The Autonomous Nervous System
OVERRATED, MISCHARACTERIZED, AND A BAD EXCUSE TO STOP REASONING OR ...
A MODEL GNOSTIC LAZINESS TOPPER IN OSTEOPATHY AND OTHER MANUAL THERAPIES FOR THAT MATTER...
This article has two original motivations, the first is the picture which renown osteopaths use and praise, it almost gave me an apoplexy when I saw this one; the second I did the work already for two presentations for the British SCCO Congress in London 2019, thus the thought popped up why not share it with a larger audience?
As through the years the confrontation with how systematically the ANS is overrated in our profession keeps reiterating like a bad bad joke...but it is not a joke, its profoundly saddening. Models are popular, but a very poor representation of biological reality, and things get worse when the models replace the reality of the phenomenon in the minds of people...which is more often the case than the contrary.
So let us try to make a grand tour and rate, characterize the lot a bit and reason.
The original title of the presentation was:
The ANS: A conceptual basis
Osteopathy is found in Nature,
Osteopathy is founded on Nature,
Osteopathy is Nature. ( A.T.Still 1894)
The ANS is often strongly overrated by Osteopaths…and as such misjudged
A quick hunting tour on the net with the keywords ANS and picture gives an overload, here some representative examples of the general mood and I fear opinions :
These are all very funny if, they would not be taken seriously ...but they are
Thus the impression pushed on me, that I can't get rid of is the following:
Is there a collective suffering of Borderline thinking in many forms of manual therapies?
Remember this is a powerpoint presentation, hence the many images
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HOW CAN WE DO THAT?
Change our thoughts or the way we look at a topic?
You can only recognize what you know…
what do you see?
This format does not allow me the animation so I have to write it and you do the mind's exercise for yourself.
The many times I tried this one out, I asked the participants to look for three seconds and then the image disappears.
Then I ask them to make up their mind of what they were looking at and interpret it... I just reveal it is an image taken in Germany, in a big forest, at beginning of winter as the little snow reveals.
The types of descriptions that result more or less:
- It is a vehicle that drove their and then backtracked (about 90%)
- Maybe it is an almost parallel animal track (7-8%)
- Maybe there is something interesting we can't see, and these are paths leading to it (1-2%)
Arguments:
- I don't know of any vehicle that has on one side large tires and on the other thin ones, moreover a driver that is so shortsighted that he hasn't realized that he wasn't going to pass through those trees probably would never ever get a driving license to say the least, and last but not least he must have had a huge gap in the right tires so that it would pass over a branch covered in snow without even disturbing it
- This sounds a lot better but is still a demonstration of either of the following possibilities: tunnel vision, and obvious lack of knowledge of Natural life, or system focussed looking while forgetting - ignoring the environment...in my head three symptoms of the same disease...
- Ok yes, with the small tiny shoed people taking the left path and the rougher big booted ones the right path or what....
Solution:
Nature is always the WHOLE, and not the (beloved by Pete Seeger) 'little boxes made out of ticky tacky', we have in our educated minds, (this type of thinking and perceiving is increased by the abusive use and exposure to models) so look at least at the whole system (tracks) and environment (surroundings) and you see and know what you are looking at...
That is seeing
Think FORM and LOOK again and SEE!
These were just to make space and give you time to do the exercise in your head before the give away
Because you can bring horses to the river but drinking they have to do by themselves...
now scroll very slowly and let the whole image work upon you
The left track is these boy's and gall's put them in the picture you don't need to be there and examine the tracks or the spoor, picture them and you SEE even the size of the Stag his antlers, look at the broken branches and the form imprinted in the environment, in your minds eye you can even see how these light-footed deer hop over the thick broken branches on the track without disturbing the snow on them... By the Form of the whole you know this is not just a track, this is a deer highway that they make use of regularly. (Wildwechsel in German)
The right track is of these guy's and gall's and half yearlings you see their form in the broken branches...wild boars....
