INTRODUCTION

Welcome

‘Manibus’ explores the origins and history of joint manipulative practice. It is the work of Francis Wilson, a practising chiropractor and researcher who lives in Cumbria, England. First published in 2022, the contents of this website were informed by research undertaken during the COVID-19 pandemic. The Manibus project is not-for-profit and privately funded by the author. It is dedicated to those of all professions who practise joint manipulation in the hope that it will foster increased understanding and co-operation.

A free PDF of material contained within this website can be accessed below. It may be downloaded for private study, but is not to be used for commercial or other purposes protected under copyright law without written permission from the author. Please do not plagiarize this work.

Preamble

“We cannot escape history. We are creatures of it. We cannot understand where we are or where we are likely to go in the future unless we know where we have been.” (Wardwell, 1992, p. 13)

Technology has transformed the practice of medicine. Today we are able to look inside the body, to see its structures and observe its functions without cutting into the patient. We are able to replace organs and influence internal processes in the pursuit of health. Advances in telemedicine allow practitioners to consult with patients remotely, overcoming geographical barriers and improving access to care. Text messages, apps and wearable devices are used to support patients trying to stop smoking, increase activity levels and eat more healthily. Technology has improved medicine and it has benefitted patients.

Manual medicine contrasts technological medicine. It is ancient and basic, yet it remains socially relevant. Before COVID-19 many people took physical interaction with others for granted. Touch was a normal part of everyday life, but that normality was challenged by the pandemic. Social distancing was encouraged and to a sizeable extent medicine moved to the telephone and online. The pandemic changed the way we live. The ability to communicate with others through electronic means was advantageous, but through it medicine became less personal. Relationships between clinicians and patients were fundamentally changed, at the expense of hands-on health care.

The Latin word ‘manibus’ is the ablative plural of manus, meaning ‘with hands’. Initially designed as a web-based project, manibus provided a succinct domain name, one that encapsulated a commonplace feature of manipulative practice, namely use of the hands. This treatise is concerned with the practice of joint manipulation and with the groups of practitioners who have employed it. The aim was to produce an overview history of developments in manipulative practice from ancient to modern times, emphasizing British context, highlighting sociology over technique, and accompanied by reflections on emergent themes.

Considered in a broad sense, joint manipulation describes examination and treatment approaches involving movement of the articulations of the body. As a treatment, manipulation has been used to reduce pain and disability by restoring normal bony alignment and easing joint stiffness. Among those health care occupations which today are subject to specific statutory regulation in Britain, manipulation is a part of the history and contemporary practice of the medical profession, physiotherapy, osteopathy and chiropractic. Arguably, looked at from a historical perspective, these, together with bone-setting, have been the ‘big five’ of joint manipulative practice. Although manipulation has links to massage, and also forms a part of the care provided by other groups such as naprapaths and osteomyologists, it is the big five that form a major focus of this study.

Architecturally, the study is divided into parts, beginning with an analysis of meanings. This is followed by an outline of early developments in the history of joint manipulative practice, from possible origins to the formation of the modern medical profession. The Medical Act of 1858 distinguished the medical profession from other groups and subsequent legislation led to further delineation (UK Parliament, 1858). Rather than taking a purely chronological view of more recent events in the history of manipulative practice, the later chapters are arranged by discipline. For those wishing to better understand the evolution of specific modern health care groups this has advantages, offering focus and relative simplicity, but it is appropriate to recognize that this approach comes at a cost, for groups examined in this way may seem to be more disconnected from each other than was in fact the case. Emergent themes include problems of epistemology and tribalism. These are reflected upon before the investigation reaches its conclusion.

References

UK Parliament (1858). Medical Act. An Act to Regulate the Qualifications of Practitioners in Medicine and Surgery. 1858, Chapter 90, Victoria.

Wardwell W.I. (1992). Chiropractic: History and Evolution of a New Profession. Mosby-Year Book, St. Louis, Missouri.

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