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nerves, and enters, by its branches into the formation of a large number of plexuses. Through this ganglion it is that much Osteopathic work is done, and the purpose of this brief paper is to point out some of the many effects which may be produced by its stimulation or inhibition. ITS POSITION.

Anatomically we know that the superior cervical ganglion is situated in relation to the transverse processes of the upper three cervical vertebrae. It gives off branches which communicate directly with the vagus, glosso-pharyngeal and hypoglossal nerves; another branch, the ascending, passes into the carotid canal and enters into the formation of the carotid and cavernous plexuses; other branches pass to the pharynx, and a branch enters the formation of the cardiac plexuses. From the carotid and cavernous plexuses pass many nerves, only a few of which need special mention; one unites with the great superficial petrosal to form the Vidian nerve which goes to Meckel's ganglion, branches pass to the Gasserian ganglion, while we have others passing to the third, fourth, the ophthalmic division of the fifth and the sixth nerve, also we have derived from the nerve the sympathetic root of the lenticular ganglion.

ONE OF ITS FUNCTIONS.

Physiologically we know that one of the special functions of the sympathetic nervous system is to control the tone of non-striate muscular tissue, and that we have filaments distributed from the sympathetic system in the muscular wall of every blood vessel, duct and organ throughout the body. We also know that the sympathetic is the accelerator nerve of the heart, being opposed in its action by the vagus which, is inhibitory; further, that the vagus is constant in its brake-like action, while the sympathetic only acts when stimulated either directly or reflexly. While the vagus is inhibitory to the heart it is motor to the lungs. Nerve force is not generated in the sympathetic system; the cerebro-spinal nerve force is conveyed to the ganglia by the rami communicantes and in the ganglia is transformed into sympathetic nerve force. We might compare the ganglia to electrical transformers. Such being the case it is not difficult to see that if the superior cervical ganglion receives the nerve-force for transformation from the upper four cervical nerves and we can prevent, or lessen, the passage of nerve-force from the spinal cord through those nerves to the ganglion, that we will, to a corresponding degree, lessen the amount of sympathetic nerve-force transformed in the ganglion and transmitted from it by its branches.

STIMULATION OR INHIBITION.

We can produce stimulation or inhibition of a nerve at will; press suddenly and with a little violence upon the ulnar nerve where it lies in relation with the internal condyle of the humerus and we will find a manifestation of its physiological action, evidenced by a sense of pain in the ulnar and radial sides of the fifth finger and the ulnar side of the fourth, together with contraction of the muscles supplied by that nerve. But if our pressure be less intense and more prolonged we will inhibit the nerve and produce a sense of numbness in the same area together with temporary loss of muscular control.

Osteopaths well understand how to produce either stimulation or inhibition of the ganglia by way of the nerves passing to them from the spinal cord, and the results of such inhibition or stimulation in any sympathetic area can be prophesied readily by anyone who has read with attention what I have written; for instance, in the case of inhibition in the region of the nerves supplying the superior cervical ganglion with nerve force, we will find, first, throughout the area of distribution of the branches of this ganglion a relaxation of the vascular walls. This will be marked by two indications, first, the skin will become flushed and moist; second salivary secretion and lachrymal secretion will be increased. Second, the vagus is now allowed full sway, and we will find slowing of the heartbeat. It is well known that pressure over the seat of the first spinal nerve for a very brief period of time will control a congestive headache; the pressure in such case is made only for so long time as to produce stimulation of the sympathetic to greater activity, when we will attain a vaso-constrictor action, lessen the volume of blood in the cranial cavity and so abolish the headache. The arteries of the body may be divided into three groups, the large, the medium-sized and the small; in the first of these we find little muscular tissue and much elastic; in the second they exist in about equal proportions, while in the small arteries we find much muscular tissue and little elastic. As a consequence it is upon the smaller arteries that the sympathetic system has its greatest effect. As we dilate the smaller arteries and slow the heart action, it follows that we reduce the blood pressure, as we reduce blood pressure we reduce temperature, and within a very few minutes after the commencement of this inhibitory pressure on the upper four cervical nerves we will find in the large majority of cases, the capillaries over the entire surface of the body flushed, this being accompanied by a fall in the pulse rate and a marked diminution of the temperature. Indirectly at the same time we produce an effect upon the lungs; as we lessen blood pressure and the frequency of the heart action we find in accordance with the physiological rule an alteration in the respiration, it becomes slower and deeper. Arguing along these lines, and applying similar reasoning to each of the branches of this ganglion, anyone can trace out the many subsidiary results which may be expected from either stimulation of the rami communicantes nerves distributed to it, or their inhibition. Exactly similar rulings will find their prompt proof with regard to any other of the ganglia of the sympathetic system. We will find corresponding results in the cases of the thoracic ganglia which form by their branches the pulmonic plexuses; we get the same results from the splanchnic ganglia; while in the lumbar region we find that we have a ready means of control of the vascular system in the lower abdomen and pelvis. Much, very much, is still to be learned concerning the sympathetic nervous system, and all such increase in knowledge can come in one way only, clinical observation of Osteopathic treatment.

