Visceral Form and the ultrasound verification
Ricerca e scienzaDi Maximilian Girardin
Elephantastic and bombastic fluidic osteopathy (EvOst)
Some summers ago, this author was asked to give a course about visceral osteopathic topographical recognition and diagnostic. The first premise for this author to accept to do this course was that the last day of the course, an experienced ultrasound technician with a functioning modern ultrasound – Doppler would be present and verify the participants osteopathic findings; in order to give them a personalized feedback of their practical findings, being the usual starting point of their diagnosis and onset of osteopathic treatment.
As this condition was fulfilled the summer course took place in a beautiful green environment.
The course was entitled:
“The art and science of visceral Form & its interpretation”
with as subtitle:
“Accessing the inaccessible, opening up compulsive tunnel- thinking in osteopathy”.
There were 18 participants, all confirmed osteopathic practitioners (not students), of which at least 5 where ‘self-confirmed biodynamic practitioners’, 5 were and still are osteopathic teachers in a College that procures osteopathic education in North America and Europe, and of these 5, 2 are visceral teachers, with several years of experience.
The course itself was a walkabout through generally accepted osteopathic theories and visceral Form, being mostly anatomy (macro and micro) and some applied physiology and embryology, as well in theory as in practice.
Describing and picturing the “normal Form” (being topography, shape, consistence and mobility) and by that way, the “abnormal ” as Dr. A.T. Still liked to call it in his books.
The next step was to question these generally accepted osteopathic models after a practice test demonstrating that the classic percussion and skeletal topographic references, generally used in practice are in fact often fallacious.
Instead the author presented a method based upon the complexity of visceral interaction between the deep and superficial visceral systems and developmental chronology of the visceral system, based upon the real developmental human skeleton: the fluidic and vascular system. As we demonstrate in several of the Morphologicum courses and Evost.
Starting from there reorganizing the picture of the patient’s factual anatomical topography.
Purposely the duodenum and pancreas (part of the deep system) being left out of the equation as they were going to be used as proof by demonstration and individual experience.
The different paradigm of using the fluidic and vascular system as topographic and functional reference ‘skeleton’ of the visceral Form, was explained and demonstrated; and practiced by the participants in groups of three.
As this model of reasoning was apparently completely new to the participants, they exercised it in a practically sacral silence and focus. The participants’ dedication was impressive, and they behaved as reasoning osteopaths, once they had been ‘pushed’ actually forced out of the usual ruts of habit.
The last day arrived and all of the participants were asked to localize topographically the deep duodenal frame with the pancreas in its middle, as a test, on the subject with which they had been exercising several days.
As soon as the two practitioners had identified the duodenal-pancreatic deep complex with their classic – habitual methods (Doing so falling back without even realizing it, in the habitual old deep and so complacent rut) they went to the ultrasound room (adjacent to the practice room) where the technician was waiting them.
The outcomes of the ultrasound feedback were shocking beyond belief.
Nobody managed to localize the exact topography of the duodenal-pancreatic deep complex with their classic – habitual- complacent methods.
They missed it with widths between 10 up to 30 centimeters in height![1]
After this brutal landing back with the feet on the ground, an adjusted paraphrase of Rollin Becker’s quote was hovering as a dark winged angel thought through the room:
“A set of beautiful theories, self-fulfilling prophecies and absolute certainties just got murdered by a brutal gang of facts.”
Actually 18 times because the participants had switched subjects in order to have everyone getting a go at it.
The sun was still shining through the windows but the felt temperature in the room dropped several degrees.
This author relativized this mood drop, on the trot towards a severe depression, by the following words…
“The only thing that just happened is just a brutal sobering up after a phase of heavy bench drinking, nothing dreadful, think that the hang-over, will only be as strong, as the certainties each one of you had and was clinging to.”
“The old Doctor” told us that an osteopath is a lifelong student; let us put his words in acts and reason and act accordingly.
The different paradigm of using the fluidic and vascular system as topographic and functional reference ‘skeleton’ of the visceral Form, was demonstrated and applied to the duodenal-pancreatic deep complex.
Furthermore the participants were made aware of the fact of, how easily one slips again in his/her habitual practical and OOOOHHHhh so complacent, comfortable ruts as soon as the philosophy and reasoning are put aside.
After trying again, but now with the focus on the fluidic and vascular skeleton as palpatory reference most practitioners succeed localizing exactly the demanded anatomic topography on a different subject within a cm of difference. (One they had not worked with during the course).
The possible interpretations of this experience conducted during a course are multiple; so let us try some of them:
· The experiment was not really scientific because of the masse of uncontrolled parameters, but sensed as very significant as well for the teacher as for the participants.
· The too often complacently used medical-osteopathic rut of the skeletal reference is not as trustworthy as one might think, the real skeleton in human development and functioning (certainly in the visceral sphere) is the fluidic and vascular one.
· Visceral osteopathic models as well as their fallacious topography and even more untrustworthy biomechanics are extremely popular but more often wrong than real.
· Osteopaths tend to shift too much towards practical trendy models and tricks, far away from their true osteopathic essence: the philosophy and nature’s ways.
· The most dangerous disease, not to speak about epidemic or pandemic, uncovered itself among these people at that time: complacency or doing some osteopathy instead of being inquisitive towards Nature and its truths, for which osteopathic philosophy gave us a unique line of questioning.
· The osteopathic schools and profession should self-reflect seriously on the basis of the pedagogical known fact that: “a teacher can in best case pass about 2/3‘s of his knowledge to his students”. When the school takes regularly its own students as teachers, and has a student/teacher turn over of every few years, the end result will be, as happened with the Labrador dogs inbreeding when they got popular: “cretinization or moronification” as result. (Which is extremely self-destructive for any species or profession)
· There are much more interpretations to be drawn from this, but I prefer the reader to reflect upon the above ones and reason….
As final personal conclusion:
The danger of complacency and hopping on trends is huge, the more the profession and education is structuring itself, forgetting maybe the most important things that Osteopathy teaches us every day, if we want to see it:
· The whole is more than the sum of its parts: look at the system in its environment, and know that when you extract the system of its environment you can concoct fantasmagoric modeling but that has little to do with the reality of nature.
· Function (in this case osteopathic philosophy) will create structure in time (in this case schools and professional organizations) and once structure has taken form it will steer function by this reducing its potential automatically….
The rest of the story is called Natural selection.
No animals, Osteopaths or other participants were hurt during this course.
[1] Which in fact confirmed what was already discovered in the French D.O. Thesis of Gwen Ballet in 2009, “Réalité anatomique du muscle suspenseur du duodenum et ses consequences pratiques”
The same course was repeated several times and every time the outcome was very comparable…