What is traditional osteopathy? More
Disease or unhealth, normal or abnormal? More
Traditional osteopaths do not study disease More
There are no 'diseases' or 'cures' only obstructions to natural processes More
The unhealth state is not abnormal More
What is an osteopathic lesion? More
Osteopathic research More
Why randomised controlled trials (RCTs) don't work More
What is a traditional osteopathic diagnosis based upon? More
Sustained sympatheticonia as a factor in poor health More
So why does chronic stress have such an impact on health? More
Maintaining factors in sustained sympatheticonia More
Classifications of unhealth More
What is traditional osteopathy?
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'The word, osteopathy, comes from two Greek words, osteon, bone, whose meaning is clear, and pathos, whose meaning is not always so clear, especially in this connection.
In the Greek we find two words contrasted as are up and down, in and out; ethos, meaning an outgoing expression, and pathos, an incoming impression. The root meaning of pathos should therefore be taken as in the word sympathy "sensitive with" or telepathy "sensitive at a distance", and not as in pathology which is a derived meaning in that which is almost a reversal of the original significance of the word.
Etymologically the name osteopathy is correct, meaning the influence of the bones in relation with disease, causation and cure, not bone disease or bone pain.
Osteopathy then means osteo (bone), pathy (incoming effects from). The "incoming effects from bones" when disorder exists among them, was the first subject developed by Dr Andrew Taylor Still and his followers.
This study led directly to natural immunity and structural integrity, two fundamental discoveries around which osteopathy is built.'
From The Theory of Osteopathy by Ernest E Tucker DO and Perrin T Wilson DO 1936
It's interesting that the meaning of the word pathology has been changed by orthodox medicine to mean 'the study of disease products'. There are many incidences where the 'remeaning' (sic), of words has been used to hide wisdom, insight and knowledge.
'The rule of the artery is supreme and its disturbance marks the second, minute and hour that disease starts.'
Quote from A T Still, the first osteopath
'The underlying principle, as applied to osteopathy, is expressed in the word "adjustment". (This does not mean the isolated cracking of joints).
What is osteopathy? If the principle of osteopathy is, as we have said, the principle of adjustment, applied as a universal law, then we will define osteopathy something like this:
Osteopathy is a system, or science, of healing that uses the natural resources of the body in the corrective field:
For example, if the heart is overworked it does not do any good to give anything in the way of a substance that will tone it down. Inhibit or depress it. The only way you can depress the heart is through the cardiac nerve mechanism, counterbalance
in that cardiac nerve mechanism whatever is overworking the heart.'
- for the adjustment of structural conditions
- to stimulate the preparation and distribution of the fluids and free forces of the body; and
- to promote cooperation and harmony inside the body as a mechanism.
From The Principles of Osteopathy by Dr J M Littlejohn and Dr Lawrence S Meyran
'The body is its own commissariat, taking in material substance in the form of the proximate principles, such as water and oxygen. Nothing is assimilated to the body that is not first vitalised and every process that takes place in the body is a vital process; every lesion that we find in the body is a vital lesion in relation the vitality of life, of the patient. This implies that every part of the body is supplied with blood and nerve force, a dual activity that is used continually as corrective means in osteopathic practice.
Osteopathy is a complete system of therapeutics. When anything else moves in so much osteopathy moves out.'
Disease or unhealth, normal or abnormal?
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So the idea that 'diseases' are isolated conditions in their own right is not semantically correct. Traditionally osteopaths felt that we needed a new diagnostic. This would classify deviations from health in terms of the clinical adaptations in the physiology through the neuroendocrine system, rather than use the vocabulary of orthodox medicine which had become distorted, eclectic and confusing. That is symptoms can be explained as a physiological reaction to toxicity.
'There are two organized agencies for combating disease of for conducting the defence of the body against unfavourable influences - the nervous and endocrine systems'
Tucker Wilson DO The Theory of Osteopathy 1936
'Sustained sympatheticonia as a factor in disease. There is a large though scattered body of clinical and experimental literature that gives the distinct impression of a significant, often critical sympathetic (nervous system) component as a common feature in a large variety of syndromes.'
The Collected Papers of Irvin M Korr Vol 1
Traditional osteopaths do not study disease
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Studying or adopting the orthodox classification of the separateness of disease borrows terminology from a different discipline and could lead to confusion.