William Smith,
L. R. C. P. and S., (Edin.), D. O.

THE END.
FOOTNOTES

[1] Explore: (1) To seek for or after: to strive to attain by search; to look wisely and carefully for; to search through or into; to penetrate or range over for discovery; to examine thoroughly; as, to explore new countries or seas; to explore the depths of science; "hidden frauds (to) explore."—Webster.

[2] Chambers.

[3] "The secretion of the external auditory meatus, mixed with the secretion of the neighboring glands or ceruminous glands, forms the well known ear-wax or cerumen. The secretion in this place contains a reddish pigment of a bitterish sweet taste, the composition of which has not been investigated." American Text-Book of Physiology.

[4] Chambers.

[5] Disease. 1. "Lack of ease. 2. An alteration in the state of the body, or some of its organs, interrupting or disturbing the performance of the vital functions and causing or threatening pain and weakness; malady; affection; illness; sickness; disease; disorder."—Webster's International Dictionary.

[6] What has the student gained by reading the above definition of this standard author and representative of present medical attainment but a labored effort to explain what he does not know.

[7] Very true, if treated by the medicine man.

[8] My first Osteopathic treatment for appendicitis was in 1877, at which time I operated on a Mr. Surratt and gave permanent relief. During the early eighties I treated and permanently cured Mrs Emily Pickler of Kirksville, mother of our representative, S. M. Pickler, and mother of ex-congressman John A. Pickler of South Dakota. The infirmary has had bad cases of appendicitis probably running up into hundreds without failing to relieve and cure a single case. The ability of the appendix to receive and discharge foreign substances is taught in the American School of Osteopathy and is successfully practiced by its diplomates. In the case of Mr. Surratt I found lateral twist of lumbar bones; I adjusted spine, lifted bowels, and he got well. When I was called to Mrs. Pickler she had been put on light diet, by the surgeon, preparatory to the knife. She soon recovered under my treatment without any surgical operation and is alive and well to this date.

A. T. Still's Table or Device, That He Has Constructed For The Use of The Operator, The Ease And Comfort of The Patient.

It is a welcome success and does away with the lubberly old tables. It gives ease and support to all classes of patients. By its use the patient can sit in a chair or on a stool and feel at perfect ease during all treatments, then the operator gets results and is not tired to death when he has treated a patient; knows and feels that there has been some good done.

The asthmatic knows he has gotten help because pain has left his chest and he breathes as with new lungs; he knows he is helped more by one treatment while sitting on a chair with his body easy and at rest in the cushioned swinging device than he would or has received by the best skill on any table. Then the operator says, "Thank fortune, I am not worn out, and know I have gotten every bone to the place it belongs, and I know I have given satisfactory relief because my patients say so."

I think to an operator this device is his best friend. With it well understood he can do as much work as three good operators can do on the old tables. Remember this device does no part of the treatment but places the patient to your convenience while you do the work.

I feel as I am the discoverer of the device, that I know its needs and feel free to advise pupils.

The device will cost you $25 only.

A. T. STILL,
Founder.

The American School of Osteopathy, KIRKSVILLE, MO.

The course of study in The American School of Osteopathy is a carefully graded one, and is divided into four terms, of five months each. The terms beginning September and February of each year. The course thus requires two years for completion.

COURSE OF STUDY.

The course of study extends over two years, and is divided into four terms of five months each.

FIRST TERM.

The first term is devoted to Descriptive Anatomy including Osteology, Syndesmology and Myology; lectures on Histology illustrated by micro-stereopticon; the principles of General Chemistry and Physics.

SECOND TERM.

The second term includes Descriptive and Regional Anatomy; didactic and laboratory work in Histology; Physiology; Physiological Chemistry and Urinalysis; Principles of Osteopathy; Clinical Demonstrations in Osteopathy.

THIRD TERM.

The third term includes Demonstrations in Regional Anatomy; Physiology; lectures in Pathology illustrated by micro-stereopticon; Symptomatology; Physiological Psychology; Clinical Demonstrations in Osteopathy.

FOURTH TERM.

The fourth term includes Symptomatology; Minor Surgery; didactic and laboratory work in Pathology; Psycho-Pathology; Gynæocology; Obstetrics; Sanitation and Public Health; Venereal Diseases; Medical Jurisprudence; Clinical Demonstrations; Clinical Practice.

The school is open to students of both sexes without distinction, and all have equal opportunities and privileges, and are held to the same requirements.

The methods of instruction are such as obtain in the best academic and collegiate institutions, and include recitations from standard text-books, lectures, quizzes, practical laboratory

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