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DIAGNOSTIC TOUCH: ITS PRINCIPLES AND APPLICATION

- Four articles by Rollin E. Becker


From the

ACADEMY OF APPLIED OSTEOPATHY (AAO) YEAR BOOKS 1963, 1964 & 1965 OF SELECTED OSTEOPATHIC PAPERS
Published by THE ACADEMY OF APPLIED OSTEOPATHY Affiliated with the AMERICAN OSTEOPATHIC ASSOCIATION Margaret W. Barnes, D.O., Editor P.O. Box 1050 Carmel, California AAO Year Book 1963 DIAGNOSTIC TOUCH: ITS PRINCIPLES AND APPLICATION -- Rollin E. Becker, D.O. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 AAO Year Book 1964 DIAGNOSTIC TOUCH: ITS PRINCIPLES AND APPLICATION - Part II -- Rollin E. Becker, D.O. . . .. . . . . . . . . . . . . . . . . . . 153 - Part III -- Rollin E. Becker, D.O. . . .. . . . . . . . . . . . . . . . . . . 161 AAO Year Book 1965 Vol. II DIAGNOSTIC TOUCH: ITS PRINCIPLES AND APPLICATION - Part IV - Trauma and Stress -- Rollin E. Becker, B.Sc., D.O. . . . . . . . . . . . . . . . . . . . . . . . . 165

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DIAGNOSTIC TOUCH: ITS PRINCIPLES AND APPLICATION


ROLLIN E. BECKER, B.Sc., D.O ., Dallas, Texas (AAO 1963 p. 33)

Diagnosis is an art and a science. In the realm of science man has extended his senses through instrumentation and has brought in a battery of tests upon the human body and its contents. There are the usual urine tests, simple blood tests, examination with the electrocardiograph, the sphygomanometer, opthalmoscope, otoscope, X-ray and other instruments that can be found in the office. But this is barely a beginning. The patient can be taken to a fully equipped laboratory or hospital and the variety of tests and the complexity of them are almost limitless. Blood chemistries can be run that can de- fine the components of the blood stream down to the molecular level, for any given moment, their electrolytic balances and a host of other information. It is now possible to obtain an exact diagnosis of some virus diseases. Fluorescent antibody can be used to diagnose infectious disease by demonstrating antibody and/or demonstrating antigen. Thus immunological controls of the body are becoming available for testing in the laboratory. Ma- chines now give accurate blood counts for both red cells and white cells, eliminating the human error in making such counts. If there isnt a machine to do a differential count developed yet, human ingenuity should be able to come up with an electric eye to do the seeing, a small electronic brain to remember the different types of white cells, and a scanning device to make such a differential count, again eliminating human error. Enzymes, hormones, and other protein molecular actions and interactions are being analyzed and studied through a variety of approaches, electrophoresis , chromatographic processes, complex chemical techniques, radioisotopes, and the electron microscope. Sampling for the various materials needed in these tests can now be taken directly from the site of activity in many cases by the use of catheters that are passed through the arteries and veins directly to the point from which a sample is desired. A recent report tells of securing samples from the human adrenal Venus blood flow by passing a cardiac catheter to the left renal vein via the right saphenous vein and the inferior vena cava . With appropriate manipulation, the catheters

entered the central adrenal vein. Contrast media injections out- lined the adrenal venous network and the extent of the non-adrenal channels. Blood samples revealed levels of free cortisol ranging from 4 1 to 3 13 mcg. Per 100 ml. of blood. This technique will make it possible to study rapid metabolic changes in the adrenal cortical steroids. Machines have been built that duplicate renal function so that serious renal dysfunctions can be handled for hours on end while work is being done to restore kidney functioning. Other machines permit open heart surgery and chest surgery that could not be permitted a few years ago. The use of electronics in the medical field is on the threshold of its development and already many electronic devices for diagnosis and study are making their way into the market. Electrocardiographic data can be transmitted over a telephone circuit to any place in the country. A Body Function Recorder can keep a constant close surveillance on as many as a dozen patients. Five variables can be watched simultaneously, the pulse rate, systolic and diastolic blood pressure, the temperature, and the air flow through the nostrils. Miniaturization and transistorized equipment are making many tests permissible. Blood pH can be monitored continuously for as long as six hours with a tiny electrode l/20,000 inch in diameter, placed in a standard hypodermic needle. At a glance, an attendant can observe the concentration of carbon dioxide in the blood stream of an anesthetized patient, the approach of shock in an accident case, or the intake of oxygen in an iron-lung patient. More and more of such devices will be available with time to develop them. Thus the science of diagnosis is demonstrating its strength in every phase of human (p.32 - 33) existence and its potential for future development is practically unlimited. The physician of forty years ago was a simple soul who had a relatively few instruments at his command and not too great an armamentarium of therapeutic aids with which to diagnose and treat the disease and trauma of his patients. Todays physician must be a chemical engineer, an electrical engineer, a biological engineer and a physical engineer, in addition to being a physician. The physician of forty years from now will make the present-day physician look like a simple soul. Thus the pattern continues to unfold.

Diagnosis as an Art Diagnosis as an art is an important component in the field of diagnosis. It has always been. It always will be. Diagnosis as a science brings to the physician those data that can be learned objectively with the minimum of human error. The blood count that can be done by machine is more accurate than that run by a technician counting the cells. So it is with all the biological detail that can be done by scientific instruments. The art of diagnosis is that ability applied by the physician himself. It involves the following factors: his interpretative skill in analyzing the data supplied to him by his scientific tools and the use of his own personal skills in evaluating the patient before him. These are subjective in nature. These may not bring the finite detail of the instrument but neither are they limited by the finite detail that the instrument is only capable of perceiving. There is room for variables, there is the ability to perceive past events, present events, and predictability for forecasting future changes, There is a wider latitude of functioning in the subjective field in the art of diagnosis and this coupled with the scientific data gives the physician an overall picture that can bring a more complete and knowledgeable diagnosis. A scientific diagnosis is not enough. It is too limited. It is the composite use of both scientific (objective) and personal (subjective) tools that gives the physician a true diagnosis. Interpretative skills within the physician are a subtle mixture of many years of training, of knowledge of the available scientific tools and their use, of experience, of a mind that keeps itself open to any and all approaches that will enhance his abilities, of the development of his own personal subjective tools, his eyes in accurate inspection, his ears in accurate auscultation and percussion, his nose and taste where indicated, and his thinking, feeling, knowing touch. This latter I will enlarge upon later. Interpretative skills call for a knowledge of functioning within the human body, functioning that is related to past events leading to the present time he is seeing the patient, functioning of the present time, and the ability to project functioning patterns into the near future. This is different from the mere tests for functioning as recorded by the scientific tools at his command. The latter are transitory findings that reflect the picture of the moment. True functioning within the individual patient is that evaluation of what is being done by the patient with all of these variables; how is his system coordinating them; how is he adapting to the dysfunctions, where is the potential for the reversibilities of the dysfunctions. In other words, how is this

patient functioning as a living being? He is sick. He comes to you for help. Where is he now, where was he when his problems began, what is his potential for return to normal? It is the intelligent use of the physicians eyes, ears and touch that can give him knowledgeable answers to some of these questions. There are variables found in every case which must be taken into account. These are the factors that complete the case. They are as important to the physician as the vast array of scientific tools and the data there-from, perhaps more so, because these variables are the factors the patient is concerned about. He is the one who is trying to get well. Three Problems There are always three problems every time a patient enters your office. There are the patients ideas and beliefs of what he considers his problem to be: there is the physicians concept of what he considers the patients problem to be; and, finally, there is the problem of what the anatomical-physiological wholeness of the patients body knows the problem to be. The patient of today is a better informed patient than the one of a few years ago. He reads medical articles in the periodicals. He translates this information into his terminology, not always correctly, and he has been to other physicians before coming to you. He has heard their diagnosis of his problem and adds that to his opinion. He tells you his story and tries to explain his physical feelings. He is sensitive to your opinions and if you can come up with a picture that will explain his problem to him in satisfactory way, he is able to cooperate with you. But in the final analysis he still has his (p. 33 34) opinion, right or wrong. The physicians concept of what is wrong with the patient is based upon a much more highly trained set of factors. He has had many years of rigid training, can run the necessary tests and physical examinations to try to bring the patients problem into focus, and is able to formulate a more objective diagnosis. He has been taught to try to create a diagnosis that is couched in terminology with which he can communicate his findings to the patient and to other physicians. For example, the diagnosis of a peptic ulcer, viral pheumonia or whiplash injury conveys a whole syndrome of findings in the minds of other physicians to whom this same patient may present his case. While this ability to communicate is necessary, it is also a limiting factor in the true diagnosis. The body does not

think of its problem in such a limited sense. But the physician has been presented a problem and has formulated his diagnosis. Finally, there is the third problem. What does this anatomical-physiological mechanism know about this case? It has the answer in every sense of the word from an overall pattern of total stress or disease down to the smallest or infinite detail. The anatomical-physiological mechanism and its structure-function or function-structure (structure-function and function structure are interchangeable) carry the total picture. The patients body has the answer written into and through the physiological functioning of his brain and nervous system, his circulatory patterns, his fluid balance interchange, his organ systems, his endocrine makeup, his structure-function interrelationships. To sum it up as simply as possible, the patient is intelligently guessing as to the diagnosis, the physician is scientifically guessing as to the diagnosis but the patients body knows the problem and is out picturing it in the tissues. It is possible to create a more accurate diagnosis, one that is closer to the true pattern than either that of the patients opinion or the physicians opinion. We can utilize the information, the facts, the know-how of the third problem, the patients body, to bring this diagnosis into existence. We can use the interpretative skills of ourselves as physicians as an integral part of this process. In addition, we can train our senses, especially our sense of touch, to lead us into the structure-function of the patients anatomical-physiological mechanisms and make them give us the information we need. Needless to say, in invoking this process, each physician will have to teach himself the details of the way into and through structure-function. It is a self-taught process. The steps of where and how to do this can give guidance but the physician himself is the final arbiter as to methods and results. We have to learn to feel structure-function messages from within the body of the patient, not the end results of a test, but what is happening now, when did it begin, how is it going to progress. It is quite a challenge. As indicated, the ability to understand function-structure within living tissues is a self-taught process by each physician. Through our eyes for accurate observation, our ears for accurate auscultation, we can learn some things that are happening to our patient. It is through the sense of touch that we can learn a

great deal more about the patient. This is a touch designed to feel function within the tissues and to feel dysfunction when it is present. Function has to be distinguished from motion. Motion is not function; function always includes motion, but motion, per se, does not represent all the values of function. Witness the patient who complains of a leg ache. We can test the leg for motion both passively and by voluntary cooperation of the patient and find it working well according to motion. Yet the patient will say, But, doctor, why does my leg hurt? With a touch designed to feel the dysfunction within that leg causing it to ache, it is possible to say, I find the source of your disability to be thus and so. It is difficult to find words to describe function within living tissues. It is an evaluation that can be felt with a knowing touch similar to that experience of watching a patient walk into your presence with a knowing visual observation and being able to interpret information from that observation. With regard to the sense of touch, someone said to me one day, You feel from the heart, dont you? That is right. You learn to feel into the heart of the patients problem from a still-leverage point that allows the functions and dysfunctions of the patient to be reflected back into your touch and feel. The first step in developing this depth of feel and touch is to re-evaluate the patient from the third problem standpoint, just what does the patients body want to tell you? Take the patients story and opinion and set it aside, take your opinion and diagnosis and set it aside, then let the patients body give you its opinion. Place your hands and fingers on the patient in the area of his com- (p.34-35) -plaint or complaints. Let the feel of the tissues from the inner core of their depths come through your touch and read and listen to their story. To get this story it is necessary to read function-structure in tissues. To do this we need to know something about potency, which we will discuss now, and something about the fulcrum, which we will discuss later. Potency The knowledge of potency within tissues begins with a statement given to us by Dr. W. G. Sutherland who said, Allowing the physiological function within to manifest its own unerring potency rather than the use of blind force from without. (1) This is a statement of the principle upon which we will develop an understanding of what is potency. The diagnostic tool with which we will learn to read and understand this potency is the principle of the use of the fulcrum.

We will use the principle of the fulcrum in applying our hands and fingers so as to create a condition in which the principle of the potency may become knowledge for our use in diagnosis and treatment. Websters dictionary defines potency as the state or quality of being potent, or the degree of this; power; strength. (2) It defines potent as able to control or influence: having authority or power. (3) We have heard for years that the body has within itself all the factors with which to maintain health and to heal itself in case of disease or trauma. This statement is basically true. The body has the capacity to express health through this inherent potency and it has the capacity to maintain compensatory mechanisms in response to trauma or disease through variant potencies. At the very core of total health there is a potency within the human body manifesting it in health. At the very core of every traumatic or disease condition within the human body is a potency manifesting its interrelationship with the body in trauma or disease. It is up to us to learn to feel this potency. It is relatively easy to feel the tensions and stresses of trauma and disease as they are manifesting this pattern of trauma or disease. But within these manifesting elements there is a potency that is able to control or influence: having authority or power. It centers the disturbance. It can be sensed and read by a feeling touch. To bring the idea of what it means to feel potency within a given problem let us consider something outside of ourselves and describe it to demonstrate the power within potency. Let us consider the hurricane Carla which struck Texas in the fall of 1961. Why a hurricane to describe potency? Because the principles and manifestations of hurricane can, in my opinion, be shown to be very similar in analogy to the principles and manifestations of disease and trauma within the human body. The eye of the hurricane carries the potency or power for the whole storm, the spirals of the high winds feeding into the eye manifest the destructiveness of the storm. The eye of the hurricane carries the pattern for the whole storm. Any change in the eye automatically changes the spiralling effects of the winds feeding into the eye and thus the pattern of the storm. Witness the next hurricane that followed Carla. It was a hurricane that was spawned in the Atlantic and was approaching the New England states. While still some distance from the land, the eye of the hurricane closed and the hurricane was no longer a

hurricane but just another gale. So it is the presence of this eye that determines whether it is a hurricane or just an ordinary storm. Within the eye is the potency having authority or power to create the manifestations of the spiralling winds making up the storm. Carla was born in the Caribbean Sea, south and east of the Yucatan Peninsula. As she grew, she curved her way past the Yucatan Peninsula towards the coast of Texas. She developed an eye that was thirty miles in diameter and 30,000 to 40,000 feet in depth. Feeding into the low pressure area of the eye were spirals of winds, travelling counter-clockwise, a minimum of 600 miles in diameter. She travelled towards the coast at 12 to 15knots per hour until she neared the land surface where she met resistance and came to a halt off the coast of Texas. She sat there for 12 to 18hours.The tremendous winds in her spirals pounded the coast hour after hour with blinding rain at 100 plus miles per hour intensity. Finally, she moved inland and the edge of the eye had winds clocked at a maximum of 173miles per hour and heavy rain. Imagine being bombarded by rain drops travelling at that speed. As the eye touched the coast, the winds ceased and all was still during the time that it took for the 30 mile diameter of the eye to travel north-ward in its curved pathway. When the backside of the eye was reached, the winds again struck at better than 100 miles per hour from the opposite direction. To show the overall capacity of such a storm, while the winds were100 miles per hour at the coast, we in Dallas were experiencing winds up to 30 to 40 miles per hour from the east 400 miles north of the (p.35 36) coast. Not only were there high winds but there were also other manifestations within the ends of the spirals. Tornados were being formed, one of which went through the city of Galveston after the eye of the hurricane had travelled a considerable distance inland. As long as the hurricane travelled over the Caribbean Sea, the winds around the eye increased in intensity due to lack of anything to slow them up but when the eye continued inland the surface of the continent began slowing down the intensity of the wind. By the time the eye reached Fort Worth the winds had reduced to 60 miles per hour on the front edge of the eye, then a period of stillness during the passage of the eye and again 60 miles per hour winds from the opposite direction on the backside of the eye. Finally, Carla continued her way north into Oklahoma and Kansas and was dissipated by the land over which she travelled until her eye no longer had enough energy in it to maintain her identity.

