Bloodless Surgery and Mechanotherapy
Sussanna Czeranko, ND, BBE
Dr. Benedict Lust, the Father of Naturopathy and a strong advocate for Natural Healing methods, requested in 1918 in the Universal Naturopathic Encyclopedia, that some Naturopath develop Bloodless Surgery Technique, etc. He became very much interested in bloodless surgery and suggested that the writer [Paul Wendel] do something about it.
Paul Wendel, 1945, p. 2
I often think it is almost criminal carelessness to allow a case of posterior or lateral curvature to come to a state of recognition without something having been done to arrest it.
Gustave W. Haas, 1916, p. 269
True physical culture works from within outward and you will have to first teach the brain what to do, before expecting results.
Gustave W. Haas, 1917, p. 115
In early winter, 2013, NCNM held a CE event on manual therapies. There I met Dr. Segur, a living example of “bloodless surgery” and its practice. Rather than use high-velocity, low-amplitude thrust, Segur relies upon old methods that have fallen into disuse. Luckily, he has a protégé, Dr Chris Brown, who is keeping these old and precious techniques alive. My comments here will not do justice to this wide, powerful topic; however, I would like to dust off the subject so that your curiosity may be sparked to delve deeper. The old ways are so important to our medicine.
A century ago, there were numerous manual therapies, characterized as “bloodless surgery,” that thrived under the naturopathic banner. “Mechanotherapy,” for example, was defined as “a system of co-ordinative movements by the hands and mechanical apparatuses as well as a systematic manipulation, used for the purpose of revitalizing the different tissues of the body.” (Shewalter, 1916, p. 38) Mechanotherapy found expression in manual and mechanical systems such as neuropathy, osteopathy, chiropractic, naprapathy and physical culture. Benedict Lust liked mechanotherapy, which soon evolved into bloodless therapies which “comprise[d] massage, Swedish resistance and mechanical passive movements and all external manipulative methods.” (Lust, 1905, p. 318)
As Shewalter explains, the primary purpose of mechanotherapy was “to equalize the circulation of the blood and to stimulate or inhibit nerve and muscle force as the condition may require.” (Shewalter, 1916, p. 38) For chiropractors, though, manipulation as a “bloodless surgery” has always been thought of as a complete therapy which did not need anything else to be effective. The chiropractors have based their modality, which they consider a “medical system,” in fact, upon the correction of spinal subluxations. “Adjustment, concussion and pressure, the great drugless therapeutic trinity, will cure all curable disease.” (Orphic, 1926, p. 281) These highly effective chiropractic principles were not foolproof, though. Haas comments, “There are those who call themselves Chiropractors, who would attempt to adjust the spine of a jellyfish rather than admit the fallibility of their system.” (Haas, 1916, p. 531)
Bloodless surgery today, however, means surgery without blood transfusions. A century ago, our early naturopaths had a completely different concept of so-called bloodless surgery. Surgery for the allopaths, though, was often the first, and in most cases the only, option for those suffering from painful injuries and deformities. On the other hand, as Haas points out, “The bloodless surgeon’s mission, with his understanding of this great power and its laws, is to help and serve those afflicted, by natural means alone, and to avoid the spilling of life’s vital fluid.” (Haas, 1925, p. 222) He adds, “The bloodless surgeon brings new resources of healing when those of the physician are exhausted.” (Haas, 1925, p. 222) By developing therapies to correct these physical abnormalities of patients, the early naturopaths were able to prevent the perpetuation of serious complications induced by surgical interventions. Haas, as the literature attests, contributed many articles in the Lust journals on orthopedics and bloodless surgery.
