The osteopathic ideas can be summarizedinto three values or principles.
Firstly, there is the aspect that describesthe self-regulation mechanism, that keeps the human body in balance. Anosteopathic therapist is educated to stimulate this mechanism of the body. Furthermore,there is another principle that is used in osteopathic medicine. It describesthe correlation between function and structure. A functional problem in thehuman body can affect the structure, but a structural problem can also affectthe function (Kuchera, 1994). There is one more osteopathic principle left, thatdescribes the necessity to see the human body as one undivided unit. The bodyis subdivided into many parts, but every part of it works for the aim of otherparts (Kuchera, 2007).
This last osteopathic principle is better known asholism. The founder of holism is JC Smuts. He saw this word as a unit wherematter and mind became fluid (Parsons and Marcer, 2006). The human body is subdividedinto four systems including the craniosacral system, visceral system, parietalsystem and the psychosocial system. An osteopathic therapist has to integrateall four of these units because alterations in one system can affect anothersystem (Parsons and Marcer, 2006). The cause of a medical issue can sometimesbe located in another system of the body, which makes it necessary to integrateall systems. On top of that, the human body has several communication systems, sothat makes it possible for one system to influence another system. That aspectas well makes it fundamental to integrate all systems of the human body to havean effect on the patients’ complaint (Seffinger, 2003).
Apparently, it is incomplete tolimit this aspect of the osteopathic philosophy to the physical aspect. Thepatient is more than just a body with various units, but it has its own mind aswell. Mind and body are inseparable and need to be treated as one undividedunit (Seffinger, 2003).
1. Founder (written by Marthede Saedeleir)2.1 Jan Smuts: short biography Jan Smuts (°24 May 1870 – +11 September 1950) was animportant politician who contributed in an important way to the history ofSouth Africa and the world. His work on holism is just a part of his largelegacy. It is not the intention of this course work to discuss his politicaland other pursuits, but it is useful to place Smuts’ holistic thoughts in ahistorical context (Tate, 1947). Jan Smuts was born in South Africa, in what was thencalled the Cape Colony. He grew up on the family farm, in Bovenplaats, in theAfrikaner Calvinistic tradition, which was very strict and placed a greatimportance on hard labor, moral rectitude, individualism, … (norms which stillstand in the Calvinistic way of living) but was also based on the separationfrom the non-Whites at that time.
Hischildhood was marked by long lonely walks and exploring the surroundingcountryside. During these walks his lifelong passion for nature was created (Smuts Hon J.C., 1927): “Anearly awakening of the feelings and faculties that were shaping him as a personand would one day shape his thought about the atom, the cell, mind,personality, the whole universe”(Stokes, 1963,p.8). When he was twelve years old his elder brother died,now it was his duty to go to school.
He was a very talented student and made abig impression on his professors. For example, at Victoria College, he won theEbden scholarship for Christ’s College Cambridge University, where he studiedLaw, and became the only person ever to have written both parts of the LawTripos in one year and achieve a Double First. When he studied at Cambridge,Smuts was described by his Professor Maitland, a leading figure among Englishlegal historians, as the most brilliant student he had ever met. He was alsoconsidered to be one of the most outstanding students in the 500 years of theCollege’s history together with John Milton, Charles Darwin (Tate, 1947).2.2 Smuts’ vision on holism The term holism, as an academic terminology, was firstintroduced by Smuts in his book: “Holismand evolution”.
Smuts’ book is based on two important mechanisms: theunity and continuity in nature. The concept holism is derived from the Greek holos,the “entire”, the “whole”. His holism is a synthesis between Darwin’s theory ofevolution, as described in his “Theorigin of species”, Einstein’s theory of relativity and Smuts’ ownreflections on the evolution of matter, life and mind (Wilber, 2001). Smuts’ holism goes beyond this and states that theparts of any whole cannot exist and cannot be understood except in relation tothe whole. In this context, a whole is the equivalent of a system. All theproperties of a given system (biological, personality, social, cultural) cannotbe determined or explained by the sum of its component parts alone.Smuts (1927) defined Holism as: “the ultimate synthetic, ordering,organizing, regulative activity in the universe which accounts for all thestructural groupings and syntheses in it, from the atom and the physic-chemicalstructures, through the cell and organisms, through Mind in animals, toPersonality in man”(Smuts Hon J.
C.,1927,p.326).Smuts’ idea of holism was a response to thereductionistic view of reality in the 1920’s, which failed to recognize: A) The countless synergieswhich exist in the natural and human lifeworldsB) The process of creativeevolution (Smuts Hon J.C., 1927). Reductionism refers to the viewpoint: A) That all explanationsof the actions of systems could be mathematically calculated from those of thecomponent parts of the universe; B) Thatall explanations of social behavior are psychologically reducible (Wilber, 2001). Smuts brought his philosophy of life as developed inhis Holism and Evolution to practicein his political career: he merged the former four provinces of South Africa(Cape Province, Free State, Transvaal, Natal) into the larger and better wholeof the Union of South Africa.