Millions of dollars of property damage due to flooding, high tides, rain, strong winds, and tornados were the result of this one storm. Practically no lives were lost due to excellent communication systems. 500,000 people evacuated the coastal area in advance of the storm proper. Those who did stay more or less on the fringe of the storm center were able to watch the eye of Carla on their television screens through the radar readings that were being taken at the time of the storm. Modern instrumentation and communication have given us a very complete picture of Carla. Tiros, one of the satellites going around the earth in its orbits, sent down pictures of the eye and of the huge spirals of winds feeding into the eye. Hurricane hunters flying B-29s flew into the storm and into the eye itself and registered dozens of different data concerning her and plotted her course from early in her existence in the Caribbean. Radar readings followed her progress. Radio, television and news copy kept up with her through-out. This brief description, then, brings us the story of Carla, a hurricane. While those of us who sat on the sidelines were able to watch the growth, the development, and progress of Carlas existence, those scientists who flew in the B-29s were able to literally know and experience the high winds in the spirals and the potency of the eye of the hurricane. It was a physical awareness to them. It was an awareness to those who were in the direct path of the eye as it crossed the state of Texas, first the winds, then the stillness of the eye, then the following winds from the opposite direction after the passage of the eye. Men trained to understand mechanisms of this type of storm can know the various factors within the storm pattern by the interpretation of their own senses in addition to that information given to them by the instruments they are watching. They know when they are in the eye or in the periphery of the spirals. They can feel it with their whole being. Thus it seems logical to me that the physician can train his touch to recognize and accept the fact that within every trauma or disease pattern there is an eye within or without his patient, which has within it a potency to manifest this traumatic or disease condition. It is a point of stillness within that focus. It is invisible, to be sure, but it can be perceived by the trained discerning touch of the physician. How do I know? I have been aware of this potency hundreds of times. This is something that has to be learned by personal experience. It was forced upon me by learning to read structure-function within the patients who brought their problems to me. I became aware of this area of stillness centering

the trauma or disease. Slowly over a long period of time, knowledge and understanding came as to why it existed and its part in the traumatic or disease picture. I observed through the years that when any change took place in the area of stillness there was manifest a whole new change in the trauma or disease pattern. Like the eye of the hurricane that closed in the storm off the New England coast, it was no longer a hurricane. If any change had taken place in the eye of Carla before she hit the Texas coastline, her entire pattern of spirals, the intensity of her winds and other factors would have modified to meet the change in the potency within the eye: Thus I slowly learned to add this diagnostic insight to my armamentarium until it has become a day to day experience with every new patient as well as with those I am seeing over a period of time. It was by deliberately taking the patients opinion and setting it aside, taking my diagnosis and setting it aside, and going to the structurefunction of the anatomical-physiological mechanisms of the patients body that I was able to acquire this knowledge. This is not something that I have discovered. It exists of itself. It merely asks acceptance of its existence and time to develop a sense of touch and aware-ness with which to perceive it. The problem remains, as always, how to find words to express that which it is and methods whereby it may become part of ones experience. It is a self-taught process. (p. 36 37) Fulcrum To develop this sense of touch it is necessary to learn the principle of the fulcrum and then to develop a method of using the fulcrum in the diagnostic approach to these problems. Webster defines a fulcrum as the support or point of support on which a lever turns in raising or moving something; hence, a means of exerting influence, pressure, etc. (4) Dr. W. G. Sutherland in describing the fulcrum in relationship to the two halves of the tentorium-cerebelli and falx cerebri stated, The Fulcrum(the junction of the falx cerebri and tentoriumcerebelli at the straight sinus) is the still-leverage junction over and through which the three sickles function physiologically in the maintenance of balance in the cranial membranous articular mechanism. Like all fulcrums, it may be shifted from point to point, yet remaining still in its leverage functioning. The key to understanding the principle of a fulcrum is to realize that it is a still-leverage junction, yet it may be shifted from point to point while remaining still in its leverage functioning.

On a gross level of functioning the scientists on the B-29s were relatively still points, riding in a plane that was responding to the storm into which they were flying. The scientists whole bodies reflected the movements of the storm and the potency or stillness of the eye of the hurricane. This was something they could feel during the flight, could report, and interpret. The physician must bring this principle down to a much finer degree of use than that of the whole body. He must set up a still-leverage mechanism with which he can feel the stress and tension in the tissues under his hands and fingers and find the potency or area of stillness within that area of stress. He does this by placing his hand or hands near the area in which the patient is experiencing difficulties and then establishes a fulcrum with his elbow, his forearm, his crossed fingers, or any other part of him that is convenient to his comfort. From this fulcrum, his fingers become the end of a lever that can note the changes taking place within the body. His fulcrum point can be shifted from time to time to adapt to changes within the body, yet remaining still in its leverage functioning. Touch In placing the hands and fingers on the tissues under examination, do so with the idea that the fingers can mold themselves to the patients body. It is a gentle contact yet one with firmness and authority. To borrow descriptive analysis from Dr. Sutherland, It is necessary to develop fingers with brain cells in their tips, fingers capable of feeling thinking, seeing. Therefore first instruct the fingers how to feel, how to think, how to see, and then let them touch. There must be a finger-feel, a finger-thought, a finger-sight (5) with which to read the functions and dysfunctions of the body. The mechanisms of the body and their potencies are always inaction and can be felt with a thinking, feeling, seeing touch that in time becomes a knowing touch. It is like getting onto a moving train. The train continues in motion and action as I get on it, analyze the roughness of the roadbed, the side sway around the curves, its relative speed, and then get off the train while it continues in action. So it is with the problems within the patient. I move in on a living mechanism that continues to function; I make my diagnosis, administer my treatment, and leave the mechanisms continuing their ever-changing patterns. My touch is think-deep, see-deep, feeldeep and yet does not limit or lock the structure-function of the tissues I am examining.

I can go another step in developing my touch, through the still-point at the fulcrum and the depths of my finger-touch; I can develop knowledgeable awareness of potency and structure-function in tissues within the patients body. This awareness goes beyond the physical sensations of the physicians five senses. This is not what I feel with my finger-touch. That would be my opinion. Instead this is what the patients body is reporting through my fulcrum and finger-touch. This is awareness. This is a listening finger-touch. This is the patients bodys opinion. This is knowledge gained from the patients body, not mere information. I can control the gentle yet firm contact of my hands and fingers by the manner in which I establish a fulcrum from which I will develop this touch. Establish a fulcrum to provide a working point from which to operate and evaluate the case and yet let it be free enough to allow it to shift, while maintaining still-leverage functioning, to adapt to the changing needs from within the mechanisms under examination. Try examining a hyperactive child and you will see the need for a shifting fulcrum and hand-finger lever, not only within the childs mechanisms but also for the child itself. The hand and finger contact can be light and gentle, yet it (p. 37 38) can be observed that increasing the amount of pressure at the fulcrum automatically increases the depth of palpatory touch at the end of the lever, the hand and fingers; decreasing the pressure automatically decreases the depth of palpatory touch at the end of the lever. Thus with knowing fingers and the use of the fulcrum I become aware of potency within my patient. Thus I can modify my touch to meet the various needs of the kinetic energies expressed by the manifesting anatomical-physiological mechanisms and their potencies. Every patient is different and each patient is different each time he comes in for attention. The work continuously builds the physicians fund of knowledge and insight. For example, a patient comes in with a low back problem. With the patient supine upon the table, it is possible for the physician to sit beside the patient and to place his hand under the sacrum with the finger tips extended upward so their contacts are on the lower back. By leaning comfortably on his elbow, the physician establishes a fulcrum from which to read the changes taking place in the back. The patient may flex his knees with his feet on the table, if it is more comfortable for him to do so. The physicians other hand can be brought from the side and placed under the lower back. The fulcrum for this contact can be

the edge of the table against the forearm or the elbow on the physicians knee. By applying a modest increase of pressure at the fulcrum to cause a slight degree of compression through the sacrum towards the head, he will initiate the kinetic energy that will allow the structure-function of the stress area to begin its pattern to be reflected back to his touch. He learns to read these changes from the fulcrum point that he establishes at the elbow, or from both fulcrum points, if he is using more than one contact. He will feel the pull and tug of the tissues deep within them, he will feel the patterns of mobility and motility, and he will become conscious of the fact that there is a quiet point, a still-point, an area of stillness within the stress pattern. This is the point of potency for that particular strain. This is the point at which the stress pattern is maintaining its focus to be a stress pattern. I am not talking about the anatomical-physiological units of tissues. I am talking about the kinetics of the energy fields that make up this stress pattern. The anatomical-physiological tissue units are manifesting this kinetic energy and are expressing this dysfunction as tissue changes and symptoms. Any change within the kinetics of the energy field of the potency will change the pattern of functioning within the anatomical-physiological units. Another example would be a sick liver in a case of hepatitis. With the patient supine, the physician can sit comfortably beside the patient, place one hand under the lower ribcage on the right side beneath the liver. Then he can place the elbow or forearm of that hand on his own knee. Thus he has his fulcrum point on his knee or thigh and his examining fingers under the sick organ. The other hand can be placed on the rib cage above the liver and the elbow or forearm placed on some point that is comfortable to maintain its contact. Thus he will have the sick organ between his examining hands. By reading from these double fulcrums, he will be able to note structure-function changes taking place within the area of the liver. He will be able to sense whether the liver is moving or functioning upon its falciform ligament as it is supposed to do in health. He will be able to sense whether it responds to rhythmic up and down movements of the diaphragm during respiratory inhalation and exhalation as it is supposed to do in health. He will be able to allow the area of stillness, the potency for this particular problem to come to a focus. He will learn a great deal about this sick liver with time and repeated examinations on subsequent calls. As the liver as an anatomical-physiological unit regains its capacity to respond to respiratory changes of the diaphragm, its normal movements in relationship to the falciform ligament, and its venous and lymphatic drainage to begin to open and function,

he will know that this is a case of hepatitis that has reversed its pathological state and is returning to normal. All of these changes are perceptible to the discerning touch from the fulcrums he establishes to examine this organ. Application The application of the principle of the fulcrum is as varied as the list of complaints that walk into the physicians office. Each case calls for its own application. The patterns of setting up a fulcrum or fulcrums from which the examining fingers can study the problem are an individual development each physician must make for himself. The physician must know anatomy and physiology and as much function-structure that accompanies anatomicalphysiological units as is possible. With the development of this type of touch through fulcrum points into and through the structure-function patterns manifesting their changes under his hands, this (p.38 39) knowledge becomes an ever-increasing degree of understanding. It opens the door as to why this patient is experiencing the complaints he expresses. Many times the laboratory tests fail to reveal the source of the complaints but his trained touch will bring him this understanding. Why is it necessary to establish these fulcrum points? The physician is attempting to feel function within living tissues and to find the still-point from which this pattern of stress is manifesting its symptoms. He has to establish a still-point with which to be aware of the still-point within the tissues. As was said earlier, he feels from the heart of his still-point into the heart of the still-point within the patient. When is this type of trained touch applicable and to what kind of cases does it apply? There is no limit to its application. It is a tool that has some form of use for practically every type of complaint that comes to our attention. It will distinguish the difference between the congestive headache and the vasospastic type of headache. It will locate the specific sinus that is chronically or acutely filled with material. It will localize the specific lobe of the lung that is sick in lobar pneumonia. It will locate the strains and stresses of the muscular-skeletal system. It has uses from the top of the head to the soles of the feet. It is a diagnostic tool that is added to the routine examination of the patient along

with the laboratory findings. It will add insight as to the chronicity of the case, the present status of the case, and the possible prognosis for the case. Another analogy might be of interest at this point. The skilled electrical engineer is able to apply his art and science because he accepts the fact that electrical energy is present in his machinery. He takes his wires, his transistors, his printed circuits, his vacuum tubes and strings these things together to produce radios, radar equipment, television sets, and electrical circuits for home and business. He knows that the energy for these is electrical in nature and puts it to use. He does not know what electricity is itself but he can use it to develop functioning mechanisms. Electricity, too, is invisible but it can be measured and felt, instrument-wise and sense-wise. The physician has available to him a form of energy within the living body which has been called the potency in this paper. It is not intended to call it electricity in the sense that it corresponds to the electrical energy the engineer uses. It is a form of energy that is in the living body and as such can be used by the understanding physician to determine function-structure within the anatomicalphysiological units of the body. What is this potency? No one knows. Nor is it necessary to know, any more than the engineer has to know what electricity is before he puts it to use. The physician can learn to recognize this potency, accept its presence, and use it for diagnosis and treatment. As was said early in this paper, at the very core of total health there is a potency within the human body manifesting itself in health. At the very core of every traumatic or disease condition within the human body is a potency manifesting its inter-relationship with the body in trauma and disease. It is necessary to become aware of and use this potency. Within it is the key to reverse the pathology that is present and to allow the basic potency that is health to re-manifest itself. This paper is a statement of principles and methods whereby to apply those principles in the diagnosis of health, disease and trauma. It is not a paper to describe manipulative procedures. The power and authority inherent within the potencies and the structure-functioning of the anatomical-physiological mechanisms provide the motive kinetic energy with which to diagnose and modify the problems we find in our patients. We establish our contacts and utilize that which is built into the tissues themselves. However, a point to consider for those of us who do use manipulative procedures is that if we add

the principle of the fulcrum to our manipulative procedures we will be making those applications much more efficient. After we have introduced the leverage we may be using in the manipulation pause a moment, establish a fulcrum, pause again and let the thinking, feeling, seeing fingers interpret the degree of leverage and the amount of force we need to use to complete the procedure. We will find that we need less application of force from without and that we will be able to control that leverage with much greater precision. Let it be remembered, though, that it is possible to utilize that which is already built into the problems we find in our patients. We merely have to contact it and let it do the work for us. Using the principle of the fulcrum and the kinetic energies of the anatomical-physiological mechanisms with their potencies will resolve and reverse the pathological dysfunctioning towards the normal health of the individual. The question has been asked me as to the amount of time it takes to use this approach. This is not a time consuming process. Because we are using mechanisms already in action, it (p. 39 40) is only necessary to contact them and let them speak for themselves. It is possible to make a diagnosis in less than ten minutes. The average patient that comes in with a problem does not require that he be minutely examined from head to toe. He comes in with a complaint in a specific area. It is possible to go to that area and make an examination that will give the information you need to explain to him why he is having his difficulties. Of course, this may be only a small portion of the interrelated total picture of his problem but it is a beginning from which to go to other areas and finally to bring the complete diagnosis into focus. Herein is where the physicians knowledge of anatomy and physiology plays an important role. He is able to correlate his knowledge with his sense of touch and to trace the pattern of the disability and dysfunctioning until the whole diagnosis is clarified in his thinking. Subsequent office calls will add more insight until he is able to use his knowledge to understand the past history of the dysfunction, its present status, and project a prognosis for its eventual outcome. Old strains feel like old strains and can be dated as being weeks, months, or years old. As they modify their patterns, there is a point at which the physician knows that this pattern or patterns has reversed its hold upon the patient and that it will be a matter of days, weeks or months until a good resolution will have been accomplished. New strains feel like new strains. Their time-clock can be correspondingly charted. The same applies in disease conditions. It is productive work. There is something new to be learned each time you apply it. It is also

work that opens many doors for better understanding only to discover that opening those doors exposes more doors to open. References: (1) Sutherland, W. G., Preface to Reprint Edition of THE CRANIAL BOWL issued by the Osteopathic Cranial Association. (2) Websters New World Dictionary, College Edition; 1960; pg. 1143 (3) Websters New World Dictionary, College Edition: 1960; pg. 1143 (4) Websters New World Dictionary, College Edition; 1960; pg. 585 (5) Sutherland, W. G., Lets Be Up and Touching, The Osteopathic Physician; 1914