Another giant in the field of bloodless surgery was Paul Wendel. Encouraged by Benedict Lust, Wendel wrote a whole volume on Bloodless Surgery: Technique with Treatment(1945), which is now a classic encyclopedic exploration of this topic. The methods used by such bloodless surgery practitioners span many obscure therapies that we no longer know. Wendel compiled an extensive list of 46 rules based upon core naturopathic principles for administering bloodless surgery. The essence of Naturopathy was correcting or removing morbid matter and addressing auto-intoxication. Wendel exclaims, “The healing power is in the blood; it is the blood that heals.” (Wendel, 1945, p. 6) The first aim or objective was “to purify the blood-stream, because it is upon the purity and perfect circulation that each and every part of the system depends.” (Wendel, 1945, p. 6) Another point that Wendel makes in treatment is, “Always avoid giving severe pain.… Begin manipulations lightly.” (Wendel, 1945, p. 6)
Manipulation and vibration, adjustments, stretching, kneading, and massage all achieved the purpose of restoring blood circulation and relieving nerve impingements. Haas reminds us, “The relief of nerve pressure by manual therapy was for years a joke to all the profession, but thousands of satisfied patients is the best testimony to its success.” (Haas, 1925, p. 223) The type of patient seeking mechanotherapy was often one whose condition had been aggravated by conventional care, often involving invasive surgical interventions to deal with the initial presenting pain. Lumbar pain, for example, would be a case for brutal surgeries that often left scars and adhesions that would increase the deformities experienced by the patient. The medical profession devised “many crude devices and absurd methods employed by the practitioner in his attempt to straighten or correct the crippled or deformed.” (Haas, 1916, p. 63) Neither surgery nor these orthopedic attempts would allay the patient. Haas continues, “Modern surgery had not then nor has it yet made any progress with orthopedics and the general result was a plaster cast, which was a form of imprisonment as incorrect in theory and as cruel in result as its successor, the rigid iron brace.” (Haas, 1916, p. 63) Many of these iron contraptions were made by people with no understanding of anatomy or function, such as the blacksmith, machinist, or harness marker.
Having seen the damage done by these ill-functioning devices and the often needless surgeries, Wendel advised, “Manipulation of parts is to soften the muscles and relieve the nerves impinging upon the painful and hardened muscles.… Haste while giving treatment will prove detrimental.” (Wendel, 1945, p. 7) The disdain for the “carve and cut” (Love, 1915, p. 353) habits of careless surgeons was shared by Dr Love. He reasons, “An immediate operation has in countless numbers of cases saved human lives. But in making a plea for less surgery, I want to register an emphatic protest against the many needless operations hurriedly or carelessly performed.” (Love, 1915, p. 354) He continues, “The crowning point of the successful surgeon’s career has been attained when he realizes not when to operate, but when NOT to operate.” (Love, 1915, p. 353)
It is not surprising, in light of this record, that the subject of cause of pain or symptoms was very much on the minds of the mechanotherapists. Orphic offers a definition and clarity of what symptoms are. He states, “The symptoms of disease are, therefore, either for the elimination of the immediate causes of the disease and repair of structural damages…As soon as the purposes of the disease are fulfilled the symptoms disappear of themselves, as
naturally as they came.”(Orphic, 1926, p. 283)
Orphic is quick to remind us that as “Nature Curists,” we should not fall
victim to what he labeled, “allopathic phobia of symptoms.” (Orphic, 1926,
p. 281) Symptoms in his view were only symptoms, and not the cause. When the doctor is busy with efforts to suppress these symptoms, he is no longer practicing as a naturopathic physician, in Orphic’s view. Rather, Orphic counseled at the time, “We need to re-learn that the disease, that is, the aggregate of symptoms, is not the thing to cure. We need to rid our minds of our absurd symptophobia and stop our present method of going after every symptom, as it appears, with hammer and tongs.” (Orphic, 1926, p. 282)
Directing efforts to eliminate symptoms was merely suppression. It didn’t matter if drugs and serums or naturopathic methods of suppression were used. “What is the difference in suppression per se, whether we do it by our methods or the medical man does it by his methods?” (Orphic, 1926, p. 282) He continues, “What is equally certain, neither method can in any way correct the habits of living that made the disease necessary.” (Orphic, 1926, p. 282)
To Orphic and other early naturopaths, using force in the removal of symptoms was not Nature Cure. Orphic continues, “Every action of the body ‘normal’ or ‘abnormal’ is directed toward self-preservation and is perfectly adapted to serve this end.” (Orphic, 1926, p. 283) The human body always chooses “of its own accord, the best means for a hasty restoration of health, but it possesses as well, the capacity to so order its functions and processes as to delay as long as possible its ultimate destruction by inimical causes which it cannot overcome.” (Orphic, 1926, p. 283) Deciphering symptoms and treatments engaged the naturopath to look for the causes. A kindred spirit, in this regard, was William Havard.
