Writings of Dr. J. Martin
Littlejohn, Ph.D., M.D., D.O., L.L.D.
(First Dean of the College of Osteopathy,
founder of the Chicago College of Osteopathy, and
founder of the British School of Osteopathy)
THE PHYSIOLOGICAL BASIS OF THE THERAPEUTIC LAW.
[NOTE: The following article comes from The Journal of the Science
of Osteopathy, Volume 3, Number 4, August, 1902.]
INTRODUCTION - GREEK IDEA.
The history of medicine has been one continued medley
of therapeutic changes. In Homeric Greek days professional medicine
and surgery were represented by Machaon whose special attention was devoted
to healing injuries and Podalirius who had the hereditary gift of "recognizing
what was not visible to the eye and tending what could not be healed."
In the Asclepiad era moral and dietetic measures were adopted without the
use of drugs, the first records of cases being made on the walls of the
temples. This was, however, entirely distinct from the more primitive
form of medicine. The Greek conception of the physician embodied
itself in the Hippocratic ideal in which we find, (1) a profound conception
of the sanctity of the profession and its claims for honesty, sincerity
and morality; (2) great skill in the discharge of professional duties;
(3) the disease in the patient represents a process governed by internal
laws equally with life and health, according to which there was a natural
history of disease developed in the so-called symptoms of disease of clinical
medicine; (4) the dominating theory of disease was that of the humors,
blood, phlegm, yellow and black bile, being supposed in health to be in
proper proportion, whereas in disease these were irregularly distributed
or in improper proportion; (5) consequent upon this theory of disease was
the theory of cure, depending primarily upon the curative power of nature,
certain natural processes through which the humors pass, especially in
acute diseases, marking the progress of disease towards resolution, crisis
and recovery in connection with the expulsion of the excess through the
channels of excretion. Diet was of first importance, medicines in
the sense of drug; being of secondary importance, in chronic disease diet
and proper exercises being of the greatest importance.
THE ROMAN ERA.
Roman medicine was a development of early Greek medicine
and as personified in Galen we find the temperaments based on the Hippocratic
humors, the normal temperaments depending on the proper proportion and
distribution of heat, cold, wet and dry, the abnormal in improper proportion
and distribution of these. Galenic therapeutics recognized in drug
substances the same elementary qualities, cure taking place on the principle
contraria contrariis. Galenic influence held full sway in
autocratic medicine till the 18th century. In the 16th century Paracelsus
regarded the body as a microcosm corresponding to the macrocosm of nature.
Nature being sufficient for the cure of most diseases, art being required
only when the man himself becomes exhausted or is insufficient.
The Greek and Roman conception thus mark the therapeutic
history of healing up till modern times.
THE STARTING POINT OF THE MODERN IDEAS.
The 17th century gave birth for the first time to
distinctive systems founded upon the discoveries and development of physiology.
Borelli of Naples sought to explain the functional activities of the body
on physical and mechanical principles, movements of bones and muscles being
explained on the theory of leverage, digestion being a tituration process,
nutrition, secretion and excretion depending upon pressure and tension
in the vessels. Traditional medicine dismisses the contributions
of the iatro-physical school as belonging to physiological history as if
physiology were outside the realm of healing. About the same time
the English Sydenham claimed that disease represents the effort of nature
to restore health to the patient by the elimination of morbid products
from the system. The iatro-physical school under the influence of
the Newtonian principles of physics developed in Britain under Pitcairn
and Cheyne, who attempted to explain life and disease on mechanical principles.
Friend applied the same principles to the phenomena of menstruation.
Richard Mead and James Keill applied the mechanical principles to the explanation
of the body functions. These are the precursors of the new pathology,
etiology and therapeutics of disease.
THE FUNDAMENTAL PRINCIPLES.
The body consists of different kinds of matter, this
matter being arranged in tissue form and these tissues having, (a) similarity
in origin from a common bioplasm, and (b) dissimilarity in their molecular
composition, manifested in microscopic structure and dissimilar forms of
activity. These tissues differing in structure and in mode of activity
are variously arranged in mechanical adaption and adjustment to form organs,
by means of which the different activities are given special direction.
This organ arrangement ranges all the way from the mechanism of the central
nervous system in which the mechanical structure consists of minute cells
and fibres, to those organs as in respiration and circulation in which
the mechanical factor predominates.
Hence the physiology of the organism must take account
of, (1) the processes that take place in the microscopic tissue constituents,
the cells. These processes are chemical, physical or chemico-physical
and represent molecular activities; (2) the processes that result
from the tissue activities, these activities being modified and controlled
by the mechanical adaptation of the particular tissues; (3) the
fact that all these processes are intimately related to and dependent upon
the vitality which animates the organism as a whole, its constituent
elements and organs. Hence the discussion of physiological processes
must take place from the molecular, mechanical and vital points
of view, these three characteristics being associated with every part of
the organism and all its functions.
THE MASTER TISSUES.
The great tissues are the nervous and muscular, all
the rest of the body acting simply as a help and a protection to the muscular
and nervous systems, or as a complex machinery to supply these master parts
of the organism with food and oxygen through the medium of the blood, to
clear away the waste from the tissues and to keep up the normal temperature
of the different tissues for normal activity.
In these the blood is the agent and medium
and the body may be regarded as a complex mechanism for the transformation
of food and oxygen into blood, removing the waste from the system and maintaining
the normal body temperature. The blood function is performed in connection
with bioplasmic cells whose processes are partly molecular, partly mechanical
and partly vital.
Hence the physiology of the body inquires into, (1)
the principles and laws that regulate the transformation of food into body
substance and regulate the katabolism of the body substance into waste
products; (2) the laws and principles which regulate the origin and distribution
of nerve vibrations, their relation to muscular contraction, the secretary
processes and the different forms of tissue activity; (3) the laws and
principles which regulate the generation of nerve vibrations in connection
with the molecular, mechanical and vital processes of the
tissue cells, the relation of the chemistry of energy to the vitality of
energy and the relation of vital energy to movement, rhythmic mobility,
feeling, thought. These are the fundamental physiological principles
that underlie therapeutic action and therapeutic law.