DIAGNOSTIC TOUCH: ITS PRINCIPLES AND APPLICATION: PART II


ROLLIN E. BECKER, D.O., B.Sc. Dallas, Texas (AAO 1964 p. 153)

A diagnostic touch is as essential in the accuracy of determining the diagnosis of a patients problem as is the routine physical examination and the tests made by the laboratory and scientific instruments. What is a diagnostic touch? It is a form of palpation designed to fulfill the principles expressed in the statement: in the science of health, disease and trauma, allow biodynamic intrinsic force within to manifest its own unerring potency rather than using extrinsic force from without. The physician places his hand or hands upon the tissues and then establishes a fulcrum through which to read the functioning and dysfunctioning from within the living body of the patient. This is the health or the problem in the patient manifesting itself through to the hands of the physician as it is read through the fulcrum point. If I feel it, it is my opinion, if the body manifests itself through the fulcrum point to my touch, it is the body s opinion. It is the latter which we are seeking in developing a diagnostic touch. What are some of the sensations that can be felt from the functioning and dysfunctioning within the body? Since man is in total interrelationship and intrarelationship with his environment, it is possible to use terminology from all of the natural and practical sciences, astronomy, engineering, physics, chemistry, electronics and others, through to biodynamics, biology, and anatomical physiology. A partial list of terms would include compression, decompression, tensity, flaccidity, stress, drag, sag, strain, sprain, shock, contraction, expansion, torque, rotation, twitching, vibration, pulsation, mobility, motility, immobility, agitation, disturbance, oscillation, wobble, restriction, fullness, flatness, swelling, atrophy, dystrophy, irritability, strength, weakness, vigor, force, vitality, tone, power, potency, stillness, balance, fatigue, fluctuation, and many others. Here are a few questions a physician can ask himself utilizing a diagnostic touch: In a sprained ankle case, can you feel the shock in the tissues in addition to the malposition of the ligaments and the osseous articular mechanism? If you are examining for an internal or external rotation of the acetabulum, can you determine these positions with the innate forces within the acetabular region without manually testing for them?

If you have two low back cases come into your office, one with a hard fall on the buttocks resulting in a compression strain in the lower back and the other with a rotation strain, can you determine each type of strain with a diagnostic touch? In treating a serious psoas muscle problem, can you determine when that muscle is beginning a better drainage mechanism during the treatment program? Can you feel the total shock in the thorax that accompanies every moderate to severe post-coronary syndrome? In a case of lobar pneumonia, do you know that there is a relative restriction of mobility of the temporal bone mechanism on the side of the consolidated lobe of the lung? Can you feel it? Do you understand the anatomical-physiological connection of the tissues as to why this situation is true ? In treating a bursitis of the shoulder or a brachial neuralgia or neuritis, can you feel the onset of a better drainage mechanism from these congested areas during a treatment? With severe cases, this is the time to stop treatment for the day in order to avoid fatigue within the sick tissues. In a wryneck, can you feel the dissipation of the forces that caused this wryneck with your (p. 153 154) diagnostic touch? Remember, most of the strains of the body make changes at micrometric levels of measurement in structure and function at the core or center of the disturbed area. Can you feel the forces melting out of the strain pattern under examination? Can you feel the flatness and loss of vitality that accompanies every case of so called nervous breakdown, or, in all post-encephalitic syndromes? Can you feel the upsurge towards the normal vitality during your treatment of that case? In a case of sinusitis, can you locate the sinus involved by the use of a diagnostic touch: its degree of involvement? In the lobar pneumonia case, can you find the specific lobe that is consolidated with such a touch, in addition to percussing for its location? In a recent whiplash injury, can you determine the direction of force from the front, rear or side of the car by laying your diagnostic hands on the tissues involved? Can you feel fatigue in tissues, either in the patient as a whole or in specific areas of trauma or disease? This is a most important factor in diagnostic and therapeutic considerations. Can you understand what you are feeling?

These are a few, among hundreds, of items available to a diagnostic touch. There are qualitative, quantitative, prognostic, diagnostic, and therapeutic considerations for each item listed and for each descriptive word listed. Some of these factors will be further discussed in this paper. In this field of endeavor, diagnostic touch, no one is an expert. That living body lying before you on the examination table is the taskmaster. It is challenging you to find its problem. The use of a diagnostic touch, through a fulcrum, opens the door for securing cooperation from that living body in finding the trouble within it. It has been my observation that very few physicians use diagnostic touch with the degree of skill or potential that is available. Diagnostic touch is too valuable a tool to be left on the shelf to gather dust. There are several steps involved in developing a diagnostic touch. These may be summarized as follows: Position your hand or hands upon or under the tissues you plan to examine: (I frequently have the patient supine upon the examining table so that I may slide my hand under the patient or place my hand on top of the area I am examining. I am comfortably seated by the patient .) Establish a fulcrum- point for each hand contact from which to operate; (If my hand is under the patient, I can lean on my forearm or elbow in contact with the table. If my hand is on the top, I can cross my knees and place the elbow for that hand on my own knee.) Let your palpating hand or hands and fulcrum point or points become one with the tissues involved; (The weight of the patient upon my underneath hand is sufficient to make a good contact, the weight of my hand and arm upon the patient is sufficient for the top contact.) Allow tissue functioning and dysfunctioning to come through to your hands and fulcrum points rather than trying to feel something in the tissues: Allow biodynamic intrinsic force within to manifest its own unerring potency rather than using extrinsic force from without. For example, try examining a knee and extending the sense of a diagnostic touch through to the thigh and acetabular region. Have the patient seated on the examination table and place your hands around the knee with your fingers interlaced in the popliteal fossa. Try to feel what you can with as much understanding as you can. Now apply a slight degree of compression through the knee towards the acetabulum and

see what you can feel in that area. You will be able to get some information but not much. Now examine these same areas using a fulcrum. Place your hands around the knee with the fingers interlaced in the popliteal fossa and, sitting comfortably in front of the patient, drop your elbows onto your own knees. Now read the story the knee is telling you through the fulcrum points you have established. Apply a slight compression through the thigh towards the acetabular region and again read through the fulcrum points. Feel how the innate natural forces within the thigh and pelvis want to turn the acetabulum either into an internal rotation or an external rotation position. Note the quality of that turning and the quantity of that turning. Note that if you lean lightly on your elbow fulcrum points you get a more superficial reading from the tissues under your hands even though your hand and interlaced fingers remain light in their control. Note that if you lean more firmly on your elbow fulcrum points you get a deeper and deeper impression from the tissues under examination, depending on the firmness at the fulcrum contacts. The depth is dependent upon the firmness at the fulcrum contacts, not on the firmness of the examining finger contacts. If there is a problem of stress or strain deep within this area, experience will teach you that it is necessary to make a more firm contact at the fulcrum points in order to read the dysfunctioning (p.154 155) that is manifesting itself within the area of the stress or strain. Experience and the nature of the problem you are examining will perfect your understanding of this point. This simple example illustrates one use of the diagnostic touch through the knee, through the thigh, to the acetabulum. A similar type of application can be used for every part of the body from the head to the feet. Place your hand or hands upon or under the tissue you wish to examine, establish a fulcrum point for each hand contact, and start listening to the bodys story of its own problem. There are two more important considerations. The physician has to know his anatomy and physiology in order to interpret that which the body is telling him through his fulcrum contacts and, secondly, at the same time he has to divorce himself from doing something to the area under examination thus letting the story come through to him. He has to get out of the road, so to speak. This is difficult to do. As a physician, he has been given techniques to do something to this body he is examining. He is trained to do and here he is told to divorce himself from this

problem and let it do the job of doing by reporting to his sense of touch; He has learned to listen to the verbal account of his patients problem, now he must learn to listen to a tactile account through his developing sense of a diagnostic touch. This example illustrates the fact that there are no techniques involved, in the ordinary use of the word. The physician is trained in surgical techniques, eye, ear and nose techniques, urological techniques, etc. In developing a diagnostic touch, there are no techniques. He only has to lay his examining hand or hands upon or under the tissues, establish a fulcrum or fulcrum points from and through which to read what is going on inside the patients body and then he allows biodynamic intrinsic force from within to manifest its own unerring potency rather than using extrinsic force from without. He is utilizing the innate energies within the health, disease, or traumatic condition to provide the motive power to bring him the story of the problem involved. Thus he has no techniques and he is told to get out of the way. Yet both of these steps are necessary in the art and science of developing a diagnostic touch. How else can the body report to you if you keep doing something to it during your examination? How is the body going to report to you unless you establish a listening post through which it can report. Your fulcrum point or points are your listening posts. Let the tissues tell you their story and you be quiet and listen. I have said there are no techniques and yet in describing the procedure for examining a knee and the acetabular region, I suggested applying a slight compression through the thigh towards the acetabular region. In examining any area or part of the body, one does position his examining hand or hands upon the body, one does establish a fulcrum or fulcrum points through and from which to read the responses from within the body, one does modify the amount of pressure on the fulcrum points to gather various depths of tissue activity and function, and finally, one can add a slight degree of compression or traction through the examining hand or hands to initiate the motive forces from within the tissue under examination. However, this is not actively testing the tissue yourself, such as manually turning the acetabulum into an internal rotation or an external rotation with your examining hands. Rather this is to activate already existing forces within the patients body so that they will turn the acetabulum into an internal or external rotation with their own built-in-power. Thus the use of diagnostic touch is more than a passive laying on of hands. It is a form of

palpation that one might call an alert observational type of awareness for the functions and dysfunctions from within the patient, utilizing the motive energy deep within the tissues themselves. It is not the patient voluntarily turning the acetabulum for you but his tissues within that acetabulum turning it for you to observe. That acetabular area has a natural tendency to want to go into either an internal or external rotation when the forces within it have an opportunity to express themselves. When you position yourself, establish your fulcrum points and apply this slight degree of compression towards the acetabulum, these forces within that region are now able to express themselves and they activate the process to go into an internal or external rotation. You can feel it happen and are able with your anatomical-physiological knowledge to know whether it is a normal physiological mechanism at work or one that is in a state of dysfunction. If you are not sure, go to the other knee and thigh and test them. They both may be normal or one will be normal and the other not. That is up to you to determine. Why is it necessary to develop a diagnostic touch when there is so much that can be learned from routine physical examinations and with the use of the hundreds of laboratory tests available? It is possible to make a very accurate diagnosis with these aids without the use of a diagnostic touch. These tests can give you information clear down to the subcellular level of what has (p.155 156) happened within this patient. You can read the monitoring devices attached to the patient, such as the electrocardiograph, and watch every electrical detail of every heartbeat, If you can get the patient to give you a complete history for every illness, for every accident, in all the detail that it would take to get the whole picture, and correlate the information with the tests you can run on him, you have made a practical diagnosis with the present day tests and examinations. A diagnostic touch is essential because there are subtleties of tissue functioning and dysfunctioning that cannot be explored by any other means than that of a skilled, sensitive, knowing sense of awareness through the use of this type of touch. A case history will serve as an example. A lady comes in with a complaint of violent headaches for the past two years. Her history is taken and various tests are run to try to determine the reason for the headaches. Finally you are able to localize the areas in which she is having her headaches and you are able to tell her the type of headache she is experiencing, a congestive type, a vasospastic type or some other form. This is fine as far as it goes. Adding the use of a diagnostic touch

to the examination, you find an old chronic concussion in the base of the skull that has limited the mobility of the cranial base which interferes with venous drainage from her head and induces an irritability of the intracranial and extracranial tissues through which the nerves pass in connection with her headaches. You ask her when did she have an accident that could have produced a concussion or an accident in which she saw stars. She then tells you of an accident as a child in which she sat down so hard that she was unconscious for a short time and saw stars. Now, you not only have located the area of her headaches and determined the type of headache, but you have also found their etiology, both in their early beginning as well as their present state and disability. This information could not have been gained by any other means than by use of a diagnostic touch; a touch that could literally feel the dysfunctioning within those tissues; a touch that told you this was an old injury: a touch that told you specifically which tissues were doing what in their functioning and dysfunctioning; a touch that told you a lot of other information for which it is difficult to find words to express. This same touch also gave you prognostic information as to the potential help for this case. Furthermore, a diagnostic touch is essential because it is a co-partner with what one might call a therapeutic touch. Taking the case just described, one can give her some symptomatic relief with the proper medication and physiotherapy but if you were to try to secure a correction for the problem, you would have to do something about removing the etiology: the old concussion that had affected the base of the skull. This calls for the use of a therapeutic touch. A therapeutic touch utilizes the same biodynamic principles and energies from within the tissue as does the diagnostic touch. One of the most important factors in the use of a therapeutic touch is a diagnostic touch to guide and direct you through all the living corrective processes that take place within that concussion mechanism during its resolution. Therapeutic touch will be discussed in detail in a later paper. A diagnostic touch, in addition to other tests, is therefore essential for accurate diagnosis. It brings to the surface finite detail from the past, the present status of the problem, and prognostic information for the future from the tissues themselves. It picks up strains at micrometric levels of measurement. It takes you to the specific center of dysfunctioning patterns. It gives you information that cannot be gained by any other form of examination. In the case of the lady with the headache problem, the use of a diagnostic touch was the most efficient way

