Osteopathy and Tissue knowledge…

Histology-morphogenesis but then better as…

MORPHOLOGY and FORM and Mind

The invisible dimension of tissues and their cellular and other organizational network… in other words.

As osteopaths, these are the dimensions that we are dealing with every day, in the practice, that is the places where our minds should wander around, sniffing, exploring, roaming and hunting like a bloodhound with our snouts on their forest floor, then stop and listen intensely or like a birdwatcher sit still and wait what reveals itself, or passes by. 

Seeing – sensing that there is no predatory or unnatural scent of a pattern on the prowl somewhere out there.

Remember…

 A.T.Still wrote: "His mind will explore the bone, the ligament, the muscle, the fascia, the channels through which the blood travels ... " 

His mind, not his stinky fingers or was it thinking fingers?

Or Sutherland: "Crawl inside the cranium mentally and assume a reserved seat at the foramen magnum and thus have a position for visualizing the activity as well as feeling it".

Crawl inside mentally!

Creator and his work, does not necessarily mean the big one from upstairs, or the Imaginary friend, I understand it as nature's principles at work.

Were Dr. Sutherland and Dr. Still telling us that we could influence the functioning of the human body with our mental processes?

Or what?

Maybe, if you want to go there, but it will become quickly uncomfortable for most, and that is neither the point nor the intention here, is it? So let us leave that assumption for what it is: an assumption…with esoteric fumes emanating and polluting the vicinity...

But…

What they certainly indicated, without possible discussion or doubt, are a few other, less controversial things, of which neurobiology and neurosciences are endlessly breaking our B..l’s about, every time they “discover ‘novel’ aspects of these ways, as old as the ages of man…at least”: (Note: As said before in other articles science as a method of verification is running behind reality)

·     Your brain, its experiences and its imagery affects and steers intensely your perception

·     You can only really recognize what you really know

·     Your mind gets sharpened up, when your focus is increased or deepened

·     The same for all of your senses and general awareness

·     Focus is Ernst, in stillness and deepens experience and senses, but leads to little, if it has little in common with the reality of the object you are focusing upon.

I see the frowns and eyebrows raising from here, ok, let us apply the old trick again, get our snouts out of the rut or burrow we are usually by habit dwelling in.

And look with an innocent fresh children’s look, without tunnel vision, by habit, aggravating it.

I invite you for a story or discovery voyage in a world probably unknown to you

Let’s dwell together, for a while in an unfamiliar environment, and situations and let the magic happen… Come with your mind on this journey and see…

The Southern African nights, by the fire, with a red wine and good old pipe stuffed with Belgian rustic tobacco, perfect place and time to let the mind dwell…at least for as long as the environment and sounds, feel ok.

In the Scottish Highlands or deep forests of Germany we go…but they have nothing in common, I hear you think? They have, for the principles revealing themselves to us are universal… They are as present in the deepest hottest Africa as on the freezing North Pole.

That is exactly why deerstalkers in the Scottish Highlands or wild boar – deer hunters in Germany’s forests, for instance, train their anatomical knowledge and morphology of the animals they prey upon thoroughly. (The principle of the flow is in bold)

How is the form of the animal and according to sex, size and age, where and how is their vascular kill zone?

They need to see it on a distance, relatively fast, and the focus must be so deep and good that it becomes feasible to hit it center point, with enough precision as they don’t want to make the animal suffer needlessly and neither to spoil unnecessary meat, by splintering a bullet in fragments because they’ve hit a heavy bone or provoked the wrong shockwave creating a huge intramuscular hematoma…all spoiled meat.

Almost whatever position the animal is in, in their minds it becomes a “see- through”, I heard this so often…they repeatedly, all over the world where I met hunters, they describe it as follows:

“The animal stands or walks prudently, scouting, alert and sniffing its environment out, ears pointed up and turning in all directions as if they were a radar, first the hunter checks it out, by the look what kind of animal and by the behavior they have studied, they already have a differentiation starting, then they look with the glasses and see what the animal really is, a male?, a female?, pregnant?, with a young or alone?, if female, are her tits still full or empty?, does it look and behaves naturally?, or is there something wrong with its form?, how old is it?, and what is its social position in the herd, if it is a herd animal…

Slow swap around with the attention, what is the environment?, is there enough safe bullet catch?, as not too have a skimming whistler, which is very dangerous.(as some of these modern calibre bullets go for more than two kilometers and may still be deadly.)

Slow swap back to the prey, second assessment, and then comes the real first decision, lower the glasses and change them for the rifle or just enjoy and observe? The latter being usually the case, meaning that when in hunting mode, there is for most, more time spend observing and studying than shooting.

