di Maximilien Girardin
General considerations of utmost importance before reading the rest or you are in the memetic danger zone of not getting any of it at all except CHAOS
My approach is based on a few fundamental algorithms, which you should keep in mind while reading this because they continuously turn on the backstage:
· Nature (wild and mostly African and European)
· Anatomy (human, real through dissections and verification in life)
· Osteopathy (Still’s, and not the rest)
· Evolution (the story of Life and History)
The aspect History is important because history is the story of how the environment of the moment came to be.
In all of the Morphologicum courses and certainly in Evost that is what defines the reality of the moment as a process in its whole Holism: “you can’t look at a system in any dimension without its environment”.
Environment = Space-time and its history (the story… or at least the principles at play to come to where the process is momentary)
I have never put on paper what I am about to write now for you Robert (yes, you are the trigger that made me move after more than 30 years, don’t ask why, it just is?)
This article may bring something to everyone but actually I write it as if I was speaking directly to you although we never met otherwise as through some bits on the net in osteopathy works I think….
Why did I never put this in writing? Because repetitive oral transmission, with its according living pictures is the only trustworthy way of passing a complex message. (The ancient Celts and many other cultures knew this and applied it)
“Entre ce que je pense, ce que je veux dire, ce que je crois dire, ce que je dis, ce que vous voulez entendre, ce que vous entendez, ce que vous croyez comprendre, ce que vous voulez comprendre, et ce que vous comprenez, Il y a au moins dix possibilités (mais en réflexion pour la dizième…) de ne pas se comprendre. Mais, essayons quand même.”
Source: Nouvelle Encyclopédie du Savoir Relatif et absolu, Bernard Werber, éd. Albin Michel, 2009, p. 7 – Nous, les dieux, 2004
QQ Citations – https://qqcitations.com/citation/171146
If you don’t understand French here is a approximate translation: between what I think, what I want to say, what I think I say, what I say, what you want to hear, what you hear, what you think you understand, what you want to understand and what you really understand. There are at least 10 possibilities (in reflection the tenth…) to not understand each other. But let us try anyway. Bernard Weber
Too romantic or 19th century as a point of view, too Victorian …or Alfred, Lord Tennyson?
Read: “Oral Tradition as History” from Prof. Jan Vansina, University of Winsconsin Press, 1985. It is scary how untrustworthy written language is. (By the way if you get motivated to read A.T.Still, use the original stuff and not what someone says about him, even if they advertice with words like ultimate biography and so, go to the origin and use the Webster 1828 dictionary (it is free online) because that was the dictionary he used and his choice of words are really not random…
Thus we (Jean Paul Höppner and me) are teaching this orally and practically in several of our courses because it is really essential for the venous return and whole blood distribution through the body, but neither of us ever put it on paper in dread that it might be misunderstood and thus lead to a kitchen recipe-trick or technique…and in our mind that is not what osteopathy needs another trick on the mindless countless pile.
The principles behind the whole are much more important because it is not a technique if you do the handling (which is relatively simple) and you understand, see and feel what the impact is on the whole organism, it is a living principle in action that affects the whole circulatory system’s distribution (directly for the neural system and indirectly for the rest). You are working hand in hand with the natural not against it.
And there we go: Our cultures (German, Belgian, French, Boer or Congolese for all that it matters) do not function like yours (UK). Thus we think-reason-communicate very differently and as such increase the risk of not understanding each other. Thus if you have the impression that I am not writing but talking to you…excellent! … because that is my purpose
My intent is to do oral transmission by writing in this case, and above all incite you to dig and reason. Move your behind as you made me move mine today.
Read the Culture Map from Erin Meyer it enlightens the intercultural debate tribulations. I use two diagrams as illustration that might incite you reader to reason and reflect more about the principles or essence. ( we are worlds apart between how our brains are used to process – communicate and absorb new info)
Thus what is the larger environment of the circulatory system?
We tend to have in osteopathy (but we are not exclusive there) a lot of presumptions that we take for granted probably because that is how they are generally instructed, but are in fact fallacious to say the least.
The first enormously erroneous simplification is that we have one continuous closed circulatory system that functions in a very similar way, all flows pumped around by the heart. … think again about this one after everything.