to discover the etiological factor in her case. The only other way would have been to have secured a history from her of her fall in childhood producing this strain. This would have been difficult, because her severe headaches were present for only two years and she would not have easily correlated them with a fall taking place forty years ago. Even if you had possibly thought of such an accident and questioned her about such a fall, you would still need a diagnostic touch to accurately assess whether this was the beginning of the problem. You have to specifically feel this dysfunctioning at work and thus know that the fall and its present manifestation, headaches, are one and the same unit. Yes, there is a need for diagnostic touch in addition to the routine physical examination and laboratory tests. (Clinical results substantiated the diagnosis made in the lady with the concussion. Within a month, after starting a treatment program, she was symptom free and has remained so for the past year. There is still evidence, to the diagnostic touch, that the concussion mechanism is present, but it has been restored to its compensatory capacity to reciprocate with the physiological balance of the rest of the body. This is another factor in developing a diagnostic touch. In addition to finding the problem area within the patient, one should learn to determine what is happening in its relationship with the total physiology of the patient. Where is the potency or still-point or balance point that is (p.156 157) maintaining this problem area? What is its potential for restoring it to total normalcy or to a compensatory balance in its relationship to the physiological needs of body functioning? In this particular case, a compensatory balance was restored: her symptoms have disappeared for now, but they will recur if and when there is a regression in her bodys capacity to maintain physiological functioning within the problem area. Subtleties within subtleties are thus available to the trained diagnostic touch.) There is a particular group of patients in which a diagnostic touch serves a most useful purpose. This is the group who have been told, I cannot find any reason for your complaints. Your physical examination and tests are all negative. Its all in your mind. Its just nerves. You are paper healthy. These people are frequently called neurotics, psychosomatics, crocks A diagnostic touch defines and confirms the physical evidence to support and explain the vague aches and pains these people bring to your attention. There has to be a somatic component in these psychosomatic problems and the routine tests and physical examinations

are on too gross a level to pick up the dysfunction that is expressing itself as symptoms. The findings that one discovers using a diagnostic touch are at a subclinical level as compared to other tests. It is possible to obtain information from the patients body on the first visit that will give you a clue as to the reason for the complaints. Subsequent visits and continued study of their anatomical physiology will finally unfold a very complete understanding of the total problem. This introduces an interesting point. If ones examinations reveal a true physical picture to explain the disabilities that have caused these people to suffer for months or years, can they truly be called neurotic or psychosomatic? I dont believe so. My reasons for this feeling are based on the fact that, if one is able to diagnose the subclinical strains and stresses that are responsible for the complaints, then one has found the avenue through which these stresses and strains can be corrected, thus bringing back a state of normalcy or recompensation within that individual. A sensitive, highly trained, diagnostic touch has provided the necessary diagnostic tool to unlock the understanding required in these cases. It is a great help to these people to find a physical basis for their problems. They will frequently follow through with a treatment program, and again, a diagnostic touch is valuable in analyzing the corrective changes that take place during the treatment to resolve these physical strain and stresses. In either case, diagnosis or treatment for this large group of patients, a diagnostic touch is the added tool that is most efficient in handling this type of case in your practice. The clinical results you obtain will be most gratifying to those who have suffered so long with their subclinical syndromes. The hypochondriac turns out not to be a hypochondriac after all. There are legitimate palpable reasons for his or her complaints. The development of an adequate diagnostic touch is not an easy task to accomplish. To be able to find a state of health or of a strain is one thing: to be able to feel and interpret the functioning or dysfunctioning within that area of health or of strain with a trained touch is something else. The body may be considered as being basically composed of solids (bones), semisolids (soft tissues), and fluids (body fluids). This solid-semisolid-fluid structure of the human body is endowed with the biodynamic living principles of life. It is highly organized and is capable of expressing living changes taking place within its own environment. An area that is in strain within this living body can be found because that area of the body is expressing itself as being in strain. What one feels with his diagnostic

touch is kinetic energies within that strained area operating as a pattern of dysfunction within a solid-semisolid-fluid mechanism. The physician interprets this kinetic energy manifestation in physiological and clinical language based on anatomical-physiological knowledge of body functioning. All anatomical-physiological units express and utilize kinetic energy in manifesting their functioning in health, in disease, and in trauma. It is the art of learning to use these kinetic energies, with their centering potencies, wherein one develops a perceptive, sensitive, diagnostic touch. These energies vary in intensity, in quantity, and in quality for every environmental situation within patients. In discussing this phase of diagnostic touch with an electrical engineer one day, he made the statement to me, It takes a lot of energy to make a transistor or a vacuum tube work but it takes only a small amount of energy to direct that work. Similarly, in human physiology, there is already present a great deal of biodynamic energy at work but it takes only a minimal amount of energy on the operators part to learn to read and use that kinetic energy for diagnostic and therapeutic purposes. The transistor or vacuum tube has to have electrical energy supplied to it to make it work; in human physiology, biodynamic energy is already doing the job for the operator. The operators minimal energy requirement is applied through the fulcrum point or (p.157 - 158) points from which he learns to use the biodynamic intrinsic kinetic energy already in action within the patient. The results of such an examination would be phrased in clinical anatomicalphysiology or pathology, such as a subdeltoid bursitis, acute hepatitis, psoas muscle strain, or whatever clinical entity the problem turned out to be. The biodynamic kinetic energies involved and the diagnostic touch of the physician are tools to isolate and define the clinical problem within the patient. What is expressing this kinetic energy within this patient? It is biodynamic intrinsic force within integrated, highly organized fluid-fascialosseous mechanisms and fluid-membraneousosseous mechanisms of the living body. The term fascial is used because the fascial envelopes of the body surround and enfold the somatic cells of body functioning -- the liver cells, the muscle fibers, the alveolar lung cells or whatever cellular structure is involved in body physiology. The potential for clinical pathology to be examined by a perceptive diagnostic touch is unlimited. One has only to review the cases that he has seen on any given day in his practice to appreciate the variety of the problems involved: Bells palsy,

trigeminal neuritis, sinusitis, bronchitis, ileitis, a cerebral palsy child, a whiplash injury, psoas muscle strain, a ruptured disk problem an autonomic nervous system imbalance, an endocrine problem, congestive headache, an acne problem, a lifting injury problem, an epileptic, a rheumatoid arthritic, and so on through case after case. The amount of information one can gain as the tissues respond to the use of a diagnostic touch is truly remarkable. As ones perceptive skill increases, the issues will reveal something about the past history of their disability, the present status of their problem, and a prognostic evaluation as to their capacity to return to complete normalcy or to a compensatory state of functioning. All three of these factors reveal considerable detail in these findings. The cases that show promise of a good recovery indicates this to a diagnostic touch. The cases that are slow to respond or that are making an inadequate response demonstrate their lack of response and give insight as to why they are not responding. This is a big help to the physician who needs to know how to plan further care for the cases that are giving him difficulty. There is need for a diagnostic test that can give accurate guidance in the care of any case. A diagnostic touch provides this type of guidance. There is a corollary to the statement: allow biodynamic intrinsic force within to manifest its own unerring potency rather than using extrinsic force from without. It is: allow the mind to explore and interpret the biodynamic intrinsic force within as it manifests its own unerring potency rather than using extrinsic force from without. It is possible to develop a sensitive diagnostic touch capable of palpating this biodynamic force and its unerring potency but in addition it is necessary to develop ones mind so as to be able to explore this functioning and to be able to interpret intelligently the changes that are taking place. Let us set up an example to clarify this thought. Biokinetic energies or forces are always at work in all physiological and pathological processes. If we were to add an environmental force or kinetic energy to body physiology so as to produce a strain, such as a blow, a fall, or a twist, we would now have a specific pattern of disability manifest within the body mechanism. It is now a biodynamic energy field plus an environmental energy field, the force it took to produce the strain. We place our hand or hands upon or under this area for examination. We establish a fulcrum point for each hand

contact through which to initiate and sense the changes that are taking place within the strained area. Within a few seconds, we will find a change taking place within the tissues as they start manifesting the pattern of disability that is present within them. It is the biodynamic intrinsic energy within that pattern going to work. To the outside observer watching our work, our hands are apparently lying quietly on the patient but the motion, the mobility, the motility we sense from within the patient is considerable, depending upon the problem. There is a deliberate pattern that the tissues go through in demonstrating the strain that is within them. Kinetic-energy-wise, they work their way through to a point at which all sense of motion or mobility seems to cease. This is the point of stillness. Even though it is still, it is endowed with biodynamic power. This is the area of the potency for this strain pattern. This is a still-point within this functioning unit. A change takes place at this time that the physician records more with a sense of awareness that such a change took place rather than actually being able to feel it. Following this point a total new pattern manifests itself as the tissues create a new state of functioning. It is a more normal pattern of functioning as compared to the disability that was present at the beginning of the examination. Where does the second statement concerning the mind fit into this picture? The physicians mind becomes an observing tool, an analytical tool, an exploring tool, and an interpretive tool (p.158 159) that accompanies the sense of touch as it follows the changes that are taking place. One might say that the physicians mind alertly parallels the sense of touch throughout the diagnostic process just as a trained observer might sit at the sidelines of a visual contest and study the participants of that contest. However, here within this tissue functioning pattern, the physicians mind must follow deep within the patients body and go with the sense of touch as the biodynamic intrinsic energies manifest their own unerring potency in the pattern under examination. The biokinetic and environmental energies within the pattern provide the motive power, the sense of diagnostic touch follows the whole sequence of events from initiation through to what fulfillment is available for this one examination, and the mind observes, evaluates, and interprets the changes that are taking place. Because the physician has anatomical and physiological knowledge in his basic training, he is able to interpret his findings in biological language, in pathological language, in clinical language, and in anatomical-physiological language. He knows, for example, that it is a psoas muscle strain pattern he has been examining, or a consolidated lung, or whatever the pathology happens to be. By his sense of diagnostic touch he is

able to feel this dysfunctioning process as the body manifests it. With time and experience, the physician is able to read some of the past history of that disability, its present status, and prognostic evaluations for the future. This is interpretive mental skill. It is highly important to keep the mind alert and, at the same time, wide open to accept that which the tissues have to report rather than that which the physician hopes to find. Here again, let the tissues tell their story. The physician listens. With experience, an amazing amount of information comes through for interpretation. Despite the fact it sounds complicated and time consuming, it is not time consuming when one has learned the knack of securing the bodys cooperation. A lot can be learned within a five to ten minute period. That which has been called the potency in these papers cannot be described. It can be discussed. It can be understood. It can be used both diagnostically and therapeutically with the development of a sensitive knowing touch. It is a fundamental principle in nature and, certainly, the anatomical-physiology of the human body is part of nature. Any fulcrum is the site of the potency. A fulcrum has been described as a still-leverage junction over and through which action and reaction takes place. A fulcrum can and does shift from point to point, yet remaining still in its leverage functioning. The examples in nature that illustrate this functioning are multitudinous. The eye of a hurricane around which the cyclonic storm is manifesting itself is the fulcrum for that storm and contains the potency; the funnel of a tornado is centered by a still fulcrum area and yet that funnel moves across the land; the tides of the oceans ebb and flow twice a day and there has to be a fulcrum area somewhere in that fluid mass over and through which the tides operate. You can take a glass of water and by transmitting a fine vibration to it; it is possible to see the water form a pattern centering itself in the middle of the glass. This, too, is a still point around which the pattern of water is forming in response to the vibration transmitted to it. In all of these examples, it is important to realize that there is not only tremendous action taking place in the periphery around the fulcrum centers but that the potency in the fulcrum area is also part of this total kinetic energy pattern. These examples have been used because they point to the fact that there can be fulcrum points in masses of air and in liquids as well as the ones we commonly associate with solids, such as a teeter totter. In human anatomy and physiology there is a potency in all the fulcrums of activity within the bodys functioning and, like the world of nature in which this body is

operating, this functioning is providing its own motive power biodynamically. It takes skill, time, and patience to learn to feel this functioning: to learn to sense the movements, the motion, the mobility, the motility within tissues as initiated by these living structures (not that motion that as I as an operator can do to the body nor that motion which my patient may consciously do with his body but that motion which is already present as that patient lies quietly on the table): to learn to follow the patterns that are being expressed by living structures; to learn to recognize the fulcrum points or points within those patterns: to learn to be aware of the potency within the fulcrum points; to be aware of the moment that a change took place within the potency during the diagnostic or therapeutic examination: to learn to feel the unfolding of the pattern after going through the stillpoint; and to learn to analyze and interpret this material into sound physiological reasoning. Despite the complexity of trying to portray the development of a diagnostic touch in words, it is a relatively simple procedure in actual practice. Working through a fulcrum point which the physician has established after placing his examining hand upon or under the patient, he is ready to receive the information that is available within the ana-(p. 159 160) tomical physiology of the patients body, to read the biodynamic intrinsic forces at work within anatomical physiological mechanisms of the living body. For those who have followed the discussion up to this point there probably has developed a great deal of skepticism. There are two good reasons for such skepticism: it may seem that there is too much importance put on the need for the development of a diagnostic touch and that a diagnostic touch does not fulfill all that has been ascribed to its use. A sense of skepticism is a most valuable asset in this work. It serves to keep ones feet on the ground, so to speak. The physician is seeking information from the living body through his trained touch and he wants that information to come from the body itself. If he is totally skeptical to the fact that this information is available to him with the use of a diagnostic touch, he will receive very little information. If he will allow his mind to be open to the idea that such information is available with just enough skepticism to make the body prove that it is providing this information, then he will be in a position to more accurately evaluate that information. Let the body prove itself in demonstrating this functioning and dysfunctioning. It serves a useful purpose to be slightly skeptical. The importance and the degree of usefulness a diagnostic touch serves the physician will depend on the time and effort the physician takes to develop his diagnostic touch.