ETIOLOGY, PATHOLOGY, SYMPTOMS
Historically the change from the normal in the body
has been interpreted by symptoms or signs. The pathology of objective
disease has, however, emphasized the change in the structural constituents,
the cells. But normal function depends upon the normal chemico-physiological
constituents, the vital adjustment of which means the freedom of the life
forces and a state of orderly health. The cells and tissues form
the living body and these sustain physical, chemical and vital relations
within the organism, the processes of nutrition in connection with the
cycle of metabolism representing the foundation of the continued organic
life. The fundamental principle is the cell condition, changes in
the cell modifying the metabolic cycle.
THERAPEUTICS - EMPIRIC.
To meet this, empiric medicine used substances to
modify the chemical reaction and scientific medicine uses the exact analytical
and synthetic principles of chemistry to combat these changes. How?
To control the organic processes of the cell life, not by producing changes,
but by regulating the responsive activities of the cells in their metabolic
changes, so as to restore the equilibrium of cell life.
THERAPEUTICS - PHYSIOLOGICAL.
Physiology suggests two principles, (1) the correction
of maladjustment, the removal of obstructions and the co-ordination of
the life forces, fluids and processes by the removal of every abnormality
to perfect adjustment; this means the correct machinery; (2) eliciting
a response from irritable tissues and mobile cells, whether on the basis
of acceleration or retardation. The nervous system is an automatic
mechanism and the most important parts, perhaps of it from the point of
view of co-ordinating the streams of nerve vibrations that penetrate the
entire organism are the dendritic branches by means of which a process
of switching is carried out in the distribution of the physiological impulses
in such a way as to interrupt co-operating relations between organs.
It is this that interferes with the community of cells frequently when
no distinctive lesion is found in the structural machinery.
THE PRINCIPLE OF THERAPEUTICS.
There is a law or principle of therapeutics.
Can we discover it? According to Dr. A. T. Still, "a disturbed artery
marked to an hour and a minute when disease began to sow its seeds of destruction
in the human body. That in no case could it be done without broken
or suspended current of arterial blood, which was by nature intended to
supply and nourish all sinews, ligaments, muscles, skin, bones and the
artery itself. He who wished to successfully solve the problems of
disease or deformities of any kind in all cases, without exception, would
find one or more obstructions in some artery or some of its branches."
What does this mean? That the obstructed circulation
results in the disturbed balance of nutrition, and consequently throws
some tissues or organs into a state of mal-nutrition. Consequent
upon this we find diseases of organs and tissues, tumors, cancers, etc.
This places the unobstructed arterial blood at the foundation of health,
every part of the body depending on this blood for nutrition. Here,
however, we meet with a cycle. All life and life forms vibrate and
pulsate in cycles. The arterial blood builds up and develops to function
the nervous system, but the nervous system furnishes stimulus and even
nutrition to the artery in order that it may pulsate in harmony with the
master tissue of the body in the supply of food to the entire organism.
Thus in the cycle of health, arterial control and nervous direction stand
preeminent, and the law of cure must be that of uninterrupted arterial
blood supply and unimpeded nerve control. What co-ordinates and unites
these together? It is probable that we can never solve the why and
wherefore of our present being, or tell just exactly how the organism assumed
its present form and functioning. Out of a vitalized cell the organism
is evolved in its entirety, all evolution being determined from within.
Hence the cycle of primary cell life must be resolved into that of nucleus
(bioplasm), cell substance (protoplasm), limited by the enveloping cell
wall. The bioplasm is and contains the life force, determines towards
itself from without all nutritive substances, vitalizing these substances,
so as to form a basis for new nuclei for the karyokinetic process of development.
When this process has gone on to maturity, the life principle determines
certain combination cells in the formation of tissues and organs, the whole
being bound together as an organism; maintaining an independent life and
forming a unity.
THE VITAL ORGANS - HEART AND BRAIN.
In this organic unity, heart and brain seem to be
in a special sense vital organs, - the brain is the great generator of
force and fluid and heat, using as its accessories in this work all the
organs of the body; while the heart, under the stimulus of the brain, which
is a mass of neuron cells, rhythmically distributes the fluids, with all
nutritive and medicinal substances, to the remotest parts of the organism.
These functions arc reciprocal, form the corresponding or parallel sides
of a cyclical progress; mutually help and stimulate each other to the great
task of preserving and perpetuating in the individual or his progeny this
TRUE THEORY OF CIRCULATION.
After centuries of physiological vagaries concerning
the circulation, Harvey discovered that the blood can flow only towards
the heart and when flowing away from the heart is in the direction backward
toward the heart again. For a long time it has been practically taught
in the physiologies that the arterial blood flow is caused primarily by
the heart contraction, the systolic influence causing it to move out and
onward through the vessels. But experiment has shown the force of
the heart to be insufficient to drive the blood through the tubelet system
of capillaries. Attempts to inject the capillaries have demonstrated
that a force sufficient to drive fluid through the capillaries, (1) must
be greater than the heart force, and (2) such a force would increase the
pressure to such an extent as to produce capillary rupture. Hence
the key to the systemic circulation does not lie in the heart.
Comparative physiology indicates the true theory.
The systemic circulation of the fishes is carried on without any heart,
beginning and terminating in capillary systems without any central organ.
Similarly the portal circulation begins in a capillary system of vessels
in connection with the veins of the digestive apparatus. These unite
in the common trunk of the portal vein which sends its ramifications through
the liver substance, the portal blood passing into the capillaries of the
hepatic veins which empty into the inferior vena cava.
Embryonically the nervous systems make their appearance
before the framework or the vascular system. This vascular system
forming a network of vessels through the body is actively and fully developed
before any heart makes its appearance. The heart in fact is not completed
till after birth. In some forms of monstrosity the circulation of
the blood takes place without any heart. In the vegetable kingdom
the circulation of the blood or sap begins in a minute capillary system
in the roots, terminating in a minute capillary system in the leaves and
vice versa. Here capillary force with endosmosis and exosmosis are
sufficient, to send the sap frequently hundreds of feet overcoming gravity
with considerable ease.
