[NOTE: The following section is excerpted for principles Principles & Techniques of Nerve Regeneration: Alzheimer's Disease & the Dementias by David McMillin M.A. ]
In the preceding sections, the primary focus has been on using manual therapy regulatory techniques for establishing coordination of the body's systems. This section will deal with another important regulatory function advocated in the Cayce readings and the early manual therapy literature. Along with osteopathic or neuropathic coordination, drainage was specified by Cayce as an essential component in the regenerative regimen given in the readings for rebuilding the brain.
Cayce's emphasis on drainages is based on two important ideas: (1) in cases of progressive nerve deterioration the body is likely to be toxic; (2) presumably, regenerative modalities will put the body into a reconstruction mode which is likely to increase the toxicity of the body. The body has natural systems of elimination for cleansing itself. Regulation of these systems can assist the body in the cleansing process. This assistance may be needed because the pathological condition of the primary regulatory system of the body (the central nervous system) may be compromised due to the illness. Furthermore, providing support to the body's innate healing processes is fundamental to osteopathic and neuropathic philosophy and the Cayce readings.
To understand the natural process of drainages, it is helpful to review the physiology of this aspect of elimination as presented in the osteopathic literature:
"The artery carries nutritional substances and oxygen to the tissues. Its functional impairment results in deficient oxidation. Contrariwise, any circulatory perversion affects the respiratory function. Upon the lymphatic circulation falls the duty of direct cell-feeding and drainage. Veins are charged with general drainage. They are more easily compressible than arteries on account of their thinner and more flaccid walls. Interference with their physiological activities results in passive hyperemia and a storing up in the tissues of catabolic products." (Downing, 1923, p. 24)
Thus, venous and lymph circulation are the primary pathways of waste removal and tissue cleansing in the body. The expression "setting up drainages" is commonly used in the Cayce readings where tissue cleansing is needed. The osteopathic literature contains also abundant suggestions for setting up drainages. Here are some principles:
"Venous circulation is encouraged by muscular contraction. Thus congestion in a certain area may be relieved by passive movements of the muscles and by deep massage. The beneficial influence exerted on conditions about the head by thorough relaxation of the musculature about the neck in osteopathic practice, may be explained in part by its effect upon venous drainage of the head." (Page, 1927, p. 77)
"The lymph stream must always be drained first through the terminal areas.
Attempts to clear the lymph stream before clearing the edema in the clavicular regions is to over-tax the general lymph stream and cause profound reactions.
Any permanent results in treating the lymphatics must be accomplished through the nerve centers that control the vasomotor nerves of the blood vessels in the same region as the lymph blockage.
Never work over an enlarged or indurated lymph node - free the efferents and the lymph will drain.
General exercises will stimulate lymph flow, but if there is marked lymph blockage it is better to relieve the lymph tension before exercises are given. This will save marked reactions." (Millard, 1922, p. 27)
Manual Therapy Techniques to Improve Drainages
The osteopathic literature and the Edgar Cayce readings contain many examples of specific techniques for assisting with drainage. The following description of osteopathic drainage is particularly relevant because it focuses on the issues of drainage in cases brain degeneration. It is entitled, "BRAIN TROUBLES."
"The Osteopath's work is directed toward two primary objects:
First. The equalizing of the general circulation of the blood.
Second. The continued control of the blood supply to the brain and the correlative drainage.