Can a diagnostic touch be called a scientific method of examination? The scientific method or test has been defined as one that can be reduplicated, repeated, and reproduced with the same end results in test after test on the same item under examination. In using diagnostic touch, we are developing one of the five senses of the physician. It is well known that the variability of different individuals in their use of any of the five senses, sight, hearing, smell, taste or touch, would be great enough to preclude the advancement of the idea that this could be a scientific form of examination. However, diagnostic touch is scientific. It is not the variability of the physicians ability that concerns us. It is the problem within the patient that we are seeking. The problem within the patient is going to be present regardless, whether he is examined by one physician or several physicians. If a group of physicians have prepared themselves to utilize this form of examination adequately, they will each come to the same approximate conclusion concerning the patients problem. I use the word approximate because successive examinations, one after another the same day, will modify the pattern of disability enough for each physician to get a slightly different picture. However, if this patient has a relatively subacute problem and the examinations are made with a time lapse period to allow it to remanifest itself each physicians findings will correlate with his colleagues. A diagnostic touch is scientific because the problem is in the patient, not in the physicians ability or inability to find it. The emphasis throughout this paper has been upon the development of a diagnostic touch. This is not to depreciate the effectiveness of the routine physical examinations and laboratory procedures. Both of these types of examination are scientific in nature and result in a detailed insight into the patients problem commensurate with the degree of skill of the physician to bring the patients problem into focus. Diagnostic touch is an added tool for use in understanding this patients problem. The physician is seeking to perfect himself in those arts and sciences that will help mankind, to diagnose their problems, to find therapeutic avenues through which to alleviate these problems, to bring back to the individual a state of health and normalcy within his body physiology. Why not go to that body physiology and ask it to explain itself to the physicians understanding? A few minutes additional examination learning to use a diagnostic touch in every case each time that patient comes to the office will perfect this form of examination for the physician. It will give him an insight into basic anatomy and physiology in greater detail than any other form of examination. It

will give him an insight into anatomical and physiological detail, in depth, within that specific patient that he has never experienced before. It will give the patient a sense of knowing that the physician is truly seeking the etiology for his particular case. It builds the patients confidence that his doctor understands his problem. It contributes diagnostic insight and therapeutic considerations for every patient for every visit. The time and effort it takes to perfect the art and science of a diagnostic touch is in keeping with the physicians goal in life, that of serving mankind.

DIAGNOSTIC TOUCH: ITS PRINCIPLES AND APPLICATION: PART Ill


ROLLIN E. BECKER, D.O., B.Sc. Dallas, Texas (AAO 1964, p. 161)

Part I of these papers was a discussion of the general principles of a diagnostic touch. Part II indicated the usefulness of a diagnostic touch. Part III will be a group of pictures demonstrating clinical application of a diagnostic touch. A physician has two jobs to do when a patient comes to him; one, to make a diagnosis of the patients problems, and secondly, to administer therapeutic aid for the problems. A diagnostic touch contributes to both of these procedures. When a diagnostic touch allows biodynamic intrinsic forces within to manifest their own unerring potency rather than the use of extrinsic force from without, the physician is securing diagnostic information of inestimable value to him in the care of that case. When a diagnostic touch allows biodynamic intrinsic forces within, to pass through their own unerring potency rather than the use of extrinsic force from without, the physician is securing a corrective process within the problem that leads towards health for that patient. At all times, the patient and his problem presents a challenge to the physician. In this work of using a diagnostic touch, the patient is the taskmaster. His problem is the schoolroom. His biodynamic intrinsic forces and their unerring potency are the teachers. The diagnostic touch of the physician, operating through a fulcrumpoint for each hand contact, is the pupil. Diagnostic touch involves learning to feel and understand the biodynamic intrinsic forces and learning to be aware of the unerring potency within them. I am asking the biodynamic and biokinetic forces and their potencies within the patient to report their findings to me through my fulcrum points. They do so without failure on their part. When there is a mistake made, it is my inability to read that which is going on and to interpret it correctly in sound physiological knowledge and reasoning. To begin an examination using diagnostic touch, I am going to get a careful history of the patients complaint. Then I am going to place my hand contacts in the area of the complaint, establish a fulcrum point for each hand contact, and initiate the pattern within the complaint area into action. This is done by a slight compression at my fulcrum points, not at my hands. The biodynamic and biokinetic intrinsic

forces within the patient will begin manifesting the pattern within the patient. These forces will go through a definitive and palpable cycle of operation towards the area of the potency for that pattern. It goes through the area of the potency, changing or modifying the power within the potency, this pattern has received the treatment that is available for this examination. Diagnostic-wise, I feel the intrinsic forces at work in the pattern going to the potency and the corrected pattern that follows the change in the potency through my fulcrum points; I am aware of the change that takes place in the potency area with my knowledge that such an area exists within the patient and the experience of having observed it happen many hundreds of times in many patients. This cycle of operation, from initiation through to the change that takes place within the potency, will vary from as short a time as one minute to several minutes, depending upon many factors within the patient. My attention, as a physician using diagnostic touch, is on the potency within this patient because I know that within the potency is power and many other attributes around which the disease state or the traumatic condition within the patient is manifesting itself. I know that if a change takes place within this potency a whole new pattern will manifest itself, usually towards health for the (p. 161-162) patient. I know there is some basic potency that can be found in the patient when he is in a state of health. I have found that when the various potencies that are present in traumatic or disease conditions have dissipated, there is a potency and a general feeling of biodynamic intrinsic forces manifesting themselves that tell me this patient is well again. In my own thinking, I differentiate between biodynamic intrinsic forces within human physiology and biokinetic intrinsic forces within traumatic conditions and disease states. Using diagnostic touch and exploring problems in a patient through my fulcrum points has taught me that when trauma or disease conditions are found, there are energy forces added to body physiology in order to produce and maintain the strained or pathologic state. This added energy I call biokinetic energy and each field of biokinetic force has within it a potency. When a corrective change takes place in this potency during a treatment, further normalizing changes take place between office visits. The next visit of the patient calls for a new evaluation of the problem. When the biokinetic intrinsic forces and their potencies have been dissipated, vcided (sic, voided), or whatever happens to them, the more dominant basic biodynamic intrinsic forces with its potency that

is health in the individual is the only one I can find. Diagnostic touch has taught me a great deal about functioning in anatomical physiological mechanism of the body. I seek the potency or potencies within the patterns I am examining and wait for the potency to come into focus within the problem and to go through the potency for the correction for this days visit. Diagnostic insight is gained with every visit for every patient. There seems to be only one way for the physician to learn to use diagnostic touch and that is to go to the problems within the patient and be taught by the problems. In the pictures that accompany this paper, the hand contacts and the fulcrum points described are merely suggestions. Every physician differs from another in his physical makeup and every patient is different. The development of a diagnostic touch with hand contacts and fulcrum points for each hand contact should be made in such a way that the physician is efficient in his approach to the problems within the patient. Personally, I find that much of my work in this field can be done with the patient supine on the examining table. I am seated comfortably in a swivel chair, with casters, that allows me to shift from one part of the patient to another or completely around the table, if there is such a need. Sometimes the patient is in a sitting position or he can assume any position that will allow the physician the best opportunity to utilize the biodynamic and biokinetic forces and the potencies within the patients problem. If you were to watch me doing my work in this field, you would see about as much motion on my part as you observe in the pictures. I am not in motion. I am following the micrometric levels of motion that are within the patterns I am observing. To my diagnostic touch, there is considerable degree of movement, mobility, and motility manifesting itself through my fulcrum points. The sensitive perceptive patient is also conscious of this movement although the relatively insensitive patient will not be conscious of it. I use a firm but gentle hand contact that allows the forces within the patient to express their full potential of activity. If I need a firmer hand contact or a deeper impression from within the tissues, I increase my compression at the fulcrum points, not at the hand. A lighter hand contact or a more superficial impression from the tissues calls for a lighter degree of compression at the fulcrum points. I am shifting from one part of the body to another, cephalad or caudad, as I follow the interrelationship and intrarelationships of the biodynamic and biokinetic energies and their potencies as they move from one part to another. I may travel the full length of the body and

back again in an overall problem such as a whiplash injury or I may spend the entire examination and treatment time at one relatively small area in a more localized case. The biodynamic and biokinetic forces and their potencies will dictate to my diagnostic touch and interpreting mind the work I am to do for the patient on this given visit. These same forces will also dictate the time I am to take to complete the examination and treatment. As was said before, my examination usually begins with a case history and an exploration of the area of the chief complaint. In this series of pictures, a patient will be examined from the sacrum through to and including the cranial mechanism. The upper and lower extremities will not be shown or discussed at this time. Fulcrum points are marked with a white . The patient is supine and his sacrum is in the palm of the physicians right hand with the finger tips on the spinous process of the fifth lumbar vertebra. The fulcrum point is at the right elbow leaning on the table. The knees of the patient are up although the legs may be outstretched or one knee up and the other one down. The left arm and hand of the physician are bridging the anterior superior spines of the ilia. Fulcrum points are shown at both ilia because the (p. 162 163) physician may alternate his use of one or the other anterior superior spine as a fulcrum point in examining the opposite ilium in its functioning relationship with the sacrum. This position for diagnostic touch gains understanding from the pelvis as a whole, the sacrum, the ilia, and the interrelationship of the pelvis with the lumbar area above and the acetabular regions below. This is an excellent position to evaluate the functioning of the sacrum in whiplash cases.
Picture No. 1: Sacrum and pelvis.

Picture N o . 2: Sacrum i l i o -sacrum, l o w e r lumbar.

The right hand is under the sacrum and the fulcrum point is at the elbow on the table. The left hand is under the ilio-sacral articulation with the finger tips on the lower lumbar spinous processes. The left fulcrum point is on the crossed knee of the physician. Good control for diagnosis and treatment of the ilio-sacral and lower lumbar strains is afforded by this position, using the forces within the problems found to do the work.

Picture No. 3: Upper lumbar and psoas muscle.

The examining hand is under the upper lumbar area and the fulcrum point is on the physicians crossed knees. The other hand and arm are bridging the drawn up knee. A lighter compression at the fulcrum point will give an evaluation for lumbar strains as the sacrospinalis group of muscles are more superficial than the deeper lying psoas muscle. An increase of compression at the fulcrum point will reach into the psoas muscle area. The bridged knee contact is to compress the acetabular areas with the weight of the arm and hand so as to further

can be observed that the normal excursion of the sternum during inhalation and exhalation has reasserted itself. Upper thoracic strains are readily found and easily corrected in this position, using the biodynamic and biokinetic forces and potencies within the patient. Picture No. 6: Rib cage The right hand is under the rib cage with the finger tips just beyond the spinous processes of the thoracic vertebra for the ribs under examination. The rest of the hand is following the course of the rib or ribs. The fulcrum point is on the physicians crossed knees. The left hand is on the anterior ends of the ribs being examined and the fulcrum point is at the forearm or elbow resting on the anterior superior spine of the ilium on the same side. Slight compression at the fulcrum point on the crossed knees initiates motion into the heads of the ribs being examined. Rib strains are easily diagnosed and as easily treated, comfortably for the patient and physician, using intrinsic forces and their potencies within the strain patterns. These hand and fulcrum contacts can be moved up or down the rib cage to find the area of strain and to do the work of diagnosing and treating them. Picture No. 7: Liver The left hand is under the lower ribs beneath the liver. The fulcrum point is on the crossed knees of the physician. The upper hand is over the anterior surface of the liver. This position can be used to examine a sick liver, such as hepatitis. The biodynamic and biokinetic disturbed forces and their potencies are readily transmitted through the fulcrum point on the crossed knees to the physician. This (p. 164 165)

same type of contact can be used for localizing a consolidated lung in lobar pneumonia by moving the hand contacts posteriorly and anteriorly over the suspected lobe of the lung and setting up a fulcrum point through which to read them.
No. 7

The physicians hands are bilaterally bridging the entire cervical area from the base of the skull to the upper thorax. The fulcrum points are at the forearms resting on the table. The arrow points to the one not seen. The cervical area as a whole can be quickly evaluated and then more local finger contacts can be made for the specific cervical vertebra desired, always keeping the forearm fulcrum points on the table. Occipitoatlantal articulation a finger contact is made against the posterior tubercle of the atlas. The fulcrum point is at the forearm on the table. The other hand is on the vertex of the patients head maintaining a slight flexion of the head. A slight compression at the fulcrum point initiates any pattern or strain in the occipitoatlantal articulations and the intrinsic forces and their potencies will carry the strain pattern through what correction is available for this days treatment. Picture No. 9:

Picture No. 8: Cervical area

Picture No. 10: Basilar area of the skull

The head of the patient is resting comfortably in the lightly interlaced fingers of the physician with the thumbs extending above the ears towards the forepart of the head. The fulcrum points are at the forearms on the table.

A slight compression at the fulcrum points is all that is needed to start an evaluation process that includes the structures of the cranium, within the cranium, the basilar areas of the skull, and the cervical areas. An overall sense of continuity of all the midline structures from the base of the skull to the sacrum can be felt. This was the position used to diagnose and treat the concussion in the lady described in Part II. This brief analysis and descriptive text merely indicates the potential for the use of a diagnostic touch. Every existing degree of health, trauma, or disease in anatomical physiology can be examined by a diagnostic touch by modifying (p. 165 166) hand contacts and the fulcrum points throughout the anatomical physiological mechanisms of the lower extremity, pelvis, abdomen, and thorax, upper extremity, cervical area and cranium. Diagnostic touch is a form of objective communication from the problems within the patients body through to the physician. Diagnostic touch and therapeutic touch are added tools for diagnosis and treatment, not the only ones to be used in the care of the patient. However, knowledge gained from diagnostic touch through the months and years will lead to greater understanding of all patients, both in diagnosis and treatment results. The physician will find himself learning to place more and more reliance on the use of these tools in his daily practice. Clinical results have verified the validity of the principles and application of a diagnostic touch as discussed in these papers. Finding words to describe the potency and the biodynamic and biokinetic intrinsic forces that do the work for the physician has been most difficult. It is suggested that each physician apply these principles to the problems within his patients and let the results speak for

themselves. The patients will be most grateful, I can assure you. Something is being done directly to and for their problems. Biodynamic intrinsic forces are available for use, the basic potency that is always present in the patient in health or trouble is available for use, biokinetic intrinsic forces are available for use, and the potencies for every traumatic and disease condition are available for use. Diagnostic touch and therapeutic touch are available for every physicians use.

