The Concept of Regulation
[NOTE: THE FOLLOWING SECTION IS EXCERPTED
FROM PRINCIPLES & TECHNIQUES OF NERVE REGENERATION BY DAVID
During Edgar Cayce's lifetime,
osteopathic and neuropathic treatment consisted of two definite approaches
to treatment. The most obvious emphasis was on finding structural problems
with the body and correcting anatomical abnormalities (lesions).
On the other hand, manual therapy was also used to regulate the physiological
processes of the body (e.g., coordination and drainages). Regulating
treatments focused on re-establishing equilibrium and balance among
the various systems and processes of the body. Thus, the two aspects
of treatment were (1) correction of structure (anatomy) and (2) regulation
of function (physiology).
In practice, these two aspects were
often addressed by the same treatment. For example, correction of
a spinal subluxation would naturally remove a source of incoordination
and assist the body in re-establishing equilibrium and coordination.
Here are a couple of quotes from Cayce's era which acknowledges the
two basic approaches to manual therapy as exemplified by traditional
osteopathy. Note Hazzard's reference to "centers along the spine,"
a key concept for understanding regulation as the basis for coordination
In our treatment of a spine there
are two points which we may take into consideration; two objects which
we may have in view. In the first place, we may wish to TREAT
THE SPINE ITSELF [anatomical correction]. In the second
place, we may wish to REACH, BY TREATING THE CENTERS ALONG THE SPINE,
THE VISCERA TO WHICH THESE NERVES RUN [physiological regulation].
It is not always possible to disassociate these in your practice.
I have divided these points thus simply for convenience in the consideration
of them. (Hazzard, 1899, p. 32)
Osteopathic manipulation is applied
for two broad purposes; first, for the correction of spinal and other
articular lesions, and second, for its ability to effect alterations
in tissue pathology.... In actual application, no clear distinctions
can be made between measures applied solely to correct lesions and
those used for reestablishing physiological balance [regulation/coordination]
through other means, for it is probably that many of the manipulative
procedures used accomplish both objectives at the same time. (Long,
1938, p. 440)
Although much has been lost in the
clinical knowledge of the regulatory type of osteopathic treatment,
there are still a few practitioners who are familiar with this lost
art of osteopathy:
The majority of DOs [doctors of
osteopathy] do not use manipulation. Many of those physicians
who do so, use it primarily for treating musculoskeletal complaints.
They do not use manipulation for its homeostatic benefits [regulation]
to the body's physiology. (Kuchera, 1991, p. 117)
The neuropathic profession also
emphasized the importance of physiological regulation as well as specific
anatomical adjustment. Here is a brief example from the writings
of A. P. Davis, M.D., D.O., the self-professed founder of neuropathy:
Starting at the base of the brain,
at the atlas, we regulate all the nervous system involved by our particular
treatment in the adjustment of the atlas.... Our adjustment affects
the pneumogastric nervous system [parasympathetic], the phrenic nervous
system, the circulation of blood, and regulates the heart's action
... The upper portion of the cervical region we denominate the vasomotor
area; hence our adjustments in that region regulate the circulation
of the blood, not only the arterial, but the circulation of all the
fluids in the body as well.... Still further down, from the
first to the fourth dorsal, we have influences, through the nervous
system in that area, over the pyloric end of the stomach and lungs;
and from the fourth to the twelfth dorsal influences are carried to
the pneumogastric nervous system [parasympathetic] in the abdominal
viscera, and neutralizing excess of acid or alkaline secretion by
the union of the footlets of the two systems of nerves in that area....
Still lower down in the lumbar area, including all the dorsal nerves
in the lumbar region, by our treatment called adjustment, we regulate
the action of all the region or regions to the treatment in the middle
and lower area of the lumbar nerve-area.... All conditions of irritability,
excessive nervousness, may be avoided by first regulating the circulation
of the blood in the vasomotor area and at the fourth and eighth dorsal,
for the reason that the first regulates the circulation of the fluids
and lessens irritation, and the second unites the forces and equalizes
the secretion, resulting in a normal or natural condition. (Davis,
1909, pp. 58-62)
This brief excerpt from the neuropathic
literature contains six specific references to physiological regulation
as the focus of treatment. Like the osteopaths, neuropaths also
assessed and corrected abnormalities in the structural components of
the system by specific adjustment.
Edgar Cayce often recommended both types of treatment
(structural correction and functional regulation) in his readings.
Typically he spoke of "specific adjustments" and "coordinating treatments."
For example, he would frequently suggest that the clinician make the
specific correction of a spinal lesion and then go on to assist the
body in establishing coordination. Here are some excerpts from
the Cayce readings illustrating these concepts. As with the
previous quote from Hazzard, note the frequent references to "centers."
While the adjustments have in a
measure been at times helpful, these have not been - as we find -
as correctly given as some that have been had heretofore. To
make simply an adjustment and not coordinate same with the sympathetic
centers along the spine at times makes for a strain and a lack of
coordination, see? In making these adjustments, then, we would
make an adjustment in the upper cervical - as in the 1st, 2nd, 3rd
and 4th cervical; and then massage, by rotary movements, the nerves
and centers and the muscular tendons that react from same in the head,
the jaw, side of the face and the like, see? especially the
vagus nerves and the 5th and 6th nerves that come to portions of the
head ... Also, as indicated, it is necessary to make some adjustments
or rather movements in the lower dorsal and throughout the lumbar
area. These we would coordinate with the muscles and nerve ends
about the coccyx end, or along the lower spinal end, see? close
to the orifices that make their connections with the cerebro[spinal]
and the sympathetic nervous systems in the brush end of the spine.
First, then, we would apply corrections
in the lumbar and the cervical areas as specific. A coordination
of the centers along the cerebrospinal system, between the sympathetic
and the cerebrospinal system. As indicated, in the 4th lumbar
area - coordinated, of course with the 2nd and 3rd. The upper
dorsal area or through the brachial plexus area. The more specific
in the hypogastric and pneumogastric plexus in the upper cervical
areas. These made to coordinate; not so much by adjustments,
but by using the structural portions as the leverage for not irritating
but relaxing the ganglia that make for coordinations in these conditions.
Q. Have the corrections been made properly in the
6th, 7th, 8th and 9th dorsals?
A. These have been corrected in a much better manner than was
indicated when we had the body here before, - but those conditions existing
in the 11th and 12th dorsal and the first of the lumbars need to be
corrected, so there is perfect alignment....
Q. Should the osteopath treat only those areas, or give a general
A. Those areas would be specifically treated, but coordinating
all of the reflexes from same. For, the one who gives the osteopathic
treatments, if thoroughly acquainted with his business (though many
think they are when they are not!), will find that there are centers
or areas from which both the cerebrospinal and the sympathetic or
vegetative nerve system form conjunctions. If specific treatments
are given and there is not a coordination of those plexus or areas
where the specific conjunctions are made, these may tend to contract
the body rather than relax same. Hence there should be the consideration
of all of these when treatments are given.
While both types of manual therapy
are important, the concept of regulation is being emphasized here
because Cayce's requirement for manual therapy ("coordination WITH
drainage") is explicitly a regulatory form of treatment. Furthermore,
both Cayce and the osteopathic literature agree that osteopathic regulation
is achieved by influencing the nerve centers associated with vegetative