If the original observations of A T Still of 'natural immunity' and 'structural integrity' were to mean anything, physiology - or how the body works - had to be taught from a perspective that looked at the relationships rather than the differences in the way the body worked. This is because physiology is a reflexive phenomenon.
Many excellent books were written by the A.T Still institute giving the osteopathic perspective on physiology, some of which still exist. There are no books on the philosophy of orthodox medicine only books on protocols and ethics.
Studying health instead of disease made sense. If you logged all the physiological similarities in patients with gastrointestinal ulcers for example and those without the similarities in diet, posture, spinal lesions, habits, lifestyle etc would make it pretty obvious what the maintaining factors could be.
This may look obvious and begs the question why orthodox medicine doesn't acknowledge or recognise this as a logical approach. If you look at orthodox medical training you will see that its tendency towards specialism, reductionism and symptomatic suppression is the problem.
A gastrointestinal specialist is only able to describe 'perversions' that are local and distinct to the gastrointestinal tract (GIT). This is fine if there is an obstruction or an acute trauma injury; the advances in trauma surgery have saved many lives.
If however the cause is not local but reflex, then this approach fails. Symptomatic relief or palliation is the consequence, an attempt to moderate the tissues causing the symptoms is tried, and the local diagnosis leads to local treatment.
The consequence from the 'continual palliation of symptoms' as a therapeutic is to pave the way to chronic and degenerative diseases. Too often these 'symptoms' are either the body's attempts to raise alarm or actual cleaning events and the sequalae of degeneration, from suppressive approaches as in the 'atopic' pathway; is now well known.
Howard Beardmore DO
There are no 'diseases' or 'cures' only obstructions to natural processes
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Osteopaths understood from a clinical, physiological and philosophical perspective that the only 'disease' is toxaemia or the retention of waste.
The focus of toxaemia perculiarises symptoms and then names an illness by the symptoms peculiar to the toxic focus and attempts at 'cleaning' expressed via the neuroendocrine system.
Howard Beardmore DO
From this you could extrapolate that there are at least three states of toxaemia, acute chronic and degenerative. Being able to place the patient correctly in terms of the toxic state is the key to making a traditional osteopathic diagnosis.
It is an orthodox 'notion' that diseases are 'caused' by germs and viruses based on the work of the 19th Century Frenchman Pasteur. Interestingly on his deathbed he is quoted as his last words to have said:
'Bernard the germ is nothing the soil is everything'.
Louis Pasteur sourced from Bechamp or Pasteur Douglas E Hume 1923
See article on 'The role of micro organisms in health from a traditional osteopathic perspective' for a more detailed explanation of the constructive role that microorganisms have to play as a catalyst in cleaning the body when it becomes chronically toxic. The germ causative theory of disease has never been subjected to a comparative study to prove it is true!
The unhealth state is not abnormal
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Susceptibility to the unhealthy state spontaneous or caused by pathogens but is as the natural consequence of disturbed function, which usually leads to toxaemia, or the retention of waste. The retention of waste in any tissue is naturally irritative and the consequent inflammation is a normal event that starts the healing process.
Instead of classifying diseases as distinct and different, which other therapies do, traditional osteopathy studies the similarities between the degrees of compensation that occur, as a reaction to toxaemia, when health drifts towards the unhealthy state. What traditional osteopathy can therefore offer is an alternative diagnosis to the differential approach. It is not technique-led neither is it just using a different technique for the same diagnosis.
For example bronchitis is not 'irritation of the bronchioles' but is in fact cleaning of the lung!
For patients who are treated locally by killing the germ the 'cleaning' will keep on returning until either the patient expires or the cleaning stimulus of toxaemia is gone. Sometimes the body will move the waste to another organ, usually deeper. This may explain the 'atopic pathway' that moves eczema from the skin to the lung in asthma and to the bowel in anaphylactic bowel conditions as each 'disease' is symptomatically relieved by stronger and stronger methods of palliation, and pushed further into the constitution. A clinical effect of steroids is to produce a reverse transport of waste metabolites from the blood back into the tissues; this is how they moderate the symptoms of a 'cleaning' event so successfully.
The patient who is assisted to finish the cleaning, however, does not get a repeat performance unless, of course, the lung requires a new phase of cleaning.