In 1916, Havard explains in his article, A Comparative Analysis, Analysis of Manual and Mechanical Methods,how difficult it is to make an analysis of the various manual therapies “because each and every system has its own conception of the cause of disease and as a consequence has devised a different method of treatment for the specific correction of this ‘cause’.” (Havard, 1916, p. 479)
Havard was irked by the simplicity of the bone crunchers who deduced that eliminating any lesion in the spine was sufficient for the cure of the patient. Was it just enough to remove symptoms, or was the responsibility of the doctor to find out the true reason(s) for the ailing patient? Havard opted for the latter. Havard was bold to declare, “[The] system of manual and mechanical treatment correct only secondary or contributory causes of disease and symptomatic conditions, with the exception of traumatic cases.” (Havard, 1916, p. 480) Havard believed that morbid matter, and its primary role in the manifestation of symptoms, could not be ignored when mechanical treatments were used. He continues, “This correction will be permanent and assist in the process of cure if the proper methods are employed to bring about increased elimination of morbid waste products and to raise the patient’s power of resistance to the point of reaction.” (Havard, 1916, p. 480) After all, even if a headache were to disappear with one adjustment, Havard cautions, “the cause which produced both the headache and the ‘subluxation’ remains.” (Havard, 1916, p. 480)
Indeed, one of the keynotes of naturopathic treatment is to “treat the cause.” In order to treat the cause, Havard reminds us that one needs to be able to differentiate between the symptoms of disease and the compensatory symptoms. “In whatever part of the body a disturbance occurs, there is an attempted compensation in some other part.” (Havard, 1916, p. 480) Havard gives an example: “Whenever we have inflammation or increased activity in one part, we must have a compensatory constriction and a lowered activity in some other part.” (Havard, 1916, p. 420) Havard believed that many of the symptoms and chief complaints were actually the compensatory effects. He postulates, “In most disease processes the seat and cause of the trouble is obscure and the symptoms present themselves at the area of compensation rather than in the original part affected.” (Havard, 1916, p. 481)
Rather than focusing the treatment on symptoms, taking into account the cause of injuries and structural physiological abnormalities was much more productive. Genetics and acquired causes were the two main factors to consider. Haas gives examples of deformities: “Faulty elimination and accumulations of waste products in the system lead to deformity,” he writes. (Haas, 1916, p. 64) “The man or woman with a double chin or protruding abdomen are as much orthopaedic deformities as the hunchback,” he declared. (Haas, 1916, p. 64)
Haas, on a related matter, stressed to his naturopathic colleagues to take note of the importance of frequent spinal examinations for children, further pointing out that spinal deformities do not necessarily have warnings of pain. He says, “Just because the child does not complain of pain is no reason for believing that there is no curvature beginning or in existence.” (Haas, 1916, p. 269) Examinations of children included the observation of “the position of the child when standing at rest, when walking and when stooping over to pick up an object.” (Haas, 1916, p. 269) The results of deformities revealed:
… a rigid back giving the child the appearance of military erectness, generally with a head tilted back and the shoulders often retracted. The movements of the child instead of being free and unhindered are carefully chosen, indicating that they are using every effort to keep from exercising certain parts or muscles. This would lead you to suspect a beginning of Pott’s disease and if upon critical examination of the bony spine you can detect an angle or the outward projection of one of the spinous processes it will confirm the diagnosis. (Haas, 1916, p. 270)
Such physical examinations were also accompanied by observations of dress and, in particular, the shoes the patients wore. The early naturopaths recognized that high-heeled shoes or ill-fitting shoes could easily account for changes in the body. “Faulty shoes producing flat foot on one side often result in lateral curvatures and when both are involved lordosis may be the result.” (Haas, 1916, p. 64) Haas emphasized that adjustments may be indicated but not necessarily the only way to provide relief. He reminds us that shoes cannot be ignored: “You may be quite successful in relieving pains by releasing an impingement at the foramen of exit but it won’t do much good if the patient persists in wearing tight shoes.” (Haas, 1916, p. 531) He explained that deformities and especially “traumatic deformities are more often the result of injuries to some of the soft parts other than bone which in trying to ease up, we hold the body in a faulty position so long that it becomes permanent and hard to overcome.” (Haas, 1916, p. 64)
Because of such thorough observation, it is not surprising to learn from the literature that Gustave Haas specialized and was one of the original investigators in “orthopedic therapeutics” in Los Angeles. His schema followed three principle rules:
Correct the deformity by
Support the part treated by the proper appliance.