And he merged The Union of South Africa into thelarger and better whole of the British Commonwealth of Nations. After the FirstWorld War he eventually merged it to the better whole of the United Nations (Tate, 1947).2. Influences on themusculoskeletal system 2.1. Psychological system (written by Marthe de Saedeleir)The biopsychosocialmodel is the interaction of biologicalfactors (genetic,biochemical, etc), psychological factors(mood, personality, behavior, etc.), and social factors(cultural, familial, socioeconomic, medical, etc.) these aspects attributes tothe person health (Mayer and Saper, 2000;Borrell-Carrió, Suchman and Epstein, 2004).
At the practical level, it is a way of understandingthe patient’s subjective thoughts as an essential contributor to accuratediagnosis, health outcomes, and humane care (Engel, 1977). A wide range of psychological and socioeconomicfactors will interact with physical pathology to modulate a patient’s report ofsymptoms and subsequent disability (DiGiovanna, Schiowitzand Dowling, 2005). Thus, “knowing the whole person” is important inthis model as well as in the osteopathic approach. In general, thisbiopsychosocial model is in some way congruent with the osteopathic principlesand that the biopsychosocial model provides a great deal of actual evidencethat supports the osteopathic approach (Penney, 2010). (Gatchel et al.
, 2007) noted that the emergence of this biopsychosocialapproach has paralleled the evolution of scientific thought in medicine: “During theRenaissance, increased scientific knowledge in the areas of anatomy, biology,and physiology was accompanied by a biomedical reductionism, or a ‘dualistic’viewpoint, that mind and body function separately and independently. Thisperspective dominated medicine until quite recently and affected theunderstanding of the relationships between mental health and pain. The gate controltheory of pain introduced by Melzack and Wall (1965), however, began tohighlight the potentially significant role that psychosocial factors play inthe perception of pain. Pain is now viewed as a complex set of phenomena ratherthan as a simple, specific, or discrete entity.”(Gatchel et al., 2007, p.796).2.
2. Visceral system (written by Magali Desmidt)It isfundamental in the osteopathic practice to use the concept of a viscerosomaticand somatovisceral reflex. Various difficulties located in the internal organsof the human body can cause problems in the segmental related parietal region. Thisconcept is well known as a viscerosomatic reflex. It is the somatic reflectionof an interruption located in the internal organs (DiGiovanna et al.
, 2005). Additionally,somatic dysfunctions that are located in the axial spine can also affect thesegmentally related visceral structures. This concept is known as asomatovisceral reflex. Both, visceral and parietal systems, can influence eachother (Nelson and Glonek, 2007).
Irritationor disruption located in visceral structures result in an increased afferentactivity through the viscerosensory fibres that will arrive at the spinal cord.The increased afferent activity has an effect on the anterior and lateralcolumn of the grey matter of the spinal cord. This results in an increasedsensibility, asymmetry, restriction and trophic disorders which indicates asomatic dysfunction in the musculoskeletal system. The increased afferentactivity has also an effect on the anterior column of the grey matter whichresults in hypertonicity of the segmental related muscles and especially alongthe axial spine, the muscles become tense. Osteopathic therapists will evaluateall these symptoms on patients’ body to identify somatic dysfunctions (Mayerand Saper, 2000).
These elements show that it is necessary tolink all the different systems in the human body. It is futile to only focus onthe musculoskeletal system, or only on the visceral organs. The systems arerelated to each other. Basedon these viscerosomatic and somatovisceral reflexes it is necessary to see thehuman body as one unit that cannot be divided into various compositions. Allthe structures are working together to create a healthy condition. It isuseless to treat the axial spine from several somatic dysfunctions if the causeof these difficulties is located in the visceral structures, or vice versa(Chila, 2010).
2.3. Craniosacral system (written by Magali Desmidt)According to William Garner Sutherland,the liquor cerebrospinal fluctuation is responsible for the cranial rhythmicimpulse. The expansion of the ventricular system, due to the emission of liquorcerebrospinalis, causes an impact on the membranous system around thesynchondrosis sphenobasilaris. This causes a transmission on the joint, and canbe handed over through other structures such as the sacrum (Nelson, 2002).
Thatimplies the important to connect all different system in the human body,because it can result in problems in the musculoskeletal system. 3. Conclusion (written by Marthe de Saedeleir)The whole is made up of parts or units that influenceit and vice versa.
The whole has a function or identity of its own. Theparts/units are influenced /affected by the whole. Alteration of one part /unit will alter the whole. A change in the whole will affect each part/unit toa greater or lesser extend (Smuts Hon J.C., 1927). Osteopathic medicine is holistic as it looks at allparts/units (visceral, craniosacral, musculoskeletal and the biopsychosocialaspect) of the human form/structure before deciding how to treat a certainproblem rather than confining attention to the symptomatic area.
Symptoms(failure) within a body system are likely to have come in some part fromdysfunction in another system, requiring that the other system is treated inorder to resolve the presenting symptoms in the first system (Stone, 1999). This differentiates us (osteopaths) from othermanual therapies.