If the swap happens, they must become something similar to the old mythic stories of shape-shifters, if they are in the open, they can’t make a sound and must move like the environment, slow, very slow and steady, fluently, like a branch in the breeze; one jerk, one abnormal noise and the alert prey is gone.

When that is done and they have the animal in their rifle sights or scope, comes the third precise assessment but even more focused on the form, now tunnel vision is helping the focus, the scopes do that… the whole world is brought down to that single eventual prey…  and eventually decision number two forms: take a shot or wait because the position or angle can be better?, and now it comes”:

“Their focus is so intense and their knowledge about the animals’ morphology so precise, that after the ritual observing and then focusing deeper and deeper, they finally see through it, they know their aiming point, the vascular kill zone or brain, and see it through the animals body with the skeleton and organs and muscles, and think-see-sense the bullets trajectory with their minds… whatever the position or angle of predator or prey and then when everything is as it should be, the shot goes. As the bullet travels faster than the sound the animal gets a big thump and goes down before even hearing the shot…”

Sometimes in a reflex it may still make one or two jumps, but is already dead without realizing it yet…

Not only hunters but also sporting shooters told me that thousands of times, you think the shot and it goes unexpectedly, if you want to shoot actively you jerk on the trigger and miss or make a bad deviated shot because the weapons barrel deviates by the active finger-pull, instead of the steady slight almost mental slow squeeze increase in the trigger-finger…it is all in the focus, stillness and fluent unexpected flow…

In order to get police or military to that level, it demands not only tons of practice, but training-focus, training-focus and again training-focus; it is a motor thing in the beginning and has to become a minds flow. (no thinking almost a reflex flow) 

Sounds very similar to some approaches in osteopathy no?

Several old osteopaths, most of them long dead now, told me the about the same or very similar flow; in other words, evidently applied to osteopathic practice…but the essence of the principles of the flow are extremely comparable:

All different and inherently very comparable, not to say similar, Ritualized, Physical and Mental steps to get the machine and the mind exactly there in the flow…of the experience exactly where it should be.

Back to Stills and Sutherlands quotes:

Now explain to me, please, help me understand, because I don’t get it:

How can you seriously explore with your mind, or crawl inside mentally, if your anatomic knowledge, the only pictures you have in your mind, are a few of Netters publicity drawings or any other modern amputated anatomy book like the new Gray’s anatomy. (My anatomists’ heart still bleeds every time when I think of it).

 And those are the only images that pop up when you come in the flow? Or when you hear or read  from histology that “undifferentiated mesenchyme cells stay present in the connective tissue until your end as an organism” becomes just a formless blur somewhere in an Achilles or Supraspinatus tendon…????

Morphology, the ancient science of, not pruned down- and most certainly not the modern amputated – anatomy, can give you that living picture.

Obviously, we can only perceive what is going on there, deep or superficially in the body or organs by extending our palpation beyond our fingertips ... with our minds. (Fed by images and knowledge and experiences, as close as possible, with the real thing)

These old guy’s, Drew and Bill, knew…and knowing not only with the brain, but deeply understood and experienced that the living pictures of morphology in the FORM, is what it takes to go there and make contact with their mind through the fingers.

In other words how are we to recognize, and I am not even speaking about interpreting, tissues if we have not got a clue of what tissues mean or are in their morphology…

Because the next phase gets only more difficult, go from, not the interphase but descent into the continuum: Organism, systems, organs, tissue, cells and their fluidic environment towards biochemistry or molecular biology….

And please spare me the quantum physics or quantum leap now, because in our profession most, who like to make allusions to- and use those expensive words, don’t even usually know how to spell them. I even experienced that in pediatrics courses even with anatomy…such a shame.

Natalie Imbruglia’s song lyrics pop up:

Illusion never changed

Into something real

I'm wide awake and I can see

The perfect sky is torn

You're a little late, I'm already torn

And my response to that is:

Making living pictures about tissues is not that hard, even when you are already torn, it is work yes, but it is not the end of the world. (Cut maybe some television and smartphone time and dive into it, it really is rewarding)

Basic histology, meaning, the story discovered and described by Xavier Bichat towards the end of the 1700's, is a usable thread to follow, as an introduction to the world of tissues, but very fast you’ll realize that there are major bumps and potholes on that road or that story for us osteopaths. Yes, the well known, I hope, by now reference frame differences…

It all looks silky smooth and very scientific…but the practical usability for us is so - so, and the deeper you are getting into merging knowledge, images and experience, the worse it gets…

No problem if your intention or goal is playing parrot, learn by heart and repeat what the book says, or what the teacher professed; but if you really want to get a grasp that is closing in, on a real living morphological picture (Form), in the sense of what Drew and Bill were talking about, now you get in trouble.