DIAGNOSTIC TOUCH: ITS PRINCIPLES AND APPLICATION: PART IV TRAUMA AND STRESS
ROLLIN E. BECKER, BSc., D.O. Dallas, Texas (AAO 1965 Vol. II, p. 165)

The basis of science is observation, writes George Gaylord Simpson (1) in an article, Biology and the Nature of Science. He goes on to define science as Science is an exploration of the material universe that seeks natural, orderly relationships among observed phenomena and that is self-testing. Later on in this valuable manuscript he states, In fact, the life sciences are not only much more complicated than the physical sciences, they are also much broader in significance, and they penetrate much farther into the exploration of the universe that is science than do the physical sciences. They require and embrace the data and all the explanatory principles of the physical sciences and then go far beyond that to embody many other data and additional explanatory principles that are no less-that are, in a sense, even more - scientific. And again, The point is that all known material processes and explanatory principles apply to organisms, while only a limited number of them apply to nonliving systems. Finally, in discussing the unification of all sciences, living and nonliving, he makes the statement, I suggest that both the characterizations of science as a whole and the unification of the various sciences can be most meaningfully sought not through principles that apply to all phenomena but through phenomena to which all principles apply. Even in this necessarily summary discussion, I have, I believe, sufficiently indicated what those latter, phenomena are: they are the phenomena of life. BIOENERGY FIELDS In discussing Trauma and Stress, the facts and suppositions submitted in this paper will be based on, The basis of science is observation by touch. Through the years, I have learned that there are bioenergy fields of activity within body physiological functioning and that it is possible to learn to feel these bioenergy fields, to analyze them, to interpret them, and to re-evaluate them in anatomicalphysiological terminology for diagnosis and treatment. This trained touch has aided me materially in supplementing my sense of sight and hearing and the routine laboratory tests in evaluating the physical problems of my patients. The methodology for developing this sense of touch is as follows: When a physician places his hands upon or under a patient, he not only is feeling muscles,

ligaments, bony structures, organ systems, and their fluid contents, he is also feeling energy at work within all of those systems. There are bioenergy, fields of activity within the human body throughout life. There are a number of subdivisions And kinds of bioenergy fields, biomechanical, biochemical, bioelectrical, biodynamic, biokinetic, and others. I suspect that Dr. Selyes reactions can be added to this list. Bioenergy is a term that can be used to cover all of them. Bioenergetics is defined by Dorlands Medical Dictionary (2) as, The study of the energy transformation in living organisms. Within these bioenergy fields is a potency, a focus or fulcrum point around which these (p. 165 166) fields operate. I define potency as a functioning point of stillness, a fulcrum point, within the bioenergy field in body physiology over, around, and through which these patterns of activity are manifesting themselves. It can be compared to the functioning fulcrum point of a teeter-totter board or the eye of a hurricane. It has energy and power within itself. In order to use and interpret this bioenergy field within body physiology, the physician needs a fulcrum point of his own. The patient is lying supine upon the table and I am seated beside him. I place my hand under or on a patient and then I establish a fulcrum point by placing my elbow or arm upon the examination table, upon my crossed knees, or some portion of the patient. Compression at my fulcrum point, not at the hand contact, will initiate the bioenergy fields within the patient into action. Let me clarify this point of compression at the fulcrum point and not at the hand contact. When we think of a lever operating across a fulcrum, applying power downward at one end of the lever automatically lifts the other end of the lever upwards. This is not the lever mechanism I am describing in applying power or compression at my fulcrum point. My hand contact is not lifted upward into the patients body. My hand contact is gentle but firmly in contact with the patients body and I apply compression or power directly downward at my fulcrum point in proportion to the degree of strain or stress I feel in the tissues. The hand contact continues to be firmly but gently in contact with the body physiology of the patient. If a man were to have picked up a 100 pound sack incorrectly, I might be applying considerable pressure downward at my fulcrum point to counterbalance this 100 pound lift strain but I would not be pushing my hand contact with the same degree of intensity. To do so would destroy the sense impressions being received from the bioenergy fields within the patient, Try it both ways and learn for yourselves.

When I have my hand in the area of one of the patients complaints, I will feel these bioenergy fields go through three phases of activity: (i) It feels as if these energy fields and tissue elements are working their way, within their pattern, towards the point of balance for that pattern. (ii) A functioning still point, the potency, is reached at which time all motion apparently ceases, relatively speaking. Up to this time the physician is able to follow the changes within the energy fields and tissue elements through his hand contacts and fulcrum points and thus gain diagnostic insight concerning the patients problem. When the pattern goes through the functioning still point, a change takes place within the potency. Something happens as a result of this change in the potency. This is the corrective phase of a treatment program. (iii) Motion is again felt within the bioenergy fields and tissue elements. The pattern that unfolds is one that indicates a more normal pattern of functioning for the disabled area. These three phases can take as short a time as one minute to complete their cycle or it may take several minutes depending upon the degree and intensity of the pathological-physiology involved. This, then, is the manner with which I have learned to use the bioenergy fields within the body physiology of each patient for the diagnosis and treatment of his health, traumatic, or disease conditions. I have learned that these fields of force within the patient are always in action. The tissue elements, the muscles, ligaments, bony structures, the organ systems within their connective tissue envelopes, and their fluid contents, automatically go along for the ride as the bioenergy patterns unfold in their functioning. I have to get out of the way, so to speak, and follow the bioenergy patterns. It is similar to an accompanist in a concert. A good accompanist follows the singer he is playing for and lets the singer take the lead. In using the fulcrum-compression approach, the physician initiates the bioenergy factors within the patient through his fulcrum compression points and lets the pattern within the patient take him through its cycle of activity. The result of this type of observational touch is the foundation for the findings discussed now in trauma and stress as manifested by the phenomena of life in human physiology. When I have my hand in the area of one of the patients complaints, I will feel these bioenergy fields go through three phases of activity: (i) It feels as if these energy fields and tissue elements are working their way, within their pattern, towards the point of balance for that pattern. (ii) A

functioning still point, the potency, is reached at which time all motion apparently ceases, relatively speaking. Up to this time the physician is able to follow the changes within the energy fields and tissue elements through his hand contacts and fulcrum points and thus the validity of the bioenergy approach has proven itself clinically through many years. It cannot be proven in the laboratory sense but it does fulfill the requirement of one of Simpsons (1) injunctions in a definition of science, i.e., it is self-testing. I am able to recheck each patient each visit in order to re-evaluate my previous findings. The bioenergy fields within the patient provide the motive power and the patterns of activity for my interpretative analysis. More detail and understanding of this approach in diagnosis and treatment can be found in articles listed in the bibliography. (3,4,5,6,7) The problems of trauma and stress in human physiology are so complex and wide reaching that it will be possible to cover only a few points at this time. The physical care (p. 166 -167) of the abrasions, cuts, penetrating wounds, fractures, hemorrhages, bumps and bruises are superficial in comparison to the deeper underlying factors that occur to the patient within his body physiology. My patients come to me after all of the acute phases of their injury have been handled and they are still in a disabled state. It is the impact of the effects of the trauma and stress upon their specific and general state of health through the days, months, and years that brings them to me for attention. That old football injury in college is going to bring the mid-forty year old man into my office for back trouble twenty years after the initial injury. The auto accident six months, six years ago, or whenever it occurred has left damaging effects for which the patient is seeking a more accurate diagnosis, and, certainly, a more corrective treatment program. A.T. Still (8) said, Cause and effect are perpetual. Cause may not be as large in the beginning in some cases as in others, but time adds to the effect until the effect overbalances cause, and the end is death. Death is the end or the sum total of effects. I only ask of the reader to carefully note the different and continued change in effect as additional elements enter the contest and give effect the ascendancy. In light of this understanding, there is no such thing as a chronic case. There are only acute problems in various stages of compounded effects whether the injury occurred today, yesterday, or over a longer period of time.

Assuming that the acute phases of the trauma have been cared for, I am going to use the bioenergy fields within the patients body physiology through my trained sense of touch and the following factors have been demonstrated to me from within the anatomical-physiology of my patients: (i) there is a bioenergy field of wellness or health within human physiology, (ii) there are added force factors to the basic bioenergy of health in trauma, (iii) there are stress factors in trauma, and, finally, (iv) a formula can be written to express health and the addition of these force factors in trauma and stress. BIOENERGY FIELD OF WELLNESS OR HEALTH The bioenergy of wellness is the most powerful force in the world. It is a force field that begins with the moment of conception and continues to the last moment of death. We are continually told that the body has the capacity to heal itself and we accept this statement intellectually but we do not attempt to analyze it or do anything about it. Our laboratory and instrument tests give us only a superficial report. The high and low values for normal functioning in the tests are not specific enough. It is possible to literally feel the bioenergy of health at work within our patients. In order to clarify this point, let us re-examine man and his environment for the moment. A mans body is his tool for his walk about on earth. It is a self-contained mechanism, gifted with a state of homeostasis for the stabilization of his internal environment to maintain health and to handle disease, traumatic, and stress situations. He is surrounded by an external environment from which he gets the necessary basic requirements to keep him alive, air, water, food, etc. He is in constant interchange with his external environment physically, mentally, and emotionally. This external environment extends from his immediate surroundings to the farther reaches of the universe. Why, then, separate them, the internal and external environments? Instead of the terminology, man and his environment, it can be written man-environment. Another term for man-environment is biosphere. Dorlands Medical Dictionary (9) defines biosphere as, The sphere of action between an organism and its environment. The bioenergy fields of my patients have demonstrated this biosphere-bioenergy field interrelationship to me.

The bioenergy field of health is a palpable sensation to the examining hands of a physician operating through his fulcrum-compression points. It is a rhythmic feeling of interchange between the patients body and his biosphere in which there is a total interchange without any areas of restriction, impaction, trauma, or stress. It is a feeling of total internal and external environmental capacity to express wellness. It is the end point of a physicians treatment program. When the physician can sense that the patient and his biosphere are interchanging harmoniously, he can discharge that patient with the assurance that he is healthy again. This is not a verbalization from the patient that he feels fine, that his laboratory tests prove negative, but rather this is a literal sense of wellness felt by the physician through his own hands under or upon that patient through his trained sense of touch. There is a bioenergy field of wellness for each individual. It varies continuously from baby hood to old age. Every man, every woman, every child has his individual pattern. (p. 167 168) I have a young woman patient who has suffered for years with an ileitis and her health pattern of normalcy would certainly differ from a lady athlete of the same age. I have observed this young ladys bioenergy field return itself to its normal pattern and I have a working knowledge of her normal pattern to which I can refer when she comes in for future disabilities. The frail little old man of 85 years of age with his tired body would be different from his neighbor of the same age who still does his own gardening and yard-work. As stated before, this bioenergy field of wellness is the most powerful force in the world. It is dynamic. It is rhythmic. It is a quiet feeling of total interchange with the universe in which it lives. It is a force that can be called upon, through compression at the fulcrum points of the physician and thus invoked into action, along with the force factors added in trauma and disease in a diagnostic and treatment program. It is important that the physician learn to feel for this bioenergy of wellness when he examines his patient. If this thought is new to you, teach yourself to recognize it and feel it by treating your patients for the disabilities that brought them to you and, when they have recovered from their problems, sense the wholeness of the individual in his biosphere before you dismiss him. You will develop your understanding of the sense of the bioenergy of health for that individual. I have learned to sense through the mere body physiology of the patient lying on my examination table to include the biosphere of his total being each time I see him in my office. This includes the bioenergy

field of his wellness, added force factors in his disabilities, and his biosphere, in other words, his total bioenergy field for several feet around him. It is an observational fact that the physician can feel so much more happening within body physiology if he will include the biosphere that surrounds the patient. Because the bioenergy of wellness is the dominant field of energy within the patient since the moment of conception, it will be the field of energy that is his to enjoy when his pattern of health is restored. The other factors, force factors, etc., will be returned to whence they came to his man-environment and only his bioenergy of wellness will be manifest. Learn to read it within the individual and use it whether you understand it or not. It is present and can be used. The whole man, then, a term used in modern physiological understanding, must include internal and external environmental factors on a physical basis through development of the physicians sense of touch for interpretative analysis to be complete. FORCE FACTORS PLUS BODY PHYSIOLOGY IN TRAUMA Man and his external environment have to be considered in their wholeness in discussing trauma. It takes force from without to create trauma within body physiology and some of this force is left as a part of every traumatic experience within body physiology. Mans body absorbs some of these force factors and this force becomes part of his being within the traumatic area and, in part, throughout his total body. I would like to discuss this phase of trauma under four headings: (a) the whole man, chronologically speaking, (b) memory reactions within body mechanisms, (c) matter and energy are interchangeable, (d) bioelectric energy factors in bone injuries, and (e) notes on treatment programs in traumatic cases. The Whole Man The whole man has to be considered not only from a physical basis of his present complaints and disabilities but also from a chronological standpoint of the time that bioenergy factors have been present within these disabilities. Added force factors, which I will call biokinetic energy, have come into this mans body physiology through traumatic injuries. Some of these force factors remain as part of his body physiology. Otherwise, these biokinetic energies would have totally

dissipated back to his external environment and only the bioenergy of wellness would remain. These added force factors can be admitted to the body from injuries that begin before birth, during birth, trauma in childhood, through adulthood to old age. It is possible to feel the chronicity or the acuteness, in time, of injured areas. To illustrate, a woman came in with a history of severe headaches for two years. A diagnosis was made of a basilar compression in the base of the skull as the effective mechanism for the headaches. Yet the problem did not seem to be originating with basilar compression. Examination at the pelvic level revealed a hard compressed sacral strain mechanism of many years standing. When asked about an injury in this area, she told of a hard fall on the sacrum thirty years earlier at which time she saw stars. The blow on the sacrum was transmitted through to the base of the skull. Correction of the sacral concussion released the tension of the basilar mechanism and the headache patterns (p. 168 169) disappeared. The point is that the problem felt, literally, as if it were many years old and the bioenergy factors, both that of health and the biokinetic factors, gave that information to the examining physician. The injury that occurred last week has a recent tone quality of being only a week old. The bioenergy and biokinetic force factors give that information. This is why using bioenergy factors for diagnosis is so valuable. One does not gain all of this insight in the initial visit and examination but each visit unfolds a deeper understanding as the force factors within the injured areas come through with diagnostic information. Since these force factors are not part of the normal bioenergy of health coming into body physiology from the external environment, it is natural that the body physiology of the patient is constantly attempting to dissipate these biokinetic energies back to the external environment. Compression at the fulcrum points of the physician with his hands on the injured areas invokes these biokinetic energies into action along with the basic bioenergy of the patient. They go through the three phase cycle of correction described under methodology and the biokinetic energies do dissipate back to the external environment in part or in whole. How? I do not know. Does it happen? Yes. I have felt it dissipate hundreds of times in many cases. It may take weeks to secure a total corrective change in an old injury. It can take only a few minutes in a mild recent strain. In evaluating the whole man, then, consider him in depth of time as far as the disabled tissues are concerned as well as in the three dimensions of his being on the examination table.

Memory Reactions Memory reactions occur within the central nervous system in traumatic cases. All parts of the body are supplied by the nervous system, sensory, motor, and trophic nerves. An area of the body that has been seriously hurt is going to send thousands of sensory impulses into the spinal cord segments and brain areas that supply that part of the body. If the injury is severe and long lasting, these messages will be imprinted into the nervous system similar to imprinting a message on a tape recorder. After the local injury has finally healed, the nervous system does not necessarily give up its imprinted record. It tends to remember the disturbing message and becomes a facilitated area of dysfunction long after the accident. Speransky (10) proved this in his experiments. He states, Chemical and inflectional trauma of nerve structures result in nervous dystrophy; this, in its turn, gives the impulse for the development in the tissues of other kinds of pathological change, including those of an inflammatory character. Their disposition at the periphery can be predicted by us in advance, and their boundaries remain unchanged, often throughout long periods. He changed these imprinted messages by manually flushing or washing the central nervous system with the animals or humans own cerebrospinal fluid and the disabled condition in the peripheral tissues normalized. In my own practice, I have observed this same phenomena many times. A man who had a very seriously smashed left leg, which took months to knit back together, gave the impression at his lumbar area of his spinal cord that it was in a state of shock as a result of the accident. The bioenergy field for this area felt abnormal. He experienced a considerable sense of chilling in his lower extremities even though his leg had healed. When the lumbar area renewed its normal bioenergy factor of health through corrective treatment, this sensation disappeared. This was also true in two other cases for different reasons. One was a case in which the patient was thoroughly chilled in his lower back and developed a bilateral psoas muscle strain pattern that resisted treatment until the lumbar enlargement of the cord was brought back into its normal bioenergy pattern. Another case was one in which toxic effects of a series of twenty-eight rabies shots into the rectus muscles of the abdomen had affected the spinal origin of their nerve supply.