CAUSES OF CIRCULATION
What is the cause then of the circulation?
It differs from sap circulation in plants because of the structure of the
blood vessel walls. Between the outer layer of areolar tissue and
the inner membrane wall lies the coat of muscular tissue. The circulation
through the arteries depends upon the peristaltic contraction of these
arterial wall coats of muscle. These walls act as a series of plates,
sensitive and motile, so that the pulsation of the arterial system represents
the pulsating current of vitality in the peristaltic contraction of the
The capillaries are not the terminals of the circulating
system but the beginning of it. The heart is the terminal just as
it is the last part of the circulatory system to be developed. Hence
it is subject to and dependent on the circulatory phenomena of the capillaries.
The capillaries represent ramifications in the structure of every organ
and tissue of the body. Here the great fundamental work of nature
is carried on, including heat generation, vital activities, body repair
and renewal, the vitalizing processes in the different tissues. Here
the pulsating rhythm of vitality takes origin, the heart being a general
center within the continuous structure of the circulatory apparatus, where
activities are co-ordinated, influences combined and made to co-operate.
Hence the heart is not a force pump but a general co-operating center in
connection with which the general vitality and life forces concentrate
for distribution through out the entire vascular and tissue system.
Thus the heart acts as a general center in connection
with which the life processes, especially of vasculation are co-ordinated
and made to act together.
The neural impulses which produce this harmonious
contractile action of the entire vascular system originate from the C.
S. & S. [cerebro-spinal & sympathetic] systems, all the different
parts of the vascular system being supplied by fibrils from these two systems.
These fibers are aroused in connection with the center activity, the center
activity depending especially for stimulation upon the oxygen taken into
the system in respiratory activity, upon the food furnished to its nerve
tissue as a result of digestive, metabolic and secretary activities in
the respective organs, and especially upon thought, emotion, and will when
in active operation from the psychic side of life.
The heart then does not act as the great pumping
force in the circulation, does not even regulate this action. It
is simply a general reservoir and distributor which unites the various
parts of the vascular system, coordinates their activities, the real stimulation
of the circulation depending upon the peristaltic action of the minute
blood vessel system called the peripheral system. This peristaltic
action depends for regulation on the nervous system under "the guidance
of vitality." The peripheral circulation thus becomes the key
to the circulatory function. This explains the relation of the
arterial wave of peristaltic action to the circulatory phenomena.
It explains the failure of success in the use of cardiac stimulants and
depressors, and indicates the only rational system of reaching the circulation,
even the heart, by the action upon the peripheral blood system and this
especially through what is called the vaso-motor nervous system.
This accounts for the success of osteopathic procedure when these are directed
to the vaso-motor mechanism.
THEORY OF THERAPEUTICS.
The theory of our therapeutics depends on, (1) the
vital force, which represents the sum of all vital activities and processes
in the body organism, the cosmic energy in man, the energy of understanding
and will; and (2) on nutrition, the tissues and organs depending for their
vitality and vital activity upon nutritive conditions. Both of these
are controlled from the brain. The brain centers represent the higher
life, and the different paths from the brain to the body along the nervous
system are pathways of distribution in connection with vital force and
nutrition. In this we must take account of brain nutrition, in connection
with which we get (1) the production of a secretion, the cerebro-spinal
fluid, and (2) the generation of nerve energy that passes outside of the
brain in the form of waves of vibration.
BRAIN NUTRITION AND INFLUENCE.
The nutrition of the brain depends on definite changes
in the brain, these being regulated by certain movements in which the lymph
and blood play a most important part. In the case of the other body
organs like the liver, these organs receive in all their parts an equal
supply of blood when normal. It is different in the brain, because
all parts of the brain are never acting simultaneously. Hence the
difference in function forms the basis of the difference in blood supply
to the different parts of the brain. The demand regulates the supply.
The skull is an immobile structure and it limits the capacity of the cerebral
The brain substance does not entirely fill up the
cranium, lymphatic channels and reservoirs being within the brain in order
to form a yielding base for the brain, not a solid structure like the cranial
roof. In this yielding substance we find certain rhythmical movements.
The brain acts on the body and controls the body, but body reacts on brain.
We find brain movements corresponding, (1) with systole and diastole of
the heart, (2) with inspiratory and expiratory changes, and (3) with vascular
variations of vaso-motion. Brain movements and blood pressure in
the brain depend upon these three forces. Thus the variations in
blood supply to the brain depend upon anatomical structure and physiological
movements. Brain activity represented by these brain movements regulates
blood distribution and brain nutrition. These movements are peristaltic,
and when brought into relation to the mechanical motor power generated
by the cranium give rise to the lymphatic and cerebro-spinal fluid circulation.
The brain is nourished in connection with its blood supply, and at the
same time metabolic changes give rise to lymph and cerebro-spinal fluid
found in the subarachnoidal spaces and in the ventricles, passing down
into the spinal canal, thence along the path of all the spinal nerves,
and also along the cranial nerves.
Hence the brain exerts a three-fold influence over
the body, (1) nutritive, through the influence it exerts upon the
vaso-motor system, in virtue of which its selects the food materials from
the blood that circulates through all the tissues and organs; (2) trophic,
direct from the cerebro-spinal system by the cerebro-spinal fluid, which
passes out along the paths of the cranial and spinal nerves. This
makes all tissues and organs trophic. If this is not normal, then
the tissues or organs are in a state of mal-nutrition and liable to all
sorts of diseases. These nutritive and trophic conditions are controlled
by the neuron cells of the brain. Tissues that are non-trophic may
grow by accumulating substance but do not develop by assimilation.
Normal tissues are trophic when they are under the trophic control of the
cerebro-spinal system, and are in this condition immune from disease.
When non-trophic they are susceptible to disease; (3) the brain generates
impulses that pass out to all parts of the organism through the nervous
system to maintain the tonic rhythmic, peristaltic or vibratile condition
of tissues and organs. This mobility which, is the characteristic
of every tissue and organ is maintained by the perpetual stream of vibratile
impulses from the brain towards every part of the body. Here we get
the vibratility of the vital force.