Once seen, you can not un-see it anymore
What is the message?
Look at the whole in its SpaceTime!
Put the system in its environment and you'll see!
That is a principle: The Wholeness
Now let's go further on that path
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The gibberish of cultural, educational & habitual mainstream bias has this effect
The mischaracterization or misjudgment happens or taints the perception already before even it becomes conscious
If the mid green arrows are systematically fed by models, you will get cultural and educational gibberish...as I said in London: why would you want to send the people on the track to Reykjavik if you want to indicate them the direction to Rome ? Only the critical and self critical ones and or persevering ones will find the direction...but what a waste of time and energy, what is that good for?????
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The Autonomic regulation through the looking glass
Did you ever ask yourselves why the ANS did not seem to make much sense when you studied it for the first time? ...Your heart or gut-feeling was right, but your educated mind and trust in the educational system overran it big time.... Why?
?Science has evolved towards a linear method of verification
?Which functions pretty good for complex systems (CS) non organic - non living systems
?But sucks when the complexity increases up to the level of Complex Adaptive Systems (CAS) organic – living
WHY? We love and hope that science and its models gives us predictability and control...but that is an illusion, in live and reality for Complex Adaptive Systems predictability is nonsense...so Think again...
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Local interactions generate global order & highjacked Newtonian science’s view on it:
Let’s tidy up the bush in today’s Newton Style, analyze and synthesize:
Make nicely linear and symmetrical, what is not and never was,
Give it a hint of predictability and control;
on the base of stable known controllable parameters…(which only exists in lab conditions and even there are difficult to maintain in an absolute way)
This is nature's version, a beautiful old tree with its own history and according FORM
Science in the highjacked Newtonian ordered version of it
The sharpest knives in the kitchen drawer amongst you probably noticed twice the use of the term "highjacked Newtonian science" which by the way is not mine, I quote Richard Douglas here...(The author of the two Wonky teeth articles) part two: https://www.dhirubhai.net/pulse/philosophy-mechanical-principles-osteopathy-max-girardin/
part one: https://www.dhirubhai.net/pulse/nine-year-old-boy-wonky-teeth-max-girardin/
It is because what a meaningful part of Academia made out of Newton's philosophy is a real highjacking act...thanks to Richard Douglas from Daktylus of pointing that out, I hope in his follow up of the Wonky teeth he talks about it more extensively (a hint for you Richard).
Look at the complete title of the cover page of Isaac Newton's book
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Tidy up the bush
Make linear what is not
is what has been done to the ANS too, this is the kind of simplistic rubbish that is fed to students all over the world
Or variations of this...
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What does this mean?
Human dissection since 36 years &
Comparative literature study since 38 years as a practicing Osteopath demonstrates…
?4 levels of Functioning (only the hierarchy stays)
- Brain
- Spinal Cord
- Ganglia chain - para and pre-vertebral
- End organs -Enteric Nervous System
?4 different worlds of complexity = 4 different set of rules
What is maybe the worst fallacy here: in the nervous system as anywhere the natural hierarchy and even chronology of coming into Form and thus natural functioning is the contrary or reverse of how it is generally represented
( 4 should be 1, 3 should be 2, 2 should be 3 and 1 should be 4....not one right in the whole...question of how you interpret and use with your educated brain the frame of reference that Nature presents)
Let us try to entangle it without wringing your brain more as it should and follow the 'classic anatomical' chronology and then make your mind up by yourselves afterwards....see if it makes you see light at the end of the nonsense tunnel...
- Brain the ANS part is mostly Limbic and was described anatomically by the Circuit of Papez :
?Vegetativum the ANS functions as one
?O∑ and P∑ can not be distinguished
?Image of stimulating/inhibiting is incorrect
It is impossible to differentiate anatomically nor neurologically
2. Spinal Cord or Medulla Spinalis
Para sympathicus– medulla oblongata (X cranial nerve or Nervus Vagus or Nervus cardiopneumogastroentericus by its ancient name)
Ortho sympathicus – medulla spinalis from C8-L2
Para sympathicus – medulla spinalis sacralis
Not correct due to relationship with Limbic System!