As said in previous article posts, there is always a silver lining, even around the worst appearing thunderstorm cloud.

So where is the trouble? And what may be the ways out of these troubles?

The trouble starts at the very beginning of the algorithm:

Xavier Bichat and his heirs (of which, I was one, 40 kg’s ago), used a certain algorithm to come to the conclusion that there are 4 basic tissues, that form - constitutes the morphology of all the upper levels, meaning systems and organs.

The word histology comes from the ancient Greek and is a composition of two words: (histos and logos) histos = tissue, logos . = knowledge or science (speech).

The word “Tissue” (tissu) was introduced in the world of anatomy by a French anatomist Xavier Bichat (1771-1802). During his dissections, he was astonished by the fact that the body is so nicely composed by different layers of diverse texture, consistence and aspect.

He thus started to talk about "les tissus" in French, which means material, textile, and/or fabric or woven cloth.

He made the mental jump: of comparing biological membranous, fibrous layers of tissues, with the layers of textile of which a mantle is made for instance:

several types of fabric put together in a certain way in order to create something new,

a new level of complexity, with other characteristics, emergences or behavior than the separate pieces of tissue:

A mantle or a 18 th Century winter cloak.

He thus continued talking about tissues, and slowly but surely, it got common, to use the terminology “tissue” in the medical world.

In the mean time the composition of the different tissues was investigated by the use of the microscope. (Which was in its most primitive form invented by Anthony van Leeuwenhoek in 1674.) The basic light microscope is as good as they get since the late fifties. (Meaning use histology books from the sixties upwards; I quite liked the ones of the late eighties and nineties; somewhere after that the trend of functional histology was introduced and by that they make it almost impossible for the students to see the principles at work, nice way of breeding parrots...my histologists heart started bleeding when my daughter showed me her textbooks. Can you imagine I had to teach in summer for her and some friends histology because she learned it and got good points for the exam, but did not grasp any of the principles? Such a mess.)

This work is still continued today but with powerful electron microscopes and all possible luminescence and radiation techniques, to see all parts of the tissues and cells.

Histology is thus based upon a comparative functional classification, which is based on the following criteria: (Note: and here is another triad)

-WHERE: anatomical position or the place where the tissue is situated.

-HOW: how the tissue appears: cell alignment, layers, and specific characteristics.

-WHY: later as it is discovered, the so-called function of the tissues, in the beginning just conjectures and logic.

Histology or micro-anatomy knowledge and comprehension is essential for osteopaths, in my opinion, in order to see a living picture of the organized textures they have in the hands. It is a gigantic help to see:

- The mutual relations of cells

- The mutual relations of tissues

- To connect the dimensions of morphogenesis between embryology, physiology and anatomy.

The intimate interrelation between structure and function or simply Form, becomes consciously integrated and eventually a living picture, when the histological dimension and its specific features is known and succeeds in bridging and merging macro anatomy and physiology into one big living picture.

So where does it turn crooked for us?

It is, in the why, the trap lies… Our frame of reference as anatomists is the skeleton, remember https://www.dhirubhai.net/pulse/annus-horribilis-max-girardin/ or https://www.dhirubhai.net/pulse/help-something-deeply-wrong-anatomy-max-girardin/ . 

That way of looking at anatomy: the skeleton as a cloak hanger with the rest draped like wet raincoats on it, made us think in a strange goal directed way; and we do it constantly but innocently, in our way of expressing …and that carries huge consequences.

 This is so-  …in order to … so that the function can…because then it can….because of…all goal directed.

(You can walk because your leg grew in a certain way, and your leg did not grow so that you could walk… or do you really believe that an embryo runs around within the uterus, alike an hamster in a wheel in order to develop that leg or fat pad under the calcaneum and knee cap? Quote from my Morphologicum and Evost colleague Jean-Paul)

While in Nature things are (full stop), there is no real goal, as we commonly understand it; there are local interactions, zillions of them and from it emerges order, local, regional and global.

Nature functions according to some principles at work, through all the dimensions present, in the same moment. 

Nature has a story, although we in Evost prefer to call it Hierarchy and Chronology, and that is EVOLUTION.

And evolution has no goal. That is the big hiccup or mental setback.

Evolution happens, not as randomly as stated by some scientists, but it happens by: something in the environment that triggers the system (possible in all dimensions and they are all nested!) And the system undergoes it or reacts within its several possibilities; this depends of its state and complexity. It tries to maintain itself, its balance if you want. Therefore these triggers we call them “disruptive stimuli” because they disrupt the dynamic balance - state. (In complexity science this phenomenon is called ‘Stickiness’)

And it is the environment that “selects out” what is useful for survival and reproduction, so when we look backwards it just looks like there is a direction, a goal, but we don’t see the zillions of mishaps that just disappeared out of sight, got extinct or evolved if we talk about Life….