This impression is usually reinforced by synthetic well known schemes like this one for example from
In functional reality, this heresy by oversimplification, and looking at a system without its environment is easy to get, but unmitigated nonsense.
In reality especially on the venous system, we have three major systems that function differently, if you take the pulmonary system also in account actually four.
· The Vertebral venous system (of which the cranium does not make exception although wrongly drawn in most anatomy books. Halas another victim of the streamlining and simplification)
· The portal system
· The caval system
· (to be complete the pulmonary too but it is only very accessory in this story, actually following and adapting to what the rest does)
Read the science of people who have been specifically busy with this: Breschet, Batson, Herlihy etc. (In 1947 William Herlihy, an Australian anatomist, published a fascinating study entitled: “Revision of the Venous System: The Role of the Vertebral Veins.” His theme was to examine the anatomy of the spinal venous system and to relate it functionally to the dynamics of the circulation.)
Why is the venous system more important than the arterial? The arterial can follow, and up till a certain level, push its way through the tubes only for as far as the venous is clearing the way.
Let us use a “living picture” of today, which in its intent could come directly from A.T. Still ‘in spirit at least’:
“Can you solution a traffic jam on the highway by pressing in more cars or do you need better faster way out? Venous drainage or arterial pressure?
Worse, in our profession most took and amputated a so called quote from Andrew Taylor Still and complete the virtual fantasy by the, to me so obnoxious, “the law of the artery is supreme…”
Read Still that is not what he wrote and certainly not what he meant if you see the context or the environment of the amputated quote.
(See, it is a principle: put the system “what you are looking at” back in its environment “context” and look again you do not get the same conclusion. In Nature reality you cannot separate system of environment it is one whole and that whole is a process it is always active busy interacting. That is what we do our very best to teach at Evost or at morphologicum, those fundamental principles is what we call the Mechanism. (See www.morphologicum.org)
The heart is a suction pump on micro and macro level, (the easiest article to get insight on that level is probably: the heart as a suction pump, in Scientific American: Thomas F. Robinson, Stephen M. Factor and Edmund H. Sonnenblick, Scientific American, Vol. 254, No. 6 (June 1986), pp. 84-91)
And the macro and micro fascial system are essential in the activity of the heart, its proper movement. (Frank Starling ‘s law of the function of the heart falls on the short side here)
When you look at the bigger environment you’ll see the role of the pericardium and pericardial ligaments, although they are also a victims of omission or oversimplification in most anatomy and osteopathy books today. Paoletti’s fascia book is the worst case I have seen on that level. If you want better or not oversimplified nonsense you have to go towards the anatomy books from the end 1800’s up until around the first world war, after that the nonsense started almost systematically in different time frames country by country… another interesting story by the way if you put it in its environment… maybe I’ll write something about that one day
Read, study and reason! Never believe whatever is said written or generally accepted; reason and check in its environment…”Die in the last ditch…” Still would say but now I am abusing the quote, sorry
Anyway these should be enough triggers I guess to dig into the environment of our hot potatoe the pterygoid plexus.
The drainage of the brains and in the same run, the vertebral system is not as is usually suggested in most simplifications (textbooks).