1. The first pages of physiology bring out
into prominence, the vital force as that which lies behind the matter
of the structure and the material functional of the body organism.
2. The basic principle that runs all the way
through physiology is order, harmony and co-ordination, these being
established by and through the nervous economy.
3. There can be no organic disease or organo-therapy,
because no organ of the body stands isolated and alone, the sympathetic
relation of the nervous system making it imperative that the body be regulated
as a commonwealth of cells.
4. The great medium of therapeutic action is
the cerebro-spinal and. sympathetic systems, these systems being co-ordinated,
each system contributing an independent functioning to the united nerve
mechanism. The former contributes control, especially in connection
with its trophic function, exerted over all parts of the organism through
sympathetic channels. The latter, vaso-motorly, regulates the blood
supply and therefore the nutritive condition of the cerebro-spinal system.
Any weakening of these united and coordinated nerve mechanisms renders
therapeutic action less certain and may render it impossible.
5. The fundamental theory of physiological
life is that of co-ordination, co-operation and adjustment. From the starting
point of the embryological life we have the adaptation of the male and
female elements in fertilization, the gradual progressive evolution of
embryonic layers and cells, embryonic tissues and organs, until in the
co-adapted organism we find the structural and functional adjustment of
all the parts of the organism at the basis of vital manifestation.
The structural framework is functioned in relation to the rhythmic activities
of soft tissues and these in turn are regulated by the coordinate activities
of four distinct motive powers, representing four definite planes of vital
manifestation: (1) the reflex, (2) the automatic, (3) the voluntary, and
(4) the volitional center activities.
6. The vitality of the nerve tissue is the
basic life of the physiologic organism and this manifests itself upon these
four planes of activity in connection with all the organs and organic expressions
of life. The co-ordination of these within the physically and. physiologically
conditioned material body constitutes what we know of actual life, the
expression of the deeper life principle and the life force.
THE FORCES OF NATURE.
There are certain forces, - sound, light, heat, electricity,
etc. The physical basis of all these is vibration. Vibration is an
accepted fact in science. Solid bodies are composed of atoms which
are vibrating at almost infinite velocities. One substance differs
from another mainly in the modulus of vibratility, the different planes
of substance representing the planes of gradually increasing vibratility.
The higher vibratility governs and moulds the lower, just as the sun centralizes
the solar system. The most refined vibrations that mean life and
light, with all their accompaniments to the planets, in that solar system.
In man this vibratile characteristic also predominates, for within his
organism he combines the higher and lower grades of vibratility in connection
with mind, brain, bone, muscles, blood. So long as these combined
vibratilities are in harmony are in harmony the organism enjoys life and
THE VITAL FORCE.
In man there is a vital force, so-called because
there is no better term. It is not the vital principle or the soul
or the subjective mind. It is the vital force, or that force which
originates and remains in the body as the result of the union of spirit
or simple substance with matter. It is the objective mind of the
The principle of this vital force is the power
of fluxion or of vibration, which, as in the physical forces, can permeate
the substance without affecting or modifying its substance. There
are thus three planes, the pure material, the pure spirit
or psychic, and the plane which originates in connection with the union
of these other two, the vital force plane.
What is the plane of therapeutics? What is
the plane of dietetics?
THE DIETETIC PLANE.
The plane of dietetics is that of pure matter,
the food taken into the body passing through a metabolic cycle, terminating
either in being assimilated to the material tissues or else in elimination
as unassimilated or unassimilable. Here we are dealing with crude
substances, and the metabolic laws that regulate this cycle are two-fold:
(a) supply regulates the demand throughout the body, and
(b) demand regulates the supply throughout the brain tissues,
on a nitrogenous basis.
This makes it imperative to supply food substances
in proximate principle or crude substance form, and this means the antidoting
of hunger or thirst by the appropriate contraria substance, that will fill
the void and satisfy the material craving and appetite.
THE THERAPEUTIC PLANE.
In the therapeutic plane we are dealing with
the nexus of spirit and body, and, therefore, with those vibrations or
fluxions that lie at the foundation of the force called vital. On
this plane crude materials cannot be of any service, because they are foreign
to the force to be affected, and as such cannot enter the field of the
In the crude drug substance, (a) there is nothing
refining, but everything thing is crude and material body substance, and
as it is not the material we are curing, as it is the vital force we are
adjusting, there must be a refinement compatible with the force to be affected;
(b) increased vibratility is the principle of adjustment.
THE BODY CYCLES.
There are, it is true, the cruder forms of changes
in the body, (1) the metabolic cycle, representing hunger, thirst, etc.
These demand the crude changing. Why ? Because the body has organs
in which certain changing, refining and forming goes on; secretions are
the nutritive supplies of the higher forms of tissue. (2) The vital
cycle depends upon vibration. Waves of vibration pass along the
tissues, especially from the nerves and the brain to and along the muscle
tissues. There is no function of the body that does not have peristaltic
or rhythmic vibrations. How are we going to affect these ? By affecting
vibration in the substance used or in the treatment given.
VIBRATILITY IN CONNECTION WITH LIFE.
The time may come when we can measure the vital force
by measuring its vibratility. We must approximate to this normal
vibratility. There can be no life manifestation, except in relation
to vibration. As the vibratility becomes less intensive man becomes
less capable of reactive power, mental and physical decline follow.
Some call it magnetism, electricity, life or vital potentializations.
Is there anything to lead to determine potentialization. Sympathetic
life or visceral life is cruder and represents a lower plane of vibratility,
although higher in the scale of rhythmic pulsation. The cerebro-spinal
is more refined and represents a higher plane of vibratility, although
more inhibitory in its nature. Therefore, the higher vibratilities
appeal to the cerebro-spinal system. As most, if not all, functional
activities represent coordinated sympathetic and cerebro-spinal activity,
the medium vibratility represents the normal, changes depending on the
capacity to react.
(1) The principle of determination is from last to
first, symptoms disappearing in the reverse order of their appearance.
Why ? The last to appear is the least entrenched in the system.
(2) The pathway of least resistance is the pathway
of curative effects.
(3) There is a normal degree of vibratile force in
the organism. A certain portion may be over-active or under-active.