Growth = elongation = spatial differences in speed of growth! To get that completely we should do the whole neurological embryology over and there are two very good reasons to not do that here: first it is too long and secondly my colleague JeanPaul is much better at it than me, if you really want to hear that whole story follow his Morpho-kinetics course or come to the EVOST course there you get it too, both courses are at www.morphologicum.org
Right now there is a big discussion going on in our specialistic educated world that the para sympathicus on the sacral level is actually also ortho so the plot thickens even more.
3. Before moving to 3, the ganglia chain, the plot thickens even more, actually the main reason why most of these simplified models and schemes are dead wrong for practice; and even when trying to bring it back to its essence, the situations are totally different depending on the topographical location. So we have to situate the basic reason how all this confusion came to be and then look separately at the cervical, thoracic and lumbar and sacral area's. Ready? Hold firmly to your suspenders here we go!
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Historically grown, we have 2 different approaches of the same theme the ANS ganglia and plexuses:
?Anatomy
→ structural approach: morphology
description: as said previously anatomists and certainly the ancient morphologists describe what they see in dissection.
?Neurology, physiology, psychology, …
→ functional approach
Neurotransmittor, synapsis
Things have not really changed, in order to spike or pump up their books or articles, authors take - copy - steal stuff from others, without always really understanding that part they are using, moreover very often they don't referentiate correctly where they got their statements from...
CONSEQUENCE?
Anatomists plagiarized from Neurologists and vice versa, as well as neurologists from neurologists and anatomists from anatomists using the same words, so it looks good as gold but THE TWO WAYS OF LOOKING ARE DIFFERENT THUS THE SAME WORD DO NOT MEAN THE SAME THING!!!!
And the plot thickens even more into complete chaos when arrive the physiologists and later psychiatrists and psychologists (end 1800's and the whole 1900's), because they spike or pump up their publications too, without often really understanding the topic...and as it is still not complicated enough in the later generations with everything cut up in pieces (Highjacked science) everybody likes to spike his publication a little by everyone else's...a complete mess... it took me two full years of research in the 80's to disentangle that one... until at some point I could read a piece on the ANS and recognize at least, this bit or sentence is from a neurology book view and here that sentence was plagiarized from an anatomy book and / or the reverse.... Even very big names and reputations tainted their fingers at this game. And I don't even blame those people because I really think people do what they can not always what they want, and social pressure and ego pushes behind that cart. And the bigger the name and the so called reputation the bigger the pressure, BUT IT IS IMPORTANT TO BE AWARE OF THE PRINCIPLE AND ITS CONSEQUENCES!
SO let's dive in the terms and what anatomists and neurologists mean by them (think 2 different reference frames but same words) I am trying to say as close to simplicity as possible for me, as to get the essence of the message over ( When I teach this stuff it is between 4-6 hours course)
Anatomists: describe or draw what they see
Ganglion: they see a knot, with a covering capsula (one structure) hence the same word for lymphatics and nerves
Plexus: an interlace of elongated structures covered by a capsula or delimiting wall recognisable with the naked eye hence the same word for nerves, lymphatics, arteries or veins
Paravertebral: situated topographically next (para) or lateral from the corporea vertebralia no more no less
Prevertebral: situated topographically in front or anterior of the corporea vertebralia no more no less (usually on the arteries but not always hence the general choice: in front of the columna vertebralis)
Neurologists and the rest: where are the synapses?
Ganglion: the place where the synaps is; hence preganglionar and post ganglionar only for the nervous system
Plexus: an interlaced nervous structure which may have synapses or the place where nerves change their trajectory or direction
Paravertebral: the place where the synaps is for all somato-vegetative innervation (one nerve ends and a new one begins)
Prevertebral: the place where the synaps is for all viscero-vegetative innervation (one nerve ends and a new one begins)
As you can see this can only lead to chaos but it gets worse because the embryological development is very different all along the spine and its environment.
