In the common run of cases in which Bone-setters succeed, very moderate force is sufficient to break down all resistance that is encountered. This latter is a very important point. The main objection entertained by surgeons to manipulation is that it is a resort to violence; it is vi non arte. This view, however, if founded mainly on the experience of cases in which fibrous ankylosis of the larger joints has been broken down. But these, I venture to repeat, are not the cases by which to judge this method. I can recall but few cases in which free motion has been restored to a joint that could be moved only by the use of considerable force. The most striking successes are obtained in instances in which some slight impediment to motion is easily overcome. Indeed, it may be taken as an axiom—almost, perhaps, self evident, that the less the force which is required to remove the impediment, the more successful will be the result. Thus so far from the opinion being a correct one, that manipulation is necessarily a resort to violence; the truth is, that in appropriate cases, force which could inflict injury on the natural structures is very seldom required. I think when this fact is more clearly recognised, much of the distrust now entertained respecting manipulative treatment will have been removed.”
PLATE VII.—DISLOCATIONS AND RUPTURES.
29. Dislocation of spine. 30. Appearance of bones in Pott’s fracture. 31. Appearance of foot in do. 33. Fracture of patella (separation of fragments). 34. Signs of fracture of patella on knee-cap. 35. Rupture of long tendon of biceps.
Thus Dr. Howard Marsh argues admittedly on the slightest and most imperfect knowledge of the Bone-setter’s art and their method of procedure. He is kind enough to admit that they sometimes reduce recent dislocations, disperse a bursa, and succeed in nervous so-called hysterical joints and spines. (See George Moore’s case, 29-32 ante.) They sometimes, he admits, “replace a slipped tendon,” and operate successfully in cases of internal derangement of the knee joint, and in relieving joints which, though healthy, are stiffened and painful from surrounding adhesions. He approves to some extent of manipulations, and his whole paper is one of disparagement, or “damning with faint praise.”
CHAPTER VII.
VINDICATION.
“Is this then your wonder?
Nay, then, you shall understand more of my skill.”—Ben Jonson.