This explains what seems to be organic disease.
The curative principle is the economic distribution of these vital vibrations
on the principle of adjustment, such as is compatible with life.
Disease causes a re-distribution of this adjustment and in cure the vital
force is directed to the orderly adjustment of the economy of vitality.
VALUE OF SYMPTOMS.
Symptoms are the voices of the patient, or
the vital force of the patient, expressing the internal condition through
the outer or superficial plane of manifestation. At first we find
in the organism a life force and its constantly struggling against death
forces or disease causes during the life of the individual. These
disease forces are accentuated by unhealthy environment. The vibratile
life force of the patient resists these. This vibratile life force
represents the inherent rhythmic vitality of every organ and tissue.
Everything superficial represents the expressions of the physiological
life, through or from under the pathological, demanding aid for the physiological
life, to help perpetuate and keep up the struggle for existence and to
determine is in favor of vitality. These expressions may be, (a)
subjective, what the patient feels, reports; (b) objective,
what the physician sees on the surface of the body or brings out by manipulations
of the body or its parts in any form of deviation from the normal.
THE LAW OF CURE.
To meet these the law of cure is that of adjustment,
co-ordination, co-operation. All life represents forces and the
nature of this force is rhythmic or vibratile, because the disorder is
mal-adjustment, the two possible conditions being above or below
par or normal, and vibratility or motility can only be changed by something
of its own nature. Hence the value of correcting the arterial wave
and the nerve impulse.
THERAPEUTICS IS PHYSIOLOGICAL.
Is healing physiological or pathological? It
is undoubtedly physiological. So long as life persists there is a
tendency to the normal. This is represented by the reactive vital
force of the organism To this we must appeal. Here
there is much of the confusion in the science and art of healing.
It is not to the pathological state or condition we appeal, but to the
physiological, to restore order and remove the pathological. Therefore
all healing must be physiological in its nature.
Are there any indications of this curative principle
in physiology? It is this that lies at the basis of all mechanical
systems of healing, the setting up of increase in or the checking of the
vibratile impulses, the correction in the distribution of the normal vibrations
sent out from the brain center of control and distributed by co-ordination
from the different planes of center activity.
ITS THREE-FOLD BASIS.
The curative work of any therapeutic system, if it
is true, lies here. Curative action is three-fold: (a) corrective,
establishing disturbed adjustment; (b) stimulating, increasing the
local or regional distribution, and (c) inhibiting or checking an
decreasing the local or regional distribution of the vital impulses.
What does nature do? Nature does all the
curing. Every atom has a certain affinity for every other atom
in the molecules. We call it chemical affinity. The law of
gravitation has a centripetal and a centrifugal force, that is, drawing
forces; and these forces, whether chemical or physical, have their homologue
in the field of biology. The simplest living substance has an internal
force which keeps all its particles determined to the organism. Plants
grow in fixed forms, the form being definite, different from the formlessness
of the inanimate. Here cohesion is a determining principle.
This is energy or force and it is derived from the formative intelligence
of the animal organism. This keeps all parts of the animal body,
- from the simple amoeba up to man, - in order, and this order is the determining
factor in functionings. On the basis of this energy or force, the
great governing principle of the animal is adaptation. Dead substance cannot
adapt itself to environment. This vital, operating and adapting force,
which represents the life principle or constructive soul, keeps
the body continuously constructed and reconstructed in a
definite and orderly plan, and this definite orderly plan is carried out
by the executive officer of the organism, the vital force, in connection
with the vital impulses sent from its center to every part of the body.
CYCLES AT FOUNDATION OF THERAPEUTICS.
Here we have the foundation for, (a) the psychic
cycle of the will, understanding and emotions, representing the
volitional voluntary and sensitive life of man; (b) the metabolic cycle
of anabolism, katabolism and rest, representing the
vegetative life of functional activity and development, (c) the reproductive
cycle, in which certain organs are concerned in preserving the life from
destruction; first, of the individual, and secondly of the race, under
the vital force, in connection with certain glandular activities,
for example, the thyroid glands, suprarenal capsules, pineal glands, and
the sexual reproductive glands. The most profound physiological principle
illustrated in these glandular processes is change of substance to the
same character in order to assimilation, refining and double refining to
reach the central bioplasmic life substance. Poisons within the
limits of the organism are detoxinated. If the system is overborne
by poisons it cannot detoxinate. Then biological vitality gives place
to chemical activity and the organism is in danger of dissolution and the
separation of the different planes of vital activity from the central force
of the organism takes place. In this case an antidote is demanded
on the chemical plane, in order to prevent the central life principle and
its forces from being overwhelmed by the toxic action of the poison.
Poisons can have no therapeutic action, but simply an antidotal or katabolic
THE ORGANISM, A UNITY.
One of the central facts of the physiology is, that
the organism acts as a unity, consisting of a mass of unit cells.
These cells all act in unison and harmony whatever takes place. Hence
if the body is diseased there must be,
(1) Lack of adjustment.
(2) Reaction upon the vital force in
the form of disturbance, obstruction or impediment to normal activity,
(3) This reaction upon the vital force weakens
certain functional activities and results in consequent tissue changes
brought out in the field of morbid anatomy.
THE INTERNAL SECRETIONS OF THE ORGANISM.
The greatest doctrine of modern physiology is that
of the internal secretions. The internal secretions represent the
most perfect and refined metabolic products in the body. The cerebro-spinal
fluid is a secretion of the brain representing the most highly vitalized
fluid in the body; the thyroid secretion and the suprarenal secretion represent
respectively, the stimulation to the vaso-dilator function of the cerebro-spinal
nervous system and the constrictor function of the sympathetic system.
The meaning of these secretions we take to be, that a refining process
goes on in certain glandular structures of the organism to prepare the
most highly nutritive and vital fluids of the body, and on these depend
the trophicity of the organism.
PHYSICAL AND CHEMICAL VIEW.
It is being asserted very widely that physical and
chemical processes fully explain the life of man.
