“Lectures on Osteopathy - Volume Two”
John Wernham College of Classical Osteopathy, 1996.
Hardcover. 170 pages.
Perspective: Osteopathy, Osteopathic Principles
Available from:John Wernham College of Classical Osteopathy
“'There is only one osteopathy and that only way is through the process of integration… it is impossible to deal with the injured member in isolation,whether it is a joint, organ, nerve supply or any kind of break in the continuity of life.” (p 28)
“Littlejohn once commented that he preferred to begin his examination and treatment of the patient at the foundation, rather than at the roof. No doubt, it will be to our advantage if we take him at his word and look first at the pelvic base-line, working our way up to the cranium or roof. Now, if for any reason the base-line is no longer level, the vertical line will respond with a series of twists, that we can track upwards through the spine, with great accuracy.
It is axiomatic in classical osteopathy that we seldom commence out treatment directly and locally at the site of the lesion. The preliminary work is carried out at the furthermost point, where the secondary or tertiary lesions are at their weakest, with only a gradual approach to the distressed area. Therefore it is logical that we should tackle a cranial problem in this way, bearing in mind that correlation must be established between those points of special importance: the sacroilliac articulations, the 3rd lumbar, the 4th dorsal vertebrae, the occipital/ atlantal articulation. If the base-line is tilted, as it frequently and commonly is, there is a reciprocal action at the centre of gravity at the 3rd lumbar. This means that the axis of symmetry will side-track and cause the lumbar spine to curve laterally up to and including the 3rd lumbar. Therefore, the double arch, extending from 2L to 5D, which is supported on the gravital centre, will become unseated, giving rise to those familiar short lateral curves, first to the right and then to the left around the keystone at 9D. Then in line with this compensatory procession of vertebral sidebending, the upper dorsal moves to the right and crossing over into a left sided cervical lateral sidebending… The curving goes on to include the cranium, yielding a kidney shaped head, the temporal bone on the right bulging on the convexity of a right sided curving, while the left temporal bone remains flattened on the concavity of the curve… It is not without interest to note that in cases involving the TMJ, the mandible always moves in the same direction and that turning the head from left to right in the prone position is difficult in many patients.” (pp 38-39)
© 1995 John Wernham
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'Lectures on Osteopathy Volume Two' is another excellent book by John Wernham and includes discussion of the role of the Vagus nerve, the Sacroilliac joint, Cranial Technique, the Theory of Osteopathic treatment, diseases of the excretory system, and a discussion of the Principals of Osteopathy.
In the above passage, John Wernham outlines what may happen with a pelvic torsion resulting in a tilted baseline — rather than the preferable horizontal base-line of a symmetrical pelvis. As this base-line is the foundation for the vertebral column and its axis of symmetry, any tilting will result in compensations higher up the spine, as the body struggles to maintain its axis of symmetry and upright position. Wernham gives examples of (possible or common) resulting spinal lesions — here mentioning 'short lateral curves, first to the right and then to the left around the keystone at 9D'. The compensations may go higher, to the neck and cranium, even the TMJ.
It is also interesting to note Wernham's concern with 'integration' in osteopathic treatment. In fact, any effective osteopathic treatment (according to the Classical Osteopathic model) must strive for this integration (through the Body Adjustment) attempting to modify and resolve the (often complex) predisposing factors that will (also) maintain any 'local' lesion if not addressed. As Wernham writes (above): '…we seldom commence out treatment directly and locally at the site of the lesion.'
One can see how this Classic Osteopathic model, which strives to see the 'big picture' as it were, and treat the whole body (by the Body Adjustment, a form of General treatment, focusing treatment according to Wernham's 'pyramid of forces' model) is quite different from the 'specific adjustment technique' of modern osteopathy, i.e. treating, or attempting to treat, an isolated spinal lesion, as if it were possible to treat one part of the body in isolation from the rest of the body.
Yes, of course, there are certainly occasions where there is an isolated injury: a torn meniscus in the knee perhaps, or an ankle injury. Yet, generally, as far as the spine goes, and back pain in particular, the results are far better when we can see the big picture in this way, and treat the body as a whole. We are actually treating the back as a whole, yet this may also include the pelvis, sacroilliac joints, upper and lower extremities, etc.
There are also several transcripts from Littlejohn lectures — one on Cardiac Arrhythmia, delivered at the British School of Osteopathy in 1932, and another on Pneumonia (remember this was before the days of penicillin and antibiotics, not available until the following decade).