Recovery from years of palliation takes time, effort and skilled mentoring and the practitioners still able to do this are becoming scarce. You cannot learn this kind of work on a modular course with no clinical mentored practice nor by part time study. At some point the osteopath will have to experience managing a patient with a healing crisis.
Patients who were ill were studied in terms of their constitutional adaptations rather than just describing the presenting symptoms. The approach was to 'get behind the symptomatology' rather than study 'disease' in isolation. Many old osteopathic books would list lesion patterns present in illnesses, highlighting the adaptations in physiology, which sought to dispel much of the mystery of disease pointing to a new way to treat the sufferer.
For example the overproduction of mucous from any part of the body for example is nature's attempt at 'local tissue washing' when 'general washing' has failed. Whilst arterial blood brings nutrition to the tissues the venous lymphatic and digestive systems remove waste thus preventing toxaemia, the build up of waste.
If the lymphatic and venous systems or the cleaning organs can't cope then the nearest mucous membrane to the focus will go into overdrive. This is known as hyperphysiology.The traditional osteopath looks elsewhere for the failing, removing obstructions to the flow of circulation and thus renders the compensating hyperphysiology unnecessary.
These compensations are what orthodox approaches calls 'disease' and its symptoms require suppressing. Effectively the suppression of cleaning is what leads an acute toxaemia to a chronic one and finally a degenerative one.
The insistence by orthodox approaches that the cause of virtually all 'diseases' is unknown has led the focus of treatment to 'blame' poor design of the body as the culprit. This has led modern orthodox approaches to conclude that study of the genome will unlock the mystery of illness and lead mankind to some kind of nirvana of endless health. When we are able to 'redesign' the bits that have failed us and implant new bits no one will need to be ill. However well marketed the hydroponic tomato does not taste, look or smell like an outdoor variety.
The discovery of antibiotics has not relieved man of infection, quite the opposite. Recently the Nobel peace prize was won by a man who discovered how to inhibit the action of RNA, that is turn on and off cells actions. The idea is that you will be able to manipulate cellular activity and therefore turn off disease.
Personally I think this will bring us closer to 'degeneration' without any recourse to recovery because it is the accumulation of suppressed colds, influenza and micro-crisis by the focus of palliating symptoms; that leads to the prevalence of chronic disease modern man is currently experiencing. Without any 'pathway'-cleaning events the body will just go straight to terminal illness. In the words of Antoine Bechamp on germ killing as a therapeutic approach:
"If man goes down the therapeutic route of killing the germ, it does not bode well for mankind'
Sourced The Eye of Bechamp by Hector Grasset 1913 translated by Jocelyn C Proby DO MRO.
It can be so much cheaper and easier. If we had a health service rather than a disease management service and everybody was taught how to maintain health; rather like we are all expected to be responsible for our financial affairs, then we would only need an acute A and E for accident care, obstructive childbirth and injuries sustained in warfare.
What is an osteopathic lesion?
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The osteopathic lesion is not 'a bone out of place' but any obstruction to physiological processes or irritation, deficiency or excess that may, if left unaddressed, lead to the state of unhealth. This can include diet; lifestyle, posture, mental and physical trauma, poisoning and any method that is directed only at managing the symptomatic picture by palliating symptoms and suppressing natures attempt to clean.
Howard Beardmore DO
This description is deliberately transdimensional and not definitive, because the traditional osteopathic approach acknowledges the interdependence and symbiotic correlations that are continually part of the homeostasis or balance of health; which is ostensibly about negating the effects of toxaemia by re-establishing elimination. This is infinitely variable, so it is impossible to be prescriptive about treatment.
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There is a large amount of research to support the traditional osteopathic approach but some of it is conveniently dismissed by 'modern' researchers as 'out of date'. Currently you cannot use any work that is over ten years old in a literature review - an important part of any research.
This needs challenging because it means that progress cannot take into account old ideas, clinical evidence and any approach that challenges the status quo. Modern science cannot claim to be whole if it limits the field of exploration to only the present. Most brilliant discovery happens in practice not in planned research models.
Currently there is a tendency to only invest in research that has a projected marketable product at the end. This means that the traditional osteopathic approach is not popular to shareholder led research; it would however be an inspirational basis for reforming the NHS because it is low tech, patient-centred and much cheaper than maintenance medication regimes.
