsson, C., Vedin, Elmfeldt, effect of nicotine on the fetus. Nicorette isalso andconsideatonmaythe administration of activated charcoal. J.A., D., contraindicated in breast feeding mothers as Tibblin, G. & Wilhelmsen, L., Smoking nicotine is excreted in breast milk. Dosage and Administration: Dosage 2 mg: and Myocardial Infarction, Lancet. i,415 to be chewed Precautions: Nicorette cause an exacer- One 2 mg Nicorette piece (1975). may slowly in place of a cigarette when there is a bation of symptoms In patients sufferingn of sfroms crvn to smoke Up to 10 pice pe-a or of the oral ravi ng to smoke. Up to 10 pieces per dy\* > inflammationinlmmto or diseasedies of th oacvItycavity, s the usual recommended dosage although in gastritis, or peptic ulceration. Nicorette .. i u - - a in corett exceptional cases, up to 20 pieces per day should be prescribed with care in patientswith may be required. Nicotine resin complex. angina, coronary artery disease or peripheral Dosage 4 mg: One 4 mg Nicorette piece to be vascular disease.Doae4m:Oe4mNioetpictob n-s o n i. chewed slowly in place of a cigarette Adverse Effects: Nicorette can sometimes when there is a craving to smoke which is tTrademark of AB LEO, Helsingborg, Sweden cause, in the early days of treatment, apthous uncontrolled by 2 mg Nicorette. Up to *Trademark of The Dow Chemical Company ulcers, throat irritation, excessive salivation 10 pieces per day is the usual recommended and hiccups. However, these symptoms are dosage although in exceptional cases, up to usually more frequent and severe with 4 mg 20 pieces per day may be required. DOW PHARMACEUTICALS, Dow Chemical of Canada, Limited, 380 Elgin Mills Road East, Richmond Hill, Ontario L4C 5H2 "the patients who are cured never sity of Chicago, related the story of an ful drugs, induced Still to seek another cease to boast of their wisdom in Irishman named Burke the Bonesetter, system. acting contrary to authorized advice; who was elected to and remained in Still was a strongly religious man but they who are damaged are parliament as a member for County and, as he studied Indian skeletons it is ashamed of themselves and hold Clare for 25 years. He treated his pa- not unlikely.that some words of the their tongues . for the patient tients free on the understanding that Old Testament prophet Ezekiel came loves to be cured with a wonder, they would keep him in parliament. So to his mind (chapter 37, verses 1, 7 and the audacious confidence of everyone was satisfied except the Irish and 10): these conjurors is truly wonder- prime minister, Eamon De Valera, "The Hand of the Lord was upon ful.
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