To accomplish these ends the circulatory centers are first thoroughly treated; the muscles, ligaments and tissues which surround them are relaxed by pressure and by movements which will stretch the tissues. The next treatment is a stimulation put upon the deeper structures so as to secure the action of the heart and arteries. The third to fifth dorsal is the region for this work. Next, raise the clavicles; notice carefully the first rib and put steady pressure on the inferior cervical ganglion. The solar plexus, controlling the lumen of the mesenteric vessels, aid in controlling blood pressure. The hand laid firmly over the solar plexus will reduce general arterial pressure and by equalizing the flow will relieve congestion in any part of the body. The tissues of the neck demand a complete relaxation. This is for drainage. Then by holding the vertebral arteries for three to five minutes, the head thrown backward, the cerebral congestion is overcome. In cases of cerebral congestion the feet should be placed in warm water and ice bags applied at basis crani." (Riggs, 1901, pp. 52- 53)
This description of drainage in cases of brain disease is precisely the type of treatment Edgar Cayce was recommending in his formula for rebuilding the brain. Here are several more representative descriptions of osteopathic drainages from the era when the Edgar Cayce gave his readings recommending osteopathic treatment:
DRAINAGE OF THE HEAD AND NECK
"Deep drainage treatment may be done by direct relaxation behind and under the angles of the jaws with the head well extended. By forcing the head and jaw backward thus compressing these glands and again extending the repeating the direct deep drainage treatment, the glands and vessels may be "pumped" and made to increase their function of drainage. Except in acute inflammatory conditions, direct stretching of the soft palate and dilatation of the posterior nares by means of the fingers are effective; also exercises for draining the cervical lymph glands and exercising the muscles of the neck are effective....
According to Treves, "Accessory glands, belonging to the thyroid body, are frequently found in the vicinity of the hyoid bone. They are also found in the basal part of the tongue, near the foramen caecum.
In many cases of acute disease the swelling of these glands like the postpharyngeal glands cause much soreness and discomfort. In tonsillitis, pharyngitis, etc., there is usually some affection of these glands, but, as stated above direct treatment is not indicated during the acute state. Deep relaxation under the angles of the jaws externally will facilitate drainage. After the acute stage has passed, direct treatment may be done as follows: The two cornui of the hyoid are grasped between the thumb and second fingers of the left hand, palm upward, while the first and second fingers of the right hand are passed, palm downward, over the base of the tongue thus holding the hyoid firmly between these four fingers. The hyoid may now be lifted upward and thus by virtue of its attachment to the thyroid cartilage, the entire larynx may be lifted. The hyoid is held in this position for a few seconds, then pulled firmly forward and then downward and by these movements they pharyngeal constrictors may be relaxed and lymphatic and venous drainage accomplished." (Deason, in Millard, 1922, pp. 188-192)
DRAINING CERVICAL LYMPHATICS
"To drain the cervical lymphatics stand on the right side of the patient, in dorsal position, place the left hand on the forehead, and with the right hand reach over the sterne cleide mastoid muscle, draw the muscles up closely around the chin, with pressure on parotid and sub-mental gland, turn the head away gently with the left hand and continue this movement downward, one vertebrae at a time, to the seventh cervical. Gently inhibit with right index and middle finger the first and second dorsal vertebra together, drawing muscles away from spine, turn head away from operator and upward. Place the hand down over the scapula, draw the muscle up and place fingers against the superior border, laying the right arm against the chest of the patient and turn the head slowly and gently in the opposite direction from the operator.
Stand at head and cross the hands under the patient's head. Flex the head toward the chest, let down slowly, have the patient turn head to right and flex forward towards the patient's right elbow. Let the head slowly backward and turn to the left and flex toward the left. This movement stretches all the posterior neck muscles, ligamentum nuchae, trapezius muscle, flexes all anterior muscles and completes drainage of cervical lymphatics." (Haverin, undated, p. 1-2)
LYMPHATIC AND VENOUS DRAINAGE
A) Active. Patient lies supine on table. He exhales completely, closes his mouth and grasps and compresses his nose with his fingers. The doctor then asks him to contract his diaphragm and pull his abdomen inward as in attempting forced inspiration. This is repeated five or six times. With shoes removed and lower extremities at right angles to trunk, the patient is asked to flex toes, circumduct ankles, and repeat the forgoing diaphragmatic exercise to reduce edema of ankles.
B) Passive. (Lymphatic or Thoracic Pump). Patient lies supine. Doctor stands at head of table and places both hands flat on patient's chest with thenar eminence of each hand just inferior to the medial end of the clavicle and over the anterior end of the first rib. (Fig. 7.) Doctor stands with upper and lower extremities rigid and trunk inclined forward at an angle of about 60 - 70 degrees with the floor. He springs slightly up and down on toes, exerting quick, short thrusts on patient's chest at a rate of 20 - 60 a minute.