(Principle look not just at the nerves but at the whole Space-time and the story of the whole environment, like with the forest and tracks...THE WHOLE)
Cervical region
Anatomy version: 2 or 3 paravertebral ganglia, no prevertebrals
// 2 ganglia= ganglion cervicalis superior and the second one ganglion cervicalis inferior or ganglion stellatum
// 3 ganglia = ganglion cervicalis superior, ganglion cervicalis media and ganglion cervoicalis inferior or sometimes stellatum .
As stellatum is a chaos in itself: Stellatum has different versions, it can be: the ganglia mixture of inferior and medium, or the mixture of just inferior with the first thoracic ganglion, or the mixture of all ganglia media, inferior, and first thoracic....welcome to my world
Neurology version: 7 or 8 paravertebral ganglia and 7 or 8 prevertebral ganglia one of each for every medullar segment (remember their frame of reference, go back to it if you forgot it) the difference between the 7 or 8 is again the stellatum throwing soot in the soup.
Development extremely simplified...
I am almost ashamed to go there my colleague jeanPaul would slap me on the head if he read this so hush don't tell him ;-)
During the embryological development there are several phases where the extremely minute cervical region gets flexed enormously while the rest of the spine-cranium grows longitudinally(see Osteoporosis article) and the visceral system can't follow that speed of growth = extreme flexion induced with serious tension on the cervical region and actually not only pull downwards but also backwards direction anterior spine (compressive force).
Result: the paravertebral ganglia of several medullar levels tend to melt together or fuse their capsules if you want. Hence 7- 8 neurologic ganglia on each side become 2 or 3 anatomically. The prevertebral ganglia are submitted to the same regimen and as there is no strong anterior pull from the environment present, the prevertebral stay aside the spine, in other words they are not pulled away and thus stay merged in the same big capsula with the paravertebral. So each one cervical ganglion is a herd of neurological para and pre-vertebrals.
Thoracic region
This one we have to split up in two because the upper and lower part have very different developmental forces working in on them hence big difference in form and shape.
Anatomy: 12 paravertebral ganglia (6+6) truncus symphaticus 1 prevertebral ganglion: ganglion coeliacum
Neurology: 12 paravertebral ganglia 12 prevertebral ganglia
Somewhere thoracic 5 - 6 in general comes the diaphragm in play, above it and below is a major game changer
Above Th 5-6 :the visceral environment grows +- symmetrically = the pull on the nerves and ganglia is relatively symmetric thus they stay paravertebral and prevertebral together, not pulled apart and there are no spectacular mergers between left and right like we'll see in the lumbar or of levels up and down like in the cervical region
BelowTh 5-6: the story changes because of the diaphragm, the area is under influence of the abdominal visceral development and the pull is asymmetric as can be: the growth of the viscera organizes a big pull in anterior direction and for that the prevertebral ganglia are pulled away from their paravertebrals and get positioned upfront the columna vertebralis, the pull is so big that left and right paravertebral ganglia merge usually into one
Sometimes like a plexus sometimes as a bean like ganglion but to get the complete picture we must look at the lumbar region and abdomen.
Lumbar region
Anatomy: 5 paravertebral ganglia 4 prevertebral ganglia (GG 1 Mesentricus superior and 1 inferior, 2 aorticorenalis+ coeliacum on the top end (in general with many morphological disparity)
Neurology: 5 paravertebral and 5 prevertebral
Depending on the growth forces and their direction (pull) we have quite some versions coming up, and it is the prevertabrals that soot the soup
From top down:
GG Coeliacus, merger of several prevertebral ganglia as well from different levels up-down as merger of the right and left ones into one megastructure, with all variations (asymetries) you can imagine up down and left right and as well more plexiform or knot ganglion like....