Even in some of the newer fields man is spoken of as a machine and
all his activities are regarded as purely mechanical. Pure bioplasm
is structureless, at least as far as the minute examination microscopically
of it can show. It is free from granules, the broadest and most essential
difference between bioplasm and non-living matter being that bioplasm has
a remarkable capacity for movement. In fact mobility is the primary
characteristic of bioplasm. Every form of living matter has mobility.
This is not all. "Every nutritive act, every form of increase and
multiplication, each kind of growth, the production of buds or offsets,
the development, the formation and increase of every tissue, involves active
movement of the particles of which living matter is composed."
VITAL MOVEMENT WAVELIKE.
This movement in some forms of living matter is microscopic
but no living matter can exist apart from some movement, because vital
movements are essential to life. When these movements cease life
ceases. The primary movements that affect every part of a mass of
bioplasm are undulatory or wavelike, producing continual changes in the
mass of the bioplasm. In the development of the constituent elements
of a mass of protoplasm, there is a movement from the center to the circumference,
the nuclei and the nucleoli forming new centers of development internally
to the bioplasm, these being vital centers growing out of centers of bioplasm
already existing. As the constituent particles of bioplasm move from
center to circumference, the fluid containing the nutrient matter or the
non-living matter flows from the circumference to the center. As
it reaches the center it becomes vitalized and then is determined the movement
from center to circumference and so on ad infinitum while life lasts.
In the movements of one part of a mass of living matter in relation to
the rest of the living matter, the movement is peripheral, the first movement
being along the line of least resistance.
Dr. Gideon Wells writes, "all metabolism may be considered
as a continuous attempt at establishment of equilibrium by enzymes, perpetuated
by prevention of attainment of actual equilibrium through destruction of
some of the participating substances by oxidation or other chemical processes,
or by removal from the body or entrance into it of materials which overbalance
one side of the equation."
TISSUE MOVEMENTS ESSENTIAL TO LIFE.
In connection with the formation of tissue the amoeboid
or locomotive bioplasmic movement is noticeable. This is especially
true of the nerve tissue, although it is equally true of muscle and probably
of all tissues. The most essential movements in the tissue when developed
are: (a) the movement of living matter from center to circumference,
and as a result of this, (b) the movement of nutrient, non-living matter
from circumference to center. These are essential to life and
life cannot exist and be perpetuated without these. The other movements
are more or less accessory to these fundamental movements.
HOW THIS MOVEMENT TAKES PLACE.
In explaining these bioplasmic movements from the
centers of life, it is essential to remember that the primary constituent
of bioplasm is water, the solid being held in solution in the fluid.
In the most minute particle of bioplasm there is a center of vitality.
To this center nutrient matter comes from the circumference to be vitalized
and to enter the cycle of perpetual movement from center to circumference.
New matter is formed in these vital centers, this matter previously non-living
coming into contact with the living and acquiring its vital characteristics.
There is no power of non-living matter at all comparable to this.
A complex process goes on, (a) bioplasm selects the nutrient matter from
the blood, (b) the blood in turn is tissue and as such is formed by bioplasmic
processes. All the blood elements are in reality the white blood
cells or their disintegrated products. The vital action in all cases
is at some center of bioplasmic mobility. Hence vitality acts in
bioplasmic centers only upon matter that approximates to these centers,
preparatory to being itself vitalized. This center of life receives
its illustration embryologically in connection with the nucleus of the
fecundated ovum, the primary origin of vitality in the newly formed organism.
Without this center of life and mobility the new organism would be impossible.
Hence the vital actions are limited to already existing bioplasm and this
already existing bioplasm in the centers of life renders possible the physical
and mechanical phenomena, which we call change of matter. The bioplasm
thus possesses a vital force which it can project into the non-living drawing
it closer to its center life and then projecting it outwards toward the
circumference of tissue and organ formation. Whatever the fundamental
bioplasm in the fertilized ovum may be, as it divides and subdivides in
drawing within and projecting out form its own centers of vitality, non-living
matter, which it causes to pass through formative changes, there still
remains somewhere a great center of this vital activity and mobility.
DEVELOPMENT OF TISSUES.
In man the tissues constituting the organism are
definitely laid out, before the nerve tissue is developed or begins to
act, nerve tissue being the last to reach full development. How then
does this development take place? The bioplasm of the nuclei of the
embryo represents the formative force at the center of the substance of
the nucleus. This divides and subdivides, forming bioplasts that
possess inherent vitality, taking in food and pressing it out to the circumference,
until fully formed tissues are developed, the bioplasm being associated
with the nerve tissue last developed and fully developed. Here lies
the secret of that medicinal actin based on food and oxygen and the principle
of adjustment, which appeals to the centers of the vital force, because
only in this way can the circumference of vital matter be reached.
This is equally true of disease. If the bioplasm
increases too quickly, its developing power is impaired; resultant tissues
are soft and feeble in functioning because the period of formation has
been too short to allow of maturing. On the other hand, if bioplasmic
activity is too great there is no tissue development at all. This
means that nutrient matter is too quickly rushed through the centers
of vitality to permit of the vitalizing process. Here we have
what takes place in the inflammatory processes, an increased nutrition
of the bioplasm of tissue or of the organism as a whole in the febrile
Bioplasm lives very slowly, takes on nutritive matter
and slowly projects it with vitalized power into the circumference of tissue
or of the organism. In inflammatory conditions the bioplasm grows,
becomes static, no new matter being formed to be projected outwards, with
a probability of permanent damage being done to the bioplasm, preventing
future new formation. This explains why destroyed organs or tissues
cannot be reformed, because the formed or structural tissues and organs
are developed from structureless bioplasmic atoms.
Connective and epithelial tissues are most liable
to such rapid increase as is found in inflammation, but any tissue may
thus pass into pathological motivity, and from every form of bioplasmic
tissue, but especially connective and epithelial, pus corpuscles may be
found or formed, these being the degenerated or degraded normal bioplasm
corpuscles. Here development takes place pathologically, because
all bioplasm tends to grow.
THE BIOPLASMIC ORIGIN OF DISEASE CONDITIONS.