The cranial sinuses are also in direct continuity with the vertebral vein system (Batson or Breschet’s plexus) and the circulation takes the way of ease, as such equilibrating the pressures. There are a few regulator nozzles or valve (function of a valve not a real mechanic valve) like systems to compensate or bypass if necessary: the first is the sinus cavernosus and his direct pal in line the plexus venosus pterygoideus. (to really get this observe the point where a river becomes a delta and see what is happening with the speed of flow and pressure)
The main venous drainage is usually the internal jugular and in peculiar conditions the external jugular, but a big portion of venous drainage of the brain passes by the vertebral venous plexus if that is the way of ease. (see Herlihy and Batson, you might find some more about that subject in the journal of radiology of 1978 but I forgot the name of the author, sorry brother you will have to do some knife work in the trench too)
In sitting or standing position the fascial drag (mostly from the whole visceral system) closes the external jugular vein as good as completely and reduces the calibre of the internal jugular dramatically (depending on your morphology of course. (That is the first thing that went through my mind when the colleague on facebook was asking about the lumbar pain for his paraplegic patient)
In that case the compensatory systems (vertebral venous system) takes over the sudden surcharge, nicely regulated and assisted by the pression regulatory valves of cavernosus and pterygoid mainly. (But not exclusively it is a complex system thus always multifactorial, not a linear as it is in most people’s minds reinforced by the bloody arrows on the schemes)
If you don’t know this but want to see it live and verify: the next skinny patient ( easier to see with less subcutaneous fat) with a bit of visceral ptosis (usually over 40) observe their external jugular vein in standing or sitting position: it is virtually invisible (being closed), as soon as they lay on their back you will see it fill up and probably bulge a little. Now they need less compensation over the vertebral venous system but the regulators keep working (cavernous and pterygoid plexuses) Yes when standing with a bit of a belly bulging or hanging, a humongous portion of your brain drainage goes over the vertebral venous system.
Many paraplegics spent most of their daytime sitting in a wheelchair, ergo: it was only an educated guess of mine for the colleague on facebook # osteopathy works.
Now when a patient bruxes or grinds his teeth, he usually puts the musculus pterygoideus lateralis, medialis and superior as well as the tensor and levator velum palatini under big strain and not the masseter or temporalis as is usually suggested…hallas oversimplification again… anyway when the lateral pterygoid muscle gets tired of the grinding labour he tends to stay not in complete contracture but nevertheless exaggerated tonus and restrains the mouth opening a bit, which is not that problematic for some people but he compresses the pterygoid plexus more or less against the pterygoid process which is in normal cases relatively elastic but in the case of chronic bruxism a hard bone with little or no playroom. Hence the valve cannot work anymore as it should. (Which is a problem for everyone when it his like that and affects not only the skull, brain and its contents but also the spine as a whole and the rest of the circulatory systems) Try it out and observe you will not believe your eyes brother.
We did an experiment with a patient because we had the opportunity to have a bruxing patient under transcranial echography and Doppler: measuring the flow on the complete circle of Willis. The neurologist almost got an apoplexy when he measured that before and after release of the pterygoids he could measure and increase of flow on Willis of about 30 % (Willis is the arterial flow for the brain remember) I think remembering it was exactly 27 or 28 %?) He was muttering half loudly: “this is not possible, this is not possible” I answered him: “hey bro you are measuring not me, I am just sticking my finger in his mouth” and moreover “does it hurts so much when the sacro-saint Monro-Kellie principle suddenly falls?”. I had my moment of fun. Anyway the Hospital director stopped the whole thing because the neurologist was hot on starting up a complete study around this subject by what he had measured himself; but he was threatened to loose his position at the hospital if he would continue to involve with charlatans like osteopaths.
By Юрий Петрович Маслобоев / Yury Petrovich Masloboev – The photo was taken in Biomedical Systems Department of MIET, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=3432142
So we dropped the whole thing, I know by experience what it can mean for my patients since almost 32 years and got tired of riding against the wind.
I continue with what the Old Doctor left me as message, an osteopath is a lifelong student, and above all :
Osteopathy is found in nature, osteopathy is founded on nature, Osteopathy is nature.
And as the rest is not my cup of tea…let them blow with the wind what the heck…
A last wise advice review the Autonomous Nervous system because there is also an incredible mess in there, that is why most people don’t get the whole picture; and what is maybe worse the evolutionary and thus hierarchical command system is completely wrong: the Orthosympathetic nervous system is massively overrated its is just the end of the story, and the one that manages a few miles of big pipes whereas the metabolism with the pericytes manage a few ten thousands miles ( estimated between 60.000 and 80.000 in Adults) that is where our professional focus should be the cellular metabolism, intercellular fluids and connective tissue…but that is another story all together. if you want to dig a bit in that direction search on the net review articles about the pericytes and their characteristics there is a quite good one from the beginning of the 90’s I think… The pericytes are the translators for the metabolic polarities into capillary flow ….. not the Ortho…..succesfull and good hunting (Waidmans Heil in German) Cheers