GG Aorticorenalis as the development of the kidneys is +- symmetrical usually they're two, 1 left and 1 right which are the result of 3-5 prevertebral mergers top down, but of course they can ban be knots, elongated knots ganglia, plexiform or all possible imaginable combinations (I think in my almost 40 years of dissecting the human ANS I've seen them all)
GG Mesenterica superior is mister biggest mess of all times, the undisputed world champion without question.... he is a merger of several levels 4-6 top down and left right and not nicely symmetrical as is usually represented for easy modelized didactics, but as if that is not uncertainty enough, now it comes...
So in the best of all worlds we have a kind of Irish or celtic cross
The top being gg coeliacum the departure of the lower beam gg mesentericus superior, the cross beam being left and right gg aorticorenalis ( the circle representing plexiform variations.
BUT DEPENDING ON THE FORCES OF THE DEVELOPING ENVIRONMENT MORE MERGERS MAY AND DO HAPPEN ALL THE TIME
Two aortico renalis merged with coeliacum give the image of a banana
This is the famous GANGLION SEMILUNARE SUPERIUS
Sometimes the two aorticorenalis are merged with the mesentericus superior
Now the banana is a smiley
And of course is called GANGLION SEMILUNARE INFERIOR
And what the heck .... sometimes they all are +- merged and thus get the name Plexus solaris
And all intermediate half merged ganglia and plexiform shapes might and are regularly encountered
In other words you have no idea where these guy's are and in what form, neither with how many mergers symmetrical (left -right) or not at all from how many medullar different levels...so tell me where you stand with your nice cleaned idealized schema?
Not even anatomically, and when you know that most osteopaths miss the pancreas in palpation by up to 30 cm. ....What are we talking about?
Tidy up the bush, make it predicatble and symetrical...hahaha what a gullible joke
Lucky for us, poor disoriented souls the gg mesenterica inferior is a little nicer to us
He is though the merger of several top down and left right, usually 2-4 top down and left right ? Very often asymmetrical!
Sacral region
Anatomy: 5 paravertebral Ganglia, and one prevertebral
Neurology: 5 paravertebral and 5 prevertebral
The most common variations here are: two prevertebral ganglia more or less centralized GG Hypogastricus superior and the inferior or the one big plexus: plexus hypoganstricus, and all possible imaginable asymmetrical variations part plexus part ganglion etc...
Coccyx = ganglion impar 3-4 mergers top down and left right combined
Normal exists but is not what we have in our heads, normal is incredible diversity that we call variations, and it is something we forgot along the way.....
There is a difference between natural and normal and yet we’ve innocentely mistaken one for the other and that they are the same thing…
Now for what concerns the nerves....
90 % of the tissue in the nerves are not nervous but connective tissue and blood vessels
Most of the ANS is afferent - sensitive (brings info back to central) about 10 % is motor or efferent.... So if that is what is COMMANDING the whole lot, nature under furnished the system considerably....or we think wrong....I trust nature, complex not complicated.
Different worlds: complex versus complicated
?Natural & organic grown = complex
–Connections are critical, individual agents much less so
–Simple rules result in complex & adaptive responses
–Agents have latitude of responses within the rules
?Human construct processes = complicated
–Elements & their connections are equally important
–Simple algorithms produce simple and & predictable responses
–Components response is fully determined
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Hierarchy & Chronology are the only constants In Natural grown systems
As you all know for sure, osteopathy is based on evolution
?Osteopathy is found in Nature, Osteopathy is founded on Nature, Osteopathy is Nature. ( A.T.Still 1894)
?Osteopathy as representative of a process is the application of certain evolutionary forces. …on which we depend for our (practical) daily work…
?Evolution and osteopathy represent parallel lines, or rather one is part of the other. Osteopathy is applied evolution.
?We know both evolution and osteopathy to be facts, and they both deal with the welfare of the living body. ( While molding it…)
?One thing is certain, it is inviolable law that both evolution and osteopathy represent…
( C.P. McConnell :Osteopathy in the light of evolution, Journal of Amer. Osteo. Associaton, vol 12, ° 9, May 1913)
?He (Dr. A.T. Still) had worked those (principles) out along similar lines with Darwin, Wallace and Spencer at a time when the ideas of these researches were not common knowledge.