Physical culture of the musculature.
(Haas, 1916, p. 347)
Haas developed a physical therapeutic approach that used gentle traction, braces and physical exercises.
Traction was considered one of the most therapeutic aspects of the different mechanotherapies, whether it was massage or manipulative therapies. Carver reminds us, “It will be observed that [the baby] yawns, throws himself about and tractions all of his muscles and strains and stretches every part of his body all intuitively, which makes it overwhelming proof that he is correctly informed, that traction is essential for his health.” (Carver, 1916, p. 507) The example of this innate urge to stretch led a pursuit to find ways of tractioning the body.
Traction devices became popular in the pursuit of restoring a healthy spine. Traction tables or couches were viewed as “a very efficient and comfortable means of overcoming the general settling of the spine, which comes on at middle age, and faster as a person grows older.” (Gregory, 1915, p. 510) Others didn’t place such high expectations or even faith in the use of the traction couches. Carver, for example, opposed the coach, “The traction couch is but an attempt to substitute the work of a machine for the work of the hands; but it is clear that a machine can never have the knowledge and deftness that the hands have when under the direction of a well-schooled mind.” (Carver, 1916, p. 509) He continues in his support of the supremacy of manual palpation, “I know that if I should forsake the daily work of close and careful palpation and diagnosis or analysis of processes and of constant adjusting, I should lose the refined technic of all three.” (Carver, 1916, p. 509)
Gregory, though a contemporary of Carver, was enthusiastic about the new traction couches. In an article condoning its merits, Gregory described several cases and conditions that suited the use of the motor traction table. Not only did these traction tables prevent spinal shrinkage in old age, but they were capable of straightening spinal curvatures, he contended. Gregory adds, “By the use of our new motor traction table and adjustment while under traction, we quickly and positively overcome spinal curvatures in young persons, and also, but more slowly, we overcome spinal curvature in adults.” (Gregory, 1915, p. 511) The spine was stretched into normal alignment and “gradually, but surely, reform the spinal musculature and the spinal column into normal shape.” (Gregory, 1915, p. 511)
Another form of traction was manual traction that made all the difference for chronic neuritis and nerve impingements. It was gentle and could relieve discomfort when adjustments alone could not. “Traction, as a remedy for spinal deformities, has a high reputation and rightly employed can do much good, wrongly employed it is capable of much harm.” (Haas, 1916, p. 529) Further, Haas explains, “What we try to attain by gentle traction is to free the foraminal nerves from impingement, to relax the muscular fibres of the hundreds of muscles that surround the spine, … to open up the sources of blood supply to the various segments of the spine … and finally by gentle mechanical force to give a stimulus toward any particular direction of growth in cases of deformity.” (Haas, 1916, p. 529)
Haas was not in a hurry to change dysfunctional alignments that had “taken ten years of spinal abuse to produce.” (Haas, 1916, p. 531) He goes on to say,
You may bind your cases to iron frames rigidly or to any kind of apparatus that promises quick relief, the rigid plaster jacket, the un-yielding iron brace only to find that Nature doesn’t work that way. … But if you will try to correct in the natural way by gentle traction … Nature will come more than half way to meet you. (Haas, 1916, p. 531)
Gregory who used adjustments during the traction table recounted a case of a 25-year-old woman who had, as described here,
[a] spinal curvature since childhood … extended from the seventh cervical to the seventh thoracic. The lateral curvature amounted to 1 ¾ inches, and the spine raised the scapula, forcing it upward and forward, and raised it about once inch above its true position. From the seventh or eighth thoracic down to the third lumbar was a curvature in the opposite direction amounting to one inch. Right limb was ¾ inch shorter. … After 12 spinal treatments by adjustment, while the patient’s spine was under traction, the lower curvature … was entirely overcome. The innominates were brought to the same height, and the legs changed to the same length. (Gregory, 1915, p. 512)
After 4 more treatments, Gregory reported, the upper curvature was restored to normal.