The selecting is not active or thought through, as we might think by the sound of it, but it is circumstantial – adapted to a specific environment and the relation predator-prey or food and hungry organism.

Simple example with which we hit two flies in one clap: a cell demonstrates metabolism, which is one of the responses she developed to deal with disruptive stimuli: metabolize = absorb and change or partially neutralize the disruptive stimulus and throw it out in the changed-less disruptive form.

This was apparently a workable proficient solution, because since then, they all kept doing just that, however different they may look. In the human body alone we have roughly 250 different types of them.

The next big step in the process was multi-cellularity. Instead of going separate ways after mother cell division into daughter cells, some stuck together, and apparently it had several advantages because many types did just that. (In the Evost course we go through all that in detail, this is really an extremely simplified shortcut)

Today an average man (if that exists) is a self-organized organism of about 30 trillion cells and contains and carries about 40 trillion bacteria, most of which reside in his digestive tract. So actually we are just convenient niche cabbies for our gut- and other flora. Sobering thought hey?

 The keen smart pants must have noticed that at least twice I put systems before organs; strange for a guy that hammers on hierarchy and chronology most of the time?

Actually no, because that is the right developmental or evolutionary Hierarchy and Chronology. Reference frames, always the first question!

Systems arise or self organize long before the organs. But how does that happen? 

That is a very long story, within the Evost course I think it takes about a few day's to teach that, but let us try to give it a short cut version.

 Now it gets a bit more complex:

Was my use (twice already) of systems before organs a cunning way to deceit you into something you don’t want, get you all mixed up?

Not really, but as usual everything changes or seems weird like a secret code, if you don’t have the key or frame of reference used.

Effectively when you look at the developmental principles, systems appear first, long before any differentiated organ, reason for which I use that hierarchy and chronology. 

And even that is an oversimplification, if you go back to your osteopathic philosophy you know that actually the behavior or function has to be there in order to take form in a shape, getting structured; and that is the essential principle in all developmental steps leading to a second fundamental principle being hierarchy and chronology of coming into FORM. Be it for the molecular dimension, the cell dimension or tissue dimension upwards…

Systems arise functionally before they become formed:

Cells each have each their own metabolism over the cell membrane yes?

Now imagine for a second an organism of a few hundred thousands cells, like a sausage worm shape, but still a lump cells. The cells in the middle of the organism are having though times, the intercellular spaces are there but that is a hard way to get a living. (Imagine you have to feed, drink, breathe and urinate and the rest through a straw, even a few straws, that are continuous with even more straws until by deviated flows you reach the outer world…this is not going to be a physiological great party isn’t it?)

When the situation has become untenable these centre cells metabolism slows off to the point that they die off, and become a sort of tube filed with dead cell material and fluid, and the gut as system is born… (Lysosomal action) Now the change of environment in the tube and outside, leads to cell differentiation…the skin (ectoderm) and mucus membrane or endoderm are born… this is what Hierarchy and Chronology are…

Still wondering how comes that the outer layers - skin are multi-layered and that the gut’s mucus membrane is mainly just one layer of cells, specialized on exchange? If you don’t get it read the hierarchy of the morphogenesis of the gut system again…and let it go through your mind.

Each system and organ has a comparative story and that is why we end up with actually two types of tissues:

Frontier tissue (border with the environment) and inner tissue (shielded of from the environment by the frontier tissue)

Not 4 tissues but two, the frontier one, avascular and the other one very dynamic and vascularized taking care of the Frontier one, sustaining it.

BUT, but, but… Science can ‘t be that wrong? It is not wrong, always a question of what frame of reference you use… but think, what does oncology teaches us?

 If things turn out bad and the shit hits the fan: cancer…how many types of cancer are there?  4 or 2 ?

Frontier tissue builds carcinoma and inner tissue builds sarcoma… so 2 not 4.

Have Fun and reason….An osteopath is a philosopher and a lifelong student…

See you in the next article where we’ll see that wound healing and adhesions in the peritoneum…well to get them you need histology and cytology and physiology…MORPHOLOGY.

Have a look at this beautiful diagram, where the centre middle piece is missing: "The undifferentiated mesenchymal cell that stays resident in your connective tissue until the day you die..."

have a look at: https://cmapsconverted.ihmc.us/rid=1209675156937_23198942_48791/08.%20Resident%20Connective%20tissue.cmap