( Edythe F. Ashmore on the death of A.T. Still, “ The Western Osteopath, Vol.12, no. 7, Dec. 1917 )
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What is the ANS?
?The ANS is, as feedback-communication system, one of the “New kids on the block” within the overall hierarchy & chronology of health maintenance systems.
?And as such strongly & methodically overrated in Osteopathy and other manual Medicines or therapies.
Actually mischaracterized…so where is the origin?
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Why is the ANS the new kid on the block?
Hierarchy and chronology of the communication systems
?Prokaryotes (Autocrine – biophotons)
?Eukaryotes (Autocrine – behaviour Paracrine)
?Multicellulars (A, P – behaviour Endocrine)
?Digestive tube (A, P – behaviour Endocrine)
?Circulatory structure (A, P, Endocrine, C.T., beh. Neurocrine)
?Rapid growth (A,P, E, Neurocrine structures ENS, NANC)
?Neurocrine differentiates (Highest metabolism, & speed of growth)
?ENS, NANC, Parasympathetic, Orthosympathetic, Motor – Sensory - Telencephalon
Communication systems are feedback mechanisms
Local interactions generate global order (think growth-evolution) and that is how it stays for the rest of your life
In other words: hierarchy and chronology matters because: the systems are nested & complex thus summative…
and that’s how they keep functioning hierarchically
The red text is the ANS
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?Apply a just clever solution with the most potent of your skills,
?Palpate – test and finally see the natural individual Form
?And bring the abnormal back
?To its cradle …
?Natural Health = NO Pattern
Thank You
Morphologicum: is a philosophical platform for all interested in Life and human FORM in all its aspects and dimensions - hierarchy and chronology
Evost: Philosophical course on Evolutionary Medicine in the Osteopathic Field and philosophical Fellowship
The human dissection courses are in Heidelberg
www.morphologicum.org
Finally this all thing makes me think of a song from 1965 from Micky Mc Connell:
"Only our rivers run free"
When apples still grow in November,
When Blossoms still bloom from each tree,
When leaves are still green in December,
It's then that our land will be free,
I wander her hills and her valleys,
And still through my sorrow I see,
A land that has never known freedom,
And only her rivers run free
I drink to the death of her manhood,
Those men who'd rather they died,
Than to live in the cold chains of bondage,
When to bring back their rights were denied,
Oh where are you now when we need you,
What burns where the flame used to be,
Are you gone like the snows of last winter,
And will only our rivers run free?
How sweet is life but we're crying,
How mellow the wine but it's dry,
How fragrant the rose but it's dying,
How gentle the breeze but it sighs,
What good is in youth when it's aging,
What joy is in eyes that can't see,
When there's sorrow in sunshine and flowers,
And still only our rivers run free
This Irish song, because that is the Space Time it comes from,
could be seen much broader for our profession, only our rivers run free, our mind and spirit is pushed deeply into the ruts of the general simplifications, tricks and kitchen recipes....
when will we get out of our ruts, and let our eyes and minds run free like the rivers from Micky's song?
Cheers from the flatlands of Flanders....
Post scriptum:
I sincerely hope not to have upset you dear reader, just stirred you enough to set minds into action, but then I try to live Drew's words:
“Never surrender, but die in the last ditch.
This is a war not for conquest, popularity, or power.
It is an aggressive campaign for love, truth, and humanity”.
Peace - love and awareness
Sonnenmensch (:
5 年thank you,...the autonomous nervous system is most important in our work! :)
Osteopath at Osteopathie Praktijk Daktylus Bergen op Zoom / Breda
5 年Finally Max someone is actually going against the grain of what seems to be the ‘map of the underground’ mentality. Millions an millions of cell interactions every second of every day and we put it on a map and say if we get on the metro at one station we can get off at another.