The loss of independence in the NHS and further privatisation can only lead to more corporate planning and thus a narrowing field of therapeutic availability for the public.
This is why the British Institute of Osteopathy has among its aims the establishment of a free research laboratory whose only interest is the revalidation of the basic biological truths that underpin both the art, science and practice of traditional osteopathic practice. It will not use vivisection or genetic manipulation.
Why randomised controlled trials (RCTs) don't work
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Orthodox medicine demands that any therapeutic has to satisfy the 'gold standard of randomised controlled trials. There have been many failed attempts to do this with osteopathic treatments, an understanding of why these attempts will always fail needs to be discussed because a lot of time is being wasted, with good intent that could be put to better use.
One reason why randomised controlled trials or RCTs so often fail to produce any evidence to support alternative approaches to maintaining health is because RCTs were designed to test pharmaceutical interventions, only allowing one variable at a time.
Because RCTs can only deal with one variable and the traditional osteopathic approach is multi-faceted the osteopathic practitioner is forced to reduce his treatment to only one intervention to fit the trial model. This effectively means that almost all the modern attempts at research on traditional osteopathy are not actually testing osteopathy, but they are proving the ineffectiveness of RCTs on testing the validity of symbiotic, multi-faceted approaches.
The danger here is that this then produces a database of flawed research that is then used incorrectly to undermine the true clinical value of traditional osteopathic approaches. For example the medical practitioner thinks that what we do is 'crack joints' in isolation to relieve symptoms. Trials have been set up to test the effectiveness of this idea, calling it 'manipulative medicine' on 'non specific back pain'. 'Non specific' back pain for a start is a ridiculous concept, how can any pain be 'non specific?' The nature of the cause of pain is a core requirement of a traditional osteopathic diagnosis and absence of this knowledge before treatment is tantamount to mal practice.
We are then asked to 'crack' a particular joint against someone who does 'sham joint cracking' whatever that is? The trial results are announced and usually the outcome is that 'sham cracking' is no different to 'isolated cracking'. They are right; they have proved that traditional osteopathic treatment is not comparable to sham treatment.
This is a bit like someone deciding that 'surgery is cutting holes in people' and with no guiding principles I make 'non specific' holes in people and compare the outcome with random stabbing and declare that there is no difference.
It is also nigh on impossible to find hundreds of patients for a trial, all with the same condition - and more importantly the same history of health and the same constitution. If the trials focused on the diagnostic approach that traditional osteopaths used and measured the outcomes the true potency of this approach would be obvious.
What is a traditional osteopathic diagnosis based upon?
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In the field of osteopathic diagnosis a traditional osteopath considers factors that have led to the failure to adapt rather than stimulating or forcing the body to accept the state of unhealthy by suppressing symptoms.
For example a patient who has a slight twist in the pelvis may produce symptoms of pain and swelling in the knee, as a referred strain. Just treating the pain in the knee as an illness ignores the intelligence of the body's feedback, saying 'don't use it' and then may lead to 'wearing' of the knee structure. Rather like if the tracking is 'out' on your car the tyres will wear on the inside and just replacing the tyres will result in the strain being moved elsewhere.
The twist in the pelvis may be due to impaction in the bowel from a poor diet, which would move the centre of gravity producing a counter strain on the posture. There could be a myriad of reasons why the problem has presented symptoms in the knee and the key to a successful result depends on being deductive with reasoning rather than differential.
Sustained sympatheticonia as a factor in poor health
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'Chronic hyperactivity of the innervating sympathetic pathways seems to be a prevailing theme in many clinical conditions, involving many organs and tissues.
Whatever the etiological or therapeutic implications, it appears that this widely shared feature of local, regional or segmental sympathetic hyperactivity is overlooked or dismissed because of the barriers erected by specialization.'
Irvin M Kor DO 1979
Traditional osteopaths recognised that the common link between all states of unhealthy was the degree to which the sympathetic or fight-and-flight emergency hormonal state was dominant. What this means is, if this emergency hormonal mode of operating for the body was 'on' continually then the body did not repair, digest or remove waste, fertility was reduced, physical and mental exhaustion was predominant; the need for the acute cleaning effect of infection was more common and degenerative diseases were prevalent.