Now in these cases bioplasm is overfed, producing
soft tissues, the bioplasm living too fast. The active agent in disease
conditions is the degenerated bioplasm, or its particles. The pus
corpuscles in connection with septic diseases and the bacteria in contagious
and infectious diseases arise from the degenerated bioplasm. These
so-called materies morbi are not the causes of disease, but are themselves
the products of changes in the vital centers and the accumulation of the
nutrient elements which favor the growth of the germ as soon as the disturbance
of bioplasm exists. Probably in all cases vital action goes too fast,
the vital center rushing through itself the nutritive matter with an increased
vital activity, - too much heat, too much fluid, too much nutrition favor
those inflammatory, purulent and febrile conditions which present the conditions
of bacterial development, namely, heat, fluid and food. The primary
starting point, therefore, in the disease condition is the deranged,
disorganized or obstructed vital activity; secondly, this reacts
upon the metabolic cycle, causing the rush of nutritive elements from
circumference to center, with the abnormal products in the bioplasm representing
degeneration; thirdly, the pus corpuscles and bacteria are developed
and propagated rapidly in the favorable medium, thus created by disorganization.
NERVE TISSUE IN HEALTH AND DISEASE.
In the highest form of tissue in the body, nerve
tissue, we find all of these principles illustrated. Behind the simplest
nervous action there lies a nerve current and this can be set free in connection
with chemical change. Before such chemical changes take place the
material must be formed in connection with the central bioplasm.
The current that passes along the nerve fiber is generated in the cell
and in its nature it is analogous to electricity. These currents
are undoubtedly associated with nutritive acts, these being governed
by nerve force. The minute nerve filaments to the capillary blood
vessels represent an automatic nerve apparatus connected with blood distribution.
If the nutritive process becomes too active, these fibers in the capillaries
communicate with the trophic nerve centers in the spinal cord (anterior
horns), resulting in the transmission of efferent impulses to the circular
muscle fibers of the arterial walls. This diminishes the caliber
of the blood vessel and checks the flow of blood to the capillaries, diminishing
the amount of nutrition allowed to pass to the tissues. The same
nerve apparatus restores nutritive harmony, equalizes the blood supply
and balances the nerve force. In this way the supply of nutrition,
the regulation of temperature and the balance of nutrition are preserved
- all in connection with the arterial wave action.
All these nerve fibers and centers were gradually
prepared for functional activity by a formative process in the bioplasm
and only as bioplasmic vitality is preserved will the mechanical functioning
of this nerve apparatus continue. The nerve force arises from the
changes that take place in these bioplasmic centers. These centers
are very closely associated with the sensitive peripheral terminators,
especially in connection with the special senses and the terminal expansion
of the motor fibers in muscles and other end organs of motivity.
In comparison with these very few bioplasmic particles
are found in connection with the nerve distribution in serous membranes.
We are justified, I think, in concluding that the
bioplasts at the periphery of the nerves, both superficial and central
have a threefold function; (a) in the formation, preservation and renovation
of the complete neural apparatus; (b) in the development of the nerve wavelike
currents of sufficient intensity to act as stimuli to the nerve centers,
these nerve centers with their bioplasm being the great centers of neural
impulse generation; (c) the same bioplasm is concerned in the thermogenic
(heat) function (body temperature), especially when an unbalance of the
nerve economy exists. Heat is then generated instead of nerve impulses,
or rather the heat is not converted into nerve force or energy. This
last will explain the relation of the nervous system to the development
of temperature, whether physiological or pathological, for example, in
In the human subject the activity of every organ
and tissue of the body is subject to the higher parts of the nervous system,
where the bioplasm is found in greater abundance and complexity.
Here we have nerve cells that continue to develop after the rest of the
nerve mechanism and the body have attained their maximum. In the
caudate cells of the gray matter of the brain we have the centers of fiber
formation and the centers of nerve force generation. In the bioplasmic
substances found superficial in the gray matter, where the interlacement
of fine nerve filaments takes place, we find substance not enclosed in
any cell wall, but supplied with such an abundant blood that the changes
taking place within them are very rapid. These minute bioplasts are
constantly changing during life, and in all probability their close and
intimate relation to the nerve filaments forms the basis of a formative
function in connection with neural impulses. This is the center of
the vital nerve activities. Here the dendrite development is most
SUMMARY OF FUNDAMENTAL LAWS OR PRINCIPLES OF THERAPEUTICS.
In the principles we have laid down we have the foundation
of a number of laws: (a) nutrition moves from circumference to center;
(b) vital activity with all its formative energy moves from center to circumference;
(c) the central activities are the fundaments upon which peripheral expressions
are built; (d) the only rational therapeusis is that which rests upon the
central law, that the change in the current of activity must begin at the
center, the vital force, distributing its curative effects along
the pathway of least resistance in the nerve fiber economy, in order to
reach out to the weakest part of all the organism and thus restore it to
harmony, with the rest of the organism; (e) vital adjustment is the law
of cure, the purely chemical, physical or mechanical can never cure, unless
in so far as these can be converted into a vital equivalent; (f) the nutritive
law is that the proximate principle must be supplied in crude form, because
this passes in the fluid stream from the circumference to the center of
bioplasm activity, while therapeutic action cannot be effected, through
the crude form, because the starting point of therapeutic action is in
the central bioplasm; (g) order in the vital economy can never be restored
by recourse to counteraction or counterirritation, but only by the application
of the law of simillimum, on the basis of the principle of adjustment.
The vital force never decreases, never increases,
therefore it can restore order only by an orderly distribution of that
vibratile activity which from the center of life keeps every organ and
tissue in rhythmic relation to the organism. The vibratile adjustment
takes place on the scale of the existing mal-adjustment; (b) When dissolution
takes place the central vital activities gradually, from without in, let
go the material previously constructed under their formative action; if
this dissolution is checked before it terminates in death, the reverse
order must be followed in the reaction of the vital force, upon the material
part of the organism. Hence the ab ultima ad primam principle
is the principle or law followed out in the rejuvenescence or restoration
of the organism.
These are the basic physical, chemical and biological
principles at the foundation of the true system of therapeutics.
THE BALANCE WHEEL OF LIFE.
