Studies in the Osteopathic
Basic Principles: Volume
Louisa Burns, M.S., D.O., D.Sc.O.
BIT OF DISEASE MAY PERPETUATE ABNORMAL CONDITIONS FOR
any organism becomes adapted to an environment which is foreign to its
inheritance, it becomes thereby unable to respond in the normal manner,
at once, if it is placed again in the surroundings originally normal to
it. In the case of the simpler organisms a new environment very quickly
becomes the normal one, -- that is, the cell reacts quickly to external
factors, and the series of chemical changes that are forced upon it in
the stead of its normal metabolism succeed in a comparatively short time
in impressing their rhythm upon the metabolism as a constant factor in
the reaction of the cell to external changes. After this, the one
time abnormal environment is the normal one for that cell. During
the stage of progressive adaptation, the cell is not able to react in any
logical manner to either the new or the old environment.
is evident that the more complex is the organism undergoing adaptive changes,
the longer will be the time spent in the formative, or unstable, or pathological
Individuality of Cells.
of the cells of which the body is composed lives a life which is to a certain
degree an independent one. It is true that they do depend upon one
another, almost absolutely, so far as the maintenance of life is concerned,
but it is also true that there is a certain individuality in the life processes
of the various cells of the body; that they live, each in its own life;
eat, each its own food; eliminate katabolic products, each of its own kind,
and perform each its own duties. They react to their own environment,
each for itself, though this environment is composed of the other cells
of the body, and the fluids formed by them. Thus, the body acts as
a unit, because the cells affect the environment of one another.
Of all cells, the neurons affect the other cells in the most conspicuous
Individuality of Reactions.
any cell group of the body is subjected to the influence of abnormal conditions
its metabolism undergoes certain changes, characteristic both of the cells
themselves and of the nature and force of the abnormal influences.
Every cell group gives its own characteristic reply to changes in its environment,
both normal and abnormal. The connective tissues abnormally stimulated
thicken and harden; the nerve cells act extravagantly, wear and die; epithelial
cells multiply, and only become broken down in answer to the presence of
insuperable obstacles to further metabolism. Muscle cells multiply
with increased function; nerve cells never multiply after differentiation
is well begun, long before birth. Many structures atrophy with disuse,
but others may maintain a non-functional existence for years; in the case
of the embryonic nerve cells, they may live undeveloped for a life
time. In all these instances the principle holds true, that the reply
which the cells of the body give to abnormal changes in their environment
does not long remain that which is characteristic of their normal metabolism.
The Habit of Health is Persistent.
a period of reactions to an abnormal development, the cells of the body
do not at once regain their normal activity. There must needs be
a second transition period, usually very much shorter than the first, during
which the cells again accommodate themselves to environal changes.
In some cases, recovery is much more tedious than the onset of the apparent
disorder, but the period of apparent disorder is not always equal to the
period of reaction to the abnormal environment. The habit of health
retains at least a potential influence upon metabolism, even during long
periods of disease.
Cells Retain History of Their Past.
return to the normal function often seems perfect, but there is much more
rarely a perfect, or even very nearly perfect, return to the normal structure.
The cell usually retains in its structure the history of its unhappy experience.
In this respect, the cells of the whole body share with the highly differentiated
neurons the phenomenon of memory.
principle holds true also for many very complex organisms, and for species
of organisms. Plants and animals undergo certain changes as a result
of domestication. If they escape from captivity and again lead a
wild life, they regain many of their ancestral traits, but they never lose
the acquired characteristics. The history of their captivity remains
ineffaceably written in their bodies and in their habits.
is true among mankind also. The Indian who, having been educated,
returns to his ancient habits, is never the aboriginal person. The
degenerate in civilized communities is never the savage. Atavism
is never complete; recovery is probably never absolutely complete.
Habit and Prognosis.
facts have an important bearing upon the prognosis in any case. If
the patient has been suffering from a given disease for a long time, it
is almost certainly true that the metabolism of the cells of the injured
organ have made some steps toward adaptation to the abnormal condition,
and that recovery will be complicated by the embarrassment of the cells
in another adaptive process. The question will often arise as to
whether it is wiser to subject the cells to this second adaptation, or
whether it is wiser to let them alone in their new estate, and to facilitate
the compensatory changes, by securing the best of food, air, nerve supply
and elimination to the injured structures. There is no doubt that
in dealing with old people, especially, the latter method is usually wisest.
They have no time to spend in rearranging their physiology. They
are to be made comfortable and as happy as possible. The number of
years required to make a person old is not to be stated in this connection.
are some cases among young people where the reaction of the body to an
abnormal environment is so fixed that any effort at correction is unwise.
The kyphosis of Pott’s disease is a very common example of the deformity
which is permanent and incurable, and not productive of serious visceral
the other hand, it must be remembered that the human body is one of tremendous
complexity, and that a whole life time is not enough to secure any essential
changes in metabolism. Adaptation more nearly normal than efforts
at adjustment could be are not rare, abut perfect adaptation to an abnormal
environment is an accomplishment requiring many times one life time.
must be remembered also that during the time in which the cells are in
process of adjustment they endure the abnormal metabolism characteristic
of the period of change. They are more intensely affected by external
changes than are normal cells, more easily invaded by bacteria, more easily
wearied, and enjoy less of the “habit of health” than normal cells.
instances of the persistency of the habit of disease may be mentioned.