- This treatment should not be continued for more than three to five minutes.
- It should be used guardedly in patients past 55 years of age on account of danger of separation or fracture of costochondral articulations.
- It should not be used on patients with emphysema.
- It should be used with great caution on cardiac patients with inadequate compensation." (College of Osteopathic Physicians and Surgeons, 1941, pp. 15-16)
THORACIC LYMPH DRAINAGE
"Going back to the lymph drainage of the lymph drainage of the muscles [of the thorax] we may reach and influence the flow of lymph through a better vasomotor control of the blood vessels that supply the tissues and nodes. We may also reach the lymph drainage through correction of lesions that remove muscle tension over and around the lymph vessels and nodes. This will call for adjustment of the cervical region to insure normal tone in the brachial plexus. Correction of upper thoracic and rib lesions will stimulate vasomotor and trophic centres. Costal correction will regulate the upper thorax so that the lymph drainage into the subclavian veins will not be checked. The scaleni may be overtensed through cervical lesions." (Millard, 1922, p. 76)
TO STIMULATE LYMPH FLOW
"Among the noteworthy methods are:
- Deep Breathing. With each inspiration the flow of blood through the innominate veins causes a suction at the openings of the thoracic and right lymphatic ducts. This may be augmented by intra-abdominal pressure if the abdomen be forcibly drawn in.
- Manipulation of the extremities by flexion of the joints and compression of muscles. This may be either active or passive.
- Raising intra-abdominal blood-pressure by direct work over the abdomen and by compressing the ribs.
- Restoring normal tone to the diaphragm if it is prolapsed or relaxed. Dr. Still suggests that such prolapse may cause embarrassment to the thoracic duct. Hazzard elaborates this suggestion in a chapter in his Practice entitled "An Osteopathic Study of the Diaphragm," which is well worth pondering.
- Drinking hot water, or preferably hot salt solution, or injecting the same per rectum and retaining it."
(Downing, in Millard, 1922, pp. 139-140)
TO INCREASE THE VOLUME OF LYMPH
"The VOLUME of lymph may be increased in various ways, among which may be mentioned
- Active and passive muscular movements. Landois says: "Muscular activity causes increased lymph production, as well as more rapid escape of the lymph. The tendons and fasciae of the skeletal muscles, which possess numerous small stomata, absorb lymph from the muscular tissue,"
- Increase of blood-pressure by any of the manipulative means noted above. In this connection readers are commended to carefully study an address given by Dr. Hazzard at St. Louis in 1904, on "Osteopathic Manipulation of the Blood-Mass."
- Quantities of hot water or salt solution per os or per rectum. The reason for advising the use of hot water rather than cold lies in the fact that heat dilates the blood vessels, and absorption takes place more rapidly, while cold water causes contraction of the vessels."
(Downing, in Millard, 1922, pp. 139-140)
TREATMENT FOR DRAINAGE AND CIRCULATION OF THE THORAX
"In cases of pneumonia and allied conditions, there is one master treatment which accomplishes amazing results. This, I term the "make and break" movement. With one hand one the heads of the ribs posteriorly and the other on the ribs anteriorly, spring the ribs rhythmically in a line with their angle, alternating the pressure from hand to hand.