I have learned it pays to consider the segmental origin of any traumatic condition in a treatment program by using any of the cerebrospinal fluid fluctuation techniques to give the central nervous system within the cranial and spinal mechanisms a normalizing action to wipe out old imprinted messages from disabled areas. The cerebrospinal fluid fluctuation techniques developed in the cranial concept are certainly far more physiological in their functioning and far less traumatic than those developed by Speransky in his work. The fact that the imprinted dystrophic processes within the central nervous system are voided or dissipated to allow the normal physiological processes of the nervous system to reassert themselves is merely one of the many benefits derived from the use of these fluid techniques. What does an area of the spinal cord seg-(p. 169 170)ment feel like when it is imprinted with nerve impulses from a disabled area? The only way to find out is to examine a case who comes in with a history of a severe injury. Go to the segmental area of the spinal cord supplying that part, place the hands above and below the area involved, i. e., posterior and anterior contacts, establish fulcrum points, apply compression at the fulcrum points, and feel the change in the bioenergy fields within the area being examined. Compare it each succeeding visit as it normalizes in a treatment program. It is a distinctive change in tone quality just as there is a distinctive change in tone quality in the tissues at the site of trauma in comparison to adjacent normal areas. Once it is felt and understood, it becomes more easily evaluated in subsequent cases. Tissue memory changes are a part of traumatic experiences. I am convinced that clearing up these memory areas of the spinal and central nervous systems by dissipating the biokinetic fields back to man-environment materially speeds the recovery in any traumatic case. Matter and Energy Matter and energy are interchangeable in body physiology-biosphere interrelationships. This was demonstrated to me very clearly in one specific case and since then I have wondered if it could be proved in many other cases if we developed the right instrumentation. The case in question was a lady who had a serious impaction in the cranial, cervical, upper thoracic, and pelvic mechanisms of her body physiology. She came into the office one day and weighed herself just before a treatment. She weighed 107 pounds. During the treatment, one of many leading up to this particular day, a corrective change took place under my hands and I was able to feel many changes in the bioenergy fields within all areas of her

complaints. It seemed as though the total pattern came to a focus, a still point was reached for the whole mechanism, something happened, and then an unfolding process was manifest as though all bioenergy fields were assuming normalcy again. The total treatment time was about twenty minutes. She stepped on the scales again immediately after the treatment and her weight was 104 pounds. Where did this weight loss of three pounds disappear? The only interpretation I have is that it went back to the surrounding biosphere from whence it came, her total pattern of disability for that given problem was gone and it has not returned in better than fifteen years. I do not have an explanation for this phenomena and can only report it. It is my opinion that there are added force factors in traumatic injuries. Is it possible that this also means an increase in weight within these individuals at micrometric levels of measurement in minimal cases and in a more gross level of measurement in more severe cases? A whiplash injury is a severe injury involving the whole person in many cases. Would it be possible to measure the difference in the exact weight of that individual before and after the accident and detect a difference? If every patient were weighed before each treatment and again afterwards, when an overall correction of his total disability pattern made a change, would there be a significant change in his weight? I have not tested this concept for many reasons. I do not feel the average physicians scales are sensitive enough for relatively minor problems in traumatic cases and it is unpredictable as to when all of the bioenergy fields and biokinetic fields within any given trauma are going to come to a focus and release the total pattern back to the bioenergy field of wellness. It would be at this time that a significant change in the weight of the patient would indicate that matter and energy are interchangeable between body physiology and man-environment. It is far more common in a treatment program for bioenergy and biokinetic energy factors to come to a focus with a corrective change between office visits. This would make it very difficult to measure any weight change within the patient before and after the total corrective change within their bioenergy fields. It still leaves the question to answer, does man-environmental energy as force factors become matter when introduced into body physiology in traumatic conditions and do these traumatic conditions return biokinetic energies to man-environment by changing matter into energy during a corrective change to wellness?

I offer this idea of a weight differential for your considered evaluation. I feel it has merit but I have not proved it, except by accident, in this one case. When a physician is working with bioenergy fields between body physiology and manenvironment in the phenomena of life scientifically, he is dealing with factors for which there has not been devised laboratory instrumentation up to this time. The fact is that bioenergy fields in wellness, trauma, and stress as defined by the trained sense of touch are personal experiences for each physician. It can be duplicated and retested by each physician in his own practice but the lab-(p. 170 169)- oratory has not been brought into active participation in this field in more than a mere fringe of its potential. Bioelectric Energy One area in which the laboratory has been brought into active participation is that of the bioelectric energy fields involved in bone injury. Modern Medicine (11) reports, Biological electrical fields, long considered only by-products of chemical activity in the body, now appear to be intimately associated with the functioning of human and other organisms. Pioneers in the new discipline of electrobiology foresee applications in human medicine: the promotion of wound healing, production of anesthesia, and study of mental disease. One of the first investigators in electrobiology, Dr. Robert O. Becker, has shown in experimental animals that bioelectricity is produced as direct current and is carried throughout the body by the nervous system. The previously unknown mechanism of current production is similar to that of the semiconductor mechanism of the transistor. In certain tissues bioelectricity apparently plans an important role in wound healing and regeneration. Dr Beckers investigating group also has shown that chemical anesthetics halt the flow of current through certain parts of the brain. Similar levels of anesthesia were produced in animals by counteracting the normal bioelectrical current with another, artificial, current or with strong magnetic fields. The magnetic field of the earth itself seems to have some effect on the bioelectrical currents in the brain. The group gathered evidence to indicate that human beings are affected by disturbances

created in the earths magnetic field by so-called magnetic storms on the sun. Working with Dr. C. A. L. Bassett, Dr. Becker demonstrated that bone fractures and bending stresses applied to bones produce electrical currents by means of a semiconductor mechanism made up of two parts of bone tissue. The current passes only in one direction and apparently has the function of causing the growth of new bone in the proper amount and position to promote best healing. This field of bioelectricity is listed as a new frontier and the information concerning it was released in 1962 with the added footnote that a previous study was made in 1957 by E. Fulcada and I. Yasuda (12). Similar results were obtained by both groups and served to corroborate each others findings. It indicates that bioenergy fields, whether they be bioelectrical biochemical, biomechanical; or otherwise are relatively new in research work. The potential for future investigation is challenging whether by a developed sense of individual touch, instrumentation, or laboratory testing. The future is promising in all fields as long as each process offers a means of self-testing for each given case. In the last analysis, it is the individual who determines the result, not the instrument. Notes on Treatment Programs A program wherein the physician uses bioenergy factors in human physiology as the motive power for diagnosis and treatment poses problems not encountered in the usual manipulative approach or in physiotherapy. I would like to discuss a few items in the treatment program of trauma using bioenergy factors. I used the manipulative approach taught to me in school for ten years and had good results. I switched over to the use of the motive bioenergy field approach with far superior results. With the manipulative type of treatment, I would treat a given problem in several cases and some would make more normalizing changes than others. I could not accurately determine why they didnt all make a satisfactory change because my manipulative work was adequately given in each case. With the bioenergy treatment program in the same given problem cases, the motive energies within the patient do the work in all of the cases and it takes about one half as many office visits to secure the desired result. The degree of the bioenergy of wellness is at a higher level of functioning in comparison to

manipulative cases when the case is dismissed. The patient is able to stay away for longer periods of time between new injuries or a breakdown in his compensatory pattern. Finally, I am able to understand the progress of his case throughout the treatment program and can understand why the ones who do not make a good recovery are responding poorly. There is a much higher percentage of recoveries with the bioenergy program than with the manipulative approach. Whether you call it concentration or decentration, the problem for the physician is to observe with his sense of touch the bioenergy of the patient manifesting its diagnostic and therapeutic powers. I had good results with the bioenergy treatment program from the very beginning of its use after the switchover from the manipulative approach but it took a three to five year period for my sense of touch to develop to a degree that I could rely upon it. This (p. 171 172) of was true for two reasons, I had to unlearn old habits of trying to do something to body physiology as in a manipulative treatment and I had to learn to understand the interplay of bioenergy factors working within my patient through my sense of touch. At the end of a five year period, when the concept of using bioenergy became a sense of reality, I became an expert. I could evaluate diagnostic information and predict potential treatment results. Another five to ten years of using the bioenergy approach found me constantly re-evaluating the diagnosis given to me by the bioenergies of the body and reappraising the prognostic data. This could be called a re-evaluation period. Now, after twenty plus years of doing this work and better than 40,000 patient visits, I am in a wonderment period, wonderment over the information I am receiving in both diagnosis and treatment results and wondering what else there is to learn in using these bioenergy fields. Since anyone observing me doing this work does not see me in motion and since the patient is not in apparent motion during a treatment program, it has been suggested that it is a mere laying on of hands that does the work. I have been told dozens of times by the patients, All he did was to lay his hands under or upon me and, for some reason or other, my condition improved, or words to that effect. There is no justification for these statements. The best way to explain it is to illustrate with an acute case and then to discuss some of the things that happen in more chronic problems. Suppose a man lifts an 80 pound sack of fertilizer out of the rear end of his car incorrectly and the next day finds himself with an acute low back pain and muscle

spasms. He comes into the office, gives his history, and lies down on the examining table in the supine position. I am seated beside him and slide my hand under the area of his lower back where his complaint is most marked. The other hand and arm are resting on top of his flexed knees. I apply compression at a fulcrum point at my elbow resting on my crossed knees for the hand under his lower back. The weight of my other arm on his flexed knees is enough compression back through his thighs and hips to aid the fulcrum compression point of my elbow on my knees. Since this was an 80 pound sack of fertilizer, I find myself leaning with an approximation of that 80 pound lift at my fulcrum point on my knees. My hand contact under his back remains relatively intact but it is not pushing against his back because of a leverage at my fulcrum point. It is registering the amount of compression at my fulcrum point and this in turn is being registered by the tissues in his lower back and its strain area. The biokinetic energies within the strain pattern are invoked into action and go through a three phase cycle or pattern of response using their own inherent energy along with the bioenergy of his total body physiology. The pattern of their activity gives me the diagnostic information that I interpret as the fact that he has a rotation compression strain at the level of the fourth lumbar on the fifth lumbar and that there is considerable muscle spasm in the psoas muscles on each side. The pattern continues to evaluate itself to me by reaching its focus, coming to a still point, going through a point where something happens within the potency, and finally unfolding into a corrective normalizing change within all structures involved. The total treatment time varies from five to fifteen minutes. The patient gets off the table considerably relieved and is back to normal in the next few hours or day or so if his tissues have not been too seriously damaged. According to the patient, I did not do much. He felt changes within him during the three phase cycle of operation, but this is not always true. An outside observer may say I did nothing for he did not see me or the patient in motion. But had the patient or the observing friend put their hand between my elbow and my fulcrum-compression point on my knee, it would have been a different story. I was applying enough compression to counterbalance the 80 pound fertilizer sack, enough compression to match the biokinetic force factors added to his body physiology to produce this strain pattern. When I matched this force within the patient, the bioenergy factors within went to work with their maximum level of efficiency to return the biokinetic force factors back to his biosphere and the

pattern that was left was that of the bioenergy of wellness for the patient. I have leaned so hard on my fulcrum-compression points in some cases I have bruised myself. The patient does not feel it because in counterbalancing the forces within him, I have voided the sensation of the factors involved within his strain pattern. All he feels is the relief obtained by matching or countering the energies involved. It is far more than a mere laying on of hands. It is a knowledge of body physiology, bioenergies, biokinetic energies, and the scientific application of many factors for each case each time it is used. Deeper seated problems, the so-called chronic cases, respond equally well to the use (p. 172 173) motive bioenergy factors. The time interval involved from the onset of the problem and the intensity of the pathology until they consult you has a great deal to do with the progressive corrective results you obtain. The first one, two, or three treatments may blow off a number of surface symptoms and the patient reports he is feeling better, although to your trained touch through your fulcrum points and hands, the tissue strains feels as though very little improvement has taken place. The symptoms return and the patient is sometimes disturbed. In actuality, the tissues had never really made as much change as they indicated to the patient. Sick tissues coming through to make corrective changes do not do so with a sense of relief. They begin their corrective changes by complaining that they are now invoked into action and express themselves as symptoms to the patient, not exactly as the patient usually experiences them, but as a varied pattern of those symptoms. Gradually, as the pattern of bioenergy factors and biokinetic energies and tissue elements can come toward the focus for the total pattern, there is an overall sense of accomplishment within the patient, felt by him symptomatically and by the physician through his examining hands and fulcrum points. Finally, comes the day, usually between office visits and occasionally during an office visit, when the bioenergy patterns of wellness take the ascendency within the patient and he makes a positive change for the better. His biokinetic energies from his traumatic pattern dissipate to his biosphere to the maximum potential for the time he has been under treatment. He may be only in a re-compensated stage of recovery but it is a better re-compensated state than he has ever experienced before. If he is dismissed at this time and comes back weeks or months later, his body physiology will show the continued effort of his tissues to restore themselves as his bioenergy of wellness continues to normalize tissue functioning. He will not show

the intensity of his original pathology. He may need more treatment, because he feels the patterns again to some extent, but the physician will be starting at a higher level of functioning in giving him more aid. I wrote a letter to Dr. W.G. Sutherland (13) in 1954 which will summarize these few brief notes on bioenergy healing as a principle in a treatment program. It reads, I have a comment or two to make on explaining so-called connective tissues reactions that take place for weeks after treatment to secure balance in those laws not framed by human hand. At one time I made the statement that a pattern of stress or strain had to go back through its pattern of disability to recover and this proved to be a bright bit of misinformation. It was wrong. I agree. But here is a new version to explain some of this syndrome of healing. Here in Texas, us ignorant cotton farmers plant cotton until we get no crops because we dont rebuild the soil. So we are told to plant vetch to rebuild the soil during the winter. We do it. The next spring we replant cotton and the crop is a failure. The vetch is given the credit for the failure. We dont plant vetch the next winter and the following spring we again plant cotton. We get a whale of a crop. Our conclusions: Plant vetch, no cotton crop; Dont plant vetch, good cotton crop. We are smart. Department of Agriculture conclusions: Plant vetch and the soil is so poor it takes all of the energy of the following year to absorb the vetch and transform the nitrogen into the soil for the next spring when that nitrogen is available for use to grow cotton. Me, cotton farmer, Im smarter, I know when I got a check. In cases of severe disabilities, could we use the same simile. As bioenergy levels are restored to living fascias that have been depleted, the first crops of functioning within the fascias express symptoms of revival towards normalization and use but they havent had bioenergy strength for a long time and an earlier reevaluation of this is expressed as symptoms. I think you have the idea I have in mind. I have two ladies who have been thoroughly burned out disability-wise for many years, They are experiencing tremendous renewing changes throughout their entire bodies as broad symptom complexes and yet to my examination, I would say they are fully interchanging their bioenergy field with the environment that surrounds them. Dr. Sutherlands laconic reply was, A true bale of cotton.