(i) In the preservation of the organism it is well
to remember that the great balance wheel of life is around the spine, the
spinal cord and the spinal column representing the mediating influences
between brain and body. In the brain the peristaltic variations are regulated
by the vaso-motor influences that center in the dorsal spine. In
the systemic circulation stasis or equilibrium between the two blood circulating
streams is prevented by vaso-motor activity. Hence the key to
the continuous blood circulation is found in the vaso-motors.
Probably everywhere in the body the vaso-motor system holds the balance,
acts as the moderating influence or represents the regulative action.
This is in line with the idea of the body life as a cycle, complete in
itself. Self preservation consists in the due and proper balance
of the different cycles we have already referred to.
THE INTERNAL SECRETIONS - OSTEOPATHIC MEDICINE.
(k) Among the most interesting facts of modern physiological
life is the doctrine of the internal secretions. These internal secretions
represent refining processes to prepare for the closest and most perfect
assimilation. One very interesting fact is that the vaso-motor system,
the regulative balance wheel, is itself controlled by two of these secretions.
In the ductless glands we find organs which in the
earlier life act as blood forming glands, but in later life their function
is transformed into that blood disintegrating, blood detoxinating glands.
The body embryologically consists of certain segments,
or regions, and in each of these segmental regions we find a series of
glands. In the head, the pineal gland, whose metabolism in secretion
affects the bones and the nervous system, for nutrition; in the neck and
thorax the thymus grand and thyroid bodies, the former disappearing as
soon as the independent white, corpuscle life is established in the child
life, the latter remaining through life as metabolic and secretary glands.
The internal secretion of the thyroid is prepared, (1) by picking the toxic
matter from the blood, (2) detoxinating it, (3) the glands living on the
toxic matter and metabolizing the detoxinated material into a secretion
which is thrown out into the blood, and carried to the nervous system,
especially the cerebro-spinal system. It acts as a nutritive fluid.
These bodies are very vascular and nervous, especially vaso-dilator.
Myxoedematous conditions result from an abnormal condition of these glands,
because of nutritive disturbances of the nervous system. The normal
functioning of the glands prevents the body from being intoxicated, and
as the nerves that enter the glands are strongly vaso-dilators, the secretion
when emptied into the nervous system stimulates vaso-dilation. Stimulation
of the thyroid nerves lessens carotid blood pressure. This means
that the secretion of these glands is the main stimulant to the dilator
function of the cerebro-spinal nervous system. Here we have the completion
of the cycle, the waste of the blood is converted into a nerve tonic, that
tonic acting so as to promote cerebro-spinal nerve functioning over the
blood system. This is part of the internal medicine of osteopathy.
The suprarenal bodies also detoxinate some materials
in the blood, forming therefrom an internal metabolized secretion, which
through the nervous system has a strong stimulating effect upon the constrictor
or inhibitory function of the nerve centers in the medulla, with the result
that it stimulates the constrictor effect upon the arterial walls through
the sympathetics. Hence this secretion has a stimulating and regulative
control of the arterial sway exerted over the blood circulation throughout
the entire body. The fact that in the case of the division of the
spinal cord and the removal of the medulla the same constrictor effect
is produced upon the systemic arteries seems to demonstrate that the substance
acts directly through the sympathetic nervous system. This
is in line with the embryonic medullary part of the capsules, which allies
the medulla of these bodies with the sympathetic system in structure and
function. This makes the secretion of these glands stimulative of vaso-constriction.
THE BLOOD TONICS OF NATURE - ANTI-POISON.
Here we have therefore two sets of bodies which are
both concerned in preservative life processes, picking up the waste and
toxic elements of the blood, to utilize these in preparing substances used
in governing the dilator and constrictor functions of the vascular mechanism,
the twin blood tonics of nature.
It is of interest to notice, (1) that the material
is furnished from the blood to these glands, and the reaction results in
the control of the blood itself, presenting a cyclical action; (2) in order
to fit the material for organic use it must be detoxinated. Probably
this represents an organic law, that poisonous substances are not designed
normally to reach the centers of vitality, those organs being placed at
the gateways of the life processes, to prevent, as far as they can, the
passage of toxic agents to the life centers. Thus the body itself
teaches us the deleterious effects of the use of poisonous substances,
teaches us not to use crude drug poisons.
We can control these osteopathically, the thyroids
from the middle cervical region and the suprarenal bodies from the splanchnic
and vasomotor areas of the lower dorsal and first lumbar regions of the
THE REPRODUCTIVE SECRETION AND THE BRAIN.
The other secretion which is of vital importance
in the preservative and reproductive functions of the body is the secretion
of the reproductive organs or glands of the body, the secretion of the
reproductive sexual organs. Although little is known of this subject,
those glands are concerned in a very similar process in metabolizing and
forming a secretion, both internal and external, concerned in the preservative
and reproductive functions of the body. In addition to spermatogenesis
and ovagenesis, these reproductive glands form an internal secretion.
These organs are not glandular properly until puberty, the internal secretary
function being most active about puberty. Hence these organs are
both duct and ductless glands. Maturity of body and mind develop
with the maturation of these organs. It is not unreasonable to suppose
that the sexual glands secrete material of service in the nutrition of
the brain and the nervous system. Serum therapy has at least in part
demonstrated this. When these glands are impaired the blood is deficient
in nerve and brain food.
These sex glands are united to the cerebro-spinal
system by double connecting links at the extreme opposite end of the nervous
system. Thus the nervous circuit from brain to sex glands is complete
and its integrity depends on the same blood waves as the rest of the organism.
If these glands are weakened they return to their distinctive animal function,
failing in the internal secretary work, thus affecting directly the gray
matter the brain through deficient nutrition. This reacts in turn
upon the sympathetic system and there is as a result, the upsetting of
the rhythmic harmony of the nervous economy, such as is found in hysteria,
neurasthenia, insanity. The re-establishment of the preservative
and reproductive function depends upon the adjustment of brain and glands
through the arterial rhythm of the blood system and the connecting nerve
fiber system, as they co-operate through the machinery of bone, muscle,
etc., in the body mechanism.
These are the foundation principles of physiology in osteopathic