This idea is not so 'left field' if you consider how many conditions are treated, or symptoms moderated by steroids - eczema, asthma, anaphylaxis, cancer, ulcerative colitis, arthritis, transplant rejection, hepatitis, sarcoidosis, nephritic syndromes, lupus, rheumatic disease, allergic rhinitis (this list is not exhaustive). These are all conditions related by degrees of sustained sympatheticonia.
So why does chronic stress have such an impact on health?
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The hormones of stress -(cortisol and adrenaline) put repair on hold, shunt blood from the digestive system to skeletal muscle so you can run, force waste from the blood back into the tissues, shut down fertility. After prolonged exposure this causes physical and mental collapse, stops the body from being able to localise infection, thereby precipitating the likelihood of degenerative diseases.
Virtually all states of unhealth can be explained in terms of sympathetic nervous system expression, as stimulation or collapse. If you study pharmaceuticals it's interesting to note that virtually all drugs are sympathetometic in their action that is they either stimulate it or block its action in an attempt to suppress, or moderate symptoms
So instead of stimulating the sympathetic emergency system, which is designed to get us out of danger while temporarily suspending more usual activity and relieving symptoms, the traditional osteopath inhibits the sympathetic nervous system with treatment by addressing the maintaining factors that are keeping it on overdrive.
This allows the true toxic state of the body to 'emerge' so that the process of elimination can begin. This is when the patient may experience a 'cleaning' crisis as the 'cleaning' or production of symptoms in the acute phase marks the beginning of the return to health.
'As the organs and vital processes come 'back to life' the waste material that has lain embedded in the tissues is stirred up and excreted. This may cause what is known as a 'healing crisis' and will herald the return to health and wellbeing.'
Extract from a leaflet in a traditional osteopathic practice
Maintaining factors in sustained sympatheticonia
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A refined diet will provoke adrenal output:
There are two ways you can raise adrenalin and cortisol (in the blood) - consume a stimulant - tea, coffee, chocolate or cigarettes or react stressfully, causing and increase in your own production of adrenalin.
Patrick Holford Optimum nutrition for the mind
Other factors include:
- Over exercise, chronic inflammation and poor posture which demands more skeletal muscle to stand and therefore greater sympathetic tone, All of these factors can vary in each patient and the traditional osteopathic practitioner is trained to identify them.
- This is why the traditional osteopathic emphasis is on the patient not the condition. The condition only tells you where the compensation has ended up. In a nutshell any factor that causes the body to deviate from the neutral position at rest will produce the likelihood of sustained sympatheticonia.
Classifications of unhealth
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Adaptations from health can be classified into four main groupings:
- Acute. Natures attempts at cleaning and may include fever, sweating, boils and skin eruptions, diarrhoea, vomiting, overrun of mucous, inflammation, organ discharges and bleeding to name a few. Used to be referred to as 'vicarious elimination.
- Sub acute Just below the level of symptoms
- Chronic. Nature's failed attempts at acute brought about by either not enough vitality to produce an acute or the result of continued suppression of the acute process.
- Degenerative. Final stage of chronic. The body is unable to muster an acute event. The continual saturation with waste metabolites eventually leads to the break down of tissue.
So when making a diagnosis from a traditional osteopathic perspective the main focus is to assess the toxic state and ascertain whether the patient is acute, chronic or degenerative. The 'reserve' of the patient also needs consideration.
The reserve is the capacity of the patient to manifest the various cleaning crisis necessary for a return to full health, often leading to 'preparatory advice' to maximise the beneficial outcome of treatment.
Physiologically the 'reserve' could be measured by the degree of alkalinity in the blood because this is directly called upon in the cleaning crisis to neutralise the acids of waste, into salts, thereby rendering the acids harmless and ready for excretion.
'The best solution to disease is health'
The greatest advances in public health have not been through drugs and vaccines, but through clean water, clean air, sanitation, transport for fresh food, and dealing with urban overcrowding.
In both prevention and treatment of disease, it is all too easy to overlook the basic things the body needs in order to be healthy. Yet these things should be central to the task. Hence most osteopaths prefer a drug-free approach; instead placing the emphasis onto the body's in-built healing mechanisms, and the basic necessities of life.