( By Dr. Krishna Murari Modi )

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After completing my MBBS, I joined the Central Institute of Orthopaedics, Safdarjung Hospital, New Delhi, as a house surgeon. This is a leading orthopaedic centre in India. To me, orthopaedics seemed a rewarding branch of medicine to specialise in. A person gets involved in a severe accident, fractures a bone, and comes to the orthopaedic department. The doctor examines him and confirms that he has suffered a fracture. The X-ray taken also confirms the diagnosis. Bones are manipulated under anaesthesia, placed in position, and the plaster is applied. Once again an X-ray is taken to confirm that the bones are in place. After six weeks the plaster is removed, and the broken bones are one again . The patient expresses his gratitude. The Doctor is happy because his hands have been able to help somebody. His job satisfaction is complete.

This is the ‘emergency’ face of orthopaedics. Let us now examine the less dramatic side. Here we deal with patient suffering from backache, sciatica, lumbago, cervical spondylosis and other pains of the spine and the joints. The story is not the same. The patient come with acute and chronic pains. All possible investigations are carried out. In most cases a diagnosis is made, but the treatment remains unsatisfactory. Inspite of the genuine efforts of the doctor, the recovery often remains incomplete. The patient keep coming week after week, month after month, and feels frustrated at the doctor’s inability to help despite all available knowledge. What is missing? I started looking for new methods to help. I read about the maniopulation of the spine and different joints. But I wondered why we did not practice this method.

This was the time when newspapers were filled with the news of osteopath Stephen Ward, who was involved in the sensational Christine Keeler case along with several bigwigs in Britain including Profumo, a British cabinet Minister. Profumo had to resign because of his involvement in the case. The news ended in the tragic suicide of Mr.Ward. This was the year 1965. As I read the name of the osteopath again and again, I wanted to know what osteopathy was. I learned that osteopaths relieve their patients of aches and pain by manipulation.

I remember a story my grandmother used to tell us. Once upon a time there lived a King. He had a severe backache. He would turn, toss and roll in bed because of the severity of the pain. He would not allow anybody to touch him. This went on for a long time in spite of the best ministrations of the royal physician. The physician was worried. Several physicians from all parts of the country were summoned and an award was declared for the one who would cure him. All efforts were in vain. Ultimately a physician arrived from far off. He ordered the royal horse to be kept without food or water for four days. The horse was then brought to the king, who after some persuasion, was asked to mount it. The thirsty animal noticed water in a ditch and galloped towards it. As he bent his head to drink, the king gripped hard to save himself from falling. In the process the king’s back clicked –and he was cured.

I was keen to learn manipulation. To my surprise, it was not a routine practice in our department. Manipulation under general anaesthesia was a rare occurrence. I decided to go abroad to study more about it. In London , I sought out orthopaedic surgeons, consultants in physical medicine and osteopaths. I watched them manipulate their patients and became convinced about the efficacy of osteopathic manoeuvres. I joined in London College of Osteopathy. The secretary of the college, Mr.A.F.Lockwood, admitted that osteopathy ought to be grateful to the ill-fated Dr Ward –he had made osteopathy known all over the world.

Two interesting historical cases relating to manipulation may be mentioned. Doctor Corvisort, the physician-in-chief of Napoleon and his wife, used to visit the royal couple twice a week. The Emperor enjoyed good health, so the physician’s services were required only rarely. But one day Napoleon began suffering from violent lumbago. The doctor, who was summoned, asked Napoleon to disrobe and lie across a table. He then administered a sound and well-aimed slap on his hips. The stunned Emperor turned in fury but during this movement the painful contracture of his lumbar muscles mercifully disappeared. The insolence of the celebrated physician was pardoned. This was the first example of successful manipulation recorded in history. The difficulty of finding the exact point of application of force in this manoeuvre makes us avoid it in practice. We use other manoeuvres which are not so spectacular but have an equal measure of success.

Hitler suffered from severe pain which could be relieved only by osteopathic treatment. During the 2nd World War, an osteopath was always at his side during front-line operations. Why has manipulation been so little appreciated? This book is a humble effort towards acquainting people with the art and science of manipulation. My hope is that eventually we will have an osteopathic department in the medical colleges in our country.

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