Studies in the Osteopathic
Basic Principles: Volume
Louisa Burns, M.S., D.O., D.Sc.O.
NORMAL STRUCTURE IS ESSENTIAL TO NORMAL FUNCTION.
While this statement is true, in the long run, it seems observed more often
in the exception than in the rule. The most conspicuous deformities
are associated with apparently normal functions, and slight or gross mal-positions
are sometimes a long time present without attracting any attention, or
any apparent interference with the functions of any part of the body.
It is the place of this chapter to discuss the significance of this rule,
and its exceptions, both real and apparent.
Normal Structure and Normal Function.
word “normal” literally means “according to rule,” and this original significance
still underlies its later usage. In this connection, the “normal
structure” is that which is the rule among living things, and “normal function:
is that which is according to the rule of these same living creatures.
The rule, in all living things, is the maintenance of the longest, strongest,
and more productive life possible to its kind.
structure which makes possible the longest and most productive life is
the normal structure, and the mode of activity which is maintained by the
longest and most productive life, is the normal function. Both of
these conditions are the result of many centuries of progressive reactions
to changing environments.
the time during which life as we now know it has existed in the world,
all living things have been affected by the changes in the seasons, in
their food, and in their neighbors. The manner of the reply which
living things make to these environal changes is the test of their right
to continued existence. Thus, they have adapted themselves to the
present condition of life by both structural and functional changes.
That structure which is best adapted to the conditions of the environment
of any organism is the structure which is normal to that organism, and
that manner of living which enables an organism to derive the most energy
from its environment is the function normal to that organism. Thus,
both function and structure, considered in the biological sense, are what
the mathematician would call “functions” of the relation between the environment
and the inheritance of the organism.
ordinary conditions, the structure of any organism is the result of the
sum of its inheritance through all its phylogenetic history, as modified
by its ontogenetic history. If this sum of traits is such as to facilitate
its powers of deriving energy from its environment, and its powers of making
a strong and rational reply to environal changes, it lives a normal existence.
unusual conditions, the structure of any cell or organism may become abnormal.
It is then unable to derive the energy from its environment which is required
for its normal metabolism. It s function is then also abnormal.
The Structure of the Biogen.
that common and mysterious thing, the molecule of living proteid, be thought
of as a machine, it is very evident that the normal relations of all its
parts are essential to the maintenance of its normal activities.
The living proteid molecule is very like a machine, as far as we now know
it. The very simplest of living molecules are very complex, compared
with inorganic molecules, and there are unquestionably an almost inconceivable
number of varying structures of these molecules. The simplest living
cell contains, beyond question, a very great number of molecules of different
composition and structure. Each of these molecules may be considered
as a machine for the performance of certain duties in the life history
of the cell. The chemical structure of the simplest of these living
molecules is unknown—while it is living—but their variations are shown
by the variations in their manner of reacting to external changes.
these complex machines are structurally inefficient, the duties devolving
upon them must be improperly performed. If the relations of the molecules
with one another be compelled to vary from that to which they are adapted,
they must be rendered more or less inefficient. In the living cell
there are groups of molecules, apparently somewhat similar, arranged for
the performance of certain functions. The nucleus is made of many
such groups, differing from one another, and yet differing in a common
manner from other groups of molecules in the cell. Any abnormal relation
of nucleus and cytoplasm causes an abnormal condition of cell metabolism.
Structure of the Cell.
experiment of Gerassimow’s is very suggestive. But the influence
of low temperature on the cell of Spirogyra caught in the act of dividing,
he succeeded in driving all the nuclear substance into one daughter cell,
leaving the other quite devoid of a nucleus. In a series of such
experiments, it was seen that in twenty-one days the growth of the enucleated
cell amounted to from four-tenths of one per cent to four and five-tenths
of one per cent of the growth of the normal cell. That is, the most
active of them all made only about one-twentieth of the normal growth,
and the least active grew only one-two-hundredth part as much as did the
normal cell. The growth of the other cells, with the excess of nuclear
material, exceeded the growth of the normal cells by as much as seventy-eight
per cent. At the same time, the solution of starch by the enucleated
cell either did not take place at all, or proceeded very feebly; the outer
cell membrane was less extensible than usual; the color of the chlorophyll
bands became constantly paler and their contour less clear.
also has made experiments in determining the effects of nuclear changes
upon the activity of the cell. Nothing which affects the structural
integrity of any cell is without effect upon the metabolism of the cell.
There is not yet found any exception to this statement.
Structural Relations of Cells.
multicellular organisms, every cell must maintain its structural integrity
if it is to maintain its normal function. It is the cell structure
that must maintain its integrity. Things which affect the gross structure
of the body are efficient causes of malfunction only as they affect the
structure or the environment of the cells of the tissues. This is
the reason why gross deformities so often cause such slight malfunction,--the
cells have remained fairly normal in structure and environment. For
the most part, however, any gross structural change does affect the structure
and environment of the cells themselves.
changes may be quickly and forcibly produced, or they may be the result
of long acting forces, and be slowly caused. In the first case, the
functional effects are usually intense; in the second case, the cells of
the body may accommodate themselves to the slowly changing conditions,
and the functional disturbances be comparatively slight. In the case
of human beings the functional changes resulting from slight injuries are
frequently not noticed because of the abnormal condition of nearly all
bodies all the time. The human race, at its best, falls far short
of the longevity, strength and beauty to which it is entitled. Failing
in the perfection of function, further causes of embarrassment often remain
a long time unnoticed. Another reason for the non-appearance of functional
abnormalities is found in the fact that the human body has become adapted
to a vast amount of ill usage, by being so constantly ill-used during its
discussion of causes and the nature of the effects produced by the structural
changes of the tissues of the human body belongs more properly in text
books dealing with osteopathic diagnosis and therapeutics, but a short
resume may serve to illustrate the principles stated in this chapter.
Structural Relations of Complex Bodies.
Abnormal structural relations may exert direct pressure upon cells of the
tissues. The body contains no waste spaces; if any tissue is misplaced
it must exert tension or pressure somewhere, and it must itself be subjected
to tension or pressure. Any pressure upon cells produces an effect
which varies according to the nature of the tissues affected. No
cells are able to maintain their normal metabolism for any length of time
in the presence of abnormal pressure conditions.
structural relations may partially or completely occlude the nutrient arteries
of any tissue. The cells are thus starved for both food and oxygen.
The effects produced are those characteristic of starvation throughout
the whole living world. These phenomena vary to certain extent, but
not in any essential feature.
structural relations may partially or completely occlude the venous return
or the lymphatic drainage from any tissue. The cells then are forced
to continue their life processes, as far as they are able, in the presence
of their own waste products. No cell is able to do this,--even the
unorganized ferments cease their activities under such conditions.
structural relations may exert pressure upon nerve trunks. The normal
stream of nerve impulses is thereby more or less seriously impeded, and
the function of the tissues affected suffers a corresponding embarrassment.
structural relations may initiate abnormal nerve impulses. These
may cause conscious pain, or they may occasion reflex nerve stimulation
of a more or less urgent malignancy.
effects from all structural mal-adjustments mentioned are numerous.
Any satisfactory discussion of these is beyond the limits of this volume.
Osteopathic Lesion, Carl P. McConnell, D. O., M. D., in The Journal of
The American Osteopathic Association, May and December, 1905, and May and
Special Pathology of the Nerve Cell, in Mental Diseases, Henry J. Berkley.