Mechanical supports, such as braces or plaster of Paris supports, were used to correct muscular dysfunctions. Haas strived to make advances in “light airy and perfectly fitting brace[s].” (Haas, 1916, p. 65) “A brace is used for two purposes either for fixation of a part to prevent injury or as a therapeutic adjuvant to active treatment.” (Haas, 1917, p. 601) The best brace was flexible to prevent rigid confinement of the body. Haas adds, “Flexibility is one of the prime requisites that make a brace useful, for the body rebels at fixation and especially such a fixation as the rigidness of a plaster cast implies.” (Haas, 1917, p. 602)
Haas, though, was generally an avid opponent of the plaster brace or cast. He says, “Don’t think I haven’t used a plaster for I have had a most extensive experience with it and knowing it so well and having seen its bad results so often, is what has made me an open enemy of its use.” (Haas, 1917, p. 602) Instead, Haas employed Irish linen tape for the braces that he used in his wrappings of injuries for stabilization. To add more support, steel supports were added to the linen wrappings to reinforce correct alignments. “The brace when completed is light, airy and strong and serves the purpose for which it was intended.” (Haas, 1917, p. 602)
Besides adjustments, traction, and braces, Physical Culture was also used. Wendel comments, “Bodily exercise, once the requisite for continued human existence, in primitive times when man had to chase his food, clamber for it, or speed away on foot from enemies, human and otherwise, is now an important health measure.” (Wendel, 1945, p. 94) He continues, “One of the most important functions of exercise is to maintain the flexibility and the marvelous freedom of action possible to the human body.” (Wendel, 1945, p. 94) The treatments included the use of physical exercises to teach “muscles not only to do their own work but oftentimes the work of others that have become impaired.” (Haas, 1916, p. 349) When muscles become permanently disabled, training neighboring muscles to compensate for those that are injured was, in his view, critical.
Exercising muscles was more than a physical activity, however. Awakening and aligning brain function with muscle activity was implicit, Haas explained often. Haas phrases it this way: “The practical aspect and application of physical culture is one of mental rather than mere physical work.” (Haas, 1917, p. 114) Haas gives the example of correct posture: Muldoon who had a perfect physique “says he learned to stand up straight by trying to touch with his head some imaginary object just above his head. In other words, the will to do was ever present and it kept him lined up at all times. (Haas, 1917, p. 114)
Mechanotherapies and bloodless surgery techniques offered patients an alternative to incisions of the scalpel. The early naturopaths championed countless exercises and gentle, manipulative therapies that have been overshadowed by the current practice of high-velocity and low- or high-amplitude thrusts by naturopaths. Isn’t it time to reflect on what we have lost?
Sussanna Czeranko, a graduate of CCNM, is a licensed ND in both Ontario and Oregon. Practicing since 1994, she has developed an extensive armamentarium of nature-cure tools and techniques for her patients. Especially interested in balneotherapy, botanical medicine, breathing and nutrition, she is a frequent presenter and workshop leader. As Curator of the Rare Books Collection at NCNM, her present projects include an 11-book series entitled In Their Own Words, soon to be published by NCNM Press. This series will restore the best of the early literature from the Lust Journals for the profession. Sussanna is the founder of The Breathing Academy, a training institute for naturopaths to incorporate a scientific model of breathing therapy called Buteyko into their practice. Her next large project is to complete the development of her new medical spa in Manitou, Canada.
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