Promoting healing through use of bioenergy and biokinetic energy fields and the biosphere does introduce many factors for the physician to analyze which he has not experienced with other treatment approaches. However, his hands upon the responding tissues and working through his fulcrum-compression points and allowing the bioenergy fields within the patient to guide him will clarify his thinking and his understanding. It is a direct approach to specific problems within the patient. STRESS FACTORS IN TRAUMA The general adaptation syndrome enun-(p. 173 174)- ciated by Dr. Hans Selye (14) always accompanies every traumatic experience. Stress shows itself as a specific syndrome yet it is non-specifically induced, says Dr. Selye and trauma as a stressor initiates the G.A.S. mechanism into action. Trauma stimulates the pituitary gland which in turn stimulates the adrenal glands which in turn modifies a response in the stomach, endothelial systems, and the white blood cells. Selye speaks of conditioning factors, -- that the whole development of the reaction largely depends on conditioning factors. These can be invariables which act upon us from within: our hereditary predispositions and previous experiences (internal conditioning), as well as variables which influence our body simultaneously with the agent from without (external conditioning). All these are integral elements of the response during stress; they all contribute something to the picture of the G.A.S. Furthermore, Selye also refers to tissue memories as did Speransky, The lasting bodily changes (in structure or chemical composition) which underlie effective adaptation or the collapse of it are aftereffects of stress; they represent tissuememories which affect our future somatic behavior during similar stressful situations. They can be stored. It was necessary for Selye to develop the fundamental concept of a functional unit of life, the reaction, to explain the reactions of body physiology and its biosphere. This is a functional unit energy in body physiology and can be classified as one of the many forms of bioenergy expressed by physiological functioning. He defines a reaction as, -- the smallest biologic target which can still respond selectively to stimulation.

It is enough to say that trauma is a stressor and discuss a further phase of this concept in relationship to a field in which we, as physicians, have a more direct interest. Selye speaks of conditioning through the use of chemicals, drugs, diets, etc., that modify stress reactions. The greatest and most direct conditioner of stress reactions are membranous-articular strains in the craniosacral mechanism that lead to a disturbance of mobility and motility of the cranial articular mechanism, abnormal patterns of mobility of the reciprocal tension membrane, venous retardation, loss of mobility and motility of the pituitary gland within the sella tursica, disturbances of the hypothalamic areas, hyper and hypo irritability of the central innervation of the sympathetic and parasympathetic nervous systems, and hormonal changes that accompany all of this reaction to strain and stress. There are many pituitary hormones involved in the anterior lobe, thyrotropin (TSH), melanocyte stimulating hormone (MSH), luteinizing hormone (LH), follicle stimulating hormone (FSH), luteotropic hormone (LTH), adrenocortico tropin hormone (ACTH), somatotrophic hormone (growth, STH), parathyrotropin, pancreatropin, to name those that have been discovered to date. In addition, there are the disturbances between the posterior lobe of the pituitary gland and its nervous connections to the hypothalamic areas through the infindibulum. Knowledge and use of the osteopathic concept and the cranial concept and the craniosacral mechanisms gives the physician direct access to analysis of stress and its hormone agents. The physician is in a position to analyze the dysfunctioning in terms of mobility and motility of the pituitary and hypothalamic areas and then to be able to do something about normalizing it. Birth trauma, specific head injuries, occipitomastoid lesions, sphenobasilar compression, condylar compressions, torsions, sidebending rotations, vertical and lateral strains, sacral concussions, and a host of others are all directly available to our diagnostic insight and treatment programs. I recall a case in a 16 year old girl whose growth hormones were disturbed in a most unusual manner. She sustained an occipitomastoid lesion at the age of 14. As a result she suffered severe headaches, which was her presenting complaint. Examination revealed that she had developed the left half of her body normally during the intervening two years but the right half of her body still showed the immaturity of 14 years of age. This also was a cause for alarm for herself and her parents. Correction of the occipitomastoid lesion and its complex not only

allowed the headache pattern to disappear but the right side of her body normalized its full growth potential over a period of a year and she was symmetrical by the time she was 17 1/2 years old. There have been no more headaches or other disturbances in the past 12 years. The total osteopathic concept enunciated by A. T. Still for the whole of body physiology is important in the diagnosis and treatment of the stress syndrome. The cranial concept developed by W. G. Sutherland is an integrated part of the study and cannot be considered a separate entity. Dr. Sutherland insisted his work was an extension of Dr. Stills work and it is true that Dr. Still has indicated in his (p. 174 175) writings that he had a deep insight and was cognizant of the craniosacral implications in total body anatomical-physiology. In addition to the work that Drs. Still and Sutherland have given us, the osteopathic literature has many articles on the interrelationship of Dr. Selyes stress syndrome and the osteopathic concept by several authors. There are biomechanical answers in the osteopathic concept that explain questions in the G. A. S. syndrome. Stress, too, involves bioenergy factors of body functioning and, whether they be called reactions or bioenergy, the palpatory skills of the physician are able to localize, analyze, and use these energies in a diagnostic and treatment program for the overall management of the stress pattern induced by trauma. It will differ for each case each treatment. It is important to study Selyes work so as to be able to define the stress syndrome in traumatic cases, to be able to recognize the symptomatology and concurrent pathology involved, and to know that stress adds a chronological time factor in the recovery of the case. The traumatic condition may make an adequate recovery but still the patient does not feel he is well again. There is no question in my mind that the stress syndrome is prolonging his total recovery phase and this factor has to be eliminated to re-establish his bioenergy of wellness. These stress energies can be returned to the biosphere, or wherever they go, and allow the bioenergy of health to be the only forces left for functioning. Since the cranial concept does include the primary mechanisms for normalizing the mobility and motility of the pituitary gland and hypothalamus, I make sure that the bioenergy fields in this area also normalize themselves in all traumatic cases. I also check the segmental areas of the thyroid, adrenal glands, spinal segments of the traumatic areas and all other areas involved in the G. A. S. syndrome. I feel these biokinetic fields of the stress syndrome are a part of the

total traumatic pattern and include them in my overall care of the traumatic case. They all contribute to a more rapid recovery of the total problem. A BIOENERGY FORMULA As a summary of the discussion up to date, a series of equations can be arbitrarily formulated to explain the reactions of a body physiology to trauma and stress and the bodys effort to dissipate these added force factors back to the biosphere. It is true that this is merely another form of terminology for the use of bioenergy factors in diagnosis and treatment but it does serve to condense it to a minimum idea of the concept. A few definitions are in order to clarify the equations. In previous papers written on this subject, I have named the bioenergy of wellness or health as biodynamic energy, so in the equations that follow, the letter D will be used for this factor. I have stated that the biodynamic energy of wellness is one of the most powerful forces in the world and begins from the moment of conception until the last dying moment. Therefore the first equation can be written: 1. D=l wherein 1 is the symbol for wellness. When body physiology is subjected to trauma and stress, force factors are added to the bioenergy systems of the body and biokinetic energy is the term that has been used to indicate added force factors. The letter K will stand for biokinetic energies. The equation will now read: 2. D+K=DK There is a potency within the body that is constantly working to restore the body to the base pattern of health, D=l. Any factors added to body physiology from the biosphere in the form of trauma and stress will find the body attempting to dissipate these factors back to the biosphere. The biodynamic and biokinetic energies and associated tissue elements will automatically wind themselves in towards the focus for that pattern at which time a change takes place within the potency - the something happens phase - and some of the K factor is released back to man-environment. So three new terms are needed for the equations: Potency, for the inherent power within bioenergy fields in body physiology towards normalization, SH for something happens at the point at which the potency comes to a focus in the three cycle corrective program, and a small k

for the force factors left after dissipating some of the K factor back to the biosphere. Now the equation can be written: 3. DK Potency SH (-K) = Dk The body continues to normalize itself through the hours, days, or weeks and the all k can be modified to read k-1,-2,-3,-4, -n to express the descending order of intensity of the K factor. The equation will now read: 4. Dk Potency SH (-k) = Dk-n If the patient makes a complete recovery from his trauma and stress pattern, the equation would read: (p. 175 176) 5. Dk-n Potency SH (-k- n) = D wherein only the basic bioenergy of wellness is left. The patient we see in our practices is the one in equation 4., Dk Potency SH (-k) = Dk-n, or if he is in an acute state, he would be equation 2., D+K = DK. The physician is going to examine this patient using the bioenergy factors as the motive powers within the body for diagnosis and treatment. He will do this by applying compression through his fulcrum points while his hands are under or on the area of the patients complaints. This compression at his fulcrum points will invoke the biodynamic and biokinetic energies and the potency within the patient into action and they will go through the three phase treatment cycle operation. It will be necessary, then, to add the terms fulcrum, F, and compression, C, to the equation to include the role of the physician in the diagnostic and therapeutic program. FC will stand for the fulcrum compression point of the physician in the equation that follows: 6. DK+FC Potency SH (-K)=D for the case that makes a complete recovery in one treatment: 7. DK+FC Potency SH (-K)=Dk or: 8. Dk+FC Potency SH (-k) = Dk-n to indicate the case that needs many treatments to gradually dissipate the K factors to the biosphere. When this more involved case finally comes to a focus for the total pattern and is restored to normal, the equation will read: 9. Dk-n+FC Potency SH (-k-N) = D and the patient is restored to his basic pattern of wellness wherein 1. D=1 is present again. This is palpable to the physician through his hand contacts and

fulcrum points and he can discharge that patient with full knowledge that he is healthy. Equations 1 through 5 represent the body physiology of the patient operating within its own mechanisms to correct its disabilities. Equations 6 through 9 represent the role of the physician in augmenting and aiding the bioenergy factors in body physiology to bring about a more complete resolution of the traumatic and stress experiences. Why does the Potency SH phase create an interchange between body physiology and its biosphere to permit the K factors to dissipate to manenvironment? I dont know. I can report that it occurs because I have felt it happen hundreds of times in many hundreds of cases. I can ask many other questions considered in the content of this paper. What and why is this Potency? What and why is this something happens at the focusing of the potency at the still point of the three phase cycle ? Why do force factors of stress and trauma continue in body physiology after injury? Why are the memory reactions left in certain parts of body physiology? Is there an interchange between matter and energy in body physiology and its biosphere? There are other questions that can be asked on many other points. My answer to most of them is a qualified, I dont know. I say qualified because I have ideas concerning them that are satisfactory to me in my care of traumatic and stress cases. The bioenergy factors within the patients have given me clues that allow me to follow the progress of each case until I feel the bioenergy of wellness again in the ascendency within each patient. I can follow the progress of any given case through to normalcy or to the point where I know that a case is irreversible and that certain traumatic and stress factors will continue to be part of that patients body physiology. I realize that discussing trauma and stress from the bioenergy viewpoint have made it difficult to follow some of the reasoning involved but using these bioenergy factors has produced a more satisfactory diagnostic insight and has resulted in a higher recovery or reversibility of many problem cases. This statement is made in comparison with other treatment approaches. The credit for the reversibility and recovery goes to the Potency and something happens factors within the patient. I observed it through my fulcrum-compression points and my hand contacts, my trained sense of touch. A friend of mine, a space

scientist, gives a clue to our use of these bioenergy factors without the total understanding we would like to have in the care of our patients. He told me that it would take 500 mathematicians working for one year to compute the necessary data to plot the flight of Ranger IX to strike the moon as it did in March, 1965. The scientists have to rely on data supplied to them by computer machines. They feed their information into the computer and then take the results of the machine with less than total understanding, accepting it as the answer to that phase of the problem, and add this information to the next phase of the problem involved. Finally, the Ranger IX is sent into space and corrective procedures are invoked based on material given to them by the com-(p. 176 177) puters. The point is that they do not understand all the steps between each new calculation but accept the machines analysis from early measurements until the final crash landing on the moons surface. They have confidence that the computer is correct and the successful launch and termination of this particular flight within four miles of their target is proof of their accepted understanding. If this is true in nonliving systems, how many more variables do we as physicians have to accept with partial understanding when we work with the phenomena of life? So it is in the use of bioenergy factors in diagnosis and treatment of trauma and stress in patients. These factors are present within the body physiology and biosphere of each patient. They are available for the physicians diagnostic insight and therapeutic care of that patient. The bioenergy approach has been tested and retested in case after case within my own practice and the validity of its approach is beyond question. Continued search for answers to explain the in-between steps will bring answers to the physician of many of the problems involved but meanwhile the patients continue to benefit with resolutions of many disabilities, although the physician does not have total understanding. I believe the key lies in analyzing what occurs during the still point of the three phase cycle when something happens. I am certain that when this door is opened to understanding it will reveal many more doors for which more keys will be needed to further deepen our knowledge of the phenomena of life.
BIBLIOGRAPHY 1. Simpson, G. G. "Biology and the Nature of Science, pg. 81, Science 11 Jan., 1963, Vol. 139, No.3550 2. Dorland s Medical Dictionary, 23rd Ed. , pag. 180

3. Becker, R. E., Force Factors with Body Physiology, pg. 58, Acad. of App. Ost. Yearbook, 1959 4. Becker, R. E., Whiplash Injuries, Pg.91, Acad, of App. Ost, Yearbook, 1964 5. Becker, R. E. X Whiplash Injury, pg. 96, Acad. of App. Ost. Yearbook, 1964 6. Becker, R. E., Diagnostic Touch: Its Principles and Application, Part I, pg. 32, Acad. of App. Ost. Yearbook, 1963 7. Becker, R. E., Diagnostic Touch: Its Principles and Application, Part II, pg. 153, Part III, Pg.161, Acad. of App. Ost. Yearbook, 1964 8. Still, A, T., Autobiography, pg.202 9. Dorlands Medical Dictionary, 23 Ed., pg.181 10. Speransky, A. D., A Basis for the Theory of Medicine, pg.275 11. Bioelectricity: a new frontier, pg.64, Modern Medicine, Nov. 11, 1963 12. Bassett, C. A. L., Becker, R. O. Generation of Electric Potentials by Bone in Response to Mechanical Stress, pg.1063, Science, 28 Sept., 1962, Vol 137 13. Letter, personal communication, W.G. Sutherland 14. Selye, Hans, The Stress of Life, pg.56, 98, 233, 285.