Examples of Disease Habit.
abnormal food is taken, vomiting may occur, which often persists after
the stomach has been thoroughly emptied. This vomiting may become
a factor in perpetuating a diseased condition.
anyone eats too much sweets or starches the excess of sugar is eliminated
from the blood by the kidneys. If the habit of eating too much sugar
be continued for any length of time, the physiological glycosuria becomes
a pathological one, and sugar continues to be excreted even after the carbohydrates
have been eliminated from the diet altogether. This is a form of
the persistence of a habit of abnormal function, for it must be granted
that the presence of sugar in the blood in so great a quantity as to cause
its elimination by the kidneys is itself an abnormal condition.
Habit of Pain.
sensory nerves are a long time subjected to abnormal pressure, as
by tight shoes, or clothing, or by abnormally contracted muscles, they
cease to seem painful. The removal of the pressure upon them, the
relaxation of the abnormally contracted muscles, with the concomitant return
to the normal conditions of blood supply and drainage, is frequently followed
by much pain. Because of the habit of disease, the occurrence of
the pain may be deferred for some time, and the careful physician may be
able to evade much of the pain by making the recovery rather slow.
persistence of pain is a very common occurrence. This is due to the
lowering of the liminal value of the neurons concerned. If the neuron
systems which carry sensations of pain are frequently stimulated, the continued
passage of sensory impulses over them lowers their liminal value until
even normal impulses arouse sensations of pain in consciousness.
reaction is essentially physiological. The lowering of the liminal
value of neurons which are frequently stimulated is a very important factor
in perpetuating the habit of health, in preserving memories, in making
possible such education as we know, and in adding to the value and strength
of life in many other ways. But this factor in normal neuron metabolism
becomes a means of perpetuating the consciousness of pain long after the
cause of suffering has been eliminated. After the cause of the suffering
has been eliminated, and the structure of the body becomes normal, the
return to the normal neuron metabolism can not be very long delayed.
The habit of pain is self-limiting, but it must always be considered in
determining prognosis and therapeutics.
Habit of Drugs.
a long illness which had been dealt with according to the strenuous methods
of our grandfathers, recovery was very long and difficult. Even yet,
though the most severe methods have been superseded, recovery from the
therapeutic methods seems to require more time and more discomfort than
recovery from the unaided disease. This is due, in part, to the fact
that therapeutic procedures which are not wisely determined work rather
injury than good, in part to the toxic action of the drugs employed upon
the depuretic organs, and in part to the acquired habit of drugs.
cells of the body, in reacting to the abnormal condition which was the
original cause of the disease suffered certain changes in their metabolism.
The doctor of ancient days added to this already complicated problem other
abnormal factors,--various drugs, heat in an abnormal degree, impertinent
stimulation of many kinds, -- and the cells were compelled to adjust their
metabolism to these factors also. The patients usually recovered,
if they were young and robust. They were of the type that endures
and survives hardships. During their enforced idleness, the overworked
tissues became rested, disorders due to trauma were apt to heal in spite
of meddlesome attention, bones subject to slight subluxations regained
their normal relations when the muscles attached to them became relaxed,
the bacterial diseases were usually self-limited anyway, and so recovery
usually occurred in spite of the most absurd and harmful methods of therapeutics.
the subsidence of the symptoms due to the diseased conditions, the effects
of the therapeutics were still to be overcome. The cells of the body
had become partially adapted to the presence of stimulating drugs, the
excessive heat, the close, dark room, and they had now to readjust themselves
to the environment which was normal to them before the onset of the diseased
condition. This second adaptation was forced upon the cells at a
time when the blood was poor, their reserve forces were depleted, and the
whole body was more or less permeated with both the toxins of the disease
and the poisons used to combat the disease. It is not at all surprising
that the accidents of convalescence were so often fatal, nor that morphinism,
alcoholism, and other drug habits so frequently followed severe illnesses.
dealing with disease by osteopathic methods, the complications of recovery
are very slight. The efforts of osteopathic therapeutics are to secure
and to maintain, as far as possible, the conditions normal to the cells,
and not to produce additional causes of confusion. If this be successfully
done, long and tedious convalescence is usually avoided. The exceptions
to this are found in the cases of chronic diseases which have been treated
by abnormal methods for a long time, and in other cases associated with
long and severe exhaustion. In all cases, recovery is not complicated
by the necessity for a readjustment to the lack of abnormal stimulants.
a matter of clinic experience, those patients whose recovery has not been
complicated by any marked interference with the nature of the reply which
the cell groups make to their environment are those whose recovery is most
speedy, most comfortable, and least hampered by unexpected complications.
of any of the acute diseases, in any text book of medical practice. Decide
which of the sequelae are probably due to the disease in itself, and which are
due to the therapeutic methods employed.