To promote vaso-dilatation, sit down beside the patient with the hands at the 2nd and 3rd dorsal vertebrae. Exert pressure enough to relax and inhibit for 10 to 15 minutes, repeating as the case necessitates. Then, standing at the head of the bed, grasp the neck as low down as possible so as to get straight traction on the 2nd dorsal. Make and break for dilatation of the lung arterioles. Direct pressure movements downward and backward over the sternum and upper seven ribs on each side, the patient lying on his back, are very efficacious in stimulating the lymphatics." (Snyder, in Millard, 1922, p. 177)
Edgar Cayce often recommended osteopathic treatment to improve eliminations by assisting in drainages. In fact, he considered this as one of the primary benefits of osteopathic treatment:
The things that hinder physically are the poor eliminations. Set up better eliminations in the body. This is why osteopathy and hydrotherapy come nearer to being the basis of all needed treatments for physical disabilities. (2524-5)
In many readings Cayce gave no specific instructions when he suggested that osteopathic treatment be given to improve drainages. Apparently, he assumed that the practitioners knew their business. Occasionally, when he felt that the osteopath wasn't getting the treatment correct (or if he was asked for specific directions), he would note the specific centers for drainage. In other words, there are nerve centers which regulate drainages. Stimulating these centers promotes drainages.
As we find, it would be well, with the corrections that have been indicated and which have been administered for some time, to turn these more to those centers where eliminations may be set up. That is, in the 2nd, 3rd, 4th and 5th cervical; in the 2nd, 3rd and 4th dorsal; as well as along the locomotory centers or the axis in the lumbar area. (717-3)
We would also have, at least once or twice each week, the proper manipulations and adjustments osteopathically given to those centers where the drainages are set up in the system, so that the activities to the whole of the body will be for a normal coordinating condition throughout the system.
Stimulate specifically the 4th lumbar center or area for the drainages through the activative forces of the lower portion of the abdominal area.
Stimulate those centers specifically in the 9th and 10th dorsal area for the solar plexus reaction through the beginning of the digestions, and the alimentary canal.
And in the brachial area, or the 1st and 2nd dorsal area, for the stomach - and the activative force in the organs of digestion.
And the hypogastric and pneumogastrics in the cervical area for the general circulation, that these may be kept coordinated in the building of the general strength for the body. (726-1)
Also we would set up drainages by adjustments made in those centers governing the central portion of the assimilating and digestive forces, or along the upper dorsal and through the cervical area; stimulating occasionally in the axis center, and then the general exercises that come with the activities of the body and those of the more specific nature that would keep a coordination from those activities below the lines across the abdomen - or for the lumbar axis....
In the rest periods between the periods of taking the Atomidine, we would take two or three of the adjustments in the areas indicated. Not as adjustments alone, but rather as stimulating the ganglia for drainages that are stimulated by the activities of these properties within the bodily functionings themselves. (1063-1)
Q. Have I fibroids in and around uterus? If so, what size _ and should I have these removed?
A. As we find, these are rather the pressures upon the organs by the improper drainages because of the disturbings in the circulation. We would not in the present have these removed, but if the drainages are set up from the 9th dorsal, the lumbar plexus being CORRECTED, specifically, and coordinated, with the proper drainages set up, these should be absorbed ...
Q. What is the meaning of drainages?
A. When the activity from the nerve forces and the muscular plexus along any portion of the cerebrospinal system, from which organs or portions of the body receive their nerve impulse, are stimulated, this sets up a circulation that allows for refuse forces or drosses from the system to be carried out in a normal way and manner. This is drainage, see? Not necessary that excesses only through the alimentary canal be increased in eliminations to make for proper drainages, but the muscular forces or tendons or bursae or the areas along the system where the nerve plexus produce the improper impulse need to be stimulated. This is why the activity through massage properly osteopathically given sets up such drainages better than the administering of those things that stimulate an already disturbed condition between the deep circulation and the superficial, see (that is, through cathartics, etc, see?)
Hence these are the indications as we find for the body.
While it is necessary to stimulate the activity of the organs that are showing a tendency for slowness or laggardness in their activity, this must be done properly - from their impulses or centers along the cerebrospinal system - to be EFFECTIVE and to MAINTAIN an equilibrium.
Q. Is Miss Mabel Todd the right osteopath for me to go to in the Essex House, W. 59th Street?
A. If she will make the adjustments in these specific centers as indicated, you see, and not attempt to make drainages ONLY by stimulating the upper DORSAL and CERVICAL areas, correct. She has the ability! If she will follow these suggestions, correct. (1140-1)
Q. I have taken osteopathic treatments every other day since reading. Do you see any improvement in the cerebrospinal system?
