Viscera! Manipulation

The human biological materials may be solid (bone, teeth, hair, nails, tissue), semisolid (blood, faeces, viscera) or liquids (body fluids). Treatment of the solid samples usually demands some extra steps during sample manipulation, e.g. particle size reduction, homogenisation, sub-sampling etc. Heterogeneous liquid phases, e.g. blood and certain body fluids, additionally need stabilisation and homogenisation so as to avoid occurrence of any changes in their composition, prior to actual analysis (Anand et al., 1975). It is also advisable to keep the total number of transfers to a minimum, and use accessories made of non-wettable and inert materials in case of the liquids. 

From the earliest days of osteopathy, direct manipulation of the viscera has been included in the armamentarium of the osteopathic physician. In his last book. Osteopathy, Research and Practice, Andrew T. Still, the founder of osteopathy, discussed the treatment of many disease entities and emphasized the treatment of "lesions" of the vertebrae and ribs as well as describing techniques applied directly to the viscera. His stated goal was always to improve the circulation of arterial and venous blood and lymphatic flow to and from the viscera, as well as assuring proper neural function. His preference in visceral treatment was to have the patient in a knee-chest position, from which he would lift the viscera being treated upward toward the diaphragm. He described using this type of technique in the treatment of dysentery and appendicitis. He used a technique for dyspepsia in which he placed the patient on his right side while he lifted the stomach toward to left. 

In 198.3, Jean-Pierre Barral and Pierre Mercier published a text in Paris on visceral manipulation entitled Manipulations Vice rales. In 1988, this was translated into English as Visceral Manipulation, This text led to a renewed interest in direct treatment of the viscera. 

Intrarectal and intravaginal techniques can be performed for the purpose of more direct manipulation ofthe pelvic viscera, as well as some musculoskeletal structures such as muscles and ligaments. 

Osteopathic visceral manipulation is directed toward restoring normal mobility and motility of the involved organ, assuring normal lymph flow and circulation, establishing a normal cranial rhythmic impulse, and removing abnormal somatic or nervous influences on the viscera. 

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