A. Well, as yet, that these be continued, at least every other day. The manipulations are not only that the system may be in perfect alignment, without proper inactivity through any of the incentive-producing ganglia along the system, but to also keep these conditions in such an attunement, in each ganglia, as it were, that the system may adjust itself, as the reduction of the growth in system is reduced to allow same to be eliminated, and not taken from the system would be very much in the same manner as to build a fire in a furnace and leave the ashes where they would smother the heat units produced. To smother the body with refuses that are thrown off from the system is to bring detrimental conditions to the physical body. The manipulations, properly given, do THIS for the system - keep the eliminations in their proper channels, and the coordination between the various forces that act in the capacity of taking refuses from the system must be kept in accord, or else the conditions become acute, as is seen in that now being eliminated from this body. (1377-3)
We would begin, as soon as the body rests well, with those of the manipulative measures, osteopathically given, as to correct those centers through which the ELIMINATIONS, as drainages, are set up in the system - especially in the cervical, upper dorsal, and the sacral and lumbar. These, in their reactions, will bring a nearer normal reaction to the body....
Q. How often should the osteopathic treatments be given?
A. These, as we find, would be WELL were a sedentary character of treatment given every OTHER day, and every other day a DEEPER manipulation. One that will make the body REST. Each day, then - see? and every other day one that will make for CORRECTIVE measures in the cerebrospinal system; for - as the nervous system is that greatest involved, with the lymph and emunctories - the sedentary effect of the gentle massage over all centers will bring the greater response and the better rest to the body. That's common sense, see? (2373-1)
About once a week, or once in ten days, DO have the osteopathic adjustments - this in the main to set up better drainages through the alimentary canal. For, a portion of the disturbance is the effect of the incoordination between the superficial and internal circulation. Thus poisons and accumulations produce those forms of the skin irritation....
Q. What specific areas should be treated osteopathically?
A. As indicated, have these to set up drainages through the alimentary canal. That's the upper dorsal area and through portions of the cervical. Of course, then, kneading the abdomen and the stomach itself. The 6th dorsal area, especially. (2518-3)
Keep in mind that osteopathic techniques for regulation involved both stimulation and inhibition (relaxation). Here is an example which advocates holding a steady pressure on a center to relax the system and set up drainages:
One of the best methods, even for the osteopath, whether he's ever tried it or not, he will find what it will do here: When the body is upon the back for treatment, raise the head and place the [osteopath's] fist on the 3rd cervical, and let the body rest full weight, even pressing gently - not hard, but gently - until the body does relax. Hold the fist there for a minute, two minutes, and after a while it may be two and one half to three minutes. This will drain, as it were, the whole system, setting up better eliminations throughout the whole body. (3624-1)
This technique for setting up drainages is often referred to as the "third cervical release." Obviously Cayce was aware that some osteopaths were using this technique. Interestingly, William Miller, D.O. an osteopath recommended by Cayce, claims to have learned this technique from A. G. Hildreth, D.O., a prominent osteopath and co-founder of the Still-Hildreth Osteopathic Sanitorium.
Another technique for setting up drainage by holding a steady pressure over nerve centers is described in reading 1010-11:
These [treatments] may be found to be of more specific help if there is an equal pressure held upon the segment between the last dorsal and the first lumbar and the third and fourth dorsal center. A pressure held here, one on the left, one on the right side of the cerebrospinal column, will tend to ease or drain the system and to make the body become not numb but the constant awareness as felt through the abdominal area, the constant tendency for the expectancy of shortness of breath and the quick pulsation will be found to be near normal during such times. This then should be as a part of the applications when the neuropathic or chiropractic adjustments are made, and will be most beneficial. They must be held at the same time, the body prone. (1010-11)
Thus, the Cayce material and the manual therapy literature contain abundant examples of the concept of drainage and specific techniques for this type of regulatory treatment.